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HomeMy WebLinkAbout020-1376-46-000 o ~~ 3-on ~ ° C ~ c ,. ~~ ~ ~ ~ + ~.A 3 ~ c t~ ~ :.: 1 ~1. ~ A m ~ o I ~ ~ ~ ~ ~ ~ I :. ~ i A~ O I ~ d ~ t~N O C N N A N ~'~ • S .* _. CQ C Q ~ ~ ~ C S ~ ~ Q y uu~~+ ~ ~ ? ~ J ~ O N a j Q S I ) O - ~ n O A N d ` ~ W '~ ~ 3 UI ~ ~ ~ ~ O ~ ~ ~ a ~ I cn Z D ~ ~ S. ~ e ~-. m ~o D N a ~ C W ~ ~ ~~~ N I o 0 o a n r to W W y f S p a ~• ~ l~l O O O o ~ '° `~' ++ to I ~' c 3 N t/~ too rn ~ I c 3 ~ ~~t7~ f~D 1 0- ~ W ~ ~ m m I ~ ~ ~ N I .. ~1 a I o ~ I ~, I ~ ~ ~ ~ o, o o a v o ~ ~ s ~ m ~ ~ y I a ~ I ~ ~ ~ N , ~ ~ ~ pp 0~ O Ca I N m . ~ Z ~ ~ +_ -i y a y C ~ .~ N G p. A ~ 7 ~ .. ~ ; ~ C ~ A , . ' to ~ ! G I m ~ ~ I ~ Z A I ~ 3 ~ ~ a ~ J I F W A I ~ m H a ~~ a ~ I b ~ ~ a •-• o QQ d c I ~~ ~ o o a , I ^~ ° N. ~ j I ~ m a a, I o s ~i ~ 3gQ a I a s ~, k I ~o,~f ~ ~ a fi I ~ a~ ~ ~ m ~ `°_ ~ ~ y o N ~D A I 3 ~ I ~ o ~ b c I ~ ~ N I o~ A ~ I $ o ~ 0 ~ a . i ~ WisLOn~in Department of Commerce PRIVATE SEWAGE SYSTEM Safety end 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)]. 'ermit Holder's Name: City Village X Township Stout, Richard Hudson Townshi ;ST BM Elev: r Insp. BM Elev~ BM Description: ~t7~•o Oo.o CST guw~Z TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic w ~c S+r2 t uao ~6So Dosing ~ _ 1 _ \ CJ U Aeration Holding TANK SETBACK INFORMATION TANK TO P!L WELL BLDG. Vent to Air Intake ROAD Septic "` ~ I ~ ~s, zZ! Dosing ~., •-• •.~ ^' '30 Aeration Holding ELEVATION DATA County: St. CrO1X Sanitary Permit No: 429920 0 State Plan ID No: .~ ~- Parcel Tax No: 020-1376-46-000 Section/Town/Range/Map No: 14.29.19.2307 STATION BS HI FS ELEV. Benchmar Z ~, 02-~{ ~ ~Cfo•o Alt. BM Bldg. Sewer ~, ~ 43-~ St/Ht Inlet 9.30 St/Ht Outlet Dt Inlet Dt Bottom Header/Man. ,,,~;,,. ~~ ~ b $~ Dist. Pipe ~ S S ~ ~' Bot. System f.o . 9 Z .3 ' ~• Final Grade 5.3~ `l~~lo' St Cover _ (~•oS r 96.35 PUMP/SIPHON INFORMATION r Model Number 1. ~ r TDH L' ~ Friction Loss 2.(0.0 Forcemain Lengt ~ O Dia. SOIL RPTION SYSTEM RENCH idth ~ Lengl DIM ~ ib~ SETBACK SYSTEM TO 10~' INFORMATION Type Of S stem DISTRIBUTION SYSTEM System Head t ~ Dist. to Well ~•) I C Z ~ ~f 2 ~/ `a~0 ~, y~-. - H Ft q •~i0 ~ ~ ~,~ .u~o C.err..4/' CHAMBER OR UNIT Header/Manifpl Distribution x Hote Size x Hole Spacing Vent to Air Intake .,.- Pip -~- 3~' Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedlfrench Center Bed/Trench Edges Topsoil Yes [~ No i-~ U Yes n No 93 i. COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ /~1~ Inspection #2: 7~-'/'- Location: 975 Florence La~ne~~H~~u~~d~~s~~oppnn~n,~~WI 54016 (SW 1/4 NW 1/414 T29N R19W) et Gr s Lot 46 Parcel N~ 9.2307 1.)AItBMDescription=~'`' "^^`""-"`-C~~ ~~~~~~/~ ~~~~~ r ~~ 2.) Bldg sewer length = 2-rj t jilt - amount of cover = ~ u ^_ ~ ~~ . Plan revision Required? ~~ e No ~ ~ ~, r ~~ ' ""~"'""- ~ j Use other side for additiona ' ation. _ '~__ U"`+- ~ ~~~._ _~ ~L___ ~f ~___~ -' ---- SBD-6710 R.3/97 ` to ~~ :p tor's Signature ~ Cert. No. Depth ~~ _... L ~ ' y Safety and Buildings ~I?ivision ~ County ~ ~ I 20i W. Washington Ave., P.C. Box 7162 __t~ ~.,~y'u ~ l(' Permit Number (to be filled in by Co.) itar 7162 S WI 53707 M di '' y an - son, a ,~~ ~ i~~~O~~ Department of Commerce i (608) 266-3151 ~~~~ j ~f ~ 9 9~~ ~ - - ~ - - - j Sanitary P+~rmit Application te Pi at,~~I(.D. AQ',umbar 5 ~ ~ In accord with Comm 83.21, Wis. Adm. Code, persona! information you provide /1 _-_ '" may be used for secondary purposes Privacy I,aw, s15.D ^ Pr iect Address (if different ` n m fling address y 7 S YL -t. ~---- E I. Application Information -Please Print All Information I ~ I Property- Owner's A`a me ' ~ ~- ' ` Pa ~enl ~ 13 Lot # Block H V / ~' r'~ roprriy pwner's M ailing Address ty L ation ~~ s3 ~~ 7` >- ~ r r ~~ i4 /Lti<;G/ ~~4,Section /mil Ciry, State Zip Code Phone Number , ` r ~~Dl~ ,~- .~~ (circieot •23b~ T ~Lv; R rI Eor II. Typo of Buildfng (check all that apply) t~i 7 or 2 Family Dwelling -Number of Bedrooms ~__~1.~ Lxiivision Name CSM Number I 1I ~ [ ~ PubliclCommercial -Describe Use `S~ e~ `. ~ ~~ S s-._} "-'--5 _ _ .. i-~'_ .~/ ^ State Owned -Describe Use _~7F(AG~LG~ ~ }~ ~O~ !''f ~i~C~2~~~ry _____ l I ^Ciryv^Village~`Iewnship of~~~~u f ~ ~ III. Type of Permft: (Check oNy one bar on line A. Complete lfne B if applicable) ~ y ~ A"" ~ New S stern ^ Replacement System J TreatmenrlHolding Tank Replacement Only I ^ Other Ivlodsfication to Existing System { _.. _i^- ~ B. ^ Permit Renewal u Permit Revision j -, ~; s List Previous Permit Nutnber and Data Issued t ~ C:ha.nge of I ~ Permit Trans.er to New i i Before Expiration Plumber Owner IV. Type of POWTS System: (Check al] that appiyj ~ E Non -Pressurized ln-Ground ^ Mound > 24 in, of suitable soli ^ iVlaund < 2~ in. of suitable soli ^ At-Grade (_I Single Pass Sand Filter { I U Constructed Wetland ^ Pressurized 1n-Ground ^ Haidmg Tanis C Peat Filter G Aerobic Treaunent Unit ^ Rec~irc/ulating Sand F/ilte-r STGi -~tY l'TY~~ l i f ^ 01 + ~ ~er (exp n) _ a J Gravel-less Pipe Leachinb Charrtber ^ Drip Lira ^ Recirculating Synthetic Media Filler ~ ~ ~f-~ ~6~ 2 I ~ ~ r ~ ~ . 1 V._Di~rsaUTreatment Area Information: - I-_- 1 --~L• ~-----_~ -. { Design Flow {gpd) Design Soil Application Rate(gpdsf) ACSpersaE Area Required (sfl Dispersal Area Pro sed (sfj System E~ adon ~~ y ~`~ T`~,ite Stee: VI. Tank Info Capacity in ! Cotal Number Manufacture: Prefab 'Fiber Plastic Gallons Gallons ~ of Urns ~ ~-~ ~~ - ~ Conerere Constructed ~ ~ Glass ~ ~ i ~~ sting ~ / New Ex i ~ i Tanks Tanks ~ ___.~ Seprc ar Holding Tank ~~__~~- ~ ~~°~ --~'~~t---•--t--~..~-~- Aerobic Treauytcnt Unit i i ~ i I 17osingChamber ~ f~~ ~ y. j ~~~ ~~ v II. Responsibility Statement- Y, the' undersigned, assume responsibility for installation of the POVVTS shown on the attached plans. ~ t--Plumber's Na me (Print) i Plumber's Si gnature P! PRS Number Business Phone tiurrber i Plumber's Addre s, (Street, City, State, Zip Cods] Ill. ount !De artment Use Onl _ j Sanitary Permit Fes (includes firounz<waeer Da a Issued ~ ~ gent Si afore tamps} Approved ^ Disapproved ~ 1 Surcharge Fee) ~ ~~ ` ~ ~~~ Z S ~ i ~ ^ Owner Given Reason for Denial ~~ ~~~ s _^ __ _ 1X. Conditions of Approval/Reasons for Disapproval nn -~, ~i ~G/IiQ~ _ ~ 1~ _ A O i u n i i/ .. 0 ~ ~" _ ~~, _ A • .. (!'~~ .v,.a~2 /I/SDA ~7Q=~fi%U-Q~i`~ ~ "" " _ '~" ~l ,.. / ~~io~3 ~ ,oti~.~.t~~- ~s less ~ Hj(~l' 1 j 1nJc~ 1~ size 1'k ~,._, wisconsin,DepartmentofCommerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page ~ of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ~:ounry include, but not limited to: vertical and horizontal reference point (BM), direction and G j' O l percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION -Please prail~infdrmation. ~ Re 'wed by Date Personal information you provide may be used for secon rq~brposes (Prjvacy Law, s. 15.04 (1) (m)). C~~~i` 2'Z Property Owner ~1 ``~• Property Location ~IChard ...31_ Govt: Lot ~f 1/4~(,~1/4,S1 ~-~ T ZGl ,N,R ~~ E (or)® Property Owner's Maili//ng Address _ L~otJ (# i~ Block# Subld. Name or C1SM# 133 I~GITCI~G :2-e -~'r . 1 Y J(.J'~`~'i ~ ~C'`' .g.~ City State Zip Code Phone Number _ '^'`City ^ Village [~ Town Nearest Road New Construction Use: [Residential /Number ~' ,rooms .~ - y Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow ~~ gpd Recommended design loading rate ~ 7----77 bed, gpd/ft2~trench, gpd/ft2 Absorption area required ,~_bed, ft2 7 S-CS tr 2 __~ esign loading rate __Lbed, gpd/ft2_~trench, gpd/ft2 Recommended infiltration surface elevatio ) a ~~~/~r! G U owe- 9 Z• ~ Q ft (as referred to site plan benchmark) Additional design/site considerations Lf. d .c -e r~ ~• O CJ Parent material ~~ V-~-~ G-S~ Flood plain elevation, if applicable /i!/ ~- ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ~ S ^ U ~ S ^ U ~O] S ^ U ~] S ^ U ^ S ~f U ^ S ~ U SOIL DESCRIPTION REPORT Boring # 1 Ground elev. 97/ott. Depth to limiting factor ~~Qin. Boring # Ground elev. 93. to Q ft, Depth to limiting factor /d9 in. Remarks: ~ Z ~° CST Name (Please Print) Address Z(l3 FS~~"`.5~~ Horizon Depth Dominant Color Mottles ture T Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ex Gr. Sz. Sh. ry Bed ,Trench v-(o 11~ ~ 3 ~msbk rn~ c. ~ -~ . 4 ~ .5 z -ice /4 ~/ ------ S 1 c.,s -- !! g Remarks: ~f ~ tt~t~l~vn, ~ ~1 `lt.~c~Le~Q~. - S~.r~?~1-Y, h2(•c.®~~S'/~~~r r ~„ 2 ~ -, ~d 1 ~ --- m s o ml cs -- ~ `1 ' 8 ... ld. ~0 /I,t/'L C ~_______----_~ Date Z, c` y- y- Telephone No. ~~S-zy~-/GU CST Number zs3 3 cs-j y .~- SOIL DESCRIPTION REPORT PROPERTY OWNER PARCEL I.D.# Boring # 3 Ground elev. 9H QO ft. Depth to limiting factor I1~ in. Boring # Ground elev. 92~ft. Depth to limiting factor ~l~in. Boring # 5 Ground elev. . ovft. Depth to limiting factor I(~ in. Boring # Ground elev. ft. t Y~• i Page ~ of Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench I o- l0 3l 3 5 i -~r GS I v ~ . `f ' . 5 r~ , G + / , Remarks: I -$ 0 13 - 5~ r L I v ~' . `~ ' . 5 2 s-~i to I _ m ! c. - ~ ' . ~' ~~yi ~/ ~ ,~ ; Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/fit in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench ~ a-`h w r3 r'3 - ~ I k c~ l v~ . y~ .5 Remarks: IDmtingo I I I I ~ I~ I ~, I ~ I , factor 'n' Remarks: SBD-8330 (R.9/98) K 7 V'"~ tl PAGE~OF 3 NAME. ~~~ LOT#'? ~ LEGAL DESCRIPTIONSGU '/aN~il/4,S1K T2`~,N,R l~E (or) K~ SCALE• I"= ~UU I BM 1 ELEVATION G BM I DESCRIPTION ~ p a ~ ("C°o~d.a ; ~ (~'kw/i=-f ~~ BM 2 ELEVATION ~ ~ BM 2 DESCRIPTION .~c,~p o~ I `~evr~clo; -{-- ~ufl w/(-(a.~ SYSTEM ELEVATIONvoDP~ 9y,(nU Low e ~ ~Z, NO ~ (~t~G f ALTERNATE ELEVATION 4 Z . ~~ ~ ~ ~ 1, OU ('(lNT(1T TR FT F V A TT(1N w l ~ I ~ / ~ Y~US c~ "~_Ls~. ~a~~t• ©~ ~~~~ C °Io _ 3S ~`~ ~ • • 3~L ad w ~1 r_ r ~oy'e,.~ c -~ a 3 d .J COPY a f O~ 3 $~, /5~~se S. i'-~ ~~oj~~d ~~ za6~~~/~~' r~ ~ ~~~ ~ ,~~~, Q ~ a,sDc6BTe..vGhrs ~ .Z2 Ch~n.derr~o%/ i 3 p q~. ~ o i 3 ~ ~ ~ ~ Ib k Q ~ '0 o n I~ lo~ a J a ~ oG~ 3g~ /~~s~ S. ~~ ~~~j<srd ~~ z~,6~~,1-~/6~' a r~ /fir ~ ~~~ oz~sDc6d ~,eyGh~s' ~ ,~~ ~~. ~.6er~-.To?~/ ~ ~ 3 3 p b ~ `~~ ~ ~ (~ 4 n ~ ~ 0 o n I~ ~ ~:H,"".S~k CRGSS SF:CTIUN Mi~~ ,;,Fi~.TPICATiCtiS SEPTIC TANK ~ F'~Mr ~,: CI VENT PIPE 12" MIN. ABOVE GRADE ?' 25 ° FROM DOOR, WINDOW OR FREgH AIR INTAKE F TNISHED GRADE ~„ CI RISER ---• 1,$" IN . 6„ MAX . ~ L£ T ~ ~~ /~ __ WATER TIGHT SEALS PPROVED IPE 3' NTO SOLID OYL ~ PUMP OFF ELc;V . ~ FT 3" APPROVE WEAT4IERPROtIF JUNCTION BOX wI'IH CONDUIT ~ ~, µ" MIN. ~, ~ ~,+ ,. ,, ,~, GAS- T I'GHT ~ , q SEAL -k•-.- ~ r B ~ ~ ~ ~ , ! + D D BEDDING UNDER TANK SPECIFICATIONS SEPTIC / DCSE TANK MANUFACTURER : iJ, •e.5"~ r" -- TANK S I ZE5 : SEPTIC 10~~ _ vAL . --"'""""- DOSE '~_ GAL . ALARM MAh'UFACTl1RER: °`"~ MODEL NUMBER ; SWITCH.-TYPE: PUMP MANUFACTURER : -'~' MODEL NUMBER SWITCH TYPE: n s, v ~~~~ ~~~~~_ l.~~ r ~. REQUIRED DISCHARGE RATE ~._ GPM APPR~OV ED MANHOLE GCVER W/ PADLOCK E WARNING LABEL VAPPROVED ~olr~TS wITN ALM APPROVED PIPE pN 3' 4NT0 SOLID 5t}IL OFF '~~ RISER EXTT PERMITTED OrILY IF TANK MANUFACTURER HA5 APPROVAL CONCRE'T'E PAD NUMBER DCSES ~'~ER DAY: ____~,,,~, . DOSE VOLUME INC'~,UDING GAL. F LO~I~AC K : l~ _- CAFA.CITIES: A = INCHES ~ s 2 INCHES _,..__ C = $ INCHES p ~ INCHES _ „ JCS ! ------GAL . _ .3~ GAL , _~GAi.. _ ~ ~GA L . PUMP ~ ALARM WI RT_ NG AS PER I LHR 16.23' WAC VERTICAL DYFFERENCE BETWEEN PUMP GFF AND DISTRIBUTION PIPE ~ MINIMUM NETWORK SUPPLY PRESSURE ' + ~ FEET FpRCEMAIN X ;?.G FT~~°00 FTCTALIDYNAMICAHEAD w~,a~~~~ INTERNAL DIMENSIONS OFiPUMP TANK: LENGTH ; WIDTH LIQUID ~ __1__..--- FEET .~' FEET ~ ~ FEET _ , ~- FEET _; DYAMETER SIGNED: ~~.--~f~-~~.~~'`~ LICENSE IdUMBERt n2~~~Qr~ DATE: .39 ~~l 1/~8 ~~ n ~~ Aplpt.iCAxIflI~S 3pet:Ificaiiy tfesigned for the fallowing uses: + Effluent systems • tomes • Fauns .Heavy duty sump • tl+latsr transfer Dewaterlnq Si+t;CiFtClll'101iS Pomp: EPQ4 • Solids handling capability: • Capacities: up to 56 GPM. • Total heads: up to 24 feet. • Discharge elze: i~1z" hIPT, • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-!V elastamers. • Temperature: 104°F ~44°Cy continuous 140°F (&0°C~ intsrrr-ittent. • t=aster~ers: 300 series stainless steel, + Capable of running dry without damage to components. iPutttp: BP96 • Sdids handling capability: ~Yi' maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feat. . • Dtsct+.at~e shtee:l'~t" NPT. • Mrscharaica! seal: carbon- rotarylaerarrtic-stationary, 81JfdA-fd elastomers. • Temperature: '~ Qd°~ (40°~} coiltitlU{}ttS 140' {t30°C) irrtermittant. c~~ Q:199a {#oulde Punfi~s, M9C. • i+asteners: 300 Series stainless steel. • Capable of running dry without damage to components. Motor. EP04 Single phase: 0.4 HP, 115 or 230 V, 6Q Hz,155Q RPM, built in overload with automatic reset. • EI7D5 Single phase: Q.b HP, 115 W, 60 #iz,155Q RPM, built in overload ~nr'th automatic reset. • Power card' 14 foot standard length, i 613 SJTO with three prong grflunding plug. Optional 20 foot ierlgth,1613 5,1TtiN ;vltl~ three prong grounding pltyq ,standard on EP05). ~terF.~s t=ar ~o~- 9 }' 3~ 2~ a z ~ s 2c 5 o a5 a 3 1{ a~L{iu3 ~'~L E~ 0~ e 5ubmer~ib~e Ef#lueut Pump ~~~~~ 38~ 1 EP05 • :°ufly submerged in high grade te;rbine oil for lubrication and efficient treat transfer. Available far automatic and manssa! apecaticn. Automatic models fttctade ttlletrtrattial i~Ioat Switch ascembied and preset at the factory. FEATtiRE5 • EPt14 Impeller: Thermo plastic Semi-off design with pump out vanes for mechanics! seat protection. ^ EPBS impeller: Thermo plastic enclosed design for irrip-oves! performance. • Casing and Base. Rugged thermoplastic design provides superior strength ana corrosion- resistance.. ^ Motor ~ioasing:Cast iron far effldent treat transfer, strertgttt, and durabUlty. ^ Matar Cavar. Thermoplas- tic troverwith Integral handle and float sv~tch attachment points. ^ Power Cabie~ Severe duty rated oii and water resistant. ^ Bearlstga: Upper and lower heavy duty ball bearing construction. tF61;1t1~:Y uS'flNG ~~ gnadiatn Mandards 1lsxaciat:an (CSA listed model numbers end in "F"or "AC''.) i ~ f ~ ,~~....--.-a ~~i-___;_____~ t ` i i f ~ ; _-__ -_ I € ;~ i ~ 1 ~ i m n nau ~Q 'r'Q i7u RV w vrm , ~ , ~ z a $ e io iz mom c~acrrv `w~'~ ,. . EfJeOdvs May,199fi • POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE l[~,(FOIiMATION Owner ~~ UAL ~ Permit ~ ~ ~ U DE&I(3h1 PARp-nnet rtca- Number of ~adrooms 3 ~ NA Number of Public Facility Units NA Estimated fiow (averagei elide f?esign flow (Peak!, IEst~mated x 1.6} ,~'~ elide Soli Application Rate ~ elide lft~ Standard fnfluent/Effiuent tlual'ny Monthly average` Fats, Oi! & Grease iFOG) 530 mglL Biohemical Oxygen Demand tBODs} 5220 mg1L iJ NA Total Suspended Solids {TSS} 5150 mglL Pretreated Effluent Quality Monthly average i f3fochemicai Oxygen Demand (f30D51 530 mgli_ Total Suspended Solids {TSSi 530 mglL NA Focal Coliform (geametrfc means S10` /100 Maximum Effluent Particle Siae Yg sn die. ^ NA per; Q NA "Values typical br domestic wastewater and septic tank ettiuant. Page of er^^R ^ rn.....~.... ~. .._ _ __ Service Frequency Ssrvlice fWent 3 moat s} (Msximum 3 years! ( ) Q NA inspect condition of tankis} At feast once every; , s p ear When oombined sludge and scum eq uals one-third {Y,} of tank volume ^ NA pump out contents of tank{si ~ ®month(s) {Maximum S Years? DNA inspect dispersal celilsi At least once every: . p yearls} month{s! t~ NA Clean effluent filter At least once every: ( ,~ ear(s) monthlsl DNA inspect pump, pump controls & alarm At least once every: ..~ , ^ rr~onth(s} ^ NA flush laterals and pressure test At least °nce every: O year{s} Q month(s) Q NA Other: At Least ante every: Q earls! O NA MAMITENANCE iNSTRUCTiONfi Inspectfona of tanks and dispersal cells shall be made by an individual carrying one of the foiiowin9 ilcanaes or certor atTank Septage Servicing Open • POWTS Maintainer, Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, inspections must inciude a visual fnspectioand scum and to heck fo any backgup cr Po dirngofaefftuentt1an the ground surface measure the volume of combined sludge Tine dispersal cell{si shall be~ i~ue UT~gspanding of effluent onfthe ground surface may~ind cafe a failing condition and ra4~ es thi of effluent on tits ground su a p immediate notification of the local regulatory authority. When the combined accumulation of sludge and sc e ~ry~c n t Ope atori and d'sp aed}ofrin accordance with chapter NRe11t3 contents of the tank ahaltl be removed by a Septag g Wisconsin Administrative Code. Aii other services, including but not limited to the servicing of effluent filters, mechanical or pressurized component®, pratreatmen units, and any servicing at intervals of St 2 months, shall be performed by a certified POVVTS Maintainer. event A service report shaii be provided to the local regulatory authority within 10 days of completion of any service Page of '~ START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanklsl for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cents}. If high concentrations are detected have the contents of tfio rankle} removed by a septaga servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above nomnal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellls} in one large dose, overloading the cetlis} and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Saptage Servicing Operator prior to restoring power to the efftuent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. t)o not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain isump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT ~'" When the POWTS fails andlor is permanently taken out of service the fallowing steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • A11 piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall ba removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soli, gravel or another inert solid material. CONTIN©ENCY PLAN 1f the POWT'S fails and canna[ be repaired the following measures have been, or.must be taken, to provide a code compliant reps a ant system: ~~A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable ropiacement area. Replacement systems must comply with tfie rules in effect at that time. O A suitable replacement area is not available due to setback andlor soil limitations. Barring advances in POWTS technotogy a hoid'mg tank may be installed as a last resort to replace the failed POWTS. site A Q T tank e Q Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biome[ at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND10R INSUFFICIENT OXYGEN. DO NOT EN'T'ER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OP A TANK MAY 8E DIFFICULT OR IMPOSSIBLE. p-DDITiONAL COMMENTS POWTS INSTALLER Name ~, ``~i'li..n ~'c G u su ,cry Phone '7! 5 - ~~G ~ ~ f o2 l POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR [PUMPER} LOCAL REGULATORY AUTHORITY Name Name Phone Phone This document was drafted in compUance with chapter Comm 83.22(2i(bltllfdi&lfl and 63.54([), (21 & (31, Wisconsin Administrative Code. ~ - -~. FR~7h1 RCS Ct]f~iST F~?( 1~7. 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CiA 1 iltd ~~ rrrx ~Ot ~,~,.~°t 2 aaw~Ea~i ``j `lte ~~awatrrdss}Gbe+ G~a[a~: Sri! ~ .~-P+~ve~.fyirs~ 13 X11 of ..~ui~~, ~+~'t14T ~[aes~ ~, ros~ea~~trs>:?*a' ~~ °~~~~ (;4 oa~f~+ ~tlata-nk~ ~ 1efy siaats ~~~ ~astot T~~ =~'bts~at5~cnanp~urssb+zt a,r i~~ ~ v M wi'G; t~.e gcttr~ ez ~~ndation.+~'as (~~ ~-~- cae n~,..~~rrct+A$4 daspo!,as s,.`s~.,. r~er:i~~atian ~ ~' ~~ ffi~.s...'s a~ s,~ec to rrit-'n'~ p' „ y~~ ~tftte a! ~3ligqur~io. ~ten~ of Nawxa4'f~d~~ gittcc w;'~~-"[ ~~ - ~ ~ ~~: vadag~'bav$ s~~ t>:e abtvC :ey+=u arc.e aad the pe? ~ to tlta 3t. W;~si~ q~'.nty ,~ot~ ~w,„i ; •~ci~cs~ set foal, gain. ~ ~,t~y ~ ~ y~,q,~ta~~~'~ to~~Z~ati aa~~ ~ tbxe~ Y~ ~,~~tss- ~ta~ ~AT~ ds' / .. ~, .~ ' t. ,1CtNA'a"~+'~ 0~ ~ am (arts) vase rc,~tezki :,f` *~ ~~m ~ {'orai erM °='~a'~' ~ .rssZ:~:~ et' a`~~cc~* giY+.aa~ '.wel Z Z 1;'we} °aeli~,' ~ ~ a~ a ~+zt't•~~.} de cc ~:.nr~e 4 ~ , ~'' ; Cj ~, w ~ r, ~ ~~~"'~ M y 6.~lr Y. i ~ ,,.,...~....~ r~ pp ~ Mr".l~a~ • B~iS.~~, "EVpkd4~ 19}' ttrs ~''s;.",S>7~ wM12YETb~S.;. r/' ((~~ /r~'~~ ~ ~e ~ i i ~wr,nrir~. ~p r3 ~F' f Wisconsin Daparsment c+i Carnrnersp St~iL AND ~IT~ EVALUATI~3i~I [xvfsiWT4af Sntally and Bu;t¢;~.,; 3¢;eeiu at lntogratiad Sefvicas in accord~nt;e with Comm 8~.A9, Wls. Adrn. Code f'~,_tl__" of ~~ Attach c4mpiete Bite piers an Raper not Ions then 8 712 x 11 7nohea in size, Plan mint ~~~~" ~'`;,~'~~de, but nat iirrutsSi to: vP3rtlC81 and tfanzon~l rofarer~ point {SM?~ direction and ~ r ~ (~ ;,~' .ant ~Pe, saa6e or dimtxisic~ng, north arrow, and tocat3on and dt~-tance :o nearest road. t'aroel i t) k APPLICANT iNFOi3MATI~CttV - Ple~ss~ pr ~~f17fCrtr,~tion:'. Rov;ewed by Date "~" Perspna! information Yas Parsv+tle may be unn. t E~,r crrn i!'u:n.r;.,.,,..nc _ _.... . _ _ .. . ~°~ ~o~ 1539PA~E 8~ 629124 • STATE BAR OF WISCONSIN FORM 2 - 1999 Y,ATHLEEN H. WR~SH WARRANTY DEED kEGISTEk OF DEEDS DacumemNumber ST. CROIX CO., WI This Deed, made between Donalda Speer, a/Wa Donalda J. _ RECEIVED FOR RECORD Speers, a/Wa Donald J. Speer and Kernon Bast, wife and husband, 48-31-i'000 1:30 PM a k a Donalda J. Speer-Bast - i{ARRAHTY DEED EXEl4PT N 3 Grantor, and Richard O. Stout and Janet P. Stout, husband and wife, CERT COPY FEE: `~ COPY FEE: -- TRANSFER FEE: .- ~- kECORDIN6 FEE: 10.00 _ PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area All of the Plat of Sweet Grass Farm in the Town of Hudson, EXCEPT Lot I Rewrn Address Name an d of said Plat. ~ / ~tG~t~If 4 () ~ ~j'~Wr. _ ~- v~ ~~3 ~- - o ~aS3 ~~~~ 7~ S G ~ ` This Deed is given to correct the ommission of additional lots in the Plat of Sweet Grass Farm between the above Grantor and Grantee hereto in that ~,1/}piJ, wt S?{Ot (,~ certain Deed recorded in Volume ~, Page ~~O , as Doc. No. tra.°1~_• 020-i021-60,0?9-1021.80,020-1021-90,020-1022-00 & 020-1062-20 Parcel Identification Number (PIN) This is not __ homestead property. 0{) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~ ~ day of August 2000 + AUTHENTICATION Signature(s) Donalda Speer, a/Wa Donalda J. Speers, a/Wa Do al J. S eer and Kernon Bast, wife and husband, ~ - authenticated ihis17 ~y of August __ 2000 + Krishna Ogland . TITLE: MEMBER STATE BAR OF WISCONSIN (!f not, authorized by § 706.06, Wis. Stets.) THiS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland ,_ ^__ Hudson, 1 54016 (Signatures may be authemicated or acknowledged. Both are not necessary.) Names otpersons signing in any capacity must be. typed or printed below thei WARRANTY DEED ~-~.-- + Seer, a/k/a Donalda J. Sp rs, a/Wa Donald J. Speer + ernon Bast ACKNOWLEDGMENT STATE OF WiSCONSiN ) ss. County ) Personally came before me this ___ day of the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * --- Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: nature. IMymalion Praesaronals Comps^v, tuna au Lac WI eaoass-zo2t STATE BAR OF W tSCONSIN FORM No, 2 - 1999 .~ - - - ~~.5~~. Lac..f-4 ~Ld ~Z ~7l/G~ 4 ZOV ~ ~ r ~ A A v s,~ ~ ~ ~ -~~ ~~~^ ~ ~- s~ ~~s~'' ` ~. ~ I p'~ ~Iv • a r~ • ~ i ~~3~G~T~.~~.1rs is • m m ~ u ;~ 0 4 ~- t~ ~. ~~ BAR `' n ~ ~, _ ~ I f C ~~ ~~ s v~ T ~ Y ~. d i ~ =.- ~~ r l~ ,~ ~t _ ~ • _~ ;~ ~~~ ti~•~ ° ~ wz ~~z ,o~ 0 , ,s-~'SL9 3A 4,S x.008 ~' ' 3,9Z~ l L 60N - - - -' ,s£'~3 t ~3a01~ ,99'SLSP M.OI,S~.00N W'-' 3,9Z~11o60N ~ _ ~ .. . ~ . _~.~- ~ _ . _ AO'O1aL I _ . ~ ~ ~ ' ....... .. ... ........... .,.~z ... ~~ ~~ l I I ~m ~ Wrr' ~~ I Qv lf/ -----; oo ;~-- (~ I !Ul I I~p lOp l ~1 I~I ~ ~ i~ I~I~ ~ i~ 0 I 0 ~ ~r I J "' t- ~' C~ ~ ~~ Qo ,oo•ooz AO'006 J i Al Qa O ~~ ~ ~~ V ,oo•ooa M„O ~,E LOON N r' a Q ~Z ~ ~~ ~ ~ J ~Z ~N ~ ~ C ~~ o ~~ ~~ y o0 ~ rn ~_ ~~ ~q r ~Nr~ A ~~ N O S _~ ~°~~P• ~ ~~ ~Q , m q 0 Q N Z ~ n m > I ~ 1 ~~~ I 1 1 ~ I p ~ m I i~A o ' I\/ T :g ' 11 . ~' a ~Z ~C s ~Z !! ~ ~V r ~A O O ~ '~ ~~ ~ ' `._ ~--~~ ~. M ' I I ~mI 1~ m rn~ I ~ ; I , A 11'11 0 I Z 1 I I~ A I 1 I I~ I 10 I I I~ _~~ ,sG-~I X i ~ I Z I a m I 111 s s ` ~ _.1._ ~ I -. Z ~ 'n I I ~ S I ~ r ~3 I m ~ ~~j~ _ .~ _. I I pN ~ i~i~ I~ W o iii I "~' I ~ i `3 i `~ I~I~ I i~i~ I ;~ i ~ I ,~1~ a;o I~1~ r ,_~~ ~~1~,~~/ ~ ~^"" ,~ ~ 5 ~~~~s~ ~~ ,~ b ansen i~.l~,ll ~ Subject: Schumaker - Sweetgrass # 46 Stout Location: Hudson Start: Fri 06/06/2003 2:00 PM End: Fri 06/06/2003 3:00 PM Recurrence: (none) 14.29.19.2307 ~~ i