HomeMy WebLinkAbout020-1020-50-050Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division ~
• INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
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
Lallensack, Kevin Hudson, Town of
CST BM Elev: Insp. BM Elev:
~ BM Description: ,/y~
~
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TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic
(,,~; e~
l z 50
F, L,QQ, IA-- !D'b
Aeration
Ho ing
TANK SETBACK INFORMATION
. en o it n a e
ep Ic 7 Jed ~ , J/~
/V 1~' ~
33 ~ _--.
osing
era Ion
o Ing
PUMP/SIPHON INFORMATION
anu ac urer eman
GPM
o e um er
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orce in I
sut~ ~-Irsaurcr ~ wrv a l a i cm
ELEVATION DATA
county: St. Croix
Sanitary Permit No:
488104 0
State Plan ID No:
Parcel Tax No:
azo - Bozo - 50 - os
Section/Town/Range/Map No:
14..29.19. 93
STATION BS HI FS ELEV.
Benchmark
3. zo
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Alt. BM
IrT deg.. Go o w
7~
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Bldg. Sewer ~ Z~
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DIMENSIONS ~ t $g'~, 97,
Da Z ~r6wc~.~ ~---_ _~.
INFORMATION CHAMBER OR ~~ ~ ( a~}-~~
' ~ UNIT
GOa~ ~y 75 „I~-• , ~,~[ J ~t~~ G~ T
viatr~roviwrv~l~~~~rr Al.ilJ.. 7.Z,d-~~S ~ ~~ iava~~
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Length Dia~_ pipe(s) ~
Length~~ Dia~_ Spacing
~ ~ ~ ~"^
d ~~ Pte,
w~~ ~.vvcr~ x rressure systems vnry xz rvwunu ~,~ .,~-~arauc.ayaacn~a .+..v r-7tyw., ~..,npc~s
Bed/Trench Center ~i . / Bedrrrench Edges \ Topsoil \ ~' 1 Yes ~.:~ No \ Yes No
GOMMtN 15: (Include code discrepencies, persons present, etc.)
Inspectwn ~~: i i mspeco°n irc. ,
Location: 759 McCutcheo/n Ro~ad,,Hudson, WI 54016 (SW 1/4 NE 1/4 14 T29N R19W) NA Lot 2
1.) Alt BM Description = ~,• ` ~ ~.BJ ~- ~.~ ~ ~y
2.) Bldg sewer length = 33
- amount of cover = ~ !
Plan revision Required? ~° +; Yes No
Use other side for additional information. i f ~ ~ D~
SBD-6710 (R.3/97)
Parcel No: 14.29.19.
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~ ~ Safety an Buil ivision
201 W. Wash' gton 162 County
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I ~~Of~~~~ MadiS n, WI 53701- ~/~
~ Sanitary Permit Number ( be filled in by Co.)
De artment of Commerce 608) ~§6-3151
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Sanitary Permit p ' at~gn 20p6 State Plan I.D. Number
In accord with Cornm 83.21, Wis. Adm. Code, nformatioh ~tBq~vi~ie
may be used for secondary putpo rivacy La l xm) ~-O(~NTY Project Address (if different than m
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I. Application Information -Please Print All In o aY ~
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Property Owner's Name ar # Block #
~ui,cJ ~ ~ e ~~ ~ ~~ .? ~
roperty Owner's M
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"" ~~ JT „~'/., ~C'/., Section
City, State Zip Code Phone Number
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T r~ Q N; R~E or4l
II. Type of Building (check all that apply) ar
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~ ~
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~,1 or 2 Family Dwelling -Number of Bedrooms ~a,ti Subdivision Name CSM umber
~
^ Public/Commercial -Describe Use C~/y~
~~
^ State Owned -Describe Use D 2 /~
^City_^V illage ~ownship of /'T
III. Type of Permit: (Check only one bog on line A. omplete line B if applicable)
`t'' New System
~ ^ Replacement System ^ TreatmenVHolding Tank Replacernent Only ^ Other Modification to Existing System
~
B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. T e of POWTS S s tem: Check all that a 1
Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^
Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^
Recirculating S nthetic Media Filter Ching Chamber ^ Drip Li ve - ess tpe (ex lain)
V. Dis ersal/TreatmentArxc Information: ,S GZ .' c -s
Design Flow (gpd) Design Soil Application Rate(gpdst) Dtspersa equtre s rsal Area Proposed (sf) System Elevation
~
7 ~
/
•/ r 7 ./ ~~ ~S9 p~
a ~~ cB
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,
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Stcel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing J. , (~
Tanks Tanks !/ ~a~,c)(„
Septic or Holding Tank ~ ~ ~ D
,' c s e ~
'~
Aerobic Treatment Unit
Dosing Chamber ~~ a ~ /• ,! -~3, G
VII. Responsibility Statement- I, the undersigned, assume responsibility for ins llation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signatu PRS Number Business Phone Number
~J~ l~.`G- s>z. a u~.ako !~/ a ~? y' 7/S• 31r~_,~~~~
Plumber's Address (Strcet, City, State, Zip Code)
1~ 7d c d-i~' Gl to ~Y~ G
VIII. Coun /De artment Use Onl
Approved ^ isap Sanitary Permit Fce (includes Groundwater Da Issu Issui gent Sign re o Stain --
^ Surcharge Fce)
~ ~'~ Od
3 23 (
wn rven Reason enial o
IX. Conditions of ApprovaUReasons for Disapproval 3, .~1~ /~ ~ ~~o n ~ ~ ~~ (` v i PC-
ax
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Akach eompleh plain (to the County only) for the ayatem on paper not leas than gill x 11 inches in size
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"~ REGEI~/ED~
~Oit~~/~ E ALUATION REPORT #1s31
Department of Commerce ~ E ~, ~- 9 idf~brdan with Comm 85, Wis. Adm. Code Page 1 of 3
Division of Safetv and Buil nos ]~ ~® ~ ~ ~;, Steel's Soil Service, Inc.
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ch in size. Plan mu
Attach complete site plan on p per nbt7ess
tfi
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~ St. Croix
irection and
inGude, but not limited to: verti
~
percent slope, scale or dimensions, north arrow, and location and dis ance ad. Parse! LD.
endi
Please print all information. Rev' By Date
Personal iMormation you provide may He used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~Z Z7
Properly Owner Property Location
Bast, Kemon Govt. Lot NA SW1/ , NE /4, S14, T29N, R19W
Property Owner's Mailing Address Lot # Block # Subd. Na a or CSM#
948 Labarge Rd. 2 na CSM
City State Zip Code Phone Number ~ City ~ village ®Town Nearest Road
Hudson WI 54016 715-386-7775 Hud~t McCutcheon Rd
®New Construction Use: ®Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
^ Replacement ^ Public or commercial -Describe: NA
Parent material Outwash Flood plain elevation, H applicable na ft.
General comments System elevation 93.10ft.trenches spaced and depth to code 5.75ft below grade.
and recommendations: ~- ~1
a Boring # ^ Boring
® pit Ground surface elev. 98.85 ft. Depth to limiting factor 120 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D1ft=
in. Munseft Qu. Sz. Cont. Color Gr. Sz. Sh. •Efi#1 •Eff#2
1 0-35 10yr3/1 none sl 2msbk mfr a is .6 1.0
2 35-60 10yr4/4 none sicl 2msbk mfr cs if .4 .6
3 60-95 7.5yr4/4 none cos osg ml gw na .7 1.6
4 95-120 7.5yr4/6 none grcos osg ml na na .7 1.6
Boring # ^ Boring
® ph Ground surface elev. 98.85 ft. Depth to limiting factor 120 ~ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Etf#1 •Eff#2
1 0-32 10yr3/1 none sl 2msbk mfr a is .6 1.0
2 32-48 10yr4/4 none sicl 2msbk mfr cs if .4 .6
3 48-75 7.5yr4/4 none cos osg ml gw na .7 1.6
4 75-120 7.5yr4/6 none grws osg ml na na .7 1.6
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Effluent #1 = BOD S> 30 < 220 mg/L an TSS >30 < 150 mg/L * Effluent #2 =GODS < 30 mg/Land TSS <_30 mg/L
CST Name (Please Print) ti.~ ignature: CST Number
David J. Steel 248956
Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number
994 200th St. Baldwin, WI 54002 12/19/2005 715-760-0347
sao.ssso (R. ~ioo)
P~perty Owner Bast, Kernon Parcel ID # Pending Page 2 of 3
Boring # ~ Boring
pit Ground surface elev. 96.25 ft. Depth to limiting factor 120 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#t *Ett#2
1 0-12 10yr3/1 none sl 2msbk mfr cs lc .6 1.0
2 12-24 10yr4/4 none sil 2msbk mfr cs if .4 .6
3 24-44 7.5yr4/4 none sicl 2msbk ml gw na .7 1.6
4 44-77 7.5yr4/6 none ms osg ml na na .7 1.6
5 77-120 7.5 yr4/6 none cos osg
lf7 l~
~~~ ~ .
^ Boring # ~ Boring
pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ett#t 'Ef-#2
Boring # ~ Boring
pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff=
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •EtT#1 •Etf#2
'Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 <_150 mg/L "Effluent #2 = BODS < 30 mg/Land 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.
SBll-8330 (K.U7/Wl - 502EPS SOiI $2NICE. IfIC.
STEEL'S SOIL SERVICE INC. 3 of 3
David J. Steel Kernon Bast ~ 994 200a' St
CST-POWTSM swl/4,NE1/4,s14,T29N,Ri9w Baldwin, WI 54002
Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347
CSM Lot, 2 Fax 715-684-3449
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use.
The location of this test may or may not be as shown, as permanent lot lines were not established at the
time the soil test was conducted.
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Legend
1" = 40'
• =Benchmark Ele. 100.00 ft
Top of 3/4" pvc pipe
• =Alt Benchmark Ele. 99.70 ft
^ Top of 3/4" pvc pipe
= Borings
Boring Elevations
~~• B1 = 98.85 ft
~~ , '75~~ B2 = 98.85 ft
~ ~, B3 = 96.25 ft
~(~ , ZS~ B4 = ~ 0.00 ft
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12/17/2005 20:36 7157491719
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NORTHLAND SURVEYING
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE SWiJ4 QP THE NE1/4
OF SECTION 74, T29N, R79W, TOWN OF
HUDSON, ST. CROIX COUNTY, WISCONSIN.
N7/4 CORNER
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PAGE 01
IW11
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~~~ ~ MELVIN & JOANNE HILLMAN
° I ~I ( I 757 MCCUTCNEON ROAD I
I Q I I I HUDSON, WI 54016
o i ° i I ~°ffi°fi~° OG7 MOCK 90~ pGQ~C~ ~~9 d0p 4 ~
i ~ suRVEYOA ~
~O4 ~ ( EDWIN C FLANUM
~~~~ ~ ,r~ ~ ~ NORTHLAND SURVEYING, INC.
~~=LJ~~f~GOG~ ~[0>+1 ROBER~WI5dD23
EXISTING CENTERUNE-7 NORTH UNE Of THE SWt/4 OFTHE NEt/4 c~
l ;- - - N89°38'18"E 380.00'._.._ _ ~.
N89'35' 18"E 22d.7g 284.00' ~ ~ ~ ~_
87/4 CORNlR
SECTION /4
LEDEND
t ~ 284.00'
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^ 88.00' to
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Q 17 z.z41a• 80. FT.
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ALUMINUM COUNTY SECTION / •
CORNER MONUMENT FOUND
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RVEY MARKER
~' ST p~p6~d ~G~1 MOdo9 U U ~pl1C~C~ q ~
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• • • 100' ROADWAY SET9ACK UNE R.97 ACRES INC. R/W
t zs.4es eo. FT.
15/18^ O.D. IRON PIPE FOUNp Z^Q8 ACRES EXC. RM-
1E7,E19 BQ.FT.
• SOIL BORING ~
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CORNea occuPElD
BY B' CEDAR TREE
PQ[R3C~C~6 0(~'] MOO do n~3~3g PLaC~C_~la ~
- ^ T SCALE IN FEET 1" = 100'
THIS INSTRUMENT DRAFTED BV KEVIN REED SHEET 1 OF 2 SHEETS
JOB N0.05.124 DATE 12.13-05 1~ 0 1~
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer ~f G Ur`,tJ ,[,~ ~G ~.y.S'~c~(
Mailing Address _ /a(o ~ J~~iu~ S f f(/u° v ~,. c~k~l (~v/ S`YG/ ]
Property Address __ ~c5 ~ ! Y I C- t ~.t~C,Y,L~1~,. r~-d"~_
(Verification required from Planning & Zoning Department for new construction.)
City/State /„~,,~~,^, fiv! Parcel Identification Number
LEGAL DESCRIPTION
Property LocationS~/ '/4 , --~~ '/4 ,Sec. s ~ , T ?~N R~W, Town of /emu-oQSo.~
Subdivision ~.S'f'~'t ,Lot # ~
Certified Survey Map # ~ / 70 7 Cp ,Volume o~ ,Page # $~ / y~
Warranty Deed # 8 a o3~~ ,Volume ,Page #
Spec house yes no
Lot lines identifiable yes no
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 §Comm. 83.52(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.
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 Planning &
Zoning Department within 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 am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
1.~.~~~~
SIGNATURE 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. 08/05)
~l
~curttent Number
STATE BAR OF WISCONSIN FORM 2- 2000
WARRANTY DEED
THIS DEED, made between Joanne M. Hillman, a single person,
Grantor, and Kevin M. Lallensack, a single person, Grantee.
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of Wisconsin:
Part of the SW "'/. of NE '/. of Section 14, Township 29 North, Range 19
West, Town of Hudson, St. Croix County, Wisconsin described as follows:
Lot 2 of Certified Survey Map recorded January Z5, 2006 in Volume 20,
Page 5149, Doc. No. 817076.
Recording Area
82m346
KATHLEEN H. MALSH
REGISTER OF DEEDS
ST. CROIX CO., MI
RECEIVED FOR RECORD
03/09/2006 08:00A![
YARRANTY DEED
EXEMPT t
REC FEE: 11.00
TRANS FEE: 240.00
COPY FEE:
CC FEE:
PAGES: 1
Exceptions to warranties:
Easements, restrictions and rights-of--way of record, if any.
Name and Return Address:
,~~ ~ .,.a ~. .._ _ _ ,r First National Bank
PO Box 89
49443- New Richmond., WI 54017
020-1020-50-000
Parcel Identification Number (PIN)
This is not homestead property.
Dated this 3rd day of March, 2006.
oanne M. Hillman
AUTHENTICATION
Signature(s)
authenticated this 3rd day of March, 2~~e~~ ~C b`,C
`, Pu ,r
* _.~ ~ 1S
TITLE: MEMBER STATE BAR O~~C~ONSIN
(If not,
authorized by § 706.06, Wis. Stats,)
THIS INSTRUMENT WAS DRAFTED BY
ACKNOWLEDGMENT
STATE OF WISCONSIN )
ST. CROIX COUNTY. ) ss.
Personally came before me this March 3, 2006 the above
named Joanne M. Hillman, a single person to me known to be
the person(s) who executed the foregoing instrument and
acknowledsed the same.
*Cheri iTiown -
Notary Public, State of Wisconsin
Peterson, Fram & Bergman -Steven H. Bruns My commission is permanent. (If not, state expiration date:
50 East Fifth Street, St. Paul, MN 55101 3/11/2007
(Signatures may be authenticated or acknowledged. Both are not necessary.)
*Names of persons signing in any capacity must be typed or printed below their signature
WARRANTY DEED STATE BAR OF WISCONSIN
1of1
FORM No.2-2000
POWTS 4WN~~"~ 11nANU1~-~ & MANAGEMENT Pi.AN Page of
FILE INFORMATION Cs ~ (; a ~-~.\ SYST SPECiFICATION8
owner ~ ~
Permit #
DESIf3N PARAMETERS
Number of Bedrooms *~ p fJA
Number of Public Facility Units, p (~/~
Estimated. flow (average} ~~ Q'Q . a /dn
Desbn flow tpeakl, tEstimated x f .5} ~~ ~ aUda
Sod Application Rate al/da /ftx
Standard inffusnt/Effluent Quality
Fats, Oii & Grease tFOGi`',
Biochemical Oxygen Demand tBOQeI
Total Suspended SoNda tTS$) Monthly &va~~ig~"
530 mgiL
5220 mg/l, O ~,
5160 mglL
Pretreated Effluent Quality
Biochemical Oxygen Demand tBODs}
Total Suspended Solids iTSSI
Fecal Colifonn (geometric meant Monthly •avaraga
~3t) mq~l.
530 mq(i.
5104 of~llQOmt
q NA
Maximum Effluent Particle Size Ye in die. i~ NA
Other: Q NA ,
~\fd..~~ ~..~L..1 t.. J~~..-sue . __ _.J ~_ _ __~. ~ui..__a +.
a~pvo. \w awnnww wwa~wawr a~w aepuc aan~ aniva~~a.
Sa~xic Tank Capacity ,~ CJ al p Nq
$epttc Tank Manufacturer ~, O NA
Effl4ent Filter Manufacturer ~ ' ~ ~ O NA
E~ftuent. Finer Mode! ~~' O NA
Purrtip Tsnk Capacity ~j°Q' al ^ NA
Rump Tank Manufacturer ~reS,~y,,, O NA
Pump Manufacturer ~.R,cc/ ^ NA
Pump Model O NA
Pretreatment Unit
(~ ;i~d/Gravel Filter
~] ~A~chanicai Aeration
l~ Qisinfeotion
O Peat Filter
^ Wetland
^ Other: ^ NA
D{apa~sal CeUtsi
q ln-ground tgravityl
q At-6rade
~] drip-Line O NA
1] In-Ground (pressurized}
O Mound
^ Other:
sr,.r ^ NA
Q'~er' Q NA
gther; DNA
MAINTENANCE scl~ouLE
Service Event Service Frequency
inspect condkion of tankts[ At feaet ones every; ~ ear s s tMaxGnum 3 years} O NA
Pump out contents of tankts} Whgr? gombir-ed elydga ant# scum equals one-third tYg1 of tank volume O NA
fn:peat disperse! cents) At taut pace every; monthisl (Maximum 3 years)
,~ eartai O NA
Clean effluent faker At {ea3t Qnce every; ~ ~ d monthtsl
• ~ ~ OMt81 O NA
inspect pump, :pump controls & alarm
At least Ance every: monthtsl
.-- 0 earisl
O NA
Flush laterals and pressure test At leA,lt Qnca ev,pry; monthtsl
~` ^ eartsl O NA
other: At {eaax pnae everw~ o eats) ^ NA
Other.
O NA
MAINTENANCE INSTRUCTIONS
inspections of tanks and dispersal calla shall 6e rYillSle lay an individual amrrving one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; ROWT$ Inspector; PQWTS Maintainer, Septage Servicing Operator. Tank
inspections must include a visual inspection of the tsnkiel to idmntlfy aryy missing or broken hardware, identify any cracks or leaks,
measure the volume of oomWned sludge and scum end to shack far any hack up or ponding of effluent on the ground surface.
The dispersal califs} shall be visually inspected to ohgek the affluent levels in the observation pipes and to check far any ponding
of effluent on the ground surface. The ponding Qf effluent on the ground eurfacs may indicate a failing condition and requires the
immediate. notification of the local regulatory auth4fity;
When the combined accumulation of sludge and Sctlrn In any tank equals one-third tY,l or more of the tank volume, the entire
contents of the tank shall be removed by a Septege Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
Ali other services, including but not limited to the servicing ut effluent f<tters, mechanical or pressurized components, pretreatment
unite, and any servicing at intervals of 57 2 monthly; sfhal( qe perforfleld ay a certified POWTS Maintainer.
A service report shall be provided to the local regulatory suttjcrltY ~ith~~ t0 days of completion of any service event.
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS cheRk trp+~xmenS tartklsl fpr the presence of painting products at other chemicals
that may impede the treatment process and/or damage the dispersal Geiilsi. If high concentrations are detected have the contents
of the tank(s1 removed by a septage servicing operatpr pnpr tQ use.
System start up shall not occur when soli conditiana erg frpxan at the infil#ratlve surface.
poring power outages pump tanks may fill above ttorrp8~ highwater I®~e1s. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, GV~rl4adinp the oel,l{s} and -may result in the backup or surface discharge of
effluent. To .avoid this situation have the contente of the pump tank removed by a septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber o~ Pg1NTS Maintainer jo assist in manually operating the pump controls to
restore normal levels within the pump tank.
iqo not drive or park vehicles aver tanks and dispersal Geiis. Do not strive ar park over, or otherwise disturb or compact, the area
within. 15 feet down slope of any mound or at-grads soil absorption arras.
Reduction or elimination of the following from the wastewater stream rriay improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette btittss gondgma; cAKtpn swab; degreasers; dental floss; diapers; disinfectants; tat;
foundation drain (sump pump- water; fruit -and vepa~a~~a pealingst gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tacri~vr)s; end water spfteher brine.
ABANDONMENT
When the POWTS Yails and/or is permanently taken, out of service the fcxildwing steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chat?tcr Comm 8~.~3, Wisconsin Administrative Code:
• Ali piping to tanks and pits shall be disCOnrjaa~ed end the abandoned pipe openings sealed.
• The contents of all tanks and pits shall he reittaved and properly disposed of ay a septage Servicing Operator.
• After pumping, al! tanks and pits shall b® expaveted and removed 4>'r their covers removed and the void space filled with
soil, gravel or another inert solid material
GONTINGENCY PLAN
if the POWTS fails and cannot be repaired the fQllrrwinp measures have been, or.must be taken, to provide a code compliant
replacement system:
O A suitable replacement area has been, ev~ly~ted and may be Utilized for the location of a replacement soil. absorption
system. The replacement area should be ~iQteoted from diatiirbaipce and compaction and should not be infringed upon by
required setbacks from existing and propgsQf~' structure, lot linen and welts. Failure to protect the rapiacement area wail
result"in the need for a new soli-and site avaiuatiQr~ to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that tlmQ.
~ A suRable replacement area is not available due to setbagk rind/or soil limitations. Barring advances in POWTS
technology a holding tank may be insteiled as'g last resort tQ replaoo the felted POWTS.
~~ ~ T site d site
e tank
d Mound and at-grade soil absorption systems may ¢e febonstructed in place following removal of the biomat at the
.infiltrative surface. Reconstructions of suph syatems`m+'asx gbrnply with the rules in effect at that time,
< <WARNINO> >
SEPTIC, PUMP AND OTHER TREATMENT TAIVK$ IV~AY COf1ITA(M },ft'fNAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHE1t TREATMEN~' 'T`ANK <1MP~R Al~IV ~}~CUMSTANCES. OEATH MAY RESULT. RESCUE OF A
PERSON FROM THE iNTERIOR'OF A TANK MAY $$ ~iI~FICUI.t OR 1MF~$SIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER
Name ~:~C~~~u ~~+ ~ !~~
Phone 7 / - J' - ~1~1z
SEPTAGE SERVICING OPERATOR (PUMPERI
Name
Phone
This document was drafted in compliance with chapter Comm ~9.2x1214b}lt
5
-, Plcpe 17 /S - 3~s(~ - ~~ ~ ~
ill ettd 83.54(11, (21 & (31, Wisconsin Admtnlstrative Code.
SEPTIG TANK E PUMP CHAMB~~ CUSS SECTION P.ND SPECIFICATIONS
4" CI VENT PIPE 12" MIN. ABOVE G~AE ~ WEATHERPROOF
25' FROM DOOR, WINDOW OR JUNCTION BOX
FRESH AIR INTAKE ~---WITH CONDUIT
FINISHED GRADE
4" CI RISER
18"' IN. 6" MAX.
T N LE T ! [~ti /~
WATER TIGHT SEALS
APPROVED .
'IPE 3'
INTO SOLID
TOIL PUMP OFF ELEV . F'T.
r
T'
R
~.
~~
~~1
~~
~s
l'
GAS- i '"
TIGHT ~ ~ ~
.SEAL " }
~ ~ ALM
ON
~ ,
I ~
i dOFF
3" APPROVED BE~?1~ING UN1~ER ~`A~K
SPEO~I'~CATIONS
SEPTIC / DOSE
TANK MANUFACTURER: ~`~?,~~..~
TANK SIZES: SEPTIC 10:,~'Q GAL.
-` DOSE ~ db^, GAL,
ALARM MANUFACTURER: LeLwN~.g~
. MODEL NUMBER: 'pi._~(
SWITCH TYPE : '~e/0.~.
PUMP MANUFACTURER : ~3-~w,~
MODEL NUMBER : ~ {~ ~
SWITCH TYPE: me~C
REQUIRED DISCHARGE RATE ~ ~ GPM
APPROVED
MANHOLE COVER
W/ PADLOCK ~
WARNING LABEL
4" MIN.
~~
/APPROVED
JOINTS WITH
APPROVED PIPE
3' ONro
SOLID SOIL
~~ RISER EXIT
PERMITTED ONLY
I F TANK
MANUFACTURER
HAS APPROVAL
CONCRETE PAD
~,~IM$ER ~-OSES PER DAY
DOSS VOI~iME INCLUDING
F LOW$AC K : ~ ~ ~ GAL .
C,P-P~1C:~T~E~: A = ~_ INCHES = ~I~rGAL.
8 = 2 INCHES = 4 ~ GAL.
C = ~ INCHES = ~i$ GAL.
D = ~ INCHES = ~~p GAL.
PI1M~' ~ AL;FIRM WIRING AS PER LLHR 15.23' WAC
VERTICAL DIFFERENCE BETWEEN PUMP Q~'F ANA AISTRI~UTION PIPE ~~ FEET
+ MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET
+ ~ D FEET FOItCEMAIN X ~~bOF'~/~t~Q ~'~'. ~'I~I~T~ON FACTOR ~~ FEET
TQ~'~~ RXNAMIC HEAD = _~~~FEET
INTERNAL DIMENSIONS OF PUMP TANK: ~IrNGTH ~ ; WIDTH ~--i' DIAMETER
s~~qur~ ~ 3g ~. ~1 ~;~L pee 1"
SIGNED: _~ ~~~r~-~.~---~,.,_ LICENSI+ N~tMBER; ~.~~ ~q l7 DATE:
1/86
~GOULDS PUMPS
Submersible
Effluent Pump
~~
3 ~ / I EP05
APPLICATIONS
specifically designed far the
following uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
• Watertransfer
• Dewatering
SPECIFICATIONS
• Solids handling capability:
'M"maximum.
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet.
• Discharge size: 1'/a" NPT.
• Methanicai seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104°F (40°Q continuous
140°F (ii0°C~ intermittent.
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Motor:
• EP04 Single phase: 0.4 HP,
115 or 230 V, 60 Hz, 1550
RPM, built in overload with
automatic reset.
• EP05 Singgle phase: 0.5 HP,
115 V, 60 Hz, 1550 RPM,
built in overload with
automatic reset.
• Power cord: l 0 foot
standard length, 16/3
S1TOW with three prong
grounding plug. Optional 20
foot length, i W3 S1TW with
three prong grounding plug
(standard on fP05}.
• Fully submergeff n hl~h
grade turbine fl;~ pr
lubrication and a dent
heat transfer.
Available for autpm~tic and
manual operati~{r, Auta~
matit modelt inFlrrde
Mechanical FIoeE ~vv~tc~r
assembled and preset at q-e
factory.
FEATURES
^ EP04 Impeller" T~ermoplas-
tit semi-open des~~n vy~h
pump out vanes for m2~lanical
seal protection. ;;
METERS FEET
ro~
9
s
6
5
~ a
0
~ 3
z
0
~ EP05 Impeller. Thermoplas-
ficenclosed design far
improved Performance.
~ C;esirtg and Base: Rugged
~armoplastic design provides
superjor sttepgth and corroswn
~~ikt+3n~S~,
I4 Mofpr }igusJng: Cast iron
for effldQnt heat transfer,
~1en~tlr, anii duraWllty.
Motor Eover. Thermoplastic
coyer wi~t'i'~tegrai handle and
~c~t sw~t>kt attachment paints.
A Power Cable: Severe duty
reted o;} and water resistant.
^ Bearings: Upper and lower
heavy duty ball bearing
construction.
AGENCY_LISTING
~• canedtan sranaa~ds assoa6loion
(CSA listed model numbers end
in "F" or "C".}
Gaddy romps is ISO Soot Aegtstered.
I 50 GPM
caracmr
Goulds Pumps
ozoooGou~d:Pumps ~ ITTindustries
Effective February, 2000
83871
, r_
Q 2 4 6 8 16 12 m~/h
-=Quick4
STANDARD CHAMBER
Quick4 Standard Chamber
MultiPort End Cap
,r
r
_~
~~ SIOE VIEW
SIDE VIEW
TOP VIEW
FRONT VIEW
Quick4 Standar d Chamber Nominal Specificatrons~' ~:x
Size (W x L x`H) 34`'x 52' `x12'
Effective Length 48•
Invert Height g•
Port. End. Gan' No[r
S¢e(WxLxHj 34'x16'x12'
Invert Height 8' or 1.25'
r~,-
INFILTRATOR SYSTEMS INC STANDARD L_IN![TED WAR
(a) 7lw structural iaetray d natli Uvarnher, erd plNe. wedp and Darer aa~ory manaacwsd by likel« (1Aib~, when irNalad and Q>~
in a IearJtrad d m «sie snPac systen it acmrcPatce witlk srllUeior's irrtiaYrrJiorc. k wamaarrd b Yra oripid P-draser 1'ibkdarl delacrFia
n4i10r1a15 Hld WarlQrlalGhp br ene year lure UIO dale a~ a1e aepib pamil ie lSSUed for af6 Septic ~n Oaraa/41g a1B Urts; piordad, IkewO•er,
that it a septic PemW is nd teclkied b app4atae law, ase uarraraV perbd wi begYr upon ako dab Arai iz9aratbrr d are aePae sislerrr tnrnnerrr.~s,
To~ex ~e ils w~ntr ~9~. r'bdar rrusl .romy kipra« in wrMng a1 i1s Cap«aM Fl~dl~.•lttis inoL saylsoak e«nacsad ~w;n ikear n~
MllratarS ~d delecl, krlYkdnr wi supply Urns tar Uric dtaamred Ay Maalcr b he ot~ dY aaa Lirtled MAanarryt
rabaiY / exdtles are Cost d rereoval ardrar itemlalron d are lJrils.
N) TFIE LadnFD WAPWW'rV AND REMEDIES aJ SUBPARAGRAPH {~ ARE E74CLUSNE. T~F.A[ ARE ND OTHER ~AN1E5 yN1H FiESPECI
ro rHE urns, wctuoxoG No IaAPIED wARRANr~s t~ MERtxunrrnBa rrv aR Frr-ssv R;]R A RNrtiwuw PIxlPOSt.
(c) Ths lmkiled vkvratay steal ne vdd d any pan d me t3ksnCer systems maraiacaaed M :•tlrxas oaa: aim ~,rra«. 1'ne tinaao vRnaray mos
nol vxl«d b incitladal, cons«abvbl spatial «Yried [kanugeg, hYtrak« stnl nd ee faMa Inr per>eCes « ltluidaled . Inclding lees d
prarkrcaon and prolas, lae« and rhaleiak, owehead mst., «dher looses «e iwred M are Fbklar «ay Hint paly. Sl+ocaraN
IheUM' s~, U ~n~Y ~~ are r}arcga b the UrYls riat to adnary wsr and key. aaerdion. a«4dera. misuse. adaat «na~act d
beig ar6jacfal b vdt:b halls «dn« cadaas whkh tie nd verrMkd bf ara (rtaleratm irsatcapr;' leiae b rmiaaUk tie
IhB lNras a a~es~icsy,~em~aiadb~ , ne dacernan a hprop« mal«kk nto tie aysMm maaFirg Iha unps: Ire a
YryroD« sang «knprgrer siting, earoessi•e water asap, Improper gmaee draposa6 «YrpmPer nperaasrr «
~na~ax ewra rat ~ W hiaralar. mss IJnried Nmrraay sIW m wid a aye rblrw ba b ooaiply wan H d aye bane sd bray r, aya Urried
Pratte«, h ro ewsa steal hrfiarabr ba resporksMe for ax loss «danrge to tlro Itoldrx, ara lhrYS, «arry tlYrd Pant resularg laorrr hcfalMaork «afip~
wah al silo~m Mi ~ bbay ctaYrts d ildder «any Third poly fu alk IJmae[f warafay b apps. Ne IMips mrsl be isl;iatf h aa~«oi3rce
regl:ed M dale arci local codas: d oarar appRppig laws: and IrllNreh•< iabRt4vr YtsbcYuns.
eao+AatFe d MklYrabr tors ll,e atWrvay b logo «exlend a,ls LYtileO Warorakc !b wemuay apples b any Poch, ease acn are ~
Tho atwve repesenls ale Sla«lortl I.'sriaeti Warraray dbred M hrllrabr. A iri1W nntber d stales and cartes Im+e dileraa wamriy na4ie-
menis. Any purGVSOr d llNls Mrodd araaU MMlhator's Cap«da Fee(klttgiers h Old Sayhrerac, GernerJicra. peer b ekldt purdaee, b daein a
«MS1' d are ~ wan«ax and sMtad careluy read argil warr«ay prior b an pudtosu d llnas.
~ ~ • ~
SYSTEMS INC
Envkanvrnprrf~Orai6e N+a~ell~erSoklri0ns""
6 Business Park Road • P.O. Box 768
Old Saybrook, CT 06475
860-577-7000 -FAX 860-577-7001
800-221-4436
U.S. Pahakls: 4,759,661; 5,017,041; 5J56,488; 5,336,017; 5,401,116; 5,401,450; 5,511,803; 5,716,1Gi; 5,588,778; 5,83Q844
Canadian Patents: 1.329,958; 2.004.564 Ottakr paterNS perking,
Intatrata, Egt.k~izer and Sidewinder are reg'slered traderkkadcs d Inrltrattx Systenks Yom. Walrata is a itigistget- trarierrlatk in Frarrka. trtehahr Cudwnc rrr
SECTION VIEW