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HomeMy WebLinkAbout020-1353-09-000 Jr JVisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buiing Division INSPECTION REPORT Sanitary Permit No: 395258 GENERAL INFORMATION (ATTACH TO PERMIT) 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 X Township Parcel Tax No: Stout, Richard Hudson Township 020- 1353 -09 -000 CST BM Elev: Insp. BM Elev: BM Description: � TANK IN � )v / nl r� v ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W i6Se ✓ .7006 Benchmark s- /v7 -15 /D o r Dosing Alt. BM I,� /0 _ Aeration Bldg. Sewer A r, zb log-34' in Ht Inl d A rta' Al 11,32.- IN, 26 St/Ht Outlet t TANK SETBACK INFORMATION . TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt I n let Septic .?5- i I ( ._--- Dt Bottom A tic d y G1- c-y Dosing ) �S . / Z 3 / Header /Man. } •�e / l' 7P Aeration . I Dist. Pipe 1, 1 5 - /0 f 0 r - —° _ / D� 01" I�- Gdtr1 Bot. System • 0. (F O IN. ZS Final Grade PUMP /SIPHON INFORMATION J 5 %ti 4ea/ Manufacturer ns D emand St Cover �/ GPM Model Number � 4 D - of -o i • 1Z PO TDH Lift Friction Loss (System Head TDH Ft ,� 1 6 . 7- _s . I 'f. ? 7- A 0 sr ti 1 p/4 , 3 - 5( P li -‘ /t) 1. a Forcemain Length Dia. Dist. to Well c/ SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS t ,/ r ' / a o , Y ,[ _ SETBACK SYSTEM TO [ P/L BLDG GG4 ci/� LAKE /STREAM LEACH! anufacturer. INFORMATION CHAMBER Type Of System: ) UNIT Model Num • .... v_,. '".b 3t del _...-- DISTRIBUTION SYSTEM U,:, VOA. 1204 ,_ Q,,� Header /Manifold Distribution // Siole Size x Hole Spacing Vent to Air Intake p(> (� � z Length ' / Dia Z t+ Length 1 / Dia I / Spacing / I / , r, 2. 4 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/Trench Edges Topsoil Yes 0 No 0Y 0 N / COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: I O/ e / 6/ Inspection #2: id / "f / '' ( Location: 638 Hillary Farm Road Hudson, WI 54016 (NE 1/4 SW 1/ 36 T29N R19W) Cottonwo R' VIM) Parcel No: 38. 19.2005 s 1.) Alt BM Description =171P it >�ec...., (1 _" 0 t,� o*,"1y'1 7 (W ti✓,l/ d /;,,..." 2.) Bldg sewer length _ /c/' / ' it amour= of cover = )24 ' 3.) Contour = ` y 4, `� /6 3.3 1 <� �l Plan revision Required? D Yes g No Use other side for additional information. --- ?•4 & =�?' 6 G SBD -6710 (R.3/97) a Insepctor ignature Cert. No. PI 44i-7-6Y Safety and Buildings Division County � � 201 W. Washington Ave., P.O. Box 7162 .5 / C `-.- o ns�n Ma dison, WI 53707 - 7162 Site Address / S C .* d 5 .c? 1 1� I4a rY 1 y ga. Department of Commerce Sanitary Permit Application Sanitary Penmit N umber In accord with Comm 83.21, Wis. Adm. Code, personal information you provide 3 3 ❑ Check if Revision may be used for secondary purposes Privacy Law, s15.04(1)(m) I. Application Information - Please Print All Information State Plan I.D / � N ber Prope Owner's Nam Parcel Number 3 6 , z 1 . / 9. Z OC) 7' 5./61,,± Off- / - 5 - 0 ? ©OC Property Owner's S ng Mailing Address � Property Location p / 3 ' / T < J` p ' , PE %c5t,u .k: s 36 T o2 ( N, R / PA City, State Zip Code Phone Number Lot Nunler Block Number Subdivision Name CSM umber guaJ -- LAJ. & Vo 7 7/3 'SW -6 73/ II. Type of Building (check all that apply) ❑City ,or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commercial - Describe Use _ jkownship L..o -�-�. ❑ State Owned f I Nearest Road ���j e v /� Fc 1 0/ III. Type of Permit: (Chet . : . on line A (numbering schemuse). Complete line B if ap b1e) A tem For County use 1 ,New 2 ❑ Replacement Sys Addition to System Tank Only Existing System B. p Check if Sanitary Permit Previously Issued Permit Number Date Issued 31 5 i/ oo( IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 ❑ Non - Pressurized In -Ground 2•1 Mound (N• 5 (00 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic. Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treatment Area Information: ).,,,,, _ /03.6 4 ,4ST/i! G 3 3 Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./ Days /Sq.Ft.) (Min./Inch) Elevation Y -CO V /S0 V 3 7s 445- / 1 0 /7 /0 37/ _. VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks . Septic or Holding Tank /0 in O �) •C Dosing Chamber 7(5-0 — > j . ���� � t-_ ' VII. Responsibility Statement I, the undersigneed,`Sgme responsibility for i allation of the POWTS shown on the attached plans. Plumber's N ■■, (Print) Plumber?. igna /1viPRS Number Business Phone Number Li- ° 3 s 7 7 /S- a 4- 6 Pc*s Plumber's Al s (Street ,Stan, Z' Code) VIII. County/Department Use Only Approved ❑ Disapproved Sanitary Permit Fee (includes G water Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse Determination # CO - 0 e� l 1 c P/ 0 / c,„,..,.„.2-7.-.---L, PP IX. Conditions of A roval/Reasons for Disapproval ((( 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. This revision/transfer was submitted to reflect a change in plumber. Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 Inches In size SBD -6398 (R. 05/01) r9S I9sa Q Safety and Buildings Division County lf . . 201 W. Washington Ave., P.O. Box 7162 57. t ;tSXIC isconsin Madison, WI 53707 - 7162 S' A ddress Department of Commerce G 3S' b -/ -ei,R. F AXPr Ab . , Sanitary Permit Applies Sanitary Permit Number _ 3152 51 In : • rd with Comm 83.21, Wis. Adm. Code, per i , information you provide ❑ Check if Revision may be used for secondary purposes Priv 1.0.* may 'N I. Application • relation - Please Print All Info • thin 4- State Plan I.D. Nt / 3 � t . fR em % u r REc�� -ED ( ` 44 J Property Owner's Name Q> P arce l 'IL./.yi. Cam/_ i 2 ,' i, I m 24.0 -- 3 - B? Property Owner's Mailing A.. . .. ST CROiX Pro • . Location t/ Ot Y '4 SZ,J 14; S 36 T.Z 9 N, R ty kill /T GfII�I(// GCS 590 - zONFAIG COU pFFtGE City, State Zip C. • • <' r, Phone Number / , Lot Number Block ` Nu — Number / /,' <r ; i c I Subdivision Name 481.4- 1 II. Type of Building (check all that apply) ✓ K pie 4 4/6.44e4 lulus. , . ❑City 1 or 2 Family Dwelling - Number of Bedrooms / ❑Village ❑ Public /Commercial - Desc ibe Use % �T'ownship / f 0 � �,,, . e. .f I p ❑ State Owned / Nearest Road s ' x,) ' or u G► --) --� ► = 0 • s '6 ti ) 5 Ifst III. T ' pe of Permit: (Check only one box on line A (n is ring me for internal use). Complete line B if applicable) A For County use 1$ New 2 ❑ Replacement System 3 ❑ Replacement , `6 ❑ Addition to System Tank Only 4 Existing System 0 A. O _ j 3 5 ---3 _ p --p O 0 Permit Num. ; Date Issued B. ❑ Check if Sanitary Permit Previously Issued I 6 . • / q O O �q 9 IV. Type of Permit: (Check all that apply)(numbe • • . heme is fo`' ternal use) 44 ❑ Non - Pressurized In- Ground 21, Mound 47 ❑ ` . Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Hob W ank 48 ❑ S' ` e Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aero • Treatment Unit 49 ❑ Rec ' "• ,sting 30 ❑ Other V. Dispersal/Treatment Area Information: Design Flow (gpd) Dispersal Area D' r ` rsal Area Soil Application `';, Percolation Rate System Elevation Final Grade Required ' ,.posed Rate(Gals./ Days /Sq.Ft.)`. (Min./Inch) Elevation yso 3 7S yso /. o /DA S" VI. Tank Info Capacity in Total Number Manufacturer ';, Site Steel Fiber Plastic Gallons Gallons of Tanks "1, Concrete Constructed Glass New Existing , Tanks Tanks Septic or fiakliag4ank ( ae , 4 / G(figZe5 i ` ' 1/ Dosing Chamber , A — .1..2 / OvIt E VII. Responsibility Stat • • ent I, the undersigned, assume r nsibility for installation of the POWTS sh ■ • on the attached plans. Plumber's Name (Print) Plumber's Signature riofr/MPRS Number Business Phone Number � � d'd , 7Yf - 3 Gr6 / 0: 0 /- wry ON/7 q Plumber's Address (S t, City, State, Zip Code) tar^ N / VIII. County 1 1 partment Use Only Sanitary Permit Fee (includes Groundwater Date Issued Issig Signature (No Stamps) pproved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse W 2 5 2 a4 .. ; Determination J s ; , n * . Coed PProv -4C- C)-Q fo� N royal VL� `- c46 ftce 14 - 41Q rw+ o^, �nr,a a C4-'14‘• Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches In size SBD -6398 (R. 05/01) • PLOT PLAN Page 3of Scale 1"=\.M. LOT 1.._l UE (z, oo rit-ve--- Lor i ..* ez, aq 2 S L , 3- 3 '0 kloT t? r OR \S' ■ !, 1S ; ZS < ► °In >a <1°43 a 13w1 Z Z \ ..\%3 °-� - - --- - = _ _ --- _ _ _ ------ �-�, t- Loa° 2 -i et.Loo3 — -h---F; __ B I P 1 1' s tPJQ F. . e%.luu 3S _ 3C O z i 3 s,'0,- y "p vz r- k . 4 ' cowel2 i 2 Bt. Ri.,� O 1 '1 - x► -I E 0 8 K SvG6 ml - - , -c ' 1J -L Ln "YJN / • , _1 t+-Z.. - -- Lam . :WI.0 6' cal KJPO L- - - 1 ry l z 1, . eL,i' tz-Y TR-L -- _ . _ NOTES: 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 1,000 gallon capacity manufactured by 1.v1 COJC-V-ETE n1ZaDuc -TS w /zASEL, Fi rm. RA-Ip1 JZ-'7•0 eE - )S0 arm.. l 4. Bench marks : ST 1"%oUt. • 5. Divert surface water around system to prevent ponding at the uphill side. • Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Wisconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 11, 2000 CUST ID No.691727 ATTN: POWTS INSPECTOR ARTHUR L WEGERER ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/11/2002/ 4, Identification Numbers '`,`';'1 ansaction ID No. 438952 FcFC! e / '� r1 '8f ID No. 199850 I � SITE _ 11 ^ r 1 t ase refer to both identification numbers, Site ID: 199850, Richard Stout `"' ` 2000 tab ve, in all correspondence with the agency. St. Croix County, Town of Hudson ) . CoUvey NE1 /4, SW 1/4, S36, T29N, R19W cp j �. ZON iG oFFJCE FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated ObjectiD :4642 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 Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • 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 mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • An effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. 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. • ARTHUR L WEGERER Page 2 10/11/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, t DATE RECEIVED 09/26/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. to Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us WiSMART code: 7633 IIt TITLE SHEET Page 1 of 7 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10572 -P and the Pressure Distribution Manual SBD- 10573 -P Cam. 619.°1 LOCATED IN THE NY 1/4 OF THE S W 1 /4 OF SECTION 3 6 , T. 2- N,R l 9 W, TOWN OF -- 1\J.50'N , S1 - C - u1K. COUNTY, WISCONSIN. L(-_ q p t= co NwooD 1Z� D 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 p.O J T.S 1.3 - M_ - C ' pl tt�triDIIU C OM ".YC kJ s LLO L p p Vtu t 1M E.NZ 0E 0`t 1lDINOS Dom A F jY AND NULNCE PREPARED BY SE E CORRES • WEGEFZER SOI . TESTING AND. - DES I G■i SERVICE P.O. Box 74 421 N.Main St. + SC'OA/ River Falls, W I 54022 3 Iji Phone 715- 425 -0165 / Fax 715- 425 -6864 'p WEGER 4 ' Q915P T PTM. f.LSWO w.. RECEI n � Ma.r••• RECEIVED •. �SIGN� M�MN�' SF P 2 f ;! q _ 2 - 0 0 SAFETY & JOB NO . Mound System Management Plan P age Z of 7 Pursuant to Comm 83.54, Wis. Adm. Code 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, 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. 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 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 -1 (R. 6/99)] 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 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. • 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 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 on the operation or maintenance of this system should be directed to the County Zoning office at V.S- 39 or to the licensed plumber who installed the system. PLOT PLAN • .Page of ' S c a l e 1 " = i - ( ) , ' L0r L«E - as q.. \2 ' e,ri►) (2. 0 0 bAZ-Z, 1-.0 r-) i ..• . \ Ea.q,g SL c3.- ',t) }J ur 0 PPrt-T' OR- DVS `S'V'13 PcTZWA �'a13�s1x' 11b' I s' r elq� - J z.3 < 1010 >! < 1 °1 (3 t3' P 4 1344 -Z ei. 600 35 —'—a = z a • ) 1 " tTL10 0 - J » o f alb' 'C L,l03? Ct ELluo 3 t - E O 0 3 Sb' OF 9tpu r-1w, LV y C.oUert 2 BDR►`'i o ro K svc ‘'`) �Zk. \-o eernON g = - = 1D Q : 0 ' � o v - N - P : o TELa t t k . * . _ Q �' 1 f\ C- _ _ _�— W-.1. t + 2 . . = _ = LO7.0 b' c .i P c.-__[ kJ . 12: " O_H- eSt1zY TRze--. - - -- - - i NOTES: 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 \%00 gallon capacity manufactured by w1Qm COX c , P1O TS w/z a. r ter . Rh pl ►z'ro eE )so Grit. 1..A Qs 4. Bench mark 5 .. S PN-13 • I. Divert surface water around system to prevent ponding at the uphill side. } Page `l Of • • • Approved Synthetic Covering ASTM C33 Distribution Pipe Medium. Sand vo w ...r� G Topsoil ' F Elev. 103 S / i� `%11ra11,leatfi /„ 7 % Slope Distribution Cell of Force Main Plowed Z" to 21/2" Aggregate From Pump Layer 0 o' SFt. E 0. Ft. CROSS SECTION OF A MOUND SYSTEM F O -e Ft. G o.S Ft. A 1 -4- S Ft. H \.o Ft. Linear Loading Rate= y.5 GPD /LN FT 8 l O Ft. Design Loading Rate= p.2.5GPD /SQ FT 1 \" •SFt. J S Ft. K 8 Ft. y04.tzeiancite Position L \\‘c. Ft. of For ce W 2.3 Ft. • Ma ' In L J . r 1 U �• - Observation Pipe fi I • -r--- K — A / /6H - – _ — � 0 =` .41 7 -1\_ --- _ F �Distribufiion \-- Cell of Z" to 2%" • z Pipe aggregate Observation • Pipe (Anchbr securely) • PLAN VIEW OF A MOUND SYSTEM • • . Distribution Pipe Layout P4ge _s of '7 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 valv$,:threaded cap or . threaded plug. Provide acc from final grade for the valve; threaded cap or threaded lus. • • p - = =.`C.s.I SS B�_ n T`t P 1 Cl3 L � S . _ 5 .--n 1v J 1 Fvc FVC PvC. Lateral A Manifold Lateral x x x x x2 x!2 x x x x Lateral Lenath - Lateral Length - P Distribution Line 1 p I - p sflX a- — Litt - hrstINFct • S o- -- I . P �' Ft. Hole Diameter !/y Inch • S a.. S Ft, Lateral " ' l 11/ Inchces) X Z� Inches Manifold " 2 Inches - Force Main " Z Inches • #of holes /pipe 2 . Invert Elevation of .Laterals lb`'-c Ft. • 25- c).y,l= Io.ZSXT Ll j.p GPry • • r Combination Sept.c:Tank and • .-' kJ CHAMBER CROSS SECTIOIJ AAMD SPECIFICATION'S ' PAGE .. OF - -VEIJT CAP WEATHER PROOF ` 1 _ JUNCTION 9OX A. ti C.I. VENT PIPC % APPROVE LOCKING IO' FROM DOOR. • MANHOLE COVER 14 - 1 1 11 :111JOOW OR FRESH 1 wAR.tJ11JG LAR3EL,. r • u�3P 1otJ P ►PE A�IUT�IKE w --* i ' � cotaCu1 r /PftRZTI s tt ' .4rP tl ��. 1.6k4 I" 6•,nw. 6�it�1F i % � ! �.- LHIL • • 1 �. 1 IB.MIU. • � `_ -_ • I _ 7 i __ �•• PROVIDE Y -- 11JL.ET z,.• 4=3 • ' i AIRT16HT SEAL I I BgFFttS fr 11 I Approved/ , II ( Approved 0 joint w/ ill ALARM PVC pipe PVC pipe Is - II . LLEY'\S' 1S F T_"— S PUMP _ 1 • ` OFF D COIJCRETC . d 1 1• % DLOCK --i tt U -� , 9 5. I 1 F * RISER EXIT PERM O►JLy IF TANK MANUFACTURZR. HAS SUCH APPROVAL DO :NGt - SEPTIC f SPECIFICATIOkIS DOSE TANKS MALIUFACTU• -'" 1■1 eR-'L' AIUMBER OF DOSES: Li ' SS PER DA,y TANK :,IZE • O30 16 OO GALLONS DOSE VOLUME r ALARM MANUFACTURER: - '. - -' • S`2S1 . s INCLUDING BACKTLOW: lob `‘`I' GALLONS MODEL IJUMINER: `O 1 l ' A U . ) CAPACITIES: Al 1 at % *LJ tJ INCHES OR GALLONS SWITCH - Pg.: �Ze�' 1 5 = Z ILJCHES'OR 3'S G(aLL01J15 PUMP MANUFACTURER: G OV -' S C: 6 INCHES OR / \i°' CALLOUS MODEL NUMBER : 38 )1 • SOS D= 9 If1CHES OR 150.46 GALLOWS SWITCH TYPE: M el JJOTE: PUMP AND ALARM ARE TO bE MIJIIMUM DISCHARGE 'RATE 1 4 ) 'd GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEU PUMP OFF AIJO. PIPE.. . ' + MINIMUM NETWORK SUPPLY PRESSURE - b'zs FEET + 10 FEET OF FORCE MAIN X 3 ' L l ( O F %oFCFR►CTIO►J FACTOR.. 0 FEET TOTAL Dy1JAMIC HEAD = 1 y 8 S FEET 4 As per manufacturer !-'1G gal /in. Liquid depth 3 b 6 .. • • Y" 17 'F>Zz.F--C) 1J CE C''.).\) .. i\ "Q. .7 0 7 _ Goulds r *'' Submers I Effluent Pump f t MODEL T ��_ , 3871 � EP / - v � 05 EPO4 • APPLICATIONS • Fasteners: 300 series • Fully submerged in high • Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. • Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and • Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. • Bearings: Upper and lower SPECIFICATIONS • EPO5 Single phase: 0.5 HP 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with construction. • EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 3 /4" maximum. • Power cord: 10 foot with pump out vanes for Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SA Canadian Standards Association f - . otal heads: up to 24 feet. with three prong grounding _ Discharge size: 1 NPT. plug. Optional 20 foot • EP05 Impeller Thermo- (CSA listed model numbers • Mechanical seal: carbon- Iength, 16/3 SJ with plasti enclos design for end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). • Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 - I • Capable of running dry without damage to 9 - 30 -- ' I 1' � ' components. j ■ ! - S te' Pump: EPO5 8 - I i _ _ ? .5 FT • Solids handling capability: 0 25 3 /4" maximum. a - • Capacities: up to 60 GPM. _ _ • Total heads: up to 31 feet. m 6 20 • Discharge size: 11/2" NPT. Z 5 - I 1 • Mechanical seal: carbon- 0 15 rotary/ceramic-stationary, BU -N elastomers. 4 - ►4 .85 i I . P05 I I • Temperature: 0 3 - 10 104 °F (40 °C) continuous I • . 140 °F (60 °C) intermittent. 2 - — 5 1- I I I 41.0 1:.. 4 0 - 00 10 20 30 40 50 GPM ' • 1 1 1 1 1 1 1 0 2 4 6 8 10 12 m /h CAPACITY • ©1995 Goulds Pumps, Inc. Effective May. 1995 W Wisconsin Department of Commerce SOIL EVALUATION REPORT • Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ,� Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 57, Cxe'l include. but not limited to: vertical and horizo oint (BM), direction and Parcel I.D. percent slope, scale or dimensions, no, o�%a8 d lota)Sc�yn d distance to nearest road. Q Z 5 D — /2.3_ / R wed by Date Please it for in . • Personal information you provide may u$ d for setRrepa treses ( , aw, s. 15.04 (1) (m)). 71m .� wo 1 Property Owner /"` ' 1 Ci = Property Location Ne f /) .STD at. `�; ,'. , 2 E0 r ! Govt. Lot k', 1/4 1/4 S34, T N R/7 E (or� Property Owner's Mailing Address , . \ 5 CR I r p:-... Lot # Block # Subd. Name or CSM# 3J 3 /it cd�u lC r r� � �!��r�r. c,�� a r < 7 , f o7�'0•01/4900 / � � u tJ . City State Zip ••:\ Phone Numb�e ❑ City ❑ Village 21 Town Nearest Road .40 X) 1� 1 o i � N ,!..iiir : , : - le ., , ' 44 / . . / e R I New Construction User Residential / Number of bedrooms 4 3 Code derived design flow rate ! rc-z2 GPD ❑ Replacement �� E� ❑ Public or commercial - Describe: Parent material ( >u'r DC(7Gd/f�'# Flood Plain elevation if applicable ////7 ft. General comments � j,K "f- Pr �� n,/ 4 fl 6'�l� � �N�C and recommendations: TtIA/ =• -g-' A 4/57:1 74/4 Of®cf,t/p 1Z-'l4 A"C/t rAis 4 S7'x'/= p #,z--z Sic D/a . ..r' G tiivioix. To G �� t to r/Yt"' f o F /ol o Boring # ❑ Boring fb JZI Pit Ground surface elev. /0 3 . 3- ft. Depth to limiting factor in. 774 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roo GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Rips •Eff#1 •Eff#2 o --.) NM .- • IIMIIM c.s /MIMIllni - RIM MillgeMl,! IIIM ,. RII1I.! ME1� "� , rrillE MI - -- /SE 0 Boring F i - Boring # V Pit Ground surface elev. /0 33.4 ft. Depth to limiting factor 6y in. 7 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 PD /ft Eff#2 1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. R ®MPIAIIM C S 2 i !EM 3 Y--37 o -2 z ingli iMMILIMMIN'MII � � • Effluent #1 = B • D, > 30 < 220 mg/L and TSS >30 < 150 mg nt #2 = SOD, < 30 mglL and TSS < 30 rngtL • - CST Number CST Name (Please Print) Signature �- 1#. 2.. /. Address Fogerty Plumbing & Perk Testing Date Evaluation Conducted Telephone Number 28288 McKenzi • • a ` r o4 "6x5: -.,0- CnrxlnP /. WI 54801 r zttidr : t.l9 ytiag0l OSttaS-, - .b, -. )43M 88SSS iu, ,It ! , .3nnoq - i :J6.i - c.a (.LX) .. - , , _- - • i ■ .. .. J • • 1 • i . ■ ■ ■ 1 i ■ + i ' L I - '. Wi sin Department of Commerce • SOIL AND SITE EVALUATION Division of Safety and Buildings Page 1 of 3 Bureau of Integrated Services in accordance with s.-.LLIJ. 83.09, Wis. Adm. Code • Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ' ,N. , County include, but not limited to: vertical and horizontal reference poilit. direFlion‘d S-} - eY01 percent slope, scale or dimensions, north arrow, and location fend distance Rp r f►pt ®ad. ``,.:- -- Parcel I.D. # I. 'vi . APPLICANT INFORMATION - Please print all nfoxmation. fi �e w d by Date Personal information you provide may be used for secondary purpose Law, TI5;�Q� (m)). ° (1,/ _A 1/1 a 6 ( I ' t`,i - ` ��(r 1 I Property Owner ((�)) ZOrVgy, Sty Lo.: 'o P A Ch l �� Govt,. % 1/4 SCj 1 /4,S 3 C¢ T C q ,N,R / O E (ord Property Owner's Mailing Address 1 ilLot,# ✓y 1 e •ck# Subd. Name or CSM# 1 �5� �a;�.�.ke Tr, _..� errk OnwoOd Q 1.35S 1dc City State Zip Code Phone Number ❑ City Village [..Town Nearest Road 1 4UQ\YJrI I I LA )I. 1540\CD 1 ( 5 )5q ( I - to . 1,1630 1 co J. 4 IS-New Construction Use: II.Residential / Number of bedrooms 3 t4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 003 gpd Recommended design loading rate • 7 bed, gpd /ft • 8 trench, gpd /ft Absorption area required 56 1 bed, ft 1'3c trench, ft 2 Maximum design loading rate • ) bed, gpd /ft ' trench, gpd /ft Recommended infiltration surface elevation(s) 95•eO ft (as referred to site plan benchmark) Additional design /site considerations Cb,n'bv r el 42,1, 9 `/, 90 Parent material C � 1 CV ]G.1 CI ii-r..0.4\ Flood plain elevation, if applicable 1/44 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ s ® u ® s ❑ u ❑ s ® u El s © u ❑ s ©U ❑ s ® u SOIL DESCRIPTION REPORT Boring # Horizon De Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 6- 2- U yr 3/3 L.S ! r■SS mfr C.- I Y-c -1 ; . Ground 5 5G - 5 1 , 10 y r 31 [ (..-.2_p 1.5 y r-' /(o 5i 1 1 TYIthiS mfr C-.5 M9 , (\ QS 1 ft. Depth to ' limiting factor 56 in. ' Remarks: Boring # - - � 1 C - (4, b yr 3r)3 LS tvri5e lrttr C. iVf . i 2 l0 -29 th \ 9 I b C - 5 ( m1 C. 5 — • - 1 - 2 . 3 2y 3'1 1t) yr 3 /y C.2p 1.5 yr- 9 /t 0 Si I l ,t,r - abk M CS Nip ; top Ground etev. $,r) ft. ; Depth to , limiting - factor LR in. Remarks: CST Name (Please Print) Signature Telephone No. clam 3ehu rrac -keY ' e--= (7/5) zy 7- ` -lUO8 Address Date CST Number Lie Ceder &L # `i Smer5e IV/ S &IaLS 4 1 -15 -99 25 3309 L SOIL DESCRIPTION REPORT PROPERTY OWNER S 70 J Page 2 of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GpD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 O -2 lbyr /3 _ —S IMS) rt,Cr C Iv� ./ $ 2 2 - Z4 lv yr 9/0 m5 Os3 c5 - • 4 Ground 3 2 ,4- 2L oy r 3l y cap 7.5 yr c ihp 5 i l I mabk irrpr e5 -- Jo t r p el gbi Depth to limiting factor __in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ........................... ........................... ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) r ------- pt -- L 0+ C er ierrtc s o o d (Z,`dt b A. .AG/ 5e..je ?,O (4 (.'n "cir^( 6 1 eleu, (Oo■O ik i t Na /b 6," cv ee-elL Gee. u— ye 5 t 13m '.Ieu I Y sir" e Its. q5 90 3 G Coi)i.e)r - eI e ,r. 9 TO Aror+k. L L. ■ ^ 33 • • • • 131 132. C3mI Find 1...e 4 ♦ -r 1 Om Z v 1 c, 1 r • ,t R , , L � ' p * ' Fogerty Plumbing i 0 1. . .,. . ti #221180 + � t . _ � � 28288 McKenzie Rd. Maintenance �, Spooner, WI 54801 10),,„ r .11 `'` (715) 635 -9609 J The interval for servicing septic tanks is set by state and local code. Throughout the United States there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel' filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtually self - cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFilter"" alarm, you will be notified by an alarm when the filter needs servicing. N \: To service the filter: • *Servicing any zabel filter should only be done by a certified septic tank pumper or installer. Locate the `` . outlet of the gs. septic tank. :!., s2 Firmly pull the filter handle F and slide the cartridge out Remove the tank cover of the case. ---- r 4 and pump the tank if 'Note: A tee handle may have _ _ t necessary to prevent �� to be used if the filter is too tar. { ., • any solids from _ 'R ; below level to reach. Contact Zabel for info on tee f .- escaping to the field ,.-=C handles :`. _ ; '' f when the filter is ..: removed, '� M Y - i . — 6.41-....al 515 ;r.' w/ . While holding the cartridge over % the access opening rinse off the «.. Insert the filter cartridge cartridge with fresh water, being back in the case making _ __t� careful to rinse all back into e the t ' ANN sure the filter.cartridge is. lie back in the tank properly�aligned.an a i • 'Note: It is not necess to dean n iter - completely i - [t irl e ; "spotless". The biomass gmwipg. ort the l to ; f ' p � ° aides in the pretreatment_,prOoeSS , , • • e . `` ,-� i be left on the filter. (1f n: • ,dia . , • . tt w ". ,. m a y : - • , Replace t �,�J,,� j � _ el..11/.■ The product(s) shown are covered by one or more of the following patents: U.S. U S. Des. 386 2445349 69, 4605501,5098568, Des. 309007, Australia: 5,779,896, 34440; Canada: 2,135,937;Ssrael: 111574; New Zealand: 26 $24.- 621 z Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 -221 -5742 • Website httpJ /www.zabe/.com A100/30C— AI 61499 • INSTALLER'S NOTES; RECYCLE GREASE! Do not pour grease down the drain. Your septic tank and filter will not handle it. NO BLEACHES! Do not introduce bleaches into your system. The bacteria in your septic tank is what makes your system work. Bleach kills the bacteria. When that happens, your septic tank will no longer function correctly. This will cause premature failure of your system. WATER SOFTENER! Do not run the brine solution into your septic tank. This solution has a high concentration of lime (that's what makes your water hard). The lime tends not to settle out in the septic tank but goes directly to the drain field. Lime is an excellent sealing agent, and yes, it does the same thing in your drain field. Think of your sewer system as you would your car. Treat the attached information as you would your car manual. Remember, also, that your car requires regular maintenance. tare must be exercised as to what you put into it. And like your car, your system eventually will wear out. The question is - how quickly. If you have any questions, please call: Dave Fogerty 715- 749 -3656 - Roberts 715- 635 -9609 - Spooner If you have an emergency, and you only get voice mail at these two numbers, call Keith Knutson at 715- 796 -5436 - Hammond I have read the attached information regarding the construction and maintenance of my sewer system. Owner's Name Date ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownerf$uyer f ze.R !t/1) -Cry Ur Mailing Address / 7 ' pf _iz # GteX Property Address C 3$ /4; l i g r et r YY\ Rot d 1 (Verification required from Planning te I partment for new construction) City/State HtiOrksirt2 t o irtte4 Parcel Identification Number 4.20 — / 73'7— 0 9 LEGAL DESCRIPTION Property Location4/E '/,, Se' ' /a, Sec. 3 , T Z9 N -R /9 W, Town of AkeDSe Subdivision © 1 t■mo4 �G�•2 , Lot # Certified Survey Map # , Volume , Page # • Warranty Deed # a0 2 y 3/ Y , Volume /574 , Page # 5. 7 Spec house yes ❑ no Lot lines identifiable I;11 yes ❑ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix 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. Uwe, 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 Zoning Office within 30 days of the three year expiration date. WAA-'1 67,ar,orce SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. know ( we ) am (are) the owner(s) of g . I the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. III .l cV . 4f' . / / / SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * *• ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed r . , , . • . v 527 6243 Document Number WARRANTY DEED KATHLEEN R OF DEED Thie Deed, made between, ST. CROIX CO., WI JON K ORMSON and LISA M ORMSON RECEIVED FOR RECORD husband and wife, Grantor, 06-06 -2000 1:20 PN and 0 STOUT and JANET P STOUT WARRANTY DEED husband and wife, Grantee. E)(ENPT II WItnesseth, That the said Grantor, for a valuable consideration of one dollar and CERT FEE: FEE: COPY FEE: other valuable consideration conveys to Grantee the below described real estate in TRANSFER FEE: 143.70 St. Croix County, State of Wisconsin. RECORDING FEE: 10.00 PAGES: 1 This IS NOT homestead property. Together with at and singular heredltaments and appurtenances thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except Recording Area easements, covenants, and restrictions of record, Name and Return Address and will warrant and defend the same. RICHARD 0. 6 JANET P. STOUT (Parcel Identification Number) 1353 AWATUKEE TRAIL 020 - 1353 -09 HUDSON WI 50016 LOT 9, PLAT OF COTTONWOOD RIDGE, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. ril 07.060 Dated this ' / day of III ^ A. /� �G ! /mow.: -�- (/'wG V.1IM't -JON K ORMSON • LISA M ORMSON AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN COUNTY ST. CROIX Personally came bdJj( M t d of the above named , " s14 V61,41t s M ORMSON authentioatedihis _ day of , _ • � to me . • ls(�si �ftW6xecuted the foregoing signature i - rument -' acknowledge 7,m. 4 type or print name so+illum r//!!I type or p• name ♦ti'•7 ?rFli TITLE: MEMBER STATE BAR OF WISCONSIN Notary P blic Cou , ST. CROIX (If not My c mission Is perm nen (If not, state expiration date: authorized by$706.06, Wu. Stats.) weit IP ) THIS INSTRUMENT WAS DRAFTED BY Na 'y of persons signing in any capacity should be typed or Robert F. Wall printed below their signatures. (Signatures may be authenticated or acknowledged. Both are not necessary.) i - -- - ,12 f k--, N �` % i A. 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