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040-1303-00-042
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574399 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: Veenendall, Gregory & Mary Jo I Troy, Town of 040-1303-00-042 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: f d r� 4� 'V , ` C'S T 22.28.19.1777 TANK INFORMATION ELEVATION DATA /, /pf 9 / as TYPE MANUFACTURER ,� CAPACITY STATION BS HI FS ELEV. Septic r Benchmark esu. a zod Dosing i Alt. BM 3 �I q.5 9 Bldg.Sewer l /Z •S �a , Holding St/Ht Inlet 13. 1 Y9'•1 \ TANK SETBACK INFORMATION St/Ht Outlet TANK TO A WELL BLDG. en o Air Intake ROAD Dt Inlet 1� Septic 2 y Z( 7-7 Dt Bottom 1!5 1 <3 Dosing 24 / '7—, / Z7 1 3 Header/Man. 2 -3 Aeration Dist. Pipe Holding Bot. System 3 ,p -75 . G Final Grade 3 PUMP/SIPHON INFORMATION Manufacturer /- V l 5 Demand St Cover ..I, / J s n 2 v (r. C.a ' _17 Model Number z?, P pE 41 ����r TDH Lift/� Friction Loss System Head 5 TDH � g t ��� o J� JoZ'1 3. 3 I / 0� Forcemain Length` Dia. t r Dist.to Well (off 1 z SOIL ABSORPTION SYSTEM BEDITRENCH Width 11-ength 'o.Of Trenchos PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 16 /_ 7�V SETBACK SYSTEM TO Ul P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type!j'System: 15 5� /3z UNIT Model Number: \ G"� / DISTRIBUTION SYSTEM Header/Manifold, Distribution x Hole Size x Hole Spacing Vent Air Intake Pipes) C L S 3� Length (0-(-0 Dia ZS Length S J Dia / Spacing 3 V�P SOIL COVER _ x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over I xx Depth of xx Seeded/ odded xx Mulched Bed/Trench Center , '7 Bed/Trench Edges Topsoil ' � s No —YOB No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: // 3 / I spection#2: Location: 222 Walnut Hill Wa�R�iver Falls,WI 54022(NE 1/4 SE 1/4 22 T228N R1 9W) Walnut Hill Farm aka The Tribu a Parcel No: 22.28.19 777 1.)Alt BM Description= ' t 1�, ccJ�' eZ G.°J4'� S��k- ivtnne.v �— �''all.�G 2.)Bldg sewer length= Z'7 SvrG�./'S Gln �c�- 10/o W V 5'dJ -amount of cover= 4Z /1 Q Plan revision Required? E] Yes No lA Use other side for additional informa on. --- SBD-6710(R.3/97) Date Insepctor's Si ature Ce t.No. 3 x IS - Wnr,,,vccT tpEA)CE Lwe-NORM P14) pg.�,of _ d PLOT- WALNUT $O.s FARM. LOT Q = Contour elevation lines. /• S -• = Backhoe Soil pits. �1 4/ff P Q = Benchmarks set, naR� WITB FLA 5 s�•4 -lathes. 1/2° steel conduft pi Dx-t$ Aux_ = 30 L `� 5 s Ntc. P— - -� _ � _ � _ � lot OV-1v S !0 F fA4z-VI Sd • Go T 41Ai-< ._ 938 o f �� WWQYJ,�--o V6-bA L-L. i County Safety and Buildings Division %�T C O /X .p� G 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) a '° p O Madison,WI 53707-7162 SEP � °�ss�oxr N� SS•��yy Permit App icatiiorr— State Transaction Number In accordance.a 3.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit Z J J d 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 used for secondary purposes in accordance with the Privacy Law,s.15.04 1 m,Stats. Z I. Application Information—Please Print All Information Ul L Lt P.t/ Property Owner's Name Parcel# Property Owner's Mailing Address Property Location ` /11-7) 1 7Z I A-) 4� + Govt.Lot City,State Al e d Zip Code Phone Number y, �� y. Section Z 1 fT Z LS W -y'd Z Z T " 2 "3�8 (circle one T�N; R�_Eorr'� II.Type of Building(check all that apply) Lot# 1 or 2 Family Dwelling—Number of Bedrooms Subdivision Name Block ❑Public/Commercial—Describe Use I City of ❑ El State Owned—Describe Use CSM Number Village of K—Town of III.Type o r it: (Check only one box on line A. Complete line B if applicable) A. J�New Sy ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System(explain) B• 11 Permit Renewal El Permit Revision El Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner W.Type of POWTS System/Component/Device: Check all that a I ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade Moun >24' le it ❑Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pr tment Ded (ex i V.Dis ersaVrreatment Area Information: Design Flow(gpd) Design Soil A Ii 'on Rate(gpdsf) Dispersal Area Required(sf) Dispersal Area P oposed(sf) System Elevation /,U VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units / sZ� .a ;? New Tanks Existing Tanks ly�f U e aj Septic or Holding Tank Dosing Chamber dyy r VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Signature MP/1, - umber Business Phone Number P s Address(Street,City,State,Zip Code) u ) .County/De artment Use Only Pemrit Fee Date 4 sued Iss ' g A nt Sign re Approved ❑ Disapproved $�Z� � (0/3 ! �h�lJ �j ❑ Owner Given Reason for Denial "9'`/ IX.Conditions of Approval/Reasons for Disapproval Oopnd � �¢ SYSTEM OWNER: 1.Septic tank,effluent filter and t,(itt-A 44, ' st 4e VA-5 1 dispersal cell must be served/maintained as per management plan provided by plumber. 2.All setback requirements must be maintained as per applicable /10r4iin0plse0ns for the system and submit to the County only on paper not less than 8 in x 11 incbes in size SBD-6398(R 11/11) MARY JO HUPPERT Page 2 9/15/2014 • Inspection of the POWTS 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.Stat • SPS 383.22(7)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. 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. 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, 'h Charles L Bratz Please Include a Copy With Your POWTS Reviewer 2,Integrated Services Payment Submittal. (608)789-7893 ,7:45 am-'4:30 pm Monday-Friday WiSMART code:7633 charles.bratz@wisconsin.gov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm I DIVISION OF INDUSTRY SERVICES 3824 N CREEKSIDE LA HOLMEN WI 54636 3 K Contact Through Relay p ` www.dsps.wi.gov/sb/ www.wisconsin.gov A�OssioNN1 Scott Walker,Governor Dave Ross,Secretary September 15,2014 CUST ID No. 224832 ATTN:POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING&DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/15/2016 Identification Numbers Transaction ID No.2455408 SITE: Site ID No. 805870 Gregory a&Mary Jo Veedall Please refer to both identification numbers, 222 Walnut Hill Way above,in all correspondence with the agency. Town of Troy, 54022 St Croix County NE1/4,SETA,S22,T28N,R19W Lot:42, Subdivision: Tribute/Walnut Hill Farm FOR: Description:Mound/Four Bedroom/Sloping Site Object Type:POWTS Component Manual Regulated Object ID No.: 1501922 Maintenance required; 600 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual-Ver.2.0, SBD-10691-P(N.01 101,R. 10/12),Pressure Distribution Component Manual- Ver.2.0, SBD-10706-P(N.01 101,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. r✓0ppo No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, ,( Of Sa stats. Df- WCOAA The following conditions shall be met during construction or installation and prior to occupancy or use: Q .0v V:�V Reminders VNIS,0 • This system is to be constructed and located in accordance with the enclosed approved plans and with the Q component manuals listed above. c�EE G • Per manual cited above,limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction,excavation,vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank,and a minimum of 50 feet from the absorption area.chs.NR 811 &812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis.Stats. i ' 0--CEIVED AUG 29 2014 "JUSMY SERVICES MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: GREGORY A. &MARY JO VEENDALL Owner's Name: same Owner's Address: 650 Pine Ridge Terrace River Falls, WI 54022 Legal Description: NE 1/4 of the 1/4, Sec.22, T28N, R19W Township: Troy County: St. Croix Subdivision Name: ek4xTE Lot Number. 42 Block Number. NA Parcel I.D. Number. 040-1303-00-042 Plan Transaction No.: Page 1 Index and title ViA Page 2 Data entry ai•oi*� Page 3 Mound drawings �1 Page 4 Lateral and dose tank ALLY .'� MARY JO••••; '�C c Page 5 System maintenance specifications /ED ' t HUPPhRT _ Page 6 Management and contingency plan D 1859 = Page 7 Pump curve and specifications ETY AND %RIVER FALL Sa Page 8 Plot plan +L SERVICES s W1 JSTRY SERVICES Designer. Mary Jo Huppert License Number: 1859-007 'RESPONDEN Date: 08/27/14 Phone Number: 715-426- 1775 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P(N.01/01),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 SBDA0706-P(N.01/01) Version 7.0(R. 03/2012) Page 1 of 8 Mound and Pressure Distribution Component Design Desian Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill(D)calculations assume a _400.00 Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor(e.g. 1.5= 150%) fecal coliform of<=36 inches. 600.00 Design Flow(gpd) 14.00 Site Slope(°�) 98.15' Contour Line Elevation (ft) 20.00' Depth to Limiting Factor(in) 0.40 In-situ Soil Application Rate(gpde) Distribution Cell Information 60.00` Dispersal Cell Length Along Contour(ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate(gpd/ft2) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N C or E) a Center or End Manifold 3.33 Lateral Spacing(ft) If N above, enter the elevation(ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter(in) 3.60 Estimated Orifice Spacing(ft)= 11.76 felorifice 2.Q0 Forcemain Diameter(in) 34.00 i Forcemain Length (ft) Does the forcemain drain back? Y 89.00 Pump Tank Elevation(ft) Enter Y or N- 4.55 System Head (ft)x 1.3 5.55 Forcemain Drainback(gal) 10.08 Vertical Lift(ft) 55.97 5x Void Volume(gal) 0.56 Friction Loss(ft) 61.52 Minimum Dose Volume(gal) 0.00 In-line Filter Loss(ft) 27.46 System Demand(gpm) 15.18 Total Dynamic Head(ft) Lateral Diameter Selection Manifold Diameter Selection in.dia. options choice in. dia. options choice 0.75 _ __-- 1.25 x x 1.00 1.50 x 1.25 x x , 2.00 1.50 x ___.. 3.00 2.00 x 3.00 x GallonslInch Calculator(optional) Treatment Tank Information Total Tank Capacity(gal) p ' k Capacity(gal) Total Working Liquid Depth (in) Wieser „ 00 se tic TanManufacturer U gal/in (enter result in cell 849) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity(gal) Polyl_ok Filter Manufacturer 22.24 Dose Tank Volume(gal/in) 525 Filter Model Number Weiser Manufacturer Project GREGORY A. &MARY JO VEENDALL Page 2 of 8 Mound Plan and Cross Section Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1/10 B :-. ..:::.:::::::: J Observation Pipe . . . . . . . . . .. . . . . . . . . . . K. r.r.1. .. . . . . . . . . . . . . . . 1��.11.1.1.1• 1.111 1 1 1 11 L• 'f•Jv J.J':d•d•f•1•l•l. .J. •1'•f:.1.�+..'•. . . . . •.1:::'•''• f:r•:•f•r•J'•f•1'.r•rot f1 1.1•••••..,..1'5"1.1.1.5":.,'.1.1.1 1 1 1•L L 1 .1• 1.1.1.1.1.1.1.1.1. In-! :'r•f•r.r.J•t•r•:•r•f•:,r•l•f.••r•f•��•' r f r f �f•r•r•f• :•r•r•:• L...'��`L i 11 11.11 1.11 1.1.1:1.1. .1.1.1�1• A 111:�3rtiJ.J•J' f•:•:•r:r.r.r.}.ftrvf.r.r:}.r.r.f.r.r. •1.1.1.1. 1.1.1.1. 1.1. '..•..1.1.1.1.1. '•J•r•.of •f.f••.J•r r.:r r f•r••r•r r f.r r r r r f•r•r. ".•L••"1.1.1'1'1.1.1.1.1.1 L%'..1.1.1. W '.L.1:1.1••.•1•S.1.L••..11L.1.1.1i.•..L.ti:S...L.S.Y J•f•r.f•r•r•f•J•r•r•l•:•J•r•J J•r•:•J•f , - 4.1••..1.1.1.1.L•1.1.1•YL•1.1.1.1.1.•.•1.1• :.1.'.:.:. ..... .:.:.:. . .'. . ...:.:.:. . . . ... . ... . . ...:...:. :.;.'.:.;.:.:.:.:..1.:...,.;. ' .���. .re. ^-^r- B . . . . . . . . . . . . . . . . L Mound Component Dimensions A 10.00 ft E 32.80 in H 1.00 ft K 11.41 ft B 60.00 ft F 9.25 in z 20.71 ft L 82.83 ft D 16.00 in G 0.50 ft J 5.50 ft W 36.21 ft 600.00 tn-) Dispersal Cell Area 1 1842.67 (ft) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.25 (ft) -► .. I F 9.98 I 99.48 (ft)-► - Dispersal Cell 9 (ft) Lateral Dispersal Cell ' '•'- . . :�. ..•.•.:.:•:.: :.:.•.•.-.'. :�:::�:::�:�:�:::�:�::: . Invert Elevation D 4 4 ' 98.15 (ft) Contour Elevation 14.0 % Site Slope Geotextile Fabric Cover Shading Key m �', -T Dispersal Cell See lateral details on Q- Topsoil Cap _o °� 1.5 ft r.r Page 4 for number,size, •Nf•J•f•f•J•m•J•r•r•d•r r• C ti 1 1 1 1 1 1 1 1 1'.1.1• Q Subsoil Cap 1 1r1 /f1 1 1.1.1 r r and spacing of laterals. M• 1.•,. ASTM C33 Sand ; Ll fti•1f•L•1f L?tif ti•1• j 1j1f Laterals are equally 6 •• r.✓rP:frf r:rtf.r.,r rrr r.r.r -° m f;;T ical Lateral ti'{:r F spaced from the Tilled Layer = o.�ft :L .1�•1.VY1 VY1•Y1�Lf r1 distribution cell's r•r.}•r•f•cal Lr;f•f•r•f.: f•fY•f � 1.1.1.1 1.1.1.1.1 1.1••..1•'. © ��1.1.1• Aggregate C ;?f r r{r{?{?{;y:ti?if:ftif`r1 f 1•�.L• :,..f• d•J•l centerline in the r• •J•r• * A - distribution cell(AxB). Project: GREGORY A. &MARY JO VEENDALL Page 3 of 8 e , End Connection Lateral Layout Diagram comtr W"lawals av"the It&84Yrn~0n _ 4�Tu rn-up,itdball valve ar of oaneutptup._. P pFamanmia'acwwtoodan irlemiaall X—ii Hol*s dr*"oo true battom aP tht Latral-rob"spaced Lotorals&ftrcmtoain Seeh 40 PVC per SPS Table 384.30.6 via Wo or Boss Oa rnaNlbid at any paint. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 It Orifices per Lateral 17 Lateral Spacing(S) 3.33 It Orifice Density 11.76 if/orifice Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft System Flow Rate 27.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 15.18 ft Forcemain Velocity 2.80 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —� SPS 316.300 WAC 4 in.min. Disconnect Tank component is properly vented E— Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Ca aci 800.00 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.31 451.59 B 2.00 44.48 C Pump off elevation(ft) C 2.77 61.52 89.91 D 10.90 242.42 D Total 1 35.97 800.00 Dose tank elevation(it) 3" Bedding uncTer tank. 89.00 Alarm Manuafacturer JSJE Rhombus ^� Note: Switches Alarm Model Number Tank Alert_AB containing mercury _ may not be used in Pump Manufacturer JGould �� this system. Pump Model Number PE 41 T Pump Must Deliver 1 27.46 gpm at 15.18 ft TDH Project: GREGORY A. &MARY JO VEENDALL Page 4 of 8 Mound System Maintenance and Operation Saecifications� Service Providers Name Darrell's Septic Service Phone 715-425-1' 25 POWTS Regulator's Name St. Croix County Zoning_ Phone 715-386-48f System flow and Load Parameters , Design Flow-Peak 600 gpd Maximum Influent Particle Size 118 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 fta Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freguency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test months Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound Inspect for ponding and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis.Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ••••••••••••.•• Grade 6-8"Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution . . . . . . . . . . . . . . . . . . . . . . . . . `�`'`► Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: GREGORY A. &MARY JO VEENDALL Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[SBD-10691-P(N.01/01),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N. 01/01)j and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Stats. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm.Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the fitter is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However,if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter,and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5,150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BODr,30 mg/L TSS,10 mg/L FOG,and 104 ofu/100 ml-for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice leaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,pump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition. See Paae 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: 6AA�il-Way � Page 6 of 8 ��•ZZ iA RAY Of p Warms aiLis FARM. Loy # f2— 0 = contour elevation liaes. • = Backhoe soil pits. rr TM i O = Benchmarks set, maR WITS FLAGGED �` S�+.4 O !!! .lathes. 1/2 steel conduit pipes. p X-1-2 c TAfJr- �- ao• r o -�v ,� .QM�r Sa • 40 r Liti rt_._ Ad 9f.38 L-0 f y/ -. L%QOULDS, PUMPS Submersible Effluent Pump PE i'Y/IM SK<MQIM mom FMAWAs Pump—i en": %nfm l: r Coffmion resish t • Disclharge:1 W NPT • Single phase construction. • Temperature.I Wq(40•Q • 60 Hertz ■Cast iron body. maximum,continuous when ` 115 and 230 vol ■Thermoplastic impeller and su • BuilE:in thermal owrioad • Solyds hand�g-'!" t+ecdm with automatic reset. ■upper sleeve and lower maximum sphere. • Class 8 insulation. heavy duty ball bearing APPtICATtONS • Automatic models include a • MOW design. construction. float switch. • High strength carbon steel ■Motor is permanently Specially designed for the • Manual models available. shah. lubricated for amended following uses. • Pumping range:see P131 Motor service life. • Mound System performance chart or curve. • 33 NP,3000 RPM ■Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 115 volts open. • low Pressure Pipe Systems • Maximum Ggmdty.S3 GPM • Shaded pole design ■AD ratings are wither the • Basement Draining • Maxims n head.25'TDH PE41 Motor. =roils of the mote. • Heavy Sump/ P641 Pump: • .4014P,3400 RPM ��20'standard lerx,�h.. ng • Maximum capacity;61 GPM • 115 and 230 volts h 1 • Maximum head:2g'TDH • PSC design 1 t���SJTW with PE51 Pump; PE51 Motor: grounding • Maximum capacity:70 GPM • SO HP,3400 RPM M Conplete unit is heavy duty, • Maximum head.37'TDH ' 115 and 230+rotes portable and compact. METERS FEET • PSC design ■Mechanical Seal is mrbon, 40 wamic,BUNA and stainless _ T.v611 steel. 1 S W 31 AO..50 ► r Stainless Steel faSbener5. 7-1 10 t 2 GPM _ IIGEICY r-t LaT1N" 30 ' 1 FT i •r'-1 •C�p .)a a 20 1 i -f-��-- t ; Tested to UL 778 oW NL 15• 1 1 .._� -rte File OUSM 10 i 1--'� �.. r ~ �..�,.-�`i Goulds ilrrps k IS0900i liegisd rim _ . 0 "___ �T 7" i 1 f'RoSE.�'c Vke-A) A U- 0 0 10 20 30 40 50 60 70 CI'M 80 - -�Y ® "rY✓ , 0 5 10 t s Ooh Wisconsin Department of Safety anS rofessional Services Division of Industry Services �V1 SOIL EVALUATION REPORT Page I of 3 QV� 0 in accordance with SPS 383,Wis. Adm. Code s _ qq �. County ST.CROIX Attach complete sit 1n aper s 8 1/2 x 11 inches in size.Plan must include,but not lime _ al reference point(BM),direction and Parcel I.D. 040- 1303 -00-042percent slope,scale or arrow,and location and distance to nearest road. (r 7 7 M� ase print all information. Reviewed Date Personal info n» you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). (��s ` C� 7 Property Owner J Property Location GREGORY A.&MARY JO VEENDALL Govt.Lot ----NE 1/4 NE 1/4 S 22 T 28 N R 19 E❑(or)❑W Property Owner's Mailing Address Lot# Block# Subd. Nam:or CSM# 650 Pine Ridge Terrace 42 -- bute/Walnut Hill Farm city State Zip Code Phone Number ity []village ■ Town Nearest Road River Falls, WI 1 54022 1 ( ) Walnut Hill Way Q New Construction User Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial-Describe: Parent material loess over tiller Flood Plain elevation if applicable NA $. General Mound System-- 1.34 ft.sand fill--0.4c loading rate recommendations: Additional borings conducted to move system--on-site with Ryan Yarrington,St.Croix County Zoning Technician PROPERTY ADDRESS: 222 Walnut Hill Way 5❑ Boring# IJ Boring 11 pit Ground surface elev. 93.55 ft. Depth to limiting factor 20 in. Soil Applicati on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP- in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 "Eff#2 1 0-8 7.5YR2.5/2 - sit 2fa&sbk mvfr -- -- 0.6 0.8 2 8-20 7.5YR3/3 sit 2fsbk ds -- 0.6 0.8 3 20-22 till/clay w/redox -7 __ __ _ -- 0.0 0.0 4 Borin # El Boring F 9 99.15 24 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/fl'- in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 I "Eff#2 1 0-8 7.5YR2.5/2 sit 2f-msbk mvfr -- -- 0.6 0.8 2 8-24 7.5YR3/3 sit 1 f-mabk dsh -- __ 0.4c 0.6 24-28 10YR5/4 c I d 5YR4/6 scl Om dh -- __ 0.0 0.0 Effluent#1 =BOD >30:5 220 mg/L and TSS>30:S 150 mg/L 'Effluent#2=BOD5 5 30 mg/L and TSS<30 mg/L CST Name(Please Print) Sig ur CST Number MARY JO HUPPERT/Hollister's Soil Testing&Desi (,�,C ( 224832 Address ate Evalua Conducted Telephone Number W9875 690th Avenue,River Falls,WI 54022 08-22- 14&09- 11 - 14 715-426-1775 SBD-8330(R07/13) Property Owner VEENDALL,Gregory&Mary Jo Parcel ID# 040- 1303-00-042 Page 2 of 3 Boring � ❑ Boring# ❑ pit Ground surface elev. 98.15 ft Depth to limiting factor l r4 ! 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 0-12 7.5YR2.5/2 -- 1 2fsbk mvfr -- — 0.6 0.8 2 12-22 10YR3/3 -- sil 2fabk mfr -- -- 0.6 0.8 3 22-24 10YR4/6 -- sl 1 fsbk mfr -- -- 0.4 0.7 24-ti I F—I Boring# Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 F—I Boring# Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1=BOD,>30:5 220 mg/L and TSS>30:<150 mg/L *Effluent#2=BOD,<30 mg/L and TSS<30 mg/L SBD-8330(807/13) X 6iTfi W�+i,AJUT IA •$, of� - - . aL WATAWT HILLS PMR. LOT i.Ar �s 14,4 A;-b j l a yrr�$TM '40# G F ar s8t, � WIC FLAG= s x -3 � steel COVAUit pipes. 30 `, 6 � 0 N _ �a- s y � �p lei so • GOT Liw — yof Wisconsin DepartmeRfirw E4449061 Services Division of Industry Services AUG 2 8 2014 SOIL EVALUATION REPORT Page I of 2 in accordance with SPS 383,Wis. Adm. Code ST. C€2 IY COUNTY County ST.CROIX Attach complCtOM&glad 1/2 x 11 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. 040-1303-00-042 percent slope,scale or dimensions,north arrow,and location and distance to nearest road. ,) Please print all information. evie D Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Property Owner Property Location GREGORY A.&MARY JO VEENDALL Govt.Lot ----NE 1/4 NE 1/4 S 22 T 28 N R 19 E❑(or)❑W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 650 Pine Ridge Terrace 42 -- Tribute/Walnut Hill Farm City State Zip Code Phone Number DCity [:]Village ■ Town Nearest Road River Falls, I WI 1 54022 ( ) Walnut Hill Way Q New Construction LlseE] Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement [] Public or commercial-Describe::: Parent material loes ove till R4 Flood Plain elevation if applicable General comments 1 &Mound System-- 1.34 ft.sand fill--0.4c loading rate and recommendations: Additional borings conducted to move system--on-site with Ryan Yarrington,St.Croix County Zoning Technician PROPERTY ADDRESS: 222 Walnut Hill Way Fq Boring# E) Boring © Pi{ Ground surface elev. 93.55 ft. Depth to limiting factor 20 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 0-8 7.5YR2.5/2 sill 2fa&sbk mvfr -- -- 0.6 0.8 2 8-20 7.5YR3/3 sil 2fsbk ds __ -- 0.6 0.8 3 20-22 till/clay w/redox __ __ __ 0.0 0.0 Borin 4 g 99.15 24 # Boring ❑ Q pi{ Ground surface elev. ft. Depth to limiting factor in. Soil-Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'- in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Efl#1 *Eff#2 1 0-8 7.5YR2.5/2 sil 2f-msbk mvfr -- -- 0.6 0.8 2 8-24 7.5YR3/3 - sil if--mabk dsh -- __ 0.4c 0.6 24-28 10YR5/4 c I d 5YR4/6 scl Om dh -- __ 0.0 0.0 Effluent#1 =BOD >30:5 220 mg/L and TSS>30:5 150 mg/L *Effluent#2=BOD 5 30 mg/L and TSS<30 mg/L CST Name(Please Print) Sig CST Number MARY JO HUPPERT/Hollister's Soil Testin &Design �' L 224832 Address Date Eva on Conducted Telephone Number W9875 690th Avenue,River Falls,WI 54022 08-22- 14 715-426-1775 SBD-8330(R07/13) pg, of a . PLOT PLAN WALNUT SILLS FARM. LOT Contour elevation lines. /./e • Backhoe Soil pits. p a Benchmarks set, maRRBD WITH FLAGGED lathes. 1/2" steel conduit pipes. sue= ," = R -p Ci4_tiSj� C�u � sft a.146SI`N h_ Vic" �A? Ing jo , 50 60 �w q � f3i 132 . 30• / Id r 91.38 Gvq��v v 7— /rfiPM TED7- Lo :fy t per Parcel w# � Page of 3� ° &o I Ground surface etev. ft. Depth to r9 factor. kt Sofl Rate Horizon Depth Dominant color Redox Description Texture Struchm Consistence Boundary Roots GPDftF in. Munson Qu.Sz. Cont.Color Co-5z.Sh. 'Etf#1 "EW 6•!3 io ye 3/ z 2fjh4 ds4 cw z . s • /o dF 5,f Z- /FS h a . Z s 9A c2-A Af o f 7-9 v1Z F-I # Q ° �-- 0- pit Ground surface elev. ft. Depth to limiting fader In- Soft Application,Rate Horizon Depth Dominant Color Redox Descriptiatt Texture Structure Consistence Boundary Roots GPDlft? kt Munson Qu.Sz. Cunt.Color Gr:Sz Sh. I Boring# Bonng , pit Ground surface elev. fl. to fimitg€actorr Svfl Application Rate Horizon Dept Dormant Redox Description- Texture Structure Consistence Boexxfary Roots in. Munson Ou.&z corn.Color G;. Sh. "Eff#1 "Etf#2 -aF i z a 8odng# Boring El Pit Ground surface eiv. ft. Depth to fig facer . Sod Application Rate' FiOrizott Depth D"ninan€color Redox Description. Texture Stcucti" Consistence Boundary Roots GPON ln. Munsefl Qtr.Sz. Cori.Color Gr.Sz.Sh. "Eif#1 *81#2 a ° Effluent#1=SOD,>30:S 220 mg&mid TSS>30<150 mglL "Effluent#2=BODS 130 mglt.and TSS<30 mgt The Department of Commerec is an squat 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. seaaz�o�cmo> r Wisconstn DAWrtrnent of Commerce SOIL EVALUATION REPORT rage / of 3 Division of Safety and Bulkfings in accordance with Comm 85•Wis. Adm. Code 57'. CA Attach ��1 EROSION CONTROL PLAN must be P� I.D. c v �c► percent Slope,scal completed before sanitary permit issuance p�ti b Reviewed/ by 1 OD- to Personal W—ason you provide may be used for secondary purposes f'rive Law.a.15.04(1)W). Q'I P� T Property Location o D �3 ER5 T�f� r— % -411e^' #A Dtc 5 c A GWL Lot 1/4 S.Z� T�B N R I/ Mfr(or)W Property Owner's Mailing Address Lot# Block# Subd.Name or CSW 1 lvo►S CA U17 AV-p- . yZ IVAL.wor W11 CFA�tif � CRY --CA I JER State Zip Code Phone Number ❑� Village (Town Nearest Road- tr�ov� HT5 MN SS07(P ( 651) ay8• 109 -..Roy so, &JovER 0 New Construction Use:M Residential I Number of bedrooms Code derived design flow rate D Da GPD I Q Replacement ❑ Public or comrr>erdat-Describe: --may- — tA Parent matefial /OAF-5-7 611A, d4i��f i/�S Flood Plain elevation if applicable ft. .�• General comments and recommendations: /gyee,+ 7TH°S rAY-,> Bolming M # y_ ssf �1 PIB t Ground suium elev. 71 6 Depth to wing factor �Z in. 1 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDi'ff< b h Munsell Qu.Sz ConL Color Gr.Sz Sh. 'Eff#1 '01#2 / D- 11 io / 3` L z-i^S hk ds A cw 3f . S • f- D /p r-i:7 h o rS s/GG /f-S 0, �- • 3 0 11! Miring Boring s s S\` Pit Ground surface elev. �• 3 D Depth to limiting factor Z in. SON Role Horizon Depth Dominant Redgx Description Texture Structure Consistence Boundary Roots GPD/ff° In. Munsed Qu.Sz Cont Color Gr.Sz Sh. 'Eff#1 'Eff#2 (N / 0 2- /o K A( Gw 3 s N y /.a -IS 16 SLL 2- s h, AGw 3 S•z!� �Si� s Gi c'S • z- • 3 � G?.� MdTS / L v • Z Effluent#1=BOD >30 1220 mg&and TSS>30<150 mg& 'Effluent#2=BOO <30 mgA.and TSS_<30 mglL CST Name(Please print)q SignatureCST • ALB t G n S Address Uibricht &Assgciates Date�" ? N Private � 7U- 73y y Z 2812 10th Ave. Spring Valley, WI 54767 �ya • io s • s • � o 1/0 . 16 96 dyo• /0,?G • zd • aa� oyo • /08* - �4 • � oyo • /0*6 70 - oyo . /a(?( • & - � 0 R I G A L PLOT PLAN WALNUT HILLS FARM. LOT # 112— Pg. 3 of 3 = Contour elevation lines. 0 = Backhoe Soil pits. O = Benchmarks set, maRKED WITH FLAGGED .lathes. 1/2" steel conduit pipes. LIP f' SCALE: 1 " = 3o V I J� z- • 3 ing 5© 20 ' GA 3b 9a3a o -I • sv y ESQ �iovv Sys�- , P- rr .57i4A.A0 'F I I S 0011'24" E 2847.98+ EAST LINE 0 830.67` 9 3 .67` 14-toe 1x8.53' 131,14' Sao AN co ONO 4 • r*% woo~ r XIRK ..r ..... .w.' to co }I .fig 8S ■. '` � ! ,,'` � ..-- d N C? t � ate,► CAI _ � , • .".. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND n OWNERSHIP CERTIFICATION FORM Owner/Buyer'', t- 1 vl.fir L,r ,�V .3 QA c Mailing Address lL) �7 03: /2-,,-,/&t- f"'4��- � �. �40 2:Z- Property Address , 220 L�t_ WA (Verification required from Planning&Zoning Departmeift for new construction.) City/State' ,J e•. Parcel Identification Number D q0 /30 4 2.2 LEGAL DESCRIPTION Property Location &3C- 1/4 ,_5 C—_ '/4 , Sec. Z"Z-, T 2.Z N R 19 W, Town of i-V , C Subdivision Plat: W14L-WU 1' f-11 L,(_ kiye-117'1 , Lot# �. Certified Survey a # Y P Volume , Page # Warranty Deed # (before 2007)Volume , Page# Spec house 0 yes kho Lot lines identifiableX�yes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed,by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system: Owner maintenance responsibilities are specified in §SPS. 383.52(l)and in Chapter 12-St. Croix County Sanita rY 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 and pumping necessary),the septic tank is P g(if �'Y) P less than 1/3 full of sludge. I/we the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning&Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE I ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12)