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018-1083-26-000
o ~~ 3w o C v1 , gi n I _. cn3 A y 7~5z fD m O o Wax o =moo Ot O) ~ ~ ~ • ~ ~~ ~ y rn coo 3 ~ ~ D ~~~ ~N d ~~ ~ W~ ~~~ W ~ . n n> °~ ~ I ~ a c o. a tD N o aD , ~ O ~ ~ c D 7C ~ I 3 '~ ~ ° ~' I f=A G ~ ~ ? ~ ~ v m I a ~ ~ m ~ D W a N 13 ~ ~ ~o~ N I O ° O ° ti ~ 003 ^Q 3 ~+• ~ ~ 'v v o °: gg ~ I e ,~~ ~vv,~ y ~ a ~ ~ ~ W obi ~ ~ S N I ~ m N a Z .. ° c x z I =; ~ ~ Q ~ ~ o x ~ ~ ~ ' a ~ ~ ~ ~ n ~ ~ 7 7 4i ~ ~ N I °' ' ~ N , ~~ ~ `~ I N ~ c N 3 ~» ~ ~ _ Z ~ ~ ~ ~ j Z W A I y 0<7 d ~:' ~ 7 I ~ ? .. ~ ° m ~ rn ~ a ~ I ~ z ? ~ I O ~ :. z J I = ~ ~ ~ I I ~ W A I ~ D 4 ~ ~ . n N ` O N X C G 1 a ~ m v_ 'm ~ ~~c°~ z a I ~ v_ o N =~ m m 7 N y tp ~ I . 3 ~ ~~ I a D ~ ' ~ ~, N ~ N ~ f C o ~, z ~ b I ~~ n . ~ Q~ ~ I o ~~ ti I ~ a + . N ~ a I fv °w I ~ " I o 'b r I ° o0 0 I c ~ ~ ~ N ~ ° ° b o ~. ~ a corrxneroe ,.g~y'~~ Division GE,N~RAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) personal trdorrnation you provice may be used for seoortdary prxposes (Privacy law, s.15.0a (1 j(m)l. Permrt H r s Name: rty Vr age ovvn o : Hammond Township' T @M E .: 1 insp. BM E v : BM Desorption: TeA1K INFt*fRMAT10N EI EVATION DAT ounty: St. Croix Sanitary Permit No.: 384163 State n t0 No.: Parce Tax NO.: 018-1083-26-000 STATION BS HI FS ELEV. Benchmark • t7 0 (. q o (~ . ~ ~ Alt. BM ~ •40 RS.O/ Bldg. Sewer ~~. ~p 90 . S`a / St / Ht Inlet ~ ~ • ~ 0 . ZD r St/ Ht Outlet ~- ---- Ot Inlet - --~ Dt Bottom (S -~o $6 . o ` Header/Man. '~ ~S: / Dist. Pipe 6 •~ c `?S• p / Bot. System ;li o 83.80' Final Grade ~. ~ ~ 4~'• !or TYPE MANUFACTURER CAPACITY Septic ~a 6 p.~ Dosing u Aeration Holding TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. vent to Air Intake ROAD Septic > S-z~ ~-S' ~ ---- NA Dosing a ~` "` -- 2~ / NA Aeration NA Holding PUMP /SIPHON INFORMATION ~~ Manufacturer a ~ c. Demand Model Number Sti~~ 3 p GPM TDH Lift Friction S tem TDH Ft Forcemain Length'&j ~ Dia_ 2 u Dist. To Welt All ARCARPT1ANtYrCTFM/~.-\ .A ~_ _ _ 0 1.,..__L - - ~ ~ crµ~r... s ~ r - - h ENCH Vi/idth i Len NO Of Trerxhes PIT No.Of Pits Inside Dia. Liquid Dept 3 . ~ I SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manu ~urer: _- t SETBACK INFORMATION YPe ~ ~ --~-~--"~ CHAMBER o e Num ` System: ~ p ~ 0 .~. $~ OR UNIT ` v f11GTRIRI ITIAIU CYCTFM He er / Mani o Distribution Pipes x Hole Size x Hole Spacing ( Vent To Air Intake Length Dia ngth Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1: ~l 06/ of Inspection #2: "t'-1`~ Location: 991 172nd Street, Hammond, WI 54015 (NE 1/4 NW 1/4 16 T29N R17W) -162917598 Pheasant Hills -Lot 26 ~~~ ~~~ 1.) Ait BM Description = ~~+^^0~ `P 2.) Bldg sewer length = ~ ~ ~ ~~ ~~ ~) ~ Wan revision req fired? ^ No Use other side~or additi nf~ation. 580-6710 (R.3f971 t Gate Inspector i Sgnat n . GM. No. -~ ~ 9 t ~ ~2• ~j Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. ~ ~~ See reverse side for instructions for completing this application PO Box 7302 " ''"' DaparUrrent of Cantimerce. Personal information you provide may purposes ~( )( )) [Privacy Law, 1 m -.. ~,. Madison, WI 53707-7302 (Submit completed form to county if not state owned. Attach com lete lens to the coon co onl for the ate on a er not lea's than 8 -1/2 x 11 inches in siu. County~~ _ n_ -x (;~( State Permit Number ~ Gheck ' 'ous applicatia- 3 ~ GCS: " State Plan I.D. Number ---___., _ I. A lication Information -Please Print all Informatio"',- ~ ' Location: Property Owner N ~ -`"i ~'; A" v ~ :. ~ a~ Prop~y Lo c atttion ~ ~ ' ,' S~ LR ~~ . ~ 1~ 1!4 W 114, ~ T N, lF ' E or Property Owne~(s'~Mailin/g Addrrss '- ~FiG (~ /"" ~~ ~~ ~ ~ ~ , ptlll~ Lo~t/NJrm/r~ber Block Number ' !/~~ Ci State Zip Code '`~l'hon ber ~' '~ - ` j' t •: Subdivision Name or CSM N ber t~ W ~~ t~Sz 5~ ooZ -- -s o ~~sMr,T lit ~I S II. Type of Building: (check one) Q -a.s ~ sw iii 1 or 2 Family Dwelling - No. of Bedrooms : v ~~`~'~ ~~ • ~ ^ Ciry I,7 _vitlage ^ Public/Commercial (describe use):_ ~ . own of ~ ~~ O State-Owned , Nearest Rosd l ~© .S T t r nn 4 zS f'Q.NIC,I~Q,s Parce Tax s) III. T e of Permit: Check onl one box on line A. Check box on line B if a licabie 5 g p) 1. New 2. O Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to S stem S stem Tank Onl Existin S em B) Permit Number Date O A Sani Permit was 'ousl issued 1V. Type of POWT System: (Check alt that apply) /~--Op j0'Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurizcd In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At- e O Aerobic Treatment Unit ^ Recirculatin O Other: V. Dis ersal/Treatment Area Information: I .Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4, Soil Application 5. Percolation Rate 6. System Elevation ?. Final Grade Required Proposed Rate (GalsJday/sq. ft.) (Minrnch) Elevation ~(~~ Smo ~~o 3 - ~~.y ~.- • VII. Tank Capacity in Total # of Manufacturer Prefab Sitc Stxl F'ber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ~% ~G ~ODC ""' ~~O ~ '' -` l~~T~ ^ ^ ^ o 0 0 ^ VIII. Responsibility Statement I, the undersi assume re nsibili f urstall OWTS shown on the attached lens. PIum~Name (print) ~ i Pl s Si o pe): MP/tv1PRS o. Business Phone Numbs /ot~ 1~ ~ P 39 ~ ~.~- Z3,~~ Plumber's areas (Sven, city, state, zip ~S'b ~ D S ~r1~ ~~ ~ 1 ~ ~7.r'i IX. County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Is sued g Agent Signature (No stamps) ~iQ Approved ^ Owner Given Initial Adverse S'r'~l'a`g ee) Zs ~ n ~~ ~ ` Determination Z~( X. Conde idorls of Apj~roval /Reason for Disapp oval: (` °~ C.e~,~ .. .~ -z'. ~,e~2n ~,C~ ~ ~j Sot. ( CArC/ t^a+~ ~nno~~t a~t.N¢QJ tWerS -~ t(S~ ` ~ n ~ n ~ A ,. Z "P"-'1"_ OwntdC. ~ ' ~ ~.hr.lh. tY~S ~dC ~ c~~-~ - ~9 sys-~~ t u . ~. . SBD=6398 R07/00 ~-J r p f' - ~ iS ~aa~.e,~'t lox. ~ ~ `C~o~-~--~~--~~~~ 1~' IS ~~` h,p pp,~ ~ (Y(',gu~t.w1l~(Dt~Tr\~ S _ ~ M(~t,i ~ Ro ~1. C.o?"'~- ,~ ,~,t y~bw~s .~ ffs~z-- s~~,~.. r ,t~.e ~,~,e~t ~Q w~- n~,~,~,~s ,.- i e T. L. Sinz Plumbing Inc. E5612 708th Ave. Phone: (715) 235-2644 Menomonie, WI 54751 Fax: (715) 235-2592 ICi 2K ~o D N ~ ~,-t ~D ~- ~ blur i'~-+~+J ~ o NE `rat NW ~~~ 5 to T'2.9 ~ -'I vJ Z ~sw~. p~.ei~~r l~ct~5 a ~ ST ero~~ Looo~T~ ,- , ~-- ~- +~ ~- ~~ S ~~ ~ 1 =100 ~~ ~~ 2 D ~ ~U~N Fri ~l~ r~ ~~ ~QI 'NE ~Y ~~ l~ ~~6 ~ ~9<j19 N ~ ' `l ~~5 ~~-G `,6~ a~ o ~ t ~ ~ 33md%m SGR~e Nornc ~~ ~ydiot~t,~ Sf/E~'3o Z~-61~ A~-ia~ ~/~' ~~ge ~.~ Kc,K. aL` ~' ~~a~v h Q~ 97 ~~ ~~ S F ~3 ~~ ~;~ E~R~. ~ ~E,~ °~'Z ads s: 0 0~\ Q1.1' K~~~~ ~ ~~.~ So, ~}~~~ rLIY y1~ ; r~1 ~ i~ --- ~- I \I--~ V W ~ A"t7i>i fi Q>i'~ ~ LOCKs-1C3 CO'V6R 3L~+~T-oK (r/rPhtiN~'Id L /4~~~ . i~ tAV~aK W~~+sCT~'1 C3- r-- "mac. br; .~ ,./ ~ '4~ ~' 4~ ~~ , t I~'.. plti?~ 3' ~ _ ~ j fG? NDiSTVRB~EA ,.. l So3L 24'' x.U. ~, d'' 4a N1tWUC~ _. f.. `(~ I Y~NT~ /rK~ r ~ 1. _- _ _ ' ~ ~~ ' ~ wG1-v ~ •• HO+~' ~}'•'Q~ L cWracvtt~ ~ ~ 4a (~T ~sjrg ~FL.ES ~4l 3' a+To Pt/f. p Z ~. N E G.T 7 o TiS `~'~~ '""/ ~' a. ~ ~ ~ . 1.r~ r Dl+t ~' Wti;c.+ZU~:e. ( ` 1 ( ` ? C}~r~c-r~G ~ ~ 1 'Y Edit : ~ d w~c~ ~..T ~1,.~ 1,Q v , ~~ 1S~ b ~„ ~ toMGKEr'~s' , „a'v . 4~aC+C SLPTfG E ~ SPEG11.1'•Gp,7'lblJS OOSC ~~~~~.~, 'r~N~.S MAIJUfACTItRCR: ItiJ11M6CR 4f DOSES: ~' PE£c O.~a TAlJK SizC ; l ilrt7t9 - Vthp GALR.bA7S • .DOSE VOL4IME n Ar^,~Rh /'~+t-*J-cruRra; S ~ 1~~~~"b. IA~CL3lDJ1.7C- bJ1LK/LOW, Oa- GALt01J$. M40CL I.Syy4btf~: .1 ° ~ ,'}' `" CAPAGlTIFS: Aa..s~~ktCHCS OR a1_L1L__ W ~ L O 4 S sWtTCN 'T'yPt; `"`Q'v`'~'` wpb J $ ~ L i1JGHE5 OR ~-. ark W~.~LCti.:~ SUMP NIJIUUF'ACYISRCR; ~/~„~_~~~„ C ^ ~ (UCrct6 OK ~•y ~.,..~...~ G~ L t 0 >,i 5 • MPDEU -JUMDLR: ~., JffEC C7 p:_,,,,~ tra~:-iE3OR ~R4-cr.,~~p~,~ ..~.._....,~ A}OT PUMP A1JD ALARM AR= TO DC l"11-JIM4IM DISCKA1lGC RJ-T ".,~,.,,GPh ~IN~S/TA~LFO pU SEPAq~TC CiKCUsr; ~ERTtC^~ OrrF[RE-1CF OfTWCCI-l PUI~ ptl AyD DIS7't1dIJTiOlJ PlpC........_.(„~ FEC1' + r,(-.~IN1uM -~ETL~/OftK SUPPfw'~ !'REi'iUR~ .. .. ~ ...~ FECT + __ ~ FEE7 OF PORGt MI-1N X ~'Q F/-pp~LiCR1LTlo-.I MASTOiI. I'S FEET ~ ,"2-.=. `"' TOTAL Q`~UAMtG 12~tC1~b ~ co,gz FF.Cr Q J7CRr.J~1-.. D(MEA16101JA gyp/ TAA~K: LEA3CiTH 1 J~-, jt ~- 2 ., 1 fi~~ ~ r~ 1~ zd WdLPJ:60 Z00Z ~Z 'hpW 860 S~Z STL. 'ON Xd~ ~JNIlS81 BIOS QBI~Il~iB~ WO~~ Pump runs but delivers only small amount of water. 1. Pump may be air locked. Start and stop several times by plugging and unplugging cord. Check vent hole in pump case for plugging. 2. Pump head may be too high. Pump cannot deliver water over 24' vertical lift. Horizontal distance does not affect pumping, except loss due to friction through discharge pipe. 3. Inlet in pump base may be clogged. Remove pump and clean out openings. 4. Impeller or volute openings may be plugged or partially plugged. Remove pump and clean out. S. Pump impeller may be partially clogged causing motor to run slow, resulting in motor overload. Clear impeller. Fuse blows or circuit breaker trips when pump starts. 1. Inlet in pump base may be clogged. Remove pump and clean out openings. 2. Impeller or volute openings may be plugged or partially plugged. Remove pump and clean out. 3. Pump impeller may be partially clogged causing motor to run slow, resulting in motor overload. Clear impeller. 4. Fuse size or circuit breaker is too small. S. Defective motor stator: return to Authorized HYDROMATIC Service Center for verification. 4 Motor runs for short time then stops. Then after short period starts again. Indicates tripping overload caused by symptom shown. 1. Inlet in pump base may be clogged. Remove pump and clean out openings. 2. Impeller or volute openings may be plugged or partially plugged. Remove pump and clean out. 12' 3. Pump impeller may be partially clogged causing motor to run slow, resulting in motor overload. Clear impeller. 4. Defective motor stator: return to Authorized HYDROMATIC Service Center. 9 -~ 30 6 ~ so 3 10 0 0 Capoaty-U.S. G.P.M. 0 10 20 30 40 50 liters/Second 0 1 ~ 3 SHEF30 Performance Curve SOIL EVALUATION REPORT Pam ~ °~-~-- ~ ~ ~ t~vision of Safety ar-!A ~~d'args ~ Code V1r s ~ . in ~ vhth Comm t35, ~~- S~ . Crc~,~. Attach oorr ~~le1e si6e Pin on paper trot less than S 12 x 11 ~ahes in fie. Pl~r must but not Irrrlibed to: vertical and horizontal r~efefemoe porbt (~, direc~oR'and include d t Parcel LD. . roa • percent slope, sr~ or dimensions. north amgw; and bealion and disbemoe b neares ~ ~e P/erase print ail infarmat+on. ~~ - ?~tto Personal irdorrnerion 11~ Pry ~Y be wed for 1 ~,'°N''~. 25.D4 (1) (m)). ,QN.Mn, V"`"a' ~> ~t '" pnpperiy Location property comer a .'- Govt.. lot ~/ - 1l4 Gtf 1l4 S f 6 K~r k ne-~leld• ti ~~~~~ E (a~ T z~ N R l ~ propeAy owners Mairrng Address _ Lot # stock # Z~ " Subd. Name ~ cslu~ ~heU qn-1 ~1\s "-~ A.re, Ig22 ~- State Tp Code Phone Number ^ City ^ lydlage [~ Tovm Nearest Road 1~. ak~wtr, WI -`1002 (115) ~~E-i8~b Hammor~d I ~~ Code derived design flow rate ~ NBW Construction Use: ® R@sidentiai / Of bedrooms ~^v SQ~G ~ O GPD ^ RemeM ^ PubGc or oonarreraal - ~ ' I ~ Flood Plain elevation if applicable ~ ~~~ ~ . Parent material General comments S Y 5~ rr ~ 1 ~ ~ ' q 3' 8a and recarnrrendatiorrs: -~ ~ -F . e 1 c U. ~(~ • gd Bo~9 #t ®Pis t~ Ground swfaoe elev. 9 ~ • `3~ tt. Depth to c'~p-- in. Sod ~ Rate Horizon DeINt- Dominant Cob Redact Oesaiption Texlrue Structure Circe Boundary Roots GPI?/ *~ 'Etf#2 in. Murrselt Qu. Sz. Cart- Color Gr. Sz. Sh. I v~ (~ t b_iD ID 313 - St, I sbk r ' cs . Z / 2 - ; 9 0 r x-41 ._- LS mS ~ ~ 5 - . lo > 1 '-~ 2 - I ~-I r' ~.s I m r~r' ~5 -' ' ~ ~ ' ~ u x$--10 ~~ -- 5 ms k m~' ~5 -" • S ' 5 ~b & ~s s ml ~ -- . ~ . Co a 3cf46 a ~# u 7• < fL Depth th Canitim9 factor _-_~___- in• rface elev d s G Sod ~ Rate . u roun Pit xture T Structure Corrsisberrae Boundary Roots GP I Horizon Depth Dardnarrt Cob Redox Destx~tiOn e ~ irr. AAurtsdl Glu. Sz Cont. Cobr Gr. Sz Sh. I o-ty 10 X312 5~1 Z blc m~' c Ivy .5 2 ly-3~ Ip r H LS Im ~, ^ .~ .1 1,2 3_ 30 - I b~ r ~i l -, L S 1 m rr~r- C. 5 .1 1.2 ~ y 2-~4 I0 ~ -'' SL Sb ~ 5 5 . 9 ~ '1( -Q I I D r g ~ l '1 ~ 5 O m l -' - ' '-l . Cp ~ ,6 .(r Pte. ~- ~vue ~~' s S ~ • Etfluer-t ~1 = BOD > 30 < 7Z0 rmglL and 1'SS >30 _< 150 mBn- `- ~ ~ ' E1~t ~ ° ~s -` ~ m9~ ~ ~ CST Name (Please Print) SrgnaUrre _ 2 "`"~` Dabs Evabation Condrx~ed Telephone Ntsnber Address .~, -- , , 4 ~ ~ `~ °d J rl P pm,~ ~ o cr'r, e~i I Parcel ID ~ rope y - ~9 # ®Pit~ Ground surface elev. , ~O R b fackor ---L-- m• Sod GP t Rat O~f' tiorizo Redarc Desatption rt Depth Donn~t in. UArarsell tbi. Sz. CoM. Color Texture SUvcgme GY_ Sz. Sh. Corrs~larroe BounderY Roo s 'EtM'1 'Eff#2 g ~ d-Ip lD r 3I3 5 ~. 2 mccb mfr LS ~ v~ . 5 . 9 Z lo-zs~ ~ y ~y ~ 5 ~' m G 5 ~ 3 -~4 1o r~l~ - LS Ims ~' c-S .~ /.2 ^ e«ins ^ ~~ ~ ^ Pit Grcu~ surface elev. _ ft. Depth m +~s actor in. ~ ~ Horizon DepU- Domir>arrt Redox Desa~tion' Texhre Struchme Corrsi~noe Boundary Roots ~ 'Eff#2 in. MunseN (~. Sz. Coat. Color Gr. Sz. Sh. ^ ~9 # ^ Ground surFeoe elev. R Depth to limiting factor in_ ^ Pit Sod ~ ~ Horizon Depth Dom~-t 1Zedox Description Texture Struc~re Consisiaenae Botuidary Roots GPD/It? in. Mansell flu. Sz. Cont. Coles Gr. Sz Sh. 'Ei~F'I 'EtT#2 • Etla~errt ~1 = GODS > 90 < 220 mglL and TSS >30 ~ 150 mglL ' fdlNierrt #2 = BDDS < 30 mgA. and TSS _< 30 mgA. The Department of Commerce is an equal opportunity service provider' and employer. ffyou need assistance to access services or need material in an alterrmte format, Please t the deparhnent at 1~8-266-3151 a~ TI'Y 18-264-87T1. sso-u3oo<mbo~ ~ ~ r _ ri PAGE 3 OF 3 NAME od d LOT# Z (oLEGAL DESC.RIPTIONN '/<,(/W'/a S (o TZR' N R E or SCALE: 1"= y~ BM 1 ELEVATION ~p0 • Q BM 1 DESCRIPTION {p p D ~ ~~ tcr~-r ;~ 13 o x BM 2 ELEVATION ~ ~. 7Z(., BM 2 DESCRIPTION,/~p ~ •3/y~~caaoQr P••p~, SYSTEM ELEVATION ~ 3~ ~~ ALTERNATE ELEVATION ~ 3• $ d CONTOUR ELEVATION GJ(~.G03 9 ~. I X + - ~ S~ c b ~M --- `ate" ~~ P~`~ ~s ~.~~-~~ ~ t I ~~ ._. o o a"z • D-3 ~,~+' ^ ar~~ Qr;''r ^ a-~ SIGNATURE DATE 3 ' ~/ "Q ~ T.L. Sinz Plumbing Inc. E5609 708th Ave. Phone: (715) 235-2644 Menomonie, WI 54751 Fax: ('7I5) 235-2592 ~Iv ~r(~ ~~ / A Swt~l = ~t,~ l Top o F ~~~ 3ox ~~ ~ f oo ~ U~~ ~~ ~ ,,,,~-- f- s~ ~ ~ z O^~~ ~ Q 3r it q7, 7~ ~/ ~ ~VFFW iT ~00~600 ~I`'4 !/ ~~ CowtC30 'f!1-~K, ~s~ V ~ ~I~Dwt-~+'~t S14~F3o p~~p ~,~~T,e-r-~ ~ a,~ ~c a3.~s ~N~i IFrvt~(uC l~ egos T~~-r~.c 5c~ r- ~l~-+~ ~~IUC ~I~cLl~ {~~-~~rtsrt-n~- ~ ~ I s ~~ 2q~~~ f T.L. Sinz Plumbing Inc. E5609 708th Ave. Phone: (715) 235-2644 Menomonie, WI 54751 Fax: (715) 235-2592 T~~. ~`/~ ~~ / ~ Bwt ~1 ~ ltw ~ T p o ~ ~~~ Sox T (1 D F 3~4'~ ~Ps2 ~~ ~~ ~_ ~~ ~ ~ sue` o^~`' ~w~ C~ ~ ~~~~ ~~ LoT ~~ ~...o-r ~~-t~~tsr~-nj ~' b-~ C I s N E B i,J 1 to ~ 9 I -? W ~c~ ~~~~ q' U~GLv ~(y._ it- W i- t'oo ~ I ~ Bev h ~~ 2 `~ Q 3 A R7, 7(~ Z ~VF~cvrr E4``S~N~ci Q ~ I~N~ 1i ~ ~ ~b00 G~~wLC30 Ti'Fr1J1;,, ~ ~ ~~ Z~[-E rE- t o0 ~f~Dwtr4-Ylt, Seh~~3U p°~ ~,v~T,H..~ ~ a,y~c a3,7s ~N ~ ~ r t-~~rr~ t-k e.c.~o s T.~e.t ~.c 5 cal , r_ ~(S ` 2`' gym{ '~~ ~, ~~ s ~~ ~ 3 ~ So Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number j~ 103 Number of Bedrooms 3 Design Flow -Peak (gpd) Estimated Flow -Average (gpd) S"p /y~ ~ Septic Tank Capacity (gal) pip Soil Absorption Component Size (ftZ) 06 S ~ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soif Absorption Component Design Flow -Peak (gpd) S'o ~,I-n Maximum Influent Particle Size (in) NA 1/8 Maximum BODS (mg/L) NA 220 Maximum TSS (mg/L) NA 150 Maximum FOG NA 30 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Should inspect once a year and clean once every 3 years Soil Absorption Component inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). 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 Management Plan for a Septic Tank and Soil Absorption Component tank shall have its contents removed when the volume of scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full comp/lance with OSHA standards for entering a confined space. The atmosphere within the sepfic or other treatment of holding tank may contain lethal gases, and rescue of a person from the inferior of the tank maybe difficult or impossible, Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of. this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 2 ~: x ! 'i^... 1, c~ ~ ..: _...~ ., P vcs,,~ .._..~_._ ......, • ~ _ ~-~ ~'i h I M --i.OC1Cl1i4 CO~'~RR ~'"'"~ ~iPit'N~ L ~8k~'C . tlvicK Waca•l~lsETr--1 Cr r--.~1•c :1a... `~ Q~ Q~ 3' +O f1tdDlS=vRE~EA ~1L /~{ r /~WKarl~R c;zT ~~a Ptl"~. NEG.TIOKS 1.~ v . 6" - y 4h .a ; Y 24'' x.p. MLW~IQt~ ,.. ~' a b 7r` ~ ~taV . h ~ wT l4 1 ~,g.8 ar.c,~ ~ ~. .~-- aN SZ ~ ~ ~ ~. WEJ1T#i~RPROU>= ~.3L~lCT~or+ 8arc r"+hu:.D Kara ~~w t~ ~rini~~ d'` 4a Y~~ e}" P`' ~ s_~, i 40 3' ono G~auxc r to~E'r~' "~v' -- 1 ~ 4tOC~C ~ ! 5SPT1C E 5P ~-fp 0450 ~ ~ ~ • T/~Cya.s MAAiUFACTUitCiC: ~- -a.r. ' ~ ~+lLtM6Gfi 4>< DOSE$: S~~ 7'^~JK SIZC : t ~"° - Val y,~u.aWa FER pA~ • bosh vOLUME AL.AItr1 MA1JLIltACTUI~,Gi[r s `l ~g't~'~-~-vr„ . IAJCL71B1L7C- b.~GIGFLQW= ~~~ ~ LA-.L01J$ M4OCL I.t~-1kQtR: . l d t 1-k ~ C a g'~ APAGITlFS: A~ te„ WCHES QR~ GA~t O 5 sWtTLN 'f'yPt; ~'~" wt~ . 4 SUMP MAU~1~'AGTISRCR: I~0 L ~~~_ '~'~-~...~~ C 5,'f, ~~ r • IUGnC6 ' MpDEL NUMDtR: Sl~~ ~ ..-,~.....~ 0ft ~...,.~.~ G~LLP~:+S ~R~" ~ ~wITGN TbPE; ~rtH..~v .~ =1r~;*IESoR ow~~o~,s 0i-• ~0~ gUMP A1J0 A1.!-,R 1~1 A R t 70 bC MIAJIMUI'~ DISCKAyIGC RAT --,.,~„~,...Grt,~ tNSTALLEO p-.~ SE P'.FIATC Cif{CusTa J£RTICAI_ RriF[R[Attf tSCTWCtu P13MP pFf A1d0 DtSTR1b11TiQl~J PlpE..~,.. RBC7 + M11J{MllM WCTWOiIK Sl1PPi.J tR~tEUR~ ... . .. ~ a` FEC? ~f~ "{' ~S F~E1' OF POItGC MAIM X `~~~ #r~potLFRILTIO~.I MACTBR. .~ Z- BEET ~' //0 ~~~ TOTAI, t~y1JAMIG NEAb is ~3,Z fl:Er .~ a .~re~c~,~~ o~M~u4laau>~ or TAA~K: t,EN4TN ,-~-" ~Z ~ ~ 2., ' W~ b T H ~,.~.,, ; L. ! q u i p O E P 7 H ,..~., zd WdtiQ1:6O ti00z 1=Z 'h~'W 8600 ~~z SSL 'ON Xtid ~JNIlS~l 1I OS QSIdI12iS0 WO~Id Pump/Motor Unit Submersible Automatic Model SHEF30A1 Horsepower .30 FuU Load Amp: 8.0 Motor Type Shaded Pole (4 pole) R.P.M. 1550 Phase f! 1 Voltage 115 Hertz 60 Temperature 120°F Ambient NEMA Design A Insulation Class A Discharge Size 1-1/2" NPT (38mm) Solids Handling 3/4" (19mm) Unit Weight 30 lbs. Power Cord 18/3, SJTW, 20' std Materials of Construction Handle Stainless Steel lubricating Oil Dielectric 00 Motor Nousing Cost Iron Pump Volute Cast Iron Shaft Steel Mechanical Shaft Seal Seal Faces: Carbon/Ceramic Seal Body: Anodized Steel Spring: Stainless Steel Bellows: Buna-N Impeller Engineered Thermoplastic Upper Bearing Cast Iron Sleeve Lower Bearing Single Row Bad Bearmg legs Engineered Thermoplastic Fastener Stainless Steel 9 30 6 ~ ZO 3 10 0 0 Capadry-US. G.I.M. 0 10 YII 30 10 SO ~ ~ ~ INxs/'SKOnd 0 1 Z 3 Dimensional Data 3'•ln 5'•7/8 (89) (149) 4'-1n (114) 3'-1 (ee) •-~n (38) NPT 3' n DISCHARGE (89) 11'-7/8 (~~) s•-v2 (241) 9'-7/8 5250 P MP N 3'-3/4 (95) All dimensions in inches. Metric for international use. Component dimensions may vary t 1/8 inch. Dimensional data not for construction purpose unless certified. Dimensions and weights are approximate. ONOff level adjustable. We reserve the right to make revisions to our product and their specifications without notice. ©1999 dromatic°, Ashland, Ohio. All Ri hts Reserved. n~n H Y D R O M AT I C® -Your Authorized Local Distributor - _1 Pentair Pump Group 1840 Baney Road Ashland, Ohio 44805 Tel: 419-289-3042 Fax: 419-281-4087 voww.hydromatic.com ISO 9001 Certified Item #: W-02-6350 10/99 t3M Deta i Is Pump Characteristics Performance Data ~,~{o ~s0°"~" ~ ~ "a PRIVATE SEWAGE SYSTEM sa~- ar>,e ~ ohrision INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal iirdocrnEiUon you provice may He used for secondary purposes [Privacy Law. s.15.04 (1)(m)). Permit H r s Name: City Vi Iage own o : _ Hammond Township T BM E ., Insp. BM E v.:8-{M-Description: I ~w'~I ~' 1 l ec~ TANK INFORMATION Fl FveTInN nAT TYPE MANUFACTURER CAPACITY Septic ~~ 6 0~ posing u Aeration Holding TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. ventto Air Intake ROAD Septic > 5-~ ~-}~ t / --- NA Dosing L~ `~` ~^ .•. Z~ / NA Aeration Nq Holding PUMP /SIPHON INFORMATION Manufacturer D ~~L Demand Model Number Sf~C~ 3 p GPM TDH Lift Friction S tem TDH Ft Forcemain Length '&j ~ Dia. 2 u Dist. To Well St. Croix 384163 018-1083-26-000 STATION BS HI FS ELEV. Benchmark • t7 c (, 4 0 ~ ~ , ~ ~ Alt. BM ~° •4D 4S 0 r Bldg. Sewer ~~. ~D 9'p . ~ / St / Ht Inlet ~ ~ • ~'o o . ZD ` St/ Ht Outlet ~ Ut Inlet _-- ~.~ Dt Bottom f ~ r'to $6 . o Header /Man. '~ ~JS ; / Dist. Pipe ~ 6 . ~o ~S. D ~ Bot. System ;ll c g3.8n` Final Grade ~ $ c R~-. /o~ a.~oe~R SOIL A6~9$PTION SYSTEM ~i ~ 1, D_ ._ _ _ L, .,. „~ _ D ~ ENCH width i Len I r No.Of Trenches `PIT No.Of Pits Inside Dia. Liquid Depth 3 . ~ I SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manu urer: _ n INFORMATION ype t - ( ~~ CHAMBER o e Num er: System: } ~D 0 "' $~ OR UNIT - au DISTRIBUTION SYSTEM Hea er / Mani old Distribution Pipes x Hole Size x Hole Spacing ~ Vent To Air Intake- length Dia. ngth Dia. Spacing SOl1 COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over I xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges i1 Topsoil ~ Yes ^ No ^ Yes Q No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: oblo6/ol Inspection #2: `-t-~- Location: 991 172nd Street, Hammond, WI 54015 (NE 1/4 NW 1/4 16 T29N R17W) - 162917598 Pheasant Hills -Lot 26 1.) Alt BM Description = ~e+^^0~~'~~ '"'ref ~P 2.) Bldg sewer length = D~ o~lnt f cgveK = ~ ~ ~er-~,„ ~.csw~ a.~v~-~ p~,.~, ~~' 3) r..~1an u ~, Plan revlslon req fired? ^ No~ Use other side for additio nfo~ation. S8D~710 t Date Inspector s Signal C~ No. ~R-~71 P -~-~L~.-'Sr~L ~ PW"P ~11L ~/~[IC. ~ ®~ I `~•~[Y~1s~.r: . . - • q g ~ ) ~'Z " $ Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. ~ ~'~ ~ See reverse side for instructions for completing this application PO Box 7302 '" ' ©ttpBftlYiA~RY O'f't;t}~trYrrl@rC'8 Personal information you provide may b purposes Madison, WI 53707-7302 [Privacy Law, s .04(1)(m)] (Submit completed form to county if not state owned. Attach com lete laps to the coon co onl for the s ste on a er not les's than 8 -1/2 x 11 inches in siu. County x State Sani Permit Number ~ ,Check ' rove evious application 3 °- !~ , t ~'i.r: State Plan I. D. Number .~---~~--,r I. A licatfon Information -Please Print all Informatio `n''~' '. Location: Property Owner Name rr -~ ~ ~,' ~ `~ ~i ~ ~~ perry Location 'PttroGG ~f ~ G SS ~'~ r~i 1 /4 ~ 1/4 S~b T N R ' E or Property Owner's Mailing Address ~ ~FtC , , Lot Number Block Number CitX State ~~.•t~ Ltd ii1J t~Z Zip Code 5~ oOZ. phbn bei t~;~ ,.- - - -S o Subdivision Name or CSM N ber ~'~s,~T {~ t f S II. Type of Building; (check one) -as ~ gw ~. 1 or 2 Family Dwelling - No. of Bedrooms : ~ ~~ r~~s • ~ ^ City Q _Village ~ . ^ Public/Cotnmercial (describe use): Town of _ ^ State-Owned w~,~r~D Nearest Road ~~~,-'{~'1 s r t i ZS I'Q.1/~.t.,KQ-S Parcel Tax Numbe s) III. T e of Permit: Check onl one box on line A. Check box on line B if a licable 5 ~ A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to S stem S stem Tank Onl Existin S stem B) Permit Number Date Issued ^ A Sanity Permit was reviousl issued 1V. Type of POWT System: (Check all that apply) I}-~Op J~Ion-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At- ade ^ Aerobic Treatment Unit ^ Recirculatin ^ Other: V. Dis ersal/Treatment Area Informatlon: l .Design Flow (gpd) 2. Dispersal Area 3. Dispersal Airy 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade r ~/~ RegLLuired dID Proposed ~ Rate (GalsJday/sq. ft.) ~ (MinJinch) ` 7 Elevation f - 7 AD r ~ ! ~7 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ~lP~ l L ~D~O -" I00~0 I }~~l~7tT~ O ^ ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersi ed assume res onsibili f tnstall OWTS shown on the attached lans. Plumb Natne (print) ~ Pl s Si o ps): MP/1vfPRS o. Business Phone Number " /o~ Z a P 39 Z- ~S - Z3S- Plumber's Asidress (Street, City, State, Zip /~S~ba o 8 ~Ir1~ ~,r~~ct 1~ ~?r~ IX. County/Department Use Only ~( Approved ^ Disapproved ^ Owner Given Initial Adverse Sanitary Permit Fee (Includes Groundwater S~~g ce) Date Issued I ing Agent Signature (No stamps) DetCrmination 2~ ~ (A~ ' q ~O~.GG~. ~ ~( X. Cond~of Ap royal /Reason for Disapp oval: ~~- ~e,~nnu.t.N: a~.r~~ Ov2~5t~~jw. -~'~ ~z-- t.e~ " Se'l. ~ GaVf! ~n i d~ p~ , ~ ~ -lrc ~ ~u t \ p • n n - n ~ , ~ ~ , L' g•^~1~ ~ OTC, ~ ~ ~~'~~ ` '~~' ~ ,Ifs. ~}rQX.JCS ~C, Z ' ~~r~1-'^ ~,~,'`-`` ~ ~ S~'~ l 1 ` ~ -~ ~ ~. ~riu-osvs xu~iiuu J ~ U V /1 ~ ~1 ~ i5 .n9.a~evlSt lo-~ a.. ~ ~ `{~c~`~ -~-e.~%C-.e.~'~~:ue...~-~ ~ iS C~.Q.o~ a~.~ r /~ 6 v/~p,t1,~,~ d, ~ tnn~N"~t~c~,una.~S f~C.C,eu.~w~e,KK,a.'~'t~~ S .~ z- s ~ ~ ~ fie. ~,,,-Q w-~- ~^"'"~~ ~u. ~~...~.~ ~ ~ c,o~-- T. L. Sinz Plumbing Inc. E5612 708th Ave. Menomonie, WI 54751 '' ~ S ~. o z 7 +il -°-' V, ~\ 4 C e Phone: (715) 235-2644 Fax: (715) 235-2592 K~~k ~ aN E ~,~ci..~ Pour ~~ NE ~~~ N~'~'~ 5 (n T'~-9 ~ »vJ ~s~ pµeds~T l~.tts .~t,,Nw,.~a ~o~JrJS~ P ST ~rD ~~ ~oo~,Ty ,n=~O~ ~~ ~" ~ f1 1~~~ ~~ ~ _. '~ T. L. Sinz Plumbing Inc. E5612 708th Ave. Menomonie, WI 54751 ~~ (~. o G 7~ ~D ~~ Phone: (715) 235-2644 Fax: (715)235-2592 JCi r2K ~-o t~-J ~ t=rc ~~ PLur P~ N E ~~~ N~J'I~+ s to T'2,9 ~ --I vJ C~~ p~,~,,~~r l~-,,cts sr ero ~~ ~ou~T i u i ~ _ ~D ~~ ~~'~9~~ Wi~corisin Department of CommerceORIGON~IL AND SITE EVALUATION Page I of 3 ~' ~ Division of Safety and Buildings ord with Comm 83.05, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8'/s x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ercent slo scale or dimemsions e north arro ar st road l ti d di t t St. CrO1X p p , , . w, and, ~a eaao s ance o ne e - Parcel LD.# APPLICANT INFORMATION - P/easy print all infotrri~tl®ul . Personal information you provide may be used for~econdary purpose~(Privacy t.riw,a". 15.04 (1) (m)). ReVlewed By Date Property Owner _ ,pr~perty Location Bonte, Ron . Lot NE 1/4 NW 1/4 S 16 T 29 N,R 17 W Property Owner's Mailing Address ~ " ~ ~.~~ ~:ot Block # Subd. Name or CSM# 1011 170th St. ~" - ~~?t , ,, 26 Pheasant Hills City State f Code 5 ~ '£~ City n Village ®Town Nearest Road d 170Th S ' Hammond WI 0,15. - 0 t. FF1-unmon ~drooms 3 ^Addition to existing building New Construction ®Resi '~ I Number of . Use: ~'~ Replacement ~ Public or comm~Tciardescribe Code Derived daily flow 450 gpd Recommended design loading rate •3 bed, gpd/ft2 •4 trench, gpolft2 Absorption area required 1500 bed, ft2 1125 trench, ft2 Maximum design loading rate •5 bed, gpd/ftz •6 trench, gpd/ftz Recommended infiltration surface elevation(s) 24" below contours ft (as referred to site plan benchmar Additional desi n /site considerations Install 2 - 5' x 112.5' shallow trenches in lower half of surveyed area (upper half suitable for mound g CP.pIaCPm Pnil nn rnntro~rc fnr ~ hr Parent material titl Flood lain elevation, if a licable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ® ^ U ®S ^ U ®S ^ U ®S ^ U ^ S ®U D S U vv.~ ... ~.~...... ............. ..... IYo..~+ [•.,e110 ., d ~` \a.41 I "1001 1 ~•k~-t- ._.-. Boring# 45 Ground elev 99.3 ft Depth to limiting factor ,~. 2 Ground elev 99.1 ft Depth to limiting factor 33" Horizon Depth Dominant Color Mottles T r t Structure Consistent Boundar Roots GP in. Munsell Qu. Sz. Cont. Color ex u e Gr. Sz. Sh. y Bed ~ Trench 1 0-4 7.SYR 2.5/1 - sl 2 m gr ds cs if .5 .6 2 4-14 7.SYR 2.5/1 - sl 2 m sbk mvfr cs if .5 .6 3 14-22 l OYR 4/4 - sl 2 m sbk mfr cs 1 m .5 .6 4 22-47 7.SYR 4/4 - sl 2 m sbk mfr cs 1 f .5 .6 5 47-65 I OYR 4/4 - sl 1 m sbk mvfr cs 1 f .4 .5 6 65-72 7.SYR 4/4 - sl 0 m mfr - - .3 .4 Remarks: nonzon ~ sox pans to ~ m pl ana nas ~ y x his oecayea organic matter - rencutatea: not apparent mots 1 0-5 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 5-12 7.SYR 2.5/1 - sl 2 f sbk mvfr cs if .5 .6 3 12-33 7.SYR 4/4 - sl 2 m sbk mvfr cs - .5 .6 4 33-58 7.SYR 4/4 fld 7.SYR 5/8-5/3 sl 1 m-c sbk mfr cs - .4 .5 5 58-62 7.SYR 4/4 - is 0 sg ml - - .7 .8 Remarks: nonzon ~ -s at vela capaclry; percnea water taote odservea Ca: ac' CST Name (Please Print) Signature: Telephone No. Henry F. Grote 715-665-2681 Address ertl le of esttng Dato CST Number Ref # P.O Box 57, Knapp, WI 54749 4/16/2000 222774 1068 PROPERTY OWNER: Bonte, Ron PARCEL I.D.# SOIL DESCRIPTION REPORT [~-~ Page 2 , of ;`3 •, -- Certifiers Snil rT ct~no Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ged Trench 3 1 0-4 7.SYR 3/2 - sl 2 m gr mvfr cs if .5 .6 2 4-11 7.SYR 3/2 - sl 2 f sbk mvfr cs if .5 .6 Ground elev 3 11-28 ~-. 7.SYR 4/4 - sl 2 m sbk mvfr cw If .5 .b 99.4 ft 4 28-48 7.SYR 4/4 - is 0 sg ml cs 1 m .7 .8 Depth to 5 48-60 7.SYR 4/4 - ]s 0 sg dl - - 7 8 limiting . . factor 2`/ ~p r<Ci i ia~ R~. 4 Ground elev 98.6 ft Depth to limiting factor > 62' 5 Ground elev 99.3 ft Depth to limiting factor > 60" 1 0-3 7.SYR 3/2 - sl 2 m gr mvfr cs if .5 .6 2 4-12 7.SYR 3/2 - sl 2 f sbk mvfr cs if .5 .6 3 12-30 7.SYR 4/4 - sl 2 m sbk mvfr gs 1 f .5 .6 4 30-41 7.SYR 4/4 - sl 1 m-c sbk mvfr cw 1 f .4 .5 5 41-59 10YR4/4 - sl Om mfr cw if .3 .4 6 59-62 SYR 4/4 - sl 0 m mfr - - .3 .4 - -- - - ~-. -o, --, 1 0-4 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 4-11 7.SYR 2.5/1 - sl 2 f-m sbk mvfr cs if .5 .6 3 1 36 ?.SYR 4/4 - sl 2 m sbk mvfr cw 1 f .S .6 4 36-60 7.SYR 4/4 - is 0 sg dl - - .7 .8 22.5 $ . ~b r~cn iai na. Ground elev Depth to limiting factor .~ T ~ ~ (0 j _~ ...~~ ~ 3 _-. ~'' 3 s ~ e o- )- ~ f .~ ~ Z ' 3 ~ 3 ~ Z~ ~- w ~ q ~ ~ Z ~ r d (lam, .~- ~,' d S O s 0 a ~. n S M ~- ~ d v ~ ~ w ~ M~ 0' ~ t~ ~ / J ~ d,. ~ ' ~~ d- ~ /. ~- d- ~ppp ~I e` i ~ ~ ~~ ~ v V 0 O~ ~ ~ s d~ ~ ~/ r ~ ~ ~ l ~ ~ ~ - 1 O /~ ~. d a u ~, o `/'v ~Q ~ i N r r ~~ ~° ,Y 0 ~ ~ ° O ~ i ~ z^ - s ~ ~ s ~ ~ ,~ ~ ~ ~ ~ ~ ~ ~ ~n o , _ %' ~ ~ r ~~ t G 1 M j ~ e i ~ 0 2 ~ ~ U~ 0 i~ ..,Y B v '~ ~~ o ~~ r ,y 2 ' 2 s •' o ~' s ~ o ~ ~ o a ~~ ~ ~~ ~ V:,' 1 f r,~ ~6 0 ~~ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms ~ Design Flow -Peak (gpd) Estimated Flow -Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (ft2) oo t Ft" Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) d Spp ~- Maximum Influent Particle Size (in) NA 1/8 Maximum BODS (mg/L) NA 220 Maximum TSS (mg/L) NA 150 Maximum FOG NA 30 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Should inspect once a year and clean once every 3 years Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filter shall be cleaned as necessary to ensure aroaer o er .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 Management Plan for a Septic Tank and Soil Absorption Component tank shall have ifs contents removed when the volume of scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treafinent of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordancewvith Comm 83.33, Ws. Adm. Code when the tank is no longer used as a POWTS component: ' ., Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing. fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once. every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 2 ' ~ ~ . ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ r t-1cL~r -r~e~r ~ e.. ~ Mailing Address ~ 902 c~ 7 ~ ~ ~ V~- '`~`C~ ` -~ ~ .~ ~~~ o~ ,Properly Address ~ 9 ~ ~ 7 ~ ~ S~ ~ 1'h0 ~ W ~ J y0 I ~J~ (Verification required from Planning Department for new construction) City/State T1C1~M.1m7~ ~~ Parcel Identification Number ~f~ 1~~g3-o~~O~~~ LEGAL DESCRIPTION ~-,q Property LocationN~ '/a, ~ '/s, Sec. ~ T ~` 1 N-R~W, Town of a-rn (~ Subdivision Y ~~-~~ ~ 1 ~' S ,Lot # ~ ~ . Certified Survey Map # ,Volume .Page # Warranty Deed # t~o~ ~ ~~ 7 ,Volume ~ .Page # b Spec house ^ yes '~1 no Lot lines identifiable `~( yes ^ no SYSTEM M~iINTENANCE Iaaproper 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 standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date SIGNATURE OF APPL DATE OWNER CERTIFICATION I (we) certify that all statements on this form are 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. ' 3 ~ ~~1 SIGNATURE OF AP DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed /o °.~. '! STATE BAR OF WISCONSIN FORM 1 - 1998 " 6~9Es?? '! WARRANTY DEED Y,ATHLEEM H. WALSH c~ A REGISTER OF DEEDS Document Number ~' ~~o-_ 1595PAGE t,)O~# ST. CROIX CO. ~ WI RECEIVED FOR RECORD This Deed, made between Ronald C. Bonte and 03-OS-2401 8:00 AM Dine M. Bonte, klusbsrr7 arld wife WARRANTY DEED Grantor, EXEMPT R CERT COPY FEE: lr o and ne ie an Susan K. Hodnefield ~ COPY FEE; as husband wn and wife, each in his or her o TRANSFER FEE: 76.50 right _ RECORDING FEE: 10.00 PAGES: i Grantee. Grantor, for a valuable consideration, conveys to Grantee the following ' described real estate In St . CrolX County, State of Wisconsin (the 'Property"): Recording Area Part of the NE ~ of the NW 4 of Section 16, Name and Return Address Township 29 North, Range 17 West, St. Croix First National Bank-Baldwin County, Wisc onsin described as follows: 990 Main Streit Baldwin, WI 54002 Lot 26 f Pheasant HIlls filed on r y th, 2000 in Volume 7, Page 86, Document #622544 018-1083-26-000 Parcel Identification Number (PIN) This ~~ homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Easements, licenses, zoning ordinances, and restrictions of record. Dated this 28th day of February 2001 ~S~~~r l~L.. (SEAL) ~ ,'iC~l/Y~~ %~ A /, ~~~1~ (SEAL) Ronald C. Bonte (SEAL) AUTHENTICATION Stgnature (s) authenticated this day of , Dine M. Bonte (SEAL) ACKNOWLEDGMENT State of Wisconsin, Q' ss. St. Croix County. Personally came before me this 2 8th day of FehrLar~ ~ ', 2001 ,the above named Ronald C. Bonte Dine M. Bonte Tilt B. LACIA~IID CTATII DAD /lC lAlTC/"ll0.TCTAI to y D z n Z C O Z 0 c~ ~~ r m O m D 0 0 z Z m O Z ~~I VJ rn X _~ N ~~ C Z z m m m m C ~ O m D D D m 0 N m c z 0 m 0 m D ~Z O O r O ~~ r O C7 C 00 D _< Cn 0 z "'~ SO ~ z ~ O __ ~ m n Y z Iv~f 1+ i~ C ~1 7 V P t O f C7 r D C7 m o i Z m c`N ~ . ~._ mom = F~_ - ~ ~, :o„ o~ ~'~ m,~ ~m JO ~~ ~•~ ~`~ ..~ ~ m~ - ~~• ad 30 d S p < 0 3 v ~~~, ~ m y~ cp m (~D ~ ~ d ~ ~ ~:; -~ j ~ C N• H• N 7 d ~ y p'~ O V C D C w J fD o ~ 7~ ''3 =. 3 ° d <.• ,~~ s~ O 7 - .. D `~ m °i ~ v m N 7 ~ N ~ ^ C d o < o0 ~ ~ y= s 3 m c ~ < m ° ~ 3 aN N s ~• ~a ~o;~'` oQ ~m ~~ - _ ~ ~ ~ ~• m ~; ~~ ~-~ ~ ~ fO ~ oNi a °' m c o ~ x,73 ? my H d ~~ ~ °: oi~m - 30 ~ ~ o a m 3m~ cam. ~ O1 ~ ~ N ? ~ N D• N ~ ,. m (p m N J atn ~ 0. ~. O ~ ~ d ti O < w _. ~ ~ 3 p~ N 3 ~ ~ C ~~ .~ n N a ~ `" ~ c m < n, m ~ " o o ~~~ `~ ~~ d d-~° 3= ~, _~, -" "d ~,~ ~ - _ o ~• ~ ~, ~, 3 ~ d c o• < ~ ~ o. ~ ~ < ~ a' ~~~ H o 3 -• o• o - s> D m A W CCT1 C y O Z y Z D -~ c m y ~~ `~ N tj ~ ~Z ,o w Oo I"-' W s0 m ~St 17tH - r~ ~ -t~s vim' Sanitary hermit Application In accord with Comm 63.21, Wis. Adtn. Coat ~"~-1~rrjrti,~ Sec reverse side fof instructions far complet9ng this app]icstian OapartrRe•ni ~•t;Qmmerco Personal infomsation you pro~ndC may bo food for secondary purposes (Privacyl,aw,a, 15.04(1){m)j Attach tom lots tnns (to the coon co von for the stem, on er not foss than -'o~ry State 3anitanj~rrmi^Number Cbeek if rc ~,~ I/'?~ (/ n n, r. YIBfOp Lo ptLYfOUS nFPt]Glt1An I. ~k'Iease 1?lriat al! Informatfon Safety & Bnilding3 Division 201 W. WashinEton Avo, PO Box ?302 Madison, WI 53707.7302 {Submit compkicd fotm to cannty if not ~N~ ( L P O I N~l/4NWU4 $/~T~~N ~ ro Ply wQntr s Mailing A ,~,, t [ , lit Nurobcr B,tock Nu ' ,State G ~ zip Codc Phone Nun~bot 5~foo~Z ? s- - Subdivision Namo or CSM ba , " .. , ,~ ,~~ ?;Y. Type of $uilding; (check One) 1 ~ 2 Family Ihvelling - No of Bedrooms : ~ '~ ^ City ^ Vil ~ d . . ^ PublidCotruncr~cinl(dcscribc uso)~ lage 'Town of o state-oWn~a / p~`S Jr ~ ~ Ncarost Road 2 3 X ~?3 •~S' p ~~ 1b~s ~t ~Q p~1r N ~-- c ~, s ~ YTI. T e of permit: Check only one box online A. Check box on line ~ if a livable ~,) i. Ncw 2, O Replacement 3. I{epl8cemegt of 4. 5, 6 ^ AddiGoi S sOcm 5 stem Tank OnI . )? S $) A Sanity permit was rcviousi iPSticd I'crmic,Yom r ~rp`, X70 '7~~„~ Dat Iasned ~•.' 3_d 1'V. Type off pOWT System: (Check all that apply)-~ -lQD !J~'IVo°-prosstutzcd Tn-Mound ©Moudnd O Pressurized In-ground O Saud Filter C~ Constructed Wetland p Holding Tank D Ab D Single Pass ^ Arip T.,iuG ^ Aerobic Treatment Unit ^ Rtcircu2atin O Other: V. ri!s ersal/Treatment .~1-ea Ynformatioa: 1, Design ow (gpdj ~/ 2. rspetsal Ass 3. Dispersal Ra4~ed Propoaed C "(~~7 4, Sort Appbcaaon Rase (GalsJduy/s ft ) . Percolation Rue (MinJinoh) 6, System Blovation 7. Final G ~ J q. . ialevation . ~ VII, Tank Capacity in Tota] if of Manufacttt:er Fr+cfab Sitc Steel Fibet- Plastic 1nfoTrnatidn C3alltms Gallons Tanks Con- Con- glas6 New Existing crate strutted '~!L r)umpera naaresa tsacot, city, State, Zip ~ ~~ ~ ~rJ ~` IX. CountylDepartmeut Use only © Disapproved Sanittay 1'ertnit Fx (include '~(,Appruvca G Owner Given Initial Advtr6c po Fee} I7ctermination 5©• ~ X. Conditions of Approval IlCteaao f t- Disapproval: Respotsslbillty Statement attached f lts ~ Z3s -' S4~?.tr to G~ `f-, ~I I ,{~ e~ °~ , ~ ,. - --- - - -- - -_ _„"~ ..,.. ,. a ~ ~ ~,~-c.o,~-to-v~.s ~e.. , o c~a.r~. ~,.at, ~ S~~„ ~~ ~ ~e-r ~~~.d~, ~~