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HomeMy WebLinkAbout026-1306-00-024 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 589713 GENERAL INFORMATION State Plan ID No: , ` Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. N Permit Holder's Name: City Village Township Parcel Tax No: Water's Edqe Construction c/o Jamesd TOWN OF RICHMOND 026-1306-00-024 CST BM Elev: Insp. 13M Elev: BM r Descript q Section/Town/Range/Map No: ~a b i I ~W 18.30.18.1631 TANK INFORMATION ELEVATION DATA TYPE MAN E~ • CAPACITY STATION BS HI FS ELEV. Septic s (Lp) v o -i Benchmark yq oy ~ba.o Dosing V Alt. BM Aeration Bldg. Sewer H i Fe -&F10 S t Inlet p j r /rj t(/ j t p TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic I ' MO 1 Dt B m Dost . a e r/Man. 'O. j1'x0 Aeration r Dist. Pipe I t. I T3_3 ,Holding Bot. System / fi 1 /.7 q2.7 Final Grade PUMP/SIPHON INFORMATION 67 R Manufacturer lct4 Demand St Cover l / D. GPMM~ D l X Model Number 6 fv TDH Lift ,9 • Friction Loss,/ _ System Headr _ TDf~ .c-Ft Forcemain Len 0 1 Di1a. Z.! Dist. to Well ,J SOIL ABSORPTION SYSTEM f BED/TRENCH Width /31 LNo. Of Trenches' PIT DIMEfJSIONS No. Of Pit Inside Dia. Liqui Depth DIMENSIONS L / I t fi: SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Man a INFORMATION CHAMBER OR + T Lw~ UNIT Model Nu rU L e Sy mm 'ct r 10j Vf IBUTION SYSTEM 5t J eader/ anifol'd Distribution IX Hole Size x Hole Spacing V t t Pipe (s) Length Dia Length Dia SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges 1Z I Topsoil 1:1 Yes ❑ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: C hcc~nsi Location: 1516 96TH ST 9,b od Sand v lwva6`p 1.) Alt BM Description = ~t f w cbVm -r wads t~ gQY"C. 2.) Bldg sewer length - amount of cover 3D ` C ~V Iti.S S -1 Lt2.i (661 ✓ p(\ X11. Plan revision Required? ❑ Yes ~;,No Use other side for additional information. -10 (R.3/97) a e I s p ignature Cert. No. S Ma Ineuslr, Serve RECE~ s isio Connie 1400 E tl%ashicin air Sr t _ ► / Lit v,X n 3 JUN P.O. Box 7162 anitan' Permit Number (to be tilled in by Co.) ' i`viadison_ WI 5' -7163 !Slate T;ansact:on % umb r (IMMUNITY t~ o f i'✓ a%1 ~ E j iu, accordancl-VOu[ SPS 393_21(2i, Wis- Autn. Code- submission-of- ubmission of N^r this (orm to the appropriate governmental unit I A a required prior to obtaining a sanitaD permit. Note: Application forams for state-owned PO',t'TS are submitt ed 4rrGjeCL~. ddress (if d flerent than nmailina address) is Deuarmlent of Safer' and Professional Services. Personal information you provide ma} be used for second 4_ n_umoscs in accordance wium the Privacy Law- s. I5.04(1)(m)_ Stats_ 15 l~ 1% _ pplication information -?lease Print All information Sr. o!merty Qr:nc; s Nz ne ` P4icel = / II 0 4/Are~as Ea6F SrtuGT,aJ G/o JA,4 /~.'•~IEt~-,i; 1306 b '!'op:;t~: O:vner s llathr.~ .~ddres; I ;'ropcrn Loratior: l I S' --Govi- Lai State Zip Code bane dumber l1 ~ SLJ ~ .S E" Section Ltf/L o (circle one) S l.1 r I O,t 7 i 7/S 74b - G o l/ C 30 t: R /8 0,3 tV Tvne o` Buiidin (eimeck ail that apply) i_ot 3 - i or2 Famil% D%velling _;•iumber of Bedrooms y Subdivis;n_m Natmm_ ` t - bk L•O~'~. Lio . - ~L£NS dF 6,114 t0 r✓ "el /14"X PubhCCommercial Describc Use ~it+-ot Sia[e ,,trn d -Describe Use CS ;41 Number of i t i Town of - /f LQ V1Yo.J, 4 61ht1*__6eAtk Ljj/~ r i T}'pe of Perrin (Check on 1". one lox on !ine Complete line B if applicable) New S.stcnm ❑ Rcpia ement St°,tenm -1 T reattnent !!otdina Tatmk 2eplac_ment Gmy j ❑ Gilmer ;viodiiicaiion to y~isiintl Stirrer (e;;nia!)) 3. I List Previous Permit Number and Date issued Permit h: astral I i emit Revision ❑ Change of Plumber 0 Permit Transfer to lNe[v Before Expiration I purer a Q tJG1 Type of ?QVVT5 SvstemFCOm onentl~et ice Check ali~ p { that'h.Ph°) \'on-Preiari'rrd 'n-Gr jind 1) Prest!rited in-Ground 01 .A!-Gr,(!c i ; AIoune I. ofsaiiabie soil [ iviound <in. or sui[ablc soil Holdln_e,Tan 3i tither Dispersai Component (exri:,inn Pretreatment Device (explain) j , . Dispersal/Treat nt = rea informatlort: Dd<ian Flow (go[!) Design Soil Application Rate(gp' f) Dispersal Area Required (a ( Dispersal Area Proposed W) sx-siem Elevation ySD 7 , 65'3 1 G 5' P. .7 j F.7.5- Tani: €nio Capacity in I Total f I u I - - i - I = ii I ~innuffi tuFiF 1 ! Gallons {Gaiters 1 Units _ I 1 Tairkz S °tr;c or 1tie44wr-raft: i /o 0o I 1/000 ? / /_-S r4 ~a,Jt,4 e7e ' i ~.ain^_c[tanaar _ a e, _ 1. Responsibility Statement- L the undersigned, assume responsibilih• for installation of the POiVTS shown on the atlached plans. ?;u=ales s Name (Print) Phunbe - ion, ure 1 \4P S'Number j Business Phone Number 02313 Y6 17/3 4 7.?- W Piuniner s Address (Street- City State. Zip Cade) _ _ if/ GA 98 Sr. ,~g, r as AIA4-D Lc.1 s`I~7 G f Hi.:.•ountvlFiepartment Use Only t = t Permit Fee Date sued l i !ssuina A t Signature a I proved ' I ^n R-.ason for Denial 4 • j Cnndi cii > isapprov; t T ProW, Jra.. disp mal cefl must all be setti'M~oss frIntair e, ^ /t as per ftw agement plan provided by plumber. 3) p(e Z. Mii!'jb iegUirements must k e mainttinad W~~ , c ss per applicable code / ordinances. Attach to complete plans for the svs[em and submit to the Count only- on paper not less than 3 12 s 11 inches in size v 4t u a• ^ ~ ~ y _ v ! V ,3 y ty Ica u r 41 ~ c Y N 'i 2 b v Q Z h 1 M ~ 1~ M v v U a Q ~c o ti o o` V4 4: 1 ~ M o IV) V _a \ L v ~ s} t 0 v~ ~311 - - -J _`~~~!iv: fE%A%f~.S G AI.E C o.✓,fT.tucTia.J - .J /.JG.t...r0 ~~c.ITY ~.+/i°~u~f .=N~.v~i`P',x. / S amv. !1 I r I z le, ~t AFIE.'+ /4 sj r/E~1 G'~4 _ v 4rruS d/d 4,114 tdiv &1 T SYo2 7 076 if C- D age 7 "i a t1. 'h=. ; P {lil?; '1(,l;i en-7 PO ~,!7TS 2-ON; SIBE V x /1 ~ h ~ v ~ v 1. Z 4 Y I ~y 14 AU ~ C 141 x k a ~ ~ t e .~M a ~ ~ h v 0 Ikk y Ml2 h h. h Q O 2 0 0~ 1~ M t ` v k2 0 V ~ ~ 1 v V a 3 a o C 7 4`c ~1 f ` ry; I 1414 iv ti ~s j h f 14 It 01 -1 l! ~ tl ~l;fl,1{~l7'1 ( 1`0N .iSEPTIC t~`t.Il 1.11~1;✓ Vl }J-~Ft1]~~r X SECT ION (DRAWINIG NO (C SCHLF} a I MANHOLE RISER L COVER - FWAL GRADE {oisrSJ 'U " ga "5 (1) 8 A! ` lV ; ~ -cL~ ,L 4'S Vent -.:a- isiope ground suriac ; a,:ray fro in »e ,r sr~.~: ! n F 8nf1012(5) 1t}i DfOpEi draln2gc) SPS 3e3.=3 L'(a) I rr / - ::L~tOF2C ! d ^r nnct r:=arm n_ { % BUILDING SEWS VEIL (per S PS, 82.3f) r - :iUNCttON BO` 316 =-nidtqEr- BOO I " iar.. 7, atu- f - - Iy~: _ - - ~£?cDri.~f7=tJ : Ie7~L•' ~1O1.clk(1:, a _ ! 1 1 I`;~ {_r•• ~ 1 1 f IJ~~: ~ I =tl~tv~f: tr ~ rrlfiiVNOi ~ [S ( 1 ~ ~ ` 7 7-1 <-t 4 n:ne'rig ~T.~,, tail -1_ t tt 8017 G.M. GE islLt_t (meat: n--t- &n) .a 1 ~ { ^ji1 f1 i I i::i°_it y:L~ f =•t 1 \ ' ' ;-t-~L,~ ~__...__~..~....~.{c.attc~tert~:~1}---- i i~~ , l I !J✓ I i f_If - = ~f/r/ :/lIi//tiI//r/rriri t vrfr! / r rirr } ' t ffff •~`j/t.%f/f/I JIJ/Jllfiit/!//1lfr~' ;n E r$ 7' = sir/i/.Jrl/L:: ;ice. :/ii/~I,• r.,: r_..~f =L _ . i G IC-/p f /LTIJc ALARM . OAT RDK. 41 !,,LET PIN: ti ~or~ai~~, APPROVED EFFWE16 FILTER EF _UEnr GEr FL O:u i REQUIRED ON (i11ll'4fN,iUiVf O L vl` SU I I ` SEDDING BEN E, T ,NIK ~ YJc,PE f2, kt,.ianulacturer 4116.:~Erc C o ae trre +DYYF tdail wasita-WaCet i194i+ V560--PD,' Septic/Pump tank model - /QO o /!ob Number Gi daily doses I, actual dose volune) M .~.lciti iTtBntli2Ciflrcr S E. Qj4/oyy~u5 ;Ier, F model number TANK .4« r I For cemain volurne 3 a x . X13 vice of iloptswitch t/R v/GAL Aciual dose itaiume (gallop) 873 f (iolal dose volume - volume of force-main) i 1 E; Tlueni pump manuiaciurer Z4 6L 4 E/L ftiuent purnD model number PUMP i ANK CP,PHGI i IES Resen7e above alarm .20-S inches = 3VJ-4 gallons i ! Miiniti~llni pump {lISCi}3rte rcic (l7}'11rl) ril8rm ilDa[ above tin T[02ia2_ inches - 33.5 ;3llQitS (Ci} I measu;mer, S inches = .T.Z S-altons (B) WON float lreri3cal iii (pump oil is disiribuiion lateral) Oil ;loaf above ianli boitom_$-_0 Inches = Z ._3Y i gallons System Read (distal pressure "1-3 lee:) - l wNI MEhzSIO+!S 4 ?UM? CHAMBER Sp_CIBUKRRONZ Friction loss in the Torcemain 3a x,o! = .3 offal dynamic head JOI;) Y. 3 Length ISO dih 84/ .ic~uia de>~ih 3G Galtonse~ liLh i TOTAL DYNAMIC HEADiFLOW 51 OF 7 PUMP PERFORMANCE CURVE PER MINUTE MODEL 151/1521153 EFFLUENT AND DEWATERING 5a I _ 153 MODEL 151 1 152 153 40 Feet %leters G Liter Cal. 1 Liters Gv. J Liter _ c 35 - r r-- ( - 5 1,5 50 189 l- 09 261 7 29. w 10 152 I t ` 70 3.0 45 1 170 61 237 79 205 -0.6 _38 ':ul 53 1 26. of 231 2 ? a-1 20 61 29 1t6 - 4d...~ 167 a2 f 97 6 6' 34 I 724 42 15 ' 25 7; 87 p0 I 30 91 i - 23 33 125 --35 _ 1 10 22 j 85 12 155'lm-o fl; N.e e2 30 H. (9-1m)_._ _81'. 1 :.am) 44 it- i,134m i _ Model 151 Models 1521153 to 30 40 50 Eo 7C 80 4". 1LIU r o- 3 i16 ~L aA a ~~7✓ . -;a r Timed dosing panels available. Electrical alternators, for duplex systems, are available and supplied with an alarm. Variable level control switches are available for controlling single phase systems. Double piggyback variable level float switches are available - - for variable level long and short cycle controls. r • Sealed Qwik-Box available for outdoor installations. See 11F _ (a - - =k = FM142O. = Wit` I Over 130`F (54"C) snenla, quotation required - 61(2444 ..-n_.. '151/1521153 MODELS Control Selection Simplex Duplex Mode! Volts-Ph Mode Amps N151 115 1 Non 6.0 ' 20.3 2141,5! , its 1 Auo 60 Included 20 3 230 1 Non 3.2 t 2 or 3 111,51 - BE15' 1 230 1 Auto i 3.2 Included 2 or 3 "Easy assembly" - - N152 115 Nan. 8.5 1 2 or 3 n (pump & discharge pine 5 52 115 Au ,.o 8.5 included 2 or 3 not included-) - - - 52 230 i Non 4.3 2 or 3 t - B'E152 230 Auto 4.3 Included 2or 3 - - 53 115 1 Non 10.E 1 2or 3 = A BiN153' 15 1 1 Auto 10,5 Included 2 or 3 3 v0 don 5,3 0' ~S -tea ~u5 t ,t'o a3 irc,ce~ r3 ! _ v j 1 Single piggyback variable ievel that switch or double piggyback vanabie level Reduces potential clogging by debris. ]oat switch. Refer to FM0477. Replaces rocks or bricks under the pump- See FM0712 for correct model of Electrical Alternator E-Pak. Made of durable. noncorrosive ABS. Variable level control switch 10-0743 used as a control activator, specify duplex Raises pump 2" off bottom of basin. (3} or i41 `goat system. Provides the ability to raise intake by adding sections of 11/2" or 2" PVC piping. LACAUTION Attaches securely to pump. Accommodates sump, dewatering and effluent applications. NOTE: Make sure float is free from obstruction. For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. li' Copyright 2008 Zoeller Co_ All rights reserved. iOtt! 6`Jl i ?5S K'1rk i?S~', FILE INFORMATION SYSTEM-SPECIFICATIONS Owner Tank Manufacturer: aleseA ~o~t.cErer ~ NA { Permit T ®Septic D Dose i l Holding Volume: /ooa )gal) DESIGN PARAMETERS Tank Manufacturer: !,/iCSf~ Coac• ❑ NA Number or Bedrooms: 3 u NA ❑ Septic WDose Q Holding Volume: 00 (cal) } Number of Public Facility Units: 9 NA LVenical Distance Tank Bouiom(s) to Service: Pad: (h) stimated (avenge} Ffo.v : (gailnay) atizontaI Distance Tank(s)) to Service Pad: loo (ti) Specific Servicing mechanics must be provided it vertical i_ >15 teat or Design (peak) Flow = (estimated x i.5): y~rp t9aUdaY) if horizontal is >150 feel- Specific instructions to be provided on back. In Situ Soil Application Rate: .'7 (galtdaylit`) [iffiluent Filter Manufacturer: (f ESr ❑ NA Standard (Domestic) influent]Erluent Monthly average Effluent Filter Model: Z' "r - 16 , Pump Manufacturer. Z oEGtE2 } h1 P. Fats, OiI Grease (FOG) <_30 mail- Biochemical Oxygen Demand (BOD=) !MD mg1L © NIA Tctal Suspended Solids rrss} X150 mg,L Pump Model: lS/ 'sigh Strength Inrluent/ESluent k4onthly average I Pretreatment Unit I (FOG) >30 mg/L I Manufacturer: (BOD) >220 mg/L r_1 NA 59 NA ❑ Mechanical Aeration ❑ Pea: Fitter i (TSS) >150 mgiL ❑ ~ i Pretreated Effluent El Di6lrtreCltgn Wetland Rtonthly average D Sand/Gravai Filter I_'7 Otner: (BODs) 530 mq/L Soil Absorption System (TS5) <_30 ma/L ❑ NA LL] -Ground (pressure) _-:11 f __-Fecal Colif an geometric mean _lo` !9 tn-Ground (gravity) ❑ In -Ground NA i f iv+aximum Effluent Particle Size in dia. E] NA ❑ DrirL ine Other. ! Other: F1 NA Other: L7 M iAINTENANCE SCHEDULE 'i Service Event Service Frequency Jm one-third of tank volume j ~ YVYhen combined sludge and scum equals p out contents of tank(s) rJ- tnlh2n the high wafter alarm Iis activated month(s) ❑ (U.0. Inspect condition of tank(s) L AL least once every: 3 8 year(s) (Maximum 3 years) ❑ month(s) Inspect dispersal cell(s) (Maximum 3 years) ! At least once every: -3 9 year(s) !_3 YI month(s) ^ N;=: I- i Clean effluent filter j At feast once every: ❑ year(s) Q month(s) ❑ N j Inspect pump, pump controls alarm l At least once every: ,j year{s} ❑ month(s) Ni 'Rr Flush laterals and pressure test At least once ever,: - ❑ yGoi(s) l Other: ❑ month(s) ❑ NA l i At least once every: ❑ roar(s) - r~'l 7 i Other: U m4 ~ i NIAINTENANCE INSTRUCTIONS hnspections Of (2Cir(S and soil absorption systems shall be made by an individual carrying one D"s the icliowina licenses or cerzi icstions: Master Plumber: Master Plumber Restricted Seder, POL'i+TS Inspector: POVt1TS iviaintainer or Septage Servicing Operator (pumper). enk 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 a check for any back up or ponding of effluent on the ground surface. The soil ebsorp+.ion system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding o, effluent on the ground surface. The pondino of effluent on the ground surace may indicate a failing condition and requires the immediate notification of the local regulatory authority. „en the combined accumulation of sludge and scum in any treatment tank equals one-third ('r`,) or more of the tank volume, the entire contents of the tank shall be removed by a Sep?age Servicing Operator (pumper) and disposed of in accordance with chapter NR 113, Alisconsin Administrative Code: !I other services, including but not limited to the servicing o- effluent fitters, mechanical or pressurized components: pretreatment units, and any servicing at intervals of <_12 months, shall be perforated by a certified PQvv t 5 iviaintainer- service report shall t)e provided to ine local regulator, authority within 30 days or completion of any service event Pace ~ Of START UP ANN OPERA T IO'N For new construction, prior to use of the POINTS check treatment tank(s) for the presence of painting products, solvents or oti chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may till above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under the_ conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber or POW T S Maintainer to assist in manually operating the pump controls until normal effluent ?evefs are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system- Do not drive or par': over, or otherv.4se 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 treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cation swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings; gasoline, greases, herbicides, meF. scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons,-and water softener brine discharge. ABANDONfviI-NT trhen the POW i S 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 s. 505383.33, Wisconsin Administrative Code: All piping to tanks, pits and other soil absorption systems 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 (pumper). o 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 Ii 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 systern, 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 neec for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. a r suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POINT S technology, a holding tank may be installed as a last resort. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluztion must be pertormed 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 wiled POWTS. i ivlound and ai-grade soil absorption systems may be reconstructed in place foliovang removal of the biornat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. b5.'ARt isG TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTQH POlsOitlOUs GASSES OR LACK f; SUFFICIENT OXYGEN TO SUSTAIN Lit=E. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POINTS INSTALLER PODUT5 MAINTAJNER. KE Name Jay~r 1~~t/<E /`dp-~?3/~fAL t Name To n/ I~Sz (',10E4 Phone 715 G7~- s;?e4 Phone 71 GT.t -S,7GL St=PTAGE SERVICING OPERATOR (PUMPER) eJCnlG~dm' LOCAL REGULATORY AUTHORITY Name J Name ~itai ZaN/✓L } Phone Phone 71S 3~G - IY4 80 u 4 - r~ yip <F } f~ s O f3 'D 3; n gy ti J g P W ,J v~ f ST. CROIX COUNTS SEPTIC TANTK,;'ViAINTENAhCE AGREEMENT C: AND OWIv'ERSIVP CERTI]rICATION 1'URM Dumerloyec T10"~'\ - 0 ov Mailing Address Property Pm}~erty Addre 5 (Lp 4 ~ -7- required from Plat~ni'~n r 8 1 l £ g Depattntent for new construction.} City/State A"'.~ 1~ Parcel Identification Number L9qAE DESC I TM Property Location 06W 1431G /,,,Sec. Subdivision -P ~ t l Certified Survey Map # Volume Page # Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AIND OWN ERTIFICA IU;11 Invroper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper mainte:nanee consists of pumping out the septic tank every three years or sooaez, if heeded, by a licensed pumper. What y3.. «=.;r the system can affect the function of the septic tank as a treatment stage its the waste disposal systotn. Owner trminterraluv. responsibilities are specified in §Comm. 83_52(t) and in Chapter 12 - A Croix County Sanitary Ordinance. Tb;„ prwu;rty owner agrees to submit to fit. Croix County Plstwing & Zoning Deparumnt a ccrtirication form, signed by the owner and by a snit `ter. plunibrx, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site v«°tsstewatcr despot . s rstesn is in proper operating co-Milian wid'or (2) after impeetion and punTing (if necessary} the septic tank is less ih= 113 full of sludge. Uwe, the undersigned have read the above requiretwnts attd agree to maintain the private: sewage disposal system. with the standards set fortis, herein, as set by the TDc-parnwni of Commerce and the Department of Natuml Ptesourcet, State of W"szorisin. Cori f"tcation stating that your septic system has been maintairied must be completed and returned to the St. C..roix County Planning & ondng Dcpartrnetn within 30 days of the three year expiration date. I/we certify that all statements on this rrn are true to the best of my;'our knowledge. I'we amore the owner(s) of the tfo property described above, by virttte of a 7"v , deed recorded in Register of Deeds Office. Numbe ro ens A U'R.E OF DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning De partment. include with this application a recorded warranty decd from the Register of Deeds Office and a copy of the certified survey mep if reference is made in the warranty deed. (REV. 08/05) asLrlx~-etc ed rs i.h "•v,u-1of mps',~ans+~rvi uzez SNOUVATB'dOlllU. X3 All, -11 1 -.i Z 1:9 03dS .wv •wuxiaisaa -0)NI 39W ~w ~lla[Oad .--y a M LEI 111M, al I ~usva-uF'z,,z alga n ~ PI O u l -1 0 - ❑ w N I 00 0 00 0 f I I I O I , a a w4 ❑ Lv e w au ld - III it ~I z O aw ±I ~o L o hlQ Y~Lfi-INL-S IL HA OW NV1d NOUVQN(lOd ZD9 JBdS i,lvie~~o~ i tc>I r.cuivvd-i.nnw .wi waaisaa 'O3NI 37Vdll3fONd I N o r,l m " LEI ff M. W I NOLLOt12ILSN W ■ OD 90(19 Sul, LdM z 3 e W d3mma ~ _ - s H oowo y a ~ oaa Z Q J CL F o 4u a. r 14 v 0 I i e ' o W I Y 4 s I X I I ~ I s 7" r I I mi i o - - - - - - - I~ Q I m I 41 i I . ~ f I III rt~R, ~ ;I I II o I i Q sSCF-ix¢-s it'xn ZP9 Dgas A ma uvoJ im ikOn -9iIKil-nw ~Ib'Id"I3A8"I NIV11 ' wiJxi• Iw~ - msax ON 37Gd ~W[Oad - M c . o z' H w°wm o, H oowo s p~~a I fl Ry 1 S 4 "+4 ~ ~ a zo do as J C LLI o J • I e 0 0 - 7A- ~ o ml f0 ~ I j~ rc ~ rl I i U I ~I I it 1 'Y I Frh v `v A N rl~ F d t ~ R I z 99 00 I III I O m m W 3 a. e I I I I p ~WiSCOns%n SOIL EVALUATION REPORT - #1474 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. 24 Please print all information. Revi d By j Dat Personal information you provide may be used for secondary purposes (Priva s. 15.04 (1) (m)). ~0 / d O Property Owner c r+CI Pr erty Location Sienna Corporation R Go . Lot SW174, SE1/4, S18, T30N, R18W Property Owner s Mailing Address 6 2006 Lot Block # Subd. Name or CSM# 4940 Viking Drive Suite 608 EP The Glens Of Willow River City State Zip C e Phone Nu b5,NT City i Village j Town Nearest Road Minneapolis MN 554 ST. CRoly Richmond 95Th St. New Construction Use: ] Residential / Number of bedrooms 3 Code derived design flow rate GPD L 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. Install system 5.5' below grade. ❑ Boring # Boring Pit Ground surface elev. 98.30 ft. Depth to limiting factor 110+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0-10 10yr3/2 none I lmpl mvfr as 2vf .4 .6 2 10-24 10yr4/4 none sil 2msbk mfr gw ivf .6 .8 3 24-38 10yr4/6 none sl 2msbk mfr cw ivf .6 1.0 4 38-64 yr6 none grs Osg ml as .7 1.6 5 64- 10yr5 6 none cbs Osg ml 7 1.6 z'$ +f 1 2 Bor Bori ID Ground surface elev. 98.49 ft. Depth to limiting factor 110+ in. Soil Application Rate Horiz De Dominant Color Redox Description Texture Structure ConsistencE Boundary Roots GPD/ft2 ,pK n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-11 10yr3/2 none I lmpl mfr as 2m,2f .4 .6 2 11-29 10yr4/4 none sil 3msbk mfr gw 1vf .6 .8 3 29-43 10yr5/6 none sl 2msbk mfr gw 1vf .6 1.0 4 43-52 10yr6/6 none sl imsbk mfr cs lvf .4 .7 5 52-90 10yr5/4 none cbs Osg ml as .7 1.6 6 90-110 10yr6/4 none I s Osg ml .7 1.6 r n IoL Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 50 mg/L ' Effluent #2 = B At /L VrTWSS S.30 mg/L CST Name (Please Print) Signature: 4 / CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 9/13/2006 715-247-2941 SBD-8330 (R.07/00) Property Owner Sienna Corporation Parcel ID # 24 _ Page 2 of 3 Boring # Boring pit Ground surface elev. 96.87 ft. Depth to limiting factor 108+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/2 none I 2fsbk mfr as 2m,2f .6 .8 2 10-24 10yr4/4 none A 2msbk mfr gw 1Vf .6 .8 3 24-32 10yr4/6 none sl 2msbk mfr gw 1vf .6 1.0 4 32-48 10yr5/3 m2d 10yr6/6 A 2msbk mfr cs 1Vf .6 .8 10yi6/2 5 48-74 10yr5/4 none grcos Osg ml as .7 1.6 6 -108 10yr6/4 none t s Osg ml .7 1.6 102 Gt Boring # Boring It C''~r*-~phf?y5 Q15V( pit Ground surface elev. ft. Depth to limiting factor Soil Application Rate F-1 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun ary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 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/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I I * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Schmitt Soil Testing, Inc. Page -7 of 3 Conducted by: Conducted For: Schmitt Soil Testing Inc. Name: Sienna Corporation Thomas J. Schmitt, CST 227429 Address: 41' I& y~ f, by 6,-"V-C- 65-6) " 1595 72nd St. City, State, Zip: ~~hxrF~ ciif , 11,7111 5*3 5'3S` New Richmond, Wl. 54017 Phone: 715-247-2941 Subd.Name: The Glens of Willow River Signature: Lot No.: Date: Legal Description: i-J 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. Top of --,2" P,"6- Slope= Contour Line El. /0 Contour Line Length Al Scale 1" = 40' 4~ 93 5-21 ~ I y t 22 ~y 5~ I )91 i ( ~t Cl 2 S- This Soil and Site Evaluation was completed to fulfill a zoning requirement. It mayor may not be in a location suitable for you u