Loading...
HomeMy WebLinkAbout042-1052-90-300 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572866 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Kamrowski, Charles J. &Sara I Warren, Town of 042-1052-90-300 CST BM Elev: Insp.B Elev: BM Description /� Section/Town/Range/Map No: Q�rJ I"_" 19.29.18.298A-30 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. p ! , Benchmark 1.15161-415 161 /6T Septic W , � �(� � r 1 uc.� Alt. B Dosing / I/Itil 4 G6b ;,� Gee 2.7'� .�7 lle�n 6:7 1 jt-I LAj`� ��� Bldg. Sewer � 95• �3 Holding f St/Ht Inlet 7.Z/6 jr4 •OS TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. /lent t Air Intake ROAD Dt Inlet 1 11 Septic ,400 /66 L6 Dt Bottom /Q•g 9 D . 4 Dosing /06 / 1 l / S- 1 Header/Man. 4.191 qq S Aeration Dist. Pipe 7 Holding Bot.System -7.IS S Final Grade �' q,� -'• sf PUMP/SIPHON INFORMATION O Manufacturer ( DeP Aand St Cover 1 ` Z.Z1 . I? Model Number TDH Lift`17 Friction Loss System Head TDH�•✓ t Forcemain Length / Dia. i Dist.to Well Z SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacture �•C�r� �r INFORMATION CHAMBER OR h r Ty?OO�stem; �a ,Iy S 1 / UNIT Model umb : 4 ��µAA_G cL��.., ` o DISTRIBUTION SYSTEM 17 x Z Z 3 44 U S Header/Manifold Distribution x Hole Size x Hole Spacing Ve tZAirke 5 Pipe(s) �_ Length . Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Dep of xx Seeded/ odded xx Mul hed Bedlrrench Center Bed/Trench Edge Topsoil Yes No No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 910 80TH AVE Rob rts,WI 54023(NW 1/4 SW 1/4/199 T2 1N R1 8W) NA Lot 2 Parcel No: 19.29.18.298A-30 1.)Alt BM Description= �� Go�`.c� OU lLOlv��s Gl a mi. 2.)Bldg sewer length= t'g -amount of cover Plan revision Required? Yes ,' o Use other side for additional information. ))) Date Insepctor's nature Cert.No. SBD-6710(R.3/97) frej -� i County * '" '" �r, Safety and Buildings Division 6T, ► � ,,, 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) Pi DES `�Q/a Madison,WI 53707-7162 �• - `7Z.<9 (o lr �i Cr'.. l3fi3�1 t,.i w=- State Transaction Number Sanitary e6it Application In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing addres 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,Slats. ' I. Application Information—Please Print All Information Property Owner's Name Parcel# CiH p•LcS I s� � JoN � �f �b5 l 0 LIZ- /052•- 90- 3300 Property Owner's Mailing Address Property Location t/ 5-53 C_ CEDAR --TK'ET Govt.Lot ' City,State Zip Code Phone Number y, _ Iq y.( / Section �lVCKFALLS WT 6-40 7—Z °7/5 yz5 77loZ ircleone H.Type of Building(check all that apply) Lot# T Zg N; R / E or W / 1 or 2 Family Dwelling-Number of Bedrooms � -2- Subdivision Name Block# 4 P" El Public/Commercial-Describe Use ❑City of ❑State Owned-Describe Use CSM Number ❑Village of J 44 2-148 Town of l.�f om2 1 a w.. V'&-- Z ,�� t1,, w l7�- G IIL Type of Permit: (Check o ly one bog online A. Complete line B if applicable) C A' ❑New �System Re lacement System y p y ❑ Treatment/Holding Tank Replacement Only El 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 ;� r IV.Type of POWTS S stem/Con onent/Device: Check all that apply) Z Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil 0-30 ❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dispersal/Treatment Area Information: Design�Flo0 w(8Pd) Design Soil Application Rat�g Dispersal Area Required(s f) Dispersal Area sed(sf) System Elevation o- 7 65/2, 86 q3. VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units " New Tanks Existing Tanks 54 a V 0 Y i5 e� 61 A w C7 0. Septic or Holding Tank r,1 I��14 0v/1 Dosing Chamber W v VII.Responsibility Statement- I,the undersigned, ume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) ti Plu ber's*natuff MP/MPRS Number Business Phone Number Olvt*'d T-1 Plumber's Address(Street City,State,Zip Code) (? - VIII oun /De artment Use Only pproved lsapprov Permit Fee Date I ued Issuin gent Signatur iven Reason for Denial �5 •°n X2. 3 IX.CondtiiBTeasons for Disapproval 1'"ttipW'tank,L-tHtffent finer ana 3, 6 5 75 .,•• �. av�oci,,�. Q.�O PA-Al dispersal cell must all bes6rvices/maintained n at per management plan provided by plumber. 2. requirements must be maintained / as par it l06bi®code%ordinan ces. a j ` v�f 1!9 (�d �I 6 5 8 Attach to complete plans for the system and sub it to the County 4gly on paper not less e#an 8 1/2 x 1 inches in size SBD-6398 R. 11/11 t • t i cc y Pg of Private On-Site Wastewater Treatment System(POWTS) Index and Title Sheet Owner: c �L�S J. - J<,AMRDWK/ Project Name and System Type: �TAf- CI�OU�b C&,I V EA 1rJDn(AL -rKQJ461�-5 Location: a S64,,AV6416 Street Ad&=s / N /V�►�/4 bF 7`Hc ,SUS/� SEC. i9, T---"?A! R!Ir W Legal Destri DHd n VU , AKEFA vT &lX Township/t.ount Design Criteria(Check erne): Holding Tank Component Manual: In-Ground Soil Absorption Component Manual: ❑ SBD-10571-P(6/11/1999) SBD-10567-P(R. 6/1999) ❑ SBD-10855-P(3/2007)Version 2 ❑ SBD-10705-P(N.01/2001)Version 2 Contents: Page 1: TADEX .AN,D fill/-' .UHF-&'t" Page 2:_ Z� G � CoA�1/�A77/DAJr1 L Wo�Ks�iF£T�CR��s-5�en6�! Page 3: Fa-r pLi1 Page 4: POLO-r5 0W1JE<'5 MAN MA*A0,5A FiU T pJ--4 ( Page 5:s Page 6:_ SC-PTIC rANK f1AAP e MM 13Ei, C"56.-5E C-rl dAl Page 7:i FkAI P 5 PC a l=fCAT/a,,rl,5 Page 8:_ 1ANK 5PF-C/FI C-4'Tl Dnl s Page 9: Attachments: 5170 fo NK .'t 41x''f rJl�}l/llC'�o �K M E,NT `````,�`w����,ta n�t s►rte,t,,y,�s� ��®�!I n ii• "D!L �i/yq L u fl'�7 Dr�I &PORfi N-4 ��� � p lumlie er: , 89-d-o �+IAPP-,Kf Signed: 4pljws - �' ` s� •6'uk WPe3 v C� deniK N�itribe� Date: I—or 2—Family Dwelling in-around Soil Absorption System (2-cell Conventional 'Daffy Wastewater Flow(D WF) = 3 #of bedrooms x 150 gal/day/bedroom - A90 gal/day Design Loading Rate(DLR1 or Soil Application Rate= D•1• gpd/ft2 (per SPS Table 383.44-1,2,or:t) Rreaulred Distribution cell area-DWF gal/day DLR 6.7 gpd/ft2 �y.�•�b fl2 #Chambers=Required D sfribution cell area 6��SSb ft2 + ft2/unit EISA = 3 �u/Chambers Chamber Manufacturer aid Model: _T51 L-) CHAM t6;4� Actual Distribution cell arnsa=Regni an cell area 1G g0 ft2 + F • Ij ft2/unit EISA End Cap Pair- q ft2 Cross-Section In-around Soil Absorption System (2-cell): <,.J � ` d ' r Schedule 40 PVC ,�—vent pipe with vent cap 12 inches minimum 12 inches minimum inches Soil Cover Trench 1 Sys- I tem Elevation i inch Chamber Height i 1 ft CP- ft Trench 2 System r ►��_ _-� Elevation Trench Separation Leaching Chamber Width $r6 g r ft to limiting factor -AA AAAAA AAAAAAA AA- AAAAyA A_/S Plan View In-around Soil Absorption System (2-cell): Trench 1 WMI Modify ft header/ design as ft Leaching Chambers needed. Trench 2 4 Inch Header Sch. 70 It with end camps �5 Draw Q for a Vent ar.d 0 for Observation Pipe above. They will be located � tie end of the cell. Vent pipes shall be Sch=dule 40 PVC and extend at least 12 inches above finished grade. Observation pipes that extend above finished grade must also be 4 Inch Schedule 40 PVC. Page 2' ofd_ n� �vsk! � P!ot Plan for Site and Soil Evaluation .Wage 3 of 8 Properly Owner C;�l �c�s.�,- r,,� ti}o�uZ;y K,-+m Rotn)sK I I" = 40 fl. Legal Description PRT bF m,,es 1/4 of rq€ 5w/yam (except where noted) sF,e. 19, Ta.V, M19W, MW4 OF vyA99EJ, Sr. CPWIX c =Backhoepit North life � FEn►c� u� _ n1 o rZ��' p��- �. cig.0fl' �o PE R lr1• N G1 O o o v fl D .►I3G� Aij i]613o b � 0 °o Ti9NK�K 24 Tf1 � 4,0� pc S�p�NC. t�,PT Cdl� I.yc's,u�ev� to o-00 3 �I�NG Q�6S�N"rt�fl �• � (3 rv-A U- PAR sFs Site Location: �G ra r POWTS OWNER'S MANUAL & MANAGEMENT PLAIT . w— E iQo A'noN SYSTE14 S aOW"TION11 i1 Owner Ch4pL&S.��-SAM l�ozL& )<A,vir�w sx� septic Tank Capacity /,TOO al 0 NA Permit if Septic Tank Manuhoturer W l65W 17 NA D1W6N PARAMWnrS Effkrent Filter Manufacturer Po mo K 0 NA Number of Bedrooms 3 ❑NA Efluent later Model l- O NA Number of Public Facility Units g NA Pump Tank Capacity p NA , Eetirneted flow(average) 3W #Wdev Pump Tank Manufacturer ta NA Design flow 1pask), lEstimated x 1.61 q60 LoIlday Pump Manufacturer �Dlt.l.p d NA Soil Application Rate b.-7 gglIdsyge Pump Model 5.3) 0 NA Standard influent/Effluent'Quality Monthly average* Pretreatment Unit )K NA Fats,00 a 4nreee (Foe) S80 mg/L 0 Sand/Gravel Filter 0 Feat Fula- Blochsmiaal Oxygen Demand 180De) x220 ma/1- 0 NA 0 Meohnnical Aeration 0 lVetland Total 9uspsnde i 8oWs USS) st 50 mg/l. 0 Diednfecdon 0 i)ther. Pratraated Effluent Qualhi, Monthly average Dispersal Coll(s) 0 NA Biochemical Oxygen aumsnd (80D.) 930 mall. 'g In-Ground lgravityl 13 l v 4round ipre surized) Total Suspended Solids 1TSS1 930 mg/L )(NA 0 A"reds 0 Mound Fecal CONM igeometrlo mean) 4104 ofull00ml 0 Drip-Line 0 Other; Maximum Effluent Particle size Yg In dle. 0 JNA eft 0 dNA Offier 10 0 "Valuae WON for dOWIft'Natewater and ssptio unk effluent. men 0 MAINTENANCE SCHEDULE Serviva EV-101t $WWc0 Frequency 13 numigi inspect condition of tanklal At least once every: ? W aer (Ai laximum$years) 0 NA Pump out contents of tankle) When combined sludge and soum equals one-third (K) of tank volume 0 NA Inspect dispusel oeu(s) At least once every: a a (N aRheiim 9 years) 0 NA Clean effluent fitter At least once every: j,J m 2 48 0 NA Inspect pump, pump contrt4a&alarm At least once every: j, o (s) TINA Flush laterals and pressure'test At least once every: 0 e is CINA Others At least once sorry: Won d] NA month s NA MAINTENANCE INBTRUOTICiNB Inspections of tanks and dispersal calla *hall be made by an Individual canying one of the follow1n; lioenaes or oertifleatiow Master Plumber; Master P'umber Restricted Sewer, POWTS inspector; POWTS Maintainer; Septage Servicing Operetor. Tank Inspections must Include a visual Inspection of the tankls)to Identify any missing or broken hardware, Identify any cracks or looks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellla) shall be visually inspected to check the affkrent levels In the observation pipes and to check for any pondhv of effluent on the ground virface. The ponding of offlusm on the ground surface may indicate a failinli condition and requires the Immediate notifigstion of tk-•local regulatory authority. When the oombMW eoMwiatlon of WWoe and scum in any tank equals one4hird (Ys) or more of the tank volume, the entire contents of the tank shah be removed by a S.ptage Servicing Openhtor and disposed of in accordance with chapter NR 1 t a, Wlsoonsin Adminietrative Coda. All other Aloes,including but not Radial to the servicing of effluent filters,mechanical or pressurized oomponelits, protreetnprit unite,and any aervloing at intervals of S12 months, ahal)be performed by a cerdfled POWTS Maintains-. A service report shall be we vided to the local regull6tory authority within 10 days of completion of any service event START UP AND OPERATION For new oonstructim prior to use of the POWTS check treatment tanklo)for the preaenoe of palrttlns products or other chemicals that may 11111*6 the treatment process and/or damage the dispersal collie). if high oonoentrations am detected have the contents of the tank(s)removed b y s septegs servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the Infiltrative surface. During power outages pomp tanks may fill above normal highwatar levels. When power Is restored the excess wastewater will be dlecherged to the dlap@nW call(s) In one large dose, overloading the cog(s) and may result M the backup or surface discharge of effiva t. To avoid this aItuation have the contents of the pump tank removed by a Septege Ser4cl g Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Molntalner to assist in manually spa ratkig the pump controls to restore normal levels whldn the pump tank. Do not drive or park vehtaise over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact,the area within 18 feet down sloe of any mound or aagrsde soli absorption area. Reduction or elimination of the following from the wastewater stream may Improve the pesfomtenos and prolong the life of the POWTS: antibiotics; be 3y wipes; cigo,9 butts; oondoma; cotton swabs; degreasers; dental floni i; diapers; disinfectants; fat; foundation drain (slurp Sump) waMr, fruit and vegetable poelings; gasoilne: grease; herblemes; m eat eerops: medloadons; off; painting products;pestle';doe;sonitary napkins;tampons;and water softener brine. ABANDONMENT When the POWTS falls aidlor is permanently taken out of service the following steps ah 1 16 taken to insure that the syatam is properly and safely abandoned in compliance with chapter Comm 85.33,Wisconsin Administrative Cc de: e All piping to tanks and pits shall be disconnected and the abandoned pipe opening&sealed. e The contents of;dl tanks and pits shall be removed and properly disposed of by a Septage Sarv)cing Operator. a After pumping, to tanks snd pits shell be wwavatad and removed or their covens removed and the vokl space filled with soil,gravel or another inert sold material. CONTINGENCY PLAN If the P0WT8 falls and cannot be repaired the following measures have barn, or mast be taken, to provide a code complleat replacement system: )A suitable replacement area has boar evaluated and may be utilized for the location of a replacement soil absorption system. The rep acement area should be protected from disturbance and compaction and should not be infringed upon by required aetbaelu►item existing and proposed structure, lot Imes and wells. i allure to prowat the repiecanent area will result In the new for a now soil end alto svelustion to establish a suitable replacement area. Replacement systems must comply with the vlss in effect at that time. la A suitable replowment area In not available due to setback and/or sol llmkatlons. 8airing advances in POWTS technology a hokling tank may be Installed as a Ian resort to replace the failed POWTS. 13 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a son and alts ,,evaluation must la performed to locate a suitable replacement area. if no replacement area is available a holding tank may be krstalled ae a lest resort to replace the failed POWTS. 17 Mound and et`grsde soil absorption systems may be moonstructed in place following re novel of the blomst at the infiltrative surf"o. Reconstructions of such systems must comply with the ruins M e'ifeot at that time. <<WARNING>> SEPTIC, PUMP AND OTH0 TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUP qCIENT OXYGEN. DO NOT ENTOt A 81"0. PUMP 11111 OTHER TREATMENT TANK UNDER AMY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THIt INTIRIVOR OF A TANK MAY 8E DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTO MAINTAINER Narne os✓ 0SR &J. 7Name JDE i�UA L-1-FK. aJ Phone `715- 7q2-- dB AI I5, Z- SEPTAGE IIERVICiNG OOPPEIP�ATOR(PUMPER) LOCAL REGULATORY Nems Name 5-. C O/K ! I I,ll i` I'll UVL Phone .r / t�= /0 Z.S Phone 715- 3'F&-I 1� TO Paoe Of SEP'T'IC TANK 5 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ►►" CI V E11T PIPE 12" MIN. ABOVE GRADE b JUNCTION WEATHERPROOF BOX RYPROV ED ? 25' FROM DOOR, WINDOW OR FRESH AIR INTAKE WITH CONDUIT W/NP�LOCKV FINISHED GRADE V -- WARNING LAB ' — i_.._ w" MIN. Z�l�_ ":Cannot* MtN- i t • INLET 3 •• ; GAS- . +DATER TIGHT SEALS -�- TIGHT, `,,APPROVED FILTER A SEAL • JOINTS WITH LM APPROVED PIP APPROVED B ► 3' ONTO PIPE 3' �- _ ON SOLID SOIL. ONTO SOLID C t t SOIL PUMP OFF ELEV . �'7rg3FT- -- OFF D I 50 3" APPROVED BEDDING UNDER TANK k CONCRETE PAD SPECIFICATIONS SEPTIC / DOSI: TANK MANUFACTURER: /�$ � NUMBER DOSES PER DAY: 'TANK SIZES: SEPTIC ICOO Lp GAL. DOSE VOLUME INCLUDING 1p7.J7 GAL. DOSE � GAL. FLOWBACK: ALARM MANUFAC:TURER: alfiF xfta .F3LtS CAPACITIES_ A = _ INCHES = y - G MODEL NUMBER: 3AN �� B = INCHES = f �C-G SWITCH TYPE: C�HfWo -- -;-""' PUMP MANUFACTURER: lao C = �_ INCHES = /0).7.0 C MODEL 1'RIMBER: • �11^_ D = INCHES = REQUIRED TYPE: -i,11Fr 7tll��f L 'L , n PUMP S ALARM WIRING C�fl. RQUIRED DIDISCHARGE HARGE RATE -^ GPM AS PER 'D'S-F5 ff VERTICAL DIF'?ERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE - /p• ( FEET + MINIMUM NETWORK SUPPLY PRESSURE - - - - - - - • - • . ZFEET + .__ rE'ET FORCEMAIN X 2.55 FT/100 FT. FRICTION FACTOR - _- �,.�� �� FEET TOTAL DYNAMIC HF�kD --1`s_Lo INTERNAL DIMENSIONS OF PUMP TANK: LENGTH I5t* t ; WIDTH Ali DIAMETER '-- LIQUID �l7 76 34,/ x p• f63 7� °ns dl? c ,7 oq — , 87 (v . 17 Idoz nR©tiUsXllCf� mot; L = , 17 Lffl GOULDS PUMPS Submersible Effluent Punip PE SPUNUTM mom WAWWS : Genea r ConTsion mG %l NPT • resisbnt fin*P� aonst nx bon. • Temper&rr 104OF(4VQ • 60 Hertz ■Cast imn body. maodmum,aontiinuous when • 115 and 230 vdts sTlierrioplastkimpellerand fully submerged. • "k*tharnal overload pro- oovM. + Solids handft:IAO tection with autnmadc reset. ■tipper sleeve and lower maximum sphere. • Class 6 insulation. heav<r duty ball bearing • Automatic models include a + Willed design. cotw+utaon. APKKATKWS float switch. • High strength carbon steel m Motor is penrh ne* sally designed for the • Manual models available. slhatt• Wric!ated for extended fothwirxg uses: • Pumping range.see PE31 Motor: senrk a Pita. • Mound Syste ms performance chart or tine. • 33 HP,3000 RPM is Powered for auntintrous •Efliuentldosing Systems PE31 Pump. • 115 Vohs opeation. • tow Pressure Pipe Systems • Maximum rapacity:53 GPM • Shaded pole design ■AD r v.IW are within the • Basement Draining • Maximum head:25'TDH PE41 Motor. world ng limits of the moto► • Heavy Duty Sump/ PE41 Pump. • .40 NP,3400 RPM m�'it Dewatering • Maximum capacity:61 GPM • 115 and 230 volts , Y starAW length,11i� • Maximum head:29'TDH Z C n t 1 S c r duty 16)3 SRW with PF51 Pump; Motxoh: Mug, • Maximum capati .70 GPM • .50 HP,3400 RPM ■COW *unit is heavy duty, • Maximum heal.37 TDH + 115 and 230 volts pontai Ae and compact. METERS Fir • PSC design ■Meth=mkal seal is Carboni, aeraffk BONA and stainless _ 1. MODtiSc PE31,Pt+44 Pf571 Steel. _ r Staird ss steel fasteners. 11P.39,ao.so 35 t 10. 2 GPM 1 :._x. AGENC f LISTLWd 30 ' 1 Fr _ �A' 20' -, Tea>ed to tIL 778 apt CSA 2.2108 Standards is t o r , ceutdr rux hoc k a09obt pfd 0 00 L t0 - :���•;-•z T-{-; �_ , .-(•.�-C-•"'�"".�•••F•-�-:�.:._ PR�2�E�'T .OrMJ��K� L�: 20 30 40 50 60 70 GM 80 /7 0 10 15 W/h- r 56" 42` ti; n n It ff f 1 f °age f 48• fI O I < f { c f I rn LA 11 � f l/) S H Z o r 1 S. �E� - ��� � .:� 4S� � � Q D � OD p ��j y C b� I*t p !)fsl rV a► � a � . 1c zz En G Z F; -.y n ViLp,ow sly-.MR ���iIEall,,W"`�, 4* �.,• �Y�. D►�: SEP71C MANUAL WMS 15s MMO. HMM ROCK. wl AM JANUARY REV_ JAN. 2008 800-325-8456 Ur-RUnOW 6W-Nut ��yl/�G tc�t5il'Ij C 11 lllllllllllllllllil[�Iililli�Iilli�MIT �I i iII�IPIIlillul'I'19dllIPI'IIIIIIIIIIIIIIIII'lIIIIIIIII'0111911q ! 'i l �'I I i ii III. I i '—/Ililillhllllldlillllillli16V166C1i11111GIIIdIIdIIdIIIIlIiIiIIVIIIiIIIIIIIiIJIIIIiVldilllllllldilildll!IIIIIIiIIiIIIIIiIJili611PiIdIIllllili11116111IIIIIiIIIIIIiIIIJ'IddlilJ'Illdll'Jll'Illilldll6611i11i1 �II0111111111I1111I'IIIIIf911111IIIIIIIIIIIIIIIIIIIPllll'I'1111110'IIIII'IIIIIII'11111''''Illllllllllllll�llllllllllil1111'II'I�IIIIIII11111110111 v�IIIPPIIII III�II�I'11111111111111111199!IIIIII�I�III�IIPIII�I911�1'11111'111 II�I I'I!II�III�I II�PI'IIIII I�II I�III ICI I ICI II�I'I!I!1111911'IIIII9�111�III'i!IIIIIIIIIIIIIII�PPPI1111119�111111�11'I IIII �� ;��IIIIJd61d�I�IIIId�IIIIIVIIII�IIdIIIhIJ�lllillldlllllld�VI�IIIIIVViililll6ldllidd�6lldldl�lldd.Ilddlll'�II�VVVII�IiIIiIId161111dddilllllill�P�II11116hIIV16116V1flllllddld�16611111n�! I�1 1'01 I I I I I li I I 1 11 1 1 1 1 1 I�IJ I Il II'I 11114 I II I I Il Il I I I II I I I f101 I I I I I I I I 1 1111 11 I I I I I I I I I I I I II011�I I I I I i l l l l l l III I I PI I l l l l l t I�I II �"�PIII'll'IIII!I'I'I'IIIIIII'I'II'I'I'III'I'IIII!I'1111111'lll'I'llll'I'I!I'I'I'19111111'191111'lllll'lll'I'I'lll!I'IPI'll'1919'1!IIII'III'lll!I'I'I'I'I'I'I'III'I'I'IIIIIIII!II'I'II'I'I'III'I'I'I!I'1191'I'll'I'll'I'll'II% nomnrauluniun'mruummm�'lll�����m���l , / j��QIIDIIIlI'Il1>1111u 1��wd'�!y!�IIIIIII�IJddlddddldlPdllddJIVIV6sdIVIIIIIbblddldd�IJdIVIId�ldidid'Ua 11 ff il' I I 111!1111 I I� I I � i L. — 1 I'I IIL. 1 1r I I/M011/111, I 14vq\AV a\lll AAAOUV�.� WO �% it �''l �✓ r% •�% r ��,1/� /r�/� �1�� ,�l r , = �-;�//i%���lllllllllll,l,;llll!l;l�ll�llll��r�!lllllll� - � • i w Y W U CO O a o U wo CO ?�: v E: !4 ! �g7 N � wV maM � M rgii7 QN gi 0o Q 0 m � 0 CL a O Q O $p ®� � U Ora a O Q M U NO U et Ch C) AGO W Cl) M co E n 7 Ou W O U ch U J E a- O N M Ch U 6 G U�l c 06 UR CD CD u O N u O U Ln r � r O N H O 0 W m U =2 W Q U m X Z c"p co w 2 otS cn E- m o I- LU M v Y w Z m 2 W U x J U U Q O ? m LL Q O C7 W m Z Z W N Z) � U CD > CL WWO = N a w Z Cif U-) W CV a- Z � j -~-io 0 = a LU Z LU LL M CO 2 FQ- W O N J ' mod = � 0 < (D --i LO ;z Z W Q N H W V5 J m H Z:) F- 0 = d [� � 2006 ST.CROIX COMITY SEPTIC TANK MA1 TENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM uyer 0,gA2LC_s-T; Mailing Address `]3 3 E. C,la4le 67 A E t V6W' E4U S, (XT '546 546 L?. Property Address___!gL0_ 0-/4, VCA)U& R©aQ2T5 Venuficatron required from Planng 8c Zoning Department for new con uc t .) City/State 15 W Pared Identification Number F qZ-/05Z- 90-3 o C� LEGAL DESCRM ►N Property Location /��%,, S r/.,Sec. )q T_,�--? N R /8 W,Town of wAK K-&V Subdivision Plat: Lot Cerdw Survey Main# Volume /5— ,Page Wa t-amity Deed# O Z-q (before 2007)Volume Zg55 ,Page# 3(1 Spec house U ywXno Lot lines ia�isable)(yes U no SYSTEM IHAINIMLkANCE AND /OWNER CERTIFICATION Improper use and mair$enance of your septic system could result in its premature failure to handle wastes. Proper maim consists of pumping out the septic tank every three years or sooner,if needed,by a licensed p�mmper What you pert into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner mamtenance responsibilities are%ecifie=d in§Comm.83.52(1)and in C2apter 12-St Croix County Sanitary Ordinance. The property o"sr agrees to submit to St Croix County Planning dt Zoning Departmat a certification form,signed by the owner and by a master plutaber,*vneyman plumber;restricted plumber or a licensed pumper verifying that(1)Sa ou-site wastewater disposal systm is in proper operating condition and/or(2)after inspection and pumping(if smeary),the septic tank is less than 113 full of sludge. Uwe,the undersigsred have read the above recpruements and agree to maintain the private sewage disposal system with the standards set forth,herein,_us sex by the DgmU2errt of Commerce find the Dot of Natural Resources,State of Wisconsin. Certification stating teat your septic system has been maintained must be completed and returned to the St Croix County Plaimma&, Zoning Dint wiWn'30 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 amlare She owner(s)of the property described above,I y virtue of a vuarr *dead recorded in Rem of Deeds Oft'= N of bed IZ /ZZ/ � SMNATUIRE OF APPLICANT(S) DATE sssAj3y infrxmation that is mmq ewnted may result in the saintary perind being revoked by the Planim S dt Zoning "` Include with this application a recorded warranty deed fiom the Register of Deeds Office and a copy of the certified survey map if reference is made in the me misty deed. 0".0"7) WV;consin Department of Safety and Professional Services Division of Industry Services _ SOIL EVALUATION REPORT Page 1 of 3 '" "' I V in accordance with SPS 383,Wis. Adm. Code Dat " -3 ao r y County ST.CROIX Attach comp l��lt �rr per not less than 81/2 x 11 inches in size.Plan must include,but it d to. ical and horizontal reference point(BM),di n d parcel I.D. 042- 1052-90-300 percent r s,north arrow,and location and di SZE Fri ,OMMU-N!1Y all information. Revie d by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). /�3 /'/�' Property Owner Property Location CHARLES J.&SARA WOZNEY KAMROWSKI Govt.Lot---- NW 1/4 SW 1/4 S 19 T 29 N R 18 E(or)® Property Owner's Mailing Address Lot# Block# Subd. Name o CSM# 533 E.Cedar Street 2 1 -- I -- City State Zip Code Phone Number 00ity []Village • Town Nearest Road River Falls, WI 1 54022 ( r5 ) tf zT- 7bZ- 80th Avenue DNew Construction UseE] Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD E]Replacement Public or commercial-Describe: Parent material sandy outwash Flood Plain elevation if applicabl A ft. General comments Conventional In-ground trenches--0.7 loading rate--system 93.50' and recommendations: 4"frost Property Address: 910 80th Avenue �j� aJ'dot-) Boring# FT] Boring !� k Q pit Ground surface elev. 98.30 ft. Depth to limiting factor 120 in. Soil lication 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 0-8 7.5YR2.5/2 - 1 2fabk mvfr cs 2vf-m 0.6 0.8 2 8-17 7.5YR2.5/3 - sil 2fsbk dsh cs 2vf-co 0.6 0.8 3 17-31 7.5YR4/6 -- sil 3fabk dh cw 2vf-m 0.6 0.8 4 31-120 7.5YR3/4 -- s OS9 dl -- -- 0.7 1.6 Horizon 3 has 5-10%u gr;horizo 4 has 40-45% gr. few stones/ cobs. by Pi A tj 11 F2 Boring# ® Boring 98.00 112 El pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-15 7.5YR2.5/2 -- sil 2fa&sbk mfr cs 2vf-m 0.6 0.8 2 15-27 7.5YR2.5/3 - sil 2fsbk mfr cs 2vf-f 0.6 0.8 3 27-37 7.5YR3/4 sil 2fsbk mfr as lvf-m 0.6 0.8 4 37-42 7.5YR3/4 — sl Om mfr cs -- 0.2 0.6 5 42-112 10YR4/6 - s Osg dl -- -- 0.7 1.6 --T T-F *Effluent#1 =BOD >30:5 220 mg/L and TSS>30:5 150 mg/L *Effluent#2=BOD <30 mg/L and TSS<30 mg/L CST Name(Please Print) Si CST Number Mary Jo Hu ert Hollister's Soil Testing&Design, 224832 Address Telephone Number W9875 690th Avenue,River Falls,WI 54022 12- 19- 14 715-426-1775 SBD-8330(1107/13) KAMROWSKI Charles J.&Sara 042-1052-90-300 Property Owner Parcel ID# Page of 3 Boring#� Boring Pit Ground surface elev. 97.50 R Depth to limiting factor 109 in. Soil Xppication Rate Horizon Depth Dominant GAor Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-12 7.5YR2.5 2 — 1 2f t&sbk mvfr cs 3vf-co 0.6 0.8 2 12-23 7.5Y1t3/2 1 2fabk mvfr cs 2vf-co 0.6 0.8 3 23-30 7.5YR3/4 _ sil 3fabk dsh cs 2vf-m 0.6 0.8 4 30-36 7.5YR3/4 __ sl lfsbk ds cs lvf-m 0.4 0.7 5 36-109 7.5YR41F -- s 099 dl -- -- 0.7 1.6 Horizons 4z5 have some gr 25-30%; cobs/ stones. 12I r F-I Boring# Boring Pit Ground surface elev. Depth to limiting factor in. Application Rate Horizon Depth Dominant Galor Redox Description Texture Structure Consistence Boundary Roots GPD/ff° in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. "Efr#1 I *Efr#2 Boring F—I # Pit Boring around surface elev. ft Depth to lur►iting factor in. Soil Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fla in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1 =BOD,>30<220 mg/L and TSS>30:s 150 mg/L *Effluent#2=Bop,:5 30 mg/L and TSS<_30 mg/L SBD-8330(to7/13) v t Plot Plan or Site and Soil Evaluation Page 3 o f g f 3 SqK Pro e� Owner Gf4�,�c�s , � �nlovv � P M o `.SK i = w 1 40 K + Iz ft � Legal Description aF m ys I/q cl= toy 5w/�;.._ (except where noted) _SFo. I9, 7- rzl w, -rows cF W�,�z sr. �Rt+x m = Backhoe pit North NJ r FEn�cE u►�t _ 1JatzTt3" P1� '�. CM 100 BZ IV It APE • U3 � Or � QB ,3 4 of s�a�w4 D 6^'� Lyo'At3ovC0 rlf<o r tic. SU- �-� ,to .sq Ljvt�ELt_.LNl9 1.100 R�ii�E �?ZJ"1� Site Location: y. t� 1°I 8p*.,»v a �, ;``�. ,, �" s��,", ,a. t �� �¢ y �' ��e '� �A. � �. �c �� _1. �`.. / �� ��� �i`,C �� ,� �� ;�. �,..�� .. "' j {f�' A8 #�� fix '�L� :-•�` y r 1-.: � ., .. ++.,`: pp k'� C' �.: '. x� GG} .,:fit �, ,�r;:;.. � � .. E y t... .. '� �a �� � k ' �� i¢�� :�..., FiF .\ ... i:.: ..�, .r,r t , ��