Loading...
HomeMy WebLinkAbout020-1439-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 572847 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Danielson, Aaron & Karol I Hudson, Town of 020-1439-30-000 CST BM Elev: Insp.BM Elev: BM Descriptions Section/rown/Range/Map No: gq _ q D 'b"�Z 25.29.19.2756 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic _ ' ZSv Benchmark4 2,- �•15 n`D•15 89, Dosing J Alt. BM 1•f D�QI Aeration Bldg.Sewer , O 0 Holding St/Ht Inlet St/Ht Outlet 5• I IJ QUS•�1 TANK SETBACK INFORMATION S 1 U TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic W ^, /� ' I I 12p I Dt Bottom Dosing IV Tl 1 Header/Man. Aeration Dist. Pipe c Sb•2 35J Holding Bot.System Final Grade I D. q' U�9•35 PUMP/SIPHON INFORMATION U b W Manuf errand St Cov / U odel Number GPM vkv- TbqLift Friction Loss ystem He TDH Ft 1 Forcers Dia. Dist.to Well 1 SOIL ABSORPTION SYSTEM 2 I + 2Z 0..M S BED/TRENCH Width ILength No.Of Trenches ' PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS q0 t SETBACK SYSTEM TO JBLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ,V Type Of System: �� ��I /1,�� � � p � /� UNIT Model umb r: �Z D RIBUTION SYSTEM y NIA r/Mani�d �/ Distribution x Hole Size Ix Hole Spacing jent/too Air Intake He C Pipes W .(,/'d,5 Length_Dia I 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 Cent y Bed/Tren es 0 No � Yes ® No COMMENTS:-(Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 906 Highlander Trail Hudson,WI 54016(SE 1/4 NE 1/4 25 T29N R1 W) Indigo Plonds Lot 30 Parcel No: 25.29.19.2756 1.)Alt BM Description n v 1 ins I � 2.)Bldg sewer length(= -amount of cover= 1 IZ' - Plan revision Required? 0 Yes X No �2ji� Use other side for additional information. LL Date Eqkoesgn ure Cert.No. SBD-6710(R.3197) �1,c._��-. l(✓,�s�:Z___1��dam/_° _. __:_ _ . _..__ __ _. . _._____._ _._. 8� I COUtdy \;�} 1i' i �ndUSf Services Division "! 1400 E Washington Ave Sanitary permit Number(io be filled in by CO-) DEC 3 2,014 P.O. Box 7162 Sps ;' Madison,WI 53707-7462 7z V41-7 = `` State Transaction Number ST CRIOI�R Sanitary Permit Application In accordance with SPS 383.21(2).Wis.Adm.Code,submission ofdns form to the appropriate governmental unit is required prier to obtaining a sanitan'perntit Note:Application forms for state-owned POWTS are submitted to �� {if differ¢nt than nutiling addr ) the Department of Safet}rand Professional Services. Personal infornration you pt�°vidz tth9}'be lsseti for secondtu} u o�ssees in accordance vvith the Privaev Lave.s. t 5.04(1)(m),Stats.L A lication Information—Please Print All I`nformstla _ P�1# Propy Ovvncr's Name �s 1 ptnl}lAcauol /� Z 7 J�lo Property Owner's\flailing Address C � Gov't.Lot lt� zle Ph one Number '+. .1 Section Ctt}I St e ,�(cap e oWl T N R /J E ot / Lot (Type of Building(check all that apply) Subdivision Name ItY 1 or 2 family Dwelling-Number of Bedrooms ak Block ❑publiclCommeteial-Describe Use ' ✓ ❑City of 7v �ti t/�'C.. ❑Village of ❑State Owned-Describe Use 7 CSAI*iumbLr Town of 4 e of Permit: (Check only one boa on line A Com lete tine B if a licable) Q Modification to Existing System(zxplain) A. New System ❑ Replacement System ❑TreatrnenttlioldingTank Replacement Only ❑ Permit Renevvl Permit Revision 13 Change of ❑�'�Transfer to Nave List Previous Petntit Number and Date Is4uad B. Plumber Owner Before>w�piration IV.T of POWTS S)'ste mlCom nentJDe�rice: (Check all that apply) Non-Pressurized In-Ground ❑ Pressurized in-Groumd ❑ At Glade Q Mound?3�}in of suitable soil ❑ l found t 2�i in,of i soil [�J HotdngTank t ev is eal Componem(caplain) Q Pretreatment Device(explain) -Yip V.Dis ersaUTreatmen Area Information: S stem E[eration Design Soil Application Dispersal.area Requir�xt(st) Dispersal 2%rea Proposed{st)/ ? y Design,flovv(gpd) Rate(gt�0 �// / , r Capacily VL Tani:Info Gallons Total 'of v �3 a l I uftcturer S v 3 a n Gallons Units New Tanks EaistingTanttt Septic or Holding Tank ❑ ❑ ❑ ❑ [] Dosing Chamber VII.Responsibility Statement-I,the undersigned,assume responsibllit•for installation of the POWTS shavvu on the attached Plans. Phone`lumber ber s igna tPIMPRS Number Plumber's Name Print) ` It' 's'ZP.A/ -� v ber's Address(Street,City,State,Zip Code) , V11LL CountvlDe artment Use Only (�,approvad Disapp Permit F� Data l� Issuing • Sigmtuse !Th _ GO{✓•� tvo-n Reason �-Denial S f IX•CondWfi-T5Kg1I At?>teasonsforDisapproval 3 ~a c. 1. Septic tank,effluent fitter and nd l' J dispersal cell must all be services!itaintalttes �ra ,r A �„�� as per management plan provided by,Wita beIr. A-0-4]' 2. Attaclt to complete plans for the syatcn:and submit to the Coantr onh•on paper not less than 8 12 x 11 index in sloe �9 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: Owner's Address: tJ Legal Description: / � Township: 441vbt t`tQ County. Subdivision Name; ��� I � ��b5 Lot Number. Parcel ID Number. 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 P{at Attachments: Soil Test&House Plans Designer/Plumber: Ff-- License Number- Date: ti Phone Number Signature Designed pursuant to the in-Ground Soil Absorption Component Manual for POW'rS Version 2.0 SBD-10705-P(N.01/01). Page 1 L y t b 3 t Soil Absorption System Cross Section ft �Grade 4"Sdmdtft 40 PVC Vem Vi,Vt""," � ,l-_ 2 ft Leaching _.®. Chamber -" System Elevation Soil Absorption SVSfiem Plan V[Sw ft Leaching Trench 9 �--=-ft Vent Or observation Pipe Chambers [OHIO f Da. Trench 2H LJIler LealCha/mb/er Soee fications Manufacturer And Model ElSA Rating =�22 _sq ft per chamber Soil AppUcation Rate 7__gpcvel it �—gpd Design Flaw 7 Soil Application Rate= -�D E1SA= Chambers 2 rows of_ _chambers each. r Page of Property Owner Parcel ID#_/C�2,7 LyD=sS o Pap { of 3 aBoring# ❑ Bong 0 pit Ground surface elev. ft. Depth to knifing factor>d��o in. Sod Application Rate t ;drizon Depth Dominant Color }Redox Cescription Texture Structure onsistence boundary Roots GPD/ft 2 in, Munseli Qu.Gz. Cont.C,T Gr.JG.Jh. t} t t —1 IIMG l /j i 1 9 4 K 4 9 - S 1 1 i I i i a i 1 tt jj I ! I 1 I I l i Boring# ❑ Boring ❑ pit Ground surface elev. ft, Depth to limiting factor in. Sod Application Rate i-inri�gn i _C-0in ii:nminant ine.�ri er�gX ilgcrrinFinrt i -S-Fxtjre I Structure LOriSiste;icv^- 6unu2rY 1 Roots GPfi/ft ._..... .: F _.. _.=. ...... �.., a .. ..,' . . Z I l 1 1 1 1 s ❑ Boring Boring# Pit Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate H Qe�oth �Daminant Color Redox Qesc iption Texture Structure Qonsister ce 601.n� ia,^•. - - 3 i i i 2 3 ` • " is 1 1 i 1 1 Effluent#1=BOD >30`220 rng' and TSS X30 c 150 mg" EfRuen'#2-BO^ e 30 mg-,L and TSS ;30 mg The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access sen ices or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBr3.3330(t-t t i!i i) r' Wis.Dept.of Safety and Professional Services SOIL EVALUATION"REPORT Page of Division of Safety and Buildings 0 E O i.0 ;n accp dance with SPS 385,Vviis. Adm. Code County Attach complete site plan on fi ;Rta3 Rh-W . x 11 inches In size.Plan must include,but not limited t6�AAl iU"rA portrt(BM),direction and Pare I.D. percent slope,scale or dimensions,no on and distance to nearest road. - Please print all information. Re by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). �i/Z 3 Property Owner Property Location 0 Govt.Lot 114 114 T N R (or)W Property Owner's Mating Address Lot# Block# I Subd.,N7 or GSW S city 'tale zip Code Phone Number ❑City ❑Village ®Town Ne st d u I IAT I ( ) !/ New Construction Use: Residential/Number of bedrooms Code derived design flow rate GPD �? Replacement n Public or corim^mer-dal-Describe: Parent material fir ems,z.4s�/ r•ioW Plain eievaiion if appli+,We General comments and recommendations: a Boring# Boring pit Ground surface elev.,��ft. Depth to limiting factor .25,' in. Sod Application Rye Horizon Depth Dominant Color Redox Description Texture Structure sistence Boundary Roots GPD/ft 2 p ky.n in. ! Mansell i Qu.Sz, Cont Cuior I Gi.Sz.Si f. ` i ` tom fiMc -YA t I t t t t ! 1 I f t S t All,I Ai a Boring# ❑ Boring ® Pit Ground surface elev.�$_ft. Depth to limiting factor >- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure lonsistence Boundary j Roots ) GPD/ft Mansell Qu Sz. Cc-.Color. I_r,Sz, , t •#ff#2 in. Al I 3 , R 9 -g 9 i Efflue #1=SOD 5>30<220 mglL and TSS Q <15D g!L ' f€tuent#2=BOO _<30 rng!L and TSB <3n n,gn I Adress Date Evaluation Conducted Telephone Number �Jj 5BD-8330(1111/11) Property Owner �0 ;}1 cSGv✓ Parcel ID#&20 / `�- i Page - -of Boring# t❑p71� Boring c� Pit Ground surface elev.-��—It' Depth to Ilrrriting faotor, Bi. Soil Application Rafe l'Orizo+I Depth ,.,..minan,Color Ro AvX t�.cSC:IptiLn ; Texture structure ^vnSiSte rCe Oundary Roots GPD/ft ^ a !11!'i ✓ llf1 in. i.i1:•.a:.. i.:uili.l.uw+ y 1 i r 'Ad q..S i ZZ 8-37i g q 4 t ( S r r Boling# ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate i-inri^Gn i _emir; fF":r_.r?^;r;an;iVn:�ri r; nta_�C�Ir4L�?! I :r,;r i Ji'ittT.Lit: a+Gna=s,a Cc- ua Tl,c,�r.a nn __"-- [` 3 1 Boring Boring# E] Boring surface elev. ft, Depth to limiting factor in. F1 pit Soil Annfi ion Rate c;TIIr r: I Horizon fleoth . . :c t^ fi G¢ DG. G�Ini Redox DSSr --_ t 7 , p . : Effll tent#1_SOD >30.<220 M-,,,"-and TSS>30 r 150^1,/ Ef l#2 SOD <30 nvy t and T$^a T 30 Ytgn The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access sere ices or nced material in an alternate format,contact the department at 608-266-3151 or ITY through Relay. ssn-s�ao tKi i?i r� j , I I I I � I I I i I I I I I _I. t 1, I i I I i - I I i I : J ' I ; : i f I : , : r i I I I i f I - -- �- - 44 - - - I , I I /- - , , JI'-__ i I i I I II I - , 1 - - - - - --ICI-- - -+-- I I , I I I I I II � _. I_ -- -I - -- - - - - --- i- - I �- - --L- ' I _ I I I _ I I L I I xn ell, 201.W aid lion vw Am, 0 SM Paz that by Perinit a— be NSW&,. � 1, ELS c� INIGI(N� N y39. 3o- N Ap IL OtIMIROW affent (v or 2FftRrDwavi., Va6v OF A. MW Q RR S an ffie A Ir- IK IMM o --7Ci y.�5a1�1 Q V. Tak Q ogw Dis~ Q Q �ilili!let f�j X24 io-of VLTx,� 0. t v -QaC y gar �tber'S ...... i- L ffie a a DAM PPrO"d Q X10 S Zy >YSTEM OWNER: 7 �� Zo/ Septic tank, effluent filter and dispersal cell must be.service_d_/ '�Q All per management plan -f11a ntained /� "v 1 � A_!i setback re uirements must'be�maintained �S 7S/�� � S� '`� f %� Y plumber. as per applicable 98(p,f t117J � " u gym, CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: a � Owner's Name: Owner's Address: zS \J DSb� wl Legal Description: :s�c I c 1141s-'S -r 2<i j\j 1� kl Township: +1 k DID County: C (`J- Subdivision Name: foQt)s Lot Number. .3t� Parcel ID Number: 07-0 - )`13q - 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: Fr t�6 X License Number: fill WS 2Z321z Date: Phone Number •715..`755- Z LY(o� Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01/01). Page t Wyk Vj LA = CID ITT 1 J�) V n � � 93.R ss XX it gz,Is— 3olAkwAmAmwm MONK cad ft 3 f raw T 2 V1�Qr t+�e i Topah S • I ManufwWmrAndModal FJSA Ram Z n.et 2 pW ChaWJW Sol AppWM Raba gpd Oastn Raw a Solt Appludw Rem #,.l..x BSA� —75 Chambers I S rowo of _�elf. • tt pap-of.._._., x 1276 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85,Wis.Adm.Code Steel Soil Service Attach complete site plan on paper not less than 8'%x 11 inches in size. Plan must County St. Croix include,but not limited to:vertical and horizontal reference point(BM),direction and percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D. / �? O�� Please prin Rev ed Date Personal information you provide may be ed for CGE4k4C.E)Law,s. 5.04(1)(m)). Property Owner Property Location ROSAMJI, L.L..0 MAY 1 1 Povt.Lot na SE 1/4 NE 19 S 25 T 29 N R 19 W Property Owner's Mailing Address of# Block# Subd.Name or CSM# 2141 Cty Rd. C ST.CROIX COUNTY 30 na Indigo Ponds City State Imp C e IV1GrfitfeE J City J Village ✓J Town Nearest Road New Richmond WI 54017 715-248-7071 Hudson I Highlander Trail t0j New Construction Use: 0 Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement I Public or commercial-Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation,if applicable na General comments and recommendations: system elevation 93.35 ft,trenches spaced and depth to code 5.50 ft below grade Boring# J Boring 01 Pit Ground Surface elev. 98.85 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKt2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-12 10yr3/2 none sil 2msbk mfr gw 1c .5 .8 2 12-37 10yr4/4 none sicl 2msbk mfr gw 2f .4 .6 3 37-50 10yr6/4 fid7.5yr5/6 sicl 2msbk mfr gw na .4 .6 4 50-110 7.5yr4/4 none Ifs om mfr na na .4 .6 a Boring# I Boring ✓f Pit Ground Surface elev. 98.85 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-9 10yr2/1 none sil 2msbk mfr cs 2c LA .8 2 9-33 10yr4/4 none sicl 2msbk mfr gw 1 c .6 3 33-44 7.5yr4/4 none scl 2msbk mfr gw na .6 4 44-60 7.5yr4/4 none Ifs om mfr cs na .4 .6 5 60-120 7.5yr4/6 none cos osg ml na na .7 1.6 /l r� COS<35%coarse fragments=36"& >35%-<60%=60"below system *Effluent#1 =BOD?30<220 mg/L and TSS>30<150 mg/L *Effluent im=ovu5—...—g&and TSS<30 mg/L CST Name(Please Print) Signature: CST Number David J. Steel — 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG,New Richmond,WI 54017 5/3/2003 715-246-5085 Property Owner ROSAMN, L.L.0 Parcel ID# Pending Page 2 of 3 [-3] Boring# Boring 1/ Pit Ground Surface elev. 89.55 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 10yr2/1 none sl 2msbk mfr cs 2c .5 .8 2 6-28 10yr3/4 none sicl 2msbk mfr cs 1c .4 .6 3 28-54 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 54-65 7.5yr4/4 none Ifs om mfr cs na .4 .6 5 65-120 7.5yr4/6 none cos osg ml na na .7 1.6 ❑ 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 PD in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 F—I Boring# I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD 2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST-POWTSM ROSAMR,L.L.C. New Richmond,WI 54017 Lic.#248956 SEl/4,NE1/4,S25,T29N,RI9W Bus.(715)246-6200 Town of Hudson,St.Croix Co. Fax.(715)246-9372 Indigo Ponds Lot 30 This soil evaluation was conducted to satisfy a zoning requirement,it may or may not be suitable for your use. The location of this test may or may not be as shown,as permanent lot lines were not established at the time the soil test was conducted. Legend 1"=40' ♦ =Benchmark Ele. I00.00Ft Top of 1/2"pvc pipe ^J •=Alt Benchmark Ele. 101.20Ft Top of 1/2"pvc pipe ❑=Borings Boring Elevations B1 =98.85Ft B2=98.85Ft B3=89.55Ft B4=00.0017t �o ls.syo sl�p� �o to a3° H �,,L�l;�1G,�,�►� (siIN • my �MOOQWPI .�y .,�► ��'�ev�eii ear AAS�.G �� �' waI�eAM'i 114,'•�:� A��♦ wee , • ams Ar fit► ~ <►�?A����►�t nA�A �e� � Af,.. '�,� POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner AeQ4N } 1. U Es Septic Tank Ca aci ❑NA Permit# Septic Tank Manufacturer ❑NA MaGme DESIGN PARAMETERS Effluent Filter Manufacturer L i MC 0 NA Number of Bedrooms 100 d/bedroom ❑NA Effluent Filter Model i Q 0 NA Number of Commercial Units MA Pump Tank CApacity gal gjNA Estimated flow(average)* b gal/day Pump Tank Manufacturer VJNA Design flow(peak),estimated x 1.5* Q gal/day Pump Manufacturer ANA Soil Application Rate gal/day Pump Model NA Pretreatment Unit A NA Influent/Effluent Quality(NAp) Monthly Average** 0 Sand/Gravel Filter 0 Peat Filter Fats.Oil&Grease(FOG) < 30 mg/L ❑Mechanical Aeration ❑Wetland Biochemical Oxygen Demand(BOD5) <220 mg/L 0 Disinfection 0 Other: Total Suspended Solids(TSS) Manufacturer: Model: <250 Di ersal Cell(s) Pretreated Effluent Quality[3 Monthly Average*** In-ground(gravity) 0 In-ground(pressurized) Biochemical Oxygen Demand(BODs) _< 30 mg/L 0 At-grade ❑Mom Total Suspended Solids(TSS) < 30 mg/L 0 Drip-line L'1 Other: Fecal Coliform(geometric mean) <10 cfu/100ml ❑Leaching Chamber Mandacturer Maximum Effluent Particle Size 1/8 inch diameter Model Q lC 1—Lf Laying Length/Chamber Ll *Wastewater Flow Verification and Calculations: Soil Application Rate , Area Req• OO f (Other than bedroom based) Infiltrative Surface/Cham er-ES1A Rating 2a fl Minimum Number of Chambers ❑Aggregate Desi Flow/Lo Rate= tP min ** Values typical for domestic(non-commercial wastewater Materials:all materials must comply with WI Adm.Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for pretreatedwastewater. and apploval letters. DESIGN CRITERIA ❑ "Wisconsin At-grade Soil Absorption System,Siting,Design&Construction Manual"(Converse et al. 0"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 ❑"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 ❑SBD— 10570—P(R.6/99)"At-Grade Component Manual Using Pressure Distribution" ❑ SBD—10567—P(R.6/99)"In Ground Absorption Component Manual" SBD—10705—P(N.01101)"In Ground Soil Absorption Component Manual"Version 2.0 ❑SBD—10628—P(N.6/99)"Recirculating Sand Filter System Component Manual" ❑SBD—10656—P(N.6199)`Split Bed Recirculating Sand Filter System Component Manual" [3 SBD - 10572 P(86/99)"Mound Component Manual" ❑SBD - 10691=P(N.01/01)"Mound Component Manual"Version 2.0 ❑SBD - 10595—P(8.6/99)"Single Pass Sand Filter Component Manual" 0 SBD - 10657—P(8.6/99)"Drip-line Effluent Disposal Component Manual" ❑SBD - 10573—P(R 6/99)"Pressure Distribution Component Manual" 0 SBD - 10706P(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 Fr uen Inspect condition of s) At least once eve ❑months s 3 Pump out contents of s When combined sludge and scum equals one-third 1/3 of tank volume Inspect ersal cell(s)j At least once every 0 months s 3 Clean effluent filter At least once every ❑months s Inspect controls&alarm At least once ev ❑months ❑ s ❑ NA Fhtsh laterals and pressure test At least once every 0 months ❑ s 0 NA At Ion Qt n"ep pvp.Tv ri months 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 seetage 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. ❑ Valves Valves shall be operated in the following manner: ❑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). ❑Septic Tanks Component Tank inspections Hurst 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. ❑ 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 75%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. REPORT 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 in compliance with Ch.COMM 8333,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. CONTINGENCY PLAN If the POW fails and cannot be repaired the following measures have been,or must be taken,to provide a code compliant replac t 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 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. ❑ 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>> 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 MAINTAINER Name Z FP X Name Phone S-Z 5-51• Z 9 Phone SEPTAGE SERVICING OPERATOR um r LOCAL REGULATORY A ORITY Name A enc U l e &V tl D m Phone Phone 10120%K.WPDATMEMPOWTS OWNER'S MANUAL.doe Page of Installation and Maintenance Instructions Installation Step 1 Dry fit the filter case onto the outlet pipe going to the drain field.Ensure it is centered directly 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 filter 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 covere4 under this warranty.improper care or malfunctions resulting from product not being installed,operated or maintained properlywUl void this warranty.Lifetime filter assumes no responsibility for labor charges,removal charges,installation or other incidental or consequential costs. I ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ow►ntyer Aaron and Karol Danielson Mailing AddreuZ Fc-,-oc�j5 4-,en k4rd5arj ^ ar Prop"Address 906 Highlander Trail (Veal$cation required from Planning A<Zoning Department:for new construction) city/state Hudson WI ' Parcel Identification Number 020-1439-30-000 LEGAL DESCRIPTION Property Location 5 6 y,M t V4,Sec. T 2:.�N R 19 W,Town of Subdivisionplat.lndigo Ponds ,Lot# 30 Certified Survey Map(0 n .Volume. .Page 0 Warranty Deed# - I S?SL(0 (belbre 2007)Volume ,Page 0 Spec house Ely"cj� Lot des idenliflablet 0100 SYSTEM HAZNTENANCE AND OWNER CERTIFICA M Improper we and maiatenance of your septic system could result is its premature Wars to handle-wales. Proper mehileuance consists of pumping out the septic tank every three years or sooner,if needed,by a bcawed pumper. Wbat you put into rho system can affect On function of de septic tank as a treatment stage In the wake disposal system. Owner maintenance, responsibilities are specified in f SPS.38332(1)and in Chapter 12.St.Coin County Sanitary Ordinance. nee. The property owner agrees to submit So St.Crok County Planning&Zoning Departnent a cwrtiflcation torn,sipw by the owner anti by a master plumber,journeyman plumber,restricted phnmbex or a used pump r ve: g that(1)the oo-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pub(if necessary),the septic tank is less&an I/3 full of sludge. V&tie undersigned have read the above requirements and agree to maintain the privak sewage disposal system with the standards act forth,heroin,as set by the Department of Safety And Professional Services and the Department of Naaual Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be conTlskd and returned to as St.Croix County Planning At Zoning Department within 38 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe sm4re the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Xumbe of bedrooms 4 SIGNATURE OF APPLICANTS) DATE ***Any information that is misrepresented may result in the sanitary permit bring revoked by the Planning do Zoning Department.•'« hwhule with this application a recorded warranty deed from the Register of Deals Office and a copy of tine certified survey map if reference k made in the warranty deed. MEV."q2) f $ �x54041372 4 STATE BAR OF WISCONSIN FORM 1 -2000 955407 BETH PABST Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between Rosamji, LLC, a Wisconsin Limited Liability 04/30/2012 4.15 PM Company, Grantor, and Aaron Danielson and Karol Afdahl-Danielson, EXEMPT#: NA husband and wife as survivorship marital property,Grantee. REC FEE: 30.00 Grantor, for a valuable consideration, conveys to Grantee the following TRANS FEE: 202.50 described real estate in St. Croix County, State of Wisconsin (the PAGES• 1 "Property"): Lot 30, Plat of Indigo Ponds, Town of Hudson, St. Croix County, Wisconsin. Recording Area Natne and Return Address: Land Title,Inc. 2200 West County Road C,#2205 Roseville,MN 55113 LTI#375398 Together with all appurtenant rights,title and interests. 020-1439-30-000 Parcel Identification Number(PIN) This is not homestead property. Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements,Restrictions,Reservations and Rights Of Way of record. Dated this 24th day of April,2012. Ros nji, LLC *Sandra M.Gelirke, President AUTHENTICATION ELSO)v ACKNOWLEDGMENT Signature(s) 0V STATE OF WISCONSIN ) T. CROIX COUNTY. )ss. authenticated this 24th day of April,2012 Y 2 /o V •2 Personally came before me this 24th day of April,2012 the .,0 ove named Sandra M. Gehrke , the President of Rosamji, * v V •yV LC, a Wisconsi Li iability Company, to me known to be the person(s) 'o exec e foregoing instrument and TITLE: MEMBER STATE BAR OF WISCON •rgTE pF acknowledged th sa (If not, authorized by§ 706.06,Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *Kelly J.Nelson T`l�,tar�r n �hl;- Crag n4t�Jli,,_ n�;n Larry S. iviourttain-Attorney At La�v Nly commission is penman nt. (It t;ot, gate expiration elate: 2200 W County Rd C,#2205, Roseville, MN 55113 4/13/2014 ) (Signaun'es may be autltcnticatcd or acknowledge(l. Both m'e not necessary.) *Nantes of persons signing in any capacity must be typed or printed bcloe-their signahnc 1of1 NVARRAN"I'Y DEED 51 ATE RAR OF WISCONSIN FORNI No. 1-2000 `' /` =:_ate • wM- -w..~ _ "184,406 WL --424-24- ` "�- �. as tat. c• 'ss: / th. qp > $N O r NN , 1 , S•vo .� 3 � ,"`.�• �.. 1 \ � � l'?" p Jr. T659J14• r 31.8r 0oa ki s QU nR WC. -J 14-L I•r-\I I _s.. ��. +�. S00'29'03"w 2616.18' ©lain's Drawing Room 2014 asn� R� ane� b a T E.°1�`3 3 =a oS°onrtu� ' gu � � =no- t � u 9 0 u o?4 a N o F y�og R.O Q 3 2 R _ u Rio I o I A F rn rn 1 � IDC� O 9 } — Z i cc rn _ o n rn rn Fn C) O O nP Q p Z MW Z N C K 0- _ 1 11 0 D 70 rn rn D II rn � o r Z o :I o�A oOz N 00 -n cli Da 70 z � o � z A n N O z I I I I P Rv,orAu roR. lain's Drawing Room. o Aaron & Karol Danielson DQW " m "-§ 906 Highlander Trail,Hudson,WI 54016 ��°' � > A A �ea716B@5 rteslffiQa ©laln's Drawmg Room 2014 g°� avo o2 osau°°� �n o d, v3 tp�T pc A 5 A� a s 3?1 u0 uN Si � ysp vav�g�'g fr11 v o v o D s O z Jill!I II II ii u i rn II rn II _> rl O I Z II (� II ` — II � II - II II i i II � i O RL = II II rL II II = ILI- rn r rn D o 00 —n 00 u 7 Q 0 G> O c A N O z N � o o Rt OE/ICr FOR: O 'p' O � � ��� � lain's Drawing Room. o Aaron & Karol Danielson DM 6q 4iTNG 906 pighlander Trail,pudson,W154016 A P A ©lain'5 Drawing Room 20 14 o6a�=3� 38,_0., o� n Quo Na F g�-0. 5--0. n a - o ° -2 _ 2 R.O.3'-0"x 5'-0"(2) 0, p p Q n s v�f R.O.3'-O"x 4'-0" n 2-2x 10 R.O.6'-O'x 6'-I I O OO p u u N 3 2-2x10 TOP Q G'-l0 1/2" --- 2-9 I/2'LVL N c N o Gh5 ELSE C50Y3040 2-555H30�� GPDGOGI I 'g r ------- --- --- ----- -- --- -- ----- °E 5:gmi'3�o 4n O nP0E�9, I — I '� r-------- 0' I ,.-WQB MU.LL-------_L------- oA3�F"Na� I rI - I � -- I I I I w �92FO.0 R I NNN O F 1 A' O I I I lmoa BOO I I 1nz� S� 1 FN I Iw z I o F J � FLOOR TRUSSES I y n 1 � E 19.2•o.C. 74a0111N.> ?. L— o NwN c J Irn Nz F o L__ J Fa � ' 0 z o z I ?' b 4 I P p 4 I r g I I U------J w I F � n,rn I r 1 y-o r ———— i g Z I Ini Aol I I I 4 O I I c I I� y I IUiOFI I rn rn G o = I I--- ---1 1 r --1 m Z m Irn I 11 m I Q n Z 4 I L_____J L_ _________ L---____- L__N_____________� T C - I p1F II _ rno I z 0 I I I I = I I I I I I 1 I I I I I I I I I I I I I I I I 1 I c I I n '0 z °- 4 o n ° rn �F I I a I I I I I ii II II z Q0 I O 'il I I mo o� I I I I O L-------)----------------------------i y I " I I -- — ---- O ^ 00 n V, O 26-0' —1 Z A N 7O Z Z s C.,+ o' Rr/1DrJiCGroR: lain's Drawing Room.. fQ Aaron & Karol Danielson MW o m o ? 906 Highlander Trail,Hudson,WI 54016 4 4 " A A C:BM71MM RB51!)�RW ©laln'5 Drawing Room 2014 Fov-�cn Wn 3 O Q 24'_0" p p b 12'-3' i T^ R p N q-O R.O.3-6"x 6-d'(2) R.O.3'-0'x 4-6 i -2x10 2-2xIO TOP Q 7'-1 1 1/4" TOP®7'-)1 114" TOP @ 7'-1 1 114" Og 2-5H3660 5H3046 3-5H3066 n ns'S 1i:IJ. WOOD.0 F 9_•'�U��_'��uN�u N�3 �_Rc a 0 u u 0 F�° w. -/n 4�x1R? �IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII I I I I I I I I I I I I I I A=_6m R1•�II I°I A_�--rO Nu'o_y Z0 Q* E 18'Fv �m�4' ._f l--MULL ULL / 0 0 MM � 1" WOOD MULL •3 �LOO 19.2 0.1 U87 o C Z o 5'-0'C.O.W/ BARN DOORS' TRUSSE LOR U Z N 8 192O48 NO F — -_- O 2'-8"C.O. -7 J w O w 4 III R45 Q 65' 4_ - DROP _ 70 g y III o ZONE 2'-e'C.O. f N rn ° C3d K =oko _ - I 4 wcp�Ow r rn Fn r w IIIIII I oA Aa�N w o °m 1 p r- O'n o o R III 4 a BENCH W1 Z I\\\ HOOKS ABOVE 2-2.10 P45 p 65" 1 114 < 5H306 z 11 2-zx 1 ....... ............ rn -' — Q: 1 I 4'-9" 3'-6' 6'-3' 4'-5' 2'-d' 2'-7' 7-O" -0' d $m I I A22 I I Som I I y< I I om wp OOO O A O D a og rn Fyrn I I z I ml O O O 2'-0' 28'-0' 38'-0' A n LN i N O z P � o r;o rzvorAcr rOR: O O � � lain's Drawing Room. o Q Aaron & Karol Danielson I� 906 Highlander Trail,Hudson,WI 54016 "71—IM&MLE m B A A A &ertn6B66 RB51ffiQY (Z)lain'5 Drawing Room 2014 W3 4._p., o,_o" -'-ILR 95 G R'R.O.2'-G*.2'-6' R.O.S-OU 4'-0' R.O.2'-6'x 2'-6*(2) 2-2'1 o 2-2x 10 2-2.10 T TOP @ 6'-10 12- OP @ G-10)12* TOP @ G'10 112- AWN2626 5173040 Emp 2-AWN2626 ........... wow 0 10 0 0 0 zc K� C� ICD P N O 5HELVE5 .20 T-1 o��Idl yR w R :E 36' OG LINEN INEN g o Q, C: 0 rn O �o , i E N i. � I K3 z 70 r'n y 0 < F!4 e4 z! zz Z C: AWN2G2G ,3o") TOP @ 6'-10 112- o n TOP I 6'-6- 2 1 o M 2-2x 0 2-2.10 7U R.O. K.O.3--O".5 r II rn < rn r Q Io 19 12 1 71 70 5h 151) T0P 3 @ G-10 112- 0 2-2�10 R.O.3'-G`x 5'-0' ,z-o- 7'-0* 7'-(Y 12'-5' 91-(Y 14'-0" 15'-0• 36-0- U1 0 Rr.,qpcAcr FOR: LA 'op 1 lain's Drawing Room.— o � Aaron & Karol Danielson HARTMAN DBM ti &MAnm 906 Highlander Trail,Hudson,WI 54016