Loading...
HomeMy WebLinkAbout040-1316-05-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572848 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: Theobald, Dan & Wend Troy, Town of 040-1316-05-000 1 -1, Insp. BM Elev: BM Description: Section/Town/Range/Map No: CST BM Elev: , 0 13- Z G ~ 05.28.19.2061 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE CAPACITY STATION BS HI FS ELEV. Septic Benchma 1- q' 3 <7 G ft"T I/ Alt. BM / / O Aeration Bldg. Sewer Holding St/Ht Inlet ?4P 7 St/Ht Outlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L,I WELL BLDG. Vent t /fir Intake ROAD Dt Inlet Septic ap*- /Tfit Dt Bottom Dosing Header/Man. $ 2 Aeration Dist. Pipe • 3 Holding Bot. System 11J,1 -13 PUMP/SIPHON INFORMATION Final Grade Y3 Manufacturer Demand St Cover GPM I"; I G t~- i Model Numb 7 TDH Lift Friction Loss System Head TDH t Forcemain Leng ist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trends PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 74 3 ire, SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:/~ CHAMBER OR 1(-, INFORMATION % Type Q6AJeA*tib Ir dg UNIT Modelhumber/ / ~tw DISTRIBUTION SYSTEM I'k 3 = T 0q V las Header/Manifold / r Distribution \ x Hole Size x Hole Spacing Vent to Air Intake Length I' Dia_j_ li-ength \ Dia Spacing \ \ E e~ SOIL COVER x Pressure Systems my xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/S ded jxx Mulched Bed/Trench Center / Bedrrrench Edges Topsoil Yes No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 542 Autumn Blaze Trail Hudson, WI 54016 (SE 1/4 SW 1/4 5 T28N R1 9W) Cedar Woods Lot 5 Parcel No: 05.28.19.2061 FI-4 ".-1- Go Jew. 1.) Alt BM Description = 2.) Bldg sewer length = 36 - amount of cover = 4y Plan revision Required? Yes KNo Use other side for additional information. t Date Insepctor's S' nature Cert. No. SBD-6710 (R.3/97) hi!V l~ 1~ jr, U~P ff L l S i L Q~Z iii Vv" 111 Lo-t LED~~ v~ ~ S 1J' ~ B i YZ p r A 63 1r~~ Y 'V- I X) ` QG -ray Tj7 Q J Cmdr DWWon I bsilisb9~o.} SaEMy and 8c 201 V- W~.Ave., P.O. ea 7102 6'1 t~~ e~~L WI MM-71 o permit App ~ In ses am ama A fxsWWfwWd ~ wd ftk~ &MkL > zm; my5y2 p yownersT~ 01 31 b - ~ ` ~ Z No ~ pmpaRyownws GwL Lot 3 ~ . zip c coma R1~- o rJ Lot; 1I. Type ofBs't~1 S Q~/ 5 r Woo iJS_ IrT. s~rt~ Q v°E ❑ SW Owned- USC ~ 't'T2.o 11 III. 3'yQe beat aw ll~g. Combs iM B K ' Ta~cR~ 13 o&ocMd0=sippeDSr'-ft (-TIMM) A ~ p~ flT mdDM II~Tc~~xea s. © PamILRvVW= ❑ owaw ~ s~ Check an flat '24 Of FOWT~ Soo Q pMwbcd ln-otoeud fl tat-Q~e fl © - O T=k II01b"nbP=dr. ( V VnsoaAppR o9~j ,-1 167Z - , of &am unit 'J/ % ekW' r To& Vu. ire S Cam" F , 'g U zz Z 2 7 l5-75S- Z PlumbWs 37E F=F Tai plu~bes''s Atli is csLy. sew zV Ox'&) dJ t~C~`t CR K/ use DOC a n DWWW"d W DeaW Sc f-?S-~°-% 11 11 Zol fl Ow=GIM >.cmd~~f~,, SYSTEM OWNER: 1. Septic tank, effluent filter and G%r! dispersal cell must be serviced /maintained as per management plan provided by plumber, y~ieCaeaolf as per applicable -o~EV e or ina ces. SED4399 (IL 11111) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Pty 4 WCOAy T~4 o I3~~0 1~^. C~ Owner's Name: Owner's Address: 2233 WOM 'RIN -I-IV1 aN W 7 5C 5 IV Legal Description: E I/y Nnl '41 5 S T Z$ N R I`t IV Township: ~RO`f County: U0I%L Subdivision Name: CHAR y oot> s Lot Number. S Parcel ID Number: /3A6 ` O5"" Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: F F -Fn ~4 License Number: )y\MS ZZ.3292 Date: UT(o Phone Number -7 (6--7EZ5-z4 (o 1 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 {-wr~S t:~~~ Vt1 i 5 y~ 1 ~ w ' flti ~,t S -T Zr-- oz n vv `M VO KJ t-,'F `1-R -Y4 CAW C 63 cDZ 3~L! tIIV~T~YI( I 7th' i1 ?~r_r~ HOC t~ SL~iL ~t~ i "1~ LS Abou" Swam gm Aid" n ~~ow gY. syft E PIM Tf ft Tex P" TWO* 8 UWMMChambw. ELBA R 7-0 eq it pw champ Sob ARNMOn Raba oxy" ft ~~J O MW Oe*n Raw ,&'I so Aomori Reba 4. ~ ELBA ~ Chambers ~ n~ n!` ~ S - S Beach. papa or Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 '/2 x 11 inches in size. Plan 11 unty St. Croix Include but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. O4O Percent slope, scale or dimensions, north arrow, and BM referenced to nearest r Revie by Date d Personal information you provide ay be s vacy Law, s. 15.04 (1) (m)) V-V) /,Zz0 d 5 Property Owner Property Location G&L Land Development, c. Govt. Lot NE 'A NWW Y4 S 8 V28N R 19W E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# W12491 890th Ave. ST. CROIX COUNTY 5 Cedar Woods City State Zip Code Phane ❑ City ❑ village 0 Town Nearest Road River Falls WI 54022 715-386-2928 Troy Coulee Trail / FF 0 New Construction Use: 0 Residential / Number of Bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or Commercial - Describe: Parent Material Flood Plain elevation if applicable ft. General comments and recommendations: B-1 was completed during the preliminary soil assessment on July 22, 2005. p" U-q- c73.55 G o,~~e +a ►~.c~ U ❑Boring Boring # 0 29 to 42&>110 • f a Pit Ground Surface Elevation 98.1 ft. Depth to Limiting factor In. Soil Apolication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Em 1 0-10 10YR3/2 None SIL 2-f-sbk dh gs 2f 0.6 0.8 2 10-20 10YR3/3 None SIL 2-f-sbk mfr gw if 0.6 0.8 3 20-29 10YR4/4 None SICL 1-m-sbk dh gw 1f 0.2 0.3 4 29-42 10YR4/4 f-1 -f 7.5YR4/6 GRSL 1-m-sbk mfr aw if 0.4 0.7 5 42-110+ 10YR4/4 None GRS 0-sg ml - if 0.7 1.6 ~ u ❑ Boring Boring # 26-63 &>120 ✓ EIPit Ground Surface Elevation 99.8 ft. Depth to Limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-13 10YR2/2 None SIL 2-f-sbk mfr gs 2f 0.6 0.8 2 13-26 10YR3/4 None L 2-m-sbk mfr gw 1 f 0.6 0.8 3 26-63 10YR4/4 None S 0-sg ml ai if 0.7 1.6 3 26-63 2.5Y4/2 7.5YR4/4 c-2-d SICL 1-m-sbk mfr ai if 0.2 0.3 4 3-120+ 10YR4/4 Non 0-sg ml - None 0.7 1.6 rt I *Effluent #1 = BOD5 > 30:5 22 and S > 0 5150 mg/L * Effluent #2 = BOD5 5 30 mg/L and TSS 30 mg/L CST Name (Please Print) atu CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 December 20, 2005 715-796-5664 Property Owner G&L Land Development, Inc. Parcel ID# 040-1022-70-000 Page --2 -of 3 a Boring # ❑ Boring OPit 34to43 & >120 Ground Surface Elevation 100.1 ft. Depth to Limiting factor m. Soil ADDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-19 10YR2/2 None SIL 2-f-sbk mfr gs 2f 0.6 0.8 2 19-34 10YR4/3 None SIL 2-m-sbk mfr gs 1f 0.6 0.8 3 34-43 10YR4/4 7.5YR4/6 f-1 -f SIL 2-m-sbk mfr cw 1 f 0.6 0.8 4 43-64 10YR4/4 None S 0-sg ml ai if 0.7 1.6 4 LAYERS 43-64 7.5YR4/4 None FS 0-sg ml ai if 0.5 1.0 5 64-120+ 10YR4/4 None S 0-sg ml - None 0.7 1.6 13• , lr7 4 Boring # ❑ Boring ❑ ®Pit Ground Surface Elevation ft. Depth to Limiting factor in. Soil AoDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 °'l M2 Boring # ❑ Boring Elpit Ground Surface Elevation ft. Depth to Limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 • Effluent #1 = BOD5 > 30!S220 mg/L and TSS > 30:5 150 mg/L ' Effluent #2 = BOD5 5 30 mg/L and TSS 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Site Diagram Page 3 of 3 0 ft. 24 ft. 40 ft. 80 ft. N r' t,~s 4 i 98~~~2;0 ! LC~ I i ` PIS B-1 I - 98.1 1 r -T N , I 918.0 1 t 100.1 y j 13M#1 - of 1!2"PVC Pipe , 0.0' r. t r -.5 7 100:0'. = Lot Lines BIVI# & Description . Bench Mark B-1 - Boring Location & Elevation House and well location to be determined Elevation 100' Owner: G & L Land Development Inc. Site Information: Completed By: Mark Iverson, PSS #197 W12491 890th Street SE 1/4, SW 1/4, S5, T28N, R19W 680 Larcom Street River Falls, WI 54022 NE 1/4, NW 1/4, S8, T28N, R19W Hammond, WI 54015 Town of Troy 715-796-5664 Phone: 715-386-2928 St. Croix County CST# 46672 POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner D NQ W6 N -V44COBALb Septic Tank Cap!Ei~ gal ❑ NA Permit # S a 9'LJP tic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer I M,E 0 NA Number of Bedrooms 100 d/bedroom ❑ NA Effluent Filter Model 1 0 NA Number of Commercial Units Pump Tank Capacity NA Estimated flow (average)* gal/day Pump Tank Manufacturer NA Design flow (peak), estimated x 1.5* Qp Uda Pump Manufacturer NA -750 py Pump Model Soil Application Rate -7 gal/day NA Influent/Effluent Quality (NAO) Monthly Average- Pretreatment Unit [ANA ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) 5 30 mg/L 0 Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD5) ❑ Disinfection 0 Other: Total Suspended Solids (TSS) 5 220 mg/L < 250 mg/L Manufacturer: Model: Dispersal Cells Pretreated Effluent Quality p Monthly Average#** -ground (gravity) 0 In ground (pressuri2ed) Biochemical Oxygen Demand (BODS) < 30 mg/L 0 At-grade ❑ Mound Total Suspended Solids (TSS) Fecal Coliform (geometric mean) 30 mg/L 0 Dri -line p Other: <10 cfu/100ml 0 Leaching Chamber Manufacturer L -A vt _ Maximum Effluent Particle Size 1/8 inch diameter Model K Laying Length/Chamber *Wastewater Flow Verification and Calculations: Soil Application Rate gpme Area Req. /b Z ft2 (Other than bedroom based) Infiltrative Surface/Chamber-ESIA Rating ZD If Minimum Number of Chambers ❑ Aggregate Design Flow/Loading Rate= min Values typical for domestic (non-commercial wastewater Materials: all materials mist comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for retreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al. 1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 p "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 0 SBD - 10570-P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ❑ SBD -10567P (8.6/99) "In Ground Absorption Component Manual" SfSBD -10705 P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD -10628-P (N.6199) "Recirculating Sand Filter System Component Manual" 0 SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572-P (R-6/99) "Mound Component Manual" ❑ SBD - 10691=P (N.01101) "Mound Component Manual" Version 2.0 E3 SBD - 10595-P (8.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" ❑ SBD - 10573-P (R 6/99) "Pressure Distribution Component Manual" 0 SBD -10706-P (N.01101) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once eve ❑ months Iyf s 3 Pump out contents of tank~s) When combined sludge and scum equals one-third 1/3 of tank volume Inspect dispersal cell(s) At least once eve 0 months X year(s) (Maximum. 3 Clean effluent filter At least once eve ❑ months Kyear(s) Inspect pump, pump controls & alarm At least once every ❑ months ❑ year(s) Q NA Flush laterals and pressure test At least once eve 0 months ❑ year(s) 0 NA , At I'met nnrA Pvrrv n months rn vear(s) ❑ NA START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. p Valves Valves shall be operated in the following manner: p Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INFECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). p Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-thud (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. p Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. ❑ In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of p Mound, At-Grade, In-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 7 ' 5% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the 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 m compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINCFENCY PLAN If the PO S fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replac t system: eqk A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. 10/ The replacement area should be protected from disturbance and compaction and should not be infiinged 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 from existing, and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. O 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. p Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAWTAINER Name .e'Fr- rj X Name Phone `i15.755• Z Phone SEPTAGE SERVICING OPERATOR u r LOCAL REG TORY A Name Agency 0 I Phone Phone r ' - 3`. Installation and Maintenance Instructions Installation Step l Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it is centered directly under 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 1"schedule 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 locks 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 locks into place Maintenance 1) Remove the access lid of the tank. Note: To ensure undesirable solids do not exit the tank and into the drain field, the tank should be pumped out until the level of effluent is below the outlet level of the tank. 2) To remove the filter cartridge from the filter case, pull up firmly on the handle of the cartridge 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 visible septage material is removed. 4) Place the filter cartridge back into the filter case pressing down on the cartridge until it locks into place. ' 5) Place the access lid back onto the tank ensuring it is secure. Lifetime filter has a lifetime limited warranty: Lifetime filter LLC warrants the filter will be free of manufacturing and workmanship defects during normal use for the period of time the original purchaser owns the product. Lifetime filter will provide a replacement fitter In the event that the original filter was not damaged during the installation or maintenance process. Damage to this product caused by accident, misuse or abuse will not be covered under this warranty. Improper care or malfunctions resulting from product not being installed, operated or maintained property-will void this warranty. Lifetime filter assumes no responsibility for labor charges, removal charges, installation or other incidental or conseauentiai cnsts. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/BuyarDan and Wendy Theobald Meiling Address 3 ~Cttb / S lY..~ ftVcrW Adtiresa S-7 z- Y'w M ! u O hl-T (VerIt calm ro*red i'tom & Zm tg Dqummn for ww eommt &&) Hudson WI ParcelldetttificationNt 1316-05-000 IAL DIS3CRIFT'ION ~d ~ f~ Pr%mty Location Mk ,Som./ T Z N R ~C W, Town of I ~D~ Subdivision Plat: Cedar Woods 5 Cerafled Sunny Map # . Vohmre . Page # Wuranty Deed # Oelbre 20nVohtme PW # Lot iiuas idesD"yes0sb lmprgw nee of yoga septic system rosWt io its faiihne 1o handle waster. Proper m"enen a coosuts ofpmeping out due septic sunk every throe years or soccer, if anded, by a liceaeed pamper. What yon pat into the system can affect des i5oction of the septic tuck ns a trestanot smp in the waste ftossl sysbm Ow= maioteawoe respor st'bilities are specifad in ASPS. 333.S2(1) and in Chapter 12 - St. Croix County Sanitary Ordieews. Tht property owner agrees to submit to St. Croix County Planning k Zoning Department a oe on fonq signed by the owner and by a master plumber, journoyman plumber, restricted paamber or & licensed pumper ven*ing drat (1) the at-she wastawale r disposal system is in proper operating condition andkr (2) atla inepectio n and pun (if asa:say), the septic took is tea than 1/31h11 of sludge. Uwe, the used have read the above requirements and agree lo maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Departmant of Netnnd Roes, State of Win onsin. Certification staling that your septic system has been maintained meet be completed and returned to the St. Croix County Pbming & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are trac to the but of m)low kwwWp. Uws amhro the owner(s) of the propaty described above, by vMw of a warranty decd recorded in Register of Deeds Ollie. Number of bedrooms 5 VI/lAryl IGNATURE OF APPLICAN ) DATE I ***Any i &mutwn that b mmvpreseated. may result in the sanitary permit being revoked by the Ping & Zoning Department. sus b elude with tbb application a retarded wanronty deed from the Register of Deeds Otika and a copy of the certified sarvvy math if rcffirenae is made in the warranty deed. (REV. wn) i 953096 BETH PABST i REGISTER OF DEEDS State Bar of Wisconsin Form 1-2003 ST. CROI:X CO., WI WARRANTY DEED RECEIVED FOR RECORD 03}26/2012 09:01 Ali Document Number Document Name EXEMPT u NA REC FEE: 30.00 TRANS FEE: 167.70 THIS DEED, made between G & L Land Development, Inc., a Wisconsin PAGES: 1 corporation ("Grantor," whether one or more), -The above recording inrormation aer-I ies that this document he8 and Dan Theob 1d and Wend Theobald husband and wife as haw" Alwetranically nncoidwd survivorship ma ital r0 ert A returned to the submitter ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): Edina Realty Title, Inc. Lot 5, Plat of Cedar Woods in the Town of Troy, St. Croix County, 400 South Second Street Wisconsin. Hudson, WI 54016 Fik No.d,aW& p 3 040-1316-05-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: This property is subject to Covenants and Homeowners Association By-Laws. Dated March 16 2012 G & L Land Development, Inc. (SEAL) (SEAL) * Glen M. Wiese, President (SEAL) k/ (SEAL) * *L06 M %~~ese /TCQQ'' T~~( AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF {YV t\t~e~-~ce ) } ss. authenticated on COUNTY ) Personally came before me on March 16, 2012 , TITLE: MEMBERS ATE BAR OF WISCONSIN the above-named Glen M. Wiese as President of _G & L Land Development, Inc. CIrA L&,3 M. aN#_-L pS ~nrsQ~P1nl~CtCES~2~ (If not, kno to on s o executed the foregoing ~°6 authorized by W is. Stat. § 706.06) in t ac ow ged the s e. Inc. r THIS INSTRUMENT,RAFTED BY: I Balers C. Heere FSA Title Services LLC Notary Public, State of r~ 5645 Memorial Ave nu ,Stillwater, MN 55082 M Commission (is permanent) Tres: \_Z1..1y ) seem (Signatures may be authentic RV5 sa ) NOTE: TES IS A STANDARD FORM. ANY MO O B CLEARLY IDENTIFIED. WARRANTY DEED C 2003 to FORM NO.1-2003 *iT966name below signatu M Comm'ssion Expires Janua 31.2014 1 of 1 oro 0 / T c'o~'~ off' ~'8 ll ` / Cj/ t`/ L i 'o j of / Cn b / / ~ ll < O ~ (D ` X11 \ / 0` / ml, v to N (1) Q) I Lo (D 0 0 (0 / Oar z 0C' LnI J i OJ Lq tD cD 71 / OI r„ 3„9tr,Sd.ldN X2, t tZ 3r.8tr,9d. tdN > tr 8 . ldN ,8c' t9 ~ LLJ d c m a~ 3119t,20. MN o ~Q ---rnn Clam's Drawing Room, LLC 20 12 3 a ,o sa r^iu ® i o~ LO ® ❑ 70 CD T / !I FETFEI T Z To < r (l ~ H ZZO G) (0 Z z z ny0 lillillit C R II II R ti rnZ p rn Z FMHH Val F ❑C A I 00 ❑ 1 70 D ❑ lE1HH -n a3 00 ~o oZ z ~o 70 A n O z urnvcn cro2 loin's Drawing Room. R 12A/'1 & WFJVDY TbEOPALD ~ y _ ? LOT 5, U PAR WOOD/, TROY, WI p ~ e e lain's Drawmg Room, LLC 201 2 ~eaU sp--2 3 ~yH n H FER IE LD rn O z rim o m G D ~ Z FEE II O FEB FMHH 0 0 -11 W -O /0 Q Oz z ~O 70 C^ \ 1 N A O z N z g cvn urOR lain's Drawing Room- R DA/Y & WEA12Y THME)ALD TMA. o== ? LOT 5, CEDAR WOODY, TROY, WI w °a_ e Qlaln's Drawing Room, LLC 2012 ~ IS ~aan~R 5gV 9xo~s?° x a~a~ c~.3 a ~==p a E. u I IYI I ~i IIII e i m? uu S I b, IIII - ~ y S~IIII Wa la °O - _JJ Ilo ~ n ~ J I JI ~ IIII t IIII I IIII I IIII I IIII I ~I I IIII I IIII w u+ ~ i l l l l l l l l gspc ~ IIIIIIII __I 1111111 11 ~ II ~ II ~ I ~ _ a Imo; ~ I((~~I I ~ rn ° a rtrt I o ~ ~ II ll II n P z v; § _ o n _ I ~ Q II I ~s p 000 -n a] 0 0 0z Z ~ ~ZO lC~1 ~ N J ^Ol Z $ ~JiO A L OR R loin's Drawing Room. L. R ° 8 DA/1 & WENDY TWE05ALD a e LOT 5, GEDAR WOODf, TROY, WI w v N ®lam's Drawing Room, LLC 201 2 ~ak~s~a I If ° 3np~~3~ FSRa =saa 3Qdgo aBa ~9~ p O O o ~ I I b F I I # u h ~ I ~ I I Ib v ~ m I - I A ? ~ p N Ilo I .E to ; 4~ w 1~ i I I I y I I I § za I -------------J S I y , I E 0 o O I x o R 4 aR ~G § I iw iu row .o I I I II I II I ? 4 II I I Y I 1 I y„ ° I I I 7F' § z S I-AcY i I I I I 3 '..V~UUUUVVV~UUU . 1 _ I D G rn - 'o ~ § .oP gy § ~ III Q Z I § ~ O---ll # ~R z II z _J 0 '94 -i § Y 9y \ i~// ry~ ~ ~Inl i W r ~ or ®a- c Nil g zs s~ z 11 00 eb - - Oa 7 n O G> c1~ O ~ z c O N A W O Y z A F Dr t rOR ° lain's Drawing Room. R 12AA & WE GV THEOPjALD ~ y" ? LOT 5, CEDAR WOODJ, TROY, WI ? N ~r lam'5 Drawing Room, LLC 2012 g~g ka o? R- ds~,~au'~ °Iq a a,a~g4 I I I I I I I I I I I II I I I I I I I I I II I I i I I I I I m uz I I l I § I I I c II _ W a I " a" a ~ ' ~ P u I rn u F ~ b I 9g " ~ co ° ~o S I e N d IN e 7- a" rn s 4 urea w X ON Z u I LJ i Qz l 1 ~ ~ ^t 1- 1. / N.... P 6 C ~'a4 IJ ,g ~r~" X11/i I / C / C \ ♦ I / c qy Q 0 °2. O a 70 o Oc 00 c~ n N O Z n Rcnocn¢roa: loin's Drawing Room R E DAA & WEADY THMPALD ~ AN o ;H ? LOT 5, CEDAR WOOEY, TROY, WI r w ? °a_ Q lam's Drawmg Room, LLC 2012 N R3 y4.3ygR 3 If ~n I vas. _ 33A ;;jo 4- !1- 1 ________________N_ wl I I I I I , ~I I I d. I I ~ 1 I ~N I I II I I I I I I I I I- II I I I 'o I I I I 1 I , I I I I , I I I I I - I I ~ I I ~ I I I I I ~N I II I ~ I I I II I I I -j 1 o I I I O I j ~N ~ I O II f__ J T I I I - I A all I I I I I O = J I I I I - - < I I JN I I J" I I I I jm OO -1 70 O a 7 a O~ czi~ O z c n pN O S Z F ig W-AVM crow lain's Drawing Room. Q n 7A/9 & WENDY THEOBALD o ~;e ? LOT 5, CEDAR WOOq/, TROY, WI w r © lain's Drawing Room 2014 , VROKcnl° =o a ~ a F s o~o,a v~o 33p~°Oa to .°.soo an~nRU~ " 3 ~ a n u ~Q"v_aoN v N z v - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - f,,a n.nN I o s o m I L4 ~""~o I 4 I I 3 ~ I I\ u"~°~°m I ° I 1 fI ~`3 o'c3~ I ° I =~m'a 33 I r J rn I I - a J I I I I I I ~ ~ I I I o I I I I I I ~ i I I I I I I ~ I I l i _6• N I I ~N . I I I o ~N I I i I I ~N I I IN I I I J I I I ~ I I I I I I I I I I I ~ I I I o I I I I I i I I I I I _6, I I Z I I I I I I I I I II 4 I I I I I i I I I I I l i~-s~ O I I I I I I I I I I I I I I I m I ~ I I I I § I I ~m ~ ~N I I I I I ~N I I I I I I I I I - I I F- 4 N----~ I I I I i I I I I z O I 1 ? I O -1 70 4 ~N I rn I N I r I t o I I I O i ~ I I I i t j I I ~ Q I q (0 ~ O z -70 A C) N O z Rrnocnce roa: o o lain's Drawing Room h Aaron & Karol Danielson VESM 6 m ~ g ~ ? 906 highlander Trail, Hudson, WI 54016 4 4 " C:BM;, A A A