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HomeMy WebLinkAbout018-1086-48-000r Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: Gity Village X Township Krue er, Dan Hammond Townshi CST BM Elev: / //~~ W ~ ~ Insp. BM Elev: ~ ~ ~ BM(D~ets_cription: ~ d_ "~L ~1d~s~"~~~'^^ - ~m ~f TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic //~~.~~ n-, ' Dosing ~~-D Aeration . f. ~ _l Holding TANK SETBACK INFORMATION TANK TO P/L ~~s'r WELL ~- BLDG. Vent to Air Intake ROAD Septic ~ )~ ~ / ~~~ ~ Dosing ~ ~ V ~ -er Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ( Demand ~O pJL GPM ~f Model Number ~~~ ~ ~ ~ ~~ Y TDH Li+3 2 Friction Los System Head TDH Ft ~~ Forcemain Leng$t~ ~ Dia._ ~~ Dist. to Well` 7 ~ ~ / ELEVATION DATA county: St. Croix Sanitary Permit No: 420349 0 State Plan ID No: ~~ Parcel Tax No: 018-1086-48-000 STATI~O~ID 3 qs HI FS ~V.~ Benchmark ~u CJ!',' ~ t7 i ~}~ t1J~ C~ Alt. BM ~ ~ ~ Bldg. Sewer ~.3 9' D- G SUHt Inlet ~d `.3 SUHt Outl t ~- ~~ Dt Inlet Dt Bottom la.,..,~~~ Header/ an. ~ ~ ~ ~ ~ , , Dist. Pipe ,F TP 3, g /cri~ d Bot. System ~~ s ~ ~~ c ~, Final Grade ~ t' ~ ~6» ~~ /~! ~~ J St Cover tv- ,T7 ~' SOIL AF35VKF' I IVN SYS I tM BEDITRENCH DIMENSIONS Width ~ length 1 ~b No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth / L / ~~ SETBACK SYSTEM TO P/L BLDG WEL LAKE/STREAM ACH G Manufacturer: INFORMATION CH B R OR Type,O_f Sy/~~~~ ~~/ y // 17 Model Number: DISTRIBUTION SYSTEM ~j ~~~~_ oiler/_ U.(` 7 /~~,,~,~ Header/Manifold I ~ ~ Distribution t t/ Pipe(s) x Hole Size ~ ~/ x Hole Spacing 7 Vent to Air Intake ~ ~~ j j th Di L ! th Di L I S i ~ ~ ~j eng a i eng a ng pac SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched / ~ Bedfrrench Center -~d'i N ` Bed(rrench Edges Topsoil [~ Yes L~ No ~ Yes [ No fir- l COMMENTS: (Include code discrepencies, persons present, etc.) Insp tion 1: /CX S ~~~ Inspection #2:~/ / d Location: S84 161st Street Hammond, WI 54015 (NW 1/4 NW 1/4 20 T29N R17 ) m n aks Lot 4/8~eol~^~ Parcel ~No:, 2~0-.~29.17.668 1.) Alt BM Description = S'f'I~Y~L ~ ~jt:,cf"..5~%r:~S ~X` / `1~h1``~'~~ ~~sr~`'~'~~ 2.) Bldg sewer length = 2 ~/ ~ ~ J~t,~,~,,,hotds ~ Y~~j.~ ~.-f~~L~ ~ 5 l Cdlrv--ttf.~ C~~l-Uc. l ~ ~~e J~ - amount of cover = ~ ~y[.~~~ ~~,[ ~ ~ ~Ytltit~r- ~-at' ~ C>f~'hR ~ ~F~LCaa ~ 3. Contour - (~~,, ~ ~ ~,ti [.~ , D 0 - v a ~iY1T000~I{ QYL 0 Y1 ~ h~ f.097 YIQC~71JYt p,~ r- - q ~ ' Yes _, r-- ~ --- - r --- _ - - -- .~- - _ -- - -- -- - -~_ -_ i Plan revision Re wired . ~~No ~ ~ I Use other side for additional information. _~~ ~~~" ~~ ~ ~~•~_~_ ~%1 ,~ ~~~~ _ . ~J Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ~~~ (/t/"C.L.~ I~LVYY~ WLI'~- ~il~- ~ ~~/ ~~O I't/ I~2.fl't/t^~ ~.. ~Q o «~~ 3 Safety and Buildings Division .~ / w `~ - 201 W. Washington Ave., P.O. Box 7162 ~/~-[h-o ,~~O~S j~ Madison. WI 53707 - 7162 Site Addre[ss/ L 7~ ~ ~- ~ ( ~~ J De artment of Commerce Sanitary Permit Application ~~ P t Number In accord with Cotnm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ma be used for ses Priva Law, s15. 1 m I. Application Information -Please Print All Information ~ E C ~ i ~ E ® State Plan I.D. Number 7 Prope Owner's Name Parcel Number , / //~~ h~~U 2 ® 202 /~ V '_ C~ "~ ! Property Owner's Mailing Address ~ Property Location ~ ~~ ST. CRUIX COUNTY • Q () NG UFFICE ^~ L/ ~~1ii !4; S ~?OTa (N, R / ( E City, State Ztp Code um r Lot N er Block Number ~ Subdivision Name CSM Nom ~- Sy~o ~ - -6~ t II. Type of Building (check au that apply) ~ ~ s.yb~. ^City i (~ 1 or 2 Family Dwelling -Number of Bedrooms ^Village ^ Public/Commercial - ri Use ~ownship ^ State Owned ~ _ Nearest//Road~• III. Type of Permit: (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 Fur County use stem Tank On! E ' stem B. ^ Chxk if Sanitary Permit Previously Issued Permit Number Date Issued l:V. Type of Permit: (Check all that apply)(numbering scheme is for internal use)-~ f}-~loD , 44 ^ Non -Pressurized In-Ground 2~ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ pressurized In-C,round 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ Ai-Grade 46 ^ Aerobic Trratment Unit 49 ^ Reciroutating 30 ^ Other V. D rsal/'Iteatment Area Informati on: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate stem Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.FtJ (Min./Inch) Elevation ~~D y sv y~o ~ ~ ~ S ~ . VI. Tank Info Capacity in .Total Number Manufac r Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Foisting Tanks Tanks °- Septie or Holding Tank _____ Dosing Chamber ^-._ VII. Responst`hility Statement- I, the undersigned, assume responsibility for tion of the POWTS shown on the attached plans. Plumber's Name (Print) T~ Plumber' Si tore RS Number aae3~~ Business Phoce Number ~~s~ ~~o - ~q~s Plumber's Address (Street, City, Stn Zip Code) / /~J(/' ~'~J //t// ~t ~ ~~i~" s ~V ~ . Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) , Surcharge Fee) ^ Owner Given Initial Adverse 3zS~_ ZZ Determination IQC. Conditions of ~ pprovaVReasons for Disapprovall ` ~ IC)u ~ ~~t~"r~w0-l~~t~ •~. ~•W.L.. otn~AD ~~-~ ,n-I' ' c ~~ST~''~s, ~'~- wntu,+~ l n~ao ~ W~-cs, n ~ ~tl s~.~ ~ ' ~_a~,~~ e1 tyt~... SBD-b398 (R. OS/Ol) eu 'c- `~. J ~ / ~ a° PLOT PLAN Scale 1"= 30' 1..1`x', ~' ~~7 S ~ 6 6 ~- , ,J L~~~ -~ ~ 3 gD~~ . i ~~E ~~ 1 ~ 4 PSG 10 ~ ~~~, q~ Osr Or \c~ `~oZ't-~JY~ OF o4n~L ' ~ t'~- qq.S ' g9 Page 3 of ~ ~ ~o NoT c01~PfleT o tz D 1sT~tu3 'Ri-~ 3 prt~A ---~•3 q7 1 ~ i15 6~~ ~ ti5 31` -- - _sZ- .- s - - -- .1 6~' ~°! I 4~~o i a~ ~a ) 0o'ci~iv s Cv~ _ L~ - SA C Q~ 1#-! - E2 ~ ~ ~ - o ' oar ~/Z `' ~ LoT e.uR.~J L~v2 -- -- _. 3wi ~-Z- LZ. 1 ~ Z, y ' ~~ gip- C1t= _~L.S~''~~1Z.LC-i?~ •----__ -_ .~ ~- N ~ 1 m ~'~ ___ - i I I i -' ~~ ~~ ~~ ~3r~~-'L 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 1000 pgallon capacity manufactured by 4. $ench mark 5 ~ S~ A~oV~ _ ~. Divert surface water around system to prevent ponding at the uphill side. C C isconsn _ _ _. _ _ __ __ Department of-Commerce _ _ _ - _ _ _ _ __ AtrG 2 2 ~~~2 sr. cROiXC Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 _ _ --- 64877T-- y~vw. commerce. state.wi. us/sb Scott McCallum, Governor Philip Edw. Albert, Secretary August 16, 2002 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/16/2004 A7TN.~ POWTSlnspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Dan and Kristin Krueger 161ST Street Town of Hammond, 54002 St Croix County NW1/4, NW1/4, S20, T29N, R17W Lot: 48, Subdivision: Hammond Oaks FOR: Object Type: POWT System Regulated Object ID No.: 866052 Description: 450 gpd design wastewater flow mound system. Identification Numbers Transaction ID No. 776890 Site ID No. 649169 Please refer to both identification numbers, above, in all correspondence with the agency:. 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 Waste Treatment Systems" SBD- 10691-P (N 01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10706-P (N O1/O1). • 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 mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. ~ A • Maintenance information must be given to the owner of the tank explaining th pc~ le~ig~the filter is required. Access fo the filter for cleaning must be provided per Comm ~proc,_~,~~rit~er+~i • A Sanitary Permit must be obtained from the county where this project is ed in'dicr~~ith the requirements of Sec. 145.135 and 145.19, Wis. Stats. C~ ''~~,E"E„~~ ,l, /' . • Inspection of the private sewage system installation is required. Arrangements fo~ ection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)( ,Wis. Stats. . ~: ARTHUR L WEGERER pale 2 8/16/02 A copy_.of the approved_plans,.spedfications and..this lettershall-been-site-duringeonstruction-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 meat 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. Sinc ly, Fee Required $ 175.00 ~ Fee Received $ 175.00 ~ Balance Due $ 0.00 Thomas J Perkins POWTS Plan Reviewer, Integrated Services WiSMART code; 763' (262)521-5064 , 7:30-4:00 tperkins@commerce.state.wi.us cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 i r TITLE SHEET Page ~ of 7 FOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance Keith the Mound Component t4anual SBD-1057 P and the Pressure Distribution Manual 5BD-10573-P CR. blgq~ Clz. ~14q~ LOCATED IN THE ~w 1/4 OF THE ~1w 1/4 OF SECTION ZO~,T Zg N,R ~~ CJ, TOWi1 OF ~-~f~ytiJ OyJ~ , S~f". C.(ZlJ.LX COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHE,:,T PAGE 2 Of 7 SYSTEM rlAdAGEMENT 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~IBER CROSS SECTION PAGE 7 of 7 PUriP PERFORI4ANCE CURVE PREPARED FOR ~P~N ~a.~b ~~,z,~.sit ~ ~z.~ES~~~ tL[89 svMMt~- s~~-r ~~-L~w~,~J ` ~ t S~l~o2 RE~~t~~U ,1UL 2 '~ 2002 SAFETY 8 BOGS. D111. PREPARED BY u1EGEE~ER SOIL . TEST S tvG AND . DES I G~'V S~1~V = CE P .0 . Box' 74 421 N.liain St . River Falls, TdI 54022 Phone 715-425-0165 Fax 715-425-6864 JOB N0: C~Z-~•~~ 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. Theo rating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th utlet filte shat( 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 ugfi o$"the if jt'er 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 tune of a triennia! assessment, maintenance personnel shah 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 S tem 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 far frost protection. Influent quality into the mound system may not exceed 220 mg/L BODS, 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 [SBD-10572-P (R. 6/99)] arid 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 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 far service and assessment shall be seated 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. Continoencv 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 _ 1. ~S- 3~~ _ ~ (~ g ~ ST Z~~v - The system installer a~t ~\~_ 2G B - 6 ~q S V`rr a-2.1/` The tank manufacturer at $oc~ ~ 3zs - h ~s~ w~~~~2 7 The effluent filter manufacturer at ~'U~ ~ ZZ[ ~ 571~Z Z,f~g~r-~ The pump manufacturer at `-- - ~3 Q = ~ - ~ '~ G w ~.US - PLOT PLAN Scale 1"= 30' ~~~ 7 ~ ~~~~ ~ B~~`-~ ~y,~~•, Page 3 of _1 ~0 1ut~T C-0)~1.Pfle-T / ~ o ~. ~ ~sT~~zs3 ~N PvC ~ `Ri'!3 ~t~A ~•3 q1 ,~ 15 i5 ;~ J 'M~ '"/~ 1'44-Z- ter`-1 tf-- - fit. L 0 ~ - 0 ~ oar s/Z t' ;!:~ LET euR.~l L'`~2 - . _ _~ Q,o ~Zfi'D1v S Cv~ _ L~`E - SA C -~ ~- N ~ -1 ~ , m ~ 1 ... . NOTE5: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( 2 required). 3. Septic tank to be 1000 p gallon capacity manufactured by 1~.~ l ~ N1Z CUhJ ~~~=~ 1~ - l~Ul~ 2~3~t.. ~-~ ~TL~IZ 4. $ench mark 5 ~ S~ _ fN~~V~ - ~. Divert surface water around system to prevent ponding at the uphill side. P_pproved Synthetic Covering ASTi~i C33 .I Medium Sand Topsoil-" t ~ ~ ~~-- 3 E - Page ~~ OT 7 istributian Fipe jc W J -~ F Elev. 01 R • 5 ;, „_ o . . _ . % Slope ~ . Distribution Cell of ~ Force Main Z" to 2 Z" Aggregate From Pump CROSS SECTIOiV OF A MOUVD SYSTEM Linear Loading Rate= Q - O GpD/LN FT Design Loading Rate=p.3gCPD/SQ FT -~ ""~ Sian -e~-- . ~nrro M-=- •~ L ` . ~ A ~_ Ft. B S 0 Ft. I ~5 Ft. J 7 Ft. ' K ~_ Ft. L 6S Ft. ' W ~ ~ Ft. Flowe d Layer D \-0 Fi. E 1.3( Ft, F t~, S Ft. G 6-S Ft. hi ~•~ Ft. ~. ~ -Observation Pipe 8 ~ K A ~----6.e---- --------- ------------ = ------ W o--+-~---~------- ----- ------------I--o Force Main . $~~ . Distribution ~ , „ ~ ~~ Pipe Cell of z to 2 z ~ aggregate Observation Pipe (.'~achbr securely) - PLATT VIETd OF A MOUYD SYSTEM Distribution Pipe Layout Page S of 7 Place the holes at the bottom of the distribution pipes at equal spacing. Remove alI burrs from the pipe and holes. Extend the end of each lateral up with the use of Iong turn or 4f° fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valye,:tlireaded cap or threaded plug. provide access from final grade for the valve, threaded cap or threaded plug. - Fvc Fvc Lateral ~ ~ Manifold ~~ C ~-- Lateral ~~- L'H'N V \E~ __ a- _ . P ___.__~ ~ r~C Cis Bon - -o h YS'L11 FJ ~ 4- -- __-0 PVC w~c~, ~ ~riiJ i o- _ ~q ti~v - P ~_ Ft. ~ ~ ~Nole Diameter ~~3 Inch- S 3 Ft. - Lateral ~ ~ InchEes) X Z3 InchPS Manifold Z Inches Force Main " Z Inches ~ of holes/pipe 9 ~ ~~ - Invert Elevation of.Latera1s100.0 Ft. ~u ~~~1= S. 33 x b = ~ 31-~18~ 6P~`-1 ~ 3P ~G1ptJ P -pE w /N1CLT1 s ttT• Gtp ' Ft N tgI}p G ~t•U E !s'nrta. 1 UJLET Approved joint w/ PVC pipe A,lk IuTAKE ~ ~ COt.7DUtT .. ~ ~ I .• . _ ~ I --~ PROVIDE I - ., •,;~ ~7'AiRTIGHT SEAL. I I • • ( II sa ~~~c f I I I Z~tB~. ~~~ --'~ ~ I I I AP P r o v e d • ~ _l~ I I II joint w/ s I ! r -ALARM PVC pipe I • c I I 1 'I I ou S_00 CLE1t ~_ f'G I ~ '~j' PUKP -~ I --~ I OFF 0 COUCRETE T-l _I.]~ 1 ~U. ~r ~ ~ BLOCK 7 RISER EXIT PERMrITED OIJLy IF TAlJK MA>rLlFACTUR]`ft Hq5 SUCH APFROVAL~3NApPQortp 8>:DD s N4 SEPTIC F ~ SPEGIFICATIOt~1S DOSE Tt.-JKS MA-IUFACTUitCR: w`~~Z ~UC2~~ f,JUMBER OF DOSES: ~' I TA!`!K SIZE : ~ ~C~ 1 6 S O PER DAB • _ CALLOUS DOSC vOLUME r ALARr1 MAUUFACTURCR: - S~S• ~-~~T~1ZO S~ST~~-{ -!~CLUDIUG 6ACKr~o w: ~ l ~ Z- GA~tO-~S MODEL -..It1M8ER: L ~ l ~w taPACITIES: A = ~"o IuCHES OR 3 0 6 GALLONS L ~' SWITCH TYPE: _ ~C~Z~R-~~ 8 = Z IuCHES'oR 3~ G~.LLOUs _ PUMP MA3JUFACTURCR: ~~V Lr~~ C= ~ l~Z MODEL fJUMBER: ~~ 5 ~ 0 ~ Z IUCHES OR GALLOIlS Z'd~ = INCHES OR GALLQf`75 SWITCH TYPE: ~~Z~~~ R AR bt iJOTE: PUl1P A1J0 AL A M E TO MIlJtMUM DISCKARGE RATE 31•~g GpM INSTAlLEOO A! SEPARATE CIRCUITS VERTICAL DlFFERElJCE DETW1<EU PUMP OFF AUO..OISTR-BUTIDIJ PIPE.. ,S'~0 FEET -f- r'ttl~IlMUM AIETWORK SUPPLY PRESSURE ~ , C- Sc~ FEET S_O~c,t.~~ ~'~y~ -~- 85 FEET OF FORCE MAIAJ X Z" ,QF~o Ft FRtCTIOU FAt:TOR_.=~_r~ FEET TOTAL Oy1JAMiC HE:AO = 2.3'3 FEET - ' As per manufacturer t~•O gal/in. Liquid depth 3gh ' Combination Sep1:,3.c~.Tank and PUMP CHAMBER CKO55 SECTIOtJ AAlO SPECIFICATIOt`1S ' PAGE .~ OF ._ . •VEUT CAP ~~ WEATHER PROOf • ,IUUCTIO-.! 90X . ti C.I. VEtJT PIPC ~ ~IPPROVED LC)CK1AlG ~ 1Q' FROM OOOR, MAIJHOLE COVER wi"M :it1~pOW OR FRESH ~ wA(iN1tJG LAaEL• Goulds Submersible Effluent Pump i~+r ~ o~ ~ mooe~ 3871 EP05 APPLICATIONS Specifically designed for 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: '/" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge s¢e:1'r~' NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. `) ~,J ®1995 Goulds Pumps, tnc. • 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,l6/3 SJTW with three prong grounding plug (standard on EP05). METERS II FEET 10F 9 3i a 2! 0 a w U a z 0 J O s 5 4 3 2 1 0 2l 1E 1( 00 lU 1U :3U 40 50 GPM 0 2 4 6 8 ~ 10 12 m'/h CAPACITY Effective May, 1995 • 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 assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plastic enclosed 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 "P' or "AC°.) ~ ~;;-- j ~ ~ - ~ 1._ - .. ~ ~Y ~f, ~ 't` I p " fi ' 23 ;36 i . i i 3t q ! j _ ' j I ~ ~ ~ - EP0 ' ' I i I --~ ~ ' !. 5 - i I ' ( i ,* s Wisconsin Department of Industry, Labor and Human Relations Division of Safety and Buildings SOIL AND SITE EVALUATION in accordance with s. ILFiR_83.09, Wis. t •7riesidential /Number of bedrooms ~ Addition to existing building [r]'New Construction Use: ^ Replacement ^ Public or commercial -Describe: Q Recommended design loading rate bed, gpd/ft2._ '. ~ ._trench, gpd/fi2 Code derived daily flow ~- 9Pd 2 ~, ~ 2 _ ~ d/n2 •7 trench, gpd/fit Absorption area required ~_bed, tt trench, ft Maximum design loading rate ---F-bed, gp Recommended infiltration surface elevation(s) S;~ ~ ft (as referred to site plan benchmark) Additional design/site considerations N/~, ft Parent material ~DESS• DVr~ D~NsL~' T/~~f Flood plain elevation, if applicable . _ ..__ ~_ e..~•e.,, ~., Gai Holding Tt S Suitable for system ,., ~ U Unsuitable for system ^ S lld'U Boring # Ground Qp elev. -1 b . fin. Depth to limiting factor Horizon Depth in. Dominant Color Munsell ~ o •$ ~o yR 3l3 Z ~• ~9 ~o y 3 r~ 3 iv yR ~/ ~•y ~oy~~/ Attach complete site plan on paper not less than 8 1!2 x 11 inches in si include, but not limited to: vertical and horizontal reference point (BM), percent slope, scale or dimensions, north arrow, and location and dish APPLICANT INFORMATION -Please print all inform Personal information you provide may be used for secondary purposes (Privacy Boring # .~~ . Ground elev. yg•~.tt. Depth to limiting Ou I ^s ~ ~ ^S SOIL DESCRIPTION REPORT Mottles Texture Structure Qu. Sz. Cont. Color Gr. Sz. Sh. ,.~ ~ ifshk .- si /L. Z,w+ S - s~~ ~ ~» MOTS I Ufsc.l 1 of Page ~ of ~' ~~~ ^ s 0-~ ~ 0 s ~u ( •~~~~ Consistence Boundary Roots GPD/fiz ged ,Trench ~ ~ i:v ~ •~ ..s ~ CS -- .5~.4 ,,~,r ~ - .s~ •~ Remarks: n. y ~o y2 3l -- ~ / shy Sti cw ~ ~ • s .~ 5i~ z fshk ~. ~ s ~ ~. •/ O~ S~[ Z,•M h,~ ~ ~i2 ~S . s, . 4 of 5 ~' M ~ 3 5/L / f `~'~ ' : ' ~n Remarks: {~p~ CST Name (Please Print) Rpi3~s'•r' ~Lp~. `C,~T Signature _ Date Address /1. ~ ti / _ //'r .fir 7/S• 3~G ng~ ~ S CST Number zzC~375 V,t,~ $ ~ ~[~ L ~~~ S01L DESCR1PTlON REPORT PROPERTY OWNER ~~ ~ ~ .S (7 g `o T- ~/g ~AHHoN~ PARCEL I.D.# s I y Page ~' of •'1 . ~i .2 __--- ~~ Remarks: -------- Horizon Depth Dominant Color in. Munsell Boring # Mottles Qu. Sz. Cont. Color Structure Consistence Boundary Roots Bed ~ Trench Texture Gr. Sz. Sh. , Y • - Uibricht & Associates Private Sawaye Consultants 655 O'Neil Rd. Hudson, Wis. 54018 CST 22 43~ S \~ i ~ .- ~P . 3 o f 3 - ti ./ = ~8~~~~e p ~' r-s ©T ~f g Mo~,~D sy/5T• ~~~ • wi~ ~~.~1 S'>MNp ~/t ~/oZ ~ ~~~ v ~` w ~M ~ 2. SET ~3 ~~.. 5-Ft~~ La T L,N~ ~ / G~~ . Olr ~ I 3~e ----- ~/ ~o ~g ~ ~ .. j- 7l, L, L . /3f ~ ~- ~~ ~ ~ ---.._ /9 , 39 , ~~ 0 V l~ to ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address S 5 mmi X i~ls~ ~+ Property Address ~ 15y OOZ (Verification required from Planning Department for new construction City/State _~1Q1'Y11'Y~~ n('~_~ ~'1/ Z Parcel Identification Number OI~ - I Og ~D -y ~ -O©O LEGAL DESCRIPTION I~IW Property Location %,, '/,, Sec. ~ZU , T~N-R~W, Town of CJYl Subdivision t-t (~~rpm~n(~ (~ Q~~S ~U C`~ I y } S10Y1 Lot # L Certified Surve Ma # ~- ~-- Y P/ ' J Volume q .Page # Warranty Deed # (~ ~ 7 g ~ ~ Volume ! I ~Z .Page # ~3~- Spec house ^ yes [~ no Lot lines identifiable, yes ^ no SYSTEM MAINTi~.NANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance 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 fom~, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on-site wastewaterdisposalsysrem 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 and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days the ee y ar expiration date. t SI A ~ "OF PLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the r perry esc ' ed above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ /Z/ OZ SI A OF A ICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with ttris application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I 2932;' t;32 STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY DEED This Deed, made between Hammond Land, LLC, a Minnesota Limited Liability Company Grantor, altd Daniel D. Krueger and Kristin A. Krueger, husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Oaks Subdivision,Town of Hammond, St. Croix County, EtE346£31 KATHLEEN H. NALSN REGISTER OF REELS ST, CRDIX CO., yI RECEIVED FUk RECORD 07-L4-200L 8:;f@ All _WMZ!!NNIr CtEU Lr.=~/i 3 kEC FEE: 11.00 TRANS FEE: 77.70 COPY FEE: CERT COPY FEE: PAGES: 1 I Name and Retum Address ~I~I1_2~' .tt>. ldt~~ ~ 018-1086-48-000 Parcel Idantitication 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 ceten6on,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 County, 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 $25,900.00. Dated this __ 12th day of July , 2002 Hammond Land, LLC AUTHENTICATION Signature(s) authenticated this _ day of , r TITLE: MEMBER STATE BAR OF WISCONSIN (If no[, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Paul A. Baillon, Attorney at Law (Signatures may be authenticated or acknowledged. Both are not necessary.) ~ by ~_~ a, P ryes ed nt . Austin J. Baillon ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Ramsey County. ) Personally came before me this 12th day of July , 2002 the above named Austin J. Baillon to me known [o be the person(s) who executed the foregoing instrume and acknowledge the same. PAULA. BAILLON 'Paul A. Ba1110R j~:~' NO7ARYPU It. Notary Public, State of is ' 'sin 15sicN e:.~,aey lo,.xaos My Commission is pe a January 31 2005 ,) 'Names oC persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED 57A7E RAR OF WISCONSIN FORM No. S - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 81x1-a55-20]1 ~ ' of ~x Fe 7n" {/{ atf}-lpl SONr7~03t1v1rN11 fAC~~( t ' ,t['tttt w,tO,Sr.Nf '1611SC1 I I dCt[tt ~~4 tY Fygq {•tw 2Yrw 2~nt Ftt•t J.'M .4'Mt y9~ ...t.. pp4~ "~`~-i i ~+~~ ~ R$Y ~ ~ r ~ r . 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