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020-1353-33-000
� c • CO 0 M - 0 �) C� c co O r Z m N 3 N -0 V.,' a _ M 3 m m cir (1111114 FF a; 0 Cn , X T O o co = rn o ,� • . O �iy m m C r, m C S < < C N= 0- N O I- co - m O 7 N N T • O R Q W ".1. W C I ) 4) 0 O N ,? 0 O� W O ij 0 G m m Ir D3 D ( ' D a c CX7 m c-....' - C C O r 0 0 N V 3 0 O W O (D "airy O O Co -< N N = co 0 0 00 En 0 O r co 0 0 0 C 0., G G G A • Cn - D W '• C cn O W O_ N N N N .. v 0 a m r? d 0 • 0 M .. N a A ,„ m _ • 73 a 0 z • z Z z N N Et; j o o w 0 O N c �. FD` • 6 0 0 w � ET F 0 yq C 0 0 0 0 O Q — N m O = 1 y o ,p Z m N N O 77 A O .p Z O . O O m N cn CO m m co Q C _, z 3 A ° • � z 3 z O p A • O to N 0 O N N N r (n w N m O a O CC 0 y -o N N N(0 • 0 w p) , O co C N n N - N 01 —0-N N 7 — N 0° 0 O — 0- (D i 0 7 3 N m • • • 5 O • N O O o 0 0 0 f - . N. x 7 • • m ( D O �= * 0 (n -p N (D Z Q v_ x 0 •o D 5 < _. O 3 D m m m m y co v @ U ^O O ? ._ 0 3 O» m Cr - a N O7 O Ofp_ 0 . 3 r N 0 • A 0 ff1 rz 0 N a 4 6 , 0 - (D 0 T N N O N N 0 7 O O Q= y CD W v m �a m O n , C N (� m N ' (� O o _ Qv .N-. co _, p ) N j n N ''� A 0 0 N. 0 ^ 7 f� ° N CD W N f CO v 6 0 N.- < W N O O 3 Cr. WJ_ _. 0< ( D N rn 0. I N X 'k p..< a Q m O N if 13 y O co m °• N 7 7' O ti ° (D O a N m o O (D 6) 3 O d ap. 0 . * O 0 to 3 co O O N a N 0 co C O V > 3 (0 O o. N o' 0 ~ o Z, o O (., 0 O v 8 463 - 7 (t if ` 8 7 5 P 5 5 6 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI Document Number Document Title RECEIVED FOR RECORD St. Croix County 08/26/2005 11 :20AN AFFIDAVIT Occupancy Affidavit EXEMPT if REC FEE: 11.00 TRANS FEE: ITI 1 rk ('� k COPY FEE: FEE: Name — (Owner) Typed or printed CC CC FE: 1 being duly sworn , states, under oath, that: 1. He/she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume / Page ydJ Document Number j p!QCAD St. Croix County Register of Deeds Office: Recording Area Name and Return Address A parcel of land located in the V, of the ''A of Section, 3 /P k� B T G/ N - R / q W, Town of / fDr7 , St. Croix (s 0 1.-cU Sc LAW - County, Wisconsin, being duly described as follows (include lot no. and �,v L 620) subdivision/CSM or detailed legal description): - Ivr,Soit ` to Lo-- 3 .3, C0-16.7 woccl &Qye £f i'v),s/o� . Q /,_i53 - 33- ono Parcel Identification Number (PIN) As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a bedroom home, or a design flow of lati /� qpd. The design flow is calculated by assuming 150 gpd for 2 individuals per bedroom. There are currently occupants living in this residence; 8 occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, l understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and /or contaminant loads. I also acknowledge that 1 will make this information available to any future parties interested in purchasing this property. Dated is 2` of A „ , ZOOS . I / / E ni E41NKE * * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. authenitated this day of St. Croix County. ) - i;'1 Pe lly came before me this __. day of _� the above named * f.Cfih t�' 2t1Y0<e- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who execut ., authorized by § 706.06, Wis. Stets.) instrument and acknowledge the same. l ti- THIS INSTRUMENT WAS DRAFTED BY NI • �,��pp���, \. __! GCtIl11� ii - Al 1` I ` * mu kRi k . IA \ _ ir � 1� Notary Public. State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission Is permanent. If not, ., ration date: necessary.) Date: C01 . , "THIS PAGE IS PART OF THIS LEGAL. DOCUMENT - DO NOT REMOVE” ` • Mk 1Mormstion must be completed by submitter. fizicaedgile, at asjastmegazo, and P.t Of required). Other Mormation such as the parking causes. leagal description. etc. may be placed on this first page of the document or may be placed on additional pages of the document. taw Use of this cover page adds one page to your document and ag910132.fiNstalinsif02. Wisconsin Statutes. 59.517. (i 7?/l6 �-� -+) --CjihrYjiLl _ ta _.__ i, . --,4/nAl _----..- -- gy i Y 1 Wisconsin Department of Commerea ` . ' ., PRIVATE SEWAGE SYSTEM County: St. Croix 1 Safety and Building Di'isior • . INSPECTION REPORT Sanitary Permit No: 408226 0 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: Behnke, Keith Hudson Township 020 - 1353 -33 -000 CST BM Elev: , Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic J 42ego / Benchmark 0 b Dosing Alt. BM Aeration Bldg. Sewer Is- ' L ) � 13• � Holding St/Ht Inlet Ld J ` - 93• °S St/Ht Outlet i TANK SETBACK INFORMATION ) « -3a 92 -� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD I Dt Inlet •••••■■ - Septic / . S / 5 f I Dt Bottom • Dosing Header /Man. Aeration .Qist.-Pipe 7 C tiw e 4 .2k ca-t" -t 6.,K 5 ( t � Holding Bot. System J"`.' 402 Final Grade (6,t PUMP /SIPHON INFORMATION `~ cn. J Manu cturer Demand St Cover D• D Se Model Nu er GPM J 1 � � �' p — !7 —' � �.4 20 J oz•. D 100 -D TDH Lift Friction Loss System Head Y 1TDH Ft F emain Length Dia. Dist. to Well SOIL .±. = • RPTION SYSTE 41.. > . , , 0 ` - ' 4 D I idth / Length f No. Of Tr ches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth 3 8 1 -2) (eA • ) C SETBACK SYSTEM TO P/L BL G WELL LAKE /STREAM LEACHING ufacturer: INFORMATION 1 CHAMBER OR Type Of System: ,1r 1 `� ) UNI Model Number. DISTRIBUTION zf; i' M,L; rl-, x Hole Spacing Vent to Air Intake HeaderlMa fold n • Distribution x Hole Size p g Y4"' ,1 Pip �__��� Length Dia Length Dia Spacing � . � � • SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only nr'�� - ^O Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched v Bed/Trench Center Bed/Trench Edges Topsoil / I Yes I No I,_ ] Yes ) J No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /0 / ' / G. I nspection #2: - • Y ---- Location: 670 Louise Lane Hudson, WI 54016 (NE 1/4 NE 1/4 36 T29N R19W) Cottonwood Rid! e L • 3 • .rcel No: 36.29.19.2033 4 t t,ket__ 1' �/S ' eue • 1.) Alt BM Description = r' 2.) Bldg sewer length = rj ((- S Cs -a 90•Sa 6.1 - amount of cover = 1,l . CO = qo • Sb� . 9 ata 4 cce) .• teedoNek 1. 12 .t---D C Plan revision Required? ' _! No I C9� z T I r.;, of r si �for Qr additi na • : mation. � Date Insepctor's Signature Cert. No. - (R.3T9 p7 ) "°7 , re AN r k �, fg '� t � lyM E P, / oF 6ff.o/v 1_o cijf o o 31 ? c f) ( co fri"5MfJ N .1 y i, t f vfr �i .. , /1Zo ' (t0 siw►ui a► 5 / f g1 • i . , -�.., • • tp$f'`_ Pice5 — ' ID J s.6 ;a /62 hiNk / . &i 4 if,stf F[owsa. G�nte, ' ot / 1(13'&4 q `k " / 0' 0 0' / 4 , 1,5 P 74 67o 4,90 4 Sanitary Permit Application Safety & Buildings Division 53707-7302 WI , 537In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. PO Box 7302 See reverse side for instructions for completing this application W Wisconsin Personal information you provide may be used for secondary purposes form Department of Commerce [Privacy Law, s. 15.04(lxm)] (Submit completed to 537 county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. Counq State Saninuy Permit Number 0 Check if revision to previous application State Plan I. D. Numb T PA r6l, orZ2(0 L Application Information - Please Print all Information Location: Property Owner Name Property Location ,{,h lJK6 RECEIVED 1/4 6 1/4, S3(0T02 / p ,N, R 9 (or Property Owner's Mailing Address Lot Number Block Number 1 Ro 7 1.- i , ebrl0 OCT 15 2002 33 City, State Zip Code . Phone Number, Subdivision Name or CSM Number ST. C COUNTY � 1) l �� yp g 01 to L& iN j z1) OJ )1 I. Type e of Buildin : (check one) 5 0 City ❑ 1 or 2 Family Dwelling - No. of Bedrooms : Lf. 0 O Village e n of 40 c0S1/1 ❑ Public/Commercial (describe use):_ /n� Q ❑ State -Owned C 7 / pJ Nearest Ro Pabe i `Nrteg6 — 33 -00 III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. * New 2. 0 Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number I Date Issued 1 A Sanitary Permit was previously issued 4 9 22,4y i f V I et - 010. 2 — IV. Type of POWT System: (Check all that apply) I'Non- pressurized In -ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank 0 Single Pass ❑ Drip Line 0 At -grade 0 Aerobic Treatment Unit 0 Recirculating 0 Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Galsiday /sq. ft) (Min. /inch) Elevation (9 o g- g7o — P. 0 2a'"f- VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility fo nstalla of ` - e POWTS shown on the attached plans. Plumber's Name (print) Plum r' Signal Mr (no r. ps): IvIP/MPRSNo. Business Phone Number r( 0flD L cn) -- V4P 13`1462_ - 7 lS= Z3� Zb4s 4 Plumbers Address (Street, City, State, Zip Code lb X60 70 M/ wl&t/t6 Al-t 04( 6- l.()z .L¥7T7 IX. County/Department Use Only ❑ Disapproved Sanitary Permit ee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) ❑ Approved ❑ Owner Given Initial Adverse Surcharge Fee` . • 1 AO Determination 50 ilf . I - Z X. Conditions of Approval /Reasons for Disapproval: L • * rts— ,;.1- - n c t tq -fi r s ys OD T1 c9 no /D /11 /AM _. • • T.L. Sinz Plumbing Inc. E5609 708th Ave. Phone: (715) 235 -2644 Menomonie, WI 54751 Fax: (715) 235 -2592 www.tlsinzplumbing.com ii /( KC f Lor tit A I 6 I/ N6 /�' S34 A_ 1 _, r 3 Arrmi wood ,eoi. ✓ �'% 6./ l / , 1-1 -la"' • 5.q- ) ■ 4 i '' ,-(1. 51 . 7 5 4 - a 3- 2 x to 75 (I I J"$7 5T Vet Fr /froPf r 0,66P F 35 saw. ,,,, x 4 ' " 1 • 44:4.4,,,,ao■ 1 ' , •, � r7c e# ' vr 2 1: 4 1 • " ai,z�� / I FFwrr 11.p Ai 0 5i Ow 2 51. t o nc Z rtBt� �4 boo �I I { At, U 1Q° I ea - [ ___Fiff,,./1-...40-81... wai_ ! g I t: . #„_._al 1 4 / ■11111 i r 1 19 l ( I 06/1212002 09:34 7,152354841' (iREA1 AMER iCAN HOMES PAGE 02 06/ 10!2002 09:28 7152354841 GAT AMER/CAN HOMES PAGE 81 /81 twig ON VW taa)i PAS 71$ not oiteg sr co to MAIM Marne Watt mAINTIVlitafica N3RIPMEINT AND ) Silaning Memo -_. ' 1 0 1 , L f Lt-r J (t /E F# ) �..L SV 4 i 4 )1C- Pavony Adams rr C 70 L 0 E LAW n ./ eirstec+e.seartttirieeei fawn Plimilisikvaltiest Ito me tosonotfoot... , ,, , ., Cltreilic 11.1 ti. .4 ("1 „7 sac 0751. t3C1- 33 -r OZO - tsc -33 -jot) 3 - 1"2o3 3 rsopetty Laotian Sox 8 , 1 ” Lle $4,12. Marti of s ‘tit griereatir r ,.. ... 1 40 ' 2 : Rau . r._...... intar wasicii3 iwasibrilvdmirs O s=ritrle*co r Ow mot or m m astelogio . etegaggitgangie VisivIvagla i dielembalni adaddie grin wane ' e iffnenotataa. ft+ie.. diamagnets 'i1= MOM gaget Annan so alt. s gualtnigo arr ow= peg, 41110 .e. ia.rgls+weilttibt*eeeo 1lliSBO'a0e'e00.1**01MtAa `4WIAIN" lifteara '0- � �ea eee �iessa.=santi�AM. *re il�ee �"jtl'��1e1�e0f"ikageto dti. et,etley slate sow himearattiCataiMittlia_camplamitwatsemmembra lag at.,0114k0IMItZpolue afiltomuliklot le itiatUCANOZ Ittete ■ gamma& abet! ant get grin Rogow ho D!>t fe.a sneer O, ix°''" i t sos got aesalia #eraaMOai4 ar TfeembCleft& I r -• 6 ! lo ea . APPLICANT AWLS N Wool. regeE agepaili imam don Ina ea ilagagatc4dVasada sage Ans. 'tar togaiti mow ono IrallIerniefig whip Jr. to vinuesgto 41rig $50.00 fee for this revision, part of $325.00 fee paid by T.L. Sinz for permit 420324 (VanBeek) originally designed as mound system, but revised and installed conventional system. /- /sin POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner !� r 0m Septic Tank Capacity 1(pp 0 gal ❑ NA Permit # �/ v Septic Tank Manufacturer 6o r r ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer p p 77.46 ❑ NA Number of Bedrooms r 4. ❑ NA Effluent Filter Model OrZZ - /4 ❑ NA Number of Public Facility Units — ❑ NA Pump Tank Capacity ga l CN-A Estimated flow (average) WO0 gal /day Pump Tank Manufacturer IZI-NA Design flow (peak), (Estimated x 1.5) It GO gal /day Pump Manufacturer 13-N Soil Application Rate r 7 gal /day /ft� Pump Model 12I-NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit WNA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanic& Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection , ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L A'In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y8 in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: CI month(s) 3 1119' year(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 CI JO year( ►(s) (Maximum 3 years) ❑ NA Clean effluent filter At (east once every: / ❑ month(s) ❑ NA %Needs) ❑ month(s) ,(g NA Inspect pump, pump controls & alarm At (east once every: ❑ year(s) Flush laterals and pressure test At least once every: ❑ ear(s) month(s) fp-NA Y Other: ❑ month(s) At least once every: ❑ year(s) il Other: fe NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a'visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals oie -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ` Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or•must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. • ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name TL Sidi, n-ab- /N L Name 7`L g fat Ft6- I Phone �`S -2:35-_ qv Phone 7�.5." - z s -22,44,(70 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 7 Grjc ( Z'Lt Phone Phone 7'd V( - L 6 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. I C) m 0 3 v C) d0 d Z -o � c ;`* gF ' e. 0 n M 1 E . O •P W = W O • y 00 0 3 N o co d m C 1 en o O Co 1 a °' (`' • ' • - `7 .. N N ' - 0 n. •3 3 + 7 n N C d . 7 n N N 7C Q w 0 om 7 c �o Wom 7 c� O °) .5 l cow O 0 O) 5 m X -I iv c c"' ' n N 7 7 Q C 7 7 O' O O W o -0 0 N O -, Q 0' W W O O C }, N C M C p� C 7 W �- 3 3 _ - o, p s r o M V -n O O ° cn Z cn D ° cn Z v? D e o �� c . 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O N ■ p ( (0 ^: O p - � MO vi Q p co ?w 7 7 m 3 rt.= 7 St m'o > > 3. m 3 3.a 7 1 O -^ ▪ N* 0 `< N O O N n ( D M 0 7 F y N O O O n 7(O °) .< y 0 7 O a 7' 7. O 0 << N 0 7 O a? > > �3A as f D3a�� d �(o 0 I po -"g3- � yao m p a''- o 3 a y7om a N N 7 21 cdo m 7=, coo m .< , O. y' 1 03 69 2 CDD - •- i, CD N •aa . N 7 3 � _.v, fi 1. CD 7 a o N < _'o ^' CD d 3 c a c fD O N v,'cD cNi,3 O v 3 1 (q a Q V1 v U7 • a O a y a Q Z-.. - a 7 O y (o moo• mo.o co ( o m p o • d o . - mo° N -0 0 7 3 .. a - c a) c3- • f0 _ • 7 cu 3 01 °• ' f0 5 7 a (n .<a 7 0. m K Q 5 O cz - < 5' .< 0 o I b :A I CD i en so 0 0 o o ` o oo 0 o a oo oo 10 ti Fax To: Sinz Plumbing Fax #: 71.5 -235 -2592 From: Keith Behnke — Hudson / Great American Homes property Pages: 3 (including cover sheet) Date: 09/20/2002 Subject: revised plans for 4- bedroom septic system Here are the revised floor plans for downsizing the septic system from a 5-bedroom to a 4- bedroom system. T changed one of the basement future bedrooms to a future office by removing the closet. Let me know if you have any questions. Thanks. work# 651 - 310 -3410 cell# 651- 253 -3862 1 6 „co 20 /T0'd E6SFS2ZSTLT6 Ol 628E 0T . ET9 SAO W d 1fHd '1S dd 60:80 F0. OF dS5 20 '02 08:10 FR ST. PRUL F & M CFS 612 310 7839 TO 917152352592 P.02/03 r 801;,• r I # f-17--- \ ; a. li \ ,__...._ X Ain ----j I Y 7. 1--).—'1 x 1 it I i N d ` 1 $ 1 ;I L y C- — ,10 1 c t l " 4 a I 1 .0 r-6 --• — 6.4 .y ^ --r 8.7 L.77 14 4. L , . 11111111 m . 5 t ,. -i si x 1 , [ ' , . h iil i l q r m S. of 4–" is + t 111110.11111 , I k-, 1 alb . ig __-,,tr g ---7, -i. „, ..c i ( / ''''' """''' 7 ; 11 r.z - e< *-E, —e 2'.0 r-- s s —mow- - Er-0 . .1 i I it 1. 1 t EOSIN , i__: � I (= ,Y- OWx -0r IN ! I— 7 --r— 6.4 11'• k 1, -00 1 pro , 20 '02 08: 12 'FR ST. PAUL F & M CFS 612 310 7839 TO 917152352592 P.03/03 • z 11 ° � -� 1 t W:41"! " immiimismowsam=01•16111111:11•11163M.MTL. WIMI i m!grg,a II! I \ 1 z 1! l'i, I I i - L. i I ° -4-1 , rte---- 4 b { 1,l' ti ji i 1 4J,1 — _ -- I �.�..� '.!143 i 0.11 i lu I C i 5.., ..` 1111 Yt r. i Y. a 1 11 I 01 ! P + k f '' \ . 4 - ''` I -- I 111•=1111.111111111111 raw I:: r..:sro -- -..... It 1 • { I { O 7.7 1 f e,r — / ( ' / & \ r zj : \ "C' -ti } .S Q�r I• 4'.7 1'-0 J- P�..�.... ,µ'.7R ' P 3 1J'r 7PA Pt-0 ** TOTAL PAGE.03 ** 646 1-6um-- t. • • Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. Wisconsin See reverse side for instructions for completing this application aaqq��, PO Box 7302 Personal information you provide may be used for secondp oses Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15114.1.,14 ) . 3J ? k (Submit completed form to county if not ,/9/D p C . state owned.) Attach complete plans (t6 the county copy only) for the systeth CE than 1 -1/2 x 11 inches 'n size. County State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. lumber 57 efo i y tot -am 1 7 -29432 I. Application Information - Please Print all Information Locat' n: Property Owne Name[ ,� �L / ST. CRO1X C QUUT -X mop Location p �q �/ rl T Se"/ KC zQNf flFFIGEv /0 61/4 /U61/4, s36 T? ,N, Rl /E (or& Property Owner's Mailing Address 1 ` of Number Block Number l �07 AM 4 ni �/ `' , 33 City, State Zip Code Phone N mber Subdivision Name or CSM Number liddi 1,0r- 5 01 & 7 ?t S ) 3?i - !! -..., earoi. t,�occ 949 c onl . Type of Building: (check one) v ctis .u- ( b�hWwe (Awls . El City tOrP 1 or g ( ) S per r' A,SOt y 1 or 2 Family Dwelling - No. of : edrooms : ❑ Village a) ❑ Public /Commercial (describe use):_ Air Town of x A ; ❑ State -Owned (3 F,, . ) NeareRgad 35 a.mw f 'ays Cri t+ • « ' = 12 `` ,M,JtO) 1 Par ' 3 33- o0 III. Type of Permit: ( my one box on a A. Check box on line B if. pplicable) 4. 19. 2033 A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5 6. ❑ Addition to System System Tank Only Existing System B) Permit Number D a ss r ❑ A Sanitary Permit was previously issued I 19 i IV. Type of POWT System: (Check all that apply) on- pressurized In- ground ❑ ound ❑ Sand Filte \, L Constructed Wetland Pressurized In- ground ❑ Hs • ing Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aer c sic Trea :'= nt Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. ^11 Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed R. (Gals. /day /sq. ft.) (Min. /inch) Elevation VII. Tank Capacity in Total # of anufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tank Con- Con- glass New Existing Crete structed Tanks Tanks 5eeTre_ iboo `— !Lot) '/ - 0/ ❑ ❑ ❑ ❑ Nut io go gOU I gWu/ ' ?" ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for i• .tallati• of /•OWTS shown on t - attached plans. Plum Name (print) Plumb s • ignai r r .. s ps): MP/MP' . No. Business Phone Number /ov L SjA) z �, HP/ 9�� z 1(S -23S- Z 4' Plumber's Address (Street, City, State, Zip Code • .Sloa 9 Toe ' ievi. l 6 J i€2101 ti, G(/. c S Li 7 IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issu'ng Agent Signature (No stamps) Approved ❑ Owner Given Initial Ad rse Surchar a Fee) 00 Determination 225. • 's r 2-002.— ; �'� ' — X. Conditions of Approval /Reasons for Disapproval: L% r (.91-- i vi oem- r\Ai. A-- 6_ 0-tf :4-e r... .'k) .L.. • `' , , CJ'14,l,Nate anQU,e ) 0a S 6^-... • a-1 —_ OA (Set- "way) . \c t'�l,r�a'4 .5y 'MS —1 ` e . `` ` � - 4 6 " - e- 0{01421 " c / ` v>� -�r�Z .4 II I o..A l P.A0 .AA- A- - Spec t t GR. , -S-BD-6398 kt salt a-r-t- lum.A.t tw �" � &A l o.. ptit`tc c44g (o1c�tx .�i ece S, (R. 07/00) T.L. Sinz Plumbing Inc. E5609 708th Ave. Phone: (715) 235 -2644 Menomonie, WI 54751 Fax: (715) 235 -2592 www.tlsinzplumbing.com /E/ ,gCKC 'L 0 pt,J N r 3 Iron/ td 060P ,Pr 'AC Ora / `! ( f / Till riaa 3 - 2 7 x f, 75 C (c.Co — -$ / , k 57717 tom✓ T/r Fi /fr^ 0,& x g� 3s 5ge Gl-uFFwn- ?oo oasi l awtr loot) 9 0,440 1 f ° 5 ' Q w4 Z Seenc - M416 vhnd , 'ar too z rt g� 6--J00 r) r fr2 wide,. P F r3a'. Z a.L. - to .0 " �l 3g IA J i/ 1 r Po t 3 •-g3 g -t -L.L__../a.33 40fr" .Sc..I.L. 1 60. X na;l :e. t5 el w% ik „I 6 w� I elt.T. inn") s W 6A4 INIII $ deli. 90. upps.r gp.7C) Ai-t. elt,r• - ow.crIT.(pD Ca +fo,.., wood_ !-e-. - o - C.._ L / • e&1 A-I t% • • • ' f 7 "" a5 >1 • 4►hZ ( D (9 t Ste ( ;] , / ii) Ci fyilAS Q 6 1 , c \0 6r411 \ c \ij W , `A' S �� I• (��' j ,, , r 1 � � ' (1 /- . �'C •0e SOIL VALUATION Page 1 of 3 rt- n �p� in accord a :With - S. ILHR 83,('19 Wis. Adm. Code � , A County �L t and horizontal referenc point (BM), direction and S4 - C 1'0 t X , s, north arrow, and locat .and digtfte to nearest road Parcel I.D. # �i.Mn.e_ 2.( Loo z- / �, % c°o .., " mrri -iv iii I till .,....,,,,.JN - Please print P al � ntormq 6�9 }+ / Review d Date c Personal information you provide may be used for secondary purpose , 'A� ( Law, s. i5 4�(rAin `. ' 6, /�� �� 144 (, 1 � 9 Property Owner ; Pr,¢{ety ation Rtc_h cod Souk. r _L_ . of 1/4 1/4,S T ,N,R E (or)® al NF 3l9 �� ! Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 1353 / d"ukee lr'• 33 0O nW d,,c,. 12 tci -e. ❑ City State Zip Code Phone Number Ci ty ❑ Village [1. Town Nearest Road cJ 4udor 1 Wl 15'4otb 1Fli5 )5&4q- 10131 Oudson i 0.-4-y Qd N IN New Construction Use: Residential / Number of bedrooms 3'4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: �/ Code derived daily flow (OO gpd Recommended design loading rate A 7 ! 8 bed, gpd /ft trench, gpd /ft 7 Absorption area required 251 bed, ft 150 trench, ft 2 Maximum design loading rate . ! bed, gpd /ft * 3 trench, gpd/ft Recommended infiltration surface elevation(s) 70. 7 0 ft (as referred to site plan benchmark) Additional design /site considerations car/ 70- ?D /_o&.e r g� 60 Parent material G IQU4 t (�u-t 5f 1 Flood plain elevation, if applicable 4/A 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 © S ❑ U ❑ S ® U ❑ s ® u SOIL DESCRIPTION REPORT i■)o,,,} Gbh, '3 J I 1 ?,cso � �[ , � Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft %�1' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench it ( 1 / G -to ' r 7 —' SG- 1 ins5 m-Fr c 5 l 4 , .. s .1 E- la -yg 10 y r S /ti — S ■ I ). fnabt w -- r C ,S - . 5 . 6 3 Ground .3 yss -f26 toy r q/6 141.5 ci.s Wn 1 C .5 7 - . 7 .8 . 7- �� • J {00 ft. t6 ` ‘146 Depth to t ? \ . limiting 4/4" 0 / aA. g, - ' . , factor ' tP �. - - . tz6 in. 7,�' 4 GolgG 4-2/ tot Remarks: Boring # 1 0-10 o/ r 3/z 5 1 I w►ab K w4-rr C S 1 4 . Z , 3 . 2- oZ z to y9 to y r we/ -- 3 r' ) e ).tytcc. b/< 6A-cc C 5 _ . 6 .s .::..:........:.:.::::::::.....,. 3 36 -izt 1,o r y / b - v►13 0.S MI C S - , 7 3 •1- Ground elev. fZ.k. ft. Depth to , limiting factor 17.1 in. Remarks: CST Name (Please Print) Signature Telephone No. 4 _ .. S . .. _ . __ = --' z %1 ---- r 7 - Y Address Date CST Number z 4,3 et S/ X Y S r s-e w/ . S Ya J 4 2 4- 7 - 7 ,,S 30 1.' SOIL DESCRIPTION REPORT PROPERTY OWNER . v t Pate Z- of 3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP D /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 a - 11 'oyr3 /z — 5 I /» c bk m--r c,S /-C it 1 ayr 9H Si' I 2rvta bk rvIS cS .S; , 6 •y elev. Ground 3 l() /r y/6 !13 o s 2M I C c5 ? i 7 ,O • 'f Depth to ca 0.0/ limiting -. (oA (k , (. fa�cqt�o�r l�lo. in. :r Remarks: Boring # 1 o - 1z do yr 3/z –' s4- 1 kn --Fr t • y ,s •`• ,2-341 toy r44 // 5 ' 1 ;►,, rn-'r- e_ 5 `� r —•� •�� 3 toy r W62 U. S m l 1.3 T — • 7 :.3 .�- Ground elev. 9Z•Ro ft. Depth to limiting factor 1 /'/ 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 # oyr 3/ Si' / / L /S rvt -cr. Cs .2., 3 • Z i2 -;9 to vr o ltigab Yr- r C5 - , (o . S 3 — vvi Om mI 52 — .7 •8 Ground /,• elev. ?r ft. 94. ° Depth to 80. 11 f° . q limiting \..t0 t fact r f T. i Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) t 3 ° 43 Movf 1 o-t- net: l .n ! ClwN 6W ela.,r. ►1u; �•�► is''aa4 13n elc.,• r60.6 y c•FCW e lg.tr. 70.70 vpp4.- 10.7o Cm + 10 f tAlo o t . r: /6.( • (5l 4,2 t. o • t '0 • • 7 -- 61 • en1 am' 1 I , 06/13/2002 11:57 6087859330 SAFETY AND BLDGS PAGE 01 •• Page of PUMP CHAMBER CROSS SECTION l — vent Pp7e with Cap 10 frcm door. window Vent Gap or fresh air intake �``-- -" - Weather !'roof Jun ..icn box Appr -oved bekmg mar. hole / covor w/ warning Label . Final 1 � - 11 / -`. 1 -^_� Grade 1 i� f n i! �" MII�t } 41, C cl 1 l8' 41N 4 Conduit � / - ? _ . 18' MIN � ._ �, a \ / ..`' 11 . : • t 11 ,, 1/ ll 11 1 ✓ 1 1, 11 — \' / / 51 r Ill Il i ' r " `� i l i Inle'G 1 l i i t Provide 1 1 1 I � ,Jcin 11 AlrtiehtSeal ) l I 1 App Joints ,JcirrC A il 11l �lI � t I "arm / 1 i • 1 1 On I ■1 C Pump I -Oi u t • , FLev, ft - v ft l 4 "/17. i U ... 11 Concrete 6Tack ,g 3 I 3' approved bedding rrtateriai under sartk SPECIFICATIONS Note: Pump and alarm are on separate Number of Doses: P _ Per Day circuits as per ILHR 16. 'Wis. Adm. Code Gallons Per Day 14# of Doses: 1 zS" Gallons Vokime of Back q'' ' Tank Manufacturer: gd r eA i Total Dose Volume: _ j y .Gallons Tank Size: ?DO Gallons Alarm Manufacturer: 5T , ( - 1 - Capacities: A ,lq,L inches or 3.7.5 G ati�c\s /D/ l-/Z) B o inches cry-' CaP4 -?..5 Model Number: C 5.8' inches or 1 Gak.ris g pfUh?r�lc. D � inches or /37 Gafkoi•rs Pump Manufacturer: -- Total, _, Tom inches or 993. Gallons Mode! Number: Si4- F 3 0 � - Minimum Discharge Rate_ aS, I GPM Vertical Difference Between Pump Off and Distribution Pipe: : 7 Ft. Minimum Required Supply Pressure: 4- A Lo Ft. of Force Main. x Oct Friction Factor /100 Ft. + ' 8 Ft. Total Dynamic Head = 1 Ft. lnterrral Pump Ta Dimensions: Length 3 - Width S1 ; Depth to inlet y 3 Signature: .�. 1 ` License Number / 11 / 901-162-- Date G / o v H a it , �y back switch A k‘ 4.,;s t CL Q. ��,, r. 0)NYDROMA TIC Z W IP HYn' QMATIC p LL - LL W — SHEF40 Typical Application* Sump/Effluent pump Typical Application* High Head Effluent and Dewatering Capacities to 44 GPM (2.8 I /s) Capacities to 70 GPM (4.4 Vs) A . " ; Heads to 24 h. (7.3 m) Heads to 35 h. (10.7m) Electrical 115V, le, 8.0 FIA, 60 Hz Electrical 115V, le, 12 FLA, 60 Hz Motor .30 HP shaded pole w /thermal overload 230V, le, 6.5 FIA, 60 Hz x ' I 1550 RPM - . Motor 4/10 HP shaded pole w /thermal overload Minimum Recommended Simplex = 18" (457 mm) protection,1550 RPM Sump Diameter Duplex = 30" (762 mm) Minimum Recommended Simplex = 18" (457 mm) Automatic Operation Wide -angle float switch Sump Diameter Duplex = 30" (762 mm) Materials of Construction Class 30 cast iron and engineered thermoplastic Automatic Operation Wide -angle float switch (manual available) Impeller Thermoplastic vortex Materials of Construction (lass 30 cast iron Discharge Size 1 -1/2" NPT(38.1 mm) Impeller Thermoplastic vortex Solids Handling 3/4" (19.1 mm) Discharge Size 1 -1/2" (38.1 mm) Power Cord 20' , S1TW Solids Handling 3/4" (19.1 mm) Superior Features • Carbon/Ceramic mechanical seal Power Cord 20', SiTW, (30' optional) • Oil- filled motor w /automatic reset thermal overload Superior Features • Carbon /Ceramic mechanical seal • Uses single row ball bearing construction • Oil - filled motor w /automatic reset thermal • Piggyback plug available for easy maintenance overload for maximum protection and switch replacement • Ball bearing construction • Piggyback plug available for easy maintenance and switch replacement - r • Patented inlet design for better solids handling 12 40 1 i 121 40 9 — 30 30 W Z 6 -220` . 6 b ° 20 SHEF40 ` CS 3' 0— 0 1 (opacity G.P.M. 10 20 30 40 50 Capacity-U.S. G.P.M. .P10 20 30 40 50 60 70 Liters /Second 0 1 2 3 Liters /Second 0 1 2 3 4 14 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity k ga l ❑ NA Permit # c ( 0 8,224 Septic Tank Manufacturer tktf . t ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model � . - (f ❑ NA Number of Public Facility Units Pump Tank Capacity N(y' ga l ❑ NA Estimated flow (average) 6 gal /day Pump Tank Manufacturer (t . f ❑ NA Design flow (peak), (Estimated x 1.5) tl gal /day Pump Manufacturercitctkit_ ❑ NA Soil Application Rate d.1 g /day /ft2 Pump Model $ fie,C- *30 ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit 1KNA Fats, Oil & Grease (FOG) 5.30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5.150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 5.30 mg /L 'ilkln- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 5_10 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: " JJA Other: ❑ NA Other: cial A *Values typical for domestic wastewater and septic tank effluent. Other:A MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: �y (Maximum 3 years) ❑ NA 3 Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA ❑ month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: VCyear(s) ❑ month(s) ❑ NA Clean effluent filter At least once every: ) - 2, - y ear(s) Inspect um every: ❑ month(s) ❑ NA p pump, pump controls & alarm At least once eve 3 Iyear(s) ' ❑ month(s) 14/41A Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. ve the performance and prolong from the wastewater stream may improve p P 9 the life of the Reduction or elimination of the following POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name --r p . Name Phone s- - 2 2 cp.( Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name s 1✓ /SC Cou4K ?plum/ 6 Phone Phone 6-, L0,60 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &1f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 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