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018-2009-59-000
Wisconsin Department of Commerce - 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)]. ermit Holder's Name: City Village X Township Hetrick, Nathan & Kell Hammond, Town of ST BM Elev: Insp. BM Elev: BM Description: /'6D r3 ,nn ] T TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ar ~J ~ / Dosing Ca,,...~loa "7~ b Aeratior~- ~~ Holding TANK SETBACK INFORMATION TANK TO F~/L n WELL BLDG. vent to Air Intake ROAD Septic ~~ / ~~~ ~~ I ~-- Dosing /CJ / / ~~! p~1 O T! _,__ Aeration Holding PUMP/SIPHON INFORMATION a~ ~ Manufacturer Demand GPM Model Number ~ ~~ 3/ ~~ TDH Lift Friction Los System Head TD Forcemain Length i Dia. ~// Dist. to Well Soil ~RSnRPTi(~N SYSTEM county: St. Croix Sanitary Permit No: 463464 0 State Plan ID No: Parcel Tax No: 018-2009-59-000 Section(TownlRangelMap No: 04.29.17.1043 ELEVATION DATA STATION BS HI FS ELEV. Benchmark 3 . z o3 . z /60 Alt. BM Bldg. Sewer A, /` 7 ~ ~9. ~~ SUHt Inlet q~.55 3.~3 SUHt Outlet \, ~~ Dt Inlet ~~ .~ Dt Bottom ~ ~~ ~rlp O Header/Man. 3 . ~~ qp ~ ~~ Dist. Pipe 3 g~ ~ ~~ Bot. System -` C,f `~- JT ~ `.7~ Final Grade -$5 lad , Sl3 St Cover ,~ .55 ro7.~~ 2-ZZ /a~ , o~ BEDITRENCH Width ~ Length ~ No. Of Tr hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ / ~ ~ '~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ~~ Type t~: Z~/ ~~~/ _ / UNIT Model Number: IIISTRIRIITInN SYSTEM tUe~1a.~ Header/Manifold 71 ( ~ ~ Distribution 3 1 Ir ~r ~ ~ ~ ~' x Hole Size ~ I ~ ~ x Hole Spacing / 3 • ~ Vggt to Air Intake / ~d 0 o Dia Length b ~ Spacing Length /~o Dia S(~II_ CnVER v Prc~~ura Rvefcmc Only YY Mnnnd nr At-Grade Systems Only ~ Depth Over Bed/Trench Center ~ ~ Depth Over BedlTrench Edges ~ xx Depth of Topsoil ~ xx Seeded/Sod-ded / ~„~/ N xx Mulched ~ i No Y s [ i 7 / \ `r ~ o eeelll^^""'~"Yes ~ J e ~ ; COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 / ~ b / U 7 Inspection #2: G ~.:s~ -~v.l / / n Location: 1122 178th St~rfp~~t Ha} ~mon 154015 NE 1/4 E 1/4 4 T29N R17~v) Ilide Hei hts Lot 59 J~ ,~._.Parcel No: Y'(~r`^~-~ ~JcJ~- L~:.n._s d- L-o~S av.. f,~l d 04.29.17.1043 1.) Alt BM Description = ~ 2.) Bldg sewer length = /~Z ~ ~ "~ ~~ 1 / ~ ~ G -amount of cover = ~! '7 4 Z ~ - ~ ~- .,~ Plan revision Required? ;Yes i oo -~f a5 G Q -_ - J -(„~ ' - YrJ I Use other side for additional informa wf n. SBD-6710 (R.3/97) Date - - -- Insepctor's Si ture Cert. No. ' ' ° Safet Buildings Division 201 W. hi n Ave., P.O. Box 7162 County ` ~ ~~~~,~ M 53 707 - 7162 Sanitary Permit Number (to be ed in by Co.) Department of Commerce (~ -3151 Sanitar Pe it A li t State ]an LD. Number y rm pp ea In accord with Comm 83.21, Wis. Adm. Code, personal informatio ide q ~ ~ 3 ~ ~ / maybe used for secondary purposes Privacy Law, s15.04(1 MAY 1 0 20 roject ddress (if different than mailing address) f l L L ~ - r' ~~ ~ I. Application Information -Please Print Alt Information CROIXCO ST• .. ~ ~ . 2S TY E 1 ~-t 5~1~ U U NG OFFI .- Property Owner's Name Parcel # Lot # Block # ~- Kul I ~~ ot~-Z~,-S,-~ . ~d~+3 Property O ne ~'s Mailing Address Property Location • l t ~ w r ~ ~' ~ ' City State Zi C d Ph /<, _ /., Section ~ , p o e one Number _ ~' 1~ D ((~~ crrcle T ~" ~ ~ II. Type of Buildin (check all that apply) 1 N; R Eor ~~ro0 ~~ ~ ~1 or 2 Famil Dwelli -N b f B d Subdivisio n Name CSM Number y ng um er o rooms __ e p~ ^ Public/Commercial -Describe Use ~nd~SR- / ,aati - ii ~~pp 1 ~ 1 ~ ~'e ~ L l m t ^State Owned -Describe Use / / -~,,~,~ ~,~ `a k (p ~ o ~ ~g~~/- ~/ Q •---~ ~ . D ^City_^Village ~'ownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' ew S stem y ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issuzd Before Expiration Plumber Owner 1V. T e of POWTS 5 stem: Check all that a t ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ~]~Iound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank //^ Peat Filt re ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip e ^ rave]-less ipe ^ Other (explain) ~ V. Dis ersal/Treatment Area Information: q, / Design Flow (gpd) Design Soil App a~ ~~ te(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation r ~ ..H~ / (o ~~ . Z VI. Tank Info Capacrty in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ~T U / , „ ~J (^J ` ~ ~( Aerobic Treatment Unit ~ , /1 ~ ~~[~ 6 Dosing Chamber ~ 1 e-~J ~-~, . VII. Responsibility Statement- I, the undersigned, assume respon ' ' i[y for installation of the POWTS shown on the attached plans. Plumber's Name (Print) ~i?lu Si -° MP/MPRS Number Business Phone Number ~20 -- ~ a3 -~~3~ Pluumber's Address (Stree ity, State, Zip Code) e VIII. oun /De artment se Onl pproved ^ isapproved Sanitary Permit Fee (includes Groundwater Date Issue Issuin A t Signature o Sta ^ ~ eason for 'al Surcharge Fee) , /~ . ~ Lj( ~ J/ D~ / IX. Conditions of Approval/Reasons for Disapproval aeptie tanit, effkient ~ and a fe, ~ ~. ~~c.~ t.,J f ~ : ~ ~Q_('',(v..t ~ d- . disnersat cell must a ~erYices / makltaiead as per management plan prOVided by plumber. ` ~ W a~c~ p ~- ~o C 1~2.TS d ~' t i i t b J ne e ma n a 2. AA setback requirements mus as par applicable code / ordinances. complete ptaus (to the t:ounry only) for the system on paper not Tess than 81/2 x It inches in size SBD-6398 (R. O1I03) R~VtWr M~T'e?v ~, ~ - i , w ,.. f.: o ~; ty.,. t, ,, ~., ~. i `r N I STEEL'S SOIL SERVICE INC. David J. Steel 994 200' St. CST-POWTSM Cutting Edge Four, LLC Baldwin, WI 54002 Lic. #248956 NEl/4,SE1/4,S4,T29N,R17W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 6843449 Hillside Heights, Lot 59 This sail evaluation was conducted to satisfy a caning requirement, it may or may not be suitable for your use. '. I _ Legend 1" = 40' • =Benchmark Ele. l OO.OOFt Top of 3/4" pvc pipe • =Alt Benchmark Ele. 10020Ft Top of 3/4" pvc pipe ~ =Borings Boring Elevations B1 = 96.SSFt B2 = 96.SSFt B3 = 97.SSFt B4 = OO.OOFt ~46L ss ~:~ 0 ~°~l o...e Q b~ 43 ~ c-s,.- ~o w Q.. t,,~„ ~, _ ~- ~l o ~.~. S: ou ' ~ - bh ~Y r W ~ Q-S a.. ~ Z. S1~ - ~- Sb c.o ,.,_vo ~e-~ J: r i~ ~~_~G•~ z S' Z" 1' a c s ~Sl,. 40 TQ~lG Q~ 1... q-; vl / ~Z/ 0 i ~ ~ (%~~ g ~, ~-~y <<~~ h~~~ 3 ~ g ~~ _v - ~~~~ t y i .., t.. k ~s N l STEED'S SOIL SERVICE INC. David J. Steel 994 200 St. CST-POWTSM Cutting Edge Four, LLC Baldwin, WI 54002 Lic. #248956 13E1/4,SE1/4,S4,T29N,R17W Bus.(715) 684-5680 Town of Hammond, St. Cmix Co. Fax.(715) 684-3449 Hillside Heights, Lot 59 TEus soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. `~ 1 ~` ~~ i ~ Legend 1" = 40' • =Benchmark Ele. l OO.OOFt Top of 3/4" pvc pipe ~ =Alt Benchmark Ele. 10020Ft Top of 3/4" pvc pipe 0 =Borings Boring Elevations B 1 = 96.SSFt B2 = 96.SSFt B3 = 97.SSFt B4 = OO.OOFt 3' r ~ ~ ;sS ,/.2 w~ 3 ` a 4tta t~.~i St O ri~ ` / KJ/~Y'/( L--d ~/^~. /'l.L ,~ ~ C~ ~~~ O~..e Q bvU• iii <-6~- aO w. C~ l/~J ~ 0 C.w, ~ ~~.. ~~. ~~~h~f~ ~ ` C /[ w~(o1 ~~~ JQ.r ~:cC 't/!(l!' ~-'~ ~ ~S a.. ~ 2 Sty - Z-1~ c.o ~..~.~p l.agwt h (/fib ~l.~i(.~ 2, S' ~, " 1'v c S ~ 40 Yoo-c Q~ b. q.; v~ 3'~f ~. 9 7.,~j~f ~ ~%~~; g ~,~~y 3 ~~ g s commerce.wi.gov ^ ~sconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. com merce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary April 29, 2005 CUST ID No.225094 AT7N: POWTS Inspector MICHAEL P ROGERS ZONING OFFICE ROGERS PLUMBING ST CROIX COUNTY SPIA E445? HWY 12 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 04/29/2007 Transaction ID No. 1131694 Site ID No. 697463 SITE: Please refer to both identification numbers, Nathan & Kelly Hetrick in all comes ondence with the a enc . above County H T , wy Town of Hammond, St Croix County NE1/4, SE1/4, S4, T29N, R17W Lot: 59, Subdivision: Hammond FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1014969 Maintenance required; 600 GPD Flow rate; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.01/O1) 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: Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" BBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.01/O1). ' • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. CG • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption ~~ area. chs. NR 811 & 812c DEPART ~ A Sanitary Permit must be obtained from the county where this project is located in accordance with the 0 requirements of Sec. 145.135 and 145.19, Wis. Stats. Z SEE G • 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. Stat MICHAEL P ROGERS Page 2 4/29/2005 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site durine construction and_pen to inspection b~authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of constnzction/installation/operation. 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, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerc e. state. wi. us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Henry F Grote Nathan & Kelly Hetrick -Mound Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (O1/O1) Location: Lot 59, Hillside Heights NE '/a, SE '/<, Sec. 4, T 29 N, R 17 W Town: Hammond County: St. Croix Date: April 27, 2005 Owner: Nathan & Kelly Hetrick Address: 211 W. Warren St. Roberts, WI 54023 Plumber: Mike Rogers Signature: ---- License: MP 225 4 Attachments: SBD-10577 -Plan Approval Application SBD-8330 Page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management RECEIVED APR 2 2 2005 'r'P`r'~,~n~Iy ~~f ~~ page 1 of 8 !T OF COk±,t~,F~~E 3S tESPO!Vt~E> ~~ ,~c~ SAFETY & BUILDINGS I Design Criteria ~ ~'~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L ~ Bedrooms x 100 gal/bedroomlday x 1.5 ~' `'ro gallonslday hydraulic load Design Calculations In situ designed loading rate `~ ~3 l~ gallons/sq. ft. per day Depth to estimated high ground water ~i ~ 4 in. Depth to bedrock ~~ ~~ in. Cross slope at system 3 ~ 0 Force main length ~-S ft. of ~ in. 4, a g Manifold/header length b • ~~ ft. of ~`~ Z in. o . ~ ~ Drain-back 4-- ~ `l gallons Lateral length ~ @ S~~ o ft. of ~~l2 in. Lateral elevation ~ 9.Z~ ft. @ bottom of lateral Lateral hole size ~~~ b in. @ ~-2, ~ in. ( ~ ,S~ ft.) Spacing `~ holes/lateral S" ~ holes total Lateral volume ~ ~ ~ ~ l~ gallons Total lateral discharge rate 33 •~°b i gallons/minute @ 2 •~ ft. head Network pressure compensation losses O~~'S~ ft. Elevation difference ~~ ~'Z~ ft. Friction loss o - ~s i ft. @ 3 S gallons/minute Total dynamic head 1 ~° ° ~ Z ft. Pump/siphon ~~ gpm @ 2 ~ ft. of head Manufacturer ~ o ~llo~ Model # ~ 5 ~ Dose volume 4 `•} Z gallons Lift/sipPn6n tank ~ ~ ~ ~,. ~ z~-o ' ~S~ ~ --~ ~~~ gallons Septic tank ~ y ~ 1 t~~ gallons Effluent filter ~ ~ ~ ~ 't'om ~'i ~ ~~ °° ~~~ X 22' ~~ QA Measurement pump on and off ~ ` ~ in. Height alarm from tank bottom ~ ~~ o in. Reserve capacity 4-~ ~ gallons specs.calcs.res Page 2 of g r ~~ 'f ~~ •. I I `~ Z., ' 3 1rOC` R.~w Mt a~~~ {~~~~ W.1ow~ K 41s o~ae ~w. ~+G cw a.v ~ `~ 1 ciu , ~ Z ~ m ~ m .. \ ~ 3 ~~, ~ , ., a ~ ,~-s , stir, e ~ o,p t ~ ~ 1 2 , 2~ 13 h t w-e ~ ` ~ b s ~+b c o :1 s•.•.SZ s.v~` a b~`8S~ 3~~ d 2,g' ~~-S' 1o,n' Is,o ~ ~-~ ,. ~ Y. ~, ~ ~~ p ` C ~ ~~ Z, c...~,w~a~a.a, t ©~~-q~ 1 . _ ._ -. .... .. .. ~~~ O ~-~ ~. " 1 10.M v ~a~.. ,. ~ _ fi.. \ 0.3 r ~~. ~ ~' -~ p ~,b~~ 1 0. o' ~.az, Z8, b I~ 1 e ~~ ` ~ ~~ 13,1 ~ o,p~ -) 13,1' ~ ~,z' ~~~Z, ~~ve. LJh ~ ~ _1~.~ L Prr1V C. S C.~ \~ v. a ..: ~+ \ i~ T~a.~l ~.~1 'ice+o \~.~a..~\S S ~,o' I ~.~-G,c. Sr~ 'u-/ lr ~`~t ~• XaC G`- ~+q K:oovrt.~OM.t ~~ ` ` ~/~" ~ o \ ~, o r. 1 ."~ ~. ~ Q.o.,.. ~ ~.~- ~ o~ c ~., 1; ~ c.~ CJ ~'Z, `~" o,~~pQ e~-~ ( 3 " S' ~Sl ~ O.blo ~ > _ ~3,~b, r, to~ ..1 ~~ ~~"' ~ 2'S ~ ho..~ ~ ~ a~ ~ ~~ ~ °~ g- r ~, .. ' tyi ~~ c>-~~ ,~ ~ g ~.<< ~~~ ` ~ P~v~ 3, 'oK1b kNpISTuR6EQ \ Soy L ,--- i~cs r ~ Q~ROVLD CIiSKET ~iJT'J ~,Ru. Plrz F~e~ 4~•0 C ~ ~~ m~ c9ror..~.p ~T-o52ZZ. 14~~ 3fk,O'~ AIaRM z,. ~~~' ,~. o., occ ~~, Z ~~ F oar Mr-i~- wE~-THERPaooF n ,JUNCTION 6cac `~"wcca H O:r C~s~ ~ I ~-~-" i PuNP GoNt~tE-rF BcoCK IZ' iii~i~i I? ~ 4" ~- a YENT ~, ~~~ PAL z~~ ~ 3' ono ~T~. G RouKo ~~ ~~ O - ~ Flo,\L~~t~ ~, ~ SEPTIC c _ SPED-FI GATI QIJS '~ "(, oo s c ~ ; ~ ~ ~; Tn-JKS Ml~-i F ~ ~ ~ U ACTURC:R: (JUMDER OF DOSES: ~ PER Din T^1JK SIZC: ~1j~'' ~'~~ GJ-LCOIJS DOSC VOLUME ~~ }~ ALARh1 11N1UFACTVi«Q' S~ F~~'-~~a IAJCLUOINfa 6ACK/LOW ' GA~~ON$ MOOCI. IJUMDCR: Ion ~~`' U-PACITIES: A_~0~° IuCNC50K drg3~~° Wt.l.O-;S 9 ~ Z WCHES OR 1L ~ WuLO- ;S PUMP MAIJUFACTURCR: ~O e' ~~ , C. ~, ~ iUCHE ~IP'~Z _ MODEL WUMDCR; IS ~' S OR GA~~OuS D~ 9'~ i4~'o g l INCHES OR GA~,~0~5 JWITCH TyP[; __~"`O'"`'""'~ ~~b uOTE_ PUMD AUD ALARM ARC TO DC MIWIMUP~ DISCMAR(iC RATE 3~'~ (,/H INSTALEEO 0-J SEPnRATE CIRCu~TS VERTICAL DIFF[REWCf ~fTWCCtJ PUKP Oi- Al,10 oISTRI~UTIOAJ PIPE.. `Z,ZS FELT I + Hi-.11MUM -uETWORK SUPPLY FRELSURE ~ ~ ~ ~ ~ ~ ~ ZS ~ 2'~ FECT ~0 ~7.5~ S ~ ~ 3 i + FEET OF FORCC MAIW X ~__~g F~ loo-xFRICTIOU iACTOR.._~_ FEET ~ `~ ~~~, '~i - TOTAL Cy-JAMIC HfAp t b'~'~ FEET c1''i~ I-JTERIJA~, DIME-J5101Ji 0I TAA1K: LEIJ4'fH \Z1~'1j -.-.- 1 ;WIDTH ~~; LIgUID OCPT H ~I Pa~..~ 6 ~ F g ~~- .. ~' ., , ~ : ~, , ~r ~fi S:T `f I.OCKINa COVER - Lv,Ii~iv,w6 ,c i4BE•C . Q>riCK D~~GOrwCT- g„ ;:~ •. ~ • _~ HEAD CAP, MODEL ~~ W W ~~ 0 w S V z 8 r 0 a 0 4 o+.soe LITERS 0 80 160 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • ElecUical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle conVols. • Sealed Qwik•Box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series _ 15?J753 MODELS Control Selection Model _Volts•Ph Mode Am s Sim ex Du x _rtt52 tt5 t Non 8.5 1 2a3 8N t 52 t 15 1 - Auto 8.5 Included 2 a 3 E t 52 _ 230 t -- Non 4.3 1 2 a 3 BE t 52 230 1 Auto 4.3 Included 2 a 3 N t 53 t 15 t Non 10.5 t 2 or 3 BN t 53 u 5 1 Auto 10 5 Included 2 3 TOTAL DYNAMIC HEAfS/CAPACITY PER MINUTE EFFLUENT AND DEWATERING MODEL 152 153 Feel Meters Gol. Liters G01. Uters 5 t.5 69 261 77 291 10 3.i 61 ~ 23t j 70 ~ 265 '. 15 4.6 53 20t 61 231 20 6.1 44 t 67 52 ! 97 25 7.6 34 r 129 ~ 42 ~ ' Sy 30 9.1 23 87 23 '~~ ' 35 t0.7 -~ -- 22~ 5 40 12.2 -- -- t t c2 Lock Volve: 38.0 Ft. (t!.6m)ec0 F; ('3~~' 3 z~/3 ~- ~- i Ij ,_ ;~-,- 12 ,fig I ~ -~ , i ~ ~_ ' _~ sKZOe. - a SELECTION GUIDE E t 53 230 1 Non 5.3 1 2 a 3 BE 153 230 t Auto 5.3 Included 2 a 3 1 • Single piggyback variable level float switch or double pggyback variable level float switch. Refer to FM0477. O CAUTION 2. See FM0712 for correct model of Electrical Alternator E•Pak. All installation of controls, protection devices and wiring should be done try a qualified 3. Variable level Control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All elecMcal and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). Or (4) fl08t System. ~s~ ~ d RESERVE POWERED DESIGN ~ 0 For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. BOX 16347 louisv8le, KV 40256-0347 • SHIP T0: 3649 Cane Run Road Manulacfurars of . . e Louisville, KY 40211.1961 aaurr P~•t+vs S,vcE /999 (502) 776.2731. 1(800) 928•PUMP Q http://www.zoeller.com PUMP ~O FAX (502J 714.3624 © Copyright 2000 Zoeller Co. All rights reserved. >r • System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715-235- 1132, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofmg with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run-off; fmal settled slope should be 2-3% over the system or 2-3% diverting surface run-off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 11. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 ~- 1560 /~ ~ SOIL EVALUATION REPORT Page 1 of 3 Wisconsin Departure of Commerce Division Of Safety an in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service, Inc. County than8?: x 11 inches in s¢e. Plan must Attach cam late site Ian on r not less n ' p i St. Croix r¢oMal relei~nce point (BM), direction and ot limite l and ho mdude, but d to: ve percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Pending Please print all information. Reviewed By Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). s ~~ ~5 Property Owner Property Location Cutting Edge Four, LLC Govt. Lot n/a NE 1/4 SE 1/4 4 T 29 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# E976 170 TH Street 59 n/a Hillside Heights City State Zip Code Phone Number ~ City ~ Village ~ Town Nearest Road Hammond ~ WI 54015 715-796-2793 Hammond Cty Rd T W'j New Construction Use: ~) Residential / Number of bedrooms 4 Code derived design flow rate _( Replacement Public or commercial - Describe:n/a Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable General comments and recommendations: Mound design, system elevation 98.60 tt. based on contour line elevation 96.85 tt. 600 GPD n/a Boring # ~ Boring ~J Pit Ground Surface elev. 96.55 fl. Depth to limiting factor 60 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GP D/ft= 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 10-24 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 24-41 7.5yr4/4 none sl 2msbk mft gw na .6 1.0 4 41-60 7.5yr4/6 none Is/sl 2msbk mfr cs na .6 1.0 5 60-80 10yryr8/2 c2d 7.5yr5/6 andston residumm ml na na .0 .0 ^ Boring # ~ Boring iI! Pit Ground Surface elev. 96.55 ft. Depth to limiting factor ~ 4 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft= in. MunseN Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sil 2msbk mft cs 1vf .6 .8 2 10-15 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 15-27 10yr4/4 c2d 7.5yr5/6 sicl 2msbk mfr cs na .4 .6 4 27-36 5yr4/4 c2d 7.5yr5/6 scl our mfr na na .0 .0 * Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: ~~ CST Number David J. Steel _ ~ 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 9/13/2004 715-684-5680 Property Owner Cutting Edge Four, LLC Parcel ID # Pending Page 2 of 3 Boring # ~ Boring Pit Ground Surface elev. 97.55 ft. Depth to limiting factor 22 in. ~~ Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots in. Munsell Qu. Sz. Coat Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 12-22 10yr4/4 none sicl 2msbk mfr cs 1vf .4 .6 3 22-48 7.5yr4/4 c2d 7.5yr5/6 sl om mfr cs na .2 .6 4 48-60 7.5yr4/4 c2d 7.5yr5/6 scl om mfi na na .0 .0 ^ Boring # ~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Mur>,sell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # --~ Boring ~ Pit Ground Surface elev. ft. Depth to limiting factor in. Sod 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 = BODS> 30 < 220 mg/Land TSS >30 < 150 mglL * 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. . Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 994 200th St. CST-POWTSM Cutting Edge Four, LLC Baldwin, WI 54002 Lic. #248956 NEl/4,SE1/4,S4,T29N,R17W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 684-3449 Hillside Heights, Lot 59 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend 1"=40' ~ I ` • =Benchmark Ele. 100.00Ft " 1 ~ pvc pipe Top of 3/4 • =Alt Benchmark Ele. 100.20Ft Top of 3/4" pvc pipe ^ =Borings Boring Elevations B1 = 96.SSFt B2 = 96.SSFt B3 = 97.SSFt B4 = OO.OOFt is~ o ~~~ 3~ ~S/~- ®~ ~ n~ ~\ I ~~ ~,P~'~1 ahfour {~ ~ ~- _ ~4~, ,~-/~ lr.~ 3 ~ ~~ • ~~f ,~ `~_ ~~ ~~~~ /tor~~~ ~d ~!~%~ ~., ~ 7,,,~t- ~ ~~~ -i ~--oy ~_ ~ ~ ~~ ~PI~fl. `2.05 Ac. - ~ / ~ -B~ ~ . d' ~ ~3 4 SOIL EVALUATION RE~'ORT ` Wisconsin Department of Commerce Division of Safetyand Buildings in accordance with Comm 85. Wis. Adm. Code 1560 Page 1_of 3 Steel's Soil Service, Inc. Attach com ete site pf plan on paper not less than 8'/: x 11 inches in size. Plan must include but not limited to: v rtic l d I ¢ t f l i BM di d t ti County St. Croix , an wr orr re ®rerlce po e a a ), rec on an n ( percent slope, scale. or dimensions, north anow, and logtion and distance to nearest road. Parcel I.D. Pending Please print all information. Reviewed By Date Personal iniomra6on you provide may be used Tor secondary purposes (Privacy taw, s.15A4 (1) (m)). Property Owner Property Location Cutting Edge Four, LLC Govt Lot n/a NE 1/4 SE 1!4 S 4 T 29 N R 17 W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# E976170 TH Street 59 Na ~ Hillside Heights City State Zip Code Phone Number J City ~ Vllage ~ Town Nearest Road Hammond ( WI 54015 715-796-2793 Hammond Cty Rd T /~ New Construction Use: ~/ Residential / Number of bedrooms 4 Code derived design flow rate J Replacement Public or commercial - Describe:n/a Parent material _ Ground and end moraines, pitted glaical drift Flood plain elevation, if apptipble General comments and recommendations: Mound design, system elevation 98.60 ft. based on contour line elevation 96.85 ft. 600 GPD Na a Boring # J Boring /J Pit Ground Surface. elev. 96.55 ft. Depth to limiting factor 60 in. So~7 Application Rate tiorizan - Depth Dominant Calor Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 1:0-24 10yr414 none sicl 2msbk mfr cs na .4 .6 3 24-41 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 4 41-60 7.5yr4/6 none Is/sl 2msbk mfr cs na .6 1.0 5 60-80 10yryr8/2 c2d 7.5yr5/6 andston residumm ml na na .0 .0 ,Boring # J Boring i/ Pit Ground Surface elev. 96.55 ft. Depth to limiting factor 14 in. Soil Application Rate Horizon Depth Dominant Color Redox•Description Texture Structure Consistence Boundary Roots GP D/ftz in. Muraell Qu. Sz Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 10-15 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 15-27 10yr4/4 c2d 7.5yr5/6 sicl 2msbk mfr cs na .4 .6 4 27-36 5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0 - ttttuent;x~ = IipDS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <30 mg/L and TSS g30 mg/L CST Name- (Please Print) ~~ Si nature: CST Number Qavid J. Steel 248956 Address Steel's. Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 9/13/2004 715-684-5680 i'S 0'I.~S ~ ~ \ l 1 \ \ \ ~ 1 \ o ~ ~ ~~ ~n I 1 ~ \1 {.~~~ ~ ~ - - ~~'~ •~•N rib' bS' !) "~~`\ O ~~ i 1 / ! ~ \ \~ 1 ~ ~ -r •e-N,- ~ , / .o-s~o ~ = oar! ~ ~ ~ \ Q ~ ~ ~ / '~'S SLL89' '8'N ~ / 1~ \ ~ ! // ~~ ! ~ ~ / ~'S 89099 i~ l ! .! 1 I / Z ~ I ~ ~,l 1 !~ y // 1/ x r LJ~IJ ',/Y t 1 ~ / // l ~ , ~ ~ f 1 I / / / ~ /'J ~ f ~ ~~ f / ~l ~~ /I '~11 ~6'l •8'N \~ \ '~'S ~lZ-b8 '9'N x (~ ~~ ~ ~ '' ~ ~~'S ~OSLL l o "~ ~ i~ ~~ ~ N \\ _ Q - x ~ A'SB~i-3-oB-7 ~ 1 ~ ~ \ ~ ~ F \ -- ~\ ~ ~ \ ,,,_ - , -- ;. s Private On-Site Wastewater Treatment System (POWYS) Index & Title Sheet Owner: ~~~ ~ Glv~ ~- K~ ~ ~vl ~~t.ir Project Name and Svstem Type: Location: Township/County Hey Contents: Page 1: Sanitary 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 Survey Map Page 11: Copt/ of House Plans Attachments: Plumber/Designer: Mike Rogers Signed://%~-L~-~~ -----~- Credential Number: 225094 Date: a Le al Description Parcel #: 018-2009-59-000 05/11/2005 11:04 AM PAGE 1 OF 1 Alt. Parcel #: 04.29.17.1043 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 * 1122 178TH ST 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 SE BEING HILLSIDE Block/Condo Bldg: LOT 59 ' HEIGHTS ( 04) LOT 59 (1.500AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 04-29N-17W NE SE Notes: Parcel History: Date Doc # Vol/Page Type 02/28/2004 775409 10/31 PLAT 9nn~ CI IMMeQV Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class Acres Land Improve Last Changed: 03/23/2005 Total State Reason Totals for 2005: General Property 0.000 Woodland 0.000 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 0 0 0 0 0 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 'J 2??.ln 3Ct2 STATE BAR OF WISCONSIN FORM 1-'1998 WARRANTY DEED Document Num This Deed, made between Cutting Edge Four. LLC.. a Corooratiol Grantor, and Nathan M. Hetrick and Kelly J. Hetrick. Husband and N Grantee. Grantor, for a valuable consideration conveys to Grantee the following described real estate in St. Croix County State of Wisconsin (the "Property"): -7 ~rZ>'4E32 KATHLEEN H. iYALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 0;~/251's:0Q15 09:1ii1AM MARRANTY UEEU czEMFi 11 REC FEE: 11.00 TRANS FEE: 116.70 COPY FEE: CC FEE: PAGES: 1 t~~ [ tlLtilw TO: Bu,ranct T'itlc 7530 France Ave. S. First Floor Edina, MN 5S43S ATT?V: Poor Ct~cing Centre] O(~ ~o~F ~zo a o a VM7i O/ /00 ro0 pig loo-; ~~ Ptiroel Ide-_1nt~cation Number (PII~) p.~/()p(o This is Y1l7C' homestead property. (is) (is not) Lot 59, Hillside Heights, 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 22nd day of March, 2005. (SEAL) David Dalton, Organizer Cutting Edge Four, LLC. AUTHENTICATION (SEAL) Signature(s) . ~ ~ I ; STA-~ i= uF WISCONSIN authenticated thI~y'F rJl ~d~y~'~-1TZINA NOTARY PUBLIC TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stets) THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Burnet 1301 Coulee Road Hudson, WI 54016 5-25598 (Signatures may be authenticated or acknowledged. Both are not necessary.) ACKNOWLEDGMENT St. Croix county State of t~sconaln, (SEAL) (SEAL) } SS. Personally came before me this 22nd day of March, 2005 the above named David Dalton as Organizer of Cutting Edge Foyr. LLC., a Corporation to me known to be the person ~_ who executed the foregoing instrument and acknowledge the same. ~pp Notary Public, State~of WisfXinsin My commission is pe an nt. (If not, state expiration date: ~~1~. •) .~ Names of arsons si nin in an ca aci must be ed or rinted below their si nature. ~-+: ~ / ST CROIX C~~pY,GRELMENT "1 ~ SEPTIC TANK I~'LP- OWNBILSHII' CERTIFICATION FORM ~wner/Buyer N1~T~~N f K~~~y f/~/LICl~ r syoZ3 ltiailing Address rr w_ w~R~E~r S, /~ ~aat~~ s ~ Property Address ~ ~ `~ (Verification required from Planning Department for new construction) City/State Parcel Identification Number LEGAI DI;SCRTL'TION • G% ~ '/ . T ~ ~ N-R ~ i ~, Town of /~~„w~ ~~ Property Location .~~'/+, ~ .-- /+~ Sec. - -- ~ ~ Lot # -y..._• i ~ r~~~ f'r w i 1. s~1 Subdivision ,Volume ___~__ ..Page #i Certified Survey Map # 2 7 7 ~ 3 ~ ~-. ~' 0 `~ ~Z ,Volume , .Page ## Warranty Deed # Lot lines identifiable ^ yes ^ no Spec house ^ yes ^ no // ~la~ ~ ~75~d`~ g M hZA1NTENANCE ro use and maintenanceof your septic system could result inat ap~Ym l ~nsaefll p~~ ~~~ou Pu ~r~~ ~ system ~P Per consists of pumping out the septic tank every three years or sooner, rf n osal systeru. can affect the function of the septic tank as a treatment stage in the waste lisp ~ b the owner and by a owner a es to submit to St. Croix Zoning Department a certitication form, sign Y The property $re um r verifying that (1) the on-site wastewat ~~c ~ slusydge~. masttirplumber, j lumber, restricted plumber or a licensod p Pe tie tank is less than is in proper operator'' g coy dia'on and/or (2) a fter inspection and pwnping (if necessary), the sep ce to maintain the private sewage disposal system wig the ~'~ ed have read the above requirements and agr State of Wiscons~ Ce rt~f icati°n I/we. the undersign Zo~g OiI"ice withht 30 set forth, here' et by the Department of Conunerce and the DeparUuent of Nature Resources, stating that tptia cyst has n maintained must be completed and returned to the St. Croix County days of year a t' date. ~ 0~ 0 6/ ~ ~ r /' /~ ~ .~ ~ DATE SIC3NATfJItE OF APYLIt:Ai~ r - ~ R CE TICATLON our lmowledge. I (we) am (are) the' .waet{s) of I (w 'fy that all atem a of a warranty deedtreco ded in Register of Deeds Office. the prop cribed above y ~ o~D~/ aS ~~ ~ , ~ DATE. SIGNATURE OF AP LICANT «««**« emit being revoked by the Zoning Depa~ ;nt. «««««. pny information that is mis-represented may result in the sanitary p •« Include with this appttcatlon: a stamped warranty deed frommthe Rf rgefercnceDis madetin the warranty deed a copy of the certified survey I POWTS OWNER'S MANUAL MANAGEMENT PLAN a FILE INFORMATION Owner Permit # DESIGN PARAMETERS Number of Bedrooms 100gpd/bedroom ^ NA Number of Commercial Units NA Estimated flow (average)* gaUday Design flow. (peak), estimated x 1.5* gaUday Sail Application Rate v gaUday Influent/Effluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mgJL Biochemical OxygenDemand (BODs) ~ 220 mg/L Total Suspended Solids (TSS) < 250 mg/L Pretreated Effluent Quality ^ Monthly Average*** Biochemical Oxygen Demand (BODs) < 30 mg/L Total Suspended. Solids (TSS) S 30 mg/L Fecal Coliform (geometric mean) 510+cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter *WastewaterFlow Verification on and calculations: {Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank effluent. ~ pretreated wastewater. ***Values typical for SYSTEM SPECIFICATIONS Septic Tank Capacity / Z50 gal ^ NA Septic Tank Manufacturer ~,.~ ; eg~,f~ ^ NA Effluent Filter Manufacturer A ofe~a ^ NA Effluent Filter Model /6p ^ NA Pump Tank Capacity gal ^ NA Pump Tank Manufacturer (J ; c se,(` ^ NA Pump Manufacturer Ze ~llp~` ^ NA Pump Model /~'Z ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) 1n-ground (gravity) ^ In-ground (pressurized) ^' At grade ,~Zvlound ^ Drip-line ^ Other: ^ Leaching Chamber Manufacii~rer Model Approval Stipulatio n Soil Application Rate_gpd/ft2 Area Req. Absorption Area Credit per unit ft2 Minimum Number of Chambers ^ 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. DESIGN CRITERIA p "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) "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". RJ. 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 (8.6199) "In Ground Absorption Component Manual" ^SBD -10705-P (N.O1/01) "In Ground Soil Absorption Component Manual" Version 2.0 p SBD -10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD -10656-P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual" ^ SBD -10572 P (8.6/99). "Mound Component Manual" ^ SBD -10691 P (NA1/01) "Mound Component Manual" Version 2.0~ p SBD -10595-P (8.6/99) "Single Pass Sat;d Filter Component 1Vlanual" ^ 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 MAiNTF.NAN("E MnN1T(~RiNG SCHEDiILF. Service Event Service Frequency Inspect condition of tank(s) At least once every ^ months yeaz(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (1/3) of tank volume Inspectdispersai cell(s) At least once every ~ ^ months year(s) (Maximum 3 yrs.) Clean effluent filter At least once every 2 ^ months y s) Inspect pump, pump controls & alarm At least once every ^ months yeaz(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 Yage or Y ART UP . For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment. process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System stark up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION. 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 discharged 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/tiuit peels and seeds, bones,. and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only papex that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigazette 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 your POWTS 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: p Alarms 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. INFECTIONS 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). Septic Tanks Component Tank 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 effluent 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 tQ prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (i/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 NRII3, 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. p Pump Chamber/Treatment Tanks 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 hardware and the condition of the filter. An~,service needs or repairs shall be promptly taken care of. p In-Ground 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 dischazge to the ground surface must be promptly repotted to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of Mound,. At-Grade, In-Ground presswe 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 dischazge. Any discharge 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 failwe necessitating more frequent monitoring. The presswe 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 onceevery three (3) yeazs. presswe checks of systems with multiple laterals should be done to ensure that equal distribution of effluent 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 POWTS fails and/or is permanently taken out of service the following steps shall be taken to enswe that the system is properly and 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. - ARer pumping, all tanks and pits shall be excavated and 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 measwes have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and maybe utilized for the location of a replacement soil absorption system. The replacement area should be protected from distwbance and compaction and should not be infringed upon by required setbacks from existing and proposed structwe, lot lines and wells. Failure to protect the replacement azea will result in the .need for a new soil from existing and proposed structure, lot lines and wells. Failwe to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement azea. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement azea. Upon failwe 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. Cl Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» ~ . SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT .OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THF. INTERIOR OF A TANK MAY BE DIFFICULT OR ..IMPOSSIBLE. ADAITIONAL COMMENTS POWTS Phone Phone K;\WPDATAIEHIPOWTS OWNER'S MANUAI..doc POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Agency ' ~ ~ ; ~ Phone ~ .. _ g Page of