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HomeMy WebLinkAbout018-2011-46-000 I I I I n~ ~ o N o N N ~ ~ ~ (p N W N ~- ~ = 3 ~ ~ 0 ~ n 3 ~ d O O Cn Z D I m co D ~' I ~ n. W I ~ O ~' ~- -C I ~ N I t z ~ W 'U n d C N ~ a I ? ~ m c N I ~ d O ~ Z 0 I =^ ~ O I o• ~ ~ ~ I ~ ~~ m I c I w m i Q 3 Z ~ ~ o m n (`V'T v V ' I I W I I I W~ N~ 7 7 ~. ~ A pD, d Spo ~ m a.o =a~a a .px j ~~p <~ ~y o~ ~ ~ ~ ~ 'O (D O ~ N ~ o~ a ~ _ ~ v N ~ -~ 0 ~ ~ fD O O (D 61 ~ N W ~ < ~ y Q !/i ` X X O N C ~ (D fD '? G N - C 00~ Q°Qa~O O~ m ~ mcno ao cn I n eoa_, ~ ~ A ~ N 7 ~p M O ~~. ~- ' O C> N y "' p 3 I ~ Q<.oo x SCn Q ~- y~ C N~ N N I ~~7~`s~ar.~ (D ~ O. 3 r S O -per' N (D S~ W~ N N•~ d ~Q~ p N <%'. r d >> ~ ~a y ~ O 7 O 0 I o° a o m F ', w N N ~ ~ ~ ~ ~ 3 ~: 3 o ~ ~ N ~ ', O ~ 3 O 7 I V ''., O '' y N O ', Cl ~ N 'I, - a ~ ~ ' a a'', ~'', 0 0 ~ '', c~ w w = ''', N N N O O COT ~ o ~ ~ ~ ~ N N N ? ' O ~~~~' °'. ~ m _ d ~ N 3 °-' N •• 3 D D D w a m <D fD a 3 o' r. o .. z !, ~ I A T c 3 a 3 ~ c ~ ~ ~ C'f ~ d ~~ o ° IV Q~ ~ O V i O ~ O O O O O y O C 3 ''• v .. ~ m ~ m fD d a n fD N ~~ a a A ? ~ ~ ~ _~ A 2 O •• ~ 7 m N O ~ Z Z ~ ~ ~ Wisconsin Department of Commerce r PRIVATE SEWAGE SYSTEM Safe~and Building Division ti INSPECTION REPORT GENERAL IN~ORMATiiSN (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Bast, Kernon Hammond, Town of :ST BM Elev: Insp. BM Elev: BM Description: . 9b w~. Z GS -. SANK INFORMATION TYPE MANUFACTURER CAPACITY Septic I' ~tv~Z,~s~- 1 Z 5 0 Dosing Comma 50 Ae; ~o.c~-~ ~ / Holding _~ TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~ ~ i Flo c ' ~ J C , + J ~ / ~ Dosing 1 ~i t J lD ~ + ~ i + ~ + i ~~ Aeration Holding PUMP/SIPHON INFORMATION ~~ Manufacturer ~ Demand ~ GPM Model Number „ I ~ ~ •~ / ~ / Z~ TDH Lift Friction Lo ss System Head TD ~ ~ Ft ~ , 3~ Forcemain Length r Dia. „ Dist. to well ~ -7l~ Z ~~ SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 463279 0 State Plan ID No: Parcel Tax No: .(OLl SectionlTown/Range/Map No: 30.29.17. STATION BS HI FS ELEV. Benchmark y. Z /03.1 ~ . ~a Alt. BM / `7~-.. ~.(~JL`~ Bldg. Sewer •~ c~ /~ St/Ht Inlet I ~i SUHt Outlet Dt Inlet S Dt Bottom ~ ~ ~ Z ~~ Header/Man. GG ~.O Dist. Pipe . ~ ~`~7. 3 Bot. System ~ ~) / ~~ a / Final Grade Z ~ / ~~ , 3 St Cover 3.Z ~~ co~.~-o~ ~- ~.~ ~d ~ 3 BED/TRENCH Width ~ Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~~ ~ ~ (~ ~_ ~'~ ~. SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: i INFORMATION CHAMBER OR T e S stem YP >~ ~~ ~ I ~ ~~ / ~7 /~ UNIT Model Number. `~ DISTRIBUTION SYSTEM Header/Manifold Length~_ Dia Distribution / ~ PiPe(s) Ca Length `~ Dia Z Spacing~_ x Hole Size ~~ ~ 3 Z x Hole Spacing ~ Z Ve(j~~t to Air Intake 1 V ~ 0 SDIL G'~VER v Proca~ro Svc4cme Anly YY Mnund C)r At-Grade Systems Only Depth Over ~ Bed/Trench Center Depth Over - Bed/Trench Edges xx Depth o Topsoil ~ xx Seeded/Sodded T: N Y xx Mulched ' No Yes ' ~ .,j o es i ~ ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Z3 / b5 nspection #2: / /_ Location: 1522 78th Aven Hammond, WI 54015 (NE 1/4 NW 1/4 30 T29N R17W) Emerald Acr 1st Addition Lot 6 Par el o: 30.29.17. 1.) Alt BM Description = ~~u.. i~5 ~D6~ I~~ ~~ 2.) Bldg sewer length = '7Z, ` - amount of cover = ~ r Plan revision Required? ;; Yes No ~j __ ~j Use other side for additional information. ...J ~~ i Date SBD-6710 (R.3/97) a~ ~k ~~~ Cert. No. ° Bwldings Division ety and Ave hi 2 County (~ / ~/`,~ J T ~SI ~ ~SC~ g . n n as 53 I W ~ /I~ECEI Pe it Nu m ber (to be filled in by Co")p , O$ ~ L 3 51 ~ / ? ~~ 2 ~ ~ " ~l Department of Commerce v ' Sanitary Permit Applica ' MAY p g ~05 Plan D_ Number personal information rovide Code 21 Wis Adm rd with Comm 83 I ~ ~ '~ ~ t ~ ~"' , , . . . n acco • may be used for secondary purposes Privacy Law, s15.04(I)(m) $Z. CR~IX C Q ~l~ Ad (if different than mailing address) I. Application Information -Please Print All Information CE / J~~ ~g°~` l9 Property Owner's Name ~ Parcel # t # Block^# Property Owner's Ma~il/ing Address ~l ~ CG /- Property Location ~ ~ /, '/,, ~v`'r/,, Section ~ y City, State / / ~I (j(J J ip Code ~~~ ~ Phone Number ,,,/ rcle T ~ N; rK~E W l h k l h at app y) ec al t II. Type of Building (c L I ~ Subdivision Name CSM Number ~ o ~' I or 2 Family Dwelling - Number of Bedrooms 2 V~ _ J ~ t ^ PubliclCommercial-Describe U/ns~e /~ i U 01~ ~ /~ ~1 ~ A / ^ ^Cit)' ^Vit ip of- se be State Owned -Descr 1 I I~"___~ ~ - ~~r TIT. Type o ermit: (Check only one box on line A. Complete line B if applicable) ' - ~~ _ ~ A" a System ~-- ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permit Renewal iration B Ex f ermit Revision ~---- ^ Change of Plumber ^ Permit Transfer to New Owner List Previous Permit Number and Date Issued L.~ ~ 3 Z7~ ore p e Iv. T e of POWTS S stem: (Check all that a 1 ^ Non -Pressurized ln-Ground ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil At-Grade ^ Single Pass Sand Filter ^ Consbucted Wetland ^ Pressurized ln-Ground ^ Holding Tank ^ Peat Fiher ^ Aerobic Treatment Unit QRecirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersaVl'reatment Area Information: levation E Desi Flow (gpd) Design Soil. Ap lication Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sfj System l `g Ca aci to Total Number Manufacturer Prefab Site Steel Fiber Plastic VI. Tank Info P tY _ //~ Concrete Constructed Glass Gallons Gallons ofUnits W~ ~l _ _ Q /~ GGJ " A New Existing ~- ~~,T..~ ~~^{tt, n:lr Tanks Tanks Septic or Holding Tank /Z ~ Aerobic Treatment Unit Dosing Chamber 6~ VII. Responsibility Statement- I, the nndersigntd, a responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si MPMIPRS Number Business Phone Nu fm~r ~ ~~ ~~ ~ z ~9G~ ~-~ ~ y ~„ Plumber's Address (Street, City, State, Zi /v~~ ~~.~ ~'t~ Gam, D/ VIII. Coun /De artment Use Onl A d ^ Sanitary Permit Fee (includes Groundwater Date Iss`~ Lssuing t Sign (No pprove sapprov ~ Surcharge Fee) ~ a . Q~ U C /` /b~ J caner G on ial IX. Conditions of Approvsl/Reasons for Disapproval 3, ~ ~ ~~ e a ~ ~ SYSTEM OWNER: ~(~ ~ ~ -0.~~ ~ C Septic tank, effluent fifterand Yur~ / dispersal cell must ail lie services / miintah~d n f as per mane ment plan provided by plumber. \ , ~ S~~ ppC ~L I~~"~ ~ ~ ~ Q ~ . ~ aJ ~ 2. All setback re uirements mud be msirkain.a J C t ~- ~ o ~s ~ q I 1 as per applicable cxde / ordinances. l ~ ~ w~ ~` ~-- ~ ~' t L' ~ .. - . n e Atmc6 complete pleas tt0 tht t":OUnly Onty) rot me system on paper uua aas ew.u o=.s +. __ ~.+~..~ -iav ~.ce SBD-6398 (R. O l /03) . ~., PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarae Rd Hudson Wi 54016 N"E 1!4 NW 1/4S 30 JT 29 N!R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 99.4 BEDROOM 4 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA ~99-~ ~~af chambers none ,BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL * H. R. P. Same as Benchmark a~;~ Scale = 1 /4" = 10' Pro Town Road to 150th St. Please note: system is being designed as a at-grade due to pressence of mottles at a lesser depth in adjoining lots. Home is a 3 bedroom with a possible 4th bedroom someday. Tank is to be properly bedded and provided with lockdown covers with approved warning Area 15' below system is 5% Slope to remain undisturbed M B-2 ^ ~ 9 8' 99 B.M. 99.4' ^ 100' labels Huffcutt combo tank Pro 4 Bedroom House B-3 Grading is to be done to divert run-off away from system Well is to meet all setbacks found in Comm. 83 . .~ commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.wi.gov/sb! www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary May O5, 2005 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/05/2007 Identification Numbers Transaction ID No. 1134142 SITE: Site ID No. 698022 Kernon Bast Please refer to both identification numbers, Town of Hammond above, in all comes ondence with the a enc . St Croix County NE1/4, NW1/4, 530, T29N, R17W Lot: 46, Subdivision: Emerald Acres FOR: Description: Proposed Four Bedroom At-grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1016908 Maintenance required; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade System(s): At-grade Component Manual, SBD-10570-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and with publication SBD- 10570-P (R. 6/99) "At-grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems". • The pressure network is to be constructed in accordance with publications SBD-10573-P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". • 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. Stats. The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. ~? ~• ~`~' ~~~~I °j''~'lly f~!~. _ . t ~ ~r SHAUN R BIRL' Page 2 5/5/2005 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 mawinclude local inspectors. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -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. 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. • 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce. state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code:. 7633 .~ Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Cover Page A~~~/'/~ APR29 O SgFE~.~~ Zoos s Date: 4/25/05 Owner:Kernon Bast Location:NWi/4 NW1/4 S30 T29 N,R17W Lot 46 Emerald Acres Hammond System type: At-Grade Manuals Used: At-Grade Component Manual version 1.0 SBD 10570-P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01 /81) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve - `~~ 7-8. Maintance and Contig n plan .. ,~N~rMENr OF CD~AMERCE DIVISION F SAFE Y AND BUILDINGS 9-11. Soil test t SEE CORRES Nn~NC Shaun Bird Signature License number 226 0 / 4 . t ~I w ~~ ~t B PYZ ~Ot~C,E.1WAli1 ~.: 2i ~~-TuRIJ"' t~PS.. ~. -- _ ~?~-_________ _~ ______ __- i ' ~-- L~45Tllt~•'~.iTtQ~t LA"r~RRt ""~ A ~ StA$lLi~~D O$b=='•~cRTt0~3 ~EI.L~ I/6 B ~ /6S ~If2B f~ ~' A = l~ ~'~. S = .~.,~ fit. - L=t~~ ~{. vJ - ~~-•' fit. R PP RbV E h S'1' ~iTtl£~1L ~L'i b ~ t ~ -- 5s~8ti~.i~~~ ~bserva#~on-----...,~ We ~ I ~ ~~:.. -- > ~,` _ ~ _ A ,~ 1 ~~ GELt Q~ %z ' 2 /2 p-t,GR~Gti~fE Dis~ribu~ion Laieral _~ Soil COVSr ~~o_____~_ 2~. 6« .~:_~. ,. -- -- ~~ ~~ ~ ____~_. ... ~l.DVJED 1.AYEK > ~' pj,g~n View and Cross Section of [.~isconsin At-grade IIait with a Single Absorption Area on a Sloping Site L.ttErtSE ~~ '~,ti(ae~3A7la RE ~. Page flf, Distribution Pipe i}et~il Ior lateral lietworfc ..~ - . * Last Hole S~sould 8e Next Ta ruR,~•u~ --.~ PYC F©rte Hain - ^~---'{ ~- i~VC 'Distribution Pipe :~'~________ P iQCces~' ~, 3Q,~ qg~~j Hole Di a;aeter `~~ Inch P /~ Ft. L Lateral Diameter ~- Inch(es} x ~ Inches ~ .____-- Force Main Diameter Inches ~ ~ y~ Ir~che5 ~ /g ~~ ~ flf Holes/Pipe C1 Q~ Ft. invert E; Q~atian Qf 1.atera7 s Signed license ~twnber: Date: ~- ~: ND SP£Cti FCA f TIQN~S ANiC ~ ?~3MP Ci#AM&£R CROSS s~r-r~c T + S£CTiON t~£AtH£R~R~F ~_= G:- t~ENT PIPE Zg" HTN- ABDVE GRADE ~ J'tiNC'fZ~i~ $t3X APPROVED HA~iHE}LE COYER s ~:~~` ~1I ~I}OS~I 4R ~'R8M D4f3R. ~IT~€ Cfl[~~3U~T ~/ PADLt1CK ~ FR£a~: ' , "tR ii~TAiCE ~~.~,~, r ^d ~ SHARKING LA$EL FI~i~ :~ ; ~} ~~i 1 ~ ° ~ / J'"` 1 J ~ ~ rD GRA#7E f L ~O ~'• .,,.. a ~~,,..,...~ MIN . ~ ~~ :. ~ ._._.~:. ~. s. D. u 1&" I~ - 5 ~~ INLET = • GAS- } ~ T ~ ~~~ y„AT'£R TIGHT SEALS. T . ~ DEAL 3t?Ii~itS 1~IT3i A 8 Y ' ON ~1 ~~L APPRt~ED '~ ; ' r ~iPE 3` SOLIfl ~FT. c "~"` t}£F ~##4P {3FF ELF - L3 3' A PP R~~ED BEDI7TNG p~EF3EK '~~~ CpNC};ETE PAI1 SPE~IFICATIQI35 ~ ~~~ ~CffY~~1~'/~ ••~ SEPTIC ! DOSE iK riAN~FACTURFR = ~ TA1+ ~''.S'~ GAi.- Z TA1iK SIZES : 5EpTZC . ~,_„_.~----- GAF. ~'~'"~ A1.AR1"# MA~it1FAC1s3itER,. J N2~~`~ i ~b ~L. • .w7.~• r~~~~ J 9 / MAiaEJFACT~R£R ~Ut'48~ ~flS£S PER i)AY = _~.---~---- _ ~s~sE F ~~ACx. / ~ ~ -GAL. ,r~,..Q CRPACI~i IBS ~ #3 ~ I3r1CHES = ~~~L. / ~ pUtSP ~v r ~ ~ 15, 23 WAC MonE~ tau~aER= - ~ ~ ~sxR~xG As p~R ~LHR SSd'1'~CFi T'1'PE= '~ ~ Ga?4 pr~jTlP £ AL;~R '~ FEET REQL'+YRE3 i~ISCHAR~E RATL _-___- DZS,TNZ~'fIC?N PIPE. • ~'p ,~.-'~-FEE'S EEN pC~1P i3FF ANg - - `~ 1, p FEET VERTICAL DIPFERE3dC£ HET ~'T~lG~t3'FT_.fRZCTIbI3 FA~~ -`jam++-~ FEET + MI~NiI'#~H il£T~1flRK S#3FP~~ ~R~ S~N£ ~£3TAL DYN~ZC ---~-^'_ ~,ENGTH ~ ~ J.-~~. FUM? TANK= ~,IQi3ID ~~~' FN'f£KNAL DIMENSIONS ~£ SFGNED= _ i/&8 1; i v Q } Q 0 r FLOW PER 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 p ase systems. • Double piggyback variable level float switches are available for variable level long and shoR cycle controls. • Sealed Qwik-Box available foroutdoor installations. See 1=iv11420. . Aver 130°F. (54°C.) special quotation required. 1511153 Series TOTAL DYNn'v1iC NEfiD/CAPACITY PER MINUTE Ei"FLU ENT FtdD DE'FaATERIPdG MOCE~ 752 153 Feet I Miters Goi. Liters Gol. i Liters 5 1.5 gg I 201 77 291 14 ( 3.1 C1 231 70 I 265 15 4.6 I 53 201 S 1 231 24 .~ 6.1 I 44 ~ i 67 I 52 97 25 7.6 34 12g 42 159 30 9.t 23 87 33 ~ 125 I 3~ 70 7 I __ ~ _-. 2L ~ f g~ ~p 12.2 ~ _- 11 i ~ -- TZ I ~ ack Valve 38.0 i. (7t.6m) 44.0 Ft. (t3.4m)I o~asoo 3 ?7 T- iz ~~/s i } ~___-- ~~ SELECttON GUIDE o CAUTION All installation of controls, protection devices and wiring should be done by a qualified rrcecerlt Na~tion~ Electric Cod {NEC1 and th Ouupational Safaty and Helalth Ad (OSHA}~~ 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 Aftemator E-Pak. du lex 3 3. Variable level conVOl switch 1Q-0225 used as a control aclivata, spei5fy P ( ~ or (4) float system. RESERVE POWERED DESIGN for unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. afarf. ro: P.o. sox is~47 Lnuisvile, KY 40256-D347 Manufacfurersof. . SHtP T0; 3649 Cans Run Rcad ~~11 LL~~ oo ~Q ® Louisville, KY 40211-1961 Q!/~![JTY/`•!/MaS ,,pNC£ I9J9~ ~ /~IJIY//~ ~D• (502) i78.2T31 • t (840) 928-Pump FAX (502) 774-3624 hnp:/llivtyty zo ell er. com ©Copyright 2000 Zoeller Co. All rights reserved. AGENiENY PLAN • S Q~NER'S MpNUA~ gMSTEM SPEGIFiCA'~OKS pOV1tT """...~ septic Tank CaPa~ .,~ N~~' ~ nits ~_____... Number ~ ~ . ~~~ lion tom? _ ...~.,,~r~d x ~-~ Son App~°r' Rem tnauent/8~'~'t °'~ Fats Oil Dem~ (B Oo s~ t3ittcbe ~ ceded Sot"tds {TS ) ~{uent CZuaCdY ~ ~ ~ Pt ~ Demme (80Ds) j B~ocheTotai Suspended goiids n('Sesn? Fecal Cotiforcr- (ge°snet~ric...~-.--- Maximcur- went Fa d-~'''_~ --"' ;A1H7 ~"^"- $erylGe 8vent inspe~ o°nd'rdon of t$nk(5) ~...~-•-- ~ntents of tank(s) -----• Pump tnsped disPe~ C[ear- effluent filter Cbnt~o~ S alartT~ Inspe+~ pu~s+p, Pump and prossure test Flush taber~s pAo thn ~ Vie: X30 m9n- Q2fl mgn- Mo !hn y aveca9e~` ~i0 mgt 530 mgn-- --- ya inchdiametsr c~,gQtic Tank ~"'•°•"~-- Effluent F;tter ~la~acturer ~uer~ Fir Mode! ` Tack CaPa~ pump. pump Tank Manufacturer ~ ufa • Pump Ulan x Pump Model =i o ~~~ ~~ U Med~anical perat~on ~ Disinfection Q months volume every uais one-~th~~ (~) of tank Ai least once a and scum ~ 3 rs.) r(s) (M~imum Y when combined sludg ',~ ~ month _ A~ev~~ At least once~•_„ -"~- every p~ least once pS least once e~erY,_,. --""-'J errecY At feast once pt least ante every Qa9e of J 3'lat ~ NA taa ~~ ,~~~ DNA ..~--gal DNA l NA D Peat FTEter p wetland ~ pther_ a ~ p Irionu,~ - Ks) ~ NA p months Y~ p months t3 ~~$) ~ NA a months g Yes) ~ NA Other_ gone of the foltawin9 miner, Seth UGTtONS tt be made try an ind'n/Idua-~~ actor. POwrSa~ mtsSin9 or ~)cen CE tNSTR t Qeits sha ~ $eyver. t'O nk s ~ idenfifY back uP ~~~ of tanks a~ ~~~ Ster plum~r Restri pn of the to (~ check for any i r,s: Master Plumber: ~ ~ must indude a visual inspe~ ~ sludge and scun- and to ~ the effluent ~~ tor. Tank ins oped~ ~~ure the votu~ ~ll~ j 5~ u ~ ~,ua-lY ce ~~ing of effluent °n the ks, The disPe ~ ground surfs autitO~' h ~ ,1den~Y amo round su~~- nd~4 of effluent on motion of the toc~1 re9u~ ~tume. the of etlluen ~~ for any P° ups the trnme'diate noti or Pondtn9 pipes and to cond'rdon and req ird (K) or moretank ,~, ch• NR in the observati ~Y ind-c~te a farTing min any ~k ~ ground ~~'~ •on of sludge and scar a ~enriGng OPerato~d disP~~ . rdance mutatr moved ~, a Septa9 , t ~ponents, and any when the combined as k shall be re retreat+F~ g Ma;ntainer. entire cetrtents of the tan e - POY~S comp°nents, ed by a ~fied pOVYT 113, Y~i~sin pdrninistrawe ~ ressutved Gwent. mechanical or P ce -n of effluent filters, 12 months or less shall be Pz of cempie$on of any servi The setvia 9 at intervals ~ utatory aufttority min 10 days outer mainUenan~ or mon~n~ to the lot~l reg ~ oflter A serviQe ~Po~ shad ~be i~ flte pence of painting products TlON tteattnent tank(s~ ~ if high oonoentratlons ate STARTUP AND OPERA the ppWTS chi. ~l cell(s). or to use ~ s and/or damage the dtsP rior to use. ~a< t1t3Nr ~~~h' An a the treatment Proms a septage servicing operator P chenti~lg tftat may «t~p~ k s removed by deieCted have the contend of the tan ( ) O ~n~cn„ ~. csal Cett(5) ~ t7 In-ground (preSSUtTted) ~ j ground (9~ p Mound .grade p Other. p pn ine ~q was~~ and • Yslues tYPlGat for doh tnon-oo~'me`~` t~ ytttuent ~ mater. .. ~/S at u tYS3~. far pretrea Se~yice Frequency t(s) tpflaximum 3 yrs•y ~ ., • at the infiltrative surface. Page of_,,,--,,,_ ' shalt not Occur when sots condrtsons are frozen ~ fP,StDC~ the P.XCeS5 System start up ~ above nonrtal titghwater levels. when P~ sand may result in the Dur{na outages PurnP ~~ tlk~Y cep(s) ~ one large dose. oYedoad-ng the tom( ) do the disPe~ cin't tank removed by a waste+~rat~''^~ ~ d~a~ ~ e~~t To avoid this sifi~ation have the contents of the P F baciwp or surface d'~ to the effluent pump or contact a Plumber or POWTS MaIlttatrter tin sePta9e Setvi~n9 Operator prior_tc`t'esLDting p~ ~sist in manually ope~hn9' ~ p~P ~~ tO restore normal levels Yvi#t-in the pump tank-. over tanks and dispersal cells- Do not drnre or patio over, or otherwise disturb or caomPact. po not drive or park vettides mound or at-grade soli absorption area- the artawithin 45 feet down slope of any im rove the peliorman~ and Prolong the fife dental floss; drapers; Reduction or~eGminatlotl of the following friDm the wastewater strum may p of the POVYTS: antibio6c~; ~ ; ctgar~ette butts; condoms; oettr~n swabs; degr: ~, v+rater'; fruit and vegetable peelings: gasoline; gt+ease'~ herbicides; meat drsinfectants:l~ ftxlnda~n drain {sump P F} - ex brine. moons; flti; ~n8ng pnDdu~~ pestiades: sanr~ary napkins; tampons;'and water soften ABANDO[+1«MFNT taken out of service brie following steps shall h~ tam tp Insure that the y~~y ~ p farts andlor is permatte~Y fiance with ch_ Comm 83.33. yriscnnsin Administrative Code: ~~ ~ prnperty.and safety abandoned to cxxnP n1 s sealed. to tanks and pits shat! be disconnected and the abandoned Pipe oP'e Art piping disposed of by a Septa9e Senritdng Operator. .. The conterris of art tanks and Ptis shall t7e removed and properly and the void space ., Auer pimping, art tanks and Arts shat[ tze excavated and removed or their cowers r~`='O1~ fitted yy~t soft, grave! or another inert solid material. CON71NGF1YCY PLAN !fie following measures have been, or must be faker. tQ Provide a code if the i~OWTS ~~ and cannot be repay cempGant rep<aoement system: nt-area has been evaluated and may be utilized for the location of a repta~ nd sboutd not Q A suitable nePia~^~ tacement area sflould be protected from disturf~ance and compa absorption system- The riep from e~dsting and proposed structure. lot Fines and wefts. Failure to be infringed upon ~ rt~uired setbacks protect the repiacenlent area w-~1 result in the need for a new salt and site ~evaiuatitsn to estabtist't a ~~ e replacement area- Reptacernent systems must comply with the rules in effied at that time- - p A suitable replacement area is not avar l~ as a taster ort to replace failed POyyTSns advarlCeS in POWTS ology a holding tank ~rsay be instal n failure of the P~WTS 2 sod.and e site has not been evaluated to identify a su"rtahie replacement area- Upo s evaluation must be perfo~~ ~ ~~ a sortable replacement area- If no replacement ama is available a olcGng tank may be installed as a last resort to replace the failed POWTS_ removal of the biomat at curd and at-grade sari absorption systems may be reconstructed in place fnftowing surl<aCe. Reoonstru~ions of Such systems .crust comply wrth the rules 9n effect at that time- the rn <cYttARIVIN((~~ Gp,~~SES AAtt310R tNSUFFICtEIYT OXYIsEI~(- S>`PTIC. PUMP ANO OTHER TREATM>-NT T~~ MAY CONTAIN LETHAL CtRGi1MSTANCFS. DFJ4TN MAY 00 NOT EI~'ER A SF~'77C, PUMP OR OTHER TREATMENT TADiK UNDER AI+iY RESULT.. RESCUE OF A PERSON FROM THE INTERIOR OF A TAI+iK MAY BE DIFFICULT OR IMPOSSIBLE. ADORiONAL COMMENTS POWTS INSTALLER Name ~ ~1.~~z.-~/ ~,.~~ Phone / J ~ ' ~ ~ "~ % J~ pQVYTS MAiNTAtNER Noma ~ ~~ ~ 1~--~~ Phone ~..'~''_'' ~~!" ~-- J LOCAL R.EGULATQRY AUTHORITY SEPTAGE SERVICING OPERATOR P MPER ~ Agency ~ ~~ ©~~ b Name ~ ~ ~ ~ ~ Phone r~/''.','_" .~~~'~6 Phone ~ /,,;'-.~-- G ~ --- ~~` arsd San?fatrort 2gendes- This daalmeni r'rt~ 71tis Qoam~t ryas tfcafGad ay tlta sttrifs of the iGreen Lake. Marquette and 1Narrshara County Zarinq _ t does trot the m,nmwn re+4u;eeenents of dt_ Comm 83.22~Z}(bH1Hd7~{f) and 83.5x(1}. (2) 8• (3), uYsscnnsin A6ministtattv!a Codes Use Of this dOCUrne~ ~i~tl guarantee the performance of the POVYCS. Dec 27 04 03:12p ' ' • ' • RECEIVED W'rowtsin Deperhrtertl of C mmerce S Olvisio.:of5efalyand8ufkf gs QCT 2 1 9(1(IQ ur a witt+ 1111adr opnrplete site plan pn~r.r~Rl (r~(Qj~!'x 11 rc tneluds, lnrt not Ilmlhid to• erUrafP(1fF(p~+~.(t~rertca fi psrcentsrups,scaleordG a Please print all lntomraUwi. Perxnel As/ametMn rmr y'ov1d~ meY bt/ wed ror weafdarY DwPOSOs p.2 L CVALUATION RCPORT Paye ~ _ d _ Tun 05, Wis. Adrn. Cole co~r+ty ~ _ ~'r'o~x res inJJsffi~~ze. Plan must - t(©lrectiorrartd Porrxl LD. rr! foneared+uad. fiovlewed by Uato Pdrocr w~, 5.O~II-Un)). I 1~~c~ Grr4 ~~ ~~- G" ~ try n,r,~,/t/a s 30 r ~ N It -~ a (or Property t]wner's Maffing /lddress l.ut >a! luck /1 Subd. IVenne ur CShff(< l 35 3 f~wa-~u~tee Tr- • ~~ ~ nernti~. c~ _(~ n Cdy Slaea Zlp Ccxlo f'hurre Nun+Erer ^ Cgy U vik~ye 1~uwn IJearest Ru:nl o Wt c ~~ -~~3~ ew Construction Use:~'fiesidenl'el l Number of ber)roums ~_ CuJe doriveJ deslyu Owv rate ___ ~}~ _ ~O OQ_._ GPD ^ RepiacBmeut / ,.' ^ Publlc or camnre+clai - Desaibo: _______ __ _ I ~ ~ ._ . __~--- Persrtt material ~f7 1/ -_~ __~_^~__ Fluod Ptaln etavtrifwr if a rfrlicabro ___- ~ ~ R. Gsrreral rzormnents Sy , /_~ ~ /,~~r G/ ~ -~ Q . errd rdoomrner+dalla+r ~l`~ -C~ [ (/ ~'C.) (~ Bodripll ~ 9orni9. c3i r7Q un ~/\ SaOAp~licafiat Rale Flurizar UepQt Dominant Cofvr Redux Uescriplion Texture SWclwe Cojrsisrmrr:e _ _ Ouundary ____ Rrarl GP UlIF in. Munsen Qu. Sz. Cunt. Cubr Gr. Sz. Slr. 'FIt/Rt _ 'EifAZ I b--2 (t~yr3(2 Si ( _ _ _ c5 _ ~~r ~_ .B 4 a/z r5 ~., mv~ - - . y ~ Q BodrsQ K ~ Boriny ((~~jjQQ // ~~ /! ~F~ ~t Groun0 surface elev. '~o~`-t~ _ It. Depth to fkniUng tacWr ~-B~ In. Sai Applkatiarr Rate Ilorizon DepUt Uaninarrt Color Radox DesCriplion Ter<ture Struduie Cortslstence Duundary Ruins T- GPDRN Kt. Mwtseil Du. Sz. Coal. Cobr Gr. Sz. Sh. 'Elf/ft 'Eilp2 U' 5 (05'85 (b 8 Z C ZP 7.5 r ~ ~[o SZ V-~ m ~~ ~v-~+ ~S, -" _' _ _ Cv /_ a to --•---. • - . - _ ....y~~ mrv ram ~av _ ~av myn, - turuerrt rr2 = 60D < 3U nry/L arrrl TSS < 30 rrrglL CST Name (Please P ' q Signature ~ CST Nurntxrr Address ^7 - ~~0 3 Dale Evalualiat CwrJucle'cl 'I'e~tepl+ono Nrn +bcr T~' 171aD-z~Z `~ Dec 27 04 03:12p - .. Prape+ty av+rler " Pa+cel l0 tl ~~~~ __--•- p.3 2 3~• - - Page ---°1----- (J Bering 3 Borir)g>< j ~ 1l. U {I7•Ip rititr tactur~~ in. ~it Ground surface elev. •~_ eD Soi A lion Rata :, .. Ilorizon DepUl Dtxntrrant Color Redox Descri{)lion Texlwe` ~. "~$Ii~u -e Consistence Buwrdary Roots GPDAF MurrseU Qu. 5z. Cart. Cabr i ~'~ ~~y. Sz.51r. _ 'Efflfl 'Elf#2 ql . 4Z ( - SL '~1? c 5 -- _(, 1.13 4 tog 85 ~ 2 ~ ~. y-~~ m ~m v - `_ , ~{ _ . L a Boring # ~ Boring ^ pit . Ground smfars elev. ft. Uepllr tp Ih7nGng fac•tur - Hr• SoR A icaUen Rate llorizar Depth Dominant Cukx Redox Descriylion Texlwe Strur3we Consrstence Brwndary Ruols GPDffP In. Mtrnsci Qu. Sz. Cont Cobr Gr. 5z. Sh, 'Eff#1 'Elf#Z Boring Borrrrg # Ground surface elev. _, il. Depth w firniliay lactur _--_,~__ in. ^ Pit Soi A IiceUon Rate Hafzon DepUl Dominant Color Redox Dosaiplion Texlwe Structure Consislon~ Bow+dary Rrwts GP DtfF In. Mansell t]u. Sz. Cont Cobr Gr- Sz. 517. 'Elf#i 'Elf#2 ' EtRuent #1 = BODE > 30 ~ 220 mg1L and TSS >3U < 150 n+yll ~ • EUluer+t it2 = BUU6 ~ 30 rrrylL anJ TSS _< 30 n7glL '1'6e fJeparttnent of Corncuerce is as equal opputtunity service provider and etnpioyer. tf you need assistance to eccps servicca or need material iu alr altcrnatc format, pleose cuutact the tleparw)cnt a- GU8-2GG-3151 nr "I't'lf G08-2G4-8777. SAD~~l01x.07/dry II Dec 27 04 03:13p p,4 + i .• __ y t)•' ~V ~ J c. l'AGL' ~Oi~~ NAhtl:: S'bJ'E' LU'['ll ~~O1.li(iAf.I)E,`i(:IIiP'CiC)(•!:~/Fi/•1,(,1.~l/•i,~;,3o'I"Lri_.h(,it,)~li(urJ® SCALE: i"=~~L"---- ------•-•-•----•- -~ --.-,__.._•. ---- ~jrv~(ELLVA"i'101~1:__(Oc~ O !_~......,------._.~_~.. '-V-- DM l UL•SCill!'"I'Ii7hl:~.~- o~~.~~,py,~-~l~~-.--- ~. - "~ DM 2 ELEVA'ctuN:. -_~ 0 t 3,~,c, ~ __ f3M 2 DLSCIS,I[`'i'iUhf:~v~v~`~_P~~ P '~~ -_ SYS"1'Ehl E•LGv/\1-tVi•J: ~to~ ~- ~ SYS't•ClV1'I'l'1'1:: CC~Y~+l~~ _'v_.!~a.~ -_- . _ _._ nn T i ~ ~i L 2 r ~ , ry ~ ~~~~ / DU ~ Y !' ~ ~ ~- • ~ S~,U a9 6~ ,~! a3 • 1~ .a SIGNATUKL•;-.~~a%~~_.__~~~~~ ~ _..-------(~A'i'1:---~f ~ ~~ b~,2 i/` 1 /\ Division . Safety and Buildings CO11`ty~ ~ f ~ ~~ , 201 W. W n Ave., P.O. Box 7162 WI 53707 - 7162 s ~~~~ Sanitary Pettnit Nambec (bo be filled is by t:o.l `f (v 3 2 ~- ~ ~~~Q~~~~ Number LD l De artment of Commerce .O ' nitary Permit App S - an StaOe tthantaaiWtgaddt~s) s ,°n nC a ~' ~ 20 Codc Adm ~ Proje Address Gf ~~ . is. Pa~ ~ s 1K) In ac~,rocd with Comte 83.21, lil may be usod for aeooodacy PutP°~ ~, i ^vE ~g 1 # S ~SZZ / ZONING OFFIC on ~tformatIon -Please Print All ~o~dQII L Apph~ ~ ~ Blodt# Parcel -~ Pmp~' pwnec's Nstnc ~ ~S~ Pro t1 z7 Property pwnot's ~ Address «, T b ,, f, ~+y~. Sectim er Phone Num Trp ) City, S V ~ N; R or W V ~ S of Bnlltlsn8 t~~ at aPP~) Subdivision N CSM N ~' or 2 Palydly D'M'W~f N°1~ ~ ao~ of hi Publis/Commercisl - Dtxcribe Use p ~,ry : Yilhtge awns State Ownod -1 Use A Compl~e line B if app>f ) , Type of Permit: {Check tutly owe boz on Only III t3~a tea to 1Btdatlog system . Trdflment/Hol~ Took ~ ew System ~ Systran I,ut Pnvioas Permit Number and Daps Issued c of . Permit Transfer to New B. PccmuReae'"sl PeamtRcvisioo ~ ner Before F.xp~O° Check all that a 1 of POWTS ound < 24 ia. of Atitsbl4 soil Ijt At-Grade single i~ss Sand l~lkr _ , ~ Mound ~ ?A in. of suitable soil .I. Fats Aerobic Trat>a~t V~ ~~ 3t Non -Prscsu:>t~ Z ~~ Construetod WedMd ~ In t7lbet ( ") ~~ 1,~ asvel-leas Pi ~ S ~a Filter 0 on: ~ {t~ ,Disposal Area Proposed (sfl ~ ..., ~ Arat Are /` ~. t at ' D ~ p / ~~ e 'gn Plow (E~1 Plastic She ~ vr_ Tank Info z,r ~ ~ Totad cf ~~~~u~ Glat<t Cot>~ Constter-0ed for imla Ste) ~ ZSo- .o'S V~ 3) ~ ~~~ h-S~~- s IX. Conditions [ I Z _ I ~ _ p ` f . ~5 ~ ~/ l~e~' C~.w~ SYSTEM NER: ~ / ^- S~ - ~~ tc 'r- ~° 1 Septi tank, effluent fitter and ~~' \ I ~. ~ r f1 :~~~ dispersal cell must all be serviced /maintained o,,.Q~.S y '~~S ` tie.-o~- ~ I as per management plan provided by plumber. o ~- ~,~~1~c.( 2. All setback requirements must be maintained vas-8.C ~~ ~ as per applicable code/ordinances. (to We Count! oal9) Ior the s~att oa papa O0t ~ tM° fiat s ii iaetKa to the Attuh t P~ PROJECT Kernon Bast ADD SS 948 LaBarge Rd Hudson W 54016 ~~ NE i/4 N1N 1/4S 30 /T 29 R W TOWN Hammond COUNTY ST.CROIX 12/27/04 BEDROOM 4 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN-GROUN P ESSURE CONVENTIONAL LIFT HOLDING T NK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DO TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1586 # o chambers 51 ,BENCHMARK V.R.P. Top of 1" pvc Pipe ASSUME ELEVATION 0' Filter Zabel A-100 ^BOREHOLE O WELL *H.R.P. Same as Benchmark -' Wel O meet all SYSTEM ELEVATION 97. .52/97.2 2.2' below grade Plans Designed Using setbacks uired by Conventional Powts WDNR Manual Version 2.0 Property Line Please riote• his • est will be field verified Top of 1" pi 120' before system is installed, also further testing will 3-3' x 1 'ells with >3' sp ing bedone in order to ~o' find more suitable soils! Pro 4 Bedroom 25' B-3 __-- House ~ Vent >6" of Cover 6' Long 11 " 25 Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area at System Elevation COpV 50 lo' B_1 ~ Vents •,10 20 Property Line RECEIVE ,Wi~:cons'mDepartmerrtofC mmerce S IL EVALUATION REPORT Division of Safet and~Bufld' gs Y Q T r~al ~~Ja04 wiUr ornrn 05, Wis. Adrn. Cade County Altaclt cvnrplete~slte plan t Pa~.'~~6'i®itJJt~~'x 11 rclres in size. Plan must htdude, but not Ihnilad b: articalg(~p~rpr~t~~rnnce int (I]M traction and Paruel I.U. percent<bpe,scale ordlr andv `~.../ ton©areslroad. _^_ Please print a!/ fnforinaf/on. ~~r t jawed by /i Pmeonel Inramrn0on yev provide may be used rw eowodary gnpoaos (Piivncy w, ~.0}~(1) Qn))• ~ 1 IAA. 1Q-- 1' Dale ArJ _ J 3 s, PropertyOwner _ _ - t r Callon t _ ~l C,~ GY~_~bt) ~ G ,t _~_ v1 ~,,,Jtl_s _30 'r ~ N R !~ E (or Property Owner's Malling Address Lot # luck # ISulnl. Name ur CSM/l ~ 353 ~wa~1~e zr . yt~ _ l.~err~lc~ Acr~S_lsT_A.i~. Cly State Z(p Crxlo Phune Number (_J City ^ Villaye Flown tJearesl Ruad -~-uC~~ cry I ~( IJ`~l~ I (p I (7151~`~l ~~3 r _~_C ~ ~ew Constructiat Use:~tesidenlial ! Number of bedroans _.~_ - Cuda durived desiyn Iluw rate ___ 7_~~ _~ ~_. ~~__ GPU Replacement ^ Public or commercial - Describo: _ -________ _-__- __-__--__ --- Parent meterlal _~____ -___-__-__- Fluod Plain elevation if aptilicablrt ____-_~~~_ - -------- R. General crnnmertls f" ~Y'l ~ ~, ~~ ,~-y/ mid reconrmendalkxts: ~ y 5 -` ~ ! ~ ~ 7 '-•~ C "'~~ ~..'° ~ r:B'~.w~ a~ ~d. a~!,`. ~ / i Boring # D BUting /~ ----- t I I ~~t Ground surface elev. Q"l ~ ~-~'b_ It. Uepur b Ittnitiny tactur __ ~___ in. _ _ ~___ _- ___. _ _- __- Sol A r Iwalion Rate tlurizon UepUt Dominant Cobr Redox Description Texlure SUuclure Cunsistence Quandary Rcxrls GPUlfI' _ in. Mansell Qu. Sz. Cont- Cobr Gr. Sz. Sh. _ 'Etf#1 'Eft#2 2 I Z 3i{ t rJ ~ ~ cl 2,~5bk. _~' ~- _ - • `~ • ~ 3 3~t-SS 1 s .~ c S - • Co ~. d - - ---- - - ~ _ ® Boring # p oriny ~ (~Q / f `r V~ `i U it factor ~P Ground surfa e elev De th b limitin in - - . _ _ . p g . c 1~t Sol Application Rate - - I Iorizon Uepur Uorninant Color Redox Description Texlure Struduie Consistence ©uundary Kuots T GP DltF _ in. Mansell Du. Sz. Cont. Cobr Gr. Sz. Sh. 'Etf#1 'Eft#2 I ~~15 0 312 st` ~ ~~ _ ~ I,.~ . 5 .~ _ --- _ -- - - 3 - 5 ~ 5 ._._ 5 L ~~,~- -fir c S _ _ (p / - a U' ' (~5 -$5 I b g Z C ZP ~ . 5 r ~ [o V 5 ._ ~ ~mv`~ i ~ ~ _ ~ -c~ n-z~-~ ~-~,c.~~ ERkrenl tM1 = BOD > 3U < 22U mgll artd TSS >3U < 15U my/L 'Effluent #Z = BOD < 3U mylL and 7SS < 3U my/L CST Name (Please Print) _ Siynature CST Number Date Evaluation Conducted Telephony Nw tber l' ~- -- / 2~~ - z y _C'_`l .- - --- ---~7,_~~7~ 4-cam z_~ ~' Paye _ ` ut _ q '~. 1 ,~, t . Properly Owner S-~~' ~{ 2 ,,, 3 Parcel ID # ~~_~-%_ ~ --------- Page -.--- Boring # ~- 3 Horizon DepUr in. i d-I~ 3 ~Z -~ Boring Ground swface elev. (~. ~ it ~it _ DorninanlColvr RedoxDesc.-riplion Mrnrsell Qu. Sz. Crnrt. Cobr tv 2 ~- ~ - • D Texture S~ I S L epUr to Gnrfting't $trUr:tUIE Gr. Sz. Sh. b~ Zm~ pp; actvr ~ 00 Consistence ~ ~~ irr• Boundary e~ c 5 Soo ~ r IicaGrnr Rale Roots GPDIfF 'EIII-t 'Eff#2 ~"`~' ~ 5 _ ~ --__-- CQ _ _! . d - LJ Boring Boring # - ^ Pit :Ground surface elev. __ It. Ueplh to limitiny (actor _-_ irr• Solt A IicaUon Rate liorizorr Depth in. Dominant Cokx Munsell Redox DesaipCron Qu. Sz. Cont. Cobr Texture SUudure Gr. Sz. Slr. Consistence Boundary Roots GPDIfP - '[II#1 'ERfl2 U Boring Boring # Ground surface elev. ___-__ ft. Depth to limiliny [actor _ in. -_- ^ Pit _ _• ~-- _ Sorl A IicaGon Rale Horizon DepUr Dominant Color Redox Description Texture SUudure Consistenr.~e Boundary Rcwts GPD/fF in. Munsell Qu. Sz. Cont. Cobr Gr. Sz Sh. __ 'Eff#1 'Eff#2 'Effluent #1 =RODS > 30 < 220 mglL and 755 >3U < 1511 my1L ' Effluent tl'L = BUUS < 30 mylL and l SS < 30 nryll. 'the Uepatttnent of Commerce is an equal opportunity service provider and emplvycr. If you aced assistance to access services or nced material in an alternate fomtal, please contact the deparUncnt at GU8-2GG-315[ or "1'I'Y GOB-2GA-8777. sno-ruwra.mronr ., r ~ ~ ___ _ _ - ---- Q~rhICLLVA"PION:__~~~ • 0 _ _ __ __ ___ ~ ~ ~ ,~ ~ I'~lG[; `7j01'~ ~. . NAME: .S~ ~ "~---------Ll) C!! _ '1 ~OI.I~:ci~\l. I)IS~.'Itli~'I'1~)t l: ~F I/~l~li~1,S 3o'I z~t.N,lt, l~l:('n - - ~ I~ f ~ ~ '~ ._- BM t DL:SCRfI'1~fOFI:_~~___q_,~._f~~~~e.,-._~c:~e--.-_- f3M 2 LLL'VA'IIUN: ~ ~_- ___ _ ~ _____-_~ ___ .____. _42c'-~ ~ --- -- -~_-~- f3Ni 2 D[:SCR11'"I'IOt~l: ~o o-~-_~ ~~__ - YC- -- e_ :: SYS'I'L'iv( L•LL:Vi\'1'lt ~tJ:_ _ _ ~(Q. ~" ~ -. __ _ ': SYS"1'LN1"1'ti'1'i::_CC~~dev~~..'v/~o~(_ - _ _ e ~~ ..~^+ - - _ ~, ~: ~ ~~ wpb .~ l `~. ~ ~~oX1• ~~ ~ .~ ~``~ -a-• .. ~ ~ ~, f ~ `` ~ ' Y ^ ~ ,~ ~ q < o~ ~ ~ \ .~ ~' Rq ~ ~ goo !s-~ ~~ SIGNA"1'URI~: ~~ ~ _--UA"fl::_ _~:_~ -~~--- T~ ,~ ~~ ~b~ i) Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over. system. 7. Watershed is to be diverted away from system. 8. Discharge into system is Trot exceed those required as per Comm. 83 "" g ncy Plan ,a_ ption # . If system fails, determine cause of failure, use >ernate ~r~d and insta(I new system in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any otherfaifing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 Dec 27 04 05:OOp ._ _ ___. p' 1 ,. < . ST CRO ~~~ AGF~GE~N~ . .S$p"TIC'C' ~~r1~"D . _ _ .1.IdN FORM PLe~°8 Dot s ~+asa Pi~1. ~~ ~~~ ~~~~ t idcx~-fi'~°a N~~a Pare N'~ ~~~ •r ~N- W, o~ of Subdiv~on ,~- Volume vr'~ SorvtY 11~p # "~ '. 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