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HomeMy WebLinkAbout020-1450-11-000 (4)Wisconsin Department of Commerce PRIVATE SEWAGE. SYSTEM Safety and Building Division M ~, , ~ 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 Grand Properties L. P. Hudson, Town of CST BM Elev: Insp. BM Elev: BM Descriptygn ~ TANK INFORMATION TYPE / :,. MANUFACTURER ~ t u ; ~ r r ,6APACITY f( . f.. , fit. --a r.Ji; ~'-I T.- :R.~,sw> 4 ; , ~~, . Septic _ (F Dosing ~~ ~ , ~ ~, r i ..~''~h1A. Aeration ~ oding _._._..__- , TANK SETB/kCi~}INFORMATION en o it n a e ep Ic . l ~ ~ , ~_.~ , ( L~ osmg ~ °7. ~1 '; ~~ era lon o mg _ PUMP/SIPHON INFORMATION ~ ~.:.,::ws.~..~ GPM o e um er ~ _ ~pl,f,i~l ,(~ i ~ 3 ic~'7 ~ Ys em / /'"` ~~ cem en i r, t~ SUILAt35UKYIIVN,YSItM .IfrJ ,~7 ^~ ,~,~n,,,,~~~ county: St. Croix Sanitary Permit No: 488079 0 State Plan ID No: Parcel Tax No: 020-1450-11-000 Section/Town/Range/Map No: 22.29.19.2881 ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~~ `x,1.1 ~ r'_- `/~,t% t ~ tJ Alt. BM Bldg. Sewer ~3 i l•~2 Av, 7~ t/ t Inlet ~.9 5" p~GtS t t ut et ~j~" t net ~.-= ea er an. ~, S Q is . ipe ~r ~4 ~~ o.. ys em I p ~' ma ra e Nar~- -~ o ~-t ~ ~ , o over ~p~i%~ ~tj~ A ~(p-/ ~:. ~ 5 ~- • r~ ~ 5P f ~ s..~~ DIMENSIONS ~/ ~p~^~l ^ 1 ~T ` INFORMATION CHAMBER R ~~ +- L/IJ 1 RIOV I IVI• X71 J 1 GYt `.L..~ry ~~' ,' I,)( _~,. ,;~~ - Pipe(s) TT 4 (A~`', 2 / Length Dia Length Dia Spacing / ~~ ~- t~ ~~~~'~~!/ x Pressure Systems Only xx Mound Or At-Grade Systems Only Bed/Trench Center ~ ~ ~ ../~J ~ '/' Bed/Trench Edges Topsoil I~ Yes ~°, ; No ~ it Yes ~, :'I No GUMMtN 15: (Include code discrepencies, persons present, etc.) Inspection #1: t st ~ u' '- r cy~, Inspecnon ~~: -~------r- --- Location: 636 Roberts Lane Hudson, WI 54016 (NE 1/4 SW 1/4 22 T29N R19W) Hudson E tates Lot 11 Parcel No: 22.29.19.2881 Ta~ -s'rC'a~ ~I /n 1.) Alt 8M Description = ~ ~^ 1~~~' ~~ !/vl, 2.) Bldg sewer length = ! ,~ - amount of cover = ~ ~ ~y ~ • r Plan revision Required? Yes o I _~_Davte- „~ -~ _ - - -Ins s-Signatvr - - -- - - __ _ ~-EertL-No-- Use other side for additional information. i ~ 6 L/,~/ _ '_ SBD-6710 (R.3/97) r---~:.---- )~~ ~ .. afrty and ', ---v- CD W. ashingto Ave, 7Ib~ my yr'"`~ c y'e ~` ~ I~ -~~o #f -' ' Ma n, 33747 " 7162 i t S ~/ 1 S 'tary Permit Number (to be filled in by Co.) Department of Commerce 8) 66-3 2 3 2006 ~~ ~ ~- 9 Sanitary Permit Ap i n _ eta Plan LD. Number _ In accord with Conrm 83.21, Wis. Adm. Cafe, personal ati ST. CROIX COUNTY . You Provide may be used fee secondar . y purposes Privacy Law, s15.0a ~ 4 roject Address {if diffzreni thar: mailing address) I. Application Information -Please Print All Wornlation~ "- # / ~~ ~~~L-rs ~N~ CO __--~~s e. Z b~ 5 Property Owner's Na me ~ // Parcel fl Got k Block k Property O w ner's M ailing Address ~~ , ~ /I'~`t1a-Y~ ~~ Property Location + City, State Zip Cotle Phone Number ~=- `~~ ~~ '.Section ~2 ~ S'a `~ i` ~O~?,S' l~ ~ 7 S-Q®.d II (circle on ~ T ? p . Type of Building (aleck all that apply) ~ ~, n ~l I ~C ~I eA ' N; RL_E o ~ . ~ S w Q_ .~ or 2 Family Dwelling -Number of Bedrooms __~ \S~ ~~~ '-~'_`-- Subdivision Name CSM Number ^ Public; Commercial -Describe Use / ~~ - ------ -_ - 4 C .~ ~ G S L~ State Owned -Describe Use ~__ _ _ _ ! T I _ -~ ^City ^Village ,t~,r ownship ~~f ~~ e~ r i III, _ Type of Pet'mit: (Check only one box on line A. Complete line B if applicable) O _ _ j~ _ QeO ~ 2 ~/ A, New System ^ Replacement System f ^ TreatmendHolding Tank Replacement Only ^ Other Modification tc Existing System ~ ~ B • ~_ IV -~--~ ^ Permit Renewal ^ Permit Revision ^ Change of 01 Permit `Cransfer to New List Previous Permit Number and Date Issued Before Expiration Plumber .Owner T -~ - . ype of POWTS System: (Check all that apply) _ _ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soli ^ Mound < 24 in. of suitable soil ^ At-Grade ~.] Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tanis ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ~i Recirculating Synthetic Media Fitter Leaching Chamber Drip Line ^ Gravel-Jess Pipe ^ Other (explain) V. Dis real/Treatment Area Information: %')~~' „•r ~- L / ~ 2) `fo r ~ B2 ! ~ , aor S 2• ~ Design Flow (gpd) Design Soil Application Rate(gpdst) ispersal Area Required (sfj Dispersal Area Proposed (sf1 System Elevation (JO r 7 .~7 ~S 6.. Y ~e~o.c/ eo.d ~ YI, Tank Info Capacity in Gallor>s Toral Gallons Number of Units Manufacturer fj _ /~ ,~'(~ Q Prefab Concrete Site Constructed Steel Fiber Glass ~lastic~ New 6zisting t. . ~[I„ LT~~ Tanks Tanks Septic or Holding'fanl• tad ~ % <S ~~ Aerobic Treatment Unit Dosing Chamber ~ ~ `,~$ t,' ~, - ~0 ~ - ---- , VIL Responsiblllty Statement- Y the undersigned assume res onsibilit for ° t llatio f th POWTS h h d , , p y a e s u o own on t e attache plans. `Plumber's Na me (Print) - Plumber's Si gnature /MPRS Number Business Phone Number ~ W,`~(,`R'sK ,~cG a.~.el~rily~~r~-,~ vza ~ P~ © -z ~s~e- .4~.~1 Plumber's Addre ss (Street, City, State, Zip Code) VIII. Count /De artment Use OnI _ ~. ~i Approved ^ Disap Sanitary Permit Fee (' eludes Groundwater Date Issued I uin gent Signamr (No Stamps) Surcharge Fee) , ^ 0 Rea n far Denial _ '- , 23 ~(, IX. Conditions Approv I SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ~ Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD-b398 (R. 01103) ~N ~.~ ~. .~ G ~~g~ a "a°~ ~ y~ ~r OP~I G +~/~ lf'Sl'6',~ 1 ~ ~ ~ /~ /'~~~56~ ~s''T f~l~,~i/.J~ ~/~` ~! X115 r ~ ~ ---~ .R ~ ~~ r ~c~~C~ l ~Y.G "Y A _ ~_~ ^~ ~ . PROPERTY OWNER: cnana rrooerties. Lr SOIL AND SITE EVALUATION 1205 P`aye ~ of 4 PARCEL I.D.# Tan Schmitt REPORT MEMO Discontinuous silt inclusions were observed in B1 with redox features. The redox features in the silt are present because the smaller particle size of silt holds onto the water stronger than the surrounding sand, it even has a stronger hold than the force`of gravity trying to pull the water down. The water that flows into the sill inclusion will not seep out until the silt inclusion is completely saturated and cannot hold any more, then the force of gravity can start to make the excess water start to flow. This is why redox features {mottles) are present in the inclusion. The outwash sand that the silt inclusion is deposited into showed no signs of seasonal saturation or high groundwater. ** INSTALLERS** When a ill inclusio (silt ball) is encountered, the chambers that are installed in the silt should not be counted. More chambers shout be added to the end of the trench in sand to make up for the lower gpd/sgft rate of the silt. This way the 0.7gpd/sgft rate of the sand can be used and the system is only enlarged as needed. ~ ~- ~-r" S ~ ~f-- ~ ~c.:Z~.a.~..c~S ~. ~-e.~.v.. .e,~c~~e.,~.aQ c~-v~ ~ I D~r.SL- l S -z+^C~CNL~..~7~0! ~ ~: ~~ ~~ `S~ , o ~, '~ S . ~'~S ~S ~ r ~ -~- i°~ ~ C N~.ps~l ~-~s ------~ 1210 Wis~nsin Department of Commerce SOIL EVALUATION REPORT P~ 1 0l 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmdt County Attach complete site plan on paper not less than 8%: x 11 inches in s¢e. Plan must St. Crobr include, txrt not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimemsiors, north arrow, and location and distance to nearest road. Please print all information. , By Date Personal information you provide may be used for secondary purposes (Privacy l.aw, s. 15.04 (1) (m)). ~ 23 Property Owner ~ ~ (`, ~ ~ ~ A ~," ~`•;; Property Location Grand Properties, LP ~ ~ ~ ""'""°"`'' Govt. Lot NE 1/4 SW 1/4 S 22 T 29 N R 19 W Property Ownel's Mailing Address f Lot # 61ock # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 ~ ~~~ 2 ~ ZOOS 11 Hudson Estates City S e Zip Code Phone Number ~ City ~ Village ~ Town Nearest Road Somerset ~ I 54 ~ "' `~ ~ fi=590 Hudson Roberts Lane ~,.+'f New Construction lJse: ~ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial -Describe: Parent material Outwash Plain Flood plain elevation, ff applicable nor General comments and recommendations: Area is suitable for a conventional system. //P~~os~~sible syste ' n U Boring # .I~n9 ~,JU.J ~ Pit Ground Surface elev. 97.67 ft. pepth to limit car,d.~ or 101+ P``~- in. ~ Soil lication Rate 1 Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ 'Eff#1 'Eff#2 1 0-8 10yr32 none sl 2fsbk mfr as 1f .6 1.0 2 8-13 10yr3/4 none sl 2msbk mvfr gw 1f .6 1.0 3 13-29 10yr4/4 none sl 2msbk mvfr gw 1f .6 1.0 4 29-39 7.5yr4/6 none Is Osg ml gw - .7 1.6 5 39-65 10yr3/4 none grs Osg ml cs - .7 1.6 6 65-101 10yr5l6 none s Osg ml - - .7 1.6 S `fog ~~ ~ _ /o`~~ gym. Boling # Boring - Pit Ground Surface elev. 97.67 ft. Depth to limiting factor 103+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfP 'Eti`#1 *Eff#2 1 0-7 10yr3/3 none I 2fsbk mutt as 1f .6 .8 2 7-21 10yr4/4 none I 2fsbk mvfr gw 1f .6 .8 3 21-30 10yr4/6 none sl 2msbk mfr gw 1f :6 1.0 4 30-52 7.5yr4/6 c2d 7.5 18 7.5 /l Is 1 msbk mutt gw ____ .7 1.6 5 52-72 r--- 10yr5/4 none grs Osg ml r~ - .7 1.6 6 72-103 10yr5/6 none s Osg ml - - .7 1.6 ' Efrluent #1 = BOD ~ 30 < 2Z0 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS<_30 mglL and TSS <~0 mg/L CST Name (Please Print) Signature: _ CST Number Thomas J. Schmitt 227429 4ddress Tom Schmitt Dam Evaluation Conducted Telephone Number 1595 72nd St., Never Richmond, WI 54017 4/13/04 715-247-2941 ' Property Owner Grand Properties, LP Parcel ID # . a ~~# ~~ Pit Ground Surface elev. 95.95 Page 2 of 3 ft. Depth to limiting factor 97+ in. Sal Applicetion Rate ,~ .. ~ Conducted by: Schmitt Soil & Site Evaluations Thomas J. Schmitt, CST 227429 1595 72nd St. New Richmond, WI 54017 Page 3 of 3 Conducted for: Name: Grand Properties, LP Address: 712 Rivazd St. Suite 100 City, State, Zip: Somerset, WI 54025 Phone: 715.247.2 41 ~ Subd. Name Hudson Estates Lot No. 1/4, S~/ 1/4, S: 22 , T 29 N, R 19 W Township of Hudson BM El. 100.00' Tp p ~ ~" ~~~ ,~/~~- Alternate BM El. ~~, 7/ ~~ ~ ~ dP ~,~~~ P/,0~ Slope = S" % Contour Line El. /1/i4 I Scale: 1" = 40' ~~ r ~ r ~~ r i m~ wu rGpun was cone w rumti a ummg requuemem. i~ may or may nut oe m a iuc;auon mat is suitable for your use. No permanent lot markers were in place when the test was conducted. _, , SEPTIC TANK ~ PUMP CHAMBER CRG~SS SECTION AND SPECIFICATIONS 4" CI VE2dT PIPE 12" MIN. ABOVE GRADE 25' FROM DOOR, WINDOW OR FRESH AIR INTAKE FINISHED GRADE ~+'~ c I R z s ER -,- ls" IN. 6" MAX. ii ~_ I N LE T I (-~ .r WATER TIGHT SEALS tPPROVED 'IPE 3' )ri1T0 SOLID 'OIL PUMP OFF ELEV . FT . WEATHERPROOF JUNCTION BOX APPROVED WITH CONDUIT MANHOLE COVER W ! PADLOCK 8 WARNING LABEL ~-_ ~ ~..---. =4'f MIN . .. ~~ ~, ~~ I` GAS- ~ 1` TIGHTS ~~ A SEAL ~ ~ __~._. ~ BALM B ~ ` ON _f_` C ~ ~ --~--- ~ OFF D 3" APPROVED BEDDING UNDER TANK ~t ~ /APPROVED JOINTS WITH APPROVED PIPE 3' ONTO SOLID SOIE ~rst RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: l,Jce.se..cz TANK SIZES: SEPTIC ~~.$'~ GAL. _._. DOSE Rpm GAL. ALARM MANUFAGTL'RER : I..@v e~p-t~~ MODEM NUMBER: p~.~/ SWITCH TYPE : 'M~tz.s PUMP MANUFACTURER : ~ ~"~, a,,,~_ MODEL NUMBER : F, (> ~~ SWITCH TYPE: 'C`j~,e.2c_ NUMBER DOSES PER DAY : `1" DCSE VOLUME INCLUDING F LOWBAC K: 1 S 9 GAL . CAPACITIES: A = aa,, INCHES = y ~ a GAL. B = 2 INCHES = ~ ~. GAL. C = ~ INCHES = ~rGAL. D = ~ INCHES = J_a.~ GAL. REQUIRED DISCHARGE RATE ~{O GPM PUMP ~ ALARM WIRING AS PER ILHR 16.23 WA VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE JdL FEET 7 3 + MINIMUM NETWORK SUFPLY PRESSURE . . .%V~~~FEET + (~,p FEET FORCEMAIN X a.l~oFT/100 FT. FRICTION FACTOR 1.5'7 FEET TOTAL DYNAMIC HEAD - l3 •$ZFEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH -- ; WIDTH -- DIAME7.'ER .-- LIQL'ID ~~ ~S ~~ ~1 GA) . Pe-2 ~ ~~ ~. SIGNED: ~%~l~' A~ LICENSE NUMBER: ~a ~ 9 9 n DATE: 1/88 ~GOULDS PUMPS APPLICATIONS Specifically designed far the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/," maximum. • Capacities: up to b0 GPM. • Total heads:. up to 31 feet. • Discharge size: 1'/:" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C} continuous 140°F (60°C) intermittent. • Fasteners: 344 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 64 Hz, t 550 RPM, built in overload with automatic reset. • EP05 Singgle phase: 0.5 HP, 115 V, ti0 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 1613 SJTOW with three prong grounding plug. Optional 24 fioot length,16/3 S1TW with three prong grounding plug (standard on EP05}. ®2000 Goulds Pumps Effective February, 2000 83871 • Fully submerged !I! high grade turbine q!I #A- lubrication and efficient heat transfer. Available for adtomatic and manual operalipn. Autq, math models inclpde_ Mechanical F1oaE Switch assembled and preset at the factory. FEATURES ^EP04 Impeller; Thermoplas- tic Semi-open des[gn with pump out vanes fof rrechanica! seal protection. METEns FEET -.,.. to ,. ~ ..... 8 + .......................... ......,...,, 25~ ,.,.._. _,..._...... ~ ~ x V 6 20 ^~F, _._ 5 i ~ a is _..,. ...._ . l- _ _ _ Submersible Effluent Pump „ 1 EP04 3~~ I EPOS ^ i=PDS lmpeBer. Thermoptas- ticenclosed design for impivved performance. ~ Casing and Base: Rugged thermoplastle design provides superior strength and corrosion resrsfance, ^ Motor Housing: Cast iron far ~fflcient heat transfer, sttett~th, and durability. ^ ~lotdr Cover. Thermoplastic cQyer'~rith integral handle and fiaat switch attachment points. ILRower ~aible: severe duty rdtecl all and water resistant. .r,....... .,.._:,.,._ .. _._._ _.i ~. o ~ o ......... .. 0 10 ~U 4 6 CAPACITY ^ Bearings: Upper and lower heavy duty bail bearing construction. AGENCY LISTING ~' Canadian Standards Assfldation (CSA listed model numbers end in "F" or "C".) Goulds Pumps is I50 9001 Registered. 40 50 GPM 8 t 0 12 m'/h Gauids Pumps ITT Industries k4~ uc STANDARD CHAMBER Quick4 Standard Chamber MultiPort End Cap 12" ~ _~ 34" SIDE VIEW FRONT VIEW SIDE VIEW TOP VIEW :a. ~ .. Quick4 Standard Chamber Nominal Specifications ~~r ,~,,~~MuItlPortr,End Cap~,Nomirial Sp~ecrflcations, ~ u-~~`~= ~. .,. Size (W x Lx H) `' ~ ''-34` x 52"'x 12"' ~ ~~Size (W z L'~x H) ` '' "~ ~ ~`'`34` x 16' x`'12" Effective Length 48" Invert Height 8" or 1..25" Invest Height $, INFILTRATOR SYSTEMS INC STANDARD LIMITED WARRANTY (a) The structural integnly of each chamber, end plate, wedge and other accessory marnrlaclured by InliNrator ('units"j, wlren installed aid operated in a leachfield of an onsite septic system ar accordance with Mfillrator's Mslructims, is wartanted to tFq original purchaser 1"lidder~ against delectlve materials and wakmanslxp la one year Irom Iha date that the s~tic permit a issued for the septic system oonlaitirg Ihff lhrits; provKled. hcnvever, that II a septic permit is not required by applicable law, the wenanty period call begin upon tMr data that inslafiation of the septic: systr:m Cormlences. To exercise ifs wartanry rights. Folder must ratify Infiltrator in wilting at its Corporate Headcpfarlers h O!J Saybrook, Cax»clicul wlthit fifteen (15) days of the alleged defect. Infillmlor will supply replacement UnAs for lMits determined try InfJUalor to be covered by this lknital Wananty. InOtrator5 liability specifiraly excludes the cost of removal arrd/or installalxJn of the Units. (b) THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH la) ARE F~(CLUSNE. 171ERE ARE NO OTHER WARRANr1E5 WRH RESPECT TO THE UNRS. INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FRNFSS Fbli A PAR110UV+H PURPOSE (q This Limited Wartanly shall be void it any part of tMf chamber system is manufactured by :ary xra other ttwn Inlillralor. The Llmiled Warranty does not extend to incidental, consequential, special or Indirect damages. Infiltrator shaft not be iahle Irx pdnaAk~s a liquidated damages; includkg loss of prodtx:tien and profits, labor and materials, overhead costs, or other bsses a expenses incurred by the Holder a any Ihlyd party, SpaclTicapy exckrded from limited Wananty crrverage are damage to the lMils due to ordinary wear ancliear, alleralbn, accident, misuse, alxtse or rreglecl of the Units; the Units being subjected to vr;hicleirelfa a other conditions wtxch are rrot permitted by the installation sulnx;tions; failure to mafnlain the minimum ground savers sat filth h the installaton krslruclbns; the placernenl of Mnproper materials info the system containing the lhuls: faAure W the Units a the Septic system due to improper siting a Improper sizing, ez('ASSive wafer usage, improper grease d'sposat, or IrtproPer operatbn; a arty other event not caused by Infiltmta. Tftis Limited Warranty shall be void if the Hdder IaNS to compy with aft-of the terms set lodh M This LhnNed Wananty. Further, in no event shag Infiltrator be responsible Id arty kxs or damage to the Holder, Ifre lMits, or arty Third party resulting Irom wctalialion a ship- ment, a Irom arty product fiabilily Calms of Holder or arty third parry. For this L.inJted Wananty to app~•, ttq Units must be Installed Nr arxordar>ce wllh ail site cgrtdilions required by stale and bcal codes; aft other applicable laws; and Inldlratdrk krstallatbn n>^,tmclkxu. (d) No represenlalive of InfAtralor has the aultadly to charge or extend This Ulniled Wartanly No wanany apprres to arty pady other than the origi- nal Holder. The above represents the Standard Umiled Wananty oAerad by tnfllrator. A imilocl nrxnber of slates arM counties have different Wananty requ'xe- ments. Arty purU»ser of Units stauM contact Mldlrator's Corporate Headquarters n OM Saybrook, Cpnectiwl, prior to such purchase, to oblaln a copy of t7re applicable Wartanly aM should carefully read that Wartanly prior to the ptechase ul lhtits. ~ , • ~ 0 SYSTEMS I N C Environmental Onsite Wastewater Solutions' 6 Business Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-577-7001 800-221-4436 u.S. Patents: x,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,x59; 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 and Sidewinder are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in Franca. Infiltrator Systems Inc. nECraEnvAVea is a registered trademark in Mexico. Contour, Contour Swivel Connection, MianLeaching, PdyTuff, SnapLock, ChamberSpacer, PasiLtxk, QuickCul, QuickPlay and Quick4 are trademarks of Iniiltralor Systems Inc. ®2003 Infil6alor Systems Inc. Printed in U.S.A. 0011203HP-0 SECTION VIEW POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of 3~ FILE INFORMATION • ~ }- on ~.St L." ~ Owner ~, ~ a ,~ ~.~ Permit # ~.. DESIGN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units NA Estimated flow (average) al/day Design flow (peak), (Estimated x 1.51 ~' gal/da Soil Application Rate gal/da /ftZ Standard Influent/Effluent Quality Monthly average` Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand IBOD61 _<220 mg/L ^ NA Total Suspended Solids (TSSI 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBOD51 <_30 mg/L Total Suspended Solids (TSS) <_30 mg/L ^ NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Maximum Effluent Particle Size Y8 in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~JJpC9 al ^ NA Septic Tank Manufacturer s' ~~-~,, ~ ^ NA Effluent Filter Manufacturer ~~j~ ~, ^ NA Effluent Filter Model ~ ~Q ^ NA Pump Tank Capacity ~ al ^ NA Pump Tank Manufacturer ,/ E'3'~y. ^ NA Pump .Manufacturer ~aA ~~ ^ NA Pump Model ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cell(s) ^ In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: other: ^ NA Other: ^ NA Other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ~ earl )Is) (Maximum 3 years) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y31 of tank volume ^ NA Inspect dispersal cellls) At least once every: ~ ~'yea~ls)(s) (Maximum 3 years? ^ NA Clean effluent filter At least once every: monthls) yearls) ^ NA Inspect um pump controls & alarm P P. At least once eve ry~ ~.. ^monthls) ^yearls) ^ NA Flush laterals and pressure test At least once every: .-_.. ~ ^monthls) ^ yearls) ^ NA Other: At least once every: ^ month(s) ^yearls) ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellls) 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 (Y,1 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of S12 months, shalt 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. " Page ~ of Z START UP, AND APERATiON For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemical that may impede the treatment process and/or damage the dispersal cellls). If high concentrations are detected have the content of the tankls) 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 b discharged 'to the dispersal cellls) in one large dose, overloading the cellls) and may result in the backup or`surface discharge c effluent. To avoid ths.situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restorin power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls t 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 are 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 th POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system i 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 wit) 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 complian replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorptior system.. The replacement area should be protected from disturbance and compaction and should not be infringed upon b~ required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wil result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems muse 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 POWT; technology a holding tank may be installed as a last resort to replace the failed POWTS. ~~ ^ The site has not been Pvalua+A.+ +~ o.+ ~«~:•• •~•-~-~- ---~--- --- ---- "--- ~-~~••-e of the PDWT$ a seil and site gvalnatinn m.. .nnl~nomnnt area If nn ronhnn.~=--~ •-:h{~la a hnlrline tBnN ^ 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. DU NO7 ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~//t`~~,'~c •~,-, »-c~~~ Phone 7 ~ ~- _ ~ ,_ 31..x' POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) - LOCAL REGULATORY AUTHORITY Name Name Si • C~9 (X UTY ca4Na !N ~' ~1 Phone Phone S ~, , This document was drafted in compliance with chapter Comm 83.22(21(b111-1d1&lf) and 83.54{t-, {21 & 131, Wisconsin Administrative Code. k16/ 14/ 2005 09' a1. i 71=~~ 47~ 622 PAGt 01 Ff2QM : SCF~.1MflKER P~LU"f~J 1 hIG FAX N0. :7153863~.~1 J;.zn. ~,4 20195 10~23AM P1 x CtaL~iZ,K CUUL~'X`Y s+~ ~•~xr~ ~.mrr~x~.t+Fr,~ ~aR~ ~~ G~'R'rtFI~A'~I~ON P~R,M bwnalau~ror ~~~~ ~r eaarars P #63~ a- L~ ~.1 5 ~~ °~~S L~N6 ~+Ct[~c.a;;op ~~ ~ ~ ~,~pACat foa' posy V Psi! )dsa~~t~lr.~t;on Ntr~mtaor o zo - ~ S'a - i ~ _oan (. 258~~) ~~ „~ CRkP~~ '~ t~aN~~- y,-~'`~ ~i~ saG.a? , T?9,.N-~ 1 ~ „~¢ town ct'„~c~,5.~ fiubdiviaion ~, lit #~.~,, C~u#et! 5arvtp lisp # volcano . laa,~ # ~'~rrttu~y mew # ~ q 3~- vo1G P # firma hopes Q yes [~ na C.ot Tinos ident$e~bl~m D yes t~ na I~rapaa' oza ansl maibaF'yaur Qyszem c,outd=esttit bt trti premseutw 13~~two to ham w~sasas. t'ropet`me3rtbeaarnce :rl gw'~~i out the tan1~ every th~+oa yeece or eoot~ i[ atedod by a Uc~uod put~wt, What you psit into the rys~m ran acct the tba~oa of ~e ego hak a~ a ~t etxge ita thr+ ate diap~assl eyttam, maat~~. O'~10P~~~dP~~mb~ara+rat eta ~~ stwtus~e;0ewseterontAer "`j b~' a is la ' ~pczryug sxytididaea su~dtar C3) attrr inspbr.~fitne ~ ~ ~ C 3 ~j F~P~ ~ rz~'}.die Ada ink 4i !aM tlgen 1 /3 lfrlt of ~Iur3~e. Jlw'e! ttum ttt~ned bevy tmtd the obvve t~aiteanaab add aka to rot6n~ttzt the private ,oaa~e ~diw~l apataoe with ac stsoderds aet forth, h+ezda, at !el by the Dept of mo cad the Dent oB' Natuorel Reaoutnee, $btte of '~~SCaasilt. Celion ~t yaer eeptie ayAtem ~ beesi toxi~aia;ed ttst,~t he rxrttrplakmd sad reuuned M dse Sit (mac Zoniag ~3lAioe Okla 3 Q slays of t5e tlux >~ e~tba disc. f Usl SIC3~A Ap1~LICA UA7'B I (°~) *-;s~ t al! ~it~Gpts aoa tt~ form are true to sbe bets oC uYy fcria~ kAOa~te~ts, ~ (we} tm (ate) tlta owa4t{e) of ~ petty! derrrib~rd ~rbave~.~ v ofa prq~ty skcd dod io Rtgitter at° O~ave. ___ ,.+ F APpLIC,r4~V'[' b ~ "~~' iiifii ,~~ ~~~ ~ ~ ~~ tried ~Y ++ewit ~ t3u<,ewltary ~ee~eus bdag t~n-oked ~'Y the 7~aoGng poplartcueat. ««*e" s `~ ~ as r. IadEnde wig tlsis :ppifoation. It tWt~ad wsttapXy daed tram t1u+ ikd of Iyeads odclce a ae-py at' #~e aortitied survey nup if ro~eeba to saeda ~ the wammgr deed ~~ 1 G~~ y~E~. ~7 2'i 8 7 P ~1 1 ~ 7~`~`~37 t3 l STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number I WARRANTY DEED This Deed, made between Willis D. Savadg_e. Grantor, and Grand Properties, LP Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County,-State of Wisconsin (if more space is needed, please attach addendum): See Attached Exhibit "A". KATHLEEN H. wALSH REGISTER DF DEEDS ST. cltolx co. , wr RECEIVED FDR RECORD 01/07!2004 11:LSAN wARRAHTY DEED EIEt~T # REC FEE: 13.00 TRANS FEE: 3240.00 COPY FEE: CC FEE: PAGES: 2 Recording Area Name and Return Address ~~I 1058-80-000 020-1059-00-000, 020-1059-10-000, 020-1058-90-000, Parcel Identification Nup~ber (PIN) This ~s ~U'G- homestead property (is) (is not) Exceptions to wazranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~ day of `C /~ ~ G7- . * - -- ` * Willis D. Savadg - - --- AUTHENTICATION Signature(s) i ~ CKNOWLEDGMENT STATE OF w ) ~( / ) ss. ~/ County ) authenticated this day of _ _ Personally came before me this day of --` _ ---- ._ ~ jn the above named * ``~~,~~tttsA »y Willis D. Savadge, _ ` TITLE: MEMBER STATE BAR OF WISCONSIN ~~` ~ / 's _ -- _ __ __ (If not, ~ ~ . ~ • ~j td ' •~nown to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) =~; .~ r ~nsttt~ent and acknowledged a same. O . ~~ `~ ~ THIS INSTRUMENT WAS DRAFTED B7~ ~• `~tj~, Attorney Krishna Ogland '`%~iS'• • ' * _ Hudson, WI 54016 '~i,, • $!N • ~~~ tary Public, State of /sC /AJ ' nn~~ _- My Com/mission is penrmanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) I/ G~ 9 G%~_ •) * Names of persons signing in a[ry capacity must be typed or printed below their signature. Information Professionals Co.. Fond du Lac. WI STATE BAR OF WISCONSIN 800.655-2021 WARRANTY DEED FORM No. 2 - 1999 02/11/2006 10:39 7153862979 `Ci~EN RTOHNSON PAGE 02 f"1~4l1'I .S~.I~yWI'INM.CK P"LWI'IdJIVL7 ~ nr' ""' ' ~•,•.• -'-~- - SEPTIC TAN'Y~. MAYI~"1'~NANG'~ AOREi1EaM~t`1'~ A~ owN~~sxrP c~~zc~Tro~a Fay ~WnCTBl1yG~ f ~ r••~ p~ ~ 1 -- N(ai]ing Adams '1J Propsr<y Addra~a "' (VeritStaliom taquired from Plan.~rig & Zoning Dcpatvtfetst 6or tsew aotrattuGtion) Cityl5tate Utz Patrt'l identification Number __....~.,~..._ __ r,~ne~, n>~SCRIP'Y'I4N ~`t'aperty Location _.~.~'/~ , ~'/• ~ Sec, g~~,, T ~N R,W,'fowa of .~~~ ~. Subclivi~ion ~-~,,~ •~~~ - ~t ~ ~ c~t~ survey ~~~ ~ - ~ volts ~ ~ _ .~. _~.. ~ ..~.~...., ~ ......~.~ l'a a Warranty Deed # ~~ Volumo ..... --• Page # _ ..---. Slec haunt yts no Ldt lames identifiable y~ ne ~'1lSTEM Mp11~i'i'~I~ D OV1' ~ CERT~l,~~AT~, l'opor usa and maiubaa~rnca of your saptic rlyAte~1 could result An its ryremetutro flsllttre to l,andlC wastes. Proper t~aai~at>'aattec wnaiats Of pumpia8 out th+e sapdc tank suety three years or sooner, if needed, by a Htxnsocl pure~er, 'gVbat you put imo t3se system can affect the functina of ttie septic tan]c es a treatment stage ~ the waste disposal system Owr-er t~.iutenancG reepeTr~billties are sptcrfred in §Cormm. 83.52(1) and in Chapter l2 - Si, CYoix County Sanitary Ordinance, 'x'1*a praPah' uw~~rr a~oae w submit to St, Croix County Plsnuiftg J~ 7on~ Uaparement a uertif4os~ian form. siYneYl by rhr owner uad by a muster phtmber, jOttmoyn.n piurslbrr, ~dyrrictocl plumbat or ~ 110onsed pui[tpbx vMrit'yfrg that (1) tha nn.nito wastewater dispcisat system is im proper oporadng cnndirivn and'or (2) aRcr iaapnaticna aid pumping (iitteevseary), tha septic souls is ltsi than 11~ t`uU of sludge, Uwe, the uncle+'sigaed Nava xead the about requirctneats and agzee to tttaisYtai,q the private eewegt dtsposel system with the standards set forth, bem~ as set by the Dapariment of Canamerce and t$e Department of Nt~ttu~el Raavutcos, State of Wiacona~. Cesii$catiop :tatielg that your saptlc xystr~n hs~ been malnta4nsd moat be catrrpleteci wnd tetureued do fife 9t. Ca+obr f'.otmty Planning dt Zaoi~g Z7cpextr~ysnt witbua 30 days of tiro three soar expiration date. t/we certify that all statementx an this form sre true tv the bceli u4 cxsylour leeowledge. 1{we amJ~lre tits owne*(k) ot'~e property described above, by virtue of a warranty deed retarded in Resistor of pneda Qfflee. Nutxrr of bedrooms ~ SiGNATTJfLE OF APPI.IC(5) ~ t7ATE +4e~oy infortnsdo>~ dart is misrapre~rnted mr~y result :n the gania-ty penttit being revoloed by tba Flarmirig ~ Goning Depaitrnenr.'*" l~aaludue witl'~ this application r iecarrdaad axrr~.ry de+ul fxetr- the l~glgtet of lhteds ~Q said a copy of the CCltiffed Sun't:y rT1ap if rei'erence is madt in dtc wstt'atuy load. - ; ~~~ "~ '~ ~~ ~% . ,U 2y87 P lly EXHIBIT A That part of the SW '/. of Section 22, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin described as follows: Commencing at the SW corner of said SW '/. of Section 22; thence N89°51'27"E, assumed bearing, along the South line of said SW '/., a distance of 1298.51 feet to the point of beginning, being the SE corner of that certain Certified Survey Map recorded in Vol. 15, Page 4192; thence N00°32'31 "W, along the East line of said Certified Survey Map, being the East line of the SW '/, of said SW '/., a distance of 493.73 feet to the NE corner of said Certified Survey Map; thence S89°48'23"W, along the North line of said Certified Survey Map, a distance of 31.25 feet; thence N00°32'31"W, a distance of 1447.58 feet; thence N89°41'03"E, a distance of 31.25 feet to the East line of the NW '/. of said SW '/. of Section 22; thence N00°32'31"W, along said West line, a distance of 690.94 feet to its intersection with the East-West quarter line of said Section 22; thence N89°37'56"E, along said East-West quarter line a distance of 1301.09 feet to its intersection with the North-South quarter line of said Section 22; thence S00°29'07"E, along said North-South quarter line, a distance of 1318.71 feet to the SE corner of said NE '/, of SW '/.; thence S89°44'41 "W, along said South line, a distance of 649.90 feet to its intersection with the West line of the E '/z of the SE '/. of said SW '/. of Section 22; thence S00°30'51"E, along said West line, a distance of 1317.44 feet to said South line of the SW '/. of Section 22; thence S89°51'27"W, along said South line, a distance of 649.27 feet to the point of beginning. r SURVEYOR: PREPAREDF w ~ ~ SY1 WAD lURrE17NG 717 NVARDTS ~ `°"'"""~T' HUDSON ESTATES ~~ ~~ ~°~• ~ ~°~ cocATBD IN r8a N8f/~ of rBa swf/<, PART of raB sB1/~ of res s~-f/<, PARr of TEB N1I1/4 OF T88 Swf/<, AND PART OF T$8 SII'1/< OF TH8 Si't/<, ALL IN S8CT10N YY, T28N, Rf9F, TOIIN OF HUDSON, ST. CRO1X COUNTY, ~ISCONSI ,a1iii1i001111C„ rsri. ~rw r,-s~ rs 1ar,1st ~,OT ~ ~ t. ~~~. 7{,q' I , V,QL 11 r~isr I UNPLA7TED LANDS ; PC. 2975 ~' ..~o.rwc.wa ansT.llss>f tN Wa ~ wow r+a..... t ~ - - - rt ~ 1T/. ~ 1~0. ~>• u7s - _ ls7w 1~ LOT / 1 LOT 10 nK r ~ # s.oss ~p~ '4 y, s.°°~ ~ ~rA~ .` ~ LOT f ~ Z M.fN i0. <R. ~ • FT. 4./.O. • ~IwAO ,~^~ l.~M AOllr ~, L1.0. • ft1J0 p,i74 i0. R. xfa• I.1.0. • t1~A0 712y ~ ~^4 ............ .......... ... Nor .~ / \ . ' / 1N.M~ ' i )~ Yf6 .. ' T7JY •F1~7T ~' -- ,I' 1t~~ I `" ~ V ~ L . 11/7711'1 AAI~' ~ `~ ~~ '~" I Z ww,. ti.s . ~- - -IIOiLItT: LANt--y ~ . 71,7v r ~ ' asst I s ~ ~ • • ~• IM'i7'M'C ~ \ ~ RCN tr7.N• I ~ Q "ttV., ~ m ... sest I ? r ~ .. 1 ~ ~ ~ a.rrn LOT ~ ~ b: ~~ ~ ~ ~„ •~•,, ~ • • • .; LOT 1f ~ ~ ;~ ' • •, ~. ~.ooona.. u~iv i ~ ~ LOT 1 i •.' / ~ ~ . ~ ~!v ~ /~!-r u y.,n '. ~ •• ~~ u.o.. ~~ ~.ro ~ ~ s.sso eosrs ,• I ; • u1~rt ~~vwi~ ~ ~ .• ~ •. ~ ~'+0 ~, sw,w so. -r. • ~ ~ ~ ~"~ ~ ~ LOT 1• ! I uo.. sn.so: ~ amp ,1on~s \'~ . , Y ~ ~ I ~ I aa+' Q.M~ 10. R. .~ / ... tit' r1. w • . ~ la ~ ~ I s~.s~ b . ,y •• lam' ~~ bU Y .. I aR c ~~~ ww '~" ~ ~ 1~a.wrc w or s1-sr x,11• ~, LOT 17 • = I ~, _ - ~ b , ^oM rre-wa = • s.t st sat • ' .. ........ ~ "I Iv I ~~• i . i ~ ems. I ,/ ~ ~ • • ~ so.~ss ~o1rs -; u7n ~~ '~ mass sro. rr. ~' ~~ ~ ~ ' LOT 1• ' sue' ~f4• soos eollss cu „~ a_ao. • s~s.w .es~ ~ ~ ~ • sssa sw. rr. aw• ~ _... ~ ~ ~• 78.11' M /YpMIM {11.71 CUlrOifrG iNYrYR. 4,~ •~ , L61C H-OY~~p~ ~ I / Q71' Qy I ~ n7r d~ / 4 , lnsr ~ _ ~ 1~w• - 7ss~• ~ w~ . e.m ~- -- 171• ~/,Ml. ~Mr 7a7r I ~.. g ~ • ~ I o~ ,~ ~~ ~ u7.n 1e4»• p ui7v lrowwc for d r.ortwe lo, tia- ~~ i ww rw..lea. w1, nrt-~a a raM' i 1R7F ~ ~ Od L~~ 1 71J7' I 4ri I 1lp1/TM IAN! oP TN! -NIM O/ TIC ~1N ~N su V \ ~ ~ ~ ~ . ' ~- ' ~t yNP;uTr~n L-rrDS ~ ~~ .ai,• I ~ ~ ~ :. 11:,1• I I / ~~ i ~ ~~ o.~ 6 , l1~s/ ~ ~ 1MwVt1 ~ M,.M' ~ ~ ~t~'7' , ~ Y1t .. ~ ]Cy' 10N1„,~ 0011 t ! 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