HomeMy WebLinkAbout018-1086-41-000 Wisconsin Department of 6ommerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building D;,visirin
INSPECTION REPORT Sanitary Permit No: 408237 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. g
Permit Holder's Name: City Village X Township Parcel Tax No:
Zehm, Mel & Darcee I Hammond Township 018 - 1086 -41 -000
CST BM Elev: Insp. BM Elev: BM Description:
,0 1 oo -E) CST t3wct� 1
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic L.,� Benchmark �;-
�{_� � (�� C f" S
Dosing C .p l l Alt. BM 0 •�D
O
Aeration Bldg. Sewer / • 3S ��
b /I •
Holding
St/Ht Inlet �,�/
�2 - e l
St/Ht Outlet
TANK S TBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic so -. q( , 1 2 , �. Dt Bottom //� ! -' O`
Dosing L Header /Man. 1 1 LL92
1
Aeration Dist. Pipe
3. lob `1 S
Holding Bot. System 4. 1 . ZD
ZAD )1 >1.3r`
Fina G� td►� toe � Z 1t
PUMP /SIPHON INFORMATION
Manufacturer Demand St ver
G P M
odel Number
c� �u
0� DH Lift Friction Loss / System Head TDH Ft
(0.!;o tS-Zt
Forcemain Length O i I Dia t . t I Dist.toWell �,. ,
SOIL &55,0RPTION SYSTEM
allllpftRENCH Vildth eng tt} N0. Of Trenches PI7 DIMENSIONS No. Of Pits Inside D' Liquid e
DI Z
SETBACK SYSTEM TO � J P/ BLDG IWELL LAKE /STREAM LEA I Manufacturer:
INFORMATION Type Of System: CHA OR
, rte , 3' ^,, f O �� NIT Model Number:
DISTRIBUTION SYSTEM �► s (Q
Header /Manifold Distribution i << x Hole Si e x Hole Spacing Vent to Air Intake
a< Pipe(s) o.6
Length P Dia Length �ia 'D Spacing �'
SOIL COVER x ressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of ed /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil xx Seed
FS I Yes � No � Yes ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:�i/ 4 2 4 1 2. Inspection #2:
Cl ) flay.,-
Location: 886 162nd Street Hammond, WI 54015 (NW 1/4 NW 1/4 20 T29N R17W) Hammond Oaks Lot 41 Parcel No: 20.29.17.661
1.) Alt BM Description = �D'�►�`J- P°r'T °'�- �l�iie S'J
2.) Bldg sewer length o
- amount of cover =
3.) Contour
= (pp
Plan revision Required? ) Yes o
Use other side for additional information ______ — 1
SBD -6710 (R.3/97) Date Insepctors Signature Cert. No.
Safety and Buildings Division county
201 W. Washington Ave., P.O. Box 7162 S� C Y d
VISconsin Madison, WI 53707 - 7162 Site Address AR
Department of Commerce - .t —Q "t— 3S3 a f �$(o
Sanitary Permit Application Sanitary Permit 22 3 1
in accord with Comm 83.21. Wis. Adm. Code, personal irfonaation you provide ❑ Check if Revision
ma be used for ses Privacy Law, s15. 1' m
1. Appacidon Information - Please Print All Information State Play I.D. Nutnbe
Property Owner's Name Parcel Number s .
e/ a . aac- .g zed ate - 1 am
Property owner's M'at7ing Address Property Location
AA
City, State Zip Code Mu r Lot Number l Block Number
3 1 Q 2pQ2 Subdivision Name CSM Number
U. Type of MWIng (check all that apply) s� o FF ic Caw
i or 2 Family Dwelling - Number of Bedrooms
❑ Public)Co �t W a1- Describe Use S To
" C:e�-4�. 0 Road
0
State Ownod t t a �• p' 12h / z S 7
III. Type oY Permit: (Check only one 1= online A (numberutg scheme for internal use). Complete line B if applicable)
14� Ncw 2 ❑ Replacement System 3 ❑ Repimmant of 6 C1 Addition to For C °imty, nae
Tank ON system
B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Peru&. (Check an that apply)(numbering scheme is for internal use) Aq r .
44 ❑ Non - Pressurized In- Ground z J(Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized In-Ground 41 ❑ Holding Tank 48 G single Pass 51 ❑ Drip Line
45 ❑ At - Grade 46 ❑ Aarobic Treatment Unit 49 ❑ Recirc ' 30 ❑ Other
V. esdonwt Area Information:
Design Flow (gpd} Dispersal Area Dispersal Area Soll Application Percolation Rate System Elevation Final Grade
- 7 Required Proposed Gals./Days/ Ft) (Min./Inch) Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
owions (Woos of Tanks Concrete Constructed Glass
New E%isdai
T TIDIES
Septic or Holding Tank
VII. nsibiflt $tatemeAt- I, the tmderatgated, "Fume rLponsib0q for of the POWT5 shown on the attached phms.
Plumber's Name (Pclat) Plumber's Signature RS Number Business Phone Number
N d,� 7 1 1 91-5 1
• j�`aA a Aye
Plumber's Address (Street, City, State. Zip Code) J , l
" VIII. /De ent Use O
1 � Apptavad ❑ Disapprovod Sanitary Permit Fee (includes Groundwater Date Issued issuing Agent Signature (No Stamps)
Surcharge Fee)
p ❑ Owner Given Initial Adverse �
mot' Deurminadon 3 �J .
I%. Conditions of Appro as for D' p o S ` S&&W l f r
�o• +s�-� -sue let tkes; �' r.(Ls ,•
Attack cempide *0 (ta the Co z 11 inch" in size /" �(
tnt�u4 c�[t'Jtn e0 �1`t
S .05!01} spe u`(';cm;6%&s ,
' PLOT PLAN
Scale 1" = 1 4Q ' Page 3 of 7
"T LlrJL
Do r� o T to r1p
CUNZ D ts
"$ 8o'0i =Z j:'M '
ri
11b 4
Do
5. � ' c Zq r• cr J � V
�• Q.1/ Zoe �t� �� �l4.
LUT utiq
eon Z EA
s!� 4 L - ez. 100.o' cw .11zP zB. nor
NOTES:
I. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. Z
3. Septic tank to be \ Ibo /$Op gallon capacity manufactured
V 1LS F_Nz C17_e7� w / r)- l b Up
4. Bench mark SL`s p�S U L
7 5. Divert surface water around, system to prevent ponding at the u hill sid
s Safety and Buildings
4003 N KINNEY COULEE RD
RECEIVED LA CROSSE WI 54601 -1831
Nvisconsin TDD #: (608) 264 -8777
www.commer ,wis ons i n ssb
Department of Commerce JUN 1 www
3 2002 .wisconsin.gov
Scott McCallum, Governor
S CROix COUNTY Philip Edw. Albert, Secretary
June 10, 2002
CUST ID No.267341 A7TN: POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06!1012004 Transaction I D n7551 Identi ers
SITE: Site ID No. 64558
Mel & Darcee Zehm Residence Please refer to both identification numbers,
886 162ND St above, in all correspondence with the agency.
Town of Hammond
St Croix County
NW 1/4, NW 1/4, S20, T29N, RI7W
Lot: 41, Subdivision: Hammond Oaks
FOR:
Description: Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 854486
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 10 1.01(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 l/ 10706 P (N.0 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 feet from the absorption
area. chs. NR 811 & 812c
faun al
LOVED • 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.
OF Cp(yIMERCE
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
SPONDENC
• 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.
f
ARTHUR L WEGERER Page 2 6/10102
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 /instal lation/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.
v I addressee hall rovide a co of this letter to the owner and an others who are responsible
The above eft s p copy y P
for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Charles L Bratz f �
POWTS Reviewer 11 , Integrated Services WiSMART code: 7633
(608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544
I
i
TITLE SHEET Page of
ROUND SYSTEM
FOR
A LI BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD- 10691 -P and the Pressure Distribution Manual SBD - 10706 -P
(N.01 101) (N.01 101)
LOCATED IN THE 1-3W 1/4 OF THE �1W 1/4 OF SECTION 2 . 0 Y T Z- N, R 17 W,
TOWN O y�M07V17 , ' e (Z.13 L X COUNTY, WISCONSIN.
Lb ( OF "M MOMS O aks
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN
PAGE 3 of 7 PLOT PLAN
PAGE 4 of 7 PLAN VIEW -CROSS SECTION
PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT
PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION
PAGE 7 of 7 PUMP PERFORMANCE CURVE
RECEIVED PREPARED FOR
MAY 2 9 2002 R QII Z) �' Z EIP"
SAFETY & BLDGS DIV. S �J � t v`' s�b ���
PREPARED BY
W FEE GEFcaFR SO -1 L . TEST" I r4 CS
AND .
]DES I Gam! SEIRV I CE
P.O. Box 74 421 N.Main St.
River Falls, WI 54022 r p�N
Phone 715- 425 -0165 �
Fax 715- 425 -6864
f ~ t
�\
jZ ARTMSIR 4 •�
N'EGERE.i
C oR d ' 6 LLSWORTH-
e SIGN
Of 0 41i
SEE C
S L
JOB NO.
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code Page Z of
Seotic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. t il
The erating condition of the septic tank and
outlet filter shall be assessed at least once every 3 years by inspection. Th outlete shall be cleaned as n _ ss;;C to.
ensure propetr o eration. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that
may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if
the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pum — p Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October - February) dictate that the mound be heavily mulched for frost protection.
Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg/L TSS, and 30 mg /L FOG. 'Influent flow may
not exceed maximum design flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each
lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be
compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is
required to maintain equal distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,
and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual - - 9�j} and local or state rules pertaining to system maintenance and maintenance
reporting. BBD— 1pbqI -�
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and
pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump 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 a tank or component.
Continaencv Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be
immediately repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning Office at 3b 't_ 680 Sr- \X
The system installer at ls_ <jdjQ , ZX66 S1.il-5NG
The tank manufacturer at �p� � c�'�1S�j wLE-
The effluent filter manufacturer at
The pump manufacturer at - 3C) Zak - R C�ouL -
PLOT PLAN
Scale 1 " =4}) ' Page 3 of
�T l.lh.1L,
i
J pis �
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f 1
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L 4 1a) \ZY1
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OF -LS 9 PrDDzzsS 7
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__ W�t,C. � 4 3� ? S p ' '�Zt1M V� Dvr� �w } ZS,' �cOw -t �'►.Jvz , _ _
r
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. ( - L required).
3. Septic tank to be \ Ix3/80p gallon capacity manufactured by
w 1 Ls �-OQ c2-E7� w / r) - I Z � 0- F
4. Bench mark S - SLRo U L
5. Divert surface water around, system to prevent ponding at the uphill side.
Page L ) Of - 7
Approved Synthetic y c Covering
QST.H C33
Medium. Sand Distribution Pipe
Topsoil.. - - - - -- -- H - - - - -- - ' _- a
—1� -------------- - - - - -- =,� =-_= = =' I F E1ev*. I0O.�
.c
3 E
T
o
Z IO
S e
p -
T; Force Main Plow
D_..t_ bLtion Ce_� _ � of ed
z" to 2 ". A- recate From Pump Layer
(undisturbed D O Ft.
Soil
E l•
Cross- section of a mound system using F - $ Ft.
2 cells for the absorption area
G 0 -5 R.
A Ft.
—�— H
1•o Ft.
B - l5 Ft.
C ZO Ft.
Linear Loading Rate= y,0 GPD /LN FT I Ft.
Design Lo
g adinQ R
p Z GPD /SQ FT t
J - 1 Fes.
K q Ft.
L Ft.
W y Ft.
L
'T
$ K
A - - - - -
- •— — — = — - - -pox
1 C bservafiian
( A n c`�or s securely) ( -- - �•7`1� \2 S pc'�
— o =_ - - -- - - -- —Q -- Farce
— �
W
Moin tl.�J
Distribution �n �
Pipe Cell of Z to 2
aggregate
... a „re o ate .
1
Plan view of a mound system usiz.q
2 cells for the absorption area
Distribution Pipe Layout Page 5 of -]
.o
Place the holes at the bottom of the distribution pipes
at equal spacing, Remove all burrs from the pipe and holes.
Extend the end of each late -al up with the use of Iong turn or 45' f rEnz to a point witbia sa
inches of the final grade. Terminate the ends of the late.-als with a valve,:threaced car or
threaded plug. Provide access from final grade for the valve; threaded ear or threaded plus.
�— ss
7�tt'1cr —,L
C. F�J� PVC
Latent Manitgld Lateral
x x x x/2 I x!Z x x z x
Lateral Length —t lateral Length — P
IT
Oistributign lJne �
G—
C F�A= 1ti Fr�J
P __ Ft. Hole Diameter ) )8 Inch --
S Z.O Ft. Lateral ) Inch(es)
X 2 Inches Manifold Z" Inches
Force Main " Z Inches
l of holes /pipe lq
Invert Elevation of.L ate raIs j01" Ft.
l�Kv.ql Y Lt 31.I� Gam
_ - Combination Septac: Tank and
PISMP CHAMBER CROSS SECTION ARID SPECIFICATIONS ' PAGE OF 7.
•VEIJT CAP_ WEATHER PROOF
JUUCTIOU BOX .
4'C.Z. VENT PIPE APPROVED LOCKIMG
1 10 ' FROM DOOR, tAIJHOLE COVER P01
:111JDOW OR FRESH wASiNIUG LJ�$t;(.
u.ig�zo� PtpE A!k Iu TAKE cotapu
Ft N tsi�
G R ^c'o c I 18' Ml IJ.
IIJLET i" PROVIDE I -
_ •� ;� � AIRTIGHT SEAL
Approved ZfMEL ir e I III Approved
joint w/ A —l8ou I Ili joint w/
ALARM PVC
PVC pipe I II pipe
° I I
l I oIJ
c i I
9b -�33 I I
LLE1: F �
PUKP -� OFF
D COWCKETE
5LOCK
5
RISER EXIT PERMITTED OIJLy IF TAW MAIJUFACTURER HAS SUCH APPROVAL —13"AVPQotiF„
6EDO I IJ 4
SEPTIC f 5PEC,IFICATIOMS
DOSE I.vLt
TAkiKS MAIJUFACTURE QeIZ � AJUMBER OF DOSES: 5-O
PER DAB
TAIJK :,IZC: - GALLOQ DOSE VOLUME r
ALARM MAUUFACTURER: - S -� Zi��nzo IKJCLUDIAJG OAGK /LDW: CALLONIc
MODEL wumBCR: `4w CAPACITIES: A tig
- pJCHCS OR --4t: GALLpu5
SWITCH TtIPE: _ �-AR1Ze-fjkZ� 5 = INCHES �' LLOLJS
PUMP MAMUFACTURER: G � c j u �-�)S C= INCHES OR � � �
MODEL IJUMBER: — " D= l� INCHES OR_ ZZ �' TGALLOWS
SWITCH TYPE: u OTE: PUMP AUD ALARMARE TO 6C 6
MIIJIMUM DISCKARGE - RATE GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE DETWCEU PUMP OFF AIJO.,DISTRIBUTIO►J PIPE.. � FEET
- P MJI.IIMUM IJETWORK SUPPLY PRESSURE , , , , , • • , • . 6- S � Z FCE T(S - OX 3)
- F �� FEET OF FORCE MAIM F /Ioo fr.FRICTION FACTOR.. \' b FEET
TOTAL OtIMAMIC. HEAD = �� ', FEET
As per manufacturer Zz- ZI-f gal /in. Liquid depth 3 6
Goulds pp�GE of
Submersible
Effluent Pump
i 1
u
EPO4
EP05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas-
• Homes components. tic cover with integral handle
Motor: Available for automatic and manual operation Automatic an float switch attachment
.
• Heavy duty sump • EPO4 Single phase: 0.4 HP, points.
• Water t ransfer 115 or 230 V, 60 Hz Mechanical
, 1550 models include
RPM, built in overload with Float Switch assembled and ■ Power Cable. ,
Severe duty
• Dewatering
automatic reset. preset at the factory, rated oil and water resistant.
• EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower
SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing
Pump: EPO4 built in overload with ■ EPO4 impeller: Thermo construction.
• Solids handling capability: automatic reset. -
3 /4" maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for
i • Total heads: up to 24 feet. with three prong grounding mechanical seal protection. SA. Canadian Standards Association
• Discharge size: 1 /i" NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- numbers
(CSA listed model
• Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in " to or "A C".)
del
rotary/ceramic- stationary, three prong grounding plug improved performance.
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F 40 °C ( ) continuous superior strength and
140'F (60'C) intermittent. corrosion resistance.
Fasteners: 300 series METERS FEET
stainless steel. 10
• Capable of running
dry without damage to 9
I I components. sol — - - - —^' -� SGPM
Pump: EP05 s
• Solids handling capability: 0 25
3 /4" maximum. Q 7
Lu
• Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet.
• Discharge size: 1 NPT.
• Mechanical seal: carbon- } 5 -
rota /ceramic- statio
5
ry nary, a �
-
B N
U AN I
e astomers.
- EP05
Temperature:
1.
i 3 10
0
o i
104 O F (40 continuous
ous
i
I i
140'F (60 intermittent. 2
I I
0 oO 10 20 30 40 50 GPM
0 2 4 6 8 10 12 m
CAPACITY
®1995 Goulds Pumps, Inc.
Effective May, 1995
1
b K, !H 7 0 i - 7
NF -02
-
WIM"(1 SOIL AND SRE EVALUATION z
Lubw teto Human fliq%guft
DIVIS!" of addly 014 &.911kireega In accordanc&*0 o. ILHP 03.09, ft-
XOR0 wffoalb Wilt 00, an papal no less Than 9 12 X I I 1rTj,W in Sze• mom rFWcI
Includs. Met twat L"Oed W. v4)IWM end hoil ottal Mamma pot fAM, Iffactaft UM
"evard d1Civ, ocAs or dmanolix-, rare, ■ vqw 4n ( orts! j%oW4* I* Aemefbaf Mod,
. � � " M
APPUdART mr-onmAraN - Pis swe Finiou informarion. Swawsd by
PCOWIrthwuMm KteprrAde MW be U604 1 w W—Weelk I. (Lft III W)
Ow" f4ijAs1wD id lip ZZ;JS • ell Prc*&Iy LouA!cn
PALI I l 1060 16 A III GOA. Lot �Yxj ' T M PI- W
rMp" ow"rev vwi� "*" his a jq0q
SIZ. hioatSoTA T" S 6ASr
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SOIL DESCAMT(ON REPORT
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OWSS •, Will. G*Clia
Wisconsin Department of Industry SOIL AND SITE EVALUATION
Page ! of
Labor and Human Relations 1WIS
Division of Safety and Buildings in accordance w I l ly
Attach complete site plan on paper not less than 8 1/2 x 11 inches in n must
r �fr ction a6d
include, but not limited to: vertical and horizontal reference point (B t �e
percent slope, scale or dimensions, north arrow, and location and di a to nearest road. Parcel D. # M O
Review y Date
APPLICANT INFORMATION - Please print all inficir f n, ST CriQ;�•. ,Y 'r I r
Personal information you provide may be used for secondary purposes (Privacy 15� Vim'
r wner H l L7p l.�ll7 d roperty Loca oA ; N.R �7 E'{U a � /4/V1V1/4,ST / , L�(or)W
6 S 0 N' BA f l'0 A,7 L # Subd. Name or CSM#
wner's Mailing Address M iuNt SOTA sr. ' GAS I 4M~vp NearestRoad State Zip Code Phone Number City 0 Village Town 0 u� JH�. 55�o I 45/
) :ii •5555
Q'(Vew Construction Use:
residential Number of bedrooms 3 Addition to existing building
❑ Replacement ❑ Public or commercial - Describe: Z
Code derived daily flow 4'6 49 9Pd
Recommended design loading rate bed, gpd /fi trench, gpd /fl
Absorption area required bed, ft trench, it Maximum design loading rate •� bed, gpd /fl A f trench, gpd/ft
Recommended infiltration surface elevation(S)SAL • 3 ft (as retorted to site plan benchmark)
TYp� AfooAso Qua u t' Q�—•t�
Additional design /site considerations N ft
Parent material /D EIS
600e Q �N$E 7 /��f Flood plain elevation, if applicable
Convention Mo In Ground Pros AT Grade System in Fill Holding Tank
S = Suitable for system ,� S O U � S U ❑ S U El S ❑ S U
U = Unsuitable for system Os
SOIL DESCRIPTION REPORT
Structure GPDlf1e
Boring # Horizon Depth Dominant Color Mottles Texture in. Consistence Boundary Roots Bed ; Trench
Munsell au. Sz. Cont. Color Gr. Sz. L Sh. ,/�
s• !Ls�h K•J 3
D•I toyR .3� •Go
/oYX 31 S/ L a f dsA
S� 2"S" 6,r M+ fir' c s - . S
Ground is oe 3 ` ; • 3 IL
elev. /f• �ft. L fSh /c em PAY
�d
Depth to
limiting ;
factor
X /`in.
Remarks:
Boring # •!S /O Y/� 2,� Z ,7 !GS�JI� !� 4/ / f' • Z 3
3 lo e
Ground
elev.
yy & #7 ff. y/C 4 Z• !NC`'gy GFiK� r0 / N
Ae
Depth to P
limiting
factor
3 5--in. Remarks:
ROBF -e - 9 1 Ck'T"' Signature Telephone
CST Name (Please Print Q�1
1� fA 1v7h� '7�� • � �Cj ' v'
Date CST Number
Address /)r�. Z�_ I Geri 2X4137
A 4 g I e p Aad SOIL DESCRIPTION REPORT p age Z of
PROPERTY OWNER w D OA 19: S S D
.#
PARCEL LD 4
2
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots
Gr. Sz. Sh. Bed ,Trench
in. Munsell Qu. Sz. Cont. Color
3 S� z-FS g 44-.1.2
Ground
elev.
lo ' •F ��S C�
t Depth to
limiting Y
factor
in
Remarks:,
Boring #
Ground
elev.
ft. '
Depth to
limiting
factor
- Remarks:
PD /ft
Mottles Structure Tture Consistence Boundary Roots Bed ,Trench
Horizon Depth Dominant Color Qu Sz. Cont. Color ex Gr. Sz. Sh.
in. Munsell
Boring #
Ground
elev.
ft. '
Depth to
limiting
lector
in. Remarks:
Boring #
Ground
elev. ,
ft.
Depth to
limiting
factor
r .
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T� ilk
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
•AND
OWNERSHIP CERTIFICATION FORM
Amer /Buyer _ Soh
�c
bailing Address
'roperty Address
(Verification required from Planning D a nent for new construction)
rh
amity /State
Parcel Identification Number
LTGAI, DESCRIPTION
�a, � T ' ��'N -RI�W, Town of
Property Location - � +, ,, Sec. —,�=
� ® �
Lot #�.
Subdivisions �r
Coed Survey Map It
, Volume _ Page #
Warranty Deed # Gd 3G �3 , Volume
/ 9 Page it
Spec house ❑yes M no
Lot lines identifiable)Zl yes ❑ no
SYSTEM MAINTUNANCB'
result in its premat>�enfsa�il p um p er- � wastes. y pu into the system
t
Improper use and Inamtenanceof your septic system could
consists of pumping out the septic tank every three years or sooner, if needed by
can affect the function of the septic tank as a treatment stage in the waste disposal systeuL r and by a
the owne
rt owner a grees to sumo t. Croix Zoning Department a certification form, signed by sal stem
The prope � bit t S r veri that (1) the on -site wastewater disposal s
mastcrplumber, journeyman plumber, restricted plumber or a Licensed pumpe �g the Septic tank less than 1/3 fun of sludge.
is in proper operating condition and/or (2) a 1ler iuspeciion and pumping (if necessary), eP
Pe
sal e with the standards
Uwe the undersigned have read the above requirements and agree to maintain the private sewage Resources Stat of m Wi certificati
set forth, herein, as t by the Department of Coce completed and returned to the St. Croix County Zoning office within on
stating that y c t n ma in tai ned
days of th e i do
DATE
SIG A O ANT
OW t ? RTII+'IC "owled e I (we) am (are) the ownel(s) of
1 e) ni t s Cements on this form are true to the best of my ( our ) e
.
the p s ab c y virtue of a warranty deed recorded in Register of Deeds Office
i ZioZ
DATE
SI N T[3RL PLICANT
« « « * +* ay result in the sanitary permit being revoked by the Zoning Department. piny ormation that is rots- represwitcd m
** Include with this application: a stamped warranty deed front the Rf cif renee is 0 in warranty deed
a copy of the certified survey nut
f
07!09/02 TUE 13:05 FAX 715 388 4887 1tEGISTI'1t OF DEEDS X001
• l 19 2 9 p 14 1 ►r
STATE BAR O A
K P WISCONSIN FORM 2 - 1998 $ 3 6 8 c - .
TMLE6M M. IIALSi1
WARRANTY DEED REGISTER OF DEWS
ST. CROIX Co., vi
poeumeDt Numbs
This Deed, made bct%— Hammond Land, LLC, a Minnesota RBCSIVED FOR RECORD
Limited Liability Company J 07 - 09 -2002 8:30 AM
WPANK[Y MD
_ l7m #
Gtaotor, and Melvin Q Zebm and Damm L, Zebra, husband Said wife RUC FEE • 11.00
TRAMS FEE: 71, 70
COPY FEE.
CERT COPY FEEL
PAGES 1
Grantee. Grantor, for a valuable Consideration, conveys and warrants to
Grantee the following described real estate in St. Croix
County, State of Wisconsin:
No and dR Return Address
of 4 Hammond Oaks SubdivisiosJown of Hanu Wild, St Cmix CMIty,
018-1086.41 -OW
Raresl IdeatifR mm N ®ber MN)
This is not homestead property.
(is) (i3 not)
Exceptions to Warranties: Subject to notes, easemads restrictions coveoaals and IWO of way of record, if any,
iMhrding but Wt limited to those for drainage,water reWauoWndi And or utilities a$ may be shown on the plat of
Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, St Croix COUDO, WiscoDaiA
The warrant= ofthm deed, either expressed or m4giod am lindted by the grantor to the
grantee, or anyom in the chain of title, to [be Consideration exptotsed herein, that being the sum of 23,900.00.
Dated this 6th day of June , 2001
Hammond Und, LLC
• by Prxaident
•
• Austin J. Baillon
AUTHENTICATION ACKNOWLEDGMENT
STATE OF WISCONSIN )
) $a.
Sigaature(a) Ramsey Cou )
Personally came before me this 6th day of
at<thenticated this i day June , 2002 the above nameed
Ausda J. DiNon
TITLE: )DER STATE BAR OF WISCONSIN to me known to be the porsou(s) who exccuted the foregoing
(If not, TNotaryPublic. aclmawledge a same -
aDdtoriaedby 4 706.06, Wig, Stets.) THIS INSTRUMENT WAS DRAFTED BY PAUL Ad Paul A BaiRon, Aitotncy at Law liion X0 `"'" % State o sm
Ja 31
(Sigestarm may be authenticated or ar,�pYrtedged. Both are not Jar 31 ian is
2085
y -) _ )
"Names of persons signing in my tap sty should be typed or printed bel" the aigoamres
STArR RAR or WI
WAAAANYY 0999 FORK Ne-1 nOpyMATIONPROVESSMNALSCOb1PANY PCONDDULAC, WI aea.655.2021
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,46't L
# - Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
isconsin www.commerce.state.wi.us /sb
Department of Commerce www.wisconsin.gov
RECEIVED Scott McCallum, Governor
Philip Edw. Albert, Secretary
JUN 1 1 2002
June 10, 2002 ST. CROIX COUNTY
ZONING OFFICE
CUST ID No.267341 ATTN.• POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/10/2004 Identification Numbers
Transaction ID No. 755118
SITE: Site ID No. 645580
Mel & Darcee Zehm Residence Please refer to both identification numbers,
886 162ND St I above, in all correspondence with the agency.
Town of Hammond
St Croix County
NWl /4, NW1 /4, S20, T29N, R17W
Lot: 41, Subdivision: Hammond Oaks
FOR:
Description: Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 854486
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 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.
ARTHUR L WEGERER Page 2 6/10/02
Owner Responsibilities:
• m
Co m 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensurin g P 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, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Charles L Bratz
POWTS Reviewer II , Integrated Services WiSMART code: 7633
(608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544