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HomeMy WebLinkAbout030-1077-30-000 (2) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 579016 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: LaCasse, Jon & Karen St. Joseph, Town of 030-1077-30-000 CST BM Elev: Insp. BM Elev: BM Description: Sectionlfown/Range/Map No: lAr rn t &~rT 27.30.19.274D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER//. CAPACITY STATION BS HI FS ELEV. Septic w Benchmark 1 4 Fi L ~tl' 6 ICS s ! ✓D Alt. BM 60T 6.100 ~lc~7•,7 Aeration Bldg. Sewer /3. 79• 57 Holding St/Ht Inlet Y7• 98 TANK SETBACK INFORMATION St/Ht Outlet / fa3 Y9 yZ TANK TO nPA WELL BLDG. 7yenAir Intake ROAD Dt Inlet Septic 5v ~ Dt Bottom Dosing SG a . Head `/Man. ' 7• C( 9S 4S Aeration 7 Dist. Pie 7-('07 Holding Bot. System ~J 93.y`S /6'(5 PUMP/SIPHON INFORMATION Final Grade f,z5 9'8- Z Manufacturer Demand St Cover Model Number ' O TDH Lift ( Friction Lo st System Hea /1_ TDH4/ / t Forcemain Length / Dia. Z it Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len th No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS "j /1 rem ( _ A SETBACK SYSTEM TO T P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~`~fR~ INFORMATION CHAMBER OR / Type Of System: UNIT O i! 9 7Z / g - Model tuber: z 661 1 a DISTRIBUTION SYSTEM 4- 7.6 ~s -76 Header/Manifo}d Distribution x Hole Size x Hole Spacing Ve to Air Int e Pipe(s) N-_ Length Dia Length ` Dia cin SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only et` Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No as ; ]N, COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 664 Perch Lake eRRd,Hudson, WI 54016 (SW 1/4 SE 1/4 27 T30N R19W) NA Lot 3 Parcel No: 27.30.19.274D 1.) Alt BM Description G.OJw, G~Q~~~b r.. p Q tom. 2.) Bldg sewer length = Z~ -amount of cover 4 a X0 YO... Plan revision Required? no Yes No ~7~j Use other side for additional information. ✓ J ~0 J SBD-6710 (R.3/97) Date Insepcto Signat Cert. No. l County `~rg Safety and Buildings Division C :Pei 1" 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) = Sp _ Madison, WI 537 1 74 577 R-7 1i U-) (4 6~CSroelhti ST. CF OIX COUNTY T'°nN 10 Application In accordance with SPS 38321(2), arts. Adm. Code, submission of this form to the appropriate govcrital unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PORTS are suimiitted to Pro ject Address (if " difent than mailing address) the Department of Safety and Professional Servies. Personal information You provide may be used for secondary urooses in accordanx with the Priwacv Lax', s. 15.04(1 (m), Stan. All L Application Information - Please Print All Information I f/- f / Property Owner's Name % Parcel # 0 so II - 10-77 - 30 . 0( 90 Property Owner's Mailing Address Property Location , tj N, Govt. Lot C' , Stare Zip Code Phone Number 1/ ~ p _ 141 Sect (circle one ooo TAN; R/TEar IL Type of Builditt (check all that apply) Lot Subdivision Name ~ 1 or 2 Family Dwelling -Number of Bedrooms ❑ lock- Public/Commercial - Describe Use ,A ❑ City of ✓ r 1 CSM Number a 11 V -Wage of ❑ State -/De_scnbe Use g _ 2 ue YJ i a'S Owned 3 ,54- 3 12 dlww" D ® Town of III. T Check onl one box on line A. Complete line B if applicable) New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit F--vision ❑ Change of Plumber ❑ Permit Transfer to New , ~ - / Own ~ __rA Before E 41 of POWT'S Sv Com onent/Device: Check all that apply) X Non-Pressurized In-Gro ❑ Pressurized 1n-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ~w s Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsaLlTreatment Area Information: Design Flow (gpd) Design Soil Application Rats(gpdsf) Dispersal At- Required (sf) Dispersal Area Proposed (sf) System Elevation VL Tank Info Capacity in Total € of anufa__m;1ar s Gallons Gallons Units SZS U New Tanl¢ Existing Tanks ( 1 a ~ o ~ ~ ' c is - U cif ~ rn i% ~ c% Septic or holding Tank Dosing Cbamber VM Resp nsibility Statement- I:, the undersigned, assnme responst ity for' ation of the POWTS shown on the attached plans. Plum ame ) Plumber's Si MP/1viPRS Number Business Phone Number Plum er's 'dress (Street City, YAV, Zip Cod; ,Z It) NM Countv/De artment Use Only ved ❑ Permit Fee Dalq r~ a Issuin dent Si_ ason fat D S 'j ;5~ I+./ IX Condii8►>~EWftexsons.forDisapproval 1. 8*ie tank, effluent fitter and 3 dispersal cell .must all be services ! mahlilded as per management plan provided by plumber. rrW+ts must ba r~tairdaird, 4WF 2: AAfl'84111Wk rag as ' ,cam / ord Attack to complete plans for the system a" submit to the County only on paper not less than 8 in 111 hebess in size SBD-6348 (R. 11111) adl,l 0 A i t7~Ja~ Q6 T'~'~Kd _ I r I . .33 ~ ',,C O py CONVENTIONAL COMPONENT DESIGN Residential application INDEX AND TITLE PAGE R •.•.M}v ''v::i. •~.....v._ - >n} .'vl' 4 j;5htiy; r?-,r'aS'j . x~ES~~ yY~<'-,=.."•x- {k Project C \\\4r'Y^ei-.i'v {.b4r.Y-.\>.kv-• Name: rlC v\v '>y vv._•k'<J-r+tk..,_:4}•,}NYr.<+f-rr:ti :Y ~ r~i.~~i• }Ltfn- [In•. ln(. K Ff^.>\Wa`$:}s '/~i. k~,n~..~:r>--v ;Y'v:•\-v..v:,- Y. E. v.v y:1. 1•S':::CY•'• ~`+lvvnYr_-;: u-4. •ti_~C~..,.k \ . w 4= Owner's t----- Name: . wner's >t A:,.: Address: - ..''ti, _r'n •-:•tiy:\ fib\ip': S . 42:~ ,:y-a •-%a"::_-,,:.'•:-.•, ~14n:;.;i4'Y~}:r<i;~.->iyry~}~[; .Y_i:h ~ `3.:<y.. ,'~•:r [F y • 515 _ ~ i':".,', :~'G\`• -x;;`\44:;}'\: v~'L~:`y:~ivvS~-E\~ _~-'}?,;:.vci • y~n _ ~4:=:Lf-siti'~fn.,'=<.iA{T.l'iv\[v_ Legal Description: Lot # Subdivision: . Town: County: ParcelID# i License # 5 Designer/Plumber: Signature: Date: Comments nociancrl m irct rani-to tho In_(-,rni inrl Cnil Ahcnrntinn rmmnnnPnt Mani m1 fnr POVYTS Vertinn 7.0 IL lf~2',©X J7 5~d~ Se nr~ 0 I t 1 n ' i 7,'Y' 7L a 77- 33 knit ~,i9sorl on System G Coln • ~ft Final Grade 4° SdedLft 40 pvO Vent Pipe wmVeM Cap Leaching Chamber SySWM Elevation ~ogitat[On S1fs I Plan view ft ft Leading Trench 1 Vent or Ob n FIPe Chambers 4° D1& Trench 2 Header manufacturer And Model sq if Per chamber Sojj Application Rate gPd/-sq it EISA Rafing:- - - Chambers - EISA = . - Soj Appacanon Rate _2C _ gpd Design Flow 4 Z rows of ___28_ clambers each. page-=:3- of } IL%-6v MTOR, ME; ..f 33-;,et _ ~ _~_1,• ~ ~ ,.yam ~ j 1 s. _ifiI' -rte - . .Si'. ~p ~ ih& (A) C~ ~i~ou~ on the step t c tank- (A) Before insfakUM pbce (A) h_« tau c, he se i may- housing on to to outphpe- outlet Opel-, tank wVer and Pump flank (8) ~ sttre ~.ffte h ~8: avdft s 9e• the wor so fheIMOr tin be and ifnete rY- Mme tat* for GarbkVS is ~ the h0~ ny& terra ve, and satvic e_ con*iabdy MRINTEN Cr= INSTRUCTI©14S fffijiigpjp~ll K n-'72~ 05=v 3 ?..i" =t f.. • -n. .y Fr4s'as '}T Y...• "t '3 W-1 R = F ~x .F;~ r Y i IoM; '?y .sa ~F~~" g '..~•y.. t " .~y'„~~r~~~.~~ _a J h Z ~~`f'~. ~t...•-::. Vie.. .'r f'~ jr: ~ : _ C `""Y''S"iiz" - M s '~j _ t yc__- - "L,p- ' ti't:i`~y ~+'..t• Y 'Y i Y>'„5... .Sri y=•-. •i J~ ' sup Z -f---- _ ~ 9~ back Sf+ep hmmbv tag the oufie€ of the septic ian . (A) Remove hank cover and patnp ~ ~ suFe Lacaft e ` t (g) Pug the aw outofft hock- inswfiv - and cwplebk ~ (C,-) Htw CffftM r't - tM*- (B) Repiwa O tank duvet' S Make sure ag sOiiftfaI franc in€o ft USE FtiiJl3Bif' Septic W* Z/C POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 7 of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity gal ❑ NA Permit # Septic Tank Manufacturer - ❑ NA Effluent Filter Manufacturer ❑ NA DESIGN PARAMETERS ❑ NA Effluent Filter Model ❑ NA Number of Bedrooms I(NA Pump Tank Capacity gal ❑ NA Number of Public Facility Units Estimated flow (average) ~ gal/day Pump Tank Manufacturer ❑ NA Pump Manufacturer NA Design flow (peak), (Estimated x 1.5) gal/day. Pump Model ❑ NA Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average' Pretreatment Unit NA Fats, Oil & Grease (FOG) :30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) :5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :_150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) _:30 mg/L 4 In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) :_30 mg/L O NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100ml ❑ Drip-Line ❑ Other: Other: ❑ NA Maximum Effluent Particle Size Yg in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: month(s) (Maximum 3 years) ❑ NA year(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: month(s) (Maximum 3 years) ❑ NA year(s) ❑ month(s) ❑ NA Clean effluent filter At least once every: in year(s) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: JH( year(s) ❑ month(s) X NA Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) RNA At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4101) Page Z of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage 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 normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) 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 Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. 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 (sump 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 and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be 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 soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: Pf 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 replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat 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 AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALL R POWTS MAINTAINER Name Name Phone j 7 5-7L _ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name I Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND 0WNTERSHIP CERTIFICATION FORM OwnerBuyer J x~ ~x~___!✓_-~~~ss ~--7 Poe Mailing Address Property Address (Verification required from Planning & Zoning Departm for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location -~a 14, Sec. ; T AN RW, Town of Subdivision Plat: , Lot Certified Survey Map # Volume _~Page # Warranty Deed # (before 2007)Volume , Page # Spec house ❑ yes $no Lot lines identifiable`I 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 §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on is rm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a w: , deed recorded in Register of Deeds Office. Dumber of bedrooms 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. 04/12) Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tank Model Number Pump Model Number Total Tank Capacity Alarm Manufacturer - ' Max. Bury Depth' Alarm Model Number Switch Type / - Filter Manufacturer c Total Dynamic Head (TDH) - Feet Filter Model Number Elevation Head 5 Distal Pressure Network Loss Minimum Pump Performance Required Force Main Loss GPM Ft TDH Total Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted Weather-proof --lo, 1 Junction Box Finished Grade " - Depth of T Cover Vent Min. 12" Disconnect Ft Above Grade Means with vent Cap > , > > > > > > > > > > > > > > > s > > > > a > > > , , <,< < Outlet Outlet Filter Inlet Inlet Baffle - - a; s > t y >t A < Switch Settings and Reserve Capacity >i /a" ><a ,t Tank Volume = GPI Weep s<s < { ' f a > Dimension Inches Volume Hole Gal. < B (reserve) A -X 's (alarm) B 2 Off Elevation C ;i> Ft < (dose) C 9 9 Bottom > > (dead~)D D Elevation Total 7 i:s < S'< < < f < s~. Ft a;s a s s a a>> s a a> s a> s s s> a r> a a a s a> a s s a { i< f i S i t i i i{ S< i{{{ i{ f{ i i{{ t 4<< S S i< i{ S S< i 1{ f i S S S i t S S i i S{ i{< > a a> a s> a a>> s> a a a> s a a a a a a a a t o a s a a a> s> a a a s s> a a a> a s a s> a a:> s>> GENERAL INSTALLATION: The septicldose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4°' Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28 WAC, 02/05 LJ Page of [qGOULDS PUMPS Submersible Effluent Pump 't PE y ra, s 8AIENT PUMP SPECIFICATIONS MOTOR FEATURES Pump - General: General: ■ Corrosion resistant ` • Discharge: 11/2" NPT • Single phase construction. • Temperature: 104°F (400C) • 60 Hertz ■ Cast iron body. • 115 volts ■ Thermoplastic impeller and maximum, continuous when fully submerged. • Built-in thermal overload pro- cover. • Solids handling: 112" tection with automatic reset. ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing design. construction. Automatic models include a Oil-filled • APPLICATIONS float switch. • High strength carbon steel ■ Motor is permanently • Manual models available. shaft. lubricated for extended Specially designed for the • Pumping range: see PE31 Motor: service life. following uses: performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous • M Mouound Systems • Effluent/Dosing Systems PE31 Pump: • 12.0 Maximum amps operation. ■ All ratings are within the • Maximum capacity: 50 GPM • Shaded pole design • Low Pressure Pipe Systems Basement Draining working limits of the motor. Heavy • Maximum head: 25' TDH PE41 Motor: ■ quick disconnect power • Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM Dewatering • Maximum capacity: 60 GPM • 7.5 Maximum amps cord, heavy 20' duty 16/3 standard d length, with SJTW • Maximum head: 29` TDH • PSC design NEMA 5-15P, three prong, PE51 Pump: PE51 Motor: 115 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maximum amps portable and compact. • PSC design ■ Mechanical seal is carbon, METERS FEET _ ceramic, BUNA and stainless 40 iMODELS: PE31, PE41, PE511 steel. -PE51 HP:.33, 40, .50 ■ Stainless steel fasteners. 10 - 2 GPM AGENCY LISTINGS 30 !-OE4-1- -41 o - 1FT E31 -P W 1 25 C US e- _ s 1 Tested to UL 778 and 10 _ CSA 22.2108 Standards - - p By Canadian Standards Association Fie #LR38549 Q t j Goulds Pumps is ISO 9001 Registered. 10 A 5. - 0 00 10 20 _ 30x 40 50 60m 70 GPM 60 0 5 10 15 m3/h Goulds Pumps CAPACITY n 7nn7 fnnlrk Pumnc AOL, ' pf i 9S ~ fug vsn-NisNOOSUn ffl~! ~~1 a j ~°~lSi9 o c~ g .a . a~ as 3WOH H318WvH woisno - assvodl i ~ I ~I ~ r I I I I q ~i k I g I g dm g MIN, g o, I i I Qk I e I ~ 11 I I - I I uw ~ ' - > ly ~ I Q I I ~ ~ ry s9 ° q I } w !r'.G$'Y 8 I e IJ I I I Q ~ r-- I ~ I ~ ~ - it I s o 5 ~ ~33 LL~~ya9 I 3s4 8rn~a~ I I I I I ' I I I I I I , I I t P§atl vsn-rrls"Oos'm tl°I ~tl~ iitla~~9 yystlf99.tl M t a§~t~n3~~h°~ t~9 t8tlr E § €s G i 3WOH M318Wvid WOlSfIo - 3SSV3V1 o~ 4! q~ tl¢ A taa; e, t,"q tljta t 3 4 I i II M lp ass I R ' I a. 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U U Z¢3 ¢ U L4 Z w N Y 3 m U S J i m J Z Y 0 Z J `j 0 0 Z Q O ~ Q Z Z 73 J ~ 0 U Z w cr N Y Z r w ¢ w t- > j L6 O a a IL l' I I 9 i LS ?i u w w ` LLI Lo w w I _ i < w m I: JW¢ I U_ om I L 1 N Z n~5 „98 „99 RV JUL 3 _.1.6.?-- Wis. Dept. of Safety and ProrQT.-i %XGQUNTY SOIL EVALUATION REPORT Page of Division of Safety and 131WWJN1TY DEVELOPMENT in accordance with SPS 385, Wis. Adm. Code County. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must j include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. ~7 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 636 -j/6 / 3a ~d Please print all information. Revi ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7//3/1: Property Owner ^ Property Location E (orw 151 1,4 6 _ Govt. Lot 1/4 ° 1/4 T N R Property Owner's Mailing Address Lot # Blo # Subd. Name or_CSM# 9 A 71 City S to Zip Code Phone Number ❑ City []Village Town Near st Road ( ) New Construction Use:0 Residential/ Number of bedrooms Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: ,op T~ 9 Boring Boring # /[21 pit Ground surface elev. 9s, 4 ft. Depth to limiting factor in. F Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * fF#1 * ff#2 J 6-9 h9 a3 X42 'd 4 ' 0 5 Boring # Boring 14 Pit Ground surface elev. , 927 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2 .3 -l ~l $ i * Efflu nt # - BO > 3 < 2 g/L and TSS >30 < 15 mg/L t #2 = < 30 mg/L and TSS < 30 mg/L CST Name (P Print) Signatur CST Number Address Date Evaluation Conducted Telephone Number SBD-8330 (R11/11) 4 " Property Owner; Parcel ID # Page 1---2 of Boring # Boring' Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 f#2 -i3 s a Q a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft s in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2 * Effluent #1 = BOD s > 30 < 220 mg/L and TSS >30 < 150 mg/L , * Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330 (RI 1/11) Property Owner -1A Parcel ID # Page of Boring 4 EBoring' YSJ Pit Ground surface elev. ft. Depth to limiting factor ~f5 in. Soil Application Rate z Horizon Depth Dominant Color. Redox Description Texture Structure onsistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 " ff#2 /n - 13 Al 1-4( s- s 7 .C ,5 ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. :-f#1 *M2 Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 Effluent #1 = BOD e > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD e < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330 (R11/11) Al fe~ ear 11-51- ' i T c s , Zt -3 ' -z ~la 1 Page of Wisconsin Department of Com ~ " SOIL EVALUATION REPORT Division of Safety and Buildings Comm 85, Wis. Adm. Code County Attach complete site plaa 1 bt*ss than 8 1/2 x 11 inches in size. Plan must include, but not limitedt 6rtical and horizontal reference point (BM), direction and Parcel I.D. 7 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. o 7:2- 3D ano Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). -G 7 Property Owner / Property Location ~jCQ tv SC f~ Govt. Lots 1/4,j ~ 1/4 S ;7-' T N R E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2 c's`~ UJ f ,Z City State Zip Code Phone Number ❑ City ❑ Village Town arest Roa 66 New Construction Use -jir6esidential /Number of bedrooms Code derived design flow rate r(~ GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable Ai z,4 General cormtents and recommendations: System Type !L" System Elevation/ [a] Boring # E] Boring Eg pit Ground surface elev. I ft. Depth to limiting factor 3o in. Sal 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 0 V, -70 1 ')L- 61 V1 Boring # ❑ Boring ® 1151 pit Ground surface elev. Q f ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 z -i p~ , S"b FYI V f- .2 4 _ y✓ yr, - " ' r~/ ,tF y Y Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30:5 150 ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401 J 715-246-4516 Property Owner _ Parcel ID # Page of 13 f4 Boring # ❑ Boring Pit Ground surface elev. V ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#1 'Eff#2 0 Y 'Z. 5 lr Z A, V ~ a F-4 ❑ 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. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BOD, 130 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. SBD-9330 (8.6/00) Soil Test Plot Plan Project Name Theresa Schwertel Shaun B Address 1482 Russel Ct. Eau Claire Wi 54703 C #226900 Lot 3 Subdivision Dat /31 /15 S W 1/4 SE 1/4S 27 T 30 N/R19 W Township St. Joseph ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" pipe System Elevation TBD *HRpSameasBenchmark 330' Property Line 14 Scale is 1" = 40' unless otherwise noted 120' 99, 98' 100' B-2 JF4 90' 45' 30' 5' 75' B-3 6% Slope 15' B-1 627' Property Line Perch Lake Road 2015 Property Record I St Croix County, WI Assessed values not finalized until after Board of Review. Property information is valid as of APR 26 2015 10:22PM . OWNER CO-OWNER(S) THERESA A SCHWERTEL 1482 RUSSELL CT EAU CLAIRE, WI 54703 FORMER OWNERS 2! 0071 STEVEN J & THERESA A SCHWERTEL PROPERTY INFORMATION Parcel ID: 030-1077-30-000 PROPERTY DESCRIPTION Alternate ID: 2730.19.274D SEC 27 T30N R19W SW SE LOT 3 OF CSM 2/584 School Districts: SCH DIST OF SOMERSET Property Address: 664 PERCH LAKE RD Other Districts: Municipality: TOWN OF SAINT JOSEPH WITC Section Town' Range Qtr Qtr Section Qtr Section DEED INFORMATION Lot. Block: Volume Paae Document # Plat Name: $85094 CSM 02-0584 030-78 1287 555 570961 Plat History: 1095 466 2 1 CSM 02-0584 030-78 QM NOT AVAILABLE LAND VALUATION Valuation Date: 20141020 TAX INFORMATION Cade Acres Land Value Improvements Total Net Tax Before: .00 G 1 5.000 62,800 0 62,800 Lottery Credit: .00 5.000 62,800 0 62,800 First Dollar Credit: .00 Total Acres: 5.000 Net Tax After: .00 Assessment Ratio: .0000 Amt. Due Amt. Paid Balance Mill Rate: 0.000000000 Tax .00 .00 .00 Fair Market Value: 0.00 Special Assmnt .00 .00 .00 Special Chrg .00 .00 .00 Delinquent Chrg' .00 .00 .00 INSTALLMENTS Private Forest .00 .00 .00 Woodland Tax .00 .00 .00 Period End Date Amount Managed Forest 00 .00 .00 Prop. Tax Interest .00 .00 Spec. Tax Interest .00 .00 Prop. Tax Penalty .00 .00 Spec. Tax Penalty .00 .00 Other Charges .00 .00 .00 TOTAL .00 .00 .00 Over-Payment .00 PAYMENT, HISTORY (POSTED PAYMENTS) General ecial Date Receipt # Source Tvpe Amount Tax Status Assess. Status Interest Penalty Total ` SOIL PROFILE DESCRIPTION Owner: SG,q wiFF--l eL CST: System Elev. Proposed: ft Syst. Range ft to ft Ld Rate: # ! Elevation: i 7. 7 # z Elevation: 99 7 # 3 Elevation: 99 o Boring Boring o Boring o Pit Pit Pit AV ~g 97 - G! - 9G - 5 fZ eo -