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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 569538 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. %.6,p Permit Holder's Name: City Village X Township Parcel Tax No: Nault, Christopher& renda Troy, Town of 040-1316-12-000 CST BM Elev. Insp.BM Elev: BM Description: To No: I/S S . 4 L l0V ut;Z 05.28.19.2068 TANK INFOR ATION ELROVATION DATA i TYPE MANUFAC ` {n u STATION / B HI FS ELEV i'��l its q& Septic - / Benchmark -q� v (Q-6 rl4�j Dosing L4 N � Alt. BM ,/ Aeration 153 6 Bldg. Sewer'/a 0 •/Z 13. Holding St/Ht Inlet 3.7f v o TANK SETBACK INFORMATION St/Ht Outlet 3 1 If TANK TO L WELL BLDG. Vent to Air Intake ROAD Dt Inlet / Septic a Dt Bottom / Dosing } Veader/0 an. Aeration /• / c� Dist. Pipe ������ -�/'/� s A V '^✓ Holding 7 G Bot. System 3 _ i • !10 PUMP/SIPHON INFORMATION Final Grade / '„/�e 3 I �. , L Manufacturer Demand St Cover ! �-( l / ® pyt ail /D Model Number ai 3 - 4 r TDH Lift Friction s System H ad TDH Ft Forcemain LenM Dia. Dist.to Well SOIL ABSORPTION SYSTEM _7 `] 4-( k BED/TRENCH Width PO4 gth No.Of Trenches DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS � �� 4 r„SETBACK SYSTEM TO P/L Y BLDG WELL LAKE/STREAM EACHING Manufacture./� / INFORMATION O Ty Of System: CHAMBER <.--R UNIT Model Number: S 5-0, 1- pa f Z(' / IBUTION SYSTEM Header anif N Pipe(s)Distribution D, I ' x Hole Size x Hole Spacing q)w it Intake Length Dia Length Di Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil �/ � Yes No E Yes 70No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1:�/ a 7/�� Inspection#2: Location: 517 Autumn Blaze Trail Hudson,W�1 54016(SE 1/4 SW 1/4 5 T28N R1 9W) Cedar Woods Lot 12 Parcel No: 05.28.19.2068 �L 1.)Alt BM Description= / uP 01 �(.eA dL _ , aj+ l c6,,� � 2 2.)Bldg sewer length= / G bt v �Cr `' -amount of cover ( S Ns � (����Qak/ _ Plan revisid'ffo�4w ? # [ ITO Q' Use other slide fdr"Ngg .lti al information. qure F tq/�;J/���j,f- -Insepctors Si Cert.No SBD-6710(R.3/97) VVV C /Y` Jd '„' �.!; 3 / L;D-T /Z, 0-6:�4. 1&=t 5 s6-lly s,.)liq s7 'P.-epJ, rf v✓ TKoi blD a /�D 3 � g ,3 a w UERIZ TQ-1 l z 1 o a 1 h\o �a�Y Z P .v iow .9(0 Q ,M 70 of �o� 4ri� SS , Lo L z Sa iL 'SCANOG S � — Z ulakv 1 rye Infiltrator Systems -IM Series Page 1 of 1 Call for Tech Support 1-800-221-4436 Search... Email Tech Support HOME I ABOUT US I INDUSTRY I SOLUTIONS I D&VI VIDEOS I FAQS HOME PRODUCTS&SOLUTIONS TANKS IM SERIES IM-1530 IM-1060 IM-540 IM-Series Potable Water Tanks Long-Term,Exceptional Strength and Durability A revolutionary improvement in plastic septic tank design,the injection molded IM-1530 offers exceptional long-term strength and is compatible with Infiltrator's line of custom fit risers and heavy duty lids.Large cpacity,lightweight,durable and watertight. Septic Tank Effective Volume:1537 gal(5818 L) Total Storage Volume:1765 gal(6681 L) Size:176"L x 62"W x 55"H(4460 mm x 1567 mmx 1384 mm) View IM-1530 Cutsheet View IM-1530 CutawM All IM-1530 tanks are a two-piece design that efficiently nests for shipping and available through our network of certified Infiltrator distributors. ©Infiltrator Systems Inc. JOIN OUR SOCIAL NETWORK ® I® 4 Business Park Road I P.O.Box 768 I Old Saybrook,CT 06475 1 USA 1 1-800-221-4436 http://www.infiltratorsystems.com/products-solutions/tanks/im-series 7/24/2014 INFILTRATOR SYSTEMS INC. Page 2 March 12, 2014 Product File No: 20130413 • This product is approved to use the following: The tank provides one inlet and one outlet port. Inlet and outlet pipe diameter is 4 inches for the inlet and outlet. The pipe can be Schedule 40 or SDR 35. - Inlet/outlet pipe water tightness is provided through the use of a rubber gasket, Serco Septic-Tite gasket. A detail of the tank wall penetration is provided in the installation instructions - Mechanisms for pump electrical connections from riser lid or other locations through the riser must be completed in conformance with the riser manufacturer's installation instructions. -Compatible risers include 24-inch-diameter riser products suck as the Infiltrator TW-Riser, Ezset by Infiltrator, PolyLok @, Inc., and Tuf-Tite@ Corporation, in addition to 24-inch diameter corrugated HDPE and IPEX Ultra Rib@ PVC pipe. Maximum riser height is per the riser manufacturer's installation instructions. • Additional information is included as attachment(s)to this letter;see attachment A, B and C. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Glen Jones, M.S. POWTS Product Reviewer phone: (608) 267-5265 fax: (608) 267-9723 email:glen.jones@wi.gov I pART4f DIVISION OF INDUSTRY SERVICES 025 r T°� Plumbing Product Review P.O.Box 2658 3 J, Madison,Wisconsin 53701-2658 TTY:Contact Through Relay Scott Walker,Governor 810S S� Dave Ross,Secretary March 12, 2014 INFILTRATOR SYSTEMS INC. GOVERNMENT AFFAIRS DEPARTMENT 4 BUSINESS PARK RD PO BOX 768 OLD SAYBROOK CT 06475 Re: Description: SEWAGE TANKS,THERMOPLASTIC Manufacturer: INFILTRATOR SYSTEMS INC. Product Name: SEPTIC, SEPTIC/SEPTIC, SEPTIC/PUMP, PUMP OR HOLDING 1 WAR T, `V ,� . - 1765 l`F SAC LAL CAPACII Y VV1=N "T1 AS A HOLDING TA 1 o-. �lfvl 1' FO ENE RESIN, 2-SECTION TANK WITH MID-LEVEL SEAM) [44.0 IN. L.L.; 6 IN. MIN.AND 48 IN. MAX. DEPTH OF BURY;848 G.P.D. WHEN USED AS A SEPTIC OR SEPTIC/SEPTIC TANK;481 G.P.D WHEN USED AS SEPTIC/PUMP TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER; SEE ATTACHMENT A FOR TANK CAPACITY IN ONE-INCH INCREMENTS;TANK DIMENSIONS (OD) = 176 IN. L X 61.7 IN.W X 54.5 IN. H] Product File No: 20130413 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384,Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of March 2019. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • Installation and servicing of this product must be in accordance with the manufacturer's instructions. A copy of the manufacturer's installation and servicing instructions must be given to the owner of the system. • When this product receives wastewater from dwellings and is used as a septic tank, it will produce an effluent quality with a maximum monthly average value for BOD5 greater than 30 mg/L but less than or equal to 220 mg/L,TSS greater than 30 mg/L but less than or equal to 150 mg/L and F.O.G. less than or equal to 30 mg/L. • Before this product is installed a warning label meeting the requirement of SPS s. 384.25(8) (b),Wis. Admin. Code must be securely attached to the manhole cover. SBD-10564-E(N.10/97) File Ref:13041301.DOC 1 S IL u r f N W ro CcPi L OS � g y q L)Ws Z$J W �..N$�$J �� C$ 1 m Q Ell f�g� C. S........ I.J. Ia'�• .8' iL° bS o^O 1 m W "°lSh E to y N ro�..-4 Z J U. U. °a cw z� � V G woy> F ' — " T c �ww � g rw j D Z Sw.. z j o Y O Z LU a u� w N W IL 09 , Z 2 a^ 0 . 0 � Z G y D o 0 LU Iva) F �{ W sad o ego o U WI WO O O yl r m ,Y Z O F7f CO p .._.._...�....� a� D w F W O p U U � Z CYQ m 4 z w z 3:(L m a I-0 LL O 0 a ¢pOi 20 hp _ p ........... =Lon�= Z 5 F to w z — O. U7 U z 3_I G0 69 t CpUOl - I�1 ro Egg j Q Ed�I� E,-,o_ �`ZfaQC WT T Z 2 O Iii R c�R_ O 0 I w Z pp or W l � s -.o U.,LL �� XU' a ZVS W a O� ': alw- °aZd�F��o��o u° C U. IZ 3: J ZO Yommoquuo 3 N bl Ci_ Z - .... � .°CSR- -� SL W.F.r� •'$ 1 Z OI�jSZZQa�ZY�.Fawo. . 7 WWM O J LL VA 0 Q Z r N M V 1N fC h sD C/f r C1926001 IIHI'l/NVdW072 pNYl 71N3tA']'OCStWJGSSi•1VVYAI CegeW'�Wf>�. GNPI/s1.��P.N I¢•td!MN-sp�noteypapwnek0 i ............ ....................... CL _j 10 C)c z iu U) g F_ z .............. 0:0 kr S2 Jl 0 z to co 52 z 0 Co Z_ fl z& 0 e 0 v w z or c w w w CL U)[L c 0 S17 0 0 z 0 2w w j* 't H C2 0 aa o pig X 0 0 z LU N CL U) z d 0 im ........... z- .. zi ............ 0(ZD WJ--I U.1 z LZI um,21 W FLL 0 1< 0) ik E5 S z aim J rL o W IS U_ Ed6L<L E 1 0 lq i U),3 8- M W 61 (Z' t ('9 LL w Ei<21 ILI) !W5 01 uo z 0 co M,O- LLI Z�c 4 2 w 8 z TL F_ 0 z 4 C4 cd 4 wi(6 tz C6 6 MUM lismaydWoo L rit4v I a)For a tank loll cover depth that Is greater than 2.0 feet and up to 4.0 feet(600 to If needed.Long-term groundwater such as underdrains and 1,200 mm),suitable soil textures include: interceptor trenches may be sensible If the site Is amenable to construction of a ,00x CLAY control system and such systems are not prohibited by regulation or law,and the tank ............... ..... NEY location is not subject to flooding.Property installed underdrains and groundwater so w O • N,.•e,aox interceptor trenches may prevent the need for tank buoyancy control measures. .soil dlanem SiXiDN INSTALLING UNDER SHALLOW GROUNDWATER CONDITIONS( row aA ao a rm oily. For am For n5N 9rosler than 60%rr,.we Buoyancy control measures may be required if the Infiltrator tank is to be installeu day eoa baddll shall be septle gravel or sirdiar Angular stone,sized W Inch With less than 12 Inches(300 mm)of soil backfill cover,and where the water level 50 -f rz IndteS. outside the tank has the potential to rise 30 inches(750 mm)or more above the elevation of the tank bottom.Otherwise,no control measures are required(see P.—M CLAY so 5o PNMMSLLT Table 1).The need for buoyancy control measures must be determined based on e«r backfill cover depth and height of water outside of tank above the tank bottom Sera„ w according to Table 1.Refer to Infiltrator IM-and TW-Series Tank Buoyancy Control LONA Guldance document for more information. 30 to zo w Table 1:Tank models'and conditions requiring buoyancy control' I ax L as Soil cover dept above tank' ID Water height above KT 6 In 050 mrn)to Above 12 In 100% 100x SILT tank bottom 12 In(300 root} (300 mm) eo w 7o w w 40 ao ae to P"°•`nSAAI° Above outlet ,Sou pipe saddle Do not Install Do not install 36 in(900 mm)to 1.Backfill should not have stones greater than 3 inches(75 mm)in diameter All models None or excessive clods that do not break apart during placement and compaction. outlet pipe saddle4 Backfill must be capable of occupying the spaces between the tank ribs and 30 In(750 mm)to Ali models except None beneath the haunches. 36 In(900 mm) IM-540 and IMA060 _r 2.Standard field soil classification methods shall be used to determine the soil Less than 3I in None None textural class. (750 mo Note:Under most circumstances,the determination of soil dilatency will 1.IM-540,IM-1060,TW-1250,TW-15D0,and Ita61530. not be required.Dilatancy shall be determined in the field using a test that 2.See useilof to Ilv-and TW-Series Tank Buoyancy Control Guidance for detailed Information on does not require specialized equipment,per ASTM D2488,Section 14.3. 3.No controls are required for soli cover depths exceeding 12"(300 mm). Complete Instructions can be found at www.inflitratorsystems.com 4.The tank shall not be Installed where the water level outside the tank exceeds the height of the 3.Do not backfill top of tank before sidewalls are completely backfilled. outlet pipe saddle.Follow Table 4 guidelines. 4.Place and compact soil by walking-in beneath the haunches of the tank. 5.Place backfill around the four sidewalls in an alternating manner,so that the backfill height along the four sidewalls Is maintained within a 12-inch(300 mm)tolerance. INSTALLING RISERS 6.Continue to place backfill along the sidewalls in 12-inch(300 mm)lifts.Place 1.Compatible risers include 24-inch(600 mm)diameter products such as the backfill between the ribs on the sidewalls such that the space between the ribs Infiltrator TW-Riser,EZset by Infiltrator,PoiyLok®,Inc.,and Till-Titea Corporal' is completely filled with soil. in addition to 24-inch(600 mm)diameter corrugated HDPE and IPEX Ultra Rib 7.Compact backfill material either by walking-in,hand tamping or mechanical PVC pipe.Follow Infiltrator's IM-and TIN-Series Tank Riser Connection Guidance. compaction(includes backhoe bucket).If mechanical compaction is used,such 2.In Oregon only,watertightness testing shall Include filling with water at least 2 as a walk-behind tamper or backhoe bucket,a single pass is recommended. inches above riser connection,with no more than 1 gallon leakage per 24 hours, Compact each lift prior to placement of next lift.Compact backfill from tank per OAR 340-073-0025(3). walls to excavation sidewalls. 8.Complete backfilling and grade the area. INSTALLING PUMPS AND RELATED EQUIPMENT 9.A minimum 6-inch-thick(150 mm)layer of suitable soil must be placed over the Pumps may be supported on a stable,level 16 x 16 inch(400 x 400 mm)platform top of the tank.The balance of backfill placed to finish grade above the tank may positioned on the bottom of the tank.One 16 x 16 Inch block or two 8 x 16 inch be either suitable or unsuitable soil. (200 mm x 400 mm)side-by-side blocks may be used.Limit block height to 10.Establish a strong stand of erosion-resistant vegetation. account for pump height and liquid levels during pump cycles.Block(s)should be Note:Grade to prevent the backfilled excavation from filling with surface placed below an access opening and level upon the tank bottom.For two blocks, runoff.If the water level in the backfilled excavation exceeds the height of orient them perpendicular to ribs on the tank bottom,9 present,for stability. the outlet pipe saddle,tank structural integrity may be compromised. Installation of products such as electrical conduit and wiring,pumps,water level 111. control equipment,valves,siphon equipment,etc.shall be in accordance with the No backfilled excavation from filling with surface Establish a strong stand of erosion-resistant vegetation. product manufacturer's instructions and compliant with applicable state or local Note:Grade to prevent the back rules and regulations.Appurtenances shall be fastened to the tank riser system and runoff.If the water level In the backfilled excavation exceeds the height of not the tank body or access opening rim.Where possible,appurtenances shall be the outlet pipe saddle,tank structural integrity may be compromised. installed to facilitate maintenance and repair access via the tank access openings. MOUND WKFILL FOR MINIMUM S'SOILCOVER POSITIVE DRAINAGE SWABLE SOIL GENERAL SPECIFICATIONS COVER FILL •failure to comply with installation instructions will void warranty. �� �...:. •Prior to ground disturbance,check for subsurface obstructions and utilities in _ p conformance with applicable requirements. PLACE SOIL Mat)T:IMUM •Operating water temperature shall be less than 100°F(40•C). BETWEEN RIBS PARTICLE SIZE •Tanks are not fire resistant.Store away from ignition sources. PLACE SOIL IN a Removal of structural bulkheads is prohibited;removal of locking clips on the SUITABLLE NATIVE L FTSAND I IM-Series tank mid-seam connection is also prohibited. SOIL BACKFILL COMPACT a Suitable for potable applications only if the tank bearing an NSF/ANSI 61 PLACEANDCOIAPACT certification mark,otherwise tank is recommended for use in septic,rainwater/ SOIL BENEATH HAUNCHES stormwater storage,and pump applications or other non-potable unit. 1T'•30'(306954 mm) IM-1060 shown for reference •Infiltrator tanks are designed for installation underground. SHORT AND LONG-TERM GROUNDWATER CONTROL •Contact Infiltrator Systems for above-ground use requirements. (. It may be necessary to implement groundwater control measures during tank A WARNING:IMPLOSIONS MAY CAUSE SERIOUS INJURY installation.Maintain dry conditions by expanding the excavation to create a short- term groundwater collection sump for temporary placement of a dewatering pump Follow Infiltrator Systems Inc.vacuum test instructions 111111111111M . . at r Infiltrator IM- and TW-Series 2 3 4 3 C NOVEMBER 2013 Tank General Installation Instructions rriNFILTRATOR* tanks BEFORE YOU BEGIN be drilled on either the sides or ends of the tank,as required based on applicable 'trator Systems'tanks must be installed according to state and/or local codes and site conditions. julations,which supersede the manufacturer's Installation Instructions. Florida,Indiana,Kentucky,Oregon,West Virginia and certain Texas tank Inlet/ If unsure of the Installation requirements for a specific site,contact the health outlet holes are factory drilled. department or permitting authority.The IM-Serles referred to In this document 3.The gaskets supplied with the tank are compatible with Schedule 40 and SDR includes the IM-540,IM-1060,and IM-1530 tanks.The TW-Series includes the 35 pipe using a 5-inch-diameter(125 mm)hole saw with IM-Series tanks,and TW-1250 and TW-1500 tanks. a 51/4-inch-diameter(133 mm)hole saw with TW-Series tanks. AWARNING:IMPLOSIONS MAY CAUSE SERIOUS INJURY 4.Install the rubber gaskets at the inlet and outlet. Follow Infiltrator Systems Inc,vacuum test instructions 5.Using the tank's integral lifting lugs,lower tank into excavation. 6.Slide the Inlet and outlet pipes`through the gaskets.Soapy lubricant may MATERIALS be used to slide the pipe in. 'For North Carolina,the Inlet pipe shall be a straight pipe with no tee. •Infiltrator tank ❑Shovel 7.Horizontally position the tee 1Y2 inches(40 mm)from the access port rim, •Access port lid(s)(included) O Level allowing the tee to fit Into the recess in the access port lid(see detail). i ❑10 screws per lid(included) ❑5-inch-diameter(125 mm) S.Install lids and risers(see Installing Risers section)as necessary.Rotate lid ❑2 inlet/outlet gaskets hole saw(IM-Series only) over access opening until it indexes to tank and drops into position. (included) ❑5.25-Inch-diameter(133 mm) POSITION TEE 1.0'110 mm) ❑Inlet/outlet tees' hole saw(TW-Series only) FROMPORTwM ACCESS PORTRIM ❑Tape measure ❑Utility knife CASKET ❑Pipe,risers,etc. ❑PVC pipe glue with primer ACCESS ❑Socket wrench tee Inclusion varies by state/province ,°,D°EN1NO ❑Excavator TAIAC wAIa-- (INFIMTHOWN) TANK —INLET TEE INTERIOR (TYPICAL) INSTALLATION SITE SELECTION 1.Do not Install the tank in vehicular traffic areas.The tank is designed for TW 1250ANOTW-1506 51 inn.275 mm) non-traffic applications. IW54D.IM-1D50.AND INM520:551.(1.575 mm) 2.The allowable soil cover depth Is 6 to 48'Inches(150 to 1,200 mm). '18-Inch(450 mm)max.in Florida for Cat.3 IM-and TW-Series tanks; 48-inch(1,200 mm)max.In Florida for Cat.4 IM-Series tanks;36-inch MRl1lAN (900 mm)max.in Massachusetts,Now Hampshire,North Carolina,and Oregon. A�r«" 3.The tank shall not be installed where the subsurface water level outside the tank 9xceeds the height of the outlet pipe saddle.Follow Table 4 guidelines. 'AVATING AND PREPARING THE SITE 1.Unless buoyancy control measures are required,the excavation width and length should be 12 to 36 inches(300 to 900 mm)larger than the tank on BACKFILLING THE TANK each side.See Infiltrator IM-and TW-Seres Tank Buoyancy Control Guidance Note:Infiltrator tanks do not require filling with water prior to backfill document,available online at www.infiltratorsystems.com,for specific excavation placement.Water filling and backfllling to the tank mid-helght Is required requirements. if the tank is left in either an open or backfilled excavation that may fill with 2.Excavate to account for the height of tank.55 Inches(1,375 mm)for the water from rain or other sources. IM-Series tanks and 51 inches(1,275 mm)for the TW-Series tanks.Also account 1.Backfill with suitable native soil.If native soil Is unsuitable,replace unsuitable for 4 inches(100 mm)of bedding(if required),and backfill thickness(permissible fraction with suitable soil.If suitable soil is not locally available,contact Infiltrator cover depth is 0.5 to 4 feet(150 to 1,200 mm)of soil). Systems for assistance. Note:If the water level outside the tank exceeds the height of the outlet 2.Suitable soil shall include soil textural classes defined in the United States pipe saddle,tank structural integrity may be compromised.Follow Department of Agriculture soil triangle.Suitable soil textural classes are based on Table 4 guidelines. the tank installation depth,as measured from finished grade to the top of tank. 3.Inspect bottom of excavation to verify suitability of native soil for tank a)For a tank soil cover depth of 0.5 to 2.0 feet(150 to 600 mm),suitable soil installation.Soils with large,protruding,or sharp stones or other similar objects textures include: that may damage the tank are not suitable. ---- loozCLAY KEY. 4.The tank may be installed either In suitable native soil(see Backfilling the Tank 1AISUIIOb. section)or a minimum 4-inch(100 mm)layer of well-graded granular soil having 90 10 ! 3 il able particles less than 3 inches(75 mm)In diameter,or maximum 0.5-Inch(13 mm) siltam.ndilamRt diameter crushed stone. 00 20 Arkansas o*: For sites w%h greater Than 509%native 5.Create a uniform,compacted,level surface to ensure that the bottom of the 7. uY Clay SOIL bacuu shall be septic gravel tank is evenly supported.Verify that the installation surface is flat. or similar angular stone,sized 1n inch to 1-112 inohae. aVRVl OGTN / 80 40 IF I143ANi4MNNAU4 w(1,2,9"IxN,AU4 CRMIF PO ACLAY 50 50 Patent SILT BERMAY NOM —4 9Aiq,MFI0p9,NgIV101665M(3,3I9-4 t1LTY; lo��r 1W126DANOTYhI39691M(1.2N—) S"Ace PLe50E90N04OKFXLOEPIN 40 so RUNOFF Y CAAn1WTl0 04TAM.E NMI9EOQLOR 01bWUlM IAA19MK 50 l0 70 nAO4.P1,wK.,y wrwll w 20 co NeM S.YMY93m � avawdon,5wr. -y.'B .. 10 eo 37ALLING THE TANK 10oa t00%SILT inspect the tank for damage before installation. 90 w To Bo s. 40 2,If the tank inlet and outlet penetrations are not drilled,drill holes using the drill Pi1a&11 SAND SNW points provided at each of the inlet and outlet ports according to the applicable Inlet and Outlet Hole Locations section of this document.The inlet and outlet may Faildre to comply with these installation in5truclions may invalidate the warranty.Contact Infiltrator System s'Technical Services Department for assistance at 11 i INLET AND OUTLET HOLE LOCATIONS locations,as allowed by state and/or local regulations.The drill height Drill height marks are provided on all Infiltrator tank models to guide mark indicates the center point location for the hole saw.The pilot drill inlet and outlet hole drilling. On the TW-Series tanks,marks'IN,(lower) bit on the hole saw should be positioned at the center of the drill height and"B"(upper)are located at the inlet end,while marks"C"(lower)and mark to align the hole saw property. Table 3 provides drilling and invert Information by regulatory jurisdiction for the installation of 4-Inch- i "D"(middle)are located at the outlet end. A single drill height mark diameter(100 mm)pipe. is provided at each end or side port on the IM-Series tanks(example illustrated below). Holes may be drilled at the end or side inlet and outlet Table 3:Inlet and Outlet Hole Locations Inlet Invert Height(in)[mm] Outlet Invert Jurisdiction' Inlet Drill Outlet Drill Invert Drop Above Inside Above Height=and Liquid Location Location (In)[mm] , s Level(in)[mm] Bottom of Tank Excavation Base IM-540 and IM-1530 "WIM All All All 3.00[76) 47.00[1,994] 47.20[1,199] 44.00[1,118) I f 1.1 End End 3.00[76] 47.00[1,994] 47.20[1,1991 44.00[1,118] All Side Side 3.00[76] 47.50[1,207] 47.70[1,212] 44.50[1,1301 Side End 3.50[891 47.50[1,207] 47.70(1,212] 44.00[1,118] End Side 2.50[64] 47.00[1,994] 47.20[1,199] 44.50[1,130] • 1• FL B D 2.750 42.75[1,086] 43.45[1,102] 1 40.00[1,016] DE,IA,MA,ON A D 2.00[51] 42.00[1,067] 42.70[1,086] 40.00[1,016] AR,CA,CO,CT,ID,IN,KS,KY,MO, B C 3.00[76] 42.75[1,086] 43.45[1,102] 39.75[1,0101 MT ND OR,PA,SD,TX,VT WV All Others A I C 2.25 57 42.00 1,067 42.70 1,086 39.7511,0101_ NOTES:11.bottom of hie tank to thelinvert.Oregon, .Invert heights i )are measureid tr m the base eof the excavation ttorythe Invert.Invert State heights provincial and local regulatory requirements supersede e Table 3 Information. INFILTRATOR SYSTEMS,INC.("Inflitrator") Top of Tank INFILTRATORO SEPTIC TANK LIMITED WARRANTY FIVE(5)YEAR MATERIALS AND WORKMANSHIP LIMITED WARRANTY (a)Thin limited warranty Is extended to the end user of an Infiltrator Septic Tank.A Septic Tank manufacture. A 0 Infiltrator,when installed and operated in accordance with Infiltrator's Installation Instructions and local regulation by a licensed instsler,Is warranted to you;0)against defective materials and workmanship for owe(S)years after Installation.inf itralor will,at Its option,to repair the detective product or(it)replace thedefective materials.Infiltrator's Ilabifity specifically excludes the cost of removal and/or Instalation of the Septic Tank. (b)In order to exercise Its warranty rights,you must notify infiltrator In writing at its corporate headquarters In Old Maximum allowable Saybrook,Connecticut within fifteen(15)days of the alleged defect. water position (c)YOUR EXCLUSIVE REMEDY WITH RESPECT TO ANY AND ALL LOSSES OR DAMAGES RESULTING FROM ANY B corresponds to the outlet CAUSE WHATSOEVER CONSEQUENTIAL SUBPARAGRAPH E LIABLE ANY OR IN IDEN DAMAGES OF ANY KIND,HOWEVER OCCASIONED, pipe saddle invert WHETHER BY NEGLIGENCE OR OTHERWISE.SOME STATES DO NOT ALLOW THE EXCLUSION OR LIMITATION OF INCIDENTAL OR CONSEQUENTIAL DAMAGES,SO THIS LIMITATION OR EXCLUSION MAY NOT APPLY TO YOU. THIS WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS AND YOU MAY ALSO HAVE OTHER RIGHTS WHICH VARY FROM STATE TO STATE. (ATHIS LIMITED WARRAHTYISTHE EXCLUSIVE WARRANTYGIVEN BY INFILTRATORANDSUPERSEOESANY PRIOR, CONTRARY,ADDITIONAL,OR SUBSEQUENT REPRESENTATIONS,WHETHER ORAL OR WRITTEN.INFILTRATOR Tank base DISCLAIMS AND EXCLUDES TO THE GREATEST EXTENT ALLOWED BY LAW ALL OTHER WARRANTIES,WHETHER Table 4:Maximum Allowable Subsurface Water Elevation EXPRESS OR IMPLIED,OR STATUTORY,INCLUDING ANY WARRANTY OF MERCHANTABILITY,FINESSE FOR A PARTICULAR PURPOSE AND ANY IMPLIED WARRANTIES OTHERWISE ARISING FROM COURSE OF DEALING, Vertical Distance to Maximum Allowable COURSE OF PERFORMANCE,OR USAGE OF TRADE.No PERSON(INCLUDING ANY EMPLOYEE,AGENT,DEALER, OR REPRESENTATIVE)IS AUTHORIZED TO MAKE ANY REPRESENTATION OR WARRANTY CONCERNING THIS Water Elevation Outside of Tank THIS WARRANTY IS NOTA WARRANTY OF FUTURE PERFORMANCE,ANCE BUT ONLY A WARRANTY O REPAIR OR Tank Model A-From Top of Tank B-From Tank Base REPLACE. (e)YOU MAY ASSIGN THIS LIMITED WARRANTY TO A SUBSEQUENT PURCHASER OF YOUR HOME. IM-Series' 13" 330 mm) 43"(1,075 mm) (0 NO REPRESENTATIVE OF INFILTRATOR HAS THE AUTHORITY TO CHANGE THIS LIMITED WARRANTY IN ANY ( MANNER WHATSOEVER,OR TO EXTEND THIS LIMITED WARRANTY. CONDITIONS AND EXCLUSIONS TW-Series` 11"(280 mm) 39"(975 mm) There are certain conditions or applications over which Infiltrator has no control.Defects or problems as a result of such conditions or applications are not the responsibility of Infiltrator and are NOT covered under this warranty. 1.IM-Series tanks include the IM-540,)M-1060,and IM-1530. They include failure to Install the Septic Tank in accordance with Instructions or applicable regulatory requirements 2.TW-Series tanks include the TW-1260 and TW-1500. or guidance,altering the Septic Tank contrary to the installation Instructions and disposing of chemicals or other materials contrary to normal septic tank usage. The above represents the Standard Limited Warranty offered by Infiltrator.A fimited number of states and counties have different warranty requirements.Any purchaser of a Septic Tank should contact Infiltrator's corporate headquarters In Did Saybrook,Connecticut,prior to such purchase to obtain a copy of the applicable warranty,and should carefully reed that warranty prior to the purchase of a Septic Tank. 4 Business Park Road Distributed By: P.O.Box 768 Old Saybrook,CT 06475 861577-7000•Fax BW-577-7001 INFILTRATOR' 1-800-221-4436 systems Inc. www.inflltratoraystems.com U.S.Patents:4,759,661;5,017,041;5,158,488;5,338,017;5,401,116;5,401,459;5,511,903;5,716,163;5,588,778;5,839,844 Canadian Patents;11.329,959;2,004,564 Other patents pending.Infiltrator,Equalizer,Ck&k4, and Sidewinder are registered trademarks of 1nf ltralor Systems W.Infiltrator is a registered trademark in France.ed Strait uator Systems ems Inc.Is a trademarks of registered Systems Inc, Contour,MIcroleaching,Poly-tuff,ChamberSpam,MukiPoM PoslLock,OuickCut,Q*kPlay,SrePLock 9 PoyLok is a trademark of PolyLok,Ino.TUF-TrrE is a registered trademark of TUF-TrTE,INC.Ultra-Rib Is a trademark of IPEX Inc. TANK01 1113-04 ®2013 Infiltrator Systems Inc.Al tights reserved.Printed in U.S.A. i l 2 � C Table 2:Infiltrator Tank Nominal Volume Chart 0 1 3U 4 3 Height' Total liquid volume in tank at indicated height in cm IM-540 IM-1060 TW-1250 TW-1500 IM-1530 U.S.Gal Liters U.S.Gal Liters U.S.Gal Liters U.S.Gal Liters U.S.Gal Liters 1 3 3 11 3 11 14 53 17 64 8 30 2 5 8 30 13 49 30 115 37 140 24 89 3 8 14 53 28 106 58 218 71 267 43 164 4 10 21 80 46 174 87 330 107 404 67 254 5 13 29 109 1 65 246 117 1 444 143 543 93 353 6 15 37 141 86 326 148 558 180 683 121 459 7 18 46 173 107 .` 405 178 674 218 825 151 571 8 20 55 207 129 488 209 791 256 968 182 687 9 23 .64..:. 243 152 575 240:. 910 294 1,112 1 213 . 808 10 25 74 279 176 1 666 272 1029 332 1,257 246 932 11 28 84 317 200 757 304 1,149 371 1,404 280 1.060 12 30 94 356 225 852 336 1270 410 1,561 315 1,191 13 33 105 396 251. 950 368 1393 449 1,700 350 1324 14 36 116 437 277 1,049 400.. 1,516 489 : 1,849 `:386 1,460 ' 15 38 127 480 903 1,147 433 1,640 528 1 2,000 422 1 597 16 40 138 523 330 1,249 466 1,765 569 2,152 459 1736 I 17 43 150 566 357 1351 500 1,892 609 2,305 496 1,876 18 46 161 611 384 1,454 533 2019 650 2,459 533 2,017 19 48 173 656 411 1,656 567 2146 690 2.614 570 2,159 20 50 186 702 438 1.658 601 2 275 732 2,769 1 BOS 2,302 21 53 198 749 465 1,760 636 2,407 774 2,928 648 2,445 ' 22 56 210 796 493 1 866 671 2,541 816 3,091 684 2,590 23 58 223 843 521 1,972 708 2,678 860 3,256 723 2,735 24 61 235 891 549 2,078 745 2,819 905 3,425 761 2,881 ' 25 64 248 940 577 2,184 781 2 955 948 3,589 800 3,028 26 66 261 988 605 2,290 815 3,086 990 3,747 839 3,176 27 69 274 1,038 633 2,396 849 3,215 1,031 3,903 879 3,326 28 71 287 1 088 662 2,506 883 3,342 1,072 4,057 918 3 477 29 74 300 1 137 691 2,616 916 3,469 1,112 4,210 958 3,625 30 76 313 1.185 719 2,722 950 3,594 1,152 4,362 996 3 772 31 79 326 1,233 747 2,828 982 3,719 1,192 4,514 1,035 3,918 32 81 1 338 1 281 775 2,934 1,015 3,842 1,232 4,663 1 073 41064 33 84 351 1,328 802 3 036 1047 3,964 1,271 1 4,810 1,112 4,208 34 86 363 1,375 830 3142 1,079 4,084 1,309 1 4,956 1,150 4,352 35 89 375 1,421 857 3,244 1,110 4,203 1,347 5,101 1,187 4,495 38 91 387 1,466 884 3.346 1.141 4.320 1,385 5 243 1.225 41637 37 94 399 1,511 911 3,449 1,172 4P436 1422 5 384 1,262 4 778 38 97 411 1,555 938 3 551 1 201 4,548 1,458 5,521 1,299 4,918 39 99 422 1,598 965 3,653 1230 4,657 1 1,494 5,654 1.336 5,057 40 102 433 1640 992 3,755 1,261 4,772 1,632 5,798 1.372 5,194 41 104 444 1681 1,018 3 854 11286 4,869 1,562 5,915 1408 5.330 42 107 455 1,722 1,044 3,952 1,314 4,972 1,596 6 042 1,444 5,464 43 109 465 1,761 1,069 4 047 1.340 5,074 1.62 6,167 1,478 5 596 44 112 475 1,799 1,094 4,141 1,366 5,172 1,661 6 288 1,512 5,724 45 114 485 1,836 1,118 4.232 1,390 5,263 1,690 6,399 1 545 5.849 46 117 494 1,871 1,142 4,323 1,410 _5,337 1,715 6,492 1,577 _5,970 47 119 503 1905 1,165 4 410 1427 5,402 1,737 6,574 1 608 6 087 48 122 512 1,938 1,187 4,493 1,439 5,446 1,750 6,626 116-38- 6199 49 124 520 1,970 1,208 4,573 1,448 5,481 1,762 6,669 1,666 6,306 50 127 528 1,999 1,228 4,648 - - - - 1,692 6,407 51 130 535 2,027 1,247 4 720 - - 1,717 6,498 52 132 542 2 050 1,265 4.789 - - 1.737 6.575 53 135 547 2071 1,278 4838 - - - - 1,754 6,639 54 137 5512 2 087 1,287 4,872 - - - 1,7662 6,6B6 i 1.Height measured from lowermost inside surface at bottom of corrugation In tank. 2.The total capacity of the IM-640 tank is 552 gallons;the total capacity of the IM-1530 tank is 1,769 gallons. a 201 W.WwWgtonAvw,P.O.Box 7162 Samba Permit Number(to be Stied in by Co.) JUL 8�Q14 Madmn,WI 5=7-7162 'nn��` � � i Applic a sa»�Ttah NhD)d>ef is aecotaaooe with SP&3E3�t`1 wg Adm Code,anbmis oPf fm f0m to the;elrpriase g unit /U A- isrequnrdpnortoobtmmgasmdtoypemuL Holm Apphcu im tixrns for sh*o-owned Po rya to nrject Addtcss(if fiffi 'dm mazilling and—) the DqmUnmt of Say and Pty Setvmm Pehsaual inforehmeon yon provide slay be used for in a=rdmace wft*e Pdv=Y T.aw s.15. )(ml SWL C L 'eatien __.)Information— All Information vi f ` l u w\ O A GC Prope►iyUwner's Nattie P&cd# Property Owner's MMfna Attthess Property Loeatim A 2 Q S RI %,— 0ovt.Lot u cm>stagy zip Code Pbtxhc Nhaober 0 V, S`✓ V, Setdim _ 50113 ®I b T_�N; R j II.Type of Building(check all that app1Y) I of a Mor2F=RyDweH*—NumberofBcdooms ' Z SubdivisimNamne 6 K 04 PA, ❑Pub&dCwmmcW—Describe Use Aj -I 0 --f ❑State owned—Describe Us-- CSMNhhmber ❑vw of IIL Type of Peraiifi (Clink oidy one box on line A. Compite tine B if applicable) A. $-New Systtsn ❑Rep>a=ncnt 5ystm ❑TrtammVEldtbag Talc Replamamw 0* ❑otter Modificom to Sysw-(-Ph—) B. ❑Permit Rmmg ❑Permit Rovisim ❑Change of t ❑Pemoit Traosla to New List lhevim Perink M mbar and DO TmUw tin&&afim t P: L a IY.TnmDf POW" a nemNDeviee: Cheek A that ` kNogi-Press�Ta-C ❑Ptcssmiud ❑At-Gt>tde ❑Mamd>24 m.of su"W sm7 ❑MouW<24 in.of=AM,-d ❑Iiol&%-fm& ❑06"Disposal[Component(c plaia) ❑PtW=&mentDmU*(explain) V.Din eut Area iimfortaation: C Design Fkw(lam Deshga SoA/O pplhcafhon jlDispctsWArcaRcqd(Aj D Sy = &00 1 o 1600) o tr 97 - q7 Zs VL Tank Info capacity Q1 Told #of Manufacturer- p v NCWTaala Tanis Septic Z® ZOO I J VM Rmpons-ibitity Stattmeet-L the underagmd,asmme respousaffity for inststltation of tin P0Vn S shown oa the ached Puns. Phnnber's Name(Pant) 's S' & Phone Nmber zZ3z�z �ls- Plumber's Address(Stzect,City.Std Zip ) el()I k J&S D - K. t 5y V III. un rtmemt Use Only 4 Pcrmit Fee Date ,/ issuing _ is�hue b-qv�- �Rcasoe CA I DL Con /�easoms for DisPP a roval II� R ,�� 1Y`*tid'tank,effluent filter and ts0mal cett•must all be serAces/lnairitalned as per Management plan provided by plumber. � I t>?gwYeFnentts rnusl t»'1naiM�%nesi ss PW code/ordinaitcxat: .Altw h to eomw0le a glass for the sy mW suhaft to the COMISIT aais m paperact lm tins 8'a I U ,ts sec SBD-6398(R 11/11) (-4NRi;5 A)Av�-r c-,D"T /-4 crs.,Wv; oopS Er'/y 5 V 14, 5 S 'T'OOJR rt 14/ TP,oy ws,P �V bjlD "Ay V. � g.M• iJall �N b �� a E tZ ��- z , Qa AZ 70P OF r6UrU0YA110r- 5L t� SaL TOL-11 6S Aug-15-2013 08:53 AM 5t. Croix County Plan/Zoning 715-386.4686 3/4 d2 f ' �ft 4.8ahe"40 Rnel Gfeck PVC vad Olp with VWA �� z5 100 LewHng Chamber • �--X17°ZS-� SYS"a atlon Z R ft f �9 98 Soft Abnom ado NO Vt�ec 68 f Lmdft Chwbers Trench 7 I tt 4"COIL f Trench 2 Neador Vent or O[earyNop F" Trernctt S l ewhina Chamber MHOWARM 'I MenuiacturerAnd Model 1=�-�';! r•►�•� Q°� T G�.aoe1 EISA Rating eq It per chamber SoU AppfCaflon Rate+_b__gpd/sq ft ..l�ddL9pd Design Raw,& Sop Appica n Rift 4. Z() E13A �J� Chambers 3 coals DQUE chambers soh. • Page of RECEIVED SOIL EVAIN�T�QN�fPORT #1203 41� an d Professional Services 6r rge 1 of 4 "tn S Buildings ST. CROIX COU Keith E.Stoner in accordance wjttllAMUtPli1l [ Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must TCouMy include,but not limited to:vertical and horizontal reference point(BM),direction and St.Croix percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D. Please print all information. 040-1316-12-000 Personal information you provide may be used for Reviewed By Date secondary purposes(Privacy Law,s.15.04(1)(m)). Property Owner Property Location Christopher&Brenda Nauft Govt.Lot SE1/4,SW1/4, S5,T28N,R19W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 2401 Golf Dr. 12 1 I Cedar Woods City State Zip Code Phone Number City ❑Village ® Town Nearest Road Woodbury MN 1 55129 1 Troy 1 517 Autumn Blaze Trail ®New Construction Use: ® Residential/Number of bedrooms 4 Code derived design flow rate 1300 GPD ❑Replacement ❑ Public or commercial-Describe: Parent material Outwash Plains Flood plain elevation,if applicable Na ft. General comments Propose 3 dispersal cells 3 ft.x 70 ft.using a.6 SAR.Center the upsklpe cell over the 103.00'contour w/a S.E.of 99.00'.Center the and recommendations: middle cell over the 102.00'contour w/a S.E.of 98.00'and center the lower cell over the 101.25'w/a S.E.of 97.25' F-1-1 Boring# ❑Boring ®Pit Ground surface elev. 101.34 ft. Depth to limiting factor >132 in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-12 10YR2/1 A 2mgr-sbk mvfr cs 3f-co 0.6 0.8 2 12-36 10YR3/4 sil 2msbk mvfr gs 3f-co 0.6 0.8 3 30-40 10YR4/4 Is Osg ml gs 3f-co 0.7 1.6 4 40-132 7.5YR4/4+5/4 Osg ml --- 2f-co 0.7 1.6 Shovel and hand auger were used t4l rovi boring data below 92"to prevent caving of sidewalls. 21 Boring# ❑Boring ®Pit Ground surface elev. 101.24 ft. Depth to limiting factor >100 in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDh12 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. •Eff##1 *Eff#2 1 0-18 10YR2/1 sil 2mgr-sbk mvfr cs 3f-co 0.6 0.8 2 18-30 10YR3/4 sil 2msbk mvfr gs 3f-co 0.6 0.8 3 30-100 7.5YR4/4 Is Osg ml --- 3f-co 0.7 1.6 Shovel and hand auger were used to provide boring data below 0"to revent caving of sidewalls.Also note A-horizon varies due to terracing of *Effluent#1=BODS>30<220 mg/L and TSS>30<150 mgA- *Effluent#2=BOD5<_30 mg/L and TSS<_30 mg/L CST Name(Please Print) Signature: . CST Number Keith E.Stoner e�' 224059 Address Keith E.Stoner Date Evaluation Conducted Telephone Number 23220 Wood Creek rd.Siren,WI 54872 5/9/2014 71"53-2324 SBD-8330(R l l/11) Property Owner Christopher&Brenda Nault Parcel ID# 040-1316-12-000 Page__2_of 4 E]Boring F3] Boring# ®Pit Ground surface elev. 103.24 ft. Depth to limiting factor >108 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. -Eff#1 -Eff#2 1 0-12 10YR2/1 A 2mgr-sbk mvfr a 3f-co 0.6 0.8 2 12-24 10YR3/4 sl 2msbk mvfr gs 3f-co 0.6 1.0 3 24-34 7.5YR4/4 Is Osg ml gs 3f-co 0.7 1.6 4 34-108 7.5YR4/4+5/4 s Osg ml --- 2f-co 0.7 1.6 l� Shovel and hand auger were used to vide boring data below 88"to prevent caving of sidewalis. F ❑Boring 4 Boring# ®Pit Ground surface elev. 105.64 ft. Depth to limiting factor >110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. -Eff#1 -Efr#2 1 0-12 10YR2/1 sil 2mgr-sbk mvfr CS 3f-co 0.6 0.8 2 12-22 10YR3/4 sil 2msbk mvfr gs 3f-co 0.6 0.8 3 22-36 E7.5YR4/4 Is Osg ml gs 3f-co 0.7 1.6 4 36-110 4/4+5/4 s Osg ml -- 2f-co 0.7 1.6 scl inclusion approx. 16"x 30"W a depth of 60"may be an example of flow till.Hand auger used to deepen pit depth. rJ F-1 Boring# Boring ®Pit Ground surface elev. 109.14 ft. Depth to limiting factor >118 in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. -Eff#1 -E02 1 0-20 10YR2/1 Sil 2mgr-sbk mvfr a 3f-co 0.6 0.8 2 20-26 10YR3/4 sil 2msbk mvfr gs 3f-co 0.6 0.8 3 26-37 10YR4/4 sl 2msbk mvfr gs 3f-co 0.6 1.0 4 37-52 10YR4/4 Is Osg ml gs 2f-co 0.7 1.6 5 52-64 10YR4/4 c2d 5YR5/8 sid 2msbk mfr CIS if-m 0.4 0.6 6 64-118 7.5YR4/4 s OSg ml --- if-m 0.7 1.6 Boring exhibited inclusions of sid 24-36"wide x 24"deep.May be examples of flow till described by Ed Taylor on a site near Cameron WI *Effluent#1=BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L The Department of Safety and Professional Servicese is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. 4 Property Owner Christopher&Brenda Nault Parcel ID# 040-1316-12-000 Page 3 of 4 F]Boring 6 Boring# ®Pit Ground surface elev. 113.75 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Ef1#2 1 0-6 10YR2/1 sil 2mgr MVfr cs 3f-co 0.6 0.8 2 6-22 10YR3/4 sil 2fsbk mvfr gs 3f-co 0.6 0.8 3 22-43 10YR4/4 sil 2msbk mvfr gs 3f-co 0.6 0.8 4 43-63 1OYR4/4 sl 2msbk ml gs 2f-co 0.6 1.0 5 63-80 10YR4/4 c2d 5YR5/8 sl m mfr gs if-m 0.4 0.7 6 80-110 7.5YR4/4 s Osg ml --- if-m 0.7 1.6 F-1 F-1 Boring Boring# ❑Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Ef1#1 *Eff#2 F-1 ❑Boring Boring# ❑Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMF in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1=BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<_30 mg/L The Department of Safety and Professional Servicese is an equal opportunity Service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3131 or TTY through Relay. Soil Test Site Plan Page 3 of 3 For: Christopher and Brenda Nault P/L Lot 12 of the Cedar Woods Sub. Parcel in the SE 1/4 of the SW 1/4 Sec.5 T28N-R19W Town of Troy-St.Croix County 0 20 40 ar paso sods (F-0 i inch= 40 eL P/L 99.00' 101.25' 1>20% #2 102.00' 2.12 Acre Parcel 103.00' 105.00' BM#1 IB 3 B *1 I B #4 Wooded Slope IB #s 11% I B #6 P/L ABM#2 BM#2=Top of Foundation.Elev. =115.96' Proposed 4 Bedroom Home Elevation Data B#1 = 101.34' B#2 = 101.24' B#3 = 103.24' B#4 = 105.64' B#5 = 109.14' B#6 = 113.75' Lot Iron Top of pipe sleeve below BM2=113.72' FN#517 Autumn Blaze Trail A BM=Nail w/Pink Ribbon in 6"DBH Cherry Tree �E HRP=Same May 9,2014 ASSUMED ELEV.- 100.00' Keith E.Stoner CST#2-2*9--1 ' =Backhoe Pit Ina 1 1,04L Pcolik 9s Safety and Buildings Division ��� T C 114— 201 W.Washin A e.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) Ma , 7 7162 ` = 5� 53 4 Sanitary Permit Application Stater - Number W accordance with SPS 38321(2),Wis.Adm.Code,submission of ibis form in the unit is required prior to obtaining a sanitary pert. Note.Application foams fur state.owned POWTS arc submitted to Project Address(if diffa+ent than m-ling address) the Department of Saf y and Professional Seavies. Personal information you provide may be used for secoodazy Vurposes in awmAnucc with the Pfiv8cY Law,s.15. m I Stars. o' !5/ 7 (�f^!J.r,✓� 1c' L Avalicatiop InformMUCa—Pleas Print All Informs' Property Owner's Name Parcel# a eels 4 0 Au LT APR 0 8 2014 640 - /31(0- /Z- 000 Property OwuWs Mailing Address ST.CROIX COUNTY > y Loin 'S11 4,TN I� �LNzc i 1tiOMMUNiTY DEVELOPMENT Govt.Lot $ onel- city,state Zap Code //__ Phone Number SC— /., S b1/ V, SSection A/I � 0/lo T Z8 N; R A �E0& IL Type of Building(check all that aPP1Y) Lot �Ll or 2 Family Dwelling—Number of Bedrooms _ 2 Subdivision Name D k o-d I" Block C�D•A'R.- Wpb�S ❑Pubbic/Conmrerciat—Describe Use t� 0 City of ❑State —Describe Use CSM Number 0 Village of &•(,n of--T M 0 III.Type of Permit: (Check only one Vax on line A. ComPjft line B if applicable) A )tNew System 0 Replacemcat System ❑T din;Tao%Rcp ❑Other Modification to Fxisdn8 Sin°( PU1°) B. ❑Permit Renewal ❑Permit Revision 0 Chaaa ransfer to New List Previous PermitNamber and Date Issued Before Expiration IY.T of POWTS S stem/Com nent/Device: Check all ,�.lon_pized In-Ground ❑Pressurised In Ground 0 At ❑Mound?24 is of suable soil ❑Monad<24 is of suimbk sas7 O lioldmg Tank 0 Odter Dispersal Component(CxPlain) Dso.v ce V.Dis t Area Information: t C Vh R. Design (tom » �� fl � }8S7 D � VI.Tank Info Capacity m Units �ufiKw= Q Gallons n cc r septx� Tsdc - ! Z:So rZSo Dosing r VII..Responsibility Statement-1,the aader*Wd,assume responsibility for ins tion of the POWTS shown on the attathtd plants. Plumb's Name(Print) Plumber's S' Business Phone Number sF I s-?ss-ay�l Plu aber's Address(Street City,States Zip Cock) VIII.Conn !De rtment Use Only Perm/it Fee Date Issuing i Si_ Approved � S ''7`� • Al $ / DL Condi*W4WWH6Meas0w for Disapproval 1, Septic tank,effluent filter and J dispersal cell must all be services/maintained p ra,� G�^ �� (� e,nte . as per management plan provided by plumber. Yt/ /^ � 2:f upw aoce lldrtiitac (4 V U Att &to complete picas for the sysirm and seb®it to of can.ty ady on paper not hss than s ra=11 iactaes in size SBD-6398(R. 11/11) CE3NVEllillAL CoMpONENT DESIGN Residential aeon INDEX AND TITLE PAGE P"em Ownees Nam: Aires: IN - Legs1 Description: 5 liq S 9 Ict v+! Subdivision: C 01 L Lo # Z Town: TI�Oy County: Pare b LI b - 13 ! to= r 2 ODD Des grwfflumber: Llcig Si commends Desired pursuant to the in-Ground Solt Absorption Component Manual for POWTS Vet5lot12-U Anne Will II C r2 lSS -�- �►��DP � L`C LOT- It C�z vJ DDS r ?OP o r �l2'' PYC 106 9 G �L �flIZINS * OF � - f D Wisconsin Department of Commerce SOIL EVALUATIO Page 1 of 3 Division of Safety and Buildings In accordance with Comm 85,Wis.Adm.Code County Attach complete site plan on paper not less than 8'/1 x 11 inches in size. Plan must St. Croix Include but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. 0 - Percent slope,scale or dim sions north arrow,and BM referenced to nearest road. ease )r$ tioII Reviewe y Date Personal information you provide m be used for secondary purposes vary Law,s.15.04(1)(m)) a� d 5 Property Owner DEC 2 7 Property Location G&L Land Development, c. 2005 Govt.Lot SE '-/, SW '/4 s 5 T 2 N R 19W E(or)W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 2 W12491 890th Ave. ST.CROIx COUNTY 12 Cedar Woods City State Zip Code Phone ❑City ❑Village 0 Town Nearest Road River Falls WI 54022 715-386-2928 Troy Coulee Trail/FF El New Construction Use: 0 Residential/Number of Bedrooms Code derived design flow rate GPD ❑Replacement ❑Public or Commercial—Describe: Parent Material Flood Plain elevation if applicable ft. General comments and recommendations: B-I was completed during the preliminary soil assessment on July 22,2005. The lot lines were not clearly marked during completion of the final soil assessment. Sufficient area is available for installation of the POWTS,however the plumber prior to installation of the system must confirm the location of the lot line. Gon�ewTla� Boring ❑Boring g 0 Pit Ground Surface Elevation 98.5 ft. Depth to Limiting factor >I 10 in. Soil Aoolication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Efr#1 'Eff#2 1 0-5 10YR3/2 None SIL 2-f-gr dsh gs 2f 0.6 0.8 2 5-15 10YR3/3 None SIL 1-co-sbk d gs 1f 0.4 0.6 3 15-22 10YR4/4 None SIL 1-m-sbk mfr gw if 0.4 0.6 4 22-43 1 10YR4/4 None SIL 1-c-sbk mfr gw 1f 0.4 0.6 5 3-110+ 10YR5/4 None GRS 0-sg ml - none 0.7 1.6 Boring ❑Boring g OPit Ground Surface Elevation 100.3 ft. Depth to Limiting factor >140 in. Soil ADolication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. "Eff#1 `Eff#2 1 0-14 10YR3/2 None SL 2-f-sbk mfr gs 2f 0.6 1 1.0 2 14-27 10YR3/3 None SIL 2-m-sbk mfr gs 2f 0.6 0.8 3 27-41 7.5YR4/4 None S 0-sg ml gs 2f 0.7 1.6 4 41-140+ 10YR4/4 None S 0-sg ml - None 0.7 1.6 •Effluent#1=BODS>30:5 220 mg/L and TSS>30:S 150 mg/L •Effluent#2=BOD5<_30 mg/L and TSS 5 30 mg/L CST Name(Please Print) Signature CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 December 20,2005 715-796-5664 Property Owner G&L Land Development, Inc. Parcel 1D# 040-1022-70-000 Page--Z-of 3 Boring# 0 Boring OPit Ground Surface Elevation 96.5 ft. Depth to Limiting factor >120 M M. Soil Molication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. "Eff#1 "Eff#2 1 0-8 10YR3/3 None SIL 2-f-gr mfr cs 2f&m 0.6 0.8 2 8-21 10YR4/3 None SL 2-f-gr mfr gs 2f&m 0.6 1.0 3 21-30 7.5YR4/4 None LS 0-sg mi cs if 0.7 1.6 4 30-120+ 10YR4/4 None S 0-sg mi - None 0.7 1.6 r( l� Boring# 0 Boring 1i OPit Ground Surface Elevation ft. Depth to Limiting factor in. Soil Aimlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. "Eff#1 *Eff#2 F Boring# 0 Boring OPit Ground Surface Elevation ft. Depth to Limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 *Eff#2 •Effluent#1=BOD5>30.-s 220 mg/L and TSS>30:5 150 mg/L •Effluent#2=BOD5 5 30 mg/L and TSS<_30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. ' r , ,.j, -Site Diagram 0 ft. 24 ft. 40 ft. 80 ft. Page 3 of 3 LOT 12 r ir .f- ti,��, I 5' ,t BNI#1 -Top of 1/2PVC Pipe 100.0' �• �' t B-1 } 98.5' t ��Ogs'Oli = Lot Lines BM#8 DescriptionolL = Elevation g Bench Mark B_i - Boring Location &Elevation House and well location to be determined 100' Owner: G&L Land Development Inc. Site Information: Completed By: Mark Iverson, PSS#197 W12491 890th Street SE 1/4, SW 1/4, S5, T28N, R19W 680 Larcom Street River Falls, W154022 Town of Troy Hammond,WI 54015 St. Croix County 715-796-5664 Phone: 715-386-2928 CST#46672 Soil Absorption System Cross Section Q , ft ft 4"Schedule 40 Fi I Grade PVC Vent Pipe L/ With Vent Cap ft Leaching Chamber 9y• ft System Elevation ft 40 ft ft Soil S Absorption stem Plan View p Y ft ft { fp ft Leaching Trench 1 Chambers 4"Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 Leaching Chamber Specifications Manufacturer And Model ]I,�G61TIZkxw- tULC°_L EISA Rating -Z<) sq ft per chamber Soil Application Rate .-7 gpd/sq ft gpd Design Flow-t P-7 Soil Application Rate Zd EISA= Chambers 3 rows of chambers each. Page of �i � ILTER Ai 'RIDGE INST� 1 'iNS d O� Installation I ' STEP 1 D rY fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not,then either insert more pipe into the tank through the outlet or solvent weld (glue)additional pipe onto the outlet pipe. STEP 2 While the case is Still dry fitted on the outlet pipe, measure the length of 3/4-Inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support.if side support method is not utilized, proceed to step four. STEP 3 For Installations utilizing the optional supplemental side support: solvent weld the U-Inch pipe onto the filter case. If side support method Is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter ' cartridge Into the case,pressing down until the filter locks into the bottom of the case. le STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning £>, clockwise 900. Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. 2. Open the outlet access opening to inspect the tank and filter. r 3. Pump the septic tank completely, making sure to remove the sludge ' layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe,firmly pull up on the filter handle to dislodge the cartridge from the case. f` 5. Slide the cartridge up and out of the case for cleaning. ` 6. If a VRS switch connected to an alarm is present,the switch ; should be removed by turning counterclockwise 900 and cleaned with water only. 7. While holding the cartridge on its side(large flat surface facing down)over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. X „ 8. If VRS switch is utilized, replace by inserting into filter and p turning clockwise 900. I 9. Insert the filter cartridge back into the case, pressing down until 1 I the filter locks into the bottom of the case. 10.Replace and secure the access opening on the tank. BEAR ONSITET"FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY Bear Onsite filter cartridges are warranted to be free of defects in material and workmanship for five(5)years from the date of consumer purchase. BEAR ONSITET"Filter Case-Lifetime Limited Warranty Bear Onsite warrants the filter case will be free of defects in material and workmanship during normal use for the period of time the original purchaser owns the product. If a defect is found in normal use,Bear Onsite will,at its election,repair,provide a replacement part or product,or make appropriate adjustment.Damage to a product caused by accident,misuse,or abuse is not covered by this warranty.Improper care or malfunctions resulting from units not installed,operated,or maintained in accordance with instructions provided will void the warranty.Proof of purchase(original sales receipt)must be provided to Bear Onsite with all warranty claims.Bear Onsite is not responsible for labor charges,removal charges,installation,or other Incidental or consequential costs. In no event shall the liability of Bear Onsite exceed the purchase price of the product. FILE INFORMATION SYSTEM SPECIFICATIONS Owner- Cf eLc. + P,(0lul ULt Septic Tank Capacity al ❑NA Permit# Septic Tank Manufacturer j 2. ❑NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑NA Number of Bedrooms 100 edroom ❑NA Effluent Filter Model A F❑NA Number of Commercial Units KNA Tank Capacity __.- gal NA Estimated flow(average)* '-)00 gal/day P Tank Manufacturer NA Design flow(peak),estimated x 1.5* 00 al/day P Manufacturer N A Soil Application Rate gal/day ft P Model 0t NA y Pretreatment Unit A NA Influent/Effluent Quality(NA❑) Monthly Average** ❑ Sand/Gravel Filter ❑Peat Filter Fats.Oil&Grease(FOG) < 30 mg/L ❑ Mechanical Aeration ❑Wetland Biochemical Oxygen Demand(BODS) 220 mg/L ❑ Disinfection ❑ Other: Total Suspended Solids(TSS) Manufacturer: Model: <_ 250 mg1L Dispersal Cell(s) Pretreated Effluent Quality❑ Monthly Average*** X In-ground(gravity) ❑In-ground(pressurized) Biochemical Oxygen Demand(BODO < 30 mg/L ❑ At-grade ❑Mound Total Suspended Solids(TSS) 30 m ❑ Drip-line ❑Other: Fecal CoIiform(geometric mean) <10 cfu/1 0 1 ❑ Leaching Chamber Manufacturer 1 ICTR Maximum Effluent Particle Size 1/8 inch diameter Model ( i C,{C Laying I,ength/Chamber *Wastewater Flow Verification and Calculations: Soil Application Rate ,7 gpd/ft2 Area Req.-b5'7 (Other than bedroom based) Infiltrative Surfaee/Chamber-ESIA Rating 2 O Minimum Number of Chambers � 3 ❑Aggregate Design Flow/Loading Rate= min ** Values typical for domestic(non-commercial wastewater Materials:all materials must comply with WI Aden Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At-grade Soil Absorption System,Siting,Design&Construction Manual"(Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System:Siting,Design&Construction Manual"Converse,J.C.and E.J.Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems"Publications 9.6 "Design of Conventional Soil Absorption Trenches and Beds". R.J.Otis-ASAE Publications 5-77 and"Design Manual- Onsite Wastewater Treatment and Disposal Systems".EPA 625/1-80-012 October 1980 ❑ SBD- 10570-P(8.6/99)"At-Grade Component Manual Using Pressure Distribution" ❑ SBD- 10567-P(R.6/99)"In Ground Absorption Component Manual" ❑ SBD- 10705-P(N.01 101)"In Ground Soil Absorption Component Manual"Version 2.0 ❑ SBD- 10628-P(N.6/99)"Recirculating Sand Filter System Component Manual" ❑ SBD- 10656-P(N.6/99)"Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572-P(8.6/99)"Mound Component Manual" ❑ SBD - 10691-P(N.01101)"Mound Component Manual"Version 2.0 ❑ SBD - 10595 P(86/99)"Single Pass Sand Filter Component Manual" ❑ SBD - 10657-P(8.6/99)"Drip-line Effluent Disposal Component Manual" ❑ SBD - 10573-P(R 6/99)"Pressure Distribution Component Manual' ❑ SBD - 10706-P(N.01 101)"Pressure Distribution Component Manual"Version 2.0 ❑Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency_ Inspect condition of tank(s) At least once eve ❑months e s (Maximum 3 Pump out contents of tank(s) When combined sludge and scum equals one-third(1/3)of tank volume Inspect dispersal cell(s) At least once every j ❑months s (Maximum 3 -) Clean effluent filter At least once every. . ❑ months 1�year(s) Inspect pump,pump controls&alarm At least once eve _vft ❑months &year(s) ❑ NA Flush laterals and pressure test At least once eve ry ❑months Z year(s) ❑ NA Valves At least once eve ❑months ❑ s ❑ NA Other. At least once every ❑ months ❑ year(s) ❑ NA Page of START UP For new construction,prior to use of the POWTS check treatment tank(s)for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s)removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports.The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS.The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume.Also the brine or waste from water softeners,iron removal units,other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible.Note:this does not include laundry waste,showers,dishwater,etc. This system is designed to handle domestic strength wastewater,however the disposal of food based greases and oils,vegetable/fruit peels and seeds,bones,and food solids such as those produced by a garbage disposal should be minimized.Toilet tissue is the only Y paper that should be discharged into the system. Other non-biodegradable items such as baby wipes,tampons,sanitary napkins condoms,cigarette butts,dental floss,and cotton swabs should not enter the system Chemicals such as petroleum products,paint, disinfectants,pesticides,antibiotics,solvents,etc.,should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week.Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. Valves Valves shall be operated in the following manner: ❑ Alarms Alarms should be tested on a regular basis by the home owner.If an alarm sounds,contact an individual licensed to service POWTS,There is normally a 1 day reserve under regular operating conditions,however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications:Master Plumber,Master Plumber Restricted Sewer POWTS Maintainer > or Septage Servicing Operator(per the attached Maintenance Schedule). ❑ Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware,identify any cracks or leaks,measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface.Access openings used for service or assessment shall be sealed and/or locked upon completion of service.Any defects shall be promptly corrected.Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third(1/3)or more of the tank volume,the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113,Wisconsin Administrative Code. The outlet filter(s)shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications.Provisions are to be made to retain solids in the tank.Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. ❑ Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps,alarms and floats.A visual check must be made for leaks,backups,surfacing,missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. ❑ In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding,if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge.Any discharge to the ground surface must be promptly reported to the regulatory authority.Ponding at depths greater than 75%.of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of Page of ' START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. _ During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications, oil; painting products; pesticides; sanitary napkins;tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN I If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant i replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name —T CF Name Phone 5_ "Z j'v- 2y ( Phone SEPTAGE SERVICING OPERATOR(PUMPER) LOCAL REGULATORY AUTHORITY Name Name ST 0_0 2d I k) Phone Phone �_ 3g6 -� 9(®�� This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.5411), (2) &(3),Wisconsin Administrative Code. 8138525 State Bar of Wisconsin Form 1-2003 Tx:4111876 WARRANTY DEED 974738 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI 03/11/2013 12:43 PM THIS DEED,made between G&L Land Development, Inc.,a Wisconsin EXEMPT#• NA corporation REC FEE: 30.00 ("Grantor,"whether one or mode), TRANS FEE: 258.60 and Christopher S.Nault and Brenda K.Nault,husband and wife,as PAGES: 1 survivorship marital property ("Grantee,"whether one or more). Grantor,for a valuable consideration,conveys to Grantee the following described real Recording Area estate,together with the rents, profits, fixtures and other appurtenant interests, in St.Croix County,State of Wisconsin("Property")(if more space is Name and Return Address needed,please attach addendum): FSA Title Services,LLC Lot 12,Cedar Woods Subdivision,St.Croix County, Wisconsin. 5645 Memorial Avenue Stillwater,MN 55082 File No. 130020 040-1316-12-000 Parcel Identification Number(PIN) This is not homestead property. (is)(is not) Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except: This property is subject to Covenants and Homeowners Association By-Laws. Dated February 22,2013 G&Q�L�Land�Dy�e,�velpo�p�ment,Inc. (SEAL) !Li u,A)� , tO Ze� (SEAL) * * Glen M. Wiese,President (SEAL) �< � ✓ (SEAL) * * Lola M.Wiese,Secretary AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) authenticated on )ss. WASHINGTON COUNTY ) * Personally came before me on February 22,2013 , TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Glen M.Wiese as President and Lola (If not, M.Wiese,as Secretary of G&L Land Development, Inc. to m wn to be the person( cuted the foregoing authorized by Wis.Stat. §706.06) ins ument cknowled a the same. THIS INSTRUMENT DRAFTED BY: Baiers C. Heeren,FSA Title Services,LL * State of Minnesota _ !� 5645 Memorial v Notary Public, � `�`s p My Commission(is permanent)(expires: 1 1 ) be authe icated or acknowledged. Both are not necessary.) N S A STAfWM7V1 ODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DE CtNnmitielonEx t►aJ 3 STATE BAR OF WISCONSIN FORM NO.t-2003 I'DM name below ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHEP CERTIFICATION FORM Owwmuyer Mailing Address %V VAr ROW Property Address ifrefh (Ven 'on iced firm Phlnm"dt Zoning Dot traction.) City/state—liv Parce Identification Number LEGAL DESCRIPTION Property Location.:G M Y4,.a'/4,Sec._0 ,T N R 11 W,Town of Y+P Subdiv eion Plat: Certifled Survey Map# Volume .Page# Warranty Deed# (before 2007)Volume ,Page# Spec house Elyes�lao Lot lines idendfabla Nymono SYSTEM MAINTII+NANCE AND OWNER CERTIFICATION Improper use and maintenance of you septic system could result in its pie fidlure to handle wastes. Proper msinterame Comm of pumping out the septic tank every throe years or sooner.if needed,by a licensed pumper. What you put into the system can aflbct the huctim of the septic tank as a treatment stags in the waste disposal system. Owner maintenance responsibilities are specified in$SPS.383.32(1)and ht Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning dt Zoning Department a certification f xmk signed by the owner and by a master pknmber,joumeyman plumber,r atricted plumber or a licensed pumper verifying that(1)the an-sits wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessety),the septic tank is less than 1/3 lull of sludge- Vwe,the undersigned have road the above requires and agree to maintain the private sewage disposal system with the stendar&ad forth,hernia,as set by the Department of Safety And Professional Services and the Department ofNaftiml Resaucas, State of Wisconsin. Certification stating that your septic system has boat maintained must be compleW and returned to the St.Croix County Planning dt Zoning Department within 30 days of the three year expiration data Uwe certify that all statemew on form are title to the best of my/our knowledge. Uwe am/ara the owner(a)of the property deacn'bed above,by virtue of a y deed recorded in Register of Deeds Office. Number of bedroo OF APPLICANT(S) DATE ***Any information that a misr4preseeded may rmk in the sanitary permit being revoked by the Planning&Zoning DepertmeaL*** Include with flea application a recorded warranty deed iioas the Register of Deeds Office and a copy of the certified survey map if rehrence is made In the warranty deed. (REV.04/13) SOO"52'56" W 1282. 17 W SOO*52'56rxw 320.07' S0005255" (n \ L6 cn ° E 00 .9`�'��* 0 Cq fr ,- N r C N ° ) W a Zr Go t7 o N cn c r) O N o ie) t�j cD 1 f N Lq 00 4-j �? CO L ¢ 3,,L 1,9Z•00N a. , CN cc �z•os� w a N o W -0 t * 0 z \ 0 i.J • . `- -C 3:: 00 .. -" ---" -�" _._---461.13' QNo �--- ' __--- 'S't-\ r!�• `t 0 0 4- --� '