HomeMy WebLinkAbout026-1286-06-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
569537 0
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)).
Permit Holder's Name: City Village X Township Parcel Tax No:
O Richmond, Town of 026-1286-06-000
everin , Kenneth J. &Am aro c
CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No:
/00 (J n M 1 GS r 34.30.18.1428
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
i
Septic _r_ 7- Benchmark
) ;a... /Do0 $. L a5 � /
Dosing J.aQ 3' \ Alt. BM -r
0 O ! (D av c der"' t'p n A/T a 1 "-5. $
Aefetian-' Bldg.tewer
Holding SUHt Inlet
_ 7. Z. 98
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/� WELL BLDG. ent t Air Intake ROAD Dt Inlet
1 •
Septic y 50 1 A 1/- 3.7 _ Dt Bottom
AA— �/ ' 4•
Dosing '7 Sv/ /n in— 3 / �� 1 Header/Man. +,7 /62 S
Aeration Dist. Pipe 5
7 .-7 OZ
Holding Bot. System 3 • /,6// /
Final Grade ! �o
PUMP/SIPHON INFORMATION /63 . 5
Manufacturer t/'L .3 Demand St Cover
G,. � �j a J_ GPM t"i 1 Jt v
Model Number /
TDH Lift Friction Lo System Head TDH Ft
Forcemain Length Dia.2 / r Dist.to Well ^
SOIL ABSORPTION SYSTEM M�__7 BEDITRENCH Width Length N s PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth
DIMENSIONS �Z 16b __
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type f System: `g 16-7 A)A- I/t UNIT Model Number:
DISTRIBUTION SYSTEM E
Header/Manifold Distribution / 1 t x Hole Size 00 JxHoleSpaciny V to Air take
Pipe(s) S a
Length_Dia Length Dia Z Spacing 3Z Z
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 I `�[ Bed/Trench Edges Topsoil t ❑ No ❑
1 es �s es No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: s / /(o / / q Inspection#2: / /
Fod�- f-��-�. J�Se.d1
Location: 1203 124th Ave New Richmond,WI 54017(NW 1/4 SW 1/4 34 T30N R18W) Sunset Ridge Lot 6 Ql IC-Parcel No: 34.30.18.1428
1.)Alt BM Description
I /
2.)Bldg sewer length= b `,.a k- Go f ,iw //41 t14,%j C_ Lee w l ot,,%e rt
-amount of cover= 5�+.c� :3 oQla: ... e,
q2. o�.
v`-
Plan revision Required? ❑ Yes ❑ No 5 f I� 93 4 7,S
Use other side for additional information.
-- -- -- -- --
SBD-6710(R.3/97) Date Insep ors Signat Cert.No
I
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW. 1/4 SW 1/4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX
SYSTEM ELEVATION 100.3' BEDROOM 3
CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 1001
❑ BOREHOLE O WELL -H.R.P. Same as benchmark
Scale = 1 /4" = 10'
Tank is to be properly
bedded and provided with 316' Property Line
I oc kdow n covers with
approved warning labels Well s to meet al I
&^'!' WDN setbacks
244' Property Line
Pro 3 Bedroom
Ho use
120th St
Grading is to be done t 5(,
divert run-off away f om
system
H uffc utt
B-
100.5' Combo Tank
100.
100,
B- 1
B- 1
209'
rope rty Li ne 2% Slope
Rention area
,Y a
Area 15' below system is to remain B
undisturbed
✓vYp County t
Industry Services Division . (p�
(Alv
X (°� y 1400 E Washington Ave Sanitary Permit Number( be filled in by Co.)
P.O. Box 7162
�" `f ;< Madison,WI 53707-7162 7
Sanitary Permit Application State ransagtjo
In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit 3V0( V
is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be us r s I��� 12 i
purposes in accordance with the Privacy Law,s.15.04(1 m,Stats.
I. Application-information-Please Print All Information
Property Owner's Name Parcel#
Property Owner's Mailing Addre Property Location
` ✓ t`A O Q a Govt.Lot
City,Statel / Zip Code Phone Number N(L�y"sG 7 / Section
N�crJ �` -i1 0o 'q ircle o
1 - ,_R rW -
II. ype of Building(check all that apps .� Lot (j J
_Family?welling-Number ofBedroo -}- �Q bdivisionName
Ok Bloc
❑Public/Commercial-Describe Use I n1 C.r` �--
F�o��- ❑City of
❑State Owned-Describe Use CSM Number I` El Vil)age of
woof `
f
III.Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
System ❑ Replacement System
Treatment/Holding Tank Replacement Only El Other Modification to Existing System(explain)
B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumbe} ❑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)
❑Non-Pressurized In-Ground ❑Pressurized In-Ground t-Grade ❑ Mound>24 in.of suitable soil ❑ Mound<24 in,of suitable soil
❑ Holding Tank ❑Other Dispersal Component(explain) Pretreatment Device(explain)
V.Dispersal/Treatment Area Information:
Des i n �gpd) I Design Soil Application Rate(gp Disperl Area Required(sf) Dispersal Area Pro pf) System Elevation'
VI.Tank Info Capacity in Total #of Manufacturer
Gallons Gallons Units d o g v
Now Tanks Existing Tanks ��
�ec'r I a U in w V a
Septic or Holding Tank
Dosing Chamber /
VII.Responsibility Statement-4 the undersigned,mum onsibility for installation of the POWTS shown on the attached plans.
Plumber's N me(Print) Plumber's re MP/MPRS Number Business Phone Number
— /
Q. . Z J l
Plumber's Address(Street,City,State,Zi7Ce)
,
�� z 2
VIII,County/Department Use Only
rApproved Disapprov
Permit Fee Date Is ued f t Issuing ent Signature
❑ iven Reason.for nial
Condit easons for Disapproval' I
1. Septic tank,effluent filter and i (�
dispersal ceilf•must all be servIces/maintained -' �.� Ake,,� CL^c o _ t`,r► r+v1Ca�j`
as per management plan provided by plumber:
2. All setback eequ�emeMs Must b •ariaikiihik f
as pet apple tai orar �. . 1-,0�5 1`,� 5d-a�l-� r�,,kat �Acr AL
Attach to complete plans for the system and submit to theCounty only` `pe q t I th 8 t 11e inches In si
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5ti row DIVISION OF INDUSTRY SERVICES
�o$ F 141 NW BARSTOW ST FL 4TH
I WAUKESHA WI 53188-3789
Contact Through Relay
www.dsps.wi.gov/sb/
www.wisconsin.gov
a�ssror��15�
Scott Walker,Governor
Dave Ross,Secretary
April 01,2014
CUST ID No. 226900 ATTN.-PO WTS Inspector
SHAUN R BIRD ZONING OFFICE
BIRD PLUMBING INC ST CROIX COUNTY SPIA
1432 120TH ST 1101 CARMICHAEL RD
NEW RICIrr"bfOND WI 54017 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES:04/01/2016 Identification Numbers
Transaction ID No.2384894
SITE: Site ID No. 800770
Oevering Homes Please refer to both identification numbers, ;
Lot 6 Sunset Ridge above,in all correspondence with the
Town of Richmond agency.
St Croix County
NWl/4, SWl/4, S34,T30N,R18W
Lot: 6, Subdivision: Sunset Ridge
FOR:
Description:At-Grade,3 bedroom
Object Type:POWTS Component Manual Regulated Object ID No.: 1477094
Maintenance required; 450 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade;
System(s): At-grade Component Manual,Version 2.0, SBD-10854-P(N.03/07,R. 1/12),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 requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
This system is to be constructed and located in accordance with the enclosed approved plans and with the At-grade
Component Manual, Version 2.0, SBD-10854(N.03/07,R. 1/12), and the Pressure Distribution Component Manual-
Version 2.0, SBD-10706-P(N.01/01,R. 10/12)
In the event this soil absorption system or any of its component parts malfunctions so as to DRk%hazard
the property owner must follow the contingency plan as described in the approved plans. In adiqftlifthe owner
must comply with the operation, maintenance and monitoring duties as described in staPTIOK the at-grade
component manual. A copy of this information must be given to the owner upon cpRlotoohe project.
Maintenance information must be given to the owner of the tank explaining that penoil leaning of the filter is
required. Access to the filter for cleaning must be provided per SPS 384 product al conditions.
A Sanitary Permit must be obtained from the county where this project is loc~accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Slats.
SHAUN R BIRD Page 2 4/1/2014
Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stats.
Owner Responsibilities:
• SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under
s. SPS 383.54(1).
• SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. SPS 383.54(4)shall be considered a human health hazard.
• SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
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. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of 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.
When You Receive That Invoice,
Julia Lewis-Osborne Please Include a Copy With Your
POWTS Reviewer 2,Integrated Services Payment Submittal.
(262)397-6005, Fax: (608)283-7481 WiiTt�s 153
julia.lewis@wisconsin.gov
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.
r
RFcEiV�D
MAR 2 82014
Cover Page �NDUSTRyS
�RVICFS
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 3/24/14
Owner:Oevering Homes
Location:NW1/4 SW1/4 S34 T30 N,R18W Lot 6 Sunset Ridge Richmond
System type: At-Grade
Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07)
Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01)
Page#
1. Cover Page
2. At-Grade Plot Plan
3. At-Grade Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9-11. Soil test
12. Filter Specifications
JALLY
JVED
Shaun Bird ,� AFETY ANO
Signature '° 'ONAL SERVICES
INDUSTRY SERVICES
License number 226900
/SEE CORRESPOND
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW, 1/4 SW 1/4S 34 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX
SYSTEM ELEVATION 100.3' BEDROOM 3
CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
hk BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100'
❑ BOREHOLE O WELL *H.R.P. Same as benchmark
AL
I
Scale = 1 /4" = 10'
Tank is to be properly
bedded and provided with 316' Property Line
lockdown covers with
approved warning labels WeiI is to meet all
DNR setbacks
244' Property Line
Pro 3 Bedroom
Ho use
120th St
Grading is to be done to
divert run-off away from
syste m
H uffc utt
B-2 Combo Tank
100.5'
100. '
100,
B- 1
B- 1
209'
rope rty Li ne 2% Slope
Rention area
Area 15' below
system is to remain B
undisturbed
At-grade System Sloping Site Cross. Section and Plan View
�'
E { Dimension Feet
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E a w 2Z
E .�--- B
0 Slo e
L
A =Plowed r:r~ =Clean aggregate 0 =4 in. sch. 40 p�c
:ti %z to 2 '/z in. dia.
basal area observation pipe
Lateral with 2" Topsoil Cap '
aggregate over pipe
Observation Pipe
Geotextile G With Cap
Fabric
�■ti'�■:rs■ l■ ' l 0, 8 Ft Lateral Invert
■l'1•l■r■• • ■j:l j:.i'i i r•r• Topsoil Cap
r�.�:ti•tiM•�•■r■r;'0i r■j�■r�ir���r�r■r~•t■f�f■ •
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r ■r•r ls;;,�. , a,3 Ft Contour L. 1'h Kjy
D Plowed Surface
C
Slope Direction -...`�
GENERAL INSTALLATION: The at-grade area is staked out along the desigd contour.', Existing
vegetation is mowed and raked off the site. The basal area(L x W) is staked out and plowed with a
moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow,depth'to
between the
alms of the hands: .The A x B area is
be
1 sample is
rolled . P
. form.a /4 inch soil wire when a p
covered by clean aggregate deposited overhead by a backhoe. . .Special rae must be used when
placing the aggregate to minimize compaction of the plowed surface., topsoil P Ply
the entire at-grade is seeded and mulched to promote vegetative gr ; limit erosion and protect
from freezing. The observation pipes are perforated in the lower:6Jn es:and secured Ply
03/051gj Page of
Pressure Lateral Layout
One Lateral — End Manifold
A Threaded
Cleanout
Lateral Turn-up —� Plug
Force Main
i
X ---�
L Long
Sweep
90
Bend
Pressure System Construction
Distribution Network S eci$cations ? ,<,
Lateral Diameter Z In. Laterals are`construcied of Schedule 40 PVC
Orifice Diameter .S Z In. pipe. Orifices are drilled perpendicular to 11
X Orifice S in In. the pipe with a sharp drill bit and face down.
L(Lateral Len Ft. Lateral turn-ups terminate with a threaded
Di Z In.
Force Main Diameter cleanout plug and are enclosed in a 6-8 inch
Force Main Di Ft. dime'lawn sprinkler valve box accessible
from finished grade.
• • • • • Grade ,
6-8 Inch Lawn
in
S rinkler Valve r
p Box � � 4"
Page of
03/051gj
. .Da Cross Section And Purvis Performance Specifications
5eptic-Dose �'
ti
T •Maoeui'aw'turer PuYn lviodel Number
Tank Model Number �
Ahem
Total Tack playa Model Number c-•
Max.Bury
Switch Typo
f2— Total Dyaesnia Hood(TDB'Feet
Filter Elevatiian Hoed �
Filter Model Number Distal Pry
NetVMO�It LOW
L
gegwnd
------ me Main �
IASs
Minimum Pump � `-
DH To
GPM• IS Ft Ttal
Oatteit Manhole NO&C Above Grade With ��n.4"Above Grade
Lociing Dew$• bW Manhole Lpeksng Device
Waf w Secuely
<6"Be w Gae Sed
1
Jutsctiou
F iatbd Grade `" em .. .., ,..
t
Vast Min. i2" Disconnect
Abm Grads Maws
• With Vast Cap
'a►r•�..:.'.••► ►f f,, ft 1 i s aia's;s;a4'i.'.t'a t;•a;a;t►t a;t►f a► ,;f
Outlet Filter �--.y _ -- ---
Inlet Inlet Bane X.
A 'd
SW1tC11
and Reserve
f' � WOCp
GPI
Tank VOhMW=
,;,: ftf Hole
{; B ''►
VOIUMC W-
�'
Dimension; Inds
(rrserve)A. 7 glaystion C
Est) B. 2 c7 ;
.,.
r � Bottom
}: (don) C:
:r
t. D .,, EkNmon FL
•. 1,1, .. f
Total
s f a,a a,as •a a a,t a t,./afaa i:::,sf,t: :r;f;► .si ,sf:a:::f'i.'►';iai fat•►efts 'f e'h►ala,a►,a a, ►:,s.:,►',',• a,•i►'f i ;
; ►•';;:.
riiis'ta1'iiiiss4's'a t,r�taat..rasa. asla•
a'ta ta•,•aasaaa
aftftaatat t Iat►taatlt�ssatss•1 a•sa
GENER AI. jN$T'A�,LATION: The aptiddoeo tank is bedded and book mod in accardmwe with the :
maw's p appmvai apooifioat m. Maacimum•depth of t Ury as spool W by the menufactat+er may not
be excoa3ed witliout Pear W •
Mwbale coverer akpoeed to grede b ve an wive looking&vice(padlock)
ingtallod. Piping at the iolot end outlet is of 4,Ww ad material,coWwOWd to the tack with wg*tW Mthi , and
kid on stabl sail to prsvmt settling or leggin& The force main is deoved with 4"Sch.40 PVC to bridge the tank
excavation a#d the Agave is sealed watertight. F,lsot Wd mvice eompfin wi h NBC 300 and Comm 16.28,
02/05 U PW of
Effluent
Al
its
s
r�u
. 1
SHtiT-Ci`F ;n AEI;III
PS'
r r Fil' '1i1P -
�11
11
1 4 1 1 1
1
POWTS OWNER'S MANUAL & MANAGE(((MENT PLAN Page of
ILE INFORMATION SYSTEM SPECIFICATIONS
Owner' Septic Tank Capacity gal O NA
Permits Septic Tank Manufacturer ❑NA
IGN.
Effluent Filter Manufacturer — �� 0 NA
PAF"ETERS
Number of Bedrooms 0 NA Effluent Fiter Model ❑NA
1 Number of Public Facility Units IVA Pump Tank Capacity I NA
Estimated flow(*era* 200 gal/day Pump Tank Manufacturer O NA
Design flow(peak),(Estimated x 1.5) ��"� � Pump Manufacturer � ❑NA
Sol[Applicedw Rate S ali !R! Pump Model — 17 NA
i
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit �6"
Fats Oil&Gras— (FOG) 530 mgA. ❑SandlGrevel Filter O Peat Filter
Biochemical Oxygen Demand (BON) 420 mglL ❑NA 0 Mechanlcal Aeration 0 Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑Disinfection 0 Other.
.mgIL Monthly average Dispersal Cell(s) 0 NA
;Pretreated Ei Quality
Bioci cal 0 In-Ground(gravity) 0 In-Ground(pressurized)
O Oxygen Demand (BODs) 530
Total Suspended Solids (TSS) 530 mglL At-Grade 0 Mound
Fecal Colfonn(geometric mean) 51(Y4 cUl00ml 0 Ddp•Lkm 0 Other
Maximum Effluent Particle Size 36 in dia. O NA Other 0 NA
O�r odwr: 0 NA
'*Values typical for domestic Mnstewatsr and septic tank efluent Other DNA
NTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(*) At least once every: s s (Maximum S yam) 0 NA
Pump out contents of tank(s) When combined sludge and scum equals oneahird(75)of tank vbksne ❑NA
bnsped dispersal ceM(s) At least once every: 0 monih(s) (Maximum 3 years) DNA
45 frisson effluent filter At least once every: month(*) O NA
Inspect pump,pump controls&alarm At least once every: 3 0 month(s) 0 NA
0 month(*) 0 NA
Mush laterals and pressure best At least once every: g
0 rnoMtt(s}
At.least once every: O NA
❑ s
❑NA
LiNNTENANCE INSTRUCTIONS
(inspections of tanks and dispersal cells snail be madeby an individual carving one of the following licenses or codifications: Master
(Plumber,Master Plumber Restricted Sewer,POWTS Inspector,POWTS Mgintainer Ssptoge Servicing Operator. Tank inspections must
include a visual Inspection of the tank(*)to identity any missing or broken hardware,Identify any cracks or leaks,measure the volume of
wmbined sludge and scum and to check for arty back up or ponding of effluent on the ground surface. The dispersal cells)shall be
Wsuatiy inspected to deck the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface.
The ponding of effluent,on the ground surface may indicate a failing condition and requires the Immediate notification of the local
I-egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third(16)or more of the tank volume,the entire contents of
On tank shah be removed by a Ssptage Servicing Operator and disposed of in so=dence with chapter NR 113, Wisconsin
Administrative Code.
All other services,including but not limited to the servicing of effluent filters,nvx* tical or pressurized components,pretreatment units,
W any servicing at intervals of 512 months,shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
I
Page of
START UP AND OPERATION use�� PODS check treatment tank{s}for the P
X108 painting products
haw the contents of thO
For new construction, prior andlor damage the dispersed cWl(s). if high oonGOntrains
may impede the treatment��g oPe�PrIa to use.
tank(s)rerrmoved by a septage are frozen at the irmflttrative surface• will �
System start up shall not owx when soil conditions is restored the s�acess mwaatswe W
tanks may fill above normal highwater levels• ni the badwp or surface discharge 01 OMuent'
During Power outages Pump sin one isrge�•ov icading the WI(s)and may Servicing th Operas•d� to restoring P� �e
CeN
discharged void °ti' cw*w N of the Mpu mp tank MW to assist in�manually operadn9 the pump controls to restore
effluent pump or contact a Plumber or POWTS the area within
within the pump tank. or park men,or otherwise disturb or Compact,
vehicles over tanks and dispersal ce" Do not drhre pe
Do not drive or Park or at-grate soil absorption area. the life of the POWT�.
15 fit down slope of any mound stream may improve time performance and prolong fe; foundation-drain� dental floss, diapers; ols)nfadants;
Reduction or eflmination of the following from the. swabs; deg des; moat scrape; medications; 00; painting ��;
andblotim, baby wipes; cigarette I+ condoms; asotine; gree"; hetb'd
(sump pump) water; fruit and vegetable Peelings; g brine.
pesticides;sanitary nom:terrmpens;and water softener shall betaken to irmsure that the system is voPeily
ABANDONMENT out of service the following steps.
When the POWTS fails andlor is pernaremui Comm 83.33,Wisconsin Admirastratnre Code:.
and safety abandoned in compliance with chapter
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. ervking Owator.
• The contents of all tanks and pits shall be removed and Properly disposed Of by a Septage
tanks and pits shalt be excavated and MMO"d or their covers removed and the void apace filed with sd►il,
•
After pumping, all .
gravel or another inert solid material. to provide a code comp)Ont
CONTINGENCY PLAN of be repaired the foliowing measures have been, or must be taken,
if the POWTS fails and cannot er1 soil absorption sysWn.
replacement system: of a repiecem
area has been evaluated and may utilized for the location uioed
0 A suitable replacement from disturbance and Compaction and should notes am��In the need
The replacement area should be P � sYster�°must ccmPh►with the nd"in lot
setbacks from existing and Proposed to establish a s lines �Failure Repi
for a now soli and site evaluatiot �rmpiogy a
effect at that time. armor sod limitations. Bening advances in POWTS
0 A suitable replacement area is not available due to csetback th �Pis•
holding tank may be i vMled as a last resort to replace area Upon felture of the pOWTS a soil and aite evaivat)eon
to identify a suitable rep*wnent be installed as
�...�tme site has not been evaluated �. if���ment area is avaYeble a holding tank may
must be performed to locate a sultabls replacement
a last resort to replace the failed POWTS. in place following removal of the biomet at the info" ve
�ound and at grade soil absorption systems may be =with the rules in effect at that time.
/ surface. Rew*ncdions of such systems must comply
«WARNING» BASSES AND'OR INSUFFICIENT OXYGEN. DO NOT
SEPTIC,PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL
ENTER A SEPTIC,
ptJMp OR OTHER TREATMENT TANK UNDER ANY CIRCM8TANCEB. DEATH MAY RESULT. RESCUE O A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFlCULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS _
ppy�(g MAINTAINER
POWTS INSTALLER Name ,
Name v✓ �� f
� Phone �
P hone J._ _ .) �
LOCAL REGULATORY AUTHORITY
SEPTAGE SERVICING OPERATOR LIMPER 138rT1e r---
Name Phone
Phone / = -- Ad<ninWild b 00d•-
This do=rM*urge drafted in 0WOonce with chspbsr SPS 383-22")(1)(d&M and 383.54(1).(2 E(3),
.•�f.,, FILTER CARTRIDGE INSTRUCTI®NS
=ice
STEP i Dry pt the MW case opts the and ofthe outlet pipe to ensure it.is
centered under the access apenbq. If not then Wier Insert more pipe into the
tank through the outlet or Wiftnt Wed(glue)•additional,pipe onto the outlet
pipe.
STEP 2 Whge the case is still dry fitted an the outlet pipe,measure the length
of%-inch pipe needed to brace the Aker to the tw*end wal 9 utgzing the
optional wpplernantaF side support•If side support method.is rat utiized,
proceed to step fonw
5.7FP 3 For pct 1,Rlons u0lfaing the optional v4*kn W side support:
solvent weld the YA4hch pipe onto the liken case. N side support method is not
ut",proceed to step four.
-
Solvent Weld the filter ease onto the outlet pipe. Insert the Alter
age Into the case,Pressing down until the filter kKks into the bottom of '
If a VRS snitch is utilized:insert into the tttr and lock by turning ;4•,
clockwise g0-, f7�7;';•;':.
Maintenance
1. The effluent Alter,should be cleaned Mry time the septic tank is
serviced.
2. Open the outlet access opening to Inspect the tank and fgter. a
3. Pump the septic tank armpMb*,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,ftrMlV Pull p on the liner handle to dislodge the z
cartridge the
S. SO"the cartridge up and out of the can for cleaning.
6. If a VRS switch cwmedx-d to an alarm is present,the switch
should be removed by turning counterclockwise 90-and cleaned ; ti{*•.
with water only. f
7. Wfu7e holding the cartridge an its side(large flat surface facing *.:.
down)over f#re 4=8=opwdn&rinse elf the cartridge with Water '
ordy,making sure ag septage..wain is rirused back into the lank
` 9. If VRS switch is utilized,repkUa by insartMO into Rher and
turnbw clockwise g0-.
S. Insert the f w cartridge balk bats the ease,pressing down until
the Mar locks into the bottom of the case. � r
10.Replica and secure the access opening on the tank. `
Y.>W•.}rcls'•--"•'+}L'•7R 74R'RI�7G4 rKE••'}Y,.:irrlt':.L:Y;RH•7�'•.
wwwbearonsibe.eom 877-MMSERS(653-4583)
12 --1�
+Wisconsin Department of Commerce S ORT Page / of J 2
Division of Safety and Buildings 4 {� j\/
in r ceit omr i!+3rT* ibunty
Attach complete site plan on paper not less than 8 v i e: it size.Plan must
include,but not limited to:vertical and horizontal refere I t(i3h�.� ec�tprYpnQ�05 arcel I.D. �j�-0& _/u
percent slope,scale or dimensions,north arrow,and locati0 and Ji a tance t n ares road. l C/
Please print all informatio ST.CROIX COUNTY
evigwedpy Date
Personal information you provide may be used for secondary purpos s Fr v�, 'eaw,�`�i�a t J /6
Property Owner Property Location y
E
Govt.Lot 1/ 14 S T3 O N R E(o W
Property Owner's Mailing Address 7 Lot Block# Name or CSM#
City State Zip Code Phone Number City ❑Village own NeAest Road
New Construction Use: esidential/Number of bedrooms_ �— Code derived design flow rate "�� _ GPD
❑Replacement Public or commercial-Describe: --
Parent material _ Flood Plain elevafion if applicable ft
General comments
and recommendations:
Boring#FT ❑.Boring
it Ground surface elev.�-�_f— Depth to limiting factor in. Soil Application Rate
Hatton Depth Dominant Color Redox Description exture Structure Consistence Boundary Roots .E GPD E
in. Munseil Qu.Sz. Cont.Color _ Gr.Sz.Sh.
EEE .................... .........................
.... .. ........ ......
Z� Boring [] Boring l
# Ground surface elev.! , t. Depth to limiting factor in.Pit ligtio 1 Rate
Horizon Depth Dominant Color Redox Description I axfure Structure Consistence Boundary Roots J!'E GPD Eff#2
in. Munsell Qu.Sz. Cont.Color _ Gr.Sz.Sh.
r rn-o:�r 1,
Ip / c a k
7
r,-tr I F
•Effluent#1 =BOD >30<220 mglL and TSS>30:<-5: ; `Effluent#2=BOD <30 mglL and TSS<30 rrtg/L
- CST Number
CST Name(Please Print) 226900
Bird Plumbing, Inc. Shaun Bird
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 _"Iel_70 715-246-4516
Property Owner_ Parcel ID# _— Page of
Ij Boring# ❑ Boring -X�_\ ft. De t :i ritir9 factor,
it Ground surface elev.
S oil Application Rate
Horizon Depth Dominant Color Redox Description Texture tture I Consistence Boundary Roots GPD/fg
Q
in. Munsell Ou.Sz_ Cont.Color >'- >h. 'Eff#1 'Eff#2
3b S ( o�a CS •�
5
Z _Z
K
,� ,�y �' F 5 r y/ -.n�►" rte►�'; a .�- s � ',
❑ Boring# ❑ Boring
❑ pit Ground surface elev. ft. Dept :o limiting factor in. Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture '•tr n:hure Consistence Boundary Roots GPDM
in. Munsell Qu.Sz. Cont.Color 3z.Sh. 'Eff#1 'Eff#2
❑ Boring
E Boring# Ground surface elev. ft. Dep!i .o limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description. Texture >t<ucbire Consistence Boundary Roots GPDM
in. Munsell Qu.Sz. Cont.Golor =r.Sz.Sh. 'Eff#1 'Etf#2
•Effluent#1 =BODS>30<220 rrxllL and TSS>30<150 mg/L "Effluent#2=BOD$<30 mg/L and TSS_<30 mg/L
The Department of Commerce is an equal opportunity service provider aid 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.
SBD-8330(RAM)
e r q
Soil Test Plot Plan
Project Name Sunset Ridge LLC shau ird
Address 838 Summer Pines Circle
Hudson Wi 54016
#2269
Lot 6 Subdivision Sunset Ridge Date 4/15/05
W 1/2 S W 1/4S 34 T 30 N/R18 W
Township Richmond
Boring Q Well PL property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Nail/Iron
System Elevation 100.3' *HRpSame as Benchmark
244' Property Line
Scale is 1" = 40'
unless otherwise
noted
100.5' 316' Property Line
100'
Rentention area B-2
2% Slope
209' Property Line 30 30'
15' - 55'
B-1
100'
B.M.
- `- ST.CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
O NERSH[p CER.TI]FICATION FORM
Owner/Buyer -
Mailing Address 3 3 C'Pr,�
Property Address /263 , 2
_41
e�►
k--eation required from P U�
nmg 8c Zoning Department f w
City/State emistnrtfion.)
Parcel Identification Number _
Property Location /U cJ / Sec. J�, T c7N
RW,Town of iv f
Subdivision
certfffed Survey Map# ------ Lot#�
--_____- 'Volume �` Page#
Warraui3'Deed# �
Volume `i page#
Spec house no
-� Lot lines identifiable Yes no
sYS�EM Iy�A,n�rrENatvc
O'R'NERRTCATI�N
n�in Pei'use and maintenance of your
tmence consists of "Pt'c system could r
the PPm$out the exult in its
SbCin c an affect the faiiction tank every three years or hem failure to handle wastes. proper
responsibilities am Vmified in§Comuu,83.52(11��ia re tment stage in 'sten��als a licensed Pun4w- 'What you put into
The after 12-St.Croix Connty Sanitary fiance
,�, and b ParoPerLy owner agrees to Croix Co
0 8r submit to St
wastewater Y master plumber,journeytnsu Plumber,restrlctued�lP�g&Zoning Deponent a certification f
less than l full of s is in proper Plumber or a licensed °�,signed by the
Ong condition and/or(2)after inspection sand vimg(if that ar the on-Site
Pimping{ifnecessary) the septic tank is
I/we,the h���d�b e the d���e agree to '
standards set forth, r�luirements and a
Certification stating c s #et of Cow and rho D � private sewage disposals stem
8 °m seP Ys has b eP rie>rt of Natural 12ea Y with the
Zoning Dvarbnent within 30 days f the been�nitarned must be conTleted and re °uSt o&, of County uni
Ys three year expiration date, turned the St Croix'County pig
Uwe certify that all statements on
Property described shove,by virtue of a �r�to the best of my/our knowledge, Uwe atWare the o
ecorded in Rq&ter of Deeds Qtfice, wuer(s)of the
Number of bedrooms--s'
IGNA F APPLICANTS)
***Any information that is DA
mrer'epresented inay result in the sanitary Permit being
Include with this application a recorded w revoked by the Planning Zoning Department **
reference is made in the warranty deal warranty deed from the Resister of Deeds office a
copy of the certified survey map if
(REV.08/05)
i
!IIIIfE IIIII IIIII illEl fllfl 11ff1 1111 f IIII1(III Ilfl
* 9 0 0 5 7 3 1
900573
STATE BAR OF WISCONSIN FORM 2.2000 BETH PABST
REGISTER OF DEEDS
Document Number WARRANTY DEED ST. CROIX CO., WI
RECEIVED FOR RECORD
THIS DEED, made between Sunset Ridge, LLC, a Wisconsin 07/22/2009 08:OOAM
limited liability company, Grantor, and Kenneth Oevering and Amparo WARRANTY DEED
K.Oevering,husband and wife,Grantee. EXEMPT II
Grantor, for a valuable consideration,conveys to Grantee the following REC FEE: 11.00
described real estate in St.Croix County,State of Wisconsin: TRANS FEE: 413.40
PAGES: 1
Lots o6 8, 14, 20 and 21, Sunset Ridge in the Town of Richmond, St.
Croix County,Wisconsin.
Recording Area f
Name and Return Address:
Oranzo Oevering �
PO Box 179 G
New Richmo/,WI 54016
026-1286-06-000;026-1286-08-000
026-1286-14-000;026-1286-20-000
026-1286-21-000
Parcel Identification Number(PIN)
�{Y� This is not homestead property.
Dated this `b day of � ,2009.
Sunset Ridge,LLC,a Wisconsin limited liability
company
s * B
* * By:
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
COUNTY OF ST.CROIX )ss.
authenticated this Personally came before me this M.
day of
the above named Sunset
* Ridge, LLC, a Wisconsin limited liability company to me
known to be the person(s) who executed the foregoing
TITLE:MEMBER STATE BAR OF WISCONSIN s ent and acknowledged the same.
(If not,
authorized by§706.06,Wis.Stats.)
THIS INSTRUMENT WAS DRAFTED BY
Notary Public,State�f COrIsm
Robert L.Lober CNj� .
g My colnmiss''n i �It1ad�(If not,state expiration date.
Loberg Law Office sw/ SFA7235
(Signatures may be authenticated or acknowledged. Both are not necessary.) ..7
w
Nam ti es of persons signing in any capacity must be typed or printed below their signature -
r,: G�• ,,t. . .'
WARRANTY DEED STATE BAR OF WISCONSIN S CQ.I.• � S" FORM No.2-2000
1 of 1
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