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HomeMy WebLinkAbout030-1096-10-200 v'.lsconsm T:p:et..remul!:o'*noerce PRIVATE SEWAGE SYSTEM cf- St. Croix Safm mul R"id,ng Orve on INSPECTION REPORT Ssnnsryr'errrnFl°' 592235 GENERAL INFORMATION (Al I ACH 10 PERMIT) ;state Plan ID No Pcrso-al minunsl on you orovvle may be used lot scconcaty pnpoar,: iPnvacv Lar o: 1S Od (1)(m1) Permit Hoicc s Namn City V sge I oAnsMp Pamr:l Ta. No Donald Jaszewski TOWN OF SAINT JOSEPH 030-1096-10-200 CS7 BIV Lev: I Insp. F lieu rM re>z:~.: bl SectgmTvemRnnil P No ye) - G 5 ( 32.30.19.350C TANK INFORMATION ELEVATION DATA IYPF MANUFACTURER CAPACI IY STATION 13S HI FS LLLV. Septic y^,,. Benchmark : e3cr t ai cYb 4Z•3 `ID Dosing ` f+ 3+ (4,00 Alt .HIM ~ on 6 ~d YL- Sz Bldg. Sewer a,' (folding SIMI Inlet T 9. 83.i TANK SETBACK INFORMATION SUHt Outlet TANK TO Pil Vwt L BLDG. dent to Air Inlakr. ROAD tN Inlet Septic A)A ~ 7. S ut Bottom 13 7 ?$,58 Dosing J , L r r leader/Man -3 .1 17• . YP3 Vo Acrahon Dist Pipe '97, i Hording - Bot. System 37,44 1(01 (A Oil Final Grade PUMP/SIPHON INFORMATION 2`43 4" -77 Manufaclurer Demand 4-- SI Covrr S7- ~L GPM ~ O 77 Model Numtrei C; V ~ TDH Lift Friction LSystem Head IDIA },y S: to 1M1'ei Fon:enenn' Lon 1h + Dia. 1! 1 Z SOIL ABSORPTION SYSTEM (.0)<.9z jeor:4- mA- 20 BEDITRENC14 '.':dr. Lcngfi Nn. Or Ten es PITDIMENSIONS No. C`Pi':: Inside Jia ❑R~li<: 7er:~,h DIMENSIONS 7 ~V SETBACK SYSIFM 10 PiL BLUG WELL tAKF/SI RFAM LEACHING Idmwlactu•e r. INFORMATION Type Cl System w CHAMBER OR bJ UNIT fJOdel Nu:r• r: DISTRIBUTION SYSTEM 1 1n...d.:Llandold) 0stributicn x Hoe Size x •4;Ir Sxong Vent lu or (nuke PIPC~s) Leng:h-1K Diu ~ I ntg4t_ \ L`ia acing SOIL COVER x Pressure Systems Only xx Mound Or Al-Grado Systems Only .VIO(I~ Deph 0- Depth :D.er rot Depth of xx Seeded/Soddec xx xlulcne ll..ch ^,I, bed'T(unch Edees R>p:xwl 1 -f y~ No es - No COMMENTS: (Include code discrepe.nr:ies• persons present etc.) Inspection #1- G / r Inspection #T Location: 1215 TROUT BROOK RD N 1ti~ {-•G5 e 1 ) All HM Description 2.) Bldg sewer length = (o,3 - amount of cover - bra SZ on l Plan revision Required? Yes I No 7~ Ilse other swe for additional information. 10 ~•J Q~J Dam Inscrr.: ,i, Sql re Cert. No. 33D-6719:R V97) COMBINATION SI:1111('I)OSE CHAMBER] ANK K, I'I:MP SPECIFICATIONS PER COMM 84.25 CODE, CHANGES 2%1!2004 Access Opening, not top of cover, Access Opening, not top of cover, must aidend to a point no greater most extend al least than 6" Below Finished Grade 4" Above Finished Grade Cover with locking Device Finished Grade (typical) Min. 23" Access Opening 1 Min. 23" Access Opening - Oulet Effluent Filter Union Inlet gaff le pump Two Compartment Septic/Purnp Tank SPECIFICATIONS TANK MFR: JJ e6 e-r DOSES PER DAY: 5 TANK SIZE: SEPTIC 140b GAL. DOSE VOLUME: 9a GAL. DOSE 60a) GAL, (INCLUDES FLOWBACK & <20% OF DWF) ALARM MFR: CAPACITIES: A = -20?-INCHES= 3 76 GAL. MODEL # Switch type: B = -2-INCHES = 34 GAL. PUMP MFR: 0~~5 C = 5 INCHES = S'4 GAL. MODEL 6Po SWITCH TYPE: D = INCHES = 117- GAL. REQUIRED DISCHARGE RATE 2-4~) GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) _ '42- FT. MINIMUM NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) _ + FT. Ipb FT OF FORCEMAIN x , RZ. FT./100 FT. FRICTION FACTOR. _ +FT. TOTAL DYNAMIC HEAD (TDH) _ 1'1/7 FT. INTERNAL TANK DIMENSIONS: LENGTH WIDTH LIQUID DEPTH :3(6 MP/MFRS SION.A I URE.: LICENSL NUN11 iR: ZZS'V /O ~GOULDS PUMPS Submersible Effluent Pump li 11 EP04 & EP05 Series APPLICATIONS • rt&h submeiaed in Itigi, ■ LP05 Impeller: Thermo- ■ Bearings: upper and lower Sponfic, ly designee fo'the grabe Ilurbim. oil for plastic enclosed design for heavy duty ball bearing core following, uses. laoriwtion and efficient inluroved prrioman;e. structior. r,; • Effluent sysienls !:cat tr- ■ Casing and Base: kuageo • Humes Available for automatic thermoplastic design provides AGENCY LISTING • Farms and superior rirenUth anc corosioo - manual operation. Automatic Canadian stancard: •Hea'.ydurjsump models include Mechanical mMotoe_ SH• Associatior • LVatcr trait<.far Float Switch assembled and • Motor Housing: Cast iron for File # LP38549 • Dmvatedng preset at the factory efiaent heat transfer strength, anc durability. Goulds Punyn K 1504001 Registered SPECIFICATIONS _ FEATURES ■ Motor Cover: Thermoplastic • Solids handiing .dp3bHir : - - cover with integral nandle and ' maximum. ■ EP04 Impeller. Therma- fioal switch attachment points. • Capacities: up to GO G11M. plastic semi-open design with Power Cable: Severe duty • Total heads. up to 31 feet- Pump out vanes for rnechanictl p seal protection. died oil and water resistant. • Discharge size: 1 b4" NPT. • F•fechanica' sea!: carbon- rota ryrcerami c-s a i i o na ry, BONA-tv elattomers. • temperature: PA. EPC =EET - 104" F OV Cl continuous t c,.. 1400 F (GV CI intermieent. L • Fastene s: 3W series s 30 ~~-Jwscnt stainless steel. -Capable of running dy without damage to 25 ` Components. Motor: • EP04 Sinaie prase: 0.4 HP, a s 115 or 2301', 60 hz, 1550 a 5- - - - RPIA huAt Ir. ovedrad with a E°QS auiomOtlc reset n EPOS Single , pt.ase: 0.r Hn , ~ ~ 115 V o 2301'. 60 Hz. 1 b5C PUa RPM, built i:, ovedaad wrin atromalic reset s • Powe. card: 10 foot j 4 >.andar lenjh.13 c zc - 3c-- - ao s: - GPM 5JRR at tnr-e oton grounding plug. Optional 20 fact length. loi35JR4!with 2 5 -5---- 1C ,z mllh three prone oroundmg piuo !s-.anda•d on EPOS:. uana v Goulds Pumps C zoos i, I wate• L=:hoot c'ai~~•~. ITT Industries FM yhr smuary. E3S1 A OOO-{gpldM { II: 9(' r f 11R 01.1 V. Al. •N:1CN NMVW !1. AR.F :f9:/SM Z al1JC _iOd 31tl0 old l•:{ (Ili-0W.: L.~ n3a 31380000 13531M divnNVVI -009/~ud35 -a~od aad -c ,I-.o; . --Nos _'.,Y.:n~ nmva.. . 009/OOOIdIM O ~ w of w J N H Q o g > V/ F J p m O Z w J O w O a U Q U O (f) m w V) 0- 0 p w aM ° 4 w d OI Q U w a a to Q o o U w W Z w p z? a. < m¢ M v o i Q r- °z a ? H O w ci o a JQ V) a ° zo 3LL . 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Tiie llma.:hon4tanmher _ In a.eonlann mfl, SI'S ?31 f 1, \5'1, AJm C1,31 , vdlrai.. uai o, is 1,1111 h 11.: ap,nopr:nc• go•: c+nm; nlal Ulm I t p 11. or l d tnl n a attar, '•n lit V) APpn u n n lurou t 1It mJ l uAV IS are stlhmnod to N,,., cl AdJles> In Jdlmunt!Iran oladme address) I I 1) I .I t a C.nU al J I I t s m ! s I ,sat II inf -no::1 I°o: idc t t , ti; usad tiff scconda uq m r n d t Ili uc l: I+ am r slat, 1215 TTOUt Brook RD N I \ppha Ilion Info oration I RI, _ \II Inlm m.ltluu Dnnald T Jeszewski 030-1096-10-200 P:opa:'~/)an 1,l' t Mail m.. 11IJte,> - I'ropa•tly Locauan /r'36 3079 Juniper Ln Woodbury, MN _55125_ Goel Lot 2 slate Z'p Ceale Phone Nomtvl slsl SW Secnnn 32 Woodbury YIN 55125 do omy ' 11. 7\pe of 13udJmK (check all that app!)') I.rt 1 30 N. R 19 itorN ~ - - Ll 1 (it'- Pam1k IM6 n., W I I. i ul ncdmo:ns 3 > dsln rmn Nanle nl.~~ a - CSM Pub6.::(on:n¢I: ial - Ikscnh rya _ , Cny of Ll State (Amed-Des e..I, 11,, CS NI Nnnher 1 U Village lit ~Qi r, P 1,J 1/?j fmvn nl St Joes1)h III. 7}pc of Pernril: IChcck onk one x on line:\. Complete linr R if applicaL Vc•. \+-t m .J K LIa'cm n m .h.m Ll lT almenl H I Pq> 1atA R q huu)t nI puh .J UUtel Mlyddl.aenn to P.zlsnn System l (esplam I It. .J I'ennn R. •.l a'. I I. n .il Kc +.on L I I.Ind TI:e.Nt t In V; I W Precious Pel t Numt,r m d Dal, ksucd Ilc' h, i. a: I trthn n I\'.'I looi I woal ow l 'PC ofPO%A I S Syslem~Lonlponcnt Ilas u•c: heck all Ilia( apply) : ~G i'~ \ 19.+>I c.~ In Ground I`. ..on7 In 1,'7. ..n. GtvJe L. M1luarJ - D7 in or x:ulahlr sod L M1h)und < ?4 m al >unahle xnl F] I : iu; I;:uA , . L pn s.:! t on l t U;ip:::.nl :1 Pro"itillent 1) :I:uo) - \ Dlvpcrsalflrcat enl \ret lnh)rmau _ Rn f o. •pdI UD;w •t \nll :\pp.:ca Ralr•;gnlsq UtsRrsal At,., It.ymn.dRyu:w.Jy1) Dtsit:>al Arco Proposcc sl i 0.•m Klcvatlon %I.IanhInfi, Ca 4.115 IL al h d"%act u L l Galloon,4>hnp -lau:: a f~ 1,r { {J c v, v_ iZ J a -AO u r ta..,~ C l 0 \'ll Itesp,11 11iIilp Ntaten) ent- I, the undrr4 na•J, assume I v, %ihilih Inrlast Whitton litthe PON_I S Show n on the attached plans. I Ili I :f's Name IPrinU I ornher t t )live M1t I'+AII'RS Nun)It;t It o<,s Phone Number 'Oe tit.,"fVT \JJres:; I:Sttrr l m. /Ip CoJe1 \ III (~mnt\!I/c )arllncnl I. sa l1nM Pretll l-ec I)a1>ccd I+nl Sy•talufc ' a \t1,".,..1 s 7v-" 00 71-- . IS. (ondiI MM. a'.' I C Pfor icapprucal 3 ,C Q C uc ^ ' Illy r7J (A%Wr. rill nu at ell t1, N.per marayemer' pear. p, noen w t., t~l 0.0tfC~ • 2. MI per pck mlq ^,en;s m'.Jt W I'. a0 _ ~ / - 1 C`7C - M per i1llFliGabi~ cM'! i :n1i17~.1r,[l Ll ~ ~0- %1wh uu mn..41, plnno for the,.arrn.o.l v:b u m Ih' t unry ono on lope ul I . n:au S I 11 u:. hrs.' lo~ F13Ddii98 1;12. I I: I I I Y// Properly line extonds back . Total length is S ft. from front corner lot. SCALE 1 "40 FT. N1 SW 1/4 SW 1/4 S 32-T30N-R19W SYSTEM ELEVIION 83.82 Wieser 1000 Gal septic! Poly lock tC Proposed 525 filter ~ _ 3 bed room Proposed well ~pJ 1 PC Plum nR nls 5 +n R' Drive way 3 • • B2 Two GS ft ez flow trenches Sw lot stake (fuel 100. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Trout brook road north CONVENTIONAL COMPONENT DESIGN Resident al Application INDEX AND TITLE PAGE Pro;ec: Na ne. Owner's Name Ihmald I..leaccvNski Owners Address: 3079.Iunipcr Lane. Woodhurv \IN 55125 IegalDescription SWI'd.SW1'4.SI(( +'.T 0,N ROW Township Sl loseph County St Croix Subdivision Name SNI Lot Number Parcel ID Number WO-1096-10-200 Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 FiJ:er Specs Page 5 Ma r:enarce information Page 6 Management Plan Page 7 St Croix Cty Septic 7an,k Maintenance Fort-, Page 8 Warranty Deed Page 9 CSM or Plat Attachments. Soil I est & Ilouse Plans Designer/Plumber: Countre,idr Plumbing L@ I IeatiLicense Number. ()(),17 1 Date: 02_!11 2017 Phone Number (715)2_246-2660 Signa!L%! resigned pursuant to the In-Ground So I Absorpt en Ccmoorent Manua' for POM'TS Vers!,q 2 C SUU-1C705-P ',N Ovot j Page 1 Property line extrnds bark . Total lenCth is 5 ft. from front corner lot. NI SCALE 1 " 40 FT. SL'v 1/4 SWl14 S 37-T30N-R1914' SYSTEM ELEVTION 83.82 Wieser ]000 Gal Septic, i r r i I r Poly lock Proposed S'S filter 3 bed room I Proposed well 0 ! 7% slope B4 Plum ns vents o Dave way a B 1 ! B3 ' a JI 62 ?wo 65 ft ez flow trenches I I~ - - - - - - _ - - S•,k lot stake c:,-el 100. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Trout brook road north SOIL ABSORPTION SYSTEM DETAIL 1 GRAVELLESS LEACHING UNIT Page_ot_ Project Name: No. of Cells ZS Per Cell e Cell Width Total No of M Cell Length s~ sQ ft EISA Per Cell V. Cell Spacing sq n Total EISA Manufacturer Model Laying Length EISA Rating Infiittalor LZ12014"54 n 25.D F~:70:?H tUn 1C.0' SUL Gravelless Leaching Unit Manufacturer: ~/f ~~iw~o v Gravelless Leaching Unit Model' 00 Typical Cross Section Finished Grade C%-ft Observation Pipe with approved cap or vent ~A Soil Backfill -Geotextile Fabric mintrative Surface 12 in 0 t~ - .7f-, Limiting Factor Slotted and Anchored Vent/ Observation Pipe with Cap PlumberlDesigner Signature: License Date: 2r,'Z ZV 2e POWTS OWNER'S MANUAL & MANAGEMENT PLAN Paq, et 2 FILE INFORMATION SYSTEM SPECIFICATIONS Cwaner - Septic Tank Capacity IOU gal 7 NA ='cnnit Septic Tank Manufu:aui_ • NA i LJey DESIGN PARAMETERS E'flaorc Filter Manu'.actum C NA Nuniom :)f Redrooms G NA ctfiuent Filter Mode! ❑ NA Numher of Public °aci[av Jni= -id,NA Pump Tank Caperity gal aA' NA Estimated tloro Iaveragei Pump lank Manufacturer "T NA _:osign flow (peak). IEstimeted x 1.5) YS'D galiday, Pump Manufacturer ITNA ,;:)ii Application Rate 7 gaj!;dayt!W Pump Model QNA Stantlard influenUF)fluent Quahry Monthly average' Pretreatment Unit ~NA Fats. Oil & Grease IFOG) 530 mg:L C San&Gravol Filter- J Peat Filler B)ochomical Oxygen Demand (BOC,) _220 mp.L ❑ NA C Mechanical Aeration C NVctland Total Suspended Solids (TSSI '150 n1WL C Disinfection C Othor: Pretreated Effluent Qcaliiy t•Aonvily average Disporsul COWS! Ll NA Biochemical Oxygen Demanr' IBOpr! 530 mgJL 6ZIn-Ground Igravityi C In-Ground (pressurized) Total Suspended Solids JSS) 530 n,git- F, NA = At-Grade O Mound Fecal Colifor r. iguonwtric mean) ' :0' cfur 00m1 C DriD-Line 173 Other: Maximum Effluent. Particle Size- - 'j_n dia. G NA Other: - ❑ NA :char. - ~tner. - _ 7- NA 11 NA ~ nlun[: tyu:cal lo- uomestic wastewater vu;l cep:itl tanY, ettluant. ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect cononion of tanwsl At least ono: every: ❑ month sl _ i.Q v onm (Maximum 3 years) r LA Pump out contents o' :a:: nisl Ydhen combined sludge and scurn equals one-third o' tank volume _ 7 NA Inspect dispersal celllsj least G rnmuhlsi vearlsi (Maximum 3 yearsl C NA Clean effluent filter At least once every: /,7_ O monads! NA Byearls, C InsPba puma. pump controls & alarm At Peas; once every: C monthts; _ L. yoarls) -ANA Flush laterals and pressure test - At least once every: G month's) O vearlsi other: 'l monthisi $NA At least once evey: Fl vearlsi flA MAINTENANCE INSTRUCTIONS .ap,:rlionx n= tanks and d:spesal culls Sall De made by an wrinvidua ca--yin one of the =ollovning licenses or ceriflca-ions: fvleste- Plumber. tslaster Piumber Restricted Sewe-; POWTS irspocto~; P0%VT4 Maintainer 5eptage Servicing Operator. -a is i rsoeutioss must include a visual inspection of the tank's) to idunWi any *n:ssinc pr broken hardware, identify any cracks u: lea!:::. cxwoscre his volume of combined sludge and scum and tD ::heck for any back up or pon ling of effitent on tho ground surface. The d:slowsa! cellls) shall be wsaaliv inspactec to cnecK lira tffluent levels in the observation proves and to check fur any pending Df oiaaatl: on the ground surface. The pending of e1f.ent on the ground surface may, indicate a faiiing condition and requires the :nIIilarate notification of the local regulatory juthurity. VAwri ere combined accumulation of slunge atlC Spurr`. in any Ian,t equals one-laird (1.) or mole of the tank volume, the entire can tans of tire lank snali he removed oy a 5awaoe Serv:cing Operator and dispnsed of in accordance vaith cnamer NR 1 'dVisconsin Administrative Code. All ether services. incntding but not limited to Ire servicing of effruent fihers, ntucitanical or pressurized components, pretreatment colts, a-,d any servicing at intervals nt si2 months. sr.all be performed by a certified POWTS fvlainiamer. t. e.e ,wl report snul': be pmvioed -c'ne ,o-al regulatory anihnrity withir days of cumplotior of any ser-vicc evor•.t. F.y_ of ~I START UP AND OPERATION nera construction, prior to use of the PDVi7S =heck !rf!alrnertl rantisl fo: the presence of painting products w other cnemicals tr:at may impede the treatment process andiur damage the dispersal cell!si. If high concentrations are oetected have. the contents n' th-n tank;st removed by P. septage sw•vicing operator prior to use. System start u;. shall rot occur when soil conditions are bu_c:t at tnu infiltrative suifacu. luring pores dirt ages pump lanky may fill aoove normai highwater levels. When power is restored the excess veasiewator wil: be d`,charged :he dispersal cellist in one large. dose, overina(iing the cellfsl and may result in the backup or surface discharge at effuren:. -o avoid this Situalion rave the contents or the pump tank removed by a Septage Servicing Operator prior tc •eswhng pnveer xa the effluent pump or contact a Plumber or POW-S Maintainer tc ass:st in manually operating the pump controls to wore normal levels within the pump tank. :>n no; drive or part: vehicles river tanks and disporsal tolls. Do not drive or park over, or otherwise disturb or compact, the area svithir 15 fee. down slope of any mound or at-grade soil absorption area. F.rduction or elimination of the following from the w'aste.vrater stream may improve the performance and prolong lire life of the P')%V7S: antibiotics; baby wipes; cigarette butts; condoms; couun swabs; cegreasers: dental floss: diapers; disinfectants; fat: foundaBon drain isump purnpl water, fruit and vegetable peeiings; gasoline; grease; hurbicides; meat scraps; medications; oil; painting products; pesticides: sanitary napkins: tampons; and water softener brine. ABANDONMENT When the POWTS fails andiur -x ocrmanently taken pot of service the ;ul,o'wing steps snali be taken to insure the: the system is plotsty and safely abandoned in compliance will, chapter Carom 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and tx abandoned pipe openings sealed. • -he contents of a:' tanks and pits shall be remover wvi properly disposed of by a Septage Servicing Operator. • Afler p;cnpiny, all tanks and pas shell be e>:c aunt r:d and :emoved o: their covers removed and the void space Tilled with soli, gravel or another inert solid material. CONTINGENCY PLAN It the PVVVTS tails and cannot be repaired the io.Ovaing measures have been, or must hr: taken, is provido a code compliant rreplacorncnt syston:: .A suitable replacement: area has been evaluated and may be utilized for :he location of a rxp:acenlen: soil absorption system. The replacement area should be protected frorn disturbance and compaction and should not ore infringed upoc by required setbacnS from existing and proposed structure, lot lines and wells. Failure to protect the replacement a,u will rusuh in tare nuod for a new soil and site evaluatior to establish a suitabie replacernenl area. Ruplacer unt systems must comply with the rules in effect at that time. ❑ A suitanlc replacu.ment area is not availaSiu due to setback andror soil limitations. Rarring acvances in PCPA 1 S technology a holding tank may be ins:allec as P. last Iesol: to replace tire failed POW1 S. p /Ir [rJ't -rwisKC-.A;e.-ne•.Fr-en'-trhrrtrd-tr.-itf.:trTf:-a--`tlRAhiF.T2.T5'ac'en+rA--rrrw-~Jfx+++Seikseu- "I;.-a-rot-aw"sitc.• IJ/r .••af Iali• . r r ~ . .a(^mt rtt-: faiia 'o o ant ne :e afc3 r,. PfZD~lydrTEn rro2ti `CanS77zu .noJ ❑ Mcxjrld and at-grade soli absorption systems may ire Iuconslrucwd in place following removal of the binmat at the infiltrative surface. Becorstrucnons of sack systems must comply verh the rules in effect at that time. WARNING> > SFPIIC, 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 TI4E INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER ~j POWTS MAINTAINER Name 'none 21-r 2 - l~ Pnnne J/L 23El- 2,5r~,O SEPT AGE SERVICING OPERAI OR (PUMPER] LOCAL REGULATORY AUTHORITY tdamc Name .-f?-(i I Y: Cp_lr_A.+I__ 2ON!41. - - - Pilot Thi- document ;•:as dratted Ili ~ompi.anc: rttr cdapter Ccmrr 53.L2i Zrlbi;:Iidi&If. ane 53.54( 1 i.:2I & ;31. W---oram Adimm,vntive : udn. S'1. CROIX cou.'N•1 SIT111 TANKMAlVTIi1~ANC3.Af3).LI:D473N'1' AND OWNERSHIP (17,RTIFICATION FORM 0wriet/Buyer 1 , Mailing Address J: _l i rt 1:~ _I L~1tt ( fill tii b f~ PmpertyAddress ~t r it I~'I (Vilification rc uned flat, l'lanniuf lc 7.onirp Dopartrnen: lot new conenucuon.) city/state _+-L't ' , ± "d I Parcel Ideutificalion Number LEGAL DESCRIPTION Property Local ion b' 'ir N 12 I ' fib', Town of Subdivision I , l rt f1 1 . Certified Survey Map # i 1 r- - Volume Page tt Wan auly Deed # t: l__ Voluule Page h Spec Mousse yes no 1.01 lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic svstcm could result in its premature failure to handle wastes. Proper maintenan;:r consists ol'purlipurg out the septic tank every three years or sooner, if needed, by a licensed pioneer. What you put inta the system can affect the fimction of the septic tack an a lrramrent stage in the waste disposal vst-al. Uwnci unainleaancc responsibilities are s;reci Bid in §C'omm. S:4 52(l) and ill Chaplcr 12 - St. Croix County Sanitary Ordinance. 7lie property ow•nei agrees to submit to St. Croix C'uunty Planning & 'Lonny, Department a certiticauon loan, signed by the owns: mud by a master phiualrer,.iournoyma:i plumber, restricted plumber or licensed punspet verifying that i the on-site wastewater disposal system i. in proper opetaling condition:u:dioi (2) alter inspection and pumping {if necus:vy), the septic tank is kxs than 113 fill] orSludge. Vwe, the undersigmcd have read the above requirements mid agree to maintain the private sewage disposal systorn with the standards set forth, herein, as set by the Department of Cmnrerce and the Department of Natural Resources. State of Wisconsin. Cerfi:icatitm slating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning D-p:munent withal 30 days of tlue tl: rer, yaar expiration date . I/we ccmfy that all mailenanta tut ll f""I tnic to the best of my:'out knowledge. l:we am/are. thr. owner(s) of the property described above, by virnue ofa wa arty decd recorded in P-gister of Dccds Office. Number of bedrooms SIGNATI.`RP.OFAPPLIC.ANT(ti)--- - -D.41'li *Any information that is nusreprwentcel rally result in Ihr sanitary pctnut tx:iug revoked by the Planuiug & Loniug Department. luchide with this application a recorded waimmy deer{ from die Register of Dccds office and a copy of the ecrGfied survey iuap if reference is made in the warranty decd. (KEv. 08!65) Vr,scnnsm Department of lndus.ry SOIL AND SITE EVALUATION REPORT Pace -l_ of 3 L:i of and Human Relaaor~ Dr; span of Safety &.,oddinps in accord with ILHH 83.05. Wis. Adm. Cocle ~ y Attach complete site plan on paper riot less than 8 1 2 x 11 mChos in size agingat rinctude bLt, St. Croix ,,of limited to vertical and horizontal reference point tBM„ dsection and °9 of Bfope, scale or .~ARCE_ LD a jj~ / cimenswned, north arrow, and location and distanco to rearest rocs' ,-xperi_i5w APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION , - W ~ r CATS ~'PC' RIVOWSL:. I, PR". FR"VLCCATON_ !T~ (-,3V?_CT S:V' 1'4 SkS 32 T 30 .N3 19 ic(oriW cq0PcRly OWNER S :'AIL NG 1)CRESSO L0~ nL6CKx S1.&N iIE09C5: a 12? 8 Trout Prook_ Rd. N lcsm C-V S7A-E IPCC.I.- P•iONE NUMBER ❑c, IV. ❑';ILAG(= .C'04'N rNEARES ROAC lluc'son, KT. 540'6 1715 549-6476 c '1Yout Frock Fd. tC. j~ New Construction Use [ Residential r' Number of bedrooms A~ 3 ( ] t clitioonn7to, ex/lSS't.-l bb Ild I) Replacement j Public or commercial describe- V:1_ L~- l Code derived early flow 450 gpd Recommended ders+on loading rate .7 ed, gpd f? .8 _ trench, gpd.~"2 Absorption area required 643 bed, «2 563 trench ft2 N4aximum design loading rate .7 ___bed. gpd+h2 .8 - trench, gptlift2 Recommended infiltration surface elevation(s) 85.67 _ft !as referred to site clan benchmark) Additional design; site considerations alt. area system, eL.=83.82 ' Parent material outwash Flood p ain a evation, it apc.irable na It S = Suitable lot system "JVVENTICNAL ^CI.VD N :rrCJN7 ?ae55C5E n4U= iVS?L' IN F _L FCL~ING "ANK U= Unsuitable for svste n KI S ❑ U ©S L U ICJ S❑ U S❑ U C3cS U if ❑ S U SOIL DESCRIPTION REPORT ~iou Root GPDift Depth Dom,nantCo'or vottles Texture Structure Consistence r' Boring # Horizon in. Munsetl Ou. St. Cont. Color Gr. Sz. Sh. i Bed TenctV 1 0-n L0 r3/3 none sil 2msbk mfr CS lm .5 + 1 - i 1-39 !..yr4/G none sicl 2msbk mfr gw if .4 ~.5 Gioa9d 3 39-88 .5 r4/4 none ms - osa mvfr na_ na .7 .8 90.0 It t Oe.Dth to limbng factor C 88~ ¢--lt _cT .S ` .1 ao Remarks: _ Boring # 1 0-7 1Oyr3/3 _ none sit 2msbk mfr cs lm li .5 .5 2 2 7-33 10yr5/~ none_ _ sic) 2msbk mfr :w l _.4 ! 5 Ground 3 33.138 7.5yr4/4 none ms os mvfr na na .7 .8 elev. 9U.f@ l 1\ Depth to limiting t(~ Tk actor - Remarks: CST Namc:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th.: t New Ri ihtnunel, WI 5401 Sicnature: ~ Date: -5-95 CS'I'Numbcr. m02298 f,._ , PROPERTYOWNER Clzlire.-11DULS; _ SUrL utSGhrrriurv ritrUni 2 3 PARCEL I.D.# pending I Depth Dominant Color Mottles Texture Structure Consistence Baxrdary Roots GPD!ft Boring # Horizon - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrend z 0-.S 10 r"2 2 none sil 2cshk mfr cs lm 5 6 2 6-28 7 0 rnone_ csl-,.k al fr 2 Ground 3 _ 28-82 7.5 r4 ,Inone . , ms yg mvfr n~ na .7 _.8__ elev. 88. 0(fl D Depth t to Depth limiting factor +82.. - Remarks: - - Boring # (;w if .4 5 9-27 10yr; 4 none mfr-- 3 27-80 7.5 r4 C> none .7 s Ground elev. 86.8 ft. Depth to limiting factor +80.1 Remarks: Boring # 1 0-1C 10yr2/2 _ none sit 2msblc fr rs lm .5 _.6 5 2 (10-37 10 r4 4 none sic] 2msbk 4 ..`L . Ground . 3 31-801 7.5yrV4 none ms fr-ra _,nn .7 •8 e 86. 8 it Depth to - limiting facto.' -80" I - Remarks. - - - Boring # Ground elev Depth to limiting factor Remarks: - - S8D 8330(H 0592;' PROPERTVOWNER Claire Ii. Pitts 6UIL UtJGHIFIIUrv nerUn' ru~o P ,,._3 PARCELI.D.t- - Pending Boring # Horizon Depth Dominant Color Mottes Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. COnt Color I Gr. Sz. Sh. Bed Trend) §1..' g 3 7 0-5 10 r2/2 I none _ Sim 2csbk mfr cs ]m 5 .6 2 5-28 10 r4/4 none ----aLCL--Jrqbk mfr Uw if .2 .3 Ground 3 28-82 7.5 r4/ , none elev. - - 88.0,. Depth to limiting L- factor - ` 82 -1_ Remarks: _ Boring # >a c° 1 0-9 i0yr3/ non bk__ . lID-. r, r, 4 „ 2 9-27 10yr4/4 none sicl - Ground 3 27-80: 7.5vr4 6 none elev. 86.8 If - J i Depth to limiting factor - - ! - - +80•• T Remarks: Boring # rrt;r i _-,0-10 10 r2/2 none sil .2 1 m 5 .6 5 2 110-31 10 r4 4 none if f x Ground 3 31-80 7.5 r_4/4 none mv-f 7 3 elev 86.8 ft. - Depth to Iimitng y~ factor +80" Remarks: - - - Boring # i i nos - _ _ Ground - - elev. Depth to - limiting factor - I Remarks: SBD 9330(8 05192) STEEL'S SOIL SERVICE Gory L. Steel Claire H. Uilts 1554 200th Ave. CSTM2298 s[•;';sw s32-T3oN-R19w New Richmond, WI 54017 MPRSW-3254 town of St. Joseph (715) 246-6200 lot #2-csm N 1"=40' BM.= top of SW lot stakes el. 100' k G~ G)C 2 20 ~ -~r~5 92 ~ I Cary L. Steel 9-5-96