HomeMy WebLinkAbout038-1049-30-050 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT sanitary Permit No: 572833 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: Village X Township Parcel Tax No:
Edin, Clay City A. Star Prairie, Town of 038-1049-30-050
CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No:
cs 11.31.18.208A50
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER .� CAPACITY STATION BS HI FS ELEV.
.v
Septic �ryy-- y i Benchmark
V Z>
Alt. BM �--
Ts a Fou.n 11+' —1-7 /d7 ,
Aeration Bldg.Sewer `7-/6 !,
3 .5
Holding St/Ht Inlet To X43
aZ
TANK SETBACK INFORMATION St/Ht Outlet 5. 3
TANK TO P/L WELL BLDG. FF Vent tj Air Iroake ROAD Dt Inlet
Septic 17—o ' /v_t 7- 7 gQ i Dt Bottom
Dosing Header/Man.
Aeration Dist. Pipe 07r•
/ !�3
Holding Bot.System 7• q I00+
7. 160".
03
INFORMATION Final Grade LOL J �• n 4/
Manufacturer GPM nd St Cover
Model Num t �P
TDH Lift Friction Loss System He TDH Ft
Forcemain Length Dia. Dist.to well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No.Of Trenches PIT DI NSIONS No.Of Pits Inside Dia. Liquid Depth
DIMENSIONS ( � Z —1,(.t i— �_
SETBACK SYSTEM TO �+ P/L BLDG WELL ++ LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type f System: f'�� S �� UNIT Model Nu er: ` /
p N.�leiry d�. �^
DISTRIBUTION SYSTEM AV " a /v
Header/Manifpld Of IDistribution x Hole Size_ Hole Spacing Vent to Air Intake
4 Pipe(s) \` e � e S� ✓\ S
Length Dia Length \ nr Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth o xx Seeded/S dded xx Mulched
Bed/Trench Center -3.I Bed/Trench Edges Topsoil Yes No es No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2:
Location: 2206 127th Street Ne Richmond,WI 54017(SW 1/4 SE 1/4 11 T31NrrR18W) NA Lot 3 (r Parcel No: 11.31.18.208A50
1.)Alt BM Description= - j
2.)Bldg sewer length= 24 5 I
-amount of cover= �t y .76"A ce a GCtlu h� Qb1( 0
Plan revision Required? 0 Yes No
Use other side for additional information. `� J
Date Insepctor's gnature Cart.No.
SBD-6710(R.3197)
PLOT PLAN
PROJECT Clav Edin ADDRESS 220 127th St. New Richmond Wi 54017
SW 1/4 S E 1/4S 11 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST.CROIX
SYSTEM ELEVATION 100.2/99.8' 4' below grade 10/31/14 BEDROOM 3
DATE
CONVENTIONAL X)OC IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Top of 1" steel pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BORkHOLE O WELL *H.R.P. Same as Benchmark
.M. 100' 46' 55 539' Property Line
35'
102'
80' B-3 80
4% Slope
Vents
B-1 -2 104'
2-3' X 66' cells 20'
with>3' spacing
',,ST
r
to
Pro 3
Bedroom
House
kale = 1 /4'1 = 10'
127th St.
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40.
Vent
301' Property Line >6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
4' Long
12" 5.6ft^2/pair of end caps
'qci fc® � }� 3479
Grade at System Elevation
�, County r County
"' /1
Safety and Buildings Division . l r
D ' 201 W.Washington Ave.(,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.)
�p 312 1 Ma sor I ''1 J
oc 7 S72-133
out ►
s�N ry Permit Application State Transacti umber
In accordano *PS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary pemut. 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. 1 m,Stats.
1. Application Information—Please Print All In tion
e
Property Owner's Name Parcel#
033— p --
Property Owner's Mailing Addok Property Location l
V 1 - • Govt.Lot ZoB �✓
City,State ) c Zip Code Phone Number y / Section I
N eJ-</ !V k�pe�
T_��_N; R EbrW 1
geType of Building(check all that apply Lot#
2 Family Dwelling-Number of Bedr Subdivision Name
6k OA �,a Block❑Public/Commercial-Describe Use
❑City of
❑State Owned-Describe Use / CSM Number ❑Village of
2- 6, `'^ / 23~ �, Town of�7r7L r 6 f eJC.i/1. -�
III.Type of Permit: (Check onl one box on line A. Complete line B if applicable)
A. System
New ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain)
B- ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner �n��l •�q,���
IV.T of POWTS S stem/Com onent(Device: Check all that appl, 11 6 LdLle-k— 4 (25
Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil
❑Holding Tank ❑Other Dispersal Component(explain) Pretreatment Device(explain)
V.DisDersaVrre iment Area Information:
Design Flow(gpd) Design Soil Application Rate( Dispersal Area Required(s Dispersal Area o ed( System Elevatio
7� � 6y �- -
VI.Tank Info Capacity in Total #of Manufacturer u ^
Gallons Gallons Units n u o u
U
,Tanks Existin Tanks
New g d °b'
o
P..U M � in ii v ... �
Septic or Holding Tank / X
Dosing Chamber
VII.Responsibility Statement-1,the undersigned,assumoQnsibility for installation of the POWTS shown on the attached plans.
Plumber'3 Name(Print) Plumber' e MP/MPRS Number Business Phone Number
Plumber' Address(Street,City,State,Zip Code)
VIII untv/De artment Use Only
Approved isap Per Fee Date su Issuing tSignature
weer Given Reason or Denial
IX.Condi RVKHMeasons,for D' approval
t S"iEpti�'�ank,effltlant filtmr�n
ditorsal cell--must all be serbl�es P'mailitalnst!
as per management plan provided by'plumbiee•
All s lck r"wrements mint be mait6#Q
as per applicable code/ordintinces.
Attach to complete plans for the system and submit to the County only on paper not less than 8 rr x I1 ioches in size
SBD-6398(R. I1/11)
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
I
Date: 10/31/14
Owner: Clay Edin
Location: SW 1/4 SE 1/4 S11 T31 N,R18 2206 127th St. Star Prairie
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications S t
Signature
License num #226900
PLOT PLAN
PROJECT Clav Edin ADDRESS 220 127th St. New Richmond Wi 54017
SW 1/4 SE 1/4S 11 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST.CROIX
SYSTEM ELEVATION 100.2/99.8' 4' below grade DATE 10/31/14 BEDROOM 3
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
IL BENCHMARK V.R.P. Top of 1" steel pipe ASSUME ELEVATION 100° Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
M.* 100' 46' 55' 539' Property Line
;351
102'
80'
B-3 80'
AL
4% Slope
Vents
104'
B-1 L B-2
2-3' X 66' cells 20'
with>3' spacing
ST
30'
Pro 3
Bedroom
House
Scale _ 1 /4" = 10'
127th St.
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40. AL
Vent
301' Property Line >6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
L
4' o
12" 5.6ft^2/pair of end caps
ng
3 4" Grade at System Elevation
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 104'
Grade Vent
411 3'
X30/34 Septic Tank
,Iven'
5' S' Long 1»
Grade at System Elevation
36" Grade at System Elevation
Spacing 5'
2-3' X66 ' Cells
Same on other end Observation tubeNent
At end of cell
A
16 chambers per cell
B
System elevations:
A-1 00.2'
B 99.8'
r NVIsconsin SOIL EVALUATION REPORT #1588
Department of Commerce in accordance with Comm 85,Wis.Adm.Code Page 1 of 4
Division of Safety and Buildings Schmitt Soil Testing,Inc.
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 poi QM),d' ectio nd
percent slope,scale or dimensions,north arrow,and location a sta to ares d. Parcel I.D. (�
Part of-.038- 9-30-f�6�
Please print all information. Rev
ie By Date
Personal information you provide may be m Z
Property Owner Property Location
Edin,Clay onn,7 Govt.Lot W1/4,S 11,T31 N,R1 8W
Property Owner's Mailing Address ULU U 0 LUUI Lot# Block# Subd.Name o S
2220 127th St 3 CSM i ,�$ 5
City State Zip ZONING OFFICE
WOMKer ❑ City ❑Village ❑ Town Nearest Road
New Richmond WI 5210 1 1 1 1 Star Prairie 127Th St.
❑New Construction Use: ❑ Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD
❑Replacement ❑ Public or commercial-Describe:
Parent material Outwash Sand and Gravel (91 k/���f S `e/� Flood plain elevation,if applicable na ft.
General comments
and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area
1 is 100.65'. Slope of area is 4%. 161/00, C C
Boring# El Boring
❑ Pit Ground surface elev. 104.15 ft. Depth to limiting factor 112+ in. Soil Application 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
1 0-10 10yr3/3 none sl 2fsbk mfr as 2vf .6 1.0
2 10-18 10yr4/4 none grsl 2msbk mfr a ivf .6 1.0
3 18-56 10yr5/4 none vcbcos Osg ml a ---- .7 1.6
4 56-112 10yr5/4 none grcos Osg ml --- ----- .7 1.6
6
147,
❑2 Boring# Boring
❑ Pit Ground surface elev. 104.15 ft. Depth to limiting factor 109+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-11 10yr3/3 crone sl 2fsbk mfr as 1vf .6 1.0
2 11-22 10yr4/6 none vgrsl 2msbk mfr cw 1vf .6 1.0
3 22-52 10yr5/4 none vgrcos Osg ml Cs ----- .7 1.6
4 52-109 10yr5/6 none grcos Osg ml --- ---- .7 1.6
Z.
*Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L "Effluent#2=BODS<_30 mg/L and TSS<30 mg/L
CST Name(Please Print) Signature: CST Number
Thomas J.Schmitt 227429
Address Schmitt Soil Testing,Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond,WI 54017 11/30/2007 715-247-2941
SBD-8330(R.07/00)
Property Owner Edin,Clay Parcel ID# Part of:038-1049-30-000 Page 2 of 4
3 Boring# ❑ ring
❑ P8 Ground surface elev. 102.25 ft. Depth to limiting factor 110+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. `Eff#1 •Eff#2
1 0-9 10yr3/3 none grsl 2fsbk mfr as 2vf .6 1.0
2 9-85 10yr5/4 none vgrCos Osg ml Cs ------ .7 1.6
3 85-110 10yr5/4 none grCos Osg ml — ---- .7 1.6
El Boring
F-1 Boring# Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
F-1 Boring# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistencei Boundary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2
Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L 'Effluent#2=BODS<30 mg/L and TSS<30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330(It07/00) Schmitt Sal Testing,Inc.
Page 3 of 4
Conducted by: Conducted For:
Schmitt Soil Testing Inc. Name: Clay Edin
Thomas J. Schmitt, CST 227429 Address: 2220 127th St.
1595 72nd St. City, State, Zip: New Richmond, Wl 54017
New Richmond, WI. 54017
Phone: 715-247-2941 Subd.Name: CSM Pending
sigmture "ffLf a t-u , Lot No.: 3
Date // oo Legal Description: SWl/4 SEl/4 S 1 T3 IN RI 8W
■ Backhoe pit Township, County: Star Prairie, St Croix County
A Bench Mark El. 1 00.00' Top of 1" Steel lot corner pipe,NW lot corner
0 Alternate Bench Mark El.102.25'top of 1" steel lot corner pipe,NE lot corner
Slope= 4%
Scale 1" =40' C//6
3S�
r
�a
w
Parcel #: 038-1049-30-050 04/10/2014 PAGE E 1 PM
1 OF 1
Alt. Parcel M 11.31.18.208A-50 038-TOWN OF STAR PRAIRIE
Current O ST. CROIX COUNTY,WISCONSIN
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units
12/02/2008 00 0
Tax Address: Owner(s)' O=Current Owner, C=Current Co-Owner
0-EDIN, CLAY A
CLAY A EDIN
2220 127TH ST
NEW RICHMOND WI 54017
Property Address(es): *=Primary
*2206 127TH ST
Districts: SC=School SP=Special
Type Dist# Description
SC 3962 SCH DIST NEW RICHMOND
SP 1700 WITC Notes:
Legal Description: Acres: 3.730
SEC 11 T31 N R18W PT SW SE CSM 23-5592
LOT 3(3.73 AC) Parcel History:
Date Doc# Vol/Page Type
12/02/2008 884932 23/5592 CSM
10/23/1995 535262 1145/298 QC
03/02/1988 434916 804/249 WD
01/13/1988 433686 801/49 QC
more...
Plat: *=Primary Tract: (S-T-R 40%16o'/4) Block/Condo Bldg:
*5592-CSM 23-5592 038-2008 11-31N-18W SW SE LOT 03
2014 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 09/13/2011
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 3.730 7,100 0 7,100 NO
Totals for 2014:
General Property 3.730 7,100 0 7,100
Woodland 0.000 0 0
Totals for 2013:
General Property 3.730 7,100 0 7,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch#:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Tank Manufacturer: C(,( ,� ❑ NA
Permit# 8 Septic ❑ Dose ❑ Holding Volume: / (gal)
Tank Manufacturer: A
DESIGN PARAMETERS
Number of Bedrooms: ❑ NA [3 Septic C3 Dose [I Holding
Volume: (gal)
Number of Public Facility Units: NA Vertical Distance Tank Bottom(s)to Service Pad-
Horizontal Distance Tank(s)to Service Pad: A " 14 (ft)
Specific servicing mechanics must be provided if vertical is>15 feet or
Design(peak)Flow=(estimated x 1.5): ��'� (gal/day) If horizontal is>15o feet. Specifc Instructions to be provided on back.
In Situ Soil Application Rate: . '7 (galidaye) Effluent Filter Manufacturer: � 2 ❑ NA
Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model:
Fats,Oil&Grease (FOG) s30 mg/L Pump Manufacturer: A
Biochemical Oxygen Demand (BODs) s220 mg/L ❑ NA Pump Model:
Total Suspended Solids(TSS) s150 mgfL
High Strength Influent/Effluent Monthly average Pretreatment Unit
(FOG) >30 mg/L I Manufacturer.
(BODs) >220 mg/L /�1-- Cl Mechanical Aeration ❑Peat Filter
rr SS) >150 mg/L Wetland
❑Disinfection ❑
Pretreated Effluent Monthly average ❑Sand/Gravel Filter ❑Other.
(BODs) s30 mg/L ` �, Soil Absorption System
(TSS) s30 S10 + ` In-Ground(gravity) ❑In-Ground(pressure) [) NA
Fecal Coliform(geometric mean) s10 ❑ Grade ❑Mound
Maximum Effluent Particle Size '�in dia. ❑ NA ❑Drip-Line 0 Other:
Other: 2fNA Other: NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) hen combined sludge and scum equals one-third(X)of tank volume
❑When the high water alarm is activated
[4 month(s) (Maximum 3 years) ❑ NA
Inspect condition Etank(s) At least once every: ears)
❑month(s) Maximum 3 years) ❑ NA
Inspect dispersal At least once every: ears) (
months) 0 NA
Clean effluent filter At least once every: ar(s)
❑month(s) ❑ NA
Inspect pump,pump controls&alarm At least once every: ❑year(s)
Flush laterals and pressure test At least once every:. ❑month(s) ❑ NA
� ❑years)
Other: At least once every: ❑month(s) NA
❑years)
Other: NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper).
Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil
absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent
on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any treatment tank equals one-third (%)or more of the tank volume,the entire
contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code:
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units.
and•any servicing at intervals of<_12 months,shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event.
GMW-005(02/05)
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior to use.
Pump tanks may fill above normal highwater levels prior to startup or due to pump failures, Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be--discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the
area within 15 feet down slope of any mound or at-grade sal absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment
tanks and sal absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump)discharge,fruit and vegetable peelings, gasoline, greases, herbicides, meat
scraps,medications,oils,painting products,pesticides,sani4ry napkins,solvents,tampons,'and water softener brine discharge.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is property
and safely abandoned in compliance with s. Comm 83.33,Wisconsin Administrative Code`.
• All piping to tanks,pits and other sal absorption systems shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator(pumper).
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A guitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in
effect at the time of their permit issuance.
❑ A suitable replacement area is not available due to setback and/or sal limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology,a holding tank may be installed as a last resort.
• The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a
last resort to replace the failed POWTS.
• Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE
�r
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER.
Name i Name cC/lcCt� l7jl /,
Phone s 6 Phone
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTH RITY
Name 701-111. Name /O%
Phone qJ ` Phone
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f)and 83.54(l),(2)&(3),Wisconsin Administrative Code.
; E INSTRUCTIONS
FILTER CARTRI
TM
Installation
STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is
centered under the access opening. If not, th n either
onto the outlet the
tank through the outlet or solvent weld (glue)
pipe.
STEP 2 While the case is still dry fitted on the outlet pipe, measure the length
of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the
optional supplemental side support. If side support method is not utilized,
proceed to step four.
STEP 3 For installations utilizing the optional supplemental side support:
solvent weld the 314-inch pipe onto the filter case. If side support method is not
utilized, proceed to step four.
STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter
cartridge into the case, pressing down until the filter locks into the bottom of .
the case.
STEP 5 If a VRS switch is utilized- insert into the filter and lock by turning
clockwise 901,
Maintenance
1, The effluent filter should be cleaned every time the septic tank is
serviced.
2. Open the outlet access opening to inspect the tank and filter. ,
3. Pump the septic tank completely, making sure to remove the sludge
layer on the bottom of the tank and not just the scum and effluent.
4. Once the effluent level has been lowered below the invert of the
outlet pipe, firmly pull up on the filter handle to dislodge the
cartridge from the case. =
S. Slide the cartridge up and out of the case for cleaning. =
6. If a VRS switch connected to an alarm is present, the switch ' Yi
should be removed by turning counterclockwise 900 and cleaned
with water only. r
7. While holding the cartridge on its side (large flat surface facing
down) over the access opening, rinse off the cartridge with water
only, making sure all septage material is rinsed back into the tank. {'
8. If VRS switch is utilized, replace by inserting into filter and '. y
turning clockwise 901.
9. Insert the filter cartridge back into the case, pressing down until
the filter locks into the bottom of the case.
10.Replace and secure the access opening on the tank.
BEAR ONSITET"FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY .-rvr,•�a'SY:p`c f` '�
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BEAR ONSITE filter case-Lifetime Limited Warranty
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ST. CROKX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
� ..^,^'
`',,/.ERSz/IrCER1UICA1lCN FORM
Mailing Address
Property Address A 4D
(Verification required frorn Planning&Zoning Depa I rlel�constrllction)
City/State —------ Parcel Identificatim Nuriber t'193
LEGAL DESCRIPTION
f'ropedyI.noaUnr`!� >{ `^� E V4 , 8eo , T N lY, Iovvun|
. -
SDhdiviolozl ~~~~~~~~
Lot
Certified Survey Map #
Warranty Deed # 53 ~5 z— 6
----�-----
Voiuuzc Page#_�r~� /\
Spa.,ho b|entifiub}nG no
SYSTEM MAINTENANCE ANJ) OWNER CERT1171CATION
Improper use and maintenance of your septic system could result inits p—r-xzmt^xr*failure h~handle wastes. Proper of puopioAontthexcpdzmmk*vezythonoynmumvr^»mner » 000«eu »Yubcno:»dynopor. Vbntyou put into
the system can uffieot the bzoctiouof the septic tank us a treatment utagoiuthenms/e6i«y»»eJ»y»tem Owner maintenance
«dbu@C000 8].i2(1)ux/mCuuptm lu-xt. 'rvix( puzdy8uzitryOzdinau;o ooxP»»odbilidoo�nopnci�
o�oo�
The pn����'owner agrees to submit tvScC,oix County 9luuoio�^�Z*n n8Doparuuoox��nr��uu(�uo�nu� i dh
�ao��uamnyazuua�rymo�»e�jnucnnyoumplood,e�n:a�`cocdpiqu/6oruru600xmndpuopnzvrr�dn&&at(1)�e o�»8uc by the
]om ^°"=/ msyouul�w�zuxouuprupezopera�ogoou6idnoaud/or(2)u6zz�xpoo�inuaudyo- `^~(�fuu�«»»a�y) zu�u�nn
ozuou 1/3 fuVx[oludgo. "e"*y 'mn oopbctuo��x
4 "l/ve,the undersigned have read the above requirements and ug»cotouaiu`mio&oprinu vox» uur disposal
system with d/o xmouard «*zz»rtu^u^rnbn,n^«^t by the Department nf-Cououercn and the Doymrtirmmnf uNatunn1«:s»noos, State«fW»"»«»oiou�od� � �«»mp/e{«`|»oJrv«uzed/»m«S1 Croix County Planning&C rdfi aUoostudogdu�ynuroopduoyoteu6uu6e»o Zoning Department within 3O day's of the three year expiration date.
�
�
Dwu -' --uD,tate,uoots
on s form are true m the best»f illy/our k u» v]odg«. D*euuvaro the/ wu
ou�^fu o�deed recorded iulogixkzof Deeds OlG mz(u)of the
Property described above, 6yvirtue
3'IGNA
DATE
*-*^Auy information that io misrepresented May result ill tile sanitary Purolit being m�okcd6y the Planning&Zoning Department.
***
Include with this application a recorded warranty deed from the Register ofUoeJe Office and ucnpyof��coz6�odxunny� �/f^`"^"u"n^xumuozomonmonn4/dued.
(REV.08/05)
DOCUMENT No STATF. 13AR OF WISCONSIN FORM J-1 132'.% THIS SPACE RESERVED FOR RECORDING DATA
ctliT CLAIM DEED REGISTER'S OFFICE
_._ _-- S3 CI30fXCa„ill a
Re%:'d for Record 9
---•---•-•--....-- --•---•...............•-- OCT 2 3 I995
I� .............................................-_-_-_.--.----—-——--—-—.—--------------------------------------------
'I •-•--• ...._-•--•-......-_--- ••-----•---•••-•---------- ----- -•---- ......_.....---•---•---• F at 10:00 A.m
quit-claims to ...... ay - .Edin --------------------------------------- -- �I
1
................. •---- ••--_....... -- - . ----........ f�
!! __
! -•,.------- ----••--•--•--- ------ ---- .-----...........-•--------• •---•-. tt
!�ogi�t=r of C+�Acts
if ....--••......................•-------....... •---•--°------•••--•......•.... �o_
st. Croix Conaty, I! f d 9
the following described real estate in _--_-__-._.............................
1e CtrfP nP Wisrnnain• - - � ��?�-�—_-�� ._ ,
n North 740 feet of the South 1.171.7 feet of the ) i�
f� Southwest Quarter of Southeast Quarter (SW 1/4
of SE 1/4) and the Southeast Quarter of Southwest
�{ Quarter (SE 1/4 of the SW 1/4) lying East of the Tax Parcel No: _- ...... ._..................
j
Apple River, i�
(; EXCEPT commencing at the Southeast corner of the Southwest �!
Quarter of the Southeast Quarter (SW 1/4 of SE 1/4) , said F
point being 1322.4 feet West of the Southeast corner of it
{! Section Eleven (1I) ; thence West along the South line of _�-
i said Section Eleven (11) , a distance of 1422.4 feet to an
II iron pipe stake on the East shore of the Applo River; thence
�{ on a meander line along said shore, upstream, North 20°03' ;E
West, a distance of 459.5 feet; thence East parallel to said
Section line, a distance of 1577 . 3 feet to the East line of
'i said Southwest Quarter of Southeast Quarter (SW 1/4 of SE
1/4) ; thence South 00121 ' East with said East line a �!
f distance of 431 .7 feet to f-he point of beginning, INCLUDING
all lands lying between said meander line and the Apple w4
it Rj••c,ar, li
i� South Half of the Southeast Quarter of Southeast Quarter (SE
1/2 of the SE 1/4 of SE 1/4) . +
ALL parcels located in Section Eleven (11) , Township �!
Thirty-one (31) North, Range Eighteen (18) , West.
I� +
This deed is given pursuant to a judgment of divorce granted
Oto the parties on August 29, 1995, St_ Croix County, Case I;
No. 95 FA 12. +�
!! This ....._.._..1 _____________ homestead property. is
• Dated this .. V.'�. day -Sepf-r~irtL'e•i ...., 19__.......
i .-�� Y of 95 I
J .
----------------_-..... ---•—--- - ----•--•------.......-..__.....(SEAL) ......................
.................(SEAL)
l WENDY K. EDIN
5' " ..................................._. ........ is
i
....._......... ---•. ..............................................(SEAL) ...........................................................(SEAL) ii
« «
it �I
AUTHENTICATION ACKNOW LI;DGTABNT
y Signature(s) dy 1..
.......... .................. STATE OF WISCONSIN
ss.
.... ... ST. C ROI x f
--------------------------------------County.
authenticated this).'_�_r�rlawyof..-.•....... --'-.--..__.... 19./ Wend Personally me t9hs ----•-.•-.---e named
d
1 .��`'e.1./. - �'!�^`i Q_••---•--- --------••----.. 19...__.._ the above named
......••
t!!1 ... �fi?'L� ........................-.-.----------- ..------------. --°......-_..._
TITLE: MEMBER STATE BAR WISCONSIN ......
(If not. .. .................... .............. . ..—........ ...._. ------.........._.................... ------.... ------................_
author;zed by $ 700.06, Wis. Stats.)
to me known to be the person ............ who executed the
foregoing instrument and acknowledge the same.
THIS I^ISTRUNIENT WAS DRAFTED BY
REMINGTON LAW OFFICES ...... ... .... ............... .. ........... -• •.
JA: ies..,1' Remingt-an--•--------------•-•--..... «
New_-Richmond,__WI- 54017 St. Croix countt•, wis.
Notary , „hti —
(Sianatures Tiny he authenticated or aeknoc,ledtred. Both My Commission is permanent.017 not, state expiration
are not necessary.)
date: .. --- -- 19---------
QUIT CLATM DEED STATE 14AII ov wlilfn\civ u:�.c••n"...n T.-anl files nk �"n. Ins.
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• �' G REGISTER OF DEEDS
ST. CROIX CO., III
RECEIVED FOR RECORD
12/02/2005 10:OOAM
CERTIFIED SURVEY MAP
VOL: 23 PAGE: 5592
ST'CROIXCOUNTY REC FEE: 13.00
-a Sp9� Ro CORD COPY FEE: 3.00
% 10 -4 u 8 36�-`\ t q� PAGES: 2
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