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Home My WebLink About032-2045-70-200 (2) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 597316 GENERAL INFORMATION 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: SCHMITT ANDREW & MELISSA TOWN OF SOMERSET 032-2045-70-200 CST BM Elev: Insp. BM Elev: IBM DescrjptSection/Town/Range/Map No: 4p 12.30.19.658A-20 6, TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1.9 Benchmark 4 0,01.0 Dosing Alt. B d. 3 l aq. yL111L (ML Aesatwn Bldg. Sewer (J ~A 7 Holr ding St/Ht Inlet 6.3V ~ . TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t I I ~q~ •r Bottom Do Header/Man. (aa. Aerati Dist. Pipe Holding Bot. System r d 10~• w Final Grade PUMP/SIPHON INFORMATION . 3 165-1Z Manufact er Ge~and St Cover I~•~ of Mode bRb&T H i~ Eviction Loss System Head I DH 'It V Dist. td W641 Fonz ain Length Dia. 1 -7 SOIL ABSORPTION SYSTEM BED/TRENCH Width 7 Length I No. Of Trenches PIT DIM ONS No. pf Pits in de Tiq~ioepth ` DIMENSIONS \ 1 - J SETBACK SYSTEM TO P/L BLDG WELL LAKEl6T AM LEACHING Manufacturer: INFORMATION CHAMBER OR ~V1. Type Of System: i I UNIT Model Number: CDvxv 11 dy DISTRIBUTION SYS EM N Header/Manifold <001 Distr ution x Hole Size ix Hole Spacing Ven o Air Intake Y~ Pipe(s) \ I / gth Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Mulched Depth Over t Depth Over xx pepth of xx Seeded/Sodded F Bed/Trench Center Bed/Trench Edges Topsof Yes Noes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 894 162ND AV(E` Iii T'~Q ab✓~ 1.) Alt BM Description = j! uvp, (,L /Q. 2.) Bldg sewer length = - amount of cover = p Plan revision Required? ❑ Yes ❑ No Use other side for additional information. Date Insepctor's Signatur Cert. No. SBD-6710 (R.3/97) V' r- ~ti~xnr.~r~y. County 4/ ~o industry Services Division St. Croix p1400 E Washington Ave Sanitary Permit Number (to be tilled in by Co.) RE IV P.O. Box 7162 Madiso 1 53707-7162 15 4a OIN", : IA 4 IL State Transaction Number ani a ermit Appli o - In accordance with SPS ATT2 QW, submission of this form to t r e r rental unit is required prior to i JP ication forms for state-owne re submitted to the Department of Safety and Professional Services. Personal information you provide may b d for secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 162" Ave 01 L Application Information - Please Print All Information Property Owner's Name Parcel # 9 032-2045-70-200 Schmitt, Andrew & Marissa 3c),. i`t. & SEA -acs Property Owner's Mailing Address Property Location 1631 85`h Street Govt. Lot City, State Zip Code Phone Number NE SE'/4, Section 12 New Richmond, WI 54017 (circle one) T30N R19Eo0 H. Type of Building (check all that apply) Lot # ® 1 or 2 Family Dwelling-Number of Bedrooms 1 Subdivision Name ❑ Public/Commercial - Describe Use lock # " h~v~e ~la~s ❑ City of ❑ State Owned - Describe Use El Village of CSM Number UISM&MEN ELLS W y UNITS O 3/ „ ® Town of Somerset w I11. T eck only one box on line A. Complete line B if applicable) New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Com onent/Device: (Check all that apply) ® Non-Pressurized In-Ground Pre urized In-Ground El At Grade ❑ Mound > 24 in. Of suitable soil ❑ Mound < 24 in, o suitable soil ersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ers UTreatment Area Information: .11 Design FI v (gpd) Design Soil Application Dispersal Area wired (st) Dispersal roposed (sf) System Elevation 600 Rate(gpdsl}857 900 102.30', 101.30 0.7 VI. Tank Info Capacity in s~ Gallons total # of B ° Manufacturer U 4,5 6 Gallons Units ~ / /O~~r'' 0 2 9 New Tanks Existing Tanks J 2 U 75 N 0. Septic or Holding Tank 1250LP i01250 1 Wieser Concrete ® ❑ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum be ' ig Inre / J F223760 P/MPRS Number Business Phone Number John Schmitt 715-760-0486 Plumber's Address (Street, City, State, Zip Code) 616 150th Ave. Somerset, WI 54025 VIII. County/ eartment Use Onl 111!~! I0 roved ❑ =7~,n Date sue Issuing AgenSgnatu d~ Reason for Denial $ ' IX. Conditions Jypv~(,~ pns for Disapproval a e,~p~~ I U be ^lejer 1 1. Septic tank, effluent filter and ✓ Y 1 dispersal cell must be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per 1c It&nWA stem and submit to the County only on paper not less than 8 1/2 x I l inches in size SBD-6398 (803/14) PLOT PLAN jv Project Name: Schmitt 4 Bedroom Septic System Legal Description: NE1/4, SE1/4, S12, T30N, R19W PID: 032-2045-70-100 Subdivision Name: NA Lot 1 Township: Somerset Parcel Size: 11.394 Acres SCALE: V=60' County: St. Croix System Elevation: T1= 102.30 Proposed 90.00' EZ Flow Trench Slope: 13% T2= 101.30 Proposed 90.00' EZ Flow Trench BM1 Elevation: 100.00' Top of 2" PVC Pipe BM2 Elevation: 97.96' Top of 2" PVC Pipe ■ Backhoe Pits: Septic Tank Wieser Concrete W1250-MR See Plat Map for complete view of parcel Effluent Filter POLYLOK 525 4 inch Sch 40 -ASTM D2665 4 inch 3034 - ASTM D3034 12C EizT-Y ZlN_ 77/ PRc}°c rJiNi \ l W LL PL7(lvC til - \ Y 7- \ 10 P~4LI c i lJ L N D Page 2 CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Schmitt 4 Bedroom Septic System Owners Name: Andrew & Marissa Schmitt Owner's Address 163185th Stret New Richmond, WI 54017 Legal Description: NE1/4, SE1/4, S12, T30N, R19W Township Somerset County: St. Croix Subdivision Name: NA Lot Number: 1 Block Number Parcel I.D. Number 032-2045-70-100 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Septic Tank Specifications Page 4 Effluent Filter Information Page 5 System Sizing & Cross Section Page 6 EZ Flow Information Page 7 & 8 Management and contingency plan Page 9 Septic Tank Maintenance Agreement Page 10 Warranty Deed Page 11 CSM or Plat Attachment 1 Soil Evaluation Report Attachment 2 House Plans Designer: John Schmitt Licnese Number: MPRS 223760 Date: 5/3/2017 Phone Number: 715-760-0486 Signature: Z-V Z In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Page 1 PLOT PLAN N Project Name: Schmitt 4 Bedroom Septic System Legal Description: NE114, SE1/4, S12, T30N, R19W P.I.D: 032-2045-70-100 Subdivision Name: NA _ Lot 1 SCALE: V=60' Township: Somerset Parcel Size: 11.394 Acres County: St. Croix System Elevation: T1= 102.30 Proposed 90.00' EZ Flow Trench Slope: 13% T2= 101.30 Proposed 90.00' EZ Flow Trench BM1 Elevation: 100.00' Top of 2" PVC Pipe 0 BM2 Elevation: 97.96 Top of 2" PVC Pipe ■ Backhoe Pits: Septic Tank Wieser Concrete W1250-MR See Plat Map for complete view of parcel Effluent Filter POLYLOK 525 4 inch Sch 40 -ASTM D2665 4 inch 3034 - ASTM D3034 ~ T 0i2TN ~/~C~Erl7 Y Z~~= ScPT' ~ ~ ~1 ~ pRe'e5~0 TANFZ wrlL .,lt~ DQ rLi Q W r` 63 id` ig= D b~ I zND ~}Vi~iUt~lr Page 2 ti E aged D z x Ln rn 52j" AS 84„ D REQD z 41„ m z ~ m N -i rn l7 0 o m I 1 \ I I I / 1 o j w I x 3„ I 441" 5° D m o I I ° I m o I 36" ~I C r I m I 1 WF I I > I, N i l r0 ~1 J X I i t \ J x m K z o0 39> m n ~ D I D I Fri D r n r- = n r o z z D or m m D O~ C7 Z DOZ Ewgr'=mc<<~m*o X tmTi X~ mZ O OCO D o zp >*Z cOOaOZRI~rz zz oo MO D~m ~Dm oF~O0N~ = n Ln D o - n 9 ~mm -1lc/) rc,~o~.N_ n TI O ow z> o r 00 cnm> DD mrn ? °b w n 0- c rn I r L/) o D 0 ~'o \ c m~ri (1) co ° o0 o z o z v o -p z m D D mo o' ;o c o v D z cm c L40 r nr-D Do m 71 C7W D W z r~ D O D ~ m D z DS O a) z o o O H t0 o°X (A z m n ;o z D X D D F O (n m r~ { C) r m r -1 rn n D l/t m 71 o o o c z ;o rri U) U) V) z o mm r m C n O 00 z r C DH m m r~ ~ m 0 \ m WLP1250-MR MIESER CDIICAETE DRAWN BY: WCP REVLE: 1/4"=l'-O" PRE-POUR: -i SEPTIC MANUAL DATE: 00/00/00 DATE: POST-POUR: z W3716 US HWY 10 MAIDEN ROCK, WI 54750 p 800-325-8456 FILE: U1250-NR ~ fr i i it .W ii Inns atiaus rn Pracasi, Drai e Zabel cl °~asf2vra?8r Products A Division of Polylok inc. Filter Th L-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-1.22, the Polylok PL-525 has an automatic shut-off bail installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. Alarm Switch ®Rated for 10,000 GPD (gallons per day). (optional) 525 linear feet of 1/16" filtration. Accepts 1" PVC Accepts 4" and 6" SCHD 40 pipe. Extension Handle Built in gas deflector. Automatic shut-off ball when filter is removed. [gated for Alarm accessibility. 10,000 GPD ® Accepts PVC extension handle., Jt~z (deal for residential and commercial waste flows up to 525 Linear Ft. U of 1/16" 10,000 gallons per day (GPD).-- Filtration slots 1. Locate the outlet of the septic tank. 2, Remove the tank cover and pump tank if necessary. Accepts 4" & 6' 3. Glue the filter housing to the 4" or 6" outlet pipe. If SCHD 40 pipe the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. Certified 40 5. Replace and secure the septic tank cover. k N5ZF/At4Rp Q+n"f47.r,4 A$3 I'1,•-"'r Maintenance: The PL-525 Effluent Filters will operate efficientty for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter Gas Deflector needs servicing. Servicing should be done by a certified ' Automatic septic tank pumper or installer. Shut-off Ball 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all ~t solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making Outdoof S*nai it ilte i? raar,r, Extend Lo k ]M sure the filter is properly aligned and completely inserted. Polylok, Zabel & Best filters accept Easily installs 7. Replace and secure septic tank cover. the SmartFilterfl switch and alarm. into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com Page 4 SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Project Name: Schmitt 4 Bedroom Septic System Gravelless Leaching Unit Specifications Manufacturer Model Laying Length EISA Rating EZ1203H-5ft 5.0' 25.0 Infiltrator EZ12031-1-10ft 1o.u 50.0 System Sizing EISA Rating per Foot of EZ Flow 5 {tz Soil Application Rate 0.7 9Pd/ 600.0 gpd Design Flow _ HE Soil Application Rate = EISA = 171.4 Feet of EZ Flow F trenches 90 feet long each 2 No. of Cells 9 Per Cell 3 ft Cell Width 18 Total No of 1203H 90 ft Cell Length 450 sq ft EISA Per Cell 3 ft Cell Spacing 900 sq ft Total EISA Typical Cross Section Observation Pipe with Finished Grade 104 ft approved cap or vent Soil Backf ill 36 inch Geotextile Fabric 12 inch >3ft ~ Slotted and Anchored Vent/Observation Pipe O i with Cap 101.30 ft. Infiltrative Surface >36 inch 102.30 ft. Plumber/Designer Signature: License MPRS 223760 Date: May 3, 2017 Page 5 I Installation Instructions for EZ OWTM EZ~ow Systems in i~iscopl isin flbyF11.TRATOR Wisconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shall Division, has reviewed the specifications and/or plans for this : be sized based on maximum daily sewage flow (GPD) and product and determined it to be in compliance with chapters the Permeability for the site. If certain criteria is met, the Comm 82 through 84, Wisconsin Admin. Code, and Chapters EISA sizing can be used in Wisconsin, resulting in a 40% 145 and 160, Wisconsin Statutes. All sites must meet the Site smaller drainfield. & Soil Conditions & Locations & Isolation distances as noted in local regulations. ; 6. Place EZflow bundle(s) in the EZflow configuration ap- proved by system design permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in ; lar site. The top or center-most bundles containing pipe center bundle in 5' or 10' lengths) and 1203HP (3-12" bundles ; are joined end to end with an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. ; additional aggregate only bundles that may be required, • should be butted against the other aggregate-only bun- A single pipe bundle contains a four inch perforated pipe sur- dies and do not require any type of connection. rounded by EPS aggregate and is held together with poly- ehtylene netting. A single aggregate bundle contains aggregate ; 7. The top of each GEO cylinder contains a filter fabric pre- only and is held together with polyethylene netting, manufactured in between the netting and aggregate. The fabric is inserted to prevent soil intrusion. The installer Materials and Equipment Needed shall make sure the the GEO is positioned upward and is • EZflow Bundles : in contact with the fabric contained in the adjacent cylin- • EZflow Geotextile Fabric : der before backfilling. • EZflow Internal Pipe Couplers • Pipe for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a • Backhoe/Excavator level trench in all directions (both across and along the trench bottom) and should follow the contour of the ground Installation Instructions surface elevation (uniform depth), with all continuous The instructions for installation of EZflow products are given adjoining 10-foot cylindrical bundles placed end to end, below. This product must be installed in accordance with state ; with central bundle distribution pipe interconnected, rules defined in chapters Comm 82 through 84, Wisconsin Ad- ; without any dams, stepdowns or other water stops. ministrative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design 9. The trench top shall be graded such that water will not manual. pond. Backfill should be seeded or sodded immediately after completion to reduce erosion. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or careful to set correct tank, invert pipe, header line or dis- other obstacles. tribution box and trench bottom elevations before instal- lation of pipe bundles. 11. EPS aggregate is lighter than water, therefore, it might be expected that natural buoyancy forces would tend to 2. Remove plastic EZflow shipping bags prior to placing cause EZflow assemblies to float out of ground when bundles in the trench(es), Remove any plastic bags in the ponding occurs. Field experience has shown, however, trench before system is covered, that this is not a problem when systems have a minimum • of 6" of soil cover as recommended by manufacturer. 3. This product must have geotextile fabric that meets re- ; quirements of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed directly on top of the product and extending 1203H-GEO down along the sides of the product to a point at least six Geotextile inches from the bottom of product. Barrier Material 4. When installed in a trench, the trench should be dug to 2^ a width of 36 inches. This not only saves labor in excava- tion, but also provides better load-bearing capacity after backfilling is complete. , 36' Page6 POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner: Andrew & Marissa Schmitt Tank Manufacturer: Wieser Concrete ❑ NA Permit # 0 Septic ❑ Dose ❑dolding Volume: 1250LP DESIGN PARAMETERS Tank Manufacturer: NA Number of Bedrooms: 4 El NA ❑ Septic ❑Dose ❑iolding Volume: gal Number of Public Facility Units: ' NA Vertical Distance Tank Bottom(s) to Service Pad: ft Estimated (average) Flow: 400 gal/day Horizontal Distance Tank(s) to Serivice Pad: ft Design Flow = estimated x 1.5: 600 gal/day Specific servicing mechanics must be provide if vertical is>15 feet or if In Situ Soil Application Rate: 0.70 gal/day/ft2 horizontal is > 150 feet. Specific instructions to be provided on back. Standard Domestic Influent/Effluent Monthly average Effluent Filter Manufacturer: POLYLOK ❑ NA Fats, Oils & Grease (FOG) 530 mg/L Effluent ter Model: Biochemical Oxygen Demand (BOD5) <_220mg/L ❑ NA Pump anu acturer: Total Suspended Solids (TSS) :5150mg/L Pump Model: High Strength Influent/Effluent Monthly average Petreatment Unit i NA Fats, Oils & Grease (FOG) s30 mg/L Manufacturer: Biochemical Oxygen Demand (BOD®) s220mg/L NA ❑ Mechanical Aeration ❑ Peat Filter Total Suspended Solids (TSS) <-150mg/L ❑ Disinfection ❑ wetland Petreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ other: Biochemical Oxygen Demand (BODe) 530mg/L of sorption System Total Suspended Solids (TSS) <_30mg/L NA In-Ground (gravity) ❑ In-Ground (pressure) Fecal Coliform (geometric mean) 510acfu/100m1 ❑ At-Grade ❑ Mound Maximum Effluent Particle Size: /6 in dia. A ❑ Drip-Line ❑ other: Other: ❑ N Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency When combined with sludge and scum equals one-third ('/3) of tank volume Pump out contents of tank(s) When the high water alarm is activated At least once every: 3 ✓ month(s) (Maximus 3 Years) ❑ NA Inspect condition of tank(s) ear s) At least once every: 1.5 J month(,) (Maximun 3 Years) ❑ NA Inspect dispersal cell(s) ❑ year(s) At least once every: 1-5 J month(s) ❑ NA Clean effluent filter year(s) At least once every: 1.5 J month(s) ❑ NA Inspect filter alarm ears) H month(s) Q NA ear s month(s) NA year(s) 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 Insepector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspeciton 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 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 indicated a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumualtion of sludge and scum in any treatment tank equals one-third 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 Admininistrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, petreatment 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 30 days of completion of any service event. (Rev.2/05) Page 7 Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil 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 extended 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 and may overload them resulting 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) discharge; 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, 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. • 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 the opportunity to obtain a sanitary permit for 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 the time of their permit issuance. ❑ A 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 POWTS 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 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: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT. ADDITIONAL INFORMATION: POWTS INSTALLER POWTS MAINTAINER Name: John Schmitt Name: John Schmitt Phone: 715-760-0466 Phone. 715-760-0486 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name: Marko Septic Name: St. Croix County Zoning Phone: 715-749-3404 Phone: 715-386-4680 This document is intended to meet minimum requirements of Ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. (Rev. 2/05) Page 8 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Andrew and Marissa Schmitt Mailing Address 1631 85th Street Property Address ~t6clq IU?-nA Nt (Verification required from Plarming & Zoning Department for u w construction) New Richmond, W1 032-2045-70-200 City/State Parcel Identification Number LEGAL DESCRIPTION 12 19 , T 30N R W, Town of Somerset Property Location NE 1/4 , SE r/4 , Sec. Subdivision Plat: , Lot # Certified Survey Map # W Volume , Page # Warranty Deed # _ ~ 1~ V-0- 3 60 (before 2007)Volume , Page # Spec house OyesEho Lot lines identifiable ByesE] 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 fturction of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by v' a warranty deed recorded in Register of Deeds Office. Number of bed~,ooms 4 n re ~ ti y 3 / 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. 04/_12) Page 9 P I , S ~ + r ~ ~ -.j,, I t i III • 11 y III i ~ II ~~,I _ x%~ ' li ~ i I I~ y ' J ~ I - - EE !~"~L---t----~! •7 i~ t i III 3 ~ i L Qwv , I I I' FBI t L.._ A I I i II LLJ s ~ I x s' I i . l i ' I I , I k I ~-1"I i1L~i4"~C1 ~✓vCiCk ~ 11O H=J~M'V'S~~ C~'W 8~,CiN4 I( ~ i t E t a g 'r t ! I i k s I : { 3 n li a i I I II i 7 ~;I E i I I q i LE07G hM RCN C7Wr ~l ! MEN zlvw3 v tiJl1® lili 't" JB t7SSI L~ .~Q .C> f : P r'r t N y w, i a _ j i i r L~D I 1. I r~ I~ P L • °o ~I , f y~ i i ! RECEIVED Iff 11 Department of Alk #1807 o SOIL EVALUATION REPORT -1 3P,t 40ty" in accordance with Comm 85, Wis. Adm. Code / 00 Page 1 of _4_ Professional Serv ces chmitt Soil Testing, Inc. ST CROIX COUNTY County Attach compfeowwwwl t~ on W reference, x 11 inches in size. Plan must St. Croix include, but not limited to: vertical an eference point (BM), direction and 03a ' o" v =rc 2_ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. ~a Please print all information. Reviewed B Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (Ji[ Z9 Property Owner Property Location v Flandrick, Richard/Schmitt, Andrew Govt. Lot NE1 , SE1/ S , T30N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or C # 1623 85th Street na NA City State Zip Code Phone Number City Village Town Nearest Road New Richmond WI 54017 715-529-3505 Somerset 162Nd Ave. New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Outwash plain (Sattre Series) Flood plain elevation, if applicable NA ft. General comments Area is suitable for a conventional syste with a 0.7 gpd/sqf e. ssible system elevation for Area 1 is 102.30'(high trench) and recommendations: 101.30' (low trench). f Boring 1 Boring # Pit Ground surface elev. 105.30 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ GPD_/ft_ Z _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *E2 1 `Eff#2 1 0-10 10yr3/2 none sl 2mgr mvfr as 1vf` 0.6 1.0 2 10-16 10yr4/6 none scl 2msbk mfr gw 1vf 0.4 0.6 3 16-24 7.5yr5/4 none grls lcsbk mvfr gw 1vf` 0.7 1.6 4 24-96 10yr6/4 none s Osg ml 0.7 1.6 107 2 Boring # - - Boring Pit Ground surface elev. 105.30 ft. Depth to limiting factor 98+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0-8 10yr3/2 none sl 2mgr mvfr as 1vf` 0.6 1.0 2 8-12 7.5yr4/6 none grsl 2msbk mfr gw 1vf` 0.6 1.0 3 12-20 7.5yr4/6 none gris lcsbk mvfr gw ivf 0.7 1.6 4 20-98 10yr6/4 none s Osg ml 0.7 1.6 61 Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 L n TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt _ _ _ 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd St. New Richmond, WI 54017 12/2/2015 715-760-1978 SBD-8330 (207/00) Property Owner Flandrick, Richard/Schmitt, _ Parcel ID #,032-2045-70-100 Page 2 of _ 4 Boring 3 Boring # Pit Ground surface elev. --_-102.34ft. Depth to limiting factor 96+ 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 10yr3/3 none grsl 2fsbk mvfr as 2vf 0.6 1.0 2 10-15 10yr5/4 none grsl 2msbk mfr gw 1vf 0.6 1.0 3 15-20 7.5yr5/6 none grls Osg ml gw 1vf 0.7 1.6 4 20-96 10yr6/4 none s Osg ml 0.7 1.6 Boring F-1 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 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 3 of 4 Conducted by: Conducted For: Schmitt & Sons Excavating, Inc.. Name: Flandrick, Rick/Schmitt, Andy Thomas J. Schmitt, CST 227429 Address: 1623 85th St. 586 Valley View Trail City, State, Zip: New Richmond, W154017 Somerset, Wl 54025 Phone: 715-760-1978 PID: 032-2045-70-100 Signature... Lot No. Date Legal Description: NE1/4 SEI/4 S12 T30N R19W ® Backhoe Pit Township, County: Somerset Township, St. Croix County ® Bench Mark 1 El. 100.00' Top of 2" PVC Pipe. Q Bench Mark 2 El. 97.96' top of 2" PVC Pipe ! Slope= 13% Scale 1"= 40' r i j t I NO E: For full view of Lot see Aerial Photo (Page 4 of 4)_ _A ~ a._ z I 7 i ~5~tA t ' \ \ ! { I , 106 t i 50 6,.Iy /"g,)16'fz T/ G-/-A/t J i 160?Nd A,2f ~O n e~ .r A ❑ u: V'F a eC LLJ Y r W 4. •q " i c'q >z . _ C Cl) m tG i[r . s Mar x.x ;~:'~1~'1 r ~ mrT~ , ~ g` ~ . ~ a 0