HomeMy WebLinkAbout008-1027-90-025 (2)
sl4sccnsin Depanme-I0fOnmme.^.P. PRIVATE SEWAGE SYSTEM Crrny St. Croix
Salelu anC Itu d~•n~ Urasi+n
INSPECTION REPORT Sanwa y Derma N,,
6050$2
GENERAL INFORMATION (AT TACH TO PFRIo11T) Stale Palo. 113 IN
Perse~a nrr.-ma'icr you prn'mce ma, hr see bN seccmdary pbrppscs IVn'.•a:q• Luv s I5 94.1,m,ll
P,,rnu1 Nc de, s Name Gty Vol age To.snsh I Parcel Tax No.
Garrett Bonte TOWN OF EAU GALLE 008-1027-90-025
CST W.1 Elco 1 Irsp f,? L r:. 61,1 Desrr pNr.^. n Sectic Range r.l.Jp Vr,
62.2 (3AA 1 GS { 10.28.16.141A-10
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS LLEV
Septic 4 Z ) Hencn-nark / /6?S 16Z• Z
K~ 'ti t G i J~
Dosing A 6141 1 .9
Bldg. Seville,
C.•e/
I S~ 15:w '-sk
Ho.anrg StrHt in et
SLHt Outlet
TANK SETBACK INFORMATION
TANK :O IIl .:ELL BLDG. Vern Au1-olre ROAD Ot Inlet
- 4k
- D: Bottcn' YI
sepc:: ' 56 r I1 of
2' l
Dosn~ 756' /Zd 33 Heacer,l 7 3 q6. L
Aeratior. Dist l
7.3 z
Hnld N, 607 System Q 4! -7 L
7• O !7 .
PUMPISIPHON INFORMATION Final Grade 4, ZS oil Z
Wtalufaclurer /I Dell ) S: Cove r_/~ t~ 11
ZCe-llL~ GPM1Y Jv T' ~/e 4Y V S o• Z
Model N-Iml 8A J 1,37 TDI1 l Frictio6, 7S System H TOW r
r 1 615
F:;ICen`ain Li•nc~tlI D az Vo,
SOIL ABSORPTION SYSTEM
BED-TRENCH :^i'Itn L,'g'h l O` Tle'1GI.vS PIT DIMENSIONS Nc tl Fi^ In, de Da. q:. d Ge:t~
DIMENSIONS 6, 1 75
SETBACK SYSTEM TO PrL BLDG l-WILL LAKEiSTREIJd LEAr•.nlNC r,fan.raaunr
INFORMATION I r Dr r CHAMBER OR a
Co ~rG 171 UNIT Mock-I NUmCev
DISTRIBUTION SYSTEM
Heirl rrlAin,"Ai (J D,1-huton x HMe Sve r Hu'o S[<icu•q `re-I:c idr InjakyF .
Lon ,l•~ 1~ D-a 4' le-3th Dia Spaciry
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade systems Only
~,-ptn cvar Decor o-ae.x urn•h or sc-d~-a+s-acec r.: r.aulc-ec
3emTm_m~~Cer LS Red.Trr_ ^,h Fape, ToPsui ....y Nn YCS to
COMMENTS: (Ir•.clude code discrel les pcrsuns pnscr 1. Irsceclon d1 Inspection 42:
Location: 244/ h--, 1-11 AVEP Glh oll
1 I At BM Description - b`
2;t Bldg sewer iengtn = r
- amount of cover = Ei(16a i N
Plan revision Required? Yes No - 'l ) IQ '7eyl
Use other side for adoitional informa: n. J
Date I.1-p1loi'- W rlure Cee No.
ss?>T CrR03-t
~j," , LL a ~ ~l. Safety and Buildings Division St. Criox
~ $01 W. Washin ton Ave.. P O. Box 7162
S lP I I 9 Smulary ycrmn Numt+er fto ~ lillcd m by Co.l
• g Matliso~,, 15307-7162 ~ T
'ems ~ I .~~_i~ 1~ Zr~B I ~o ~SD$Z
,S~atait~~r~• Pexr~ttiApplicat• S:atrTransarri melee
In ❑ccurdancc xnh CP~~ iii Ni< 4nn Ca, cT, a::bt~inc of n r ~/r/~{^!~
c u t m t rh rrppmpnak govcmmcntal unit /a'
;rgmrcd pr n u ohmmir.a ~ aw3 xr ut \ io ;\pphcnrinn lurms In ac t oeud POW 11 arc cuhanllyd to Pmicci :lddmss lif Jrtiircnt than mudmq uJJrcssl
the Ugcnonrn o tialrlp ;m 7 i .~.i-.ai ~ , PcrsnnJ nlirrmabm[ you rnus'idc may ba• uscd Iii: srewtdurv'
pugvncs ina nrinuc svich n Iii ro; f_u[ Is.U-0!lluv) 9ats. ~ 2`j"~ `j( rI
r I ~p diranon Infer mn Plcase Prinl 111 Information '!T'f~ 7(J M'h
I'm;xm' O•rnrrs \xm J - Pmccl x _
Garrett Bonte _ 008-1027-90-025 (y -~-ry }
f Pmprn} (hvnr:'s Mzihnp r\J~r62 " Pinyrn) Location / V r a O. 1 b. '~I
I 2447 50th Ave.
- _ oo~~t Lol
.(in parr /ip Cndr I Phone NumMr
NE NW ticction 10
Woodville, WI 540.28 28 '16 iclrcir one)
II ly cof Buildin - F ] K Lot\V
P K Ichrck all Ihal apph) I m N ~ - -
i u! _ Famiiy Dv.ell mF Numhcr of ReJna s 4 SubJrvision Name
1Mt Hlorl:+ ~
U Yuh6c ('ommer.lai - Drwnhc Csr _
i~ Cllr of _
J titatc (hrnrJ - Ucscribr Use ~I Cumber Q I ~lOQ ❑ VJIuFr ul
- _ v J O
A;>~ ~'~t(e (eX~ I~ ~lnHnnr EatlGalle
s6~v w F~ _
I11. Tr pe of PermiC (('hcc•k Dols line ('nmpleie line It if applicable 0 ~ - ~ 1J
~ r. - - - -
Cos Spaem ~ Kgracrn•.eut Sysicn l7e[rmrnVHoldi❑ T.nik Kc lacrmrnt Uniy '
F P (hhrr \Indincuuon w Esislwg System (rsylamj J
H• ❑Prrm:rKrnrw'al ~~Yenno Rr:ou`n ❑C'han5r or'Plwnhcr ❑Prrmi: 'iiarutcrm NCw' Lisr Previous Pcnmt Number and Uarr l'surJ
Hcli[rc Lspimunn ()aancr !•l(LL~I L~/
_ i ✓..7777f~ .J
I~. l~pr of PON' 1'R S~~stendComponrnllDesice: -(Check all Ibat_a IPP a) -
_ _
' Yon-Prr:w e C In-Ground Pr..n xd In-Gnnv:J ❑ :1rG niec ~ Mou [d ~?J in of swlahic soi! U 41m:nd <?.1 m. of swlahlC Wi:
i H Ili~.u Ian f-U,:+.cr Disprnal Conn :nc ttc~nhuCll~ _ ❑Prdrcatmtnr Lkclx icaplami__
~ Drs enaUfrc Irnl ,area l_n form etmn ! ~ -
Dcsipn Flop' IFpJ' IRu~n a it :lpphtaU n h I - i/tTrJst) Disprnal Arca Rryui;al Isr~ Dnperwl Arca ProposcJ I I 5)'a:an Glrvarmn
soo _ -7 8s7 ~ ~ 3
t'1. Tank Info i:a ~i i i~, Toad xo!' Manufacrturr -
G Jlc ns Gallons I lots ~
Ccx tanks 1 s sting ranAx yy~~ G s
/ _
W c ~ ~
ti Pre cv Heldmg Innk - e. f it ~ ~ i
v 1200 1 Idwesl
~X_ 1000 ~ 1 Midwest _ I . L
~ II Rcs lonvbrhts' SfAlerncnt- h the u y~~/_\ 'J`-ynnslbr for in. Ilarion n! the 1 UN I ti shnon nn the a_i[arhed glans.
~I Iumhi~s Namc IPnml 1'lmnbcr u•r ~ - ~ \/P:.\IPKS N:_mrcr Huvncss Phone Numbs:
Lewes B ork 253976 715-231-7375
Plumbafs:\dJrc¢111reeL (li•„~Ce 0.'. /qrl udci - -
~E7818 County Road E, Menomonie, WI 54751
!~~'I~IL Counh /nrnarlment fsc Ooh - -
1,(,\pl ~,{.h.rt.R.7,\ ,p Pcnni[ Fce flare I ucd Isswug A t Signalurc
[ ~ S
r , It r ou I\lkr.: pr _I yV S• ~ W / a
I\ (ondi ! ^~'~^~s`cacon,. for llisapprm'al
•~i aa'll meta eU ~'::~><i:!lky~~k
~IrArr.alArtlen• pkn P'o ~idNw
2 Ai~1141kw~tJArmrrsmu:tls
i~/1►1Mkl~k (qGg /:I'tLullw,
:\ttarh ru rumplem ylan> fur [he storm and suhmil to the <.ounly unh nn loyar oor leas then N r'S s 11 Inehea in xue
Slie-(7Yx (K. I I! 111
uaIsaeyl uoeoo
iaaauj Ile noA eas of adoq 1
'Wdsl-:L
- 00:9 wOJJ L ~/S ~ ~ `1145lu
moaaowol aoijoeid aq II!M aaaul
. ,•y!r• w.4r?ri
mss;
Awu
:SpIE) apeas~-Pj£ pue . oz
CHEC✓!10%1;. ASP-r-ABLE. CHECK 90X. AS Al?t EAkA
SOIL EVALUATION Scale: 1' 30' SYSTEM PAGE 2 OF5
SITE MAP g 30 aJ 60 PLOT PLAN j
PROJECT4AME: ,',oes,cNFLOW 600, GOD
_ Garrett Boflte .Attach design 8owcImituonslorwmmeraal plans.
i
PROJEC 7 A')DRFSS. _ 2447 50th Ave Pipe Mated& ! ASTM Standam ; T a61e% 384.3;[-3 8 384.30-SN Sanitary cwor 4" 3034
BIA Symbol nrt Flevatlon: ,02.2
I Ftrte Mxm. ' 2 sch 40
eel Descdmmrr Top of power transformer # 7308
IMPORTANT:
slope Ogtdient IMlrgie rant. N
4 Wcli SymaN jlf aPpewhk;. p c:auhg en emow Show ground elevation wMOUrs at sullndC intervals.
of Tnel¢tl AtMi on 1M eP~r~pnib IM.
4 ~~I\ A \ \ ~S llF- Z1-j2. - -
' ` \ BTU^, = loZi z `•I
c
Sow
Z04 4.4-1,
40
W C~
~T - a.;Vr- n
~r 3re.;~.`ss:.lC
5~A Scw~~ c.
~u.r~ lZct~ S~. ~ ton ~ 'I
n I
PAGE 1 OF 5
In-Ground Dosed-Gravity Plan
Index & Cover Sheet
Component Manual Design References:
Version 2.0, SBD-10705-P (N.01f01. R. 10/12)
Pg 1 of 5 Index & Cover Sheet
Pg 2 of 5 Plot Plan
Pg 3 of 5 Dispersal Area Cross-Section & Plan View
Pg 4 of 5 Pump Tank Specifications
Pg 5 of 5 Management Plan
Attachments: Enclosures:
Pump Curve POWTS Application for Review
c~ ! Soil Evaluation Report & Site Map
T _ Effluent filter maintenance instructions
Project Name / Description
Garrett Bonte - Additional treatment dispersal cells / diverter valve
Owner Name(s): Garrett Bonte Phone: 612 _965 _9718
Owner Address: 2447 50th Ave, Woodville WI Zip: 54028
Project Address: same
Govt. Lot: NE 1/4 of NW _ -114, Section 10 T28 N-R 16 _E ❑or W Q
Township: Eau Galle County: St-Croix
' Project Parcel ID 008-1027-90-025
Designer Information
Designer Name: Lewis Bjork Phone: 715 _231 -7375
Designer Address: E7818 County E, Menomonie WI Zip: 54751
E-mail: lewisbjork@yahoo.com
License Number: 253976
Remarks:
Signature: Date: 7-10-2018
( Original signature required on each submitted copy,
Q 10ei C , j~ -I-
CHECK BOX AS APPLICABLE. CHECK BO AS ARPLA-Ab-
Scale: r = 30 S4 SYSTEM PAGE 2 OF
SOIL EVALUATION 45 A
0 30 SITE MAP PLOT PLAN
PROJECT NAME: DESIGN FLOW. 600 OPD
Garrett Bonte Attach design flowcalwlabons for commercial plans.
PROJECT ADDRESS. 2447 50th Ave Pipe Material ; ASTM Standard (Tables 384.303 & 384.305)
N eanaay Sewer 4" 3034
BM Symbd. Elm Etevalbn' 102.2 PT Face Main 2 sch 40
BM Descripli m Top of power transformer 1117308
in.,., „w,, W IMPORTANT:
Slope G•edled (%1 well symbol (sappll abie), Q a~aM•s a, e~u« Show ground elevation contours at suitable intervals.
of Tasted Area. 4 on Lv soprordle Irw
E~Sbnn~a~1WF
S m'
awl 1Cas Z
~I 1ti k = Q~ 4.a.N'~ssb~
TOP
repo QWV= CST 253`11
t3vti-Ge 3-SS u t' - /
Z Fwt - nnr~ i
5\,.Il S wFEC
n
u;t~ s~1It►I. Z
0
PAGE 3OF5
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PAGE 4OF5
GRAVITY-DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
4"0 Vey P oa (No Scale)
>10'I'ron~
Building Epn,biwl musl comely with
12" Min. of 2.01 aC.wa SPS 310 a^d NEC 300
Eslaolis'od li wd Elevalior Wezll•elproo` Exterd n.anhWerise.,.3 nonisary.
llysral' Junclior Box
AV4xo'„~x1 Approved Lod<ing l4amole
I iN;h wemi^.0 Label AltathnJ
IMPORTANT: °at p
Anchor tank(s) as necessani _ (IV 'gab
pursuant to SPS383.43(8)(g) T t~iiii4it 4" Min. Of 2.01 eboVe
Estaolis^od Flood Elevalior
- - (!yacAl)
--w-- ~AinlgM Sea
F hiishnC G <nle
r Qu'd Di oonnaa 1
10'Ydin.
CAPACITIES @ 26.40 gal(n 4 (tyPl~l)
Depth (in) Volume (gal)
A 18 475.2 'xeet, Approved sorts wth
Heie Appwod Ran 3 h onto
B 2.0 52.8 A Solid Girard
HPnO
[C] 5 132
6~ ala"n
D 14 369.5 ~a t>_ on
I I~) PUMP-OFF
*Pump Tank Liquid Level 39 in ~>_oh ELEVATION = 82.5 it
=
INSIDE BOTTOM
Force Main Diameter= 2 in °8xxi(a
Ax,rx ELEVATION = 81.4 ft
Force Main Length = 75 ft 3• Appfo+ed Sass^xp 1.1n1c^al rimeatr Tank
Force Main Void Volume = 12.25 gal i~ 1(p l
[C] Total Dose Volume TDV = 144.25 gal/dose a pp
0.2X design flow + force main void volume) 1' q
r, FI~^ r D f I ~~5
15 r, S Vertical lift = ft
~dl-
PUMP
TANK: SEPTIC TANK(S):
Volume = 1000 gal Total Volume = (2) 1150 gal
Manufacture Midwest Precast Manufacturer(s): Lewis Bjork
Pump Manufacturer: Zoehler
Install approved effluent filter at the septic tank outlet
Pump Model: 137 & , dla„„a, l , , w e i immediate) upstream of the um tank inlet
Controls/Alarm Manufacturer: SJE Rhombus Filter Manufacturer: Sim-tec
Controls/Alarm Model: AB
Filter Model: STF-100
Float switches containing mercury are prohibited.
PAGE 4OF4
In-ground Dosed-Gravity Management Plan
IMPORTANT:
The owner of this in-ground dosed-gravity system shall be responsible for its perpetual operation and maintenance
pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2). Wisc. Admin Code. this
system shall be considered a human health hazard if not maintained in accordance with this approved management
plan Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 600 gpd; BODE 5 220 mgL-'; TSS 150 mgL"; FOG 5 30 mgL'
Inspection Checklist INSPECT EVERY 3 YEARS
type of use
age of system
nuisance factors (i.e. odors, user complaints, etc)
c mechanical malfunction (re., pumps, valves, switches, floats, etc.)
material fatigue (i.e., leaks, breaks, corrosion. etc.)
solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e . distribution / drop boxes)
o neglect or improper use (i. e., exceeding design capacities. prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
dosing irregularities - if applicable (re . pump re-cycling, float switch settings, etc )
electrical components - if applicable (te, wiring, connections, switches, controls, timers, alarms, etc.)
n distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)
n surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281,48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local govemment unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Lewis Bjork LLC Phone: 715-231-7375
Local government unit. St.Croix County Phone: 715-386-4840
Local government unit address: Carmichael Drive Hudson ZIP.
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1). Wisc. Admin.
Code Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admix Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383 33. Wise- Admin. Code.
PUMP PERFORMANCE CURVE
sc;lu1,- PLIW PERPORMANCE CJRVE SJMP =F=_JEN- MODELS
r„
YB 1.7 S 3W SOLIDS PASSING CAPACITY
_ _
1: L L I 4 !I-.
i it k 1 Et @ A: t . _
1-~ _ 1 v
H I~ ~ d 1 l ll 4 Ip
1 Hi. ~ f J: t v c-
Q _ _ - - _ _ 1 ILL - 3
1t a
- -
m of
a
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G :LA
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C G H J
op,
a ~
1 1
~~III 5 _
S 51 4 L
I\ I. 11 n
4.
4 aAUTI'3N
dn
- - - - - -
PUMP PER,FORMANICE CURVE
SEWAGE MODELS
- - 2" SOLIDS PASSING CAPACITY
I1.
CAJr )N a II iJ'. ]I 'U: V".I Je
20M' =x9a' L,. ;JI paws r5C've.'.
LAVERTER AND BACKWATER VALVES
erter Valve
tl•.e wir ptest, strongest and most econcmical diveiter valve ever irvBnted for sopac tank each fields. It s made of tough molded plastic
-.t .,If not Shatter, blind. rant of corrode. It s Fighter in mPa qht. eas er to Dandle and less ekpP.n~.ve to ship.
Functional
hverter valve stem 1'ow may be eortrolled to individual o• mt,lt ple fields aip to three] in aey combinat on. With a three-way valve stem.
'T ay he diverted to any two outlets. Tin allow !low Pr•rn.gh all wlets. 79e valve stall may he removed Oom the assernbly.
F, sy to Install
rt a' plastid -.vror and ::rain pipe to nletS and outlets on rhP flu'-way ds> rihutior bnx. t,Umu enr 1 tlcrs '113, ,!Ialed h' in--tall IT
_reede' C' r' ,i h h )L.e; Ihr ai'rerte/ Steil, ma h, -w 7t,E cd lervtl-. -,l 11 q'PV 57Y 4 PVC ONerter valvt YIMe 4 950 35PV
ARS 575 4'ASS Ominer Me elaw 4 7.50 35AB
zri%T;rListed I
2 1
i
30.5• 0
r, I TANK TANK TANK
4 ps nn. 4 5 6
C I~IAPMO hg20 ~ \a~ I•( j-IO Ir( {1~ t:r•i'r:.
I 1War ir-~L.Jrr~ ~c ra
1 6..
DANK TANK Nx,,trro TANK
-I;` I)G(,_,.C ;A% :ter vai"'[I
US grw ty Buv, sack'water Vale is eesigned to protect low arcs or h sarneots kcih :he backflav u' •aas:e rrr-n street serscrs.
_v:ilable w 2', 3. 4' and G' sizes, PVC material. It is a last-effective and a chemically res,5tant altec•tal ve to cast ~ror vzlves_
lt: ckwater Valve
- quick action flapper allows unrestricted un -directional' ow. Elaslowwic gasket in :ne flapper ensures a watertight seal. Fl3Fper can
^.ily removed and replaced it required. Threaded aaress rap,s dengrrxt for hand tAghtening. AC:OSS Cap neoprene gasket provides
r, tive seal. Valve hub outlets fit 2', 3', 4' or 6' MAN p pe and may oe ade.p:ed to 2'. 3'. •7' or G' sewer and drain eP3 with NUS L'VN
r & =vain P,daot"-, ^ntr 't. easy in. irs;311. -onzortal,rislaaatior required, •,v tr arrows in top cd the valve huh po-long in t+,
t' - i,ir`i . r er n'fer5 a s.male. econo nical acre,,: in the •;atve f-• inSrudt :-1 and rnamtenance.
275P, 275 2.13' sat, 253 I6'•
Al C 2751-8 2.16' 5.03' 353' ' W 4
375-,375 35:' 7.56' 6.10 16" G ' Z
(n
' ;75PA.375B 351" 736' 6.10' 16" r,
_I r 475P475 4.47' 11.18' 7.18" 16" c
B 1 475PB.4?5B 4.47" 11.18' 7.18" 16'
07SP, 675 5.50" 15.25' 9.90" 16' w
4 p pawals anokcabte to voNe only.
SP
:
J,--l ndspro.corn 9
Tank Al a 0 1 AB
Indoor Alarm System (Auto Reset, Battery Backups
T',,e Tank Alert` AB indoor alarm system monitors liq~,id
level conditions in lift pump chambers S,:rp pump',%asi^s
holding tanks, sewage, agricultural ~Jte,s and othe- wasta
applications
The sleek design of th-- alarm features a .ser `fiendhy tout` SfE-RhO/ribtl5
pad with colored LEC Indicators for easy visua, detec-
tion. The alarm horn and red LED indicator activate for i
high water alarm condition. Once the condition is cleared
the alarm automatically resets. The green LED indicates
120V primary power to the alarm. If primary power fails the
alarm continues to work due to 9V battery backup►
sae tree
NEMA 1 rated enclosure for in<iocr se
automatic alarm reset
°VDC battery backup with :ow ch rp
olored LED indicators
Red alarm - - Sp s UL
LISIND
Green power on
Installation Diram
-farm test switch
"
Horn silence switch
External terminal block for easy boat installation
Includes 15 SJE SignalMaster' control switch
Alternative kat models for high and low level alarm
Optional auxiliary contacts for remote devices
Model Description
10'1421 T" "P High 'S SJF Sgnal%las;pr
1 L_~
L~LLC-rLLLI,II
.,;.slerF:o•rbus nori Toll f d F^.one 2"c-347-131, -
ST. CROIX COUNTY
SEP'1'IC'I' \NK ti1AINTFN'ANCE AGREEMENT
AND
Adam IgeSO NEKSI 11P CERT11 ]CATION FORM
(hvncr/E3uycr n "
\taifine Address 2447 50th Ave.
Property Address 2447 50th Ave.
I Vcrirication required fFum Planning & Zuning Department fur new construction-)
Chy:Statc Woodville, WI Parcel ldentifcationNutnher 008-1027-90-025
LEGAL. DESCRIPTION
Property Location NE NW " Sec. 10 T28 N R16 'Town ofEau Galle
Subdivision Plat: Lot 4
Certified Survey Map # Volume Page et
-
Warranty Decd # (before 2007)Volume Pare #
Spec house❑ycsdto Lot lines idcntifiablc9yes❑no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use arid maintenance otyour 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 :v,tcin can affect the function of the septic tank as it treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 38 .i?(I) and in Chapter 12 - Sc Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by arc
owner and by a rrrasler plumber,.iourney.ntan plumber. restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal s) stein is in proper operating condition and;'or (2) after inspection and pumping (if neeessaq the septic tank is
less than 1!.3 full of sludge.
1. we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set lortlt, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources.
State of Wisconsin. C'ertilication stating that your septic system has been maintained must be completed and returned to the St. Croix
County planning & 7oning Department within 30 days of the three year expiration date.
I: we certify that all statements o this form are true to the best of my%our knowledge, I, we am. are the omvner(s) at the
property described above, by virtue of ' varranq' decd recorded in Register of lleeJs Office.
Number of bedrlxans 4
SIGNATURE: OP APPLICANT(S) DATF.
"`Any iit lbrinan(in that :s misrepresented stay « suit in the sanitaq• permit being revoked by the Planning & Zoning Department.
Include with this application a recorded w'aramy decd from the Register of Decds Office and a copy of the certified survey map if'
reference is made in the warranty deed
(REV. 03112)
• ' • (.~-ZolB-!3Z
Wisconsin Department of Commerce SOIL EVALUATION REP Page of
Division of Safety and Buildings 19N
_ in accordance wiln Comm 85. Ws. Adm. Code
County St. Croix
Attach complete site plan on paper not less than 871p x 11 inches in size. Plan must
include, but not limited to. vortical oric1 hoe lilorn reference point (BM). direuan and Parcel I.D. (111 -1027-90-02
percent slope. scale or ¢irrlenslpaanorth arrow, and location and distance to nearest road.
Please print all information. Rev. by Date
Perscnal,,forma on you pomde may be-se., to, se""A)-q ow,^.oses ;Pn u:u:uy act'. 1 15 U
Properly Owner Property Location ❑
Garret( Bunte Govt Lot NL 14 41-4 S I T 28 N R 16 E Or) W
Property Owners Mailing Address ;fly Block # Subic! Name or M#
.'.-147 50th qo'e Page 2209 \o. 4586.51
City State Lp Code Phone Number Village • Town Nearest Road
Woodville \1'I 54028 ( 715-695-9718 58thave
New Construction tlseQ Residential t Number of bedrooms 4 Code derived design flow rate 600_ GPD
Replacement FiPublic or commercal Describe* N A Z p7, a
Parent material Lucss ovcf out gash Flood Plain elevation 4 applicable ft.
General comments During real estate sale existing treatment dispersal cell was inspected . cell has what appears to be sonic effluent
and recommendations:
fxending in single vent PiP' c propose adding a divc•rier vah.e and installing a two ew ~ m replacement area eau
of existing cells. add pressure effluent filter. cells fix ul ur .below surface average .
1
BI Boring# a Boring u -
Pit Ground surface elev. 98.2 ft. Depth to limiting factor :-72 fn
Soil A I cation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 04 1Ogr33 Noncohwr,cd sil 'fgr mvfr gs 21 .6 .8
2 4-8 IONO,~2 \o:xobsar'ej stl 2fsbk Ill»'fr If G
cs 8
3 8.13 75y 1:54 ]nncob*..,cd ,,rsil 2fsbk mvli' as If (i .8
4 5yr•I6 Nouco6xncJ nlvfr _
13-18 ,r cl --r ,rlnbk s A .6
5 18-45 Syr-L'6 N;ncohcr*.c grs Ose nil 's - .7 1.6
6 4s_72 Sgr4;4 Noncn!+:rn:c grs Osg ml ,7 1.6
1
1
~ 17
B-' Boring # Boring r
0 Pit Ground surfaceelev. ft pth to ung factor in.
Soil A I cation Rate
Horizon Depth Dominant Color Redox Description Te , e Structure Consistence Boundary Roots GPDrfF
in Munsell Qu. Sz. Cont Color Gr. Sz Sh. 'Eff#1 -Eff#2
1 0-4 10\r.3 33 Noncohscnai sil 'fgr invfr gs 2f .6 .8
4-11 10\1-3.2 Nnlr ohscr.ed sit 2lsbk nix fr es 7f .6 .8
3 11-14 7.5yr5.'4 Noncunwtr cc it 2fabk n1vG gs If .6 .8
4 14-19 sNi-t6 Nonco~.cr•.cz ersel 2nlsbk mvfF gs - .4 .6
i 19-46 5vr4!6 Nowo',l r.ci I, r% Ng ml gs - 1.6
6 46-77 5vr44 Noncubsrv<'~ 11 s Osg rill - - .7 1.6
Effluent #1 = BOD > 30 < ,t nd O mgrL ' EfR{ient #2 - BOD. 30 mgrL and TSS < 30 mgrL
CST Name (Please Prim) 1 e CST Number
Lewis Rork J 253976
Address - Date Eval n Conducted Telephone Number
E7818 Count L Menomonie 141 54751 6.5.2018 715-231-7375
CHECK 60X 41 4PPLIC.4a E, CHECK PAX 4S APPUCASIe.
SOIL EVALUATION Stele: 1 30 -=30 []SYSTEM PAGE3OF3
SITE MAP I Bo
PLOT PLAN
PROJECT NAME: 75* oesierFtwr 600 app
Garrett Bonte I Attach design flow calcul86ans for commeraal plans.
PROJECT ADDRESS: 2447 50th Ave Pipe Material; ASTM Standard (Tables 384.30.3 8 384.30.5)
BM Symbd 7 BM Elevation: 702.2 FT N Swkwy Sexes 4" j 3034
BM Des colon: Top of power transformer # 7308 Face Man: 2 sch 40
Stcpe G•adlmt;Yrf^ak•u wrm by IMPORTANT:
of Tested Area. 4 Well SyTtCor ;e apo~catk). p d.e«t,q •^•^nw Show ground elevation contours at suitable intervals.
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CST ~ 253`t1~
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