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HomeMy WebLinkAbout026-1306-00-022 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 584702 GENERAL INFORMATION State Plan ID No: A / Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'V Permit Holder's Name: City Village Township Parcel Tax No: Todd Marek 7 TOWN OF RICHMOND 026-1306-00-022 CST BM Elev: Insp. BM Elev: BM Description: 6-F ^ II - Section/Town/Range/Map No: I 18.30.18.1629 TANK INFORMATION ELEV TI N DATA HI FS ELEV. TYPE MANUFACTURER 'A CAPACITY STATION BS 105b Septic ~j6 Benchmark ~ .'l V ' C1 T6_ 5 Alt. BM ~O AerBTion Bldg. Sewer Q`17. HotdtfSg OOS t/ Inlet 7 ~ S Ht Outlet 7 7 . TANK SETBACK INFORMATION TANK TO ~P/L~ WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom 10, fe.7deMain. Q, pl Dos' !!tion Dist. Pipe 9 / Q1O, I Holding Bot. System / gJ . Q / PUMP/SIPHON INFORMATION Final Grade • Z Manufacturer Demand St Cover n I~ GPM I V Model umber TDH Lift Friction Loss System Head TDH Ft Forcem Len Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width ~'J Length No. Of Trenches ^ PIT DIMENSIONS No. Of its Inside Dia. Liquid Depth DIMENSIONS f✓~ qD'I L SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Ty e Of System: UNIT Model Nu r ~ UTION SYSTEM H r/Mold ~f Distribution =Hole Size x Hole Spacing Vent to Air Intake 0 Pipe(s) Length Dia Length Dia Spacing J SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Depth Over xx Depth of xx Seeded/Sodded 1xx Mulched Be nc Center i Bed/Trench Edges I 11 Topsoil Yes E] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Wit! no;- 1 A%- d @ '1 fm~ al%-, *OS t/SA1 0MA WAS Location: 1523 95TH H ST ST ~1 ~t /~~~1 ~ 11 1.) Alt BM Description = V- IML Ctivw_ 40WA 4f / alkhaf F/~ 2.) Bldg sewer length ~ / l~ M J • - amount of cover dt/ a ~ aE'a`r' * o, -7 qZ Pf C ove ✓ o n Ott. Plan revision Required? ❑ Yes ~LNo n 7 Use other side for additional information. Date ISignature Cert. No. SBD-6710 (R.3/97) County RECEIVE Safety and Building vision ~ ~ ~G ~ x p $ , 201 W. Washington Ave., B 7162 Sanitary Permit Number (to be filled in by Co.) p Madison, WI 5370 - 76 O n s1At2 8 0 CJ$ O'Slos tip' CROIX 00, INn(I '14% comuNgt WPFWff Application State Transaction Number in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m , Stars. 9v 1. Application Information - Please Print All In ion Property Owner's Name 11 Parcel # tic Property Owner's Mailing Address Property Location V l -Z Govt. Lot City, State Zip Code Phone Number /4, Section - circle one ZZ/A0 C ff~,')" C:.^v`c~) Ci.'' T .-5 71. - l~ ~ ~ ~ ~ v6. T N_ R ~f) ( E o 11. Type of Building (check all that apply) Lot # or 2 Family Dwelling - Number of Bedrooms Z _Z_ Subdivision Name Block # t JS F1~Ct t tE'IC~c ❑ Public/Commercial - Describe Use _ p['01- ❑ City of CSM Number El Village of ❑ State Owned -Describe Use NT'own of ,C'¢ / 2 A;st- (,_.4J2/+-2-Z. 111. Type of Permit: (Check o ly one boa on line A. Complete line B if applicable) A. Q--New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that a 1 G Non-Pressurved In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat nt Area Information: Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Propo d (sf) System Elevatio L'~ 4VIT~1,nk Info Capacity in Total # of Manufacturer Gallons Gallons Units L °o 2 New Tanks Existing Tanks o .2 E y a ro a a U v v w C7 a W VGV /Z) Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/ANumber Business Phone Number 73 Plumber's ddress (Street, City, State, Zip Code) _)'Ilk. County epartment Use Only Approved ± El Disa r Permit Fee Date Issued Issuing nt Signatu e $ 41 S6 • a° 3 L9 I Owner Gi eason for Denial L\. ConditkReasons for Disapproval 1 Septir tank, effluent ftte, and JC+P.JPJrO tlisperts,i cell must all be seivices! maintairec' CX_ as per management plan provided by plumber. 2. AN slttspk re,{uiftr>,nts must be nairrtziriiad of pe applib code / crdinanoei. a County only on paper not less^tb(an~j8`rrz x 11 inches in size r J Attach to complete plans for the system and submit tpi SBD-6398 (R- 11/11) Lc P/~ i l SP 1 f, f Ddb .s co i otaw 4- AlkD E /ti p f^ i P~ CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Owner's Name: G~ p p fsJ,~J- C=am Owner's Address: Lr i~~% 0~ (C Ff~► a uE t% 5~/~" /7 Legal Description: f?- s c - 7 3 c_: Township: i~ %C hf 2t~ p County: 5 7- L'G c' ix Subdivision Name: Lot Number: G Parcel ID Number: Page 1 Index and title F' fd sEt~ -~q~i~ Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: /l,/ License Number: Date: 3- Z'--j Phone Number Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 L~- ~ ~ ~l x PAP i Cl. ~F/c ~ 12s~; S.f - t' or 2- Family Dwelling In-ground Soil Absorption System (2-cell Conventional) Daily Wastewater Flow (DWF) _ # of bedrooms x 150 gal/day/bedroom = C ~a gal/day 03 Design Loading Rate (DLR) or Soil Application Rate = g; gpd/ftZ (per SPS Table 383.44-1, 2, or 3) Required Distribution cell area = DWF gal/day + DLR'7 gpd/ftZ ftZ # Chambers = Required Distribution cell area r ftZ ftZ/ unit EISA Chambers Chamber Manufacturer and Model: k f/)- 44-e, / 6u-cz--(d Actual Distribution cell area = Required cell area L ftZ + 2- ftZ/ unit EISA End Cap Pair = fi Z#t2 Cross-Section In-ground Soil Absorption System (2-cell): 4" Schedule 40 PVC vent pipe with vent cap 12 inches minimum IL12inches minimum S~ inches Soil Cover Trench 1 Sys- tern Elevation ~ 2 inch Chamber Height ft _ft Trench 2 System i4 Elevation ft ~ ft Trench Separation Leaching Chamber Width 73 ` ft to limiting factor Plan View In-ground Soil Absorption System (2-cell): Trench 1 Modify ft header/ design as ft Leaching Chambers 14 0 needed. 11 Trench 2 4 inch Header Sch. l ~ftWithendcamps Draw O for a Vent and 0 for Observation Pipe above. They will be located ft from the end of the cell. Vent pipes shall be Schedule 40 PVC and extend at least 12 inches above finished grade. Observation pipes that extend above finished grade must also be 4 inch Schedule 40 PVC. 3F°_ N m co c c L O E15~ o s U C y t~i V O m m ,*4y N o E c L c v a m m °W rn CD I w p ~i a c t" 25 • R ID AE= E - add a Ilk -3 N LL W d C _y V' V 4m* 0 c, zca0o E 4) m yy C f EW LL 7 N 7 W M L O D) i~ It U' O C •O 'O Gi C ~ C L O) 3 m O m w • -p O a mm'~LWp~ O"-m'mY IL- IL- 'O N a C F- w= L h=t v m-° c° ; aOi a E ~I p . aNi v c H ' c w m r t o • m N 3~ m~'~ E W N> c• W 9 CL N C a ~L 3-0 m W N m W U C c O p c?: _0 M C 'O W W ,O c O Ct m W W C Y N Q D f0 m° E pp ` .C 01 p. WW W O C mm Y3 4:! m n Y F yy m o 3-C n o d $ I'~e e U-C 9 t7 N W ~N mmoy~ W o? %Eo yr~e QI d H3Fa CL d~cYEWy 41. ~E 'T E Y~ m o E m LL U Y i --0 m W t0 N 'O O N O LI)C: w W.- 1rcpmm t`+ ° o air o W M U. ~c c m3`mYE ~,E~Y ti 2 W- E§ Q F-3ESS He a~1n 1-cNNr3° w ~g -6 C4 COL X39 C 7s~y~ ~a ~ s•- ~ ~ • all r. ~ .G 7 gg all e"$~ I {sss ~yEE~i ar ~S m8 v§a CC ~fi` rvf 2 O $ _ 1(. v LL r m A "r, IA W 00 C $ g v» C 3 a ~ boo m~ ~ .gym eg © +m an ao v=i g ~Em mSEE ~ ~ ~ tiu ~ nx~l8du4~{dJffi~4i1Et''''bW~L` is~0iWAatlUlbkFaSlwW''Sk~''^`'b"' POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner r,.~ 41`- - Septic Tank Capacity /zoo al ❑ NA Permit # Septic Tank Manufacturer (.l.) f ES C-R ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number-of Public Facility Units f>~( NA Pump Tank Capacity al ❑ NA Estimated flow (average) 4160 gal/day Pump Tank Manufacturer (,O(2 ❑ NA Design flow (peak), (Estimated x 1.5) (c,00 gal/day Pump Manufacturer ❑ NA Soil Application Rate al/da /fts Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODb) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD,,) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510° cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ya in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA i MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 3 0 ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA ❑ month(s) Inspect dispersal call(s) At least once every: 3 ® year(s) (Maximum 3 years) ❑ NA (s) ❑ NA Clean effluent filter At least once every: ® year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA 3 IB year(s) Flush laterals and ressure test At least once every: year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) 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(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) 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 (4/01) bl i START UP AND OPERATION /f For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemical: that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System. start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent; To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells, Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve.the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; 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 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 POWTS MAINTAINER Name Q (2 C L SOS Name Phone - 773 _ 11!1 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name ~o HNSa~ 5 ~}Nr f,}¢ro Name S~ -"tx zo, Phone 7/5 Z 73 Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. i ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer~ ~1 e2~ Mailing Address I Z `i _3 5=rt ti E cc.) Property Address 5L 3 C75 1 (Verification required from Planning & Zoning Department for new construction City/State Aj f tj P, (e..t4 ; 6 Parcel Identification Number c _27 C - l 3o L_ - eT 0 Q "Z Z LEGAL DESCRIPTION Property Location ~j Sec. N) , T ..j C) N R W, Town of i~ 1 C ztA o ti'j Subdivision ~ AC- c r L r o ~ it,~r c-t c L/ s /z , Lot # Z Z Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house es no Lot lines identifiable yep 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. r~ 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 ar expiration date. Uwe certify that all statements on s form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a w anty deed'recorded in Register of Deeds Office. Number of bedrooms ._r y 3 2 G/ e, ek SIGNATURE OF APPLICANT(S) 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) 03/14/2010 07:22 FAX 0 001 k y Y w N ,-I .rocvr iy .s F ~ O ~ •f 'Olt MAI ~LQOg1p'Cel b' N~~ m 1 H l ~ ~ ,y ,'L G+ 94 J " 5 TN tY 1 ii1F. i . _ _ , -i 5.15•- , . ~ ,.1 . N ae•27'W j17221'----- - - 9, TH STREET N00°39'27-W 2619.97 Nairn-Opunl 1/f f 1 I L aw-osZLdIM:3'IlA 991ve-SZc-008. 90OZ 'Ndf 'AIJ \ o p soot A8vnNbr : LVa 0944S IM 'N008 N3alVM 'OUMH sn 9LL£M z lyf1NdW 011d3S 1MS:1.8 NMV8(l w p 313HOl :31Va 'ON AMI L ' b L:3~vos log 13531M Wl-09Z Id-M F- w F- -j Z Z W Li LLJ N ~ LLJ Q U O O O W O J G: Z U J W V1 NO W O O W f~ U ¢ Z Pi- U a w N U) U LL) F- J J F- O- I z F- OO U- O F- C¢.~ G: N O F- U cr- CL O a °m o¢ z to >Z ¢ ZJ= \ LJO ¢ .O Z N x O p O W U Q OW Z F- a- O ¢ I O Q dip O min JWW O U O ZO U = uj J L2 0N U 3 \ Z W U M .1 O - _ m Q 2 J~ w F- N LLJ U \ W J W I W N ¢ N' 1O'^^ LL No~'`~ NF- mw a-C> X uJ U NW N\OOF-Wm C) I (n WQ¢ ~Na Ja m ~0 1Jm O FO. Of C.4 C-4. l~ NO .0f.: -JF- OQW 0OZW ¢ ZF-Q W 2~ w U U W m F W n- w =3 O Y ¢ W W W U) Oj JH ZCOZQOJO2 Ze,¢ ZNO U ~OU O YJZ Z W f%jm J ~ Y Z3m°<=J~m~3 ¢~CO ¢$i.. O Z0 z Q Q U N ZQ O z W W W 7 ~ ~Q ~ Y H U n z W Q O Z Z :3 _ W Y a: _N QZ O < U) O Z D U ¢ _ W W ¢ IJ N Y D O Z H c / ~ II ~ II I o! a_ ~ 0 ( W a W > -i m > I o W 0 Q .S Ibb c$ I 9 Cni ~ ~ II Fw~-J N J Z_ „48 „lb „f z9 tt ni3 . r ~ ~ SSG - i ee"`; 3 Quick4 `Plus Standard Chamber Side and End Views 48" (EFFECTIVE LENGTH) t 12" f, C a 34 , luick..4 Plus All-in-One 12 Encap Front, Side and End Views 11.2" s r13" 8" INVERT ~ 8" INVERT 5.3" INVERT p ~•F-18.2" 33" 1 Quick4 Plus All-in-One Periscope R DUICK4 PLUS ALL•'N-0NE ERISCOP~ r-O SWIVEL ) QUICK4 12.7"INVERT EN DCAONEsz I Quick4 Plus Standard, Chamber Specifications Size (W x L x H) 34" x 53" x 12" (86 cm x 135 cm x 31 cm) Invert Height`,,,... 0.6", 5.3", 8.0", 12,7" 48" (1.5 cm, 8.4 cm, 18.5 cm, 22,6 cm) Effective Length (122 cm) INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltratpr ( "Units"), when installed and operated in a Ieachfield of an onsite septic system in accordance with Infiltrator's Instructions, is warranted to the original purchaser ('Holder") against defective materials and workmanship for one year from the date that the septic permit Is Issued for the septic system containing the Units; t! provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of the septic system commences. To exercise its warranty rights, Holder must notify Infiltrator in writing at Its Corporate Headquarters in Old Saybrook,~ Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered Y by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or Installation of the Units. WARRANTIES WITH RESPECT (b)THE LIMITED W&RRANTY AND REMEDIES IN E UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHANT ABILITY OR FITNESS FOR A PARTICULAR PURPOSE TO H (c) This Limited Warranty shall be void if any part of the chamber system Is manufactured by anyone other than Infiltrator. The Limited Warranty INFILTRATOR does not extend to incidental, consequential, special or indirect damages. InflIVEtor shall not be liable for penalties or liquidated damages, systems inc. including loss of production and profits, labor and materials, overhead costs, or other losses or expenses Incurred by the Holder or any third party. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units: the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road P.O. Box 768 to Ihe Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal, T 6475 all of the Old Saybrook, C 0 void if 'f the Holder falls to comply shall be ol A or improper operation; or any other event not caused by Infiltrator. This Limited Warranty PIY with t terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 • FAX 860.577.7001 hud party resulting from installation or shipment or from any product liability claims of Holder or any third party. For this Limited Warranty to t apply, the Units must be iri'stalled in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's installation instructions. 800.221 .4436 x (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.com original Holder. The above represents the Standard Limited Warranty offered by Infiltrator.' A limited number of states and counties have different warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the puichase1 of Units. p 0 U S. Patents: 4,759,661; 5,017,041; 5,156,468; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer, Quick4 and Quick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. PLUS0510101SI-2 is a registered trademark in Mexico. Contour Swivel Connection is a trademark of Infiltrator Systems Inc. ® 2009 Infiltrator Systems Inc. Printed in U.S.A. doio -oaa W n Safety and Professional Services Dislon of Industry Services BAR SOIL EVALUATION REPORT Page 1 of 2 CROV( rout N in accordance with SPS 383, Wis. Adm. Code C,~~ ~FLOPMEMT County ST. CROIX ~~~PMILi~'Slte plan on paper not less than 8 1/2 x 11 inches in size. Plan must ~+~f hide, but not limited to: vertical and horizontal reference point (BM), direction and Parcel /026 - 1306 - 00 - 072 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re ed by Date Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). V4,::) 3 L / Property Owner Property Location TODD MAREK CONSTRUCTION INC. Govt. Lot SW 1/4 SE 1/ S 18 T 30 N R 18 E❑(or)W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1298 138th Street 22 The Glens of Willow River City State Zip Code Phone Number ity Village ■ Town Nearest Road New Richmond, Wl 54017 ( 715 ) 377 - 6240 95th Street New Construction Use Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement E]Public or commercial - Describe: Parent material sandy outwash Flood Plain elevation if applicable NA ft. General comments Conventional In-ground Trenches 0.7 loading rate and recommendations: Additional borings to extend area out of building site. Boring # ❑ Boring a Pit Ground surface elev. 100.59 ft. Depth to limiting factor > 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-16 till 2 16-30 10YR2/2 sil 2fsbk mvfr cs 2vf-co 0.6 0.8 3 30-36 1OYR4%6 sil 2fsbk mf cs of m 0.6 0.8 4 36-48 1OYR3116 sl Ifsbk mvfr cs 'f-f 0.4 0.7 5 48-1 1OYR5/4 S Osg Icy - 0.7 1.6 Horizon 5 has some pockets of cos. few cobs. 'oe a Boring # ❑ ❑ Boring 130 Pit Ground surface elev. 104.19 ft. Depth to limiting factor < in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 1 0-12 10YR3/2 sil 2fabk mvfr cs 2vf-m 0.6 0.8 2 12-30 10YR3/4 sil 2fabk mfr cs Ivf-m 0.6 0.8 3 30-40 1OYR3/6 sl lfsbk rnvfr cs lvf f 0.4 0.7 4 40-50 10YR5/4 cos Osg tail cs lvf-f 0.7 1.6 5 50-130 10YR61;"4 s Osg ml O.7 1.6 few cobs f ' Effluent #1 = BOD > 30 < SS >30 < 150 mg/L * Effluent #2 = BOD < 30 mgvL and TSS < 30 mg/L CST Number CST Name (Please Print) Sig MARY JO HUPPERT Hollister's Soi Testing&Desi n 224832 11,--~IduaaLL Address Date Evalu f n Conducted Telephone Number 28497 King Arthurs Court, Danbury, WI 54830 03 - 18 - 2016 715-426-1775 SBD-8330 (R07 13) Plot Flan page _2- of2 Property Owner Legal Description (except where noted 5w or tt{~ 544, see, t8,T3o,j R~Bw, -rows o~ Q= Backloe pit MMAA oni 11), -ST. CKoI x am Any, w i s(!U~ 5 w _ North i ►e, Po10 ~ -W? ore ~ v X •5 577~ .~o~a~ ~ tn ZZ- ~ovE 1 t pu•~ ~ ko a ss- L Rpevlou-e, ~ Ax p~oFbs o 00' Loe*t10Al c~ tD2 ` PRopo.S~p 1 SVs~r~ i iv F,1:- CuT y Fok k~Ou'r Me ID ~G- ' fioP oFPw. PIPE ~oUNb ~Soa plc. APovE z`} q5e... 100, 00 _ ~ . h ; . . r Y'y~°yy ~ r r 1 ° u ,Y 3 ire, _ mot.: r sa: 4 0 5Q 106 ,~,~}P r . b15t4HRfd R- his tao mt A ar rasa to be I' ~ M ~ ~ z a ; nert .t, mpete and .Sa}n~c morons drawn re r o~t~lity W the F. L SOIL EVALUATION REPORT #1472 ~scons~n Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Schmitt Soil Testing, Inc. Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 22 Please print all information. Revie By Dat Personal information you provide may be used for secondary va Law, s. 15.04 (1) (m)). fQ /D O (o Property Owner V t-- Property Location Sienna Corporation Govt. Lot SW1 4, SE1/4, S18, T30N, R18W Property Owner's Mailing Address 6 2 of # Block # Subd. Name or CSM# 4940 Viking Drive Suite 608 22 The Glens Of Willow River City State p Code CPppmM r City Village Town Nearest Road Minneapolis MN 35 T Richmond 95Th St. New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Flood plain elevation, if applicable na ft. General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area 1 is 92.74'. Slope is 1 F11 Boring # Boring Pit Ground surface elev. 97.12 ft. Depth to limiting factor _ 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-15 10yr3/2 none sil 2mgr mfr as 2m,2f .6 .8 2 15-25 10yr4/6 none sl 2fsbk mfr gw if .6 1.0 3 25-36 10yr4/4 none sl 2msbk mfr gw 2f .6 1.0 4 36-44 10yr5/6 none Is Osg ml Cs .7 1.6 5 44-96 10yr6/4 none grs Osg ml .7 1.6 _ 2 ,y b j Boring Z Boring # Pit Ground surface elev. 97.92 ft. Depth to limiting factor 100+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10yr3/2 none I 2fsbk mfr as 2m,2f .6 .8 2 11-24 10yr4/4 none sicl 2msbk mfr gw ivf .4 .6 3 24-38 10yr4/6 none sil 2msbk mfr gw ivf .6 .8 4 38-100 10yr6/4 none s Osg ml .7 1.6 it al q~ *Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt _ s..K • "L--=--- 227429 Address Schmitt Soil Testing, Inc. i Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, Wl 54017 9/12/2006 715-247-2941 SBD-8330 (R.07/00) Property Owner Sienna Corporation Parcel ►D # 22 Page 2 of 3 Boring # Boring - pit Ground surface elev. 97.07 ft. Depth to limiting factor 100+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/1 none sil 2mgr mfr as 2m,2f .6 .8 2 12-20 10yr4/4 none sl 2fsbk mfr gw 1vf .6 1.0 3 20-29 10yr4/6 none sl 2msbk mfr gw 1Vf .6 1.0 4 29-40 10yr5/6 c2d 10yr6/8 sil 2msbk mfr cs 1vf .6 .8 10yr6/2 5 40-69 10yr5/6 none grs Osg Ml Cs .7 1.6 6 69-93 10yr6/4 none s Osg ml as .7 1.6 7 93-100 7.5yr4/6 none sil imsbk mfr 4c 6 Boring l f NY C / ~ ❑ Boring # q Pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application Rate 51,9 A Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # Boring Pit Ground surface elev. _ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Schmitt Sal Testing, Inc. Page of Conducted by: Conducted For: Schmitt Soil Testing Inc. Name: Sienna Corporation Thomas J. Schmitt, CST 227429 Address: 4 7jv j j k r, y Llr f It e S~ k GC~f 1595 72nd St. City, State, Zip: New Richmond, Wl. 54017 Phone: 71155J-247-2941 / Subd.Name: The Glens of Willow River Signature: s/-/ Lot No.: Date:i 0C% Legal Description: 1/4 SE1/4 S18 T30N R18W Backhoe pit Township, County: Richmond, St. Croix A Bench Mark El. 100.00' Top of 2" pvc pipe A Alternate Bench Mark El. 00. / 7 Top of Slope= Contour Line El. All--~ Contour Line Length Scale 1" = 40' vrivT (~21vL 9S t~ i ~(LrA - s SS ~ C/C, i This Soil and Site Evaluation was completed to fulfill a zoning requirement. it may or may not be in a location suitable for you use. 2s' SOIL PROFILE DESCRIPTION Owner: CST: System Elev. Proposed: ft Syst. Range ft to ft Ld Rate: 6,~ e^ - 5 # 5 Elevation: # Elevation: Z # 1 Elevation: o Boring o Boring „ Boring o Pit C) Pit o Pit Yr, /60 - = 6 1 t Y ` 3fo