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HomeMy WebLinkAbout040-1174-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 572856 0 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: Sullivan, Steve Troy, Town of 040-1174-30-000 CST BM Elev: Insp. BM Elev: BM Descron: Section/Town/Range/Map No: 5,11 24.28.20.669 TANK INFORMATION ELEVATIQAI DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark C a 3 cy Dosing 7 Z, S Alt. BM I.V Ae;a l9n Bldg. Sewer HFolding -7. ~ (0`73 • St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L W L BLDG. Vent t Air Intake ROAD Dt Inlet Septic Dt Bottom /Z. 5 Z S ~ ~ 1 7~ l0 81 S Dosing H der/Man. e re.14 v-0 Aeration Dist. Pipe 7 1706,35 Holding Bot. System `1. 75 7 OS • 33 9~`I -o 3 ,iV PUMP/SIPHON INFORMATION 33 0~ Final Grad e/h 3 . 7a / 9 Manufacturer Demand V~ ~ St Cover GPM t ~ F.~•. 2S 6b Model Number ~ J~.'}. oJ~ S (6609B'. 3 TDH Lift Friction Loss System Head )I- TDH 1 141 /117 1 A) I Forcemain Length I D. Z i Dist. to Well /OS Z 15 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches a J PIT DIMENSIONS No. Of Pits kInsidejDia. Liquid Depth DIMENSIONS '7dl INFSETBACK ORMATION SYSTEM TO Q P/L BLDG WELL LAKE/STREAM LEACHING uft Type Of System: n CHAMBER OR G,6A%GO /I Z~ 57 7/UNIT elNum er: DISTRIBUTION SYSTEM bWV~e( •G/ 4 u Z 3g lv s Header/Manifold Distribution x Hole Size rle Spacing Vey to Air Intake Pipes .J Length / 6 Dia Length \ Dia` Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded ,i as0 a Muic ed Bed/Trench Center r Bed/Trench Edges ` Topsoil Yes [E] Nob es [ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection Inspection #2: Location: 284 Cove Rd. Rber Falls, WI 54022 (NE 1/4 NW 1/4 24 T 8N/ R20 St. Cr Cove Lot 12 Par el o: 24.28.20.669 1.) Alt BM Description lot SQ LJ ate`, 2.) Bldg sewer length = / t - amount of cover = i t Asap f 100 /,A 314 a ~ ~ C t tis G~G~ I b ~ Plan revision Required? Yes No Use other side for additional information. Z3 C J SBD-6710 (R.3/97) y Date Insepcto s Signa Cert. No. ~Vwv~e.~ ~<<` ~a•n.~ pa~ 6~~ ~L aw1~L alcJt 6aF,~4oei ~gAp7Afp~•o County Safety and Buildings Division St. Croix (=f:'" 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) D, Madiso 1 Kn2-7-IR2 f r' ~ ~ 2~ 5~ g S (o ary Permit Application State Transaction Number In accordance with .21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Na is required prior toYobtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing ) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 1 rn Stam Same 1. Application Information - Please Print All Information # n ' ,ue- t Property Owner's Nagle Parcel # Steve Sullivan 040-1174-30-000 Property Owner's Mailm* Address Property Location 284 Cove e ' Govt Lot I City, State Zip Code Phone Number ''/a, _ '/4, Section 24 (circle one) Hudson, WI 54016 763 300-5305 T 28 N; R 20 E or W H. Type of Building (check all that apply) Lot # r3zz I / Subdivision Name El I or 2 Family Dwelling -Number of Bedrooms Ae P lat of St. Croix Cove `4f„e„h~e Block # ❑ Public/Commercial - Describe Use Na ❑ City of d -Describe Use CSM Number ❑ Village of State Na ❑ Town of Troy Z G ~,,J 17 III. Type of Permit: (Check only ne bog on line A. Complete line B if applicable) A. ❑ New System >Kieplacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. 11 Permit Renewal 11 Permit Revision 11 Change of Plumber F00WPr ermit Transfer to New List Previous Permit Number and Date Issued Before Expiration er IV. Type of POWTS System/Component/Device: (Check all that apply) eJ XNon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ZTif er T,,persal Componen plain) ❑ Pretreatment Device (explain) V. Dis rsaVI'r ment Area Informatio : 38 fil r" Plus" Standard chain & 4 end caps, S Tech & Pol Lok PL-525 effluent filt Design Flow (gpd} Design Soil Application d Dispersal Area Required (sf) Dis al Area Proposed 40 System Elevation 450 Gpd 0.60 Gpd/Sq. Ft. 750.00 sq. I. 60 Sq. Ft, - .4 705.0' & 707.0' VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units °o _ New Tanks Existing Tanks r t+' U va w C7 p» Septic or Hokling rank 1,010 Na 1,010 1 eser Concrete X Dosing chamlkr 608 608 1 Combo. W/ Super screen X VII. Responsibility Statement- I, the undo red, ass~me responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP/MPRS Number Business Phone Number James K. Thom son orb - MPRS 30021 715) 248-7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulson Lake Lane, Osceola, WI 54020 VIII our /De artment Use Only Permit Fee Date suedature Approved ~ ~ Ok~i $ pa /Iss en Reason ial ~ UL CondWWgKj/ yWWR1Jtp dons for Disapproval 1. Septic tank, effl**,fifter and, v6 ~t~tJ'~5 6 dispersal cell nvdall be services / malritaly.*d Pf nn , as per rnanagem it plan provided ,by plumber. t e r✓~ w 2. All sefltack requi'i ants must bw;MaiMa# e.d ,L R ) 6 1 L 6,46~e., as per applicobt~ebde / orditla =s. 4 G Attack to complete plans for the system and submit to Xtheavity, orally on paper not leas than 81/2 z 11 inches in r S13D-6398 (R 11/11) ~r SOiI e!/Q IG R E i pn tjk- EXiSf; nq e 11 c'a 'zb~z s~p,►n0xi..ca~ /oc¢•Er•097 ffu.d.SCJrl, rc~/. Ss~o/6 Ez:sb-}~/~ sep,E,•~•~••+~' ~o✓~/otl ~/l~~ne~%c~5ec1-~! Ta bQULSwreJeytea, t•ZDCf7, /~it.o~%~~yr I ~ a s ~ Co d6 • S.~_ e/'O i Jc ~'tI y u.~/. -Y 11741- 30 0,S;"o /cd ,Z!Y y I I _ I I Qifi t-nGC. I Llllt~%m Of ',4.:E,7-,4- ~ ~ Srd;i, ab~u~e.bu;rd;H G9SO - Sc~ E/et/ = ~y5. y -7'n SL,/Sea/ bu.IC4- d 44 well y .9E.~ EX~s~~q EX Proposed d:5pusa/ce/% 7-Loo(t) vr, v{~~✓~~ ~t'e.,-IC,1.0,52t 3'X79'w//su©-~{" S; i/'oni^e~aa~• /t~-'a-fin'' e-~.am bs.~d /tl"esx~. Lr/e~l . 1097. SG,~ rte E'v{ Ce ZleP'' 6o be = -70S.6 '-t 707.o 8 2 yn5u/Sea ce a- . \ ~9, C•~ e-Aee: o., aJ,,~(f E/eJ2~,'vn,5 Xesu ean~rcfe CYd:ncY,. 1080.E d;st!(ba~:a+, b°X- t`~O! vt o { 5r n lv9s 7'S r (,~pio~~'/ov~dce~~¢1,/csl.o/a1 G46.89r Gtd. ~G ~r./RC. 109soo Bot>~o•,, oFST./lie. : G89Sp, r~,dc~ of d,s~•bgr;n/ 7118•c)o ~~~/Fi«.~ivC Sc.-FueeT-1 ~ 705' • fin'/tia~i~C Scarce T-Z : 707. dd ir1co,~ Conventional POWTS Index & Tilte Sheet Project Name: Sullivan 3 Bedroom Replacement Conventional POWTS Owners Name: Steven F. Sullivan Owner's adress: 284 Cove Rd., Hudson, WI 54016 Site address: Same Project Location: Subdivision: Na Legal Description: Gov't lot 1, Sec. 24, T.28N., R. 20W., Tn of Troy, St. Croix Co., WI. Parcel ID 040-1174-30-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Dispersal Cell Sizing & Pump Chamber Calcualtions Page 4 System Cross Section Page 5 Septic/Pump Tank Cross Section Page 6 Pump Curve Page 7 PolyLok PL-525 Effluent Filter Specifications Page 8 SymTech STF-IOOA Effluent Filter Specifications Page 9 Disstribution Box Cross section Page 10 Infiltrator Quick4 Standard Chamber Cross section Page 11 System Management Plan Page 12 Septic Tank Maintenance Agreement Page 13 Parcel map Page 14 Waranty Deed Attachments: Soil Evaluation Report Mater Pl r Restricted Service: James K. Thompson, Dept. of SPS Credential #30021 Signature: S-- Date: Opt Page 1 Of 14 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01101) A.C.E. Soff & Site Evaluations Amalicant: Steven F. Sullivan 284 Cove Road Hudson, WI 54016 Agent: James V. Thompson 340 Paulson Lake Lane Osceola, WI 54020 Permit Request: Land Use Permit - Filing & Grading, <10,000 sq. ft. outside Slope Preservation Zone within the Lower St. Croix Riverway District as required by §17.36 F.2a.2 Pr_ oiect Description The site is located 122 Black Bass Rd., Gov't, lot 1, Sec. 25, T.28N., R.20W., Town of Troy, St. Croix County, WI., identified by the St. Croix County Real Property Listers Office as parcel #040-1162-70-000. The parcel is located on the St. Croix River. The proposed project includes the replacement and abandoned of an existing hydraulically failed POWTS septic tank/drywell. Abandonment will be accomplished by removing all liquid waste and filling with compacted sand fill. A connection will be made to the existing building sewer at approximately 11Zbelow grade and will be extended from the southeast side of the house within a trench at V wide and 7/2deep. Total trench length will be approximately 25. A 1,000/600 gallon combination septic/pump tank will be installed requiring an excavation of approximately 7 wide, 12 long and 7 deep. The forcemain trench will then be extended approximately I W uphill to the beginning of the in ground dispersal cell. The dispersal cell will consist of two(2) trenches at Y wide x 79% long spaced at 9 on center and installed at VIbelow existing grade. The total disturbed area of 1T wide x 79 long, or approximately 1,950 square feet, falls within the requirements of the St. Croix County Lower St. Croix Riverway Zoning Ordinance, Chapter 17.36 F.2a.2. The proposed POWTS location is approximately 150? upslope of the established floodplain elevation. Slopes within the proposed project area range from 15% - 24%. There are no drainage ravines nor wetlands present on the site. The proposed areas of disturbance will be stripped of topsoil immediately prior to construction of the POWTS. Topsoil will be stockpiled adjacent to the system area. Excavations for material installation will be completed immediately prior to, and will be closed immediately after installation of materials. Topsoil will be replaced within 4 hours of completion of installation. Re-vegetation will consist of spreading grass seed and Erosion control mats across all areas of disturbance upon completion of project. Erosion control mats will be installed over all disturbed areas to minimize erosion potential. Class I, urban Type A approved Erosion Control Revegetative Mats (ECRM) will be installed as per manufacturer recommendations. Matting will meet will comply with ASTM D6460-07 and the minimum product Cover Management (C) Factors from the Revised Universal Soil Loss Equation (RUSLE) of the USDA-ARS Agricultural handbook 703. Four trees of approximately 81-10'diameter will be removed to accommodate the installation. The remainder of the site will remain heavily wooded and brushy. 0" t~ 5~l✓~, ~~~//,vim ~o~~. ~by/ ~ndc '2d. s~piaxiM~ f{ccdsan, SSA/(o E>4sE.~j s c fi+t' ~o✓'~/otl ~dEyt/J~r~%~See Zs! 41 f ` - - _ To be(Lt b a IIII-.7 7'?6~•, e.7 o CA), '14.1 F T oy, Pc%lyos/o- f/7V-30-coo ' 64e4%?q 0.soa creel z~~y dew ~ erX=s~- i-~c ~ &t{s~m o{ ?✓~su/sec/ bu:/c%„ ~ v~~ EJed. ¢ G95.7~ S~w•~. 4 o J fF IS~i 0 Wei( ~ Ex's~~J EX.s 3 9°r"~ Asa P~oposodd-Sp~ c/cel/. Two(tJ Z7 oiK: T,~ooF e+~oL. s at 3'X 79'w/if "p-~f " Sz' iron rely ,~N /frn-Lv+'- e.la,m bs.-~s /tr'a.x,L• SM-1,V-6,n 've Sur~ee eft via ~'/e~_ loJ1 SG, bo be = 9oS.0'4 707o ; 82 Z'nsa/sue Cc Ma;n. \ . V06 a.., arPZ,.. d,,rVe may. EJa✓. = 7//.~S' ' ~rese~ edtiucte and;.may cJo-Cv~P,f.. e 6.8o0 d;stwbaCzGn box- ~~crod ~ /a'•., ~ ~9.~. o' X of~orw o~5'al:h = G9S75' 4PJ~`~ F/ao~ dee~~tl ics4 o/d : 4-96.89' Gad . a•L ST./P. C. `95 00 ' BottLo.,~ o-0, S-rM.'.. 68p50' Z-„ dcrE c e, d, sE. boar: n /,14 . 708. o0 ~•r/Fro.Eivr Sc.rFaccT-I 705.66' ~n ~'/~~a~r vl Sw,~ c C T-Z : 707. dr1 ' ~S.~or /5J Sullivan 3 bedroom Dose Conventional Sizing Calculations Dispersal Cell Calculations 1. (3bedroomsx100 gallons estimated flowxl.5 design factor) = 450.00 M design flow 2. Infiltrative capacity of native soil = 0.6 gpd/sq. ft. 3. Absorption area required: 750.00 sq, ft. 4. Absorption area as proposed: 77160 sg ft. (386ambers total,) Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per ,h her, Infiltrator "Quick 4 Plus" end capper pair= 5.80 sq.ft. EISA 750.00 sq. ft. - (2 pair end capsX5:g0) = 73$.4 sq. ft. 73&40 sq. ft./20.00 = 36. ohamQN required ,13 ci , (p Number of trends: 2 19 chambers Pg trench Trench width: 2.83' Trench length: 79,00' Trench spacing: 9.00' on center Total system area w/ 9' center spacing: 12.00'x 79.00' Pump Chamber Calculations 1. Force Main: Diameter 2" Length 115, Flow rate 30.00 gal./min-t Friction loss 2.24' (115')(1.94 ft./100') = 2.231 ft. 2. Total dynamic head: Mim supply pressure 0.00' (forcemain will discharge to distribution box & gravity feed to trenches) Vertical lift 17.50' (P.C. bottom = 689.50',Off float = 690.501, Dist. box invert = 708.00') Friction loss SymTech 0.50' Friction loss .24' / Total dynamic head = 20.24' J 3. Pump selection: Manufacturer & Model number: Zoeller BN 151 Pump will discharge approx. 28.0 gpm @ 20.24' TDH (Flow Velocity 2.86 ft./second) 4. Dose chamber: Wieser WLP 10001600MR Super Screen 3600" a 16,89 gal /inch (608.04 gal actual) Sizing: A) One day holding capacity: 18.00" = 304.02 gal. B) Alarm setting: 2.00" = 33.78 gal. C) Dose volume: 5.00" = 84.45 gal. (450ga1.)(20%) + (.164)(115) =108.86 max. dose D) Reserve storage: 11.00" = 185.79 gal TOTAL 36.00" = 608.04 gal. Pg. 3 of 14 i Soil Absorption System Cross Section 707.E 7i/.'!/ ft k4"iSth chedule 40 Final Grade C Vent Pipe 704.0'd Vent Cap ft Leaching 705.0'O' Chamber 70700 ft System Elevation .Z. ft ft Soil Absorption System Plan View 79 ft a. 0s ft 6 ft 'Vent Or Observation Pipe Leaching Chambers Trench 1 4" Dia. Trench 2 Header Leaching Chamber Specifications 7,SARa rer And Model ~ix,~,cy "©-4l's~4/a✓d/ks Q sq ft per chamber Soil Application Rate O. GO gpd/sq ft w T D. (o Soil Application Rate .20. D EISA = .38 Chambers 2 rows of chambers each. Page P~. yon ~s~ A I V A1~ A v W ~ W w I 2D ~ \ I r I Z j O 1 i 1 00 .D AIW O X Z f W X D N Z (n D r o m O O - - N rl D I i r ~1 Q I I ; I D N m T7 i / Z G-) i ~ i i i v m r j Fa m rn p u c i 0 i w rv Q °W Z + f G! su O p D 0 z --I cie a D m x D r ~ r- ~I II II M 61 O 1T Ln N (7 C) O O II r I- m O p G7 D r 1600 C TRIPLE DRAWN BY: MAW SCALE; I = 1' x WLP1600 TRIPLE MIESER COHCAETE m WIESER CONCRETE 2815 RILEY ROAD PORTAGE, va SJ9D1 DATE: 11 1D O4 REV. DATE: 800-362-7220 FILE: se tfc tanks state drowin s new 1600c triple s~~t~ p~. PUMP PERF0 CE CURVE TOTAL DYNAMIC HEAD/FLOW MODE 51 521153 so PER MINUTE 14 153 EFFLUENT AND DEWATERING 12 MODEL 151 152 153 Q 35 152 Feet Meters Gal. Utters Gat. utem Gal. Liters = 10 5 1.5 L 50 189 69 261 77 291 30- 10 3.0 45 170 61 231 70 265 0 8 25 t5 15 4.6 38 144 53 201 61 231 .20•.Z91+ 9 20 6.1 29 110 44 187 52 197 T~•~ 25 7.6 16 61 34 129 42 159 30 9.1 23 87 33 125 4 15 35 10.7 22 85 40 12.2 11 42 to Shut-off Head: 30tt.(9.tm) 381 L(tt.6m) d4 ft.(73.4m) 2 5 0145088 0 10 20 30 40 50 60 70 60 90 100 1 d 46200 '-de LfIFRS 40 80 0 1 •240 3 ROW PER MINUTE 0145MA Model 151 Models 1521153 f CONSULT FACTORY FOR SPECIAL APPLICATIONS 67132 6114 V18 4518 327132 - 45B • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and 327r32 supplied with an alarm. 3718 4 • Variable level control switches are available for controlling ® 1 $7A ~ 32742 single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130.17. (54'C.) special quotation required. f 11 1 U16 12 U6 151/1521153 Series 151t1521153 YODELS Control selection Yodel Vdts-Ph Mode Am Simplex Duplex re 4 s I 34 N151 115 1 Non 6.0 1 2 or 3 BN151 115 1 Auto 6.0 Included 2 or 3 3~_ E151 230 1 Non 3.2 1 2 or 3 RE151 230 1 Auto 3.2 Included 2 or 3 5x2444 SK2064 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 El 52 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 9153 115 1 Auto 10.5 included 2 or 3 E153 230 1 Non 5.3 1 2or 3 SELECTION GUIDE BE153 30 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float O CAUTION switch. Refer to FM0477. All installation of controls, protection devices and wiring should be done by a qualified 2. See FM0712 for correct model of ElectricalAllernator E-Pak. licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). 3. Variable level control SWltch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 7O: P.O. BOX 16347 Lousvifk, 49 40256-0341 Manufacturers of.. SHIP T0: 3649 Cane Run Road ® Loulsvfae, ICY 40211-1961 r&AL/ry aawff SNZr /9y9, httpJ/www.zoollercom PUMP CO (5~) 7 Ax (502) 774.36&PUMP 0 Copyright 2004 Zoeller Co. All rights reserved. Filters PL-525 EFFLUENT FILTER ) Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters. The PL-525 is rated for over 10,000 GPD Alarm (gallons per day) making it one of accessibility Accepts PVC the largest commercial filters in its t extension handle class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok ' PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1/16" removed for cleaning, the ball will filtration slots Rated for over 10,000 GPD float up and temporarily shut off the system so the effluent won't leave the tank. No other filter on the market can make that claim! Accepts 4" & 6" SCHD. 40 Pipe ~j PL-525 Maintenance: The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before requiring cleaning. It is recom- mended that the filter be cleaned every time the tank is pumped or at least every three years. If the installed filter contains an optional" alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be Gas deflector done by a certified septic tank' Automatic shut-off pumper or installer. ~ ball when filter is removed 1. Locate the outlet of the U.S, Patent No# 6,015,488 septic tank. 5,871,640 W+ 2. Remove tank cover and pump m.,,~.y.,......,. tank if necessary. PL 525 installation: 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary. 5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the tank. Make sure all solids fall 4" or 6" outlet pipe. If the filter is not centered under tre back into septic tank. access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making Sure to center filter. the filter is properly aligned and 4, Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank cover. P5.7 a/"i~ at, SIM/TECH FILTER FILTER Sim/Tech Filter The GAG Sim/Tech Filter is unique to the industry, engineered to provide maximum protection for your sanitary pressure system. The Sim/Tech Filter has been designed as an effluent filtering device to assure small holes in the distribution piping remain unclogged. Pressure s distribution systems are very effective in treating effluent, but only when r holes remain open. Many of these systems only partially fail, causing t' contamination of ground water long before the system shows any visible signs of distress. Placing a filter just before entering the forced main is a simple solution. The filtering device installs by simply screwing onto the discharge port of any effluent pump, thereby filtering out contaminants before they enter the distribution system. Thus, maintaining even distribution of effluent. The GAG Sim/Tech Filter protects any pressurized system including: Sand Filters - Spray Irrigation Systems - Pressurized Chambered Systems Recirculation Sand Filters - Mound Systems elsy .J'ristallat/ori - ,Copt, IlRaiitt.ertanee - Zcoytornlcal - Zxtertds li fie o~ )zai4ield - JYVtpzoves Slceertt qjualittl 6tl assuzirt5 even `~ist.zi6c<tiort -idea( ~o7 filuertt Su6Ynezsi6le ;burnps - tuart 6e used in both Residential artd CornY~tezcial applications Order Model Description List Price STF-100A2 STF-100 GAG Sim/Tech Filter (field assembly) 468.95 The STF-110 has well over 1/2 mile of filtration media with over 319 cubic inches f of open area to eliminate clogging. The 2,215 square inches of filtering surface allow a flow rate of over 1200 GPD, filtering to 1/16 inch diameter. This incredible amount of filtering surface is achieved through the unique shape of each triangular bristle, which more than doubles the filtering surface, with no uniform holes or slots to plug. Order # Model Description List Price STF-110 STF-110 Disposable Septic Tank Filter (yellow bristle) 23.86 6-~ L _ d 1 7155475181 l1E' E_, CONCRETE P"uE 02 4r N 0 O < A w~ z Fri Z / D N ~ O O T O_ C I r \ o o C l o m o C z r ~y W0 6 HOLE DISTRIBUTION BOX ® scue a• i REV RO. DAM \~0 SEPTIC MANUAL DRAWN BY:SMT V WM8 US Nrma. tiu M Roca, " 54750 DATE: JMIUARY 2005 o REV. JAN. 2005 800--325-8456 FtiEc6 HOLE DIS ISU110H Box Pa. 9i~ The Quick41'Standard Chamber The Quick4 Standard Chamber i-s SI I~ t `~i - 12 i IslIB— a gsl - - 34" - 48" (EFFECTIVE LENGTH) MultiPort End Cap F7 _ O 16" - 8. 34' FRONT VIEW SIDE VIEW TOP VIEW Quick4l, Standard Chamber Specifications Size (W x L x H) ........34" x 53" x 12" (86 cm x 135 cm x 31 cm) Louver Height ..............................8" (20 cm) Effective Length ......................................................48" (122 cm) Invert Height 8" (20 cm) INFILTRATOR SYSTEMS. INC. STANDARD LIMITED WARRANTY ,gIlly of each c, bet ~.d other acee>sc y . ,.r, cc In .fral i iI w IMf I Iod _ d op ~ pled In a : 11 ste septic .Y ,G f'voto -l" I in ar .a tod to 0 . nal put - ,o 1'Huldcrl aga sl a id -rkmansh p for one, ,a from t data i~ cc ,I.+ 'nq the Units. < it f sep[ ) ,I s of Ili - 1 .,y { pl ri IY I "f t II' t' ll I rtl I',c~ , ♦ • - e m . c, Toe P c se its waf a y ighls Hod lust I ly M1,11 11 I gal le He d a 3 1 Old a IC t within ( fleet I ( 15) da of the alleged defect. Infiltrator V,111 up aly p arume n U t lot U t doormi,ed by I rfiltrato, I, s re b s Limited Warranty Infiltrators tab Pity specifically e ciud(, Ohs r,Is of mmoval a d/or nstallat on of the Units_ LIMITED 1ARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE THERE ARI NO OTHER WARRANTIES WITH SYSTEMS e~ O THE UNITS. INCLUDING NO IMPLIED WARRA;tIIES OF r`1PR ,PiANTABILIIY OR FITNESS FOR A PARTICULAR PURPOSE ' V :I S fed Vag anry shall be -1 if and I e c+.a„bet system is manufactured by anyone the, flan Inri"tator The Limited Warranty Environmental Onsite Wastewater Solutions'" ices ~I- ar tend to ngidenial, consequential Sr << 3 I, i:ld ect damages. Inf trator sI a`ll no[ be ri le 7r p~n0,I 09 or liquidated damages. 7 o is oft od lion and profls, labor a 1 r t -a o'e head Crisis o other los e' o -p s c seal by the Holder or any third cecfrar excluded from United W„ rrar _y coverage rre damage, to t.. U .ts durc to ordinary wc:u and tear, alk rat on acCdenf 6 Business Park Road • P.O. BOX 768 o se gle t o. the Units, he U ,t b g li,biecl d to 0 cl t Ific or oll c J ldl o .s which are, I f itt. d by the in la ll ition Saybrook, CT c s. to I, O a stain the mum g o na c Veirs(t forth the st atlation t ccY s th pl a n, I 1. ,pe 1 ate a ato the Saybrook, C X6475 r i'a te Units . fa e, or the Un fs or tl c 'e sle , du, to nproper a ,ml cr improp i g_ o-o i c wah,r a 'y„ lnpropa >cosal. or -mope, ope a6on; or ary III(- e,o:,t Irot t"--d by to ,IVator nimd W, , ,ty `I all t. yt, d Ifthe Hride.r taus to 860-577-7000 • FAX 860-577-7001 -e teals set forth n r- Ln -E d Nagar l Fa r , ,o 11" 1 .nap Ilor be spu . ,le to< a y loss of can aye to It I. ,y rhrd pa ,.ul .ng i - n ! -.i ir,hll t of Hold, nsy thin, party. Fur n app;_ e, Uf)ilta t,t.s p st , t . I e 11, apse: l if Ohm 1-800-221- 4436 o... d Jatprs .alai psi n ..I~ i vep nlltr3lcr has fire auiurry U,an ~0 of ez'nd ols L.-.feetA1. ant! N ua ra,l/ f,Ye. od_y party oil- lathe www.infiItratorsystems.com -Is .he Standard L rhtL'd Nm a ,y Jler_d oy bltrato A r o,lefl r moP 'I'll ca _ tUO hli- diffonnnl warranty -~ls 4,-y p.robaser o L,,, ,!s should c it ,a.;t I',fii:.ratcr' s Corporate Heat gJah C cok prior .o such pal ase. coo, of the applicable warranty. anti should cam'Jly read that r aft!, I, I iho purr hale of Units_ For technical assistance, installation instructions or customer service, call Infiltrator Systems at 1-800-221-4436. i U_S patents 4,759,661, 5,017,041, 5,156,488: 5,336 5.401,116. 5.401,459, 5.511.9015,716,163: 5,588,778: 5,839,844 Capad:ar Patents. 1.329.959: 2,004,564 Other patents pending. Bator, Equalizer. Quick4 and SideWinder are registered trademarks of Irtiltratni Systems Inc. Irif trator it, a registered trademark in France_ Infl tratnt Sys 'rnp rc. 5t reC fed marrk in rcU.,..'. an,,; St a t in are exIco CharnberSpacor G n;dur Co tot SNVC C,t ,3tton M ,rot , k u), MultFort, Poyiuft. PosiLoCla. Quo ut. Q,,wkP'.ay. g traderna ks of Ir` fra,ur Syotc s „ 20tu, F ,tmd I U SA. Dose Conventional Septic System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10705-P (N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the St. Croix County Zoning Department at (715) 3864680. Septic Tank Septic tank servicing mechanics comply with SPS 383.54(lxe). Septic tank to be located within 150' of service pad, with bottom of tank to be 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Puma Tank The pump (dosing) tank shall be inspected at least once every two years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed at the pump discharge, it shall be inspected and serviced as necessary. Soil Absorotion Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contin¢encv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Pg. 11 of 14 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Steven F. Sullivan Mailing Address 284 Cove Rd., Hudson, WI 54016 Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Hudson, WI Parcel Identification Number 044-1174-30-000 LEGAL DESCRIPTION Property Location Gov't ,/4 Lot 1 ,4 , Sec. 24 , T 28 N R 20 W, Town of Troy Subdivision Plat. St. Croix Cove Lot # 12 Certified Survey Map # Na Volume Na , Page # Na Warranty Deed # 980706 (before 2007)Volume . _ , Page # Spec house OyesEj o Lot lines identifiable Dyesono SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number f bedrooms 10/06/14 SIGNA-WRE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) P~.1z o~i~ e~ SrM PLAN IV ROO~RM1 HEV'Ik1H_6ot0 o>,.wx surAmxawoEawqumaro,666.0. LOCATED IN PART OF OOVBRNMQNT LOT i OF SECTION 04. TRM4. PROW, TOWN OF TROY. nw~OOna+uio~oer°W'w~+e s rtc'~w a ~o irwn aav. ST. ORM COUNW. WISCONSIN; OEM LOT 12 OF THE PLAT OF ST. OROK COVE, x~ ~ ncuarw aonsc ,em~nw,zasounFw,uavoF,s p~~~ oxwx (fDlfyNS0.,BI5Q Ff. H2~y a o~roEwsn,c9,k.orq wreu;rooneYO,6w,v,s[x.cr S lOCnIaIN OFT.IEOPaitaV.ft000RM1 GOgtpRleEV~llpp OF 6W wOIILO BEfo®Ik7HW BEPlEEg111EMVf+~il W.W. /j / 'e ' / +4]b ti W7 LoTil +m6b'... + ancK OCpq,,xv ress.i +mav +mar +mas cxaxr~riaon oa.-masr ~ ,w 112 ~u 116 W LOT L llm Northl"d Surveying 349 LEoewO I r1 r P.O. IIoX 152 OYYNER ® aroxsserawo 4 ,u,voa noorouno Amery, iR 54001 er. sows awxxs srtMx axuww p Zp PH 71b-258-2454 who rx{uprvmm • s.woo xEan auo p a~x,enowrca,Wfi wawa N ,mua rt~uEmroor FAX 716-288-2494 'L`SD S '~K°~ we aaee~s I°~ . 13 bF IIIIIIIIIIIIII ~ I IIIIIIII IIIII 8 Tx64133526 STATE BAR OF WISCONSIN FORM 1 - 2000 980708 BETH PABST Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between Robert W. Fleming, a single man, Grantor, 06/18/2013 3:18 PM and teven F. Sullivan, a married person, Grantee. EXEMPT#: NA Grantor, or a va ua a consideration, conveys to Grantee the following REC FEE: 30.00 described real estate in St. Croix County, State of Wisconsin (the TRANS FEE: 1377.30 I Pro a PAGES: 1 Lot 12, S roix Cove in the Town of Troy, St. Croix County, Wisconsin Recording Area Name and Return Address: Land Title Inc. File# 402863 2200 W. County Road C, Ste 2205 Roseville, MN 55113 Together with all appurtenant rights, title and interests. 040-1174-30-000 Parcel Identification Number (PIN) This is homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Easements, Restrictions, Reservations, Roadways and Rights of way, if any, of record i Dated this 7th day of June, 2013. * ert W. FI ing * * AUTHENTICATIO ACKNOWLEDGMENT Signature(s) ATE OF WISCONSIN ) 0% A MW *S CROIX COUNTY. ) ss. authenticated this 7th day of June, 201313 1 Personally came before me this 7th day of June, 2013 the N~ PUBLIC ve named Robert W. Fleming * to me known to be the * rson(s) who executed the foregoing instrument and TITLE: MEMBER STATE BAR OF WISC F VV~S knowledged the same. ttan (If not, authorized by § 706.06, Wis. Slats.) *Meril e J. Bune THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wi onsin My commission is permanent. (If not, state expiration date: Larry S. Mountain, attorney at Law 10/27/2013 ) (Si_naiures may be authenticated or acknowledged. Both arc not necessary.) *Names ofpersons signing in any capacity must be typed or printed below their si_nature 1 of 1 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 / l / ti. 7-N 2369 Wisconsin Department~jf SOIL EVALUATION REPORT Page 1 of 3 Commerces r014 in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach PCIla than 8'/ x 11 inches in size. Pla County St. Croix incl orizontal reference point (BM), directio scale or dimensions, north arrow, and location and distance tc Parcel I.Q. 040 174-30-000 Please print all information. Reviled By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. Property Ownei Property Location Steve Sullivan Govt. Lot 1 NE 1/4 N 1/4 24 T 28 N R 20 W Property Owner's Mailing Address Lot # Block # Subd. N e or CSM# 284 Cove Road 12 r St. Croix Cove City State Zip Code Phone Number City Village Town Nearest Road Hudson WI 54016 Troy Cove Lane New Constructior Use: V Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ✓ Replacement Public or commercial - Describe: Parent material Glacial Outwash Flood plain elevation, if applicable na General comments and recommendations: Site suitable for conventional POWTS dispersal cell with 0.6 gal./sq.ft./day loading rate. Recommended infiltrative surface elev.to be 705.0'& 707.0'. ❑ Boring # Boring Pit Ground Surface elev 710.92 ft. Depth to limiting factor >91 in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft' in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 * f# 1 0-4 1Oyr3/3 none I 2fgr ds as 3fm2c 0.6 0.8 2 4-17 1Oyr4/4 none sir 2fsbk dsh cs 3fm2c 0.6 0.8 3 17-32 7.5yr4/6 none Is Osg ml cw 1vf,f 0.7 1.6 4 32-44 1Oyr4/6 none s Osg dl cw - 0.7 1.6 5 44-91 1Oyr5/4 none s Osg dl - - 0.7 1.0 7 N I -0a 21 Boring # Boring ✓ Pit Ground Surface elev 707.81 ft. Depth to limiting factor >88., in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft; in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 1 0-4 1Oyr3/3 none I 2fgr mvfr cs 2fmc 0.6 0.8 2 4-34 1Oyr4/4 none sil 2%bk mvfr cs 2fmc 0.6 0.8 3 34-46 7.5yr4/6 none sl 2fsbk mfr cw 1fm 0.6 1.0 4 46-67 7.5yr4/6 none Is Osg ml cw 1fm 0.7 1.6 5 67-88 1Oyr4/6 none s Osg ml - - 0.7 1.6 p * Effluent #1 = BOD y~ 30 <_220 mg/L Land TSS > < 1 mg * Effluent #2 = BOD5< 30 mg/L and TSS <.20 mg, CST Name (Please Print) Si ature: CST Number James K. Thompson ~2~ X;~' S_- 3602 Address A.C.E. Soil & Site Evaluation Date Evaluation Conducted Telephone Numbei 340 Paulson Lake Lane, Osceola, WI 54020 8/20/2014 715-248-7767 Property Owner Steve Sullivan Parcel ID # 040-1174-30-000 Page 2 of 3 3]Boring # Boring Depth to limiting factor >90" In. Ground Surface elev 711.40 ft. . Soil Application Rat F Horizon Depth Dominant edox Description Texture tructure Consistence un ar Dots GPDM in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh •Eff#1 `Eff#2 1 04 10yr3/3 none I 2fgr ds as 3fm2c 0.6 0.8 2 4-19 1Oyr4/4 none sil 2fsbk dsh Cs 3fm2c 0.6 0.8 3 19-35 7.5yr4/6 none Is Osg ml Cw 1vf,f 0.7 1.6 4 35-45 1Oyr4/6 none s Osg di CW/ - 0.7 1.6 5 45-90 1Oyr5/4 none s Osg dl - - 0.7 1.0 It clon F--] Boring # Boring Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat Horizon pt Dominant Redox Description Texture Structure Consistence Bounder Roots GPD1fC in. Color Qu. Sz. Cont. Cob Gr. Sz. Sh `Eff#1 `Eff#2 ❑ Boring # Boring " Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Bounder Roots GPD/ft; in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh 'Eff#1 'Eff#2 ' Effluent #1 = BOD y> 30 <220 mg/L and TSS >30 < 150 mg " Effluent #2 = BOD 5<-30 mg/L and TSS < 30 mg, 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 fonnat, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) A.C.E. Sod & Site Evaluations J • `foil el/ll /AR~;on EXiSnq C ~t c'a SE c✓~ ~ //,'(/a.~ Provo. ,Zb~ C~dc ,Pc~! s~prr'~:i~~/~~~~', ffudsUn, ,,J/. ,550/6 EXiS~.~j 3e~0~i'G'~~ ~oo✓~/o'tl ~r1~~~uJ%t)See'Z~! - - - - TG b e(~[t. bar ~.rtta~ 7; ~ Z a o /-(oy, s ode. St. &-oiX Cp., v/. os~0 - 117V- .30 c5'0 o.soacres .Z w/ 34ry i dtcK ~ Q~Si d NtcG. 1 . &t-6,n of .4.5X,4.30 3S/f'de. ✓ , = Sra;~,,1 abvvcb4~ld;•, Tnsu/sec/bu:/C'.- G9S0 ~e EIeK=(,9S.~ ' .Sswe•.^. ~ a cvsil d i3E.Y1 ti EX/,q EX o!a Q s~ PPoposGd dsp~~a/Ce/% Two(z~ w.K: T,~o aF ~j cytc~as at 3'X 79',41/f "Q-'{" 5.2' iron re~aac! elekt'a 6o bt = 70S. 0'4 707.0 ~o y ~"5c4. clop,✓.L', 82 tn5rc/Sea ( . Force md-: B ~V y 5,00 a., a1P~,L~ , E/edo~+'a.~.s: •[il d✓(✓ccO~y. E/a✓ = 7//.S &A' xestr ~~u cfe (084. o baac. 1~/wd r0 la-;17 lo9.Z• o , 60%YCM (v 9•S 75 j(haA'f/°a~d~~ ~cska/d : 696.89 Gad. aL S-rlO 1-6 7c'6-L)o sn~/Era.Eiv~r Sur~cee T-( 705.x' ~n{/~~a~iVf Skr~fice T Z : 7e7.4v, (,5,_3 of 3