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020-1439-51-000 (3)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and 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 Rin enber ,Bob & Karen Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: '~ Cry ~~ ~ ~~ c TANK INFORMATION TYPE MANUFACTURER ~,,.~t, J CAPACITY Septic Aeration Holding TANK SETBACK INFORMATION TANK TO P!L WELL BLDG. Vent to Air Intake ROAD Septic 7 /~ ~~ Z4 ~ ~~ ! Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Li Friction Loss Syste ead TDH t.. Forcemai Length Dist. to well SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 499290 State Plan ID No: Parcel Tax No: 020-1439-51-000 Section/Town/Range/Map No: 25.29.19.2777 STATION BS HI FS ELEV. Benchmark .~1,9 /~ ~ / ~6 Alt, BM 1-~ ~- S~. Ga~e~ ,,. f~ e~ %~1 ~ ~ Bldg. Sewer ,L ,,' .~~ / a~ , ~, SUHt Inlet * i'C ~ rfa,y ~/ j ./~ SUHt Outlet ~. ~ r~ 3 . ~ Dt Inlet ~ .~ Dt Bottom ~ ~ Header/Man. /a . 3 9~. rY Dist. Pipe ' 1 a„rJe~. /Z . 4 f . 3 ~6. /(,~ • 2~ Bot. System v Lcw % ~. 3 15.3 `tea . Z4v~ °-3 . LtG. Final Grade 7~~ ~ f• 5 Lou- ~' ~ q.o '~r•S~, /, ~ ~ BED/TRENCH Width ) Length i No. Of Trenches ' PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 I~~ ~„ ~~8 *L ~ p ~ ~~~ ~, \... SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:. I I ' ~ ~ CHAMBER OR ~- ~ ~'{^~ ' INFORMATION Type Of System: ii ~ i , ~ ~ 33 ICJ' " ~ UNIT Model Number: 1 f~ , ; _J,, ~(~ -- ~.:`c1x. ~e:tiJZ++~' / ~t DISTRIBUTION SYSTEM IJ,~-~--' z ! L a~,e.~.. Z:L uP~~ Header/Manifold ./ ~ ~ Distribution _, Pipe(s) '\ \ ~ x Hole Size \ x Hole Spacing ~ Vent to Air I tak~ ~/' ` ~ C. Length Dia Dia Spacing Length_ CP111 (`/l\/GR ., o .............. c.,~w....,~ n..i., .... 11Annn.i nr A4_l~rarln Svefams C1nly Depth Over / Depth Over xx Depth of il T \ xx Seeded/So ded xx Mulc e~ ' Bed/Trench Center ~ a ~ Bed/Trench Edges ` opso Yes No No Yes ,r~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 Location: 879 Highlander Trail Hudson, WI 54016 (NW 1/4 NE 1/4 25 T29N R19W) Indigo Ponds Lot 51 1.) Alt BM Description = ~ ~~ ~ ~ Gc ~+~ l.J 2.) Bldg sewer length = (~~ Inspection #2: / /_ Parcel No: 25.29.19.2777 ~...'w., c commerce.vvj.goV Safety and Buildings Division County ~ ~~~~ 201 W. Washington Ave. P.O. ]~,,*- ^~'! ~ j ~ Ma tson, ~~~6"~i l~',~~ Sanitary Permit Number (to be filled in by Co.) ^Depa7rtVmertVt at Comm^e^ rce L~ Sanitary Permit Appli ati~,~ 2 3 2001 State, Transaction Number submission of thi form to the appropriate governments Wis. Adm. Code In accordance with s. Comm. 83.21(2) , , unit is required prior to obtaining a sanitary permit. Note: Applicatio form~f(ar(s~e(~w~(~jQ~fS ar be used for secondary rovi ma formation o l i f C P d h D i ProjectAddress (if different than mailing address) y y ersona u p ommerce. n e epartment o tte to t subm u oses in accordance with the Privac Law, s. 15.04(1 (m), Stats. ~ 1 ` A ~ Q ~^( ~ . ~~ ~r"'V ""~/f/~'~ ! C L A lication Information -Please Print All Information . Property wner's Name ~Q ~• ~l N ~N ~ Parcel # ozv.- -Sl-oacv Property wner's Mailing Address Property Location 2~~~ f~ ~~ aog , Govt. Lot Ciry, State Zip Code Phone Number ~~ y, /y~ y., Section ~_~ /) i' ~ A,t , / 1•{'x'1• , V ( /V C q 7 (/ ~ Ircle ones T ~ qN; R ~ E or ICJ Q. Type of Building (check all that apply) ~ of # -"~T v ~ / Subdixtson Name_ __ _.. - 6 /5) 1 or 2 Family Dwelling- Number ofBedrooms C ~t ~I v'SC.. 7'~w.~_ / Block # Q Q ~ ^~~J ^ PubliclCommercial-Dwcribe Use ~! ^Ciry of ^ State Owned -Describe Use CSM Number ^ Village of ®-Town of ~~ ~O z D~ s+- c~ ~ ,~.~ z z ~ 21 ~ .,,,,, e r _ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ew S stem ~'N y ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B. ^Petmit Renewal .Permit Revision ^ Change of Plumber ^ Petmit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner ~f Z 9 b Z- f T -Q IV. T e of POWTS S stem/Com onent/Device: Check all that a 1 ^ Non-Pressurized ln-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound > 24 in. ofsuitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersalfhreatment Area Information: ~ ~ x 9 • +'S •~= 7 . De ign Flow (gpd) Design Soil Application Rate(gp t) ~ Dispersal Area Required (st) ~ Dispersal Area Proposed (s ~f stem Elevation s- C~ q 6 S~ 3 u.rc ~ ~ Vl. Tank Info Capacity in Total # of Manufacturer ~ Gallons Gallons Units ~ ~ t? ,~, N T k i i T k E ~ ~ " ~ ro ew s an st ng an s x D / I ~_ /nJ / D d o C . (mil a. U a„ v~ ~ v~ ~ 'w C7 a Septic or Holding Tank / ~ l ~~, .Z 1 ~ Y __ ~~ _ Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsi6Ility for installation ofthe POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/[\4PR3 Number Business Phone Number Plum er's ddress (Street, City, State, Zip Code) VllI. Count /De artment Use Onl Approved ^ sapp d Permit Fee Date Issued Issuing A Signature ^ caner ~ en R or Denial p 5' ~~ 3 ~3 d 7 IX. Condition of Ap roval/Reasons for Disapproval ` OG 8V's~TEM ~ WN~R ~ ~ J ~o ~" ~..: ~..¢,~j tntiJb ~- n r ~ P uent filter and dispersal cell must all be servic i l ~ ! '` r~o ~ ~ '( `'t f " ~ es (ma _nEa r^ed , - ~.y,r 1 ~ v ~J o { as per management plan provided by plumber, U ~ U 2 All setback requirements must bs maintained G o ~ i ~ 6+~ aF+MIGi1lRIR 16~gYtllp~NlaBOQa'Jte system and submit to the County oNy on paper not less than s uz x t t mcnes m stze SBD-6398 (R. 01/07) Valid Ihnt 01/09 Lok PAR ~ ~-~~ R1.9~ ~~~ ~n~ 2~~`97 NT ~~~~~ W~~ ~L ~~~ ig~ `'~ i ~~ 4~~ ~~ ~~ ~t i~"';~ ~' ~~~ ~~~~E pM ~ ~ l~.o ~ 3 mWL~~ ~{ ~ w ~ ~ `~ ~ ~~s~ (LSD ~~ ~o~ 51 Ok Pia ~/ ~~~ ~19~~~~~n~ 2~ x`97 ~ q ~~g~ ~~ ~~~~L ~,t ~3 5 g~ ~~ G g~t~ S ~ St"~ d-'n 1 { Lt~p S"R~ ~~ ti k k+~, o Gof 51 NT Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page 1 of 3 in accoroance witn t;omm ts5, vws. Nam. ~oae ~mY ST. CROIX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 020 - 1439 - 51 - 000 percent slope, scale or dimensions, north arrow, and logtion and di lance to nearest road. Please print all information. Revi ed by Dat Personal infortnaGon you provide may be used - ~ Z 3 ~ Property Owner Location ^ • LEE SIGNATURE OMES vt. Lot ---- 1!4 NE 1/4 25 T 29 N R 19 Property Owner's Mailing Address L t # Block # Subd. Na or CSM# 201 Packer Drive, ite G 51 -- Indigo Ponds City State Zip Code Ph ~ ity ~ Village Town Nearest Road ~®~@r~, WI ~~®~~ I~l~llla~ft~~~ `F~atll New Construction Use Residential !Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ®Public or commerclal -Describe: Parent material outwash Flood Plain elevation if applicable NA tt- General comments Conventional In-ground trenches -- 0.7 loading rate -- to be designed by Roger Nelson and recomrr~ndations: Frost encountered 3-4 ft. -trenches to be located in thne 0.7 sand below frost depth. ~ H I ~H l-~lAi~ L ~K~c~•~! ~J- ~ 1 1, esrs,,... •~..e.~' S o; l 1 Boring ~ d'~..~ed ~ ra.po~ reoc . Boring # / Pit Ground surface elev. 101.00 tt. Depth to limiting factor 130 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ P D/fY in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.' `Eff#1 •Etf#2 1 0-12 10YR2/2 -- -- -- -- cs -- -- -- 2 12-36 10YR3/3 -- -- __ -- as -- -- -- 3 ~~_~~] 10YR4/4 -- sil 2fsbk ~~ flh lvf-~ 9,~ 0.8 ~ 57-130 10~RS/4 _= ms Osg >nl __ -- 0,7 1.~ Horizon 4 has some cos & 1-5% gr. N ~r 2 10 2 Boring # U Bonng 100.00 120 Pit Ground surtace elev. ft. Depth to limfirxl factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft° in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Etf#2 1 0-10 10YR2l2 -- -- cs -- 2 10- 10YR3/3 -- -- -- -- cs -- -- -- 3 30-40 7.SYR4J4 -- sl 1 fsbk mvfr c~'~' 1 of-m 0.4 0.7 4 40-120 10YR5/4 -- ms Osg ml -- -- 0.7 1.6 Horizon 4 has some cos & 1-5% gr. ~t ,, "Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 <M 50 mg/L ' Emuent #Z = B~u < ;~ mgrs ana i ~ < su mgru CST Name (Please.. Print) re CST Number' Ma Jo Hollister Hollister's Soil Testin & Desi (~ 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 02 - 15 - 07 (715) 426 - 1775 >~- Rroperty Owner Lee Signature Homes ~Lc r 51 Parcxrl ID # 020 - 1439 - 51 - 000 Pagg of 3 Borin # U Baring g ~ pit Ground surface elev. 93.00 ft Depth to limiting factor 110 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-16 10YR2/2 -- -- -- -- cb -- -- -- 2 16-26 10YR3/3 -- - cs -- -- -- 3 26-~ ?.SYR4/4 -- is _- aw __ -- -- 4 44-110 10YR5/4 -- ms Osg ml -- -- 0.7 1.6 orizon 4 has some cos & 1-5°lo gr. ^ Boring # ~ Bonng pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Description Texturo Structuro Coneletence Boundary Roots OP D/1`P in. Munsell Qu. Sz. Cont. Caor Gr. Sz. Sh. "Eff#1 'Eff#2 ^ Boring # ~ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fl= in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 * 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. 560.8330Test (R.07/00) Plot Plan ,for Site and Soil Evaluation Property Owner ~,E~ ~imN~-tut~ +bAn~s Legal Description gym- s~ , ~~~ ~~s, ~~~~y of -~~ ~~~., ~.~. Zs ~z4~ R~g~ ,~,~a OF l~t 5T' C i20~ ~ tSCON S1 ~ `-,,, ~-`: ~~` ~ /,x~~ ~ ~~ ~ ' / 1~-~ J Q. ~`{s ~ `a ~ 9b~,..~~ ~~- ~-~~ .&,,~ i -co? ° yN~~t ` 7 ~~~ GQuua~'~ X08.00 cw0 Q~C' ~pp~D H~ ~A1D'1' "t0 sC./~LE~ Page 3 of 3 1"=:50f~ (except where noted) ~1= Backhoe pit ,, ~~ orth w ~ AV 1 '~ Sate Location: cOmr»erCe.wi.gov Safety and Building Division County 1 " ~ ~ O ' ~ « 201 W. Washington Ave .Box 7162 l /~ T f't~ n ~ ~ ~ Madison, WI 5 -716 Sanitary Permit Number (to be filled in by Co.) Department of Commerce g 9 z / Sanitary Permit Application StateTransactiogNumber /NV/n~ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate go ental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWT e ct Address (if different than mailing address) submitted to the Department of Commerce. Personal infom~ation ou provide may be used fo u oses in accordance with the Privac Law, s. 15.04(! (m), Stats. ~ n _ / :e~ ~ ~ N~ ~ /T T+'~ L A lication Information -Please Print All Information Propeny wner's Name 2~~ Parce # N ~ - d ~- '~ - l - ~ - D 0 D 's Mailing Address Prope ~ Ow e r OIXCOU ~ropert Location / _ ~ ~ / (~7 / { ~ CR ST of V Ciry, State Zip Code Phone bey m / /~ y, N~ y., Section Z / 1~ y-~ ~ / ~ (circle one C z E o~ r N; R ~ T ~ IL Type of Building (check all that apply) ~~ t Lot # _ _ i I or 2 Family Dwelling-Number of Bedrooms ~ on Nam@ _ _ _ $ubdiyis i tov~-' Block /~ ~' ® Q ~ 5 ^ Public/Commercial -Describe Use ^ City of ^ State Owne d -Describe Use CSM N er ^ Village of ~ Town of ~l'(- ~f~ /~/ f ~ 2 Ut I-tJ ZZ} 23 (~,, III. Type of Permit: (Check only one box on line A. Complet ine applicable) Z ~ ~ ~ °f - 5 ~ ~• '4' New S stem y ~~ ^ Replacement System ^ Treatment/ ng Tank Replacement Only ^ Other Modification to Existing System (explain) B. ^ Permit Renewal ^ Permit Revision ^ Change lumb ^ Permit Transfer to New List Previous Pern~it Nttmber and Date Issued Before Expiration Owner IV. T e of POWTS S stemlCom onentlDevice: Chec 1 that a l Non-Pressw~ized In-Ground ^ Pressurized In-Ground At-Grade ^ Mou > 24 in. ofsuitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersal/I'reatment Area Information: Design Flow (gpd) ~ Design Soi! Application Rate(g s Dispersal Area Required (s ~ ~ Dispersal Area Prop~os/ed (sf1 $rystem Elevation ~ ~ / Q~ ~ ~ ~~~ ~(~GC(C(t Y /i/~ Vl. Tank Info Capacity in Total # of Manufacturer ° ~ Gallons Gallons Units ~ ~ o , ~, T N T k E i k `" " ~ ~ ew an x , r ~ an s s ~1 d o ~' 2 ~ ` ` Septic or Holding Tank 7 ~ U ~`.~ 1 1 ` L f ~ Dosing Chamber e_._~" V1I. Responsibility Statement- I, the u ersigned, assume responsibility for installation of the POWTS sho on the attached plans. Plumber's Name (Print) ~~ ~ Plumber's ignature MPf umber Business Phone Number S 0 z 26 ~ ~~ Z73 ~~y~ Plumber' Addy ss (Street, City , S tat e. Zi ode) , • ' a 1 ~~ ~ IN 8 ~ W VIII. Count /De artment Use O Approved ^ ~ pprove Permit Fee °~ Date Is ued Issuing A t Signature ^ Ow en Reason for Dema LSD ' z ~~ 07 IX. Condit%Aq~~~~p~xlgy~j~easons for Disapproval 3, ~ S ~ , ~1. SettptMMic taWWnkryry, effluent fitter a-td r ~' /~ dispersal cell must all be servibes /maintained v ~ ~, - it ~..o J'SL ~ o G~..,~~ av`" i S Ma JC' as per management plan provided by plumber. 2. AO setback requirements must be maintained "° r"" 'RYTrdTh~o co5rip1eTe p1a~Ts lo~'ffie system and submit to the County only on paper not less than 8 In x I 1 inches in size SBD-6398 (R. 01/07) Valid thru Ol/09 (~z of p~,9-~/ ~~~^~ 1I~l~E ~~~~~9~ ~~ ~~ ~ ~ ". ~~~ 5~ ~o~ ~o~ ~~ z o f p~~-,~ ~~I~CL~ 1~1141e ~~ ~~ ~ z z6 X97 ~ ~~_ ~~, N ~' 5~ ~~k ~.~ ~v ` ~ ~~OSI l~ ~dl~ i~~ l- • 1273 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code Steel Soil Service County Attach osmplete site plan on paper not less than SY: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical artd horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. G ~ ,(!.~ ~ ~ -~ Please print 1 ~n ~~ be u for sewn ary _ (FTri~~Ldw 15 (1) (m)) Personal information rovide ma s ou Rev ed By Date Z ! , . y . p y Property Owner ~~~A~ ~ 3 P operty Location 2aQ~ ROSAMJf, L.L.C vt. Lot na NW 1 NE 1/4 S 25 T 29 N R 19 W Properly Owner's Mailing Address t # Block # Subd. Name o CSM# 2141 Cty Rd. C ST ~i`~l x COU'':7~Y 51 na Indigo Ponds City State Zip o e ~ City J Village N Town Nearest Road New Richmond ~ WI 54017 715-248-7071 Hudson Highlander Trail New Construction Use: t>~ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement J Public or commercial -Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments ~ ~-J and recommendations: system elevation 92.50 ft, trenches spaced and depth to code 5.00 below grade~dp~"~-~ r~. S~~O u a Boring # ..~ Boring Pit Ground Surface elev. 97.50 ft. Depth to limiting factor ~ 20 in • Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Strrcture Consistence Boundary Roots GP Dlft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/2 none sil 2msbk mfr gw 2c .5 .8 2 12-20 10yr4/4 none scl 2msbk mfr cs 1 c .4 .6 3 20-34 7.5yr4/4 none Is osg mvfr cs na .7 1.2 4 34-120 7.5yr4/6 none cos/ms osg ml na na .7 1.2 r 1, It X1 'C Boring # ~ Boring iM' Pit Ground Surface elev. 97.50 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roois GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 'Eff#2 1 0-5 10yr3/2 none sil 2msbk mfr cs 2c .5 .8 2 5-36 10yr4l4 none sicl 2msbk mfr cs 2c .4 .6 3 36-60 7.5yr4/4 none sl/cos 2msbk mfr na na .5 .9 4 60-120 7.5yr4/6 none cos osg ml na na .7 1.6 I ~ ZbU ~ ~~ COS <35% coarse fra ments = 36" & ,,i~ g >35% - <60% = 60" below system " Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L "` Effluent #2 = BODS < 30 mg/Land T55 < 30 mgii_ CST Name (Please Print) Signature: _.__ CST Number David J. Steel `~ 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/25/2003 715-246-5085 Property Owner ROSAMJI, L.L.C Parcel ID # pending Page 2 of 3 Boring # J Boring Pit Ground Surface elev. 96.40 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. CoM. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-6 10yr2/1 none sil 2msbk mfr cs 2c .5 .8 2 6-27 10yr4/4 none sicl 2msbk mfr gw 1 c .4 .6 3 27-45 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 45-120 7.5yr4/6 none ,cos osg mvfr na na .7 1.6 S r ~ / J ^ Boring # ~ Boring J Pit Ground Surface elev. fl. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 'Eff#2 ^ Boring # ~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Raots P in. Muruell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 "Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 < 150 mglL "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. ~! Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST-POWTSM ROSAMJI, L.L.C. New Richmond,WI 54017 Lic. #248956 NWl/4,NE1/4,S25,T29N,R19W Bus.(715) 246-6200 Town of Hudson, St. Croix Co. Fax.(715) 246-9372 Indigo Ponds Lot 51 This soil evaluation was conducted to satisfy a caning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend 1"=40' • = Benchmazk Ele. 100.00Ft Top of 1/2" pvc pipe • =Alt Benchmark Ele. 100.1 OFt Top of 1/2" pvc pipe ^ =Borings Boring Elevations Bi = 97.SOFt B2 = 97.SOFt R2 = O~ dflFt N :'Z~ `~e .a - - - - \, - .: -- J - 3. 071 • AC ( __ t r ~ _ ~. .-. _` __ `~ `~ ~ `-- -- -_ 1.442 AC. N.B.P.A.) j ' ~ 91811 5.~, ,` "--` °, f r 87839 S~. .~,.~ '~ ~ ~ -. y4'` ; ~ (2.i08 AC.) ., ~. _ r ,~ / (2.016 AC.) _~ -- ~~ ~ ~ • ~ j ~' ~ . -~:- ` ~ ~ ~ .. ~~(1.090 AC. N.g.P.A.} f- ~, _ ,~"(1.384 AC. N.B.P.A.), - -'- f f ~~ .~,t ~ F~ ~ ~ I ~ .~ _.___. ~ ! ~" '~ ~ . ' t~ ~ ~ ~ '315.66' .~ti s . , . o; '~`'. t i~ `~ _ .~ .. __ ^ e 0 Y / , ~~" ~_ I 5. o 157.92' ~ +5-j,X2' ~ ~ i . +~ _ ~" - ~~~ *-57 157.92' /~ ~` 3 .6 09 ac ,,- _.__ ; - -. ~t ,~ `•,, \ ~ ,J _ ~ ~ ~ 1.022 AC. N;B.P.A. ,,'. d r ~ ~ ___._ ' ~ y , -~ i X8.13'-~-~. .78 --= F ~ . = `_ -- -' ~ ; ~ - , i ~ ~~ } ~. _.96890 S.F •' _ ~ ,/ ~ ,- ' } ` ~ ~ '~ (2.220 AC.) ~ ti ' ~ `~ t , " ? ; E ~ ~-'' (1.114 AC. N.9.P.A.~..- ; '; ~t 1' ~' ~ ' _ _ ~ ~` ~~' " ~ '` `~ 1 ;~, ~ ~. _. ~ _ ~ ,,... ~ ,~ { S~ ~ • , ~ , r . ~ ~ ~: ? ~,,' ~ ~, `~ _~ 4j Z ~ 180 ~ ~ ~/ f ~' v . 7 ,, f r -- ~ .+JC { :` . 1 ~ 14i~ ~- ~~ rte,. i ~ ./ • -. _... /~/ ' INDIGO PONDS kntN n tla Nrtlpln Oulr d h SauNINI OwAe4 N Np Iprtlpul Oualr al ep SwUtan Dppr, n Ip SouUlnd Qpllr d Ne N SadhNd 0»ir, ek n qe Soulye[! Oulr d Ae SaUlnd Oirlr, d 4 Adkn 2R, law 29 NaM Augl H 1[[L eM h U[ IMhlml Dear d IM NaD.pl arb, H Ie NorAlpf DIr41 d el Naumd Darlr, e W SwUwa O,alr of ap Nrlpea Qrrk, d ~ k SaUaad Duly d Mp Na1h[all Dapr, d a SANa >S ian 8 Meal Rug[ 19 Mell, twn d Nudlrl SL tick CaNµ e¢mo[ ~~Rtl~ t~ ~~^`~ ~ um l Ague Ann Nwnl 1 fl6 NmM nle stt soar s a ~ e r.n mn Ai SP~~ 3: 3 ~; ~~ eap• nn s x falm rlm mf 1111! Sf, N.YA eN R R IIR •A }- lam~lp / ~{d'r ' ~Ln' gl. - I m atm IA um mmt teems ~@i3iY ~~" ~ '~/ g~ ~~' i u ea lm~°i. airm ws monc ml uNrt 2 ~ . -' ~ ' J / ~ IeVat sal In{NYer IllmmlR ws Inp u. , -m- Anar IRa uR ume"" pnta; ~ ., ` ~ lprr C .~'~ , ' .~ Mai _ _ L ` , ; ~ DER All" q ~ 46 omme ImnraA a uan ptA fn wut n u[i /~/ ~~(~{~ ~ 'G /~ 47 •r nm u. An r na rla a lam lacer 1~ pR ~ urlw -~- / nmU. (anacl retWrNAVaAmaAaem 0 uman s analm ~'~ // ~k ) I (an KI a wan Au 11rnn • pNw Ipx rrmna[ new / ' , -m a' I'F .I 8 I® / a ,~ J ~„~, 45 ~[ s[[r f o e I ~ I a nlts sr. ~ ~ ~ I I - --r f / , ~ a+~Kl I a ,+ / ~ --~--- .. 7 I - -------- --- ~----~---- ------ J'-- k~--- ~ + -~ flsau. ~' ~ ? 49 r _ ^~ : •' //~ twat v. + 1 ry~ e~, b' eDlla qnl (top KI r fix, . '~ / (iAl ILI ~ t IQ 1wl ~? I I 1 Mn171 W ;-nsl .. ~ ~~ SI ~ ~p i ~u. eoltwp % I I I arXptunrrt~ 3 N~ ~ ias e" Ki ` ~ am KI lama ons~iA ua°ai"a ! 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' ~' s~ 3J loam a•I ~ / ata sr ~: [o aEllp ~~ ~ S ~ ~ ~~ ej" Iceot¢I tnaa, ~ ~ re vaNa .. allpalna °14n' 32 IlEWI0I 11U' ~~a ~~~~~~ i' J4 ~{` ~ ~ u°DNCp,n°'raRr I~el ', ~ e Iz>N ~f ~; ~ ra a[n m--~ 9 ef', ~ I~ a'I{r laal' Sa [LtMiml•IN1Y 'r alb f ~ y[ ~ a t aNpp Inar 35 /nura liar ~ a" S 1' mu v. ,tW ~9 36 i[ ~ ~nl ~ ~ f ,~,. r ~, nave, aAeeAla ~*,~ ~ ..~~ ` ~ g1 as al oanta Nu !L ~ ~ ~ M Ut~0~ ~ D• ' ~i I t tatl[[ N M Iruraamlftc ',/ I.An,n llr a „owm Imes n to o eR panrnf IIf. I. AllnNr, fpX _`~ e~ ....... INx tlpl Ittrn 1 nlnp faw e[ONIAMam ./ UfE S89'25'S9'W250&35' i%!r_jrl!4ti_lnlslt~. ~'°."'""~`_".`~."-=~ ` ~ \ d/ ~' .. 1r•rw b Ilw n Mn K,4p C IMM Snn JANI~3 ~dFp~I,~NC •eenal S ~ -.. N z ~ . ..~£ 3„40 ~£.Z 4S o ~rnm ~QOxZ 1 ' Vr n m ~ ~ WmD N D~~~ ~ ~ `~~` 1 pp~ ~ N 5 Z r ~~~ ~~.~ ~ ~0 N~ ,~ Se N ~ D $ ` 2 1~ ~ ~j v O 7 ~ `° ~ J ` ' / ~~ ~ ~ 1~ ~ ~\\\ 1 1 I m -i ao <~~ ~~2 w Zm~ ~ r~ ~~ ~C~)t ~ N ~rn 00 J ~~%. I ~ ~ ~ `• .C ~ ~ ~ ~ ~$~, ~ ~ ~ • ~ ~48'8~' 4 1 _ _ _ ` \ 75' r ~ /aa ~ ~ -~I j X' S01'37'22"E 433.56' N~ O ~~ N, w N vs ~; ~ ~ `~ n N v ~ ~ ~ ~ ~ ~`~~ ~~,~ ~ ~ - ~ v~ fIj ~ \ ~~+.~ ~ ~~ _, .Z£'L51- ~.~~..,~ 9 3"Z£.04. • `- 1 / ~ RI W ~ ~ `~ `~ =~ \ 1 t 1 ~~ ~ ~ \ O \ ~• Za± ~~~~ = N L ~~ I~ rNN~~ ~ r SC I ~1 ~~ \~ ~ ~- ~'~, ~ ~ ~ \ D n ~~ 1 .OS ~££ ~££ D r I .Z _~ ~ mz „~xp ° ..~ I nor„ I o `' ~z~ ~~~ Cn N ~O g > ~ rm" ~ v~ ~ ~ '~ I N N I D~~ r ~~ Q .£~ \~+l~` a`'.\~', 1Q ~ f+1 2 N C ~ \ `\ f*1 X p NO~p w p, ~~~I T m m-i ~E v~ n y I D~ o ~ $~ >m v'1 ~m z ~z g z m ~ c i 15 -~ ~ ' ~" m x ' z5 ) O0~' _ ~ i I ~ ~ ~ N'r° ~ ' ~m ~~ n~ ... . ~'. ~ ..,~ , -. .. ___~. rrrr~rr^r ~ ..... November 25, 2003 James Rusch James R Hill, Inc 2500 W County Road 42, Suite 120 Burnsville, MN 55337 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 • Fax (715) 386-4686 RE: Shoreland Zoning District /Indigo Ponds Subdivision Dear Mr. Rusch: Certain lots of indigo Ponds may require a County Special Exception Permit for filling and grading due to their location in the Shore d Zoning District. The lots include: 36, 37, 38, 39, 40, 41, 45, 46, 47, 49, 50, 51 52 and 53. Lot 53 is currently under review for further subdividing. If the building site is located within 300' of the Ordinary High Water Mark (OHWM), has direct surface water drainage to the ponds and exceeds the grading limit that is allowed by ordinance in the Shoreland area, a Special Exception permit will be required prior to commencement of construction. Affected lots whose building site is beyond 300' from the OHWM of the ponds will not be required to obtain a Special Exception permit. Please note that on these lots an erosion control plan must be reviewed and approved by the Zoning Office before the issuance of a sanitary permit for the particular lot. It is preferred that the erosion control plan and the sanitary application be submitted to the Zoning Office at the same time to better coordinate our review. if you have questions or concerns, please feel free to contact this office. Si rely, ~~ C~~ ~s~r Rod Eslinger Zoning Specialist RE/jh CC: Town of Hudson, Brian Wert file ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer IJd~ 4-- ~i PAN 1~ 1 n~bEai!..~e~B~.~ Mailing Address P . ~+ . 6ax y308 ~ Pnv~ . /1/! N . 5~ /o~/ Property Address (Verification required from Planning & Zoning Department for new construction.) City/State ~vosc~vl (,(~' Parcel Identification Number ~T SI LEGAL DESCRIPTION Property Location lU iA~'/4 , /U ~ 1/4 ,Sec. ~, T ~N R~W, Town of ~u ~ SO ~ Subdivision ~ ~ ~ j g ~ ~ d ~ ~ ~ _ _ ,Lot # S~ . Certified Survey Map # Volume ,Page # Warranty Deed # ,Volume ,Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What, you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §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. Uwe, 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 the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe arn/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms / ,~° SIG AT OF ICANT(S) z i~3 ia7 DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number Document Name THIS DEED, made between American Classic Homes, LLC, a Minnesota Limited Liability Company ("Grantor," whether one or more), and Robert D. Ringgenberg and Karen L. Ringgenberg, husband and wife ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Lot 51, Plat of Indigo Ponds in the Town of Hudson, St. Croix County, Wisconsin ~4-44t~7 KATHLEEN H. WALSH REGISTER OF DEEDS ST. GROIX CD. , tFI RECEIVED FOR RECORD 0~/13I2007 10:30A![ WARRANTY DEED El(EI~F'T # REC FEE : 11.0Q1 TRANS FEE: 516.1?! GOPY FEE: GC FEE: PAGES: 1 Recording Area Name and Return Address River Valley Abstract & Title, Inc. 1200 Hosford Street, Suite 201 Hudson, WI 54016 File #: 2693057 020-1439-51-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions and rights-of--way of record, if any. Dated February 9, 2007 AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE B~ WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix COUNTY ) Personally came before me on February 9, 2007 , the above-named Donald F. Nelsons MPmhPr t e known to be rson(s) who executed the foregoing i s nt d ac wle g d the s Attorney Doug Berg N Pub c, S to of Wisconsin ~~ 1200 Hosford Street, Suite 201 Hudson, WI 54016 My Commission (is permanent) (expires: - .'~ ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ©2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. Member (SEAL) (SEAL) RiN ~ ~ ,~ Can/-1-dµ 2 .~-. (~. cvN t ~ Quick4 Standard Chamber 1,5 MultiPort End Cap FRONT VIEW n.` V~4,1~.` .(~i~,~er ~~~ .~~~ ~s r,~,~~~~-~~~.- uick4~ .~~ STANDARD CHAMBER SIDE VIEW ,~~Nc ~ 2 INFILTRATOR SYSTEMS ING STANDARD LIMITED WARRANTY (a) The siructur~ integrity of each rdterrtbec end Plate. wedge and other accessory manufactured by Infinator ('UrrtsO, when Installed end operated h e leachfield of an onsite septic system h accordance wkh Infinretor's hafnx;tkxts, is warranted to the odghal purchaser Pflelr>e'"1 against defective materials end wwlunanship for one year from the data that the septic permit is Issued for the septic system contaYtytg the Unns; Provided. tawever, that If a septic permit is rat regtered by applicable law, the warrartty period wifi begin upon the date tllal hslalletion of fhe septic system commences. To exercise ns warrant' rights, Bolder must ratly Infitator in wrkhg at Its Corporate Headquarters h 171d Saybrook, Comectictlt within fifteen (15) days of the a9eged defect. Infiltrator wB soppy replacement Unns for Units detertn4ted by hflflretor to be covered by this Limned Warranty. Infinrator5 labiGy spedflcaly axcWdes the cost of renavel and/or nnstallaton of the Units. (b) THE LIMITED WARRPMY AND REMF~IE3 IN SUBPARAGRAPH (at) ARE IXCLU^u1VE. THERE ARE NO OTHER WARRAfiT1FS WfTH RESPECT TO THE UNRS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANfABILfTY OR FITNESS FOR A PARTICULAR PURPOSE. (cl This Limited Warranty shall be vnid tt arty part of the chamber system is rrtarwfactured by anyone other than Infittretor. The Lhnited Warmnry does not extend to inck7erttel, cortsecNranllal, spacial or indirect damages, Infiltrator shall not De liable far penanlea a Iiquldated damages, htckldlrg bss of productlon and profits, labor and materials. overhead costs, or other bases or expenses hrxrred by the Holder or any tldrd party SpedfaalN ezcWed from Limited Warrenry coverage are derrtege to the Unns due to ortlinary wear and tear. alteration. eccklent, misuse. abuse or neglect of the Units; itte Unks being sub(ected to trelticle tre(fa or other cortditiorta wftldt are not pemtided by the Installation hstructbns; IeArue to maintain the mktirnum grolxa covers set forth h the ktstattatbn klstructfana; the placement of Ynproper materials hto the system oontahkg the Units: falure of the Untts or the septb system due to knpmper stthg or Improper sbYg, excessive water usage, Impoper grease disposal, or Ynproper op~atbn; or arty outer event rat caused b`/ hflttretor. This Lhdted Warrant' shall be void tt the Holder fails to compy with all of the terms set forth h this United Warrant'. Further, h no event shell Infilta[or be responsible for arty kiss or damage to the Honer. the Urdu, or arty ihW party rasWtlng from hstallation or ship- ment, or from any proAat IiebilNy dekne of Holder or arty third party For this Lirtaetl Wananry to appy, the Unks must be ktstaYed h ecwrdance with NI alts coraitkxts requked by state end keel cotles; eN outer ePPficeble laws: entl Inflnrelork ktstepatiort InsWCikxts. (d) No rePresentaWe of Infiltrate has the euntodtY to dtertge a extend tltb Lknned Warranty. No warranty applies to arty perry other then the origi- nal fielder. The above represents the SterWertl Urtdted Warrartry offered by Infiltrator. A pmited number of states arW countles have dnferent wamanry require- ments. Arty purchaser of Units ahotdd contact hRtralor's Corporate Heedgtlarters h Old Saytxook, Connecticut, prior to such purchase, to obtah e copy of the applicable warrant', and slaukt carefuly read that warant' prior to the purchase d Untta. TOP VIEW ~ . • ~ SYSTEMS I NC 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 r U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,718,183; 5,586,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer and SldeWinder ere registered trademarks of Infiltrator Systems Inc. Inflnrator is a registered trademark in Frertce. Inflltretor Systems Inc. is a registered trademark kl Mexico. Contour, Contour Swivel Connection, Microt_eaching, PoyTuff, SrtapLock, ChamberSpacer, PosiLock, QuickCut, OuickPlay RECrccEnvavER and Quick4 are trademarks of Infiltrator Systems Inc. ®2003 Infiltrator Systems Inc. Printed In U.S.A. 0011203HP-0 SECTION VIEW ~~ ~ ~ ~ ~ _ ~-_~ ~ ~ ~ ~ P' ~ ~~ ~ ~ ~~ i I'' ~ '~ ~ I I I r~ ~i ehelving - i~1 FOYER 11' GEIUNG L i r o' ~ 3'-On ~ 4 ail ~~ m ~ ' ' l-NDRY. j _ __-------- ~ ~° I f ~ 9' GEIL,NG i cv ~ i e i e e 8,-O i ---- gold dawn ' ~ ~ Iron board I _ - -- -Y'-8° °- ~ ' ~ i ~~ - a ~. ~~ ~ n Q + ' ('v ~ ~ Q I n ~ ~ IY ~. 3'-0" c sad o~eni~g 4 2' _ -- ~ Q O ~ MUD RI"1. 9' CEILING fl ~qa OFFICE a 13'-611 x 12'-O° ~ ~ II' CEILING /~//7 9 -o T 1420^3 P I. 2468-3 II' GEIUNG 7g 1= I I. I flt lllse - - 10'-O° i4 IB/O x 8/O i. 3'-61I ~ n , u 3'-Illi•' 4-8 -4~4 1'-3'• I~`-6" I~ I I ~I i I ~ ~ I ' ___--___ - , ' ~ i ' ~ i I ' ~~ ~ ~ ~ ~ ' _ I_ _-- m ~ ~, I KITGNEN ~~ ~' I u~ 9' CEILING ~ ~ =1 I I ~i I I I I - - - I ~ I 1 -___- 1 ,F'4 ANTRY 'T'-3" 3~•6'I 3'-6.. 'I'-O" ~~ r FILE INFORMATION Owner ~ 2i ~ ~~ Permit # DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ,.._ ^ NA Estimated flow (average) al/da Design flow (peakl, (Estimated x 1.5) Q ~ al/da Soil Application Rate al/day/ft2 Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODb) 5220 mglL ^ NA Total Suspended Solids (TSS) <_150 mglL Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODb) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) 510° cfu/100m1 Maximum Effluent Particle Size Ya in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE POWTS OWNER'S MANUAL & MANAGEMENT PLAN SYSTEM SPECIFICATIONS Page ~ of Septic Tank Capacity 2 ~-d al ^ NA Septic Tank Manufacturer ~.t' ~ (~~ ^ NA Effluent Filter Manufacturer 'Z, L ^ NA Effluent Filter Model ~ rj ^ NA Pump Tank Capacity al ^ NA Pump Tank Manufacturer `- ^ NA Pump Manufacturer .._- ^ NA Pump Model ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cell(s) I~In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: ~ ^ month(s) (Maximum 3 years) ® earls) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third IY3) of tank volume ^ NA Ins ect dis ersal cellls) p p At Least once eve ry~ ~ ^ month(s) (Maximum 3 ears) m year(s) y ^ NA Clean effluent filter At least once every: ^ month{sl 0 year(s) ^ NA Inspect pump, pump controls & alarm At least once every: - ^ month(s) ^ year(s) ^ NA Flush laterals and pressure test At least once every: ~ ^ month(s) ^ year(s) ^ NA Other: At least once every: ^ month(s) ^ year(s) ^ 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 cell(s1 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 IY,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components,.pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4101) ,,,~, Page ~ of START ttiP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process andlor 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 celllsl in one large dose, overloading the cellls) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails andlor 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. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name Q ~ /U~~--~~ D .n..~ Phone ! . ~~ POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPERI LOCAL REGULATORY AUTHORITY Name Phone Name ,~~ ~ ~ ~ ~/ ~~.,J Phone ~f~ 3 ~6 ~~ Q This document was drafted in compliance with chapter Comm 83.22(2)Ib11111d1&If- and 83.54(1), 12- & 13), Wisconsin Administrative Code. 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