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HomeMy WebLinkAbout018-1083-38-000~v ~/ CPS ~ S rrn,~ wiscon'xin bepartnrent of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Bonte, Ron Hammond Townshi .ST BM Elev: Insp. BM Elev: BM Description: LTD . ~ ~ 6D . ~ ~ N w ~ 19'~ L` J`Cllti . TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~r ,~}- ~ ~ ld,~ // ~ 'v Dosing (., `-'!) G Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic / 1 5O ~ ~ ~ ZS Dosing ~ ~ t ~ u Z s ~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ,. ~ Dem Model Number S~T ~ ~~ DH Lift ~ Friction Loss System Head TDH Ft Forcemain Lengt `~, Dia.Z i~ Dist. to Well SOIL ABSORPTION SYSTEM (s RLD Width Length DIMENSIONS .3 r 13• ~' SETBACK SYSTEM TO INFORMATION Type Of System: C.o w~. DISTRIBUTION SYSTEM Of Trenches ~.e~• ELEVATION DATA county: St. Croix Sanitary Permit No: 395215 State Plan ID No: Parcel Tax No: 018-1083-38-000 STATION BS HI FS ELEV. Benchmark ~~ (o$'.(O ~ 1Q~ . (~ Alt. BM 2.0 03.~o r Bldg. Sewer ~~.~,0 ~ J ~ i 'F SUHtlnlet ~~•9 p ~ / 1•~ ~ St/Ht Outlet Dt Inlet Dt Bottom L~.ry O ~0 t 40.5,yr I Header/Man. ri1 ~ / 1 , 9~- Dist. Pipe ~. Z 0 ~~,,. J0~ 7 Bot. System • .Z 4 •~ , O Final Grade _ ~ 6, e i ~. /0 St Cover P/L BLDG WELL LAKE/BYRE ~ ~' --cis` .~ --, U {. lae.~E• P /i 1 Of Pits CHAMBER OR UNIT Depth - Sr~ Header/Manifold u 1 / Distribution Pipe( x Hole Size x Hole Spacin Vent to Air Intake ? ~ ~ t Length~~~ Dia `(~' Length Dia Spacing SOIL COVER v Praccnra Svstnms Anly YY Mnund Dr At-Grade Systems OnIV Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedlrrench Center Bed/Trench Edges Topsoil ^ Yes ^ No ^ Yes [] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: OQ /~~ Inspection #2: / Location: 980 172nd Street Hammond, WI 54015 (NW 1/4 NW 1/416 T29N R17W) Phea ant Hills L Parcel No: 16.29.17.610 1.) Alt BM Description = 2.) Bldg sewer length = yS:D A 3 - amo~ ver = ~ ~ ~~`5~ Ir - Plan revision Required? ^ Yes I No 0 ~, Z Use other side for additional information. I Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) t~ ~ i o ~ ~~ r q 8'D ~~Z ~ S-~-rce~" Sanitary hermit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W, Washington Avo, ~, t~~rx,~ Sec reverse side for instructions fpr Completing this application PO Hox 7302 Oapsrtmeni of •CommerCO Personal information you Pro~tide may be used for secondary putposea Madison, WI 53707.7302 [Privacy Iaw, s, 15.04(1)(ra)] (Submit cornptctcd form to county if not Atuch coin, lvu tans (to the voun co v ot,l for the sum, on er not loss than $-1/2 x 11 inches in size. scare owned. rO~~/ ~~ ~ State Sanitary Pum' Nurnbcr O Check it rcvtaion to previous aPphcadon State Plan I.D. Numbor N a„ I, A licadon Information - 1?Iease 1?rint ali Information Locarion: Property O t Name ,/~ Property I~r'.arioa l31~i T~. IN.c oN~~c. G ~~1 /4 1/4 S T~9 ,N, at Property Cwncrs lvfailiyg Address Ivt Number 9loclc Number 01~'~ ~o~ S; 38 ~ c, , state zi Code p t?hon , ~~, r Subdivision Narno or CSM Nom trJx s' ors ;1~' y- l5" ' s'z a Pl-~ts,~T- -- XY, Type of Building: (check one) ''j ~ ^ City ,(~~1 or 2 Faruily Dwelling - NO. of Hedraoms : / '~~1 ~rf`CIC(E0 \ S - ~ ^ village ^ PublidComtnorcinl (describe usv)L ~/ Lt,C YY ''~ " Town of O State-Owned ~,~ rn ~ ~ ~~ Ncarnst Road ST (',AOIX ~~- Pamol raxNum s a r ~~ .. III. 'I' a of permit: Check only one box online A. ~ bo I' ~} 6 • • ~ • ~`~ ,~ A) 1. New 2. O Roplacetnent 3. Seri of 4. 5, 6. ^ Addition to SV60em 5 stem Tank On . E ' S o~n B) Pc m r (~, Date Issued ^ A Barite Petrnit eves Ycviousl iasucd XV. Type of pOwT Systeut: (Check ell that apply) ~.tlon-pt>;ssurizcd In-ground ^ Mound O Sand Filter (~ Constructed Wetland p Pressurized In-gourd ^ Holding Tank O Single Foss ^ Drip L-yue l ~ D At- ^ Aerobic Treatment Unit ^ it~eirculrrtin O OS}Iel; }r~/ ~ _ V. l~ls ersal/I7eatment AreaTotormatioAt ( A,~~oC> . f >< 3.~5 1 • Drsign low (gpd) 2. tspvrsal 3. ispcrset Arcs 4, 5otl Appbcaaon , Perco lion G, System Blovatioy 7. Final G9 O Re4tdr_,~ Propoacd_ Sly i~ Race (~ slsJdnY•~v~ inlinoh) ~~, ~ ~ 1?lcvatiof I VII, Tank Ca aci in -Tote] --~` tF of ~" ~~ A ri M» facnuer Ft~cfab Sitc Ster-l Fiber. Plastic Information C3allons Gallons Tsnks Can- Con- g]as6 New Existittg erase structed Tan]~•s T'aaks fig /8vO - /o ~~~ o a VIII. Responsibility Statoment 1 the rsi assume tuibili f in talladon of the WTS shown ou the attached lams, Pl s Name (ptutt P tun t (na ^tan ); ~ MPMfP o, Bruintrs J ao Number L ~- ~'!3 9~~ Z its -(,;S- Plurnbc~s Address (9acet, City, Srue, Zip.C, L 0 Y d S` T ~ ~ P.~t ~ l-~/~ ~ 5f7 ~7 IX. County/Deparuaeut Use Only O Disapproved Sanitary Pcmtit ee (Itteludvs Graund~vatot Dntclccvod Issuing ant Sigoaatre (No stamps) ~Appruvcd G Owner Givcrt Initial Adverse SurcharBo F Determination ids LdD ~ ~ l ~ ((,g.~,( X. Conditions of Approval /Reasons for Disa proval: `f~ ~ta>Mt.awr~l ~, r.~.~,1,e.-Ice ~t, ~,~~L~w.~e, ~.`f~.~e~tt. ~-r~..~ e~jl~e W~~.~e~1 ,~-t w~-N~~t,~-~+:a T.L. Sinz Plumbing Inc. E5609 708th Ave. Phone: (715) 235-2644 Menomonie, WI 54751 Fax: (715) 235-2592 ~~v~u.tlsinzplumhing.com D -7 1 v_~ by 9~ e~h + Wisconsin Department of Commerce division of Safety and Buildings SOIL EVALUATION REPORT Page I of III GI.l.V1UOlll.C WIUI lrVllllll p:7, YYIA. F1U111. IJUUtl County ~~ • Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must 0 ~ Y . include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 16• Z9 •t~-• 6~ ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~ pg 3 _38 --ate Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). R ~~ ~ g 1~ O' Property Owner Property Location fag Govt. Lot ~ 1 /4 ~ 114 S ~ (~ T ~ 9 N R 17 E (or) Property Owner's Mai ng Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ^ City ^ Village ~ Town Nearest Road c~ ~~ o~~ (7~S'S 7 96 -SZS~ / 1~ 5f New Construction User Residential / Number of bedrooms _~_ Code derived design flow rate _ r` j GPD ^ Replacement ^ Public or commeraal -Describe: ,r ~ ~ ;~ Parent material ~/~ Flood Plain elevation if applicable ~ ~ General comments / ` z and recommendaflons: -~•~f~l~ ~~~~pl,~! jY~~ A'~" r 3 ~~ t- ~'` y °' ~ s .y arrr o ~ o~ ~° s yam,,->, ®v~,c !~ ~„~ s 3 , ~ , ,~,.~ .~, St ~otx ~= c>` COUNTY ~ Boring ~,~ --.......... ~.~~ ,,=~x~ Boring # ,, ® Pit Ground surface elev. _1~'$o ft. Depth to limiting factor ~I 2. in. ~~ ~~. Soil A' ` motion Rate \ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary RootS' ' ' ~~ GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •1=ff#1 'Eff#2 3 '19 ~iz ~~ yd $/6 ~-- 5 0 ~1 1 C. S i~ . l 1, 2 `1 l1.7~ IJ ~~ ~ ~ ~~~ ~1 i Yr2s/8 -~ S d h. i C S - .'1 , 2 5 lb -~~ '1,S ~ -- Si ~ ~ d - - p.o , 2 w,~ a Boring # ~ Boring ' ® Pit Ground surface elev. ~0 • fl ft. Depth to limiting factor qJ~ in. 'Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOlfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 -fo ,.S ~~r -- 5 ~ a d ~ S , ~ .~ 3 ay ~1~5`S~'/~ 51 m. Id' ~I1 C l~ .$' ~ 9 'Effluent #1 = BODS > 30 < ZZO mg/L and T55 >30 < 150 mg/L 'Effluent #2 = BOD• < 30 mglL and TSS < 30 mg/L CST Name (Please Print) nature CST Number ,~c~~ ,t3,:,r~ ~ 0?'S3976 Address Date Evaluation Conducted Telephone Number v?/S /~dt~ fit' /~G~~iG t!/L' -~~/~~``/ -7~ 1 S ~b% ~~ l ~ 33S =~1 `~ Property Owner ts7t~fV~ s ~o~ Parcel ID # ~a~~ 38 Page ~` of a Boring # ~ Boring ~ q Pit Ground surface elev. ft. Depth to limiting factor 9 `'I in . Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ _, ,,s~KZ~, -~ sI ~ ~s if .s , 4 y~.~ ~\~ B©ring # ~ Boring Pit Ground surtace elev. g ~ s9' ft. Depth to limiting factor ~~ in . Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EfF#1 'Eff#2 ty 12 ioHd sl6 - ~ m~ V C.I C /t' , 4 `1 ~ ~ 7,5`l~ s ~ ~ 5 ~ I' , s o ~9~ ~D ~ - S bs - .1 rl . Z Boring Boring # ® Pit Ground surface elev. eptn to limiting factor ~_ in. Soil A lication Rate Horizon Depth Dominant Color Redox Description exture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ rf .'7.SiR~ ~ S r ~S ~F /S , 4' ~ ~,r :~ ~~.s y~ y - G ~ ~ ~ ~ 9 .~ :5°7 7. sir ~ - 5 © I - 'I ~ , 2 ..q ~~ ,f ~I - S O s ~, -- ~ -1 ~ 2 ~ 'Effluent #1 =BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODb < 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 j~' need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. I SBD-8370 (26/00) ` ~ ~ Q ~ ~ ~ ~ 3 ~ ~ .. ~~ o `~ MAC O~ a ro ....... F_-_ _-- 'i ~ o ti ~'~ ~~ ~ v ~~ s L~- i-- a u T fl h 0 .-. c Q Q 1n ~ ~ ~ .~ o- Q O 0 ~s ~ ~ Q~ r' ~ ~"r~~ ~ 3 ~ ~ ~ O II ~ ~ M a ~: o' ~ o ~ p vy 0 ~ ~1 3 \ Z ~ ~~' a ~c -~ a v S ~ b ~ Q ~l~ ~~ Wiscorwtir,,Department of Commerce SOIL AND SITE EVALUATION ~/ Page 1 of 3 Y 9 ccord with Comm 83.05, Wis. Adm. Code ~rJivision o ~~,at and Buildin s ORIGIN/fit (~/,-~ ~ g Certified Soil Testin Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must Count y include, but not limited to: vertical and horizontal tefecenG„e point (BM), direction and St. CTOiX ercent l sc l or dimemsions n rth row; antl?l nearest road ti d di t t p , ar . s ope, a e o oc~ o _ n s ance o ' - 1 Parcel LD.# APPLICANT INFORMATION ~` Please pript all lnforr'Aation . Personal information you provide may ber/u~ed for secgndary qurpas~s (Privac~ri~8w, s. ~s.oa (t) (mp. Reviewed By Date Property Owner ~ Property Location _ Bonte, Ron ~ ~ fi, r~ ° ' ,; i i Govt. Lot NW I/4 NW 1/4 S 16 T 29 N R 17 W Property Owner's Mailing Address ~ ~ ; ;. Lot # Block # Subd. Name or CSM# 1011 170th St. ,, F1 38 Pheasant Hills City St' e Zi Cfid~ '`f'AbrleNutftber H d 5015 71 " ^ City n^~ Village ®Town Nearest Road d 170Th S H ammon 5-796-524,0 t. ammon New Construction ^ Residential-/ tdtnfiber of bedrooms 3 ^Addition to existing building ^ __ Use: Replacement ~ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate •4 bed, gpd/ft2 •5 trench, gpd/ft2 Absorption area required 1125 bed, ft2 900 trench, ftz Maximum design loading rate •4 bed, gpd/ft2 •5 trench, gpolft2 Recommended infiltration surface elevation(s) lateral to follow 94.6 ft (as referred to site plan benchmar install 9' x 125' effective (11' x 129' overall) at-grade rock unit on 94.6 contour Additional design /site considerations Parent material till 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 ^ S ~ U JVIL UC~7VRIr I IVIV RCrVR 1 Boring# 32 Ground elev 95.0 ft Depth to limiting factor > 84" 2 Ground elev 94.4 ft Depth to limiting factor 43" Horizon Depth Dominant Color Mottles T t Structure Consisten Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. ry Bed ~ Trench 1 0-6 7.SYR 2.5/1 - sl 2 m gr ds cs if .5 .6 2 6-18 7.SYR 2.5/1 - sl 2 m sbk mvfr gs if .5 .6 3 18-23 7.SYR 3/2 - sl 1 m sbk mvfr gs if .4 .5 4 23-56 7.SYR 4/4 - sl 2 m sbk ds cs lm .5 .6 5 56-69 7.SYR 4/4 - is 1 m sbk dsh gs lm .7 .8 6 69-82 I OYR 4/6 - s 0 sg dl as - .7 .8 7 82-84 SYR 4/4 - sl 0 m dh - - .3 .4 Remarks: 1 0-4 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 4-11 7.SYR2.5/1 - sl 2 m sbk mvfr cs if .5 .6 3 11-29 7.SYR 4/4 - sl 2 m sbk mvfr cs - .5 .6 4 29-43 l OYR 4/4 - sl 2 m sbk mvfr cs - .5 .6 5 43-54 l OYR 4/4 fld 7.SYR 5/8-5/3 sl 2 m sbk mvfr cs - .5 .6 6 54-64 7.SYR 4/6 - Is 0 sg dl - - .7 .8 Remarks: CST Name (Please Print) Signature: Telephone No. Henry F. Grote 715-665-2681 Address ertt to of esttng Dat CST Number Ref # P.O Box 57, Knapp, WI 54749 4/1/2000 222774 1048 PROPERTY OWNER: Bonte, Ron PARCEL I.D.# 3 Ground elev 94.6 ft Depth to limiting factor > 70" 4 Ground elev 94.0 ft Depth to limiting factor 40" S Ground elev 94.7 ft Depth to limiting factor > 64" SOIL DESCRIPTION REPORT ~ Page 2~rofr 3 ... ('ertifirr~"~:nil'Tactin:,='i Horizon Depth Dominant Color Mottles Texture Structure onsistence Boundary Roots DIft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, Bed ~ Trench 1 0-4 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 4-14 7.SYR2.5/1 - sl 2 m sbk mvfr gs if .5 .6 3 14-21 l OYR 4/3 - sl 2 m sbk mvfr gs 1 m .5 .6 4 21-39 lOYR 4/4 - sl 2 m sbk mvfr cs if .5 .6 5 39-46 7.SYR 4/4 - is 0 sg dl cs - .7 .8 6 46-70 l OYR 4/6 - s 0 sg dl - - .7 .8 RCI I IdI1l5. - ---------- °-' --- ---- .. . 1 0-5 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 5-10 7.SYR 2.5/1 - sl 2 m sbk mvfr cs if .5 .6 3 10-40 l OYR 4/4 - sl 2 f sbk mvfr cs 1 f .5 .6 4 40-53 7.SYR 4/4 f2p 7.SYR 5/8-5/3 sl 0 m mvfr cs if .3 .4 5 53-66 7.5YR 5/8-4/6 - is 0 sg ml - - ,7 ,g i ~cn ial na, - - - - 1 0-3 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .S .6 2 3-8 7.SYR 2.5/1 - sl 2 m sbk mvfr cw if .5 .6 3 8-48 7.SYR 4/4 - sl 1 m sbk mvfr cs if .4 .5 4 48-54 7.SYR 5/4 - fs 0 sg dl cs - .5 .6 5 54-64 l OYR 8/2 - fs 0 sg dl - - .S .6 i~ci i iai na. Ground elev Depth to limiting factor ~ ~ , ~~~ Z ~ ~ ~ ~ ~ ~.. - a ~ ~ ~ 6 ~ 9~ ~- S 3 ~ ~ ~ 'f° --~ 3 ~ ~ tl a ~I 0 d 0 S 0 0 M ~r b .J a ~, v- 9 ~, .~ i ~~ f d a J ~~~ ~ n cJ O fir, ~~ ~~ 0 ~~ ~~ ,, o ~ o/ ~ V N Q; ~" ~ ~~. V el' v M d ~;, v '~ / v- 0 o`f ~ ~ ~ ~ ~ ~ u ~ r~ ~ l~6 ,~ I o ~ ~~ ~' 44 ~-~ b o ,~ v r f ~J O ~ `i > r W ~~ "~ r% ~ ~~ ~ ~~~ l.:' l.' ~ nl f ...._...,_._~,....,.:.,~._.~_ _._.._ .._. .... __..,y..._...._.._ ............. W EJ-Tk>c RPRtwt= ilyCKt-•1C3 CCYVCR ~ 3Ur1CT-or. ~r/R.•t'iv~vc G t i48k'~ . 8~it QLitK A+~LO•J•tiGT'-~1 Cr ~SZ-c la... "~--~j 4 ~ ('v~ ~..4 ~777~7!7' ~ P1 Pf~ 3' tQ I~ND~STVRBEA „ ~~• S~~ L. /~4ts r iG pr' Kcvi.C! (.I;T JAM'S PtP>f. NELT1oKS L~~ „FV SCPTIC E oos c ,~. ~.. .-. ~r~ ~,~, i gAFFI.ES ~~ : h dw'}La..~ SPEGI~J' ATJ~I.JS ~. ~ S. ~ ~A~' ~.I GyLF ~ ~ ~, "wun Kos ~~~ torrGt~T't , f/~o CK 13~ r Tlfi~if7 .j. Pvc -.1. ~ dk 4 0 YE-1T) ~" Q~ ~ s~k 40 3' ono U+~L~:Z1iae.- (~ a`~uK G 4~~ ~-2/,-~, ~~ 93 TA1J..5 MA1JUFl-CTUitCR: ~'y ~~' .~ 3 ~.11tM6CR 4P DOSES: ~ ~~ 7'/1AJK SIZC : ~ t?•t}L°+ ~ (~Q'L'y CiAL.R.0A75 ' _~pCg Q1, • .DOSC VO{.t1ME ~ ~.C. O ~ ' / "l7 I ~~ Al,Aill•1 MA-J1J/iACTL1tZ,t:Q,• S `~ ts ~ `~-~-v•> , IIJCLtlA11.7G SaGKFLOW= I 8 • . GALLOtJ /'~QO>~L Uuj'40CKS . \ ° I ~"k ``~ CAPACITIES: As ~~,1 WCHCS QR yU3. 7 GALLO~;S sWtTGH 'T'yPt; "'"~'"";`' "•«o 2a g L' S = i1JCHES OR _ Gwci.P~.:S ?UMP /'1A-JU~ACTIlI[CR: ~Dro-~t IC. ,. -'~' ~' •, (P,c~ C ~ IUC cE6 OK r~~ ~. MppEL AIUMDLR: S~f' 3U r ~. ~ ....~_ GALLONS ~R~ ~WiTCK TbPC: V~2.L..sv •.. ~--~ p~ lN-:HES OR GAlLGuS ~~TE:. PUMP giv0 ALARM ARC T3 DE f"SIAIIMUM D15CkA1lCif RATC ~ 'N rNSTALLEO p-.1 SEPhi~ATC CiKCI:~T; 1ERTrChL R+iF[RCUC£ OCTWCtu PUMP prf AUO DISI'RIbUTi GAJ PlpC., ~~ ~ECY ~` ~ ,,.,:•~ ~ + rttuiKUM ~ETWORx SUPPLE rREi>iuRl; ... . . FECT ~- .~~ f f; E7 of FoRCC l~uiRJ X S f~ ~9a/LFRIGTIO-.1 t+ACTOtt. FEET ~ o~J ~^ ~~~ TpTAL Oy1,JAMIC HCAb ~ ~~ p T .~~ ,, J7'[R~..tAl. Olr~[1.14101JL •CI TAIJK: C.EA2C.TN • • ~ ~ •W,pi-y.~ 1 ~ 2 4 ~"~ -L , , .~. ~ l.. I Q U f O O C P 7 H p zd Wdti0:E0 I00Z 5=Z 'fiEW 860 ~~Z Sti L 'ON Xa~ ~JNIlSSl ,IOS QSI~I12~S0 W02~~ 6'~ - ~~r!`m ..-«.... 24" x.'a. tla~uo~ ..~! ~ 4 b Pump/Motor Unit Submersible Automatic Model SHEF30A1 Horsepower .30 Full load Amps 8.0 Motor Type Shaded Pole (4 pole) R.P.M. 1550 Phase 0 1 Voltage 115 Hertz 60 Temperatwe 1T0°F Ambient NEMA Design A Insulation Clots 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 OB Motor Housing Casf Iron Pump Volute Cast Iron Shaft Steel Mechanical Shaft Seol Seol Faces: Carbon/Ceramk Seal Body: Anodized Steel Spring: Stoinless Steel Bellows: Buna-N Impeller Engineered Thermoplastic Upper Bearing Cast Iron Sleeve Lower Bearing Singie Row Ball Bearing Legs Engineered Thermoplastic fastener Stainless Steel 9 30 6 20 0 3 ~ 10 0 0 Capadry-U.S. G.P.M. 0 10 20 30 40 50 ~ ' - J IiterslSecond o 1 2 3 Dimensional Data 3'-1/2 5'-T/8 (es) (ias> a•-vz (iia) 3'•1/ (38) NPT 3' 1/2 DISCHARGE (89) J.~ _ ~ 11°aia (301) s°-1 ~z (za1> s°aie (2501 PUMP N 3'-3/4 (95) All dimensions in inches. Metric for international use. Component dimensions may vary ± 1/8 inch. Dimensional data not for construction purpose unless certified. Dimensions and weights are approximate. On/Off level adjustable. We reserve the right to make revisions to our product and their specifications without notice. ~~ HYDROMATIC Pentair Pump Group 1840 Baney Road Ashland, Ohio 44805 Tel: 419-289-3042 Fax: 419-281-4087 www.hydromatic.com ISO 9001 Certified © 1999 Hydromafic®, Ashland, Vhlo. All Klghts Keservea. -Your Authorized Local Distributor - Item #: W-02-6350 10/99 8M Details __, Pump Characteristics Performance Data 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: Svstem .Design Specifications Sanitary Permit Number .~-1 ~ Number of Bedrooms 3 Design Flow -Peak (gpd) ~ u Estimated Flow -Average (gpd) S`o ~tLtr--ts A~eic. Peec~h 1Rt2 Septic Tank Capacity (gal) i9oo Soil Absorption Component Size (ft2) S"oo Fes' Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) l'OOO ~ cS~b Maximum Influent Particle Size (in) A 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. Interm~itt~,nt filter alarms may indicate surge flows or an impending continuous alarm. Tfie 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 compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment 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 accordance with 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. pp Co+ti-h~ ~(' ~ `~'. ~ Iti ~ .P,Jfht~ ~ l~..Ylpb, `wl.(, , ~1,t, SA~wI WI,d 5`~" ~ ~~'71,aL~Lp~ ~. 11~ ~M Uy ~ ~o-c.. ~,u,...ln-~ -~Dv~~~'N'~f/l '~t.~ ; a a... i,1 i '~ ~ -Iz-, t e~ ~G1 /~(Ght J Vii. -'tottiJ` X61 l ~5.~" a,.ol ~ C ~ ~ -rz..~ ~~ ~y, ~r ~ ~ s~~-w~.e ~..0 ~ w, ~zQ o-Turf-, $~_ l 2 -~ SE ~Cro~ ~~ ~'~kq 'T' 6'- 3~c • Yl~fr~ ' ' ~ ST CROIX COUNTY SEPTIC TANK MAIN'TETIANCB AGREEI~NT AND pWNBRSHIP CERTIFICATION FORM Qwa~Buyer ~1~ Mailing Addrea~ ~ I `~0""' ~V2 ~-I o ~ d IN ~ ~ Proporty Address ~ ~O ~ ~ ~ndal` ~- ~h ©-'~ d , W 1 c (~/crification required from Planning Department for new amrnond , ~ t _____- -Parcel Identification Number des- ~cR 3 •'~°"° Citylstate N -- zti . ~-~. ~ ~ o tr~ T F,r i. DES~~'TION W 1 N Y~ % Sec. I ~ . T Z`~ N-R.~w~ Town of I-~ .m ern t~ ~ ~hea5an~~' ~i Lot # .~$.: Subdivision , Volume -,.Page # Cert£fted Survey Map # U a a5yy ~~fl ~ .Page # 3~ ~warraaty n~ # volume S~ house ^ yes [~ no Lot lines identifiable t~ yes ^ no c~~~rrr~~ *~rAiNTENANCE maturo failure to handle wastes, Pr+c~ maiatenancc use snd eeof y~ c ~~ could result in its pre What yoau Put into the ~m consists out ~ septic tank every throw years or soora+r, if needed by a liau~ can. affioct ~ won of the ae~ic tank as a treatment stage m the waste disposal a certificatior- form, signed by the owns and by a 'The pmgeriy owner agrees to submit to S't. Crnac Zoning Depattmendtg $~at(l) the on site wasDe'wa~dil S+~Pluml~ restdctodplumber ~ a licensedPumPa ~ ~~ tank is less than 1/3 full of sludge. is in prop' oPeratiu8 condrtion sad/or~ (2) ~ and pio~mping (if noeessarYk to maintain the private sewage disposal sy''stem with the standards I/vre~ ~ o~ love r~cad the above ~ and agcbe of Natural Rescx~rccs. State of Wisconsin- Certification met fo:d~, hemio+ as ~ by the Department of Commerce and the ~~ to the St Croix County Zoning Office within 30 stating that yamr ~~ has been maintainal must be colleted and returr-ed of the three year Lion date. ~ 2S0 I - DAT$ 5it3I~IATUKE OF APPLICANT _ .^, ~' :~R CER'[7F~CATION sal are tl~e owa«{s) of that all statements on this form arc true to the best of my (om) knowledge. I (we) ( ) I (~) comfy virtue of a warranty decd recorded is ~' of Deals Office. ~ y descn'bcd ~ f 2~0 l DATE SICiNA'iZ7RB OF APPLICANT .:««*«~ «««««« Any infomnation that is mis-represented may result in the sanitary Pmt ~~ evoked by the Zoning DoPs~n~ wamaty deal from the ~gister of Daads office «« Tndude vrith this application: a ~ thG ~ seuvtY map if reference fr ~`~ ~ the warranty deed ~~1.15()1P~~E372 Dine M. Borate, as Trustee and Ronald C. Borate, first alternative Trustee of the Karl M. Ulferts and Katharine G. Ulferts Family Trust, for a valuable consideration conveys without warranty to Ronald C. Borate and Dine M. Borate, husband and wife, Grantee, the following described real estate in St. Croix County, State of Wisconsin. ~~~' y~~ ro M. Borate Trustee `~~` 'f t`~-See 'Ronald C. Borate Trustee The North Half of the Northwest Quarter (N 'i4 of NW'/.) of Section Sixteen (18}, Township Twenty-nine (29) North, Range Seventeen (17) West. Dated this 24thtiay of March , 2000. AUTHENTICATION Signature(s) authentlcated this _____ day of signature type or print name TITLE: MEMBER STATE BAR OF WISCONSIN (If not, dhorized by 5 7oe.vts, wts. scats.) THIS INSTRUMENT WAS 0 J Thomas A. McCo a ! ~ ~' •~ Baldwin, W 1540d~' G - ~ q t ,. ~~ ~ ,. 6209Es3 KATHLEEN N. WALSH REGISTER OF DEEDS ST. CkOIX CO., YI RECEIVEI FOR RECORD 01-10-2000 10:30 AM TRUSTEES GEED EXEMPT M CERT COPY FEE: COPY FEE: TRAN$F1R FEE: 240.00 RECORDINS FEE: 1D.00 DRGES: 1 Name and Rerum Addn Thanes A. tvlcCamack 102010'" Ave. 8aklwln, WI 54002 018-1034-80, -70 (Parcel Identification Number) ACKNOWLEOf3MENT STATE OF WISCONSIN ST. CROIX COUNTY Ptxsonally came before me this 24traay of Bch 2000 the above Hamad tine M. Boma, Trustee and Ronald C. Borate, as tint aRemative Tnutee of Karl M. Ulferts and Katherina G. Ulferts Family Trust, to rrte known to be the person(s) who executed the foragoin9 Instrument and acknowledge the same. _ sprutura trDe er pfd Hama Dale $~ Jensen Notary Public St. Croix County, Wisconsin. MyOc~m~issi4n is permanent. (It not, state expiration sate 'Mamas of psntons signing in any capacMy should be typed or printed below their signatures. wam,uan aw.s.anw Garo~ roe a ~.c. 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