HomeMy WebLinkAbout008-1059-10-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT sanitary Permit No
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 597397
:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2949369
Permit Holder's Name: City Village Township Parcel Tax No:
TIM & JODY RAMBERG TOWN OF EAU GALLE 008-1059-10-000
CST BM Elev: Insp. BM Elev: BM Description: 1 11 Section/Town/Range/Map No:
w ~ IppG 20.28.16.296
TANK INFORMATION C ^,hYS' O& SATION DATA
TYPE MANUFACT ,,cG b1 ' CAPACITY STATION BS HI _ FS ~ LEV.
Septic ~C ✓ ,rK-- f I IV 1 `,V l ~~l/ Benchmark's
Dosing Alt. BM
Bldg. Sewer G
law : o
vk 5 ~Z.~s; S 96, 3 k
t Inlet _
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO OP/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic , J OD S/00 Dt Bottom qp,
Dosing ~ "v
Head / 103,,7/
Aeration
Dist. Pipe
Holdi
Bot. System 3
al Grade
PUMP/SIPHON INFORMATION
Manufacturer I and
St Cover v"
GPM
Model Number
1 ;
TDH Lift Friction Lod, System Head Tj Ft
Force irk Le ,L Dia.~ t► Dist- to Well
SOIL ABSORPTION SYSTEM U
BED/TRENCH Widt / Ler"h_ No J{ey~cp~s ~ PIT DIMENSIONS No. Of s Inside Dia Liquid D
DIMENSIONS 111-7 uC
SETBACK SYS EM TO P/L BLDG WELL LAKE/STREA LEACHING Manufacturer:
INFORMATION T CHAMBER OR
ype ~tQr►:~ / 71/~~ _2~~ UNIT Model Number
///V o
DISTRI UTI YSTEMIV/ IL4,,j AA,,
Header/ Distributio ix Hole Size ix Hole Spacing r TVA Air Intak !Aa. Length Dia Length-_Z J • 5 Dia~ S acin V
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only la
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx rvfu Bed/Tren C I Bed/french Edges Topsoil
Yes i_ Not es No
CO M NTS: nclude code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 263 222ND ST
1.) Alt BM Description COW-
2.) Bldg sewer length =
- amount of cover = UPI a~ Vn~i~ IDIKi2
l 6~' See #4
Plan revision Required? EI Yes No l
Use other side for additional mforma on. L L
SBD-6710 ale Insepcto s Signature C
(R.3/97)
~s 1 County sl i. ,I o(,
Safety and Buildings Division ~J~V
1 201 W. Washington Ave., P.O. Box 7162 St. Croix
Madison, WI 53707-7162 Sanitary Permit Number (to be tilled in by Co.)
JUL 07,317
►sT. 'tT9rmit M6QMJRW9B9H12 State Tr an etionyN~nmber
In accordance-QM N383.21(2), Wis. Adm. Code, submis!...... d unit 1 '"1 .3 W
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mAlmg address)
~1
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04(1 )(m), Slats. Z45 Same
1. Application Informat on - lease Print All Information
property Owner's Name Parcel #
Tim & Jody Ramberg V 008-1059-10-00
Property Owner's Mailing Address Property Location V
263 222"d St. Govt. Lot ~C
City. State Zip Code Phone Number SE /a, NW /A, Section 20
(circle one)
Baldwin, WI 54002 (715) 928-0667 T 28 N; R 16 L or W
II. Type of Building (check all that apply) Lot # Block # ~'1~.J
I or 2 Family Dwelling - Number of Bedroom 3 Na Subdivision n Name
N a et~ IQ. C
[I Public/Commercial - Describe Use `
Na ❑ City of
❑ State Owned- Describe Use CSM Number ❑ Village of
Ov Na Town of Eau Galle
X / 1 Z. •
:5
111. Type of Permit: (Check only one box on line A. Com e B if applicable) fo,
A.
❑ New System Replacement System ❑ `IYeatmenllHolding Tank Replacement Only ❑ Other Modification to Existin stem (explain)
1
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner
IV. Type of POWTS System/Component/Device: Check all that apply
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable oil
❑ I folding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dispersal/Treat m t Area Information: PoIy1,o1VV PL-525 effluent filter
Design Flow (gpd) Design Soil Application Rate(gpdst Dispersal Area Required (st) Dispersal Area Proposed (st) Syst
450 Gpd 0.2 gpd/sq. ft. 2,250.00 sq. ft. 2,250.00 sq. ft. 103.00' at 4" above
101.00' contour
VI. Tank Info Capacity in Total # of Manufacturer
L
Gallons Gallons Units o o
U a; ro
New Tanks Existing Tanks ❑ a
w ~ 52 ~ ~ ~ w ~ is.
Septic or Holding Tank 1,000 Na 1,000 1 W ie e Concrete X
Dosing Chamber 600 Na 600 1 Combination
VI 1. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
Dale Hudson MP 220853 (715) 684-3378
Plumber's Address (Street, City, State, Zip Code)
820 Main St., Baldwin, WI 54002
VIII ount /De artment tJse Only
Approved Permit Fee 'D tte sued Issuing nt Signature
G iven Reason for Denial $ ~~6 I 1 7
IX. Condi Disapproval f
pFut prv titierf by plumber.` ate- f
22. Must.` be rrwrr VEd
Attach to complete plans for the system and submit to the County only on paper not less than S 1/2 x 11 inches in size
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MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Names Ramberg 3 bedroom replacement residential Mouna v~ .
Owner's Name Tim & Jody Ramberg
Owner's Address. 263 222nd St. _
Baldwin, WI 54002
Site Address: Same _
Ct i :"LjITIC~,r,LLY
Legal Description SE1/4 NW1/4, Sec. 20, T 28N R 16W APPROVED.
DEPT OF SAFETY ANA
Township Eau Galle PROFESSIONAL SERVICES
DIVISJ,P4OF lh"STRY; ERVICES
County: St. Croix
Subdivision Name: Na SEE Cpt r
Lot Number. Na Block Number. Na
Parcel I D Number From 008-1059-10-000
Plan Transaction No.
Page 1 Index and title
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 Site Plan
Page 9 Attached Soil Evaluation Report
Designer Dale Hudson License Number 227594
Date 04/27/17 Phone Number: (715) 684-3378
Signature
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 1 1/12), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10112)
Version 7.0 (R. 11112) Page 1 of 9
Mound and Pressure Distribution Component Design
Design Worksheet
Site Inforr nation
(R r C) RI Residential or Commercial Design Note: sand fill (D; calculations assume a
30 Table 383-44-3 in-situ soil treatment for
- - j
_0.00 1 Estimated Wastewater Flow (gpd)
1.50 Peaking Factor (e.g. 1.5 = 150%) fecal conform of - 36 pinches.
450.00 Design Flow (gpd)
7.00 Site Slope
101.00, Contour Line Elevation (ft)
1 00 Depth to Limiting Factor (in)
L0.201 In-situ Soil Application Rate (gpd/ftr)
Distribution Cell Information
112.50 Dispersal Cell Length Along Contour (ft) = 4.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft2)
1- Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution r~ Y
Pressure Disribution Information network? Enter Y or N
C or E) c Center or End Manifold
2.00 Lateral Spacing (ft) If N above, enter the elevation (ft)
_ 4 Number of Laterals of the highest point _
0.125 Orifice Diameter (in)
2.00 Estimated Orifice Spacing (ft) = 4.02 ft2/orifice
2.00 Forcemain Diameter (in)
210.00 Forcemain Length (ft) Does the forcemain drain back? l ' _
` 85.50 Pump Tank Elevation (ft) Enter Y of N
6.50 System Head (ft) x 1.3 34.25 Forcemain Drarnback (gal)
17.21 Vertical Lift (ft) 70.79 5x Void Volume (gal)
9.02 Friction Loss (ft) 105.04 Minimum Dose Volume (gal)
0.00 In-line Filter Loss (ft) 46.14 System Demand (gpm)
32.73 Total Dynamic Head (ft)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice-
0.75 1.25 x _
1.00 1.50 x {
1.25 x x 2.00 x l x _
1.50 x 3.00
200 x
3.00 x
Gallons/Inch Calculator (optional)
Treatment Tank Information 592.00 Total Tank Capacity (gal)
1000 50 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (In
Weiser Concrete Manufacturer 16.00 gal/in (enter result in cell 349)
Dose Tank Information Effluent Filter Information
592.00 Dose Tank Capacity (gal) PolyLok - - 9Filter Manufacturer
6 00 Dose Tank Volume (gal/in) PL-525 Filter Model Number
Weil ser Concrte:] Manufacturer
Project: Ramberg 3 bedroom replacement residential Mound Page 2 of 9
Mound Plan and Cross Section Views
0 J
Observation Pipe
1/FKf-
A
B
z
a
L
Mound Component Dimensions
Down slope toe extension made.
A A24.00 ft E 27.36 in H [A8. ft K 11.73 ft
B ft F 9.25 in ft L 135.97 ft
D in G 0.50 ft J ft W 28.11 ft
450.00 (ft 2) Dispersal Cell Area 2250.00 (ft`) Basal Area Available
4 00 (gpd/ft) Linear Loading Rate 11.25 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 104.77 ft
_ ♦ H
I/A
G •I
F Dispersal Cell 103.50 (ft;; Lateral
Invert
103.00 (ft)-
7
Dispersal Cell ~3 r
Elevation F D
101.00 (ft) Contour Elevation
7.0 % Site Slope
Geotextile Fabric Cover
Shading Key a Dispersal Cell See lateral details on
• Topsoil Cap o a 1.5 ft Page 4 for number, size,
Subsoil Cap w o and spacing of laterals.
ASTM C33 Sand .5 J F Laterals are equally
spaced from the
~I Tilled Layer 0 5 ft Typical Lateral distribution cell's
T Aggregate a o Qr centerline in the
- A, distribution cell (AXB)
?roj:~ct. Ramberg 3 bedroom replacement residential Mound Page 3 of 9
.
Center Connection Lateral Layout Diagram.
F,f, e rr R --~_flrlayt;fl~S!%,,ate.• ,f cfoI..: t0 minisoid 34 an)¢afilrl{ I~a4813i~ ~ilrnt,w_al
t 1['
•=Turn-gyp e it,i 17v a ive ix (.=x-yle-r1G.~-xt1 i) Lc+i>=FF715 lilrulYi ir1 -~IJ PVC
c1~7noW1~.~lrt~+ I { Y
per Csrht.itr~ 3~A 3t~_,`r#ule% Urllta^tf crE tk.r a+~tt~s~, of tape 6atkrsl
Number of Laterals 4 Orifice Diameter _ 0.125 in
Lateral Diameter 1.25 in Orifice Spacing (X) 2 02 ft
Lateral Length (P) 55.55 ft Orifices per Lateral 28
Lateral Spacing (S) 2.00 ft Orifice Density 4 02 ft`/orlfice
Lateral Flow Rate 11 53 gpm Manifold Length 2 00 ft
System Flow Rate 46.14 gpm Manifold Diameter 2 00 in
Total Dynamic Head 32 73 ft Forcemain Velocity 4 71 fLSec
Dose Tank Information Locking cover with warninq
label and locking device anti
sealer watertight
Ek,ctncai as par NEC 300 and I~
SIPS 316 300 WAC 4 if, !nin
Disconnect -111111i
Tank component is properly vented Alternate outlet
location
Forcemain diameter
Weiser Concrete Manufacturer - 2 in
Capacity 592.00 Gallons - T
Volume 16.00 gal/inch A
Weep nole or ant-
Dimension Inches Gallons B sipnon device
A 18 93 302.96
B 2.00 32.00 C Pump off_alevation tft,
C 6.57 105.04 862 9
D _9.50 152.00 D
Total 37-00 592 00
Dose tank elevation (it)
-
3" Bedding un er tank 85 50
Alarm Manuafacturer SJE Rhombu_s_ Note_ Switches
Alarm Model Number SJE 1011421 containing mercury
may riot be used ire
Pump Manufacturer Goulds tms system -
Pump Model Number 3885 WE07H
Pump Must Deliver 46.14 gpm at F---3-2-7-3-1 ft l DH
Proji3ct Ramoarg 3 bedroom replacement residential Mound Page 4 of 9
Mound System Maintenance and Operation Specifications
Service Provider's
POWTS Re ulatorName Dale Hy dson g _-p Phone`(715 684--13-378
g Name a St. Croix County Zoning De t PhonE 71 5) 38E -4E~80;
System Flow and Load Parameters
Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in
_stimated Flow - Average 300 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 150 mgil-
So I Absorption Component Size 450 ftz Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 ctu/10C m'L
Service Frequency
Septic and Pump Tank Inspect and/or service once every 3 years
Effluent Filter Should inspect and clean at least once every 3 years
Pump and Controls Test once every 3 years
Alarm Should test monthly
Pressure System Laterals should be flushed and pressure tested every '1.5 years
Mound Inspect for ponding and seepage once every 3 years
O.her~__
Miscellaneous Construction and Materials Standards
ODservation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap
and are secured in as shown in the mound component manual.
Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code.
All gravity and pressure piping materials conform to the requirements in SPS 384, Wis Adrn Code
4 Tillage of the basal area is accomplished with a mold board or chisel plow.
The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration_
Lateral Turn-up Detail
Finished
Grade
6-8'Diameter Lawn - - Threadec Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Prciect Ramberg 3 bedroom replacement residential Mound Page 5 of 9
Mound System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SIPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its'
component manuals [SBD-10691-P (N.01/01, R. 11/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual
Ver 2.0 SBD-10706-P (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,
defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an
effective locking device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281 48, Stats. The contents of the
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter
shall be assessed at least once every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless
provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped
with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an
impending continuous alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of
the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner
of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such
products are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify
proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within
the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that
the mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or
30 mgiL BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum
design flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral
be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial
test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal
distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and
any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system
in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and
dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating
condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Pretreatment Units
The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or
disinfection units are attached as separate documents and are considered part of the overall management plan for this system.
Project. Page 6 of 9
GOULDS PUMPS Submersible
Effluent pump
rtr 1 1
F
3885
PROSURANCE AVAILABLE FOR RESIDENTIAL
APPLICATIONS.
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APPLICATIONS w Shaft: Corrosion-resistant Single phase: W Bearings. Upper _r d
Specifically designed for the stainless steel. Threaded • Built-in overload with lower heavy duty ba l bear nc~
design. Locknut on three phase automatic reset. construction.
following uses: models to guard against • All single phase model-, w Power Cable: Severe duty
• Homes component damage on feature capacitor start
• Farms rated, oil and water resista~l,.
accidental reverse rotation. motors for maximum E ox seal on motor end
• Trailer courts p y
• Motels M Fasteners: 300 series starting torque. provides secondary m~Dissure
• Schools stainless steel. 9 A and '12 HP- 16/3 SJTOW barrier in case of outer ja-ke.
Hospitals U Capable of running dry with 115, 208 and 230 Volt carnage and to Preven, cil
•
• industry without damage to three prong plug, wicking Standard cord is
• Effluent systems components. • /4-2 HP - 14/3 STOW with Optional lengths are ovaiao e
bare leads. m O-ring: ASSUreS ositi,,e
W Designed for continuous Three phase: sealing p'
SPECIFICATIONS operation when fully • Overload protection must ng against cor:t~rlin3r is
Pump submerged, be provided in starter unit. and oil leakage. • Solids handling capabilities: • 112-2 H P - 14/4 STOW with
bare leads.
maximum. MOTORS AGENCY LISTINGS
• Discharge size: 2" NPT. U Fully submerged in high- ■ Designed for Continuous
• Capacities: up to 140 GPM. grade turbine oil for lubrication Operation: Pump ratings are rested to JL 118 an3
• Total heads: up to 128 feet and efficient heat transfer within the motor manufacturers r4c 6, CSA22.2 l ob Stana;rds
.
TDH, recommended working lmlts, By CanadianStandares
• M Class B insulation. can be operated continuously c us Ass°"at,on
Temperature: y rile i4ER385
104'F (40°C) continuous without damage when fLily
40 f (60°C) intermittent. submerged. Goujds Pum[)s IS jso 9001 Regist red
• See order numbers on
METERS FEET
reverse side or specific HP, 40- 130 - - -
voltage, phase and RPM's WEN StRIES 383
available. s zE t
35 20gu
RPM
3500
_ I 750
110 1 WE20H
~~-S GPM j
FEATURES 30, 100;... _ _ . {
L F
- Ji
U Impeller: Cast iron, semi-
25-
open, ; _ -
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WE10H
, non-clog with pump-out 80'
vanes for mechanical seal 70
protection. Balanced for Q 20 E07H
r 60i
s;noo:h operation. Silicon - -
50 r wEOS--
bronze impeller available as o 15 E05H an option. 3z. 3 r
40, i - - - _
Casing: Cast iron volute typeTrz/-/
tor maximum efficiency. 20 wEOaL_
t5
2" `.'PT discharge.
a Mechanical Seal: SILICON I
CARBIDE VS. SILICON 0 10 20 3,0 40 50 60 70 80 90 100 110 120 130 140 150 6~ FPM
CARBIDE sealing faces. ' _ ! ' - -
g 0 5 1 15 20 25 3U 3ms hr
Stainless steel metal parts CAPACITY
BUfIA-N elastomers. ',xc~.+. -5-w1Vr,-_1r iYW.
Goulds Pumps
2j02Goulds Pumps ITT Industries
Eifecti,e October, 2002 www gouldscom
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~fnnovanouns in pteesst, Drailagd Zabe ` PL-525 Effluent .g~
]v"as1 s"rater Products A Giv3slon of Folylo, his.
PL--525 Filter
Tire I'L-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the lamest filters in its class. It has
525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the. Polylok PL-525 has an automatic shut-off ball
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.
1'eatures; 111.6" Filtration Slots
rated for 10,000 CPD (gallons her clay). r- -per yy r--
1~ 000 S,.ai I (O tiona3)
525 linear feet of "1 /16" filtration,
\ccopts 7 P\ C
Accepts 4" and 6" SOID 40 pipe. 1 xtc"nsictn 1 I,~ndie
• Built in gas deflector.
• Automatic shirt-off ball when filter is removed.
l~ati"~t for
Alarm accessibility. 1,I I
• Accepts PVC extension handle.
IT-52 Installation-
Will for residential and commercial waste flows up to ,25 L.mcar Ft.
t I/
1 0,000 gallons per day (GPD). F;ttr<+tionSlots
1. Locate the outlet of the septic tank.
2. Reprove the tank cover and punr_p tank if necessary.
Accepts 4"
3. Glue the filter housing to the 4" or 6" outlet pipe. If S-CHD 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 PIS 525 filter into its housinc,
Certified to
5. Replace and secure the septic tank cover. :A 18 NSl Standard 415
I'l 525 TAI raretc:nance , AM,
The. PL-525 Lffluent Filters will operate efficiently for
several years under normal conclitions 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
k _ = Cap Deflector
needs servicing. Servicing shouts{ be done Irv a certified
septic tank pumper or installer.
Shut-Off BAI
1. Locate the outlet of the septic tank.
2, Remove tank cover and pump tank ifnecessary.
3. Do not use plumbing when filter is removed.
4. Pull PL-525 cartridge out of the housing.
5. Ilose off filter over the septic tank. Make sure all
solids fall bask into septic tank.
6. Insert the filter cartridge back into the housing making
or€t€$€as»'`~a~v arEt€7ter t';a"~~r i-r es~~ sr i rFty=',
sure the filter is properly aligned and completely inserted. Poly 101 , label hc"t filters aece:'pt t a5~ly in talt5
,7. replace and secure septic tank cover, the SrnartFilter w sivitc:h ind A,irnn. into rxv ting t'lnk',
Polvlok. Inc. 3 Fairfield Blvd. 'W"allingtord. CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 N~,xNAv.polylok.com
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ST. CROIX COUINTY
` EIPTIC TANK MA1NTEN:kNCE AGREEMENT
AND
OWNERS1lip CERTIFICATION FORM
O`yner/I3tttier Tim &I Jody Ramberg
Flailing Address 263 222nd St., Baldwin, WI 54002
Property Address Same - -
(Verification required frorn Planning & Zoning Department for new construction.)
('its/' tats Parcel Identification Nunlher 008 1 059-1 0-000
LI UAL DFISCRIPTION
Pt,operty Location SE NW ,4. Sec. 20 -I'28 N , R 16 44',I-own of Eau Galle
SUbdiVis1011 Plat: Na . Lot Na
Certified Survey Map # N a. Volume ~ a Page 4 ~ a
Warranty Deed # - ("before 2007)Volume Page
Spec house ❑yes[Dno Lot lines identifiable Elyes0no
sysn-Im MAINTENANCI? AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result i15 its premature failure to handle,,vastes. Propel.
maintenance consists of, pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 383.52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner a«recs to submit to St. Croix County Planning & Zoning Department a certification firm, signed by the
owner and by a plaster plumber, journeyman plumber. restricted plumber or a licensed purnper verifying that ( I ) the on-site
wastewater disposal system is in proper operating; condition and/or (2) after inspection and pumping (it necessary), the septic tank is
less than 1%3 full ofsludge.
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 d, s of the three year expiration date.
I/we certify that all statements on this Io m are true to the best of my !our knowledge. I/we ant/are the owner(s) of the
property described above, by virtue of a warrant deed recorded in Register of Deeds Office.
Number of bedrooms 3
4 24 17
t
GNAI'URI-: OF' APPl_, T(S) DAT F
`Anv in€iorrnation that is misrepresented /nay result in the sanitary permit being revoked by the Planning & Zoning Department. x
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)
St. Croix County Final Property Report Page 1 of 1
St. Croix County 2008 Property Report Print Report
Generated: 3/31/2009 4:31:40 PM Data Updated: 3131/2009 1:00:00 AM
PARCEL COMPUTER NUMBER: 008-1059-10-000
PARCEL MAP NUMBER: 20.28.16.296
NOTICE: All payments received by County Treasurer will be posted the next day.
2002 2003 2004 2005 2006 2007 2008 2009 Click on the year to select the annual record. F,
ark red = delinquent)
Property Description Billing Information
Municipality: 008 - TOWN OF FAU GALLE Name / Attn.: ELDON A(LE),& TIMMY8UODY RAMBERG
Document Number: Address: 263 2224D ST
Volume & Page: V, P
Public Land Survey: SECTION 20 T28N R16W City, State, Zip: BALDWIN, WI 54002
Quarter: Country: USA
QQ / Tract: Ownership
Plat: NOT AVAILABLE Primary Owner: ELDON A(LE),& TIMMY&IODY RAMBERG
Description: SEC 20 T28N R16W 40A SE NW Secondary Owner:
Total Acres: 40.00 ACRES
Site Address: 263 222ND ST
Assessed Value Other
Valuation Date 10/7/2008 Fair Market Value: 0
Assessment Type Acres Land Improved Total Assessment Ratio: 0.9509
Value Value Value Net Assess. Val. Rate: 0.014995867
G1 - RESIDENTIAL 2.00 27,000 184,600 211,600 School District: 0231-BALDWIN-WOODVILLE AREA
G4 - AGRICULTURAL 9.00 1,900 0 1,900
G5 - UNDEVELOPED 2.00 2,500 0 2,500
W8 - MFL BEFORE'05 27,00 48,600 0 48,600
CLOSED
Totals--> 40.00 80,000 184,600 264,600
Tax Installment Dates Tax Detail
as. ,n t .inn -),,I installn en s arc! _ eIrvii,wr, Laye5 te'h unt~,Category Tax Amounts Paid Balance Due
Real Estate Tax Due 3,202.07
Period Pay To: Date Due Amount Lottery Credit 85.49
1 County 1/31/2009 1,557.94 Net Property Tax 3,116.58 3,116.58 0.00
2 County 7/31/2009 1,601.03 Special Assessments 0.00 0.00 0.00
Total Taxes 3,158.97 Special Charges 0.00 0.00 0.00
Tax Payment History Delinquent Charges 0.00 0.00 0.00
Date Paid Receipt Number Amount Private Forest Crop 0.06 0.00 0.00
12/1912008 10807 3,158.97 Woodland Tax Law 0.00 0.00 0.00
Paid By: RAMBERG Managed Forest Lands 42.39 42.39 0.00
Total Payments 3,158.97 Penalties 0.00 0,00
Specials Interest 0.00 0.00
Category Amount Totals 31158.97 3,158.97 0.00
NONE Notes
it
3 Qf 3
http:/Pvww.landinfo.co.saint-croix.wl.us/-,vebsite/LRPortal/total process-asp?IDValue=00... 3/31/2009
S 921"7
Wisconsin Professional Services Page 1 of 3
Division of B06HRH947FNXG
SOIL EVALUATION RMYRT
MAY 19 Z0 1 7 In accordance with SPS 385, Wis. Adm. Code County
Attach comple$LiiG$tMC WJfW less than 8 1/2 x 11 inches in size. Plan must include, St. Croix
but not li. M(~~I®r0MEWence point (BM), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road. 018-1059-10-000 Ref #2474
Please print all information. Rev' ed by Date
Personal information you provide may be used for seconds purposes Privac Law, s. 15.04 1 m
Property Owner Property Location
r W
Tim & Jody Ramberg Govt. Lot SE '/4 NW S 20 T 2 N R 16
(0
1K
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
263 222nd St. Na Na Na
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
Baldwin WI 54002 (715) 928-0667 Eau Galle 20" St.
® New Construction Use: ❑ Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD
❑ Replacement ❑ Public or commercial - Describe: 3
Parent material Glacial Till Flood Plan elevation if applicable na ft.
General comments and recommendations: Site suitable for mound POWTS. Recommended infiltrative surface elev. to be 103.00' at 24" above 101.00'
contour. Onsite soil verification completed by Ryan Yarrington 3/31/17.
1❑ Boring # ❑ Boring
® Pit Ground surface elev. 101.04 ft. Depth to limiting factor 16" in.
k~ Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
1 0-8 10yr3/3 none sil 2fgr mvfr cw 2vf,f 0.6 0.8
2 8-16 10y4/4 none sicl 1msbk mfr cw 1v,f 0.2 0.3
3 16-24 10y4/4 f2d7.5yr5/8 sicl 1msbk mfr cw 1vf,f 0.2 0.3
4 24-38 10y4/6 c2d 5yr 5/8 sicl 1 msbk mfr cw 1 of 0.2 0.3
saturated flow at 28"
I 2 Boring # ❑ Boring
I_~ ® Pit Ground surface elev. 98.60 ft. Depth to limiting factor 14" in.
~.Q Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
'Eff#1 `Eff#2
1 0-9 10yr3/3 none sil 1fgr mvfr cs 2vf,f, 0.6 0.8
2 9-14 10yr4/4 none sicl 1msbk mfr gw 1vf,f 0.2 0.3
3 14-20 10yr4/4 f2d 7.5yr5/8 sicl 1 msbk mfr cw - 0.2 0.3
4 20-27 10yr4/6 c2d 7.5yr5/8 scl 1 m&cabk mfi gw 0.4 0.6
5 27-36 10yr4/6 m2d 7.5yr5/8 scl 1 msbk mfr 0.2 0.3
saturated at 27"
' Effluent #1 = BOD, > 30< 220 m /L a lid TSS > 30:5 150 m /L */Effluent #2 = BOD, > 30:5 220 m /L and TSS > 30 s 150 m /L
CST Name (Please Print) ignature CST Number
, -64
James K. Thompson
4VP" 30021
Address -Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020-5413 April 6, 2017 (715) 248-7767
SBD-8330 (R04/15)
3 Boring # ❑ Boring
4 ® Pit Ground surface elev. 98.71 ft. Depth to limiting factor 12" in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
'Eff#1 'Eff#2
1 0-8 10yr3/3 none sil 2fgr mvfr cs 2vf,f 0.6 0.8
2 8-12 10yr4/4 none sicl 1msbk mfr cw 1vf,f 0.2 0.3
3 12-16 10yr4/6 f2f7.5y5/8 sicl 1msbk mfr gw 1v 0.2 0.3
4 16-23 10yr4/6 c3p 5yr5/8 sicl 1 m&csbk mfr cw - 02 0.3
5 23-33 10y4/6 m3p 5yr4/6 scl 1 msbk mfr 0.2 0.3
saturated flow at 27"
T
❑ Boring # ❑ Boring
® Pit Ground surface elev. 101.02 ft. Depth to limiting factor 12" in.
4+4 Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
`Eff#1 `EfF#2
1 0-8 10yr3/3 none sil 2fgr mvfr cs 2vf,f 0.6 0.8
2 8-12 10yr4/4 none sicl 1fsbk mfr gw 1vf,f 0.2 0.3
3 12-15 10yr4/6 f2f 7.5yr5/8 sicl 1 msbk mfr cw- 0.2 0.3
4 15-19 10yr4/6 c3p 7.5yr5/8 sicl 1 m&csbk mfr cw 0.2 0.3
5 19-35 10yr4/6 m2p 7.5yr5/8 sicl 1 m&csbk mfr 0.2 0.3
saturated flow at 25"
El 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/Ftz
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
'Eff#1 *Eff#2
Effluent #1 = BOD, > 30:5 220 mg/L and TSS > 30 5 150 mg/L " Effluent #2 = BOD, > 30<_ 220 mg/L and TSS > 30:5 150 mg/L
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ST. CROIX COUNTY
WISCONSIN
v ZONING OFFICE
A hp N n n up ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
• ' r - - Hudson 'VVI 54016-7710
(715) 386-4680 FAX (715) 386-4686
Page I of 1
C LINTY ON-SITE VERIFICATION FORM
Inspector: 9Y- 47 Date: l0 ~1 E40 CnalLe-,
Parcel ID Numbe
PropertyOvmer / PropertyLoeation
W% 4- JJ, GuA. Det 114 V4 5 T N R E (or) VN
Property O :ner f,tailing Address Lot # Block # SLW. Nance or CSk#
2Z
Wit --te Zip Code R-ioneNumber ❑Citq ❑Village ❑Town Nearest Road 11
p.J ( ZZ
❑ NewConstruction Use: ❑ Rsidential t Numtyr of bedrooms Code derived design flow rate _ _ PD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elovztion if applicable ft.
General comments
and reeommendations:
LNO 110" t,
❑ Boeing
Being
❑ pit Ground surface eleti. Depth to limitirrl factor----- in. Scil Application Rate
Horizon Depth D7jminantColor Redox. Description Texture Structure Consistence Boundary Roots GPDfF
C'y
> 4 33
in. f~lunseil Ou. Sz. Cont. Color Gr. Sz. Sh. E11 1 `Effta2
33 L
-f3rJyQw IS6 k'
Conditions: 6c Ct,IOL~ ~d~~
Soil Survey description:
Notes: f ~1
p„ FEE:
i