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HomeMy WebLinkAbout020-1454-00-096 r • - CI C 0 ■ U 0 k§ • \J O ftFIC -0 , , t f / _ @ CD i / = /ƒ J J[„ ° A 2 m G Q • § s a E Q e d } \ -< 4 ( 2 \ \ (0 « k R \ / q % ® 1 / i \ 2 2 7 \ k \ \\ 2 ° \ g 8 § \ \ \ � 0) � � ( 9 § . 7 ® 2 ,E5 co ° 7 \ - --Z. 1 m li t Q / \ § k § E c ° C7) Co z 0 'zi 0 0 13 — & . F z g 2 2 2/ = o ` I ) )) 5 ® a W I C - ) \ 2 m / § %k 8 a 3 K I X. rki N.) X. z e , & z E_ f 1 / o z > 3 I a - �� a lten■ ' � / N ' 4 I C CA 3 0 \ } . Z \ ` 2 2 E co , _ @ 2 \ e ¥ co CO '0 $ > o I co § / { I \ 5 { / I / I ± $ § G c % § I I / I 7 I ƒ � 1. I G % I 2 1 5 I 0 ' 0 / / A 7 o / • 4 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' y a S anitary Permit No: INSPECTION REPORT 488110 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: Bast, Kernon Hudson, Town of 020- 1454 -00 -096 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /00 f3 rc■ 1 e..$1 36.29.19.2911 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ! 1 Benchmark Weeks r 2;,,.. / �O 1 Z. ai /62 .4 AZ, A- ' Alt. BM Aeration B ldg. Sewer c l .11.. 11. Zg v Holding St /Ht Inlet g. 93. TANK SETBACK INFORMATION St /Ht Outlet °(• 12. 93,28 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1 Septic 56 / ( 3 � 2 4 7 6) _ D t Bott Dosing Header /Man. 1.1 93 Aeration \ Dist. Pipe 9 .1-1 Q Holding t3ot. System I Final Grade PUMP /SIPHON INFORMATION + ,1 �•D ? . Manutacturer uemand St Uover 41. �� t GP r■ % model lvumo P - r • nc ion oss ys em - ea•i - i-orcemain Leng n • -. MST. TO vven SOIL ABSORPTION SYSTEM litut 1 rctim.rt Vv can Lengtn No. Ur I tem:nes rt 1 u1NICIVJ1uNJ rvo. Ur rub In KI slue ula. LuIO tiepin DIMENSIONS 3 ) c j � 9L • Z - --w =MAUI JYJ I tM I L ) F/L t3LUb VVtLL LHttt/J I LCAUrnrvu Ividnufdt,turer. INFORMATION CHAMBER OR ' ( tk 4 type ui Jystern. ! UNIT Nluuet tvwnbet. p L a rwe - roinaQ�, , 33 ` 31 75 Ai 6�, , ,..le. DISTRIBU I1ON SYSTEM Z 34- Z Z 4 7 1. 5 T x Mule site x tide opaulny Vein w t i h t dke HedJer/Mardfu J a DiaulLutiun � � fo L� Length ` 3r T Spacing � Dia Length Dia Sp g e , �� SOIL GOVtR x Pressure Systems Only xx Mound Or At - Grade Systems Only Deptlr Ovei r Depth�ver ro-Durrt 0 AA SeeJeJ/Sudded AA Mul�l , ` CJ Bed /Trench Center ( r II W Bed/Trench Edges Topsoil yes No \Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 681 Mary Jo 9tJrt u nb ,�, 5 1 1 ( 1/4 NW p/4 36 T29N R19 ) Cottonwood Ridge 2nd Add Lot 96 Parcel No: 36.29.19.2911 1.) Alt BM Description = l��j SS ` ta OY 11 E.i S 2.) Bldg sewer length = 3v - amount of cover = .Gf , / I N Plan revision Required. ( ]Yes o Use other side for additional information. -- I� � . � — -- Date - — - Insepctor` .Hato - C - e o: ` - SBD -6710 (R.3/97) / Safety and Buildings `'vision County P d / 7 C 201 W. Washington Ave. . . 4. Box 7162 7 � /�Car1 sin Madison, WI 707 y' Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 1 Y 4g0 1 Department ! State Plan I.D. Number Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Laic s15.04(1)(m) Project Address (if different than mailing address) I, Application Information - Please Print All Information RECEIVED I / AA // /, - Property Owner's Na the /� �/ ) MAR 3 0 2006 Parcel # � ( � ; Block # Lot N C f BZ D o 0 ,r Q ) ACT )_ O lll0 30 ©0-t3/ cr �' lV — Proper Owner's M ailing Address 1 ST. CROIX COUN I Y Property Location c1 ( g I. A(- S� y n� �// �^ ' ` � ik,lV w'k,Section City, �State l Zip Code Phone Number 4-(`t � /C� J D!J ( D /G /- 77 leg 7 T 2 Q / N; R (/ (c eiori5 ) II. Type of Building (check all that apply) dk Solo;FlP 'I n Subdivision Name CSM Number '6g:'1 or• 2 Family Dwelling - Number of Bedrooms AJS>z Ala v4 p ❑ Public /Commercial - Describe Use I �l I 0 'f 1'c t/ n6 E Z � -- ❑ State Owned - Describe Use 2 ow- (el t,J /2Z'�' -Z3 C.ti�4:w Jo'Cr� ❑City ❑Village Tow of 1 4 US$' 6 // III. Type of Permit: (Check only one box on line A. Complete line B if applicable) O (3 -- / 9 SO " V ' A. ipkNew System p System g P Only Existing y' ❑ Replacement S stem ❑ Treatment/Holding Tank Replacement Onl 0 Modification to Existin System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that apply) Cit Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal /Treatment Area Information: 7 , I 41.- a Design Flow (gpd) Design Soil Applic n Rate(gpdsf) Dispersal Area Required (sf) D . - ; • ' • posed (sf) System Elevation // [oD b • , 7 . $�$ z ( s &u «k 9 /SP" F3, 7`S✓ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons o s of Units Concrete Constructed Glass New Existing Tanks Tanks 1J Septic or Holding Tank / Aerobic Treatment Unit ��1��� Q Dosing Chamber C� r9/0 / cl r ' 4p VII. Responsibility Statement 1, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumbs •'s Si gn e MP /lb� - Number Business Phone Number g oT 6 R 1�aa..5oi Z2 ¥97. fly 3 —?7 - Plumbcddre ss (Street, City, State, Zip C e) P't-L W w 1 5 ( I VV County /Department Use Only lgApproved ❑ '►':;..rove l Sanitary Permit Fee (includes Groundwater Date Issued Issuit gent Sign r No Surcharge Fee) L.71. x7c 0 a 3/30(0 ❑ • *vine . wen Reason • e nia! .� IX. Conditions of Approval /Reasons for Disapproval ^ t SYSTEM OWNER: 3) QJ, Idler INN 1...1..54 Su(Ql at.Jv�er A ��'en��c4 - 1. Septic tank, effluent Mer and I V / / disperse' cell must all pc Jce-4— d-t /l-)e t .. J Ha AA ed e.J of . as per management pan provided by plumber. 2. Al setback requirements must be maintained as Per applicable code / ordNisncss. 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. 01/03) of" . 14314W0 WOW Y;.,' hot 101A tneuttle And 3ifama . f senstosaLrttc,e.ftfi its 4.1.;tr, Isaimxpotb Lisdinud d bitlivng tflscnoedram leo a o Wisdom ed m efrkorn-r ,p‘f, )hsciasar NA .S .asonsfabv %boa sicsoiiqqa Isq as P2.0+- L kf Ksiz,v 0 FA 5 ( '/p 1. Gm fi 1 200 ,p�Eft of /Jr �UEu 03 cr ° ft1°` /WIRY So O 0 hp c...)+, 4 V * , 7 6 ge `' ----� �r 62A-o0 Z C Dpy fi 441 'fizz b ,7 pi.o+- FLA KeRN o 4 IP 5 sck1. f I +'0 6 P� 0t 1: 3° ' gwe. 1 101) • �� of w�- V 33 10 I 441- f °-" /? z mtlA y So co-0A 4. C.14 g 4 7 s �3ea"z`7 ----� p V� e/Z*o& t oo Z N 7 a 4f zz bcict7 I v ►Wisconsin SOIL EVALUATION REPORT #1642 Department, of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service, Inc. County Attach complete site plan on paper not Tess than 8% x 11 inche IL, . Plan must St. Croix include, but not limited to: vertical and horizontal reference poi (: •.',„� ion and percent slope, scale or dimensions, north arrow, and location and d' . • o arest road. Parcel I.D. Pending Please print all information. a ewed By Date ����� Personal information you provide may be used f CEfl7EsriPrivacj Law, s. 1 It m)). kI.A / /. . 13 260 LL.. VV CCLLJJ Property Owner Property Location Bast, Kernon A PR 3 2-005 Govt. Lot na SW1 /4, NW1 /4, S36, T29N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 948 Labarge Rd. gT CROIX COUNTY 96 na Cottonwood Ridge 2ND Addition City State Zip C IN I City J Village Z Town Nearest Road Hudson 1 WI 1 54016 1 715- 386 - // /b Hudson 1 Cty Rd N ❑ New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement ❑ Public or commercial - Describe: na Parent material Stream terraces and pitted outwash plains Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 95.15ft. Trenches spaced and depth to code 4.75ft below grade. (w><.c gI 4 t32) and recommendations: ---- ---- 1 Boring # Boring Pit Ground surface elev. 99.90 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -11 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 11 -22 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 22 -33 7.5yr4/4 none si 2msbk mfr gw na .6 1.0 4 33 -120 7.5yr4/6 none cos osg ml na na 1.6 r cr(- qs. Is -- 2 Boring # El Boring A Pit Ground surface elev. 99.90 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 9 -22 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 22-48 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 4 48 -120 7.5yr4/6 none cos osg ml na na .7 1.6 * Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) _ :: .9ignaaure: CST Number David J. Steel Steel's Soil Service, p !_____ 248956 �, ,�.�.. -�� Address Inc. . Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 4/11/2005 715 760 - 0347 SBD -8330 (1107/001 fYoperty Owner Bast, Kernon Parcel ID # Pending Page 2 of 3 3 Boring # L Boring f z Pit Ground surface elev. 98••20 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3/1 none sil 2msbk mfr es lvf .6 .8 2 8 -26 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 26 -41 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 4 41 -120 7.5yr4/6 none cos osg ml na na .7 1.6 J _ 93. /I 51 11 (13 , ❑ Boring Boring # ❑Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 # Boring Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 <150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. SBD (R.07 /00) gel's Soil Service, Inc. STEEL'S SOIL SERVICE INC. 3 of 3 David J. Steel Kernon Bast 994 200 St. CST - POWTSM SW1 /4,NW1/4,S36,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St. Croix Co. CeII (715) 760 -0347 Cottonwood Ridge 2ND Add. Fax.(715) 684 -3449 Lot, 96 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend N 1 " = 40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ( • = Alt Benchmark Ele. 100.50 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations 4 C B1 = 99.90 ft k B2 = 99.90 ft , B3 = 98.20 ft tik B4= 0.00 ft �; -e � v erk i 46.0 t s // o 5-- CjO w � �o� i.ki / CY{ i w I . i , r f % % r; \ \ 8 00'05 0 • g l5'L9E ir ii . ° \ ° a X •• � e . L ° ;' . • \ 2 m •0 0'05 / / ' 1 11 o_06) - • P 1 ¢ a s • i �' �`��, ° ` • • y /. /� /,/ /�_: `•: / \ a , �/.€ : :_: Xo I ll X • 1 , ��/r `` •' / , r II \ • r it iro f ; : V o • ��o • .., / 6 X d I ° ¢ • •�'c` o N eb UO • i, ilif i : cV 111 < q i , M W M �L�o i z � ¢ '$ O o II 11 • i lg. 6 4& x •i ,`," . ' !!iiiiir:::: 011ill ....:::::. ..:::iiii , WI ''' 'ill 1111' '''''''''''''''''''''''''''''''''' :::::::::::::. /..,.: . .: : re 6 ' 4 k .iiiiiiiii i .- : . ' ... **"111i' -: :i ';'• • f e igglir -v.:::::::.: • . ( 0 1 N X 1 .s, 0 , . i.,iii.:: : /,' ' . /4/ „i ll: v/ H: : : f .,,, , „iii , /// > : ...,. ';;; "" iii ii iiiii! o N ,n --° X / � f /? / o X X X ..�% �/ ••� Ili - co a o . ' ;1 /� /� l M " : J �� ♦ p • txl° //, 1:: iiiiiiiiii _ 1 \ \ ---- . I l .i I I / I i A. i i �;.'�.,;c .? / / � I / I i `': ;' iii � ..,- .."----- '' 2 — ---- - NE OF THE $W1 /4 OF THE NW1 /4 OF SECTION 36 uw w Uf _ _ _ _ _ 586.59' a X 131.51 ■ 156.21' x 1107.40' 1 h It 1 • COT 9 1 H.W.L = 986.00 2.07 ACRES 90292 SQ. FT. 1l L6.O. _ .: :.00 '‘3 �v e - 6Y I � •a I n 'J 9 a • - LOT 9O / - - = - -- ' Iv'. / // NE6°5oo7w263 - T, 2.57 ACRES 2 / 6 112036 SQ. FT. / L = / LB.O. - 9e6.00 / , LOT 89 \_ , � 4.78 ACRES 20827 / 9 SQ. FT. \ /' // L.B.O. = 988.00 0 ` / / L- / BENCHMARK : / a TOP OF REBAR cjo c - .y' / / ELEVATION = 1039.41 r II r A ' "rr 4 61 . // S � 2 p r r z. \ \ r \\ . - / ' - . r.�, / -- h- \ �\ ! �� / . . /... - // // �-- 3 \, ..„ ?" \ Gt — \ A , / 4.' / o �� LOT 94 /' O // � � 0 2.02 ACRES / LOT 95 - �-. (, Q. FT. �` ✓ 2.02 ACRES � � y . • / 88007 SQ. FT. � \ p / / A , / �A A 1 • ` 4 PP / 1 1 / / ��Y . / ; X2 "rr 4 4 / / '4r9 1 7r eV (,- / t$ a gl e/ N / _ J� 0 ' c O / / � A �� .— �1� • c ° °n �° / z, /,`y LOT 96 / c' 2.00 ACRES ,A' O _ — /4* A ° / / DEDICATED TO THE N / ?g / / / A Q / / / � 0 61.42'_ _ . /; / �� • / / /N." NC - I , . ' te/f 64 1?4,Y-- , - [6] GOULDS PUMPS e Submers�bie I • Effluent Pump IIP I' Pnc)D[[ )' . PE Gala SPECIFICATIONS MOTOR FEATURES Pump — General: General: ■ Corrosion resistant • Discharge: 1'W NPT • Single phase construction. • Temperature: 104 °F (4Q,?C) • 60 Her • Cast iron body. maximum, continuous when • 115 volts • Thermoplastic impeller and fully submerged. • &ilt -in thermal overload pro- cover. • Solids handling: W tection with automatic reset. • Upper sleeve and lower maximum sphere. • Class8 insulation. heavy duty ball bearing APPLICATIONS • Automatic models indude a • Oil-filled design. construction. float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor: • service life. •Mound Systems performance chart or curve. • .33 HP, 3000 RPM • Powered for continuous • Effluent/Dosing Systems PE31Pump: • 12.0 Maximum amps operation. • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor working limits of the motor. • Heavy Duty Sump/ PE41 Pump: • • .40 HP, 3400 RPM ■Quick disconnect power Dewatering • Maximum capacity: 60 GPM • 7.5 Maximum amps cord, 20' standard length, • Maximum head: 29' TDH • PSC design heavy duty 16/3 with NEMA 5.15P, three ee pr prong, PE5t Pump: PE51 Motor, 115 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM • Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maximum amps 7 portable and compact. METERS FEET • PSC design ■Mechanical seal is carbon, 40 ».J..L...t_.,... �.. _ ceramic, BUNA and stainless "fEFY1! ~•i..... . i ...,... ; ::.i :' . : : i : : :I: ; : :j. : : :t.: : : } r :: : : :1 : ::� :: : 1 MODELS: PE31, ES1 Steel. 35 tile. - - 1..., Mk 33, so, .50 ■ Stainless steel fasteners. �S �r - ' i:..!.. I . ..� .} : ::: J : " ' '- --► 2 GPM I :: .; ... t .. :...... : ..:....... ....,_; �.....i....;...�... :: t . + . .; : .. .. �:. i . , .:: AGENCY LISTINGS «.. {.. . y. �!� .f...i.. .,_.4 . »: : : l :::.. j . ,'.: t ..:1...i :.:..» ._ ` » 1.1...r..4-- r.. f . : t..r_.i. :. C US 20 ba... I ..1:..,... . +......... •.. . Tested to UL 778 and ?» _}- CSA 222108 Stnda :. �...,..: }. = _':: 1 ... � f.. +.. :: t ...... • ,... ards 15 t flee.. ` "t° :�^ i : , , . :' : : :.}.. ByCansdianStanda►dsAssxia8on t--}' $: ! : :i::.: 9 ! �I j...i.. He ln1R38549 10 T i...1...... $ r « }. , 4 - 4 Goulds Pumps is 1509001 Re lets ed O 0 .4.-1- . }..4..... : ::I...I...I.....i... .: :.....1 ..!... _.i...j..� ::. : :1 : : :'i..�:: :1 : :. :.. : :f :t: : .: • 0 10 20 30 40 50 60 • 70 GPM 80 Pez,e. 70.P p 0 5 10 1 t 5 m Goulds Pumps < ' 72cAPAaTr © 2002 Goulds Pumps ,,.^ opE31 Effective November, 2002 /'' ITT Industries ef'E31 /41 COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 • Access Opening, not top of cover, Access Opening, not top of cover, must erdend to a point no greater mud extend at least • GA 6" 4" Above Finished G ade . than 6 Below Finished Grade f CIO/ 4 Cover with kA t,.. 'l F� EJZ '' F' �•• Y /�'r` � � i — xi r Locking Device - ,J 541' IAPP'�` CAS (typical) �� 0 Finished Grade /Z 116.1 se Min. 23" cess Opening WSW-Mt M in. 23" Access Opening , „ 17I 1 Z P VG nR ceznAiA Ouh:t Effluent Filter _ j d IN /77i I "P✓c s a VV 1 Union RoYEp P /PC 3 PT. Inlet Baffle / e . . 0 : F Kt1► ON � -s ' SO/ - r 1 , l C r r Pump re 3 ",Sand ar r avr_l bedderli under -lank with een r 2 /suer''an edes Tinto Compartment Septic/PumpTank C1/4 k /Q � j ¢ e 0v/sae/wags) SPEIFICATIONS . TANK MFR: W(EC DOSES PER DAY: TANK SIZE: SEPTIC I ZOD GAL. DOSE VOLUME: / Z GAL. DOSE ' O GAL. ( INCLUDES FLOWBACK & <20% OF DWF) ALARM MFR: -4 A 1 A-1 - - `'"r CAPACITIES: A = 23, SINCHES = 7 I GAL. MODEL # 1-1 1 4) /6 / LL// Switch type: B = _ 2 _ INCHES = L P, Z GAL. PUMP MFR: go w._ o C = 7 INCHES = Jy 1`, z GAL. MODEL #: Pe 4`/ = /( _ Z 3 b SWITCH TYPE: D = l0 INCHES GAL. REQUIRED DISCHARGE RATE f GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) = 4, Kr FT. MINIMUM NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) = + O FT. '9 FT. OF FORCEMAIN x q I ?9 FT. /100 FT. FRICTION FACTOR = + 2 FT. TOTAL DYNAMIC HEAD (TDH) = F, g5- / FT. ✓ INTERNAL TANK DIMENSIONS: LENGTH ; WIDTH ; LIQUID DEPTH MP/MPRS SIGNATURE: Y LICENSE NUMBER: 4 j /j� Z Z‘1 r . • e IR---,--i- ,. , .... • 7.4 ( -; ii5 -,- Icrit — / / TM -- - off k4 STANDARD CHAMBER — 52" Quick4 Standard Chamber — 48" ,\, (EFFECTIVE LENGTH) T a fa e 1 2 " , 8 F k 34" SIDE VIEW SECTION VIEW MultiPort End Cap _ -- l 11 — ' iimmi mm 12" -si ullin \ 7 1 rid .. ..� • • 34" SIDE VIEW TOP VIEW FRONT VIEW • ::c y .mx 5C"" iru / k ' 'S e r ri i 5 _ �, 7 7 �'p „sf z, �� it is v . j # >i� } w ! ,m" xr # rx r. + 4' 1 ,k : > y ... +, � , ;�.,. f y _ ;f M ilt "'' f and ; ‘ti i S�'49l" r'�?"t ,m V��f a "` S , iG'r< y : v ' 1 ■ Y f rs :. , • at =y AA v a ,� t i - . � 7 et r a�{ a w... �E ryr�'3 4 t , t �+ , � ,# � ' y t � ' ' ..�y ° al • r 7! 3 . • y � �r f,611. 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''x � w + ` ' r i� j ;%A, - > o- y I � + � l Y v x v I ' . gr ti, .i r`�- 'ztf'"' y i"�r i,j' arw , a n i a r f k l� ���Lz 3aY.au�c,1_.?<;: a Jar, w .,...., ,, o.. _ .,..... ,, a . �., - ._ .'i ..ak :fi+' �l'.P��s„tt•1r..1um: ..A v �...taeLkhs�...�..a.,a �...�✓'d -sca �„rJ.�,w..,...x.,... �....a'+�,tv - t INFILTRATOR SYSTEMS. INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ('Units ", when installed and operated In a leachfleld of an onslte septic system in accordance with Infittratw's Instructions, Is warranted to the original purchaser rHoidel against defective materials and workmanship for one year from the date that the septic permit is Issued for the septic system containing the Units: provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of the septic system commences. To exercise its warranty rights, Holder must play R h writing at Its Corporate Headquarters Old Saybrook, Connecticut within fifteen (15) INFILTRATOR O days of the alleged d defect. Infiltrator w41 supply replacemeaceme nt Units s for Units determined by Infiltrator ator 1 to be covered Umited W d by this Limited Warranty. . Infiltrators lability spedficaly excludes the cost of removal and/or Installation of the Units. R THE UN WAR AND ED WARRANTIES IN SUBPARAGRAPH TI OF ES ME H (a) ARE EITN FOR SS ARE NO OTHER WARRANTIES WITH RESPECT TO SYSTEMS INC TO THE UNITS, ffS, I NCLUDING DING IMPLIED MPLILIED ARRANf1FS OF MERCHANTABILITY OR OR FITNESS FOR A PART1CULACUlAR PURPOSE. (c) This Limited Warranty shall be void if any part of the chamber system Is manufactured by anyone other than Infiltrator. The Limited Warranty does not extend to incidental. consequential, special or Indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, hcluding loss of Environmental Onsite Wastewater Solutions' production and profits, labor and materials, overhead costs, or other losses or expenses Incurred by the Holder or any third party. Specifically excluded from Umited Warranty coverage are damage to the Units the to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the Installation Instructions; failure to maintain the 6 Business Park Road • P,O, Box 768 minimum ground covers set forth in the Installation instructions; the placement of improper materials Into the system containing the Units; failure of Old Saybrook, CT 06475 the Units or the septic system due to Improper siting kg or improper sizing, excessive water usage, Improper grease disposal, knproper operation; or any other event not caused by Infiltrator. This Umited Warranty shall be void If the Holder falls to comply with all of the terms set forth in this Umaed Warranty. 8 60- 577 -7000 • FAX 860 - 577 -7001 Further, In no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any third parry resulting from installation or ship- 800 -221 -4436 rent, or from any product liability claims of Holder or any third party. For this Umted Warrenty to apply, the Units must be installed h accordance with al site conditions requited by state and local codes; all other applicable laws; and infiltrators Installation instructions. (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the origi- nal Holder. The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of states and counties have different warranty require- ments. My purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units. U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844 , Canadian Patents: 1,329,959; 2,004,564 Other patents pending. + ' Infiltrator, Equalizer and SideWlnder are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a else registered trademark In France. Infiltrator Systems Inc. RECYCLED PAPER is a registered trademark In Mexico. Contour, Contour Swivel Connection, MicroLeaching, PolyTuff, SnapLOCk, ChamberSpacer, PosiLock, QuickCut, QuickPlay and Quick4 are trademarks of Infiltrator Systems Inc. ® 2003 Infiltrator Systems Inc. Printed in U.S.A. 0011203HP -0 i 03/29/2006 12:37 6514392462 MCCORMACKCLASSICCONS PAGE 02113 Mar 29 06 11 :25a ream Speer F3�ifin 7159868660 p. ]. trs,. :moo to:un lJ{�s•tr�O�o ST CROIX COUNTY SIiP•TIC 'TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwncrfBuyer _ 41041 ' gA S'�' Mailing Address 94{P 4484a6. gdfgdpA 4403544" — 147114 445114-3 X161 vAs0.4 - info 5'x101 Property Address _ . btI my .SP — (verification required front Planning Departrltent fax new construction) City/State , HUOt0 I MJ Parcel Identification Number sgAL DESCE T � QJ Property Location' 1 ' V t . U)1.4, Sec, T 89 N_R_ _ _W. Town of P . Subdivision as/ aa.luaCl06 Rgrto 1O040 AQa 11,0) Lot as • _ 96 - . - Certified Survey Map N %lolumo � ....�s ('age sF Warranty Deed N _ 7 ALL. 9 volume Page Spec house e s 0 no Lot lines identifiable Ctil yes CI no SYSTEM MAINTENANCE ertec improper use and msinterwretor your septic system could result in Its premarare rar)nrC.to hand wastes tux Proper r the t o r stern consists of pon'1ping out the septic tank every three years et sooner, if needed by a Itccnscd pumper earl affect the function of the repro tattle as a treatment stage in ihv waste disposal system. The property owner agrees to submit m St. Groin Zoning Department ■ censticetion form. signed by the owner and Sy a masts 012rn bcr, jou*tteYrian plumber. testricti: tdplvrntwcr or a licanserf ptttngsr verifying at (1) Ilse tank n site w s tewattc 1 x3 fu p cal s et c is in proper operating condition an l trnr 12) aftr, inspection end pumping (if necessary)• septic lfwe, the und- s ned have read the above requirements and agree to maintain the private sewage disposal system with the staid rue set forth , as set the Department of Cornmetce end the Department of Natural Resources, Stott or wisconsrn Ce fl stain • at y ur to $y. • s been marnl;tr�1C. must be etttwpleled and returned to the St. Crain County Zoning Office Win n w 30 days of • t eye cx n dote. �•• r � DATE Si • ' !CANT sF _ON (ve) e - ify ilt ertc un tars form arc 11 to the best *fray (pre) knowledge I (we) am w (arc) the aner(sl or the properly de Eh re. ue of a 0.orranry dead recorded in Register of Deeds Office. p _ stGNA OF� AAt'i ••+• • Any info that is nos-represented may result to the sanitary permit being revoked by the Zoning Depanment. "• • • lnetude what this applitRtton: a stamped cp o f lee c enrf d survey map Register rcc ften c is made in the warterny deed Deeds a copy Y p z'd OGSL9BESTL uosu4oC uoser dlt:jp CO 8Z 2.00 U 2739P 316 786 ,3 10'9 • KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 01/28/2005 03:15PI! THIS DEED, made between Neil L. Wilcoxson and Mary Jo MARRE XEMPT * DEED Wilcoxson, husband and wife, Grantor, and Kernon J. Bast and Donalda J. Speer -Bast, husband and wife, Grantee. REC FEE: 13. Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS EE COPY FEE: : 4212. the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A • Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2" St. — Suite 115 Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights -of -way of record, if any. 456780 0— I•— • -1 $ 020- 1110 -30- 000... 020 - 1109 -55 -050 Parcel Identification Number (PIN) This is not homestead property. Dated this 28 I el: y of January, 2005. Ad I CZ-94 Crly ( 11 L. Wi cox!. * Mary Jo i oxson AUTHENTICA cM „sin ACKNOWLEDGMENT Signature(s) NC j \j jC.. STATE OF WISCONSIN ) � y te, ST. CROIX COUNTY. ) ss. authenticated this 28th day of January, 2005 Personally came before me this January 28, 2005 the above named Neil L. Wilcoxson and Mary Jo Wilcoxson, * husband and wife to me known to be the person(s) who TITLE: MEMBER STATE BAR OF WISCONSIN execut: • , • e fore oing instrument and acknowledged the same. (If not, f authorized by § 706.06, Wis. Stats.) / THIS INSTRUMENT WAS DRAFTED BY *Chen : rown Notary Public, State of Wisconsin Peterson, Fram & Bergman — Steven H. Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MN 55101 3/11/2007 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 A U 2739P 31? • EXHIBIT A Parcel 1: A parcel of land located in part of the SW % of the NW '/. and part of the NW '/. of the SW '/, of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; more particularly described as follows: Beginning at the W '/ corner of said section 36; thence N00° 16' 10 "E, along the west line of the NW % of said section, 1248.49 feet to the north line of Lot 1 of Certified Survey Map recorded in Volume 3, page 669 at the St. Croix County Register of Deeds Office; thence N63 °02'59 "E 148.42 feet to the north line of said SW ''/ of the NW '/4; thence N89 °26'58 "E, along said north line, 1182.70 feet to the east line of said SW '/, of the NW '/; thence S00 °21'37 "W, along said east line, 350.04 feet to the north line of Lot 73 of the Plat of Cottonwood Ridge First Addition recorded at said office; thence S89 °26'58 "W, along said north line, 10.00 feet to the west line of said plat; thence S00 °27'24 "W, along said west line, 2096.76 feet to the centerline of County Trunk Highway "N" and a point on a 1999.00 foot radius curve, concave southerly, whose central angle measures 7 °10'30 ", whose chord bears N84 °30'41 "W and measures 250.16 feet; thence westerly, along the are of said curve and said centerline, 250.33 feet to the point of tangency; thence N88 °05'56 "W, along said centerline, 83.64 feet to the point of curvature of a 2700.00 foot radius curve, concave northerly; whose central angel measures 3 °17'53 ", whose chord bears N86 °26'59.5 "W and measures 155.40 feet; thence westerly, along the arc of said curve and said centerline, 155.42 feet; thence N04 °29'56 "E 244.01 feet to the point of curvature of a 167.00 foot radius, concave westerly, whose central angle measures 34 °24'12 ", whose chord bears N12 °42'10 "W and measures 98.78 feet; thence northerly, along the arc of said curve, 100.28 feet to the point of tangency; thence N29 °54' 16 "W 274.22 feet to the easterly extension of the north line of Lot 1 of Certified Survey Map recorded in Volume 12, page 3456 at said office; thence N89 °' 12'45 "W, along said easterly extension, along said north line, and along the westerly extension of said north line, 670.44 feet to the west line of the SW %. of said section; thence N00 °37'50 "E, along said west line, 496.89 feet to the point of beginning. AND Parcel 2: A parcel of land located in part of the SW '/. of the SE ''/ of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; described as follows: Beginning at the South '/, Corner of said Section 36; thence N00 °27'05 "E, along the north - south ' /4 line of said section, 1216.78 feet to the centerline of County Trunk Highway "N "; thence S76 °47'47 "E, along said centerline, 1354.82 feet to the east line of said SW '/. of the SE ' /.; thence S00 °07'02 "W, along said east line, 897.02 feet to the south line of the SE V4; thence S89 °33'25 "W, along said south line, 1326.80 feet to the point of beginning. 0t, POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner ((1 m6 0 6 [ 4 Septic Tank Capacity ZJ ga l ❑ NA Permit # 1 Septic Tank Manufacturer LA)(6 E ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Et_ ❑ NA Number of Bedrooms T ❑ NA Effluent Filter Model A l © 0 ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity ea) ga l ❑ NA Estimated flow (average)" gal /day Pump Tank Manufacturer Ul46`7� ❑ NA Design flow (peak), (Estimated x 1.5) (2 t70 gal /day Pump Manufacturer 06 c t.L .D ❑ NA Soil Application Rate f 7 gal /day /ft2 Pump Model P e 1-0 ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BOD 530 mg /L *In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100mI ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y 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: 3 ❑ month(s) (Maximum 3 years) ❑ NA 9 year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 CI month(s) (Maximum 3 years) ❑ NA ®year(s) Clean effluent filter At least once every: ❑ monthls) ❑ NA f • I ®yearls) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: 3 B year(s) Flush laterals and pressure test At least once every: 3 ❑ month(s) ❑ NA '® year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: 0 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. GMW (4/01) • Page 2. of 2. 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 y p m tpr o e / g d p (s ) g of thetank(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 in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed • 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. ID 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 03 a. [L . 50 Name Phone 1 j S'- Z73 4/4(4'5 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 14 Ce C Ott t∎) Phone Phone 7/ 3 g'6 gO 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. , . . . • . . . • . . • , ' • . . . . . . • . . • • . . . • . • . • . • . . . ..• - -.. , • . . . • • • . 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