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HomeMy WebLinkAbout026-1153-19-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No 592275 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township Parcel Tax No: OEVERING HOMES TOWN OF RICHMOND 026-1153-19-000 CST BM Elev: Insp. BM Elev: BM Description: SectionlTown/Range/Map No: 19.30.18.1157 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchma rk c/ • (J V iJ ~ a Alt. BM rl Besiflg ! lY Aeration Bldg. Sewer Q~•~ Holding St/Ht Inlet C) St/Ht Outlet C9 TANK SETBACK INFORMATION -9 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom D _ [ Header/Man. v J` 62 v O,K Aeration Dist. Pipe / ~•(Q Bot. System (0 g 'I, ,4g Final Grade PUMP/SIPHON INFORMATION • a 9~• Manufacturer Demand St C er GPM / CY ~ Model Number SystertLHead TDH Ft TDH Lift Friction Loss Forcemain Le tng h ! Dim Dist.~to Well I I _T_ SOIL ABSORPTION SYSTEM BED/TRENCH Width Lengt ~ / No. Of Trenches PIT DIMENSI Inside Dia. Liquid Depth DIMENSIONS (/J/ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: { u t INFORMATION T e Of System: UNIT CHAMBER OR Model Number: ypCI~ LI 1 (l tktj DISTRIBUTION SYSTEM -,T i4 Hea rlManlfold Distribution x Hole Size x H e Spa Ve t to Air Intake Pipe(s) Length Dia Length S aci SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded jxx Mul hed Bed/Trench Center ♦ Bed/Tren Topsoil es , No Yes No yI COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 945 146TH AV[E~p 1.) Alt BM Description 2.) Bldg sewer length Lk-A - amount of cover = . f 1 3-6 Plan revision Required? ❑ Yes K No • - k ; ~ ' ~ ~ , Use other side for additional information. L Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) }9~r xtrtti~ County r' r~l Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) i Madison, W1 53707-7162 ~~t Application St=TransactiQnNumber In accordance with S SA"/~VJ►~' is required prior to ob i permit Nd to Project Address (if different than mailing address) the Dcpartmeut essional Servies. Personal information you provide may be used for secondary purposes in accordance with the Priv Law, s. 15.04(1 m), Stats. ifs f /9 4/ h L Application Information - Please Print All Informati 1( _J Property Owner's Name Parcel # Property Owner's Mailing Address Property Location Govt Lot 4 City, State Zip Code Phone Number y., Section -le o J1. - 11 ype of Building (check all that a y) T Z N; R rV Subdivision Name pg J 1 or 2 Family Dwelling-Number of droom 7 BIM ❑ Public/Commercial - Describe Use City of A I/) 6 i - Number ❑ State Owned - Describe Use A Qr,~. SM ❑ Village of Z+6 ,L6 / `3 of - ` III- Type of Permit: (Check only one boa on line A. Complete line B if applicable) A. ystem ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain} B. ❑ Permit Renewal 4P- t Revision I ❑ Change of Plumber El Permit Transfer to New List Prevot~ ermit Number and Date lss ed t' Before Expiration Owner e~_ E j W. Type of POWTS System/Component/De-vice: (Check all that apply) -Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in_ of suitable soil ❑ o ding Tank =eFral omponent (ex plain) ❑ Pre catrnen Device (explain) V- Dis rsaVrreemation: Design Flow (gpd) Design Soil Application Raie(pds Disp/eal Area Required (sf)/ Disal posed (sf) llevatign VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ° v v New Tanks Existing Tanta -Jr, I L o v' a m v 1~^~ U rn cn ~ L Septic or Holding Tank Dosing Chamber - VII- IZrsponsibility Statement I e undersigned, ass responsibility for installation o the PQR "TS shown an the attached plans Plumber' Name (Print) - Plum Sidmature MP/MPRS Number Business Phone N~ f n h f' Mel 2 l' T lure 's Addrt (tree[ City; Ta Zip Cod w- ountv/De artment Use Only _ pproved isapprov1 -1 permit Feed Date sued issu5mg, Signature 5 /Z 17 eGiven Reason -f~o~rrDe al 1 Condi °Ry_,~afRX?pproval ` U t0l~iel:,W, WN r.►ust alll oeessPles~~tn 31 oI-V 6AL-c- AekJ t/ '(t v r~lr AB psr•~r8i~emen! plan pru rider) by plumbet~. i ~ 2. 'M.~Crus,u»t.te i irie'f I 1 as spFila+bla c I'adiumm. 14 Attach to wmpiete plans for the system and submit tot County o von paper not less than 8 rP_ z I1 inches in sir SBD-6398 (R. 11/11) Soil Test and System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 NW 1/4S 19 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 87.8/86.8 elow qrade 5/11/17 3 `r , 7 DATE BEDROOM CONVENTIONAL XXX ✓ t CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line 35' 89 150' B.M.* 10' B-3 i 91' 12% Slope 0' Vents 593' 15' B-1 to 146th St. B-2 2-3' X 66' cells with 3' Spacing 10' S 20' Pro 3 Bedroom House All piping shall be ASTM SDR 30/34, within 378' Property Line 10' of tank, piping shall be ASTM F891 95th St. Vent >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 2/pair of end caps Scale is 1 = 40' 4' Long 1;7--,56ftA Grade at System Elevation unless otherwise 34" noted Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County `J~ include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Review y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). S //Z-h Property Owner Property Locatigp Ad r 1!4 y /`,r„ J1 /4 S T N R E( ' W I T r.. 4 t r~ Govt. Lot Property Owners Mailing Address L Block # Subd. Name CSM# City /State Zip Code hone um r city ❑ /V*age fiC own Ne rest Roa New Construction User[ Residential / Number of bedrooms Code derived design flow rate ~ GPD ❑ Replacement Ptiblic or commercial - Describe: Parent material 04 Flood Plain elevation if applicable General comments and recommendations: System Type ~;;.°A~~'2c~ ~.PMf< System Elevation Boring # ❑ Boring 9 Pit Ground surface elevf_ ft. Depth to limiting factor t min. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 \I D Boring # Boring pit Ground surface elev. t`3 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 I t II Z Effluent #1 = BOD. > 30 < 220 rr;/L and SS >30 < 1 rr1Jn ' Effluent = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) i ure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address i~ Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 540 / 715-246-4516 Property Owner _ Parcel ID # Page of ❑ Boring # 1:1 Boring ~jt Pit Ground surface elev. " . ft. Depth to limiting factor// I~ 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 J 12, / F-F-i -1 Boring # ❑ Boring F-1 ❑ 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD5 > 30 < 220 rng/L and TSS >30 < 150 mg/L • Effluent #2 = BODs < 30 mgA. 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 (8.6/00) Property Owner _ Parcel ID # Page of ❑ Boring ❑ Boring # pit Ground surface elevn' ft. Depth to limiting factor/0 0 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 i ❑ Boring # U 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff 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/t_ ' Effluent #2 = BODS < 30 mg/_ 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 (8.6/00) I~ t~~ 1 L County r 1 Safety and Buildings Division < 201 W. Washln ton Ave., P. Bo) 7162 Sanitary Permit Number (to be filled in by Co.) 57 j 0 20,1 Madis Vt 07 62 COUNTY C 11 M Mat Permit App _ State Transaction Number In accordance with SPS 383 21(2), Wis. Adm. Code, submission of this form to the appropriate governmental tmit I r.. is required prior to obtaining a sanitary permit Note: Application fortes 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 secon purposes in accordance with the Privacy Law, s- 15. 1) m), Stats. _ C y 1. Application Information - Please Print All Informpft Property Owner's Name Parcel # g Property Owner's Mailing Ad S' Property Location i q• . ZY -s n 1 \ L,t/r--"+. -1 Govt. Lot city, state + ip a Phone Number /lam 1/4 A /(t y. Section !4 7 crrcle ope) T~N; R W II. Type of Building (check all that a Vry) Lot # amily Dwelling-Number of oo I Su 'vision Name (7 Block # ❑ Public/Commercial - Describe Use v 1kc ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of ) of ` 2. III. Type f Permit: (Cbeck only one box n line A. Complete line B if applicable) A. IVew System ❑ Replacement System ❑ Treatment/Hlolding Tank Replacement y ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal 11 Permit Revision El of Plumber ❑ P to New List Previous Permit Number and Date Issued Before Expiration l\ Q "14 IV. Type of POWTS System/Component/Device: C eck a that apPI4., FR ❑ on-Pressurized hi-Ground ❑ Pressurized In-Ground \AIte, > 4 in. of suitable soil ❑ Mound < 2 m. of suitable soil g Tank ❑ ` ter Drs ersal Component (explain) Pretreatment Device (explain) 11L 0 71 V. Dis rsaUTrea eut Area Information: i GC 10 --S Design Flow (gpd) Design Soil Application Rate(gp Dis ,.a Required (s Dispersal Pr posed (sZ Elevationj, Vol, Tank Info Capacity in Total # of Man actu er Gallons Gallons Units hew TankE xisting TanlS Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- f the undersigned, assume res rty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si MP/MPRS Number Business Phone N ber Plumber's Address (Street City, State, Zap Code), ~7111._Co6itvif]Department Use Only Approved ❑ Di Permit Fee Date sued Issuing . t Sigrtattzre eason for Denial 4113 7 ~ DL Conditio _,T + 51 ~,It pproval 4i4w.sti cell riust all be sel ~c>s ! n+~ ntc;r e~ /ha, .^.~.~a► Per,. plats pro rtged by N nbei • 2 7 1 must t*rtalrsftiml PIR #MAW FlI COW / iMiN A!. t 1f`~ Q J ' Attach to complete plans for the system and submit to the Coun only oa paper not less than R1rrz z t l i a in sue dCA, SBD-6398 (R_ 11/11) System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 NW 1/4S 19 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 92.7/92.3 4.5' below grade 3/30/17 BEDROOM 3 DATE CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale is 1" = 40' unless otherwise noted All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 to 146th St. i Pro 3 Bedroom House y II 30' S 2-3' X 66' cells with >3' spacing 20 40' B-3 97' 96' 378' Property Line 30 B-1 80' B-2 95' 5 S ope 95th St. Vent 35' >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 90' B.M.* - 2 /pair of end caps ' Long ;:_5.6ff 3 4 Grade at System Elevation C! x X Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/30/17 Owner:Oevering Homes Location: NE1/4 NW1/4 S19 T30 N,R18W 945 146th st. Richmond Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross ction 4-6. Maintanance a c( Conting cy Plan 7. Filter Cross Sectio Signature License numb r#226900 System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 NW 1/4S 19 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 92.7/92.3 4.5' below grade 3/30/17 BEDROOM 3 DATE CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale is 1" = 40' unless otherwise noted All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 to 146th St. Pro 3 Bedroom House 30' S 2-3' X 66' cells with >3' spacing 20' 40' B-3 10 M :Fu 97' 96' 378' Property Line 30' B-1 80' B-2 95' 5 S ope 95th St. t 35' if Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 90' B.M.* 5.6ft^2/pair of end caps Grade at System Elevation Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ftA2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 97.2 Vent Grade Vent 3' 4„ 3, A~30/34 Septic Tank 5' Long 5' 5' Long 1 3 6" Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tube/Vent At end of cell A B 16 chambers per cell System elevations: A 92.7' B-92.3' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM _ Owner/Buyer (52e ue ; ' n Mailing Address A/ Property Addr Zt (Verification required from Planning & Zoning Dep t or new construction.) City/State - Parcel Identificati - on Number v LEGAL DESCRIPTION Property Location Nt I4 , SeC. r 3 L Nft W, Town of Subdivision L-> /e,A,/~ ~ i Lot # Certified ~ Survey Map # Volume Page # Warranty Deed # Volume Page # Spec house yes no lot lines identifiable - yes no SYSEM MAINTENANCE AND OWNER CERTIFICATION lir>proper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of ncm out the septic tank every three years or sooner, if the System can affect the function of the septi tank as a treatment stage in the waste disposal system. licensed responsibilities are specified in Co pumper, 'What you, put into § mm. 83.52(1) and in Chapter 12 - St. Croix Coun Sant Owner maintenance County fury Ordinance. The property owner agrees to submit to St Croix County planning owner and by a master plumber, journeyman plumber, restricted plumber r a l ginning Department a certification form, pumper verifying that the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and site by the less than 1/3 full, of sludge. pumping (i#'neeessar y)> the septic tank is 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 De a Certification stating that your septic system has een maintained must be completed and returned to the St- Croix C ~ Wisconsin Zoning Department within 30 days of the three year expiration date, ty Plann ing & Uwe certify that all statements on form are true to the best of my/our lmowledge. I/we am/are the owner(s of the property described above, by virtue of a anty deed recorded in Register of Deeds Office. ) Number of bedrooms w IGNA OF APPLICANT(S) r~ l a I DATF, ***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) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE INFORMATION SYSTEM SPECIFICATIONS Owner E' Septic Tank Capacity g9j 0 NA Permit # Septic Tank Manufacturer ❑ NA )ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA 1 ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model Number of Public Facility Units -.O_NA Pump Tank Capacity al NA j Estimated flow (average) 27 aUda Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) J'rj aVda Pump Manufacturer NA I: Soil Application Rate % aI/da /if Pump Model NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit lb NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BODr,) <090 mg/L ❑ NA 13 Mechanical Aeration D Wetland Total Suspended Solids (TSS) :5150 mg/L ❑ Disinfection D Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NA Biochemical Oxygen Demand (BODs) 530 mg/L In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/LNA 11 At-Grade ❑ Mound Fecal Coliform (geometric mean) <104 cfu/100ml ❑ Drip-Line 0 Other: Maximum Effluent Particle Size X in dia. ❑ NA Other. ❑ NA Other. NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent Other: ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency !inspect condition of tank(s) At least once every: ❑ meonts(s) (Maximum 3 years) ❑ NA !Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume 0 NA ear(s) (Maximum 3 years) ❑ NA !Inspect dispersal cell(s) At least once every: D month(s) ~ ' month Clean effluent filter At least once every: ❑ ear(s)s) ❑ NA NA 1 nspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ year(s) 1:lush laterals and pressure test At least once every: p Yeart(s)s) NA Dther. At least once eve'}': ❑ 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 I-egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (36) or more of the tank volume, the entire contents of j:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. INN other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. .I% service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of r other chemicals START UP AND OPERATION for the presence of Painting products ° that For new construction, prior to use of the pOWTS damage check treatment s) if high concentrations are detected have the contents of the may impede the treatment process and/or the dispersal 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. is restored the excess wastewater will by h in the backup or surface cis r9e of eftluenlt During power outages pump tanks may ill above nomnal highwater levels. When power have cep(s) in one large dose, overloading the cell(s) and may Servicing Operator ~ to restoring power to this To discharged the contents of the pump tank removed by a Septage the pump controls to restore normal levels this to the situation dispersal effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating within the pump tank, disturb or compact, the area within Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise 15 feet down slope of any mound or at-grade soil absorption area. performance and prong the We of the POWT$: Reduction or elimination of the following from the wastewater stream may imprOl the perfo dis rrfac arms; fat; foundation drafin medications; oil; painting Prod antibiotics, baby wipes; dg butts; condoms; cotton swabs; degreasers; dental floss; diapers; uc~s; ( ble ins gasoline; grease; herbicides; meat Maps. ter, imp pump) water; fruit and vegeta P~ 9 Pesticides; sanitary napkins; tampons; and water softener brine. at the system is propetly ABANDONMENT taken out of service the following steps shall be taken to insure th When the POan fails and/or permanently dw taken Comm 83.33, Wisconsin Administrative Code: and safely abandSoned in kxxnpii d • 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 Serving OPerator- • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space fined with sail, gravel or another inert solid material. CONTINGENCY PLAN vide a code cornpCont it the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide replacement system: ion systeystelmm. infringed soli infringed upon absorptior suitable replacement area has been evaluated and may be utilized for the of a replacement ( The replacement area should be protected from disturbance and compaction and st=Id not will result in the nded setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement am crea will r with the rule;) in for a new soil and site evaluation to establish a suitable replacement area. Replacement systems effect at that time. advances in POWTS technologW a ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring holding tank may be installed as a last resort to replace the failed POWTS. luation site in evaalua as ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and be must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in piece following removal of the biomat at the infittraiive surface. Reconstructions of such systems must comply with the rules in effect at that time. A <<WARNING>> INSUFFICIENT SEPTIC, PUMP AND OTHER TREATMENT EiM T~AISY UCONTAIN LETHAL NDER ANY CIRCUMSTANCES. DEATH MAY RESUL~ REESCUE O~ NOT ENTER A SEPTIC, PUMP OR OTHER TREA PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWTS MAINTAINER EPOWTS iNSTALLER Name ~ Phone ~ J 'O`-c ~ _ `~l J ? Phone j - J11b 5-/ L7 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Y ~,,,,r. - 1~ r y =~3 Phone - This doaaneM was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), viisc onsin AdrninWastive Code. N j 1 I~ 1 P ' MI ON 1 , fi I I i o ~ P ~ O O -41 -v-. a Y f Ll V I ?v, J ~ i E N`~~ I I 1A' ~ i . lY Q I 6 71.284 S.F. (1.84 ACRES) 17 LJLO. EL - 927.00 , + i 81.015 IF. + 15 (t.e6 ACRES} 1 8 OT 1 L 8.0. EL - 927.00 + ' t + 74,037 S.F. #8,801 S.F. / IJ t r (1.70 ACRES) (I D4 -CREW l +r rr I r 10 B.O. EL - 923.00 LILO, EL 00, , ! { AGE 2783 ~ ~ 111 ~i 2 r 3'» .3e-E i la / f 19 SOUTH QUARTER CORNER S EEC. 19 t3/0N, Rie BAR FOUND (1.98 ACRES) l Ti r - , Ar P7' ST. M= m wm d /l n`y r Reco,d z3. 21 22 67.789 S.F. 20 1.510 S.F. 0.56 ACRES) 87.517 S.F. (2.01 ACRES) b ACRES} Q j J • 936.10 / r Q t ~ r ' ~ l y rr off ~89.ps• f x ' Zf ~OO~ D J ITCORNER (AS NOTED) [w apI / / 200. • _FOUND 3/4YN BAR O- 1 1 4x30 U!/Lk1 L FF00T 1-- T /fix/ 24' I ~REAROAauWEKH?NG Qg OTtfM 1D7 COIN eo + BEHCMARKS ON PROPERTY CORNERS [ELEVATION -ELEVATION 1"MENCED TO U.S.ItS. (NAVE 29) ~0~ r •ET f r _PROPOSED DRIVEWAY LOCATION ~ ~r ~ , -_RECaRlSEn 9Fa►xtt+chx7.urr Y q TIM A a sir sir ^ El N yy$$ x d N g z e ~ w e~ . i 1 y ~ ~ 1 1 Wiscctisin Department of Commerce SOIL EVALUATION REPORT Page of3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County C' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ` L p i include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. I / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. (O - //S3-/j D Please print all information. Reviewed by Date ~ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). A t~ ` 1 jtl.ti ~ ry • C. Property Owner Property Location rt.~e, Govt. Lot *W 'LA S T 3C N R E (o W PropertyOwner's Mailing Address lot Block # Subd. Name or CSM# City Tate Zip Code Pone Number ❑ City ❑ Village To Nearest Road 14'A "k-- & let, ' Code derived design flow rate New Construction useA Residential / Number of bedrooms GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material [~/c- Caw r) ~t Flood Plain elevation if applicable (V//' ft. General mments and recommendations: Se, Bori /f1C/ ~~1~'~K~✓ Boring ® ng # 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/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a~ I i ® Boring # Boring 1hL[73 pit Ground surface elev. C/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 OW 4" ~o To r- if Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mgL and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715-246-4516 Il Property Owner Parcel ID # Page of ring # Boring Pit Ground surface elev. 2- ft. Depth to limiting factor J G in. Soil lication Rate a Horizon Depth Dominant Color Redox Description Texture i Structure ! Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. f 'Eff#1 'Eff#2 E ' .3 Boring ❑ Boring # pit Ground surface elev. ft. Depth to limiting factor in. Soil ~Eplication 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 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil lication Rate F-1 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 Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/l. ' Effluent #2 = BOD, < 30 mg/L and TSS 5 30 m91L 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. saD-9330 (re.sroo) Soil Test Plot Plan Project Name Lakes and Hill Development Shaun d Address P.O. Box 10598 White Bear Lake Mn 55110 CS #226900 Lot 19 Subdivision Glen View Date 7/18/03 1 /4 N W 1/4S 19 T 30 N/R18 W Township Richmond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 92.7/92.3 *HRPSame as Benchmark Alt. BM Top of Survey Iron @ 97.4' Scale is 1 40' unless otherwise noted Please note: survey was not completed at time of testing, Please Note: Tested area setbacks from lot lines may may not be suitable for change. Installer must verify desired building area. all lot lines and setbacks Check system location before installation. before excavating. 40' B-3 97' 30' 96' 378' Property Li B-1 80, B-2 95 5 ° %pe 95th St. 35' 90' AIM. .M. ED LANDS lm 0 , loovto w "Ol 8 8 6 8 - .5304.65' •O•N' i~ ZO Q: Ytaa ; m 0 .00'00 f O E 605.11' _ ___soovLlo'E 444166' .1 ri bS z i n : 9'• o s - W ` 1011' 604.4Y O 1" U ~e.+ • mo 226.51' 126.53' 64.90' _ - W ap c ~{{=yy nJC g~JV{~ k2l M n b` g r ~ 3 eq me 40 C ~ Oc u~; ' h~ •l~ `jam` _ ~•f• - N = n y' co • ~```~ry ~i 9~ N O M m r + 1 m .i n r:J ~ m ~ M i ` \ m ~ q o m• • ' S04-532M a26.S4' h y N • M 1 'M .Mhos I \ ' m co I• m m m 2 m C'4 4N-. 04 ~ ~ \ 26251' (O ~ a \ 3A2,32 141 O ~ N16,+p16 \ ~ 1 ~ \II \ M N LO F tf~v \ \ 1 • M m• q'bii '68F&& ~YSJ \ \ i ml • [ `I .g M a m \ \ N m 9~ .rt M, .52-1 mod' • i 7y ' \ m N to m !Pp N \ M m a C-4 (N N 1 zW .t M • © b"w • N I I `I: ~H D I i ! .pia t 1 m 531E mfg m Ij i 1! ,Lz+ g _ N m • 1 69624~m i ~W 346.20' `I s1o'S 78 • +2+71 j o n.fr 1 1yj } < `mil ^ m 17a u% 166.07• «•41 i i '~r• ! ~/,ia = 3 N CO I iuq ° P~ i - 1° N M m X'1~ Zen i i 1 ! 503i 3 i n 1 I 1 owl Qe+ i 1 w ~A = m m i Z 1 1.-.. .1. • 5, NGE ~ 7 L CN -XI e I 1 / 7 M mI • / to X9`3' • / I N M / / yS1•s1 I ~ O / te) I 1 O N i 1 i O '1 SEE SHEET 2