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HomeMy WebLinkAbout020-1416-20-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM `'°"~"Y~ St. CrOIX Safety and Buildl5g Divisicii INSPECTION REPORT Sanitary Permit No: 479271 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: West Lake Builders Hudson, Town of 020-1416-20-000 CST BM Elev: Insp. BM Elev: BM De cription;J ~~"" ~~ Section/Town/Range/Map No: S ,~, qs /0 S'ig ~ ~,d.k..~ 8 Z ~" ~/vl.a~ 5 20.29.19.2630 TANK INFORMATION EL ATION DATA TYPE MANUFACTURER CAPACITY Septic ~~ / Dosing Iw Aeration I Holding /'r~ , TANK SETBACK INFORMATION TANK TO P/L L f WELL ~~ BLDG. Vent t it Intake ROAD Septic ~ ) ~ ~ Dosing Nb Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Frictio ss Syste d TDH Ft Forcemain Length Dia. Dist. to Well snu nRSnRPTInN SYSTEM'72 .Ll_7~ ~ ~f' ~ STATION BS HI FS ELEV. Benchmark ~- //`. !~ / OS Alt. BM ~- ~~~- ~.~ Bldg. Sewer 4., ~ ~ ~ f U ^ SUHt Inlet ri h 6• L o SbHt Outle_ t ~ ! ~ Z !~ f Dt Inlet Inlet ~-. _ .~- Dt Bottom ~~ ~~ Header/Man. Q~,,~ P G~ O ~ d Q /OS'• G Dist. Pipt~•~d le - ~ rt- / .-v ~~r, y , /a . 3 5 eot. syst~ lr olG ~~~~ ~ . a /~f ,y~" Final Grade ~ _ ~ 6 ~/_~c St Cover .----- / t/11 • ~ 3/ ? ~ ~ ~ Z 9~ / BED/TRENCH DIMENSIONS Width ~~ Lengt .~ No. Of Trenche~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG W LAKE/STREAM ACHIN AMBE OR M~De rer: ~-,/ N ~ -° , Ty f System:-' ~ w / ' ^~ ' / U Model Number: 1'11CTAIRIITInA1 CVCTFM )C1Tl' ~ .t G~/f-Fa~.~ I/cu ~0.~/ ..e U!/ ~f b Y~Af[~!"h t'/ `~ Header/ anifold 1 ~ Distribution ~J ~ ~ Pipe(s) (/ ~ ~ x Hole Size ~' x Hole Spacing "~."~ V ^~'r I[n'take , / J / Length Dia ia Spacing Length ~ Cnll RnVFR ~ „ o.e~~.a c..~~e..,~ n.,t.. .... Mnnnrl (lr A4_(:rarlP SvcfPmc Only UQ/Ll ~~Yl. Ill: ~u Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched ~ Bed/Trench Center Z S-~ "~. Q Bed/Trench Edges Topsoil ~ _I Yes ~=] No 0 Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ L~ / U 7 ~7 Inspection #2: / / Location: 426 Swift Circle Hudsont,'WI 54016 (NE 1/4 SW 1/4 20 T29N R19W) The Glen Lot 36 ~(,( Parcel No: 20.29.19.2630 1.) Alt BM Description = ST' (,pti(~'~~-~i ~ D~~~/(~j, 3 ~ij~jy,, ~,Q/(/y jis.. 2J Bldg sewer length = 1^ f~1 _ /_~~ .~ r ~.~~,,,Q rum _~ j/ ~ ~ ~2,~~v/n~~ ~j,~ - amount of cover = 38 11(()li.,-,^ ~ <`n ~~~ ~ ~I- ~ ~ s~,~'iLlw" ~' "` - b lL~vt ~b TGU/n" ~.1 D~' 4~ /tp ~ ~` - -- ---- - --~ Plan revision Required? ~~ Yes o O~ ~ c~ / ~ ~7, I, Use other side for additional information. ~ ~ _____ _ f(J J v Date Insepctor's i nature Cert. No. SBD-6710 (R.3/97) Safety and Buildi s Divisio -- - --- ` 201 1W, Washilt ~ n County , ""~ Department Of Commerce /.- Madison gV426~~~t31" I6~'~~ Sanitary Permit Numbor (- to !re titled in by Co) ! . ~___._ • 7gZ 7~ anitarp P r --.._.,_.._._ d ~ rnlRt ~ ~nf ~~ r State Plan t.D. Numfxe In ace ~! ~ i ~ ~ and with Comm 83.21, Wis. Adm. Code ~ ~ '~ "~a~- . peraonal i lion ou r rna h ovr e us ~ de Y ed fur seconds p ~~-- rY purposes Privacy >raw, s S _f~in3~~ JIB: CG~UNT~ ~~ ,________~ r• Application Information - plese~ pr;rr<t Alt Info amt ~ ~' l~N;~tiG GFFtCE Project Address (if different than ntail[n-g address) on ~ ~ ~~t!p J~~/ ~' Grr~r'~ Property gwner's Na me -».-....~, ,~5~ ~ ~ L~ ~ r \ p ~~ Parcel # ~-' Lot N Block # F Property Owner's M ailing Address "~--•-~--~------. ~ ~ ~ [~O,K .7 O 3 Property Location ,City. Stag ._..~'~`_ - ~ ~_ `' ', f Zip Code Phvne Nambgr --~~ '~'•-J~L'~,Socrion ___a~_ ~ ~( v`a.5o ~ w ~ I s ~ o II. Type of Budding (check sIi that applYl ~ I ~ '~ s - ~ a b~~ $ ~ g ! T ~c~ N: ~ `(~ (E vr~W~~J or 2 Family Dwelling -Number of Bedrooms ___ " f ~~ 4~~r 1/W J ~~"~ Subdivision Name '~- ~ CSM Number NubliciLommercial -Describe Use _ ~' ` State Owned -Describe Use - -_____-~~~' ~,1~ ~~~ti III,-----_.._.__,.____ "'-~-------- = G~~e-~ I ^City~~.JVillage ~'ownshipcf~~N ype of Permit: (Check only oae box an lane A. Complete fine $ if applicable) a b - ~ ~ II--A~ - --- ~ '-""-"--~--- New System ~~ Replacement System ~' TreatmentlHolding Tank Replacemerx On} ~__ y ^ Other Mactifica[ion tv Existing Sys[am B • ^ Permit Renewal Ji Permit Revision _ ~~ B L Change of ^ Permit Transfer tv u ~ List Previous Permit Number aixi Uatc Issue efo a ew d r Expiration Plumber Owner ~----~-__._-___~. _..l____ { r IV, Type of pOW7'S System: (Check all that a~~~_ "~`~'"' -~"~---- f ----- f _ ~._._.__-_...1 Nort -Pressunzed In-Ground ^ Mound > 24 in. of suitable sail ^ Mound < 24 in. of suttahie sail ! ~ AaGrade '`7 Stngie Pass Sand Filter ~~ Cunstructcd Wetland ~ ~ Pressurized In-Ground ^ Holding Tani, ~ Anwh!<Treatmeru Unit ~~ Recirc Mating Sand Fetter ^ Recirculating Synthetic Media Filter caching C r L1 Drip Line ' !Grave}-less Pi I V. Dis creel/Treatment Area Information: ~ 0 (explain) _____ ~~ Desi n Flaw ~' ~ `~ ~~_ ,~ B lBPd) Design Soii Application Rate(gpdst}~bispersa! Area Rrqutre s ~ [s rsa tea Propostd (s~ System Elevation ~-----~ CpoO _ o~ / ~ ~j 7 / i > VI. T'a3tk Ltfo Capacity in "i"ota! ~Nu b rr -, -~__ ~ ~ ~ ~ y __ __~_1 ~' ~~~ / Gallons Ma iufacturer i Prefab Si[e ~ Steel rFibez Plastic Galiatss of 13nits ~ I Concrete I Constructed f I Glass New Existing ~----.~._ Tanks Tanks Sept« or Hold;ny Tank ~ .. K / a V O X ----T- -~--+ ' Aerobii~nlCOr Unir """'--~'~si"' ! hosing Chamber _______ ~ ' vIl• Res~ctnsittility State t- I, the and ~.i. ~ ~~`.'~ ~- .---~ ______--_L.._-_! ~.,~.~_~---~ ' men ersigned, assume respottsibiUty ~ tgll8tion nP tAe POWTS shown on tho attached pierce. _ 'uPlnmher's Na me (Print) plutrrber's 5i gnat re t;2P PRS Numt:er - ~~ ~" `A~ ~\ Business Phone Nun:Ger 1 "~'~keR. ~/ ' ~.~ ~ q 4 b ~?t 5 - 3 8 to _ 3 t a,1 Plumber's Addre ss (Street, City. State, 7.ip Cade) - f VIII. Calut / -~--- ~ t Ik artment Use OnI _ i '~l pproved ^ D'.. Sanitary Permit l+ee (includes Grvurtdwater Dat Issu Issuin gent Slgnaru IN Stem ~ Surcharge Fee) ~ ~_` _„~ C wne yen Reason for _nisil ~~ !X. C'or:ditions of Approval/Reasons for Disapproval -._~~3~~_"- ~ " ~ zy ~~1 --__ -.- ' SYSTEM OWNER: 3) ~ f ~ ~ 5 ~ ~-~ 1 • ~ Septic yank, effluent filter and / r CT VLl VS t~ C ~ ~~~ /y~ cz; ~~~ ~ ~Q ~ dispersal cell must all be services /maintained ~ ~~- ~ ~~ ~0/~~CaC.~J ~ as per management plan provided by plumber. ~ rrr~~~i e~ 3. AU setback requirements must be maintained I as par ap~able code /ordinances. Attt-s!r eomplote pilau {to the %°ewlly only) Por t8e system on paper not lew than 33/2 x t t inches in site ~~'~` _ " ~ -""'"' -J C.71T I'1f~n ir> >.. .n.r. ~~ ?a ~~~ vr` $~ 1 ,..~ • ~~ 5 ~ y~ ~ t'~'~~`~ ~, ~/~/ f ~~ Boa, ° ~ ~ k, i o~.Ys d. ~~ ~~ ~ ~~ T~~-.~~e~ yi v -, ~ ~ ~ SOIL-E1fALUATION DEPORT Wisconsin Department of Commerce. Division of Safety and Buildings. in accordance with Comm 85, Wis: Adm. Code County Attach complete site plan on paper not less than 8'~ x 11 inches in size: Plan must include, but notJimited to: vertical and horizontal refen;nce point (BM), direction and Parcel l A. percent sbpe; scaleordimemsions; north amntir, and lerztion and distance4o nearest road: Please. print all information. -^ RevieM2d By Personal infom~ationYa+Drovide maybe used fw secondary ~'T5t~ (~ (rr~) -A~,_ i / 1095 Page 1 of 3 Step Soil Service St. Groot pending Date ~h_ U Property Owner ~ ~ ' °' `' Property Lacati Sienna Corporation .Govt Lot NE 1/4 SW 1-/4 S- 20 T 29 N R 19 W Property Owner's Mailing Address ~ ~ ~ `~ I:~t #' ~ ~-~ ~ # Subd. Name or CSM# 4940 Viking Dr, Suite 608 36 a The Glen City State Zip Code Phone- umt>r£i ~ _~ {Crty „~illage Town Nearest Road E~Linq MN 55435 951- - °-- " ' "°~~Hudson Carmichael Rd. New Construction Use:. ~!`` Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD _, Replacement Public or commercial -Describe: Parent material Pitted outwash Flood plain elevation, if applicable na General comments and recommendations : System elevation102:35ft;trenches spaced and depth to code 3:50ft below grade ~~•~n~~ y~`~~~,~ Boring # Boring. r Pit Ground Surface elev. 105.85 ft. .Depth to limfing factor ~ 02 in• So8 Application Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPD/ftz `Efi#1 `Eff#2 1 0-7 10yf3/3 none -scl 2msbk mfr es 1f .4 .6 2 7-Y2 5yr4/4 none ~ osg mvfr _ gw 1 of .7 12 3 12-102 7.5yr414 none.. cns osg m~r[r na na ~ 1.6 ~~ ``~~Z" -d~~~~sys-~ Boring # ._~' Boring ~ 1O2 i Pit Ground Surface elev. 105.85 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= `Eff#1 `Eff#2 1 0-10 1Oyr313 none sicl 2msbk mfr gw 2f .4 .6 2 10-24 7.5yr4/4 none- ~ osg mv(r gw 1 vF .7 12 3 24-102 . 7.5yr4/4 none.. ._., ~~ osg. mvFr na na ~ 1.6 trrruenr ~~ = rsvu ~ 3u < zz0 mglLantl TSS >30 < 150.mg/L * Effluent #2 = BODS< 30 mglL and TSS < 30 mglL CST Name (Please Print)- Signature: CST Number David J_ Steel ~ 248956 Address Steel Sal Service ~'~`"-l~ Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 9/5/2002 715-246-5085 iccz. ~ Property Owner Sienna Corporation Boring # Boring ~/ Pit Parcel tD_# .pending. Ground Surtace elev. 102.05 ft. Depth to limiting factor 102 in. Page 2 of 3 Soil Application Rate Horizon Depth DaninanYColor Redox Description- Texture- Structure Consistence Boundary Roots GPD/itz *Eff#1 *Eff#2 1 0=16 _1Oyr3/3 -none -sil _2msbk -mfr gw 2f :4 .6 2 t6-31 tOgr4t4 none sici 2msbk mvfr gw na .4 .6 3 31-45 7.5yr4f4 ~----. none is osg mvfr gw na ' 12 4 45-102 ~ 7.fijrr4l4 / none cos- osg mvfr- na na .7 1.6 ~ 3, S f~,v~ ", ~ ~ - ~-~ `5~-d-s~IS ~, , ~ /~~- ~ i ~` Rnrina # Boring' * Effluent #1 = BOD ~ 30'<220 mg/C and TSS >30 < 150 mglC '.Effluent #2 =_BODS <30 mg/L and TSS < 30 mg/t_ The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Boring # Boring Page 3 of 3 STEEL.' S SOIL SERVICE This. soil evaluation. was conducted. to satisfy a zoning. requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established. at the time. the soil. test. was. conducted.. Legend 1" = 40' • =Benchmark El, 1 OO.OOFt ' r Top of 1" steel pipe N ~ =Alt Benchmark EL110.50Ft Top of/z" pvc pipe ~Jor~ a =Borings ~~ ~'"`" Boring Elevations ~O• ~.~ ~ B1=105,85Ft B2 =105.85Ft f~, Jo2. ps~'~ B3=lOZ.QSFt B4 =Od.OOFt __~ ~-~r~•103.so•F•~- ~~ David J. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 NE1/4,SW1/4,S 20,T29,R19W (715) 246-6200 Town of Hudson, St. Croix Co. (715} 246-5085 The Glen lot 36 ~t o 5 •• ~5~'~ / ~ Iii ~ ~J ~O S(~~- ~YGG~ \S ho F ~t (r`ha ~~:..~-~ 9- 5 0~ f~ " .. ... .. dam""- `` .. m t , 1'I I /~ \ ~ ! k I n ... ~ A ~- ,~ ' tom{{, + J 1 I p+~. ec 83 E~ 1 ~. I , '. '~. / ~ I `~ isa + 1 , Ik - y. ,' .: - v ~ _ 1 ~ ` r' \ - .. __ ,,. 79 78,,. ~._ ;', ,; ,- ;- '. 465 Ad ! °~ `t I 7 ~ ._... 1 e 1 `~ ~ ; 7 ,. .' \. s i~~, ~ .., /~ /~i -l '\ __ az .. ~ { j\ •~ +~~~ - 344. '.,, ~, r. ~~i/ I ~i_... . + 1 1 I I ~~ ~' `1 I/ ~•.~ J ~ ... .'- ia. '~ \4. • '.. Il~ F~ .'~, ~ 6!~ ~ ~~ Y 111111 ~ \ ~1 .*WI{ ,` ~ ' +i r/~ ~ , t '~~ I7 ' -- + ~ .. \ .... ~ ~ 1 1 1 t ". ~ ~ ~~ ' \ ~ ~ \ .. E'i'e i `~' `. ~ ~x1 ~ ...~ .~j 441` - J I' 1 t.~ / ~ I..~ 9 " ; •~--• I 4 2. '` \. i- • ;rv-/ 1 Y ! u ,, d '1, .:' . .tea ' "! 4 \ \ -- ,I I .'ali ~. , ... ...... i I ~ e..1 _ 1 ,' . ~ 1. ~ ~ , ___ .~ - - _ ,' _ , , 5~ 35 7' : : t ~ t a N _ _ ~ 69. a ~~ 22+~ lT .. . 1~ .... . ..,e , .., ,U/. ~.:. ~~~ ~ ~~` \ 1~ ~ at _\~.,` i :~~. ~ 243 ~• i• ~~138- 1 ! t ', ~ ` -.. ~ • ~ I• ~~ / I 1 I 7r 11i 11:1 1 ~~. •t• \ ~. 1 ,. + I '~ n , .... t 1 ' - 1~ 7, , ~ it ' ; "' \ ~ ~ ` ;, ,1.,; . - ~ ~yl a ~ f Ith l / 1 il~ \.\ \ __ ~/ 111.1.'1 l~, 1 t I a 4 it. { ~ a w ;, 1 + p .+, - 1 1 \ 7 ~, t ~, t 1 E ! I '' I I 1 1 /' +' '+ 1 1'~l.1 ~ 1 III ~ 1 I + '; ~ +-r7 1 ;I 1 `, ra --___ ' _. ~~ ~ .I. N 'i 1~' ~./ f it f.l ~ i' M1,/f t ' ~~,1 I I I I 6 1 1 .. •., . .n- . I , 7 ~7 ~ III - ' 17 1 '' . --' ! to l 1 ~ I I ---- i ., "1,' III ~ \1 ; ' r '`, i -}-- , I '• i ~ ~ II ~ 5• / / ` S6p~ ~ ~ \ ~.` \ ~ i \ ~ \ i ~ i i \ `, ~ ~ i ~ \ `. ~ ~ \ ~~ i ~~ \ ~ ~ ~ NO DWELLING \ `~.~ ' 1 i F100R ELEVAl10NS \ ~~ ~Gp BELOW 858.0 \ `~\ ~Gg J C ~ J 40 ~ ~ 6~O 'IPE ---' 46129 S.F. `rB , ~ o- ~ .90 (1.059 AC.) , ~ ~ ~ ~C 4 i ~~ \ BLOCK 5 ~~' ,- !j ~ ~ X855 ~ \ ~~, , ~~ ~ ~ ~ 56452 ~ ~ \~ `~~~ i '4 ~ ~ \ ~CHMARK i EEL PIPE __, ~ ~ 'o. ~ f ~' . ,~ g0 = 851.76 ~~~ , ~ ~ ~ ~'~ ACCESS AND DRAINAGE sm \ ~~ oy i AND UTILITY EASEMENT ~ 299.71' ~ 0 90.93 _ o _ ti A~s~ I I ~,~ FLOOR ELEVATIONS 39 I I R~'~+ BELOW 858.0 47697 S.F. I I 'd9, (1.095 AC.) I I I I _ _ -_~ j - - - - - ~'S~~ - - N89'25'02"E 5309.18' - - / of ~. N I ( NO DWELLING O~/ / 31 I FLOOR ELEVATIONS 1 ~o• / I I BELOW 858.0 j / ~I I / / °ol I // / inl I // // I I 36 / / I / o I 52067 S.F. /0 / / ~0 I I (1.195 AC.) / /0 I I / ~~ I I / / °~~ / '~ / /~6 h0 ISBL / / ~ ~\ ~ I / ,/ 37 I Sg / / 48240 S.F. ~ ~~ ~ ~ ~ I I ~ ~A/ / / (1.107 Ac.) `- / '~ ' - / 46 ~ `\~~ / ._ ~ ~ // SEE SHEET 7 ~ uy;, v~ • SEPTIC: TANK E PUMP CHr~.i';BFR CR SS SECTIGf3 Afv'D SF'ECIFCF,TIONS ~+" CI -1ENT PIPE 12" MTN. ABO`dE GRADE ~ WEATHERPR40F 25' FROM DOOR, WINDCW OR JUNCTION $OX APPROVED FRESH AIR INTAKE ~ WITH CONDUIT MANHOLE CO'JF,R W/ PADLOCK ~ FINISHED GRADE WARNING LABEL 4" CI RISER 16"' IN. Y b" MAX. ~ ~~+~ ,• .1 ~tvL,ET ~ ` t~ ~ ~, WATER TIGHT SEALS GAS- ~ ~ ` TIGHT i t+ ~ApPROVED A SEAL ~ JOINTS WITH +PPROYED ---~- ~ ; ALM APPROVED PIPE 'iPE 3' $ ~ ON 3' QHTO )N70 S(}LID ~ ~ ' ~ SOLID SOIL ifllL PUMP OFF ELEM. FT. --~-- ~ '~~ RISER EXIT OFF' D PERMITTED gNLY IF TANK 'K.4NUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC ~' DQSE WANK MANUFACTURER : ~ ~E.,~E.~ TANK SIZES: SEPTIC 1~~'Q GAL. ~~ DOSE w, GAL. A%.~AFtM MANUF'ACTURI:R : _ I..'~~ix:.~.p-4~rr~ MOULL NUMBER: ~t_~/ SWITCH TYPE : ~`c~~. ~. PUMP MANUFACTURER : G MODEL NUMBER : '~ ~ t~ SWITCH TYPE: ~.e~~rr11 RE~L'IRED DISChARGE RATE _~~GPM NUMBER DQS£S P£R DAY: ~" DOSE VOLUME INCLUD NG r LOWBAC K : I ~ 9 GAL . CAPACITIES: A = ~_ INCHES = LI~~ _GAL. B = ~ INCHES = ~a GAL. C = ~ INCHES = b$ GAL. D = ~ INCHES = ~~`GAL. PUMP E ALARM WIRING AS FER ILHR 16.23 WAC `IERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRI$UTION PIPE ~~ FEET ~ MINIMUM NETWORK SUPPLY PRESSURE 0 5 FEET ~ -~ FEET FORCEMATN X ~~~bFT/1d0 FT. FRICTTOIv' FACTOR FEET TOTAL DYNAMIC HEAD = 9 FEET ihTERNAL DIMENSIONS OF PUMP TANK: LENGTH ~~- ; WIDTH •-~'' D+AMFTER ~~ LIQUID ~"P"I'F~" ;j 8 ~: -- a -- SIGNED: .~,r/~~~r---__. LICENSE NUMBER: ~.,~ qq '~ DP.T'E: lase A ,~- u/Ck~~ STANDARD CHAMBER Quick4 Standard Chamber MuitiPort End Cap \'a~ I '"_ ) t ~~ r - r~--., f l -~ ~~ T'z• r ~ ~ t ~, ,~ z~ i I-------- 3a° --...T._-~i SIpEVIEW sln~ vlEw TOP VIEW FRONT VIEW x ~ . « ~ ~~ ~ tir} s ,. Qulck4 Standard ~Chatnbe"r tJominal Specifications u f "~~r ~ MultlPart==Eird Lap'Naminal Specs#icaliens F ~~' Size (W x L x_. HL 34" x 52" x 12" Size VJ x C x H) --~ 34'x16"x12" Effective Length 48" lnvert Height 8" or 1.25" lnvert Height 8,r tI~ILTRATOR SYSTEMS. ly(`. 5TANBARD LIM3TEb WARRANTY (at TY st uU,r' I taJ I r r, a 1. r a )t%lr, en(1 Mate, werfye a. R other q c5 :'lvy manL'L'/ZlUrod by I t ralC (`Ur .,"1, wftarl R18t811g1 aril Oparatr,d in a 7. ac Id Nd of an L nE sgp'r stsl. rn ;n act ~ordatxer with Infi f alb s I I lx'I4'A13. is watranlatl to tl .f orkytwi purol racer 1"Flokux") ggairmt dercrlive n .nerlal5 and woV awhip Ir one year Jnun the Dale that tlxf seG+/~ pe mil is rs&run) I(x the septic system (xxuahiny the Urx ,; IinniUfNJ, rawever, r*al N a septw tt2rmrl is not re~u"cxt by appGCahle law, Nw warranty ;.Brad wid Uar,{In upon the da'.o That irrslallatim of She sePtk: sysleryr. tc+nmencas. Tu ror ISe Le wammty ngttts, Helder mL51 rfotlfy 6-si:frata m wrr In~y at Ns Car{xua".e i-MV(kpradcrs in CI!d SayMWk CJmnaclglA wittflr IlNgen (tit) d, y ~ of i~. a aikiyai detect lnfittrator will supply mplarsment UnNS far Units dolern"ned try NNJtrakir to be cr>vbrai by this Limped Wanarxy. InIJlralorS liability spanlical!y axCWdes the cast of rentaral anti/vr ritalaaairon c!!he Units `bl i tF UiM; t FC: NiARRAtJ?'y rLVC HEMP.-71ES NV SUypAF1gGFAPH la} Aftf=. EXCLUS'VI:. 1 tY:'i2E AtiC Nfr uI HER'JJARgANTIE: 4Nn ri HESPE•GT TC• 1HE tlNrrS. iNGLUCNNG Nr,~ LIEU 6NARRANTIE5 L~r• AAEfiCHANTA6ILITY riR 817NE53 F.±R A h'Ari?IC'.UI,AJ'i PURPQSE. (e ti s _ .dtuC W r n .y strap t)e vi. f y ny parr o[ the mar t ror aystarr ' nanuhaC.lwe 1 u myane oU,or than Quill ator. 'rYa Limiters 4yananty (Wes nr I t to d ton - JM ensoq m 1 per eyf ~r axArert da/ ayc+s. fnlAVatU arraN nut (w 4l[,fe Mrfxan~lkss w IigVKfB-tz' Ja+ndge5,'nr;ludlext loss 0' pr(rIUCUOn and V oFi ftN p ~ C mat MI5 overheats cosU of utttOr losses pr ex.{yv was irnurrexl by IM3 :1olUar nr azry t7 c: parry. ;iC.M3GjhGVly r+xc! Cr:d em Llm tM N _ nta - ig ,xe danx•~e'o tna Unrls due .v ordrt ary vmaat ano War, aaerBLpn, acddeN, m5uaa, noose cy rrrfgtect 41 th tits' 11' A tht f6 tJa J ti:.L'foG eel J HI`it:ie t'a(IIC Or Ua1~1 condtions WhtGn Ere nCt rxlrmlited ny itrs Inulaltalx"1 i{ISIrUGllan6; lall,lre to IndlntAY1 the mrnimum g,ound corers sa" twih r the r".Stelktion rnstrurlrcxts; the pldCpnrr,I nt imprc~[M; maleriais into the SySIBm U~rfntainmg the Unhs; lai4"B o' a,e Unr!s ov ihy sepllc sy>tern due ti improper siting pr improper sizing, oxlA3ssive water usage, improper gmase disposal, a improper operalicn; a anY other event not rauseU by'-nflvatar. Ths L'rmitetl Warranty sha!I ba void .f the Holler 'ail; fn comply with air of II'.e trxnrs set forth xl this ;,incited WarrFnty. rurthor; :;~ no eyer:t mall Infilva!er be resFensilile ftx any IGSS w damage to the HPldar, the Knits, tx any Itrrd Uarry rasuhing Wm mslal4nlgn or ship• meni. or fmrn any {xoU..ct Nablirly ct2ims of Hbtder a any child pang. For lh's ~imitad VvanaMy l0 app Y, YF UrJS mull ce installed Nt ac: ordanco with alt site c(xtdilidnS re:Jl;ired by slate and gcal Bodes; all other applicable law;; aril infRlralnr; installaliort instructions rd; Nu r::*.presmi(allve of IrthfhalUr has fire authority io change or aziund l`is I.in5i7ucf WarrartiY. Na wa+raniy appoaa to arty party other IYxin the origF nal Holder- the atavn repre nl the Stan _4 U L'mlci War -dy naorcx; y Infll -:lo. A iu ncU n,;nJ.e of ';ak;r a. td : ttnnies hu/e dlftererH warral;tV nkJuire- m m-'. Arty p'xr.ha O( Units rx Jld d'mla I nti.tratar'3 C'/J p[xa.P, H(mIXluarte-. ut :)IU Y.JIIX)K, f.tNlrlOrtw,Uf, n or to Sl:(:11 puryhrlse, Ia W)liiin a c~PV o! I:`~n applrcab«; warranty, end should ~~~arpfuliy rears tt:al warranty qwr !o lho {wrcitase :+I k.ktils. O SYS~'EMS I IOIC EnvJronmema! Onsfta WastswaterS~luNonss° 6 Business Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-577-7001 8i}0-221-4436 ' - vv .:,rJD,468: tl,330,V1 (; J,4V I,i !b; 7,9V- 47!1, b,b' I US; rJ.Y I[j.l ti;j: S,59t3,778; 5,839,1344 Ganadtan patents i 329 9P,9 2004,564 Otner patens pending. C`~.li}~la) Infiltrator Equaiizer and SideYJintier are registered trademarks of Infillratt7r Systems Ira infitrator is a reglslettx1 traremark in France. Infiltrator Systems Inc. is a reg+siared trademark in Mexiw. Cpniour. Contouf Swtvel Cennecilon, MicroLeJar:;+ling, FolyTUft, r>flaplock, ChanlbarSpacer, PesiLxk, QuickCut. CtlickFtay Rf=crc:tEnrAVER .vxi (lr rir,«1 :,rr, Nor tornar«c ~,f t..fia.ot~,. c„~rn...~ t.,,. re .nrv: i..ea..a.,. c,,,. r....,.. r.,., o...,.,.., .., r : c n Jt~ nVN VItW ~GOULDS PUMPS Submersible Effluent Pump 3871 E 05 APPLICATIONS Spedficaliy designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handUng capability: '!i' maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: t'h° NPT. • Mechanical seal: ca+tian- ratarylceramiastationary, BUNA-N elastomers. • Temperature: t4d°F (40°C~ continuous 140°F (60~} intermistent. • fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: OA HP, 115 or 230 V, 60 Hz, i 550 RPM, built in overload with automatic reset. • EP05 Singgle phase: 4.5 HP, 115 V, 60 Hz, 1554 RPM, bu~i in overload with automatic reset. • Power cord:l0 foot standard length,16I3 S170W with three prong grounding plug. Optional 20 loot length, 16,13 5J1W with three prong grounding plug (standard on EPOS). • Fufly submerged in high grade turbine cii for lubrication and efficient heat transfer. Available for automatic And manila! operation. Auto- matic models include Mechanical Flotit Switch assarrtbled and preset at the factory. FEATURES • EP04 fmpefier: Thermoplas- tic Semi-open design wikh pump out vanes for mechanical seal protection, errs to 9 B s 0 Q 7 Efi s~ 4r 9 a~ ~ EP05 impeller. T'herrnopias- tic enclosed design for improved performance. ~ Wsi+tg grid Base: Rugged thermoplastic design provides superior strength and corros'xM resistance, ^ Motor Housing: Cast iron fpr eifldent heat transfer, strength, and durabiflty. ^ Motor mover. Thermoplastic cover with Integral handle ark float switch attachment points. ^ Power Cable: Severe duty rated o~ and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing tonstructian. AGENCY LISTING ~' [anedNn Standards ksoaiation (C5A listed model numbers end Weds Pumps k iS0 9001 Aegist~nd. i _ , _._ i 4 ~-•.. r 204...,.._..., ._.... ._-. .....r.,. . , ,. _ ..»«. .-... .... ,_ ~ ~ , tsp. _ ._ . . , _.. __M _ . .. ..... _ _____ .__._,. .._..~. _ . ........., .... ... ... ...~..,._,. . µ......~--... ,. ...... , ,_....,.... _.,..__......... ._. 1 ~' EP04 o~ _ . 30 EP05 40 _ 50 GPM , .~ ~ 4 2 4 6 8 10 12 mjlh c~-P,atrTv Goulds Pumps Cr 2000 Goulds Pumps ~r J` tTT Industries Etf•ctlve iebruary, 2000 83871 ':a zo ST CI20IX COLN'i'Y SEPTIC TANK MAINTENANCE AGREEMENT AND owrtERS>t~IP CF;ItTIFiCATION FORIvI Q~wner/IIuyer W Ivlailit~g Addrt~ss _-_ 7'~ ~. ~©~c•• `70 ~ . ~, -~ n ~~- 1~~.•_ ~ 5!~l~ -...____. Atroperly flddress ~~ rd. 5~v (Verification required from planning Department for new construct City/State ~s. ~a , Wi ~ karcel Idt:ntification Namber OZa - ~ _(~, Zd - ~~ LEGAL ~~'. );ti 'I~ SON / ' Property Location ~ ~ '/,, .~ ~ '/., Scc. ti2.© , T ~..~ N-R ~ q tiV, Town off' ~~~~~...•.,.._• Subdivision ~~ti~ .~'~,~~-t.~ _ ~ _, Lot # 3G_ Certified Survey NI~p # -,, Volume --- , Pagt; # '~Varratnty Ueed # _._:~~.,~/mil _-. _ -, Voltune 2S~U ,Page # ~~._~ Spec house~'yes ~ no Lot lines identifiable',~yes D no S"~'ST)F11~ 1~iAi~t~'ENAh'CE Improper use and maiatenance of your septic system could resalt in its premature failure to handle wastes. Proper tnaintenaace consists of puruping aut 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 aazces to submit to St. Croix Zoning Department a cettification form, signed by the owner ahd by a ruasterplumber, journeyman plumber, restrictedplttmberor alicensed pumper verifying thac(1) the on-site wastewaterdisposat system is itt proper operating condition and;'or (.2) after iospeetioa and pumping (if necessary), the septic tattle is less than 1/3 full of shtdge. Uwe, the undersigned have read the shove requirements and agree to maizttai~n the private sewage disposal systcrrt with the standards set foatla; hetei~n, as set by the Department of Commerce and the T)cpartineat of Natttral Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be competed and returned to the St. Croix County Zoning Office within 30 day t~~Iee~~r expir ioc~n d~,t~~ ~~ t~ ! ~~,/ ~ ?/ Obi SIGNA'T'URE OT'.AI'P[,IC.ANT D.P`• •E O`~'NFR CERTIF„~.~'ATIbiV I (we) ctrtify that atl statements on this fotirt acz true to the best of my (uur) knowledge. the propci~~Ctibe¢ abpve, by ~•ir~}~,e oC t~~•arranty decd recordt:ci in Register of Deeds UfCce. y. L-Cc.Kt1~. uc LaltP,iY4 .~is~ ~~ ~~~~~ SIGNATt_JRE O.C APPLICANT I (we) am (arc} the ot4~er(5} of _-_~__ ~?l l css' DATE. • •*•"`* Any information that is mis-represented rosy result in the sanitary permit being revoked by the 7,oniitg Department. ••"" •" Include wllh this application: a stamped waranty deed from the Register of Deeds' office a copy of the certified survey map if reference is made in rite warranty deed POWT~ t3'WNE~t"$ N~ANLJA~~. & MANAGEMENT PLAN Page of ~o , FIiLE INFORMATION ~'~@'~ ~--~..3 1~ O weer ~ e_S'~ ~.a.~c ~~-.~. ,~ Permit e DESIGN PARAMt;:TFRS Number of Bedrooms ~/ {~ NA Nurttbet of Public Facility Unite, p i1-A Estimated flow {average) ~4'~1 as a Design #low (peek), {Estimated x t .5i ~~ d elide Soil Appliastlon Rate elide /fit Standard InftuentlEfftuent Cluality Monthly auera;le" Fats, Oit & Grease {FOGI 530 my/l,o Biochemical Oxygen Demand (BODs1 .x220 mglL Q NA Total tl;uapended Solids {TSS) 51 b0 m,i/h Pretreated tffluent Q,ualtty Monthly average Biochemica! Oxygen Demand (SOD4! 530 mQtl Total Suspended Solids {TSSI 530 mg/L Q NA Fecal Coliform (geometric mean) 510• ofu/10Qm1 Maximum Effluent Particle Size Ys in die. Q t~lA 8thsr: Q NA °`Vslws typical for domestic wastewater and septic tank effluent. SY TI:M $PEGHCATION8 t~ptia Tank Capaafty ,? d ai O NA Sepals Tank Manufacturer ~ ~ ~, d NA Effluent Filter Manufacturer ' ~ .~ O NA EfH~nt Fitter Modot ~~' d NA Pump Tank Capacity al O NA Pump Tank Mastufaoturer ,yes t°Y ~ ~ pump Manufacturer ,G,.,,~/ DNA Pump Mndet DNA Pret>'patmsnt Unit Q $and/Gravel Filter Q Maattanical Aeration Q pbinfsaticn O Peat Filter O wetland D Other: DNA QI'aai Celt(s) Q Ins-Ground Cgravityl q At-Grade q grip-Line O NA [] In-ground (pressurized! D Mound D Other: tttisF~ p NA r. d NA 0 NA M ANCL SCHiOULE tiMervice ~Yent Service Frequency inspect condk'Ktrt of tanklsl At lease once eypry; ~ a s CMaxlmum 3 years} ^ NA Pump out contsnt>! of tanklsl Whop combined =luclgs and scum equal: one-third {Y~i of tank volume C7 NA inspec! dispersal cell(s) At le+uc ante oupry: 3 ssr ~lsl (Ma:~dmum 9 years) DNA Clean effluent faker At leant once every: D rn°^tt' s1 (. / ~ e) O NA Inspect pump, pump controls & alarm At )salt once s `~1t' .---- rnonthtsl C3 a! d NA Flush laterals and pressure test At le#it once every: ~-- ~ sate! a1 p NA Other. At leant oncM s~vsry: ~- month(s) D ear{s} ^ NA Other: Q NA MAINTE'kIANCf: IN$TRUCTlON8 Inspections of tanks and dispersal calla shall tee msrde by an indiv'Iduai carrying one of the fo{(owinp liaenaes or oeRtf+cations: Master Plumber; Master Plumber Restricted Sewer; Q4W'T~ inspector; Pt)WTS Maintainer; Septags Servicing Operator. Tank inspections must Include a visual inspection at the trtnk{41 to identify ally miss'sng or broken hardware, identify any cracks or teaks, measure the volume of combined sludge and scum and t0 check for arty beak up or ponding pf effluent cn the ground surface. The dispersal cetl{sl shall be visually Inspected to check the effluent levels k- the observation pipes and to check far any ponding of efituent an the ground surface. The pondtng of effluent cn the Around surface may Indicate a failing condhion and requires the immediate notification of the {ocal regulatory authority. When the combkted accumulation of sludge and swim an any tank equslla ons•third {Y,1 M mare of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator end disposed of in accordance with chapter NR 113, Wisconsin Adminlatrative Cods. Ail other services, Including but not limited to the servicing of affluent fllten, mechanical or pressurized components, pretreatment units, and any ssr+icktg at intervals of 54 2 months, shall bs' performed by a certified POVi/TS Maintainer. A service rapoK shall be provided to the local regulatory puthorit+,+ wlth~ 1Q days of completion of any service avant. •apo~ on11B11SIUtwPd uwuooslM 'IE) ~ (ZS '14}49'E8 Pus it}~Ip)(tltgllLit$'E:$ wwo~ Jo;deya 4um +iaus{ydwoa u{ pex;aJp SeM iuauJooop 81111 ouot~ euoyd awsN - ~ vweN AZI#ioH1f1V Aa0171i103a 1~+JOl l>33dWCtd1 llClt~i~3d0 I,NIOIAl138 3DV.L.d3S auot~d o~N d~NIV1.NItlW 81MOe! i13'17V1SN1 81MOd sa.N~wwoa ~rvNOlllasw '3'1g18!>10dY111 ~1011tl~IdsIIQ ~1! AMW ~IN1l1 d d0 !#O!#131N13H1 WOad NOS#13d V d0 3f10S3#i 'llflS3!! A~/W H1V30 '830Nr-1SWf10>dl~ ~Hd aislGNt1 i1NM1 1N3W1V~11 k13N10 !1{i dWt1d 'OU.d33 d il31N3 lON OQ 'NdQAXO yN3101ddI13Nl 1!0lf~NV S9SSV0 `IVNl~"1 NIM1Nla~ JIdW 8»N1I1 1N3W1V3>dl ll3Hlo aNV <ON1Nd~IM>$> 'S,LMQd Pal!B# ayi aoaldaJ of ttooa~ isaj a ss palls;sal oq ,lauj ~luei 9u{p{oy a ~tsolouyaa; S1Mgd u! seousnps BulaJeg •suolisilwll I!os Jo~pus ~oegies of anR eigellene iou sr seas iuawooeldeJ algeilns d 'euulx leyi ie iae}~a u! selnJ eyx yi{M Alduuoo xsnw swaxs~ts iuawayaldea 'eaJS iuawaasldoJ algeuns a ysllq~i:e of uol3orryono axas pus {{os Mau a Jo; peso syi ur ilnsoJ IIlM eeJe ;usuleosldeJ oyi ioaxoJd of aJnped 'spats pus s0ut~ ia{ `aJnianJ~ po>:odoJd pus 9u{islxo woJ; s~loagxes p®alnboJ ~cq uadn po8uu;u1 eq tau p{Hoye pus uoliaeduJao pus aou~q~naslp woJ; pe~aioad aq Plnoys seas ;uawaosldeJ •yl •weisAs ua~;dJOSge Iles xuaweos{daJ a ;o uo}xsooi oyi Jo; pezi{{zn aq ArsuJ par pex~en~ene uaeq say aeJS iuawaoe{daJ elge;lns d oar O O ' :waists iuaweos{doJ iue{{dwoo epoo a aplnoJd of 'uo~lex eq xsnuJ Ja 'uaaq aney seJnsesw 6wMO~lo; 9yi panedeJ eq iouuso P ~1d1d A~N30NI1NC30 •{e{Jeiew pllos x.reu{ .1e+}ious Jo laneJB '{toe yxlnn Pall!b sands plop ayi PUe panoweJ sJanoo J{ey; Jo pi-nouJeJ pus po;en~oxa aq (lays s;id pue 9~Iusi ils '6uldwnd Joi;b JaxeJSdO $uca{nJeg eBeideg a ~tq }o pesodslp A{~odoJd pue panowsu aq pays sill pus s~~.Jel !Is ;o sxueiuoo eye, • pe{eas s6wuado wild pauopuege~ ayi Puy pa~bauuoaslP ~1 Ileys eild pus slue; ox Suldld !fV a :epos enlis~islulwpy ulsuoolllM `~>r'£8 wwo~ #oid~y` yilM aauelldueoo u{ pauopuege Ale;las pue AiJedoJd s{ waxs~s syi ieyi aJnsul o; ua~ei aq {{eya sdeis Bu1MO~}o; ayx ao4nJas ~a 3no ue~lei n{xuauewJed sl Jo~pue ells} S.LMOd ay; u~lN1 1N3WNOaNVBH •oul~q Joust}os JIa1oM Pud tsuodwQx :sut~Ideu AJeilues :saplousad :sianpoJd Buliu{ed :I{o :suolieolpauj :sdaJas xEe1u :gap!algJAy :88asJ$ :®ullaas$ :sBu{Iaod elgaie6on pue x{nJ; :Je38I+n Idwnd dwns- u1eJp uol~ttpuno} :xe; :sxuexae;u{s!p :sJadelp :scot; Isiuep :aJSSeoiBsp r'cgaMa ucxyo5 :suJbpuoo :sunq auvJS6lo :sadl~- Ageq :salxolq{xue :g,~Mpd ay; ;0 2;lt ayi Sua{aJd pue eouewJO.~ad ay; enaJdun A¢w wee.lls Joler++8lseeu- eyx woJ; 8ulMO{lc; syi ;o uol;eulw{le io uolionpea •ebJe udl3clJOSga {tfls appJ$-xe Jo punouJ Aue ;o ado{s uMOp iaa# g t ulyilM seJe eyx 'i0eduaao Jo gJnislp aslM}ee{xo ,!0 'Drano ~{JSd 1o en~1p iota aQ •+3~1e~ I~¢sysdslp pue s~ur31 Jano setolyen )IJed Ja snap xou o0 •~usi dwnd ayi u{yx1M s{enal (swJOU oJaxsaJ o; siaJiuoa dwnd ®y3 ~ws;@Jado ti{Ienuew uq islsse of Jau~o;lJ~y~j S1MOd ~o ~egwnid a ;aaluoa Jo duJnd xuen{}}e eyx ai JeMOd $U110~98J Oi JOiJt~ JL1;BJadQ 6US51nJe~'j 6$e3.deS B Aq PanoweJ ~iuei tfuJnd py; ;o g~uaxuaa ay3 aney uonenils sly; pone al •;uanl}}o }o abJSyas{p eas.~na Jo dn~oeq eyx ul x{nsaJ ~l¢w pue tg?Ijao eyx If+ilpsa~Jr3na 'oaop a$Je{ ouo ul Is!{{ea {esJadslp eyx o1 paeJSyoslp sq ill~^ Je313Ma39eM ssaaxa syi peJOisaJ sl seMOd uey/N •+r{sne! .reieMyB{y t»WJdu onoge {'!; new s~{usi dwnd saBalno JaMOd dulJnp •eDe}ln8 9A{ieJi{{}U! Ayi xn uaxoJ; r:JU SUolllpUDO {109 UeUM JR9a0 x0u {{sy8 do xJtRiB WexQAS ~san of sti4Jd Jb3eJedo BulalnJaa e8eides a Aq penowaJ (s)~{uei syi }o sxuaxuoa eyx aney peioei>aP aJe suolieJiueouoo y6ly #i 'is}il~-o Ig~#edslP a4i o~sursp io;pue sseooJd luewxeaJi syi epedua} Aew isy3 s{ealweya a9yxo Jo 5;anpoJd Bu{ruled;o eauesBJd eyx Jt1j ~al;lutrf iui3wiae~ ~IoYya S.LMQd sy; #o esn of JO{.~d 'uo{3onJisuoo Mau Job NOl1VH3d0 ONV d11 l~f1S ~o e8e,~ •swj1 isyi ie iav;}o ui setw out yilN+ A~dwoa ~nua sum2sAs yens }o cuol~nJxsuooe~ •aas;Jns an{isnlyw s~~, ,R ,au-o1a aui io IsnowsJ $~nMOI{o; aosld u{ psxanJ;suoa4~ eq Aaw swd;sAs uondJOSgB i{os epeJ6-is pue punoyy ~~~ Pape O( START UP ANO OPERATION For new construction, prior to use of the POWTS otrsck ifsstrf+enj tankla) far the presence of painting products or other chemicals that may impede the treatment process andJor dama~s the d4aper(i4xE c{±alit~ii• !f high canaentrations are detected have the contents of the tank(s) removed by a septage servicing oper8ti}r priR- ><0 use: System start up shall not occur when anti conditiarti~ srlr fraxen at the inflltrstlve surface. During power outages pump tanks may fill above narr»ai hI$hwatar levels. When power is restored the excess wastewater will be discharged to the dispersal csil(sl in one large dole; ayerlosdini~ that ceills) and may result in the backup or surface discharge of affluent. To avoid this situation have the contents Af Ehe pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber ar PQWTffi MeintAinpr to assist an manually operating the pump centrals to restore normal levels within the pump tank. Do not drive or park vehicles aver tanks and dispersal Gems. pt4 (got drive ar park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption arya. Deduction or etiminatian of the faNowing from the wastewater stream may improve the perfomlanee and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butte; candprna; cnttQn sv+Eaga; degreasers; dental floss; diapers; disinfectants; tat, foundation drain {sump pump) water; fruit and v4ggtaple fseelinga; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; :and watelr softeher brine. ABANDONMENT When the POWT5 fails and/or is permanently taken put of service thA following steps shah be taken to insure that the system is properly and safely abandoned in compliance with chgpcer Comm 433.33, Ndillconsin Administrative Coda: e AN piping to tanks and pits shah be disconnected and the abandoned pipe apenktgs sealed. • The contents of ail tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • -After pumping, ail tanks and pits shall be ex~cavsted and removed or their covers removed and the void space filled with soil, gravel ar another inert solid material. CONTINGENCY PLAN It the POWTS falls and cannot be repaired thg fo!(owin~ measures have been, or~must be taken, to provide a code compliant replacement sy>atsm: ~~A A suitable replacement area has been evaluated and may be utilized for the location of a replacement soN absorption system. The replacement area should be protected from cliet4rbaAnae and compaction and should not be infringed upon by required setbacks from existing and proposed ;structure, lot Nees and wells. Failure to protect the replacement area will result in the Head for a new soli and site eveiue~ian to aataabfish a atritabla replacement area. Replacement systems must comply with the rotes in effect at that time. D A suitable replacement area is not available due to setback and/or soli limitations. Barring advances in Pawls technology a holding tank may be Metalled ae a tairl: resort to replace the failed POWTS. 0 Q Mound and at-grade sail absorption systems may be reconstructed in place tonowing remave~ v~ ~~~a ~~..~,~p. ~• •~~~ infiltrative surface. Reconstructions of such systems myeit gomply with the rules in effect at that time. < <WARNlNO> > SEPTIC, PUMP AND OTHER TREATMENT TAl~KB MAY CONTA~Iy l~13THA(. GASSES ANL?/OR iN8UFFECIENT OXYGLsN. OQ NOT ENTER A SEPTIC, PUMP Y}R OTHER TREATMt»Nl` TALK UNDkR ANY GIIiCUMBTANCE8. OF.ATH MAY tRFSUt.T. RESCUE OF A PIrRSON FROM THE INTERIOR OF A TANK MAY S8 i~lR~lC(~t.T l}11~ f;(MifD4~SIRl.E. ADDITlONA6 COMMENTS - POWTS iNSTA1.L.ER Name ~/='~l,'Gt ~r~ o/7~Q 1~ Phone ~ ~ , ~ ~, ~ Pq . B IirtA1NTAINEFi Name Frhone SEPTAGE SERVICING OPERATOR !PUMPER) GQ • R4GULATORY AUTHORITY Name ~ Noma Phone I~F-ane This doa(uttant wet 4rafted in campiisnce wkh chapter Camm at3.7~i~i{blttl'{diAtfl Ind 83.54(ti, (21 a (31, wieconsln Admintstrativo C~c+d. U. 2560P Document No. I~ STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED SIENNA CORPORATION, a Minnesota corporation, conveys and wan WEST LAKE BUILDERS, INC., a Wisconsin corporation, the following described real estate in St. Croix County, State of Wisconsin. rJ 8 7 6 1 1 2 1 IIATHLEEH H. YALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 09/30/2004 10:00AM MARRAHTY DEED EXEMPT REC FEE: 11.00 TRANS FEE: 289.50 COPY FEE: CC FEE: PAGES: 1 \~ Sienna Corporation Suite 608 4940 Viking Drive Minneapolis, MN 55435-5318 Tax Parcel No: 020-1416-20-000 Lot 36, Block 5, Plat of The Glen, in the Town of Hudson, St. Croix County, Wisconsin This is not homestead property. Exceptions to Warranties: Easements, reservations, and restrictions of record. Dated this a~ day of AQ~R , 2004. AUTHENTICATION Signature(s) (SEAL) SIENNA CORPORATION, a~nesota corporation (SEAL) Marsha A. Pierce Assistant Secretary authenticated this day of 20_ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06 Wis. Stats.) This instrument was drafted by: Sienna Corporation ACKNOWLEDGMENT STATE OF MINNESOTA Hennepin County } }ss. } Personally came before me this ~_day of Cia?~Jl~ , 2004, the above named Marsha A. Pierce, the Assistant Secretary of Sienna Corporation, a Minnesota corporation, on behalf of the corporation, to me known to be the person who executed the foregoing in trument and a Howled e t p sa e. Catherine M. ThornhtTl, Notary public 4940 Viking Drive, Suite 608 Notary Public of Hennepin County, Minnesota. Edina, MN 55435 My Commission expires January 31, 2005 Signatures may be authenticated or acknowledged. Both are not s,~~ ~~ CATHERINE M. THORNHILL necessary. ~~ NOTARY PUBLIC -MINNESOTA .,,.~~` My Commission Expires Jan. 9t, 2005 Names of persons signing in any capacity should be typed or printed below their signatures. r Pa rce I, #: 020-1416-20-000 06/24/2005 11:19 AM PAGE 1 OF 1 Alt. Parcel #: 20.29.19.2630 020 -TOWN OF HUDSON Current jXJ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " =Current Owner * WEST LAKE BUILDERS INC WEST LAKE BUILDERS INC 1714 CRESTVIEW DR HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description `426 SWIFT CIR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.195 Plat: 1983-GLEN, THE 02 SEC 20 T29N R19W NE SW SE NW LOT 36 BLK BlocklCondo Bldg: 5 LOT 36 5 THE GLEN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-19W NE SW Notes: Parcel History: Date Doc # Vol/Page Type 04/30/2004 761121 2560/587 WD 12/21 /2001 666080 1797/613 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.195 57,500 0 57,500 NO Totals for 2005: General Property 1.195 57,500 0 57,500 Woodland 0.000 0 0 Totals for 2004: General Property 1.195 57,500 0 57,500 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 1095 Wisconsin Department of Commeaoe. SOIL EVAL~IATION~-REPORT Page 1 of 3 Division of Safety and Buildings ~ accordance wRh-Comm~85, Wes: Adm: Code Steel Sal Service ~~~ Aitach txxnplete ste plan on paper not less than 8Y: x 11 inches in size. Plan must St Ccoa include,. test not lanited to: veRic~ and haizwrtal n;fererxe. point (B1N).. dion. and Parcel .l.D. peroeM slope, coals-eF dions, north anow, and-laeatioe ark-distance to-a~rest need: ~d~g PCease. printali infomtatfon. Reviewed ~ ..Date Personal infarnation you~ravide may ba used for secadary purposes (Pmrecy law, s. 15.04 (1) (m)). Property Owr>er Property. Location Sienna Corporation Govt Lot NE 1/4 SW 1/4 S 20 T 29 N R 19 W Property Owner's flAailirg Address: t~t# Bbck # Subd. Narrre.or CSM# 4940 Vtlcing Dr, Suite 608 36 na The Glerr City State Zip Cade. Phone Number City. Village Tam Nearest Road ~eQ;nu MIFF 554359~z.~3S-2Flo>r Hudson Carmichael Rd. New Consttudion Use: Residential/Number afi bedrooms- 4 Code derived design flaw rate 600 GPD Replacement Public or carnmersial _Describe: Parent material Pitted oufinrash Flood plain ele~ration; 'if applicable na General comments and recanmendations: System•elevation102:35ft;trenches spaced and depth to coder3:50ft bebw•grade ^ Boring ~ ~ ~~ Pit Ground Surtaoe elev. 105.85 tt. Depth to limiting fades 102. in. ~,gppl Rate Horizon Depth Dominant Cobr Redox t)esrxiption Texture Stnx~ture Consistence Boundary Roots GPDrYIz *Eff#1 'Etf#2 1 0-7 10yr3/3 none sd 2msbk mfr es 1 f .4 .6 2 7-12 5yr4ht none' Is o;;g mutt gw 1 of .7 1.2 3 12-102 7.5yr4/4 none. cos asg.. mutt na na :7 1.6 Big ~ Boring Pit Ground Surface elev. 105.85 ft: Depth.to Itrniting factor 102 in. ~ pppl-fin Rate Horizon Depth Dominant Gdor Redox Description Texture Structure Consistence Boundary Roofs GP DflF~ 'Eff#1 *Eff#2 1 0-10 1Oyr3/3 none sicl 2msbk mfr gw 2f .4 .6 2 10-24 7.5yr4/4 none Is osg mutt gw 1 of .7 12 3 24-102 7:5yr414 none.- cos osg mutt na na .7 1.6 cmrrenr a:~ = esvu ~ su <rl[1 rr~rL.and T5S >30 < 150. mglL * Effluent #2 = BOD < 30 mg/L and..TSS <~0 mglL CST Name (Please Print) Signature: CS'i• ~~ David J. Steel ~G`^'_~lvJ'~~~ 24895fl Address y-t~ sod Service ~ ~.../ Date Evaluation Conducted Telephone fVumber 1564 CR GG, New Richmond, Wt 54017 9/5/2002 715-246-5085 Property.Owner~ Sienna. Cot'potati0 ~~ ~ &xirag Pik 1 .0=16 'f0jrr3/3 2 16-31 t0yr4/4 3 31-45 7.5yr4i4 4 45-t 02 7.5yr4G4. Part~al~tD,# . Pending.. Page 2 of 3 Ground Surface elev... 1®2.05 ft. Depth to lim iting factor i02 in. Sod Application Rat Redox Desaiptksr- Texture Structure CorBisterrce~ Boundary Roots GPDlfI= .. 'Eff~'I 'EffdF2 none -stT _2insbk ..mfr gw 2f .4 .6 none sict 2trtsbk mvrfi- gw na ~ .4 .6 none ~, osg mvfr gw na .7 1.2 none cos- osg. mufr na na n .7 1.1i 'Effluent #1 = BOD ~ 30 < 220tng/L and TSS a3p < 150 mg/L '.Effluent #~2 = BOD$ <30 mg/L and TSS <~0 mg1L The Deparhnent of Commerce is an equal opportunity service provider and employer. if you need assislaace to access services or n ~n9# ~. Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 NEl/4,SW1/4,S 20,T29,R19W (715) 246-6200 Town of Hudson, St. Croix Co. (715) 246-5085 The Glen lot 36 This soil evaluation was conducted to satisfy a zoning. regmirement, it may ~ may not be suitable for your ale. The location of the test may or may not be as shown as permanent lot lines were not estabtisked at the time the soil test was conducted. Legend 1" = 40' • = Benchmark El, 100.00Ft Tap of 1" steel pipe ~ =Alt Benchmark EL110,SOFt ~ N° Top of/s" P~ Piles =B i hoJ- ~,;.~ a or ngs ~~ ~ ~ Boring Elevations ~ B1=105,85Ft B2 =105.85Ft ~~~, to2. oS.Ca- B3 =IOZ,OSFt A~ _~.-_ B4 ~O.OOFt ~~ 1 ~ ~13~ C~'Y~ . Sao s~ep~- ~~~ 9- s v to3.eeFf- ~~ u 5 •• ~ST~- SYG~~ \~~~ ~~ / . / .. ` L. .' x'74 `t 1~` •ai . _~ - ~ ~_: ./' t la ~ ~ '~~ i _' ' '/ •`. '. `,. 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