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HomeMy WebLinkAbout018-1083-42-000I- - /* -Wisconsis~DepartmentofCommerce PRIVATE SEWAGE SYSTEM Safety anti Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, X.15.04 (1)(m)]. fii~,e:Jid~1i19a ^ cty ^ vi+l>~Fn~cTrnd~ ~ownsh CST BM Elev.: C U Insp. BM Elev.: ~~ BM Description: S TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ZO Dosing Aera Holding TANK SETBACK INFORMATION TANK TO P J L WELL BLDG. Vent to Air Intake ROAD Septic ~ >'y6/ '~ ~S' ~(S~ NA Dosin NA A on NA Holding PUMP /SIPHON INFORMATION facturer Demand Model Number GPM TD ift Friction stem TDH t L Forcemain Length Dia. Dis . t p State Plan ID No.: ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~ p Bldg. Sewer S ~ ~ ~ ~ r / Ht Inlet Q S~/ Ht Outlet 6 ~ • S~ Header! Man. ~ .S' ~ Dist. Pipe ~ ~•~}•s r (~"; 37 Bot. System ~ e~ t •~ ~ , F~ M . 3 9 9. SS S ~ SOIL ABSORPTION SYSTEM I Z _ ~ _ I_ _ _ lI BED / NC Width / L th ~ No. Of Trenches c PIT No. Of Pits Inside Dia. Liquid Depth DIME ~ DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE /STREAM LE HING Manu cturer: SETBACK INFORMATION Type O (~ ~/ TAB Mo a Num r: System: ~ 7 ~ r I •'-~ IT DISTRIBUTION SYSTEM Heagder /Manifold d~ / I Len th t/~ Dia. 7 Distribut9 n Pi e(s) ~ 9 ~ I Len th ~Z~Dia. Spacin ~' ~D I x H~ ~ Size I 'V& I x Hole S~acing I ~~SI- I1 Vent To Air;ntake ~~~~ SOIL COVER x Pressure Systems 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 InS ectl0 #1~ Yes / ^/NO In e~tl~®f!'1 #QZ No / /.COMMENTS: (Include code discrepancies, persons resent, etc.) ~" Z Z /a / Location: 1707 100th Avenue, Hammond, V~%I 54015 (NW 1/4 NW 1/4 16 29N(R17W) -162917614 Pheasant Hills -Lot 42 y )gyp fie(( Q{- ~/~~ (~ 1.) Alt BM Description = , S~ ~evc/ /~,~ /30 of 2t~r4~ r/`+1~ 2.) Bldg sewer length = ~~' S`~ 1 {{ -amoLUnt of cover = w.ll tia~~ [~ `~ (~,~ SYS f~• cCCva,~ o,•. (vwer / ~ wt 3.) OY1sev~~/eU~a-,. p ~ott in~5t-,~ll'CO t`N Z Z ' 2 ~ ~~ LC ~OW dr i ~`~ d'~P ~-~ l-.~r, Plan revision required? ^ Yes No Use other side for additional inform ion. ~ Z ~ c SBD-6710 (R.3/97)I ~ Dat \ Inspector's Sig ure Cert No (I~~CC~O~r pt~iwvlp ih.5tl~~ ,~---- ~,, ~~~ N~ N.PP~J' l''~P (.G-- ~ ~~ d~~9 ~e~~ . ' F, 6~~ R 3S~ $ 1 i ~~ ~ ~., . • 4. r M ,?,a ~Ct91f• tY '° 201 ~~ ~' 1 R ~r~h~~ ~ ~ ~ San#tary Fermuit Appkcatian In accord with Gomm 83.Zi, WiB. Adm. Gods Scc reverse side for instructions far ccxnpletlag this apple peas o~e•Cermmertia, Parstn;al information you pmvidp r;tay be usod far secondary jPrivaey law, s, 15.04(1){rn)] AttACh co lots tans to the oaua co o;r for a aystein, qrr paper rwt Gity~ s ~`~` I76 ~ ~ ~T ~p Coda /~~t•~t 0 'it/L $~{ D l S- Ix. 'hype of 8tffildfng; (check one) ~ i +u' 2 FarailY Dwelling - No. of Bedrooms IidGgrrsmerciN (descrlba uso)L a ste~a-own~t „~ ~,. ., >TX. a of l?etmit: Check oxtl one box on Ii ,q,) 1. cw 2. D Replacement 3. E~Si-f-r /a- ~. P1~one on ling ~e JtinZtarr Avo, P() Sox 7302 53707-7302 com-ty if tfOt i~s~g~~~a 5(, Td-,N,R' E ar ~ .nber N Subd'vi o Naroo or GSMi'•.••• a City /~/~' v~taga ~-h~t I~b~2 L> ~Pown of ?o '``~~ Nearosi Road _tQ/~ /D~^- ~Z -600 Pargol rmc2~ual~ s~ "-"- 6. ^ AddiAaa to xV Fe of ~Qw'Y' Systetmt (Clieclc all that aPP1YN~ -/(Jj~ . aR-pressurized Yst grp~md 0 Mound It d ~ i7 Sand Fdtcr O C'onstruct¢d wetland t groun ^ linldittg TaiilC D At- ^ Single Fees ^ Arip Line ^ Aerobic T' V. 171s ersall'i~aatment A;reaYnfol~malioA: tment LJnft ^ Ftecirct:latin p ~Q; 1. I?esign w ~ / ~ 2. ~speesat Anx Rimed (o~}~ 3. iapusal Peopoaed G(og~ s, 4, oit A aaa Rate (GatsJdayJsq. t-.3 ~~ Pereolahan (ivtinlinohl 6. Syistena Stovatioo 7.1?tpal G )?l v ii ~O Leo ~o , m .~ ~ ~- gg-3 ~ e a on ,00, `VYI, Tank Information Cepscity in Gallons Total Gallons # of Tanks Menufactta~ Prefab G Site C Steal Fret. Plastic on- oa- gias6 New Fstisting cress strutted Wanks Tanks ~?~~ o © ^ '~rItII. R onsibiHiy St~toment I the u+rdcrsi asstane nsibrl ins the POW"1'S drown on the attachc,d 1er>s. Plum sf ame (p;r1;t P stamps : MP o. usj~ l~iuanber / D ~ ~ ~ L P t ~ Z-~--' ~ ~ ~r 2 - Zb Y' lmnbet'R Address (8tseet, City, Srare. lip ~~ \\ IX. CauntyJDepar4nent Use Duly ~ bi8approved Sanitary pet;tyttFec (Includos Gmundwator DateGeaved ~ Ageet tNo emmps) '~'~pprorcd Q Owner Given Initial AdvEr6e o Fee) ~ ~ Soterminatl Z2~. ~ z ~ I X. Conditions of Approval ~easona for Diasp~rYOVai: IZ ~, ~ se~~ eo~el rv.:~e-t' ~ ~~ o+tea' s ~•s-I~-- ~ ~ ~,~ ~~.w,w, . GI.. ~ 3~ (.,~•4 ~ t ~`L~ ~ ~ Duel s~~ . SSD- 98 R4%!UO 'j~" '~ S?~h,~-- G if ~Q•~ ~~ s ~S, TOti!TgQI~ ZISIS Qaai tFf .LNSNIdO'ISAd4 ?~ZN110~ NIAIRQ 660b Z~Z 5Td T XE'3 gb.~T 17.H.L TUOZ/ZI/60 - - f' .~~'.L. Sinz Plumbing Inc. ~~~ E5609'70$th Ave. ~ Uch ~ ~ ~ ~ ~L~ Phone: (715) 235-2644 Menomonie, WI 54751 ~ Fax: (715) 235-2592 J ,~ J~~ X01.5 ,~ ~i~ 1 ~ ELF J M ~E 12~rJ = Ioo ~ ~~.~ ~ ~ M N~~J teJ>1 ta~,3 ~Q~~9~6v ~w tJ~ 1b 29 1~ ~ D vv ,rJ tc1'~ttil wl tM (P 3 w ~ ~. \I~ ~{ "~crJ ~~~ ~ Z ~O st+E:- ~ w~ P SAS f<~~ . .~- 9a' a°` ~.~~. ~~,~ fig. ~ ~''/ c5'/ sNs~~t 3- z.~~ ~~,2~ .~Fi if r*r~.C k~+ ~ TvrTt ~ Sti-~cQ n a~ ~S o o ¢'~ ~~,~ !~~ 3rir ~So.r K..,<y~ ~~ y2 ~.r.Q-.iw {6 6oemar ~~ ~~: `~~e t' x *~ .. T.L. Sinz Plumbing Inc. E5609 708th Ave. Menomonie, WI 54751 ~~ i(,pi a~i \~1-~ a" ~"/~ • 1 ,,,~ ~L F_ J r~ ~~ -~orJ = I~~ ~ aK/ ~~ M ~.J UJ I QJ~ 1~~ ~3 a~ 6v ~Q~~9~ ~w rJt~ ~b zq ~~ ~ 3 W ~~ Sys ~~~ • fig. ~ Phone: (715) 235-2644 Fax: (715) 235-2592 ~as~ k,~e~n~ ~~~. ~ y~ L ~ w c .P'J ~~~ ~'L ~ ,~uGFW~ ~av 1 i„i ~rx- ZK-fli..F P,-r H;. t ~ e~ . s~ ~ W ~ p c~% Tn~sr-n-c I 3 - Z,-11~ F 1 ~ 2~ ~JJFi 6F r~-T~.C_ l~ t~-ro T~rT'~ E StF!-~Q D a~ ~~ ~ D ¢'S u.~ 1'~ O ~_ N~+~ w~.~r'1~ERpaat~F WCKtNCa C+~~R 3itNtTwH GcJA~N~ .C~IBE.~. Ii~r Gi1++tIL D+accw~csct'---~ '~~~ .4~ C.T. a+i~+t+tlsarOVw~+~. ~. bN ~ ~¢ ` .~ 12' ~~ i ~ 1?f7mT~ ' p1 P6. 3' .. ~ Att7ISTUAt3~ . 'D • ~ V~-NT MAN. l~ML~i't ' A ~0 3 ' ~ Ko.r APr'kOVS-A .j C.Y. a+, Ecz':ora::- ""~""' r ~ ' G~uKo ~ ~~~ ~/ ~~ ~, U ~ ~* q . 0 6„ tovrat~,~-.t _ o~. ---- - ~ ~~acx ' il:PYtt E S P A. T~ ~ 1: q, ~os~ ~~•1-4-~ r. s 3 ~ 1 -3r MA-AUFACYURER: ~ ~~~~"' JSL1P1 OF DOSES: f'ER Dw~ TANK SIZtiL: ~2'~'~0 - ~ GAl.LO1JS • .ROSS IJMr ALARM /rlAaluFAGruRiR: 3~ lc`~~.a. lt~3CWDl lSAtKft.OMf~ .~..GALLOAiS rcptasLt. i.tttt~tptKS e t 1-~ w CAPAGIYIS:Ss 30,3 U,iCA[5 OK 517,2 GALUOUS 3W+TGH TJtrC; ~ "` $a ~ i1rCNC5OR ~`~'~~GALL4-.15 LIMP !"~AIJU?ACTt1KCR: ~~~~'~~ tL _ Ce ~ s~1CKie GK ~~s L^t.t.O+JS MOpEI. AJLIMDC ~'El-ter 3D D~ tAic;HES OR 1c'L.~Z- GALLOIJS awtTCH 7>3Plir ,,,_,~ ~''""' ~° UOrE: pUKP ACID AAA M ARC, TD aL Mt111lMUl''l dl HA1tGE 0.1~TR.,.. 3~,,,_,...GF~ I~STAI.EfA 01J P/,RATC CtRCl;s75 ERTlG.,I. DtiFtRfAJC 6fTklt[y PLIMr OxF /WD pISTRI~I{T101J PlpS.. ~D ., PfE'!" - Mgtt.i~1MUM -~lET ORK SUPPLY P1tEiSUit~ . , ~ ~ - ~ ~ ~ ~ FEl`T - ._._L~ FCET f tORCf MAIN X....'~,.fi'~ (~-1 ~g as rtPKtt:Tlo-r t:ACtoK.._,,,,~_ FEET ~ .,~ TeRUAs„ ~~ ~ / TOTAL D5lUAMlC. NEAP .~. ~ ~ fEE7' ME1,151p1,t4 oP TA1JK: LEt.16Tht ._;k~.DTH _~~;Ltqutp DCPT--~ ~ ~ - ~i~~~L• u~'- td Wd00:60 1002 ~Z. 'fi~'W 860 ~~Z SSL 'ON Xdd ~JNIlS~l BIOS QSIdIldS~ WOZI: Details Pump Characteristics Pump/Motor Unit Submersible Autonwtk Model SHEF30A1 Horsepower .30 full load Amps 8.0 Motor Type ed Pob (4 pole) R.P.M. ' . ; ~. 1550 Phase 0 ~ } ~' Voltage 115 Hertz ~~ 60 Temperature 120°F Ambient NEMA Desiga A Iasulatioa Class A Disclwrge Size 1-1/2" NPT (38mm) Solids HmrdBng 3/4" (19mm) Unit Weight 30 lbs. Power Cord 18/3, SJTW, 20' std Materials of Construction Handle Stainless Steel Lubricating OB Dielectrk OB Motor Housing Cast Iron Pump Volute Cast Iron Shaft Steel Mechanical Shaft Seal Seal Faces: Carbon/Ceramic Seal Body: Anodized Steel Spring: Stainless St Bellows: Buna-N Impeller Engineered The slit Upper Bearing Cast Iron ve Lower Bearing Siagle Row Bearing Legs Engineer plastk Fastener S mess Steel Ir,'~j° HY OMATIC Pentair ump Group 1840 Baney Road Ashland, Ohio 44805 Tel: 419-289-3042 Fax: 419-281-4087 www.hydromatic.com ISO 9001 Certified Performance Data 9 30 6 ~ ZO 3 10 0 0 cony-u.s.e.rx o io tnas/sKO~d o 1 Dimension~61 Data s•-m ta:at so a Z t„at tset NPT DISCHARGE to so 3 t ~ "a/a (sot ) s••t/2 (241) 9'-7/8 5250 P MP N 3"-3/4 (95) All dimens(ons in inches. Metric for international use. Component dime ns may vary t 1/8 inch. Dimensional data not for construction purpose unless certified. Dimension nd weights are approximate. ONOff level adjustable. We reserve the right to make revisions to our pro t and their specifications without notice. m 1999 Hydromatic°, Ashland, Ohio. All Rights Reserved. - Your Authorized local Distributor - Item #: W-02-6350 10/99 8M ~sconsin,Department of Commerce S//OIllL__ AND SITE EVALUATION Page 1 of 3 ~ Division of Safety and Buildings ~R'Gt~M'~i~d with Comm 83.05, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8%z x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and d t a i oca St. Croix . roa (iort~ and distance to neares percent slope, scale or dimensions, north a~ov+T r d l Parcel LD # ' ,, \ APPLICANT INFORMATION - ri tall inf6ritl~tion R(ease . ; . p 0 ' rs R B Date 4 (1) (m)). Ppo (Privacy. , s. 15. eoo ary Persona( information you provide may be ed fo ?~ m Property Owner (~ ~ 1 Property Location Bonte, Ron f , ~ `•, Govt. Lot NW 1/4 NW 1/4 S 16 T 29 N,R l7 W Property Owner's Mailing Address ~- ; ~ Lot # Block # Subd. Name or CSM# 101 1 170th St. ~° " ' `, , ';, 42 Pheasant Hills City Stag- . Zip Cate'~'~aftdnet~lG4h{Ser 4 ', ^ City Village Town Nearest Road 170Th S ~ 015 715-796-5240. Hammond WI , ,5 t. ammond ~ Re~tdentiall Nutrtber of bedrooms 3 ^Addition to existing building New Construction Use: Replacement ~ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate •3 bed, gpd/ftZ •4 trench, gptllftZ Absorption area required 1500 bed, ftz 1125 trench, ftz Maximum design loading rate •5 bed, gpolft2 •6 trench, gpolft' Recommended infiltration surface elevation(s) 24" below contours ft (as referred to site plan benchmar `nstall 2 - 5' x 112.5' shallow trenches on contours for 3 br Additional design /site considerations Parent material tilt Flood lain elevation, if a licable Np' 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 X U .7VIL LJCJVRIr11V1Y RCr'VRI Boring# 48 Ground elev 99.6 ft Depth to limiting factor > 72_ 2 Ground elev 100.4 ft Depth to limiting factor i H Depth Dominant Color Mottles T t Structure Consistenc Bounda Roots GPDIft~ or zon in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. ry Bed ~ Trench 1 0-3 ~ 7.SYR 2.5/1 - sl 2 m gr ds cs if .5 .6 2 3-10. 7.SYR 2.5/1 - sl 2 m sbk mvfr cs if .5 .6 3 10-29• 7.SYR 4/4 - sl 2 m sbk mfr cs lm .5 .6 4 29-72 • 7.SYR 4/4 - is 1 m sbk ds - - .7 .8 ~ .3 Is ~r ~~ L ~r Remarks: honzon 4 has pocKets/mclustons "/.J YK 4/4 s (U, sg, dt) wr some ~~ Crags vteow au" + one mclus~ons ~ r us s on west pit wau - is pro t e rea o no pt wa • 1 0-4 , 7.SYR 2.5/1 - sl 2 m gr mvfr cs 1 f/m .5 .6 2 4-12 • 7.SYR 2.5/1 - sl 2 m sbk mvfr cs if .5 .6 3 12-36- _.~- 7.SYR 4/4 - sl 2 m sbk mvfr gs lm .5 .6 4 36-59• 7.SYR 4/4 - sl 0 m mfi gs - .3 .4 5 59-67• 7.SYR 4/4 - is 1 m sbk mvfr cs - .7 .8 6 67-70 7.SYR 3/4 - sl 0 m mfr - - .3 .4 y'~` 3 ~S . CST Name (Please Print) Signature: Telephone No. Henry F. Grote ~ 715-665-2681 ertr to of esttn Address g Date CST Number Ref # P.O Box 57, Knapp, WI 54749 4/15/2000 222774 1053 Remarks: PROPERTY OWNER: Bonte, Ron SOIL DESCRIPTION REPORT 2 ~ PARCEL LD.# ~ ~ Pc9rtlfied•Soi~f e"T^slinv~'~ 3 Ground elev 101.3 ft Depth to limiting factor > gg• , 4 Ground elev 100.1 ft Depth to limiting factor > 60" 5 Ground elev 100.7 ft Depth to limiting factor > 66" Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr, Sz. Sh. onsistence Boundary Roots GPD/ft2 Bed Trench 1 0-4 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 ~ 4-9 . 7.SYR 2.511 - sl 2 m sbk mvfr cs if .5 .6 3 9-36. 7.5YR 4/4 - sl 2 m sbk mvfr cs if .5 .6 4 - ] • 7.SYR 4!4 - sl 0 m dsh cw - .3 .4 S S 1-68 • 7.SYR 4/6 - Is 0 sg dl - - .7 .8 rcemancs:...,__ ................. .......... ...., 1 0-4 - 7.SYR 2.5/1 - sl 2 m gr mvfr cs lm .5 .6 2 4-9. 7.SYR 2.5/1 - sl 2 f sbk mvfr cs lm .5 ~ .6 3 9-24 • 7.SYR 4/4 - sl 2 m sbk mvfr cw 1 f .5 .6 4 24-56 . 7.SYR 4/4 - is 0 sg dl cs 1 f .7 .8 5 56-60 , 7.SYR 4/6 - sl 0 m mfr - - .3 ' q Gt~h ..~ Z I. L f r ~ ~n f\GIIIQII~J. - --- - ---------- -- 1 0-4 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6 2 4-10 " 7.SYR 2.5/1 - sl 2 m sbk mvfr cs if .5 .6 3 10-30 • 7.SYR 4/4 - sl 2 m sbk mvfr gs if .5 .6 4 30-60 " 7.SYR 414 - sl 0 m mfi gs - .3 .4 5 60-66• 7.SYR 4/4 - is 0 sg dl - - ,7 ,g ~.~~~~a~~~. Ground elev Depth to limiting factor a .-~ ~ . N „_ S ~- 0.~ Q, I - ~ ~ a ~ o ~ o bo ~~ t3 r1 ~` s-u ~s.,. Ste ;goy ~\cso.o~ '~ f .~ 1.~, e...a;~ aaC.~.+~, CZd~ ~~pK~e -~'10~ ~~la~ 1 ,~ ~rn zzz z~ 4 ~~ 4z.7.~ Z, ~~ R. M `1 0 ~.~ /.pl• -~ .~~ e a-ra 28Z. ` vv.H~ I"l w...wpv.~ ~,~, z ~ S 3 x.27. b ~ RK~~o-o.o~ OvvnerJBuyer Mailing Address ~~ V~ W ~ ~~V Pmporty Address ~ ~~~ .,~~~'~ ~~- (Verification roquired from Planning Department for new construction) - ~,J City/State ~M 1I'~ ~ ~ Parcel Identification Number ~ 1 ~ ~ ®~ " ~ °~ -E~ properly Location ~ '/M ~ ~ r/a, Sec. ~ T~N-R~W, Town of Subdivision ~1n2r~~+~~ 17 ~ ~ ~S Lot # ~a Certified Sarvey Map # ~ a a ~~ ~ .Volume ~ , ,Page # ~~_. Warranty Deed # ,Volume .Page # Spec house D yes` no Lot lines identifiable ~] yes D no ~YSTLM MAIl~iTE1~iANCE F use and, maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of ~iag oat the septic tank livery three years ~ soccer, if needed by a licensed pumper. What you put into the system can affiect fire fimdian 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 plumber, journeyman plumber, restrictedphrmbex or a hccnsodprmapu ~YmB that (I) ~ on-site vrasbewaterdispc-sal system ~ is proper operating condition and(or (2) aRer iaspa~ion and pumping Crf nGCessaty), the septic teak is less than 113 full of stodge. Ilwe, the oadcssigncd have rrad the above trots and agru to maintain fire private sewage disposal system with the standards set fordr, hexein, as set by the i;l~aurmaent of Commerce and the ~~ of Nabual Resources State of Wisconsin. Certification sWpimg that ymrr septic system has bcea maintainod nwst be completed and trfirmed to the st. Croix County Zoning Office within 30 da of the thnx year expiration date. c ,~ o! SIGNA'I'LJRE OF APPLICANT DATE OWNER tERTTFTCATTON I (wG) 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 descry'bed above, by vutuc of a warranty decd recorded in Regrster Of Deeds OflieG. ~ ~~- ,~~1 SIC3NATURB OF APPLICANT DATE Any information that is rots-repa~esGnted may result irr the sanitary permit being revoked by the Zoning Deparhnent, ST CROIX COUN'T'Y SEPTIC TANK M[AIN7CENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 1^c~` ~ C . ~ r~ ~ ~~5~ en e, «'` Include with this appilcation: a stamped warranty decd from theReg~f l oo itt the warranty deed a copy of the certified survey map ' 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- 10567-P (R.6199). Table 1: System Design Specifications Sanitary Permit Number 3 3 Number of Bedrooms Design Flow -Peak (gpd) pp Estimated Flow -Average (gpd) ~ / ,~ f ~( Septic Tank Capacity (gal) ~Sb Soil Absorption Component Size (ft2) ? ~ ~-r' Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soif Absorption Component Design Flow -Peak (gpd) ~gp--~tzS~ ~pQ (o`g 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 th tic tank and outlet filter shall be assessed at least once every 3 years by inspection. The u et filte shall be cleaned as necessary to ensure proper oper .The filter cartridge shout not be removed unless provisions are ' 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 sepfic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. F1fe atmosphere within the sepfic 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, 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 yr+1.1.5#11P,~~3~i2 Dine M. 8ante, as Trustee and Ronald G. Banta, first attema6ve Trustee of the Kati M. ltlferts and tCa~rina G. tllferts Fanu'ly Trust, far a valuatue eansideration ~nveys without warranty to Rattald G. Bonte and Dit>Et M. Bcmte, Aid and wife, grantee, the folbwing described real estate in Sk. Groix County, State of Wisconsin; sao9t~3 KATHLEEN H. WALSH REGiSiER ttF DEEDS 5T. CROiX CO., Wi RECEItlED FOR RFOORB 04-is-zooo io.aa iw ~ETEDS DEED t~ttr canr FEE: COPT FEE: tf'tptSFEli Fff: 20.00 fiEtifRDINE FEE: 10,00 I'A6ES: 1 Thomas A. McCormaric it1201W Ate, t3akia~, w! 5atxi2 Oi$-i834-G0.-7Q (Parcel IdettGfigtion Nurnberj The North Half of the Narthwesd Quarter (N 'r, of ivw Yj of Sertiort Sixteen (167. Township Twenty-tune (29} Narth, Range Sevt~iteen (1T} West. Data:d this 24thday of t~tarch .2000. Y~.xL~~~ ~~~~~.~ 'Ore M. Etonie Tn,uee -~a.c° ~~ rtes ~.~ -Ranatd C. Etanie Tn~tt~ AUTHENTtCATtON Siyrre(st _ day at &8na~ qpe or paa% name TITLE; MEM$ER STATE EtAR OF WISCONSIN (d nat. erwrtzed ay § 706.0, Wis. Sta4s.j 'fir,-~' ~ J Trris avsrRUltr:NT wAS t :~ Tttornas A. t4leCon~sa~.c ! -' Eialdwira, W154t>r~ }" t ~ + ; ': :'1~ ACKNOWLEDGMENT STATE OF WISCONSIN ST. GRt?t)(COUNTY Perscxtagy carne tteFone me Gas 24ttyay of tDarct: Zaoo die ahwve named Dine M. t3oMe. Truster arw Ranaid C, eoeue, as ~ aAemadive 7tusiee of Karl M. tltrerts and K9#I~!!a G. Utterts Fatrahr Tt~t, to (r!e knoxm !o tae d,e pe!sorKst who executed the foregoing instturnerrt and hve a prat name Ii31e I~~.7er:sen - f~a,y PubNC St. Croix County. Wisconsin. 1uyDc~ss3an is permanent. (If not. state expiration date 43 .) blames of persons s7gn«g in any capacity should be types a printetf taebw tlfeir signatures. MrolNrl~oel Pphggllyl~r CprpmY sen0 Ou Lit. 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T 26 .. salts ~ ~' LOT 44 - a•sa'w'*Ea ~ loa, as F7. ~~ sara Ix.oer an Fr. ~ 'o \ i ar.ase as Fr. ~ ~ ~ ~ r• ' 6 ~ ~~ o r aft.fr '~ ~ Y ~.ao' 41'~ es . ~ LO T 2 7 ~ I ~ t $ ~~I0.aFt ~ 1 ~ ~~ ~ a o sacra I s°'t4 . $ laa.aes as Fr. ~ ~~ ~ ~ l/aa•a ~ 4rr aaa s ' oe i ' ~` Lor as ~ ; I 4 LOT 45 $, a.rr Barra ~ `• i. Q ~ OT 28 r.aa sots '" Isr.4aa sa n . ~ i~a saga ra~ 106 7ifa a0. FT s l~sa~ . . ~ ._ lla. rla aQ R. v ~ • ar 4aa• • 414. N' X11' I! ~~~'4Yr I tea' alaN' L LO T P9 ~ aN of art ea4.ar x LOT 37 z Bata loq, CERTIFIED _ r.a~la~a - sa Fr. RN'O1' J7"IF 3A3. IE' -__- ar. !m sa Fr. - --- - ~. _. ~ 4a1.~ 's 4 O ~ aTa'~' 14 kt URPLATTED ! SINPYEI' LO7 36 °- • e DT a p t ~ F ~ ~ s F7 OOa a0 I IW LAAIDS _ , ~ ~ . N.a0.! a T. 0. 11W ~ . . . _ ~•~ I ~~ MN'01'aTr a01. a4' afa'j4'ar~ ~~ '~ ~ ~, 4{~ ~C aO•~' L O T 3 5 y ~E ~ ~ tt p p ~ IO6: NO a0. FT. Id ~" ~' ~ $ ! l'a~E •~ T 34 ~' `~ ! s LO N6•sa'ra•t asa.ar' IRS LOT IE e. N Bata ,$ ~, ar rea oa °i iT l It 600 a0 s. a sacra . _ . . ~ 110.06! a0. ~ i = LOT 31 I a $, t. se sacra ~ LOT 33 ~ y ~ a>'a ~• F*• i O ' n ~ ae, r ~' i arses ~Y CERTIFIED loa.an as Fr. aat•rr Ir na. ar ~E ~ ~S ~ ` ~. ` ~ i ~ `~ ~ ~` I q. ' i - ~' ~ b S i SIRIVEY ~i ~• ~ L aee'rr Irt '~F ~ O 2 11:. N• ~ `~a LOT 10 =- LOT I6 $ s PI/gl ~ t t. ro rrs.aa t a ~ua4oa Fr. ~ LOT 4 Ii1P ~' $ 4. la suers LOT 5 ~ I Ix.aN f0: FT, r.N Aar1 yy !lt.ON a0. fi. & 4 O I