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018-2009-66-000
Wisconsin 4ppartment of Commerce PRIVATE SEWAGE SYSTEM Safety and B, ~Iding 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)]. Permit Holder's Name: City Village X Township Witti , Bradle & Pam Hammond, Town of CST BM EI ~ ~ ` (] Insp. BM EI~ BM Descripti~^ / 4 ~~ ~~~` ^^ / A j ~~ TANK INFORMATION TYPE MANUFACTURER , ~. ~ ".~' ~ CAPACITY Septic / ~ , ;~~, M Dosing ~, fi` ; r,.~ ~.,a,w, .~ `.~ Aetas:ion / ,- (ra I % ~.,.. ~:,~~ ~ Holding ` ~,c;~ ~.;„,(.-..ti.. TANK SETBACK INFORMATION TANK TO ~ P/L ~( WELL BLDG. Vent to Air Intake ROAD Septic / ~~ ~ : ~ ~ j ~ f / `~~ ~_ Dosing ~ ~ :,~'' ~~ - Aeration Holding ~~---""" PUMP/SIPHON INFORMATION ~". I .- ` Manufacturer Demand .- ~+~1 ~ ''~ `"' GPM Model Number ~~"~ -°° ~~~, ~~. TDH Life ~ Fricti ~ Lo ss System Head TDH w•. Ft ~ e ` ~~ ~ . Forcemain Length Dia. ~' Dist. to Well " SOIL-ABSORPTION SYS a-EM county: St. Croix Sanitary Permit No: 515175 0 State Plan ID No: Parcel Tax No: 018-2009-66-000 Section/Town/Range/Map No: 04.29.17.1050 ELEVATION DATA ~ , (`f /0,3 . I `{ /T1C~ STATION BS 3 • ~~ HI /o3•~`d FS ELEV. da Benchmark .3 ~ /o ~• l~, Alt. BM 2 • ~ /DD ~ ~ T Bldg. Sewer ?• 5 5, S f ~~ SUHt Inlet ~ ~~y O ~ 5 ~ ~~ St/Ht Outlet a `_ Dt Inlet ~ Dt Bottom ~/. ~,~/ .7~ Header/Man. 3.0 /cb .o g Dist. Pipe 3•a~ /eo .oS Bot. System 3, la X60 , a Final Grade Z.o /al. ~Z St Cover t,.,~, ~ ~-~.~,, ~ ~ ~ c.~ ~ 1 /~,~ q !- BED/TRENCH Width Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. ~ Liquid Depth DIMENSIONS '~ ~ ? Q Ue '~----- ~' ~` -\ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: --~.~ INFORMATION ~ CHAMBER OR Type ,O~j~`'stem: ~~ ~ , t~ ~ a UNIT Model Number "'~~ DISTRIBUTION SYSTEM Header/Manifold / Length 3. 5 Dia /~ ~ Distribution // Length~~ Dia ~ r ~ Spacing ~ ' ~ x Hole Size ~ ~ 3 Z / x Hole Spacing z Vefr~to Air I ake `•'/ SOIL COVER x Pracc~~ra Svstamc r)nly YY Mnuntl Or At.Crade SVStems OnIV : J ~ Depth Over Depth Over xx Depth of xx Seeded/Sodded xx ulc ed -- Bed/Trench Center / ~ ~ BedlTrench Edges •~ Topsoil t ~..~~-. `Yes ;.~ No J. Yes ~ No L~ Ok '~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspecti #1: . / ~ /~(~ Inspection #2: ~ ~ / ~3/ a ~ Location: 1102 178th Street Hiammond, WI 54015 (SE 1/4 SE 1/4 4 T29NR,/17W) Hillside Heights t 6 ~ -T[/ 1 Parcel No: 04.29A.1-7.1050 1.) Alt BM Description = ir`• i. `~t.'`• ~--r ,,' :.,~.., _ ~°6~~~LQ ~Gl/~L.~ ~~_ `~'!?,g'N,~~ £~/~oc~t.~C/R~j !!~ 2.) Bldg sewer length = ~ ~~ yY~~L~~~~s ~~~ ~ fGaP/[~ - amount of cover = ~ ~, f ~'' / ----- - I _ _-- - --r l -_ - -- ~- G _ ~~ ----; Plan revision Required ~ Yes No a ~~~ ~ r ~:: ~ r f ~' ~, ~ ~~( ~C f ~~ ,, ,, lu ~ l Use other side for additional information. ,_~ j ~ " L_~ ~~ I ~,'~ - -~--____ _ -y ~ "•~'"'"'"`-- ~--- - L ~ r--- Date ~ Insepctor's Signature ~ Cert. No. SBD-6710 (R.3/97) _ , commerce.wi,gov Safety and Buildings Divisi 201 W. Washington Ave., 62 County ~ ~ N c i i1 g Madison, WI 5 62 Sanitary Permit Number (to be filled in by Co.) V DepartVmenVt o^f ff~MV arnerce~ R O ~, ~O ~ 5 ~~ ~oN\NG ^~ ~ Sanitary Permit Application fate Transition Number ~~ , ? q~E~[titnental submission of this form to the appropria Wis Adm Code 83 21(2) accordance with s Comm I 2 .~d 7 (~ s . , ; . . . . n 'POWYS aze f t i f Project Address (if different thanmailing address) or sta e- on orms unit is required prior to obtaining a sanitary permit. Note: Applicat submitted to the Department of Commerce. Personal information you provide may beQused for secondary u ses in accordance with the Privac Law, s. I S- t m , Stars. -1'~j 1. A lication Information -Please Print All Information ~ ~~ ~ Prope Owner's Name Parcel # A ~ ,~ o~ .c ~ ~ /~ ~ `~- -1 tea' - G- mo Pr perty Owner's ailing A ~ss ~I~ F~~,....o n / /~ Property Locatio / ~ d ~ t!~ _ (.. Govt. Lot State C Zip Code Phone Number ~ y, ~~ y., Section _~ ~ f/ (circle one Type of Build g (check all that apply) ll Lot # . ~Loc2Family.Dwelling-Numl.~erofBedmoms 3_ . / - - ... Subdivision Name - _ _ ____ _ v Block ~ S ~ ~ ^ Public/Commercial -Describe Use '~'~ Sw .~-- ^ City of wt.1 ^ State O med - Descr' Use f k , ~~ CSM Number ^ Village of ~/ ~~ !7 TOWn of~'„hSPiyitrD t[l. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B. ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued ~ Before Expiration Owner 1 V. T e of POWYS S stem/Com nent/Device: Check sll that a 1 ^ Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grads Mound > 24 in. ofsuitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersal/I'reatment Area [nformati4n: ~ Design Flow (gpdj Design Soil Application Rate(gpdsf) Dispersa! Area Requi Dispersal Area Propos (s ystem Elevation / Vl. Tank Info Capacity in oral # of -Manufacturer Gallons Gallons Units ~-, ~ ~ ,fl R v v _ .~ New Tanks Existing Tanks /~ tr u c ;? ? °~ ~ `~ R - ` Septic or ~ ~eO ~- ~Da ~ ! Y Dosing Chamber r ~ `/ V17. Responsibility Statement- I, the undersigned, assume responsibility for installs n oft~e POWYS shown on the attached plans. Plumber's Name (Print) ~ Plumber' ignature MP/MPRS Number Business Phone Number ~i~v,~ ~v ~~KT / ..- 8 !,a - 6 -- 7DGb Plumber's Address (Street. City, S te. Zip Code) ~~~ 7~ tI/~6 ~ p~ Vll onn /De artment Use Onl Approved Permit Fee Date Isstted issuing m Signs $//~ ~ ~~ oa d9 ~ 2 rven Reason for iat . to IX. Condifj~plyq~Reasons for Disapproval /n~ ,, r ~ /~ ffluent filter end -3~ t/ Ql fi{ 1 ONt k S 1 ~1 ~~l ~~~ ~'~ t- ti t S i ~w an , e ,. . ep c ~ 1. dispersal cell must all be services / maintained t M ~ , / ~ l (~, / /- G }ems!'' C~J~ ~f~(,t,~ ~eri~A'r P' as per management plan provided by plumber. ~ , 2. all setback requirements must be maintained a ble aide / ordinartcee. Attach to complete plans ror the system and submit to the County only on paper not less than s trz x i i incnes m s¢e SBD-6398 (R. 01!07) Valid thtu 01/09 0 "~ .~ .~ •s ti a~~ b •~ ~~a ~ °' w ~~ ~~ ~o `~ a b a a g ~~ 13 ~g ~~ 0 0 N COPY A ao 0 eo ao a° tl .~ C r~~ •~ tT y 'R a~~ ~~a '~~y tl b N c3 ~o ,b O 3 E~ QC N rt °o a S ~d R ~g ~~ 0 0 N commerce.wi.gov ^ ^ ~scons~n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 Contact Through Relay www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary October 20, 2009 CUST ID No. 224059 KEITH E STONER KEITH STONER SOIL TESTING SANITARY DESIGN 23220 WOOD CREEK RD SIltEN WI 54872 A1TN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/20/2011 Identification Numbers Transaction ID No. 1725076 SITE• Site ID No. 752246 Brad & Pam Witter Please refer to both identification numbers, Dalton Farm Rd above, in all cones' ondence with the a enc Town of Hammond St Croix County SE1/4, NE1/4, S4, T29N, R17W Lot: 66, Subdivision: Hillside Heights FOR: Description: Mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1244365 Maintenance required; 450 GPD Flow rate; 24 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.O1/O1), SSWMP Pub. 9.6; Effluent Filter ~ ~.) V'V' . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Co~~;~~ t.r~~" ~'.~~~ and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be cons .~' s> ~ _~~~~`' and located in accordance with the enclosed approved plans and with any component manual(s) referenced abo~ ~' ~ ~"~ The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code pFFAP~rM'~ N( DIV S requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.l stats. SFE CORRESP The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the azea 15' beyond the down slope edge of the mound per Mound Component Manual. KEITH E STONER Page 2 10/20/2009 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • he existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, 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: All permits required by the state or the local municipality shall be obtained prior to commencement of construction/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 maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a co~o y of this letter and the POWTS management plan to the owner and any others who are responsible for the instdilatjon, operation or maintenance of the POWTS. Sincerely, Patricia L Shandorf /' POWTS Plan Revi wer ,Integrated (715) 634-7810, F : (715) 634-1' pat.shandorf@wisco go~+/ M-f 7:45 am - 4:30 pm Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Monday, 7:00 A.M. To 3:30 P.M. David B Fogerty ,Fogerty Plumbing & Perk Testing Inc (Plans Mailed To) Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs arty building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 9D. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-Buildin~ContractorProgram.html KEITH E STONER Page 2 10/20/2009 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • he existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, 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: All permits required by the state or the local municipality shall be obtained prior to commencement of construction/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~ ~c~oRy of this letter and the POWTS management plan to the owner and any others who are responsible for the instdilatjon, operation or maintenance of the POWTS. Sincerely, Patricia L Shandorf ~ ~/ POWTS Plan Reviewer ,Integrated Arvices (715) 634-7810, F~x: (715) 6340 , M-f 7:45 am - 4:30 pm Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Monday, 7:00 A.M. To 3:30 P.M. David B Fogerty ,Fogerty Plumbing & Perk Testing Inc (Plans Mailed To) Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs arty building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a buildingproduct not on the building site. For further information, go to our website: www.commerce wi eov/SB/SB-BuildineContractorPro~ram html MOUND AND PRESSURE DfSTR#BUTION COMPONENT DES#GN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: Owner's Address: Legal Description: Township: County: Witter Mound Bradley and Pamela Witter 2035140th Ave. Baldwin WI 54015 SE1/4-NE1/4 Sec.4 T29N-R17W Hammond St. Croix Subdivision Name: Hillside Heights Lot Number: 66 Block Number. NA Parcel I.D. Number: 018-2009-66-000 Plan Transa~ion No.: Page 1 index and title tl ~ ,~ Page 2 Data entry = w Page 3 Mound drawings Page 4 Lateral and dose tank ~ - ~ , E Page 5 System maintenance specifications ~ ,_~ j~Lpiw.~ Page 6 Management and contingency plan ~ Page 7 Pump curve and specifications Page 8 Plot Plan ~~- ~ ,e\\\\\f1;111I IIII flflfl~0 CO ~~ 4± ~ WlS /'~~ Designer. Keith E.~toner'°`•°~~ ~''••'LS~~°e License Number. Designer# 1575-007 Date: 1010/0-~-~---.~ ryF° : ~ ~ Phone Number. 715-653-2324 __ ~~ Signature: ~_ •. ~"~'"_ t~' ~. ~~'%.,~fG' . P.~'~suant to tt~ Mound Component Manuaffimr/ , , ,_ ~ e8"'~ersion 2.0 SDB-10881-P (N. 01101), and both SSWMP Publ'~cation 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10708-P (N. 01!01) Version 5.1 (R. 06/06) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Infor nation (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) 2.00 Site Slope (°~) 99.00 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ftz) (C or E) tL ` ~ !_~ ~ yr~ .\ . `~ !; r`~ ~ '' Distribution Celt Information 64.30 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz} 1 Influent Wastewater Quality (1 or 2) Pressure Dlsribution Information E Center or End Manifold 3.50 Lateral Spacing (ft) 2 Number of Laterals 0.158 Orfice Diameter (in) 2.00 Estimated Orfice Spacing (ft) = 2.00 Forcemain Diameter (in) 120.00 Forcemain Length (ft) 87.50 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 12.00 Vertical Lift (ft) 3.01 Friction Loss (ft) 0.00 In-line Filter Loss {ft) 19.56 Total Dynamic Head (ft) Lateral Diameter Selection in. die. o lions choice 0.75 1A0 1.25 1.50 x x 2.00 x 3.00 x Note: Send fill (D) calculations assume a Table 83-44-3 ir--situ soil bestrnern for fecal colifortn of ~= 38 inches. 7.00 Cell Width (tt) Are ftte laterals the highest int in the distribution Y network? Enter Y or N If N above, enter the elevation ft of the highest point. 7.03 fly/orifice Does the forcemain drain back? C Y Enter Y or N 19.57 Forcemain Drainback (gal) 57.74 5x Void Volume (gal) 77.31 Minimum Dose Volume (gal) 34.46 System Demand (gpm) Manifold Diameter Selection in. dia. o lions choice 1.25 x 1.50 x x 2.00 3.00 Galbns/lnch Calculator (op4onal) Trea~rtent Tank Information Total Tank Capacity (gal) 1000.00 ~ nic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete Manufacturer gaVin (enter result in cell B49) Dose Tank Information Effluent Filter Information 602.82 Dose Tank Capacity (gal) Pol ~lok Fitter Manufacturer 11.82 Dose Tank Volume (gain) PL-525 Filter Model Number Wieser Concrete Manufacturer Project: Witter Mound Page 2 of 8 Mound Plan and Cross Section Views 1- 1_ ...................................... 11~:f Observation Pipe ~' K •L L•L•L•L•L•L•~.•L•L•4 L L L•L•L.L•L•L•L•L•L•L•L•L•L.L•S•L•L• •L•L••• • r.f.r.f. ,r..•.f•.•.t.r.,t.r. 'r•~ 1. r.r.••.r.,,•.r.r..•.,•.,•.:.,r. ,•. j. . ~•L•L L•L•L•.•L•L•L•L• rj ~•1 L•L•L•L•L•L•YL•L•L•L.L• S•L• • r•~••J'•~..••:.f..•.r.~•.r..•~r.~.j. r.r.••.f.r.r.••.j.j.r.j. f.r.f. . • l:~ l~'."•:~.•~:~t1:ti1`~.•~d~r•.r•r~r : ~'r~ rtif~'r%1~r~r~: ~tSr r r.~.;"j.}1,:j. . ~. 1 L Mound Component Dimensions Dispental Cell Finished Grade 101.79 (ft) i~ .. ~ H ~ ~fri.~iiri 2 t~i~i~i G fl~is~f i{f~ F Dispersal CeH '~"- 100.50 (ft) Lateral 100.00 (ft)--- ~ : ~ Invert Dispersal Cell [3] ; = =p ~ ' ~ ~ ~ Elevation E . ~ ~ . .. ... . 2.0 % Site Slope Shading Key ,1~ ~ Topsoil Cap © ~'"'~ Subsoil Cap ASTM C33 Sand ®Tilled Layer r~r.r1. A99~~ A 7.00 ft E 13.88 in B 64.30 ft F 9.50 in D 12.00 in G 0.50 ft 450.10 (ftz) Dispersal Cell Anna 7.00 (gpdfft) Linear Loading Rate Mound Cross Section View Aggregate Dispersal Area _0 1.5 ft a ~ Z 0.5 ft a c _~ H 1.00 ft z 7.76 ft J 6.49 ft -+ _fi _l K 8.59 ft L $1.47 ft W 21.25 ft 949.11 (ft~) Basal Area Available 6.43 (ft)1/10 B Obs. Pipe Placement Cabaret *--- A 99.00 (ft) Contour Elevation /'~ Geotextile Fabric Cover C See lateral details on Page 4 for number, size, and sparing of laterals. F Laterals are equally spaced from the I distribution celPs centerline in the ' disMbution cell (AxB). Project: Witter Mound Page 3 Of 8 End Connection Lafierai Layout Diagram a~oais enRan3ovsr ~ •¢Turn-up+rf~llwiworol~anoutplup P --~ f Ah laterals sre irkntioal I{- y~--~I Hops drihd on Rht b~ottotn of tKt IaMral i I e4~M1 sPa~ ~ Foray main aonnaotion via tQe of Wass to matlNOld ~ .any poke. Laterals >k force main of t'YC Bah 4D (per COW'NiA Table e~.30-s) Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Fknly Rate Total Dynamic Head 2 1.50 in 62.93 ft 3.50 ft 17.23 gpm 34.46 gpm 19.56 ft Orifice Diameter Orifice Spacing (X) Orfices per Lateral Orifice Density Manifold Length Manifold Diameter Foroernain Velocity Dose Tank Information Ebctr'ical as per NEC 300 and -~- Comm 18.28 WAC Tank component is propery vented Wieser Concrete Ca 602.82 Volume 11.82 Manufacturer Gallons gallinch Dimension ~ Inches Gallons A 30.46 360.03 13 2.00 23.64 C 6.54 77.31 D 12.00 141.84 Total 51.00 602.82 3" A B C D Disoonned Alarm Manuafachrrer S.J. Electro Alarm Model Number Tank Alert Pump Manufacturer Goulds _„ Pump Model Number EPO-5 Pump Must Deliver 34.46 gpm at 19.56 ft TDH 0.158 in 2.03 ft 32 7.03 ftz/orifice 3.50 ft 1.50 in 3.52 ftlsec Locking Dover vvktl vvaming label and locking device and st~lbd toratettight i 4 ll. min. ~~ E- ARemate outbt kxa3tton Forcemain diameter ~ 2 in. Weep hob or arltl- slphon device Pum ofF ebveUon ft 88.50 ~Qose tank ebvatbn R 87.50 Project: Witter Mound Page 4 of 8 Mound System Mai ~benance anti Operation Specifications Service Provider's Name Tri-County Sanitation Phone 715-388-0114 POilV1'S Regulator's Name St. Croix County Zoning Phone 715-386-4680 1 [1:11 ' V ' . L i Design Flow -Peak 450 gpd Maximum influent Particle Size 118 in Estimated Flow -Average 300 gpd Maximum 8005 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Gomponent Size 450.1 fly Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Serves freaPencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other In andlar service once e 3 tB Should ins and clean at least once eve 3 Test once eve 3 rs Should test month Laterals should be flushed and ressure tested eve 1.S rs Ins for din and once 3 rs Miscellaneous Cong~ructlon and M~terisls Standards 1. Observaflon pipes are slotted and materials conform th 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. Ali 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 distut~d areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. (lateral Tum-up Detail Finished • ............. ............... Grade 6-8" Diameter Lavin Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degnae iBends Same Diameter as Lateral Project: Witter Mound Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, tiVts. Adm, Code This system shall be operated in accordance with Comm 82.84 Wis. Adm. Code, and shall maintained in accordance with its' c~rrponent manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.8 (01/81), and Pressure Distribution Component AAanual Ver. 2.0 SBD 10706-P (N. 01/01)] and local or state rules pertaining to system maintertanoe and maintenance reporting. No one shouin ever solar a septic or prxnp tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shag lDe in accordance with Comm 83,33, Wes. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers shook! 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 b failure must be replaced. Exposed access openings greater than 8-inches in diameter ahail be secured by an effective locking device to prevent accidental or unauthorized entry irrto a tank or component. ~sotlc Tanis The septin tank shalt be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shag 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 titter shall be cteaned as necessary b ensure proper operation. The titter cartridge should not be removed unless provisions are made to retain solids in the tank that may abugh aft the filter when removed from its enclosure. ff the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuousy. Intermident filter alarms may indicate surge flows or an lnpending continuous alarm. The septic tank shag have iks contents removed when the volume of sludge and scum in the lank exceeds 1/3 the flquid volume of the tank. ff the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel ahaq advise the owner of when the next service needs to be performed to maintain lass than maximum scum and sludge aocumuletbn 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. j?umo TankTank The pump (dosing) tank shall be inspected at keel once every 3 yearo. AN switches, alarms, and pumps shag be tested to verify Proper operation. If an effluent filter is installed within the tank it shalt be inspected and sensed as necessary. Mound and Pressure man 8vafwrr Pic trees or shrubs should be planted on the mound. Plantings maybe made around the mound's perimeter, and the mound shag 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 IMiltrative surface within the rwund and snow compaction in the wither wNl promote frost penetration. Cold weather installations (October-February) dk#aDa that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mglt_ GODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/l- BODg, 30 mg/L TSS, 10 mg/L FOG, and 10' du/100 mL for highly treated effluent. Influent lbw may not exceed maximum design fkna specified in the pemtit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it k recommended that eadt lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared b die initial test when the system was instaged b determine if orfice dogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal coq shag be checked for effluent pending. Pending busk shag be nsported b ttre owner, and arty levels above 6 inches consrdered as an impending hydraulic tequre requiring additional, more frequent monitoring. Congnoarrcv Plan If the septic tank or any of its canponents become defective the tank or oorrrponent 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 pertormance. If the mound component fails b accept wastewater or begins b disdtefge wastewater b the ground surface, q will be repaired or replacxd in its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and related piping, and repladng said components ~ deemed necessary b bring the system inb proper operating condition. See Page 5 of the plan for the name and telephone number of your local POWTS regulator and service provider. units The information and sdraduie of mananagement acrd maintenance for pretreatment devices such as aerobic treatrner-t units or disinfection units are attadred as separate dorximerrta and are considered part of the overafl management plan for thin system. Projf3ct: Page fi of 8 Page 7 of 8 ~GOULDS PUMPS _. ~ FEET v APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 'la" maximum, • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:l'Is" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40~C) continuous 140"F (60"C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. •EP05 Single pphase; 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 1613 SJTOW with three prong grounding plug. Optional 20 foot length, 1613 SJi1N with. three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer, Available for automats and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS 10 9 s 0 u c 0 >- Submersible Effluent Pump 3871 EP05 ~ ^ EP05 Impeller: Thermoplas- tic enclosed design for improved performance. ^ Casing anti Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron For efficlertt heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil armd water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING ca,rredmn standatrls A~oasAlon (CSA listed model numbers end in "C" or "F".) caAds Purlpr is ISO 9001 7 6 5 4 3 z 0 zs_ 20 15 10 -~-1... ..._ .__..i _~ ____. i .... I _. .._ 00 10 20 30 ~ 40 _ 50 _ GPM 0 2 4 6 8 10 12 m'/h u-PnaTv Goulds Pumps ®2001 Goulds Pumps ~ ITT tndusfiries Effective May, 2001 63871 ......, ...... s Gann ~_.__... zsrT r °~ +, ,.+;; ~ .' 1546 + Wisconsin Department ~f Comrne~ ,; , SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and ~uildings `'' ~~ ~ Steel's Soil Service, Inc. in`~ordan~e with Comm 85, Wis. Adm. Code / Attach complete~an Qh pager itotless ttran $'/ x 11 finches in size. Plan must i d d b li f d d r County St. Croix n u e, ut not ni b"ve ~,al ~rt eferende point (BM), direction and kbfi~pntal percentslope, scale or dimensions, n"~tttrarrow,~nd lodadon and distance to nearest road. ->x Parcel I.D. ,, - ~ -G,: ~. -~~ ~~ Please print all information. Reviewed By j Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (t) (m)). ~ ~ ~ 5 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 66 n/a Hillside Heights City State Zip Code Phone Number J City ~ Village ~ 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 ~ 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 100.30 ft., based on contour line elevation 99.30 ft. 600 GPD n/a Boring # ~ Boring ~J Pit Ground Surface elev. 99.40 ft. Depth to limiting factor 40 in. Sal Application Rate Horzon Depth Dominant Color Redox Description Texture Stnx;ture Consistence Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sit 2msbk mfr cs 1vf .6 .8 2 10-22 10yr4/4 none sicl 2msbk mfr cs 1vf .4 .6 3 22-40 10yr4/4 none scl/Is om mfr gw n/a .0 .0 4 40-60 5yr4/4 f2d7.5yr5/6 scl/sicl om mfr n/a n/a .0 .0 Boring # ~ Boring /~ Pit Ground Surface elev. 99.40 fl. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 9-24 10yr4/4 none sicl 2msbk mfr cs n/a .4 .6 3 24-60 5yr4/4 f1f7.5yr5/6 scl 2msbk mfr n/a n/a .4 .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) ~--%ature: CST Number David J. Steel / ~ / 248956 Address Steel's Soil Service, Ina Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 9/10/2004 715-6845680 Property Owner Cutting Edge Four, LLC Parcel ID # Pending ~ Page 2 of 3 goring # ~ Boring / Pit Ground Surface elev. 98.60 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 10-17 10yr4l4 none sicl 2msbk mfr cs Na .4 .6 3 17-31 7.5yr4/4 none sl 2msbk mfr cs n/a .6 1.0 4 31-60 5yr4/4 none scl om mfi n/a n/a .0 .0 ^ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Applkxtfon Rate Horzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 ^ Boring # .:.~ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sof Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture 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 SEl/4,SE1/4,S4,T29N,R17W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 684-3449 Hillside Heights, Lot 66 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. 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I •. zru~wo s7uoa '~i °Uo ~ c t W u ~'n wm yN wwi .~ 0~ 4 I x Oa~pa~ ~Jiuaz3f ~ ~ ~ ~/ II n z u ¢ mFtz. zr I ~wsoa~m razz ' ~ ~ ~ /~ ~ -i i ~ m y a ~ J 'm~ „u oo aozJcmazz7w mp i ~ ~ ©m o 4 n ~ ~ e°m"i N rn. ~' r ~ zm?OUeazmoamam # UU~ II ~ '. d a~ > Q r~ ~ ..... ~~ o UV . ~ ~ ~~ / ~ ~ .~ 66828 S,F. ~ u ~~ r . 1.53 Ac. ~O c N.B. 66828 S.F. ~ ~ J N.B. 1.53 Ac L! ~,.,,~ 8 , » ~t ~ -- .-- -x'32, cC o~ 1~ ~ ~i5593 S.F. ~/ / '~t N_B. 65593 S.F. f ~/ N ~ ~ N.B. 1.51 ~'7pd (r ~ _ _ z ~~,~"` ~ 6 ~~ S1 /4 CORNER ':~ECTfoN 4 ~a - ---- MG+If?dp`~~o ~.~, nMDD ~ OO mi,7nMGD DS7 ~O nM[~DD 41C~~L3L30DD [~f~4fJgC~ f#a~ll ~r r r ~vvr, b'd 966L98ESTLT S3WOH Hl?J019Qf1H eBE=TT 60 8Z daS ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~=,-~~' ~T=~ ~~L~ ~/ ~~_~5~.eo ~ Property Address ~ / f ~ (Verification required from Planning Department for new construction) City/State „ l~~N-1~vuv/D ([~[l~_ Parcel Identification Number ~° ' ~.t" LEGAL DESCRIPTION Property Location .~_~ '/., ~ '/., Sec. ~, T~N-R~W, Town of ~. Subdivision ~` / ~~y'~o~ 4~ ~ ~~°~f~ Lot # ,~~. Certified Survey Map # Volume .Page # T' Warranty Deed # ~~,~ ~ .Volume ,Page # Spec house ^ yes ~no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standazds set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year~~exp/ira ' date. ~/ ~, ~ cGv(/ ~ L /~/ ©~ SIGNA OF APPLIC DATE OWNER CERTIFICATION I (we) certify that all statements on this form aze true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above by virtue of a warranty deed recorded in Register of Deeds Office. q ~ ~Q ~` ~~ SIGNA OF APPI:IC DATE ****** Any information that is mis-represented may result in the sanitary pemut being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed STATE i3AR OF VNIBQOTiS1N FORM t - 2000 ~MdNRA1V7'Y t>~iCD !'NITS DYRD, atade betwee0 Cutting 1Bd~ Foa~, i¢irJ Btydlsy A. and Pumeh J. Wit ~'~• G+stt6ur, ltnaetr, Orswtee. ~' wed attd rife as Joist Cxrtlnbx, for a wlaabk aonsid op~"eYs to CKarttee the £allordss de::ctitard reN eatsta in Cotatty, SgOe of wiscor>!ia (the "PrOitarty"): [.tit fib, HNhede Wits. Tom os Baaipaotod, St Crda Winea~vi. Cony. Tir„etlxx wilt ell aP~tYwat ripltla, tbie and , _ ~L/~G . Oe16oe Oli-~pp9.~Fr.ppp Piety ~ur6v (p!M -" Gratuor wanana that the title to the Property y 6004 1ndelPeasble in fie s Thte L4114! homestead pt+opsrty. e$Qjp~-.,,rs, its. and cadki~ oFreaord. ~e +~ nee rme cler of etncumbamoes a"togti i]a4tc! ibis 2Z'~ daY of Seprembcr. 2009. r _.,_ Sigatrure(s) audr:tup:aled this Ap7HBN1'1CA7701V TITI.di M~tBtER STATE 6AR OF WISt:ON9tN (I ~ net, xkihmi>9ed by § T06.06. Wis. 941s.) 1t/t3 tNSTItexNEK~ WJ49 DIt/1F7'Ep 8Y ~ ~ 90436 SEIN PABST RE16ISdE'R Of DEEDS RECE111EDIFOR READ A9/24/2008 11:3pAp MMiRA1~iTY DEm k7Bri ~ REC fEE: 11.00 TRAMS FEE: 86.00 PARES: 1 Chisago County Ab:Krtec2. Company 13201 St. Croix Avt;nue P.O. Hox 948 ~ Lindstrom. IVCN 55045 ACKNpVyj„gp srwTE of wiscoHSni ? crnJNrY sr. cxpnc ) st. Peraoasib. Done before too this 22'' ay of s~tetabv. 2009 the above armted ~~ Foter, l.I.C b ate Intown to be the peeseta(s) vrho executed the fore~g htstrrttaeat .rta od fife mrtt~ .., R.Obett l« L0601ti ~ Lob Law O ' pe a _ - (Slyaea'n.~s say to abmpicaMd w '- ~Wrww tt'rc~ sieoiy to ~p.~p, a~ •1 aRlri3prWC ~YA11pAp7'y pgyy ~~ Of ~ SPATC ttiMt OM MtaODlr~t E' d 9Ei6L98E5 i L I S3WOH H12101~Qt1H (]toot, elate ~ €~~ ~ ....t ~ 4) yi : r ~'i~ o'.r ~ ~'` mss, Qw,,-v< «..- q~• rflownt Ni t.~~e~ S~ r d;o~ao so ez des