Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-1048-20-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Dalton, John Hammond Townshi CST BM Elev: I Insp. BMaElev: BM Des ript~~n: ~ ~( b0 ! ~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic , / ~ Aeration / Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic y ~ ~. S/ ~ L / Dosing Aeration olding PUMP/SIPHON INFORMATION M acturer Demand Model Number TDH Lift Fric' oss Sy Head TDH Ft Forcemain ength Dia. Dist. to we SOIL ABSORPTION SYSTEM ~/ ,,,~~,~,~,~ p~~ County: St. Cf01X Sanitary Permit No: 399505 0 State Plan ID No: Parcel Tax No: 018-1048-20-000 STATION BS HI FS ELEV. Benchmark o ~Q 0 Alt. BM /y ~~ D ~. 3 t) Bldg. Sewer ~, Z S ~,O S S Ht Inlet ~ /L Q ~ / St/ t Outlet ~ ~ ( r6 ~~ Dt Inlet Dt Bottom Header/Man. Dist. Pipe ~ 9, 3 3. Bot. System L ~ Final Grade x ~~ St Cover Z ~,6 ~l" ( I( 2, 3 , BED/TRENCH Width ~ Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 ~-~ / Z SETBACK SYSTEM TO PIL BLDG WELL LAKE/STREAM L NG nufa turer• Ma INFORMATION Ci A~E OR ~ Type Of System: l ~~ ~,~ I .~-~~ / ~~ Mod Number: dQ ~ r DISTRIBUTION SYSTEM Header/Ma 'fold y Length Dia / rr Distribution / ~ ~G~- `~l ~r Length~J Dia ~ Spacing ~t '.S ~ x Hole Size x Hole Spacing ~ Vent to Air Intake Z ~ ~ .SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Center Bed/Trench Ed es g To soil p ~ Yes No >C Yes ~ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 5~1~/~ Inspection #2:_~/~/mil Location: 1873 90th Avenue Hammon , WI 54015 (NW 1/4 NE 1/4 22 T29N R17W)NAyLL~NA/,~ Parcel No: 22.29.17.337 1.) Alt BM Description =-~6~ d~" 't7~~,; ~ ~~ J s~f ~~" r`~"4 ~`~4 [Cr'- O~` ~ ~ fJ f~~/. ~ ~ ~y~ 2.) Bldg sewer length = Zp ~ ~,q/ ~~~GV f,,/7~'`/~/lt ~CG~CQ~ sre .f~c /rte r~Cp~ ~~J -amounto~~f cover = 7 `~ 0 ~ (~ /Z 1d ~ . `! A~ 7/'rG*,C~ L~ ~~~,CO( [~ ~~~S ~~W/ld~ 3., O~ se r ur0~~'ti ~ -;r. ~ a /,~,~1/l/~ ~ ~ ( C a ~i.~1 Plan rev~ion R qul~6y~ Yes ~ No Use other side for additional information. O l SBD-6710 (R.3l97) Date Insepctors Signatur Cert. No. ,s :~ SY s~ e r i e ~.~"a.~-~'h-- C ~ ~ d~ 5 ~l~ Z~ ~~,~iGr' V"`` ~ ~~p~~ 4~ I:3d ~G~~ ~ ~~ ~~~ ~ ~ ,., y b~ ., ,~~-- ,_ ~_~ Safety and Buildings Division County ~ ~ ~, ~ 201 W. Washington Ave., P.O. Box 7162 , ~ t y, ~seons~n Madison, WI 53707 - 7162 Site Address Department of Commerce ~~ 3 ~'~~- - ~. Sanitary Permit Applica ' 2 Sanitary Permit Numbed ~~ ~ 3 9 9.sa~ In accord with Comm 83.21, Wis. Adm. Code, personal i o ^ Check if R vi i may be used for second u ses Privac L 1 (1)(m e s on I. Appiicatiou Information -Please Print All Informatio .~tlr REc~ovE('~ . k UU ~ --' State Plan I.D. Number . "Lt,G Y N, Property Owner's Name `~ `~ ~- ~~~ ~ ZQQ~ l.cs,+ ~ Parcel Ntunber LZ zg.1l~_~,33 ~- ©l ~ - i Oy 8 - -- a d-~ pC:~ Property Owner's Mailing Address 00111~~( ~/ ( Property Location City, State Zip Code rt i Lot Number Block Number ` ~ t~ ~ u ---" Subdivision Name CS~t tiumber (. ~ /~' ` Q Q \ II. Type of Building (chec I that apply) [~;~_ 1 or 2 Family Dwelling - \umber of Bedrooms ~ ^~ge __ _---- Public/Commercial -Describe ,Township ~',m/\ ^ State Owned I ~ r / ~ S' P/G Nearest Road ~ ~t,- /cLt. /I'r~. bit ~ Y e. IL'. Type of Permit: (Check only one ox ernal use). Complete line B if applicable) A. 1 ^ New 2~ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem Tank Onl Existin S stem B• Check if Sanitary Permit Previously Issued Permit Number Date Issued Z ~ t/ Z ~d0 IV. Type of Permit: (Check all that appl}')(numbering scheme is for internal use) 44~ Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter 50 ^ Coruttvcted Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment unit 49 ^ Recirculating 30 ^ Other V. Dis ersaUTreatment Area Informat ion: Z t Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percola ion ate System Elevation Final Grade Required Proposed Ra[e(Gals./Days/Sq.Ft.) (Min./Inch) •~~ I Elevarion ~ / ' 9 9~,8 ~c~ ~ 3~ ~ ~ ~~~. ~ I+a C. : ~. VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Ezistirg Tanks Tanks Septic or Npldr~erdt y /~ 1lLfL Dosing Chamber VII. Responsibilit}' Statement- I, the undersigned, assume responsib' 'ty for installation of the POW"TS shown on the attached plans. Plumber's Name (Print) er's Signatu MP/MPRS Ntrmber Business Phone Number Plumber's Address (Street, Ciry, S te, Zi Code) ''. 11 o ~ ~ ~ ~ _ y 5 l . n. VIII. Count /De artment Use nl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued issuing Agent Signature (No Stamps) Surcharge Fee) ^ Owner Given Initial Adverse ~J D V~ J ~ L~ Determination IX. C4nditlj~et~€ t°t1I~~`~if~a~'t~t t~AI't~tY~~r manufacturer's recommendations. 2. The existing system shall be abandoned per code requirements (Comm 83.33). 3. System shall be installed 80-90 inches below uniform contour line to ensure proper location within soil profile. Chamber louver shall be installed in soils with a soil application rate of .7. 4. Property is zoned Ag-residential -only one principal dwelling is allowed on this property. Attach complete plans (to the Couotr only) for the system on paper not less than S1iZ r li inches in size SBD-6398 CR. OS/O1 10/28/2001 22:39 17153534628 CVBWEY ~NU~X SEE j~._ PAGE 01 .~ ° . ~.l _ NJ~ - ~~' -~ ~ _T~~I b,~ ~~ ~ T5 ~.~,~ L~~~v~~~ a ~ ~~ ~ ti '~i~ ~ ~~i I O ~ _ - 1M Q ~ ~. C7 ~ U ~~~u ~ ~gTL~r~Y LEI N.~ 1C~4R-~t~^ ri ~ D / ~ h I ..t V v ~ o~~ ~ 2 ~~w a [/ k.J~r era ./ 1 A~'1JdA~1, . 10/28/2001. 22:39 17153534628 CVBWE'~ _. .~ PAGE 02 Conventional S ace Owner' Manual Sanitary Perin l[ #_ ISSUed „_` Desigttod wastewater flow (gpd)_ ~JO Owner Name^~a~fGv1 ParcellA# ~~~j- ~Qy~~~ `Kris septic system is designed and approveu -u meet specific requirements outline In Comm $3 and $4 Wl. Adm. Code so that it will provide safe ttt:atment of wastewater, thereby reducittg human health hazards caused by improperly treated wastewater. The longevity of this system depends greatly on proper and timely maintenance and system use within the limits it was designed to handle. The owner of the system is responsible for the operation and maintenance of all components. Following is information that well assist you in inQeasing the life of your systems. Sc tic Tank Ins ect and or service once eve thrx ears Outlet filter Should ins ect once a car and clean once eve three ears Drainfield Ins eel once eve three ears Septic "t_, ank(s) 'The operating condition of the septic tank and outlet filter shall be assessed at least once every three years by inspection. The outlet fillet shall be cleaned as necessary to ensure proper operation. "fhe filter cartridge should not be removed unless provisions are made to retain solids in the tank that may sloughs off the 61ter when removed from its enclosure, If the filter equipped with an slarmi, the filter shell be serviced if the alarm is activated continuously. l;ntetmittertt filter alarms may indicate surge flows or art impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and or sludge in the tank exceeds 1/3 of the liquid volttme of the tank. Ifthe contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to perform to maintain less than the maximum scum and or accumulation. Manhole risers, access risers and covers should be inspected for water tightrtess end soundness. Access opening used for service and assessment shall be sealed watertight upon completion of service, Arty opening deemed unsound, defective, or subject to failure must be replaced. An ef'f'ective locking device to prevent accidental of unauthorized entry to tank shall secure exposed access openings greater their eight inches in diameter. No one should enter a septic or ocher trearmenr or holding rank(s) for arty reason wlrhoat being in fall compliance with t7,SHA standards for entering a coned space. The atmosphere within the septic or ocher trearmen[ or holding tank -nay contain lethcl gases, and rescue oja prison front the inferior of the task may be dlfJiculr or impossible. Tank abandonment shall be in accordance with Comm 83.33, wI Adm. Code when tank is no longer used as a POWTS componctt. 5oii absomtion eomnonetnt (Drainfeld) The soil absorption component swing this structure to accept domestic wastewater from a residential faciliry. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in txtending the useful life of this component. 'llte soil absorption components operation must be assessed by %nsQection at least onoo every three years. The inspection shall include rewrding the level of pending, if airy, in the observatipn pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites. area of erosion should be identified and resorted to the owner for repair. The swface discharge ojdomertlc wostewofer or sewage from the sysfe»t id prohibited and consldF~ed a hr<man Itralfh hazard -A~,e z6~ 10f28/2001 22:39 17153534628 CVBWEV PAGE 03 `ontvigrncy Pfaa: ,n the event that this POWTS or a component or Jtis POWTS Fails and cannot he repaired the fallowing is proposed. Replarrtrtent arm For absorption cell (per Soil evaluation ), or add an A?U to recover a wiling drain rSeld, ar other repair or replacement co code. tf dosing tartk is used - dosing tank pump, pump controls, alarms or related wiring becomes defective the defxcive comoanent shall be iatmediacely repaired ot: replaced with a component that is better or equal too periorraaaee. Questions an the operation or maintenance of this POW'I'S should diraaed to Counry Zoning or Health lltsnectnr. _ ~-~'C~'C,x ~o~ Zur. i~ C71~ ~ 38t.- ~ro8~ ~~~_ gig -.831 Y in P ~~`~ i 16.°w ,, I ~" . ~~` `1 ~ i ~-s~~ ~. ~~.c~5 ,. ~~ ,,.J~ ~.~ ~va~s y~ ll ~l ~~ r~ n~.~ ~~,~ ~a l.~ve ~ ~I~ .,. ~ ~ t~~e ~e~ ~ 10/28/2001 22:39 17153534628 CVBWEV PAGE 04 . JI r i ~~ 24~ 3 ~-. {~ ! `~M y~ ~ ~~-_ ~.. V _~ I f~ ~+u WI U .~ .... _ I I C7 OJ 1+ u U LJ rJ C. L: ~. a. ..a N _~•. ~ ^1 .n :, u ~2n ~-^ •' `~-~_. :~b•~ j i f n. 1! 'r ~ ~ ~' ~ vl ~~~ ~ :iii! ':"'r ~> ~I ~ I ~~~;' ~~ I I( f:3\ f +~ ~~,~ 1~1 j~llf `` ~ 1,~ !~ ,. ~ ,+ . , ,'~ ,, ~~~ i ~ ;~,, ~_, 4; . ., T' - ' '~~ - ~, 1.+..'~1 i.:.. I ~ , ,~. a)t 141 , ~`" '.ir r ~ 1.1- ~ ~~ :; ~ s z ~~~ :~ ~~ -;~ - -~ - C T ... J .._. .. ~ .. ~ ,. ~1 . ry " ~ 1 -. ,. !, I . % Q .; ;1• ~ : , ~;'• 1 1 ~~ ~ _I i~ 1}• . r •~ ~ + `j ` ~ . i,/ I 1 .W L. ~~_..{ ~ ~ y ~ ~ a n, .., :l J ~;~ ~ J.i N e~ •~ N ~j ~ s ~~1 1,~ r~ IJ ~~ to _ ,.+~ . - ' ~ 1 -- ~iJ --- Jf~ ~ ~,,,~ ~ f 1 _- t \ y~ \`.J1 f ry J . ~ 1~ ~ _ ~I ~ ~ r~ ~' '~ ~ ~ I 1 ::~ ~ ~ ~f ~~~% ~ I 1_.~ ; . ~ ; I.i ~ ` ~ ' .-. i ~, ~ ~ ;,~ ~ ~ ~~,!' ~~ i __ I I . 1 i I ._ -ter L {~~ ~~. ~ l~ r ~ .7 ^~ = ~- ` ~ 1 ~ ~ ` ~ ~ ~ ~ ~ ~~! ~ ~.1 ~ ~ ~ 1 ~ ~' 1~1 ~ i . ti r . =^- ~ _) ~`~ ~ `; ,' 1 /1 I t i ~.~ ~ ~ ~~ ~ 10/28/2001 22:39 17153534628 CUBWEY PAGE 05 . • • ~ ~ • . .......,..,r .........................._..................... • , .................................. , .............,.......................... _..... r... . .._ . .... .... ..~ . .r*... ...+... • , ,... . -._¢-• i • • • .. .. ... .... r... ... • ...a.. x.o,.r _ I , • i ,,_ (~ ~• • ~ ~ , • . . , • ......_....• ..................._....,......r .... ..._.._ ...............,r., ...;.... '.. ,.x .~_. • y .. .. r .r..,....... ......................rrr.rrr........ ......,....,.r.. .........:....._.....r...,...r,r.: V .~. .~.. p..Q ~ IA .. . . ...•.. ...;... ...7 . ..~ . , , • • ~• ................x,.r..,......._.........._._... ~ ~ , • rixr ~ ~ ~ ~ • .....,....r.:.........._.............:...... ...,............K.......................n.~.._....~............ i~,r.r . ..r.._._ I........ - .r.........r.. n_._ ..............._.vrlvwx......:.._.....~..._.._........v..a...w..n...1r...._.._. j.._.._._}.. ...... .. r...I..v.vr.r..wr,.rrrmxlrxrxr•x.wirwrrurru.L....._...:~....t_ • ~ i • .. ..x. .... _...-.. ........ x.. .......~... .........+........ ........~... rr ... _.. ...4..w„r.w1..._._....!.._.......ir'r..rw._.,t........ .... . _ i rr..r•raw.r......~.._......i..._.....i.rrrw..,r..;rr•x..r.r..w ...... .._.iw.__...r _ , _._1 _... ! „.L..rw.wr • • i ~ ~ _..i ... ...4... ; ~ ~ ~ j i i i • . ~ ~ ~ •. • ~ i ~. • ...w,. r.,.._ ...._ r. • • ~ i 1 • •. r. ...~.. a r.. ~.. .r. ..... _ ... ...._ rrxr xr w . _.. _..._ _. • ``~ b ~ l /~y~~, I .._... .,... ._._ ....r,~rr ...._._~._..... r .r_.._ ._ _~.~,~.~`.~_~. _ r,..rixr,~......~.- -- - r _._ -._.~.1~~..~~~ ,.~w._irxW ~- ~• • ,~ . , • ~ ~ ~ r _ . ~ , • . ......_.} .............Ivr.vev.__._._.1_. .p.vrr..,.., ..r_.._..j...__.._~....._.v..,,... .. ._. _.. r ' . 1 ~ ~~ ... _..}_._._:. .,, ,xj..r.,... }_.._......I...... ¢,r..rr.n..i.,r_r h-._._._ _~~.5.~..5...._._ i ,~.,.rx.rwrlxrr.x..w i 1 t........ .._ _ ._.._ .._...j..rx..,,.x~.rw..__~..__~ ~. _ ...j..,..wr.,r.~n„ n__.7...._._.i..... r,,, _ .~._._.__.._._.•.•._._.. A4-7Q i'7.! • r r • ~ ~ i ~ I I • r ~ ~ r i ~ r i i I f r ._ _ .-..ri.,.,,. „j...._._ ~.~._..... .Trrrx,r....rj.._.__t_~ .._~..__..j_..~._~._rr-.:.x.rrw-.j...,x..rrx}r.xrr..xr:r..xrx,tijx.x.,....i~r~ ._.. ~ ... ,,.j,rr r_• __. __.. r,rr ._._ _. ,.r.xrj.__._..i _.~_.....';.~•r,,...rrir,xx,>_~_...._..!~...~........,.i,rxx...~.....»...~.._-_--_!___. _ _.~y wjw...rr,..M.r,r..rr...r~ .r..x, ...... _ ._.~_., xr.,t.r.x._ -- $-' ~.r_.w_..;.~'"~'j...~ ~Ij._._._.,t.. r rrr ,„jr.,r.xw_ ~ I r i h..__.;.._.._..:_._x..r,.r-.,.rrr•.~r.,GRr~r*w.x. r~...,.pxr-•_r ..-"-i--- ~ -f ...... _ .._.._ ... ,... _.. _ rrrr rr.i--._._!._.__..~_..w..rf,.xr,.r. ----!- - - r r. ,r...._1-._._ ..._T.._._.v..,x.rrrx~ir...r,..,.,r1..99~ x.r.~,.,_ ~ ~__~_.. _..... _.__ r,,, __.•~- . _ _ ~w..w x .w.. _._ I . ,r,.~,xrti_.i.._.. ;_ ;M_~f~r-.x~~ ~ i _....i.___.._...._~.rr..M.r~.,rr ~ ~ ~ :.-- t -- - + ....... .__ ..,i.-.x,,.wL_r_. _..L_ _ r,.w+,. x... .._. _ ,r ' ..._~-__ - ._. ` rxr ~. ` ~ ~ ~ j ' '' ~ ~ ' ' `• '~r7rh+~/l'~,c j ..._.._J _.._. _._- - ,,, _._.~ ~ _ .~-+- w ..Mw.r. ._ _._.._L_...r...,•jrr..,,_.._r __. _.__ I ._. I/ . ' r ~~ ~ ~ ~ ~ r ~ I «~.dr.~,..x~Aid.:..x.r..rxl _.+~r.xx,.hx~_1r ..{__.~j!_.,.j.-•,~1.1~~.._.~~w..r...x,.brr..«..,r..l..,..rr..,,.j„x..rr..r..r« f~~. i ~ I 1 r r , i , /r / . 1 1 ......._ ..... ,. „_. __...+___ ...._¢„rxr.., _ ._._ .._ ...~-••.'•.~.p_. ~ _._ ,x.~r.1-rte.-.._..q~~ rr r..~r•..,x,..r±rr.x.x.rrw,n.,n..._!--_.r.~........_~_r...r-_f._.._...:_...._..~.._n..__.__.!.___ w.. xM.. ,. . . ,~ r • r , w ,: • , A _ _ • • ~ ~ ~ ~ , • `- ^ rr ,r~rx~.,.... _._.._ _. ._.. ' _x .., rr rr..,...j.tir_...ly.~L.... ._.j--~_.._+_.._..:__._.. ...... ...... _ .... _ _• w.i_._ x,r xrp„_. ~_.l-.,. rxyr. rr_ _._ _. ..ry,.xr.,,' _ _ ~ .._ , .j-. _.a,_._.._. 1._.._._•,,... rx,t ~ i ~ ~ w'~ . I ....... .,,.. „rx, .x.j.r. ._ _...{_.~ xr __. _rr,,..Jrxr._..}---•_•_ •,. xrlrr....r. ...._ _.~...j.~~'I.* .~:~~~_.`fi.~, 1Q.x r r...~r..7~r.,..lllTSr..r~ I __I_ ~ i , _ • r ~ ~ ~ ~~' ~q • i i 1 ...,...,rxxx,..,..•r,•r r.xr.~._.a...._._.:._._..._..x..,..,.,.,..wx.. ~...__;_.._....~.,.rrx _j,. ~ ~ ~ ~ ~ I _.._.4__._..,y.....r,..rr.~, ._._ .... _._....rj,...,...,,.rL ._._ _._.1._...._.j ~ ~G ~ #G ,.~xrrT.r I ..~3 ` ~..~. ~~.~. ,r~,..r..n.xr,. ,,.ix~. w_F--i-- • ~ -~ j r - - - - r_ir_.. .._. ..xr _.r_ _._ ._. ._._.;_._.._.M.._......._:.x...w.,.;.,,..x.x.j„x.x,..n;rx,rw....' ir.~rxr.n.._~ • xi ~ i ~.r..xrrnr +---• r • + , ~, , . • • • ................._.......,..,......,,..,....,.r._......_._ _....._...._._._....ww.... ~ ~ , x. a . _.~. i ~ ~~ • • r ...,.......,..,..,...x..xn.rxr.....a,w,_......4.._._.._.F.....-_..~..~...rrvrgre._._.r...._.....~..rrrn........._.__vrr.xrr.....{. ~ ..... ...._ ..... ._.. ,r..r ........'__.._ _.._...t_ r..,rrm . ~ _._ w, ,.....p... ~.. ...jx.. ...._ _.. ..~.._._._. :,....._.. L.,. r, w rr i .. _. i ~ , ~ ~ ~ ~ ~ ~ I i ~ i i ; • vrlw ~ • i ~ • ' i ~ i 1 ~ ~ ~ i • i i i ~ i ..........~..........._._........y....xr..r....xrrrxr...rl......._._1............._.......nl.r...r._..J...... ~ i i 1 ~ . rrr _._.._.._ r.xi... _.. ... .. ..... ..... ..... _..,, .r._ .... .......L..._. .._....i....... • , x.l..r ..n .r_.r_}._r_ _ __ ..._.I.._ i ~ i i r ~ ~ ~ i i ~ I r ~ ~ , ........... .............1....._........._....._y................,r..rw._.r................._...._._.._.I.r.....n. ' ~ i ..4... ...._ ...u..'~..« ~ ...... r ..._,... r......__....... ..... ..... ...~.. r u..nl..n.._.._.. _... ..... ._. ._. _..._ wwr~.x rv r wurxi yr ru. ~ ~ ~ i , • i ~ . r.rr.. _..........,_...... ,rnr ................._..... .r.h..._.....x r r . n..............._..... ..... ..... .ww .........._i......._._.......... ._. ......................r....._ _ .... ... . r..,...awrrxx .rx._Lrr.r.. i ........ •............ ~ ~ r i Q1~I1P~ .......n...... • ~~ ~....~~ ri I~' ...~. Clarence G~okfe~ty ...... ......... Bnvir~Tech Syste>tns 8s Se>rvices ~-- N4955 Sunny Hill Road _ • Weyerhaeuser, WJ 54895 0 10/28/2001 22:39 17153534628 CVBWEV ' SYSTEM SPECIFICATIQNS In-grouted Soil AbsoYptivn Component SBD - Project Name- ~~~`~ v~ 1l'~~~~ Distribution Cell Type , Aggregate ^. Leaching chambers„] Waste~xrater Quality 7ratted ^ Untreated Number of Bedrooms Design Loading lZate (DLR) Qb(asia-um 5oi1 Appliwa6on Rase) Combined wastewater. Number of bedrooms _~ ~L gal/day/bedroom a1~Q Daily Waatc~vater Flow (DVS _ j~ Clear and gtsywaaer Daly: Number of bedrooms gal/day/bedroom .x24 Daily Wastrv+acex Flour (DUV~ = O Blac:kwatrr Number of bedrooms gal/day/bedxooca ~ Daily Wastcwaoer Flow (DWG ~ " ,; Disttibudoa Cell Sizing ( " DWF / DLR Distdlpudon Cell Siring (lcachirig cbarnbess) Leaching Chatnbcr MsusuEactute ~ ~ r-~.-~: r- .. Model `~ " Adjuseed Design Loading Rate_ / . a gpd/f~ Chamber sizt, bottom area / 7 • / y k Sysneaa sizing = DV~F / ~_ ~ - ~, ~~ t~+D~1 A.I7LR /Chamber size ~' _ ~7 - (sy.Et.) ~ of chftnbers Number of cha,cnbtYrs to be used = Septic ?aak ' Min. Septic Tank Volume _ ~...~ dal Septic Tuck Volume _ ~ gal Maaufactvtet _..- - Ili-t-. Effluent Filter / Manufacturer _._...._ . ~!r{~ Cr Model ~''l ~ (~ Q Pump Tank Manufacturer Pump Tatilc Volume gal. Divettet valve ^pes ^ao Manufacnite Model Note :The use of a divertrr valve sha!! be indicated on tht msnagomau plan iadicatittg how and when the valve shag be wed. Page~of~ Wisconsin Department of commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST C~ !X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must inGude, but not limited to: vertigi and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 ~ 8 - l 0~'~ - Z,IJ -~U O Please print all informs ~ 1 ) ~~; Reviewed by Date ,~_1.._c._- Personal information you provide may be used for second s (Privacy Law, s~19.0 1) (m)). ~~~ ~ 1 ~ ~ ~ ~~ Qg'/7 S~~r~ ('~)Vp C'_l~2~ 1..~-L h.) '~-p ~~~E+{~/E ce~to~'~.w-_ 1/4N~ 1/4 S 2.Z.T Z. q N R ~~ E (o W Property Owners Mailing Address /; Lot # B, ck # Subd. Name or CSM# City State Zip Code P r.. umber (~~~, ` ^ City .;'. ^ Village ®Town Nearest Road 1~t1110~> w I S4 ~ L S (7 )~'~ ~"~ 'MY~'l 1v~ °t ~ YN -4U ~ . New Construction Use: [~, Residential / Number of b ~ o0~sl 1 i ^ ~ .5'' Code derived design flow 'rate ~ S O GPD ^ Replacement ^ Public or commercial -Describe: ' Parent material _ ~ C.'P~C, L Y~L Ou ~ W'Pc3l~ Flood Plain elevation if applicable ~ ~ ft, General comments and recommendations: 3 i~rLLS ~ ~-eL`1~ 3 'X. S p' l~Y~/ 6 I~tJ ~ ~ l~N L ~ O~ ~`~'l 6 L~ ~°~}7fj~c ~r7 ~0~~ or_~S 1`u Bc- 84 "~~ .~~lu . b 4~~ s ~. Gr 1~v~.lzoty> ~~ A ~~ ~~ a Boring # ^ Boring - ® pit Ground surtace elev. ~~-8 ft. Depth to limiting factor ~ ~~ in. Soil Application Rate Horizon Depth Dominant olor Redox Description Texture Structure Consistence Boundary Roots GPDlftz in. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 0_lo Lo~.~Z ~z ~ sl1 .3~sbk s~ clv ti~~~ • s •~ 2 do-Z~ z0 ~t(Z ~ ~ s i ~ ~ ~ Sbk s1~ ~ -~ • 5 . g 3 2~-~[I !p~(fL.3 ~ s~1 ~csbk `n Ck, - •Z .3 ~, 2. >a . Z - tmuent t,:i = BvD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L • Effluent #2 = BODS < 30 mglL and TSS < 30 mg/L CST Name (Please Print) ~ to CST Number Arthur L. jJegerer d. -~t-~-~9 220254 Address 4d e g e r e r S o i l T e s t i n g & D e S 1. g n S e r v i c e Date Evaluation Conducted Telephone Number 421 iJ. %iain St. River calls, [JI 54022 ~.Z,-?_0~ 715-425-0165 Boring # ^ Boring ~ ® pit Ground surface elev. ~ ~ ft. Depth to limiting factor 2 L Z S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efi#1 'Eff#2 ~~1.Z 1p~,IZ-31 _ s?1 Z`F:~~~ s C~ Ian ~1 •S .~ z 12-3s tDt-trz3l6 - si ~ 3~sbk sl t^_.w ~( • 5 • ~ 3 o S_6 3 lO~t23~b -- si ~ L~Sb (~.h C..~v - 'Z •3 [] n ~+-~0 ~~`112~f ~~ 1 \ ~{ lS YSl ` `,~ L~~-c _f 1 n(_ l~l ~ l.i~'1 C ~ "t~ ~ s ~-iZS ~D~,2s16 - S ~Gr o s9 ~ .~ L 2 Page ~ of ,.. ~-,` Property Owner ~~.-1 U N Parcel ID # ~ ~p ~ ~ O ~~ -~ - OQO Page,, ~ ~- of 3 i~ Boring # ^ Boring ® Pit Ground surface elev. q ~ ~ ~ ft. Depth to limiting factor 2 l Z ~ in. Soil Application Rate Horizon De th p ' Dominant Color R` edox Description Texture Structure Consistence Boundary Roots GPD/ft' r- in . Munseil Qu. Sz.' Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2"~ 1 0 -~Z ~D IZ3 I z - si 1 Z-~'sb s cw lm -1-f- , S . 8 ~. 12 37 lD ~ 231-b - si 1 ~ 3~'gb sl>1 ~W ~/ - S . ~ ~ 3~-65 )Dyrz3lb _ si ~ lesblz ~" r1 CLV _ ~ • 2 - 3 6s ~-t ~o ~a-~L~b ~ ~ 1s~sl l,~ssb~. ~, I- 1~ ~S , 4 b i S ~-ti'~~ lp~~slb . - s~t6~- osg I - ,-~ Z.z: a111 a r • ` . .a ^ Boring # ^ Boring ' ^ Pit Ground surface elev. ft.~ Depth to limiting factor in. Soii Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. " ` ' ""-'' `Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots_ GPD/ft2 In. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. ~ ~'Eff#1 •Eff#2 ,.:, ,} _ _ .. -~F "d • .. ~ ~ • Effluent #1 =BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 =BODE < 30 mg/L and TSS < 30 mg/L t The Department of Commerce is an equal opportunity service provider and employer. If-you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. -~ ~ ~' t .~ ~,. sao•ea3o trt.woo- ~, ..m . ....... T1T nm TT ~ TT 1 ~ ~ € /Scale 1' =3p ' Page .3 of 3 ~N ~~T" C~w..h P v~v~~ ~Pi,b.l~.. 01;8_- Z~ _Zd-00O _ - __ ~ T 1'~ -- --- S~LF -~D~~S ----- -------- - -_- __ _. .__ -- -- 3 BD ~1 ~M ~, ~5~ ~ ~~ ~o~ W ~ZL~ S ~°~o ~w- 0 ',~C~ ^~! ~ • g.~ \~` a$ ~q ~~ ~/ X3.3 Ga,~ S ~ ~ ` ~~ q$ -----L'Z.1o~;-p` prv 8``~CC~-c..;_3~"._SSi~-==Pv~==P ip~ =__~1-~~#~-_ - __ - - ~...._ __.. K..-_ . _- ~ .__ _ _ _ -___ _- _ _~_Y_.~_. __ __ 8 _Z-~_~~ 715-425-0165 220254 CST Signature Date Telephone Ilo. CST Plo. o~-Z~ ,lob rio . ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer 7D ~ ~ ~~ l lcl~ ~ Sao /S Mailing Address ~ 7 9 ~ // ~ Q ur' `~.~, ,~ o~e~~~ Property Address /(J Gv " N C BSc c .. Z ZT L g .~. /R /7w ~~.-~ rYr u,~~ ~~yv~ ~ > 57.3 9~ 4 ~ (Verification required from Planning Department for new construction) City/State ~ ' S Pazcel Identification Number Q /f~ -~ /6 ~ ~° - Z~I - cT a d LEGAL DESCRIPTION cation '/. NE '/. Sec. Z Z T L ~l N-R / 7 W own of ~.-», h-1, o Properly Lo A~ Subdivision .Lot # Certified Survey Map # Volume .Page # Warranty Deed # ,Volume ~~ -7 ,Page # ~ ~ ~ Spec house ^ yes~no Lot lines identifiable Oyes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standazds set fortis, herein, as set by the Department of Cori-.merce and the D:.par~ent of Na*: *rl RPso~:s=es, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. 9/ b/ ©t SIG TURF OF APPLICANT DA OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~ ~~ ~ SI TURE F APPLICANT DATE ****** Any information that is mss-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 x $a3~~t~ !~'O~ ~ ,# ~V ~.... f .. ~ _, t'NM fTRQt !OW M14 ATE OI et!-~Oa~! 94 ~~ t ~ ~ ~~ , ~ ~ ~ { ~, ~ _ ....,s..._.. ._ (M~ ~ O~pN ~ * ~•.. f TN BANK ~ ~ 3T. CROIX CO., W~. '. A .............,.._...a~..__...,.___.._. h kr Retxxd Nds S t ( ~'~ ` a tvs~pratloa ~ Ot~isad •nd ng node asdd ~ ~ictnt of tse Ines oit ~ _, • ~" x Mts Rb-,e of Wises, gaotor, of St • Cro ~I ~ ,p~ Au_____,,,,~A.Q. 1,~ ~~ _ CoaehJ, ~ ~! tm~s snd wsmtnb !o ~Ei~T r7~'~'nw ~~ a 8:34 ~ al~sl~.~.~;~t~...biltlL~nd ~~ F ~ ~ 8t . Cro f x , Wisaada, foc the ~ Q . F " Od an . __c slur of Que ~ S ~ . d d) ~.~,,~;..AIL 4th~r I ' valuable consider on _ ! ._ tre tad of Lad ia. St. Croix ~,~,tf, i~ ~"'•' " ~ 8laes of Wiacaaia: , ~r The N-1/Z of the N8-1/+t and the Sw-1/4 of the NE-1/4 of Section. 2Z, Township 29 North, Range 17 West, excepting the l:'ast 10 rods of the SW-1/4 of the NE-1/4, all such i lands lying in St. Croix County, Wisconsin. SUI9JECT TO easements, reservations, restricti ons and rights of way of record, if any. r ~ ~~ 3 Zz.zR.)~, 3~~ 3 ~ ~ ~ 6t°~"3t3, ~3a~~}. (rr tf7C~92, o0t,rtNtral DfDaCRIP?tON ON II=7$RB1S RtDf) L Wicoea Whereof, the said graator bas cYnaed these present: to 6e ~gned h .__ _ .--.-.------ " ........._.._._..., its President, aad conatenigned bl-....__ ..__._._.._.._ :., its Seaetary, at~..._.__H4~......___.._____.__.., Wixonsin, aad its corporate seal to be hereuato affiud ehia .~_..`._ ._...._..... dad of .___~]~ly _..._._.., A. D., I9_~. aiaxsD axn ess~ nr r~ccs or H~EHAI~QOND ST E BAN! ~~~.~.~. .. "°°oee Naa. Dale J. rowle CO SF ..~ _._._ .. ...._.. s.a•~ STATE OF WISCONSIN 5t. Croix ~ ~ ._.._._.__._. Coaat~. PkrsooaltT came before me, thic._._ 31st _.._,_. dad of _ Jul~r~ .., A. D., 19_ 87 --- ._._, Presidents aad._._._....._.._.___-- --_ .___..., Secretaq e~f ebe abort named Corporation, to me kaowa to be the persons ~vho ezacnted the foregoing inatrummt, and to me 1~auwa to be sock President and Secretary of said Corporation, and acknowledged that they ezanted the foregoing i~strament as such officers as the deed of said CarpOtfti authority. ' saxn ~w~rwuHarrr w~-s o+ewrrea ar .. rI ~ . •: Robert W. Budge, Attorney " ~ o i : ~~`,,~~~~_.._~'~~ Budson, WI 54415 ~ ' : ,.~~".•`F Public, .._._...,~~..~...CLQix..__._.._.__...Count~, Wis. ~ ~ ~-r~ ii' ~f3 ' pD° ~ a, ~r `~ ~( G Q~N~ ~. ~ t ~ ~~xa~ ~~c~ L~~~~J~ 2~~ ~~,~ ~~ Flr-Y O ~ ~ --~ _T ~l ~CH~ aJ ~ATN ~~"`, .~--- ~~~~M -`lX+° ~~ ~° ~ ~ k,D ~~~~°~ 1 a ~ ~-a _ ~~ ~. -. _ , ~~ Sanitary Permit Application safety & Bu-ldings Division In accord with Camm 83.21. Wis. Adm. Code 201 W. Washington Ave. ~~ ~ See reverse side for instructions for completing this application PO Box 7302 ~-~sconsin Personal information you provide may be used for secondan~ purposes Madison. WI 53707-7302 Department of Commerce (Submit completed form to county if not (Privacy Law, s. 1 ~.04(1)(m)] state owned.) Attach com lete Tans (to the county co v only) f v e ! a of less than 8-1/2 x 11 inches in size. Coun ~v k C' State Sanita Permit Number e - revision to pre,~pvs plication , State Plan 1. D. Number , . 9 ~ ~. 4, I. A lication Information -Please Print all Informatio ~a J Lo tion: Prope Name d .~ ~ '! ~ ~ ~ ~ ~e~t- 4~*~ P perty Location / '~ .1 i~ ~fd 1/ ~ -~ ~ ° zZ- /4N~"1/4 ~ W z-9 £ l ,S T ,N.R E or Property wner's fling Address ~~ -' ~ - Lot Number Block Number ~ 7 9 i/~ r~ ~ ~ ~~ .,. .- ~., ~. .~. City, State Zip Code a tuber s~ '~ Subdivision Name or CSM Number r _ ~, S~ I ype of Building: (ch k one) ~ ^ City ill ^ 1 or 2 Family Dwelling - . of Bedrooms: ` age V j$Town of ^ Public/Commercial (describ se): 1 ^ State-owned drrr ~ lJtil~ III Typr of Pc::..it: (Check only ,e box on i~•te A. Check box o<< line >; ' apy~licablc) Barest Road 9p th ~ U ~ A) I. ^ New System lacement ^ Replacement o 4. ^ Addition to Parcel Tax Number(s) S ste Tank Onlv Existin S stem ~ / B -~d 5~' ~ ` Z.U 'd0 d B) Permit Numb Date Issued ^ A Sanita Permit was revt tss d o7. ~ ~, 3 7 Type of POWT System• heck all that a ly) Non-pressurized In-ground ~i 9~ edPd ~ ^ Mound ' ~ ^ Sand Filter ^ Constructed Wetland G ;,~ " ^ ressurized In-ground ~h,~ - ~~ f~~ ^ Holdin ank ^ Single Pass ^ Drip Line ~ • ^ At-grade ^ Aero c Treatment Unit ^ Recirculating ^ Other: / -, p~~ ~ = - rte, cs - - ` k y " - J - ' x o- '~ ~d -To J llt~'"- V Dis ersaUTreatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Ar 4. Soil Application 5. Percolation Rate yttem Elevat n 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) /~ 9.f, 7 Elevation ~~5~ 3 ~ s ~ -7 /. L -- z - 9~. 9 99 8~9 ~- 9a. ~ VI Tank Capacity in T al # of Manufacturer Prefab Site St Fiber- Plastic Information Gallons Mons Tanks Con- - glass New Existing Crete structed Tanks Tanks S~A1 w X ~©AA ~ ~~d ^ ^ ^ ^ ^ I ^ VII Responsibility Statement ~ i, GiC iiriderSt ned, aSSitme re5 Sibllit foi inStallattvn Oftlie POWTS ShOWn On th ~ PI ber's Name (print) Plumber's Signature (no stamps): MP RS ae~u~ ~~,~~ s zz PI tuber's Address (Street, City, ate, Zip C ) VIII County/Depart ent Use Only ^ approved 'S`! 85 Date Business Phone Number ~l7L ~y~ Approved ^ caner Giveq Initial Adverse Surche Fee ~ ' termination IX. Condition f Approval /Reasons for Disa proval: ,tom ,~.~- ,, ~R- , t , ~P v w`w• ~~' ~ er cRs.w.~a.d[ .d~.t~ ~G~„s.,. s+~. to ~ ~ ~ ~ o7©s_ / l~jN_ o / d l) . ~ ~ ~ea.~i~ Issuing Agent Signature (No stamps) ~o,.~._. '~ ~~~-P'i'n `~ Lam- 9a -~' ~ w ~ // ~Ocls~ z O ~,S U~ A ~ ~ -3 .~P~-~ ZZzB?z-- ~~ Z /aoo 9d/. ~,tio,c~/-c ~~ ~ g~, 1 ,~a °~ ~~d a ~ ~~~ f 3 ~c~,b qg, v G ~~ ! Z `' . ! L , ' ~ , I I ~ / 3 ' 3' w ~Z ` ~~ .~ ~ ~ 9 ~~ ~- ;~~ Pte-) / - 3 ' x So S"". ~7~•" ~~v~~~ 9bh~ ~dl~d~ / ~~ ~ ~~,~~ ~y = ~d ~~~~~~ j ~~ ~'• -- - ~ ~ ~~~~~L~ ~~ ~-~ r ~. ; s~'c~~ a 7' a~d ~d~~S~i ~y~ t o ~G ~l o w ~ ~ Fj0 . ~~~Z ~ _~~~ ~~ ~ wweagc ~,~ s~z z~ ~~,~ ~~ 2r ~ s ~~ ~6 L~ ~/ ~~~J id wd~O:Le i0ez ie •~~o TZbZZLb "oN Xd.~ woad POWTS OWNER'S MANUAL 8t MANAGEMEf~T PLAN ~ILE IN1~OR TION Ov~~er ,v d d'~ Permit # ..~^ non•VZTiflC SYSTEM SPEClF1CAT10NS Septic Tank Capacity Septic Tank Manufacturer Effluent Filter Manufacturer YiiJ~V~~ •~vv .. .~-~-- Number of Bedrooms ,3 ^ ~'• Number of Commercial Units -- ^ NA Estimated flow (averag }!S'~ gal/day Design flow (peak), (Estim d X 1.5) ~S-~ gai/day Soil Application Rate I , v gai/day/ft2 Influent/Effluent Quality Monthly average* Eats, Oil 8t Grease OG) <_30 mg/L Biochemical Oxygen Demand (B s) <_220 mg/L Total Suspended Solids (T ) <_ 1 SO mg/L Pretreated Effluent Quality ^ NA Monthly average* * Biochemical Oxygen Demand (BODs) <_30 mg/L Total Suspended Solids (TSS) <_30 mglL Fecal Coliform (geometric mean) <10'` cfu/100m1 Maximum Effluent Particle Size ' 'nch diameter Effluent Filter Model Pump Tank Capacity Pump Tank Manufacturer rage of /oa6 gal ^~ Z ab£ ^NA /} / v a ^ NA gai ~ NA tSLNA Pump Manufacturer m. NA Pump Model 8 NA Pretreatment Llni ~-NA ^ Sand/Grave filter ^ Peat Filter ^ Mechani Aeration ^ Wetland ^ Disinfe on ^ Other: Manuf urer Disp al Cell(s) -ground (gravity) ^ In-ground (pressurized) At-grade ^ Mound ^ Drip-line ^ Other: * Values typical for domestic (non-commercial) wastewater and septic tank effluent. * * Values typical for prevented wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency t condition of tank(s) I At 1 on every ^ months year(s) (Maximam 3 yrs.) nspec l t contents of tank(s) P W n combin sludge a ume nd scum equals one-third {Ys) of tank vo ump ou ) 3 ersal cell(s) di t feast once e ^ months year(s) yrs. (Maucimam sp inspect Clean effluent filter At least once eve ^ months year(s) Inspect pump, pump controls 8t:alarm At least once every ^ months ^ year(s) B.NA Flush IateraLs and pressure test At least once every ^ months ^ year(s) ~ NA other: At least once every ^ months ^ year(s) `6J NA ` ocher: At least once every ^ months ^ year(s) 9 NA MAINTENANCE 1NSTRlICT10 Inspections of tanks and dlspersa ells shall be made by an individual carrying o of the following licenses or certifications: Mast Plumber; Master Plumber R ed Sewer; POWTS Inspector; POWTS Maintain • Septage Servicing Operator. Tank inspection must include a visual inspectio of the tank(s) to identify any missing or broken har are, identify any cracks or leaks, measure tl volume of combined sludge d scum and to check for any back up or ponding of a ent on the ground surface. The dispersal cell(s) shall be visually insp ed to check the effluent levels in the observation pipes a to check for any ponding of effluent on the ground surface. The nding of effluent on the ground surface may indicate a failin condition and requires the immediate notification of the local r latory authority. When the combined ac mutation of sludge and scum in any tank equals one-third (Ys) or ore of the tank volume, the entire contents of the tank sh be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 1 13, Wiscon~ Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion ~°f any service event. START VP AND OPERATION For new conswction, prior to use of th a Pd0/O damage the dispersalacell(s)f o If h gh concenuauons are deed d ha etithe con e'r that may impede the treatment proces ~r r1~ rantr(s'~ rampvP~ `;Y ~ SentaRe servicing operator prior to use. Pie ^ oF._ System start up shall not occur when loll conditions are frown at the Inflltratlve surface. During power outages pump tanks may fill above normal hlghwater levels. When power h ratond the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloadlrgT the cell(s) and may result In the backup or surface discharge of oftluent. To avoid this situation have the contents of the pump tank removed by a Sepu¢e Servking Operator.prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist In manually operaclrtQ the pump controls to restore normal levels wlthln the pump tank. Do not drive or park vehicles over unks and dispersal cells. Do not drive or park over, or otherwise diswrb or compact, the area wlthln l S feet down slope of any mound or at•~rade sot( absorptikn area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the lift of the POWTS: antlblotl ; baoy wipes; cigarette butts; condoms; cotton swabs; degreasers; dental flo ,~dtapers; dlslnfeccants; tat; foundation drain Is p pump) water; fruit and vegetable peetings; ~asollne; grease] herbidd eat scups; medications; oil; palntJns; products: aes ~ Ides: sanitary naukins: tampons; and wacer softener brine. ARANDONEMENT When the POWTS tails and r is pemianencly taken out of service the following see Il be liken to insure that the system is property and safely abandone n cornpilance with ch. Comm 83.33, Wisconsin lntstratlve Code: • All plptng to unks and shall be disconnected and the abandoned pl opsnings sealed. • The contenu of a(I tanks a ptu shall be removed and property d d of by a Septage Servking Operator. • After pumping, all tanks and u shall be excavated and removed their covers removed and the void space filled with soil, g~~avel or another Inen Boll aterlal. CONTINGENCY PLAN !f the POWTS fans and cannot be repaired th ollo~ replacement system: O A suitable replacement area has been eva system. The replacement area should be pr required setbacks from existing and proposE result In the need for a new soli and site ev< comply with the rules In effect at that t1me. {seen, or must be liken, W provide a code compliant and ay be utllited for the location of a repixement soil absorption k orn disturbance and compaction and should not be Infrfnged upon by cwre, lot tines and wells. failure to protect the replacement area will An to esub{Ish a suitable replacement area. Replacement systems must O A sultabte replacement area is not avatlab due W a a holding tank may be Installed at a last to re cc O The site has not been evaluated to id tlfy a suitable evaluation must be performed to I to a sulubie reel be lnsalled as a last resort W re a the failed POWTS. O Mound and at•grade soil absor on sysums may be reco~ lntlltrative surface. Recoru Ions of such rystems must < <WARNING> > SEPTIC, PUMP AND OTh OXYGEN. DO NOT ENT DEATH MAY R>;StiLT. IMPACCIRI i. AD0171CyNAL COMM TS ck andlor soli llmltatlotts. 6an"Itit; advances in POWTS technology the !ailed POINTS. xement area. Upon failure of the POWTS a soli and site ent area. if no roplacement area is ava1able a holding tank may In place following removal of the biomat at the with the rules In effect at that time. TREATMENT TANKS MAY CONTA LETHAL GASSES AND/OR INSUFFICIENT A SEPTIC, PUMP OR OTHER TRIE~- ENT TANK UNDER ANY CIRCUMSTANCES. UE OF A PERSON FROM THE INTERI R OF A TANK MAY RE DlFFICUIT OR POWTS INST ti,ER Name Phone i11~ y -~ y ~/ ~e SEPTAGE SERVICING OPERATOR (Pt1MPER) Name t" ~ c! 2~ ~~ .~. ~"~ f~ ~ ~ Phnn• 32`7 -~'S~d ~ POWYS MAINTAINER Narne Phone c,[ - ~ S~ ~(, A¢etxy ~ ~~'. ~,~ o % k ~., u ,,..~,., ~ of ," 1L. ~ '/4-NW 7/4 340 1012/598 ~4-N W ~/4 NW ~/4-NE ~/4 337 787/376 SW ~/4-NE 1/ 338A 787/376 343 ncn /nnc AVENUE J( NE ~/4-NE ~/4 336 ~ 787/376 I 4 a - 313 ~ I 339D 0 N 875/36 313' ~ SE 1/4=NE ~/4 ~ ~ .~ ~ ~ 339C ~~. ~ ~ " ~ ~?~~ ~ °~ '~~ 84,/469 ,3.39, ..> ~' ~ '"' 3388 ~ ~ 06~',~33~~~~~ . '~s.