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HomeMy WebLinkAbout018-1087-62-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) s r 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 Luedtke, Kit & Jenn Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: I/ `'fI TANK IN FORMATION ~ ' TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION e~luCX 7~`t ~dQ ~~,~p~y TANK TO P/L WELL BLDG. Vent to Air Intake R AD Septic ~ ~~ ~ ~~~ ~ ~ Dosing ~~,~ Aeratio Holding PUMP/SIPHON INFORMATION /'"'`~~ Manufacturer Dema GPM Model Number Y~~ ` ~~~ ~ ~O TDH Lift . ~ Fricti ~ ~ Loss System Head 3 2/ ~ TDH ~ Ft • S l Forcemain Len th ~ Dia. oZ~~ Dist. to well /~~ T SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 453156 0 State Plan ID No: Parcel Tax No: 018-1087-62-000 Section/TownlRange/Map No: 20.29.17.682 STATION BS HI FS ELEV. Benchmark b ~~, ~ Alt. BM - -k. /D q 3 - Bldg. Sewer SUHt Inlet .3 SUHt Outlet _~.. _~ Dt Inlet _~ Dt Bottom (~, / ~.._ ~ ~ /,n T 7 Heade /Man. .~ a ~//~. Dist. Pipe Bot. System .~~t y• ~~ ~ i. / Final Grade C ~ St Cover i L~' ~J(~ ~~ 11.~- BED/TRENCH Width / Length ~ No. Of Trenches DIMENSI Of Pi ia. Liq DIMENSIONS ~ ~ ~y ~ //f - SETBACK SYSTEM TO P/L BLDG WELL E/STREA ACHING Man urer: INFORMATION CHA R Type Of System: ~~ ~ ~ ~ ~ ~ ~ ~ ~ IT Model N DISTRIBUTION SYSTEM ,~Qe Header/Ma~jnifold Length /' Dial Distribution ~~ Pength ~) / Dia I Y Spacing ~/ x Hole Size 3~~, x Hole Spa'c/ing ~7 ~~ Vent/~to~Airjln~take /~/ r" SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of . l xx Seeded/Sodd d xx Mulch d Bed/Trench Center r~~ BedlTrench Edges ~ Topsoil es No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/(~t~• Inspection #2:Q~/~/~ICL Location: 1640 86th Avre~Unknown (SE 1/4 NW 1/4_2.0LT29N'R,,1~7,,W,)~Hammond Oaks 1st Add Lot 62 ParcelrNo:\20.29.17.682 1.)AItBMDescription=gfTft7jyYl~j~~,p/VI,Q`,QA~'~ ~Y''~w'~' ~3) ~~~~ `~J ~~ 2.) Bldg sewer length = ~Q 0 (~~ ~//~ _,,= ~~ -amount of cover = 7'f 2'~ ~ ~j~~(y~ `s sl~{~'(/!,(Jr~G~ ~/'~ • f f ~P~ = Q R-~ Plan revision Required? Yes No ~~ n(( - (j'~ ~/~ Use other side for additional information. _ . 1 _ O~ i - l ~ SBD-6710 (R.3/97) Date nsepctor's Signature Cert. No. ~~ tP( ~ nd Safety and Buildings Division P.O. Box 7162 Washington Ave 201 W Counry~ 1 ~ O -f-~ 1` ., . ~ l~eons~n Madison, WI 53707 - 7162 3151 266 f 08 Sanitar Permit~er (to be filled in by Co.) 3 - ( a ) J Department of Commerce ~ lication it A P ~~ ~p~ State Plan I.D. Number // pp erm Sanitary ~ ~ In accord with Comm 83.21, Wis. Adm. Code, personal infor may be used for secondary purposes Privacy Law, s15 4(1)(r~~~~~~,~~ ferent than mailing address) o ect Address (if d J 6 I. Application Information -Please Print All Information ANR ~ 6 2~~4 ~ (a ~~~~ rcel >k Lot H / _ Block !t Property Owner's Na me ~~N/IV ~ S i . CRGLC.,t~~N7 • ~ _ (~ DoO. Propert Owner's M ailing Address - operty Location a [~ , ~ ~_ `7 L l/t~,'a'fl,G G'/~C L ~" '~ (r S~ ''/n, N w'/a,Section ~ ~ City, State j~ ,,~y~ t~V~(J ~C /. ~ ~ Zip Code ~°([_~ Z Phone Number - ..., ~ ~^7(circle orye) II. Type of Building (check all that apply) S Subdivision Name CSM Number \ p ~~~M ~ ~ ~ 1 or 2 Family Dwelling -Nwnber of Bedrooms ~¢,,~a~ ~~~ ~~ ~~ ~ D Q ~~ ~~ ^ Public/Commercial - Describe U e _f•______ / ' Q~ ~ r 'ice ~ ~"4' 4 I ~ eR ^Village Towt hip of N ^Cit - DetSCr U e ~s G ^ State Owne - _ ~~ ~ ~ ~~ tt = III. Type of Permit: {Check only one box on line A. C mplete line B tf applicable) A' New System .placement S stem ^ Re y g Tank Re placement Onl ^ Treatment/Holdin 1 y Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V. T e of POWTS S stem: (Check all that a 1) Non -Pressurized In-Ground ^ Mound > 24 in. of suita soil Mound < 24 in. of suitab e soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized Iu-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Are equired (st) posed (sf) Dispersal Ar a P ro System Elevation ~ ~~~ e ] ) '~ • / VI. 'attk Info Capacity in Total Number Manufacturer Prefab- Site Steel Fiber Plas[iC Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ~ ~,O / ~~~ 'iA~ Aerobic Treament Unit Dosing Chamber ~ ~ ~ `/ VII. Responsibility Statement- I, the uudersigtied, assuute respot "bility for utstalla[ion of the POWTS shown on the attached plans. Plumb is Na me (Print Plumber's gnature ~ MP/h~f~t3 Nwnber Business Phone Number ~~ Plumber's Addre ss (Street, City, State, Zip e) VIII. Count /De artment Use Onl Approvzd ^ Disapproved Sanitary Permit Fee (incl des Growtdwater Surcharge Pee) ec44~~ ~ Dat ssued D~ I sui Agent Signatur (No Stamps) ^ Ow en Reason for Denial ~/V ~ ~~~ IX. Conditions ppro al SYSTEM OWNER: 1 Septic tank, effluent fllhr and dispersal cell must all be serviced 1 maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ~••w~„ w,uµet~ p,wts tw ute trounty omyi ra• ute sys[em on paper not IesS than St(1 x 11 inches in size SBD-6398 (R. 01/03) ~c1' b I g6 ~ Rvt-, $~1~-1 _ ~ 100,0' Ot.~ ~P OF Sly °~j l'A PVC P 1 P~ -_ _ _ W~1--L.~O _BE _~ Sod ~~M M~~M~ ~~•n~ ~ ZS ~ ~-~~-~t `f~k G~pY .moo 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 1o0u 16 5~ gallon capacity manufactured by w ~~s ~ co~,e2~ ~w~ ~ooo/USo M ~ w~ srF io o SAM 1T~C Fi.~`R~c 4 . $ench mark ~~ ~BpV E 5. Divert surface water around system to prevent ponding at the uphill side. DT.(1T Pi.A\I Scald 1 "=50 ' ~~Z ti0 C~ti~ wz tom-. q q. 5 ~ s~C 3 o-i'TVwI OF C~ g•~- ~ 10 ~•D ~ u ~c ~fl~yP 31~ D RM M~"' G v~2 ~/~ . o'-^~ ~. b~ '' G~~` .~ ~~~- ,~ b .\ / h \~ ~\ ~~ ~~ F3.3 ~ ~ ` Page 3 of ~ L.~T 63 LuT (, Z 0 2 ~ l sZ,tzt3 \~1 s ~'iL`3•A c~ ~5 / qto 1S'oF ~~` 2v f~7Colo 2$ s ~ ew~1+-1 - ~~~~ _ ~ ~~ ~~~.= dim ~~~~~~ ~~ . o~/Z~/~~ commerce.wi.gov i ^ iscons~n 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 Jim Doyle, Governor Cory L. Nettles, Secretary April 19, 2004 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/1 /200~F~~~~~~~ .Identification Numbers Transaction ID No. 985697 SITE: ~~~ ~ ~ ~~~~ Site ID No. 681849 Kit & Jenny Luedtke Please refer to both identification numbers, 86TH Ave ; ~. CROiXOO~~;T'j" above, in all corres ondence with the a enc . Town of Hammond ZONING OFFICE. St Croix County SE1/4, NW1/4, S20, T29N, R17W Lot: 62, Subdivision: Hammond Oaks FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 950568 Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual, SBD-10572-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99); Biofilter 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 Condi chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, ~~p stats. pER RTatE The following conditions shall be met during construction or installation and prior to occupancy or use: Of SEE ~oF 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 Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. ARTHUR L WEGERER Page 2 4/19/04 • 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 b~authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human 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/installati on/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, `, ~j~~Z ~~X~ ~~~Z Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 TITLE SHEET i~OUND SYSTEi~1 FOR A 3 BEDROOrI RESIDENCE Page 1 of `7 This plan has been prepared in accordance with the Mound Component I4anual SBD-10572-P and the Pressure Distribution I•Ianual SBD-10573-P LOCATED ICI THE SE 1 /4 OF THE NW 1 /4 OF SECTION Z-~ , T Z~ N, R 11 6•], TOidi1 OF ``~Y~1v~yYV~ ~ ^~r,~C~UC COUNTY, WISCOidSIId. ~.oT 6 ~ o F l-4~~~H~1u-~~~ (JP:~-S l sue- f~61?1_~-~J INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTELi I'Ir1~vAGEi'1L~'T PLAi1 PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEt]-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAIiBER CROSS SECTIOid PAGE 7 of 7 PUriP PERFORI.4AilCE CURVE PREPARED FOR 1^C~ 1 1'~1ti.Jv~ S ~it~.~`1 LU ~'Tlt.- 3Z~ ~v~~~wcx~~ C12CLE ~O~3~``-2TS , ~~l Syp Z3__ PREPARED BY ~~1~~j-y WEGE~ER SOIL .TESTING ~~~ FaND ~ r CO MERCE DES = Gfii SSRV I GE ~NGS P.0. Box 74 421 IZ.iain St. SPONDENCE River Falls, t•]I 54022 Phone 715-425-0165 ~~®t~~~y4, Fax 715-425-6864 ~,, ~~~ ~" ~++ ~R ~37 F OOCC Jy +~ . ~. ~4 RECEIVED. ~•~ "` `~ 3r `~ APR - 9 2004 :7 ~~~F~ SAFETY & BLDGS D1V~~ _ ~-6 -o y • JOB N0. Oy-3~i Mound System Management Plan pa~E ? of `7 Pursuant to Comm 83.54, Wis. Adm. Cade 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, ~~/is. 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 ere 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 cr 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 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. Pum--- p Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's per'meter, and the mound shall be seeded and mulched as necessary to prevent erasion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended sine 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 GODS, 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 paint at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at (east 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. Fonding 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)j acid 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. Cade 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 er•~try into a tank or component. Contingency Plan If the sep4- 'c 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 ~ ~ _ y b ~ p ~~-~ C1~U lX The systeer installer at -715 _Z,-'~ 3 _ ~y~~ ~SpN The tank manufacturer at ~-'Up_'~Z.S._ ~y,S(~ 1uti~sg~ The effluent filter manufacturer at ~$QS-~a9-3Zejp 5Lb"tlTE'C The pump manufacturer at ~ loj - Z.~ 4' _ l l l~ y Vv1~-( ZS PLOT PLPs~i . Page ~ of ~ Scale 1 "=S0 ' L.uT 63 LCT 6 ~ ~- ti \ v3 o-mjy~ of C~ 3 1. ~~ ~ ~ ~ ~ v NOT C~M'1PAfT ~ 101.0 \\ g. 3 `~\ 2 O I StiRl3 ~ ~~ ~ ~~'1 S PCYL`°'R ~~~ ~ 313p1z~ '~ ~ C G v~2 $~1~~ _ ~ 100, O~ ~w ~T~P OF 3{y ~~ l p ~'V C 1 1 ~~ ._ - _ _ _ c.~3'~-L `r0 B-F._> S0~ ~1~M MVVM~ P~ ? LS'_~--t~U1~t ~"h-~k. - 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 ~oou 16 Sv gallon capacity manufactured by >ti `~ ~ CO-~ (",~,L -ooo/C,SO-"'1 ~ w~ STF l0 0 Sth~ /~ F1,L`CLsR 4 . $ench mark ~_ ~~ p~gpV E 5. Divert surface water around system to prevent ponding at the uphill side. ~6 -~- RuL Paoe y Or ~ Approved Synthetic Covering AST~i C33 Medium. Sand Topsoil -~ ~'"' ~' ~ > -~ 3 istribution Fipe F D a i 8 /a Slope Distribution Cell of Force Main ' Z" to 2 Z" Aggregate From Pump CROSS SECTION OF A MOUND SYSTE;i ~fl/ Elev . 1'O 2 :, p - q~, so -f- ~of.r,o Plowed Layer p \ .S:Ft. E ~ •~g 8 Ft . -FO.~ Ft. & 0.5 Ft. A 6 Ft. H ~-0 Ft. Linear Loading Rate= ~ -~ GPD/LN FT B ~ S Ft Design Loading Rate= p_3.GPD/SQ FT j ~S Ft. J ~ Ft. K \ 1 Ft. Position ~ q~ Ft. OT Force Main W Z~ Ft. .. L ~ i I ' t . ~y ~ ~ -Observation Pipe '~ _ 8 --- I ----- -- ~ ACCFs C~-~-- ------------------ ------------- ----- ~ ~ BoX g '' O _ A i ~~6 8 -t W -~_^~'_ --- ---~ - -------- - - --- - ~ - , _ . ~-- - Distribution ~--Cell of %" ' '~ . z to 2~ ' Pipe ~ aggregate . . Observa tion ~ Pipe (ksdibr securely) PLAN DIET OF A MOUND SYSTEt4 Distribution Pipe Layout P2oe S of ~ Place the holes at t:~e bottom of the distribution pipes . at~equal spacing. Remove all burrs from the pipe and holes. Frxtend the end of each Iate.-aI uD wirh the use of Io~g turn or 4f ° fitrng to a point witiua s;.~ inches of the final made. Te.•minate the eads of the Iate.-aIs with a valva,-t~readed can or • threaded plug. Provide access from final ode for the vaIye; threaded cap or thresded plug. ~---=,cc~.ss ~~~_ i~~~ cr, L ~,~5 S s-; ;Z~ N FVC F~J~ PVC I later! ~ ~. Manriold ~ Laterl x ~ ~ x ~ x ~ xfZ x PLAN V\~•,~ F --j+ c- - ~ ~ h r;-~ ~ r-~ ~: ~- -- ~- 1=0 ~c~ ~^ ~w ~ ; rc~s six - -o --ti P 3~ Ft. ~ Hole Diameter 3l! ~ Inch --" S 3 Ft, ~ ~ Lateral ~1~~~( InchEes) X z~ ~nchps Manifold ~.- Inches -- ~ ~ Force Main " 'Z Inches ':~;. _ #of holes/pipe ~~' . Invert Elevation of.laterals ADZ- ~ Ft. 12. ?~ i ~~~'T' ,. . ~ ~ - Combination Sept3c~ Tank and • PUMP CHAMBER__CKOSS SECTIOtJ AAJG SPECIFICATIOIJS' P?Gc, ~ OF -7 _ ---- ~~ i ~ WEATHER PROOF • l~ Fi~11 nuulZ.,~.:,~~,~UW _Ci1~ ~VEUT C . - i~~s ~uucTlou eoz . '~-rL~L'~ l~1 {~. Ilv~'P~'Yt_L~ ~/~ APPROVED LOCK11.1G MAl1HQLE COVER wt"Tl'{ wA~i,tJl-JG LRgEL• CCJ.IDUIT ~C Z iZ@p~~ ~ . N 2 ~ .~ I i ~ Y~HI1,:. ~ E2 1 ~ ~ S ~ . l~N~ 61~L ~ - - ~ 7E' -... ~ . ~ ,ti = =_-- - ~PRCViGE I ~ ' • -AIRTIGHT SEAL I I~ V --A -~~crs~ ~I Approved ~AF~•L.L 8 r~rF><L~ -~ ( joint w/ _.::~~ -~~n~vco~w~- -,I i I ALAA?'. PVC pipe 7 ,--~ ~~, gS.oo •I ' >;1-.~V . FT. - ~ I I PJF'.P-~ ~•-• I Ir ~ OFF ~~V, q~ . 00' I..CQ LOCK--~ i FISER EXIT PERP'11iiED G-.iL~ IF TA1JK MA1,L'FACTL'RLR HAS SUGF{ APPnCVAL~3NAP~~? C7~.L.~ TOTAL Oy-JAMIL HEAD =. • As -per manufacturer \~ -~ gal/in. SEPTIC f SPEC.IFICATIOf.!5 CCSE TA~,IKS MAt`IUFACTURCR:w\~~~ CO-UL`SZ~ lvLMi ER OF DCSES: S'Z' F}R (;,A ~ TAMK :,IZE : ~ Do0 ~ 6 SL1 GALLOA:S DCSE , , VOLUME r I,LARh1 MI,?rUFACTURGR: S'S, ~~D SyS'T~t-Ig IA:CLU DIUG 6AtKFL01J: ~~•3 GALLONS /'tiOD[L -UJMBER: ~~~ ~'It~J .CxPAU 7lES: A. \$•~,~rHLS oR 31I3~$ GALLCC;: =WITCH TyF'C: ?~IER.CvR`T _ g . Z u;C-+ES OR 3~'U G~.LLO-~S (JUMP MAIJUFACTURCR: _ ~yl~S C: S'ZS INCHES OR ~°I'3 GALLOl:S MOOEL IJUMBER: ~~ ~'0 .+ \Z Zpl~ 0 ~= • SWITCH TYPE: 1"1~~2C1~~~ NOTE: INCHES OR GALLOA:S pUl~P AUALARM ARC TO D~, Ml-JtMUM DISCKARGE RATE S~' ! ~O r;p/.~ INSTAlLEO OAl SEPARATC CIRCUITS VERTICI~L DIFFEREAlCE DETWfEU PUMP OfF AUD..D157RIBUTIOIJ PIPE.. ,' S0 FEE7 •f- KtiJ{MUM AJETWORK SUPPLY PRESSURE , , , 3_ZS FEET ~Z,S k ~, 3~ ~- , ~ FEET OF FORCE MAIM X 5•UZ F~,...FK~r7IOU FuTn¢_ c D~,'7 F T . ~,oa~ Z''~ ~ -FEET Liquid depth 38 ~~ . ~" ' ;, , ~, ~~ ME40 Series r~ 4/'10 HP Effluent and Drain Water Pumps Pertormance Curve 40 MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 35 I j 30 W <L ~ 25 O W 20 J ~ 15 O H 10 5 0 ~ 0 12.~p Its. o.l 12 10 N W H W 8 ~ Z rr 6 ~ t= J Q 4 f- O r- 2 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805-1923 419/289-1144 .FAX 419/289-6658 Telex 98-7443 nasz0 ,//yl Printed in U.S.A. o'~vv~i ~S~/!ms's ~ ML~~G%,v G~,t~v Co , GG c . rMsconsin Department of Commerce SOIL EVALUATION REPORT '~° ' -i i i 3 ~ v s on of Safety and Buildings Page of in accordance with Comm 85, Wis. Adm. Code Attach cornplele site plan orl paper not less than 8 1/2 x 11 inches In size Plan must C unty RE~i'~~ ~ . include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimenstons_, north avow, and location and distance to nearest road. reel I~D~~/8. 7. ~ ~) ~S v y ~ Please print all Information. v iew by Date Personal information you provide maybe used ror secondary purposes (Privacy Law, s. 15.04 (1) (m)). ST. Ci~OIX G T D f~/Z / r( g` Property Owner _ / ~// 3 J ~ Il~/~ Y L U ~/~ T/~E~ ~ Property Location N~ 2O q Govt Lol s~ 1/4 2 ~ 7 Property Owner's Malting Address . 1/4 S T / N R b(or) W / 3 27 l!///Dl~j pOQ C/%~Gee~ Lot # G 2 Block # Subd. Name or CSM# 4` City ff~ o~up o.9-,rs - D~~T~a .v State Zfp Code Phone Number ~~TS ~~ syo Z3 7iS ~~~• o~s~ (] Cily ^ Village ®Town ~ Nearest Road ~ ( , ~o~~ . ~~ ~. ,9.~ ,~ - ---- °~•• ^ Replacement ~• • ~~C. t~ r<esroen0ar r rvumoer o- bedrooms ~ Code derived design flow rate too d"a GPD ^ Public or commercial -Describe: Parent material _ General comments ~pESS O'/9E~ UE,uSF' Flood Plain elevalfon ff applicable ~ ~'~~~A./ ~~ ~ ~/ n. i S • and recommendations: J s~ ~ 3 A'~~~ SUi TES /moo /' ~l o Utiv s ~S~-e>~_ ~ , Boring # ^ Boring ~ p~ pit Ground surface elev ~ ~ d fl ~~ -- ~ d U~Q - . . Depth to limiting factor in. Horizon beplh Dominant C l Soil Applfcatlon Rate o or Redox Description Texture Slruclure Consistence Boundary Roots GPD/ft: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff# ' ~ 1 Eff#2 o-(o /Dy P 3/3 G , /~s,6~ ~~,e w 3f . y , ~ ~ s d ~ i®yR ~/~. ~z ~ x o Ts ~Si~L .I I ~.~ ~ Boring # ^ Boring C c ~/ ,~ Pit Ground surface elev. / ]I tO fl. Depth to limiting factor ~-Z in. Horizon bepth Dominant C l in. o or Munsell Redox Description Qu. Sz. Cont. Color Texture Slruclure Gr. Sz. Sh. Consistence i - ~ a ~ oy~P 3i3 - ~ ~fshk ~ ~>c~ Z • l3 /~ L ~ •{ShiC~ iwl~fip 2 • 7•S/,PS c z Mo7-S SGL /7GS`j iyrtSCj. s • • GM.. ... ~ u• - --..---.., ... - .-.....mss - ov ~ ccv rnyi~ anU r Ss >3V _< 150 mg/L ie (Please Print) Signature Roams T 2r~d/~%~~ r Ulbricht & Associates Private Sewage Consultants S55 O'Neil Rd. Hudson, Wis. 54016 Boundary Roots ~ 3~ ~, z y ~s ~,~ 'Eff#1 'EtT#2 . Y .~ S .s • 9 .Z .3. ElOue~~nt~~#2 =BODY < 30 mg/L and TSS < 30 mg/L /~ ~- ~'~~liril ~ ~ CST Number ~W~ ~.2C~3~7 s Date Evaluation Conducted Telephone Number `y' ~4D ~--- 7/S• .3Q to ' ~l ~.~ 3 Lve~~~-e ~uy,~s= ~ w ' .~ ~~MMoND o,4,~s i~ r ~4~v~`T- Property Owner ~ lj G G ~ Parcel ID # ~ /~ - ~ ~o ~ ~ 4a ~ r~ Z 3 Page of Aoring # ^ Boring ~J* ~ ~].-pit Ground surface elev. ` ~~ ` ~ fl. Depth to Ilmiling laclor ~ in, Horizon beplh in. Dominant Color Munsell Redox bescriplion Qu. Sz. Cont. Color Texture SIrQCture Gr. Sz. Sh. Consistence Z a - 9 9~ ~~ /6 y2 3/ 3 ~D ~ L ~ i~sb~ s ti-~- ~ie ~v- 3 i ~ Zo o y ~ ---- Sid 2r~h~c ~~ie /D S C 2 0 5 ~aC' S~ ~]~% e _ I I Boring # ^ Boring L__J ^ pit Ground surface elev. tt. Depth to limiting laclor ftorizon Depth in. Dominant Color Munsell Redox bescriplion Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence r ~ I ,Boring # ^ Boring ~--_J ^ Pit Ground surface elev. t(, a Horizon Depth Dominant Color Redox Description Texture in• Munsell Qu. Sz. Cont. Color 'Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L Soil AppBcalion Rate Boundary Roots GPD/fl' r 'Eff#1 'Eff#2 CS 3-F , y . ~ c~ Z r .. CS /rc . s • ~ ,Z , t~ Depth to limiting laclor in, Soil Application Rale Structure Consistence Boundary Roots GPD/tl' Gr. Sz. Sh. 'Elf#1 'Eft#2 ' Effluent #2 = BODE < 30 mg/t. and TSS < 30 mglL The Department oCCommerce is an a ual o , need :material in an alternate format, please contactpl a deparhnent~at1G08r2GG--3151 ordTTY G08-2G4-8777 services or sno-e~~o Irt Fmo1 C ~~ b ~ ~ ~ ~ ~ ~: y ~~ V O O C (N ~„ G ti -p G n ~ oo °' m ~ ~ - m O ~ ~ ~ C ~ J C ~ ( A v, © ~ ~ m ~ ~ ~ o ~ ~ ..~ w ;, _------ ~ o ~c 1 _ a~ ~ ~ ~ z P W C. o ~-~ 3 --~ co ~~ W ~- o C 'Q G _ ~° 3a~ w ~_ o, oc~ G °~ d ,~ • ~~ m m C. ? ~. C 'D -r ._ c a - t -~ ~° ~~ it d .s, ..c~ ,~ P 6~ z C'G • `~~ .~ v ~ - w a , ` N 0 .. z~ rn~ ~~ 0 Z O~ ~ ~~ ~.. i''.i` 1 s ~, ~' ST CROIX COUNTY SEPTIC TANK MAINTEI?IANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer i t Mailing Address ,~a~ W~ 1~~~~ ~ir~~{ Q~~,' ws 'S`Yoz~ Property Address City/State LEGAL DESCRIPTION (Verification required from Planning Department for new Parcel Identification Number ~ it ~ ~~ ~ ~~~j ~ d ~ 1- C ' 6~2~ Property Location ~ '/,, ,~'^! '/a, Sec. "2- ~ , T Z °~ N-R l ~ W, Town of ~"^"`~~.J Subdivision }~~-~~ ~~ ~~~ICS Lot # ~_. Certified Survey Map # ------Volume ~ ,Page # ~- Warranty Deed # U I~ t 2 ~ ~- ~~~ ,Volume _' ~ l l ~, Page # ~~ Spec house O yes (~ no Lot lines identifiable [~1 yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper tnaintenar consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the systc 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, signed by the owner and b~ master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal systc is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludg Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standai set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certificati stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within days of the three year expiration date. SIGNATURE OF APPLICANT / / DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of m~~ (our) knowledge. I (we) am (are) the owner(s) the property des ed above,. irtuc of a warranty deed recorded in Register of Deeds Office. r _ TURF OF y ,~3, oy DATE ****** Any 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 Deeds office a copy of the certified survey map if reference is made in the warranty deed fit. GrQix ~QUnty Q~~up~ncy N~rne - (t~wner} i"yp~d or pr~nt~d being duly swam ,states, ands: c~sth, r ~?~f~~l~lFl ASR 2 8 2004 s.~~zu~x:,vu~ , ZO ING OFFICE 1. HeJshe is the ownerlp8rt awclcr of eke folio ~~t. Croix Cc~un#y, Wisccansir~, re~rded in Ynlumc Page ___,~___ T~acumen# Numbtr _ 5t Croi7t C~aunry Register of Deals Office; A ~arceI of land located in %. ofthe~ ~{. f Sxtion Z v 'i`,,,,~9.,~. N - R,,,.~~ w, Tcawa of _,f(ghu„e„c~ , St Crain '`^~atmty, V~iectansia, being du!}~ dc~cait~ed as fradlor~t (iuctudt icrt na. a'a4: su6+di'visiot3f~l~ or detaileet legal drscziption): :,,~ and As owner ~f the above descnt'~d pro , i scknowiecige tfiat thO s~ptlc system setvirtg this resktence iri sized for a beds'bartti tu~me or a design t'tow cf C~ gpd. The design ttow is cakjulaked by assurtting 150 ppd for 2 individuals i~+` bedre-am. There are cxtrrerttly ____ cccxtpan#s ~ kt ttuS nesldentse; ,~„ pc+xtpart~s era permitted t~tsad tm the design Raw. Therefiau~e tits septic system serving mis residentte is code aompiiar-t. Hrnvev~, I t~derstartd that it #h~re are intentuans #a exc~aed the numbef pf permitted occup~rtts, system watt treed &a be modifred #G ,srcxxrtodate any increased +mastewatef ttows andJor contaminant leads. i also ackno+srledge ti~at 1 will make this irtfotmatton available to any ftature parties interested in purrhasirtg this property, cct a~ ~ `~ ear or ~~ :ate 7Jals Starr t~ bs ~ fS' aerrbrrMCtsr say and ~(tt-~rr.d)- cXt+arrManm.Gat+ sncda as Sas t~ des. ;f dew eto. they 4e pieced on trots ter f d ~+e carat orsasy bs preasO an abtdktar{M pl!pes ottha ~ darxtaa~end, lY~t~ tJst cittads cow~arpe~p!e aofi3s eau parts tb ~srdCtasraenr ar+d 51.00 ra errer~nrertnn ties, W9seoeatrs St~uf~R ~ Si7. € 1 ~~~ ~ ,~ '~, T~, C11 ; ~ ~f.ri ~.I *~~=~~.l tly ~~V. YFFP ( y ' b ~. y ([ .. ~ '(~ ~/ j } ~y ` )~~phjll~' j 1 1i Y}F~ ,,...• 3 • ~ ~ F " k... ~ 1+ +.J / ~ ~ ~ p NV ~ ~ J ~ }1 ~ l.f i ~4 ti" 'x y ~yry / ~ lTir. r P ~ F w ... ,. .. ,.. .:.. ~g` .~ `+wr Mi / ~ . Wlm.. ... .+ . ev r.av~:~.wv. ,_ /' 'Y .... . . .. .µ rM ,Myi ~4 ~ ~ ~ ~~ A,.r"" IrY~V j ~ ,p ~ mow/` ~"~'^hw. ~` . ,~- ~ ,.~.,.~.._ __ m__ _ ,.~. ~,. __ .~ ~ ~~„ ~ .. ~~ , ~. .,M.~ .w,~.n...~ ~.M _. ; ..~ M~,..~ .~ ~. ~NisconsiifDepartmentofCommerce SOIL AND SITE EVALUATION Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Page 1 of 3 Gustum Septic Service Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must County include, txrt not limited to: vertical arxi horizontal reference point-fBM~, direction and 'l St. CroiX percertt slope, scale or dimensions, north arrow, a1.xf ocation and dista[tce to nearest road. ` Parcel LD # % ' i APPLICANT INFORMATION - p/ ~A ~ - t al fo ti . J~, v_ ~ 8 o ~ p i r i>t rma on. _ ~ Personal information you provide may be used seccgndary g (P~acy Law, s. 15.04 (1) (m)). ~ (' Reviewed By Date Property Owner ""- ~ ProQerty Location Humbird Land Co oration 6; r ~- 4 ,;._:~ Go Lot n/a SE ll4 NW II4 S 20 T 29 N,R 17 W Property Owner's Mailing Address t - Lot Block # Subd. Name or CSM# ~ St' 332 Minnesota Street, East 1404` `- "'~ ~ ! )r~~ n/a Hammond Oaks Addition City State Zi ode.,. PIti~NRIfr~- _ City ^ Village ^Town Nearest Road Saint Paul MN 55 /'`; 6,5.1-222-55.55; '~ `~ ' Hammond ~ 160Th Street ^ New Construction ~ Residenfi ~ rooms 3 ^Addition to existing building Use: ^ Replacement ^ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd~ .6 trench, gpolft2 Absorption area required 900 bed, ft2 750 trench, ttz Maximum design loading rate .5 bed, gpd/ft2 .6 french, gpd/ftz Recommended infiltration surface elevation(s) atone 96.T contour ft (as referred to site plan benchmark) Additional design /site considerations BM 2 = 96.7' Parent material ground moraines Flood lain elevation, if a livable n/a ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ^ S ®u ®S ^ u ^ S ®u ^ S ®u ^ S ®U ^ S ® u SO1L DESCRIPTION REPORT Boring# 1 Ground elev 96.7' ft Depth to limiting factor 28" 2 Ground elev 96.4' ft Depth to limiting factor 79" Horizon Depth Dominant Color Mottles T t Structure Consisten Bounda Roots GPD/ftZ in Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry Bed ~, Trench 1 0-8 10yr3/3 none sil 2msbk mvfr as 2f,lm 0.5 I 0.6 2 8-14 10yr3/2 none sil 2msbk mvfr cw if 0.5 0.6 3 14-20 7.Syr4/4 none sil 2msbk mvfr cw - 0.5 0.6 4 20-28 7.Syr4/6 none sil 2msbk mfr cw - 0.5 0.6 5 28-35 7.5 r4/6 Y c2-3 10 7/2 7 SyrS/8 gr. scl 2msbk mfr - - 0.4 0.5 Remarks: 1 0-9 10yr3/3 none sil 2msbk mvfr as 2f,lm 0.5 0.6 2 9-13 7.5yr4l4 none gr. sil 2msbk mvfr cw if 0.5 0.6 3 13-24 7.Syr4/6 none gr. sl 2msbk mvfr cw if 0.5 0.6 4 24-29 7.Syr4/4 none gr. sl 2msbk mfr cw - 0.5 0.6 5 29-36 7.Syr4/6 a2 ~ g ly~g7/2 gr. scl 2msbk mfi - - 0.4 0.5 Remarks: CST Name (Please Print) Signature: Telephone No. Tom Gustum ~ ,~ 715-658-1344 Address Custom Septic Service Date CST Number Ref # N13450 937th St., New Auburn, WI 54757 3/1/00 227618 1183 r PROPERTY OWNER: xumbvd Land Corporation _____ SOIL DESCRIPTION REPORT PARCEL LD.# 3 Ground elev 97.3' ft Depth to limiting factor 26" 1183 Page -__2__ 0~,.- 3 n..~,.,., ea..~:,. ce..,:,.o Horizon ~~ Dominant Color MotQes Texture Structure sistence Boundary Roots ~~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ~ Trench 1 0-10 10yr3/3 none sil 2msbk mvfr as 2f,lm 0.5 0.6 2 10-14 7.Syr4/4 none gr. sil 2msbk mvfr cw if 0.5 0.6 3 14-18 7.Syr4/6 none gr. sl 2msbk mvfr cw if 0.5 0.6 4 18-26 7.Syr5/6 ~ none gr. sl 2msbk mfr cw - 0.5 ~ 0.6 5 26-35 7.Syr5/6 ~ ~ SNS/g ~ gr. scl 2msbk mfi - - 0.4 0.5 rcernarxs: I ~ Gnwnd elev Depth to limiting factor Remarks: --- - -!_ - - ~ - ~ i _ ~- _ J ~~ Crl ~ C n N n m 0 .yi N C V ~ ~ T C ~ a o - ~ a e ~3ZOn ~~ ~Np N ~'O fD 'a ,~_ a' m ~ w N c~ G D 0 a 0 a 0 ~ m ~ ~ c1~ IV n m II II II II m m (n m m ~ ~ O C < r fTl cD -' ~ m ~ o O z J o ~ o o _ z ~ I ~ ~ ~ ~ o -' o _ ~ ~ _ o ~ ° ~ ~ n r~ O r ~ ~ rn C ~ = r~ O Z fTl ~ ~ -~ -~ rr, ~ r~ O cn i Tl Property Line 0 Proposed Road 0 z y .~ ~ n 0// 0 i~