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HomeMy WebLinkAbout018-1087-67-000 c ~ ~ 0 0 ~ ~ ~ b ~ ~ I N :r .. O ~ W ~ ~ ~ C ~ <''> O C H ~ N W~ N N ~ N ~ N ~ C' N Q. 3 Q N. O ~ !nD C C ~ v I 3 3 y a I O m ~ Z D tll y ~ ~-'~ ~ w a I m co D ~' I a ~; I c ~, W ~ ~ I 3 O o o D ~ ~ N N ~ I Z o p p ~ ? ? 2 I 01 3 ~ ~ ~ 3 Z O O O ~ C v_ Q a ~ o v ~ ° ~ ~ o :; ~ W ' y p d o ~ m .~ ~ ~ ~ ~ 3 N 7 Q w Z •• O ~ ~ j a 0 I o fD ~ ~ o v a o I ~ ~ ~ ~ a c N :~ y n b' 3 7 N I Z 3 m a I ° ~ ~ m ~+ c Q O 7 ~ N a ~ 3 C : ' I !n Z w ~ m A a ~' ~ ~ ~ I via ~ ~ T o - w ~ c I o Z m a I ~ y 'O p N (D 7 O ~ ~ ~ 0 I o~ ',$~ o ~• m v I~d ~~ = Np O 01 p ~ IV O -' OpD V 7Q p v 0 ~ V O ~, o S -o y O C 3 °'• ~ .. v = N 3 0 a O x y ~ ~ y A Z N i '~ M A ~ ~ m N O -' Z A ~ d ~. ~, C O O CI ~1 O ~• H ~ A 0 v O A ti N V N O A ti V '~ tip ''4 ~ A ti ~ ~, a sconsin Department of Comme~e PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Bloomquist, Brad Hammond Townsh CST BM Elev: ~y Insp. BM Elev: BM De cription: ~~ ~~~ ~'~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic W E(S~ u~o (oc~ Dosing ~ r( f ~ l H in TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ` J 5 i r----. Dosing ~~ l f Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand g~.LL.p GPM Model Number ~~S TDH Lift Friction Loss System Head TDH Ft 2~ -Z 3. z, Forcemain ^eng~r ~~ Dist. to Well ` Dia. ~~ 2 SOIL ABSORPTION SYSTEM t, ~-~ ~.or D Width Length ~ No. Of Trr~s~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ENSIGNS / _ f 5 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufa INFORMATION CHAMBER OR Type Of System: ~n J ~~ r ~ \ UNIT Mo umber. DISTRIBUTION SYSTEM ~Ls~ {o v{zp1t~ t;~tQQ~ ' Header/Manifold i rJ r a~ Distribution t y r Pipe(s) t' / ~ ~ x Hole Size // 3 x Hole Spacing i Vent to Air Intake Length ~'~ Dia! Length 3~°• a~~Dia ~ T Spacing ' /~~p 3 - ZCO SOIL DOVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No ~ Yes [] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~~/ /,,,~Zl(/~, 6`'} Inspection # :~/~ a Location: 1631 87th Avenue Hammond, WI 54015 (SE 1/4 NW 1/4 20 T29N R17W) Ham on~0aks Lot~6~ ~ Parcel No: 0.29/.17.687 1.) Alt BM Description = S•T' ~ ~'''"``"S • ~ R. ~ `~ C ~ 2.) Bldg sewer length = t5 r •~ Cc~~~ ~~i ~"L I~lo„J - amount o; cover = ) Z ~.. ~ ~~ ~~ • Plan revision Required? ~1 Yes ~ No ~q, ~ ~ ~ ~ ~ Use other side for additional information. lI _ Date `e I Insepctor's Signature Cert. No. / s~~~~o(_. R.s/g~) '~Ga ~°~^~-J ~ ~~~~~ ~~~-T-'~ C~p~q,~, 0~-w~.~ '~ ~ C;~-~-~+~' ~,a,e a ~---, ~I~O~,~: ELEVATION DATA County: St. Croix Sanitary Permit No: 463103 0 fate Plan ID No: Parcel Tax No: 018-1087-67-000 Section/Town/Range/Map No: 20.29.17.687 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer d.~ ; SUHt Inlet ~3.a .~eor SUHt Outlet Dt Inlet Dt Bottom ~ ~. fo~ ~' . 9 S ~ Header/Man. ce. re ~ ~ ~ Dist. Pipe • ZS ~• ~ ~ 3S" Bot. System ~ 9 ~-~ - Final rade ~ w : ll ~, ~r 12 + St Cover r,~,~~„~g ~,cip q ~J . I ~:~~~~ ~ d 3.~~ A ,~,,, ~ z S.~•o o~ 9~-zo y and Buildings Division Coui Wit. ingt ox 7162 isconsin y~~aa (~) 5330~~~~1 ec ~I Oe artment of Commerce "- ~ 4/C ~U Sanitary Permit Applicati n ~ C i E- ~ ~~,~ ~ In accord with Comm 83.21, Wis. Adm. Code, personal inf you provide may be used for secondary purposes Privacy Law, s15. IXm~T. CRUIX CC) ~, L Annlication Information -Please Pont All Information CF,,. F!~'E ~ t xx (to be filled in by CoJ 3 /0 3 er T-e~q~trs . r ffetent than mailing addrrss) /r Lot N Block p .. ~.,~~ _ ..._.. -- Ste'/., ~~/., Section ~_ Ci ,State ~ ~ f Zip Code Phone Number W [~E . ' J~-l~-(~-C~t6~d`~ J ~ / ~ or T ,Gd--1- N; R '"^'` II. Type of Building (check all that apply) ~ S ~ r Subdivision Namc CSM Nu ^ 1 or 2 Family Dwelling - Numbu of Bedrooms , C ~ ial - Desuibe Use dC bl' ^ t. h r~ omtnoc i Pu ^City ^Village giownshipof ^ Sane Owned -Describe Use o ~6~,-- aan 8- 6g~ III. T ype of Permit: (Check only one bos: oa line A. Complete line B ifapplicable) 01 t - tj A' New System ^ Replacarient System ^ Treaurioit/Flolding Tank Replaoanent Only ^ Other Modification to Existing System list Previous Permit Ntmibu and Date Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfu to New Before Expiration Plumbu Ownu r ` ' [V. T of POVY'I'S S em: Check all that a ^ Non -Ptrxsuriaed Irt-Ground ^ Mound > 24 in. of suitable soil ~jv[ound < 24 in. of suitable soil At-Grade ^ Single Pass Sand !'ilia ^ Constructed Worland ^ Pressurized In~'iround ^ FTolding Tank ^ Peat Filtu ^ Aerobic Treatment Unit ^ Recirculating Sand Filtu ^ Recirwlating Synthetic Media Filtu ^ Leaching Chamber Drip line ^ C+i'a~' P~ ^ l>ihu (~~D 2 ` V. Dis rsal/I'reatmeat Area Information: K Area Required (sf) a l pplication Rate(gpdsf) Dispos Design Flow (gpd) Design Soil A ~ I Arcs Proposed (sf) Systan ovation P~ L ~ ~ / ~ ~ / / , D -l SCE 7 ~a / Prefab Site Steel Fibu Plastic YI. Tank Info Capacity' in Total Numbu Manufacturu Concrote Constructed Gass Gallons Gallons of Units Aerobic Treatment Unit DosiagClumber O~ -- b0 -"2_ YII. Responsibility Statement- k Hie aaderstgned, assame responsibility fort tattoo of the POWTS shown oa tke attached plans. Piumbu's Name (Print) Plum Signature MP RS Numbu Business Phone Numbu ,Plumber's Address (Strcet, City, fate, Zip 10 ~ v- ~ z ~- ao VIII. Cozen •/De artment Use Onl Sanitary Pumit Fce includes Gro watu Date Issued lssuin Agent Signaturo No Stan Approved ^ Disapproved Surcharge Fa) 2 ~ ^ OwnerGiven Reason for Denial J~ ~ i3 ~ l~. Conditions of ApprovaU[teasons for Disapptnvrtl 3~ ~~ ~ ~ ~ ~ p~, ~~ SYSTEM OWNER: .~l~ ~ "~~ " 1 Septic tank, effluent fitter and S~S ~-w. i ~ dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances.. witch eemetete o4ai fto the CeuntY ash') for the system en paper not Lett than stns 11 inclw la tiu SBD-6398 (R Ol/03) .,,. -_ s. _,- 1 `~ ~ : ~l7 ~ ~~-~ ~M~ c~^' r~ boo y~~ S ~ y 7, ao (ru,w~ ,~s S Py~s~v /~ ''" `Y Sao 3s7 commerce.wi.gov ^ ^ iscons~n Department of Commerce Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.wi.gov/sb/ www.wisconsin.gov Jlm Doyle, Governor Cory L. Nettles, Secretary September 27, 2004 CUST ID No.220357 BRADY J UTGARD 110 KELLER AVE N APT 112 AMERY WI 54001-1034 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/27/2006 Identification Numbers Transaction ID No. 1057587 SITE: Site ID No. 689115 Brad Bloomquist Please refer to both identification numbers, 160TH St above, in all comes ondence with the a enc . Town of Hammond St Croix County SE1/4, NWl/4, S20, T29N, R17W ' FOR: Description: New mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 978973 Maintenance required; 450 GPD Flow rate; 25 in Soil minimum depth to limiting factor from original grade; "~ System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes ikr; and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ~ `, ~ ~;F 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: t~Sc i_ ~,~ stats. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) • The, designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to . the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above. finished grade with a watertight cover. Note • .The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total dynamic head increases, the proposed pump must be reevaluated and may be inadequate. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. BRADY J UTGARD Page 2 9/2712004 ' • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. Provide frost protection per COMM 83.43(8)(c). A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. -All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In grantirig 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. Tlie above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~ Fee Required $ 175.00 Fee Received $ 175.00 ~-/ Balance Due $ 0.00 Patricia L Shandorf / POWTS Plan Reviewer , In~te Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150 , M-f 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: BRAD &HEIDI BLOOMQUIST Owner's Name: BRAD &HEIDI BLOOMQUIST Owner's Address: 1930-4TH AVE. W. BALDWIN, WI 54002 Legal Description: SE 1/4 NW 1/4 S 20 T 29 NR 17 W Township: HAMMOND County: ST. CROIX ,,~ .r ~~ . . ~; . ll Subdivision Name: HAMMOND OAKS /~f ~~ fi y Lot Number. 67 Block Number: .- N/A *~ r of cOM RCE DINGS II Parcel LD. Number: N/A . ETY AND /~ Plan Transaction No.: Page 1 Page 2 Page 3 Page 4 Page^S Page 6 Page 7 Page 8 Page 9 ESPONDE E Index and title _ Data entry ~ ~ 5 7 Mound drawings Lateral and dose tank System maintenance specifications Management and contingency-plan Pump curve and specifications PLOT PLAN soil test Designer: BRADY UTGARD License Number: 220357 Date: 08/30/04 Phone Number: 715-268-6995 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) colrforrn of `° 36 Inches. 450.00 Design Flow (gpd) 4.00 Site Slope (%) 97.00 Contour Line Elevation (ft) 25.00 Depth to Limiting Factor (in} 0.50 In-situ Soil Application Rate (gpd/ftz) Distributio n Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 2 Dispersal Cell Design Loading Rate (gpd/ft ) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information (c or e network? Enter Y or N ) C Center or End Manifold 3.00 4 Lateral Spacing (ft) Number of Lateral If N above, enter the elevation ft s of the highest point. 0.188 Onflce Diameter (In) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.38 ftZ/orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 9.92 Vertical Lift (ft) 2.12 Friction Loss (ft) 15.28 Total Dynamic Head (ft) 16.31 Forcemain Drainback (gal) 46.90 5x Void Volume (gal) 63.21 Minimum Dose Volume (gal) 31.46 System Demand (gpm) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 x X 1.50 x 2.00 x 3.00 x Manifold Diameter Selection in. dia. o tions choice 1.25 x X 1.50 x 2.00 3.00 Gallons/Inch Calculator (optional) Treatment Tank Information 600.00 Total Tank Capacity (gal) 1000.00 Se tic Tank Capacity (gal) 51.00 Total Working Liquid Depth (in) WIESER Manufacturer 11.76 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information .600.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 11.76 Dose Tank Volume (gal/in) A100 Filter Model Number WIESER Manufacturer Project: BRAD & HEIDI BLOOMQUIST Page 2 of 9 Mound Plan View 1- 1 11 /10 B~ • Observation Pipe ' ~ ' •• j• j, f~ :•~• f• f•r• f•r.• .r• • • •~• f•~•• •r•r• f• f.r• j• f•• •• • j• f•• • 4•L•L•'.•S.•'L•L••.• ~ •S L.S,.L.L.L.L.L.L.L.L.L.'L.ti,. • • •L• • f;~•~ •~: f•~• f• f• f•r•f.r ~vr•f.f•l •J.. f•r•l• f• j,~• j•~• f •~~ . S• ti,.•,.ti,.•,. •.••.••.•~ 5, L • L•L•1•L•L••. •'L•L•L•'L• •','Lf. f• r• • • ~• r• f• f•r, j• f• f• f•~• f•r•~•r• f• • •• •• •r. f•r•~•r• f•• •t• r•r`•r.. •• . L.••.L. L•L•••••.••.••.••.. t•L•1.1.1•L•L•L•L• . L•1•L•L•L . 'L•L•L. .~• _ _ ••B .~. i-~. I L Mound Component Dimensions A 6.00 ft E 13.88 in B 75.00 ft F 9.25 in D 11.00 in G 0.50 ft 450.00 (ft2) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate -T -~ -~ -/ H 1.00 ft K 8.42 ft z 8.28ft L 91.85ft J 5.86ft W 20.13ft 1070.67 (ft2) Basal Area Available 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.69 (ft) :~,,,,, F 97.92 (ft)=- - ~:~ Dispersal Cell [~ Elevation -I H Dispersal Cell 98.42 (ft) Lateral Invert 'p ~ ~ ~- _ ~ 4.0 °/o Site Slope Shading Key ~ ~, ~ Dispersal Cell ~ To soil Ca p p c .a 1 5ft ~'~~~ Subsoil Cap ' ~' ~ ~ w o w . ,'~~~• f; Lftir.r ;'~ L: •L •L•L: ~ '' © . • : ~ ~ . ASTItA C33 Sand :~ ~ f:; ~}: :1 •:tir:~s3:tirtiftir F ® 5 . ~. } Tilted La er f.f:f: A r ate © 99 ~ m u~ a o 0.5 ft r:r. Typical Lateral 'f:}:} -.f;:' L••.•L•L•L.L.;,.•, ti f~r•' .f•r•' •' r.f: r.r r f f•r•r r ~ ; ; ; ; ~'- A Project: BRAD 8~ HEIDI BLOOMQUIST 00 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. I ~E P ~=Turn-upYa'ballvalvaor IFX-4 cleanoutplug Hotes driVled on the bottom of the lateral. Laterals & force main of PVC Sch 40 per COMM Table 84.30-5 Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.20 ft Lateral Length (P) 36.80 ft Orifices per Lateral 12 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 ft2/orific Lateral Flow Rate 7.86 gpm Manifold Length 3.00 ft System Flow Rate 31.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 15.28 ft - Forcemain Velocity 3.21 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -- Comm 16.28 WAC min ~ 4 in Disconnect . . -~_ Tank component is properly vented E- Alternate outlet location WIESER Ca aci 600.00 Volume 11.76 Manufacturer Gallons gal/inch Dimension Inches Gallons A 37.65 442.71 B 2.00 23.52 C 5.37 63.21 D 6.00 70.56 Total 51.02 600.00 Laterals are identic aI S A B C D tank. Alarm Manuafacturer LEVEL `~ Alarm Model Number DLV _ Pump Manufacturer GOULDS Pump Model Number EPOS Pump Must Deliver 31.46 gpm at . '1.28 ft TDH Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pump off elevation (ft) 88.50 Dose tank elevation (ft) 88.00 Project: BRAD & tt~IDl BLOOMQUIST Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name UTGARD PLUMBING ~ Phone 715-268-6995 POWTS Regulator's Name ~ ST. CROIX ZONING Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum 80D5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfuJ100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins t and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for ndin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .~~~~~~~~~~~~~~ ................ Grade \ ' 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Balf Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: BRAD & HEIDI BLOOMQUIST Page 5 of 9 Mound System Management Pian Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and i 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 lie in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhde risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, State. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced. if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be perfom~ed to maintain less than maximum scum and sludge accumulation in the tank. The addition of bidogical or chemical additives to enhance septic tank performance is generally not required. However, ff such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. Ali switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fixer is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not. recommended since soil compaction may hinder aeration of the infiRradve surtace 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10' cfu/100 mL for highly treated effluent. Influent flow may not exceed ma~amum design flaw 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 soids 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 lev+als above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continpencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or r laced to k operating condition. ep eep the system in proper If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a componentof 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 and dis piping, and replacing said components as deemed necess to brin the s tem into r ~~ medre; and related See Page 5 of this plan far the name and telephone number of your local POWTS reg~or and~sendce provider. Project: BRAD & H~l~I flLOOMQUIST Page 6 of 9 ~GOULDS PUMPS • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Series APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/<" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/z" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary; BUNA-N elastomers. • Temperature: 104~F (40~C) continuous 140~F (6010) intermittent. • fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: •EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16(3 SJTW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). ®2003 Goulds Pumps Effective July, 2003 83871 Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic semi-open design with pump out vanes for mechanical seal protection. METERS FEET 10~- 9 a °a 7 x v 6 5 0 a 4 0 ~ 3 z 1 0 ^ EP05 Impeller: Thermoplas- tic 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: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. 10,"- ... ~.... ~~____. _. _._ 5r ........~_. _.:_. _..... ._...._....... 00 Submersible Effluent Pump .. EP04 & EP05 ^ Bearings: Upper and lower heavy duty ball bearing. construction. AGENCY LISTING S A, Canadian Standards Auociation ~, File #1838549 Goulds Pumps is ISO 9001 Registered. 30 40 SO GPM 0 2 4 6 8 10 1'2 m'/h caPaclnr .,~ q .Goulds Pumps Gz~ ~ L ITT Industries ~~ ~~ ~~ ~~ t 'll ~ _~~ A . ...... IoU ~ S~ ~~ 9 7. 3 0 Cn.c~..r .s S ;~~ s~ 9 /~ ~' `V aao 3s lAiscons~~DepartmenfofCommerce 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 cromplete site plan on paper not less than 8'/ x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference 1110, direction and St. Croix percent slope, scale or dimensions, north arrow, on and dls to nearest road. ~ parcel I.D.# _ APPLICANT INFORMATION P t irto - io~t ` i - at /ea~a e,~r n all rn .. D ~ Personal information you provide may be used foj~cOnQary purp~5 (Pliyacy law; s. 15.04 (1) (m)). G ate Reviewed By Property Owner ' . ~ Property Location Humb%rd Land Corporation Govt Lot n/a SE 1/4 NW 1/4 S 20 T 29 N,R 17 W Property Owners Mailing Address '~ ~ ~ Let f / Block # Subd. Name or CSM# {Sy- 332 Minnesota Street, East 1404 '_ '` ! I) bl n/a __ Hammond Oaks Addition City State Zip Code Phon~Ntl~ 'rls~l= ., City Village Town Nearest Road Saint Paul MN 551 1 65~I ~~22-555~~ Hammond ~ 160Th Street ~ Residen`tiala Alti'm~eF ~ `rooms 3 ^Addition to existing building New Construction Use: ^ Replacement ~ Public or commeraal describe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpd/ft2 .6 trench, gpd/ft2 Ab_somtion area required 900 bed, ft2 '750 trench, RZ Maximum design loading rate •5 bed, gpd/ftZ •6 trench, gpdfft2 Recommended infiltration surface elevation(s) along 97.0' contour ft (as referred to site plan bendlmark) Additional design /site considerations BM 2 = 97.2' Parent material ground moraines Flood lain elevation, 'lf a licab~ n!a R 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 SOIL DESCRIPTION REPORT Boring# 1 Ground elev 97.2' ft Depth to limiting factor 27" ~` 2 Ground elev 96.2' ft Depth to limiting factor 25" Depth Dominant Color Mottles Structure n i ten C Bounda Roots GPD/ftz Horizon in Munsell Qu. Sz. Cont. Color Texture Gr ~ ~ o s s ry Bed ;Trench 1 0-12 10yr2/2 none sit 2msbk mvfr as 2f,lm 0.5 0.6 2 12-16 10yr4/4 none sit 2msbk mvfr cw if 0.5 0.6 3 16-27 7.Syr4l4 non e sit 2msbk mv$ cw - 0.5 0.6 4 27-35 7.Syr4/4 p ~ c2 7 S~Oyr7/1 5/ ~ gr. scl 2msbk mfi - - 0.4 ~ 0.5 ~- ____~ - --~ Remarks: 1 0-10 10yr3l2 none sit 2msbk mvfr as 2flm 0.5 0.6 2 10-13 10yr3/4 none sit 2msbk mv$ cw if 0.5 0.6 3 13-18 7.Syr4/4 none sit 2msbk mfr cw - 0.5 0.6 4 18-25 7.Syr4/6 none gr. sit 2msbk mfr cw - 0.5 0.6 5 25-35 7.Syr4/6 c2 ~ 5~ jjg7/2 gr. scl 2msbk mfi - - 0.4 0.5 Remarks: CST Name (Please Print) Signature: Telephone No. Tom Gustum ~!~~ 71558-1344 Address Gustum Septic Service Date CST Number Ref # N13450 937th St., New Auburn, WI 54757 3/1/00 227618 1188 .. k . (~ . ,~ ,~. ~_ PROPI=_anrownl~: x~mb~a i.~a c SOIL DESCRIPTION REPORT ~~~_- PARCEL LD.# :. »ae . page _ 2 _ ~~3 ~, r .c...,.. ca,..:.. c.....:.. Horizon Depth Dominant Cobr Mottles Texture Structure sistence Boundary Roots GPDIIr? in, Munsell Qu. Sz. Copt Cola ~. ~. ~, Bed ~ Trench 1 0-10 10yr3/2 none sit 2msbk mvfr as 2f,lm 0.5 0.6 2 10-14 10yr3/4 none sit 2msbk mvfr cw If 0.5 0.6 3 14-20 10yr5/4 none sit 2msbk mvfr cw - 0.5 0.6 4 20-27 7.Syr4/6 none gr. sit 2msbk mfr cw - 0.5 0.6 5 27-35 7.Syr4/4 c2 ~ gyrg0%g R gr. scl 2msbk mfi - - 0.4 ~ 0.5 Remarks: Ground __- -- --- -- - --------- -- -- - -- ----- ------ __ elev limiting factor . ~. • (p .~ r /~an~~~h~ ~R KS ~di'~'7`~vyi sE IV ~,/ Sic ~0 7-a q N R ~ 7 tc/ 97,. ~VY ~~ Cave-o by~ ~oa d ~~ S~z. ~~ 97, Z r; n~ S ~o:~ P~tQc~aF 3 May 12 04 08:27a {}wnerlBuyer Mailing Address Praperiy Address ~~ L I SR RtYN KROLL 715-246-5700 sT cRO~x eouNT~r SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C;sRTIFICATIDN FORM v, 7 ~" ~ U. ~ ./ (VzrificatioII required from Plancung Department for new p.2 Z City/State Parcel Identifcation Ntunber G~~ ~Q ~~(rJ - 6bp LEGAL DESCRIPTION ~ . {Q8~') Pro ~ ~ J ~ __)) r PAY Location .~,,• ./~, ~/. Sec. ~- ------~ ~ ~ ~~ "I`~N-R,~W, Town of 17 ~~~.U,.y~ .. Subdivision ~_ Lot ~- Certifed Survey Map # Volume ~ Page # Warranty Did # ~~) <~~-~..~ ~ _, Volume ~~ ~ .Page # d 7 ~ - ~_- Spec house ^ Ye5 ~ no Lot lines identifiable ^ yes ^ nQ SXSTEM l1-La ~`~`IKA,i~ICF consists of~~r nse 8nd mainttenaace of yoar septic syxtrm could cessi[t iu its premature faiIme to handle arastes. p~+ng ~t ~ septic teak every three yew or sooner, if aetded by a Iic~ensod Pr°~ mainteaa~ can affect the futon of the septic tack as a heatmCnt stage is the waste disposal system„ Wbat y~ P~ into fhe system The pm~zty-ovr~er agrees to submit to St c~ont I,onmg Ikpar~t a ~eatiaa faa~, signed by t~ ow~r and by a ~~' pl~c'.3~Y~ plumbct, rtstriatedptnmber ar a licr,~d p~pav~ that {1} the ou-site wasbetvatezdi~OSai sys~ is is proper ogeratiag canditioa acxl/or {~} after inspectioc- and wing (if Y}- tbue septic tank is icss than Ili faclI of sIttdge. Ilwe, the gxied have read the above regairemegts aid age m maiataia the private scare e sat forth, hecreia, as set by #~ ~ of Commerce and the llepactmea! of I`Fatucaf g I ~~ with the standards stating that your septi,e system has been incd must be feted and ~' State of Rriscoasia_ goon days of the three Year expiration date. OOmP r+etetcacd to the St Croix County Zoning pffice within 30 SICsN OF APPLICANT ~ ~ ~' ~ ~ 4 DATE QWNER C~R~TFI ATIpN I {wc) certify that all ~ on this form an true m the best of my (~•} kaa the property described y virtue of a warranty deed crcorded in `y#~g~ I {°~} am (ace} the o~waet{s) of ,,,,,--- Register of I}ecds Office. S NA'f dl+ APPLICANT ~/ l 2/ 0 4 • DATE """`"` Any iafornaatioa that is mis-re'pnesented may restctt in the sanitary pesicsii being revoked by the I} «.ss~s Zoccing epartrncnt. *` IacEude with this zpplicAtion: a stamped warratttq deed from the Register of Deeds office a spy of the certified survey map if reference is made in the warranty deed SEP-17-2004 07:01 FROM:M&L CUSTOM BUILDERS 5311815 u zsssP o7~ STATE SAR OP WL4CONSIN FORM 2 -1999 ,,T„~ wst~~rsr D$sa '~'~ Deal, tlTade bet~aan wed and wlfe __ Grantor. ~ ~y„ w. ~..~... ~ e~..r . n. - -- - ~ aTd wth c Grantor, [O! a v,4,able co~otideratioo. ooarvay, aad•varraws to t~csntee the tdlowmi dr~cilbed real state in ~ayyy. yyatt of Wisccesin e 9paT70 U mod. pleaeb atlaC~ addeodo~on): fat ~ Plsto[HTTOTmopd Oahe 1' StdrlittWols Itt ~e 11bnp o[H1mgloal, C'rdTt . W6~-"' T0: 3869391 P.2'2 77•r-3 i !5 ~ ~ p~lx~ t9/!~/~Nt l~e~ r~ ~ ~ ~~~ i~. ~ Pdti~9~• i RccaNlat Arai rtam.,sd xsurn Asi.~ ~1~7.~/ 1~plppdTp NvioEer t~ This ~ .or homaetead poperly To warraatles: N) (is aoA ralrietinas sad rl~rd-wtJ d tuaoM, Q s>~. DatM dais ~~ ~~'~,~/~ -.. AUTBENI7CAT,[prI a~twKs) - _ - _- aurt~d~Tlwred mb ~ _ '[uPf10T ~o~ry public State O T177.fi: IdBM9ER ST11TE BNt OF wIS000+iSA1 (if noT~ __~~ smfiorizea ur 1706.06, wis_ saus.i THIS INSTIt[1MP~Vi' WA5 DAA1rI'BD BY AteoTfsey Ti;elTdoa ~ (Siprews meT !w wtlwtiesOd or eeloowlydpd. Dolt ass ^at r~rrargy.) i of prcroos >~ Ta eq w,~R~AMI'X D>mD ` At~NO~f~(R11l9~11' 3TAT8 C?R ) ~• ~,Q~_ ~+ ) wme before me This ~ dry of sew the sburo aamo0 1Mezlc G .id Ioooe n. amr, bubttgd.rd .r1h to kuorrn to be 1be peaao(s) who taTeatted The ss1 enr:_ N Fnblie. as wacarraer Z - tf1! 1~ ~~, ~' lxflfl ~4t~~ 40 , ., \ .,.,,~ ~ .___ ~~.~a .~ _ ~, ~ `~ _ ~ b ~ r i y ~,~, t ~. ~ P C ~ 1 ~ t Y A~ t y 7 ~ ~ T V~aIW~ ~.: ~~ w. ., r ,„„,,., µ ._..,~,.f J ~ ,......~ a <.. ` •. 1M~ (~,j W • ~ ~/~qj "~ ~ V' 7 N a. ~~ 4,391 B sq, ft 4u ~ ~ ~ '~ ~ ~' Sq. ~t n~ ;~'' ° '°• `` ~ ~ <_ ... ,~. ~ r ~` ~ u. ~r~ _ ~ ~ ~ 3 ~~"' t ~ ~ Cam` -~89"45`08" 337. ~{ ~-- ~~ <s 1, ~Q3 Acres dd923 sq. {; % ~ c` ~ ~ ca . .