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HomeMy WebLinkAbout040-1303-00-058 rParcel St. Croix IE SEWAGE SYSTEM Wisconsin Department of Commerce ' mit No: 0:safety and Building Division INSPECTION REPORT 569536 (ATTACH TO PERMIT) D No: GENERAL INFORMATION ur oses[Privacy Law,s.1 5. (1)(m)]. Personal information you provide may be used for secondary p P Village X Township No:ity 040-1303-00-058 Permit Holders Name: Tt0 , Town of C&J Builders Inc., C/O Jeff J. Husb wn/Range/Map No CST BM Elev: Insp.BM Elev: BM Description: 22.28.19.1793 113,80 j13� CS—r8 ELE TION DATA CAPACITY STATION TANK INFORMATION BS HI FS ELEV. TYPE MANUFACTURER mo" � Benchmark Septic co t 13e'n- _ I { Q� Alt.B 2 q/29 �� 113 W Il 3. Dosing > ch t& - L � P T'ZV 110'& Aeration w O 5 Bldg.Sewer r St/Ht Inlet 0, Holding SVHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet DtBotto 1311 !�^ 2 1 j1, 10(0 '44 Septic o, . Header/ n. Z.� �� -�2�- Dosing tt `( L( 3 Q f V ( 1 Dist.Pipe Aeration sot.s stem Holding )) .Z'9 Fin Grade 14 PUM /SIPHON INFORMATION /_/ ' '�Lt �� 2 4-S arnd G_�r Q—�— Manufacturer GPM Model Number Z !/ ,_ Ft TDH Li Friction Lost System Head,/ TD �� r Well Force Force main Length Dia. 11 Dist.to 2— t o Ct , s' S IL ABSORPTION SYSTEM No.Of iia.ues IT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth ED Width 1 Length l NSIONS O W 3, LEACHI G anufacturer: p/L BLDG WELL LAKE/STREAM CHAMBE SETBACK SYSTEM TO UNI Model Number: INFORMATION Type Of S stem: f f \ 6StAM DISTRIBUTION SYSTEM x Hole Siz Hole Spacing t vent to Air Intake Distribution ion 11 tl HeaderlManifoldl I pi e(s) ,� Dia r�?'� Spacing 3`3� /� Length(0.0104, Dia Length SOIL COVER x Pressure Systems Only xx�Mio d Or At-Grade Systems Only ,r,r Mulched Depth o xx Seeded/Sodded Depth Over Depth Over Topsoil;' Yes No Yes n No BedlTrench Center Bed/Trench Edges ..__..� Inspection#1' � /Z3/� I spection#2: 9 \CO ME T�clude d' cr a cies,�elsl,ons pre§ont,etc.)Walnut Hill Way River Falls,WI 5402 (SW 1/4 SE 1/4 22 T28N Fii9W) Walnut k The T ute Parcel No: 2.28.19.1793 ocation: 207 ,o�b� 1.)Alt BM Description 2.)Bldg sewer length= 2Z) Y Sei�`2� 3) �I2 f CKIII&V4 k � r amount oft-=tD- `L/No a� � _ J1 111111111111 -- - —jq�Plan revision Required? FR Yes _ de for additionanormation. L1—� —— ---r'- Ce t.No. Use other sr l if Date Insepctos Signature BD-0710(R.3/97) / I / �. plot.plan for Site and Soil Evaluafi on Page S of 6 property Owner L J� ��c�L =►-^7`- 1» = 40 ft. . _ � (except where noted Legal Description s • �� �-"�N � =Backhoo pit i 5 1st /y OF f gpR �►G 'TI ov Na t" �- 1-50 Ort A—- S J L WAN-� rr 81 ' 'prfc� ��" , (y b Z. Ott; 1tt, N NK ifl.bt� y'%51-AI DI 7 es s�y.vo pIL Site Loc 'n= V E Kf- � ue. 6 -CI -9Zb-STL 2ul4sal ITOS s, �a�sTiZoH clop- :90 61 62 BOO rari County Safety and Buildings Division / r; 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) ,$ ;f Madison,WI 53707-7162 S� 53 '��F.9t(ti•i�4cc�� 9k IVP_ a rmit Application State Transaction Number In accordance with SPS 1(? s.Adm.Code,submission of this form to the approp overri t unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owned P submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may becondary u oses in accordance with the Privacy Law,s. 15.04(1)(m,Stats. 1 n , J I. Application Information—Please P ' t rmation Cr /7 WQ�h n ��T�� ✓tiles Property Owner's Name / 3 M C J Parcel# eq-T 010- Property Owner's Mailing Address V Property Location q (-745 5/ c A e-d P- • �4O04 Govt.Lot ;5 I / City,State Zip Code Phone Number T Sl r 1 '/4, ' y ) S� /4, Section a �V cr �u 40Z y �/J o? — LI 9 3/ (circle one T oZ g N; R I R Eor� II.Type of Building(check all that apply) Lot 1 or 2 Family Dwelling—Number of Bedrooms '� L� Subdivision Name l 6k� Bo V ) u1 I 1 —a10'/r,� tl ❑Public/Commercial—Describe Use ❑City of ❑State Owned—Describe Use A CSM Number ❑Village of / � r D� /6 Ar (o 0aA. P?Town of � III.Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New System y ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) B. El Permit Renewal [I Permit Revision El Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: Check all that apply) d v ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dis ersal/Treat nt Area Information: e1 Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Dispersal Area Proposed System Elevation 6cc) b, 10 &0C) I51� &o D q. l VI.Tank Info Capacity in Total #of Manufacturer , Gallons Gallons Units o 'd n U v ti New Tanks Existing Tanks Y 0.U co &Z is. C7 a Septic or Holding Tank I p O Dosing Chamber BO VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Signature MP/MPRS Number Business Phone Number car )e9 Bt ' r!�LN ` 0 SS9 Gs1 49.2 Plumber's Address(Street,City,State ip C de) r �Y VIII.Coun /De artment Use Only Approved ❑ pp Per/mil Fee Date ssue L� Issuin gent Signatu ❑ =nReason for Denial $ wZ 5 Obn ZJ L / IX.Condi8lffiff:tiO4"F tReasons for Disapproval 3 '� PrdJ� 1. Septic tank,effluent filter and /,n r+o �I o� dispersal cell must all be services/maintained �n.i S VKA.:nk c.¢.. as per management plan provided by plumber. /n� ^_ nn I I 2.,:A#set�ack nagt*emerft,Fnust betn ain at. !{) CG�n�G;�-,a✓i5 t`rl �-'n It Sd-0.�c. /t�'J(oJ�•IG rl a�r a r, •s prr �yotf e l drtrric `lI III Attach to complete plans for the system and submit to the C ly yyn paper n°�less tpan 8 1/2 x 11 inches in SBD-6398(R. 11/11) MARY JO HUPPERT Page 2 10/30/2013 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. • 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.SPS 383.54(1). • 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 This Amount Will Be Invoiced. er M Sw' When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (608)789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. jerry.swim @wisconsin.gov WiSMART code:7633 cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed fl by SPS Chapters 360-366. 9tipART.t DIVISION OF INDUSTRY SERVICES 54' roe 3824 N CREEKSIDE LA o� ; HOLMEN WI 54636 u c i'r Contact Through Relay www.dsps.wi.gov/sb/ www.wisconsin.gov sroNALS� Scott Walker,Governor Dave Ross,Secretary October 30,2013 ' CUST ID No. 224832 808 ®,5 `)0 ATTN:POWTS Inspector MARY JO HUPPERT f c;y uJXC, ZONING OFFICE HOLLISTERS SOIL TESTING&DESI6W"A'7Y ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/30/2015 SITE: Identification Numbers C&J Builders Inc Transaction ID No.2321791 207 Walnut Hill Way Site ID No. 796845 Town of Troy Please refer to both identification numbers, St Croix County above,in all correspondence with the agency. SW1/4,SETA, S22,T28N,R19W Subdivision:Walnut Hill Farm;lot 58 FOR: Description:Four Bedroom Mound System/7%slope Object Type:POWTS Component Manual Regulated Object ID No.: 1454924 Maintenance required; 600 GPD Flow rate; 11,.in Soil minimum depth to limiting factor from original grade System(s):Mound Component Manual-Ver.2.0,SBD-10691-P(N.01/01,R- 10/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12),Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code CONDI 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, APP DEPT OF stats. PROF Essro The following conditions shall be met during construction or installation and prior to occupancy or use: D(yISION OF INDI Reminders: • 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. ic 4V • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with CORRE the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stats. • 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 SPS 384 product approval conditions. • The area within 15' downslope of the dispersal component shall remain undisturbed.Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. MARY JO HUPPERT Page 2 10/30/2013 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. • 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.SPS 383.54(1). • 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 . This Amount Will Be Invoiced. er MS When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (608)789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. jerry.swim @wisconsin.gov WiSMART code:7633 cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012,all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed �. .: by SPS Chapters 360-366. -�7- MOUND AND PRESSURE DISTRIBUTION COMPONENT DES4&W 120 i Residential Application INDEX AND TITLE PAGE Project Name: C&J BUILDERS INC. Owner's Name: (same) Owner's Address: 243 Steelhead Drive River Falls WI 54022 Legal Description: SW1/4 of the SE1/4, S22 T28N, R19W Township: Troy County: St. Croix Subdivision Name: Walnut Hill Farm (Tribute) 101YALLY Lot Number: 58 Block Number: NA__ ?OVED 'AL 3E AND Parcel I.D. Number: 040-1303-00-058 SERVICES Plan Transaction No.: JSTRY SERVICES Page 1 Index and title Page 2 Data entry ``\```�1�1�{I111011Nfp Page 3 Mound drawings ONaENC� �`���� Page 4 Lateral and dose tank 1* �®�,.•••••••.•�► Page 5 System maintenance specifications '•� * Page 6 Management and contingency plan ' Page 7 Pump curve and specifications Page 8 Plot plan ."� • sS.o 4 a: ■ • bl5 M O a g g 1 designer. Mary Jo Huppert License Number. 1859-007 Date: 10/08/13 Phone Number: 715-426-1775 Signature: � I Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P(N.01/01),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01) Version 7.0(R. 03/2012) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill(D)calculations assume a 400.00 Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor(e.g. 1.5= 150%) fecal coliform of-36 inches. 600.00 Design Flow(gpd) 7.00 Site Slope(%) 112.60 Contour Line Elevation (ft) 17.00 Depth to Limiting Factor(in) 0.40 In-situ Soil Application Rate(gpd/ftz) Distribution Cell Information 60.001 Dispersal Cell Length Along Contour(ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate(gpd/ft2) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.156 Orifice Diameter(in) 3.50 Estimated Orifice Spacing (ft) = 11.76 ft2/orifice 2.00 Forcemain Diameter(in) 20.00 Forcemain Length (ft) Does the forcemain drain back? Y 103.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft)x 1.3 3.26 Forcemain Drainback(gal) 10.78 Vertical Lift(ft) 55.97 5x Void Volume(gal) 0.33 Friction Loss(ft) 59.23 Minimum Dose Volume(gal) 0.00 In-line Filter Loss(ft) 27.46 System Demand (gpm) 15.65 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/inch Calculator(optional) Treatment Tank Information Total Tank Capacity(gal) 1200.001 Se tic Tank Capacity(gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) I Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity(gal) Pol Lok Filter Manufacturer 22.24 Dose Tank Volume(gal/in) 525 Filter Model Number Weiser Manufacturer Project: C &J BUILDERS INC. Page 2 of 8 Mound Plan and Cross Section Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1/10 B ' :.... ..:.......:.:....... . . . . . . . . . . . . J Observation Pipe .�•..... _ l K• r•d.r•r•1.r.r•r•r•r•l•r•r.r•r•J•r.r•r•r•i•r•}Y•r.r•f•?•r.r•r 1 d 1 d r l r J f f•r•r•l L•L•L•L•1.1•L•1.1.1.1.1.1•L•L.L•1• L•L•1 L ti L.L.r.r.r.r.r•r.r.r.J•�'•r•r•� J•J•r•r /� 1.1.1.1. ti•1•L.L.Y1.1.1.1•Y1• 5 1.1.1 1••.1.1.1.1••.x.1.1.1.1.1.1.1.1• 1.1.1.1• /-t f•r•r•f• r•r•r.r•f•J•J•J•J•r•r r•r•1•r•r•r•r•r•r•r•J•r•r•r.f•r.r•r•r• r•J•r•r•f 1.1.1.1• 1.1.1.1.1.1.1.1.1.1.1• 1.1.1 L•L.1.1.1.1.•.•1.1.1.1.1.1.1.1.1.1 Lx.. f•r•r•r•J•r.J•r•r.d.f•J•r•r.r•r•r•r•r•r•r.�`.r•r.r.r.r.f.J.Nr.r.f.J.r.Nf.f.Jjr.rtirtirtirti: •'..1.1.'1•1.1.1.1.1.1.1.•..1.1.1.1.1.1.1.1.1.1 L.L.L.L.L.Y1.1.1.1.1.1.1.1.1.1.1. 1. _ WI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . B .... ._+. . . . n. . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . • I L Mound Component Dimensions Down slope toe extension made. A 10.00 ft E I 27.40 in H A7.08 ft K 11.11 ft B 60.00 ft F 9.25 in z ft L 82.23 ft D 19.00 in G 0.50 ft J ft W 32.08 ft 600.00 (ft2) Dispersal Cell Area 1 1500.00 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 115.95 (ft) -► lee-ell, H rrrirriirrrf�rrniriii... G rnuiiiiiiiirnJf. I F Dispersal Cell 114.68 (ft) Lateral 114.18 (ft)--► - Invert Dispersal Cell Elevation D 4 4 112.60 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover it Shading Key 'a a I Dispersal Cell See lateral details on ❑1 Topsoil Ca _ ° 1.5 ft r J•r•r•r.J•r•r.r r r J r•r r Page 4 for number,size, P P O 1 tixxx•Lxxx••..1.1.1.1.1. Subsoil Cap C r.r.r•r.r•r•r•r•r.r.r.r•r•r•f and spacing of laterals. i7 r1j 1fti11 1f1ftirLf �?1.1.1•{y�J,`.•ti '..L•1 1•ti•L• Laterals are equally .r.r•r l-/r•r. t.J.r• 1'•f•r.r ASTM C33 Sand 1.1.1•••ti•1•L• 1•ti•1.1•ti•ti•1.1.1• r•r•r;s_r;r;r r;J,r;r;r;r_r•r•r•f °p � 1}}}: 'r1r:r~r F spaced from the Tilled Layer ti•1•,T� ical Lateral 1.1.1. r.r• p 'r•r.r.r , ® y c w ,`� }r}'.;}:}.r:};i:r:}:$:}:}:$:}~ I distribution cell's r.r•r•r Aggregate � � L.L.L.1.L•L.L.L.L.L.1.1.1.1.1 -Ii- © {•1.1.1• r.r•f•J•r•r.r•r•r•r•r•r•r•r. r Centerline in the � 0 1.1.1.1.1•Y1••.•ti 1•YL•1x•1 •h J•rY• . r•N J•r•r•r �._ A .* distribution cell(Ax6). Project: C&J BUILDERS INC. Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals ot+er d w A&B dltoeuslon •m Tura-u P v0ball vs Iva or aleran out pl ug P J All laterals are identical 1F x--'ll Flores*Wod on the bottom of the lateral $ *qua"spaced ILeterele&iorcemein Sch 40 PvC Per 3PS Table 384.30-6 g Force main coanedion via tee or Cross to rnanilom at and point. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ft2/orifice Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft System Flow Rate 27.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 15.65 ft Forcemain Velocity 2.80 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -► SPS 316.300 WAC 4 in.min. Disconnect �_ Tank component is properly vented 4E Alternate outlet location Forcemain diameter Weiser Manufacturer �_ 2 in. Capacity[ 800.00 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.41 453.87 B 2.00 44.48 C Pump off elevation(ft) C 2.66 59.23 F 103.91 D 10.90 242.42 D Total 1 35.971 800.00 Dose tank elevation(ft) 3"Bedding un er tank. 103.00 Alarm Manuafacturer JSJE Rhombus Note: Switches Alarm Model Number ITank Alert AB containing mercury may not be used in Pump Manufacturer JZoeller �� this system. Pump Model Number 198 ��- Pump Must Deliver I 27.46 gpm at 15.65 ft TDH Project: C &J BUILDERS INC. Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name F_ Darrell's Septic Service Phone 715-425-1025 POWTS Regulator's Name St. Croix Zoning Office Phone 715-386-4680 System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 f:2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 ml. Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seeps a once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis.Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ............... Grade vl 6-8" Diameter Lawn — Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: C&J BUILDERS INC. Page 5 of 8 • Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[SBD-10691-P(N.01/01),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N. 01/01)]and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service-and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Stats. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm.Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However,if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. if an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter,and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS,30 mg/L TSS,10 mg/L FOG,and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,pump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: �1/1�L-Ot- -i-�e'• Page 6 of 8 HEAD CAPACITY CURVE i MODEL "98' 4 5/8 -1 30 a I as _ . e _ 3 5/6 a 20 / + -�- I s Q 4 . 4 3/16 to 6 2 S 1 1/2-11 1/2 tit 0 114% cretotts to zo so so UTEW o ao 1a0 240 MODEL ss W CYCLE Feet CoSIM klelare Uters 3 72 +s ass ro s+ x+ as+ +a 45 4.0 +70 12 20 23 s.+ ss —^--� ►.a.vaw7 ar asap[ 43/16 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Bechi id alternators,for duplex systems.are ava llabie and • Vwbble W.,d raNd sae€)Ww am available for controlling tt 00 suppW wih an alarm. and Owns phase System, • itilediaNdcdl ailemadors.-for duplex systems.are available • Double piggyback variable,level float ttawwm are available with or without alarm swkdm for variable level Tong Cyde coni rois. SELECTION GUIDE 1. b*Wdond opefabd 2 Rob lmech9ld O Stolid[.no mtbrttel r n I n l tequko& ..'.Standard all models-Weight 39 lbs.-%H.P. 2.skob pip Axwk verbitb bvei Noet milich of doubt p199bwk vatlebb hwd. toes" Cottlret sakefim floe[eAWL R@W to FM0477. Vo11aPa 1Mode 3.Med0r"allonew 104M or 100075• 7 V 1 Aub 8A 1 ar 1 7 — 4.See f#A "Z forcone I nodal of Eboklaal AWMQW. st 5.Coal aw1a1 101225 toed as a Centel weje r,a lw pedty dup (3)or(4) 115 1 HM _JA 2 a4 090 290 1 Aub 4.7 1 or 1&7 - & Four(4)hob J4ftk.Aetollon btm for vmwwftht aonnecNon orwbe" Eft 290 1 Non 4.7 2 or 2&8 3 or4 a:5 sz F" orduplex opwadon.100002. 7.TWo(2)hole J.Pak,farwale d$*cmwcdon orspke• CAUTION For'In M i e an adibmil holler piodgift tefarbeddaR ae pt beck V4ftb Lwd BtdkhK All installation of controls,protection devices and wiring should be done by a qualified RrD17N,EtecYievlANatrlor.FMD198�.FlrOl1�>ltiAtp�ata�8aft*&l licensed electrician.All electrical and safely codes should be tallovrod indading the swat 9apbPtm*Skq t WnpCmdt ,P A=tAbM SIelenK,fid@T3�, recent National Electric Code(NEC)and the Occupational Safety and Health Act(081tA1. DESERVE POWERED DESIGN For wwsua3l conditions a reserve safety factor is engineered into the design of every Zoeller pump. WJL re P.O.am 109{7 lasV^KY.4ir&W .. . d epot.. �® alvilk S819eeesA N&W _ . L:ouip�;KY19211-1981 �rr/ .�' r�- Aap261atrwswMtreoet FMPM" �f't�.�'• ' `- cry • P plot Plan for Site and Soil Evaluation Page 8 of6 Property Owner CJ� F,utc I" = 40ft Legal J)esclipfon ter- 5T, WA Lti r tf IL�� F-A j ►n (exc-e-pi where noted} S W/ OF ��H a --F L�1� 37� j=! =Ba�'k�o�plt -TKpY f 5T. c ov X N©" W ice�5 rJ3 • -- = �' ►' A 5 c 03= z L AV _ Z� two !S r (f17tt /1�.IL` 41"A61-A! D 7,1�5 gctf,5� Site Loc on: K .� .,a• E 'd SLLT-92�-STL 2ux4sal TZOS s, J6451 TTOH d02 :90 61 62 400 .CS'LVZ 3 .6L_ii.00 N ;p DI 0 I W E1 a C4 do _ N pT39'tis w I z z �^ 0 1' = a o� W C4g + �,� vi �I { O � 000 J { $j z.90 Li '� Z9 II �� 2 W � � era � � r • � 1 r`3 ��` �r f ol IV � � �,� %� ���� .s�•,a wt� Y�r�•�\ art '� �/-'� /, ' /'+� "' vi / CQ CrI C%j d / 1y /",� . Oct-19-2010 01:59 PM St. Crcix County Plan/Zon ng 715-386-4686 1111 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer C+S j 1_1 4 e 3 eA 1 i' Mailing Address �4 �T�'I(` p e— VCC � o� Property Address a.07 W(A'JV 7 +" 941 VtA.'-/ i:f R (Verification required Fran Planning&Zoning Deparmmon f new construction.) City/State 1 ��V� R it Parcel Identification Number Q 40 -1 30 .�i =�0 LEGAL DEKWPTION Property Location (� 14 . �/ ,Sec. g I;z ,T_2fi,N R_IJ_W,Town of T fox Subdivision Plat: rt / a. r, f� ,Lot# . Certified Survey Map# ,Volume , Page# Warranty Deed #—q- � Z (before 2007)Volume page#E Spec house no Lot lines identiliable-Jo: no SYSTEM MAINTENANCE AND OWNER CERTIFICATION, 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 flinction of the septic tank as a treatment stage in the waste disposal system, Owner maintenance responsibilities are specified in§Coium.$3.53(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department it 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 wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(irnecesstuy),the septic tank is less than 1!3 iulI Of Sludge. l/we,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 Planning& Zoning Department within 30 days of the three year expiration date. Ilwe certify that all statements on is form are true to the best of my/our knowledge. I/we amlare the owner(s)of the property described above,by virtue of a rranty deed recorded in Register of Deeds Office, Number of bedrooms SI ATURE APPLICANTS) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planting&Zoning Department,**'� Include with this application a recorded warranty deed from the Register of Deeds Office and it copy of the certified survey map if reference is made in the warranty deed, (REV.08/05) II.I,I.III.IIIIIIIIII.III ll III 8030664 TX:4021636 STATE BAR OF WISCONSIN FORM 3-2000 938028 Document Number QUIT CLAIM DEED BETH PABST REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, Grantor, and C & J ST. CROIX CO., WI Builders Incorporated,Grantee. 06/24/2011 08:56 AM Grantor quit claims to Grantee the following described real estate in St. EXEMPT*: NA Croix County,State of Wisconsin(the"Property"): REC FEE: 30.00 Lots 33,43,44,49, 55 58 and 72 of Walnut Hill Farm,All in the Town of TRANS FEE: 623.40 Troy,St.Croix County, Isconsin. PAGES: 1 Recording Area Name and Return Address: Title One#16514 Together with all appurtenant rights,title and interests. 040-1303-00-072, 040-1300-00-049, 040-1303- 00-058, 040-1303-00-043, 040-1303-00-044, Property sold 'as is' . 040-1303-00-055,040-1303-00-033 Parcel Identification Number(PIN) This is not homestead property. Bank *Thomas W.Van Pelt,President&CEO * * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ST.CROIX COUNTY. )ss. authenticated this Personally came before me this 17th day of June, 2011 the above named Thomas W. Van Pelt, President & CEO of s Citizens State Bank, to me known to be the person(s) who TITLE:MEMBER STATE BAR OF WISCONSIN executed the foregoing instrument and acknowledged the (If not, same. authorized by§706.06,Wis.Stats.) THIS INSTRUMENT WAS DRAFTED BY 140.�V\tc �v oN`1 �Notary Public,State of Wisconsin Michael H.Forecki,Attorney My commission is permanent. (If not,state expiration date: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) 8/26/2012 'Names of persons signing in any capacity must be typed or printed below their signature QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No.3-2000 1 of 1 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of z Division of Safety and Buildings in accordance with Comm 85,Wis. Adm. Code CouPtly�.•, �r ST.CROIX Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and I.D. 040-1303-00-058 percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Please print all information. Reviewed r ate Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). T CRk C pU 0/// D Property Owner Property Location El C&J BUILDERS INC. Govt.Lot ----SW 1/4 SE 114 S 22 T 28 N R 19 ©r)W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 243 Steelhead Drive 58 -- Walnut Hill Farm(Tribute) City State Zip Code Phone Number ity village ■ Town Nearest Road River Falls, WI 1 54022 1 Troy I Walnut Hill Way E] New Construction User Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial-Describe: Parent material loess over glacial till Flood Plain elevation if applicable - ft General comments Mound System-- 1.59 ft.sand fill--0.40 loading rate and recommendations: Additional pit conducted to move system area out of proposed dwelling location. Zab 31roperty Address: 207 Walnut Hill Way E1 jBoring# 0 Boring El pit Ground surface elev. 111.90 ft. Depth to limiting factor 17 in. Soil App 1kcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Efl#1 *Eff#2 1 0-8 10YR2/2 - sil 3fabk mvfr cs 3vf-m 0.6 0.8 2 8-17 10YR3/3 — sicl 3f-mabk dsh cb 2vf-m 0.4 0. 17-Isbr ❑ Boring# © Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff? in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1=BOD >30:<220 mg/L and TSS>30:E 150 mg/L *Effluent#2 BOD <30 mg/L and TSS_<30 mg1L CST Name(Please Print) Sign CST Number MARY JO HUPPERT Hollister's Soil Testing&Desi 224832 Address a valuati n onducted Telephone Number W9875 690th Avenue, River Falls,WI 54022 715-426-1775 �� `c Plot Plan for Site and Soil Evaluation Page 3 of 3 C Property Owner ) pcu� .%�► I" = 40ft Legal Description i-eT 5g, WA LA',VT HILL r-A!.m� (except where noted) � '/y cF r ��4, s.zz, Tz��; Rlei yj �-rb 1. a L°_l =Backhoe pat -?,joys :>T C govt, Co t.t1V y X0!,5 W• j. North OT ,.� i�r r r5• �C �i/� tiLL�+ ♦ I7'Y'�'�J AS r C67C 1/Z./Z� J - i� P" CF 4iA EW rT Pt tom'A c..514AUeYC-. e4ivV < _ Site Locat'on: v x