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HomeMy WebLinkAbout018-1086-46-000Wisconsin 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.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Nelson, Larissa Hammond Townshi ;ST BM Elev: _ Insp. BM Elev BM D~ ~ ripti n:,,, I~! ~f TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic e ( • ~, ~ /T7 ~ ~'~ I i Dosing j/ ~ • ~ ~ ~ ~ Aeration _ ~~~ Holding ~~ TANK SETBACK INFORMATION TANK TO P/~l WELL ~ BLDG. Vent to Air take ROAD Se tic r I ) Dosing ~ ~~ > 7i~fi t iY~ ~L~ 1 Aeration Holding PUMP/SIPHON INFORMATION Manufacturer -) ~ Demand GPM Model Number ~~ ~~ ~ ~~ TDH Lift _33 Friction oss ~ .~~ System Head '~ TDH Ft Forcemain Len w,~ r„~ Dia. Dist. to w u ~.~ :_..: C(lll ARC(1RPT1(1N SYSTEM /'1:~~ ELEVATION DATA ' St. Croix (Parcel Tax No: 399695 0 I 018-1086-46-000 I STATION BS HI FS ELEV. Ben ma k r Bldg. Sewer ~ SUHt Inlet V t Outlet ,~ Dt Inlet Dt Botto ~ ~ %~~ ~~ ` ' ~ ~ /'/ t: i, , ~~ , ader/Ma . Dist. Pipe ~: f ~ // JJ c Bot. System ,r'~~,..1 `~<~`~ • ~ L.% ~ Final Grade ;~ ~~~ ~ !,'11.1, St Cove I/~. z ~ , ~C / ~~• lfi. p BED RENCH I NSIONS Width , ~ Lengt / No. Of Trenches ~~ PIT DIMENSI S ~ No. Of Pits Inside Dia. Liquid Depth ~ ~ , SETBACK SYSTE TO ~,~ -- P/L LDG WELL ~) LAKE/STREAM LE HI ~ Manufacturer: INFORMATION ` ~ R CH Type Of System: ~~~~~~~ 1 (r-1- ~~ 1 ~~ r ~q'~ ~ ` . ~ UNIT Model Number: ~ ~ ~ ~ r11STRIR11TInN SYSTEM %!~~~~J""` ;~,; ,/,~,. _ _ Y/~~..,,.,,~.d; ,- Header/Ma (fold fs Distribution / ~ , ~~~/ y t/ z 1 /~ x H e Size ? 11 x Hole Spacing / ent to r Intake ~~ ~ Di acin 'i1 S th (Dia ~ L ' / ~' ~ ~ ~ a Length g p eng CClll C(1VFR ., o.e«.,.e c..~•e,..~ n.,i., i vv Mnnn`I (1r At_(~ratla SvctPms Only i Depth Over s I ' Depth Over I zz Depth of ,,~: • " ~' xx Seeded/Sodded G- Bed/Trench Center ~ ~ -~ ~ Bed/Trench Edges Topsoil - ~ / ~ " ~ ~ Yes No Yes >~ No : , ~ ~ t COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1~~ / ~ ir/ r~ .L- Inspection ~~ /'~` ~ N Location: 880 161St St Hammond, WI 540. 15 (NW 1/4 NW 1/4 20.T29N R17W) Hammond Oa Lot 46 ~ Parce No 20.29.17.666 1.) Alt BM Description = .~ '''~ ~ L ~-~~~~~ f=' % /~'~~( ~ I (~ ? ~ . 2.) Bldg sewer length = /.) `' `" ,1 "~ ~ "'7 ~~"~~' !.. / A // . ( " -amount of cover= ~~~ ~ ~~ ~ ~' ~h r, ,. ' d-r/r~' , ~"t~~'r,~. ~_t/ _ ~ ~ 3J Contour = I P11 ~~ ~t t ;_ , ~~ ;: ~ i1 ~.• ~ ~~ -1 ~.(I~! ~. __ ,~ ~~„ Plan revision Required? ~ °aa Yes iNo ~~ ~ Use, ~ side for additional information. i _.__ 1 _i _ ~ .-_ _ __-- Date Insepctor's Signa ure Cert. No- s t Muched ,~~~-;~ ,y• Fd Z~$~o-L # ~~Z~ Safety and Bttitdings Division ~ ~ 201 W. R/ashington Ave., P.O. Box 7162 ~~~ ,~'~~ns,~ Madison, WI 53707 - 7162 a Address 7._. ~ Department of Commerce ~ ~~ ~ ' -s~ . Sanitary Permit Application sanitary Pergmit Number ~ ~ ! 9 ~ ~S In accord with Comm 83.21, Wis. Adm. Code, personal info il'~e ~ ~ ^ Check if Revision ~• ~ ma be used for seco ses Priva Law, -_ I. Application Information -Please Print All Information ~ '~ , ,~' ~y S Plan I.D. Number ~ ' Property Owner's Name ~~ `~, ~ ' ' ' ,,: ;, Parcel Number p~ Q' - ~ d F(~ - ~~ -DOG /~ /~ v Property Owner's Mailing Address -~'i ~ ; . ~ ~~ Property Location r e j a~ -~- iS~ ~j ~, / ~ -••~ t~ Y tC~ r' „, '~t /~ Cl.~ if t!l~i; S ~ T N, R E City, State Zip Code r '`• ~ Lot N ber Block Number ~ /a/,f„ . _. - ~ ~ /~ ~ .•`i ~ i 1 ~~ ° Y°A' Subdivision Name Number i " r ~\ (J / ~ 7/~~ /s l C~l~ II. Type of Building (check all that apply) ~ ~ ~ycr S •(nwZ miry ~1 or 2 Family Dwelling -Number of Bedrooms ~~ ()7Cllla~, ^Village l ^ Public/Co /-ia cribe~Use -~Des ~ D o~~p ~ ~ ~ ^ State O ""`""'" ~ ~''~ 4 ~ 1 t' Nearest Road, III. Type of 't: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A' 1~ New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For Courtly use stem Tank Onl stem B• ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use 44 ^ Non -Pressurized In-Ground 2]~Mound 47 ^ Sam Fiber 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recizculating 30 ^ Odrer V. D' rsal/Treatment Area Informat ion: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation ~~D ~O ySt~ < < ~ /O ~P r I VI. Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank a~ `_, b / Dosing Chamber VII. Responsibility Statement- >4 the undersigned, respoaslbility for ' tlon of the POWTS shown on the attached plans. Plumber's Name (Print) Phunbe ' igna RS Number Business Phoce Number l~~G ~~r~.3s ~ his- a~ ~- 6~ Plumber's Address (Sweet, Ciry~te, Zip e) ~ / ~ ~ ~~ f~~ . Coun /De artment Use Onl Approved ^ Disapproved ~~y Permit Fee (includes Grormdwater Date Issued Issuing Agent Signature (No Stamps) ^ Owner Given Initial Adverse Surc a Fee) t~ ~ ~ ~` ~ Determination . ~ 1X. Conditio~f ~~rpvaUReasoq~for l~' proval S ~ _q,.~ ~: 0~ ~c d/ CyK c.-'Ytdv- , ~w~~ `~wRo e~~..bb~1 l®~~ , ,~~"~, ~ CJ, . n . ~''t~-1 a ..a -,, Dr nm ~r T,,, Scale 1 "= yp ~~ lp~ l-t~t ~'~-1_- ~ , ~~p .0' oN 1/ Z`~ ~-~B. ~6T" C°p'~1 Lam.) L3~ " `o s ~~•~ ~\ ~a~o ~ ~ \ ~~ ' ot= ` Z"pvc Frt. ~ ~ ~~ ~~\ Z ~ ~~ 9~ ~~ ~ R.3 `a, D0 Iv OT eON~ ~ 02 D s P ~T \ ~ l h.~r~, ~5 , z ~ o~ t3y"1 ~ 3 ~5`~~ ~~~ pvC~ X Sv6s~T~ W `T'Ll.. LO 'fi'n oN ~r~rUUtiZ l~l-. 1pS 5 ` e o~yt o~ mss. ~ ila6,( . ~~ ------- ---- NOTES 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation ipes with approved caps. ( Z required). 3. Septic tank to be 10~u 6SOgallon capacity manufactured by 4. $ench mark S S~ Pri~OU~ ~. Divert surface water around system to prevent ponding at the uphill side. Page 3 of ~ ~~ _?, J ~' N ~ ~ ~` ~ Safety and Buildings • 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 • ~~ ~ r TDD #: (608) 264-8777 ~scons~n g~ 1 ,! 1 ~;~ ~?''~ www~commercestate.wi.ustsb ~ ww+N.wisconsin.gov Department of Commerce ~ ; ~ ~ ~~ °`~ !%;: ~., 1 `i 'i. Scott McCallum, Governor ~. RECENT-a r Philip Edw. Albert, Secretary ~._. -~ ~>, January 18, 2002 ,s~ ~ ~ ~ ~~ ~'~" ' ~-•~ ~~~t~ CUST ID No.267341 ~~ ~a:s -A7TN.• POWTS Inspector r~~.. ARTHUR L WEGERER ~~.,., -~' ~1...-- BONING 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 AI' .?t3VAL IX II2ES: Oi/1o/2004 SITE: Nelson, Larissa Residence 87TH Ave Town of Hammond St Croix County NW1/4, NW1/4, S20, T29N, R17W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object [D No.: 826900 _ _ 1de ' t " n_N_un. ers __ Transaction I 701599 Site ID No. 640392 Please refer to both identification numbers, above, in all comes 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 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (8.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (8.6/99). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption ~~j~,~r~ area. chs. NR 811 & 812c I~'"'''''``JJ'' Per manual sited 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. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. _ ARTHUR L WEGERER Page 2 1/18/02 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for e~lsuring 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). In addition, 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. • 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. • 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 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. 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 (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us WiSMART code: 7633 TITLE SHEET I~4UND SYSTEM FOR A 3 BEDROOM RESIDENCE Page ~ of 7 This plan has been prepared in accordance with the Mound Component Manual SBD-1057 P and the Pressure Distribution Manual SBD-10573-P CCZ. bl9.9.~ Ctz. 6L4g~ LOCATED IN THE tJ~ 1 /4 OF THE Nw 1 /4 OF SECTION ZO , T Z~ N, R l7 [d, TOWi1 OF _ ~-~~yy~ p-~~ ST- ~-Q-() UC COUNTY, WISCONSIN. -----_Lo'T=.-~I.6 -.6-F _j"l_f'=,1-OJUp-=-O~}~~_. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEP4 rIAidAGEMENT 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 PUI.IPING CHAP•1BER CROSS SECTION PAGE 7 of 7 PUriP PERFO_RI•iANCE CURVE PREPARED FOR l b t °t1:: 'T-ti~ R.D s>'. ~n~'rN eo~-P-T' --- -- _ _ _-- _R~~ LP~i~1p _!_. hglV _ _SS6~1 -- PREPARED BY WEGE~EF2 SL3I L . TEST S NG A!~!D . . DES ~ G~i S~F2V ~ CE P.O. Box- 74 421 I1.Tfain St. River Falls, WI 54022 Phone 715-425-0165 Fax 715-425-6864 Cond APPS ~c of ~ SEE CORRESP ~9~ ~.~ ~ ~~ ~~ ~~ ~ ~~ - ,G~ ~l ~-, o~ ~~ ~G (~ 6 ~~. ••I..IIMy1j11 ~'`I tiv _ t gRT~x,1R ~. Wci~EREA D-579 P ELLSWORTw .. ~~'ICi~s~ 1-tb-oZ JOB N0. 02-~c°, Mound System Management Plan page Z„ of Pursuant to Comm 83.54, Wis. Adm. Code 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. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic 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. Pump 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 SvStem 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 6005, 150 mglL 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 testis 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 [SBD-10572-P (R. 6199)] grid local or state rules pertaining to system maintenance and maintenance reporting. -, . 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 shalt 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 faits 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 ff 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 -115-. 3~{~_ ~6~80 ~3T. C.CZU~X • The system installer at ~) S - Z68- 6Q~S V l GP1'tZi~ The tank manufacturer at 800-3ZS~- $~(,S(~ bVI~~R The effluent filter manufacturer at g`Ot~ -Z-Z-j -~S~~~Z'. Z~$f~ The pump manufacturer at --- - - (~'3Q_ g?~, lj~t{~ ~ -----~-CSU~.1~S TT /1T T1T w~• Scale 1 "_ yp ~1~1 ~o~~iy~C ~~ i~ 0 ~.~1--~ .~ ~~,~-r QN 1IZh ~•B. LET' C°A'{?JI.IeIZ~ B~~+z.:w Viz; ~~ ~:t7' o,v ~,Z~, 5,~_.p~~~ _ L~.1^11+3- L4 99'.$ r p1V T'U(~ 0}- ~Z1~~u ~~ l~~. X Su ss ~T~ W ~Tl,lr LO ~'IION D 0 tv OT e0 M P Pre- ~ ~ ~ 02 D ISTU~Z,A T ~~~ ~ 2 epeuh~ut2 L~t,~L`S r ~~'1 S ~Z.~. ' ~~ OF ~ ~\ ~ ~~ 4i . BN'J~Z ~~ ~ 13.3 `~ ~ \ Q.Z ~ g,- `o s ti~~ ~,~ ,~~ ~~~ ~°ti° ~,~ ~ v ~~ ~~ - ~ s `~~ ~ ` ~ r~S `~ ~~ ~ or ~ ZKpvC ~W. •~ ~ ~~ Page 3 of ~ J v J r NOTES : ~ ~- 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 10~U 6SOgallon capacity manufactured by 1.`1 ~ L~ La-Z Ct~ eR.e"1~ w / f~ - l ~ a v Z ~ ~, -=t ~~ 4 . $ench mark S Ste` i~30U 5. Divert surface water around system to prevent ponding at the uphill side. Paoe ~lor ~ Approved Synthetic Coverinc ASTM C33 Medium. Sand Topsoil 31i Distribution Fipe ~~ ~=-_%` G D ~ e ~ % Slope Distribution Cell of Farce Main Z" to 2Z" AQgregate From Pump CROSS SECTION OF A i~OUND SYSTEM Linear Loading Rate= ~-o GPD/~~ FT Design Loading Rate=o-3aGPD/SQ FT Position o-" Force Main 6 A ~ J/~-----------------I ___ ~ ~ . A ~ Ft. B ~ S Ft. I 1.O Ft. ~ S Ft. K ~ Ft. L q I Ft. W Z I Ft. ~-- /~' `~ ~ ~ ~ h~z`z~ t' Plowed Layer _ _ __~ D ~. ~ Ft. \ E o- Ft. F O_~ Ft. G o- S Ft. F; ~- O Ft. f 1 I ~ -Observation Pipe ~ K ___.. _ __!~ i3oX S W ~_ ~_ ~ - ---_ ---~-------= = = =- _ ~ _.\ '~--- Distribution ~-- Cell of Z" to 2 Z" I Pipe aggregate Observation Pipe (Anehbr sec~zely) , e PLAN ~IET~1 OF A MOUND SYSTEI4 Distribution Pipe Layout 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 Iate-aI up with the use of Ion, turn or 4f° fitr:'ng to a point witlin si.; inches of the final fade. Te.~minate the ends of the late.-als with a valve; •threaded can or . threaded plug. Provide ac:r~s from final made for the vaIye; threaded cap or threaded plus. ~~~~cr L LZ.osS s,`.~u~ FVC F~J~ PVC Laterite ~- Manitotd ~ Later! x x I x I x ~ xlZ I xQ ~ x I x ~_ z~ x ~ • Lateral Lencth -~ Lateral Lnath - P ~Lt?•N V~~~ _- rr -- c- - h t',"J 1 i-J ~= ~-- -- 1 ~ Q^-~ n~'^~u • P -37 Ft. S 3 Ft. X Z~ Inches . .. Pale S of &CC-~s Boy; - -o ---0 • Hole Diameter 3~ ~ 6 Inch •~ -•" • Lateral ~ 1 ~~y InchEes) Manifold Z Inches • Force Main " Z Inches ;: . ~ of holes/pipe lq • Invert Elevation of.LateraTs~~b•'6Ft. :, . .. _. ~ - Combination Sept,3.c~.Tank and • ' PUMP CHAM6ER CRO55 SECTIOtJ AA10 SPECIFICA . : ~ - . nVEuT CAr 'T~ • ~ ~ ,~ u.~sP~i oW P tpE ' FI N Lgl•}p ' G (CKp E I la'nIN. ~_ ~ 11JLET ti C.Z. VEIJT PIPE ~ ~ lO' FROM OOOR, 4 ~t~lDOw oR FRCSH A~IUTAKE t S cor.~twlr 6".~w. - - i ~ I ~~ 10 8 ~ ~ I ' L-_ IOIJS ' PAGE ~, OF ~ WEATHER PROOF , - JtliJCTIOLI 80X APPROVED LOCK1i1G MAYJHOLE COYER wt~l'1 H~ MI>.I. 18' I'41 u. 1f ~`'~ ------- -- +- ; .. • •n -' B ra~LE LLEK.9~.00 ~ FL ~~ Approved joint w/ PVC pipe \\\~ j ~, ' ~PROViDE I AIRTIGHT SEAL I I I i Iii _. ,~ I i ~ l j i ICI I I ~ AL~,RM a -I rI I I I ou c •i I I I PUMP ~ '-~ ~ OFF D CO-JCItETE ~' BlOGK Approved joint w/ PVC pipe RtSCR EXIT PERMITTED 01JLy IF TA1JK MAlr;llFACTUR!`R HAS SUCH APPROVAL~3,•Rp~~F~ Br<DO t av 4 SEPTIC f SPEC.IFICATIOt~1S ' oosC T,~-,IKS MA-1UFACTURCR: ~ 1 ~~lZ ~~~~- IJUMgEA OF DOSES: y'~ / TAfJK SIZE : 1~U ~} ! 6 S 0 GALLO-JS GCSE VOLUME pER p r ,~,~ ALJlR1+1 MAUUFACTURCR; S'~ ~ ~~~C1ZA S~S1' s IAICLUDIAJG 6AtKFLObJ: ~ 1p~' (,ALLON: MODEL IJUMSER: ~~ I ~~ CAPACITIES: A- ~ ~ IAlCNES OR 30 6 tiALL011S SWITCH TyPC: _ ~'~~R-~ g = Z iWCHES'OR ~, G(~LL0115 PUMP MAf.IUFAGTURCR: GCUL-~s / C= 6 IuCHES OR 1 ~ ~- CALLOUS MODEL IJUMHER: ~~OS' D= tiZ Z~y ~L1ZC-LJ~~ SWITCH TYPE: IAtCHE50R AR ~_ 6ALLOUS _ 1JOTE: PUMP A1JD AL ARM E TO 6 MIUIMUM DISCKARGE •RATE SD- I b GPM IIJSTALLEO OIJ SEPARATE CIRCtl ITS VERTICAL DIFFEfCEIJCE DETWCEtJ PUMP OFF AUO..DISTRIBUTIOfJ PIPE.- ~' 6o FEET ~~ ~~ •i- MIiJIMUM -UETWORK SUPPLY PRESSURE . . , , , ~-~ FEET ~Z.Sx-1.3~ -~- ti]L_FEET OF FORCE MAIIJ X S•OZF7 ~o Ft:FRtCTIOU FACTOR. Z-p) FEET ' l :~", TOTAL QSIJAMIC HERO = ~ FEET ~~' ~~ As per manufacturer l~.p gal/in. Liquid depth 3 ~'' ~ i , _° APPLICATIONS Specifically designed far the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/4"maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge size:l'/i NPT. • Mechanical seal: carbon- .. rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3/4"maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:l'/i' NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERS FEET 10~ 91- 3( 0 a w U a z 0 J F 0 a 2! s 2c 5 4 3 2 1 0 1; 1( 00 W CV JV 4U 5U GPM ~ ~ ~ ~ ~ ~ ~ 0 2 4 6 8 10 12 m~/h CAPACITY Goulds i?~E~ °~ Submersible Effluent Pump ~~ EP04 EP05 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assemhled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP051mpeller: Thermo- plasticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- tic cover with integral handle 'and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) I4 ~ ~ ~. r ! i ;+ .s a G - - ------- --- :-~ -~~ ~ 1 tea. i-------L- -~ '~ ~5 ~,~ i - r i F "~~ FT ~ x~ ' - j i i I -- ~ -----T - --- -- ----- -- ~ ~ i I ~.. _ .__I ~ -~ ' ~ I '~ I EP05' ' - i Sp .-I ~~ ' ~ EP04 _. , ~ ~ ©1995 Goulds Pumps, Inc. Effective May, 1995 UliI5iD'2 'CI!E 7.4:50 FA% 71 ~ 388 4886 ST CR3 CO ~ ~. ~- ~~ l,..Sottil ~~,~-:~,~ Wisconsin Depertmsnl d In N~ ${'t'~ +~v~~ Labor and Human Relations Division of Safety and Buttdings in accordance wilha:,iL- Attach COmplat0 ilia pFsn on paper rqt lees ihr t a 112 x i 1 inehsv in (iz4~~an muse Hretude, bid red llndted to: vertical and honzon al reference point ( J,ZiirecNon•enrl ;' percent slope, tcnta or dtmenelnne, north arrcr ,and location and ~tspca to nearest )oa~'.° ~.. 70'a1'.G `. ~ ~UU1 ~' ~ ' \ -: ~.09. W}s. 9 ~~~ x ff ,t ; 1~,:.. ~ ~~.., Gz,,, ~ 7 . I~`=1'• t :~ a~,:'t9 APPLICANT INFORMATION - PlARS ~ prtrtt off fn .~:;(i1on. " R~ °; d ny Da» aru Paschal :ntomWbn you Drovltla may be YBStl ra ea ntlsry purposes (Pit y L;~q, e. t9.od~y +. ~L JG~ `~ PropertyOwner, ~ V W Q l e L+1ti D b ~ ~,,-. - - ~°n''' 1 S ~'~ 1774 ~ ~ ~~ 'A.7' . ~' ~ . ~-ox- ~ •/'~ ~W t/4.S 20.: T2,' .N.R f7 S (or) W Property Owns s MaiNnq Address Sut)d. Name or CSlstlt... 33Z ~tilVfo~so7'A sT. €+55T- 1yo~ ~ ff~.-rJrra~vD eart~E~sr City 5iat0 Zip Code `Ptrone NurTlber Neatest Pnad . ~ . , St uL , Nu. ~S~a ~6S1 ?mat •5555 o sty- ^ vie a Tav+n ~ ~vo Q'1(lsw Construetlan Use; [meal ~antiel r Ntsnber ct bedrooms '~ Mattior to sx'stlnq buiW;rq ^ Replacement ~~n ^ PuM : or odnmerc!al • Oesuibe: Code tlsnved deity flew a ~•~ _ DPd •1( fiscoTSnsnded des!gn loading rata . bod. 9pdAty ` ~ trench. gpd/ft7 absorpNOn arse requkee ~'?S _bed.' z ~ r.L-trench, ria Maximum design loadsrg rate bed, gPdltts~tTarKh, gPdAt2 iiecormended Infiltration surface elevatfor s) SscA_d~ • 3 _tt (as referred to s!te plan benchmark) Additkxtal daslgnrette consldernNens _ _ - -~ - Parent rvtatertal ~d E4S' O1J~ Df,~tS~ TI %/S Flood plain elevatbn, if applicable ~!~-n S Suitable far system ~r"''t°r' i~°,"/at'~ r-ou~rt~Y In- round Pres AT-Grad~e,~ System in Ftlt~ Mottling T U Uroult~le far system [] 5 ~ ~ ~~ ° ^-' U ^ S ^ S L7 J ^ $ •L^KID lam. 5 L+J ~ Boring # HoHzon Depth pominant :olor ln. Mur!sr t }s ,:..rte - z - ./ ~o yfQ ~ ~ _ Ground ~- ~~ ~ '~ ~' Depth m !imiNng factor _ . ~s Aln ~ . j 0 Remarks: - E3oring # 2' ~ v;.g-~-,r. Depth to lknliing SOIL DESCRIPTION REPORT Mottles Qu. Sz Cont. Color Texture Stntehxs tar. Sz. Sh. COrralatena6 Boundary Roots /~ 9sd T ..~. ~ 56K S w / :. S sic. afsbr c - •s ' •G _~t~"_M t S ~i~S l I a .~ ~o !/R tir! s 6ui i 2 ~ 3J - io ~ ~.~ s,C. ash c s - .s , • ~ ~vt~ cs - . 5 ~~,. Remarks: CST Name (Please Prkdy FOuLe~^~ ~ NL~ l~drose Uiprlcht S P raeCtatar revs 0 eM fig! .~n! 8eR 0':'a~N I d. Hudson, WI ~. 640tS Sigtwaxe ~~i{• f Telephone No. ,ate 14 4'S ~ aG 3 5 . '~ . ;~. Wisconsin Department of Industry, Labor and Human Relations Division of Safety and Buildings SOIL AND SITE EVALUATION in accordance withs;~~ILMR-83.09, Wis. ,~ ; . ~.__~co Attach complete site plan on paper not less than 8 1/2 x 11 inches in ze, Plan musti 4 include, but not limited to: vertical and horizontal reference point ( ~,~itfectiorraac~ ~ ,rr'~ percent slope, scale or dimensions, north arrow, and location and isba~ice to nlarest'r®ai~. ~~~ ~ m APPLICANT INFORMATION -Please print all info -on. J ~~; ,l Personal information you provide maybe used for secondary purposes (Pnv y{L~, s. 15.04 i~~ Property,Owner ~ I J fH Q ~ Qp L>AJ1~ D d b V ~ ~'D ti•/J ~~a''4 i l ~D AJ~ ~ , vt. col . Property Owners Mailing Address t 332. hiUiv~soT~4 sT: ~~iST -40 City State Zip Code Phone Number ~ City ST• Pnu~ i /yN. i 551o I ceSl >2ZZ •5555 ti S? : L~°Oi ~ Parc I I.D. # O •" -::,~ Page ~ of • 'r(7 • U v • So • a-a Date i ty/~a /5 %4 /V W 114,S ~0. T x ~ ,N,R ~ 7 S (or) W ~uqd. Name or CSM# -,H~,owD oi9`'~'s Nearest Road w ~ Z. $e ~ own I ~ (iL0 (j ~tesidential /Number of bedrooms 3 Addition to existing building [+~"New Construction Use: ^ Replacement ^ Public or commercial -Describe: Q Recommended design loading rate ~ bed, gpd/f12~`~~trench, gpd/fl2 Code derived daily flow ~_ 9Pd ' .,7 trench, /fl2 Absorption area required ~_bed, n2 ~~ ~ trench, n2 Maximum design loading rate - , bed, gpd/fly 9pd Recommended infiltration surface elevation(s) Sl.L ~ ft (as referred to site plan benchmark) Additional design/site considerations N/~ n Parent material ~~ E•SS D V ~ ~~NSL' T~ ~~f Flood plain elevation, if applicable __,___r_-__- Conventional Moun In-Ground Pressu AT-Grade System,i_n.,Fil~l O S 9 C S Suitable for system ~~ ~^ U ~ S (] S ~ ^ S L~JU U = Unsuitable for system ^ S l.~ D I~LLsd~ SOIL DESCRIPTION REPORT Boring # i i Ground elev. /4.~ ~n. Depth to limiting factor m. Boring # ~,; Ground elev. jps•~n. Depth to limiting Remarks: ~ o ~ Hoye 3/3 ~. ~fsh~ ~s~ w ~f ' ~ ;' L CST Name (Please Print) R®BERT- ?~~t~RiGt~T' Signature r..~..~ ~~s•3s~•~~~s Date ~~ Address ~..• / ' . IG CC ~ 2~t 3 7 S Remarks: l~. V,r,~ $ I ~Q ~ Aa1~ SOIL DESCRIPTION REPORT PROPERTY OWNER ~~ ~ S' S (~ g ffAHMoN~ PARCEL I.D.# BOring # Horizon Mottles Structure Depth Dominant Color Qu Sz. Cont. Color Texture Gr. Sz. Sh Munsell in.. ~ fsh~ ~ 3 o~ /oYl~ 3! -- s~~ ash /© '` ~ L / ~~~~ Ground ~ l Q -/~~ ---~ ~ / / ev. e ,~ J '~+ ~ (. , Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor in.: --- Remarks: Page ~ of Mottles, Structure Consistence Bouridary Roots ged , Horizon Depth Dominant Color Texture Gr. Sz. Sh. , ' in. Munsell Qu. Sz. Cont. Color Boring # Ground elev. ft. bepth to ,limiting factor in. Boring # Ground elev. ft. Depth to limiting .x c v ~G' I ,vo tort, . Z .~ sv~euf yb,e's ya~'' ~ ~ ~ . ~ ,~ c,J Lo T ~o,PN ~. /OD. O -----~ Lor yG SC~4GE: ~ ,~ - •Z D 'o 1' r~ ~ Mo~~,p s~sr ~r~~• lc>j ~ ~-`' SAND /OG . ~Z v ~o ~a- ~ M #~ Z 5~ r ~~ ,~ s~~~ z p;`,.rc cv~ G ~-~- ~0 u 5" ~~ i~a ?~.C~~, /0 S.~Z So _ . ~ 3 ~3 2 . _ /~~q-~~~ue P ~ 7'S f3 ,.. S'I' CROIX COUNTY SEPTIC TANK MAINT):NANCE AGREEMENT AND OWNERSHIP C;:RTIFICATION FORM OwnerBuyer _ ~C)~.'( \~7,~j.. ~~~~~1 Mailing Address _ e~ IC~1 3 rc~ S=t , s . C-~. , l~k~l~n~.~'~~1 ~s~~ rr ^^ --,~ Property Address L~)~" ~~ ~3So ~ ~1 ` 5 ~ ~~ ~ ee~ (Verification required from Planning Departrnent for new construction) City/State ~~o~e~, ~~~ Parcel Identification Number 17~~5 _ ~~~~? - ~'~` LEGAL DESCRiP'itTON i1 ~.\, property Location ~ %,,~ ~/<, Sec. c7,C . T c~I N-R ~ ~ W, Town of ~r'~~~~'n~ Subdivision ~~t~m (~~,~ Lot # ~. Certifed Sut'vey Map .# - .Volume , PZige # Warranty Deed # ~ ,~ Volume ~ t Page # Spec hoase (~ yes ~o Lot lines identifiable Id es D no y SYSTEM MAIIVT1r,Nq,NCE Imptaper use and maintenanceof your septic system could result in its premature•failute to handle wastes. Pmper maiatenaaec consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system_ The property owner agrees to submit to St Croix Zoning Department a certification form, signtd by the owner and by a tnastecplttmber, journeymanp(trmhcr. reslrictedplumber or a licensed pumptrverifying that(1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements sad agree to maintain the private scvrege disposal system with the standards set forth., herein, as set by the Department of Commerce and the Department of Natural Resotutres, State of Wisconsin. Certification stating that your septic system has been maintained must be completed sad returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF LICANT DA"C'B OWNER CER'>('IF)<CA'>f~ON I (we) certify that all statements on this form arc true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~~~~-~. ~~~ of ~~,c~- SIGNATURL• OF APPLICANT DA'I'$ ""••` Arty information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. "+"" `• Include with this application: a stamped warranty deed from the Register of llccds office a copy of the certified survey map iC reference is made in the warranty deed bd Wd08:T1 Z00Z 80 '~pf 00LS9bZSiL 'ON Xd~ JN I 1d~Fi~X3 ~~02171 W02i~ b ZZ9 OSI ~ uo~}e}S xe~ Wt18i~ti ZOOd SO Nd[' xe~ pan~aoab vol- ~~~.~ PAr,E ~42' Document Number S'I'ATG BAR OF WISCONSIN POI2M 2 - 1998 WARRANTY DEED This Deed, made between Hammond Land, LLC, a Minnesota Limited Liability Company Grantor, and Larissa L. Nelson Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Lot 4 ammond Oaks Subdivision,Town of Hammond, St. Croix County, lsconsin ~\/ 668218 N•,A'1 HLEEN H. WALSH FEGISTEF OF DEEDS I S1'. CRQIX CQ., WI RECEIVED FOR RECORD 01-14-2002 10:10 AM WARRANTY DEED EXEMPT D CERT COPY FEE: COPY FEE: TRANSFER FEE: 62.70 RECDRUING FEE: 11.00 F'AGE5: 1 Recording, Area Name and Relllnl Address ;v~~. Ol 8-1086-46-000 ___ _ i'arcel Identification Number (YIN) This is not homestead property. (is) (is not) State of Wlaoonsln County of St. Cro[K I hereby certlry that this Instrument la a fuN; true and oorreot copy of the document on file and of record in my of~oe and has been w ri>•. ,,,_ AtasstC ..l~~i~f %/~~Z ~ ~ 00 / l Gv-~:~~ 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 sho~~~n on the plat of Harnmond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, St. Croix County, Wisconsin. The warranties of tlus deed, either e~presscd or implied arc limited by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of $20,900.00. Dated this 7th day of January 2002 Hammond Land, LLC AUTHENTICATION Signature(s) authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN * by _~ __ _ President ___ ~ Austin J. Baillon ACKNOWLEDGMENT STATE OP WISCONSIN ) ss. Ramsey County. ) Personally came before me this 7th day of January _ , 21102 the above named Austin J. Baillon i~ to me known to be the person(s) who executed the foregoing 6£'ZZ t Z£'S8 t - ~ -- ? - --~ ~ I i o ~ N •~ I ~ N c°iv rn 0 d! N OOI p U ' N N Q ; N N 4 W ~~ N s~ OI ~ M I I N ply O N J ~O o~ M J ~ ~° I (n ~ ~ Z ~ ~ N I ,oo~ , ---------- -I--- ~ I,~~ £6'Z8t ,Z6'bZl ~ t9'6£Z ,OZ'80 t i a I ~- W ~, I I ~; L~.. ~ ~ i M ~ p U ~3 c/a "' ~ ~n ~ (~ Q ~~ F- ~I cNOI (N pOO •0' r~O QI , 3 J(D~ ~ry0 ~(n ~ ~ M OO OI O~ti I I IN d ~ ~~ I i ,10 ~ I Z _ ap o. ~ Ljaoa I ~ I I ~ II ~ ~~ I W W I i ~dUI ~~I ~ ~ O~ OI N~ ~ - ~ ~~I 'I _L.~_- O I ' ,9l'L9Z M,.ZZ,tv.68S ~ ~, I I ~~ ®'~ W (~ o~ I 3' 33, ~3 rna tWY ~ i~ O I II~N ~I i ~ O I J~ ~ I Z I- --- --~-~~~.. 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