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HomeMy WebLinkAbout002-1079-10-080 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 597414 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2948797 Permit Holder's Name: City Village Township Parcel Tax No: NATHAN AND MICHELLE ALVERMAh TOWN OF BALDWIN 002-1079-10-080 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ate. (b -1 6--", i- 32.29.16.465A-15 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z Benchmark AL -39 /66,4 4 no, Dosing Alt. BM Bldg. Sewer G'r I I f ti_2, 11 Z • 755 167. .-7- Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet ` TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet 1W 01_s Septic Dt Bottom 7> Dosing ; Header/Man. l ~ /g z7 z 41.3 14Z • ek Aeration Dist. Pipe Holding Bot. System PUMP/SIPHON INFORMATION Final Grade 9`3 /673. 6% bk Manufacturer Demand St Cover ~~~--4,, Model Number GPM 9' TDH Lift Friction Loss System Head TDH Ft o r 1'.51 T45 lV, Z Forcemain Length Djt Dist. to well 7L SOIL ABSORPTION SYSTEM BED/TRENCH Width Length INo.6OfTr3 ,es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS _7~ 5 66 Q I~-„ SETBACK SYSTEM TO P/L I BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHAMBER OR ~,/ate /C~ 17-3 ,g l UNIT Model Number: DISTRIBUTION SYSTEM E- 00 z kA ~ Header/Manifold / el Distributio x Hoe Sizes x Hole Spacing Vent it In Pi e s i ` C. 3 Length. Da Length/ Spacing 3' 5 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/French Edges Topsoil I / sr„~es [ No ---Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /1 / /-7 Inspection 2: Location: 2279 70TH AVE O ar- 1.) Alt BM Description = )Ole),) o k 2.) Bldg sewer length = y ~~11 - amount of cover = 413 oI~ t~ ° f ~ i Plan revision Required? [ Yes o ly d_ 1, J Use other side for additional information. j777 Date Insepctor's Si ature Cert. No. SBD-6710 (R.3/97) t s r-,,2o t VED County . ,REC E I Industry Services ivision S"f CROIX D 1400 E Washington Ave $ Sanitary Permit Number (to be tilled in by Co.) PS JUL 0 3 2017 P.O. Box 7162 ~ Madison, ft 537!07-7 62 19 ST, CROIX COUNTY ~ 17 M9 nCA =1 AMAAl=lkrr 1115 anitary ermit Af WS73PH3S4VA State Number In accordance with SPS 38321(2), Wis. Adm. Code, submission of . ~.-r,,,u- governmental unit is required prior to obtaining a sanitary permit. Note: Application f -iis ror state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(I)(m), Slats. y~ ~ ~ 1. Application Information - Please Print All Information C7^ ~ Property Owner's Name Parcel # NATHAN ALVERMAN 002-1079-10-080 Property Owner's Mailing Address Property Location j I - 9573 RD S"1' SW Govt. Lot City, State Zip Code Phone Number NE 1A, NE 1/4, Section 32 CLEAR LAKE, WU 54005 / (pircle one) I'29N R16EorW~ II. Type of Building (check all that apply) Lot # ® I or 2 Family Dwelling- Number of Bedrooms _ '~~~2 Subdivision Name ❑ Public/Commercial -Describe Use - Block # tSJ~i Crv~ ❑ City of ❑ State Owned - Describe Use F1 Village of CSM Number =5611 ® Town of BALDWIN Ill.' e of Permit: (Check only one box on line A. Complete line B if applicable) A. ® New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision [:1 Change of El Permit Transfer to New List Previous Permit Number and Date IssAed ° Before Expiration Plumber Owner IV. Type of POWTS S stern/Com onent/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 soil nT ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (st) Dispersal Area Proposed (sl) System Elevation 450 Rate(gpdst) VI. Tank Info Capacity in Gallons Total # of Manufacturer Gallons Units B L New Tanks Existing 't'anks Septic or Holding Tank 1000 1000 1 HUFFCUTT ® ❑ ❑ Dosing Chamber 600 600 1 ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement- I, the undersigned, assume respons'bility for i stallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plw gn r MP/MFRS Number Business Phone Number ROBERT HARDINAt y y,~ 824825 715-491-5039 Plumber's Address (Street, City.. State, Zip Code) 477 1701H AVE TURTLE LAKE WI 54889 VIII-County/ eartment Use Only 10 Approved ❑ Disapproved Permit Fee Date Issued Issuing ent Signature Owner GiverhReason for Denial IX. Condit 4v Reasons foK Disapproval 1., eftnt 114er t+h~i j diiiiiiper.:ui. rill must aft be sr4,jces ! rijE ink: ec f J, - Bement plan pla rideA by plumber. 2. '"i4kii ~ recuirero s must oe r wd,- ire l a♦ per rffkrAft co& ! wfdinAma3. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R03/14) _ clt P 3 oo TI 0 i i I ~ I I ~ ~ I3y q o `t A# 71 " plc P E 3 / ae OC a ~INjCO + sr X16 , l Hc~rl~ e i a~x p ° E L~ \Pt t DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 Contact Through Relay http://dsps.wi.gov/programs/industry-services i www.wisconsin.gov \ARr~F~e'siov:,tisr~ ~ Scott Walker, Governor Laura Gutierrez, Secretary June 19, 2017 CUST ID No. 824825 ATTN: POWTS Inspector BOB J HARDINA ZONING OFFICE HARDINA SEPTIC SYSTEMS ST CROIX COUNTY SPIA 477 170TH AVE 1101 CARMICHAEL RD 'TURTLE LAKE WI 54889-9187 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/19/2019 Identification Numbers Transaction ID No. 2948797 SITE: Site ID No. 838243 Nathan Alverman Please refer to both identification numbers, 70TH Ave above, in all correspondence with the agency. Town of Baldwin St Croix County NE1/4, NE 1/4, S32, T29N, RI 6W FOR: Description: Mound, 3 br res Object Type: POWTS Component Manual Regulated Object ID No.: 1707058 Maintenance required; 450 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System jvv, Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manu Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter APPR The submittal described above has been reviewed for conformance with applicable Wisconsin Adminis `(3&a `AfEV AND P Of IN and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be const 4wlsIo~ and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. SEE COR A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. BOB J HARDINA Cage 2 6/19/2017 Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ Os00 JC/ Edwin A Taylor Wastewater Specialist, Divisiono ndustry Services WiSMART code: 7633 (715)634-3484, Monday - Friday 8:00 am To 4:30 pm edwin.taylor@wisconsin.gov BOB J HARDLNA Page 2 6/19/2017 Sincerely, Fee Required $ 250.00 f° Fee Received $ 250.00 Balance Due $ 0.00 ! p. 3 Edwin A Taylor Wastewater Specialist, Division 0 dustry Services WiSMART code: 7633 (715)634-3484 . Monday - Friday 8:00 am To 4:30 pm edwin.taylor@,)wisconsin.gov a MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: ALVERMAN Sh~~ 7 2~~~ 4 Owner's Name: NATHAN ALVERMAN Owner's Address: 957 3RD ST SW CLEAR LAKE WI 54005 4.9 ACRES Legal Description: NE,NE,32,29N-R16W Township: BALDWIN County: ST. CROIX Subdivision Name: NA Lot Number: 2 Block Number: NA Parcel I.D. Number: 002-1079-10-080 )JVALLY Plan Transaction No.: )\/ED :OFESSIONAL SERVICES Pagel Index and title ,uSTRY SERVICES 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 r , Page 7 Pump curve and specifications C Page 8 Site plan 1" = 40' ~:SPO Page 9 Filter maint. Page 10 Att. Soil test 1 L4) Designer: Robert Hardina License Number: MPRS 824825 Date: 05/01/17 Phone Number: 715-986-2508 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 10/12), 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. 10/12) Version 7.0 (R. 11/12) Pagel of 10 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) N-- R Residential or Commercial Design Note: Sand fill {D} calculations assume a ' 300.00= Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for fecal coliform of 36 inches. 5 Peaking Factor (e.g. 1.5 = 150°l0) 450.00 Design Flow (gpd) 1 3.00 Site Slope 100.00" Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.603 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) = 7.50 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpdfft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N} iC or E) e Center or End Manifold 3.75 Lateral Spacing (ft) If N above, enter the elevation (ft) 2'€ Number of Laterals of the highest point. _ 0.188+ Orifice Diameter (in) _3.00= Es[Tated Orifice Spacing (ft) = 1125 ft2/orifice 2.00 1 Forcemain Diameter (in) 100.00; Forcemain Length (ft) Does the forcemain drain back? i Y 84.00 Pump Tank Elevation (ft) Eater Y or N 3.25 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 17.46 Vertical Lift (ft) 53.69 5x Void Volume (gal) 1.51 Friction Loss (ft) 70.01 Minimum Dose Volume (gal) 0.003'' In-line Filter Loss (ft) 26.21 System Demand (gpm) L 22.22 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in_ dia. o tions choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x X 1,31 1.25 2.00 / 1.50 x 3 ~E x 3.00 ! ,,._._.m... ~ ~..-..e, 2.00 x 3.00 x Gallonsllnch Calculator optional) Treatment Tank Information 62TCFO, Total Tank Capacity (gal) 100_0.00Septic Tank capacity (gal) -42.00,' _ Total Working Liquid Depth (in) ,HUFFCElTT Manufacturer 14.93 gallin (enter result in cell B49) Dose Tank Information Effluent Filter Information 627.00: Dose Tank Capacity (gal) bear Filter Manufacturer 14.931 Dose Tank Volume (gal/in) ml 1 Filter Model Number 'huffcutt Manufacturer r' Project: ~ALVERMANJ Page 2 of 10 e j' r b " 1 ~r Mound Plan and Cross Section Views 4 J Observation Pipe K 77 o A W r. : B L Mound Component Dimensions A A22.00 ft E 24.70 in H [Aft ft K 11.21 ft B ft F 9.50 in 1 ft L 82.43 ft D in G0.50 ft J W 27.14 ft 450.00 (ft2) Dispersal Cell Area 1112.64 (ft2} Basal Area Available 7.50 (gpolft) Linear Loading Rate 6.00 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.63 (ft) . H r~frfiiri v _,121,' F Dispersal Cell : ` ~ - 102.33 (ft) Lateral ~ Invert 101.83 (ft) - - Dispersal Cell Elevation D Q 46 y 100.00 (ft) Contour Elevation 3.0 °lo Site Slope Geotextile Fabric Cover Shading Key m Q- Dispersal Cell See lateral details on Topsoil Cap Q 1,5 ft ~ Page 4 for number, size, " Subsoil Cap U).0 l5k Q and spacing of laterals. ASTM C33 Sand Laterals are equally © `a F spaced from the Tilled Layer c m 0.5 ft Typical Lateral w distribution cell's © EM9 Aggregate o centerline in the A. A distribution cell (AxB). Project: ALVERMAN Page 3 of 10E,1J. End Connection Lateral Layout Diagram L ater alv centered over the.4 +x ~ dimension = Turn-up '-6i ba l l valve or al ea n out pl u a All lateraf> are identical l+ X=. Hales drilled on the bottom of the lateral ~ equall # spaced Forge main connection Asia tee or cross to manlioid at ants rsoint. Laterals facemain Sch 40 PVC per S P S Table 384.30-6 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 58.52 ft Orifices per Lateral 20 Lateral Spacing (S) 3.75 ft Orifice Density 11.25 ft2/orifice Lateral Flow Rate 13.11 gpm Manifold Length 3.75 ft System Flow Rate 2621 gpm Manifold Diameter 1.50 in Total Dynamic Head 22.22 ft Forcemain Velocity 2.68 fusee Dose Tank Information Locking cover with warning label and locking device and seated watertight Electrical as per NEC 300 and SPS t316-300 WAC 4 in- min. Disconnect Tank component is vented Alternate outlet location Forcemain diameter huffcutt Manufacturer 2 in- Capacit 627.00 Gallons Volume 14.93 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 24.81 370.37 B 2.00 29.86 C _Pump ofiF elevation (ft) C 4.69 70.01 84.88 D 10,50i 156-77 D Total 42.00 627.00 Do, se tank elevation (ft) Bedding Aer tank. 84.00 Alarm Manuafacturer •SJE RHOMBUS Note: Switches Alarm Model Number "tank alert containing mercury t,,ay not be used in Pump Manufacturer zoeiler this System, Pump Model Number hn 152 Pump Must Deliver 26-21 gpm at 22-22 ft TDH Project: ALVERMAN Page 4 of 10 L Mound System Maintenance and Operation Specifications Service Provider's Name I Robert Hardina Phone 715-986-2508 POWTS Regulator's Name ST CROIX ZONING Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound Inspect for ondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SIPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SIPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SIPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. 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 Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 De ree Bends Same Diameter as Lateral Project: ALVERMAN Page 5 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 10/12), 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 mg/L 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 10 r-1 { i , C .,1 •l 1 rwi I~ `I tl. 4 Cyr uj ......1. ~r -C ~Ilj r . _ V ~I e LL t d 9 I i 1 113! , A 1 't^I tom.. ' IJ LM.r 4 i L 1 e.:.,t 4 ".1'11 i.:J ~J' tom. y= •."7 1"? i'.ti. ....may, .',11 LX- ~Y ILA .Y •`i ' + ~ '-J U 3 1"-: 14 a 1 W } T Of -rAI; 14- o ~y ` Yv CKI oc. Oo j r^"Ar ~tf'' Tor Af 7j "Poc Pft--A F, 3 ~ r ~ I I I ~ y' ~ I [31-1feti e fil L r Installation and Maintenance Instructions Installation Step 1 Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it is centered directly under the access opening. (if outlet pipe is already in a fixed position, additional pipe may need to be added) While the case Step 2 ff utilizing the additional single side support and the two bottom supports: needed to extend from the is still dry fit to the outlet pipe, measure and cut 1'schedule 40 pvc pipe to the length hubs that are pre-molded into the case to the side wall and the inside floor of tank solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe. insert the fitter cartridge into the case pressing down on the cartridge until it locks into place at the bottom of case. Step 4 if utilizing a vertical read switch: Insert switch into the hole pre molded into the top of the fitter. Press straight down until it locks into place Maintenance 1) Remove the access lid of the tank. Note: To ensure undesirable solids do not exit the tank and into the drain field, the tank should be pumped out until the level of effluent is below the outlet level of the tank. 2) To-remove the filter cartridge from the fitter case, pull up firmly on the handle of the cartridge dislodging it from the case. (if utilizing a vertical read switch, removal of switch is optional) 3) Using an ordinary garden hose, rinse the fitter cartridge ensuring all visible septage material is removed. 4) Place the fitter cartridge back into the fitter case pressing down on the cartridge until it lodes into place. S) Place the access lid back onto the tank ensuring it is secure. Lifetime fritter has a lifetime rtmited warranty Lifetime f8ter tLC w7rrants the filter win be free of manufacturing and workmanship defects during normal use for the period of time the original purchaser owns the producL Lifetime filter will provide a reptacemcnt fitw in the event that the orw" him was not damaged during the instillation or maintenance process. Damage w tha troduct caused by accident. misuse or abuse will not be covered under this warranty. Improper care or rnatfurpWom resulting from product not being instalied, operated or maintained property wifl void this warranty. Utetime fitter assumes,po responsibflity for labor charges, rrrnoval charges, instagadon or oth& incidental or consequential costs- Coaratl: milr~Gfetirnefiliertk..4crtn Phone: S02-724-2231 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer NATHAN ALVERMAN Mailing Address 957 3RD ST SW CLEAR LAKE WI 54005 Property Address _-663 236TH AVE + 1.~-'>a - c, 'u (Verification required from Planning & Zoning Department for new construction.) _ City/State NEW RICHMOND Parcel Identification Number 009 1 L979 10-080 LEGAL DESCRIPTION Property Location NE '/4 > NE '/4 , Sec. 32 , T 29 N R 16 W, Town of BALDWIN Subdivision Plat: , Lot # 2 Certified Survey Map # 2279 Volume 22 Page # 5342 Warranty Deed # (before 2007)Volume Page # Spec house yes'. no Lot lines identifiable yes 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 function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(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 Commerce 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 virtue of a warranty deed recorded in Register of Deeds Office. Numb r of bedrooms 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. 09/07) l Baldwin Shed 1 2279 70th Ave, Woodville Statistics w V,I k} r1$isl,l¢ ~~}f" f 1001 s9 ft 1 Floor 4 Bedrooms 3 Bathrooms 12' 121 ,3. 3,Zn•:. T y. MR ■ TOv AST Fa.I 7R00 LOSET kBIED90M J~ in ~ .HOUSE (50' x 40') if 12' 2' 999.92 sq ft wI ASSAGER f MUDROOM Y E 961gft If L -A~NDRY ROOM j I F--1 ATH _100 < I i GARAGE 3201.97 sq ft (40' 3/4" x 80') III o ) 21), 20' 20- 1 0' 8' _16' 24' 32' THIS FLOORPLAN IS PROVIDED WITHOUT WARRANTY OF ANY KIND. SENSOPIA DSCLAINIS ANY WARRANTY 1:199 1I NCLUPING, WITHOUT LIN11TA%0N, SAT!' EA.: DRY QUALITY OR ACCURACY Or- DIM, NSIUNS. 1 RECLNEE d Wisconsin Department of C4merce SOIL E RT Page of Division of Safety and Buildin + in accordance with Comm 85, Wis. Adm. Code County c'-' . Attach complete site plan on paperznotjga$Ahah 81 2 x 11 inches in size. Plan must X- include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel 1. D. , percent slope, scale or dimepsionrs, rlior#htirrrew, and locafCon and distance to nearest road. 0 2- lo~lf- Please print all information. Revi d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s 15.04 (1) (m)) 7 Q Property Owner Property Location t- I ) C il<<r Go ..hot 1/4 ~L+~ 1/4 S. T N R E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number j ( ❑ Village UpFown Nearest Roa/d l ivy> e i . ( (i, ~ j J ('71 eN , I? New Construction Use: E Residential / Number of bedrooms - Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material S C t' CC l Flood Plain elevation if applicable A/k ft. General comments ( i ' r~ l) and commendatio 5'-'-i't C_~ILIC0- & ( E C EI L ~k nix CN'140(w- 10("r F -1 1 F] Boring Boring # ~y ~ ✓ LJ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 '~C1 FJ ~ K Boring # ,Poring O Pit Ground surface elev. ~ & ft. Depth to limiting factor 7 in. Soi! App:ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF n in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 f LS r' GAL \ _ ` Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Na (Please Print) ' Sig"ure CST Number Address Date E ation Conducted Telephone Number 2 76 Property Owner Parcel ID # Page < l of 3 F-3-1 Boring # F] 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Cat i✓t.; tt F ~ V -li , 6 r u n Boring # Boring it Ground surface elev. 7 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. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 7. S` 6ti1, 1 1 ~c ,tit- o - ov\ 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/ft2 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/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) C 70 . AQe • ~ ~ 5 {ems l s 15 y M I cc. Jal \ 1 11 ~ L s~ S~~rubi~ AV- C~ 9 ~ i• 3 l Slcor I a - ~eGS ~i LLB