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020-1016-60-000(4)
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CL 5 v a v Y v d L .0 m 0 It m r`N o U- 0•� X00 aLL m000 o A x x CL °' 1 } " 1 Q ¢ 0 N " rn O° ° N -i U m rn o N � LO N N O aD o O N ' 0 O N x m C d f0 x — CO " m N O 16.4 ° " z° v� c ci � ¢ rin o y O °o o CL c CL r_ E M ° o v o v E co 9 cc o l ' Cl) °° u d 0 IL O -O N_ N_ E C N N pO C C C A C M o O ` .O-. c 7 _M N O ° O N 8 d 0 +� 'O H N - N fn ; C L V t° M N v .0 c N M O ++ O L O r = C7 Cl) O z !n in -°i Y " fn (D M O z 21 z U v, d m € a € a E � 'E c � ° I c °•3 3 A uCL2 0fnu 0 0) 0 Wisconsin Department of Commerce T PRIVATE SEWAGE SYSTEM County: St. Croix Safety and B�lilding 'Wivision y INSPECTION REPORT Sanitary Permit No: 404943 0 GENERAL INFORMATIO (ATTACH TO PERMIT) an ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. d = +arti • v►. Permit Holder's Name: City Village X Town Par el Tax No: Girl ScoutCamp St. Croix Valley 3Uatfen Townsh 042- 1048 -95 -000 CST BM Elev: ' Insp. BM Elev BM Description: 1 3 ✓ aA Z� (� 100•O (SD.O / : CSC *�-1 y TANK INFORMATION ELEVATION DATA wrcjw r TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septi ( Benchmark , / `'7'•ss d t C7 Dosing IJ Alt. BM - 2) � � �tS�Y to �tse � 1 0� t�e1<. .mss Aeratiett Bldg. Sewer I 2 7 , I$ o 03.S'$ oldi St /Ht Inlet 2# I0 r St/Ht Outlet / r TANK SETBACK INFORMATION / b2. f TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 3 0 4S.'}2 Septic I Dt Bottom m . 9 4 2 IZ r > CV ? r� So • Dosing I Header /Man (( ` >str► e►d1Z '•�� 11��2. Aeratiun S . NOW S td S�+- Bot. Sy em S Final Grade -�-g .� —ft-,- � PUMP /SIPHON INFORMATION 2 S -8. �10Z.22 Manufacturer s Demand St Cover GP 1� Model Number & LS ,� �j'r 2 °6°� TDH Lift Friction Loss System Head TDH Ft 111, , Forcemain Length I I Dia. Dist. to Well r ` 2 n 1 7 l W 51'LQ r lit .r'• SOIL ABSORPTION SYSTEM ( �IZ�jvL 1k• II•oz OrD.O *!l5tERQSJj3 Width Length t No. Of Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 to Q SETBACK SYSTEM TO P/L LDG IWE LL LAKE /STREAM LEACHING M fa �r; INFORMATION CHAMBER OR Type Of System: UNIT Mod umbe ' w , /] > z� 90 t > Ia, . �lG w i.0 DISTRIBUTION SYSTEM Header /Manifoli � . %AD' Distribution x Hole Size x Hole Spacing Vent to Air Intake ------- 7 — — Pipe(s) Length Dia Le Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes [M] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection # IS - "! / 2!0 Inspection #2:� Z} / 02 Location: 400 N. Robert St St. Paul, MN 55101 (NE 1/4 NE 1/4 13 T29N R1 9W) NA Lot / Parcel NoT�9.24B 1.) Alt BM Description = S r, 0,%v r w� s ({ > �l S 2.) Bldg sewer length = / , �' •3\ a"""11e - amount of cover = / P la n Use other l side for additional informa2n No 1 3 ' _t u- � D to � 's Signature Cert. No. t SBD -6710 (8.3/97) � T c adc• S • .s i ,zb •�� 1� • of �"°1J b g '£b °�' °� •8 ,°1('SU Z}, •b � ,IS•�b to'S � Sanitary ermit Application Safety & Buildings Divisioi In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Wfthington Ave See reverse side for instructions for completing this application PO Box 730: VViscons rmation you provide may be used for secondary purposes Madison, WI 53707 -730; personal info Department of commerce [Privacy Law, s. 1 be us d f or (Submit completed form to county if ne tw 0 _ .9 � � ur // � 5 1 state owned. Attach complete plans (to the county copy only) for the system, on paper not le s.tban 8 -1/2 x I I inches in size. County State Sanitary Pe it Num4er ❑ Check if revision to previous application -State Plan 1. D. Number ,C 2 1. Application Information - Please Print all Information Location: Property Owner Name Property Location . . I / - 1 /4, S J 12 f N, (o Property Uwn6es Mailing AdIfess Lot Number Bloek Number , a7� o City, State * Zip Code Phone Number ubdivision Name or CSM Number c ) i- F II. Type of Budding: (check one) City ❑ 1 or 2 Family Dwelling - No. of Bedrooms: Village o Public/Commercial (describe use):_ n of �errX I�t/ Z1 OD 4 C O/k � Zr702 13 State-Owned L o C Lls i¢T .t/t LL / llnls ar a Tax r ) II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition System System Tank Only Existing Systo n B) 11 Permit Number Date Issued A Sanitary Permit was previously issued 1V. Type of POWT System: (Check all that apply) )eNon- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground ❑ Holding Tank ❑ Single Pas$ . ❑ Drip Line • At -grade ' ' ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. DispersaVTreatment Area Information: 1. Design Flow (gpd) 2. Dispers4Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required 't514 Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) 9t. t r Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks — O ,r��S,d- „�1 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ r- — my 6e VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the P TS shown on the attached plans. Plumber's Name (print) Plumber's Signature kLIU stam )' PRS No. Business Phone Number Plumber's Address (S et, City, r Code ° ty, �P s/ ��/v � Div IX. County/Department Use Only I ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved 0 Owner Given Initial Adverse Surch ge Fee) �e D etermina tion S�✓ LA x- X. ConditionsApproval /Reaso s for Disapproval: SVS b /� ;A;,., t ©. ` �`, tom a . aAa �. Se a So << Qu` C- SBD -6398 R.07 /00) f PLOT PLAN - Page y of a 4 ' Scale 1"=3D ' / 1 Luamtou SIccT�C.N � ' Sop Pit. PhVZAS, K S t'Tk' t l �� l ADORL=� 96s Rtt�PpvDL'1C R� , \�OaL. i z 'oY 1000 WI L . ° 20 DF -a F.H. W. ° �oL hoL � • t S too ° s.3 JyJ Ry A LZ1;R Fl tz _10, I ------ q Z °10 ell 0 lop aM �L %!L, IOO.O T1P OF mca%nN6 Vetir 7 1 3r�N z t L. lol.t' k . • I I 6 w eoz > SO' riwig C MAJ . AKJD > LS 1 r-poM "TA►Jk Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Nvisconstn www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary February 28, 2002 CUST ID No.267341 ATTIC• POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/28/2004 Identification Numbers Transaction ID No. 710267 SITE• Site ID No. 167594 Rolling Ridges Girl Scout Camp - 965 Alexander Rd Please refer to both identification numbers, St. Croix County, Town of Hudson I above, in all correspondence with the agenc NE 1/4, NE 1/4, S13, T29N, RI 9W FOR: Description: Commercial Non - Pressurized In- Ground System - 2943 gpd Object Type: POWT System Regulated Object ID No.: 830835 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Conventional Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10567 -P (8.6/99). , • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • Comm 83.52(3) - The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145Z0(2)(d), Wis. Stats. • This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. ARTHUR L WEGERER Page 2 2/28/02 General Approval Conditions Continued: • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to P P P the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 275.00 Fee Received $ 275.00 Balance Due $ 0.00 (' 6erard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4 :15 pm WiSMART code: 7633 jswim@commerce.state.wi.us TITLE SHEET Page of 8 for a Dosed Conventional soil absorption system for Rolling Ridges Girl Scout Camp swimming pool bathhouse. This plan has been prepared in accordance with the Conventional Soil Absorption Component Manual SBD- 10567 -P (R.6/99). Located in the NW4 of the NE4 of Section 13, T29N, R19W, Town of Hudson, St Croix County, Wisconsin. INDEX Page 1 of 8 TITLE SHEET IWO- "Page 2 of 8 SYSTEM MANAGEMENT PLAN Page 3 of 8 PROJECT DATA Page 4 of '8 PLOT PLAN Page 5 of 8 PLAN VIEW -CROSS SECTION go vo Page 6 of 8 LEACH CHAMBER DETAIL Page 7 of 8 PUMP CHAMBER Page 8 of 8 PUMP PERFORMANCE CURVE PREPARED FOR St.Croix Valley Girl Scout Council 400 South Robert,Street St.Paul, MN 55107 PREPARED BY ta ��,n��'�sosa3 a` P.O. Box 74 421 N. Main St. � � ��v�.,..M••- •-•.,, d��y ,� River Falls, WI 54022 j Phone 715 - 425 -0165 FATrKIa w�aeEa Fax 715- 425 -6864. } g� D•9!5 P 1� CiLSWORT- 2 k1iiN Z -ZS -oZ JOB NO. Conventional Soil Absorption System llanagement Plan Pursuant to Comm 83.54, Wis.Adm. Code - Page Z of Septic Tank tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Scats. The contents of the The septic septic tank shall be disposed of in acc_rdance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. Tne fiiter cartridce 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 s. all be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are net removed at the time of a triennial assessment, maintenance personnel shall advise the'owner of when the next service needs to be performed to maintain less than maximum scum and sludge ac urnuladcn in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Euilclings Division. Pum ---- o Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.' Dispersal cells . No trees or shrubs should be planted or allowed to grow on the component. _Plantings may be made around the *perimeter and the component shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the component is not allowed. Cold weather install- ations the component to be heavily mulched for frost protection. Influent quality into the AJMX=M system not exceed 220mg /L BODS, 150 mg /L TSS and 30 mg /L FOG. Influent flow may not exce.ed maximum design flow specified in the permit for this installation. Observation pipes within the dispersal cell shall be'checked for effluent ponding. Ponding levels should be reported to the owner and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring in accordance with 83.52 (2). General This system shall be operated in accordance with Comm 82 84_Wis.Adm,Code and shall be maintained in accordance with it's component manual SBD 10 567 -P(R.6 /99)1 and local and state rules pertaining to system maintenance and maintenance reportinn. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in ac:ard POVYi - S components, ancs with Comm 83.33, Wis. Adm. Cede when the tanks are no longer used as Septic or pump tank manhole 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 unauthorted entry into a tank or camponent Continaenc 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 rendition. If the dispersal cells fail to accept wastewater, new cells should be installed in the alternate area with plans being submitted to the Department of Commerce, Safety and Buildings Division. Questions about the operation or maintenance of this system should be directed to The County Zoning - Office at — 1 1�j _ 3�(j _ t q68 0 ' Sh L �41x The system' installer at __� LS 6 Q 609 = p6�1,Z`�/ The tank manufacturer at The effluent filter manufacturer at The leach chamber manufacturer at 00 p�>v,Q 630- cFSZ gNrP Gor✓�p PROJECT DATA Page 3 of 8 This dosed conventional in- ground POWTS with High Capacity Sidewinder leach chambers will serve a swimming pool bathhouse to be used by a maximum of 160 Girl Scouts per day and will have 1 floor drain in the utility room, 4 employees, several area drains for floor washing 1 time per day and shower room drains. 1.6 gal per flush toilets will be installed with 2 gpm shower heads. This design is based on 1 toilet use per patron per day and a maximum 5 minute shower event per patron per day. ANTICIPATED WASTEWATER toilet use ----------- -------- 160X1.6X1.5= - - - - - -- - gpd showers -------------------- 160X10X1.5 =-- - - - - -- -2400 gpd Utility room floor drain - - - - -- 1X25X1.5 = - " - - -- - - -- 40 gpd floor washing at 40 gpd = ---------------- ----------- employees --------------- - - - - -- 4X13.5X1.5 = -- - - - - -- 81 gpd Total = 2942.5 gpd SOIL ABSORPTION AREA - (High Capacity Sidewinder leach chambers) 2942.5 - 1.2 - 17.14 = 143 units required. 9 cells at 16 units per cell = 144 units provided which is suitable for 2962 gpd of effluent. SEPTIC TANK 2962 + ( 11 . 61 X39.49X3) +(46.77X39.49) 2962 +1375 +1846.95 = 6 184.39 . gal min. capacity required. A 4200 gal Wieser Concrete septic tank followed by a 2000 gal tank with an A100 -12 Zabel filter will be installed in series to provide 6200 gal total capacity. PUMP TANK A 1000 gal Wieser Concrete tank will be installed with Duplex alternating pumps and controls. a PLOT PLAN 'Page y of 8 Scale 1"= ' ivu 'ate 3e / . Sou Pte-. PhucIl. K s lf� ADORL'sc: 96S Rty�nnNl'� RD �OoL G • y�o 2 �0 'oy fP l000 ISnL . LO 0FZ1 t?Va F. Fl. a �oL 'tb2 , Li- x6 o$�z _ INI'�"Igl C�1.LS 100' 8.3 0 1 b cis RLl�2 iP�TF FlU--vi l �_ 3 . tF V rL� 10o. \Ieiir tL w B� > S0' F�tuw� �'u-S . q� LS ' FILM TA ►JkS. i •aPTs TTigdn aqj IV Vu T puod juanaad of ivaisAs punoaB aalBM aoBjans JaanTQ •y nog+ S g xaBm gouag 1� - G% Z1'001 f C` S N1 OOv2 + QQ'Z11 'Or Z�5�1M p AlToBduo uOTTO CJCYL q aq of xuBJ Oiadag •£ •(paatnbaa � ) •sdBO panoaddu giTn sadtd UOTIBnaasgo „V TTBIsu1 'Z •paaOU asiMaagjo ssaTun suotIBnaTa punoa8 2UTIGTx9 aaB uMOgs suorIBn •T s�zox p��E S OF N SF ° C c PLC S _Q - A x- t b O Ct)Nv _G' Gv -- o �• 'x-11 G� _�YpP��1'-{ S � D N vTrv�_ L2 - -CLAN Z a' p O I ZO O 3 ' I. 3� 3� 6 SO�OY LOPV,C � 3, O °tS� p yrypuC 3 ` O Lpp � q 4-o' p J pt IS -rteD T-t C� 1CA - �v t7t .. S' i P �s a-r. • N >wF7n .L in In l m m CM - ,I rf � o �i -4 a ` A 4 - � X c, o r � I Ia r a c) ` M1 co 0 -3 Lli w j c �r 9v' � i l�l l 1 7 1 � O cn cn o N n _s O a ¢) _ f L L U ( I I 1 Y _ s x S m n C m` -n I I I I �— -' Cl I 11L a X _ T il� �I� I l Jil Co o C: n Q C: 0 -U :3 � � - I Ii I D I 2 CD� � a (n C1 fJJ O' O (D O n a N ((D 0cD � i�_ irl D? k il ' CL 1z d cn CD CD co -% - I T ' C ' o I i I -i w m N N X 0 Q 3 3 ID p 1 Can, a' O O 1: .Ul X (D W -� co a3CL ca r O (0 CD o Invert 11'—f� / � 3 Y CD �. ('D^ C co O ' PUMP CHAMBER CROSS SECTION AMID SPECIFICATIOMIS PAGE _I OF VCNT CAP 4%. 1. VENT PIPE ' WEATHER PROOF APPROVED LOCKING MANHOLE 10' FROM 0009 JUUCTIOIJ DOX COVER WITH WARNING LABEL wimDOW OR FRESH 12'MIIJ. AIR INTAKE I . I . GRADE ( 4' MIN. I I O' MIN. COIJDUIT 19 "MIDI. �•: -`- -- -- -- \� N _ PROVIDE I - .INLET AIRTIGHT SEAL I \V/ APPROVED JOINT A I I I APPROVED JOINTS I I I NOM ( II ALARM 8 Install dbplex alternating controls with. the alarm I I I syatesi being incorporated into the controls I which will' be activated in the event of pump failure, I I ON simultaneously switching the remaining pump to I C dosing on each cycle. I ay.bo I 11_LCV. FT. P __� 2 , q� -DO •� UMP -� � OFF O aev. 9 3. 00 COIJCRETL BLOCK RISER EXIT PIMmmCD OWLy IF TAWK MANUFACTURER HAS SUCH APPROVAL 1 3 gEp p p l � 5 P E C, I F I C AT 10 KJ S -.I.. rOSE . wtSZ C4�►CP� = . . THE K MAAIUFACTU0.CR. , T A NK bIZC: 000 GALLOWS S 5 • ��T S`�.S`TL� NOTE: PumFSAND ALARM ARE TO DE ALAR MMJUFACTURER: INSTALLED ON SEPARATE CIRCUITS MODEL KIUMBER: SWITCH TYPE: PUMP MANI "• "' •...... 6 pv LD S I MO 4 VER C' r a Goulds Submersible --� _- -s Effluent Pump ;V 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- Homes components. tic cover with integral handle Available for automatic and • Farms Motor: manual operation. Automatic le phase: 0.4 and float switch attachment • EPO4 Sin HP, • Heavy duty sump g p . H models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, Float Switch assembled and ■ Power Cable: Severe duty RPM, built in overload with Dewatenng .- preset at the factory. rated oil and water resistant. automatic reset. ■Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, heavy duty ball bearing FEATURES 115 V, 60 Hz, 1550 RPM, Pump: EPO4 built in overload with construction. ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design -- 'N4' maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SA Canadian Standards Association otal heads: up to 24 feet. with three prong grounding m EP05 Impeller: Thermo- — size: Discharge 1 NPT. plug. Optional 20 foot p -- g plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with end in F or "AC".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA - elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 ; I ' —s�� - GPM components. I j •r. Pump: EP05 $ I :2 Fr • Solids handling capability: c 7 25 1 i /4 maximum. I a • Capacities: up to 60 GPM. _ • Total heads: up to 31 feet. s 20 i I • Discharge size: l'h" NPT. z s • Mechanical seal: carbon- c 15 rotary/ceramic- stationary, a 4 BUNA - N elastomers.` _o 405 • Temperature: 3 10 104 °F (40 °C) continuous 1401(60 °C) Intermittent. 2 _ 5 - 1 1 t t: 0 o o 0 10 20 30 40 50 GPM 0 2 4 g ,.. - 8 10 - m'!h'. CAPACITY fd: 1GQS C:rndic Pnm�c Inn - *� " "i scopsin Department of Commerce SOIL EVALUATION REPORT Page / of . Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 37- ex'01 include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. p _ dg� Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/4 r 1/4 S T 2 N R E (o� Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number City ❑ Village Town Nearest Road L v 7 1 s/) �( New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPO .r. n• Replacement Public or commercial - Describe: L L Ww/e iL S Parent material al o applicable ft. General comments c ° p�{ k / i \Cl.��'L.t� � OX ,cssr,.as�lr.� tioc�s. f6 G7 7`h, r t �zi-A,N fin, o and recommendations: ; i AIT 2 0 2001 i V3 Boring # Boring Pit Ground surface elev. /Q /. / ft ; Depth to Imitin or 2 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture 5tiu e4 onsistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color `u'Y 3z. 'Eff#1 'Eff#2 3 -SZ .s - 3 L 1 C -- L 1 q� 6' -1 - — KrL — 7 A 1 F2-] Boring # Boring ❑ pit Ground surface elev. ft. Depth to limiting factor 7J in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Etf#2 X,12 Z O A4 es •J - 3 ash At I- Jr Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/ - CST Name (Please Print) Signature CST Number G Address Fogerty Plumbing & Perk Testing Date Evaluation Conducted Telephone Number 28288 McKenzie Rd. 711 00 Spooner, WI 54801 C�'/L / — d S - Yo? 12/06 Property Owner aA I S - ,rcwX Parcel ID # j0'Y2 — /070 — 9S —XM Page __ 2_ of 3 F-3-1 Boring # ❑Boring _1 L �� Pit Ground surface elev. it. Depth to limiting factor 7 �2 In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munseli Sz. Con Color r G Q u. (. r. Sz. Sh. •Eff #1 •Eff#2 o Z — D .5— 2 3 d- v 1 / Boring # ❑ Boring ❑ pit Ground surface elev. 7 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 3 �- 7.s -sue Boring # ❑❑ Poring Ground surface elev. l� 3. / ft. Depth to limiting factor > /3Z In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 4 5 Z 2 - S- — o c e 49 . z S Pe - - s -- #fs eys G of/- • Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 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. SOD•8330 (R.N00) r V V l E 0 0 dC*4 v3�w 0 go 00^ v k Y $pr I' h x • k kj u I o� a a� a\ Aii II I j II I i I X� l � � � ► \ \ � ' °x v ` U Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component p Y p p Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number I Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) L Soil Absorption Component Size (ft Type of Wastewater Do estic r L Table 2: Soil Component Absorption Anent - Limits of Reliable Operation p p Septic Tank Component Soil- Absorption Component Design Flow = Peak (gpd) 2&D 2 (, S Maximum Influent Particle Size (in) U 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease' Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic �ttank nd outlet filter shall be assessed at least once every 3 years by inspection. The outlesh be cleaned as necessary to ensur pr oper operation The filter cartridge sho a removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the I - , Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The I septic tank shall have its contents removed when the volume of scum 9 and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank not removed at•the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation i n the tank. Manhole 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 to prevent accidental or unauthorized entry into the tank. device No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with.Comm 83.33 Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil AbsorpUon-Component - The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in , Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least din once every three years. The inspection shall include recording the levels of on p g. if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. Plantings of deep- rooted trees and shrubs directly over or within ten feet of the { component should be avoided since root intrusion into the component may obstruct wastewater flow. Mound System Management Plan Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under.s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as nece9sary 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, ndi filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending conlinuo alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liq uid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personhel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, 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 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the omote frost penetration. Cold weather infiltrative surface within the mound and snow compaction in the winter will pr installations (October- February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg1L BODS, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 mofiths. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has-occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, ; and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General l main This system shall be operated in accordance Comm al or 82-84 ae rules pertaining to system nte ce l and ma ntena ceh its component manual [SBD- 10572 -P (R. 6199)] and to reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment must be e aced. Exposed access openings greater than 8-inches opening n diameter shall unsound, defective, or subject to failure P be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Contingency 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. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. wastewater If the mound component fails to accept wastewater o area if to leakage occurs orby removing repaired ng biolog cally clogged adsorption or replaced in its' present location by increasing basal and dispersal media, and related piping, and replacing said components as deemed Necessary to bring the system into proper operating condition. f Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector. ,r Fogerty Plumbing #221180 28288 McKenzie Rd Maintenance Spooner, WI 54801 (715) 635 -9609 The interval for servicing septic tanks is set by state and local code. T hrou g h o ut g a enc es uggesi two to five years - wide difference of opinion on what this interval should be, but most regulat 9 when the The Zabel'" filter, which does not increa m ed f Howeve , our filter s virtually self-cl should be eaning. an ng. The continued ued act on septic tank is normally inspected and pu p i om of of the anaerobic organisms on th ter alarm, l odged will be notified by an alarm when the filter needs servicing. the tank. If your filter contains a martF �. , To service the filter: 'Servicing any zabel filter should only be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. m2 Firmly pull the filter handle and slide the cartridge out Remove the tank cover of the case. and pump the tank if > * Note: A tee handle may have necessary to prevent to be used if the filter i5 too far any solids from below level to reach. escaping to the field t` Contact zabel for info on tee . handles when the filter is removed. AM While holding the cartridge over % Insert the filter cartridge ` the access opening rinse off the cartridge with fresh water, being back in the case making careful to rinse all septage material sure the filter, cartridge is. back into the tank_. properly aligner -- _, .:: c ompletely i rt in e"< r 'Note: It is not necessaty.to ' t he 6 1 comp spotless'. The biomass yrowlrap.oatltefllOe % aides in the pretreatmen(�prtroc�sS be left on the filter. (If n Replace t be disassem/gf' may � w , WOE IN if The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5,580,453, 5.591 '550985686Des. 3090082Australia7134440 Canada: 2,135,937; srael 111574 New S Zealand 264824 U.S. Des. 386,241, 34906 4605501 Other Patents Pending : Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 -221 - - Website httpJlwww.zabe A100/300•I- M,614 INSTALLER'S NOTES: RECYCLE GREASE! Do not pour grease down the drain. Your septic tank and filter will not handle it. NO BLEACHES! Do not introduce bleaches into your system. The bacteria in.-your septic tank is what makes your system work. Bleach kills the bacteria. When that happens, your septic tank will no longer function correctly. This will cause premature failure of your system. WATER SOFTENER! Do not nun the brine solution into your septic tank. This solution has a high concentration of lime (that's what makes your water hard). The lime tends not to settle out in the septic tank but goes directly to the drain field. Lime is an excellent sealing agent, and yes, it does the same thing in your drain field. Think of your sewer system as you would your car. Treat the attached information as you would your car manual. Remember, also, that your car requires regular maintenance. f-aw must be exercised as to what you put into it. And like your car, your system eventually will wear out. The question is - how quickly. If you have any questions, please call: Dave Fogerty 715- 749 -3656 - Roberts _ 715- 635 -9609 - Spooner If you have an emergency, and you only get voice mail at these two numbers, call Keith Knutson at 715- 796 -5436 - Hammond I have read the attached information regarding the construction and maintenance of my sewer system. Owner's Name Date ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner gr !rZ rZ 42 / ��.#L re0AW /.ry�iirL Mailing Address Property Address (Verification required from Planning De artment for new construction) City /State Parcel Identification Number A ell — 93 = LEGAL DESCRIPTION Property Location - %s,. V,, Sec. / T�_N -R -W, Town of Subdivision . Lot # `— Certified Survey Map # , Volume , Page # — LlVq Warranty Deed # .<S345 , Volume � l Page # Spec house ❑ yes] no Lot lines identifiable yes ❑ no SYSTEM MAINTE NANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a waste lumber , l ourne y�nP ' lumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system P 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. Uwe, 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 Commerce 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 Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION 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. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed lfa. 8♦. Warne Do*& -8hort Pam 1/[A!i O/ �/IaCOif/ilq a.L U L14. WY. 84ptOr P. Ifs • luW@wd ar Ira CWn SUN & SaUm 283652 VDl H PACE Malcolm Bush a /k /a Malcomb Bush, Malcom Bush and Tbi Nbenture ,MadebyH. Malcolm Bush; and Mary Bush, brother and sister grantor s , of St. Croix County, Wisconsin, hereby conv and warrants to Girl Scout Council of St. Croix Valley grantee of St. Paul, Minnesota v,W NN, thesumof Nineteen Thousand ($19,000.00) Dollars the following tract of land In St. Croix County, State of Wiscona Northeast Quarter of Southeast Quarter (NEISEJ); South One -half of Northeast Quarter (SJNEI), and that part of North One -half of Northeast Quarter (NINEI) south and east of the town road as presently located, all in Section Thirteen (13), Township Twenty -nine (29) North, Range Nine- teen (19) West. w , a rl 3T. CROIX CO.. Wit. Recd for Record this_ 11th_ day of__P,'=b_____A.D.19 -( M Regl e► of eeds 9 In Witntoo Motnot, the said grantors have hereunto set their hand s and sea! s d 9 day of March ,A.D.,1966 Signed and Sealed in Presence of M alcolm Bush / -� E �ZQ Q .(SEAT ry Bush Hugh F. Gwin ..(SEAT Catherin e H. Poskus .(SEAJ Matt of (i toronoin, St. Croix Count 3'• ss. Personally came before me, this 1 day of March , A.D., 19 66 above named Malcolm Bush and Mary Bush, brother and sister I n .wa , Lww..... s.. L. aL- �-- - -�.-. ...L- .�- ....�.J •L. L"......... �.. .....��.....�..� w.. "7 ww Lww... /w.7..w.7 •T.a a.nw.w f - Zg ctl-3a it 3 qs 1?8 ' S 9 Y. (a ' g3 •IB� q3. 9z, c f r A Z O 1 r W N • n y CD y O A= C C N < CD CO N CO �f N Q .,' 7 n N 1a n O f0 C ^"'1 O W C 7 CO 0 N CL CJ N ° Cl) O rn r fD = 3 o r* 3 w ° ° o p 0 n CD v> v y C a CD In T 0 D G 3 O N W m CD V CD_` Z r pD �r O� N N CD '� 0 0 0 O CO) U) W N Z 3 !! CT o a 0 ID 0 ? n' cp CO) (a CO) o rf p (( W W > ti v - < .. y X w CD CL a Z M N I o D D o a Q O T c- 5 m. CA m CD = C I m N G O Z W ' n cn Z (D Cp N U O 0 A Z n n a I A Z O P 0 C W Z --I W CO CL 4 n3 Z 3 z X c m co N Z I CD o °� X. CD y' Q C U) =r N C O CD 0 3 o CD o ° x > C D v N I m a x o _ , o_ c -'ao 3 d N N CD 7 .Z1 O O In < 01 j D. M CD 3 y O CM 3 A 7 cn CT n yv c N ° o a cn _ m � 0 b w CD aro f w Fn O .. e O C ` L a, y ti Parcel #: 042 - 1048 -95 -000 05/16/2005 03:37 PM PAGE 1 OF 1 Alt. Parcel #: 18.29.18.274B 042 - TOWN OF WARREN Current X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * GIRL SCOUTS INC, ST CROIX VALLEY ST CROIX VALLEY GIRL SCOUTS INC X X 00000 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 32.000 Plat: N/A -NOT AVAILABLE SEC 18 T29N R18W THAT PT NW NE LYING S Block/Condo Bldg: OF TN RD. TAX EXEMPT Tract(s): (Sec- Twn -Rng 401/4 1601/4) 18- 29N -18W Notes: Parcel History: Date Doc # Vol /Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 03/11/1987 Description Class Acres Land Improve Total State Reason OTHER X4 32.000 0 0 0 NO Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 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