HomeMy WebLinkAbout018-2009-45-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 582011
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2603090
Permit Holder's Name: City Village Township Parcel Tax No:
Felecity Homes LLC TOWN OF HAMMOND 018-2009-45-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
Cl 9 g ^ s 04.29.17.1029
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER + CAPACITY STATION BS HI FS ELEV.
Septic Z 1ZC G. Benchmark 77.
~b
t ~ F: t ~ 5 J
Dosing r I 7 `U Alt. BM
" 7
ow.,~o _ F; lJ.~... Gay v
Aeration Bldg. Sewer
a alz ~vZ S -7-47 y3 , ~
Holding St/Ht Inlet VQ, 9 92
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. a to Air Intake ROAD Dt Inlet
Septic - J`-b / 14 Z~ Dt Bottom !5• • b
7
Dosing 7 SQ ( 110- ZV 6 ( Header/Man. Z,45 /JI0
Aeration Dist. Pipe 1-45 1p6. '7
Holding Bot. System
/ . 4I 7 13.1 Afta
PUMP/SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover
J /t t 1
GPM }ry, 5 • S 97-1
Model Number 3: , 13
z S9
~ ~ b5 Car AMCX Ma 7
TDH Li Friction Los$ System Head TDH
2•$ '/[.C (,•.5 2a• 63.3 3.13 AD .["l
Forcemain Length Dii . 1 ( Dist. to Well
SOIL ABSORPTION SYSTEM N .
BED/TRENCH Width ( Length / No. OfJ~enc s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 4
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: \
INFORMATION CHAMBER OR
Type O stem: I / UNIT
13 7z N Av Model Number:
0J ~
DISTRIBUTION SYSTEM WeS~'-°
Header/Manifpld 01Tstnbtion Z ` Ix Hole Size x Hole Spacing L le o Air Intake
Pipe(s)
Length Dia Lengt Length `1 0 - -7 Dia i J Spacing 3 :Z. 3 J
3
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded .J,rw xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil 1 No Yes No
• v~`JJ
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ///'r/Z Inspection #2:
Location: 1783 117TH AVE
I r'• I Gast-~~ C..fn •'~G. 1 /0...~
1.) Alt BM Description = P!C Q
2.) Bldg sewer length = 24
- amount of cover = 7 Z f 6 v4-
Plan revision Required? ❑ Yes XNo ~G 1 S I (6 3
Use other side for additional information.
ignature Cert. No.
SBD-6710 (R.3/97) Date Insepctor'1
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_ a County
otiF E,, Industry Services Divisi
ary umber to be filled in by Co.)
GAT ~F ' ' an
h i d; r~ r 4 1400 E Washington A Permit N
$Lt'
Q P.O. Box 7162 z~ ` f
GRGIX COUNTY Madison, WI 53707-7 l
UNITY OUNTY
yyGA
~eta'ssto rn~Sw State Transaction Number
Sanitary Permit Application -Z (V ~CY D
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
Project Address (if different than mailing address)
this a De Pl artment of Safetyland Professional Servic s. Persolnaltinfofrmatim y uaprov de may be used for secondary
4- vt,
I ~3 I I ~7 1\
purposes in accordance with the Privacy Law, s. 15.04(1)(m)> Stats.
I. A lication Information -Please Print All Information Parcel #
Property Owner's Name G Q O
l - om,t
Property
Property Owner's Mailin Address Location Q aq. 17
Kd a Govt Lot J
~ ~ ®tt ~v S £t/,, ~ f'/<, Section /
Zip Code hone umber (circle on;)
City, State I t y p% ' I T Z~ N R/ 7 E or W
Subdivision Name
II. Type of Building (check all that apply) ot #
[~-1 or 2 Family Dwelling-Number of Bedrooms •~~s', cL C
C Block #
❑ Public/Commercial -Describe Use ❑ City of
V ❑ Village of f\
❑ State Owned -Describe Use CSM Number Town of ~ v
X ~N ^ O✓y^✓YMdN
in. e it: eck only one box on line A. Complete line B if applicable) New Syste
Modification to Existing System (explain)
❑ Replacement System F1 Treatment/Holding Tank Replacement Only Other ❑
B Change of ❑ Permit Transfer to New List Previous Permit Numb d Date Is ed :,I IT
. F1 Permit Renewal El Permit Revision plumber tr Owner
Before Expiration
IV. Type of POWTS System/Component/Device: (Check all that a ly) 24 in.. ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade
Device (explain) le it Mound < 24 in. of suitable soil
❑ Pretreatment Mound
❑ Holding Tank F1 Other Dispersal Component (explain) Q
s
V. Dis ersal/Treat ent Area Information: e levation
Design Soil Application Dispersal Area Required (sf) Dispersal Area Pr osed (sf)
Design Flow(gPd)
- Rate(gpdsf)- (f - - - -
~
VI. Tank Info Capaci in
v " Y
Gal ns Total # of Manufacturer °
o Y a
Gallons Units ~_c)- - in N_ - ;71-c7- F.
New Tanks Existing Tanks 4, ' f! f /M t
D S w.w ® ❑ ❑ ❑ ❑
ept~ olding Tank 750 El ❑ 11 El ❑
ing Cham e
VII, esponsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached
plans.usiness Phone Number Number u tier's Name (Pri ) Plumber's Signature
-Y9/-
Z ~l Jr 01e kE Aµ'KS' LL071-
PI mber s Address (Street, City, State, Zip Code)
f , 6 . 02 /,(AG,k \4 S If 3
VI . County/Dertment Use Onl
ved Permit Fee 1 Date Issued Iss 'ng Agent Signature
Approved $ f7 ~ /U
plcrvenReas enial SYSTE O ER:
IX Conditions of Approval/Reasons for Disapproval U4 „""'Septic tank, effluent filter and
p- ~V O~p ~ 2 U~ Q(tv id2 Y,~ dispersal cell must be serviced / maintai ed
an provided by pl mber.
Kl/P fe, i/P~ Ia~ use per management pl _
u
l1 r S_}, iL, 0 2 All setback requirements must be maint ined
plica
S~U_ ~dLal'l°l.d /4 lL /as Per applica
I Attach to complete plans for the system pnd submit to the County only on paper not less th n 8 1/2 911 inches in size
• ' ~ ~ itiecl ~p~ ~ e~60~. ~b~,~
6TH ~ Thl S ~ ov~~ S S
N
cun-A'1Q5Z (R03/14_~
i
ptirTE~j DIVISION OF INDUSTRY SERVICES
10541N RANCH ROAD
9
1P HAYWARD WI 54843
3D S Contact Through Relay - -
P S
http://dsps.wi.gov/programs/industry-services
www.wisconsin.gov
'9 Lp,
SSfOI N
Scott Walker, Governor
Dave Ross, Secretary
September 14, 2015
CUST ID No. 222872 ATTN.• POWTS Inspector
JACQUE M HAWKINS ZONING OFFICE
HAWKINS SOIL TESTING & SEPTIC SYSTEMS ST CROIX COUNTY SPIA
PO BOX 2 1101 CARMICHAEL RD
LUCK WI 54853 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 09/14/2017 Identification Numbers
Transaction ID No. 2603090
SITE: Site ID No. 816990
Felecity Homes LLC Please refer to both identification numbers,
Co Rd T above, in all correspondence with the agency.
Town of Hammond
St Croix County
SE1/4, NE1/4, S29, T29N, R17W
Lot: 45, Subdivision: Hillside Heights Sub
FOR:
Object Type: POWTS Component Manual Regulated Object ID No.: 1554902
Maintenance required; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s):
Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual -
Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above.
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
~ r
JACQUE M HAWKINS Page 2 9/14/2015
Sincerely, Fee Required S 250.00
jw~%~ This Amount Will Be Invoiced.
When You Receive That Invoice,
Carl J Lippert Please Include a Copy With Your
Wastewater Specialist, Division of Industry Services Payment Submittal.
(715)634-5035 , M-f 7AM - 12PM WISMART code: 7633
carl.lippert@wisconsin.gov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
1
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Felecity Homes LLC Mound Sanitary System
Owner's Name: Felecity Homes LLC
Owner's Address: 1403 County Rd. GG
New Richmond WI 54017
Legal Description: Parcel in the SE1/4-NE1/4 Sec. 29 T29N-R17W
Township: Hammond
County: St. Croix
Subdivision Name: Hillside Heights
Lot Number: 45 Block Number: Na
Parcel I.D. Number: 018-2009-45-000
CONDITIONALLY
Plan Transaction No.: APPROVED
DEPT OF SAFETY A1,110,
Page 1 Index and title PROFESSIONAL SERVICES
Page 2 Data entry Page 3 Mound drawings DIVISION OF INDUSTRY SERVICES
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency pla
Page 7 Pump curve and specifications SEE C ~PONDENCE
Page 8 Site Plan
Designer: Jacque Hawkins License Number. MPRS#222872
Date: /23/15 , Phone Number: [9j_ 9A
Signature: pik,. to
r
UZWO
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)
Version 7.0 (R. 03/2012) Page 1 of 8
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a
400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for
1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches.
600.00 Design Flow (gpd)
3.00 Site Slope
98.90 Contour Line Elevation (ft)
22.00 Depth to Limiting Factor (in)
0.40 In-situ Soil Application Rate (gpd/ft2)
Distribution Cell Information
100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft2)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(C or E) E Center or End Manifold
3.00 Lateral Spacing (ft) If N above, enter the elevation ft
2 Number of Laterals of the highest point.
0.125 Orifice Diameter (in)
2.33 Estimated Orifice Spacing (ft) = 6.98 ft2/orifice
2.00 Forcemain Diameter (in)
93.00 Forcemain Length (ft) Does the forcemain drain back? C YY
90.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 15.17 Forcemain Drainback (gal)
9.57 Vertical Lift (ft) 90.56 5x Void Volume (gal)
2.45 Friction Loss (ft) 105.73 Minimum Dose Volume (gal)
I / 0.00 In-line Filter Loss (ft) 35.43 System Demand (gpm)
18.52 Total Dynamic Head (ft)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x
1.00 1.50 x x
1.25 2.00
1.50 x x 3.00
2.00 x
3.00 x
Gallons/inch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
Skaw Precast Manufacturer gal/in (enter result in cell B49)
Dose Tank Information luent Filter Information
754.35 Dose Tank Capacity (gal)j Filter Manufacturer
16.05 Dose Tank Volume (gal/in) Filter Model Number
Skaw Precast Manufacturer
Project: Felecity Homes LLC Mound Sanitary System Page 2 of 8
Mound Plan and Cross Section Views
T
F . . J
1/10 B Observation Pipe
A
W :.1.°.. ::.........:..:.:...........B. .a:::::::::
.
L
Mound Component Dimensions
Down slope toe extension made.
A 6.00 ft E 6.16 in H Mft ft K 9.15ft
B 100.00 ft F ;50 in ft L 118.29 ft
D 14.00 in G 0.50 ft J W 21.77 ft
600.00( ft2) Dispersal Cell Area 1500.00 (fe) Basal Area Available
6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 101.86 (ft)
G ♦ H
F Dispersal Cell 100.57 (ft) Lateral
100.07 ) - Invert
Dispersa ell
Elevation E.::::: = D
,
98.90 (ft) Contour Elevation
3.0 % Site Slope
Geotextile Fabric Cover
Shading Key m a I Dispersal Cell See lateral details on
0 ® Topsoil Cap c = 1.5 ft Page 4 for number, size,
Subsoil Cap m o and spacing of laterals.
ASTM C33 Sand 4 ° Laterals are equally
Tilled Layer 0.5 ft Typical Lateral F spaced from the
0 ~ an distribution cell's
Aggregate o centerline in the
A distribution cell (AxB).
Project: Felecity Homes LLC Mound Sanitary System Page 3 of 8
i
End Connection Lateral Layout Diagram
Laxerals centered over the A & B diwmmsion • - Turn-up rrrt»il valve or alosnout plug
P
AN sterols art Wwdvttal I+• X - I Holes dr4e4 on the bottom of the lateral s
equally spaced
Force main connwion ma top of cross to man"d at oW pow,
Laterals &forcemain Sch 40 PVC per SPS Table 384.30-6
Number of Laterals 2 Orifice Diameter 0 in
Lateral Diameter 1.50 in Orifice Spacing (X) 2.35 ft)
Lateral Length (P) 98.70 ft Orifices per Lateral
Lateral Spacing (S) 3.00 ft Orifice Density 6.98 fe/orifice
Lateral Flow Rate 17.71 gpm Manifold Length 3.00 ft
System Flow Rate 35.43 gpm Manifold Diameter 1.50 in
Total Dynamic Head 18.52 ft Forcemain Velocity 3.62 ft/sec
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 anA-0'
SPS 316.300 WAC 4 in. min.
Disconnect
Tank component is properly vented E- Alternate outlet
location
Forcemain diameter
Skaw Precast Manufacturer 2 in.
Capacityl 754.35 Gallons
Volume 16.05 gal/inch A
Weep hole or anti-
Dimension Inches Gallons B siphon device
A 26.41 423.92
B 2.00 32.10 C Pump off elevation (ft)
C 6.59 105.73 -t 91.00
D 12.00 192.60 D
Total 47.00 754.351 11 use tank elevation (ft)
3" Bedding un er tank. 90.00
Alarm Manuafacturer SJE. Rhombus Note: Switches
Alarm Model Number Tank Alert 1 containing mercury
may not be used in
Pump Manufacturer Goulds this system.
Pump Model Number EP05
Pump Must Deliver 35.43 gpm at 18.52 ft TDH
Project: Felecity Homes LLC Mound Sanitary System Page 4 of 8
Mound System Maintenance and Operation Specifications
Service Provider's Name Powers Sanitation Phone 715-246-5738
POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680
System Flow and Load Parameters
Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 if Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once eve 3 ears
Effluent Filter Should inspect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested eve 1.5 ears
Mound Inspect for ondin and seepage once eve 3 ears
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn-up Detail
Finished • . • .
Grade ~>I
.........7.\Threaded .
III 6-8" Diameter Lawn Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Felecity Homes LLC Mound Sanitary System Page 5 of 8
Mound System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N.
01/01)] and local or state rules pertaining to system maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet finer shall be
assessed at least once every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the
filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products
are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/- TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test
when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any
levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal
media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Pretreatment Units
The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection
units are attached as separate documents and are considered part of the overall management plan for this system.
Project: Page 6 of 8
Page 7 of 8
HGOULDS PUMPS Submersible
Effluent Pump
EP04
EP05
3871
IrL41-4110-F
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
grade turbine oil for tic enclosed design for heavy duty ball bearing
Specifically designed for the lubrication and efficient improved performance. construction.
following uses: heat transfer. ■ Casing and Base: Rugged
• Effluent systems thermoplastic design provides AGENCY LISTING
• Homes Available for automatic and superior strength and corrosion
• Farms manual operation. Auto- resistance. Canadian Standards Asmaation
• Heavy duty sump matic models include
• Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end
• Dewatering assembled and preset at the for efficient heat transfer, in "C" or 7".)
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover: Thermoplastic Goulds Pimps is ISO 900' Regisoered.
FEATURES cover with integral handle and
• Solids handling capability: float switch attachment points.
IC" maximum. ■ EP04 Impeller: Thermoplas- N Power Cable: Severe duty
• Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant.
• Total heads: up to 31 feet. pump out vanes for mechanical
• Discharge size: V12" NPT. seal protection.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104"F (40cC) continuous
1401F (6010) intermittent. METERS FEET
• Fasteners: 300 series 10-
stainless steel. s 30---
• Capable of running 5 GPM
dry without damage to $ 251
components. 25
0 7
Motor: W
x
• EP04 Single phase: 0.4 HP, Lj 6 2`
115 or 230 V, 60 Hz, 1550
RPM, built in overload with o 5 ► f
automatic reset.
• EP05 Single phase: 0.5 HP, 0 4 EPOS
115 V or 230V, 60 Hz, 1550 3 10
RPM, built in overload with
automatic reset. 2 EP04
• Power cord: 10 foot s
standard length, 16/3 1
S1TOW with three prong
grounding plug. Optional 20 ° °0 10 zo 30 40 50 GPM
foot length, 16/3 SJTW with
three prong grounding plug ° z a 6 $ t o 1 z m3
(standard on EP05). /h
CAPACITY
J oulds Pumps
Ef 2001 Goulds Pumps ITT Industries
Effective May, 2001
83871
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer t/cd, /4,Mtr 4IL
Mailing Address / Ye 3 G~ o~•~- t RC,/ - 1AVEw/ 'cLt.y► ~n cr k., 5 yQ/?
Property Address 7 -7
(Verification required from Planning & Zoning Department for new construction.)
City/State !`Y~ ,ten#r~~ ' Parcel Identification Number O/6 -L vo 9D p O
LEGAL DESCRIPTION ,r
Property Location C- Sec. T 2.9 N R / 7 W, Town of Oh-
Subdivision Plat: 1~~! 5~ ~1 r 4 g h I'S , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # W before 2007 Volume Page
#
Spec house yes xno Lot lines identifiable 9yes . 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 the three year expiration date.
I/we certify that all statements on this form are true to the best of my/our knowledge. I/we aim/are the owner(s) of the
property described above, by virtue of a warrant eed recorded in Register of Deeds Office.
Number of bedrooms
SIGNATU F APPLICA 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.
(REN'. 08/05)
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1509
SOIL EVALUATION REPORT
Wisconsin Department of Commerce Page 1 of 3
Division of Safety anc`f Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service, Inc.
Attach pI*,sil0 ptadloo,paper'-riot less tha 8%x 11 inches in size. Plan must County St. Croix
induct , but not ~jcali~rLd horizon I reference point (BM), direction and
perceand location and distance to nearest road. Parcel I.D. ~jr
Please print all information. Reviewed.By Date
Personal information you provide may be used for secondary purposes (Privacy Lair, s. 15.04 (1) (m)).
Property Owner Property Location
Cutting Edge Four, LLC Govt. Lot n/a SE 1/4 NE 1/4 S 4 T 29 N R 17 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
E976 170 TH Street 45 n/a Hillside Heights
City State Zip Code Phone Number I City J Village 0 Town Nearest Road
Hammond WI 54015 715-796-2793 Hammond Cty Rd T
New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
J Replacement _J Public or commercial - Describe:n/a
Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable n/a
General comments
and recommendations: Mound design, system elevation 100.07 ft, based on contour line elevation 98.90 ft.
Boring # ..J Boring
/m Pit Ground Surface elev. 99.00 ft. Depth to limiting factor 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 0-12 10yr311 none sil 2msbk mfr CS 1f .6 .8
2 12-18 10yr4/4 none sicl 2msbk mfr cs n/a .4 .6
3 18-30 10yr4/4 none scl 2msbk mfr gw n/a 4 .6
I
4 30-60 10yr4/6 c2d7.5yr5/6 scl/sicl om mfi n/a n/a .0 .0
Boring # Boring
Pit Ground Surface elev. 99.00 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 0-9 10yr3/1 none sil 2msbk mfr CS 1f .6 .8
2 9-2 10yr4/4 none sicl 2msbk gw n/a .4 .6
3 2-60 10yr4/6 c2d7.5yr5/6 scl om mfr n/a n/a .0 .0
* Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature:: CST Number
David J. Steel 248956
Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number
994 200th St., Baldwin, WI 54002 9/7/2004 715-684-5680
Property Owner Cutting Edge Four, LLC Parcel ID # Pending Page 2 of 3
F Boring # vi Boring
Pit Ground Surface elev. 97.90 ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-11 10yr3/1 none sil 2msbk mfr cs 1f .6 .8
2 11-19 10yr4/4 none sicl 2msbk mfr gw n/a .4 .6
3 19-28 10yr4/4 none scl 2msbk mfr gw n/a .4 .6
4 28-50 10yr4/6 c2d7.5yr5/6 scl om mfi n/a n/a .0 .0
❑ 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 GPDr
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
❑ 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 PD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 5> 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.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 994 200' St.
CST-POWTSM Cutting Edge Four, LLC Baldwin, W154002
Lic. #248956 SE1/4,NE1/4,S4,T29N,R17W Bus.(715) 684-5680
Town of Hammond, St. Croix Co. Fax.(715) 684-3449
Hillside Heights, Lot 45
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use.
Legend
1" = 40'
♦ =Benchmark Ele. 100.00Ft
Top of 3/4" pvc pipe
3~ = Alt Benchmark Ele. 99.75Ft
ay Top of 3/4" pvc pipe
❑ = Borings
Boring Elevations
B 1 = 99.OOFt
B2 = 99.OOFt
B3 = 97.90Ft
B4 = OO.OOFt
~o
51 73:
a
97, 3 ~f
7-OY
I N.S. 1.83 Ac. /
001
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\ \ \ N N B. 69-494, S.E.-
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\ j '394
\ 1013 S. F.
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\ 7-
\ N.B. k343 S.F./' /
co N.B. 2.12 Ac. 101 89 S.
OP - - ~2! 33 Ac
\ p~ \ / LBO = 10
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C ER -C~ THE LBO~1'094.0
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