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Home My WebLink About030-2153-02-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 579095 GENERAL INFORMATION 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 Township Parcel Tax No: City Wide Development Inc. TOWN OF SAINT JOSEPH 030-2153-02-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: pp Gear 20.30.19.3072 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. •A S / Septic ` 3' e~ Benchmark 4 /0- 64 D Dosing (~a Alt. BM V Cod r 7!g e V~ Bldg. Sewer 'W'Z_ 9G • 78 HolSt/Ht Inlet ~P 16,615 9~{ 99 TANK SETBACK INFORMATION St/Ht Outlet %_1 TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet Septic 57 if A 29 i ' Z.g / Dt Bottom 3. 73 V 3 f Dosing 57 1 A* I( 7 Z~ I Header/Man. 4-7 91r• 341 Aeration Dist. Pipe 4g. (4 V • .o 9 I, Holding Bot. System - *177 -77. Z11 r l Final Grade PUMP/SIPHON INFORMATION ~j .4% Manufacturer Demand St Cover 97 2d •Y 6v GPM[ _i_ OL Model Number ,pr 4te// 37 ~e^ A• I _ G~! TDH Lift Friction Loss 1 tSystem Hea TD t 1 / ~P Forcemain I Length / Dia. y Dist. to Well iyS z 4 1 7 SOIL ABSORPTION SYSTEM BEDITRENCH Width ! Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS $2 3 ( demo __1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturefn L INFORMATION CHAMBER OR er C t! [A Type Of System: UNIT i oesat q 1 _ty% Mod I .Num r: 'Y DISTRIBUTION SYSTEM U ZD tr ZO w = a Header/Manifold Distribution Hole Size x Hole Spacing Ve t to Air Intake ~l I_ i / Pipe(s) \ ~14 LengthT•r'T Dia 4 Length Dia Spacing ix SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over _TT Depth of xx Seeded/Sodded T Mulched Bed/Trench Center Q , ~ Bed/Trench Edges psoil 1 %.Q Yes 0 No as 0 No v COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 491 146TH AVE A' /L 1.) Alt BM Description U C 2.) Bldg sewer length = Zq t - amount of cover = n 4 6AL' LF2 I o C~,~L1G.. Plan revision Required? Yes io l ib Use other side for additional information. J SBD-6710 (R.3/97) Date Insepct s Signatur Cert. No. Safety and Buildings Division county 2°~ r ug l 201 W, Washington Ave., P.O. x 7162 Sanitary Permit Number (to be filled in by Co.) x Madison, WI 53707-7 . CRQIy COUNTY d5 9O-1GS UNITY DEVELOPMENT O +sa Transaction Number Sanitary permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fort to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than ring address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the PrivaEm Law s. 15. 1 m .State. 1. Application Information - Please Print All Information Parcel # Property Owner's Name Property Location 30, 19, 307 Property Owner's Mailing Address /0-50-D Lt] Q C- A 5 f ` St.~ l t ~ l~ t~ Govt. Lot City, State Zip Code Phone Number Lc IV C- 1A, Section 'Z a (circle one) T N; R Z2 E or® II. Type of Building (check all that apply) Lot # Z Subdivision Name X1 or 2 Family Dwelling - Number of Bedrooms v' - A,"..k, Block # ❑ Public/Commercial - Describe Use ❑ City of CSM Number C1 Village of El State Owned - Describe Use H`To. of_-r 7 L '~S€Pff , nly a boxonlineA. ~ plate line B if applicable) II. Type of Permit: (Check o A' ;W New System ❑ Replacement System ❑ TreatmenvHoldmg Tank Replacem=t Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. [I Permit Renewal ❑ Petptit Revision ❑ Change of Plumber 11 Permit Transfer to New Before Expiration Owner - IN W. Type of POWTS S stem/Com onent/Device: Check all that a 1 Dl' on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound 2:24 in. of suitable soil ❑ Mound < 24 in. of suitable soil s r J~ ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaVTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf~ Dispersal Area Required (sf) [Dispersal Area Proposed (sf) System Elevation 610 J f z ~v f / 2~ ~Y~ VI. Tank Info Capacity in Total # of Manufacturer v = o Gallons Gallons Units 2 w 5 H New Talcs Existing Tanks 41. a U~ (n H ~ w C7 a. Septic or Holding Tank - r L p0 1 Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's S• ature MP/IrNumber Business Phone Number p /l/Cra~' Z Z~ 7 7ls z 7~ f~ Plumber's ddress (Street, City, State, Zip Code) C L su'!f-W--- 4 C e-) r J VIII. oun epartment Use Only Permit Fee Date sued Issuing t all" 1 OF proved tsapprove S ~ 7 Z3 !J ~ van Reason for Denial IX, CondiBlU' MWAft Vm Hiteasons for Disapproval S t ^ 1,'' Septic tank effluent filter end' 6Q . ilispiarsal ce8'must all be jervL-ej I Mal ae par management plan provided by plu I ~a4k rayiu~artle,~ ~~.`~nal►>~d J of per aWlicabla tai / ordirartaa. Attach to complete plans for the system and submit to a County y on paper not less than 8 m z 11 inches in size SBD-6398 (R. 11/11) ~'2.gtJ1 !T t L a - P~/ ~'Al vc lot y or prLt ~ PLR t b r 6 sr X74 LL a~. o r CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: ~LGl~/G~n Cd nJl/ Owner's Name: Owner's Address: X0 / 2i:49 1Z 12 n ti _l mer ld z) S~_3 Legal Description: A-1 g u> Township: S D 5tc 16 County: 5+- C-9®r y, Subdivision Name:J aNIZ qGz Lot Number: Parcel ID Number: 30 - 21-57 -,o 2 --OvD Page 1 Index and title j~uF/~tzA{•~ G?urcr~ Page 2 Plot Plan N r- c fo ~3 Page 3 System Sizing & Cross-Section j f~ (2 ASS S Page 4 Filter Specs Z- pu P c Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: ,10 9'cz:0,L Xcc 5' 4J License Number: - Z Date: 9`- ~2 ( 5 Phone Number Signature Designed pursuant to the in-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 RL'O + ~v A Vc Iro IF ~k 1 ti°0 lei P~ (2,11 rA 771 or 2ftpvc 4.7 ~ N('iJ~ ZOO U Z~ 3 sr .-1,674 LL 3~~"' 1- or 2- Family Dwelling In-ground Soil Absorption System (3-cell Conventional) DailyWastewater Flow (DWF) _ # of bedrooms x 150 gal/day/bedroom = Q~ gal/day Design Loading Rate (DLR) or Soil Application Rate gpd/fti (per SPS Table 383.44-1, 2, or 3) Required Distribution cell area = DWF6,Qq)-gal/day 4bLR. r~_ gpd/ft2 = l 2O-L_;) ft2 L l- ft ' Z C) ft2/ unit EISA = tr-3 0 Chambers # Chambers = Required Distribution cell area Chamber Manufacturer and Model: f N f Cfa2,4--0 ~2c~(c Fe S Actual Distribution cell area = Required cell area ft2 + S 3 ft2/ unit EISA End Cap Pair = Z /S. ft2 Cross-Section In-ground Soil Absorption System (3-cell): 4" Schedule 40 PVC vent pipe with vent cap 12 inches minimum 12 inches minimum~ - I I `~I .eft T3' Final Grade (FG) ~ft T1 FG ~ _ft T2 FG inthes Soil Cover inch Chamber Height Trench 1 System Elevation Trench 2 System Elevation Trench 3 System Elevation q~ I ' S ft ft ~ft 7 ~f~ inch to limiting factor Trench Separation Plan View In-ground Soil Absorption System (3-cell): Trench 1 Modify 3 ft header/ design as ft Leaching Chambers needed. Trench 2 4 inch Header Sch.k~w Trench 3 ft with end camps Draw 0 for a Vent and 0 for Observation Pipe above. They will be located _ ft from the end of the cell. Vent pipes shall be Schedule 40 PVC and extend at least 12 inches above finished grade. Observation pipes that extend above finished grade must also be 4 inch Schedule 40 PVC. m m m rd c m~ ~ p~ m t... - mc~mma Z` r ~S Q c~ co < 9 3 m V- m a F. a L°~ O E m_ oc3 mL- gE~ dt ~ep rF-vrJi a,o. c F~wr~ ~ e et a' 9 L 01 m 0-Mm r: o -E • m ~ ~ mdf~j ~~wc ~c.Qo~COi j m em. O Y O C PC 0 m O y E «o~amm cm~ t7 ~~a~ ~ A o c'-LmLbi mO3~ o~ ~ C gT+ O Q C pt yt l0 $ ! m 44 O m a a p L v C m m oE CCN 2'E O I f'~ oFc EI-. kt m ps E ~0 So omnc oL~WOmc e. $ ID `ar k y Lai°w ti:e~ rk m` EEWO W Y y tt G i 6g£ P WZIA V r' H x O 'a ( mom, ~ _ ~ 3 %CI m a m ~i8 15 •C e I$~ `2 a 411 4.1Ail s b fill L , POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity 1 Zo v al 13 NA C(-1 / CvEc.oP Permit # Septic Tank Manufacturer (.l1 lESic(Z ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units J>g NA Pump Tank Capacity S700 al ❑ NA Estimated flow (average) V40 -gal/day Pump Tank Manufacturer r,() (2 ❑ NA Design flow (peak), (Estimated x 1.5) 600 gal/day Pump Manufacturer ~ 0 LD ❑ NA Soil Application Rate ~j al/da /ft2 Pump Model f76- t{/ ❑ NA a Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Celt(s) ❑ NA Biochemical Oxygen Demand (BOD6) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ya in dia. 3NA Other: ❑ NA Other: Other: p 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: 3 a ear( j(s) (Maximum 3 years) C3 NA Pump out contents of tank(s) When combined sludge and scum equals one-third W3) of tank volume ❑ NA • Inspect dispersal cell(s) At least once every: ❑ month(s) 3 ® ear(s) (Maximum 3 years) [3 NA O Clean effluent filter At least once every: month(s) ❑NA ® ear(s) Inspect pump, pump controls & alarm At least once every: month(s) ❑ NA 3 ® ear(s) Flush laterals and pressure test At least once eve ❑ month(s) [3 NA every: ~ ear(s) Other: At least once every: p month(s) ❑ NA Other: k• ❑ 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 ell(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 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 theservicing. 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 (4/01) START UP AND OPERATION ~j For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemical: 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 call(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; 'tfoundation 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: ❑ 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. I.f 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 MOM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ~ ® C L 5o^1 Name Phone -7 1 - Z 73 !T!!f Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name -o µn~san! >r,6}n!r f~} {tv Name ST'C" X Zo f j Phone 7I5 Z 73 Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.540►, (2) & (3), Wisconsin Administrative Code. SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 0/4 L f V e tog, ~ .t 7" .lam _ Mailing Address k) e-l ST - ' Z 16 '1Z Property Addre;t4l c(/ U -E-- (Verification required from Planning Zoning Department for new construction.) City/State f„4H_WIs Parcel Identification Number ~ 3 ~ z I 6 LEGAL DESCRIPTION Property Location Sec. 2 O, T N RL7__W, Town of ::F o S P / Subdivision A Pl o(az- (Z Lot 2. . Certified Survey Map # Volume , Page # Warranty Deed # _ l `f 7 Volume , Page # Spec house yes no Lot lines identifiable Ees no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper-use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper, What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning Zoning Department within 30 days of'ithe three year expiration date. Uwe certify that all statements o this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property descnbed above, by virtue of a ty deed recorded in Register of Deeds Office. Number of bedrooms I l I S A OF APPLICANT(S) DAh~TE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recordedwarranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) Y ARI uick4'Plus Standard Chamber Side and End Views 48" (EFFECTIVE LENGTH) 12 " r -A 7'= i ► r rr ems. Vii. €a a- is s r ts~~` ~ - 34" r,.Quic*4 Plus All-in-One 12 Encap Front, Side and End Views i ' 1 b.2" r 13" 8" INVERT 8" INVERT 5.3" INVERT I ----18.2" 33" ~I i O,uick4 Plus All-in-One Periscope 2 OUICK4 PLUS ALL-IN-ONE PERISCOP6~ ( SWIVEL E I 12.7" INVERT OUICK4 PLUS L_J ALL-IN-ONE 12 ENDCACAP Ir ~'lI Specifications Quick4 Plus Standard Chamber Size (W x L x H) 34" x 53" x 12" (86 cm x 135 cm x 31 cm) Invert Height 0,6", 5.3", 8.0", 127" 48 (122 cm) (1.5 cm, 8.4 cm, 18,5 cm, 22,6 cm) Effective Length INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ( "Units"), when installed and - operated in a leachfield of an onsite septic system in accordance with Infiltrator's Instructions, is warranted to the original purchaser ("Holder") against defective materials and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units; provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of they,: septic system commences. To exercise its warranty rights, Holder must notify Infiltrator in writing at Its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units. WITH RESPECT LIMITED , INCLUDIG NO IMPED WARANGS OF MERCHANTABILITY OR EXCLUSIVE. FTNSS FOR A PARRCULAR PURPOSE TO THE UNITS LT R AT O R® (c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty I N F I does not extend to incidental, consequential. special or Indirect damages. Infili rallor shall not be liable for penalties or liquidated damages, systems inc. including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure to maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road • P.O, BOX 768 the Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal, or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply with all of the Old Saybrook, CT 06475 terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 • FAX 860,577.7001 third party resulting from installation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Units must be ir'stalied in accordance with all site conditions required by state and local codes: all other applicable laws; and Infiltrator's f installation instructions. 800.221.4436 (d) No representative of Infiltrator has the authority to change or extend INS Limited Warranty. No warranty applies to any party other than the www.infiitratorsystems.com original Holder. . The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of states and counties have different warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units a ''-1'`~„9+~?&~rF~d~ 0~~~T U.S. Patents: 4,759,661; 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 Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer, Quick4 and Quick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. PLUS0510101SI-2 is a registered trademark in Mexico. Contour Swivel Connection is a trademark of infiltrator Systems Inc. ® 2009 Infiltrator Systems Inc. Printed in U.S.A. Combinatio.n Sep~Ic, Tank and PUMP CHAMBER CROSS SECTION WD SPECIFICATI0MS VE►JT CAP: WEATHER PROOF JUIJCTIOIJ BOX H'C.I. VENT PIPC APPROVED LOCKING MAIJHOLE COYER yvt !I0, FROM DOOR, 2 wARN1iJ4 LP.6EL. ' im0ow DR F9E5H cou~u~r tr.~sP~11o>J PIPE 44R iMTAKE r w / rYtiRZ 1 ttT' ~rsP i t i, him. j+ (~..,w. l00 T I 15' A1Q. i.r PROVIDE i IMLE T AIRTIGNT SEAL- I I I BA A. I I~I APPROVED JOI1JT APPROVED JoIWT ZPI$~L ~tlt I II W/ C. T. FIPE~~ w/C.I. PIPE or- Tank Construction I I i II ALARM shall comply with "I II ILH1Z "3.15 and 33.20 a I QQ C I PUKP "J • ` OFF 0 COWCRETE SS aLocx PR- R15EFZ EXIT PERMITTED OIJLy IF TAUK MAWUFACTURER HAS SUCH APPROVf.L 3„Ap 6~DOING surlc r SPECIFICATIOUS 005E ~v is CQ~Cf"i-~ TAuK MAUUFACTUKER.: ►JLtrtESER OF DOSES: PER 0.Ay TA1JK ,IZE: I7ot~~CaD~ GA•LLOAIS DOSE VOLUME ALARM /4AWUFACTURE.R: ~'SLIV~1-2 IuCLUDIMG OACKrLOW: / p~ GALLONS MODCL WUMBCR: jHl !d( CAPACITIES: A. Z ~r WCHE5 OR GALLONS SWITCH TyPC: - L~ 8 = Z IQCHES OF, LL?G~ LL0U5 PUMP MAMUFACTURCR: C;-Z IUCHES OR CALLOUS MODEL MUMDER: ( V 0= ItiGHES OF LLO1J5 SWITCH TYPE: Li'WOTE: PUMP AND ALARM ARE To OL MIWIMUM'DISCHARGE RATE GPM QQINSTALLED OfJ SEPARATE CIRCUITS VEKTICAL DIFFEKEMCE DETWCEIJ PUMP OFF AWO,DISTRIBUTIOW PIPE.. FEET -f- MIWIMUM IkJETWORK SUPPLY PRESSURE Fr-LT -1- 7 NFIET OF FORCE MAIN X ~f9fF%pfLFRICTIOU FACTOR-12-1 NFEET TOTAL OtIWAMIC. HEAP ZD~6SFEET . As per,manufacturer gal/in. 1 [QGOULDS PUMPS Submersible Effluent Pump MODEL PE ~YOW WLWW rim. SPECIFICATIONS MOTOR FEATURES Pump - General; General: ■ Corrosion resistant • discharge:1'A" NPT • Single phase construction. • Temperature: 104°F (400q • 60 Hertz ■ Cast iron body. maximum, continuous when a 115 and 230 volts n Thermoplastic impeller and fully submerged. • Built-in thermal overload pro. cover, • Solids handling: W tectlon with automatic reset. ■ Upper sleeve and lower maximum sphere. • Mass 8 insulation. heavy duty ball bearing • Automatic models include a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■ Motor Is permanently Specially designed for the • Manual models available, shaft. lubricated for extended • Pumping range: see PE31 Motor. service life. following uses: • Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous • • Effluent/Dosing Systems PE31 Pump: • 115 volts operation. • low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor. ■ Quick disconnect power • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM cord, 20' standard length, Dewatering • Maximum capacity: 61 GPM a 115 and 230 volts • Maximum head: 29' TDH • PSC design heavy duty 16/3 SJTW With PE51 Pump; PE51 Motor. 115 or 230 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 115 and 230 volts portable and compact. • PSC design ■ Mechanical seal is carbon, FEET ME7Eft5 40 ceramic, BUNA and stainless ~E51r I t ; I ! I tGN MODELS: PE31, re41PEST steel. 35 ■ Stainless steel fasteners. I 3o ' AGENCY LISTINGS _ i t I i t i I ~ o x 25 : I I , II ~ I c zo I I I_ I i I Tested to UL 778 and ! I µ I- I; I CSA 222108 Standards SZI 5 I I I i ' I' -I- I- I I I I' By Cana" standards ftwadon . I ' ' I , I Fik ~1A36549 10 •~j : ! I : , I t Gourds ?wnps is ISO goof Rey~oerod. 'Sx il~.....,I o o T 0 10 20 30 40 50 60 70 GPM 80 0 5 10 15 O/h Goulds Pumps CAPACITY 102 n-1T11%Technolopy, Inc `~a T ITT InduStrtes If fective June, 2004 9YEIT/41 Mi "'n SOIL EV LUATION REPORT #1423 sconsi Department of Commerce in accOrdan Comm 85, Wis. Adm. Code Page 1 of 4 Division of Safety and Buildings Schmitt Soil Testing, Inc. 1~w h. County Attach complete site plan on paper not less than 8% x 11 inches ' size. %nAFist St. Croix include, but not limited to: vertical and horizontal reference point (B dire an 7 percent slope, scale or dimensions, north arrow, and location and dista to ne ad. Parcel I.D. 3 l ~5-19 9 Please print all information. Rev' By Date Personal information you provide may be u for sec®d~fp~{E rEi~cy s. 15.04 (1) (m)). ~g 'ne Property Owner ~Gv" Y P perty Location Golden Harvest Capital, LLC GO. Lot SE , NE1/4, S20, T30N, R19W DEC 1 -3 ?nnR Property Owner's Mailing Address Lo # Block # Subd. Name or CSM# 14906 Blakeney Road 2 Pioneer Ridge City State Zip Code Phone Number City ❑ Village ❑ Town Nearest Road Eden Prairie MN 5 (612)202-3234 St.Joseph 50Th St. ❑ New Construction Use: ❑ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Glacial till over outwash sands Flood plain elevation, if applicable na ft. General comments and recommendations: Area is suitable for a conventional system with A~ft rate. Possible system elevation for Area 1 is,(step trenches) High trench 94.1' Low trench 93.1'. Slope is 10%. Boring # Boring ❑ Pit Ground surface elev. 98.95 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr4/3 none grsl 2msbk ds as 2f .6 1.0 2 8-18 5yr4/4 none grlcos Osg dl gw if .7 1.6 3 18-42 5yr4/6 none grs Osg dl gw .7 1.6 4 42-54 10yr5/6 none s Osg ml Cs .7 1.6 5 54-65 10yr5/4 none grcos Osg ml Cs .7 1.6 6 65-96 10yr6/4 none s Osg ml .7 1.6 9~• I .5 p 5~ .z p F2 Boring # ~ Boring a}t r} ® Pit Ground surface elev. 98.15 ft. Depth to lirT fact r 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc-e Boundary Roots GPDtft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EfW2 1 0-8 10yr3/3 none sil 2fsbk ds as 2f .6 8 2 8-21 10yr4/4 none sid 2fsbk ds gw if .4 .6 3 21-36 7.5yr4/4 none sl 2msbk ds gw if .6 1.0 4 36-75 5yr4/4 none vgrls Osg ml Cs .7 1.6 5 75-96 10yr5/6 none s Osg ml 7 1.6 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ent = BODS S30 mg/L and TSS S_30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt ~`'ay"u` r 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 7/18/2006 715-247-2941 SBD-8330 (R.07/00) Property Owner Golden Harvest Capital, LLC Parcel ID # 2 Page 2 of 4 P *1 Boring # ❑ Boring ❑ pi{ Ground surface elev. 96.15 ft. Depth to limiting factor 96+ in. Soil 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 1 0-9 10yr3/3 none grsl 2fsbk ds as 2f .6 1.0 2 9-19 5yr4/4 none vgrs 2ms k ds gw if .6 1.0 3 19-48 7.5yr4/4 none vgris lcsbk ds Cs .6 4 48-67 10yr6/6 none Ifs Osg mvfr Cs 5 67-96 10yr6/4 none fs Osg ml S-- /-0 rt vD F41 ❑ Boring Boring # ❑ Pit Ground surface elev. 014, 73 ft. Depth to limiting fa or in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Eff#2 1 0-9 10yr3/3 none sl 2fsbk ds as 2f .6 1.0 2 9-18 10yr4/4 none I 2fsbk ds gw if .6 .8 3 18-32 10yr4/6 none sl 2msbk ds gw if .6 1.0 4 32-64 5yr4/6 none Icos lcsbk mvfr Cs .7 1.6 5 64-96 7.5yr5/6 none Cos Osg ml .7 1.6 3~t 5] Boring # El Boring Pit Ground surface elev. 91.85 ft. Depth to limiting factor 35 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *002 1 0-8 10yr3/3 none I 2fsbk ds as 2m2f .6 .8 2 8-35 10yr4/4 none A 3msbk ds gw 2f .6 .8 3 35-51 10y5/3 m2d 7.5yr6/6 sl lmsbk ds w if .4 .7 7.5yr6/2 g 4 51-60 7.5yr4/4 m2d 7.5yr6/8 sl imsbk dsh Cw 4 7 7.5yr6/1 5 60-84 10yr5/4 none grls Osg ml .7 1.6 Does not meet 2 foot rule for redox features. * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L ' Effluent #2 = BODS < 30 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-8330 (R-07/00) Schmitt Sal Tesft, Im. Property Owner Golden Harvest Capital, LLC Parcel ID # 2 Page 3 of 4 6]Boring # Boring Pit Ground surface elev. 87.45 ft. Depth to limiting factor 98+ in. Soil Application Rate F 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 1 0-8 10yr3/3 none sl 2mgr ds as 2f .6 1.0 I 2 8-17 10y4/4 none scl 3fsbk ds gw if .4 .6 3 17-32 10yr4/6 none grsl 2msbk dsh gw if .6 1.0 4 32-84 10yr5/6 none grsl 2csbk mfr gw .6 1.0 5 84-98 10yr6/4 none Is Osg ml .7 1.6 M Z Boring # Boring Pit Ground surface elev. 89.45 ft. Depth to limiting factor 29 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr4/3 none I 2fsbk ds as 2f .6 .8 2 10-29 10yr4/4 none sil 3msbk ds gw if .6 .8 3 29-38 5yr4/6 m2d 7.5yra/6 grsl imsbk dsh w 4 7 5yr6/2 g 4 38-54 5yr4/4 m2d 7.5yr6/8 Is lcsbk mfr gw .7 1.6 7.5yr6/2 5 54-64 5yr4/6 c2d 7.5yr6/6 gsl icsbk mfr w 4 7 7.5 r6 2 g 6 64-96 10yr5/4 none grls lcsbk mvfr .7 1.6 Pro 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/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-8 10yr3/2 none sl 2fsbk mfr as 2c,2f .6 1.0 2 8-20 10yr5/6 none scl 2fsbk mfr a iVf .4 .6 3 20-35 7.5yr4/4 none grsl imsbk mfr gw ivf .4 .7 4 35-96 7.5yr4/6 none gris lcsbk mvfr 7 1.6 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BOD5 , 30 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-8330 (R.07/00) Schmitt Sal Testing, Inc. Page of 6ducte l by: Conducted For: Schmitt Soff Testing Inc. Name: Golden Harvest Capital, LLC Thomas J. Schmitt, CST 227429 Address: 1440 Arcade St N 1595 72nd St. City, State, Zip: St. Paul, MN 55106 New Richmond, W1.54017 Phone: 715-247-2941 Subd.Name: Pioneer Ridge Lot No.. 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