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018-1086-25-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ^ INSPECTION REPORT GENERAL INFORMATION ~ (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes (Privacy Law, s. t 5.04 (1)(m)l. Permit Holder's Name: City Village X Township Mitchell, Shawn Hammond Townshi CST BM Elev: JJ;;~~ /~©.f! Insp. BM Elev: ~~d-(~ BM Description: ~~cc Q~a 47~~ ~ (ids /~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ,., ~~ b Dosing ~ ~ 1_ ~~ f0 Aeration ~~„ Holding TANK SETBACK INFORMATION TANK TO P/L (N~S~ WELL BLDG. Vent to Air Intake ROAD Septic ~ _ / IM's Z () / 7i~ t t f~. ~~. Dosing ~~ , '3 2 y,,, Aeration 1 Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number ~~./-~t N.a~- ~ ~~ a, TDH Lif Fricti n Rs System Heas1. TDH Ft Forcemain L ng ~~j( th / (} Dial ~ Dist. to Well~~ ~l1 ~ I ~-T County: St. Croix Sanitary Permit No: 420430 0 State Plan ID No: ~ ~ 505 Parcel lax No: 018-1086-25-000 ELEVATION DATA STATION BS I ~ y.~ ELEV. Benchma ~~ ~. 2 I ~D~ ~ ~ AI M w~~,-~- o~. .n ~~•4~ Bldg. Sewer St/Ht Inlet t b. o~ ~2 SdHt Outlet ~ ~ Dt Inlet ~ ,~ Dt Bo ~~ "-~ ,r. g ~~~ ?s. r Header/Man. S'i`n /~ /; he- - 't' a l cJ 9 . ~ ~ Dist. Pipe ~ ~/ ~ ~ N A• d Bot. System &~ .3 ~. t 2 Fi al Grade .+- ll~ s~. 0 . St Cover to YLTIKII- ' ~ S ~ ~1. SOIL ABSORPTION SYSTEM / BED/TRENCH Width Length No. Of Trenches PIT DIMENSI No. Of Pits Inside Dia. Liquid Depth DIMENSIONS r ,~ Z / ~~ SETBACK INFORMATION SYSTEM TO P/L BLDG WELL ~-- LAKE/STREAM L HI CRAM R Manufacturer: Type O System: ~ / ~~SI ~ / ~ NIT Model Number: ~ DISTRIBUTION SYSTEM Stet-t-ue (.ovr~red q reader/M ni of ~ Distribution / ! x Hole Size x Hole Spacing Vent Air Intake A Pipe(s) II '~ ~ ~ 3Z rl 2 •~lo ~ ~~~~/ igth Dia_7~ Length d Dia_~ Spacing tIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Z ~'' i Over ~ Depth Over xx Depth of xx SeededlSodded xx Mulched Bench Center ~ -~ Bed/Trench Edges Topsoil Is ~ Yes LJ No ~ 2Yes ',~~_' No VIENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ ~_l ! ~Z Inspection #2:~J J~ t: 1609 86th Avenue Hamm/~~o~`nd, WI 54015 (SW 1/4 NW 1!4 20 T29N R17W) Hammond O~ks "Lot 25 I Parcel No: 20.29.17.645 ~Q Descri tion = ( ~ aer length = 2f) I Znak¢a-a~- I/1-. F~ vytruh, 4~ !~w-env-~u~..k.- ~~'4 /`r~~~d T_~7_h. t of cover = ~ r11 % fvJ-2. / j ~(,G.S~-I~-a'r.~Q~ Cu~,C,~- ~ r~Z .- SyS-~PMr ~IC~N~ _ ~ -~ -- --- 2211 -. Zequired? ~' Yes o r ~ ?~~ a-- lug-z-. 1 !o G~ Soi.~j. or additional information. _~_~ L? l ~~!' " " ~ ~_ _---- Date Insepctor's Signatu Cert. No. Safety and Buildings Division County ~ ~ ~ 201 W. Washington Ave., P.O. Box 7162 , ;~S~o~S~~ ' Madison, WI 53707 - 7162 Site Address / Department of Commerce 0 -L..OL-- p p ~~~ /~-1~.-~ ~/ Sanitary Permit Application Sanitary PermitN umber ~~ O ~~ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if ReviBio~ ma be used for second oses Privac Law, s15.04 1)(m I. Application Information -Please Print All Information ~ State Pl I ~t ber r-" Prope Owner's Name ~ D Parcel Numbe oil - /~~6 - ~~ -~~o Property Owner's Mailing A dress i ' :l ~ ~n02 Property Location 5 //~~ //~~ nn City, State Zip Code P~pAJji~~t h FILE Y ___ Lo u er Block Number . Subdivision Name CSM Number ,~T~ Type of Buildin (check all that apply) ^City 1 or 2 Family Dwelling -Number of Bedrooms ^Village ^ Public/Commercial -Describe Use ownship ,,,,~,/I~ ^ S te t a Owned ~~' : ~,~ ~ ~ X ~~,2, $- G~I,Qtin uca.~ ,-~'•R.. Nearest Road - - 7 - t?~~ ~ - S~ III. Type of P rmit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) ~'' 1 New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem Tank Onl Existin S stem B. ^ Check. if Sanitary Permit Previously Issued Permit Number Date Issued N. Type of Permit: (Check all that a mbering scheme is for internal use) 44 ^ Non -Pressurized ht-Ground 21 Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 olding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersal/Treatment Area Informati on: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate S stem Elevation Final Grade Required Proposed Rat Gals./Days/St~Ft.) (Min./Inch) ~ Elevation n VI. Tank Info Capacity in Gallons Total Gallons Number of Tanks Manufacturer ~ ~ ~ ~ /rn /.jp ~I w z~~ ~ Pre b oncrete Site Constructed Steel Fiber Glass Plastic New Existing ~VV //~ i '~""~ Tanks Tanks Septic or Holding Tank ^ _ Dosing Chamber ~ ~ VII. Responsibility Statement- I, the undersigned, assume responsihility for installation of the POWTS shown on the attached plans. Plumber's N rint) P er's Si re MP/MPRS Number Business Phone Number / ~~ f f Plumber's A d re treet, CityeSt~ , Code) d ~j ~ j ~ /~ VIII Count /De artment Use Onl Approved ^ Disappmved • Sanitary Permit Fee (includes Groundwater S h Date Issued Iss ' ent Signature o Stamps) ^ Owner Given Initial Adverse . urc arge Fee) ~ ~~ C' ~ ~ ~~~/d ~ ~~ ~ Determination ~ J / ~ ~ ~o t ~ ofvaUReason$ For Dim p ~o•yytp Gt/f ~Ol~7:f /'~ [~'~`' ~-~rtirv. undh~ ~ ~ - ~? . . 1 ~. / '"" "~ w ~ C~ ~~'~ n~piae plena go the county only) ror the system on paper not less t an iSl/Z x it Inches in sloe 3S D-6305/01) 4°~ ~~vvr~-,. d'3 ` ~~ C f/ N~ ~'h P/-~ S ~'l 4 •. ~ \~ : ,t C. h 2 ~ ~ ~ ~ ~ o T ~ ~ ti .n. L.o t 2,5 ~ ~ y e+~ w. w ~o v..7C l~ q,~ `r0 `r'KS 1~s w.wo N $ e~ ~,~.. Sr.o I ~ `to2~.,9-i t'1!*t L Z t~; 4 o ~, ~ S ... ~~(.t.~S~ ~ lt.~b-r~x~.r ~ e,,,1 ~ i o\st``t1 ~~pc.,~;uy ~wa O- ~a~:, •~ tV\w.~ c,o,., ire ~ 1 ( [ ~ iv ~t-P 3 `W OA. Va. t 3oi.o~,' 1 , c.n h~ ~~ ~:1 . ~ ~ iscons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. com me rce. state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary August 13, 2002 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING N4563 320TH ST MENOMONIE WI 54751 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/13/2004 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Shane Mitchell 86TH Ave , Town of Hammond St Croix County SW1/4, NW1/4, S20, T29N, R17W Lot: 25, Subdivision: Hammond Oaks FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 864767 ~~~ ~3v Identification Numbers Transaction ID No. 775099 Site ID No. 648878 Please refer to both identification numbers, above, in all cones ondence with the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter lO1.Ol(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. COr • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption ~~P area, chs. NR 811 & 812c D PARTM ON • A Sanitary Permit must be obtained from the county where this project is located in accordance with the (- requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE COF • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. - ~ MICHAEL P ROGERS Page 2 8/13/02 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing ., . RECErv,~,~ . Shane Mitchell -Mound SAFETY & BLDGS D11~~" Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (O1/O1) Location: Lot 25, Hammond Oaks SW 114, NW 1/4, Sec. 20, T 29 N, R 17 W Town: Hammond County: St. Croix Date: August 14, 2002 Owner: Shane Mitchell Address: 1388 N. Grotto St. St. Paul, MN 55117 Plumber: Mike Rogers Signature: - __.._. License # MP 225094 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management ~~n~~ ~V~~ ~~' co~E~ SPpNpE C~ page 1 of 8 ;, ~ ~f , e ~ ~ , Design C riteria ~ L'3 Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 1 SOmg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/I, 3 Bedrooms x 100 gal/bedroom/day x 1.5 ~~ gallons/day hydraulic load Design Calculations In situ designed loading rate ~ • Zb gallons/sq. ft. per day _ Depth to estimated high ground water ~. Z ~' _ _ - in. Depth to bedrock ? S'b in. Cross slope at system ~•~ % `^'-"-Y Force main length ~~~ ~ ~ ~- ft. of Z in. Manifold/header length ~~ ft. of in. Drain-back `'~' -~' gallons Lateral length ~ @ ~ og ~' ft. of Z in. Lateral elevation ~ `~ •~~ ft. @ bottom of lateral Lateral hole size ~~1 ~ in. @ 3 S •s Z in. ( Z •a b ft.) Spacing 3 ~ holes/lateral 3 g holes total Lateral volume 1 ~, ~ s~ gallons Total lateral discharge rate Z~ •sZ gallons/minute @ 3'~ ft. head Network pressure compensation losses 1 • ~ s' ft. Elevation difference ~ '~ • ~ ft. Friction loss ~ • ~ ~ ft. @ ~ 1 gallonslminute Total dynamic head z~ • ~ 3 ft. PumpJsip'lyon 3 4' gpm @ Zs~ ft. of head Manufacturer ~ ~ ~~l°a Model # ~ S 2 Dose volume l ~ ~•3 gallons Lift/sip#on tank L" ~ ~~. ~ cw~-~.~ CNw~+o l9cro gallons Septic tank `~ •' t ~'`'~ gallons Effluent filter ~ w ~ - ~ ~ Measurement pump on and off ~ - ~i• in. Height alarm from tank bottom ~ ~' • `~ in. Reserve capacity 31~z ~ gallons specs.calcs.res Page Z of ~ ~~ r .. ~~ „ ~OL~ 9~ 0.~~M! Stt ~1~~ ~i1ow Z~~ 1 I w~ I ~ ~ ` lino O v t w~ ~.v ~ c- ~ ~ a.v ~l'e-`~ v~~ ~ i,~' \ C~'t'S ao.a~\J ..~~Q av lwr ~...rv. ~ ~ ~ ~~ ~ ~ ~ o .,~~.1 ~,.~ e s~~~o;l ,a,.S~ \ 1 z .4' .~._ 3 .q' C r i I •` , P 1 C~ h. `~+ i e. •w.` .: ~L_.~ •~ 4 ~ ~ ~~ .~c.~ ~~~ 1Z1.q' ~~• ~v~ 1..'1 `1~ `,,~ ~...Q ~~ 11 ~ T C,~, I 1 n~ \ ~ W1` ~ ~ ate/' ~w~ . KM ~ A"1 ~...~~ ~ ~ t7 vM ~ O 1' Y Ll f~ JL ~,~..,.,,1 g ` --il Q,~-~ E- ~ 3' ~F-' 11. Z.' s' ~- ~11 )'V L Sf.~ }Oct ~:. ~.. , 35.~'L~. ~ 3S.SL" I l ~S'.S2•' I 3S,SZ~. 1 t oq.s'' (' l (~ ~^1 T~.vw `yrrl~ +"~~/ .~-~-a f.a•Vr Q ~ i.: •~w\ wI~CQ, ~ \~vOY ¢L Y~•~ `'W VN~V0. ~OK•~-~ OM Qp w~K\~.~ • J%i 2" ' ` a~ K ~ h 1 t~ G.,, w~( C.Q.y. `Y' Q.,.. b ~' O ~,.. L : w ! ~, J S •, ~" 0. •'V'~ l z • ~ ~O ' / S_ o rn ~ ___. ' t a~ • , ~~~ -----~ PIPE 3' no I~ND-SSUa6~D \ Soles i~c.t r ~aovi.Q S1CET 3D~lT'J L P ~lG wr E c.T I o raS E~e~, ~ ~.~i ~~~. °Sn•o SEPTIC f ooSC k l'(~' `~ Lr'r ~ ~ t... b'~ > 4,, -l1J.CKING~GOVfiR ---~ QWCK G~~GOUV~GT--1 24u I.D, t~a~,uo,F A \ D ~FL.E. Y+ \ T ~v h O w'T L a. 2" I~ Fo2c~ h-la~w WEAT'NERPRO~F ~~JNt:T10N Boa ~~~wc~c 2,1.C~`~ Hur 1 a~ .~-ON- ~~ 4" 3 ~„ aF Pw~IP ~„ C O~lC.RFTc I . br,oCK Ile ' T ~. ~ t/ ; ti . _ SPECIFI•CATIOt\.1S T ', i7i 7r-~,~ ., P .sc 4" 4 0 ~ c ,ti` ~ ~~•r ' q :~ _ ... 4c 3' ono U•iD.:."vtc. u:~u-+o TA-Jr.S MAWUFACTURCR,; ~ ~ieN ~ O IJUMBER OF DOSCS: PCk p..~ T/~-JK SIZ C ; I ~~ ~ ~"'° GAL.LO-JS • DOSC VOLUME _ S, ~7~..~,~v` ALARr'1 !"IMJUFACTURCR; . IWCLU011JCa bACKfI.OW: 1 u~.3 G~..Cti: r"tODCL -.IUYbCR: • 1 ° ~ 1-4 ~ ZLZ'o ; CAPACITIES; A = ~'~'~O WCNES OK :. SWITCH TyP[: ~~~~ w`b . , __ ~3•sZ c Z' IAI NCS ! ~o~,Ll HUMP t1A1JUFACTU C OA :..._..,... 3 ' ~ ~ RCR: iUCHES Ok ~O ~'3 G~,..C~: C • ~ ~ MOpEL -JUMDCR: l5 Z (0 1~.5(~ ~wITCN Tt~PC; ~~`"~ "' DOTE' PUMP A1J0 ALAR1~ AaC TO BC I'111J1!'1Ur1 DISCHARGE RATe 2~G~h1 INSTALLED Ou SEP~a~rC clkc.. -_ VORTICAL pIFfCRCAICf ~CTWCCIJ PUh1P OFF AA10 OISTRIDUTIO fJ P1PC.. ~~'~ FECT + MiuIMUM -JCTWORK SUPPLY PitftiUR E . 3'~ FLC7`~~~~,{ T / + 1`0~ FEET OF FORC[ MAIIJ X ~_ tO_ ~ ,Fioo~tFRIGTIOU PACTOIt. f`®g_ FCET ~ ~ 1 _-~ ~~~ TO TAI. Oy1JAMIC. NfAD 2..03 = F CT IAITER1 1 • ~ ~, 3 . A1_ DIMEIJ610A1i 0/ TAIJK~ LEA.Ils7H ~~ kl,pTH ~ LIQU10 p[P'C H t A~~ 6 „0. g -~ .• TOTAL DYNAMIC HEAd/CAPACITY PER MINUTE EFFLUENT AND DEWATERlNG 0 a w x U Q Z 0 a r- 0 MODEL 152 153 Feet Meters Gcl. Liters GCI. Liters 5 ?.5 69 i 261 77 29t 10 3.1 61 I 231 ~ 70 265 ~ 15 4.6 53 201 61 231 20 6.1 44 167 52 i 197 25 7.6 34 129 42 i 159 I 30 9.1 I 23 87 ! 33 ~ ' 25 35 10.7 t--- ~ i -- ~ 22 85 40 12.2 - -- ' 1 42 Lock Vaive: 1 38.0 Ff. (1t.6m) a4_Q Ft. !'3~r^1~' ousos D FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series _ 1521153 MODELS Control Selection _ Model _ Volts•Ph Mode Am s Slm lex Du lex _ N152 _ t15 t • Non 8.5 1 2or3 _ BN152 1t5 1 __ _--- - Auto 8.5 Included 2or3 E 152_ _ 230 1 i ^ Non 4.3 - 1 2 or 3 _BE 152 ~ 230 1 Aufo 4.3 Included 2 ar 3 Nt53 t15 t Non 10.5 1 2or3 BN153 115 1 Auto 105 Incuded 2 3 3 77/32-{-----~---a s/a --r---T- ~ ~' 3-~<< I B i ~ - e O v t7/~L -~--- I li _~- './g _-.~_ i --L sKZOw _____ __ or SELECTION GUIDE E 153 T 230 1 Non 5.3 1 2 or 3 BEi53 230 t Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. o CAUTION 2. See FM0712 for correct model of Electrical Alternator E-Pak. All installation of controls, protection devices and wiring should be done by a Quallfled 3. Variable level Control switch 10-0225 used as a Control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed Includlny the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. / ~ ~ RES~/ERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ~'"' MAIL TO: P.O. BOX 16347 „~ '' ' Louisville, KY 40256-0347 y Manufacturers of . . J' r... SHIP T0: 3649 Cane Run Road ® Louisville, KY 40211.1961 Qua[irr PUMPS SNCE ~9~`~ http://www.zoelleccom / PUMP ~O (502) 778-2131 • 1(800) 928-PUMP FAX (502) 774.3624 © Copyright 2000 Zoeller Co. All rights reserved. ` `~~/ 0 80 160 240 320 s ~. ,~ • System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715-235-1 132, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. Instail water-saving appliances whenever and wherever possible. i. Repair even small water leaks as soon as possible. 1. Never pour grease or oil down any drain or stool. ~. Garbage disposals are not recommended; if you must have one, use it sparingly. i. No paper products other than tissue should go into the system. ~. No chemicals should go into the system. 3. Avoid surge flows of water; try to spread laundry throughout the week. a. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 1 1. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. [f this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 FROM ROGERS PLUMBING Wlscorsln Department vl Industry, • Labor and Human Relations pivlsion of Safety and Buildings FAX hltJ. 715 235 0867 SAIL AND SITf~(L4LUATION in accordance,v,i,s, IIrHR X83 09;~YVis. ~~ ti ' ' ,ra, Attach complete site plan on paper not less than 8 1/2 x 11 inches In . Irtcluda, but not limited to; veRlcal and horizorlta) reference print (B ); i p®rcent slope, Scala pr dimensions, north arrow, and localbn end d sittn ~;. APPLICANT INFORMAT{ON - Please print all Inforn! tl Pdisonal Inlortnatlon you prov{de Rfay be used for secondary putpbs~E (PrNt~Cy~9 Prorerty owner E.} Uri (3 t, Lp L•J~rV D [ oRF'• C ta... l ~ Tnli•~] Q~4 i`1 ~0~7 Sep. 23 2002 11:51AM P1 page ,_/ w.. of ? Plan rr}G~f~i;;l,,r. r County 5?» ~/QO/•~ ~ctlon anti- ~' ~ ~ • ~• J tq pea(est road, parcel AD. !Z O ~ ' ~`•~~~ q®vle e ~ Date ~raperly owners MamnQ Aaaress ~• 332. xivf>a~SclfiA ST ~+~sT IyQ 2S City state ~Ip Code Phone Number ~ Gty 5T, Pn~~ I Nom. i 5S/o I L(eSl ~1Z~, •55s5 dtiOn ~ - v i 1/4'N~1/4,S 20 T',Z7 ,N,R 17 ~.(or) W ~ckS Subd. Name or C3Mft /fH/r70ND D/~•,fs' ,~ Nearest Roetl ~ . ~ ~» ^ vupage , ~' ' o"'n 1 ~ 1 l~ D [flew Construc-lon tise: ~'F~sidendal i Number of bodrooms 3 .._. Addition to existing bufldfng -....--•. ^ Replacement ^ Public or commorelal - Deserlbe: _„"_„ ~~JJ 5 irenoh, gpd/fry 0 Recommended d®slgn loading rate • -7,,,_bed, gpd/ft4 Coda derived dally Qow ~_ 9Pd 2 ,J Absorption area redulred ,_bed, ftz 77 ~ Vench, n z hrisacimunt resign loading rake r,~ D®d, gpd/its ' ~ french, gpd/ft~ Recommended Inflltratlon surface elevation(s) su ~ _ft (as r®ferred to site plan 4enchmark) Additional deslgNslke oonsideratlona Parent malarial ~o mss AV F~? O~~?SF' T~Y~s Flood plain alevnUon. It applicable Nf ~` ft S = Suitable for system ~nvenHon~al ,Mo~u ln-C3round ,P~r®ss/ure A'C-Grade ~ System,I.n~,f=il/l Holding Tank , U - Unsuitable for system ^ S L~ u L-t o ~ ~ ^ s LS'D ^ S U'U ^ S l~U ~ s ©,~ SOIL bESCRIPTION REPORT _ Boring # Horizon Depth Dominant Color J 1 / In. •/v Munsell ~o ~ 3 3 ~. o - ~ ~o f+R 3! Ground ~ ~ ..~ /o ~je ~ 97 • a ev. ~ ~ i•S /~ Depth to umitlng factor 3-~-'n. Boring #i Z Around elev. ~t9 to ioyR ~~~- i ~~ • ~ ~ ~,~~In Remarks: , ame (Please Print) Rpa~l^ ~~'~ ~~{,~~" Slgnalure TelQphone No. R• ~, !• 7~s• 38~ • ~~ ~ S Address Date CST Number ~.- -fi2~J-~ ... L~-~ (~-`r,~`q~~ L~rj'''`~ ' ~~~e~,~' 7 Motiles Ter;lure Structure Qu. 5z. Cont, Dolor Gr. Sz. Sh. L ~fshk S<< ~fsh~ -- 5~ f •ftf }toTS ~G i O /~ Cgnslstence~ Boundary ~ Roots cs I r~ i~-~.),s cs ~ s .. . z~ , 3 Remarks: L ~fsh~ aG~. c i f '. s FROM ROGERS PLUMBING FAX N0. 715 235 0867 ' ~ VH ~ f ~~ ~'~'~~ StyIL DESCRIPTION REpOR'1' PROPEFTY OWNER •- ~~ ~ ~ S 0 ©~ PARCElLO.tr Go ~ ~' ~ ~/~HMON1~ ~j Sep. 23 2002 11:52AM P2 Page ~" of 3 Texture Structure Consistence Boundary Roots Boring # Horizon Deplh Dominant Color Mottlss Gr. Bz. Stt. bed .Trench ~~~ Vn. Mansell Ou. Sz. Conti Color s y`:,, 3~ .:N Sig / fs/,C ~ ~ - 3 ~` S ~ ~ Ground 3 ~,~ Q r • ~, elegy. o C L u~- '- -- 2:.~ Oeplh to ; Ilmltin9 , factor ut. 3~ ~ --~--- -- Boring # Ground elev. It. Depot to limiting lactor ^_In. Boring # ^_ ... ~ ;a>.. ..~- i C']rOUr1d ~+~+~: .. CIQV. ~ _~•.h~ , Depth to "~ ' limliing lactor In. ~~ . Aamarks: Boring # Tx ..; ~ ~'d~.$: Ground elev, _ _ft. Dept„ to limiting factor 'n' Remarks: SBbW8330 (R. 08/95) ~ ' Remarks: Mottoes Stru~urr PDltt` Horzon Depth Dominant Color Texture Consrtit9nce Boundary Roots Bed .Trey ;n. Mansell ~ Ou. Sze ConL Color dr. Sz. Sh. ' FROM ROGERS PLUMBING FAX N0. 715 235 0867 Sep. 23 2002 11:52AM P3 aY f ws~ ~~ ~ zS ~ 1-l ~. _.,,. o ~ ~ g,l~, ~~ • 15'src'S~ ~~`v N ~e~ ~~.. `~ , ~ ~~ zx~~a~ ~ . 1 o is ~ *,o s .o $' s - 1~..-.~...~ to ~.~,~~,...~-~ v ~~ L (e1sLt49 3 Lbn ~~~~,,,e`~• Q Oc..r+ ~ (i~.~ t „ ~~~~ ~ ~n . - --~ 46 ' ~~z-~- 3px.o(,' :.G~~e.; ~,~~ ~~ o ~_. :: ~L~Cg~ _- ;,.~;. ~~R~IGw ~ =-~5 ~ - I h I Y Owner: Private On-Site Wastewater Treatment System (POWYS) Index and Title Sheet I,. _ Inn ©~ _ ~ s f Project Name and System Type: Location: ~ ~ ~ Street Address Legal Description Township/County Contents: Page 1: Fage 2: Page 3: Page 4: Page 5: Page 6: Page 7: Page 8: Page 9: Attachments: Plumber/Designer: .Credential Number. i. 0 ~~ YYil~i ni-on~~nr ~ ~n.en.mQn~ i~ ~~ u -~ '' 1~ . RECEIVED a ~ ~scons~n AUG 1 3 Department of Commerce 2002 ST. CROIX COUNTY ZONING OFFICE Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.uslsb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary August 13, 2002 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING N4563 320TH ST MENOMONIE WI 54751 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/13/2004 SITE: Shane Mitchell 86TH Ave Town of Hammond St Croix County SW1/4, NW1/4, S20, T29N, R17W Lot: 25, Subdivision: Hammond Oaks FOR: Jdentification Numbers ~ Transaction ID No. 775099 Site ID No. 648878 'Pl'ease refer to both identification numbers, above, in all arrespondence with the agency. Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 864767 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.01/01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 ,~ •MICHAEL P ROGERS Page 2 8/13/02 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human heath hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. MICHAEL P ROGERS Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Page 3 8/13102 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing SEP-13-2002(FRI) 14:10 ATM FINANCIAL SERVICES (FAX)763 549 5581 P.002t002 .09,13!2002 13: A0 6515615666 INSTANT HQME E;WUITY pAGg gy FRE~"1 : ROGERS PLLIh18ING ~ ~ FAX h1Q. 7A5 235 6867 SEp. ].3 ~ ~~.:05AM Pi ~'L' CRf-T~ CUl'JN7.'Y sr~p~r~c ~ r~n~rrl:~~,~hc1? ~~~1~~N~, ~-r~ OWNBRST~iI' cLr,7~~~r~;ATTON I+'~7RM O1v~rlBuyar I~'~ilrstg Adas,~ Progeny address /(00 9' b6~•' (Y~iCtcntiace Tcgttired 4tnrn ~tatlt;til$ L~a~:arltttcnt Car new evusCVCCtna) ><2S ~ CitylSt~ees ~7a/r7~ r Parcel Tdentiftcafion I~umbc_ LE~AI ~~S Ck~.] PfiI41~ . Prnpcrty 'L.occrioa'~ 'f~. G~ /i, $ac..~~/ . i~N-R~W, 'I'ovm of Subclivisian rrt. ~ a ~. Lvt ~ ~`. C~t~t"i,ed Survey Map # '~lalttma ~ ,~„~, .Page # _ _ __ , warranty Dowd #~ L 'Uolum~ _.Psgc # _ . Spec hauso CI yes rtd z..ot lines id.attitlfisbi~ yes ©110 S~STFII'E AarFC~ Improper use aad z~sr~ner~aanceo£yovrseptic aryys*:ern could re«,tlt La its premature faaiust ra 6asad3e wastes. Psagt:tmatIIrens>1ee causi.~s of puatplslg oat the septic tank eYery~tbs~e years or saatier, if Heeded by a Iiceused pUUlpee. What yeu ptrt iatt+ dso systrrn eaa. a.ECaci [I'ta ~xtctioa Of ttte sepq'tc tarok as a trea~tcaC Stage in the waste dispasgl srystau~ ' Tho ptn~xry ownr_r agrees to subtttit to St_ (~-ix 'Lorwtg 17cparrmcns a eertitfesslou form, ~igaed by she owaee Sad by a traastGrpitu>aber, journeyltutu pltttctbat, rasnsettd p9tlmber or a liaised putapar ve:ifyirag fast iI) the oa•aira crastevratcsdisposnl ayateee is is prapcr aperating_ condition aad/ar (2) afbrr FstsPccdOrs aad pumping (if ncct:ssaty), the septic taoic is lcros rbdn tJ3 felt of aiudge. ilwe, rote ucddtsi$~7at1 brave read the above rsgvixcsnen~s and area to maiii[ain the paystc sewA,ge dispdsai s;~srem wfth tbG staadardm scI Carty hercia, xs sec by site DGpattRttcut of Cottuactce altd tiro DepatmQSt:t ct~'Natusal Resources, SCate g1'~1fisconsin.. CartiCcn.doa snga~ uiiat your sepee sysrem ~ been mxintaiited must oe cnm,lrted and rettuard co tha St, Gz~oix C`Ol~ty ~ unit+g Qf~lce t4ltTtic aQ a~yS a£ ~h,c tbrea Year ~Ptr'ixva. daft. . s~~ ~ ~f ~~ crtA oz, ,~epr_zG~~rr . HA'T'S o r ~. I (~*re) ceseity tttgr ul[ sssccmcn~ an tbi,s Corm arc mse to rho beet of my (our) tasnwttCgd. t (wc) aos {9rt:) the oaJs,e,~9) at ['.-C prOlaeity dest:rif~rd 9bdvC. by vlrttile of a warranty deed rrt~ordcd ie Register of Deeds OCEcc. SYGTit Ofi A~'FL.ICAN't• f f~/ D,q,'TE ss•~wT Ray Taforsnstlaa tltaL is xhis-~rescattndmay rasult ttt rlto ayRlta MwRVww 'rY Darmit haittg rcrra6:ed ty tlta Zoning De:psrtmeor. ~'r iacleldn e+'lili (1115 ap~111CatiQli~: A StumpCd trarranty dCCiL FYOfII r~7C ACSisiSt OE DCedS Ode a copy a£L~c ecrt~ed survey map ~tcfcrence is trade io illc v~ransnty doad POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE RMATION Owner Permit # ~ p DESIGN P TERS Number of Bedrooms 100gpd/bedroom ^ NA Number of Commercial Units --- NA Estimated flow (average)* gal/day Design flow (peak), estimated x 1.5* gaUday Soil Application Rate ~ gal/day InfluentBffluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mg/L Biochemical Oxygen Demand (BODs) ~ 220 mg/L Total Suspended Solids (TSS) 5 250 mg/L Pretreated Effluent Quality ^ Monthly Average*** Biochemical Oxygen Demand (BODs) < 30 mg/L Total Suspended Solids (TSS) ~ 30 mglL Fecal Coliform (geometric mean) <_10 cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter *Wastewater Flow Verification on and calculations: (Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank effluent. * * * Values typical for pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity gat ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) ^ In-ground (gravity) ^ In-ground (pressurized) ^ At-grade Mound ^ Drip-line ^ Other: ^ Leaching Chamber Manufacturer Model Approval Stipulation Soil Application Rate_,gpd/fl Area Req. Absorption Area Credit per unit ft Minimum Number of Chambers ^ Aggregate Design FlowlLoading Rate= min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA ^ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ^ -"Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications ^ "Design of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-7 Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -10570-P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ^SBD -10567 P (8.6/99) "In Ground Absorption Component Manual" ^SBD -10705-F (N.O1/Ol) "In Ground Soil Absorption Component Manual" Version 2.0 ^ SBD -10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ^ SBD -10572-P (8.6/99) "Mound Component Manual" ^ SBD =10691 P (N.O1/Ol) "Mound Component Manual" Version 2.0 ^ SBD - 10595-P (8.6199) "Single Pass Sand Filter Component Manual" ^ SBD - 10657 P (8.6/99) "Drip-line Effluent Disposal Component Manual" ^ SBD -10573 P (R 6/99) "Pressure Distribution Component Manual" p SBD -10706-P (N.O1/O1) "Pressure Distribution Component Manual" Version 2.0 ^ Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE MONITORING SCHEXSULE ~„//SYl')I~)1~, 9.6 7 and "Design Manual - Service Event Service Frequency Inspect condition of tank(s) At least once every ^ months year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combvned sludge and scum equals one-third (1/3) of tank volume Inspect dispersal cell(s) At least once every ^ months wear(s) (Maximum 3 yrs.) Clean effluent filter At lea§t once every ^ months ~ year(s) inspect pump, pump controls & alarm At least once every ^ months ~I.year(s) ^ NA Flush laterals and pressure test At least once every ^ months ^ year(s) ^ NA Valves At least once every ^ months ^ year(s) ^ NA Other: At least once every ^ months `^ year(s) ^ NA Page or START UP For new cionstruction, prior to u$e of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process~and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. ' System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever passible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ^ Valves Valves shall be operated in the following manner: ®'Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system aze corrected to prevent back-up of sewage into the dwelling or surfacing. INFECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). ~eptic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump ChamberlTreaUnent Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hazdwaze and the condition of the filter. Any service needs or repairs shall be promptly taken care of. ^ In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any dischazge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of .: Mould, At-Grade, In-Ground Pressure The inspection shall inolude recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or dischazge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) yeazs. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of. all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space failed with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement azea should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and we1Ls. Failure to protect the replacement azea will result in the need for a new soil and site evaluation to establish a suitable replacement azea. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/orsoil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement azea. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS Phone Name Phone K:\WPDATA\EH~'OWTS OWNER'S MAIVUAL.doc POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Agency Phone Page of • U ~197NP 009 STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY DEED This Deed, made between Hammond Land, LLC, a Minnesota - Limited Liability Company - Grantor, d Shawn P. Mitchell Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St Croix _ County, State of Wisconsin: Lot 25 ammond Oaks Subdivision,Town of Hammond, St. Croix County, Wiscons n 669'371 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 09-11-2002 10:00 All WARRANTY DEED EXEMPT # REC FEE: 11.00 TRANS FEE: 83.70 COPY FEE: CERT COPY FEE: PAGES: 1 Name and Return Addresa 018-1086-25-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Subject to notes, easements,restrictions,covenants and rights of way of record, if any, including but not limited to those for drainage,water retention,ponding,and or utilities as may be shown on the plat of Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, St. Croix Counry, Wisconsin. The warranties of this deed, either expressed or implied are limited by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of 527,900.00. Dated this 30th day of August 2002 _ Hammond Land, LLC AUTHENTICATION Signature(s) authenticated this day of__, , TITi.E: MEMBER STATE BAR OF WISCONSIN (lf not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Paul A. Baillon, Attorney at Law (Signatures may be authenticated or acknowledged. Both aze not necessary.) „ by G ,M ~,~, President + Austin J. Baillon ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Ramsey County. ) Personally came before me this 30th day of August , 2002 the above named Austin J. Baillon _ to me known to be the person(s) who executed the foregoing instrume and acknowledge the same. ~~~ l~ • •.1OPAlI~A--BAfEt9N ~~. ~- IMITAP~ '~'..L!';-MlNNGSQTA +PaulA.Baillon w~cOlAA7ir.,k,cxPIRE5h37~20p5 Notary Public, State of Wisc a My Commission is permanent. (If not, state expiration date: January 31 2005 ) 'Nantes or persons signing in any capacity should be typed or printed below their signatures STATE BAR OF W19CONSIN W ARRAN7Y DEED FORM No.1 - 199 NFORMATION PAOFeSSIONALS COMPANY FOND DU LAC, WI e00-655-2021 . M1 '~ y ~ Wisconsin Department of Industry, SOIL AND SITE„~L~,LUATION Page ~ of ~ Labor and Human Relations "~ ~ Division of safety and Buildings in accordance . h s. lLHR 83.09; W is. ~~ County Attach complete site plan on paper not less than 81/2 x 11 inches in ' s Plan r :: •,,-r, JC?'; L'~~/ mi ed o: vertical and horizontal reference point (B ); direction ard...~ include, but not li t t a{ or dimensions north arrow, and location and d staryce t tueatest road. Parcel t,D. # O -" • ercent slope, sc e , p i ~; .. • SD • U~ ti ~. -,,~ CSI • /d .'._; _ APPLICANT INFORMATION -Please print all infor ron, '`` Revie gate z ~,~~~ .~ Personal information you provide may be used for secondary purposes (Privacy~vv s; 15~f4~(Qi)j3„-c?~;~. Z Property Owner -t~ U M Q ~ ep ~ ~,~ v ~ b ~ ..Property Location ~ ., V ~ ..a s~ N'l~ ~~ l ~ ~©w.7 ~Gbv~. 4oty ~ 1/4 /v W i/4,S 2~ T"Z~ ,N,R ~7 .6•(or) W Property Owner's Mailing Address -Lot # Block# Subd. Name or CSM# 33Z.. h i lufv~sor~l s1' Ens r ~ yo ~ 2 S ~4'MMOND oi4',~s' City State Zip Code Phon[e• Number c' Nearest Road w ~ ~- ST• V~- Mme. Jrsi'~ ~ (~O.S/ )222 •,755,5 ^ Ciry ^ Village Town ~ ((O'b [+]~'fJew Construction Use: L7rsesidential /Number of bedrooms ~ Addition to existing building ^ Replacement ^ Public or commercial -Describe: ~~// c 0 Recommended design loading rate _,~_bed, gpd/ft2 J trench, gpd/flz Code derived daily flow ~'~ gpd Absorption area required ~--bed, ft2 77 ~ trench, tt2 Maximum design loading rate bed, gpd/fiz • ~ trench, gpd/ftz Recommended infiltration surface elevation(s) Ste. ~ ft (as referred to site plan benchmark) Additional design/site considerations ~~ Parent material IDEt'S ~~~ DFNSF' Ti~~f' Flood plain elevation, if applicable _ ~ ft_ Conventions{ Mougd In-Ground Pressure AT-Grade System in Fill Holding Tank S = Suitable for system ~~/ ~ ^ U ^ S ~ ^ S ~ , ^ S ~ S U Unsuitable for system ^ S L7 U t~ S SOIL DESCRIPTION REPORT Structure GPD/fl2 Boring # Horizon Depth Dominant Color Mottles Texture Consistence Boundary Roots Bed ,Trench in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ti H' l •w ~a ~ 3 3 -- L i•Fsh~ cs ~~ .'' ~ . S ~ o • ~ ~p YR 3l SAC- z -F s hk cLti. CGJ - • s' . ~ Ground 3 to yR --- 5 ~ 1 f oe ~ S - .`~ ; s q1 a ev. ft. ~ o f~ f ~+oTS 5 c h ~ v -- - • 2-, ~ oy /~ Depth to limiting ' factor ' 3~in. Remarks: Boring # 1 ~.~ ,o ye 3 - L /'fsiJ>~ ~~ G ~ ~ • Y • s~ Z Z ~ . 3~ f o L ~ v . Ground /O ~" ~f Z..~ ' elev. it Depth to limiting factor ~_in. Remarks: T I hone No R l3~RT N ~„(lp • 'T" Signature a ep $l 'g S .ST Name (Please Print) ~ Vr` ~ C,~ 1 ~ 1' ~~s • 3 $G 1 Date CST Number Address Q~iT• Z. 2. ~q~~' a~.!~37~ . ~~~.r_r.• 4. A4S~CIAtAB ,~ ~ y V~1 8 I ~~ `~'~~ SOIL DESCRIPTION REPORT Page ~ of PROPERTY OWNER ~• //~~ !-~ g PARCEL I.D.# Gd / 2 S l~AMf1O~~ ~~ ~~ s ~ ` ~ • Horizon Depth in Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 2 Bed ,Trench . 5 ' ~ 3 • i z • ~o n 3/ o -- io ~e 1- G ~ /fshk ~ ~~ .~. c ~~ . .~t,.5 Rpmarkc~ Boring # Ground elev. tt. Depth to limiting factor in. Boring # Ground elev. ft. Remarks: Structure R GPD/ft2 Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary oots Bed ; Trenct .r--- Remarks: Depth to limiting factor " 'n' Remarks: SBDW-8330 (R. 08/95) \~±_ '.~., Q ~ N I~ lye -i ~ • ~ ~ ~' ~ (,~ ~~~ ~ 0 ~ ~ ~~ \ t~. ° " ~~ " _~~` ~ ~~ ~ ~ ~~ ~ • ~ ~ s ~-3 m= mr ~°~ ~ M V ~ ~ '~ .~+~ m3 N z c -o ~ a>~~ N Samx t In N 0 ~ - _ ., M Q/ (~, `, _ 'Z (~" ~O ~ ~o ~_ -z • -- ,~ ~. ~-- ~I