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HomeMy WebLinkAbout020-1417-80-000Wisconsi Depa4 ment of Commerce PRIVATE SEWAGE SYSTEM Safety an~ Building Division ~ '-~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) ~ Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Sienna Cor Hudson Townshi CST BM Elev: ~ Insp. BM v: BM Des~cr/ijpt~ion:p~ ~ ~ ~ TANK INFORMATION ~w TYPE MANUFACTURER CAPACITY Septic Dosing ,t I rJ~ ~/ ~~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/Lr W~ BLDG. Vent to Air Intake ROAD Septic ~ ~~~/ ~ ~ Dosing ~ VAS Aeration Holdin g PUMP/SIPHON INFORMATION Manufact errand GPM Model Number ~` TDH Lift Friction L Forcemain L h Dia. SOIL ABSORPTION SYSTEM System He~'~-.__ ITDH Ft to \ELEVATION DATA County: St. Croix Sanitary Permit No: 453044 0 State Plan ID No: Parcel Tax No: 020-1417-80-000 Section/Town/Range/Map No: 20.29.19.2646 STATION BS HI FS ELEV. Benchmark ~~: /OQ- ~ Alt. BM Sr, ~ob• S'~ Bld .Sewer . D /o .~ Htlnlet o •3 S Ht Outlet ~~ ~ ~ / .~ lG - Dt Inlet ~"" -.-- Dt Bottom ,~ ~--~~ Hea Man. ~ ,r /02. / Dist. Pipe 2 _ Bot. stem F~nat I Grade ~ . O St Cover ~ ~. ~/' ~~~ ~ ~- tt?.t ..D h i BED/TRENCH DIMENSIONS Width I ~/ Lengtty ~7 b ~~ ~/ b No. Of Trenches 2 PI7 DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L,~ BLDG WE L LAKE/STREAM LEACHING CHAMBER OR Ma rer , Ty Of System: ~/~ ~ r ~ UN Model Number: S RIBUTION SYSTEM Q~" 1/~t71(JO.t ~ .~t~.L Heade Manifold ~~/~ / Distribution i x Hole Size le Spacing Vent to Air Intake ~ ~ Pi e(s) M "~- Length Dia ngt is Spacing SOIL COVER (~ x Pressure Svstems Only xx Mound Or At-Grade Svstems Onlv !~- ~ ~ ~J ~ Depth Over / ~ ., Bed/Trench Center ~ Depth Over Bed/Trench Edges xx Depth of Topsoil xx Seeded/Sodded ' xx Mulched ~ - Yes '~, No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1;~/~/~ Inspection #2: / / Location: 450 Wren Circle Hudson, WI 54016 (NW 1/4 NE 1/4 20 T29N R19W) The Glen Lot 52 Q Parcel No: 20.29.19.2646 1.) Alt BM Description = ~~, ~' ,~"~ <_~~ Vl~~~ ~ ~ ~ Q,(G~~r~ 2.) Bldg sewer length =/ /„ ~ {'h(~'l.J~'-L(.GII'! ~ .( ~~~" -amount of cover ~-j,,v/~ ~~ ~ - -- - - _ Plan revision Required? l -; Yes o ~ ~ I i ~ /_ ~ ~ U d~-~ --- --- ~ --- ~-~ r- -~- ,--- Use other side for additional information. ~__ rv~ _ ~~_(~__L _-!_'_ !_____ _ SBD-6710 (R.3/97) Date Insepcto s ignature Cert. No. 1 . ~ ~~.~__._,_ Safety and Buildings E)ivi5iun ~, 201 W. washingtan .4. Box 7162 I County G`d s ~ Madison, WI 5370~r ~~~~ ~~~~ be (to be Shed In by Co) ~ Sanitary P 4, ~ l Dt3 artment of Commerce I (608) ~-315P ~,~~'~~~- .. ~ 5-3 ~ , , Sanitary Permit Apphcat n ~y~~ ~ Sta Plan LA. Num r ~ i ~ , ~ personal inform lion you provide °~ ~ il(J~ Code Wis Adm in accord with Cotton 83 21 , . . , . may be used for secondary purpasa+ Privacy Iaw, sI thi{lx~ , ~ ject Address {if different than mailitss address? C J f~,l k ~~~.' R ` v ~ ~ lication Information ~ Ple~e Print AU Information `''~=. I A II bV L.1~ ~ / ~ C+t- ~'~'~ W Q ,. . pp .. Property Owner's Na me ock k Parcel ~ Lot M BE Ss u-/v ~ / S~ ~~ b Property Owner°s M ailing Add ass Property Location City, 5tsu Zip Cody Phone Number I (cucle II Type of Bnllding (check all that a ply) ~ . p vw~t ae 5 ~1 or 2 Family DwelUng - Number of 8edrootns Subdivision Name CSM Number ~~ ^ Public~Carnmercial - Describe 11se ~~ ~` `°''~ ~ State Owned -Describe Uae ^Ciry~^Viliage~ownship of,~a d.S III. Type of Permit: {Check only one box on Ifne A. Complete line B iP applicable) 20 - 1 ~- r Zlo A' .~ New System ~ O >aeplacement System ^ Trtatment/Holding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New I List Previous Permit Number and Date Issuec Before Rxplratiaa i Plumber Owner IV, T of POWTS S stem: Check aU that !) _~ ~Nvn -Preasurfaed In-Ground i~ Mound > 24 in. of suitable soi! Q Mound ~ 24 in. of suiwbie soli ^ Atlirade ^ Sh48ie Pass Sand Filter E ^ Cwstructed Wetland ^ Pressurized In-(around ^ Holdi»g Tank ^ Peat Filter ^ Aerobic Treaunent Unir a Recirculatiu~ Sand Filler ^ Reeircula " S nthetic Media Filter d Leacriin Chamber [1 Dri Line ^ Gravel-Seas Pi ^ Other (ex in) __ V. Din naUTreatment Area Information: ~ ~~~...~ rod G -~ r ~ Design Flow (gpd) Doaign 5011 Application Rate(gpdsfl Ilispersa Ares equired (sfj Dispersal Area Proposed {sfl yttem F-kvation Qw ~ ,. 7 ~~ ~~7 ~ ~ 6 VI. Tank Info Capacity in Total Number Manufacturer Prefab Silo Steel Fiber plastic Galloon Gallons of Utti t,,,~ ,~.a.~.4.Q ~ -too E~~~~ Concrete Constructed Glass New Fxistlns , '"' / l Tasks Tanks Septic ar Holdin= Tank ~6d J '~ g /~, /~ /~' I Aerobic Treatment Unit ' . posing Cltamber >~~d ` sir VII. Res nsibWty Statement- I, the itudern , asnttme reaponslhllity for nation of the POWTS shown an the attached lazes. Plumber's Na rno (Print) Plumber's Si 8twture MP/ PRS Nurnbr#r 13usir-ess Phone Number Plumber's Addre es (Street, City, State, Zip Code) ~ .S `~- ~ ~ cn rr/ ~~ VIII. Count. /De artment USe Oni Approved ^ Disapproved Sanitary Permit Pee {includes Groundwater Date Issued I ui Agent S' tur Na Stamps) ~ ^ Owttor Given Reason for Denial Surcharge Fee) ~~ z '~ IX. Conditions of Approval/Reasons for Disapproval { 1 I SYSTEM OWNER: 3) cn.+n~t.P~-'ati2.rc y i 1 Septic tank, enluent filter and /~ dispersal cell must aN lie spy®~ / ~,~Intalned 1pe_. VV as per management plan provided by plumber. ---------"-- i 2. All setback requirements must be maintain; as per applicable code/ordinances. ~Rn-~~vr~ rR. ryl/rl~~ ~~,. wwins.c paw tw we ..vaa.y uary/ +ur tYt•,r,~~ID vn pryer ao6 lefii IpW sill x i 1 IACIIO iff ilae ck `~ ~¢. C l . (~ 1"- 1~~~-~y~~~-= -~- ~~ ate- ~~4 ~l-~D~~ y _ ~-~ ~ ~~d ~~~liG ~~U, ° ~ ~2iG' /n3 /S~ / `lg.o -y - ~~,~a~~ y . ~ SOIL EVALUAT1O~+1 REPORT Wscronsin Department of Commerce Division of Safety and Buildings in accrorrfance wtth C~nm 85, W is. Rdm: Code County.. Attach. complete sde plan on paper rx>t tens than 8%: x 11 inches in size. Plan must include, but trot limded"to: vertical and hor¢ontal reference poinf (BM}; direction and patoel t.D percent slepe seals-or dimemsiens; rwrth arrow; and leeatien and distance to nearest-read Please print aff info-rr-a4ian. ~ ' Personal infomration you provide maybe used for secondary purposes (Privacy Lew, s. t5.04 (1) (m)). ~ Location 1154 pie 1 of 3 Steel Sal Service ,Date Property.Owne~~~ --- --- ~ L~ ~ NW.114 NE1t4 S 2U T 29 N R 19 W Sienna.Co s''~-~+.' lo## Blocky ~utxi.Name~CSIVI# pr~ty:r3yvr~er's M> Address- The Glen 52 ~ na 4940 Viking Dr, Suite 608- City State Zip. Code hone f~rlD~er Ei ~"~ ~ L; C Village Town Nearest Road MN- 55435- z-~3S ~l"c~ ~^ Hudson Garnrtichael Rd. ~,'hu _...., ' '.:.~;....,4.-.a..,~ Cndederived.design Aow rate 600 GPD / NewConstnsction Use:. / Residential mss" ~~ Publicor commercial -Describe: Flood plain elevation, if applicable na Parent material Pitted outwash ~y General comments ~ ~~ ~ ~ ~ '1 and recommendations: System elevation 99.OOft, trenches spaced and depth to code 4.OOft below grade 2 . S Boring # `' Boring. 96 in. Soil Appticatian Rate 1 / Pit Ground SurFace etev: 103.00 ft: pepth to limiting factor Horizon Depth Dominant Color Redox Description Texture Structure Cor>,sistence Boundary Roots- GPDfft2 1 0-9 10yr4/4 none scl 2msblc mfr cs 2f _4 .6 2 9-26 % ~ ,2 7 5yr414 none cos, ~ ~ osg- mvfr_ cs na 7 1.6 ml na na .7 1.2 3 26-96 7.5yr416 none ms osg. ~ ~~. ~ sys.~~. ~o`' RG" 8~;,~ # g~-ng rr" Pit Horizon Depth Domina' 1 0-16 10yf3/4 2 t6-36 7.5yr4i4 3. 3fi-96 7.fiyr416 ~~ ~ ~ < '~c ~ O ~o~/9~h Grcerttf Srxface elerr: 103.00 ft: Depth to iimitirg factor ~ in. .,_~__. ~.u_.:..F:.,.. Yorfiiro Stnxture Consistence Boundary none sd 2msbk mfr cs 1 c none- ~ p/L osg.. mvfr gw 1f none. ~ asg_ ml na_ na 'Effluent.#1= SOD ~ 3tI < 22Qmg/Land_TS~>3a < 150 mg/L CST Name (t?Iease Print} Vie` David J: Steel c'Q~ .Address SteeYSoil Service Y `"'`"' i 1564 CR GG, New Richmond, W 1.54017 Soil Appl~:atron Rate GPDHt2 *Eff#1 ` •Eff#2 .5. .g _7 12 .7 1.2 " Effluent#2= BbDs<3Qmg1L and TS8 < 30 mglL 248956 Date Evaluation Conducted Telephone Number 9118/2002 715-246-5085 St. Croat Pending 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 NWl/4,NE1/4,S 20,T29,R19W (715) 246-6200 Tavun of Hudson, St. Croix Cc~ (715) 246-5085 The G~ lot # 52 This soil evaluation was conducted to satin a zoning requirement, it may or may not be suitable for youryse: "1`he location of the test may or ma not be as shown as permanent lot lines were not c§tablished at the time the soil. test was condu ted. Legend 1" = 40' = Benchmark El. 100.00Ft 77~ Top of '/2" pvc pipe • =Alt Benchmar .103.15Ft Top of/2" pvc pipe J ^ =Borings g3' Boring Elevations 43 ~qi BL =103.OOFt ~ B2 =103.OOFt ~'` B3 = 99.1 OFt B4 = OO:OOFt ~~5~ i34 ~ ~1/~- f~~ai~~- ~l ~ io' b"~' t S ~_ t ~-~ g ~~v /~. ,- ~_ ~ ~, ;_ .- j -~ - ~ Iir ..- ~ .~ i ..., i ii I ,, ___. - 55.. ,:, ~, ., ~~ - J, I ` _ i ,~ -- - _ _ i , _ ,e\ I 53- `.i~ _~- ... -. .. -- ~.' / . 1 ~ C .. - -. r ~~.-- ~r.r-.. r 1.. .., _ - - - - .... ~ - '<~ _- ~ ~ 1 A~ r f'. ;. - ~ f• .- r ~ ~ ~ ~ -~ ~. /~ 457 a"9~ ~ ~ : ,, _ ,$ y :. . _, , \ . ~ ~ \ ...111 ,,./ ~ f 1 ~ r _ ~ 1!SE + I •? _K / , .. ..' r I r S , I I 1 ~ ~ r 2t -- - ~_ r 1 8~ '\ I _.. ~ -• ' '~` .. i \ ` ~:~ , .. 1 .• f + ' 1 _.. / - _ _ _ 1 I . ,,, - _ . f 221 ~'_.`_• ---wry. - liS .... t .r 7 - ` _ / r ~ t9 \; 1 r ~ r _ ~ r _. , l ~`~ _ - .. =~ ~ m A . ~~9 .: ~?8 1 _ _. 5 --N -- _ , `--11)) r I `. \ 1 ~ ~ i It.. , .. ~ , _ _ i ~' 1 r F e'.1 a ~ 345 :; ,; A~ m ... .~4 w. ` .. ,;• ' 1 - `` \ , + '~ -- I v .. `. ~ : :' - 344 .. -.. 3-= .,., .. . ~ x. f: fit .. -fi N ~` ~ -. -~ . L ~. .. '- ~ -v •.• i-t `~: 3c~" 696 ~ ..~... ., . ~ ,r ` ~ 1 \ \ ---O,Rr \ ,`yam . w ./ ' ; t I ` ' -- l f ` ~,.13 ^ `,• 4 • F 1 \ ~---~ _ ` ' `~\`\ ~,~ f q \ 1- ~ .. ', 1 , i , , 1: 1 r~ Y .. ! -- - 39 - 3i" _ _ ~c..y -_ .cam ~~ i _. . _~ ~ ... -. . ;• ~ -~ ..._ ..,.a ~= Ire v l~l N__ . ~. c ' ..~ _- .•~ - , i ~ .~ - g 64 ` 6 \ ~" ~ ~~ .- ~- : a \ <J ! +~ , ._.. . ~, ,~/;~' ~ r;.- - .' ~ ~ ~` :r. i \` ~` ~- \ r. % ~; 233 •~-/ ...tom ..._. ...332 ~ 1 ,~ }: _,~ . ,; t 111 , ,~ , ,. i i t r I ~ I ! ! _ _ 1 ) I I 1 \ .4\' \1. r ~\ - ~ ` t 1 1 t 7 ~ r\ / \l ~~, f , ~ \ \... 1. \ \ ~•.t \ I ~ I \ • ` \ ` •\ \ `` \\ , ~ , f , tl 1 \ ... N 1\ ~~ 1 r Yi"`r I f ~I I ~ _ •. II ~ ~ _ } ., .. + PIPE ,~ ~'_-_.,.. - ~ _ r5H ~'R6~±vDpGR ~ 1w~h~r~w ' ABGvE G~A~E t- F R E S A 2R ~. N TAKL .~..~-~.»..,,..~ ~-£A ~'kFRAR~~' F~ h'IS~~; ,'RA~- 1~`NCi20~'~' RGX ~ PpRt~'~ E~ ~ ~_ . x cc,~uDi'r T ~~ ,`i~.NNOL~ LG'J ~ ~' ~tiN. ~,,~ ~ ~ ~ ~ . WaRNI~G «A8. i "1 ati L.... , i • ...~ ~ .. R ~,. -, ~ n ~.,, GA 5~ ; , ,~pRpyE3 _.... TIGHT , `, ,~~~ 3, +.r,~ i A sE~L ~ ~ R~ROY~~ + ~ ~ r ~~A:1K JOINTS ki Try ?~~~ $~?~ 1Q ARA~lpVEO P IAA P4~MP CFF ~LLV , ~ ~ ,'1, OLYB, SQYL ~ ....,,~.,.. T . ~ ~ ~ J i ~ ; ~RM~TrFn c;v;. ~" APPRv1~'~~ REDDNG U1'DE`R TA.ti7K MANUFACT'J.~ER HA ~ A PPR 4VA L .~+ ~w }~ r +..~~ 'L~ AYi~.~1r'~+r V©NvR.erTr' PA:~ :"h:VK MAN'JFAC TUi~~R : ~ e' „~.,--r...._ Zy~?'~BEiR : QS v . ~'~,~'..,.,..»,,~..~CS. N«~ ~~ SLR ~A.. ,,, DOSE G'A~• LOSW VGrU,~E IA~C:,~JDIHG dry CA,«.. ~'Law$ACK: i~l~ ttODL~'L NJhgp,R j CAPAW i «I ~$ : A ~ ~ ;,'~CHIS • SWITCH TYPE s ,..:~C~?,~,_.~NL. .: ' ~~FACTCJRER ; B " ...,,~ ., IYCHEB ~ ,~GAi . MODF;, M-iMBER : C : SNCi~ES SWITCH TYPE : „(,~,~„~3A «. DK SCliARGE R~~.T ~~~ ~P:~ PUNp }°~RiiG"~AL DIFF,}'IREAtGE $E, t A"AxM W~Ra~iG AS : ER ILKR 2.23' `+~A~ ~'xNI:~UM NETwOR~ SUPPLY PRE53;~RE0s F ANA wISTP,,"BUT~ON Fier , FEE"' ~ OJtC~IAIN ~,~ F`EP'." 'X ~'~FT/1~t3.F«y ~FR:,.T.c7N F •+ ~ ' FFET .. ~, l1~TOR F`ErT ~~'ERNA;,,; D2lKF:~'S»G7~$ LF pi~M? ^' :r, ~ +G.AL ~'YKAM:C 1~FAD : Y'FF;' .~~ R .i~:EN~`:~ yBEI? ~ • 4 ~ of V~~M...• _J ~.,, ~, ~ a- ~~ "~ ~~ ,I ~ / ~~ 1~t- iD Sa QPN. ~ ~ ; ~ae~ nN~; ~a b ~~ .~ ' o ~" 4" ~~~ .~ ~ f `~ W : aoo w,~ a ~. to a+~w: i +: o,~ pro '~~ ~~~ ~~y~~ ~ ~ fiP. 4+it~ ova ~'~~~ i ~itlt nit ~a~ ~o tmr 4 Opp. t~ ,~ mro~°j"~ '~ ~'W whn w+~~.~ Y~'b~~M, ~w-ds~~ t ~. ~M-, ~a ~~ W~~~IE~r 5~.:~I_ T~~'-LNG `~+i~ ~~9 ~cc~~~s Subs! ~~ ~ ~~ tslbl8 E~!+~ut ~'~~ 'ai fP05 . Qwa,,,ro,d~hq~, ~~ xma~rar+ M w ~~~~M.w ~~~~~~ ~1111e;r~,. ~rr~ O~eUC OroMalt~t, ~ ~ ~ Ana. ~~ ~~ ~~~~ ~ ~,~ ~d~. ~~: t~~ro,~y h~ltyr~~ IOwwr ~ ~~ ,nee ~"`~" f ""~ 4Y ~. •~ The Standard Infiltrator' Chamber The Standard Infiltrator Chamber T L - 75' Effective length > `n c~ .- a Chamber End View PosiLock'" End Plate Size (W x L x H) ..........'.....34"''x 75a x 12" (85 cm,x 191 cm x 31 cm)_ O ~ ~ O® Storage Capacity . ...........77'.5 gal (293 L) 12 ~OaQ O~O~ ~O~ O ~~~ ©0®0 Weight.... .. ......... ......:.....261bs (11.8 kg) - ~ 3q• ~ Louvered Sidewall Height ..........6" (15 cm) INFILTRATOR SYSTEMS. INC. STANDARD LIMITED WARRANTY MIFILTRATOR SYSTEMS. M1C.. rklatra[«~ STANDARD LIMITED WARRANTY FOR SEPTIC PRODUCTS ta) Ttte strucuad 4xegq a seat chambPi and end plea marx,reacauea 66yy laltratar (caueaNey relened to as'unksl. `~ Installed and opeeed'n a laedlfleld d ai anske s~uc system ~ aaardance wtm IalltramrY irtstabt)on Irdructiorts, is werraded [o Me «iginel purctrsse rHada9 agaimt daec- Wa mateMs and workrtertshp tar one (1) yes hom the date upon whirit a septc penis's isArad t« the septk system rnraeMYrg Ure Urlis: pnwided, tnvever. snot r a septc permL Is na regiired tar me septc system oy appurahle law. me «,e (1) ye« warraray perwd v+s Iterpn upon the Aare and irwaNetlon d the septk system can"rlertces. M «de to exease waoanly rigtks. Holds mss notiy H'arat« rn wrkirg a Ms carp«ate needquanas In old Seyhodr. Caarecdaa, witHn mean (15) days a Me alleged dereat. ktatratar wa soppy rep~cen,erx UMS r« Mdse shuts deermkred try kfitrat« to ne deletere end caused by Mis LimBed Warreray. Infiltrat«§ Yedity spedficely excfrdes the cost d removal and/« insteaadan d Me orals. ~) THE LMMTED WARRANTY AND REMEDIES IN SUBPARAG(tAPH W ARE EXCLUSNE. THERE ARE NO OTHER WARRANTEE WITH RESPECT TO THE UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANTA&ITIY OR FITNESS FOR A PARTICULAR PURPOSE. lU The Limited Warranty does na extend to itcidentel, consequeralal. spedal « IrKGrect damages. kaiera[« shat rxx be fable Ia pertakies « igtidated da~dY~d^9 bss d production end profits. labor and rtre[eiek, overhead costs « oMe losses « expenses klaared Dy Me Holder « airy thrd party. ezchrded ham Lftited Waneky coveage is darrege ro Me Units due to «diney wee and tear. akeration, acode«. m'suse. abuse « rtegkla d the Unas; the urns Hang subjected to vehicle tral&: «aMe condaars whim are mt pemded by the kstefedort tsUUctctions: IaNue to makl- takt the rrwrrxrm ground roves set forth In Me Instalatbn kstrrxtiorls: Me pleavtterk d Yrpropa materials xao dte system carkakwg Me UrrNs; tailors d Me Uri[s « the septk sy~m due to Yttprape skkg, lrrrprope sMrrg, ezcesshe water usage. Irrlprape geese deposal « Nnproper aperaWn « airy aMe event na caused by ri +uatac Ttlis limted vVarranty vraf ba wla Ir tna Had« raik to comply wNh of d me tem5 5a r«u, n dds LwNtea warreay. FuNte, in no even shef Mlatratar be resp«rSlbb far /xgl krss «damage to the ttoldec the lM[s. «ery Mkd party r~u~g ham YalaNedon «shiprrera. « trout any P~ Y dekrts d Hods « arty Uird party. f« dis Lkri[ed Wartaray m apply, Me Urns must be ied In acc«danca wth al site conditions requked by state and ktral codes. of other appfcable laws and Infiltrators kWebtlon kstructi«s. Idl No representative d tlhluetar has the elalt«iry to atertge tMs Lknared Werexy ft arty mama whetsoevec « [o extend Ms LYnited Warreay. No wertarlty apples to any party adds than the adgktd Holder. The above represeks dta eardard Lkrited Weranry dread by kfltrat«. A frN[ed nunibe d states and c«aMies have diterem wanaMy requieneras. Arry pureheser d shuts should carxect klatratarS c«p«ate headgrwrlers h Od Saylxoalc, CamecaarL prior [o suds purd>ese. to olxain a copy a Me appfcable werterxy end should caaufy reed Mat waoeay prbr to the purchase d Ihrks. .~ ~• SYSTEMS INC EnvironmentalOnsite Wastewater Solutions'" 6 Business Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-577-7001 1-800-221-4436 www.infiltratorsystems.com YtNtre« systems does rnd rec«rxnamd IrwafYg onnske systems ode pavernera. Chambers must De irstafed atx«dxg M mexaactueS instructions. Faikre to Nstaf accordkg to mendattureS instructions wiX void waoanly. kNitrat« Systems recamrends Una use d saptia teac Akers and letardiy filters widr aN arsite septic systems. System sizkg is detemtred by government rogteetiors. for technical assistance, installation instiructions or customer service, call infiltrator Systems at 1-800-221-4456. U.S. Patents: 4,758,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839.844 Canadian PateMS: 1,329,959; 2,004.564 Other patents ptxtding. Infildgtor, Equalizer and Sidewinder are registered trademarks d Infiltrate Systems Inc. Infifiretor is a registered tratiernatrk in trance. kfrdtrator Systems Inc. is a registered trademark in Mexico. Contax, Microleaching, PdyTufl, SnapLock, ChamberSpacer. Posil.ock, Ouickcut 1' Overlap at Latching Mechanism P©YVTS r7WNEFt'S 04lAhlUA!` & lII~ANAGEMENT WL,AlV Page ,~, 012' .~ 81( T6M a±PEGiFbGA1'1t7N8 Septic Tank Capacity ,,2` ~J el DNA 3aptla Tank Marrufactutar ~ 0 NA ~ffluant Pillar Msnutaatunr ,~ ,~ C] NA Etfkant ~tsr Modai d n NA Pump Tenir Cagaoity _ 8d4 cal O Na Pump Tank i~lanufaoturer r ~,,. ~ A Pump M~uracturar ~r,,4~ Q Na Pump Maul ~ Qp ^ MA Pratl'aatmae~t Unit 't~NA O 9and/l3ravsl Pieter Q Peat Filter !7 Maahanical Aeration d Wetiand O t~ldnfeatior- O 8thar: ctlr,~r! a Na 0 in-Ground {grav)tyi a kn-Ground ipreseurizedt ® At-Gradr p Marnd C7 >7rip-41na t~ flthar: Otftsr: d NA oth.-: o Na over: ^ NA F 1Nl~ORMA ON a~ ~ ~ ~ G f'em,it ,r X53 0 V ~ : I~l; f J_~.7TT'7i' <;:, Numbat of Badrosams 4j/ 0 NA Number of tPublb feaYitY Units A Estimated fbw taveragel ~ ~} ai da Clastpn flow {paid, li~tttimatsd x i , 6J ~ ~ AppibatbA a"t' ailda Standard lafturtttfEffJuent t2ua~ty p • ~ aikt /tt~ ht ' ont y average Pets, ®it 6 Qrease (FpGJ S30 mpJl. SioiohemiaN dxY®an Demand dBOD~) 520 mgit. p NA Total Suspsndad 8otid• fTt3Si s1 ~G mnrL Pretroatsd EtfiWnl tly Monthly average f3iocitsmicai Oxygen Darriand (8~}Dti1 t30 mg/L Tote! 5uspendsd SoNds {TS6} s30 tng/!. C7 NA Feoai CalMorm tgeornstrlc msar~) sto° cta:rtoornl fiAaxbt+urrr Efficeent Partlola Sire Kin dle. O Wl ~ NA -vaiwe typiai for daniripda wastaw~ter aruS septic tank efta,a>n. iCM~i1tE -- sandae ~ sendoe Prequator lnspeat aondltiea of tank{al At decal orttse every: ~ ~^ a {fYeaxf+ircnr ~ yearn) ~ NA Pump out cantanta of tankia} 4Vher- aamblr-ad aiudge and scum squats ona•thbd iYg} of tank voiunns DNA inspaot dtapatsai Dolt{s} At isast vnlia wary: ~ rttolt ~ ~ ~m 9 y.arsf ^ NA Cfesn sfttuairt fllltar At least one every: al ~ O NA , sl InetpeCt pump, pip controls 6c slerrn At leant once way: ,._-- ~ re~on ~ • O NA Fiuah laterals end praawre test At 4eut ones every: .---- ~ t7 a+al ~ DNA tJtllar: At !oast orwa ovary: t7 A'10A ~ti} ,,.. 0 NA other. Q NA MANYYdiIAIYR~ MISTNtiCTIQli1$ - ---- lnspaotlons o! tanks end diapers~t Celli shale be made by an indlvidwt carrying one ai the foilowinq iiasnees or oertifications: Mester Phrmber Master Plumber Restricted Sewer; taC?WtS inspector, POW7'S Msintsinsr; $eptage 5atvbing opatatar. lank ktsp~ectione must include a Wsuai inap+rctian of the tsnkia) to identify any m$atrta or broken hardware, idutttfy any crscta or casks, maasura thr volume of aorrt~nad siudgt ~ mum and to check for any back up or pandtrig cf efftuwtt on drrt ground surtace. Ths dispersN oelllsf shop be vlwsiiy ~spected to check the effluent levata to the observation pipes and to oheok for any ponding of effluent ~ the ground wrfaae. The pondr'nq Of etfluant on the gratgM etrrfaot may indiaatlr a failing aonditian and requirsa .he imrrsediate natlfbation of the local repuisaory authority. ~~ ~ oombined aoournulstlon of ~udae and scum In any tank equals one-th+rd f K! ar more of the tank votunte. the entire oantweu at the teak shell be remvwrd by a Septsge Servicing Operator and disposed of in aoeordanoe +r~ith chapter NR t 13, ~a°O^~^ Adml-da+trati,+r Code. Aii other tarvlgs, including but not lImitad to the arrvicing of effluent tlttero, machanlCal or units, end any sarvloing at intwsis at st 2 months. shalt ba partonnad ay a certlfiad PCVV1' Matntaine aomponanta, prstreatmant ~" swba rapart shale ba Rrovkiad t~o the lacai regulaROry authority within 10 dsya trf aornpietbn of any service event, Page _~ of ~~ START UP AlYD OPERATION For new conatructton, prior to use of the Pt,WTB check treatment tanklsi for the preseyca of painting produdts or other ahemicais that may impede the treatment process and/or damage the dispersal cs6i(si, If high cancentratiant3 are detected have the ccntenis of the tanklji removed by a septage servicing operator prior to use. System start up shall not oocur when soil conditions ors frozen at the infiltrative surtacQ. During power outages pump tanks may fill above Hormel highwater levels. When power is restored the excess wastewater will be discharged to the dispersai cell{si in one carpe dose, overloading the celllsJ and may r®sult in the backup or surface discharge at effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to reRtorinr~ power to the effluent pump or contact a Plumbe+ or PDWTS Maintainer to assist in manuafiy operating the pump controls to restore normal levels within the pump tank. , , Do not drive or park vehiCls# Over tanks and dispersaP cells. Do trot drive ar park over, or otherwise disturb or compact, the are: within Y 5 feet down slope of any mound or at-grade anti absorptinn area. Reduction or elimination of the fallnwing from the wastewater stream. may improve the performance and prolong the life of the PDWTS: 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; sit; painting products; pesticides; sanitary napkins; tampons; and water eoftener brine. ABANDONMF,NT When the PDWTS fails and/or is permanently taken out of service the fallowing steps mhall be taken to ir+sure that the system is properly and safely abandoned in compliance with chapter Carom 83.33, Wisconsin Administrative Cade; • AN piping to tanks and pits shall be disconnected and the abandoned pips openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Uparator, After pumping, all tanks and pits shall he excavated and removed or their covers removed and the void space filled with soli, gravel or another inert solid material, CONTINafi~1CY PLAN {f the PDWTS fails and cannot be repaired the following measures have bean, or must ba taken, to provide a node compliant repiaoement system: A auitabie 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 r+.ot be infringed upon by required setbacks tram existing and proposed structure, lot lines and wells. Failure to protect the replacement area wilt result in the need for a new soli and silo evaluation to establish a auitabie 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 limitatlona. Barring advances in PDWTS technoiogy a holding tank may be installed as a last resort to replao• the failed PDWTS. ~~ 0 ~ site tank e ^ Mound and at-grade soil absorption syatema may be rmconstructed in place following removal of the biomat at the infltrative surface. Aeconatructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL QASSES ANO/OR tNSUFFtClENT OXY>3EN. DO NOT ENTER A BarPTiC, PUMP OR QTHBR TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A t?ERSON FROM THE iNTERlOR OF A TANK MAY IiE pIFFICUtT OR IMPOSSIBLE. AGDiTl4NAL COMMENTS POVYTB INSTALLER Name ~.~~.~~~~r:t ~~ a,yQy.. Phone ~ l „ ,~ -. ~+ POtfVTt3 MANYTAINER Name Phono 8&PTAGE SERVICING OPERATOR lPUMPERi LOCAL REOUTATORY AUTMORCTY Name Name ~- . cam c>< c~u~ ~ Y ~ ~~ Phone Phone ~-(S • 3~(p ~ ~ ~Sp That document woo drafted in compliance with chapter Comm 89.2212ilbllti!dl&{fi and 83.54tti, (2i 6 tel. Wiscnnsin Administrative Code. ST CROIX CO ~ ApRBBMENT SEP'T'IC TA11K :~ AND OWNBRSHIP CSRTfPfCATION FORM OwaerBuycr ,S/~J,~JA C.o ~ P4~710 -.~ moiling Address ~ VF K ~ ~ ~ 2.: SU I ~ ~ ~ ~ Property Address y~d ~ _ aired from Plsnning Dvparlxaent for neW ~f3 S (Vcrifuaooa req f-! U DSo~ (.v ~ Parcel Identification Number 4 Z o ! I `f l }' ^ ~ " ~ ~~ 2~O'•~ (o ) C,ty~stace LTGAI-, FS Y,octttion '/., ~'-;-" %., Soc. 2,0 Property ~. . Subdivisi4a ~~~ ' 4 W, To~avn of Ml/~SU n~ T 2~ N ~ti~ J I,ot # ~~ ' ----Page # Certiiicd Sut^vry Map # ~- Volume _ ----~ _. Volume ~_~ page # 1 ~ Warranty Decd # , (v Cv~•.. D~0 ~ Spec house ~ yes O ao Lot lines ideutt5able ~ yes ^ Ao ~11'~?~wINTE=~~AI`i~ tt,,R:4ilure w handlevrutes. propcrmainieasarc Imptvpu rue raid maiale~aace of your atpdc eystem could result irl its pcema asst You ~ into t!u eyotcm oaaSlsla of pumping out the tepde Halt awry tS,1t+Gt y~ or aoaacL if aeedod by a licoascd pua>p~- aa affect the fuac,-tioa of the septic task as a trutmeut stage in the .vests dispo+al sys~- The property owaa agna to cnbmit m St. Qcou Z~oni~ Dc~a~At a certification form. eipand by ~% otvtser +~ by s c lumbu ccs4ietodpiumba or s licensodp~par~ym8 tbat (1) the an~ite ttr4stevnttx titspesal aim nuvtCrPl~t,1 11'~Q~'"'aP ~ ,f~ecresasY). the ccptic task i; less than lI3 full of eludbe- jr.,{n proper operating condition and/or (2) aiter~osptc~oa aael pomP~E (- vats txaagc dispoal tryctcra with the eamda~ !!~. rho un,darsi~ed have taad the =1wvt,cquirLmoais agsxto maintain the pct ~ fottlt lacssi4 u ect by the pcp~tnt of Comme and rho Department of Natonl Ruvurces, State of ~ O~u~t>uana30 ~~ ~~ kPtiz m~ ~~ ~~ be cnmq~lctcd sad returned to the Sc Croix Canty thsoc ccrtiry that all way inforasati~a ~thit form arc tau to Qu: txst of ray (our) iaiowkdgo. a aartanty dad recorded in Aogjetu of Deeds Offiet• ~~ DA I (we) aru (are) rho owne~(e) of 3/ ~' DA'T8 -represented may result in the unitary petmtt bomb mvok~edby -tbcZoaia6 peP°~°t' ••`••• •• Include witif this applieatloa: a cta.wped watiaDtY drod ltvaa the RCS~~ of ~~ office a cgry of eha ccrtif~rrd Hovey map if t~cfcto~ is taade in the watranry decd TOTAL P.02 t STATE; BAR OF WISCONSIN FORM 1 - 1998 .' WARIRANTY DEED t~~t t~ Yat. 1 ~97P~,t 61~ This Deed, made between Bane Corporation. _ , __ a Minnesota corporation .,... __ ,..._. » .... _ ---~ Grantor, and _Sienna Corporation. a Minngg~ a ozporat{on __-,., _„_, ... _.. ,... .... .--.. ....... Grantee. Grantor. for a winable conslderulon, conveys w Grantee the foltowlnp described rral cauw in St . CYOix County. Srate of Wisconsin (the "Property'}: . See Attached Exhibit A ~r 666054 KATIILEE'N H. WALSH FEGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 1P-21-2001 3:10 PM YRRRRIITY DEm LERT COPY FEE: coPr FEEL TRIWSFER FEE: %63.40 s:r-~ FEE: `~.oo RacnM6,g Men Nome and RatwA Acldrass Uni~r~t.L ~ ~~ 5'1Gb 5 me.+rzr~i ~ y ~- ~i.u+e. ~toi t~livtne ~trnka ~~553~ .__._ --- _w.__ . _._. _ ..____t O 20-1048-30-000 Parch IdaNiadalioA NtrrtWar fP~9 Thu is not twmestead property (IS) (h not) 20-1048-60--000 20-1048-90-000 20-1049-90-000 20-1050-00-000 20-1050-80-000 20-1052-20-000 20-1052-70-000 Togcthn• with all apfx,rtensnt rights. Utle and interests Grantor warrants that the titlr to the Property is good. lnJefeastble in fee simple and free and clear of axrunbrarues except See Attached Exhibit B. Dated this 20th - , day ~ December 2001 Bane rporation (SEAL) by Jo M. Nassef ••~ Its of ExecutivQ Offi (SEAL) AUTHENTICATION Slgnsnue(s) auttrenticatcd thlt . , day of ACKNOWLEDGMENT (SEAL) (SEAL) Minnesota State of iN2lcCOTti'Yft- lI -~- ._ y ss. - -~.~«~tiC Count . J Pcrsorwlly carr,ri before me this ~~ day of December • _ 2001 , ~ above rtamed John K. Nasseff, Chief Executiv_~,0£Eicer _ of Sane Corporation, a Minresota_ •, corporation _ _ TITLE: MEMBER STATE BAR OF WISCONSIN __ -" •~ - - __ to (lf mL _ me krxawn to be ~ pe~ wlw excr:uted the foreRoltt6 authorized by 5706.06, Wis. Stars.) inslntrnent and _~ same. Tt~uS INSTpUM[NT WAS DRAFTED t3v ~ - y ~y E• R Lockridge Grindal Law rirm ~l ~mw~tuwaaa+a+.mea inn 1,1H.Si1].p.$.t.p:l..f~ynn„n c~„th _ ~f . ..~ Minneapolis, MN 55401 No• Pubitc,StsteofWtseonssn y commictlnrt 15 pcnntuunl. (If not, stare exNiratitm tiau: (SlYtwturros Wray br autnertneated a +ctu,ovrtsdRed. Both arc not January 31 „ 2005 .) rtecessary.) - - .....--~T--.- --~ ,____... --- _.. penwa nan,r,A N ,ny aprrxy ,mat s. typos « yrYUwl Lrluw tlav'4SAUivr. WARRANTY DEEP STA7F. aAN OF W IsCONStN v,y~,y, tpy ayey ~ , ~ .A1 ~~~LVVG VJ•L~l r71 CIVIVH L.I..~I~r - JJG VJJ IVVV ~ .a./J Y~;.1797PA~f fj.14 File No: as-o49o0 EXHIBIT "Q" A parcel of land in the Northeast Quarter of the Northwest Quartez, in the Northwest Quarter of the Northeast Quarter, in the Southeast Quarter of the Northwest Quartez, in the Southwest Quarter of the Northeast Quarter, in the Northeast Quarter of the Southwest Quarter, in the Northwest Quarter of the Southeast Quarter, in the Southeast Quarter of the Southwest Quarter and in the Southwest Quarter of the Southeast Quarter, all in Section 20, Township Z9 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin, more fully described as follows: Commencing at the west Quarter Corner of said Section 20; thence North 89 degrees 25 minutes 02 seconds Easc, assumed bearing along the Ea9t-West Quarter line, a distance of 1319.52 feet to the point of beginning also being the southwest corner of the Southeast Quarter of the Northwest Quarter; thence North 00 degrees 36 minutes 14 seconds West, along the west line of said Southeast Quarter of the Northwest Quarter and Northeast Quarter of the Northwest Quarter, a distance of 1325.25 feet to th4 southerly right-oE-w8y line of the Chicago-Northwestern Railroad; thence North 79 degrees 56 minutes 29 seconds East, along said southerly right-of-way, a distance of 451.00 feet; thence northeasterly a distance of 807,03 feet, along said southerly right-oF-way, along a tangential Curve, Concave to the northwest, having a central angle of 09 degrees 54 minutes 03 seconds and a radius of 4670.25 feet; thence North 70 degrees 02 minutes 26 seconds East, along said southerly right-of-way, a distance of 429.04 feet; thence northeasterly a distance of 445.52 feet, along said southerly right-of-way, along a tangential curve, concave to the southeast, having a central angle of 14 degzees 30 minutes 21 seconds and a radius of 1759.75 Eeet; thence North B9 degrees 32 minutes 47 seconds East, along said southerly right-of-way, a distance of 7.57 feet to the west line of Certified Survey Map in Volume 12, Page 3302; thence South, along said west line, a distance of 703.32 feet to [hQ south line of said Certified Survey Map in volume 12, Page 3302; thQace East, along said south line, a distance of 593.00 feet to the east line of the Southwest Quarter of the Northeast Quarter; thence South 00 degrees 26 minutes 06 seconds East, along said east line, a distance of 1127.21 feet to the southeast corner of said Southwest Quarter of the Northeast Quarter; thence South 00 degrees 26 minutes 55 seconds East, along the east line of said Northwest Quarter of the Southeast Quarter, a distance of 191.71 feet to the north line of Certified Survey Map in volume 15, Page 4172; thence South 89 degrees 37 minutes 27 seconds west, along the north lines of Certified Survey Map in volume 15, Page 4172, and Certified Survey Map in Volume 15, Paqe 4173, a distance of 1113.42 feet to the west line of Certified Survey Map in volume 15, Paqe 4173; thence South 32 degrees 43 minutes 57 seconds East, along said west line and its southerly extension, a distance of 591.64 feet; thence south 07 degrees 13 minutes 18 seconds East a distance of 323.01 feet; thence South 08 degrees 41 minutes 11 seconds East a distance of 413.63 feet; thence south 08 degrees 43 minutes 31 seconds East a distance of 229.88 feet to the north line of Certified Survey Map xn Volume 11, Paqe 3128; thence North 89 degrees 52 minutes 10 seconds Wesc, along the north lines of Certified Survey Map in Volume 11, Page 3128 and of Certified Survey Map in volume 12, Paye 3292, a distance of 682.8,6 feet to the northwest corner of Certified Survey Map in ~0-:1797PACE 615 Volume 12, Page 3292; thence North 01 degree 24 minutes 30 seconds East, along the northerly extension of the west line of Certified Survey Map in Volume 12, Sage 3292, a distance of 5.66 feet to the easterly extension of the north line of parcel recorded in volume 1390, Page 163; then South 89 degrees 30 minutes 27 seconds west, along the easterly extension and the north line of parcel recorded in Volume 1390, Page 163 and the north line of Certified Survey Map in Volume 3, Page 776, a distance of 508.92 feet; thence North 00 dQgreQS 07 minutes 56 seconds East a distance of 1003.47 feet; thence North 89 degrees 54 minutes 15 seconds West a distance of 270.16 feet to the west Line of Certified Survey Map in Volume 5, Page 1317; thence South 00 degrees Z7 minutes 53 seconds East, along said west line, a distance of 193.97 feet; thence South 89 degrees 16 minutes 33 seconds West, a distance of 533.93 feet to the west line of the Northeast Quarter of the Southwest Quarter; thence North 00 degrees 36 minutes 14 seconds west, along said west line, a distance of 820.23 feet to the point of beginning. SEP-20-2002 ~ ~ 21 5 l t1~tlW~i l.Ur~r' -~ . , . von 17~~7~~~t 6:I6 Exhibit B to Warranty Deed dated December Z0, 2001 by and between Bane Corporation ("Grantor") and Sienna Corporation ("Grantee") 7JG CJJ i YJYJU r . CJJ 1. Building and zoning laws, ordinances, State and Federal regulations; 2. Restrictions relating to the use or improvement of the premises without effective forfeiture provision; 3. Reservation of any minerals or mineral rights to the State of Wisconsin; 4. Utility, drainage and roadway easements which do not interfere with Buyer's proposed development of the property; 5. L-neroachment of Qwest Communications, Inc. fiber optic cable along the northerly property Iine; 6. Agreement between Bane Corporation and John and Pearl Gies dated August 22, 1997 to exchange property following final determination of the location for Carmichael Road; and 7. Ameritech General Non-Exclusive ~sement Agreeme»t by and between Bane Corporation and Wisconsin Bell Telephone Company a/k/a Ameritech Wisconsin dated December i 0, 2001. TOTAL P.05 ti J ~ ,y / ;., ~C r~ , ~ .~ ,'pp0 ~ : ~ ~ SN~cjo~ .ARP \ ~rC p,N or~1 + ^~ ~}~ ~6~• E~FN NMARK ;~ \ ,. ENE ~F W ~ MPS ~ ~NE,~C~~ /•~~ TOP STEEL PIPE 'r \ \Nao fi1-N.~ pF 1,,+ 0. ~(~ 4 ~, :~ ~:LEVATION n 871 \ o ... A~~ A ~ 6 ~ ~ \ cA ~;;4~ ` \ \ ~ .\ \ At~~. \ \ \ {~ \ \ I \ S1' \ \ ors \ ~.., .::. \ \I Z \ R4 .... \ o O (,~ \ W, \r 0.037 AC.) N \ \ ~ \' 0 51 \ i\ \ ~ x+5304 ~.F. \\ \\ ~ ~.~ SgL \\ \\ \~ + (1.040 A~;,) \ \ \~ \ ~ /r \ 1 \'w~ \ \ ~ ~ \ \ \ , \ \ ~ ~, \ \ \ \ ~ J~ \ t r~ . \ ~ ~, .~- ~ ~" i ~~. A c~R Sgt.\1 ' \` ~ ..~ ~'' ~ 0 ~ 2;~ ~~~ ~5 ~- / C, 2 -1 ~ ~ ,,s. __ __ ~.. ~,., .~ L'~ /~ ,. r-.~ _; , , ~ ; `'~ ~~ ~~ °~~ y ° ~ ~ r ~ 3 ~' ~ r ~~ _ ~~;~. spa ~ ~~ ~. ~~ ~~ 3 Y ~ ~ ~ ~~ s~~k ~{,}r~ (~ ~• ~ ~ ~ i ~„~~ -1 1 ~ ~ ~ ~ L A 1 ~~(_~ , ; r t ~ •Y ~ a:. d l .~ .: .2 _ '•f ~ ~- 9 --- , P ~~ ~ /- . ~ ~~ h `~~ ' 9`26`2~~~1 " ~'~w,~, ', I ~6 ~ \,~ V ` ~~~ / 77 ~ . ;, A ;>> ;'