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018-2009-60-000
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)J. 'ermit Holder's Name: City Village X Township Nielson, Mike Hammond, Town of :ST BM Elev: r Insp. BM Elev: BM Description: ~. a ~D ~a' CS'~ (iw~~r -- PtJC. ' TANK INFORMATION TYPE ~I~LI p MARIUFACTURER ~ (~,C,A~P CITY Septic `~ ~~~~ (~D / la Dosing ~ L, Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ,., ` ~ ~ ~ ~ ~ Dosing ~~ ,,< <, ~ ~Z f Aeration Holding PUAIrP/SIPHON INFORMATION ~~ anufacturer ~~~LD _11 _ ~J~ ~ Demand `"~ O GPM q~ Model Number ~~ ~ ~ ~ 2(Q TDH Lift ~ Friction Loss System Head TDH Ft Forcemain Le 1 t~, Dia. tl Z Dist. to welt \/ '~!'C SOIL ABSORPTION SYSTEM E Rt:N9H Width ~ Length ~ 'DIMENSIONS C SETBACK SYSTEM TO J INFORMATION _ _, _ I'11STRIR1ITInN SXSTFM No. Of~reac4ies (2) I 1I5 ~~ ~~o, -ice r7]o ~ ~ '117 ELEVATION DATA County: $t. CroiX Sanitary Permit No: 479335 0 S to Plan ID o: arcel Tax No: 018-2009-60-000 Sectionlrown/Range/Map No: 04.29.17.1044 STATION BS HI FS ELEV. Benchmark -7 Alt. BM Bldg. Sewer ~ ,/ ' `~' I p 3.09 ~ St/Ht Inlet 3-~Z ~ 96.93 SUHt Outlet Dt Inlet Dt Bottom I I •~ 3.29 ~ Header/Man. ~~~ ~ •p~ ~ Dist. Pipe ; S'D t ~ `0 S r Bot. System 512., ~ 9•~f3 Final Grade u st over , ~ .t~ w~euli~ r`t. S Z- ~ T ~ • ~~ p 2.(0 9 C~t~6Nr `.77 ~3•Z ~(. ~ v~ ~s ~.. 5 •T - ~- St{.-~ af~a.. ~ S" VS No. Of Pits Ins -1~ Liquid Depth Number. Header/Manifold ~ . i Distribution ~ t v t Pipe(s) D I x Hole Size ~ t s x Hole Spacin~q Z a6 Vent to Air Inta Length~'~ Dia 2 Spacing 3• Length'! Dia 32 ~, Sell Ct7VFR v Drocm~ro Avc4cm~ Only vx Mnnnd nr At-Grade SVStemS Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil ~ °,~ Yes ~'1 No ~] Yes [~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: CO / ~3 /~ Inspection 2: / / /U Location: 1120 178th Street Hammond, WI ~j4.0,~1 ',,(SE 1/4 SE 1/4 4 T29N R17W) Hillside Hei~ Lot 60 ~, Parce~o: 04. 9.17.104 $T, tN1~~'~l•""`~.rv~ ba.-: ~ -~ Qr- ~, t3-L, ~ e-3 C a.Q.~..w.. e--•.. - -; ~~, ) 1.) Alt BM Description = , .. f , ~ ~-/ 2.) Bldg sewer length = ~ ~ .~+•~ / 1'"' •V~ t ., ti , -amount of cover = ~,~ `~.r ~~ o~ c~ u~s>~ ~~ 3) ~ ~-- ~ -- - __ _ ------- - ff r -- ~~ ~ ~ Use other'side for additional informs on I No ~ ~ ! ~ Z~ I __ -- - Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ' S d Buildings Division County ,~ ' 0~ W. Washtngt .O. Box 7162 --~ , ~ ',~c~~~~~ 1\Badison, 53~, ~ ~ 1Y~08 266- ~ ' ~~~'; itary Permit Number (to be filled in by Co.) Department of Commerce ~ , ~ 1 ~35 Sanitary Permit Applieat ' n , ~ ~ ~ i .~ 2 S to Plan LD. Number In accord with Comm 83.21, Wis. Adm. Code, ersonal inform 'on ou rovide 2~~5 P Y P = I ANS. 1D.~ maybe used for secondary purposes Privacy Law, s 15.. (1)(~~ `, r„i - l ih ;~~~ 1, ~ -, , ~- oject Address (if differ t than mailing addr s ~ 1120 1 '~] ~ ~ ~~l~ee~~ I. Application Information -Please Print All Information Property Ow ner's Name Pre # Lot # Block # ` 1 ~ \~ e ~ ~ - Property Owner's Mailing Address Prope Location I ~ ~ ' ~~ ~ 4- City, State Zip C o de Phone Number „ y, %., Section ~ ~'°~ W ~ j ~ ( ~ ~ 1, lJ ~ ~ ~ T ~ N R~E e W II Type of Building (check all that apply) ,,, s w~w~ s . , o 1 or 2 Family Dwelling -Number of Bedrooms ~~ ~ Subdivision Name CSM Number PubliclCommercial -Describe Use • ~ `~ ^ State Owned -Describe Use ^City_^Village Township o III. Typ of Permit: (Check only one box on line A. Complete line B if applicable) ~ 1 g- 2~9 - - (76a ~ O `~' ew S stem Y ep y ^ R ]acement S stem ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Pernvt Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ~~ tt ~r ~ IV. T e of 1?OWTS S s tem: Check all that a l )c s , 00 ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: ' Des^ignrFlow (gpd) ~ ~ Design Soil Application Rate(gpdsf) Dispersa] Area Regyi~~(~f~ `f JJ Dispersal Area Propose,~l~f)~ (('~~ ystem El vation ~-1 cJ b ~ ~~ ~ ~ l ~ o VI. Tank Info Capacity in Gallons Total Gallons Number of Units Manufacturer ~ /; ~~ 1 ~ I ~ ~ Prefab Concrete Site Constructed Steel Fiber Glass Plastic N E i ~~~ a -F-` / ew x sting Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber r ~~ VII. Responsibility Statement- I, the undersigned, assu responsib' ' or installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's e MP/MPRS Number Business hone Number k.~ o a~og4 ~ ~~~ 5- ~3~ P umber's Address (Street, ty, State, Zi o r~ VIIh Coun /De artment Us nl Approved roved/ Sanitary Permit Fee (includes Groundwater Date Issued Issuin Agent Signature (No Stamps) Surcharge Fee) ____ _ ~5 ~ en Re n for Dania] ~ ZZ ~cXJ IX. Conditions A prov SYSTEM OWNER: 1 Septic tank, effilu®11t i~llt~r ~A~ dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ---- -~~-r--•- r•-••' ~•~ •~~ ~-~u~•y ~LUy~ luL LYC 3~'bLC111 V V Nilt/Cf -U[ 1058 [n7L11 81/L X r 1 IneaeS In S1Z2 SBD-6398 (R. 01/03) i~~t~~l~~l~Iii~il ,V H w'y yXi~~ ~ oho $. Q o2 ` -~ ~~-s "~ ~~~ " u,,g3~ir ~~ +~Z QKm~ ~- ~~ \ ~~ ~ :~ ~a E ~ " v b ~ ~' ~ ~ ~~~~ ~ , ~~~r 1 DC- ~~ 3 g~~ ~~ `__ .~ at? S'1 ,~ ~ „~.....~,. .,,,M, •... {`z~ ~,,,•~+''~~ r~ ~ A Pv t~~" ~a Maw""'. • , commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary July 11, 2005 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING E4457 HWY 12 MENOMONIE WI 54751 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/11/2007 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1150148 SITE: Site ID No. 700673 Mike Nielson Please refer to both identification numbers, 178`" Street above, in all corres ondence with the a enc . Town of Hammond St Croix County SE1/4, SE1/4,.54, T29N, R17W Subdivision: Hillside Heights; lot 60 FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1025545 Maintenance required; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade System(s): 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); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. ~,®,~~`~.~.~. Cc»~t~~~P©nal~y G?PROVE) ' MICHAEL P ROGERS Page 2 7/11/2005 • Comm 83.22(7) - A copy of the approvedplans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: mound Owner's Name: Mike Nielsen Owner's Address: Legal Description Township County: SE1/4, SE1/4, s4, t29n, r17w Hammond ST Croix Subdivision Name: Hillside Heights Lot Number: 60 Block Number: n/a Parcel I.D. Number: 018-1008-50-000 Plan Transaction No.: l/ 5' m/y Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan RECEIVED Page 7 Pump curve and specifications Page 8 Plot Plan JUN 3 O ZOOS .Page 9 CSM SAFE r ~ ~ BUILDINGS Designer: Michael Rogers License Number: 225094 Date: 06/28/05 Phone Number: 225094 Signatur . Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.0 (R. 04/03) oi~~}siar4 aF ErTY ~p aui~oi>v! s Page 1 of 9 SEE= COF~KES ErNCE Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 5.00 Site Slope (%) 98.20 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) a Center or End Manifold 3.00 Lateral Spacing (ft) 2 Number of Laterals 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 150.00 Forcemain Length (ft) 89.00 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 10.03 Vertical Lift (ft) 2.38 Friction Loss (ft) 16.96 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1000.00 Septic Tank Capacity (gal) Wieser Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest point in the distribution Y W _ network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 9.00 ft2/orifice Does the forcemain drain back? ~_~ Enter Y or N 24.47 Forcemain Drainback (gal) 67.38 5x Void Volume (gal) 91.85 Minimum Dose Volume (gal) 26.93 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 16.79 Dose Tank Volume (gal/in) A100 Filter Model Number Wieser Manufacturer Project: mound Page 2 of 9 Mound Plan View I L Mound Component Dimensions A 6.00 ft E 17.60 in B 75.00 ft F 9.50 in D 14.00 in G 0.50 ft 450.00 (ft2) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate -T _~ _~ -1 H 1.00 ft K 9.33 ft z 9.74 ft L 93.65 ft J 6.41 ft W 22.15 ft 1180.15 (ft2) Basal Area Available 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.16 (ft) C .. ~ : i~r~{~~~~ 2~~rf~~ri:':~ •1 F Dispersal Cell 99.87 (ft) Lateral 99.37 (ft)~ - ' ~ ::: :: Invert ;,,.".". Dispersal Cell ; :::::~3 :: ~ : ~ ~ ~ ~ .: Elevation ~' E ~~~~~~~~~~~'~'~' D "' :~:~~:~. . . . ~- . x'...4,,,,,,4 ~:,,.5. ~-`~ ~ ~l "l ~ V`l ~`l~~'! ~`1~~~ "1~~,~,~ ~,~,~,~,~~,~~,~,~,~'`,~'~`,~~: 5.0 % Site Slope Shading Key ~ c. ~- 10 Topsoil Cap c ~ 1.5 ft ® "~'~f Subsoil Cap H c ` ° 1° ©~ ASTM C33 Sand - [4] "`~ ~ . Tilled Layer ~ y 0.5 ft Q Aggregate v o Dispersal Cell ~o T Typical Lateral e, p~~ ~A~ 20 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Project: mound Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over khi ~ P P.II laterals are identical IE?G~I Holes drilled an the bottom of the lateral equally spaced FOfCP mdln COM~C[IOn Vld [P@ Or Cf055 [O manifold 3[ ang pOln[. Laterals & Farce main aF PVC Sch 40 [per COMM Table $4.30-5J Number of Laterals 2 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) Lateral Length (P) 73.44 ft Orifices per Lateral Lateral Spacing (S) 3.00 ft Orifice Density Lateral Flow Rate 13.46 gpm Manifold Length System Flow Rate 26.93 gpm Manifold Diameter Total Dynamic Head 16.96 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and - rrr~~~ Comm 16.28 WAC I I Disconnect II ~- • =Turn-up v.~'ball valve ar cleanoutplug Tank component is properly vented Wieser Capacit 600.00 Volume 16.79 Manufacturer Gallons gal/inch A B C D Dimension Inches Gallons A 18.26 306.67 B 2.00 33.58 C 5.47 91.85 D 10.00 167.90 Total 35.74 600.00 3" Bedding under tank. Alarm Manuafacturer septronics ®_ Alarm Model Number mjj1 Pump Manufacturer zoeller Pump Model Number ~BN152 r Pump Must Deliver 26.93 gpm at 16.96 ft TDH 0.1561 in 3.061ft 25 9.00 ft2/orifice 3.00 ft 1.501in 2.751 ft/sec Locking cover with warning label and locking device and sealed watertight 4 in. min. -~-_ F- Alternate outlet location Forcemain diameter ~f 2 in. Weep hole or anti- siphon device P~ ump off elevation (ft) 89.83 Dom se tank elevation (ft) 89.00 Project: mound Page 4 of 9 ' Mound System Maintenance and Operation Specifications Service Provider's Name Rogers Plumbing Phone 715-235-1132 POWTS Regulator's Name ST Croix Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once ever 3 ears Should inspect and clean at least once eve 3 ears Test once ever 3 ears Should test month) Laterals should be flushed and pressure tested ever 1.5 ears Inspect for ponding and seepage once ever 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • ............. ............... Grade ~ :.:.:::::::::::.~.~. 6-8" Diameter Lawn . ~ . ~ Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution ~ ~ Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: mound Page 5 of 9 • Mound System Management Plan ' Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continslencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: mound Page 6 of 9 PUMP PERFORMANCE CURVE TOTAL DYNAMIC HEAD/FLOW ' MODEL 15111521153 w PER MINUTE 1a 45 153 EFFLUENT AND DEWATERING 1z O Q i 10 v a > 8 0 a s I 10 211 5 0 10 20 30 40 50 60 70 80 90 1 GALLONS FLOW PER MINUTE olasoaA 2643 OO~~~l.7' F~ O~Y ~'~7~i ~EOIA~ APP I~C~TIO~VS • Timed dosing panels available. • Electrical 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 controls. • Sealed Qwik-Box available for outdoor installations. See FM1420: • Over 130°F. (54°G.) special quotation required. 151/i57J153 Series 151/152/1 53. MODELS Control Selection Model Volts-ph Mode Am s Sim lex Du lex N151 118: 1' Non 6.0 1 2or3 BN151 115 1 Auto 6.0 Included 2 or 3 E151 230 1 Non 3.2 1 2 or 3 BEi51 230 1 Auto 3.2 Included 2or3 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8:5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 BE152 230 ` 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 t Auto 10.5 Included 2or3 E153 230. 1 Non 5.3 1 2 or 3 BEt53 230 1 Auto 5.3 Included 2or3 -MODEL 151 152 153 Feet Meters Gal. Liters Gal. Liters Gal. Liters 5 1.5 50 189 69 261 77 291 10 3.0 45 170 61 231 70 265 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 25 7.6 16 61 34 129 42 ~ 159 30 9.1 -- -- 23 87 33 125 35 10.7 -- - - -- 22 85 40. 12.2 - -- -- - 11 42 Shul-off Head: 30 ft. (9.1 m) 38 ft. (11.6m) 44 ft. (13.4m) olasoas Model 151 isi SELECTION GUIDE 32 32 sKZOSa 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. 11 n/1s A CAUTION .1111 installation of controls, peotection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHAj. ~ESER~f'E POIIVERED ~E~~ON For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Models 152 / 153 Manufacturers of . . QVi]L/7Y PUMPB ~7~iYCE ~~~~7 „ --~-T MAlL T0: P.O. BOX 16347 `. ' ~~ 1 ~ ® Louisville, KY 40256-0347 SHIP T0: 3649 Cane Run Road Louisville, KV 40211-1961 http://wwtvzoellercom P~MP CO (502) 778-2731 ~ 1(800) 928-PUMP FAX (502) 774-3624 © Copyright 2003 Zoeller Co. All rights reserved. 3 27 1z 1/6 4 3/8 1 ,~~ .,. l ~ `' , p7L7 $. D a ~» _. ~'~~ ~ a ~~. ..._...._..._._.~.....y„--~---..~, F.~., , v F. ~~~ lea ~. ~ ~~,`~ ~~~ ~* ~iy Svc. ~~ ~~ ~' ~~ i ~~ _.: r- ~. 4A.~J ~/ ~` ~ n 4 ~ ;~ 3 Hy ',R ~+ `1 ~. +.~ , _~ ~ ~~ ^.. " ~ .~„t r .~' '~''.~' {~ ,,r^ ~" _~ ~~ . ~~ ~~~~ ~~m Coa.~ r r ~ ~ ~`~-S a~ _~, ' .. m ~,i ~yj P/Y' ,~ ~ RA Wt~ ~e~~~~~~A ~~ ~"~'~ ~-~~~' ~ ~~~ ~~~ ~° ; ;. ~)~'Yt i..l~ ~' „'~ fib Q v ~+" ) DD ~,.~+ ~.: 1h W 1! ~~~~ ~~ { lai r 9~ »w+ .......a, ,,,,.,...,,, .,,F..~.., 1~ r ~,4 ,2 ~ 1540 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division Of Safety and BUIIdIngS " ~~` i~ ~rr+rmhnrp with Rnmm RF Wis Arlm Cnrle Steel'S S011 $@NICe, InC. Attach coit>plete,sd~pplaM..An not less than '/: x 11 inches in s¢e. Plan must -- County St. Croix indude, but not limde7to: 1 a~thorizontalference point (BM), direction and percent slope, scale or dimemsions; rror~aq~ov 'and location and distance to nearest road. Parcel l.D. Pending Please print all information. R sewed By Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` -' 'u. Property Owner Property Location Cutting Edge Four, LLC Govt. Lot n/a SE 1/4 SE 1/4 S 4 T 29 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# E976 170 TH Street 60 n/a Hillside Heights City State Zip Code Phone Number ~ City J Village ~tJ Town Nearest Road Hammond ~ WI 54015 715-796-2793 Hammond Cty Rd T New Construction Use: ~ Residential ! Number of bedrooms 4 Code derived design flow rate Replacement J Public or commercial - Describe:n/a Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, 'rf applicable General comments and recommendations: Mound design, system elevation 99.37 ft. based on contour line elevation 98.20 ft. 600 GPD n/a Boring # .~ Boring N' Pit Ground Surface elev. 98.50 ft. Depth to limiting factor - 3 min- Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 12-19 10yr4/4 none sicl 2msbk mfr cs n/a .4 .6 3 19-36 7.5yr4/4 none sl om mfr cs n/a .2 .6 4 36-48 7.5yr4/4 c2d7.5yr5/6 scl om mfi n/a n/a .0 .0 _~~ Boring # ~ Boring !~ Pit Ground Surface elev. 98.50 ft. Depth to limiting factor 6$ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell (2u. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs if .6 .8 2 10-16 10yr4/4 none sicl 2msbk mfr gw 1vf .4 .6 3 16-25 5yr4/4 none scl 2msbk mfr cs 1vf .4 .6 4 25-52 7.5yr4/4 none ms osg ml a 1vf .7 1.6 5 52-68 5yr4/4 none scl om mfi cs Na .0 .0 6 68-72 10yr8l2 c2d7.5yr5/6 Is osg mvfr n/a n/a .7 1.6 `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} ~g~ture:, CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 9/10/2004 715-G84-5680 S Property Owner Cutting Edge Four, LLC parcel ID # Pending Page 2 of 3 Boring # J Boring N Pit Ground Surface elev. 96.90 ft• Depth to limiting factor 22 in. ~ Appl~pn Rate Horizon th De Dominant Color Redoz Description Texture Structure Consistence Boundary Roots p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/1 none sit 2msbk mfr cs 1f .ti .8 2 12-22 10yr4/4 none sicl 2msbk mfr cs 1vf .4 .6 3 2 8 7.5yr4/4 c2d7.5yr5/6 sl/scl om mfr n/a n/a .0 .0 ^ Boring # Boring _j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # --~ Boring ^( Pit Ground Surface elev. ft. Depth to limiting factor in. ~~ 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/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. 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,SE1/4,S4,T29N,R17W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 684-3449 Hillside Heights, Lot 60 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend 1" = 40' Benchmazk Ele. 100.00Ft Top of 3/4" pvc pipe `-- Alt Benchmazk Ele. 99.70Ft op of 3/4" pvc pipe ^ =Borings Boring Elevations B1 = 98.SOFt B2 = 98.SOFt B3 = 96.90Ft B4 = OO.OOFt ~C~e lb~ /7~6=1~~~ ~. ~v r7G~( ~, ~~• ( ~~ ~~p2 b a .~ ~ C !~~ ~~' a~=~ ~~~r ~~ ~ ,. a3 ~ ~~ ,~^ ~~~ ~ ,~Z ~az~V' he ~hf~u 'a 5' $ ~~ ~^ ,, ~ `~ ~ \~ ~ ~N~@. 2.05 Ac. ' , ` , ~ ~ r ~ ~ ' ~ ~ ~ ~ ~`~~ ~ ~~~~ ~~ ~~~ 10~ ~ ~ ~~.~. LBO = y(}50.0' ~ ~/~ , ~ . ~ x -~_ 3S~\ ~~ \ x ~ ~ \!~I ~ - , ~ \ '~ . _' -~ \ I--~x ~~--~_ \ ~ ~ ~ - \ 0 -~ \ \ ~~ ' - LSO-=1(L85.0' - x _ _ / \ N p ~ ~ ~ ° 177503 S F~ ~ w `t 4.07 Ac. ~ ~ _ _ ~i , ~~ ~ ~ - ~ x N.B. 84214 S.F. ~ ~\ N.B. 1.93 Ac. ~ ~ /~ ~ ~ / / ~ / O / VV W ~ / ~ ~ / z / ~ / ~i ~ ~I ~ " i ~` ~ Q~ ~ / / / / I O x ~ ~/ cNV 66068 S.F. N.B. 8775 S.F. // / / ~` / ~ 1 i ~' JJ~ / QQ ~ x 1.5~ AC. N.E. 1.35 Ac.~/ / /x . ~ fdB. 7~074f' / i ~ \ `~ ~ 1 LBO = 105.0' ~ ( ~N.B. a-.~ ~ ____-- ~2 4 ~=-IAA--- /J ~ l ~ ~ i ~ 1 ( 1 O ;Naj p545$ S.~. N.B./s5453r15.F. ~~ Q COx 11.5 ACS N.B. 1.50 Ac. ~ 1~$ ~ 1 ~r ~ N a 0 jr x ~ ~N ~ ~~- ~ I 1 ~~ ~ ~ 0 ~~ 1 \ ' ~ 1 V \ \ \ ~, ~ 1\ ~ ~ ` a ~ t \ \ 1 ~ ~ 5~1.~ S.i ~ o ~, 11 65,460 `s. F. Nye. s54~~ s.F. ~~ ~ ~ 50 ~A~. ~ \~ z , ~ 1.'50 Acs N`e: 1.50 y4c. \ \\ +~ ~ ~\~, ~ \ ~ 0' ~~~~ E ~~ ~~ POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION Owner .Permit # 33S DESIGN F TERS' Number of Bedrooms 100gpd/bedroom ^ NA umber of Commercial Uzuts NA Estimated flow (average)*' gaUday Design'flow (peak), estimated x 1.5* gaUday Soil Application Rate r gaUday Influent/Effluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mg/L Biochemical Oxygen Demand (BODs) 5 220 mg/L Total Suspended Solids (TSS) < 250 mg/L Pretreated Eflluent Quality ^ Monthly Average*** Bio~hemical.OxygenDemand (BODs) S 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 fordomestic (non-commercial wastewater and septic tank effluent. ***Values typical far pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity gal Q NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model - O~ ^ NA Pump Tank Capacity gal ^ NA Pump Tank Manufacturer ^ 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) ^ ln-ground (gravity) ^ In-ground (pressurized) ^ At-grade Mound ^ Drip-line (~ Other: ^ Leaching Chamber Manufact<uer Model Approval Stipulation _ ~ Soil Application Rate_,gpd/fl Area Req. Absorption Area Credit per unit ft Minimum Number of Chambers ^ Aggregate Design Flaw/Loadiag Rate= rnin Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA ^ "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. 1~blication 15.22 ."Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 p "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 p SBD - i 0570' (8.6/99). "At Grade Component Manual Using Pressure Distribution" ^SBD --.:10567 P (8.6/99) "In Ground Absorption Component Manual" p SBD.-10705-=P (N.Ol/Ol) "In Ground Soil Absorption Component Manual" Version 2.0 SBD -10628-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-F (8.6/99) "Mound Component Manual" ^ SBD -1:0691-P (N.O1/Ol) "Mound Component Manual" Version 2.0 ^ SBD -105)5-P (8,6/99) "single Pass Saud Filter Component Manual" -.SBD. -10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" R SBD -10573-P (R 6/99) "Pressure Distribution Component Manual" D -10706-P (N.O1/Ol) "Pressure Distribution Component Manual" Version 2.0 p-litre Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units TENANCE MONITORING SCHEDULE Service Event Service Frequency lnspect'condition oftank(s) At least once every ^ months ear(s) (Maximum 3 yrs.) Pum out .contents of tank(s) When combined sludge and scum equals one- d (i/3) of tank volume Inspec dispersal,cell(s) At least once every ^ months .year(s) (Maximum 3 yrs.) Clean effluent filter At least once every 3 ^ months year(s) Inspe~ pump, .pump controls & alarm At least once every ^ months ear(s) ^ NA F ush laterals and pressure test At least once every ^ months year(s) ^ NA Valves " At least once every ^ months ear(s) ^ NA Outer: ' At least once every ^ months ' ^ year(s) NA Page of START UP For new construction, prior to use cif the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. 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/fiuit peels :and seeds, bones, and food solids such as those produced by a gazbage 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 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. '`Calves Valves shall be operated in the following manner: ~.A.larms 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 noiaially a 1 day reserve udder 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). eptac 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 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. ump 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 madeforleaks,bockups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. p l'n-Crround 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 overloading or impending h draulic failure necessitating more frequent monitoring. y of Page QUnd, At Grade, In-Ground Pressure 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 greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more 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 of least once every three (3) yeazs. Pressure 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 ensure 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. - Afterpumping, 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. CQNTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant :replacement system: ^ A suitable replacement area has been evaluated and may be utilized. for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil 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 com 1 w' es " e ith the rul m ffect at that time. PY ^ A suitable replacement area is not available due to setback and/or soil limitations. Ban-ing advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation mustbe performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Mound and at grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative ace. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» ~ . SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTLAN LETHAL GASSES AND/OR INSUFFICIENT OILYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIItCUMSTANCES. AEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS ', POWTS`INSTALLER Name nti~k.6 Ca2..5 - Nzl lu Phone ~. 2~5,~ I SEPTAGE SERVICING OPERATOR (Pumper) Name Phone. POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Agency ST = f~D( ocW'rr -i$,~ iaJ Phone S. K:IWPDAT,4.~E1d~POWTS OWNER'S MAMJAL.doc Page of ST CROIX COUN'T'Y ' SEPTIC TANK MAINTA NAI`ICE AGREE~'I`1T OWNERSHIP CERTIFICATION FO1tM ~wner/13uyer C ~ ~~ I J `t J ltiailing Address Property Address ' (Verification required from Planning Department for new construction) o _ Z~ ~ _ 6~' ~ ~~ ~ ~~ ' / OvD City/State H=~~~ P~cel Identification Number LEGAL DESCRIPTION S~ .~ 5~ '/~, Sec. = T °7 9 N_R / 7 W, Town of ~~~ ~ -- Property Location - ~{. _--- ~ ,/ ,, ~I,Ot# ~~ Subdivision G ~- S rve Map # ' Volume ~_-- ..Page # Certified u Y ~-~~- SZ ( Volume 2 ~-Zg .Page # 3 ~ 2 Warranty Deed # Spec house ^ yes ^ no Lot lines identifiable ^ yes ^ no SYSTEM MA~NANCE roper use and maintenanceof yoga septic system could result in its premature failure to handle wastes. Proper mai a enan Imp if needed by a licensed pumper. What you put into tl a system ~~~ of pumping out the septic tank every three years or sooner. sal s stem. can affect the function of the septic tank as a treatrrrent stage in the waste dispo Y ~ by the owner and by a artrnent a certification form, sign ~ al s em The property owner agrees to subwit to St. Croix Zoni'-g Dep~ verifying that (1) the on-site wastewaterd~sPo~ Y~ ~terptumber, journeymanplumber, restricted plumber or a licer>scd p P~ the septic tank is less than I/3 full c i'slndge. after ection and pumping (if necessary), is is proper operating condition and/or (2) iusp ee to maintain the private sewage disposal system with the stn ~d ~ n Ifwe, the undersigned have read the above requirements and agr Otlioe ~~ 30 herein, as set by the Dcpariment of t:onunerce and the DeparUueu eourned to theeStuC oix County ~ g ~ ~ . set forth, ~,tiag that your septic system has been maintained must be completed and days of th three y ex ' lion date. l ~ bs' ~~ ,~i~ ~ DATE SIGNA ItE OF APPLICANT O~.~ C E RTITICATLON our iaiowledge. I (we) am (are) tho ~ .wnec{s) of I (we) certify that all statements on this form are true to the best of my ( ) the grope y descri dab ve, by virtue of a warranty deed recorded iu Register of Deeds Office. I _ / ~ / ~ DATE ~~ SIGNATURE OF APP ICANT «««««« omit being revoked by the Zoning Depa~ =nt. «s«+*• Any information that is mis-represented may result in the sanitary p •« Include with lots appllcatton: a ~~ of the certifedsurvcy mapRf rgeferen Ois madefn rho warranty deed r // ~f `~ . f~. d ll; Z?28P 312 II STATE BAR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED Document Number This Deed, made between Cutting Edae Four LLC a Limited Liat Comoany ,Grantor, and Michael A. Nielsen and Kimberly A. Nielsen 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"): ~. ?'84~c^ 1 KATHLEEN H. WALSH REGISTER OF DEEDS ~T. CROI% CO. , WI RECEIVED FOR RECORD 0I/10/20@5 03:00AM WARRANTY DEED f%ct~7 #~ REC FEE: 11.00 TRANS FEE: 116.70 COPY FEE: CC FEE: PAGES: 1 Name and Return Atldress KETURN Tv~ Burnet Title 7550 France Ave. S. First Floor 55435 Edina, MN Central TTN: post Closin8 ~Oo~ ~ Par I Identiflca on Number (PIN) This is not _ homestead property. (IS) (is not) Q~~ /OO lo. ~._ 007J Lot 60, Hillside Heights, Town of Hammond, St. Croix County, Wisconsin. ~/~~~o~!_ d~~JQ~ p/~ /009-~0-~'O~ 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 29th day of December, 2004. ~~~ ~~~ Cutting Edge Four, LLC AUTHENTICATION Signature(s) WENDY SWATZINA NOTARY PUBLI authentica~d.tf),isr~~(day,~~f~_, 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 4-53227 (Signatures may be authenticated or acknowledged. Both are not necessary.) (SEAL) ACKNOWLEDGMENT ~' State of Wisconsin, (SEAL) } ss. St. Croix County Personally came before me this 29th day of December, 2004 the above named David Dalton o a izer of uttin Ed a Four LLC 1 * \ ~ \i Notary Public, State of ~/isconsin My commission 's p rmanent. (If not, state expiration date: ~~~~~ .> `Names of ersons si nin in an ca aci must be ed or rinted below their STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 1 - 1998 (SEAL) _ (SEAL) _ Wisconsin Legal Blank Co, Inc. Milwaukee, Wis. •~•• 1.52 Ac. rn 1 1 I I ~ orgy o .~- -~"~„ / ~ ! ! 4T T P U \ N ~ ~ l ~- `_`. 84 20 24 UV 355.94' ~ ' I ! ~- --- ._._.... ,_..~ -~ -___ f ~ , ~ I ~I ~ w .,.._.., ~' ~ ts..l ~ ~ I ~ 1 I ~~ ~ TED) ~ o~ 5~ I I ~ '~ ~ I. ~ ~~ 65453 S.F. I c~ v ` I ~') c~ ~ • ~ N 1.50 Ac. ~ ~ ~ $~ ,-~ , I ~ ~~ \ `l ~ 356.99' ~ I ~ 1 ~ ~ ~ ~ N 85'50' 25„ E ~ ~..~- 1 r-- t r' w ._... I -'.I, ~~ ~, ~. ~ 60 1 ~ ~ , I tf7 46 .F. 1 ~~ 1 \ ! (~ OO (~ a ~ 1.50 A c. ~ ~ 1 n~ ~ j I W 00 t!~ ~ Z.35...~-- ---i a.M. a.i=vAnoN ~ ~ o~s.s t ~ ~ ~y~ ~ ~, ~ ~ ~ 67753 S. F. ~ ~~ ~I t s~ ~! ~ Cj j ~~ rn 1.56 Ac. _ \ 'LE` ~` a 65457 S.F. oo ~- ~ ~ ~ ~- 1.50 Ac. ~~ ( ~ 6' ~~~,`'~, /' ~ r~ ~ ~ N 89'17'00" _ W 394.84' _ ~ `~ ~` p~~ ~ ~ ~, I - r W _ ~ N 47'26' S9" E / 80' TEMPOACRY I 0) --"- ,) 7.80. -~ / / CUL-OE S ~ l ~ ~ / / / EASEMENT. TO / 8E REMOVED M ~ ~ WESTERLY o! ~ ~.. 68868 S.F. ~ ~/ // EXTENSION OF l ~ 1.58 AC. ~ / / // ~ ROADWAY. Z I N / C,~1 // ~ / //C ~67'S2'34"W ~ N ~ / /, j . 88.14' ----~ ~ -~._... // ~ / / TO CENTER `~. 61.45' --`° °-~- ~ / // / / ~ ~ ~ EASEMENT ~ ~ 164~~4 ~ _ ! ,a,~. / / \ o S 89 51 ' 46" E ~ C3 ~ / ~ 1 _ ~. a _ 2 6.19' - - ~' ---=~____ S ~~ , ~ / / ~ \ `~ TOWN RO AD ~ ~ ~--5~ 4 ~~ ~ ~ / c s ~ 2 ^~ / >> ~