HomeMy WebLinkAbout032-2185-36-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division Sanitary Permit No:
INSPECTION REPORT 574361 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: F City Village X Township Parcel Tax No:
Lifto, Mike Somerset, Town of 032-2185-36-000
CST BM Elev: ^ Insp. BM Elev: BM Description: Section/Town/Range/Map No:
VII 9,5,2- 63 12.31.19.1583
TANK INFORMATION IN ELEVATION DATA
TYPE MANUFACTURERJ'n'1 CAPACITY STATION BS HI FS ELEV.
ns
Septic Benchmark I~ Z I(~5 r q5 , 2
K~ ~ Zs o C,~$T--!~ ~3 V
Dosing Alt. BM
'Fl, -1 9`8.1
D AD -15~ i+er Lb~re~ Aefetierr Bldg. Sewer , I •I,,,f 9 -i1
~1 LT~12- • ~J~(~,~ I
St/Ht Inlet 1~ Q~ OI J /
TANK SETBACK INFO MATION
TANK TO P/L~ Lp fPWELL BLDG. Vent to it Intake ROAD
Septic /A 1 `3 1 Dt Bottom
Dosing Header/Man. • ~ p p •
Aeration lJ Dist. Pipe f `t $l ~D
0 9n •y
Holding Bot. System I A-7.13 /~y
v~
9.) 9160-5
PUMP/SIPHON INFORMATION Final Grade `~1 i 1.O ) O'• / ,
-7
Manufacturer Demand St Cover O -1 0o
2~ 1° LQ~ GPM 1 ltr CbV~
Model Number N 5 2 3~ r
TDH Lift Friction Loss System Head TD~ g 2Ft
12
Forcemain Length U Dia. Z „ Dist. to Well A '
SOIL ABSORPTION SYSTEM fv
BEDITRENCH Width Length No. Of Trenches PIT DIMENSI Of Pits Inside Dia. Li h
DIMENSIONS 3 U
t DG WELL LAKE/S EAM LEA BER OR Manufacturer: n~ /
, IV
SETBACK SYSTEM TO P/L
INFORMATION Type Of System: , UNIT Model Num
i0- 1 end gL{ N/~ udk- s-r, ~
DISTRIBUTION S TEM 2-2 ZZ_
Header/Manifold Distribution x Hole Size Ix Hole Spacing Vent to Air Intake0
r I Pipe(s) -
Length Dia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center I Bed/Tr g - op.0 r (?Yes [E] No s No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 723 224th Somerset, WI 54025 (NW 1/4 NW 1/4 12 T31N R19W) Wild Turkey Retreat II Lot 36 / Parcel No: 12.31.19.1583
1.) Alt BM Description = 03 a4lLa-'n S ~ toc4s o~
2.) Bldg sewer length Well /lot /ns-m /Ced P4~rf7'Mt
4gvecv M-
-amount of cover = ) H 2,+
Plan revision Required? Fr] Yes No F11 / J2~:b(y
Use other side for additional information.
Date WInse Cert. No.
pctor's Signature SBD-6710 (R.3/97)
PLOT PLAN
PROJECT Mike Lifto ADDRESS 515 Us Hiahwav 12E Knann Wi 54749
NW 1/4 SW 1/4S 12 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX
SYSTEM ELEVATION 96.6/95.2 4' below qrade 8/26/14 4
DATE BEDROOM
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE
HOLDING TANK ZE LOAD RATE .7 ABSORPTION AREA 890 # of chambers 44
BENCHMARK V.$.P. o f 1/2" pipe ASSUME ELEVATION 100, Filter BEAR Filter
❑ BOREHOLE U ELIj1 *H.R.P. Same as Benchmark
r
Scale is 1" _
unless otherwi
noted Huffcutt Corobo Tank Pro 4
Bedroom
0' 40' 80, House
30'
B-1
537' 90'
Property ,
Line 5 2-3' 90' Cells
with >3' spacing
B-3
All piping shall be SDR 30/34, within 10'
of tank, piping shall be Schedule 40.
15% Slope
B-2
Vents 98' 96'
60' 20' * Alt.B.M.
10'
90'
Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
12" 5.6ft^2/pair of end caps
4' Long
Grade at System Elevation
34"
236' property line
Zoeller Pump Company Page 1 of 1
W,
PUMP PERFORMANCE CURVE
MODEL 53/55157/59
0
C.~
1
4-
i
8
10
M' 2
10 20 0 4050.
GALLONS
LITERS 0 80
FLOW ICE MINUTE
Pump Performance Curve Models 53, 55, 57, 59
httD://www.zoellert)umi)s.com/ImaizeDisDiav.asnx?ProductID=89&ImageName=72curve l 6/23/2010
County '
'f, T
Safety and Buildings Division
201 W. Washington Ave., P.O. Box 7162 gaaicary etmit N=bar (to be fill d in by Co.)
Mad, 9f0162
x C~ 2" vr~~N~~~ 5 .773 l~J l
State Transacts Number
Cl! Permit Application
In accordance with; S 12), Wis. Adm. Code, submission of this form to the appropriate governmental unit
is required prior a sanitary p=uL Note: Application forms for state-owned POWTS are submitted to Project Address (if diffencnt than mailing address)
the Depwiment of afety and Professional Servies. Personal information you provide may be used for secondary
Mnposes in acute with the Privacy law, s. 15. 1 m Stets.
L Application Information - Please Print Ali Info tioa 7 9-3 7,2
Property Owner's Name / Parcel #
Property Owner's Mailing Property Locution / 1 L
Govt Lot
T'Stste s •p Code Phone Numbs Section
__F'/ N; R 114 W
ILL Type ilding (check all that apply) Lot # /
of 2 Family Dwclling -Number of Bedrooms KS 3C/~J Subdivision Name
ak &b Bl GCl
❑ Public/Commercial - Describe Use ❑ City of
of ~4
❑ State Owned - Describe Use CSM Number ❑ Village of
1~ of
L J ZZ I-Z2 ....s,paC'S
III. Type of Permit: (Check only one bo on line A. Complete line B if applicable) e
System ❑ Replacement System ❑ TreatmeadHolding Tank Replacemt Only ❑ Other modification to Existing system (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change ofPlumber ❑ Permit Transfer to New List Previous Permit Number and Data Issued
Before Expiration Owner
IV. Type of POW I S System/Component/Device: Check all that a 1 1
_pressurized in-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mond 2:24 uL of suitable soil ❑ Mound < 24 in of suitabk soil P~J
❑ Holding Tack ❑ Disperses Component (explain) ❑ Pretreatment Device (explain) f!i~~ `J
jDesi is Tre ent Area Information: Flow (gpd) Design ~Plication f) Dispersal Area Required (sf) Dispersal Area Proposed System Elevation Tank Info
Capacity in Total # of Manufacturer
Gallons Gallons Units $
New Tanks Existing Tame
~ w (3 rn h b:. C7 w
Septic or Holding Tank
Dosing Cbambar
VII, Responsibility Stateme 1, the undenigned, assbility for itutallafion of the POWTS shown on the attached plans.
Plumber' Name ?rsnt) Plum MP/1viPRS Number Business Phone Number aaV
Plumber's ( City, state, Zip ;j'0
1
Conn /De artment Use Only
Approved ❑ Igxrove Permit Fee ZAsued~ Issrinent Signattue
vea Reason for Denial
DL CondttlBl( PYAM11asons for Disapproval
i s llptic tank, effit*nt fit r•at d .
dispersal cell must all be services ! maintained
es-per management plan provided by plumbef.
2: ,setback re9u~en'letttta must belmain4a8ied
as per applic" code/ ordinances.
Attach to complier pleas for the system and submit to the County only oa paper not less than 8 in x 11 inches in sin
SBD-6398 (R 11/11)
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 8/27/14
Owner: Mike Lifto
Location: NW1/4 SW1/4 S12 T31 N,R19W Lot 36 Wild Turkey Retreat II Somerset
System type: In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Pressure Distribution Manual (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
8. Dose Tank Cross Section
9. Pump Curve
10.-12. Soil Test
Signature
License number # 6900
PLOT PLAN
PROJECT Mike Lifto ADDRESS 515 Us Hiahwav 12E Knann Wi 54749
NW 1/4 SW 1/4S 12 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX
SYSTEM ELEVATION 96.6/95.2 4' below grade DATE 8/26/14 BEDROOM 4
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890 # of chambers 44
BENCHMARK V.R.P. Top o f 1/2" pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
Scale is 1" = 40'
unless otherwise
noted Huffcutt Combo Tank Pro 4
Bedroom
100' 40' 80' House
30'
B-1
537' 90'
Property
Line 5 2-3' 90' Cells
with >3' spacing
B-3
All piping shall be SDR 30/34, within 10'
of tank, piping shall be Schedule 40.
15% Slope
B-2
Vents 98' 96'
20' lt.B.M.
60'
10'
90'
Vent
>6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long 12"
Grade at System Elevation
34"
236' property line
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber To be >1' above grade
5.6ft^2 pair of end plates Finish grade elevation
Typical Installation 101'
Vent Grade Vent
3' 4" 3'
A/30/34 Septic Tank
5' Long 155 5' 5' Long 1
Grade at System Elevation
44
3611 Grade at System Elevation
Spacing 5'
2-3' X 90 ' Cells
Same on other end Observation tubeNent
At end of cell
A
B
22 chambers per cell
System elevations:
A 96.6'
B 95.2'
a y i(
f
SOIL EVALUATION REPORT Page of
Wisconsin Department of Commerrt
Division of Safety and Buildings > ft accordance with C A Code
County
Ct e/1~ i
Attach complete site plan on paper not less than 81, ( 11 in s In J
inducts, but not limited to: vertical and horizontal reference poin (B Parcel LD.~ 3a- '1 fJS_ 2
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 7
7 c~ G Date
e ' wed by
Please print all information. y
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). F-A
Properly Property Location
7e--' /v Govt. Lot p~ 1 JAW 114 S T-J j N R E (o w
Props er's Mailing Address Lot # Block # Subd. Na or CS
-2>L
City State Zip Code Phone Number ❑ City ❑ Village Nearest Roa '
.J-
as
GPD
New Construction Us Residential ! Number of bedrooms Code derived design flow rate
❑ Replacement ❑ Public or oo mercial - Describe: - 8
Flood Plain elevation if applicable
Parent material a n
General comments
and recommendafions~j~y~-,.- / / 1CJ
Brl/~ tx" I
V44, 4UAA
Boring # Boring
~ Soil Application Rate
Pit Ground surface elev. ft. Depth to limiting factor in.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
`Eff#1 `Eff#2
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •
g- 6 a f<
-30 /Y1 4,1114
sE2200
® Boring # Boring
Ground surface elev.! a ft. Depth to limiting factor in. Soil lication Rate
Pit
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfP
•E 1 `Eff#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
0 D✓ 4"L-- / /h Y- G S rn 6'
2 D S/ l G k ~r
Z-Ll 12
~o
• Effluent #1 = BOD > 30 < 220 mglL and TSS >W 150 `Effluent #2 = BOD 30 mg/L and TSS 30 mglL
CST Number
CST Name (Please Print) Si a 226900
Bird Plumbing, Inc. Shaun Bird refs none Number
Address Date Evaluation Conducted P
715-246-4516
1008 192nd Ave, New Richmond, WI 5401
S
f
Parcel ID # Page of
property Owner
13-1 Boring # Boring I
Ground surface elev. J ft. Depth to limiting factor in. Soil Application Rate
Roots •E GPDO
Horizon Depth Dominant Color Redox Descxiption Texture Struchrre Consistence Boundary
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh.
O` w
a Boring # ❑ Boring
Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
❑ Pit
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
'Eff#1 'Eff#2
in. Munseli Qu. Sz. Cont Color Gr. Sz. Sh.
❑ Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit - Soil ication Rate .
Dominant Color Redox Description. Texture structure Consistence Boundary •Eff#1 'Etf#2
Horizon Depths GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
• Effluent #1 = BODe > 30 220 mglL and TSS >30 150 mgA- ' Effluent #2 = BOD5 < 30 mg& and TSS 30 mg1L
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.
SS"330 (ILM)
f
n 4
y . Soil Test Plot Plan
Project Name P.C. Collova Blyds. Inc. Shaun
Address P.O. Box 489
Somerset Wi 54025 CS #226900
Lot 36 Subdivision Wild Turkey Retreat I I Date 11/18/04
NW 1/4 S W 1/4S 12 T 31 N/R19 W Township Somerset
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of 1/2" pipe = 13KA
System Elevation 95.2/96.6 *HRpSame as Benchmark
lternate ~ench~mar Top of 1/2" pipe @ 99.6'
100'
13-1 _ 30'
537' Scale is 1" = 40'
Property 5' unless otherwise
Line
noted
90'
B-3
15% Slope
B-2
8' 96'
60' 20' 1t.B.M.
90'
Please note: Lot lines were not
adequately staked at the time of
testing. Installer must verify all lot
lines and setbacks before installation!
236' property line
B.M. TOP OF 3/4' W RADIUS
IRON PIN ELEVATION TEMPORARY
987.24' CUL-DE-SAC
EASEMENT, TO BE
' W 1/4 CORNER OF SECTION 12, NORTH LINE OF THE NORTHWEST 1 REMOVED O THERLYPON
EENSION FOUND 3" ALUMINUM MONUMENT /4 OF THE SOUTHWEST 1/4 NR OF
ADWAY
- S 89'06'44" E 1339.17' ROADWAY
/ 361.86' 360.26' I
! I 660 SSi.05' -
/ -722.12'-
S25'I7'07"W /
91.47'
1 I TO CENTER OF
EASEMENT
80' RADIUS LOT 30 co / v/ LOT 28 N
TEMPORARY 131362 SO. FT.
CUL-DE-SAC w 3.01 AC. /Leo.4e4.op 131058 S0. FT. o
EASEMENT, TO BE w 3.00 AC.
REMOVED UPON O
LTENSION OF LOT 29
ROADWAY N 131754 SO. FT.~ ell
!
a 3.02 AC. N 89'21'04" W 599.04'
279.20'
- - - - - _ z / 319.84'
567'33'00W
%54'
TO CENTER OF
3/1"
EASEMENT IRON B.M. TOP ELOF 0,
EVATION
EL4' v
-S 89'57'58" W - - - - _ _ / / 998.04' pi
193.98' In 224 /9S) 32+ ti /~6/• / Z
0
° 193.98' ' n AVgNUNEIcC5 tibry0 rn o
~N 89'57'58" C6~ LOT 27 0 LOT 25
E
134502 SO. FT. 'O. w 131068 SO. FT.
3.08 AC. > 3.00 AC. o
f
B.M. TOP OF 3/4'
m SSJ• \ AI IRON PIN ELEVATION
In Z - - - - - 997.77'
N 83, u' /
a O° m C 1 F/ / \ 20'23" W 535.03
r- cS 0 fl! I> N y N O 10
LOT 31 9"Low
f m 137273 SO. Fr. I I \ LOT 26 / o °
I~ N N 3.15 AC. '.0 \
of O I Nt 137230 SO. F7,
,r- CA c
W B.M. TOP OF 3/4' Ep,SE~'~ I N Il ` \ 3.01 AC. / / _ - _ - - -N 89'33'57" W .pp.
a O IRON PIN ELEVATION / y 4
Z m 947.90' ~z__ G ZO / 108.33' m t+'1
Ur) A E \ G~ \ ° CS 108.90'
a N ?3'240 / / / / \\\C~\\\ \ \ \ ~`~,8619 u'~ 89'3357 E N
OD
LOT 32 \ / /
140495 SO. FT.
z
/ 3.22 AC.
0
ho ~N LOT 35 LOT 36
~O o• 130965 SQ. FT. 1 FT.
b t~
aP LOT 33 3.00 AC. J 3.00 AC.
30918 S0. FT, N LOT 34
3.00 AC. o a
130834 SO. FT. c)
2 3.00 AC. C /
428.08'
455.12' 220.69' 236.06'
z N 89'06'44" W 1339,95'
o w UNPLATTED LANDS
cw rnPnico nc ccrnnu ,o \ I
L
POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Tank Manufacturer: ❑ NA
Permit # E- '7) Septic ❑ Dose ❑ Holding Volume: (ga0
DESIGN PARAMETERS Tank Manufacturer: ❑ NA
Number of Bedrooms: ❑ NA ❑ Septicobose ❑ Holding Volume: 6 (gai)
Number of Public Facility Units: -.NA Vertical Distance Tank Bottom(s) to Service Pad:
Estimated (average) Flow : /00 (gal/day) Horizontal Distance Tank(s) to Service Pad: (n)
Specific servicing mechanics must be provided If vertical is >15 feet or
Design (peak) Flow = (estimated x 1.5): (gaUday) if horizontal is >150 feet. Specific instructions to be provided on back.
In Situ Sal Application Rate: (gauday/fe) Effluent Filter Manufacturer: 2?JE ADZ.. ❑ NA
Standard (Domestic) Influent/Effluent Monthly average_ Effluent Filter Model:
Fats, Oil & Grease (FOG) 530 mg/L Pump Manufacturer: ❑ NA
Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA • .
Total Suspended Solids (TSS) 5150 m L Pump Model: /
High Strength Influent/Effluent Monthly average Pretreatment Unit /
(FOG) >30 mg/L Manufacturer.
(BODs) >220 mg/L XNA ❑ Mechanical Aeration [I Peat Filter %,t1 NA
SS) >150 m /L
❑ Disinfection ❑ Wetland
Pretreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other.
(BODs) 530 mg/L Soil Absorption System
(TSS) s30 mg/L >eNA
Fecal Coliform (geometric mean) 510' Ground (gravity) O In-Ground (pressure) ❑ NA
❑ At- e ❑ Mound
Maximum Effluent Particle Size )6 in dia. ❑ NA ❑ Drip-Line ❑ Other.
Other: NA Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) hen combined sludge and scum equals one-third of tank volume
❑ Wfi~n the high water alarm is activated
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
Inspect dispersal call(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
❑ month(s) ❑ NA
Clean effluent filter At least once every: J3-year(s)
Inspect pump, pump controls & alarm At least once every: ~r(s(s) ❑ NA
Flush laterals and pressure test 'At least once every:. ❑ month(s) ❑ NA
❑ year(s)
Otter: At least once every: ❑ month(s) p NA
❑ year(s)
Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carving one of the following licenses or certifications:
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper).
Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any tracks or leaks,
measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil
absorption system shall be visually inspected to check 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 regulatory authority.
When the combined accumulation of sludge and scum in any treatment tank equals one-third or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code..
I
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and 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 30 days of completion of any service event.
GMW-005 (02/05)
START UP AND OPERATION Page of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process 'and/or damage- the soil absorption system. If high concentrations are
detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use.
Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be=discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent. and damage to the system. To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to-the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. 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 treatment
tanks and soil absorption system: acids, antibiotics, baby wipes, -cgarettaxbutts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat
scraps, medications, oils, painting products, pesticides, san"ry napkins, solvents, tampons,'and water softener brine discharge.
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 safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code` :
• All piping to tanks, pits and other soil absorption systems 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 (pumper).
• 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
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 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 the time of their permit issuance.
❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort.
❑ 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
TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
i
POWTS INSTALLER POWTS MAINTAINER.
N me~ Name G f
Phone ~Lf Phone
SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORY AUTHORITY
Name Nam
, B ►2
Phone Phone
J
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(i)(d)&(f) and 83.54(l),(2) & (3), Wisconsin Administrative Code.
, FILTER CARTRIDGE INSTRUCTIONS
Instanatkut
STEP I Dry At the MW case onta the end of the outlet pipe to ensure it is
centered under the access opening. If not, then either Insert more pipe into the
aek through the outlet or solvent weld (glue) additio nail pipe onto the outlet
STEP 2 Whik the case is still dry fitted on the outlet Pipe, measure the length
of 34-inch pipe needed to brace the Aker to the tank and wall if utilizing the
optional srppkmw*W We support. If side srppwt method. is not utilized,
proceed to step flour.
FP 3 For installations tamp the options) supplemental side support:
solvent weld the %-inch Pipe Otto the files' case. N side support method is not
utiUud, proceed to step four
.1
Solvent weld the
Aker case onto the outlet pipe. Insert the filter i'.'~ %i
cartridge into the lease, Pre
the case. ssin9 down until the filter ticks into the bottom of
`zr.,..+(~•
If a VRS switch is utilized: insert k ft the filter and lock by turning bra w+~n ; r
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 Ater. + I
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. v
4' Once the affluent level has been k*4w*d below the invert of the `
outlet pipe, firmly Pull up on the Alter handle to dislodge the
cartridge from the case. x
S. Slide the cartridge UP and out of the case for cleaning.
6. If a VRS sw" connected to an alarm is present, the switch
should be removed by turning counterclockwise gp* and cleaned M
with water only, f ti r,
7. While holding the cartridge on Its side "facing
-
down) over the access o~~ (large flat surface water 3
only, making sure ei • rinse off the cartridge with th water
suPtago nm t fti is rinsed back into the tank.
1 a. If VRS switch is utilized
turning clockwise replace by inserting into filter and 901.
S. Insert the filter cartridge back into the case, pressing down until
the fiker locks into the bottom of the case. "
r.
10. Replace and secure the access opening on the tank
!:1 l>• ,.:f(~^: i1C : 4Y,~R:J'+(t•C '1ti i,..} r:.: i lnt'\.1] :N..'
www.beanindte Min 877-M•RMP.S (6S34S83)
12 -(Z-
Septic-Dose Tank Cross Section And Pump Performance Specifications
Manufacturer Pump Manufacturer
Tuck
Tank Model Number "p Pump Model Number - - -
Total Tank Capacity j Alarm Manufacturer ~i try,
Max. Bury Depth Alarm Model Number
Switch Type
-Feet
Fil-ter -M- ---anuf -acturer Total DytHead Distal Pressure
Filter Mod el Number Elevation Head Network Loss
Minimum Pump p erformance Required Force Main Loss . GPM: @
Ft TDH Total ----------------_--__I
Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade
Locking Device. Inlet Manhole Securely Mounted With Locking Device
< 6°' Below Grade Sealed Watertight Weather-proof
Junction Box
Finished Grade
Vent Min. 12" Disconnect
Above Grade Means
With Vent Cap
Outlet Filter
Inlet. Baffle
Inlet X;
A
Switch Settings and Reserve Capacity Weep
B Hole
Tank Volume = GPI
Dimension. Inches Volume Gal.
> > (reserve).; , Off Elevation C
(al B z
arm} S
(dam) D D / ? r 7. aC_ Ft Bottom
(dose)
C • > Elevation
Ft
Total . `
at<,•, </,fT.TZTT~1'f t < a,< < < a < < < 1>w,<>~>a>a R>;>a>ati >t>a>~i; <I;>t>;>a)::::a>a><>a>a,t>a>al >;i~ ,I;r;r;;;>.;>1 :1>1>1><>i :t>i>:, t 1>:::1 t
GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance mwith the
ay not
manufacturer°s product approval specifications. Maximum depth of bury as specified by the manufacturer e an
locking
effective
device be exceeded without prior approval. Manhole covers exposed
material, co~ectedvto the tank with watertight fittings,
installed. Piping at the inlet and outlet is of approved laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank
excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28.
Page of
02/05 U
Mar. 30 2005 09:57AM P1
FROM BRIAN VAUGNT-PREFERRED PUMP FAX NO. : 7154256035
DYNA-VC
af' h-''.)12'VANCI (aJf(V` (L Fi_ULNI AND ii `tFYAIf N'!!J,
MODEL
15 3 Feel Meters Got. ;;Iws G„1. i L tars i ~4` y
u' - 5 1.5 45 161 69 2bi i~
to 3.1 42 231 6 1.i1
_
JF_ 201 53
1'
1 20 5.1 28 167 44_ 167 ?
_ i 511 _
25 7,6y 20 129 Sn 1.29 67 -
-30 9.1 _ _ zs >~7 ....-1 1
Y 20 _
_ 3, 10.7 zz...._
- 12.2
5hu!-oft I•Irod
~ o+•soeo,eMc
0 40 60 80 100
Grl I ON5
J1~„zs 80 1GO ,40 320
Model 151 Models 1521153
FLOW r'F.R MINUTE 9W&MTGMp
CONSULT FACTORY FOR
SPECIAL APPLICATIONS
• Timed dosing panels available. ' 7/8
• Electrical alternators, for duplex systems, are available and
7)/.t>
applied with an alarm. 1 54
7/8
• Variahle level Control sw+iches are available for controlling
single phase systems. ,
• Double piggyback variable level float switcta are available
for variable level long and short cycle oontrvfs.
• Seated Fawik-Box available for outdoor installations, See
FM1420. 1 1
• over 1301F. (5d'C.) special quotation required.
' ,z r/e l- I
1 5111 5211 53 Series
t2II1 t . -
Model Y AM _ Du '~---t-
Nt 1 111$ 1 Non 6.0 t 2or3
SN151 115 1 A 0 Irduded 20r3
E1'1 z30 1 3• t 2or3 ,s,Teaw sue'
2firll BEtSt 230 1 3 hck"
L_ -
52 2or3
1 7 111 1 _
R N152 115 1 8.5 L%Wed 2or3
152 230 t Non 4,3 1 2 w 3
i SE152 III 4.3 Inducted 2or3
• j N-i 1 N~+ i0•g 1 2or3 SECTION GUIDE
18N 1531 115 1 _ Auto 1 .5 Ntctuded 2 or 3
P53 230 1 Non 5.3 1 2 or 3
23D 30 5 .3 Mrlud°d 2or3 1• Single *yback variable level float SwtlCtt or double P99Y 'variable level foal
(
i fIF t 53 t Aub switch. Refer to FM0477.
A cAUn N 2, see FW712 for ea,W model of Elecbicel Altemetor E yak.
3- variable level control wAtch 10-0225 used as a conW activator. specify duplex (3)
Ail ,ncunal;M at eonaots. prolectfon dwKas and wiring choeld be dent by + 4wiNted
licensed elecoicia+. Ali ellwiftal and solely coda should be followed MelOM9 the most or (q) nowt sysrem.
rant National Eiacfric Code (NEC) 60 like of eupa8eo go" end Wool$ Act (OSHA)
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
M" ra, as 90K 163x? r
- Iniicvir.KY402d6G3aY Afenvacrla~a.. V
r r 5NP10: 3lirg Carle RWlRWd
e, taeisiriae Kr4p2rt-rset ;gwrrP J/,Vy saf
s ~ • ` 115071 ne-2r~t • t (eoo1928•PtA1tP
hflpJMww-zoa!lsr.com pl/MP !Q cAZ(5o~►n~.as2v
4hP.nn iAhe 9nr17 7rWl- 1 - 011 .v,h►c mawn.arl
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer I L6 - -
Mailing Address Z~
~S
Property Address /_72-5 ZZ~ _
ction.) -
(Verification required from Planning & Zoning Department for new 7.,2
City/State Parcel Identification Number ~ -JLEGAL DESCRIPTION ) J
Property Location ~/4 , ,SLR'/4 ,Sec:./ , T ! N R~ W, Town of I
Subdivision s % ^ Lot # Certified Survey Map Volume , Page # ,
Warranty Deed # /L,906 -71q Voltune , Page #
Spec house ye ~ no lot lines identifiabt~51 o
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, ii 'needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the was ce disposal system Owner maintenance
responsibilities are specified in §Comm. 83.52(]) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection acid pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Vwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three y ar expiration date.
I/we certify that all statements on s form are true to the best of my/our knowledge. I/we arn/are the owner(s) of the
property described above, by virtue of a wa my deed recorded in Register of Deeds Office.
Numb of a ooms
PLICANT(S) DAT
***Any informs o t is misrepresented may result in the sanitary permit being xi::voked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds 0fFice and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
i
. (IIIIIIIIIIII
IIIIIIIIIIIII
II I II i
State Bar of Wisconsin Form 2-2003 8 2 5 2 5 8 7
Tx:4206444
WARRANTY DEED,
1000714
Document Number Document Name BE PABST i
REGISTER OF DEEDS
ST. CROIX CO., WI
08/26/2014 11:13 AM
THIS DEED, made between Christopher W Brunell EXEMPT#: NA
("Grantor," whether one or more), REC'FEE: 30.00
and Mike Lifto TRANS FEE: 120.00
("Grantee," whether one or more). PAGES :1
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area
interests, in St. Croix County, State of Wisconsin ("Property"):
Name and Return Address
Attorney Kristina Ogland
Lot 36, Wild Turkey Retreat II in the Town. of Somerset. Estreen & Ogland
304 Locust Street
Hudson, WI 54016
032-2185-36.000
Parcel Identi
fication Number (PIN)
This is not homestead property.
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated Auzust 22, 2014.
(SEAL)
*Christopher W. Brunell
(SEAL) (SEAL)
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Christopher W. Brunell
authenticated on st 22 2014 )
) ss.
COUNTY )
*Kristi is O and
TITLE: MEMBER TATE BAR OF WISCONSIN Personally came before me on
(If not,
authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing
instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
Attorney Kristina O land
Hudson WI 54016 Notary Public, State of
My Commission (is permanent) (expires: )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED C 2003 STATE BAR.OF WISCONSIN FORM NO. 2-2003
" Type name below signatures. INFO-PROT" Legal Forms 800-655-2021 www.infbprofbrms.com
St. Croix County 1000714 Page 1 of 1