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HomeMy WebLinkAbout002-1017-20-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574363 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: Bernin , Lynn E. &Jennifer I Baldwin, Town of 002-1017-20-100 CST SM Elev: MD. &BM Elev: BM Description: Section/Town/Range/Map No: 00• & a d 08.29.16.114A10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark L ,70 10 • /oO 4b 260 rnco cvv /l rjl -<O' - Aer tion , Bld ewer �6 !� Holding / 14,eh t Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WEL BLDG. Vent to Air Intake ROAD t Inlet A Septic ( , Q/ q l / -3 9 Wt I ��, Bader/ an. jQ -0S 95.2 Aeration Dist. Pipe Al,.o ?S-.ZS" Holding Bot. yst m Q• a Final Qrade. q PUMP/SIPHON INFORMATION S[�Cr S- - / Manufacturer Demand GPM IS, r (/• /D Model Number / n, TDH Lift Fn oss Syste ad TDH Ft � /� J • Forcemain Length Dist.to 7! n� W7* avl SOIL ABSORPTION SYSTEM X R : �Z /4LrY�/ BED/TRENCH Width i Len th / No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 / SETBACK SYSTEM TO I P/L BL WELL LAKE/STREAM N4,EACUKG Manufacturer: fj INFORMATION C OR Ty Of System. / / NIT Model Number: of IBUTION SYSTEM MeadelAAanifold Distribution / x Hole Size x Hole Spacing ent Air Intake S �0 �, Pipe(s) �D !!/�/ , Length Dia Length Dia 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 �• S Bed/Trench Edges Topsoil Yes j No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: ct _/�/w Inspection#2: Location: 2222 Cty Rd EEBBaldwin WWII 54400022(SW 1/4 SW 1/4 8 T29N R1 6W) NA Lot 1 © �w�.0�,G VWVggarcel No: 08.29.16.114A10 1.)Alt BM Description= fap a I 1 T"► ✓ *t l-k UIA"• �• 2.)Bldg sewer length -amount of cover Plan revision Required? [] Yes Use other side for additional information. Date / Insepctor Sg i nature Cep c SBD-6710(R.3/97) /�Z�� ,� �! S �/nf �fllryl) et y p y V o Clot v Iso N a J v= c� Wisconsin Department of Commerce SOIL EVALUATION EPORT Page 1 of 3 Division of Safety and Buidings in accordance with Comm 85,Wis. Adm. Code County St Croix Attach complete site plan on paper not less than 8112 x 11 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. o02- - 7 percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 161 7 _LlJ 166 Please print ail information. Reviewed by) Date 4/Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04{1)(m)). �- VLF. Property Owner Property Location ■ Lynn Berning Govt Lot SW 1/4 SW 1/4 S T 29 N R 16 E(r)W Property Owner's Mailing Address Lot# I Bko # Subd. ar 2222 County Hwy E _ Name 2 2 City State Zip Code Phone Number ity ❑Village ElTown Nea t Road Baldwin WI 1 54002 ( 7)5-220-6322 Haldu4n I CTH E New Construction UseE] Residential 1 Number of bedrooms 4 Code derived design flow rate 600 GPD E]Replacement [] Pubic or commercial-Describe: NA Parent material loess cap over out-wash Flood Plain elevation if applicable na ff• General comments Install in-ground non-pressure system,SE at 94.5' and recommendations �.. 1 ❑ ten Boring# ® a Pit Ground surface elev. 100 ft. Depth to limiting factor >120 in Soil tier Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF in. Munsei Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 `Eff#2 1 0-6 7.5yr3/3 sl 2fsbk mvfr cs 2f .6 •8 2 6-18 7.5 5/4 sit 2msbk mvfr as if .6 .8 3 18-36 5yr5/3 - set 3msbk mvfr cs - .4 .6 4 36_84 5yr5/3 s 0s mt as - .7 1.6 5 84120 7.Syr5/6 - s Osg ml - - Y.T 1.6 ❑ Boring# Boring 100 ft >120 ■ Pit Ground surface elev. . Depth to i"Wting hi factor in. lion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsei Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 ;Eff42 1 0-6 7.5yr3/3 A 2fsbk mvfr cs 2f .6 .8 2 6-18 7.5 4/4 - sit 2msbk mvfr gs if .6 .8 3 18-36 5yr5/6 - set 2msbk mvfr gs _ .4 .6 4 36-84 5yr5/6 - s Osg rut as - .7 1.6 5 84120 7.5yr5/6 - s Osg ml - - .7 1.6 *Effluent#1=BODS>30<220 mg/L and TSS>30:<150',r4L •E #2=BOE < mglL and TSS<30 mg& CST Name(Please Print) re CST Number Lewis Bork 253976 Address Date Evaluation Conducted Telephone Number E7818 county E Menomonie WI 54751 9-3-2014 715-231-7375 Property Owner Berning Parcel ID# Page 2 of 3 �g 3 �# E] pit Ground surface elev. 100 ft. Depth to Gmitlog factor >120 in Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 - sl 2fsbk mvfr cs 2f .6 .8 2 6-15 7.5 4/4 - sil 2msbk mvfr as if .6 .8 3 15-34 5yr5/4 - scl 3msbk mvfr cs - .-4 .6 4 34-85 5yr5/4 - s Osg ml cs - .7 1.6 5 85-120 7.5yr5/6 - s Osg ml - - .7 1.6 F-1 Boring# Boring Pit Ground surface elev. ft- Depth to 6rrtitirrg factor lo Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *E$#1 *Eff#2 Boring# Boring Pit Ground surface elev. ft. Depth to Hmiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Texture Structure Consistence Boundary Roots GPD/F Dep Description ndary in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1=BOD,>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<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. SBD-8330Test(8.07/00) aaTUfiyT County Safety n9 and Buildings Division r 'f 0 'N� 201 W.Washington Ave., P.O.Box 7162 St Croix Madison,W 1 53707-7162 Sanitary Permit Number(to be filled in by Co.) e7l ,- ,�� it 1`1 PP 111� State Transaction Number NIA In accordance with SPS 383.7 (2 j;'v s(.�lfit.Code,submission of this form to the appropriate governmental unit is required prior to obtaining 4"., "' permit. Note:Application forms for state-owned POWTS are submitted to Project the Department of Safety , fessional Services. Personal information you provide may be used for secondary Address(if different than mailing address) purposes in accordance with the Privacy Law,s. 15.04(l)(m),Stats. _ I. Application Information-Please Print All Information Property Owner's Name .�^ Parcel# Lynn Berning d- Q✓1 h t t�v- B e V el t,kA- CQ Z - /d/"1 20-/66 Property Owner's Mailing Address Property Location /° e //11A /O 2222 County Rd E Govt.Lot /l City,State Zip Code Phone Number SW% � SW /,, Section 8 Baldwin, WI 54002 715-220-6322 — (circle one) T 29 N; R 16 West H.Type of Building(check all that apply) Lot# X 1 or 2 Family Dwelling-Number of Bedrooms 4 This proposed system will serve one 4 bedroom residential Home. Block# Na ❑City of V,CSM Number ( ❑Village of tp�S 6 Q �/ X Town of Baldwin III.Type of Permit: (Check onl a on line A. Complete line B if applicable) A. New System eplacement Syst Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) X B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner Ail)"le kn, /6-A IV em/Com onentlDevice: Check all that apply) X Non-Pressurized In-Grour Pressurized In-Ground At-Grade. Moun�>24 inPf suitable sc�jl, Mound�(e Holding Tank ❑Other Dispersal Component(explain) CS❑PIt etreattment Deb c V.Dispersal/Treatment Area Information: Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) / Dispersal Area Proposed(sf) System Elevation� i 600 gpd .7 858 sq ft 900 sq ft 96 ft Y , e& VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units tS o s New Tanks Existing Tanks a U sq3 0 U rn m in k, C7 F Septic Tank X 700 40& 2 Lewis Bjork X Lift Tank VII.Responsibility Statement- >,the undersign Sd,auume,mponsibifity for insAption of the POWTS shown on the a ched plans. Plumber's Name(Print) MPQvfPRS Number Business Phone Number Lewis Bork 253976 715-231-7375 Plumber's Address(Street,City,State,Zip Code) E7818 County Road E Menomonie, WI 54751 VIII oun /De artment Use Onl ✓ Approved ❑Disapproved Permit Fee r Date ued. t1ing ent Si ` � � q❑Owner Given Reason for Denial � �J` `U C� IX.Conditions of Approval/Reasons for Disapproval 9 ? SYSTEM OWNER: 1. Septic tank,effluent filter and /,-S PS' _- 3' .3 S dispersal cell must be serviced—/Maintained CTY 4 Vk1_Sdaa as per management plan provided by plumber v iremen s must be maintained as per applicable code/ordinances. afi In-ground soil absorption Index and Title Page Project Name: Lynn Berning, replacement In-ground non pressure Owners Name: Lynn Berning Owner's address: 2222 County E Day time Phone: 715-220-6322 Project Address: same 1 i Legal description: SW SW 8 29 16 West Township and County: Town of Baldwin , St. Croix County WI DSPS Site ID No. : Parcel ID No. Plan Transaction No.: Page 1 Index and Title Page 2 Data entry, Design Criteria and Sizing Designed Pursuant to Page 3 Plan View Cells Following manuals Page 4 Cross View Cells In-ground Absorption Page 5 Over view cells SBD-10705-P(N.01/01) Page 6 Tank Configuration Page 7abc System maintenance specifications/contingency Page 8ab Filter specs Page 9 Tuff tight riser systems Page 10 Plot Plan All materials must comply with Page 11 Plot Plan Legend DSPS 384 and installed with the Manufactures specifications Attachments: LB soil report, Warranty eed , Tank service contract, Design �inst p u is Bjork License # 253976 Signature Page 1-10 � r Data entry, Design Criteria and Sizing Residential strength waste water<30m1 FOG <220MG/L <150MG/L TSS Anticipated effluent for In-ground treatment and dispersal should be Bedroom Home 4 Estimated flow= 400 gpd 400x 1.5 = 600gpd design Flow (Floor drains will serve finished floor in mechanical room. Design Calculations In situ design loading rate .7 Depth to estimated high water >120 Depth to Bed Rock >12 p 0 Cross slope at system 2.5% >level Trench sizing 600gpd /.7 gpd per sq ft= 858 sq ft minimum effective area for medium sands. Install EZ-Flow, engineered aggregate in 3' wide cells. 858/5' credit = 172 linier feet of cell min. Propose 2 cells90'in length. 180' linear feet Total proposed sq ft area 900 sq ft d EZ-Flow ESIN 600Gallons/day .7 gallon per Square foot 50 Square foot each 10 Ez-flow = 17.16 min we propose 18-10' EZ flows Page 2-10 Y ! In-ground cell plan view vent Final and original grade 100' 12" Sch 40 pvc pipe 6" c .................. Bottom of System 96' 90-1 Page 3-10 t 1 Cell Cross Section View Final and original grade 100' vent or watertight cap 4 4" Sch 40 PVC I(D(30 (D(1,0 i I Bottom of System 96' 3' 3'min P, 4 ' Page 4-10 t f Over View cells 0 3' >3' 3 90' 0 0 4" 30/34 PVC pipe Page 5-10 LB700 Design Sequence Se tic 14 00 gallon -7ov f -7O CA/I&O- Existing 1000 gallon Midwest Proposed wiser 750 5" L7- Baffle Filter Page 6 POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION Owner Berning SYSTEM SPECIFICATIONS Permit# Septic tank capacity 1400gal N/A Design Parameters Septic tank manufacturer Lewis Bjork N/A Number of Bedrooms 4 ) Effluent Filter manufacturer Life time Filter N/A (100gpd/bedroom) Effluent Filter model MDW-FT0822-14BA Number of Commercial Units N/A Pump Tank Capacity Gal X N/A Estimated flow(average) 400 Gal/day Pump Tank manufacturer X N/A Design flow(DWF)estimated x 1.5 600 Gal/day Pump model X N/A g Y Soil Application Rate .7 Gal/day Pretreatment Unit N/A Influent/Effluent Quality(NA F-1) Monthly average Sand/Gravel Filter Peat Filter Fats,Oil and Grease(FOG) <_30 mg/L Mechanical Aeration Wetland Biochemical Oxygen Demand (BOD5) 15220 mg/L Disinfection N Other Total Suspended Solids(TSS) 15150 mg/L Manufacturer: Model: Pretreated Effluent Quality Monthly Average Soil Absorption Component Biochemical Oxygen Demand BOD5) :530 mg/L X In-Ground (non pressure) In-Ground (pressure) Total Suspended Solids(TSS) <_30 mg/L At-Grade Mound Fecal Coliform (Geometric mean) <_cfu/100m1 Drip-Line Other Maximum Effluent Particle Size 1/8"diameter Dispersal Units—Manufacturer: EZ FLOW RAggregate cell(s) Model: 1203H Calculations: Soil Dispersal (EISA)or DWF_ Application Rate= Area Required- (Aggregate Trench Width)_#Units or Total Length of Aggregate Trench(s) 7 858 5 180 linear feet 600 — Designed:900'dispersal =180 linear ft Design Criteria "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publication 9.6(SSWMP manual) "ICC Flowtech Mound Component Manual"Version 1.2 "EZ Flow Mound Component Manual"Version 8/20/2007 SBD—10854-P(R.1/12) "At-Grade Component Manual Using Pressure Distribution"Version 2.0 SBD—10705-P(N.01/01)"IN-Ground Soil Absorption Component Manual'Version 2.0 SBD—10691-P(N.01/01) "Mound Component Manual"Version 2.0 SBD—10657-P(R.6/99) "Drip-Line Effluent Disposal Component Manual" SBD—10706-P N.01/01) "Pressure Distribution Component Manual'Version 2.0 Other- Maintenance Monitoring Schedule—Maintenance and Management Service Event Service Frequency Pump/Inspect tank(s), inspect dispersal cell(s),clean filter At least once every 13 months X 3 years other Inspect pump and pump controls,alarm, pretreatment unit At least once every 13 months X 3 years other Flush and pressure test laterals At least once every 113 months X 3 years other 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 service operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. 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 the 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, c dishwashers, .e t 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 paper that should be discharged into the system.Other non-biodegradable items such as baby wipes,tampons,sanitary napkins and others of this kind shall not be introduced to the system for they may cause premature failure to the POWTS. INPSPECTIONS AND MAINTENANCE: Inspection shall be made by an individual carrying one of the following license or certifications: master plumber, master plumber restricted sewer, POWTS maintainer or Septage service operator(per attached maintenance schedule).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 check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms.Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry to the tanks. When the combination of sludge and scum in the tank exceeds one-third or more of the tank volume,the entire contents of the tank shall be removed by a Septage service 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 manufactures specifications.Solids washed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. 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. ABANDONMENT:When a POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch.SPPS 383.33 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 service 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 other inert solid material. Page 7b CONTINGENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been,or must be taken,to provide a code compliant 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, render it unusable. Replacement systems must comply with the rules in effect at the time of replacement.There are two potential mound sites evaluated for replacement areas. 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 bio-mat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. WARNING:SEPTIC,PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN.DO NOT ENTER A SEPTIC,PUMP OR OTHER TRATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT.RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MY BE DIFFICULT OR IMPOSSIBLE. COMMENTS: jorit V 0 Full Service Plumbing 715-231-7375 ca171 , ':�_Z op Il,. °Pa»Ya1„plumbing and SeT4 Page 7c 2 0 1 400 48 A m t ti Installation and Maintenance Instructions installation Step 1 Dry fit the filter case onto the outlet pipe going to the drain field.Ensure it is centered directly uinder the access opening.(if outlet pipe is already in a fixed position,additional pipe may need to be added) Step 2 if utilizing the additional single side support and the two bottom supports: While the case is still dry fit to the outlet pipe,measure and cut rschedule 40 pvc pipe to the length needed to extend from the hubs that are pre-molded into the case to the side wall and the inside floor of tank. solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe insert the filter cartridge Into the case pressing down on the cartridge until it lodes into place at the bottom of case. Step 4 if utilizing a vertical read switch:insert switch into the hole pre-molded into the top of the filter.Press straight down until it lodes into place maintenance 1) Remove the access ifd of the tank Note To ensure undesirable sortds do not efeit the tank and into the drain field,the tank should be pumped out until the level of effluent is below the outlet leu+ei of the tank 2) To remove the filter cartridge from the filter case,pull up firmly on the handle of the twbklge dislodging it from the case.(if utilizing a vertical read switch,removal of switch is optional) 3) Using an ordinary garden hose,rinse the filter cartridge ensuring all v1s;Ue septage material Is removed. 4) Place the filter cartridge back into the filter case pressing down on the cartrielge until it lodes into plate 5) Place the access lid back onto the tank ensuring it is segue. RECE IED FEB B 6K Uledute filter has a rfetine Waled warraW - SAFETY& B uu,!f r�; �. Ldiefte liter LLC warrants the ffter will be free of manubcturft and workmamJ0 defects dwiggnormaj use forthe period of time the orieawl purchaser awns the product.[ fiber vril praNide a filter at the eventth t the odgivalfltterwas not damaged during the ststaisation or mamtenance process Damage to do product caused by aoadwk manse or abase will not be covered under dds warranty_improperare or nuivunctiom resulting from product not being hmMaNed,operated ormaiftakmd properly tern void this warranty.Lifetime fliterassumes no iesponsiti y for labor removal dunes,ostallabon orother Incidental or consequential costs. COMM M1101114NOWWWAer3cmum Phone:502--724-2231 - ERMS nr OF ON)USTRY SI S fit' 70� pitw6by PW&x*Raview Uo2. T P.Q.Boot 26M Madmr,Whamsin 53701-25N I = !• TrY:CouladTf uough Relay �O ScoltlllhWCar Govatnor• Claus Rpss.Secretary March 12.2014 LIFETIME FILTER LLC MIKE HORNBACK 146 CLIFTON HALL COURT SHEPHERDSVILLE KY 40165 Re: description: SEWAGE TREA TMENT APPARATUS EFFLUENT FILTER Manufacturer: LIFETIME FILTER LLC Product Name: LIFETIME EFFLUENT FILTERS Model Number(s): LT 1/8,LT 1116,LT 1/32 AND LT 1164 JSEE ATTACHED TABLE OUTLINING:FILTRATION SIZE AND RATINGS IN QPD] Product File No: 20140048 The specifications and/or plans fur this plumbing product have been reviewed and determined to be in compliance with caters SPS 382 through 384,Wisconsin Administrative Code,and Chapters 145 and t60,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 confingent upon compliance with the following stipulation(s): • 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. • Maintenance information must be given to the owner of the tank explaining-that periodic cleaning of the filter will be necessary. • A manhole extending to grade must be provided over the filter. MAINTENANCE:Clean filter at inspection/pumping interval. • Additional information is included as attachment(s)to this letter,see attachment A. The department is in no way endcxsing this product or any advertising,and is not responsible for any sihzefin which may result from its use. Sincerely, Glen J , .S. FOWTS oduct Reviewer phone:(608)267-5265 fax:(608)267-9723 email:glen.jonesQwi-gov I Tuf-Tite Riser System ` Tuf-rite makes a full line of Risers and accessories for Pre-Cast applications. [� { Riser Lid - with Molded-in gasket. Available in 12", 16", 20" and 24" diameters. Green Only. Concrete Lid - with handle. Use the Safety Pan to cast your own concrete lids. Safety Lid - May be used in place of concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan - Safe ty Pan TM available ble for 16", , 20" and 24" Risers. Green Only. 6" Tall Riser - For septic tanks. Stackable in 6" increments. Available in 12", 1699, 20" and 24" diameters. 12" Tall Riser - For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring - For mounting riser or lid to tank when casting-in is not an option. r D"IN w N � s o t � N 3 O o n Ar Q o � - `�_ �' (it ° Plot Plan Legend 1 4" PVC ASTM D 3034. 42"Min. Cover where snow is not removed. 2 24" inside diameter concrete manhole brought min.4" above surrounding grade. Concrete covers chained and padlocked . 3 Precast concrete septic tank. (Z 4 Effluent filter location. 5 4" PVC ASTM D3034. 18" Min . cover . Effluent piping or building sewer where tank is within 30'. 6 Precast concrete r tank. J� 12-2 OF-B Power conductor . 14-2 OF-B alarm circuit conductor. Both wires are UL listed A-2057 �U 2" PVC ASTM D-2665 -09 Schedule 40 Pipe Force main. 9 4" PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. Carlon All weather pvc 'unction box. UL listed # A-241 11 Ez- Flow Cell treatment/dispersal cell 12 Inspection wells — '-f " (?VC, CO L40 Project Berning Page _11-11 � .. � PAID 1 Wisconsin De artr�etl of Com SOIL E e o SPORT Pa f 3 Division of Safety and Built c�i{1`�� g v`a,C-� i ordance with Comm 85,Wis. Adm. Code ,J2e'` County —C�►ippp � S�mix Attach complete site pl WTfot less than 8 1/2 x 11 inches in size.Plan must include,but not limited t dal and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale 0,r tensions,north arrow,and location and distance to nearest road. 002 0('7 —`W W v� Please print all information. Rey' ed b Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ��/f'M a(..... Yt/1 Property Owner Property Location Lynn Berning Govt.Lot SW 1/4 SW 1/4 S 8 29 N R 16 E(r)W Property Owner's Mailing Address Let# Block# Subd. Name CSM# 2222 County E - ,�� / City State Zip Code Phone Number ity rIVillage ■ Town Nearest Road BALDWIN WI 1 54002 ( 715-220-6322 County E ® New Construction Useo Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD. . Replace a Public or commercial-Describe: _ NA P nal Loess cap over out-wash Flood Plain elevation if applicable NA ft. General comments and rec Install in-ground non pressure system �mmend tions: 1. C R IGINAL 1❑ Boring# 11 Boring El Pit Ground surface elev. 100 ft. Depth to limiting factor >84 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 7.5yr3/3 sl 2fsbk mvfr cs 2f .6 .8 2 6-18 7.5w5/4 sil 2msbk mvfr as if .6 .8 3 18-36 5yr5/3 scl 3msbk mvfr - - .4 •6 4 36-84 5yr5/3 s Osg ml _ - .7 1.6 ® Boring 2 Boring# 100 >84 El 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/fg in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 7.5yr3/3 sl 2fsbk mvfr cs 2f .6 .8 2 6-13 7.5 4/4 sil 2msbk mvfr gs if .6 .8 3 13-36 5yr5/ scl 3msbk mvfr gs _ .4 .6 4 36-84 5yr5/6 s OSG ML - - 7 1.6 Al *Effluent#1 =BOD >30:<220 mg/L and TSS>30_ mg * fFlue t 2=BOD <30 mg/L and TSS<30 mg/L CST Name (Please Print) i re CST Number Lewis Bork ' 253976 Address Date Evaluation Conducted Telephone Number E7818 County E Menomonie WI 54751 6-17-2014 715-231-7375 Property Owner Lynn Berning Parcel ID# Page 2 of 3 Boring 3 Boring# 100 >85 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/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I "Eff#2 1 0-6 10yr3/3 - sl 2fsbk mvfr cs 2f .6 .8 2 6-15 7.5 4/4 - sil 2msbk mvfr as if .6 .8 3 15-34 5/4 - scl 3msbk mvfr - - .4 .6 4 4-85 5yr5/4 - s Osg ml - - .7 1.6 (J r 0 ' ❑ Boring# El Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure C try Roots GPD/fP in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 "Eff#2 Boring Boring# Ground surface elev. ft. Depth to limiting factor in. F-1 lapit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 'Eff#2 *Effluent#1 =BOD g>30<220 mg/L and TSS>30<150 mg/L "Effluent#2=BOD 5<30 mg/L and TSS<30 mg/L I _ _ 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. SBD-8330Test(R.07/00) r N ,r _ Qu Ar LYN y Cr- 4221 I!ATHErE-FF H. WALSH .._................ REGISTER OF DEEDS ST. CROIX CO, , WI RECEIVED FOR RECORD 12-20-2001 3:30 PM COPY FEE: 3.00 .-- ----' RECORDING FEE: 13.00 CERTIFIED SURVEY MAP Lance VanDamme Part of the Southwest 1/4 of the Southwest 1/4 and the Southeast 1/4 of the Southwest 1/4 of Section 8, T 29 N, R 16 W, Town of Baldwin, St. Croix County, Wisconsin CL NOTE:This lot is being created for purposes of farmland consolidation. UNPLATTE LANDS ------------------ N 88°00'58"E 407.77' 13.4 v RI � S Vi; GA in Z1 30� DWELLIN v SILOO v v C1� 3 M LL SHED W , iv `* o g ti N SHED Z, a; o ZI _100' BUILDING ------ ---------------------------------------------- ----- LOT 1 , 4.246 ACRES OR 184,959 SQ.FT. Na.R/ o 0 3.896 ACRES OR 169,701 SQ.FT.(M.RA ° S 89°53'18"W 460.21' 909.45' ,33.01' C. T. H. "Ell �; 33.39' 1261.39- N 89°5 '18"E ;' ----------- ------ SOUTH LINE SW 114 SECTION 8 S 89°5311811 W 464.561 CENT =LINE i� SOUTHWEST CORNER ---N 89°53'18"E 2642.40'--- .SOUTH QUARTER CORNER SECTION 8,T 29 N,R 16 W SECTION 8,T 29 N,R 16 W (FOUND BERNTSEN NAIL) U N P LATTE D LANDS (FOUND RAILROAD SPIKE) LEGEND 0 Indicates 314"x 24"Iron Rod Set °pU�o�,00c0000 (Min.Wk-1.13 Ibs,llin.ft.) ° CONa/ 00000 00 Section Corner Monument s'°°°°° °... �o (as noted) °°LAUR�fVC B W o o MURPHY O I* < S17 ° RIVER 0 coo FALLS, , . g WI. OWNER'S ADDRESS qDA 40S SPRUCE STREET �`R °°°°°°°°BALDWIN, WI. 54002 Scale in Feet P=100' D:OCTOBER 23,2001 50 25 0 50 100 150 Bearings are referenced to the South line of the SW 1/4 of Section 8,assumed bearing N 89 05318"E. This Instrument Drafted by Mark W.Peavey 2 SHEET l OF 2 Vol.15 Page 4221 8233873 Tx:4191336 SPECIAL 996676 WARRANTY Document Number DEED BETH PABST Return to: REGISTER OF DEEDS Lynn E.Berning ST. CROIX CO., WI Jennifer S.Berning 06/03/2014 10:20 AM 2222 County Road E EXEMPT#: 2 Baldwin,WI 54002 REC FEE: 30.00 PAGES: 2 Drafted by: Robert M.Piette 002-1017-20-100 Parcel Identification Number Fannie Mae a/k/a Federal National Mortgage Association, P.O. Box 650043, Dallas, TX 75265-0043, hereinafter GRANTOR and Lynn E. Berning and Jennifer S. Berning,hereinafter GRANTEES: WITNESSETH,that GRANTOR for a valuable consideration conveys to Grantees and to their successors and assigns, but without recourse, representation or warranty, except as expressed herein, all of its right, title and interest in and to that certain tract or parcel of land described as follows,to wit: Lot 1 of Certified Survey Map, recorded in the St. Croix County Registry on December 20, 2001 in Volume 15 of Certified Survey Maps on Page 4221, as Document No. 665860, and being a part of the Southwest 1/4 of the Southwest 1/4 and part of the Southeast 1/4 of Southwest 1/4 of Section 8, Township 29 North, Range 16 West, in the Town of Baldwin, St. Croix County, Wisconsin. EXEMPT FROM TRANSFER FEE AND FORM 77.25(2). RE:2222 County Road E,Baldwin,WI TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging,or in anywise appertaining; and the reversion or reversions, remainder or remainders, rents, issues and profits thereof, and all the estate, right, title, interest, claim or demands whatsoever, of the said GRANTOR, either in law or equity, in and to the above-bargained premises,with the said hereditaments and appurtenances: TO HAVE AND TO HOLD the premises as before described, with the appurtenances,unto the said Grantees,their successors and assigns. St. Croix County 996676 Page 1 of 2 And GRANTOR warrants only against the acts of the GRANTOR and all claiming by,through or under it.' By accepting this Special Warranty Deed, Grantees acknowledge that they have had adequate opportunity to inspect the property conveyed herein as well as all improvements located thereon. Except as specifically set forth in this Special Warranty Deed,this conveyance is made without warranty or representation either express or implied and is on an "AS IS, WHERE IS AND WITH ALL FAULTS" basis. Except as specifically set forth in this Special Warranty Deed, Grantor makes no warranty or representation expressed or implied, or arising by operation of law, including, but not limited to, any warranty of condition, title, habitability, merchantability or fitness for a particular purpose with respect to the property or any portion thereof. .I 3 IN WITNESS WHEREOF, said GRANTOR has caused its name to be signed to this deed this day of May, 2014. Fannie Mae a/k/a Federal National Mortgage Association, organized and existing under the laws of the United States of America By Gray&Associates,L.L.P.,its attor J -fact by Robert M. Piette,Attorney By: STATE OF WISCONSIN ) )ss COUNTY OF WAUKESHA ) Personally came before me, this�_day of May, 2014, Robert M. Piette, of the above-named corporation, to me known to be the person who executed the foregoing instrument, and acknowledged that they executed the foregoing instrument as such officer as the deed of said corporation by its authority. Notary Public r10Tq IIIli Waukesha County,State of WisconsinQf My commission expires: January 17,2016 i cn YC r i a G ti n. c GOP, C0NSV�A space of notary sear St.Croix County 996676 Page 2 of 2 3 0 M Q to 0o Gp > o es c c i a 0 H III I O I y R C � c I d I U) I U) m a Z C;) c {L C O i 0 O "O 7 QO L 3 0 v � I Z y 0. co m o 0)H N I E C7 v O Z $ c v � N O � N N •� d O 0 Z Z Z N Nd1 N C - 4f }� 0L- o o. •a % c V 0 O ` o Ln CL �w a o v) CO) v> •N 3 a a a v CL �I m � m 0 CD N J U Z II o 0 0 0 0 !V �, o o y 0 d °o °0 0 0 0 U Q N N N N N N p O .� .p O 41 00 N_ CL N d m a 2) N o N N •_ X '0 - a Z fJ) f0 ) ° 'Y t-yq C �.+ O a C ' O N N 7 C) M M 0 t� o 3 m y c c U a o 0 0 0 o r n O _ N _ 00 V _ C • , F� O� N Y y N v C N O N • _ o o m > o Z N Z Z 2 !A CA m € a CL a �`1v E c 'o