HomeMy WebLinkAbout020-1342-10-060Wlsoonsl,A oeparrent of commerce PRIVATE SEWAGE SYSTEM
Safety and BuilcH ,I Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
p.m inG you orovice may be used for secondary purposes (Privacy Law. s.15.04 (1)(m)).
Pe mit H 1 er's Name: ❑ City p Village Ton of:
w
oc er, Jay ludscn ownship
CST BM Elev., Insp. BM Elev.: BM Description:
166 f
1 Mlgr% Ilrr Vn1v1/%1 v1
TANK SETBACK INFORMATION
TANKTO
P/L
WELL
BLDG.
irl
Airi to ntake
ROAD
Septic
��'
vv
3 `
—
NA
Dosing
>s��
9 �-, 7
Bldg. Sewer
f ZG
NA
Holding
►6 ,
't Ht Inlet
TYPE
MANUFACTURER
CAPACITY
Septic
kJ f r S e V
/Z y
Dosing
LA e 5Cr
vv
l7, D r
Alt. BM
. g .
(6 7o
9 �-, 7
PUMP/ 51PHUN INPUKMA 11UN : Js s , y v l
Manufacturer s Demand
Model Number S Z_�'06GPM
TDH Lift S Frictio L Syste TDHZ Ft
LOSS H ea
Forcemain Length -_ /t Di
do a. Z " Dist. To well
Count
Sty Croix
Sanitary Permit No.:
384204
State Plan ID No.:
Parcel Tax No.:
020 - 1342 -10 -060
A
STATION
BS
HI I
FS
ELEV.
Benchmark
t,&-t>
l7, D r
Alt. BM
(6 7o
9 �-, 7
Bldg. Sewer
Q Y�
►6 ,
't Ht Inlet
Dt
Dt Bottom
Header /Man.
A 7
Dist. Pipe
Bot. System
L
Final Grade
over
C7
Q
p
0�
2.
lAe.- �
A
No. Of Pits
SOIL ABSORPTION SYSTEM
BED/TRENCH Width 4 - Len th N Of Tre ches PIT
- D IMENSIONS I
SETBACK SYSTEM TO ^^ P / L BLDG WELL LAKE / STREAN
INFORMATION sas _...1 , 0 -9 ' - �
� Y
DISTRIBUTION SYSTEM
SOIL COVER x Pressure Systems Only
Depth Over Depth Over
Bed /Trench Center Bed /Trench Edges
Lot 6 /' s� �<<
1.) Alt BM Description= ° O', a
2.) Bldg sewer length
- amount of cover
3.) contour = (s.(,o` kt = t °t:.i.o -_ • e
I)M Wj
UNIT
Dia. I Liquid Depth
xx Mound Or At -Grade Systems Only
fpsoi Depth Of xx Seeded / Sodded xx Mulched
❑ Yes ❑ No ❑ Yes [3 No
nsnec ton d 3 a Inspection #2: / / 05
t V 44 32 T29N R19W) - 3229191822 Windsor'Heights =
Plan revision required? ❑ Yes 0 No
Use other side for additional information.
Oat
SBD -6710 (R.3197)
•fk
G
Inspector s Si tune Cert No.
I
Tr CMu4A40 LOWE
Tr
es T q ?1�
ARM COMPOO PM 90 tee 10z"Y 0 Only) far the SY3#402 an POW so 1010 MW sla 3 ILA Wo In an
$BD-6398 (R. 05101)
Safety and Buildings Division
County
NV"sconsin
201 W. Washington Ave., P.O. Box 7162
Madison, WI 53707 - 7162
S r
Site Address
De artment of Commerce
C", V rAX g g,
Sanitary Permit Appli"Ca
Sanitar N $Z ujmb e) yPermit er
:39 L f
0
In accord with Comm 93-21, Wis. Adm. Code, personal itif 1AN ou pro
Check if Revision
MA be used for Privacy LAW secondary Wnll—
ymposes; SO.'
I. Application Information - Please Print All Information NtLt1VLU
Ag
laia Plan I.D. Number
- A 14-R 9 a %A / I
Property Owner's Nam 2 2001
MAY q
307 ;Zt? I)Sroel Number . t Y 'NZ
'k I—,
79e 196 J2h T 'e
J- -
) ;? ff — & 41X .- Ij 6
Propeng Owner's Mailing Address
/PropeM Location
&e-.e7X Ael 0
'A J 'A; S 3 a T - N. R P?
City, State
Zip Code
um be r Block Number
Subdivision Nam CSM Number
a E
A --d -A
H. Type of Building (check all that apply)
ocity-
141 or 2 Family Dwelling - Number of Bedrooms
ovitlage
❑ Public/Comm= nbe Use Y
wnsh
OTo 1P Alm ot S v --t/
❑ State Owne 7
Nearest Road
1 9
- Zfe >-r- 2 -e- /- 0,.A� ---
M. Type 444rmitt (Check only one box an line A (numbering scheme for internal use). Complete line B irapplicable)
A.
I XNew 20 1 am system 3
I I
11 Replacement of
I
6 El Addition to
For County use
SvSWM Tank
only
Exist
B.
❑ Check if Sanitary Permit Previously Issued
I Permit Number
Date Issued
IV. Type of Permit: (Check all that apply)(Ilu mbering scheme Is for internal use) E4,4TZ4;�:.
44 ❑ Non -Pressurized In•Ground 21NMound 47 ❑ Sand Filter 50 11 Constructed W
22 ❑ Pressurized In-Ground 41 Holding Tank 48 ❑ Single Pass 51 Drip Line
45 ❑ At-Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculaftl- 30 ❑ Other
V. ea4n
Area Information:
Design Flow (gpd)
Dispersal Area
Dispersal Area
Soil Application
Percolation lute System
Elevation
Final Grade
Required
Proposed
Rate(Gals./Days/Sq.Ft.)
(Min-flnab)
Elevation
VI. Tank WO
Capacity in
Total
Number
Manufacturer
Prefab
Site
Steel
Fiber
I Plastic
Gallons
Gallons
of Tanks
Concrete
Constructed
Glass
Now
BxbftS
Z10
Taub
Septic or Holding Tank
Dosing Climber
Vu. !22!!!LM = _#all anon of the POWTS shown an the attached leas.
q Statement- 1, uadersigned, unme responsibilio
OWO UL p
Plumber's Nam (PrInt)
Plumber's Signature
RS Number
Business Phone Number
2� 1.eo
7 11960,
Phunber's Address (Street. City. Stue, Zip Code)
e
VIII. Corm
vartineut Use Only
.-t
IAApproved
❑ Disapproved
Sanitary Permit Fee (includes Groundwater
Date Issued
Issuing Agent Signa (No Stamps)
Owner Given Initial Adverse
Surchar Fee)
Determination
-- 7- 325
i-AIA 7^1
EK. Condi I of pproy ons 1 or Disapprova
yn— Ok* %
At( V=
PC
- Is
le zuc Sefdlf-
4*W$SAPI-� �S A" f " - 4
.4
ARM COMPOO PM 90 tee 10z"Y 0 Only) far the SY3#402 an POW so 1010 MW sla 3 ILA Wo In an
$BD-6398 (R. 05101)
-Page of /
Scale 1"= yo'
f
• � � r-1 � , X00 —� I
U-,. UL"
O►Z DLS1v4ZR � 11 �'� I
1
1
L=
S
a6 `
: 7A' a r 2c� rv-
H SD R-"_
_ �pwtE
GP�1Z.
nJ
P�
I
, F
GbtivTpuit. E,'2, 100,
p. \S\ 7a
p 'NFL LLD b
�prCt -�
NOTES: 1i_ L� ::2 5 : :1 Tr'iik
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. ( Z required).
3. Septic tank to be 1 Za0 /B pp gallon capacity manufactured by
W CUty e E Pj?_OOvc n L- J/ wI oil A - l8 UO ZPCB_rL Fi c�
4. Bench mark • Q., lOb. v' o►., 'lulu of 1 `bin �
�. Divert surface water around system to prevent ponding at the uphill side.
P
Nvisconsin
Department of Commerce
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
www.commerce.state.wi.us /sb
www.vAsconsin.gov
Scott McCallum, Governor
Brenda J. Blanchard, Secretary
May 18, 2001
CUST ID No.220254
ATTIC- POWTS Inspector
ZONING OFFICE
ARTHUR L WEGERER ST CROIX COUNTY SPIA
709 S PIETY ST 1101 CARMICHAEL RD
ELLSWORTH WI 54011 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/18/2003 Identification Numbers
Transaction ID No. 642116
SITE• Site ID No. 629729
SITE ID: 629729, WEST LAKE BUILDERS, LOT 6 Please refer to both identification numbers,
WINDSOR HEIGHTS above, in all correspondence with the agenc
ST CROIX COUNTY, TOWN OF HUDSON; CARRIAGE LANE
NW 1/4, NW 1/4, S32, T29N, R19W
LOT: 6, SUBDIVISION: WINDSOR HEIGHTS
FOR:
DESCRIPTION: FOUR BEDROOM MOUND SYSTEM
OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 792434
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED
The following conditions shall be met during construction or installation and prior to occupancy or use:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 101)
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD- 10706 -P (N.01 101).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this
information must be given to the owner upon completion of the project.
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area.
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
ARTHUR L WEGERER
Page 2 5/18/01
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the
initial installation of the POWTS in accordance with an approved management plan shall be conducted by a
person who holds a registration issued by the department as a registered POWTS maintainer.
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
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 Safety & Buildings 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.
Sincerely,
��X" "",�
Charles L Bratz
POWTS Plan reviewer H- Integrated Services
(608) 789 -7893, Mon. -Fri. 7:45 AM to 4:30 PM
cbratz@commerce.state.wi.us
DATE RECEIVED 05/07/2001
FEE REQUIRED $ 175.00
FEE RECEIVED $ 175.00
BALANCE DUE $ 0.00
TITLE SHEET
ROUND SYSTEM
FOR
A BEDROOM RESIDENCE
Page of - 7
This plan has been prepared in accordance with the Mound Component
Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P
(N.01 101) (N.01 101)
LOCATED IN THE NW 1/4 OF THE NW 1/4 OF SECTION 31 T Z9 N,R 19 W,
TOWN OF J7SOiy ST. CIZOLX COUNTY, WISCONSIN.
- L-o r b o f kit 10")SCR t1 Et_vft T s
INDEX
PAGE
1
of
7
TITLE SHEET
PAGE
2
Of
7
SYSTEM MANAGEMENT PLAN
PAGE
3
of
7
PLOT PLAN
PAGE
4
of
7
PLAN VIEW -CROSS SECTION
PAGE
5
of
7
DISTRIBUTION PIPE LAYOUT
PAGE
6
of
7.
PUMPING CHAMBER CROSS SECTION
PAGE
7
of
7
PUMP PERFORMANCE CURVE
PREPARED FOR
S 14 o)b
PREPARED BY
RFeE
*47r MAY. ?001
at DG
W FEE SERER SM S L TSST = NG
AND .
DES I Girl SSRV S CE
P.O. Box 74 421 N.Mai,n St.
River Falls, WI 54022
Phone 715 - 425 -0165
Fax 715 - 425 -6864
robvNiN
JOB NO.
11
5 -3-01
Mound System Management Plan page Z of 7
Pursuant to Comm 83.54, Wis. Adm. Code —
Semitic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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, Safety and
Buildings Division.
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.�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 for frost protection.
Influent quality into the mound system may not exceed 220 mg /L BODS, 150 mg/L TSS, and 30 mg /L FOG. 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual [SBD- 10572 -P (R. 6/99)] avid 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 Comm 83.33, 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.
Continaencv 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 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 adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning -Office at - 1 lS - V68O ST C-R4 IX
The system installer at — 7 1 S— 3a �LZl Setfy�tp - {2L�2
The tank manufacturer at X00 3ZS — $q_S6 Wi t t
The effluent filter manufacturer at bob _Z.2,j _ S - )qZ. ZPrzEL
The pump manufacturer at b 3Q �� _ t t
�� _ 0V -- - -- _
PT.OT PT.21M
Scale 1"=,-/C) I
U'JILL"
qb
L4 B D TL'A
-
ti' P.
L4 BDII
Page 3 o 7
LLt . S
p;�eL- �tt��
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved capg. ( Z required).
3. Septic tank to be gallon capacity manufactured by
0 0IJC pl'unuo-t L-J/Mn)$ 6-1800 ZPCWEL F-1Lr1
4. Bench mark • M-, Iz 0- 0 0\1 - 10 P o f I
Divert surface water around system to prevent ponding at the uphill side.
Page q• Of 6
Approved Synthetic Covering
AST14 C33
Medium Sand _
'�
117. % Slope
Distribution Cell of
-' to 2z" Aggregate
Distribution Pipe.
F_
o7
Force Main
From Pump
CROSS SECTION OF A M OUND SYSTEM
G
� Elev. 100-S
Flowed
Layer
D S Fi.
E \ -4 Ft.
F o.8 Ft.
G o. S Ft.
A ° j Ft. H 1.0 Ft.
Linear Loading i Rate= �A S GPD/LN FT
B �7 Ft.
Design Loading _Rate= 0.3gGPD /SQ FT
j Ft-
J 5 Ft.
K °I Ft.
Alternate Position
L 65 Ft.
of
Force Main
W Zg Ft.
- Observation Pipe
( K
-- --
- -- — —
- - - - -- -- - - - - --
- - - - -- _- - - = = -- _ ---
-
F o- -(-- -- - - - - - -- --- - - = - --
-------- - - - - -- --- - --
Farce Main
W _ = - - - -- - - - - - --
-------- __- - - - -_-
Distribution
�� 2
Cell of � to s
Pipe
aggregate
Observation Pipe
(Ulncsbr securely)
' ' _ PLAN VIEW OF A MOUND SYSTEM '
Distribution Pipe Layout
Page S of fa
Place the holes at the bottom of the distribution pipes
at equal spacing. Remove all burrs from the pipe and holes.
Extend the end of each lateral up with the use of long turn or 45 fitting to a point within six
inches of the final grade. Terminate the ends of the laterals with a valve,:threaded cap or
. threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug.
-
T`-t F'_ 1 CTS L . CZQS S
PVC F�1C
Lateral Manifold C.
C �-- Lateral
ITA
X
rth =
T f}cc—sls soX
S
PVC wec�, rte
o --
_ � q
P 3 -S Ft. Hole Diameter 1 1 `Inch
S 3 Ft. Lateral I Inches)
X 3 6 Inchps Manifold Z Inches
Force Main " Z Inches
# of holes /pipe 1
Invert Elevation of Laterals b\ -a Ft.
• RISER EXIT PERMITTED CQLy IF TAUK MA BF Nt! HAS SUCH APPROVAL 3 " r,Fp
SEPTIC F SPECIFICATIC)US
DOSE
TA W KS MAUIIFACTURCR: I.y1�S`1Z (!4 -� 1JtJMBER OF DOSES: P DA.
TAWK 51ZL : LZ80 1800 GALLOUS DOSE VOLUME z
ALARM M/UJUFACTUKER: S - — S, ZU� S 4S -&JS IMCLUDI BACKrLDW: 1 33 - 9- GALLON:
MODEL DUMBER: 101 NLV CAPACITIES: A. Z II Z•I UCHES OK U-Z 3 C,ALLOyS
SWITCH TYPE: 1�1�Z L „ -
' 8 = Z I U CHES OR G�. LLOUS
PUMP !"IAMUFACTUFkCIt: -__ GCtUL S C= 62 I ZIUCHES OR 133- GALL01.15
MODEL DUMBER:
D = L IAICHES OR l S' GALLOUS
SWITCH TYPE: �-lL -fLCU LI DOTE: PUMP AIJD ALAR ARE T Bc'� - �
MIUIMUM DISCHARGE RATE 'J ( GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE 15ETWEEIJ PUMP OFF AUD..DISTRIBUTIOU PIPE.. 16'2 S FEET
-I- KIIJIMUM DETWORK SUPPLY PRESSURE FEET -vx t 3�
+ �Z S FEET OF FORCE MAIN X 1 F 00FLFKICTIOU FACTOR.. L 03 FEET
TOTAL OyWAMIC. HEAD = zq ' -$ FEET
As per manufacturer 20.60 gal /in. Liquid depth 3 $”
Combination Sepit J. c',Tank and
PL1-MP CHAMBER CROSS SECTIOIJ ARID SPECIFICATIONS' PAGE OF - 1
•
N EWT CAP
WEATHER PROOF
ju►JCTIOU BOX .
4 VENT PIPC I
APPROVED LOCKUJG
110 1 FROM DOOR,
TPkAWHOLE COVER ;-JI 'l
uagp QU htPE�
.iwoOW OR FRESH 1
tNP�RlJI►JG Ll;`gE[
ALP, _C.
Wir
i
UJLET
► -� PROVIDE
I - --
AIRTIGHT SEAL
Approved
ZRB�•� "
o Approved
joint w/
(4- -1.f00
if l joint w/
PVC pipe
ALARA PVC pipe
t
I OU
C
I I
CLEY $�L."1S fT
I •
PUMP—.,
_ J
– OFF
D
CouCRETE
6lOCK
• RISER EXIT PERMITTED CQLy IF TAUK MA BF Nt! HAS SUCH APPROVAL 3 " r,Fp
SEPTIC F SPECIFICATIC)US
DOSE
TA W KS MAUIIFACTURCR: I.y1�S`1Z (!4 -� 1JtJMBER OF DOSES: P DA.
TAWK 51ZL : LZ80 1800 GALLOUS DOSE VOLUME z
ALARM M/UJUFACTUKER: S - — S, ZU� S 4S -&JS IMCLUDI BACKrLDW: 1 33 - 9- GALLON:
MODEL DUMBER: 101 NLV CAPACITIES: A. Z II Z•I UCHES OK U-Z 3 C,ALLOyS
SWITCH TYPE: 1�1�Z L „ -
' 8 = Z I U CHES OR G�. LLOUS
PUMP !"IAMUFACTUFkCIt: -__ GCtUL S C= 62 I ZIUCHES OR 133- GALL01.15
MODEL DUMBER:
D = L IAICHES OR l S' GALLOUS
SWITCH TYPE: �-lL -fLCU LI DOTE: PUMP AIJD ALAR ARE T Bc'� - �
MIUIMUM DISCHARGE RATE 'J ( GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE 15ETWEEIJ PUMP OFF AUD..DISTRIBUTIOU PIPE.. 16'2 S FEET
-I- KIIJIMUM DETWORK SUPPLY PRESSURE FEET -vx t 3�
+ �Z S FEET OF FORCE MAIN X 1 F 00FLFKICTIOU FACTOR.. L 03 FEET
TOTAL OyWAMIC. HEAD = zq ' -$ FEET
As per manufacturer 20.60 gal /in. Liquid depth 3 $”
111� --
?pcsE 1 o F 7
Goulds
Submersible
Effluent Pump
M
3871 EPO4
EP05
APPLICATIONS
• Fasteners: 300 series
• Fully submerged in high
■ Motor Housing: Cast iron
stainless steel.
grade turbine oil for
for efficient heat transfer,
Specifically designed for the
• Capable of running
lubrication and efficient
strength, and durability.
following uses:
dry without damage to
heat transfer.
■ Motor Cover: Thermoplas-
•Effluent systems
components.
tic cover with integral handle
• Homes
Motor:
Available for automatic and
and float switch attachment
• Farms '
`Heavy duty sump
• EPO4 Single phase: 0.4 HP,
manual operation. Automatic
models include Mechanical
Points.
• Water transfer
115 or 230 V, 60 Hz, 1550
Float Switch assembled and
■Power Cable: Severe duty
!_Dewafenng :{
RPM, built in overload with
- the factory.
preset at
rated oil and water resistant.
automatic reset.
■ Bearings: Upper and lower
SPECIFICATIONS
• EP05 Single phase: 0.5 HP, '
FEATURES
heavy duty ball bearing
115 V, 60 Hz, 1550 RPM,
construction.
Pump:11?04
built in overload with
■ EPO4 Impeller: Thermo -
Solids handling capability ` „
--` /; maiumum:`
, automatic reset
• Power cord 10 foot `
plastic Semi -open design
with pump out vanes for
AGENCY LISTING
..Capacities: up to 55 GPM.
ptal heads: up to 24 feet.
standard length, 16/3 SJTO
with three prong grounding
mechanical seal protection.
EP05 Impeller: Thermo -
SP Canadian Standards Association ,.
'` '
Optional 20 foot
listed
� - Discharge size: 1Ile NPT.
plug.
plastic enclosed design for
(CSA model numbers _
"F' "AC ".)
Mechanical seal: carbon-
length, 16/3 SJTW with
improved performance.
end in or
;rotary/ceramic-stationary,
three prong grounding plug
BUNA -N elastomers.
(standard on EP05).
■ Casing and Base: Rugged
Temperature:
thermoplastic design provides
104 0 F (40 °C) continuous
superior strength and
140 9 F (60 0 C) intermittent.
corrosion resistance.`
'. Fastene 300
METERS FEET
`atainlesssteel.`
10
.Capable of running
dry without damage to '
'9
30
=components = {
,r..
Pump: EP05
a
z
`:.
• Solids capability
c
25
$ 4 maximum ±N
W
Y,
_
, Capacities: up to 60 GPM
6
20
i
=Total heads: up 31 feet.
=_x
.Discharge size: '1 rk` NPT
z 5
s r .
Mechanical seal carbon
15
x
"`rotary /ceramic - stationary ,
-N
4-
'1 :a
BUNA
A elastomers
o
1 2
•.Temperature r 3
. ,Y ' 6ci'_ U
X104 °F (40 °C) continuous
" 10
v
`
E`
°1'40 °F (60 °C) inter'mitfent .
2
�s y'
5
0
" 0 0
. ,
. 10
20 30
40 50
9
0 2
10 12 m
4 6 : 8
w :
CAPACITY
is
9 1995 Goulds Pumps, Inc.
Effective May. 1995
lisc�.%in Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of
Bureau of Integrated Services in cgrd4noo *it ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less tha / ill i Plan t County
include, but not limited to: vertical and horizon " rence = ,. irectioti �S ✓
percent slope, scale or dimensions, north arro , and location and distance to ne"are's road. Parcel I.D. #
DE o � 1997 �..
f
APPLICANT INFORMATION - Plea ant all f�iirdiflQ1l<ion.
`p , f Review Date
Personal information you provide may be used for seco j4, UN viewed
E s. 15.94 ( ^ t (m)). R • (Aj''� �z �• �f 7
I'll Property er <, P operty Location J
1 % . .' r Govt. Lot 1/4 1/4,S T ,N,R (or J
2�2
• ' i y t �• 1
Props Owner's Mailing Address Lot # Block# Subd. Nam or CSM#
S
City State Zip Code Phone Number ❑ City Village ❑ Town Nearest
i
New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building
❑ Replacement /�r�1 El Public or commercial - Describe:
flow
Code derived daily –��
gpd Recommended design loading rate _,_�:__ gpd4l gpd/ft
Absorption area required 5"�_ bed, ft 5 D trench, ft Maximum design loading rate 1 �__ bed, gpd* gWP
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material Flood plain elevation, if applicable ��fi ft
ru = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in FII Holding Tank
= Unsuitable for system ❑ s ® U ® S E3 ❑ s u El ®u ❑ S Iz u El s u
SOIL DESCRIPTION REPORT ems_ aX� ( 2ooa
Remarks:
Boring #
Ll
Ground
elev.
�ft.
Depth to
limiting
• S�
� fa
i . Remarks:
CSf Name (Plea Print) Si tur Telephone No.
I`
Address Date CST Number
4q /04
Dominant Color
Mottles
WA
W.W.A
M���
d
l
Mir
WMM
��i��1�1
/G7I���I
��I !` %Ill•- 7�ii'31fi��ti���
Al
W'MWI
Remarks:
Boring #
Ll
Ground
elev.
�ft.
Depth to
limiting
• S�
� fa
i . Remarks:
CSf Name (Plea Print) Si tur Telephone No.
I`
Address Date CST Number
4q /04
PROPERTY OWNER
PARCEL I.D.#
Boring #
El
Ground
elev.
1&3-
ft-
Depth to
limiting
factor
�
Boring #
L1
Ground
elev.
ft.
Depth to
limiting
factor
in.
Y
Boring #
C1
Ground
elev.
ft.
Depth to
limiting
factor
in.
Boring #
C1
Ground
elev.
ft.
SOIL DESCRIPTION REPORT
Page 4;w2 of
Horizon
Depth
in.
Dominant Color
Munsell
Mottles
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
2
Bed , Trench
l
3
Remarks:
Remarks:
Horizon
Depth
in.
Dominant Color
Munsell
Mottles
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft2
Bed , Trench
Remarks:
Depth to 1�
limiting
factor
' Remarks:
SBD -8330 (R. 07/96)
7U sC�Z
/-l5^ 7
' 9 / oa /
,� :�o r3
` 514KIF
0
ST (.ROIX COU NTY
SE=PTIC TANK MAINTENANCE AGROMENT
AND
OwNF-RSHIP CERTIFICAT FORM
t
Own er/Euyer _c
Mailing Address
Property Address _ ey- R' 4 ti
(verification required from
Department for new construction)
City /State r�dQ -�i- Parcel Identification Number
LEGAL Dk ;SC'K.I I TF01N
Property Location � ' / " " /, � ' /., Scc. 3� , T N-R V, Town of –e-4 Sc+ �
p Y
Subdivision S - ,Lot # �
> ;'�lS�.� _�;` __� . _
Certified Survey Alap Volume _ , Page #
Warranty Deed 4'4 �`` `/� Volume 18 3/ Page #
Spec house ❑ yes W no
Lot lines identifiable X yes ❑ no
SY , N1A1
Improper use and maintenance of your septic system could result in its premature failure to handle: wastes. Proper rnatt nat?cC
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 treat=nent stage ill the waste disposal system.
T7te property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner Mid by a
roa.sterphunber, journeyman p lumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is .iii proper operating condition artd'ut (Z) after inspection aud pumping (if necessary), the septic tattle is less titan 113 full of shtdtre.
I1we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system rWith the standards
set fordx, herei,rt, asset by the Department of Conurterce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be competed and returned to the St. Croix County Zoning MC within 30
days, of the three year expiration elate..
SIC AT&R - E OF kPPLICANT
OWNE CE . IFIC'AT1Uy
I (we) certify that all statements on this form are true to the best of my (out) knowledge. I (we) ant (arc) the oeeT►e�(s) of
the perty &sctibcd above, by virtue of a % arranty deed rccord.d in Register of Deeds Office.
$IG AT1.1RF.
or-'APPLICANT
• " +•'* Any information that is mis represented n ?ay result in the sanitary permit being revoked by the Zoning Department.
•" lnctude with this application: a stamped warranty deed from the Register of Deed: office
a copy of the certified survey map if reference is made ill rite wan deed
V0I.1001 PAGE 41Z)
STATE BAR OF WISCONSIN FORM I - 1999
Document Number I WARRANTY DEED
This Deed, made between West Lake Builders, Inc., a Wisconsin
corporation Grantor, and Jay A. Rocker and Paulette M. Rocker
husband and wife Grantee.
Grantor, for a valuable consideration, conveys and warrants to
Grantee the following described real estate in St. Croix County, State of
Wisconsin (the "Property ") (if more space is needed, please attach
addendum) :
Lot 6, Windsor Heights in the 'Town of Hudson, St. Croix County,
Wisconsin
Recording Area ..
644442
KATHLFF.N H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
0 01 -POM 8:30 AM
WARRANTY DEED
FXFnIPT b
CFRT COPY FEE:
COPY FEE:
TRANSFER FEE: 209.70
RECORDING FEE: 10.00
PAGES: 1
Name and Return Address
EAGLE VALLEY BANK, N.A.
1301 Coulee Rd Unit 2
Hudson, WI 54016
Together with all appurtenant rights, title and interests. 020- 1342 -10 -060
Parcel Identification Number (PIN)
This is not homestead property
(is not)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions and reservations, if any, of record.
Dated this / C? day of _
2001
WEST LAI I:LDE RS, C.:
BY:
Signature(s)
AUTHENTICATION
authenticated this day of
ACKNOWLEDGMENT
STATE OF WISCONSIN
ST. CROIX County
ss.
)
Personally came before me this _ i ` �l V0 day of
2001 the above named
cam+ - *,+*� i •;
West Lake Builders, Inc., a Wisconsin co rporation, by
TITLE: MEMBER STATE BAR OF WISCONStN
(If not, 1 ' ° , ' to me known to be the person(~) who executed the foregoing
authorized by § 706.06, Wis. Stats.) : „ +° irtstrument and acknowledged the same.
THIS INSTRUMEN 'WAS DRAFTED&Y • ! Cx� �� —r`._
Ogland -
K ristina Ogland,`Es & _ c . _. _ i �. �` �- (- �� C
Notary Public, State of L.J /SC'o/VS i N
304 Locust Street Hudson, WI 54016 - - _ - ) , ,, Y _ --
My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) • -,__ I _. .. •)
* Names of persons signing in any capacity must be typed or printed below their signature. Inrormatiun Professionals Co.. Foinl du lac, wt
STATE BAR OF WISCONSIN 800- 655 -2021
WARRANTY DEED FOR1%1 No. 1 - 1999
W
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