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HomeMy WebLinkAbout018-1051-10-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM ~ INSPECTION REPORT GENERAL INFORMATION ~ (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Yan , Ler Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: (Coat ~o~ .a ~ ~,~a- TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing ~ A t 1.~•~aa u Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ tbD / ~~ t D `_ Dosing t t u u~ Aeration Holding PUMPJ,SFP~ION INFORMATION Manufacturer Demand ~ GPM Model Number ,~ ~~J ~,~ O /~.~ TDH Lift ~ Friction Locc System Head r TDH Forcemain Leng~ 1~ Dia~t/ Dist. to Well SOIL ABSORPTION SYSTEM i BED/TRENCH ~ Width ~ Length ~ No. Of FrerTCtS1s5 I DIMENSIONS / I D~ Z IS SETBACK SYSTEM TO P/L BLDG WELL !INFORMATION Type Of System:. t t 1 ~ ~ , ~ ~ V -sY DISTRIBUTION SYSTEM VJi7~a,~e~yre[.PG Ft ELEVATION DATA cqunty: St. Croix Sanitary Permit No: 420328 0 State Plan ID No: Parcel Tax No: 018-1051-10-000 STATION BS HI FS ELEV. Benchmark ~o•~ 1~•S'D ~ ' D Alt. BM Bldg. Sewer Iq • D ~~ St/Ht Inlet 19.20 8'~.3c> ~ SUHt Outlet Dt Inlet Dt Bottom 23•sa r 83•~ Header/Man. , ~~ oz •oq r Dist. Pipe Bot. System . (0 o , o l• `{O Fi I Gra wu loiz ~Z t~~-. S over , ~ ~ ~ ~ ~~ ~ SPIT DIMENSIONS o. Of Pits Inside Dia. Liquid Depth LAKE/STREAM Header/Manifold tt Distribution r~ t , x Hole Size ~~ x Hole Spacing Vent to Air Intake t Length 3,o Dia ~ Pipe(s) O Length ~~ Dia l Z Spacing 3' S~ II 3 Z Q t~ ~v SOIL COVER x Pressure Svstems Onlv zx Mound Or At-Grade Svstems Oniv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil Yes ®No ~ Yes ~ No ~~ ~ E~TS: ~(In lug de cgde di~crepenpie ` perso~~reseryt;, eta Inspectio ~#\!_ l~y Inspection #2:~,~~~ 1~X1~ v~ C~3a'Mwc-~1 d7C-' c~,o.~j,. .) -t t Location: 1933 90th Avenue Hammon'd,nWl 54015 (NE 1/4 NW 1/4 23 T29N R17W) NA dot arcel :23.29. 355 1.) Alt BM Description = 5 ~ 1' ~"'~" ~'-• ~~ ~~ S~ ! ~ ~ 2.) Bldg sewer length = ~ 6 ~~~, ;Q~ s ~'~"'~ -amount of cover = > 3~", , ~ • ~+ \ qJ2' ~ ~F 3.) Contour = 99,~t ~ cy~' ~ ~t •i~ ~ ~ I J ~1 Plan revision Required? ~ ~ Yes No Use other side for additional information. SBD-6710 (R.3/97) BV.i ~s ~~ ~ t ~ .._ ~ Date ~ ~-- Insepctor's Signature ~ Cert. No. ' Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. PO Box 7302 `~sCO/lsin See reverse side for instructions for completing this application d Madison, WI 53707-7302 Department of Commerce ary purposes personal information you provide may be used for secon (privacy Law, s. 15.04(1)(m)~ (Submit completed form to county if not ~~y ~ ~ t~gG state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County e2 iiilumber ^ Check if revision to previous application State ~ ,P ' State ~~I. DSN~ber ~F Z ~~ L/8! 3 j,5 I. Application Information -Please Print all Information Location: Property Owner Name ~ ~ ~ ;;,.. Property Location ~~~ E 1/4 a11G~ 1/4, S~3 T~~,N, R~~ (or Address s .. ~ (~ ~ Property Owner's Mailing Lot Number Block Number / .; UN'~, Y City, State Zip Code ~ P ne N b ' '' „. 0~=f'=1G ~ Subdivision Name or CSM Number S ~b I S~ ( ) 9b- 2S`va ~- II. Type of Building: (check one) ~/ e~ ~'s...~.~.~ a • ~ ^ city ^ Vilt e ~ 1 or 2 Family Dwelling - No. of Bedrooms : Y ,I@'Towrgof ~~ ~ ~ ~ ^ Public/Commercial (describe use):_ ^ fate-Owned t Nearest Road 90 ~t, /` L ,`v Z~ I ~ n ~ k O ~ r l11 ^^ `~~ t c _ r -'~ Parcel Tax Number(s) l eS l - p -ec~ III. Type of Permit: (Check only one box on line A. Check box on Mine B i applicable) p) 1. ew 2. Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to System System Tank Only Existing System B) Permit Number Date Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) - ^ Non-pressurized In-ground Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. DispersaUTreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) Elevation 500 3a~ • a~ D~. 1n~f ~f- VII. Tank Capacity in Total # of Manu~'acturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete siructed Tanks Tanks ~t T L 2Sb --- Zrsb GJ ~ ^ ^ ^ ^ /- " ~ VIII. Responsibility Statement I, the undersigned, assume responsibility f installation the POWTS shown on the attached plans. Plumber's Name (print) stamps): Plu 's Signat MP/MPRS No. Business Phone Number D~JD ~i N z- ~ U~P l3q~f Gz 7l S Z3S'- ZL ~ Plumber's Address (Street, City, State, Zip Cod /v s~o D9 SUS ~ ~ E ~D~ rrla~ ~ !,t/s SS~`J.~"! IX. CountylDepartment Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Sign re (No stamps) Approved ^ Owner Given Initial Adverse Surchar Fee) ~ ZS~_ ~ p ~ \ Determination - 1 ~.~CCo~ ditiq~ps of Approval /Reasons for DisapBrova~l: ~~y-~--y n ,_,/ ~-`~ivt'S `•-1 '--~~ - S e- ~' t---'Y~. - Wv, g e h . zs ' ~ ~ 4 w~~ a~ ~4 a 3O _~ ~ ~ O ~ S' Z O ~~ ~ ~a4 ~~ -M~ -23-2g-1'~^t-.~ ...1 l-l uwye.w7+ O y.w: ~ws~~......,.~ ~ (~. S.S^~..a.o.. ~.. .w~t•~.~ LQ,~ L„ c:~ °"~ • o. ~ w:~ 11 `S K,Sr~ ~..'~' t Grp. ~.~ ~ ~• }.: <Ll ~ tir...Lyp ~`L N 0 - V wt ~ l'}t nn ((~~ rr s`+~ ~.a ~o JUt (~ (( n '~ ~l'~r~f1 ~G.Qh Q c-~s. ~.r~ 5... o ~ ; S,~i_ aa-z) ~,~'"' ~ 1 . j'~~ ~c pat•i 1 ~O ct. S:~ '~ '~P J - .~v Raw i - '~ ~t~l'C,~S e s qq S ~ ~ ~ w.a., s~o ~ s .$F= / 3;ue~ -- .--~ == -_=-'_ \ ~~=-__ lsy.~ r. tih~«~ .. -- _- _-_--- j `( tm4~ r e..~c !D t a t~~ Q-~ ~ Jo~~•w J 1 ' tb r~ 2 ~~ ~ a~.~ ~~o~~ n. t yr . ~.) (t JO .p) 1; K~S t7.bti a,cXi~ ~, ~'f ~'i ` ec ~,.~ ~0.u~ - ------------ ; d ~ ~ ~ ~ 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 Scott McCallum, Governor Philip Edw. Albert, Secretary August O 1, 2002 CUST ID No.139462 TODD L SINZ T L SINZ PLUMBING INC E5609 708TH AVE MENOMONIE WI 54751-5520 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/01/2004 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Ler Yang 90TH Ave Town of Hammond St Croix County NE1/4, NW1/4, S23, T29N, R17W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 863035 Identifica ' hers Transaction ID N 7725 Site ID No. 648301 Please refer to both identification numbers, above, in all comes ondence with the a enc The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes COila and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ~~~) chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTME ON SE General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORi "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.0,1/O1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component azea. 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. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. TODD L SINZ Owner Responsibilities: Page 2 8/1/02 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made tome at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608}789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.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 Henry F Grote ,Certified Soil Testing ~+ J RECEIVED Ler Yang -Mound J U L 1 '7 2002 Transaction # SAFETY & BLDGS D1V. Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /0l ) Pressure Distribution, SBD-10706-P (01 /01) Location: NE 1/4, NW 1/4, Sec. 23, T 29 N, R 17 W Town: I3ammond County: St. Croix Date: July 30, 2002 Owner: Ler Yang Address: 190th Ave. Hammond, WI 54015 Plumber: To Sinz Signature: License # 139462 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management ~nally ,~~~~ r~ MMERCE rca~ ~ PpNpEN page 1 of 8 ~) . G - S Design Criteria Y~'~S Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 ~ ~o gallons/day hydraulic load In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system Force main length Manifold/header length Drain-back Lateral length ~ @ Lateral elevation _ Lateral hole size S~z Z in. @ 2l~ holes/lateral Design Calculations ~• Zt, gallons/sq. ft. per day '- ~ 1o in. ~ ~ 8 in. o~ 1 X415 3 ~. 4.4•x' 1 ~.~ 1 nt. g bs•$ . c S2 Lateral volume ~ 8 • ~- Total lateral discharge rate ~• ~ .® g Network pressure compensation losses 1 • m ~ Elevation difference ~ 5 • ~~ Friction loss Z• Y ~ Total dynamic head Zts.s'~ Pump/si~on 3 3 gpm @ 3 "' Manufacturer ~ o ~~~ Dose volume ~ 1 ~ Lift/si~kon tank ~~ u. ~•~ ~ ti`~C' ~ zs'b . ~.s-o 4 ~•.~•o Septic tank •• '' " Effluent filter ~ ~` ~ ~ t ~ Measurement pump on and off ~ • ~ Height alarm from tank bottom ~ ~ •q Reserve capacity S t S ~ specs.calcs.res 0 ft. of Z in. ft. of 2• in. gallons ft. of ~ `fit in. ft. @ bottom of lateral in. ( `~-• o ft.) Spacing holes total gallons gallons/minute @ ~'~ ft. head ft. ft. ft. @ 3 ° gallons/minute ft. ft. of head Model # ~ ~ 3 gallons ~-~ gallons ~ Za-e gallons in. in. gallons Page Z of ~ ~~~ ~~ ` E____'ti"~a-. _' ~vs g o ~ '~« z ' ~ ~ V ~ ~~ ~Sd~.~ 1~'`30~ t ~ o ~s zo }~ h1t -M~-23-zg-1~o~ ~` 1~ uw~+ow7'• O rM; `wo `1 .a.a.~tn.., ` av 4.1.,, c;\.c 1 r d ~., w:c. ~ K V SHi Q` Y\JL.v O`H ~'~D i W ~t w.~t ~i~ i~t.. q}s> ,~, ~~. ~ ~ 90 1~M e .COCA i i \ ~ Qa. 5 1 js ~v>q' r e <<c ww ~` w ~ ~,(.~.a.,,~Sr y. S1 o a. Q.dL dO~~eW l ~t~ ~ ~~ ~y ~° Q ~u (ire ~, - ~. ~•}} 1 (o-J" ^b t CQ V qS \ 1 + (q E. L; \~ \~ P+1 Gi ` YC ~ A~ ~~w w No~3 ~~~ ~ ,,~., ~ , ~ ~ s:~.... ~! 1 ~g~~~ (~~.~1;s '~T 1.2390 -~~~++e K~ ~, ~ rl~n J,~ -- ----- _ _ .~, Q_ 3 n ~ ~ '~~= =~~z._ f ~'__.= °'-'__ _, =~- „ .. ~/2, • ~` ~ Z. w e..Z~~~ ~ w ~l 3 ~o~k ~~ ~S'h p , Z ~ ~ ~ t~~o opt ~~-~w«Q c~~w l,~' ~ C~'~3 &~.a~) ~.,y ~ aY lwr ay.,.rv. 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QUICK Dt~C.OVVtGT-~ ~~ `'~ et 2 Ala„ PIPE 3~ rl0 n+OtSTua6F0 S01 L. ~~f f ~ 4W ROVi..D. SKET 3bNf'J L P l1'` -w E C.71 o wS Clev ~ ><v $ 2 .~ SEPTIC f 00 5 C b~~ 24" I.D, MA-r u 41F > 4'' z t, ~oz~K Mn~N ' WEA'rNERPR00F ~.J~JN(,TIaN f I L~~wci.v q 3o.t~~ "o'r ~~ ~FLE 1a~ 2 QJV ~ O w'Y 1. v ~ , 4 ~. CJL~ Pt~IP D ~„ C o^IGR~'c bc.oCK SPECIFI•CATI~IJS }fig '~ ~~~ ~ ~. I'~ '~/i~~7i~7 .r P .sc. ~ ~~, d" 4 _I v~ti~/i ~1 ~u1 4" ~~ 5..~ 40 3' ono u.c~,Tv~c,c.. G~u~o Tnu~.S MA-JUFAGTURCR: ~'`~' ~ ~.Jl1MB£R OF DOS[5: ~'~ ,_,_PEk 0~~ TA-JK SIZ C : ~ ~'S'b ' ~"~ GALLOIJS • . DOSC VOLUME ` S ~ ~~~~-c.YY.~ ALARl~1 KAIJUFACTUi~GR; IIJCLUpI1JG 6ACKFl.OW: ,,~ G~~~ONS J'~ODCL 1JUlhDCR: \ ° ~ 1`F ``~ CAPACITIES: A c 30`~ IUC"CS OH S ~5.~ C,o.,~vu5 awlTCH TyPC: " ~''"'`` wpb z 34 14 . 8 = IucHcs oa ~..~.~:;s PUMP MAIJUFACTURCR; °~ t'' C a b~q 11~' ~ 153 IULMES O" L~~'.CU~ ~ MOpEL IJUMDCR: \o2,g.'Z D~ ~ SWITCH TyPC; V"~R.~~..tiv "' INCHES OR G~lLO~:: IJOTE: PUMP AIJD ALAR~1 ARC TO pC P'11-JIMUP'~ DISCMARG~ RAPE Z$'~ G-h1 INSTAlLEO 01J SEPARnTC CIKCu~r~ VERTICAL DIFFCRC1JCf OCTWC[U PUMP OFf ^1~p OIJTRIDUT101J PIPE.. ~q'~S FEET + r~l ulhlUM uETWORK SUPPLY PiICi CUR [ . 3'S FCCT'~ 1.~'~' /1 /, T / + ~~g FEET OF FOR[[ MAIIJ X ~_ ~T F~oortFRICTIOU FACTOR.- 2~~~ FEET ~ ~~ TOTAL Dy1,SAMIG HCAp FECT hh '• t.`C'~'~ IIJTER-JAI. DIMEIJSIOAJC 0- TA1JK: LEA1b7N ~ ~ t~ ~. ~~ WiDTN ; ______._~;LIgUID OCPTH • Pain 6 ~, a g _1 ,, s w~ F- W w ~ ~ 50 153 12 40 0 a w x ~ 30 8 '~ Z,t, ~ ~o J ~.• ` 20 Q o ,~y,~ 4 fr" ` 10 HEAD CAPACITY CURVE MODEL 152/153 0 20 40 60 80 100 GALLONS LITERS 0 80 16~ 240 320 ~OWOPE~ MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 152/153 Series _ __ 15?1153 MODELS ' Control Selection Model ----- Volts•Ph I Mode - Am s Sim lex Du Iex Nt52 __ __115 1 Non 8.5 t 2or3 BN t 52 _ 115 _ 1 I Aulo 8.5 Included 2 or 3 E t 52 230 1 F Non 4.3 1 2 or 3 _BE152 230 1 i Auto 4.3 Included ~ 2or3 N 153 u 5 t Non 10.5 1 2 or 3 _ 8Nt53 t15_ 1 Auto ' 10.5 Included 2or3 E 153 230 1~ Non 5.3 1 2 or 3 BE153 230 t Auto 5.3 Included 2or3 A CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Acl (OSHA). TCTAL DYNAMIC HEAd/CAPACITY PER MINUTE EFFLUENT AND DEWATERING OM DEL ~ 152 i Feel Meters j Gal. ', Uiers 153 Gol. I Liters 5 ?.5 ~ 69 i 261 i 77 291 10 ' 3.1 ~ 61 231 70 ~ 265 ~ 15 4.6 53 1201 61 231 20 6.1 44 167 52 I 197 25 7.6 34 129 42 ~ 159 30 9.1 I 23 ! 87 33 125 35 I 10.7 ~--~ - ~ 22 85 40 ~ ', 2.2 I -- -- ~~ ~ ~2 Vewe: ! Lock 36,0 F!. (1 1.6^x; i, ea C ~~ ,' 3 [rr o~asoe 3 27/32--i-~--~-..a 5%8-~-i i I j^ 32 T.~. -- 'J, =-'T_ ~~ - _ 1111 _~ I ~ _~_ =,~-- - ~----\ ' L sKZOSa SELECTION GUIDE 1. Single piggyback variable level float switch or double piggyback variable level Float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E•Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) Float system. ~ ~~ ~ RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. --~"? MAIL T0: P.O. 80X 16347 ~ ~=" L .1 ~ owswle,KY 40256.0347 Manulacturerso(.. Z SHIP T0: 3649 Cane Run Road ~,~~ Louisville, KY 40211.1961 PUMPS SNCE /9,99 ~~ ~/ (502) 178.2731. 1(800) 928-PUMP QUQ[/Tv http://www.zoeller.com PUMP l0. FAX (502)774.3624 © Copyright 2000 Zoeller Co. All rights reserved. ~~ ' . System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715-235-2644, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water qualify and public health. l . [f the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 1 I. 1 f construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance I . The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 1 1. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.4 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, andior installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 08/ 01 / 2002 16:05 6087859330 ~,(,y~` SAFETY A-GN,~D- S_LDGS _ D . - 4. J ~ ~ 7 , Wiscon,tn peparUnent of Commerce SOI L EVALUATION REPORT Division of Safety end Buildings PgGE 01 Page ~,_ of ~_ Attach complete site plan an paper not less than 8 112 x 11 tnd-es in size, Plan must County C ~ ? ,~ include, but not limited tp: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensioh5, north arrow, and location and distance to nearest road. Please print a!! information. Re lowed by Date Personal infortnaGon you provide may he used for secondary purposes (Privacy l,aw, s. 1S.od (1) (m)), ~(J~J"M ~ Property Owner Property location YC{_./~L• Govt. Lot 114 ,w 1/4 S ~ ~ T ~ N R 1 ~ E (or Property Owner's Mailing Ad s Lot # Bloch # Subd, Name or CSM# a~ City tale ?~p.Code phone Number ' ~ ) ^City ©Village ~ Town Nearest Roat] New ConslrvcUon Use: ~ Residential J Number of bedrooms 3 -y Code derived design flow rate G GPD ~ Replacement ~ ++ ^ Public of uammerraal -Describe: Parent material _.. ~~ I 1 Flood Plain elevation if appli®ple _ /ti/ I~- it. General comments ~ ~s~ VY~ ~. I G V ~ and recommendations: tl.~ ~ ~ (e V ` fU/~T~u 1 boring # ^ goring /~ ~ pit Ground surface elev. 9, ~ fi. Depth to limiting factor ~ in. Soil Application Raie Horizon Depth Dotninanl Color Redox Description Texture Structure Consistence Bountlary Roots GPD/ft? in. Munst311 Qu. Sz. Cont. Color Gr. Sz. Sh. "Efi#7 'Eff#2 I I ~ '/~ ! ~ 3I ~ ~ sr .,~mGt ~ 1'Y1 ~~ C. S I J ~ r ~5 = ~o-~~ ~o~~ ~r - sr~~~ .~ .~ ~ 1~ ~.s - ,~ ~ } ~-2 ~{ io r ~% 7, 5` r C z. S,~ .rt.sb ~ -~~ - _ ~ ~ r ~. 1 ~ 1 Boring # ~ Boring ^_ _~ .1_ _,_ ~.~ , . lL .. . rn _.__. - __-.___ -._. .. ~..~....~ ,rn., ,a ....... .. Soil Applimtion Rale Horizon Depth Dpmina~t Color Redox Destription Texture 5lruclure Consistence Boundary Roots GPD/fl= in, Munse ll Qu, Sz. Cont. Color Gr. Sz Sh, 'Eff#i •Eff#2 I ~1- `~ ~ / iQ --~` ~ s . ~ ~ ,~ rn G b ~l r C ~, ~ ~ ~ ,S v ~ _ .___~- ~n wcK~ n n ~ ~ DV V5 ~ JV ~ [.w mgrs ana r ao ~3u _~ 171J mg/L - CmUBn[ SZ =Boo, < 30 mg/L and TSS ~ 30 mg/L C57 Name (Please Print ~ 'nature CST Number Address Dale Evaluation Conducted Telephone Number L l ~ '~ ~(,~ ~~i S,~ • . Son~Sc rt.sz ~ W (. S yob ~; ~` 1- °~ i/~ ~y~-~~ SLED-83~n ~r~,;ror 0810112002 16:05 6087859330 SAFETY AND BLDGS PAGE 02 of Pa e ~ parcel ID # g ,,, Property Owner . Sgdng i~ Boring , ~J,~ [~' Pit Ground surface elev. h pepW tq limiting factor ln- Soil AppliGdtion Rate Horizon Depth Dominant Color Redox Descri{~1ion Texture G Consistence Boundary Roots 'Ef~1 PD Eff#Z in MunseN Qu. Sz Conl Color r S r S~. Sh. l ~ ~ C ~ n~ / ~+^ r ~ ~ .) ~ ~ ~1/ f o. 313 , .o.~ ! r Y 1/- ~ ~~ ~ ~ S i~c:~ rri.Sb T f ~~ ~ c z -s~ ~- 1~ ~,~ . ~ rr, . .- i _~-- I~ Bpi^s Boring # in' Sail Application Rale pit Ground surface elev. ft. Depth to IimiGng factor __ Hprizon Depth Dominant Color Redox Description Texture Structure ConsistencB Boundary Roots .E~GpDlft Ef~'2 in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh_ boring Boring # crqund surface elev. i_ ft• Depth to limiting factor in. Pit Soil gpplicalion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence boundary Roots .~~C3PDlR Efi#2 In. Munsell Qu. Sz. ConL Color Gr. Si. Sh. Effluent #~ = BODi > 3D < 220 mgJL antl TSS >30 < 150 rng/L ' Effluent #2 = BOpy ~ 30 mg~l. and TSS = 30 mglL 'r},e Department of Commerce is an equal opportunity service provider and ezrrploy¢r. if you need assistance to acetss services or need material in an alternate format, please contact the dcpattcnent at 608-266-3151 or T1Y 608-2d4-8777. seaan~e (Ra77o9) 08101/2002 16:05 6087859330 SAFETY AND SLDGS PAGE 03 ~~~ F T {~T# T YAL D CRTI'TTQN ~.r I,u~ ~ ,S ~ ~ T ~ ~N_T~ l ~ ~(or~ ~1 , SCtLLL: 1 `' _ '7 G T3M 1 I,+L,I;VAI~ION ~ ~QO. O I3.IvI I DI:SCRII'T10N~~~nrrP elegy. u~- r~~'~t Vnar.~!.rc{r' ITM 2 IrI.~~In'rioN ~q, ~=~-c~ . 13M 2 DI:SCRII'TION~(.~rn., z~~ e•(t ~. ~r~ ~.-ct+,~_nfl,/2r SYST'~.M I±I.~~/ATION ~CI,L ~~~~" // SYS'I"Elul TYI'C 1~~ U u rL ~ -'~! ~ T ~ ~ CON"1'UUR I;].I:YATION ~ ~' ,.,.,, . ____~ ~ Q ~~~ ~ ~~ DATE 08101!2002 16:05 6087859330 SAFETY AND BLDGS PAGE 04 ~~(1" x:.14 Grp ~ nn. fie. ~~TJ~ ~t~Z ~, ~ ~~ V k S ~j O S ~~.~, ~ ! 1 d ~~ Z O A V ~^~ TiN V.~ 4'i-;~~ i ~ ~. - • ~• fo Qt.4) 1 ~ ~t4.ay R` ~ ~ Wpb t /~..~~ • 1 ~ 7 0 ~ ~J 1 ~ ~` ~..le~y ~ ~~ ~L ~ ~l.a .. Z,;.. ~4-lib o +.~; tt11 ~l 1cr..\t `••M~a o, ~,w a.-~-.~ ~ee.ui~ ~ ~~ ~ ~ ~~~ ~o ( (~ L ~`{ r~tiji ~YC44 hiQ S S ~a~-~ ~o et . S : \.a~ t~ ~-~.S ~tq~.~-s (~~.~1:s ~T 3.zs7o vim...... ~ f ~b ~ t~.~ "b f ~ Ib K ((~~ ~ (q4~a g.~ b~,o~~4i 1 ~ ~ `n ~- ~ 13 Kai ef+-r. .~+~ `` Ste.. ~v.+ *i e Z •~ ~~ ~ a4 3~{ ~u=~a g~~~FSy ~~~~~~ y~~,-yy~~-pp((-~~ fl[l1~ITR.T Nkn ~~~~ 7 2 ~~;ri r m.. ry- ~~YA:: ~~ J'i i' f N~n~r {vn ~r Y%~`~~ Z• 5: ~~~~.~n~ ST CROIX COUNTY SEPTIC TANK MAINTTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~ ~ Property Address ~ , ~ ~ SCAI'~ nL ~ ~~ ~~ ~~ _~ ~ ~- ~ ~~ ~ 19 3 ~ ~ (Verification required from Planning Department for new coast City/State ~ Y'~`~~ a ~~ Pazcel Identification Number r~ ~S~a~, LEGAL DESCRIPTION x` ~,j properly Location ~ '/., / ` ~ '/+, Sec. ~~ . ~ N-R ~ ~ W, Town of 11~~ Subdivision Certified Survey Map # ~~ Lot # ohune - ,Page # ^~ Warranty Deed # C~ ~Q ~ ~" ~ ,Volume `r ~ Page # Spec house ^ yes °~. no Lot lines identifiable ^ yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof 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. 'Ihe property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastCr plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (l) the on-site wastewater disposal system is in pmpcr operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office ~vrthm 30 days of the three year expiration date. 7~I~~a IG A OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. "~ r / ~lU/ ~~ I OF APPLICANT DATE *****« *• ** Any information that is aus-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 yon 1415pacE??~. DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1 - 1982 WARRANTY DEED This Deed, made between ~~ / 61 ~ i • ti rrF ~ ,1. .. t•0 ,Grantor, and 1[~n !/iwC arA y' h.rSls.n,ra ~ W1,GL ~ s crfl ~w~ ~,~.ti. _ Grantee6' Witnes5eth, That the said Gtamor, Eor a valuable mcsidetation_ conveys to Grantee the following desetibed real estate in •~.~~~' County, State of Wisconsin: ENE yti o~ N~ y~()oF S2,U~io~~~3) --~ D~8 /o~~-~~~,-ono (. PARCEL IDENTIFICATION NUMBER cwt of 'F6GJ n.sl~;`~ ~~~) 'f'~ ,~,,~, ~~ ~ ~ ~ This homestead property. (is) (Ls not) Together with all ngular the hereditaments and appurtenances thereunto belonging; warrants that the title is good, indefeasible in [ee simple and free and clear of encumbrances except a~( C~seit,~,,.~ a;w~ -'>!Sirtv~tvts d~ ~L~~G. and will warrant and defend [he same. Q Dated this ~.~~' day of _~1/7~/ ,19~. ~' (SEAL) s h (SEAL) Signature(s) AUTIIENTICATION authenticated this day of , 19_ TITLE: MEMBER STATE BAR OF WISCONSIN (lF not, authotizettby-~7tXrOtr, Wis: Stats;}- THIS INSTRUMENT WAS DRAFTED BY ' (Signatures-maybe authenticated or acknowledged. Both-are not. necessary.) 6d044d KATHLEEN H. WALSH REGISTEk OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 0~-O1-1999 9:~5 AM YARRAIITY DEED EXEMDT N CERT COPY FEE: caPr FEE: TRRHSfER fEf: 16E.00 RECORDIIIfi fEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA ~" NAMF ANn RETURN ADDRESS ~ Yob ~ ~p~6 ~', jessa~li ne •¢ve SfP~, ~.v SSio 6 ACKNOWLEDGMENT (SEAL) (SEAL) State oI Wisconsin, ss. County. personally came be[ore me this ~5 7`- day o[ oh. I , 19~' ,the above named :t~_who executed thrfaregoing the same. ' ~a ~) I Y County, Wis. i (lf not,. state expiration date: 12 -39--.'a~ ' Names of persons signing in any tapulty should by typed or printed below their signatures. STATE BAR OF WISCONSIN WARRANTY DEED Form No. I - 1983 Wiseonain Legal Blank CA.. Ine. MiAVaukM, wia. • ~ THE AREA'S ONLY FULLY EQUIPPED FRAME & UNI-BODY REPAIR CENTER • • Complete Auto Body Repair • • Foreign & Domestic • Auto & Truck Insurance Work • Frame Straightening Auto Painting • Check Our Prices • Free Estimates 812 Hwy 63 N • Qaldwin, WI van: a n~aa. i .~ i avv ww AMERICAN LEGION & AUXILIARY Woodville Post and Unit 301 IN SUPPORT OF CHILDREN AND YOUTH Friday Night Euchre Available for Private Parties and Wedding Dances FOR GOD AND COUNTRY