HomeMy WebLinkAbout026-1121-20-000 (2)
sulsconsir• DQPoft"'erlcfca-n-erce. PRIVATE SEWAGE SYSTEM DD`nh' St. Croix
$glety no Bu di"g DvAS,On
INSPECTION REPORT San Lary Per,-..1 ND'
GENERAL INFORMATION (A1 i ACH TO PCRP.11 f) slate Plan ID No
Personal a'cnna:icn you pro'>ide may he used b' secorda'y Durnoses IP'vaq taw, 515 a< i!li mjl.
'erm 1 •io Jz.L's Nam,, c ly V rage -a&WI.P Parnell tTax No
(lnr~ ~ar[ v TOWN OF 'l~ ch l onL. l O lp` la 1 - ~G Goo
ND
CSI Bfvl E e'.' I-SD Brv1 F,ev. 61d Descuplcr SettomTcvr7Rapro+rFaO No
q ,11~ alb Co_ 05. 30.18.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic r S Benchmark
w i, . 796 2I 2- 94,
Dosing I e 4~ Z Alt. BM e q / ,
Go ~b SDD ~rn G S
r Y+ ~O zS Bldg. Sewer /d 3 'W7
S7H: Inlet ll~ ~-7
St-HI Wile:
TANK SETBACK INFORMATION
TANK TO PL BLDG vent Atr ln:aw ROAD of Inlet
r1Y~
Septic y DI Bo:tcm
Dosing / , Headcfllan.
15 903 5; 1•z> ga.a
Aeration Dist Pine
Held ng - - Bot System I
Flra Grade
PUMPISIPHON INFORMATION
r;laru`aclu-er r - De•raro St Cover
lLn cPr-i -l- Z
TCH Ld: ~4 Frcion_es~ System Hea /y _ TDH fZFt /l/NV r- 1~•` - -
T b 55 Jd~
Length DI8 ( U,51 -Well / - -
Forcenra,n
I !)A 1 7-
SOIL ABSORPTION SYSTEM
BEDJRENCH 'v'80ID Le-g:h No. Of 7'enc'e1 PIT S IN- O`Pl~~ Inside D~a Lly~idDepm
DIMENSIONS
SETBACK SYSTEM 10 PJI. BLDG WELL LAKEiSTREA1e' LEACHING F,Ian~tadLrer.
INFORMATION CHAMBER OR
Type Cf Syscn,. X r 4" AA- I UNIT %1; del Numlxr
DISTRIBUTION SYSTEM
I -J,,,' `.lap fold D s:r ou:lcf. K Hole Sze x I IDIa Spa:' og VC Air if ke
Npe{e.i v
le-g:hDia Le^Pth_ SPdc ng_
SOIL COVER z Pre sure Systems Only xx Mound Or At-Grade Systems Only a
,x SeededlSodeed !x lvLlcheO
Dc o1 Cver C'L_P' One' a.: DceP, or
tt-d7renCr ;,bete- Hen+Treoch EOgcs Icpsotl Yes, _I No "cs [ _ VC
COMMENTS: ilnc Lee code dlscrepenc'es. cersons p esert etc i Inspection kl Inspection k2.
New ~,1
Location: 195' CITY RD CC Oct r 4'
I ) Al: BM Descr phcn = 1
2.i Bldg sewer length = 421
- amount of ccve( = q /]n
>`~Z ar r/(/~ul
Plan revision Required? F _ Yes )(No I IJ N
6~
Use other side fdl additional information. L I - Si - - - - -
Date I-septtcr Sign re COR. No
SLL'-5'1' IR.'.:O~Y
Ar at Ney~- `hi _ ly>Unly_
Industry Services Division I M Croix
f~r21 1400 E Washington Ave Snnuary Permit \u
miter ilu he tilled in hl' Co.)
s l .4I • P, Ox 7182
P s s 20~~ Madison 5378 -70. I W
kN At_'
- 51@lc1mn.acttiunNuntbcr
8q]1tdnf Permit Application
In acandxicc with SIS,+ 5112x. W'is, Adm. Codc, whnusslon of this four to the appropriate govemmemal unit
ApPhe;niun linnu tin 9tatC-owncil f l l1l"fti afC suhmatcA to
N r auired proi i L Doan:, ;1. m tern fn;uurt Note
the Dc 1allment it sat'-[Nnn. Prolc,oVaal Semi c, I USOr1:11 iulivmation you Provide nlav be used lift seconday Project Address (ifdi terent Onto rnaihn_e address)
I :21 Ih9'" Street
puyn.: es in accorl nr e tell; the :'rivacu I aw s I s.);t I:-::n:. Star,.
1. Application Information Please Print All Information
;'rape m I li'ner's I mccl a
!.dmeduul Rlancc 1. f 1 . 0°6 11 21-2Uai0q
0, .3o, 19.735_
Properly owner's Mailing. Address - I Ptofwrlp I ooaoon
I I I o?1b Street
uvL Lot
t'ns. Stale Zip Code Phony Nunlhcr NW SI: Scchon 5
Nc v Kidnuond. %A I i:101? cle mtc)
1 310N RIs I
L'fype of Building (check all that apply) Lot. - -
~7
I or 71:unav Dwelling Sumiser of Hedroonu 20 Nuhdiv i,imt Name
Dora idgc Run
i""c. onuncrcDcanhe ll>c _ "I'le a - -
Cil} of
I 1 hale owncA - Ucxrihe U>e Village of
('SM Numbet
❑ Iown of Richmond
III. Type of Permit: (('heck onIx one box on line it, Complete line B if applicablO-- - - Z_C - -
i -T-
:y I7 N:w Sy"nln L. Kuplaacmcnt S>stem [ IIcauncnvlloidull.lmlk Rei>laccmpn rhr!c ) ❑OtherModil cation In h:xisling Systtm (csplain)
It, ❑ I'cnnn Renewal ❑ Permit lievivon [ ] (hanp_c oI I [l ve"na Translcr to Ncw I. isl Pro ions Perna Number and Date Issued -
Bclir, I(\Vni ion PIUmNr Ocaner ~Lr 9W L S' Z9'Z~~.3
W. Type of PoWTS Svstern: Component, I)evice: (Check all (hat apply)
[1 Non-Pm\,Ilr /cd InAgound ❑ PIe,Arrired tit Ground ❑ Al-oracle ❑ Mound --.'.4 in, of suitable srml ❑ Mound < 24 in. of alit:tble soil
f i I Ic"in! Tank other Ifiywreal Component (explain) ❑ Pretreatmcot Devi'-c (explainer--r) - -
V. Dlspersalt I rratm_ent area Information:
De lln I loo i upd, I Dc.i n N it :yp, hvauen Dispersal ilea Required 10 D.,pero l Area Proposed W) Nystem I levauon
ail Ftomg-pdA 1125 Ilcl 192.77", (912. n', 91.1.
V'I. Tank Info C 1Pegl) Ill _o c
Grill.'n' I final r; of
- MarlllladWCl
Gallons Unit - E r,
F
N"Tark. I"'ling tans (.A) I OiV,D11- 52. ~p r s r. ~C..
Sctwe or II1dd1n g I ailk 840 _ loo 18.11) % Ic,ver Concrete. liIfil'utt LEI _ ❑ ❑ 0
C
Utsing ('hanther i0U SUIT ! 1 W lcnar Concram _ I I ❑ _ ❑ E3
VII Responsibility Statement- I, the undersigned, assume responsibility for installation of the POW l S shown on [lie attached plans.
I'lundu\Nanic writai Plot] 1* Sit' -_4-.4 NIPAIPRS Wnlbcl Sushtcss Phone Number
-
h hn Scimrdl _ /c Lr 7 J/ /2 C,c-- tom, :"r✓1 ?rdLlplxL
Plulnber, Addles 6ShccC Oils. Suue Zip (udcl ✓✓yy
hob 15q'I':[vc. lonlcrsct. WI 54025
I{.(IL CounWDeparnnent Use Only
t_J Aplnln cd U v sgrpl seJ I I crnul l'cc 1) c lcsued Issuing A cn1 51gnatu j
(),cu:r 1 n co lte:nur. !,it Dental
Conditions of 4pprov ll Reasons for Disapproval V L-hJ(L "Y71"1~ I Ct aJ f
SYSTEM OVVNE.N. I ~tI-t^!iCI UC,, x( ~Do" I~l?-Y tV~i d<<~~G~~(Cf~" ~S
1. Sept c tank, effl e,t 6 ei 4r ,d
I
dlspersai cell m u h r 1 r r
P '\t to ~
a.`> - ° n` tr1%~{( I t iingpl u , Id':
f I~y IW'>Wf~y4mp rid +uhmtlho the Connl)'mlr in paper nor le" lAan 3 1:I r 1-1 Me It ra in %im
2.A I8ntb,4f.k Iegevstt:n.s rl~. _t
as pet aCpiiCeLLn ci ldt'Ir,-d ~:-~rra~.
Coll)-6398 (R0:! I I )
SYSTEM PLOT PLAN
De&, -low* t50 ±P?
Project Name: Blanco Garage N ,
- .At',acn eesigr flow -olG lalions for ff'
Project Aoalest; "Y '.C'h S1rWt comine,dal Dlans-
131di Symbol. Af lB3fd Elevation ae re' Pipe Matenals; ASIA Stantlartl
Scale- 1" = 40'
RWi Desalpbon. j TOD of existing septc:ank manlnnla cavef -ables 384.30-3&034.305 p 40 Go 3o
G 4' S_M4e PVC kS-M C23,6E
Y
BIv1 Desm oion: 8,1 Dlescnvapon.
pl o to- Z'SGI H4U pVC.__ -A~MC"55 7
Slope Graoienl of l'as:ec area' 3 dia acrd Stsndan: 'IU
Wall Symbol (it appli;:anlel
Notes: Ndax -
i
Property Line
Parking Proposed
a
Area Shed
osed
-
M " I W8 0 500 MR
M
/ Se i/Do e
Q )
E Ta connected to
v existing S syem 1
Well D
I~ ~i , I It t
vi Exi ing /Existing
roo Septic
o Drive Ho se J '
j r. ~ I System
BM1
Property Line
_
L - Page 7
CONVENTIONAL COMPONENT DESIGN
INDEX AND TITLE PAGE
Project Name: Blanco Accesory Building Septic System
Owners Name: John Blanco
Owner's Address 1721 107th Street
New Richmond, W 54017
Legal Description: SW1/4, SF1/4, S5 T30N, R18W
Township Richmond
County: St. Croix
Subdivision Name: Partridge Run
Lot Number: 20 Block Number
Parcel I.D. Number 026 1121-20-000
Plan Transaction No.
Page 1 Index and title
Page 2 Plot Plan
Page 3 Septic & Dose Tank Specifications
Page 4 Effluent Fi'ter information
Page 5 Dose Tank Cross Section
Page 6 & 7 Pump Curve & Specifications
Page 8 Management and contingency plan
Page 9 Accessory Structure Affidavit
Page 10 Septic Tank Maintenance Agreement
Page 11 & 12 Warranty Deed
Page 13 CSM or Plat
Attachment 1 Original Permit
Designer: John Schmitt Licnese Number: MPRS 223760
Date: 8/8/2018 Phone Number: 715-760 0486
Signature: ?1 J~ L7~Lc
In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01)
Page 1
SYSTEM PLOT PLAN
Project Name: Blanco Garage 7e`tgn Flow* 159SPD
Attach design. flow cah:ulahons lot
Project Address: 1 1 1 J. •.h Street commercial plans:
Bh11 Symbol. & BRA Elevation. 98 16' =ipe Nalehals i ASTM Standard
B61 Descn bonl 'Te cl exmtn :u: tank ma^1015 fC:n~ Scale. l 40'
P _F _ a4en Tables 384.90-9 & 384 30-5
0 4U 60 so
BMP Symbol A .,.BRA Elovabon. 6.1149 ASTIS 02665 - 1 _
RRt Descnption 13M Dea ,pticn 5 ;1411 PVr "rS I Id C1 i aS
Slope Gradient of Tested Area' i`tii Stanearc ~ Standard
Vdell Symbol i,l applicable:
Notes. Vc:as
Property Line
_ I
Parking Proposed
' I Area Shed
Proposed
M M W840/500 MR
oQ r Septic/Do e
E ! a Tank connected to!
F- U existing S syem
i
i
Well .o
I
Exx1droo Fing I', If xisting;
~ Drive 3 rr l ~ Septic
° Ho se ; . System
BM1
,
I
Property Line
'9°?cr G:'.C 31N7 O:]i COIF I "t l4 'Aflr:1301H1A ]I lVH
313H000O U3531M ,Vf1NVW OIld3S w
-riria:--.:::: ,c,:i. '..c •,M:~r NW-009/Mm v;
0
w
H
~ k ~J I
W a z co O
~ O J O a
K J W W d y
0 00 a~ o m w Vl Q
U wt.. _ wa a l7
2
Z N w o U H O o %i >
C~C 0 < m = ~ 9 a X, m chi F 3 LL
L Q K p 0 W a Q U Q d V: U p z i s o
ao d min ~ww ~'0 a o~ 00 i x
(O M J Q a Q W n (O O- 0 VI 00
2 Y
O ~~~Cld?~ NFI mw 01 a U~ a0 z
lnU N N^n ~ W
w~(n WQQ WQ a\ z VI~
It N..W O(Z J- ONW Ozw V VI w U W wpw ~Vl
P: V)
00 Z J~O d'~ U~O~O7pl.~ pU(n no d p m 0.
Xp WO
Z Z3m UMMJM v FdU' ~ Q Z V (n U OO
w_ W O ~
J J D a Z
p Z z ] < OUP U
4
v:
I
4
1-
(4
U
J
z o 9V z
o z
~ w
s
=r w
w
I N
N
U
WI W
.i Q
. I I ~ ~ I lJ p
x
V) 0
~r ..f is „z w
n
tt
O
~ I w
- l- n
o
s
Z U
..E7 ~
z
1 3i
„ e; - fes w
Y
Z
Page 3
k„,; Zabel' I fI IUE'llt I iltCr
CasIPFdU/NPC✓'v IIrv AC, er POifcM lr.:.
The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its ( lass. It has
)2;7) linear feel of 1/ 1(," filtration slots. Like the Polvlok PL-122, the Polylok PI,-525 has an automatic shut-off ball
installed with every filter. When the filler is removed for cleaning, the ball will float up and temporarih' shut oil
the system so the effluent won't leave the tank.
Rated for 10,000 GPD (gallons per day). :Norm swu,h
X10 000 GPD' tOt"'°"a0
52 linear feet (if 1/l6" filtration. P
:Accepts 4'" and 6" SC:I-ILt 40 pipe. Handle
Extension I" PVC
Built in gas deflector.
Automatic shut-off ball when filter is removed.
Ralcd fur
Alarm accessihilih'
f o,l>txr cr•o
Accepts PVC extension handle.
Ideal for residential and commercial waste flows up to ,25 Linear Fl.
1 (1.000 gallons per day fGPD). d l
ilt I irraCnnti1, 1,
I. Locate the outlet of Lite septic tank.
2 Remove the tank cover and pump tank if necess iv.
r\ Ihl
3. Glue the tilter housing to Lite 4" or 6" outlet pipe_ It f u In pyar '
the filler is not centered under the access opening use a
Polylok Extend h I,ok or piece of pipe to center filler.
4. Insert the PL-325 filter into its housing.
S. Replace and secure the septic lank cover. NSF1AN5I 46
® Ccr Standard
The PL-523 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
rlcaning. It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If Lite installed filter contains an optional alarm,
the owner will be notified by an alarm when the filter
c;.r. 0,11., h.,
noels Servicing. Servicing; should be dune by a certified
septic lank pumper or installer. :ann,n,a h,
tihut-:'rf %,il
L Locate the outlet of the septic lank.
2. Remove tank cover and Pump tank it necessary.
:Z. Do not use Plumbing when filter is removed.
I full IT SS cartridge out of Uri' housing.
3. Hose off filter over the septic tank. Make sure all MIP
solids tall back into septic tank.
o. Insert file filler cartridge back into the housing making
sure die filter is properly aligned and completely inserted. Polylok, Zabel fk',t frh,•r, ept Fasdy iiwI 1,
i . Replace and s(,( ure septic tank cover. the SmarfFiltcrl.. , ilch and alarm bill, I'MI nF, lank,.
Polylok, Inc. 3 Pairliuld Blvd. Wallingford, ("1 06492 'hill Fice: S?7.-65.9565 Fax; 203-284.84; 14 avi~%.polylokcom
Page 4
PAGE 4 OF 5
GRAVITY-DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
•I'@':arl Pipe
,10 1. ,.e...
build 'q -.in:Pi;~il must comply eili,
8'IJ c'2'~@~oeue ::P;; 3 If, :rJ NrC J3W
Ea:aC -hod F o~9 Ela: fll tr E.Wd r'an1'oIU -S as vocusca'y.
4:0aihel:IMat
..unction nnx
Armved Avn•ow,el l nc<^9 Llaihnle
IP f UKL\NL Vert :.a{: :•en, Wi a'rin Lao* Alla[hed
I 9
Anrhur :ank(s) as necessary
s" Stan. o: 1.1 'I ahn'.a
Pursuant to SF IS 383.43(8)(q)
Eslab,s4o0 Flucd rov:,hnr
nyPwl;
\11z/ \JZ
A night .°.ea
C ':]wrk Gn:cnr^wa
a. 1
CAPACITIES( 11.82 gplrin 4. mat;
a
Depth (in) Vo l.'no (gal) I
A 9 307.37 *T aenr, \ -A:,n:nved JniMS VAh
Ho a Aupmved ripe 3 9 crlo
B 2.0 23.64 ' sond czsy
{I•pt,mll
[C] - 3.0 35.86 I 1 . b A::....
D 12 141.84 e
- _ - - ' } I PUMP-OFF
fVl rnm" 84.00
*Purnp Tank Liquid Level = 43 in + 6_c•r ELEVATION = ft
2 r INSIDE BOTTOM
Force Maic Diameter = in 83.00
ELEVATION = ft
Force Main Length = 30 ft
I
Force Main Void Volume = 4.89 gal 1 ' - =
`r
[C] Total Dose Volume TDV = 34.89 galidose
L(< 0.2X design flo's . fore'na r old v 7IT ,;1
5
Vertical Lift = ft
PUMP TANK: SEPTIC TANK(S):
Volume = 500 gal Total Volume = 840 gal
Manufacturer: Wieser Concrete Manufacturer(s): Wieser Concrete
Pump Manufacturer: Zoeller
II Install approved effluent filter at the septic tank outlet
Pump Model: 53 immediately upstream of the pump tank inlet.
i
Controlsr'Alarm Manufacturer. SJE Rhombus Filter Manufacturer Polylok
Controls.,Alarm Model: 1036378
Filter Model: 52,5
Float switches containing mercury are prohibited.
Page -
SECTION: 2.20.010
QL,idi PE0493
1 O 0311
I
Produq ^L ml Ilc•presenn- ~ / I ~ \ a. O SupeRCttk~
~crc •e5was wndlbD^s at ~ - 9510
time of publia;tcn. Consult -
(acgr'i rFy.-~T disrc:.ei-
' cics 13 i[0 I. O"nCiss MAIL TO: uO. NOX 16347•Lwiswil HY 41-0347 Visit our web site:
SNIP TO: 3649 Ca•1e 8u^ Rax!•! ovsvdl:. KY 40211-r951 www.Zoellercom
fbPEj 778-2737. 1 t8W 926-!'uMP • FAX (502) 774-3624
N.:1 Sloggklg,c. rx mpe let 53 - 57 Cast Iron Series
F::atoaat subclernN0SYS7 mr?-l e s avCabin. nr.;71 55 - 59 Bronze Series
svr Ich & vada ble'evel cnC C cyc1le ssems ava lab is.
U_ _istec 3 wire cord plug. 911 staadald for aulor-a7c,
15 fl. standard tot nonautonrthc (For Pump Prefix Identification see News & Views 0052)
:ARCS on resistant DowCer ooa:ed epoxy rl•lis•1
No sheet metal parts to rust or corrode
Stainless steel scrr••es sa'IICI alit'. guard and handle
screens to cog
SUBMERSIBLE PUMP ,~v
t 1usnight rtight necprere "O' Virg SeFwech motor and p.1mp UL FOR
housing
Cel,oyaitpolypropylene 'loaf T.- DEWATERING (SUMP)
Moto, - 50 -I[, 151%1 RPM, oi'Al ed hernialidally scaled, _ OR
aut;;mat:::resclinern-alocedoadvro!erlcd EFFLUENT (SEPTIC TANK SYSTEMS)
Leper and lower sleeve bear .ngs mmn'.ng in bath of o.l
Ertire un.t pressure tesled af:cr assembly 11@0 Lis PASSES SOLIDS sv/~l/ l
ceamic seal
11/2 NPTDISCHARGE -
;ximim 'emperatu•efor effeH uerLr -
rcwaterng-13~"F 54°C} AUTOMATIC
Passes v; inc'1 spherical so ids MODEL
1'; NPT Discharge.
n poirl- Cfi p n -
Ilajorwdtr 7;3'~?2' 1 qri '+1N
Cast iron switch asp, I,olur 5 B i,Ize liti t. case. ^:ctDr &
pumDhaasing pump -.0.5111
~o;Ineered theanopleshe base Engineered r-ernopastc n:ne VORTEX TYPE
-,rineered glass `filed. prisic Engineered glass-filet. I,
~lpouerwlh'netal,'Sen n-„e le'wilh meal "sot, IMPELLER
Salnless s!w.1 yard 8 handle 3lar ens steel guard 5 handic
Bea-9 - iDxnr 8 .:weer rxt ted ??wring - lowp• 8 upper e^ fed
All cast iron con<1NC6rn All t'e-2CcCnsIrul'c•' _ .a,.
tar.ess steel uard :.nless stc, I Guard B handle
.~+rinl loxbr, upper f 11',A heanrig eNerS uppw ml led
:ant iron hmnrc - - ~ n
Cast':In npcllor Eton, imrelwi
a'
POWDER BN MODEL
COAIED
TOUGH'"
w'atertlgnt - dust light Permanently oiled bearings
kuu,ria:~rm NOnautoma'.id 3 HP, 1lb1i Dr 230V
'55 59'-3FR115Vor230:'
Note: Ino surly of elfceni sys[erc5 ncmlally leyuires varable ICtiCI BE53rB:=578 5N53!BN57 ava, ablerMclugetl
foabsl oortrels and properly sized tasins to adlieve reta•e~ with Piggyl Variable Levet F cat S-eltch
pumn,ry cycles cr sits ^g lmors wilh nonautorwic pumps
O Copyright 2011 Zoeller Co. Ali rights reserved
Iti
w TOTAL DYNAMIC HEAD/FLOW
w PUMP PERFORMANCE CURVE PER MINUTE
LL MODELS 53155157159 EFFLUENT AND DEWATERING
6 20 MODEL 53/55/57/59
w Feet Meters Gal, Liters
x -
5 1.5 L43 163
1510 3.0 129
4 15 4.6 72
10 Shut-off Head 25 ff.(5.9m)
0
2
cceuor
- tiiK 3'1fi
I
0 -
r.
110 0 30 40 50.
GALLONS!
LITERS
0 60 160
FLOW PER MINUTE
VacaCle level float switches available f~1 f.
Varable level long cycle systems available
1
Availab'o with special cord lengths of 15, 25', 35 (50'230V only)
A.lann systems available r-
Duplex syslerns available ; i+ v
1. Integral floatematedm cbalncr'srn;- T: e~t~-lu ~•Ircl requireo.
2 cilyk aggyback va :,bk v, of lna v..;r ur J,uhlerggYback va'abelevel
Scat Sk%r. Refor o 14x1.'+. ^''n
? tec hmic;l alternate' Al-Pak' 10-0072 or 1C COI. .
n ~ Fl,'( ;7! for couect medci of EleclncalAlte'nalnr "Easy assembly"
5. rmble wet ar1ml sxilch'0 0225 used as a contT, aaivalo x~1h 1eJ c s assembly"
era
hl l'al Allematorl3) ar4; fow syveIT. ,n n.lrf .e j
Single Sea. Control Seimbon Listings
Model Volts I -its Phau Node Ads Simplez Uaplez
i CSA UL + )
11 nV."77 15 1 Auto ?S 1
rl3J6tl-;og 115115 1 lpv
115 1 Ain, 1 - V Y -4-
' Flit
; r 1'S 1 P.am 9' 1 - IJ v
'e - llo I Ailu _ ag 1 - r v I 111E '
I Pulo _ •19
Radices potential dogging by debris
S L a3 29L 1 tJ.^.n 49 _ 2 .'!or •I & ' j Replaces rocks or blicks uncer t'le pillip
-q r . art r.: sn -v n ,dol. 10,Ae rif dllrahld, natIcoirCSve ABS
R.: ses murp 2' of. t»'tom of oasin
_¢r+ldcs the ability to raise intake by adding sections cf L''','
or 2' PVC piping
Attaches secure y to pump
Far nlemaem en tiUlo'ia Zcolr tr:VOCG ie-ter to calaog or `oliftuck synabY. Lr l Accommodates SJrnp de'A'atermg and effluent applications
FosSw:~ga.rl)04-76n1iv>alA.'.ema'dr tl/04F,5: Alech,nca:uamsor rA¢e strr; NOTE: Make sure float is free from obstruction.
Soagu vain, FlAfar aneSngle f'nase5mppr',m,a t:~n-u: dlarr ysems =htr73i
For unusual conditions a reserve safety factor is engineeren inm the design of every Zoeller pump,
Copyright 201• Loe:ler Co A, I rights •escrvod.
Page 7
PAGE 4 OF 4
In-ground Dosed-Gravity Management Plan
IMPORTANT:
The owner of this in-ground dosed-gravity system shall be responsible for its perpetual operation and maintenance
pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this
system shall be considered a human health hazard if not maintained in accordance with this approved management
plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3j. Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 450 gpd; 130135 220 mgL"; TSS S 150 mgL"; FOGS 30 mgL"
Inspection Checklist INSPECT EVERY 3 YEARS
type of use
age of system
nuisance factors (i.e. odors. user complaints. etc.)
mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
material fatigue (i. e., leaks. breaks. corrosion. etc.)
solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution 'drop boxes)
neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
extent of ponding in distribution cell prior to dosing
dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.)
electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms. etc.)
distribution lateral or lateral orifice plugging (measure lateral distal pressure compare to design specification)
surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or
as required by local orchrance. Disposal of contents shalt be pursuant to NR 113, Wisc. Admin. Code.
Effluent filter(s) shell be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer s specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
NarnO of individual or company: John Schmitt Phone: 715-760-0486
Local government unit: St. Croix County Community Developement Phone: 715-386-4680
Local governmentunitaddress: 1101 Carmichael Road, Hudson, WI ZIP: 54016
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shalt comply with SPS 383. Wisc. Admin. Code.
No product for chemical or physical restoration of the POINTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Cocc.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agercy'or review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.
System Abandonment
If use of this POINTS is discontinued. it shall be abandoned it accordance with SPS 383.33, Wisc. Admin. Code.
Page 8
Uo:wncul Numha Uo; ur:cul ~rlc
St. Croix County
Accessorp Structure,4fTdn -it
~r
Johnathan Blanco
(()lirncr) "lapel or prinle(i 1 t; `
being duly sworn . Mate,, under oath, that: r
Helshe is the legal owner of the fill lowing pareel of land located in St.
Croix County, Wisconsin. recorded in Volume _ Page Document i
Number- _ St. Croix County Register of Decd, Office.
being duly describes as follosss (include lot no. and subdivision CSM or Name and Return Addrea
detailed legal description): Lot ?b Partridge Run ~rthnalhan nlana.
I -N I 0?'I' Cheer
Nett i2 is*.monJ. \\'I Sall'
T'scd IJcnllicsnnnAUmbu p':A)
As omier of the above described property, I acknowledge that the Private Onsite Witstcwater'I*real menI Svstenl
(PON" fS) 'e" ices both an existing principal dwelling and an accessory building on this lot and is sized for a 3
bedroom home. or a design flow of 45(1 gpd. 1 his accessory building may not he used as a second residence on this
parcel. I also acknowledge that I vyill disclose this inti)rrnalion and stipulation to any future panics interested in
purchasing this property.
Gated ill], duv 01 _
Inhnahau IS!anor
k
Srgnaturcbl- _ slAII )lIli 1S(O\RIA 1
St. ( roil ( mach 1
aurhenticoled rhr. _ da of I'errrmally came balms me Ihl. _ day of
the above named
ee
I I I I I.: \11-.Mnl l( C 1A I I BAR Of wlsl'O\ N In me known fu Is,
m: La•arnt,l who cwcoled do hoR_orni MAJUMC111 and acknowledee me
aulhoriced hF ?06.1:1). 1\'i. Stak •::wi
Ails INSI VT All N. k% UR4F Tb t>'I ~
X _
fur PUhhc Nlato ol\\' ivonwn
rNr .awl., rna) he unllcnlicnled or 'wkno..lcda.l Roth .Ti: nr,l V\ i .m ill'i n I. pennanenl .I non. Lxi: a\jwaiton dale.
u~us.an ! . )ate.
"Tills P %(;E IS I'M OF Tills I. F.(:11. DO( I ND:\'I' - DO \01 RF'\IO\ t"
r fur 61Jn::iJff r4lo'f hr: ,nA rl r cr hrlllll'r' tal.
mlmt 4r0uA'u( 1_Ali,r pnr'a Jr. JOrr'.r. 'nzr.f n trc); act y T. W 01.4
.lat(trc Ogal, scr!pli nrl. m.fl fY. tla/. 1•Tie ::rtr. of llh'. .~mu.~or'A" ' h,I r
.over p ee o[71/s on.- p2ge fo l'orrr do: 11/ll' r! .:1 $_.liil! "•Ytln b l I',~r r,! f I Sf rlo!: i ' 1.' i
Page 9
ST. C'ROIX COL. NTV
SPI''IfC I'A.\}~ \1:1INll'N,A.\Cp; p(iRF.tS~lb\T
AND
I NIf KSH IP I:KfIF If':1'IION IORNI
Johnathan Blanco
1721 107th Street
%dJj,, 1721 107th Street/ r cmi.~r~ I r r 11-.." f r A:LuId Dcpsrtmrm Porn x r n mui:rn.
lir~:'Srafc New Richmond. WI 026-1121-20-000
I':rcci Id: u:ihe+tliun Nunehl-r
1.1'.(:ALUFSCRIPIION - -
SV1' SE s` 5 r 30NR 18 \t' frwnol' Richmond
un PI", Partridge Run 20
( edified Suncv Map k , A•blunlc , I'ngc _
\4`nrranh' 11roJ # _ - (berbre 2n(17)\'ulume
i4~iuum~s.~_1r^ Luo idvnliliaticrj'yc,~r.
S)S'fF.NI MAIN PENANCE AND OAV\FR CLR'I IFICA110,
rr .a r- r mnr• rt-•)+Im r L a wrcmlw eh: .ilc Ir ,r.
cuu n r. r .ol rr npia out tho s.plri ur qT tlt e y - u m r nr Jca, s a lu a xa ~,amn r wl r r.r
.'i:.Ll I Ilr ttltr r'tlVl 1. lire .4'~ JnL e~6nca n10,.(1eC ntlY as41)'.posll s4"I LL lvncr rbulu '.r
ra Lrt.es..epcu t_dn:91'~.3R_.<.l.)anJ mfTaFar?~a:. l'm xfount; a.nit rvO,dir arx
fh'r.prgy owr ray,.ttste seh.,mirro SL Croix lounly pl:mningll/oring llepumtcn: a.aGlicauon furor. arnr.l.. '.Lo
. ~rra I 'rmnte cluolri<urn ry:mn plu•r.hcq«nnietcd plumM.rxahcenwd panrcr varfy inyehn:igth.L Oo-si«
r:r'aat rAipmal sy:ICT is.n pmiznpcral're.:ondlioen:rdarf.'Iafur vcapraioaaur pumpilt :I neccss
. rhanl )loll ofatuJnc S( myV [he seDUa:er 1.
liw th ..A...i r c h., r ad the -ho e «qurcnrrms and ague IV mtintain M1c prism. sewn~e :iyrn.d s'sten:.ccr
.u.l U tol I w', -n r l Lv he Ik}' n r m rt A.1
Pr ex:.i m Scniw nni nc~ Alanmem of Salu:al Rrs., r
t N i r m. foul n n. n. 11:11 w xrn. % tens I r rn Irn.n«I roust ft rmr.lctcd ws4 mlumcd:0 t e St t
F l mma K Zoniae J r.lmrnt wrJ nr .o Jay<of the thrtr )<ur enplrutimr:I:nc.
1 vr' Ihat I a r n:nnLn hrm rrcI I t. N'. ulr A 1rlrc I r-..c:l r,ln r. ofrt
rrop; n; f rfcJ ubr.•.r .n,.. f:: wrmtn, Iri-c I If k -It. - 11111,
Number of Aedruontc 3 SI(;NA~I R f)f VPI, ICAN IIIi I)tll.--
4r 1 . l . n i as :hn: mine?n~.cated may resul: m thr s¢r-LJy 1 nm,l r -rvokN l.v I c Plar:nir',y @ /.oa:ng fkpwv:m a
I in, ulu npliamrvr--,rici r.r l;Iwc Gurrrhrt'_yacr o'Uw]. Clliar:nd. p;ot l:.utilia:I,unr•. n'.:q. '
❑ih\ i~ll]1
Page 10
.y •
THIS INSTRUMENT
E RUN
F THE SE 1/4 OF SECTION 5, MON,
JIM COUNTY WISCONSIN.
UNPLATTED LANDS
NORTH LINE OF THE SWI/4 OF THE SE1/4
80 RAD. TEMPORARY CLIL-DE-SAC
N 8959'01" M643* ' TO BE REMOVED UPON ROAD EXTENSION.
343.27' 234.10' 11
19
1.065 ACRES I j 20
46.370 SQ. FT.
CIA
N89'55'31"E 341.43' I I i
i A I y~ 094 ACRES
52,011 SO. FT.
18 : I I
I, Douglas J.
S89'55'•31"W 237.65' w that in full cc
1.090 ACRES vl
47,496 SQ. FT. x_100, r 100' IT w Stotutes, on(
I I I describe-,' ;o
N89'55'31"E 339.53': that such p
I i i s subdivision O
21 the SW1/4
7A ra
1.006 ACRES N Croix County,
17 43,837 SQ. FT. W
1.024 ACRES I I I Beginning ol
44,582 SO.: FT. 33' 33' - - - -1
south line
m`O - _ - - _I S89'S5I31"W 240.60' i SE1/4; then(
rn I m line of said S~
N89'55'31"E 240.20- I I 1
N
I- - - - _ 643.37 feet;
J
I I W feet to the r
south 1/4 lir
22 parcel contai^
0 16 I
a
t° I 1.032 ACRES
1.004 ACRES I I I 44,967 SQ. FT.
43.714 SQ.: FT. I ( I
N89-55',31"E 2.0.20' j I S89'S5131"W 243.60'
°f
N
1.009 ACRES r ! 23 rn W)
43,948 SQ. FT: N I- N I m N-
15 Pagc 13
'r.'ycml~n Da,,anovr'i at au^c.'nnnuc° PRIVATE SEWAGE SYSTEM County. St. Croix
Sa'oty and 6uJr. n11 D visicr.
INSPECTION REPORT Snn lery Pwml: No:
430012 0
GENERAL INFORMATION (ATTACH TO PCRMIT) State Plan ID No
Pen eral m4mvalic^ you p, ,W, may be used for sCf:Onddny puq:e5C5 (PR:ar:y I on'. S 15.CJ 1I';m);.
Peron H,,dro';. Name. Cl:y Vitll X Township Parxl Tex No
Richert, Fred Richmond Township 026-1121-20-000
W IW - ter. Insp. B" Iiu:. BM
onavipLw' Sectonri cwnrRanperMap No
U ' O / (~d yj 1~ / ° ,lt ~r , 05.30.18 73
TANK INFORMATION ELEVA ION DATA
TYPE NIANUFACTIIRER CAPACITY STATION BS HI FS ELEV.
Septic
Qenchmarkg.7~`' _ ./,-t^ .Z ~O~•
j (J /OGL l~
Dosing ',IRK AL BM ST d
Aeration _ Bldg. SeweY-
- - - 10 6~- -~a. i (0 90•x' ~ . 3 1
Holding SUHI Inlet
TANK SETBACK INFORMATION SuHtOutte! Sal O /p7 7 9O. G'
TANK TO P^ V`,ELL B..DG. Venttc A~Ja.ake ROAD Dl Inlet
Lf % inf
Se is r••J DI Holtom `j
P' _
f C' 7
Dosing
(M.S, Headed tan y/
Aeration - ---.1 Dist. Pipe Z1.•~ p,0
U 0-- Iul .O
Holding - - - Bot. Sy em Z.b
Final Grade
PUMP/SIPHON INFORMATION _1j lam, _ 7 LI
Manufacluer and S'Co •r yL
~ GPM ~-~'rYi,c r vT 6. 6
Model Numner
~1tt Anr 021 77 3
TDFi Lft FJie,. c•I >,u_ System Head TDH FI n S - ~f
FOrCema_P I lh Dia. Dist u; std ~1. h ~~C ~S - T
SOIL ABSORPTION SYSTEM Z 4
BE DfTHENCH A"Clo r L,!;11, 9 No. CI Tne-jl PIT IMENSIONS Ne. DI Pxs Inside Cis. Llqud Depth
DIMENSIONS
SETBACK SYS I EI.I TO P+Lt- BLDG WELL _ LAKHSTRFAM LEACHING Ienu7
INFORMATION CHAMBER OR Cf Ya
I;"w I System.
J ~~r / `UNIT, Model Nun'ber r
DISTRIBUTION SYSTEM
i luacer'far/'ic(~ Dislenul»n , xHOlu Sim ix Hoe Spacnq Vi lle An6vfli
rlntake
Lr.r.atrG ` f-G _ Lerctn y•S+"~I /r~jt 1~ ~fri
Sp.cin6-
SOIL COVER x Pressure Systems only xx Mound Or At-Grade Systems Only t'^S
Dupth 0"' f Ue;tl'r omf xx OwIh
D o` xx Scoded:SoddcV r 1~ klwq n `~r~
nir;Tran,li rei;L• ~ Renr~•mn:h E17es To sal
' Yes No
COMMENTS: Onr:luCe case disrrepenl persons present. etc.) Inspection 41: ti- ; Q 3 Inspection g2:
Location: 1721 1071h St New Hichnlond, WI 54017 (SE 1.4 SE 114 5 T30N R18W j Parrldge Ran Llot 2 - Parcel NO: 05.30.18. L
1 ( Alt BM DesGIPUOn = .Sf• c4VE ~LQ? ~L`R C.~'2, (L~? `1tS/' l~la4s[6,n' n
2.) Bldg scwor le'lg1!1 = (J ~.C_(~ Q7'-1+~k-S /"~7~4~ke-- ~r~/UT ~i WK~' G~%7``e-~•C
amour: of cover . > 41 r ~•Y/ k f ~~!!__00~~//IIJJ (Ks / Bm~
Plan reviswo Required? Yes -i No A O u ~ / ~
Use other side f:' f aciddional inrunna6on. /
Date Ifcupelas _Inatufe
SBOh?IC IR S~~r - Cert. NO.
jAp!
SlysES s"-f36 /~RlBw 2z1117
i i
LOT :2c
~V
37
7 d S
9, Sw `tor.f6.~ /o6 Z i9yo~
i
iQO J I B 1 i
Z Ti
i
i
1
u a
^ >L5: tan s, y
qc)
oy
-fa
OYl
r1- YueUM~
I I
p
ct~ c - 6E2vr ~1. s f ice. Z , S'-~
176
I~ ~G