HomeMy WebLinkAbout018-1086-57-000Wisc~r~n Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERbAL 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: City Village X Township
Jensen, Rick & Carieen Hammond Townshi
CST BM Elev: Insp. BM Elev: BM Description:
r 0 • d DD ~ 6 ~ C~
TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic ~ d
Dosing f ~
rv / D~
f ~
Aeration .- /D
Holding
TANK SETBACK INFORMATION
TANK TO !L W L
In B DG.
~ Vent to Air Intake ROAD
Septic ~ ~O i ~~ ` t
o w ~
~
Dosing ~ Z ~ 6w
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer ~ Demand
GPM
Model Number ~~ ~I ~3
TDH Li! ~ Sp
1 Fri (tio~LQ,ss System Head
"!/ Tim b ;t
For~a~ Lent Dia. ~ i, Dist. to n
SOIL ABSORPTION SYSTEM
ELEVATION DAT
County: $t. CroiX
Sanitary Permit No:
420691 0
State Plan ID No:
/~
Parcel Tax No:
018-1086-57-000
Sectionlrown/Range/Map No:
20.29.17.677
STATION BS HI FS ELEV.
Benchmark C ~- ~ ~ ~ / D~ ~ ~
Alt. BM ~-t- I- ~- ~ ~/ 3
7-
Bldg. Sewer , 7 2J b • SS
St/HJt plet I b a- (. S p~/
D 1O ' 3d
SUHt Outle ~_ ~-
Dt{nlet
D B~ 5 -~' 12 0 /. 7 s . bS
Header/Man. ~ / /
( - /
Dist. Pipe ~ 7i ~
/ " 1- ~~
~ 1
Bot. System . 7~ ~. o
Fin I ra
o
~s
3.2
~b o- s3
St Cover ~ T ~ -S
5.3~ q ~ ~
BEDlTRENCH
DIMENSIONS Width ~ Len y~
eiC' No. Of Trgnches
(/ /bG_ Ott PIT DIMENS No. Of Pits Inside Dia. Liquid Depth
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM ACHI Manufacturer:
INFORMATION T CH B OR
ype Q~S~stem:
Vt/. , //~
~ >I ~~
7 Model Number:
DISTRIBUTION SYSTEM ,~ ~ _,
Header/Manifold Distribution x Hole Size x Hole Spacing V Air Int
~ ii
~
Pipe(s) / ~ / ~
I ~ ~'
?
J 1
Length
_ Dia_ Length Dia_ Spacing
SOIL COVER x Pressure Systems Only xx Mound tjr At-Grade Systems Only / " v~~`-~~
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bedfrrench Center Bed/Trench Edges Topsoil
Yes No
[,.~i Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:_fQ__/~jl~y, _ I~n-spection #2:~/1~ ~r~~'~
Location: 868 161st St H^a~mmond, WI 54015 (SW 1/4 NW 1/4 20 T29N R17W) Hammond Oaks Lot 7 ~ K ~„YQW Parcel No: 20.29.17. g#7
1.) Alt BM Description = 1-~T ~i~'ji(Q~ ~ f_~ ~ pti, i n,Q~_ //
2.) Bldg sewer length = 26 ' ~_ " ~f' "'~
- amount of cover = ~ ~' ~
3.) Contour =Gt ~ ~ /
Plan revision Required? '', Yes !o I I I^ ~~ i Imo- ` ~ ~ ~,
Use other side for additional information. l t ~ _
~_~_~--~---I '-- -- -- - -_~~ ~-- -
SBD-6710 (R.3/97) Date Insepctor's Sign lure Cert. o.
.~.
' gal w, washirtgtatA~e•. P-o_ Box7i52
---
__.__f}?pasttnent o._ fi ~Q~??i~eTC~ -_.
~~utary permit Application
mfonottion YO1i provide
In accord wid- Comm 83.21. QVis. Adm. Cain. Dcrsoasl + ~r x Adf tV nrl -
l_ Application Iafoematlos- - Pimse Pc"int Ali Inf'ormalion
Yra .crty s ?Yams
_I l - ,tom r ` • ~ ~ /S'_. _~ ~ '~ ~'1---
ii Pt~rty flwucr's MaiGtig hddtrss
' J~lU /e t' ~~
__ti._-__
~_ k
Citv, State
Site Addres:
~~ ~ -
:-- --- _
Sanitary Petmtt N1Lrr:txr
~-zo ~ 91
U Chccl if Rerisio:r
State Plan i.D. Numhper
__ ~ d 1...
Parcel tiurnhcr
~~~- !c
ropcrty icwation
C) , ! j
~ Sr
Subdivision Natnc
1
1G l ~'
~ , ; S % ~S ~_ ° ~~- ~-/gym ~ ~~ ~ C~ ~ ~s`
._ ,
ai o~ S rw UCiry__ . . ... ~
'_"__- check sll that apply) r _...__.~__ __.__
! rj_ TS Of 13~~~ ~ UVLQa~e_ ~
4 , :sr 2 T~mrly i~wcllisaR -Number of Bedrooms _. _ -.-. - -
-ribc tlse ~---- V'ro`rmship "~ ~~ d ~-~ - i
U putrlictCotnmcrcial - L)tx Sb Nearest Rnatl
n StatcAwncd CC ~ ~S i n n/~ \ ~~~'' O•S~+C6 t/ SW~
{ (Q -?C-_-- M6a.N.dC C~.J Cow fete tiuc B if appticabie)
't: {Check only one boa on.iine A (tutrtabermg scheme for utternal rise}. P .. _.__._____-.
-ijj, 't`ype of Pe --• For County tlcc
A. 3 ^ gep)same°t of 6 0 Additioa w _ _ _
1 idew 2 ~~ Replacttrt~tt Sy~em Tam S
Date 3ssuul
Jysrccn t
B - ^ Chtck if Sasita~y Pwtmir Prtww~lY Issued
o rile ~~ ~'t .3
sir. ~ROI
ZoNrN~ C~~NTr
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.~
s,`~ ~ ,
N r:+ C `~ 5
.._,.~- - --- r .
_ ./ i
~~~ -~ S"~ ~ G~
.. ~ BIocS: Kund:cr__ i
-- - ~(:JD1 titunlrr
t: {Chcel: tsII that aPP1Y?( - scheme is for intematt arse)
11~.1ype of l'ernri d7 U Sand Filter' Sp I~ Cotuaveted iiFcdarui
dd ^ Non -Messutirul LrGrouni 21 `~`1 43 Q SistglG 1'~ 51 U DdP Lry
73 Q Presarrizctl in-Grartr~ 41 0 Holding Tanl:
3t) [1 t7tficr ---
d5 ~ Ai-Grado -W U Aerobic "i'cnamaa Uuii d4 ~) RtxirarlaonE P~at~ ~ `
,~ ~t Area Worrrnat'so~ t' pcr~fation Rare Systew Bkvanon
Design Flow its Dtspessal As'et ~ispelsal Area Soil Application Ft_ fMiallrtchi
tjte~~:rriF Ptul+OSerl Ra1e{l'~a1s./Daysl59- ) ~ ^
- prefab Sitc ~ Stec
--- htamtf3cuuer
_.~___`-._ t r3~=;~•n Taal Number
Vl. Tank Info ~ Cnrlcrctt Curutructt:d
Gallons ~ GaQons } of Taxis
Septic or Holding Tare;,
i New i ~tistu
16ti~ -` ~/r yS~=-
G s.U I `"~nr..rat,
i
__ _~_. I
i~utal GrsQc '
L•levatiun
~v®,s
1 Fit>rr i lila'tii
cl.•~. 1
1
T
fh~smg CWmbcr ~ ;
___..._ for iastalhdion of the POtirTS shown on the att3trLed plsu-s.
'Ytl. tR~ibility ~teatettth I, tLe ~+ a Ausincss Phnnc -.iumlxr ~
-------- Pluto 's Sigt[twte -~.fl11JlFRS Alumt+e: ±~ ~~ ~/ /
i'larahcr's IYamc• (l'tinr? ~ ~ .-i ~ t / ! S•° { , - ~ ~~- C /~,~_ bJ .
_ -__. -
_ __ ---.--- ~j'
nlunt`-r"s :'td3c~cs IStrecs. ['i -' Sttte_ ?. .ock) / ~, J t S' ~~/ `2. O _
i l rl.d ~
~ / , v t ~~ ~ `~se (IitlV J -- ! -•~- ~' ,d ry~rtmg Agent Siga~o-re t?i~t Sranips ~`i
~ '4t1yI, i"pttniytY}epartmeu Datc Iss>w
_ _._ ____ -- Sanitary Pcrrnst C-cc {incindes Gtoutuiwaar `
`,7p' ~ i F~isa ruve:i Surcharge Feel
R
i_3 rlwnrr Circn ieritial Advertie 3 ~ ~ ~ . I,Z ~,?j ~ -_ - -
_ _^ . ~.- - ----1-- - ._ ~ --
1~tLC177iinaCnll __.. _.-- --- _ n,,
T:~. c'«nditinttc of A.pprovallFceaS+sas fcsr l#zsapprowali 1 ~ (~~` _ _ O~Z ~. CBt~e /oT~ .
nn I ~ v~~.a7~" _-~~D.^ Q ice`
'~ l `~+~ ~ ,t ti2w ~ lid-"r*- ___ - -
u _~ C C_~~ r 1~ {to the C att7) t na ~ O°t Items thaw 8If.1 : i l iaeha hr size
`-~ ~~ S S ti c ~s 1 S
~~
J
• PLOT PLAN
'~ Scale 1 "= So '
LET S8 X S~6(~ES`i~~ .
._ _ ~~ ~ ~ W ~1. L Lo c,
b
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Page 3 of 7
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.~._ .-~-J a-Q-'-~ .11ZM Dtq. 2E' BIi~Z .--oTeoR~J1.z~ly~lg~z_-~'~1~'-SST
NOTES : ._
1. Elevations shown are existing ground elevations unless otherwise not d. .
2. Install 4" observation pipes with a e
3. Septic tank to be lOOp /(~.SOgallon capacity manufacturedrb~uired).
'~ ~~cz COyvC~ ~ ~ ~} Loo Z~-+~ ~ ~1~`Tt~2
4 • $ench mark • S~_ p~~~~~
~~. Divert surface water around system to prevent ponding at the u hill s'de.
P i
. ,
.
isconsin
Department of Commerce
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www. commerce.state.wi. us/sb
www.wisconsin.gov
Scott McCallum, Governor
Philip Edw. Albert, Secretary
August 29, 2002
:3`~~ 0 ~ 20C2
CUST ID No.267341
ARTHUR L WEGERER
WEGERER SOIL TESTING & DESIGN SERVICE
PO BOX 74
RIVER FALLS WI 54022
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/29/2004
ATTN: POWTS Inspector
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
SITE:
Rick & Carleen Jensen
161ST St
Town of Hammond
St Croix County
SW1/4, NW1/4, S20, T29N, R17W
FOR:
Description: Three Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 867594
Identification Numbers
Transaction ID No. 783092
Site ID No. 649537
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:
General Approval Requirements:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1)
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD-.10706-P (N.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
~iv~da.~lp are prohibited.
~~~ • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
~ OF COMIMERCE area. chs. NR 811 & 812c
r~r a
~~~~^• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
I$PONDEN~- 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 8/29102
Owner Responsibilities:
Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/installation operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely,
Charles L Bratz
POWTS Reviewer II ,Integrated Services
(608)789-7893 , 7:45 am - 4:30 pm Monday -Friday
cbratz@commerce. state. wi. u s
Fee Required $ 175.00
Fee Received $ 175:00
Balance Due $ 0.00
WiSMART code: 7633
cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544
Mound System Management Plan Page Z of 7
Pursuant to Comm 83.54, Wis. Adm. Code -
SeQtic 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 shalt 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.
Pumo 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
shat! 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 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 inifial 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 [S~9_.1~9~.~-P-{~;.6fggj) arid local or state rules pertaining to system maintenance and maintenance
reporting. 5 gD ,) O 6Q t - P
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 far 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.
Contineencv 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 _ ~ `~ . ~ ~-b _ 4 6 ~ ~ S`)'-- ~,(~ `X
The system installer at 1, l S - 3~6- ~ l z1 g~'"f-hJh'1A-1-~s1Z
The tank manufacturer at ~`~p _ 37 ~ _ ~~j~j 1.~~ ~~
The effluent filter manufacturer at ~~- ZZ~(. - S7~Z Zi~3
The pump manufacturer at --- - ~73~-~-~-~~ ~ -"~QVt..ps
AT.nT D7.arT
'~ Scale 1 "= So'
Page ~ of 7
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--- - .~~
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 ~0001(~SOgallon capacity manufactured by
vv l ~ COrv C2NT~ w / _ /~ - loo o Z,M~ Wiz., ~t ~`T~12
4. $ench mark •_ Ste, r''SSOU
5. Divert surface water around system to prevent ponding at the uphill side.
Paoe L~ Or y7
Approved Synthetic Covering
AST~I C33
Medium. Sand
Topsoil
~-
istribufion Fipe
0
i b
Z ~~ Z % Slape .
Distribution Cell .of Force Main
i~, i~.
2 to 2 i Aggregate From Pump
CROSS SECTION OF A MOUND SYSTEM
Linear Loading Rate= 6.O GpD/LN FT
Design Loading Rate=d.38GpD/SQ FT
rna-t~-P~a-~i~o n
-~
~- - ~ <
A G Ft.
B ~ S Ft.
I 1 b Ft.
J S Ft.
• K ~ Ft.
L q - Ft.
W Z 1 Ft.
G
Elev. q~-O
Flowed
Loyer
d ~•S - Ft.
E o•~S Ft,
'Fp.~ Ft.
rs d. S Ft.
F 1. ~ Ft.
,} -Observation Pipe
r -'-' ~ --- ----- -- I Access
c-~-•--------------------- --------------- ------ ~ '~ gax
W ~_ ~_~ -- __------_ 1 Force Main
t~J~ti-S ~S 7'
Distribution ~ Ce vo~~~s ~ `~, ~~.~p
lI of Z" to 2 2°
Pipe aggregate •,
- Observation • Pipe
(kse~br securely)
: PLAN VIEr~l OF A MOUND SYSTEIT
- ._ _. - Combination Sept,3c~Tank and
• ~ ~ PUMP CHAMBER CROSS SECTIOtJ AtvO SPECIFICATIOIUS ' PAGE ~ OF
.-
•VEUT C1~P ~• WEATHER PROOF
~UAlCT101J 90X .
ti C.Z. VE1~17 PIPC , APPROVED LOCKIIJG
~ 10' FROM OOOR, ~M~l1JHOLE COVER rvl'~!i
:itAIDOW DR FRESH 1 ~'"AR•NIUG ~-~6EL.
~ ~ ~6dU-T~~rr P
• Ft iv tg~
G~'soE
tB•Mw,
- t1,JLET
A rov /
PP ed
joint ca/
PVC pipe
A.~IUTAKE -i
qZ }
~'~
z>~~ ~~~
~-1Bop
CLEY.BD ~~ FT.
~ cora~u~r
r~ ~ -
/ I
-I
I
L__
Y~ Flli`1,
18' /+Ilp.
V ~ ~ ----------
~\
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• ~ l~
~PROVIOE I
AIRTIGHT SEAL I i I I
I
--~ I ill
I III
I I I ALARM
a I II
I I
I I ou
C 'I I
I
PUMP ~ --~
` OFF
D
CouCRETE
~ 80 •~oo -- eLOC-c,
1
Approved
joint w/
PVC pipe
~• R15ER EXIT PERM1TfED 0-JLy IF TAAJK MAUUFACTURER HAS SUCH APPROVAL 3"ApPRotit`
. - ~8><OD t rv 4
SEPT-C F SPECIFIGATIOt~1S .
DOSE
•r^-.JKS MA~IUFACTURCR: ~L~~L ~~~~~ I,J~IyER OF DOSES: ~'~
PER OA,.
TA~tK ,(ZC : - ~ O Clb 1 ~ S O CALLOUS DOSE VOLUME r
ALAR11 MAUUFACTURCR: S'J ~ ~~-~~}ZO S~S~~.~' INCLUDiA7G 6ACKFlDW: ~l ~~-~ S GALLON:
MODEL 1.lUM8ER: `~ ~ 1~"tiV CAPACITIES: A. l8 iuCHCS OR 3 O 6 CALLOUS
SWITCH TyPC: __ ~ N~-CUB--~ g = / Z I~1CHE5'OR 3 T G~LLOUS
F'UMP MAIJUFACTURCR: GGVt-~S C:_b3/5~-IUCHESOR ~~~'~SGALLOt.Is
MODEL 1.1UM8ER: ~OS 0~ 1~.ZS ~Oj~, 3
' it~lCHES OR , I GALL01J5
SWITCH TYPE: ~~Z~1Z IJOTE: PUMP AUD ALAfLM ARE TO bCT6`OS
MIUIMUrI DISCKARGE RATE Z '3Z GPK IuSTrAILEO OAJ-^SEPARATE CIRCUITS
VERTICAL DIFFEiCE1JCE DETWCEU PUMP OFF AlJO..DISTR18UT10-J PIPE.,~$~S~FEE7 , / ~~
~- Mtt.tIMUM AIETWORK SUPPLY PRESSURE , ~ , b •S~ FirET t=,~~ l~ 3~
'I- ~S~ FEET OF FORCE MAi1J X `'~4F~oFCFRICT1o-,1 FACTOR.. ~'S ~ FEET _
TOTAL Dy1JAM1C HE:AO = Z_b`~2" FEET
As per manufacturer "`'
1`1.0 gal/in. Liquid depth 38 .
' . ~..
~.
~~
APPLICATIONS
Specifically designed for the
following uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
• Water transfer
• Dewatering
SPECIFICATIONS
Pump: EP04
• Solids handling capability:
3/a° maximum.
• Capacities: up to 55 GPM.
~ 1~ • Total heads: up to 24 feet.
• Discharge size: l'/z°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/a' maximum.
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet.
• Discharge size:l'fz' NPT.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104°F (40°C) continuous
140°F (60°C) intermittent.
Goulds ~~~_°`~
Submersible
Effluent Pump
~ r~
u
3871 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 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-
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".}
30 *' ~
~
25 -- ~--
20 iZl_3Z i ~ V
i ~
15
~ ._
i -
~• ~ ~ EPO
"
10 i ! ~ ' S
i
s j ~ -
1
i
LU 3U
au 5U GPM
,
0 2 4 6 8 ~ 10 12 m°/h
CAPACITY
• 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).
METERSIIFEET
10F
9
s
0 7
a
W
v 6
} 5
0
a 4
0
~' 3
2
1
0 10
®1995 Goulds Pumps, Inc. Eftectlve May, 1995
83871
:*
Wisconsin Department of Industry,
Labor and Human Relations
Division of Selety end Butldings
SOIL AND SITE EVALUATION
in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less Than 8 1!2 x 11 Inches In size. Plan must
Include, Dut not limited to: veAlcel and horizontal relerence point (BM), direction and
percent slaps, scale or dimensions, north arrow, and location and distance to nearest road.
R 1C1rc. S'E~S ~1
APPLICANT INFORMATION -Please print all information.
Personal Inlomislbn you provide may be used for seaondery purposes (Pdvecy Law, s. 15.04 (I) (m)).
Property Owner ~ (~ H Q I Qp ~. RAJ ~ C b C~O Property Locatla
V }J ~~ ~•~ ~!'~ 1 I IO A) ~ ~ Govt. Lot ~~
Property Owner~'Meiling Address Lot N Block!
332. NiU~~sorA sr: ~E~sr lyo~l S~
City State Zlp Code Phone Number ^ Clty
Sr• Pnv~ , Mme. 155/o I (~S/ )222'SSss
~ 2
Page _ of
5T: G~POi'1L
~. M O
aiR•ioyy• so•ao
114 ~ij(~1l4,S ri/ T2'~ ,N,R I ! E (or) W
iubd. Name or CSMM
~~HHON17 ~ Neo~R j ''vY. l ~-
[~'1`!ew Constructlon Usa: L+1 „esidenilal / Numtrer of bedrooms 3.- Addigon to existing building . -
^Replacement ^ Public or commercial -Describe:
O Recommended design loading rate bed, gpdfltz trench, 9P~~
Code derived dally pow y~ 9Pd
Absorptlon area required ~_bed, g2~_trench, It 2 Maximum design loading rate bed, gpd/R~ • '~ tr~• 9~
Recommended Inllllrallon surface elevatlon(s) Su ~ Il (as refened to site plan benchmark)
Addltbnal designlsite conslderalions N/ / tl
Parent matedel ~O Etis ~ ~+~ OFNS~- ?'~ ~~~ Fbad plain elevatlon, if applicable -~--
Convenlional Mo~u ' In-Ground Pressure AT-Grade System in Fifl i 1~ Shr9 C
S Suitable for system ,~~ Qs ~ ~ ~ s rLK,~ p S ^ s L~su/
U Unsuitable for system ^ S L7 U
SOIL DESCRIPTION REPORT
Boring #
_' ..~
Ground
p elev.
f 7. ~h-
Deptn to
limiting
lector
3$~.
Boring #
.~ .
Ground
elev.
98•~.cLn.
Depth to
limiting
~ • 1 ioYR ~ -
3 ~a c:
la or
In. Remarks: 91
CST Neme (Please Prlnl) I2pl3~.RT' N ~~~) G(,~7' Signature y /~ '/ / `/' _ Telephone N~ .
Address Dal CST Number
Ulbdchl a Associates O (jr• 2 5 / ~ x4 3 7 5
855 O'Neil Rd.
Hudson, Wls. 54018
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11 1901P 322
STATE 9AR OF WISCONSIN FORM 2 • t998
WARRANTY DEED
This Deed, made between Hammond Land, LLC, a Minnesota
Limited Liability Company
Grantor, a 'chazd D. Jensen and Carieen A. Jensen ^^
us an an w e
Grantee.
Grantor, for a valuable consideration, conveys and warrants to
Grantee the following described real estate in St Croia
County, State of Wisconsin:
~t/~
6 6 0 4 3 5 s
KATHLEEN H. YALSH ~0~
REGISTER OF DEEDS
ST. CROIX CO.. YI
RECEIVED FOR RECORD
05-31-2002 8:30 AM
NARRRNTI' GEED
EXEIpT t
REC FEE: 11.00
TRANS FEE: 68.70
COPY FEE:
CERT COPY FEE:
PAGES: 1
Name and Rft~m ~A
Lot 57 ammond Oaks Subdivision,Town ofHammond, St. Croix County, ~~` ~ ' tom"'" t'`'
Ol&1086-57.000
Pazcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties: Subject to notes, easements,restrictions,covenants and rights of way of record, if any,
including but not limited to those for drainage,water retention,ponding,and or utilities as may be shown on the plat of
Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, 5t. Croix Courtly, Wisconsin.
The warranties of this deed, either expressed or implied are limited by the grantor to the
grdntee, or artyone in the chain of title, to the consideration expressed herein, that being the sum of S 22,900.00.
Dated this 23rd day of May , 2002
Hammond Land, LLC
AUTHENTICATION
Signature(s)
authenticated this day of ,
TITLE MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Slats.)
THIS INSTRUMENT WAS DRAFTED nY
Paul A. Baillon, Attorney at Law
(Signatures may be authenticated or acknowledged. Both are not
necessary.)
by ~~ ~ President
tT '
s Austin J. Baillon
ACKNOWLEDGMENT
STATE OF WISCONSIN )
ss.
Ramsey County.)
Personally came before me this 23rd day of
May , 2002 the above named
Austin J. Baillon
to me known to be the person(s) who executed ilte foregoing
instrument and acknowledge the same.
~~~. ~~~
....: i.n~.nN/.~nnnnnN.AAiw.r~wv.A^
' Paul A. Baillon ~ ; ~ =AUi 4 BAILLON
Notary Public, State of Wisconsin ^DT"`" "~~'c'vfr:nr~'ra 2$ZS
~~.~. (; .I ~V.LE.; ~~.; ~.4r1AE51.3h7o05 Y
My Commission is permanent. (If not, state expuaLOn date: S
January 31 "" ' ....~'ZII'ii'S""""',j .
•Namea of persons signing N any capacity should be typed or printed below (heir aignaluros
9TATR BAR OF WISCONSIN
WARRANTY DEED FOAM No. 3 - 7998
INFORMATION PROFESSIONALS COMPANY FOND DU LAC, Wl 800.633.3021
239.46' ~_~_"' ----N
- - - - -
~ ~ I
I
SO'23'21 "E 290.00
,
' ,~.~- 20' DRAINAGE EASEMENT ~ I
~
• ,~o /
/ LOT 54
''' I
I
LOT 31 I M ~
'~'' ''~ M
~
)T 53
/ / 53751 SQ.FT.
~ ~
~ I
I
44,640 S0. FT.
I I
~ I
~
~3
i 2 SOFT. ti / 1.23 ACRES
~y~°'~ ~ 1.02 ACRES w
)1 ACRES :~ // a~~ N I ~
cMV ~
rp
2 / ,y~j
~a rn
SO'23'21"E 290.00' .
~
~ N
____ ~
/ ~
LOT 55 o
~ 3
N
LOT 30
~
~ Z I
z
/
/ 43561 SOFT. ~ •
~ ~
0
640 S0. FT.
44 ~I
~'
~ 1.00 ACRES ,
~ ~' 1.02 ACRES
`~
~®
S05'42'42"E 299.98' I I I I
i 80.00' RAD. I
~ ' ( SO'23'21 "E 290.00'
LOT 56
I
~i'
~(,~i ,
43,603 SQ.FT.
I
LOT 29
I ~I I
/ 1.00 ACRES - I 44,271 SQ. FT.
33 ,
33
~ '~ ~ I 1.02 ACRES I ~
I
j S?6.
48 N C I
I J IN T
/
\ ~ 58 W ~ I
-- 3S?S4, 2g6 40' I ,
LOT 58 s LOT 57
' A 47500 SOFT. I .,p 29"W
N12 I
N
43561 SQ.FT. ~.
09 ACRES
1
°~
~ LOT 28
- - ~
~'
1.00 ACRES
- - - - .
•
-
- - -
I -
44985 SQ. FT. ~,
-
I
`~'o N N ~ 1.03 ACRES I
~~~ O
~ N' O
- - 916.20' - -
' ~ 00'
`- 290. ,~ 66 00'
_280.45_ _ _ _
_ _ _ _ _ 162.35 _
~ _ _
- _ _ _ _ _ _
_ _
N00'24'59"W 2535.04' ''~
W 1 /4 OF SEC. 20 N00'24'S9"W 2518.50' i~ _ _ _ _ ~ - . _.
NOTICE STATEMENT
>RCEL SHOWN ON THIS MAP (PLAT) IS SUBJECT TO STATE, COUNTY AND
P LAWS, RULES AND REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE,
TO PARCEL, ETC.) BEFORE PURCHASING OR DEVELOPING ANY PARCEL OF
ONTACT THE ST. CROIX COUNTY ZONING OFFICE AND THE APPROPRIATE
OARD FOR ADVICE.
SEWER SYSTEM RESTRICTION
VATE SEWER SYSTEM FOR ALL LOTS ARE RESTRICTED TO A MOUND TYPE
DUE TO AVAILABLITY OF SUITABLE SOILS. THIS MOUND TYPE RESTRICTION
SLY BE REMOVED BY THE DEPARTMENT OF COMMERCE, AND ONLY IF
:NTATION IS PRESENTED THAT SHOWS THESE LOT(S) MEET COMM 85
4 FOR SOME OTHER TYPE OF PRIVATE SEWAGE SYSTEM.
UTILITY EASEMENTS
NO POLE OR BURIED CABLES ARE TO
WOULD DISTURB ANY SURVEY STAKE,
OR STREET LINE. THE DISTURBANCE C
VIOLATION OF SECTION 236.32 OF WIC
HEREIN SET FORTH ARE FOR THE USE
UTILITIES HAVING A RIGHT TO SERVE
NOTES:
THE COUNTY REQUIRES THAT ALL SEI
INCLUDING DOWNSIOPE AREAS - BE
INDIVIDUAL LOT GRADING OR LAND D
MUST BE PROTECTED FROM DISTURB
DRAFTED BY:
a
;~•
1
Wisconsin Department of Industry, SOIL AND SITE EVALUATION
Labor and Human Relations
Division of Safety and Buildings in accordance with s._ ILHR 83.09, Wis.
Cou ST• CiPO/•JL
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size, ..Plan must ~ y ~,
include, but not limited to: vertical and horizontal reference point (BM),,~ueption an¢~..... j~.~ •
percent slope, scale or dimensions, north arrow, and location and distansr~ to neareht toad : r ~ ParCef I. . # O
APPLICANT'INPORMATION -Please print all informatioh. -' Revie~
,•:~:x
Personal information you provide may be used for secondary purposes (Privacy La!x, s: 15.04 (1) (m~, ; Y7-y
Property Owner (.~ (~ N t3 L eD Luella ~ ~ d- •A ~ ovt~Lot, 1/4`
~ ~d tt~/J 6>~ ~ ! ~0 ~ ~, ~ ~~:
(~ Lel# `BLock~~= `Subd
Property Owner's°Mailing Address
33z. HiuN~so7-A- ST °iE~sT lyo ~~_
Ciry State Zip Code Phone Number (~ City ^ Village
ST• P>,u~ INN. SSIo I (~S/ )~az •5555
Page / of
i • ~,- v
o te°~O
/V ~ 1 /4,S ~ T ZQ ,N R r ~ E (or) W
. Name or CSM#
,},y,~•to,vD , 'oi9'~s
Nearest Road K~ / •2
[~'~esidential /Number of bedrooms 3 Addition to existing building
O'New Construction Use:
^ Replacement ^ Public or commercial -Describe:
u~'Q trench, /ft2
Code derived daily flow ~ 9Pd Recommended design loading rate bed, gpd/tt2 gpd
trench, ft2 Maximum design loading rate . ~ bed, gpd/ft2~trench, gpd/ft2
Absorption area required _~-bed, ft2_ ~~
tt (as referred to site plan benchmark)
Recommended infiltration surface e{evat{on(s) su -
Additfonal design/site considerations tt
Parent material ~~ Et±s ~ ~+~ OFNS~ T~ ~~f Flood plain elevation, if applicable N~_.__~-
Conventional Mourn In-Ground ~Pre,/ssure AT-Grade System i~n,Fil/l , HaoldS g C
S Suitable for system ,.,~ .-~/_ ~ U ~ S L~'U [] S ^ S L~t1
U Unsuitable for system ^ S L~ ~ L`D 5
SOIL DESCRIPTION REPORT
GPD/ft2
Boring # Horizon Depth Dominant Color
nsell
M Mottles
Qu. Sz. Cont. Color Texture Structure
Gr. Sz. Sh. Consistence Boundary Roots Bed ;Trench
in. u
~oV 3~3 - L 1fS ~ CS !-~ • ~ ~ S
z io y~P y! SL ""
Ground 7 1 ,
elev.
~7• (,att.
Depth to ;
limiting ,
factor
in.
3-~--
Boring # Remarks:
-•-
•
!
/`~~! ~
~"f~
GS /'~
Z ~
3
~ ~ .1 /Q~//Q ~ -- .
,S/L ,~ ~~ ~ ,. .
~~
3 o
i
Ground
q8• elm n
f-~-ft.
Depth to
itin
li
g
m
fa or
3 in. Remarks:
CST Name (Please Print)
q~ p Signature
R~~~,R~"" NL~FIGI^T
~~
Tetephone~jNo.,~j
'7~S• 3g~j • p ~ D
CST Number
~.
UH 8 ~ ~p ~ >~Ia~/ SOIL DESCRIPTION REPORT
PROPERTY OWNER ~'~ ~ S' S ~ g
GOT S7 /fAH~1o~t7
PARCEL LD.#
«.
Page ~ of
Mottles Structure Consistence Boundary Roots Bed ,Trench
BOfing # Horizon Depth Dominant Color Texture Gr. Sz. Sh. ~ •~
in. Munsell Qu. Sz. Cont. Color / ~ c ~ ~ ~ /
a
G ~'~
y-~ s n ~ Z
' Depth to
limiting
factor
m.
Boring #
C round
elev.
ft.
Depth to
limiting
factor
in. ,
-- Remarks: . U
Mottles Structure Consistence Boundary Roots ged ,
Texture Gr. Sz. Sh.
Horizon Depth Dominant Color Qu_ Sz. Cont. Color '
in. Munsell „ -
Boring # _
Ground
elev.
ft.
,Depth to
limiting-
„ factor
i"• Remarks:
Boring #
Ground
elev.
ft.
Depth to
~:~:~:~~
r ''
~~ ~~
0
~'
Ulbticht & Ass 8°~onsultants
Private Sewag
655 O'Neil Rd.
Hudson, Wls• 54018
~ S T" ZZ 43 ~ 5
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~M~2~
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y~
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