HomeMy WebLinkAbout040-1273-10-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 600321
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:
Craig & Patricia Johnson TOWN OF TROY 040-1273-10-000
CST BM Elev: BM Description: Section/Town/Range/Map No:
77: 17.28.19.1518
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTUR R' CAPACITY STATION BS HI FS ELEV.
1
Septic Benchmark U'
14 L0 41 _ Alt. BM 3-10 O L9- (1s
Aeration - Bldg. Sewer 1-64,0 35-
Holding - - St/Ht Inlet L0
- - t t`
St/Ht Outlet 6i
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent t Air e ROAD Dt Inlet
Septic / 1 l Dt Bottom
d~
/Iy~ 60
Dosing
,,,.JIG
Aeration - - Dist. Pip. e 55-
Holding Bot. System( Oo is-, 5>5
PUMP/SIPHON INFORMATION Final Grade 6ZO b 1_57
Manufacturer G Demand St Cove CVR
0.119 101;' IP6
G
1^ (P
Model Number
4t
TDH Lift ~b Friction Loss System Head 0 TD) I Ft
(p
Forcemain Length) I Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width , Length ( No. Of Trenches PIT DIMEN S No. its Inside Dia. Liquid D
DIMENSIONS \ l
SETBACK SYSTEM TO P/L BLDG WELL LAKE TREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR 11;C1I
Type Of Syytem ( UNIT Model Numbe
DISTRIBUTION SYSTEM
Header/Manifgld Distribution ix Hole Size x Hole Spacing Vent to Air Intake
j L Pipe(s) Ek)Y
Length Dia L LDia Spacing !YY
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 4 Bed/Trench Edges Topsoil Yes No r ' Yes :No]
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 426 LOST ROCcK~ LN 1.) Alt BM Description = 1- L,-J!5
c> ~ P-vy-1-
2.) Bldg sewer length = 6?1
- amount of cover =7 LGI-V
- No
Plan 1 1
additional informationJl
Use other lo side for u -
Date Insepctor's Signature Cert. No.
SBD-6710 (R.3/97)
County
Safety and Buildings Division
L~ LI \"J U 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
F s,Sp ' Madison, WI 53707-7162
- FEB 02 2018 ~D~3Z.'
- state Transaction Number
Permit h1058VWY0HP5NG
1n accordance with SE`S 393. 2j, ors Ac mE oils sdbmis unit
is required prior to obtaining a sanitary permit. Note. Applic wuca rU WTS are submitted to Project Address (if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
u oses in accordance with the Privac Law, s. 15.04 1 (m , Stats. ? eG j fQ~'~~
1. Application Information - Please Print All Information c'
Property Owner's Name Parcel #
Property Owner' ailing Address Property Location
Govt. Lot 1
City, Sta~ /Zip Code/ 7 f Phone Number V, 5G✓ Section C 7
T z ~ ~j(circle one)
~7 C G C/ - / - LJ G ,1 f J - -Z -3d v
IL ,
N; RLZ E or(5
H. Type of Building (check all that apply) Lot #
Subdivision Name
rp l or 2 Family Dwelling - Number of Bedrooms
~k Block # fj~ Lvt D fi .p
❑ Public/Commercial - Describe Use ❑ City of
CSM Number ❑ Village of
❑ State Owned -Describe Use
A Town of 4 #K_ 07Z'
III. Type of Permit: (Check only ne box on line A. Complete line B if applicable)
❑ ❑ Other Modification to Existing System (explain)
A. New System El Replacement System Treatment/H;IdmgTank Replacement Only P y
List Previous Permit Number and Date Issued
B. El Permit Renewal Permit Revision Change of P1 Permit Transfer to New
Before Expiration wner ~p
L 1(7&/ IV. T e of POWTS S stem/Com onent/Device: Check all that a 1
ANon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank Other Dispersal Component (explain El Pretreatment Device (explain)
V. Dis ersaUTreatm t Area Information:
ation Rate(gp f) Dispersal Area Required (sf) Dispersal Area P~ropo d (s 19ystern Elevation Q
Des gn Flow (gpd) Design Soil Applic
tf~ (J ` ' ' l C CJi
-7
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units U
New Tanks Existing Tanks 0 3 u -2
.
a U n N V % C7 7-
Septic or Holding Tank
Dosing Chamber qL / lr r, f. Li y~
13 VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's §Signature MP/Ivy Number Business Phone Number
Plumber's ~A-d ss (Street, City, State, Zip Code)
VIII. Court epartment Use Only
Approved isapp Permit Fee Date sue Issuing nt Signature
❑ r Given Reaso enial $ " C Z
IX. Condii WOAp1fWfifteasons for Disapproval
1. :5epti,~ tank, Erflun, iilW n,i
wSEk3C :;v Cell'r I(la t dfl besii %-fc., S rNc !nom
as per marigemen! plan nrs idP i av lu nnr .
2. All se!ha, k rec6 iw~c :Ana mix.5t ire ;;t, ir.r
as per Vida mWi cod.- / : rd!a-o r z,,
Attach to complete plans for the system and submit to the County only on paper not less'than 8 m z 11 inches in size
SBD-6398 (R 11/11)
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CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
Owner's Name:
Owner's Address: ~c
Legal Description: 7
Township: f'- 0
County: j G~?-(U (5(
Subdivision Name: V Lti''cZ~
Lot Number:
a
Parcel ID Number: 11~ Z 7
Page 9 Index and title
Page 2 _ Plot Plan (1L d2 ulct- L{ PL U S
Page 3 System Sizing & Cross-Section. 2_ l0tt W C"1z V
Page 4 Filter Specs
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
Designer/Plumber:®C~L`~'j'~- /UDC. f License Number:
Date: Phone Number 7 `zJ,,- LLZyK
Signature
Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01).
Page 1
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- or 2- Family Dwelling In- round Soil Absorption System 2-cell Conventional
Daily Wastewater Flow (DWF) _ # of hedro`oms x 150 gal/day/bedroom gal/day
Design Loading Rate (DLR) or Soil Application Rate = r / _•gpd/ftZ (per SPS Table 383.4444 1, 2, or 3)
Required Distribution cell area = DWF ,U 'i gal/day _ DLR 7 gpd/ftZ = cJ ftZ
# Chambers = Required Distribution cell area ftZ _ L ftZ/ unit EISA = Chambers
Chamber Manufacturer and Model: It) Imo/ L /t4- 4-& eft
Actual Distribution cell area = Required cell area ftZ + ftZ/ unit EISA End Cap Pair (1+'2
-Cross-Section In-ground Soil Absorption System (2-cell):
4" Schedule 40 PVC
♦f - vent pipe with Vent cap
12 inches minimum 12 inches minimum
lei,
-NI I
! T
inches Soil Cover
Trench 1 Sys-
tem Elevation "?-inch Chamber Height
-ft 7,51 ft Trench 2 System
Elevation
-ft 3 ft
Trench Separation Leaching Chamber Width
ft to limiting factor
Plan View In-ground Soil Absorption System (2-cell):
Trench 1
Modify
ft header/
ft design as
Leaching Chambers )4 0 needed.
Trench 2
4 inch Header
F1 I
Sch. 0
ft with end camps
Draw O for a Vent and for Observation Pipe above. They will be located ft from the end of the cell.
Vent pipes shall be Schedule 40 PVC and extend at least 12 inches above finished grade.
Observation pipes that extend above finished grade must also be 4 inch Schedule 40 PVC.
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POWTS OWNER'S MANUAL MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Septic Tank Capacity I Zd gal ❑ NA
Owner r\i (2 (,I = ~i M~ ;U .-U
tz)
Permit # Septic Tank Manufacturer w far <IGR ❑ NA
Effluent Filter Manufacturer E5 ❑ NA
DESIGN PARAMETERS
Number of Bedrooms ❑ NA Effluent Filter Model ,g FG' ❑ NA
r
Numberof Public Facility Units J>il NA Pump Tank Capacity 000 al ❑ NA
Estimated flow (average) V60 gal/day Pump Tank Manufacturer L ItcSc- R ❑ NA
Design flow (peak), (Estimated x 1.5) _ 600 gal/day Pump Manufacturer 0 (A L 0 ❑ NA
Soil Application Rate al/da /ft2 Pump Model f7 j{/ ❑ NA
S}andard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODa) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Celt(s) ❑ NA
Biochemical. Oxygen Demand (BOD6) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) 5104 cfu/100ml ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Ya in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: f7 NA,
"Values typical for domestic. wastewater and septic tank effluent. Other: ❑ NA
I
MAINTENANCE SCHEDULE
Service Event Service Frequency
❑ month(s)
Inspect condition of tank(s) At least once every: 3 D ear(s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA
Inspect dispersal call(s) At least once every: ® yea ()(s) (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: IN east j(s) ❑ NA
Inspect pump, pump controls & alarm At least once every: r -j month ❑ NA
ry ❑ month(s) 13 NA
Flush laterals and pressure test At least once eve
ear(s)
(s) 11 NA
Other: At least once every: p year(s)
Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to Identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually Inspected to check the effluent levels in the observation pipes and to. check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y3) 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 Administrative Code.
All other services, including but not limited to the servicing-of effluent filters, mechanical or pressurized components,. pretreatment
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 10 days of completion of any service event.
GMW (4/01)
1.l
START UP AND OPERATION
For new construction, prior to use of the POW TS check treatment tank(s) for the presence of painting products or ot(vWM_I ca L,
that may impede the treatment process and/or damage the 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 oceur when soil conditions are frozen at the infiltrative surface.
During 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, overloading the cell(s) and may result 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) water; 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 and pits shall be disconnected and the abandoned pipe openings sealed.,
0 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 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 toestablish a suitable replacement area. Replacement systems must
comply with the rules In effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ 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> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name C L S pAJ Name
Phone S - Z 7 3 - Lt!!{ Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name 3'01-}Njal~1 N1fA +e1 Name S~ cow/X70
Phone Z 73 Phone ~~S"JOk~'T~vgU
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
S'L CR(AI`i COt NTY
SHFIC TANK I-IAINI ENANCL AGREEMENT /
AND
O\v'NERSIIII' ('FR"I'IFICATION FORM
klailing Address k~ C f ~C U /7~
Property Address L-C) wt
(Verification required from Planning & Zoning Department for new construction.) - -
City.'State 1 Jul?`X~V Parcel I(tentificalion Nwnber
LEGAL. DESCRIPTION
Property Location ~uvlt~ '14 , Sec., T 2 N R I` W, Town of w
Subdivision Plat: / U\ ' c)ouf) Lot #
Certified Survey Map #Volume Page #
Warranty Deed # t/ 1~ J (before 2007)Volume Page # -
Spec houseP"Ies0no Lot lines identitiable,®yesnno
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenancc consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put HM,
the svstcm can affect the function of the septic tank as a treatment stage in the waste disposal system. Owncr maintenancc
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 torn, signed bN 1hu
owner and by a master plumber, journeyman plumber. restricted plumber or a licensed pumper verifying that (1) the on-site
\\astewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank i>
less than I, 3 full ot-sludge.
Fwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system N,, ith il),
standards set fbrth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resource
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. t
County Planning & Zoning Department within 30 days of the three year expiration date.
brm arc trite to the best of tny:our knowledge. 1. we ain!are the owner(s) of the
1'we certify that all statentcnts on /Ih
recorded in Register of Deeds Office.
property described above, by virtue of a wy decd
Number of bedrooms
'Y U 5 C NATURC Oh APPLICANT(S) DATF,
Any information that is misrepresented nrav result in the sanital permit heing revoked by the Planning & Zoning Department'
Include with this application a recorded warranty deed from the RegktCl. of Deeds oflicc and a copy of the certified "urv ey map 11'
reference is made in the warranty deed.
(REIV. 04112)
2.00 ACRES
87,077 SO. FT. ~Z6. 20 \
49.48, 3j2124, ` , $
0
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2 8. ,~c{A
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)41 SO. FTC 4\3
f t ~N 2.00 A RES \ \ yea
w 1 41 I 87,1020. Fr.
l w 1.79 ACRES
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2.00 ACRES
\ f $ 87,113 SO. FT. \VIT i
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/SEE SHE
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~
/ 3S I UTILITY EASEMENTS
it
' Combination Sept~;ic~ a D SP~CIFICAT10~1S
PUMP CHAMBER CROSS SECTIO A
- VD}JT CAP WEATHER PKOOF
JUIJCT101.1 6OX
~I`C.1. VEIJT PIPC APPROV~O LOCKILIG
~TQ' fROh1 DOOR. "I" HOLE COYER PviTrl
wARNISJG
iIQDOw OR FRCSH ca~pu1r
t,~sP~o>J ~ IPA ~ A~_11JTAK~ r
b„ / I y' JiIU.
i.: PROVIDE
IrJLET „ AIRTIGHT SEAL I III /r
~a A APPKOYEO JOIiJT
APPROYCD J01lJT ZPSB~ttL I III W/C.T. PIPE°RP''~
W~C.I- PIPER Tank construction I III ALARM
shall comply with I II
ILFI x,3.15 and 33.20 ° I
i I OU
c t I
I
PUMP
OFF
0 CONCRETE
/ pLOCK
I 3'gPP:
RISER EXIT PLRf'1ITED OQLy IF TAUK MAJUFACTURC-K HAS SUCH APPROVAL g~pplNG
SEPTIC F 5PEC,IFICAT10KJS
DOSE
Tf. iJ K5 MA>JUF IJUMbER OF DOSES: PEP. Dd,y
,~CTURCR.:
TA)JK SIZE: GALL01JS D05C VOLUME
ALARM h1A1JUFACTIJR.CR: NCLUDII.IG 6ACKFLOW: ~ A GALLQ1JS
i-10DEL 1JUM6ER: ~Q~ {w CAPACITIES: A= Z 7 11JCHC5 OK GALLOi15
SWITCH T7PC: ~f g = Z IucNCS'oR 1 ZG~LLOU5
C = IUCHES Oft 4L~/t- LLOUS
PUMP -,AIJUFACTL KZK: I CuL f) /7
Z Q= ttCrHES OK .~1tGc;ALL0U5
MODEL ~JUM6F_R-,
SWITCH TYPE: IJOTE: PUt1P AW ALARM AKL TO :5L
MWIMLIM D15CKARGE RATE~GPM INSTALLED afJ SEPt,RATE CIRCUITS
VEKTIC,,L DIfFERE;JCF DETWI`EU PUMP OFF AIJ0..DISTRIbl1TIOQ PIPE.. HECT
{ r luIh1UM tiJETWORK SUPPL. PRESSURE . FEET
;W FEET OF FORCE MIM X F~pFrFRICTIOU FACTOR.- Z' 'FY FEET
TOTAL 1JAMIC HEAD I Z FEET
As per-manufacturer Z gal/in.
$S
1 r Y''*"~d {~y 1~~R J W~ v
JIM ar
1La PbyF+'% I >bS nr,,, , fl rn.`, : i ,p a ik"
Will
uick4 Plus Standard Chamber Side and End Views
48"
(EFFECTIVE LENGTH)
12
34"- -1
~I
r
)Iw,-3 All-in:-One 12 Encap Front, Side and End Views
s,
13"
8" INVERT INVERT 5.3" INVERT
~ y
-33"~ a
--18.2"
.,!fii c, 4 Plus All-in-One Periscope
OUICK4 PLUS C
-ONE PERISCOPE C
ALL-IN
(30 SWIVEL
i
12.7" INVERT QUICK4
ALL-IN-ON
E 12 ~5„I _ 9,~
ENDCAP fff III
Quick4 Plus Standard Chamber Specifications
Size (W x L x H) 34" x 53" x 12" (86 cm x 135 cm x 31 cm) Invert Height'`,..............., 0,6", 5.3", 8.0", 12.7"
Effective Length 48" (122 cm) (1,5 cm, 8.4 cm, 18.5 cm, 22.6 cm)
INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY
a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ( "Units"), when installed and
_ operated in a leachfield of an onsite septic system in accordance with Infiltrator's instructions, is warranted to the original purchaser ("Holder")
against defective materials and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units;
provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of the
septic system commences, To exercise its warranty rights, Holder must notify Infiltrator in writing at its Corporate Headquarters in Old Saybrook,
Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered
by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units.
(b)THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT
TO THE UNITS. INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c) This Limited Warranty shall be void i f any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty I N F I LT R AT O R
does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages,
including loss of production and profits, labor and materialaI overhead costs, or other losses or expenses incurred by the Holder or any third party. r,l S inc.
Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse t.
e
or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure tl
to maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road • P.O. Box
768
he Units: failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal,
or improper operation: or any other event not caused by Infiltrator. This Limited Warranty shall be void it the Holder fails to comply with all of the Old Saybrook, CT 06475
terms set forth in this Limited Warranty, Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 • FAX 860.577.7001
N
third party resulting from installation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to
apply, the Units must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's F
installation instructions. 800.221.4436
n
(d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.com
n
original Holder. t'
The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of states and counties have different warranty
requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook, Connecticut, prior to such purchase,
to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units.'
r , 1 . {~°4.f~'2 - x.., ~.aIV"5i;;. n~af9 I F !°°?'f r''"`'wL _ Sd d^Y t h r r :..a, vu r > v7 r's3 s
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U S Patents 4,759,661: 5.017,041; 5,156,488: 5,336,017; 5,401,116: 5,401,459; 5,511,903; 5,716,163; 5,588,778: 5,839,844
Canadian Patents 1,329.959: 2,004,564 Other patents pending.
Infiltrator, Equalizer, Quick4 and Quick4 Plus are registered trademarks of infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc.
is a registered trademark in Mexico. Contour Swivel Connection is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc, Printed in U.S.A. PLUS051010ISI-2
715 386 6144 P.01
APR-12-2005 16:28 FERGUSON ENT HUDSON
HGOULDS PUMPS Submersible
Effluent Pump
lot
PE
41yNT Pump
e~
SPECIFICATIONS MOTOR FEATURES
Pump -General; General.: s Corrosion resistant
• Discharge: 1'/" NPT • Single phase construction.
• Temperature: 104OF (400C) • 60 Hertz ■ Cast iron body,
maximum, continuous when • 115 and 230 volts X Thermoplastic impeller and
fully submerged. • Built-in thermal overload pro- cover,
• Solids handling:'/" tection with automatic reset ■ Upper sleeve and lower
maximum sphere. • Class s insulation. heavy duty ball bearing
• Automatic models include a • Oil-filled design. construction.
APPLICATIONS float switch. • High strength carbon steel s Motor is permanently
Spedally designed for the • Manual models available, shaft, lubricated for extended
following uses; • Pumping range: see PE31 Motor service life,
• Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous
• Effluent/Dosing Systems PE31 Pump: • 115 volts operation.
• low Pressure Pipe Systems_ • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the
• Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor.
• Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power
Dewatering • Maximum capacity: 61 GPM • 115 and 230 volts cord, 20' standard length,
• Maximum head: 29' TDH • PSC design heavy duty 16/3 S1NV with
115 or 230 volt grounding
PE51 Pump; PEST Motor: plug
• Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy du
• Maximum head: 37' TDH • 115 and 230 volts portable and compac,
METER5 FEET • PSC design ■ Mechanical seal is carbon,
40 _ ceramic, BUNA and stainless
! I MODELS: PE31, PUT, PEST steel.
I! I
35 HP.33..40, .50 ■ Stainless steel fasteners.
10 ..I . ' _ i • I. , • 1 z GPM
30 •~E41 I -1- i i III AGENCY LISTINGS
1 Fr
25 Ck41S
20 ! -
c • •I . •...i - ~ i ~ I i ! Tested to UL 778 and
! i I I r. ' ; I j ; C5A 22.2108 standards
o~ 15 t -I 'f By Canadian Stan&rdt Association
File #1x36549
10 Goulds Ptunps IS I50 9001 RegiuEred
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0 $ 10 1.5 m3/h Goulds Pumps
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Parcel 040-1273-10-000 04/09/2008 10:33 AM
PAGE 1 OF 1
Alt. Parcel 17.28.19.1518 040 - TOWN OF TROY
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - GANDHI, ASHISH P & LORI
ASHISH P & LORI GANDHI
11824 ALAMO ST NE
BLAINE MN 55449
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 426 LOST ROCK LN
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.000 Plat: 08-028-TROY WOOD 040-01
SEC 17 T28N R1 9W SW SW LOT 42 TROY WOOD Block/Condo Bldg: LOT 42
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/28/2003 718936 2220/148 WD
12/26/2001 666346 1799/595 QC
2008 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/23/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 89,000 0 89,000 NO
Totals for 2008:
General Property 2.000 89,000 0 89,000
Woodland 0.000 0 0
Totals for 2007:
General Property 2.000 89,000 0 89,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
1360
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Gustum Septic Service
Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
Please print all information. Revi ed Dat
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner f Property Location 0
Humbird Land Corporation Govt. Lot 1/4 SW 1/4 S____17 T 28 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
332 Minnesota Street, East 1404 42 n/a Troy Wood Subdivision
City State Zip Code Phone Number City Village ✓ Town Nearest Road
Saint Paul MN 55101 651-222-5555 Troy E Cove Rd / Lost Rock Lane
✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
-
Replacement Public or commercial - Describe:
Parent material outwash plains - Flood plain elevation, if applicable n/a
General comments
and recommendations: Part of 2.0 acres. BM #1= 100.0'. BM #2= 100.7'. Recommend system elevation 97.9' along 1007
contour. P28 from preliminary boring work done 5-5-00.
[V28] Boring # Boring
✓ Pit Ground Surface elev. 102.7 ft.
Depth to limiting factor >75 _ in. Soil Application Rate
Horizon
Depth Dominant Color Redox Description Texture Structure Consistence ! Boundary Roots GPDift?
*Eff#1 *Eff#2
+ yr2/2 none sd 2msbk mvfr as 1 f 0.5 0.8
1 I 0-11 1 0y I - - - - - _ - -
- r314 none sil 2msbk mvfr cw
2 11 18 1 0 ! 1f 0.5 0.8
3 18-29 10yr4/6 none sil 2msbk L vfr cw - 0.5 0.8
- - - -
4 29-41 10yr4/6 none 2msbk mvfr cw - 0.5 0.9
41-55 10yr5/6 none gr. s 0 sg ml cw - t 0.7 1.2
6 55-75 10yr6/6, 4/6 none s 0 sg ml - - 0.7 1.2
❑ Boring # Boring
✓ Pit Ground Surface elev. 100.2 ft.
Depth to limiting factor >7 in Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft
-`Eff#1 *Eff#2
1 0-11 10yr2/2 none sil 2msbk mvfr as 2f,lm 0.5 0.8
2 11-16 10yr3/4 none sil 2msbk mvfr cw 1f 0.5 0.8
3 16-26 10yr4/4 none sil 2msbk mvfr cw 0.5 0.8
t -
I I
4 26--37 10yr4/6 none gr. Is 1 msbk mvfr i cw - 0.7 1.2
5 37-7 10yr5/6 none s gr. s 0 sg ml - 0.7 T1.2
- - - -
T* Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 S_30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: CST Number
Tom Gustum 227618
Address Gustum Septic Service Date Evaluation Conducted Telephone Number
N13450 937th St., New Auburn, WI 54757 11/21/00 715-658-1344
S.
Property Owner Humbird Land Corporation Parcel ID # pending Page - 2 of 3--
a Boring # -i Boring
_f✓ Pit Ground Surface elev. 102.0 ft. Depth to limiting factor >72 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture i Structure Consistence Boundary I Roots ; - GPDlft1
*Eff#1 *Eff#2
1 0-14 10yr2/2 none sil 2msbk mvfr as 2f,1m 0.5 0.8
2 14-21 10yr3/4 none sil 2msbk mOr cw 1 f 0.5 0.8
3 21-31 1 0yr4/4 none sd 2msbk mvfr Cw - 0.5 0.8
- ~
-
4 31-42 7.5yr4/6 none gr. Is 1msbk mvfr cw - - 0.7 1.2
5 42-72 10 r5/4 none I s, r. s 0 s ml 0.7 ~ 1.2
I ~ it I
7 Boring # -1 Boring
1_1 Pd Ground Surface elev. 100.7 ft. Depth to limiting factor >72 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM,
*Eff#1 *Eff#2
1 0-10 j 10yr2/2 none sil 2msbk mvfr as 1f,1m 0.5 I 0.8
-
2 10-15 10yr3/4 none sil 2msbk mvfr cw 1f 0.5 0.8
3 15-22 I 10yr4/6 none sil 2msbk mvfr Cw - 0.5 0.8
4 22-31 1 0 r4/6 none gr. Is 1msbk mvfr cw - 0.7 1.2
gr. Is 1msbk mvfr Cw - 0.7 1.2
5 3143 10yr5/6 none
6 43-72 10yr5/4 none s, gr. s 0 sg ml - - 0.7 1.2
F-1 Boring # J Boring
ft. Depth to limiting factor in. Rate
Ground Surface elev.
Pit G
~ Soil Application
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
*Eff#1 *Eff#2
i
I
j
* Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD5 <_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.
rot_:artp Owner Humbird Land Corporation- Parcel ID # gendinci Gage of 3
Bring -
Bo'i~r^
rrj 7rC}11 Su!Ta3e -et'. _z. tt urnl ! 1 aet _ ~
picauor
Z) 4?
1 0-14 10yr2/2 none sil 2msbk mvfr as 2f 1 m 0.5 0.8
1 0 - - -
ii
y - ~ f -j
2 14-21 r3/4 none sd 2msbk mvfr cw 1 05 0.8
-1- -
3 21-31 10yr4/4 none sil 2msbk mvfr cw - 0.5 j 0.8
4 31-42 7.5yr4/6 none gr. Is 1msbk mvfr cw 0.7 1.2
5 42-72 10 r5/4 none s, r. s 0 s l - - 0.7 1.2
I~
1-1
3 Boring # Boring r - - - -
I - I Pit Ground Surface elev. 100.7 ft. Depth to limiting factor >72 in,
J✓ Soil Application Rate
Horizon Depth Dominant Color Redox Description 1 Texture Structure Consistence Boundary Roots GPD/}t2
*Eff#1 *Eff#2
1 0-10 10yr2/2- none sil 2msbk mvfr as 1f,1m 0.5 0.8
i
2 10-15 10yr3/4 none sil 2msbk mvfr cw j 1 f 0.5 0.8
I I I
3 15-22 10yr4/6 none sil 2msbk mvfr cw j - 0.5 0.8
4 22-31 10yr4/6 none gr.ls 1msbk mvfr cw - 0.7 1.2
Y 9 - 0.7 j 1.2
5 31-43 10 r5/6 none r. Is lmsbk mOr cw -
6 43-72 10yr5/4 none s, gr. s 0 sg ml - - 0.7 1.2
I I 1 I
F-1 Boring # -1 Boring
J 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/ft
*Eff#1 *Eff#2
I
j :
;
!
j I
I
* Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_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.
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