HomeMy WebLinkAbout026-1306-00-064
NOV.ors n Deoan-'en: of Comme,: PRIVATE SEWAGE SYSTEM •'"rrty St. Croix
Sare^i and Bdilcing Cuimr.r
INSPECTION REPORT Santa-y Per-t No
(ATTACH TO PERr11T) 606958
GENERAL INFORMATION save Pla-, ID No.
Pe.'nonai Irformatior feu F'svlde m3'y ne...sec fof Se.Gcndari Purposes Ir"'any . aw, S 15 ~-1 ;1 i(^"*
'el-f Hotcers Na-e City V loge Towns-rp. Parcel Tax No
Brandt Peterson & Nadia Junqwith-Acb TOWN OF RICHMOND 026-1306-00-064
CSI BM L e'r 1nsp. [Al E ev. Grd Description Sect orJcrsnRa" jerMap No
ioI.e4 A-1;4- 6M L-M - fl, 18.30.18.1671
TANK INFORMATION ELEVATION DATA
I YPE MANUrACTURER CAPACITY STATION BS HI FS ELEV.
Septic S fill
Benchmark `D'9~ /ar• gb
4-t to v~Z$ nit. BM~ 8 93
Al on Bldg. Sewer $ 5 16 -7 13
Holding SuHt Inlet 2-41 MV
TANK SETBACK INFORMATION SrHt O.ttle: `•41 /dS. Sil
64~ WELL BLDG. Ven Air n:a~e ROAD DI Inlet
TANK TO p
Septic I '91 l Bottom
I,q 366 'b-7
Dos. rig header.-Man. 7• q /Q~•
Aeralicr - Dist. Pipe 7. 913 g
/d 3
Holding - - Bot System t? O /d3 o
'.ral Grade 11 k
PUMP/SIPHON INFORMATION F 3.3 /09•d1Manufacturer Demand St Cover r i 1 C t o
GPr~t
Model Numb
TDH Li -ricuor Loss System Head m ii Ft
ForceTain Length D15t Ic "Nell
SOIL ABSORPTION SYSTEM
BEOiTRENCH d'h Lou ,t- No Or tines PIT DIMENSIONS No. DI Pits Ins, D.n Licuic Deptt-
DIMENSIONS 9A Z t 4e1 _
SETBACK SYSTEM TO CJ P+L. BLDG WELL f LAKE:STREAM LEACHING R".ary:aryrt~~~
INFORMA110N CHAMBER OR
L..6 AJ2 eT r0 ~7 UNIT 1.lrcel ct. ~-t
T
DISTRIBUTION SYSTEM 2.7-111 'V44
i7Q~ v
Heaclft0i IC / OistriGdtitr H;Je Si'e x •iola SPaGng V i'to Al1 r[[11 lakeL
P Pets: L /jO t it G
1
I_engir_ D a Spacinc
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Def p h ve• r cp:h C'c'; av Depth M xx Seeceol sodded KK l Iched
t Bcdr",cr^n Center S ' BPcrTrene.-. Edges ~ Ten>ui 1 Yes No
COMMENTS: ;Include coce dis✓epencies, pe•scrs present, etc: IrsceCron #1: Inspection #2.
Location: 981 152ND AVE I / Ja A
1 } All Btvl Descr pt; or = LO V t ,a.._- `,,,Q
2 ) Bldg sewer length -
311
- amxnt of cover = 42,
Plan revs on ReQuil Yes X No L Z3 ( C`
Use other side for addilioral information. 4~+
bale ozrelc' Sigra:I. Cen No.
513D-5r1C ',R 3,97',
S-~vv ao1s _ 37( 1
trP 1F1 t12 P.~. - ~ 1.'II IC
- JI dustry Services Division
- 'Li 400 E +::'ashinylon Ave.
_ $P$ ; P.0 fiox 7'6) Saur .uylunm Nuull a itob I:id In by co.)
q 2016 1r', disun. •::'I 53707-,7'162 r
1
I
II I r. , .I,11 - UI119er
xl[lllrll~' Pt l~ljl atlnll ~r{ -
In a ,dd xilh NP \ \ II l n A ~dc'C , is n I thy, In I Ih. Ippr plat ovelo cnial unit
i, rrynnrd LrLI t 11 um 1 wlm 1,runt \ 1 q,b. I TI I In i;. 1 I. _oJ I I _ _ -
IvlmN nSal n au,. 711 1 i n J S;nu I Jl(rti l m 1 .ui..o ll l iJc lox, I'M asul to -ml m i n lddre, Ill is:ua. Ill. o l nl_ A,fic~i;•
I
Ia1:1 srv u,;I, rxdvu.l,„dh for 6nVU.u law,, I Ili l i ml\tl
1. ;%pyluation Information Please Print All lnnf matioo
-Pnp tV O-AIICI'nNmr 3o'
I- _OQ "06 y---
~ J 1„ c V b ./v p
P:rI uh Ownel's \tadnlg Addrr.. > f r~pe'ly Lnads,u 0 iJ
C it lot
Ci:V' SIaU' /y: ('uae _ Vklme Nurehcr Section % r~•.
11 Type ofIfl1h clIit- N:IIIthat apply) Lotr
I cr fnmilp U r alngunthrr al Haln •nrsx ~ / , / Au1Jn~si.n Name
OlC ( /I /
1 nblrYCommu 1 Dc.ul _ I_ _P i/ LA.S V
~1 ,tip ❑ ('ny of
❑ Stale Owned Lh <_clibc l. _s<
' \illaec ul
Ill. 'Cs it: ((-heck on1v one box on lineal. Coulplcle line IS if appbl able) _
\ ~ Vew SCV•¢-' RclAw meal s)sRm ❑ Cl aunc:101 ldig_ I't L. duly ❑ Other Meddicalion to kwsbnr, tiycl:m (explain)
It. ❑ i'cnnit Rcncwal L] Permit R e\ W. 11 ❑ l t lTI, of ❑ I'cnnil'Cmnakrlr: Ncw 1 I.,t Picvioua I cuni; Number and Dam Iscuc,'
n Illy L.q.u l t u : Iunlh.r Owner ~A WaJ~ / ilr
~_1rI-V,( -Ial zoft'f2 111v.1.mComponln Dtuur (Chock allllnl apply) P~
5
~-\r n n [ 1, ;:ni I In c i ua P I i s v J llr and LJ Al Grxk LJ Mound I in el sutlable soil ❑ Mound N in of suaal,k soi
C lC
~~--j't'htie+wle-t rnlr }7!'r ;ran I, JC,.mp n, 1I,:~plaiu) ❑ 1ichcatm.u.Druice. iesplain>
V. UISpcl Sat' Crc ,tment :Art l AI,, e Information:
i)ra ni r_pJ. j I)o it n\e.. lpp:ni:.n )iypcr>a!llu ltrq ^.teJ l'>Q Dlcl. a-e1;1tC5 Fropostd (aft Ss.l:m l'.Icu•ation
I:a n pd,Yi /
VI. Tank
Info c;:pl ,cm `
C I I u' ToWI ; of
M1lrm fa-!urcr ' 8 d
Gallotu Uni I• o
Scp:l r F -.Idm;y Paull / - El El El 1-1
\'ll. Regnnuihility Slaten,cnt- f. Ole unJcrsiGneJ, asxunc rapon.ilrilil)' I'nr in tallation of the PO%% l s eho»n on the attached plans.
PLnn a ~iU'Inu ii Iqf I P wld,cr'.YI,numrc RIP..MpHS ]wnbcr Rusinc>s Phonc Number
I'll,--.hcis Addre,;, tSircct. City. Slzlc. "/.ip C,,Jc) /
I'll 'onnly!Department f.-sc Canty
:11•Ier.cJ 1y' I-u•:r Pai°/:j~1'ec Date S,Ilf p 1_w •MentSi.,n tine
ell ki.:!" 11 11, IX. Cnndilam of +I •IS s Disc , nviVal J) J ~D / a, 5 ~ Abe
T. 1 ~ P~•.~t,~G~i1. 111~.1R.5 11 later'
aspen cell emp ull be I W i a C~•
as pelf aar3gement plan pw ~laei ylniumoe:.
2. All xtR>,r:k tKlil9r-xns moat w r.-z.rk it a
AIM pw trpFkrb t c.1r51 ! :M~:wrci. 11// (I,I_L (NA~,J(~[J~ •r}-6 I`f!^~a
mach to <enlplcrr plans Im Ihc,aslrln s,.d . ,A,mit In 11 • r'u u.tr nutV • , I", nla'I x r_ , I I il1Lhax in aiea -
SBD-6' 9R IRO,' 14 )
r
11 4
1 1 I'.
1
G \ j
-
c~
1 \
I 1 M
~'j~ Ki
CONVENTIONAL COMPONENT DESIGN
Resi k"" Appfi mkm
INDEX AND TRLE PAGE
Project Name
Owner's Nam
Owne/s Address:
Legal DesurWr
1
Township:
Countir / ' ✓
r
Subclvisim Name
Lot Number-
Parcel lD Number
Pagc 1 Index and We
Page 2 Plot Plan
Page 3 SY31WD Siag9 & Cioa,-~-
Page 4 RW Specs
Page b Makitteriance b9birnatioh
Page g Management plan
Page 7 St Crm Cly Septic Tank ltfadenaloe Form
Page 8 Warranty 13e,3,d
Page 9 CSM or PIS
Altachtnerds: %50 Test & House Pkarrs
- lroa=e Number
Date- i Phone Number i_
SignaWre
De.-Ir,w pmsnartpme r.Gleoea saAhsmom cmyanand YreoaNor purrs Venice 2A seo-tar s-p PLUr }
Paver
v
i 1 -
r t~-
\ i' t _
ri j I
! ? III
t y I
C`
`g~ ' ` .mot
' !j j
i
Soil Absomtion System Cross Section
ft
a' Sch"Wie 40 ~rnal Grade
PVC Vert Poe
with Vert Cap
- ft
Leaching
Chamber
-Y SYstem Elevation
ft ft
Soil Abso fion tem Plan mew
_ ; ft {~~f[I~IIIIDI~II~Iif~lli~l -
f
Vent Or Observabon Pipe Chambers _ amb -
o,J F.Jas : ers Trench 1
4° Dia
l Trench 2 Header
Leaching Chamber SPeCif7catiOns - - -
Manufachirer And Model
PISA Rating sq ft per chamber Soil APplication Rate i
_gpd/sq ft
gPd Design Flow : i Soil Application Rate FISA =
Chambers
2 tows of_ umberseach.
Page of
za
Filters
z,..,
ALI
PL 525 EFFLUEN RLTER C" -`O~ff
`
2..
Polylok, Inc is pleased to add its
new commercial fitter to its existing c
line of quality effluent filters. The
PL-525 is rated for over 10,000 GPD P ALUM
(gallons per day,) making it one of 4 accossrl>~ty h~ S
the largest commercial filters in its f { F
class. It has 525 linear feet of 1,10
filtration slots. Like the Polylok t `
s°
PL-122, the new Pblylok PL-525 has
an automatic shut of ball installed 525 rerear feet
with every filter When the filter is ot'Ine' , s
removed for cleaning, the ball will taaation slats Rated farnva
float up and temporarily shut off a 7O GPD K
the system so the effluent won't
leave the tank. No other tier on f s~
the madwt catr make that claim! 1 g
SM. 40g F _ f
Pipe i E
PL-525 Mainterrartce:
The PL-525 Effluent Fitter should yam":
operate efficiently for several years i
under normal conditions befcxe
requiring cleaning- It is recom-
mended that the filter be cleaned t 1~1
every time the tank is pumped or ` r
at least every three years. If the i
installed fitter contains an optional j
alarm, the owner will be notified I' t
by an alarm when the filter needs i ! - dellectur
servicing Servicing should be ? ~F.---- ^ G~
done by a certified septic tank
pumper or installer. ~ fia,tina~
1. Locate the outlet of the E us ~,r rJOR 6AIF088 is removed
septic tank ssnsro
VI'lemove tank cover and pump
tank if necessary. PE.-525 Installation: 1. Locate the outlet of the
3. Do not use plumbing when septictank
fitter is removed. Ideal for residential and com- 2. Remove the tank cover and
4. Pull PL-525 out of the housing- menial waste flows up to pump tank if necessary.
5_ Hose off fitter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the
tank Mahe sure all solids fall 4' or 6' outlet pipe. If the
bade into M septic tank fitter is not centered under the
access opening use a Potylok
6. Insert the filter cartridge back Extend & Lok or piece of pipe
into the housing making sure to center filter.
the fitter is properly aligned and 4 Insert the PL-525 fitter into
completely inserted- its housing-
7_ Replace septic lank saver. 5_ Replace the septic tank cover.
`.F .
POWTS OWNER'S MANUAL & MANAGEMENT PLAN
FILE INFORMATION SYSTFM SPECIFICA I IONS
Talk U N!,
PwI"It; GfSoptic I. I Dose ❑ Holding Volume:
DESIGN PARAMETERS Tank Paanutaaurer. _~V( NA
Nlnnbe,rnflsedrecros: I I NA t_I Septic ❑ Dose ❑ Holding Volume.: q
Nijw4cr rt Punfc. ?vilify U,iils: Nit Vciftal Distrnw Tank Bottom(s) to Scrv'ce Pad: :p
I Aimated fa e -4e) Flow: i Ion 6-1 Honz i III 1, n<(s) to Scwicc Pad: (c;
>pr il' sir i t r iechar tr s in rst Fe rmo gded i` verlical i9 `75 fc, ~.a
De>Ign (DCat HD1': (Eitl n tb.l / l.o): (1 r i ri i rt hultua.l.' I I. D Ir.er I r:cif~ n s,r <hors o Le prcvided on bn -k.
In Srcu SJI it.lp i..-1,sm 1?-1tn: (get n i Ff'luont Fi; Minurac. Ier. f',-
_ I]NIA
Stanchrd (Dome tic) I.nf!cenUEffluert Paorthly average f ffhue•it hiller C9edel:
FaN. Oil & Gr..=ss:e (FPO` -30 nlgil Pump Manufacturer:
b';e:a:cmical Oxygen !?errand (ROD,) <22D mdl. i. N:-i 1>lNA
Tcfai Suspalded SaIICS (I SS) - 150 mglL f urnp hlide
Hlan S7ength Intlllerl"'E luerd Mcnthly average I":1unatment Unit
(FOCj >3d my,'f t,~tan~facf-trot.
(eoD;) >2o moat. L] h;: 1 I NA
U S_S) >220 in iL I_ I klecl ,,.cal Acmllon L] Peal Flltur
Pretreated Fr. lt!cnt Ivlonlhi/ average i - I ! Sand;Crav DisirPGravcl filter I_ Ci IY` Otther.
I
her: d (HOD,) =30 1119;' SDil A.Lsorption System
(TSS) -:31 rnwl, f'3 NA
-en:] Cclifor.•n (gcunu:lae mean) <?O` i In Ground (graroay) -.1 in Graund (Pressure) n_ NA
❑ A.144ace ❑ NI aired
10,wincrl Fitluen' f'a[Lde Size ;n -tin LI NA ❑ Drip-ure ❑ OtFer:
Other: I I NA Other: NA
MAINTENANCE SCI IF.DULE
Service Event Service Frequency
°I VJi•:.r p--nbineu sludge a•:d scut. c;uas occ thin i;:;i ai:lturlo
Pun a vi.l ca ten c t irk(.^,j I f7 4:rhon lne high Ir 1 11.13n 1 cti ntcd
r ri~nlh.iai
L.^sp U wndiLu of tnnRs) At least orre every - (Maximum 3 years) L I NA
_ y_ar(s)
Inspect dispersal cell(s) - I l month(s)
A: te: t arx every: r (Maximum 3 years) G NA
~Y'ea; (Si
Clean efuae•x filler At east ono.: evrpt: _ ; ~ n or as ❑ KIA
r -.l
r ,nliys)
n pert puma n„rop centlu:: R alarm At least orrc~ ovary: ❑ _r
IN: i
c
Flu ; temis 1:dpres_t.'ete_t Atl.nstOrce -ter'. O'L,I, L4 NA
A' le-'S: llrc.o. ~Vrl
I NA
)lieu
❑ NA
MAINTENANCE INSTRUCTIONS
Insoe_tio m if t._n<a1 snd sot' absaptio i e;yzitoms Iii he I d- b7 an rn d:zl c pry' g oro of the folo•:;i^g licenses or certucztions:
Master Plumber. &lastor ?L_mber Restriued srsac•• FCY'vVTS I:ropartcr, I'CVJI , Nl umninnr rr Scl:tagr. Serv'ici^g Operator (pumper).
!ark inspeM~ers mull io::L:do a vis;:al inspediun of the tar.k(s) to idontify acy !niss:rg or broken harde:are, ident&/ any aaoks or ;eats,
measure the •vcdume of corit::ccd i;lud3e and scum and a check for any back up or ucuding cf eTuect on the ground surface. The soil
aosorp'_'on systern shall be visoa%y inspeccd to crack the effl :ent levels in the ob,nwrition pipes anti to check for any totaling rf effluont
on the ground surface. The pcx:ding of etffunr.t un the ground surace may indicate a fading coeilition and requires the immediate
no'.icaGcn of the Ioc;>m regt0fury• authorily.
Pvhen the cornhircd accumu alien of sludgo and scum in any treatment tanR equals onc-third ('f,) or more of the tank Volume, the entire
cunler.ls of the tank sha!1 be removed by a Soplage Se: viciug Operator (pumper) and disposed of in accordance with chapter NR 113,
Wisconsin A.dm:nisnative Ccde.
All OU:e: seiv,ces, includinj bU not limited to tho servicing Of effluanl Titers, mech n' -,.l or pressurizrd nompononts, pretroatrnent units,
and any serIcing nt int2vals of sl2 mo-iths, sha!I be per""Xiied by :1 r>1r rod PO':'di-9 .'.dainta:nel'.
A servioe report shali be proridcd to the Icaf regutalcry <:ulf cri:,r'.vitn'r 30 dates of rr.:nple±icn of a:;y service event.
C41 1W
cs ra~n:ci
Pago
START UP AND OPERA I-ION
I cl rev;: cormir-c li: poor to use; cd the PoiVIS check treatment link(s) for the presence of panting products, solvents or other
chemicals of Sod'mcnt that may !IT,-:cde the lreatmont process andlor damage the ,:oil abscr.oCon system. If ^igh concentrations are
detected have the c:afe',s of ti,o t::nk(s) removed by a Septage Scnricng Operator (pumper) prior io use.
Pump tanks may fi I move normal ihiowitir levels prior to startup or due to pun'p failures. Start up or restoration of pourer under these
cond1ions is rot recommended, as the exfias ; imasteiwa:er will be discharged to the soil absorption sy's-Mm in ore large dose causing an
overlo;1d that may resu t in the baccup or surface discharge of effluent and damage to th:~ :;ystom. I'o avoid this situation have the
contnns of the pump tank rernuvec -oy a Septage Servicing Opeialur (pumper) prior to resloiiny pcvrer to the pump or contact a Plumber
or p01r'!TS irlaintainrr 5o assist in manually operating the pump Controls until normal efCment !--vets are lestu:ed •.vithin the pump lank.
System start UP $hall nit occur :vlhen soil a)ridi;:ons are frozen at the in`itrative sudare,
Dn not drh;e or park vef:icles over tacks or the scil absorption sysle'n. Do rnt drive or park v vei, or otheroise disturb or compact, the
,.rco wili,in 15 feet dawn slope of ary mound or at-g ido soil absorp"on area
Reduction or r.'.imination Of tike fol'l.ow ry hum tine. va'st(,nater stream may improve the perfc.'warce and pic'uny the I of :he treatment
tanks anti Soil absorption sy'stem' accts, antioictics, baby wipes, cigarrttc, butt,, condcros, cotton sveabs, degreasers, dental floss.
d<roeis, disin-CCt !1JS, folS, foundation drain (sump pump) discharge, fruit miA vegetable peelings, gasoline, greases, t.erb tides, :neat
s;aa;s, nhodic;no:+s, oils, pa'n-ng prod-lets, pesticides, sanitary napkins, solvents. tampins, and vealei softener brine cischarge.
ABANDONMENT
';Vhea like Plx^J i s fails andlor is pormanenth; taken out of service the fol'ovng steps shall be taken to insure that the system is properly
and safely abauidonec in compliance with s. Comm 83 33. W sconsin Adminstrave Code:
• All piping to tanks, pits and other soil abscrption sysinms shad be disconnected and the abandoned pipe openings sealed.
• The content, of all Tanks and pits shall be refroved and properly dsposed of by a Septage Servicing Operator (pumper).
• After pumpino, ail tacks and pits stall be oxcavated and removed or their covers removed and the void space filled with Sot, -
gravel or arotner inor solid material.
CONTINGENCY PLAN
If the POV118 fails and cannot Le repaired the &)Ilowing measures have been, of must be taken, to provide a code canr.ant
rcp'ac emenl system
Lid A su!tabin roplaceme:'a area ha been evaluated and racy be utilized for the location of a replacement soil absorption system.
The replacement area shruld be ,crelected from distu:barce and compaction anc n.ho"Id nct be Infringed upon by required
setbacks from existing and proposed structure, to lines and yells. Fail..re to protect the replacement areo will reSUa in the need
for a Ilea Sol and site e.'Jaluaton tk i5taJIIStI s suitable raptacement area. Rep'acemen: syste;ns must comply with the rules in
effect at tho time of their permit issuance.
A suitable repleccrr;ert area is not available due to setback a^d!er soil limitations. If tno soil absorpton system cannot be
rehabilitatod and barring advances in FOV•!iS technology, a holding tank may ho insfnl'orl as a last resort.
❑ The site has rot bee:h evaluated to identify a suitable replacement area. Upon m urc of the PO'o'VTS a soil and site evaluation
must be performed to Iocite a. suitable rep:accment area. If ro replacomnrt area is a vailible a T-cirg tank may be rstillod as a
last resod to reolace the failed POWTS.
Mound and at q,ace sri; a" ' option systems may be recenstnlcted in plan: fd'o•.v'.ny removal of the b!ornat at to infiltrative
scra~f)- Retort?ruc'iors of such systcma .must oonhply with tPC rules in ef`oct at that t rte.
WARNING
TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
qtj SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM TI IE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS: _
POWTS INSTA11FR 1'OWfS MAINTAINER
Nan.-- IF, N=in'. r,
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL RFGIII.. TORY AUTHORITY
l„ire lame. - ~ „ - ~..4:..
. a~~ crritl I ..mss dratted ins 1:1in 11'r Cr.-.nn and Vv'..u..frlla Gaunt/ ideT`; r ulo;ary a}c ae'r. i~ ~or'r iv u.r m1h ser`nns
i n Lt.''%r11 t i u..ijS(t l i' ~i•4(1. ,v, , 0
START UP AND OPERATION
-o paw .o-struciicn prior to osc: of the POV•ii S check treatment fank(s. for the uresscce of pairbig prodacts, solvcn, or other
or s-•cimem tna- ma;v impede the treatment orocss aT:Sui damape the soil absorption system If '_,iqr co7oe. nations are
....^.cied hrjve the r..:rate^r-:: cf the tank s) rarnoved by a Septace Seroi~ng Operator ;nl:mperl pric-te use.
vnnp taul(S may fiLl a )0'1 : n.+sr:a ..,Ter I ^ ortnr tc stamp o- dug tc o.::rn fa'ures. Start up or :es:oia cn of poveer trader these
^ndzions is rot *emm:nnnned. as the exrss wastsmerer will be oisi;ha'ged to ih : q11 system jr nne large cose causing an
r%,crioad thu: may result in :h= ba::kuu or surface cscharye o: e:fluen: anc dama3c to tno s;stem, ib avoid this situation have t^.e
:::n-tents of file p.Imp ta+ removed by a Seuta9e Servicing Operstor TIL:rnnor,` nrior e restorna pDwer :o the porno Gr conlaCt a Plum Be-
of I'O? sTS Pufai:raiser Ic assist :c manual:c operaiing the pump cen:rcls _rn*.i nocn:al efAue:r level:: are restcrec v+ilhir.:t pump tank.
star star up anal rot o-ou-w'ne:i soil cGnd.tom~ a: a fro%e:~ at tie infitrative saran:.
D:~ no- drive n- pa-k veaio ns n talks Or the :;Di absOrpiion system. Do not drive or nark over, or otnorevi.^.c: disturh Or commo:., the
a. -r.-: vrfnin 15 reet down s op-- o` any mound c at-g'ede soi, absorption area.
;ed_xdion of elimination of Iha `oliosvfn;l "roil: the'o;astasvy strearr: may imp-eve the perforrr-,ance an: p-Dlmip L,.e life of the treatmen:
-n-i<:a arc Sol' absorpfion system: acids. anti Lietcs, ba Sy w*.pes. cgerc3:r. butts condoms; wtton swags, dagreasers, den: al floss.
:iiarrxs, cisi:iectan's, fa:6. lo-Jn9atio° drain !sump pumui discnarce. r-ui: and vecefab'.e peelings, gaseCre. greases, herbiados, mea:
:;cr3az. rued:ca:ions, oi,s. uain ^g proriuc s, pas does sanitary napki sofvenis, tampons. and v;a:er softener bring dscharga
A3ANDONMENT
'J:rhe: t PO'•i: i S fails al'to' is perrr,arcrtly taken our o'`he foLuwiNa steps sra:I re taken :c instre that the systcm is pmp^r''y
ere. sctciy anandoned in anrnpiiancs sv:':h s_ C:rnrr, 83.33,+:?+isconsin AdminisLati've Code
• A:l pip;ng to tan:4s, pits and D?hat sci. a::so!plien syslems snail oe disco'nncted and tie aoanJxiec pip-- openings sealed.
• -ae contents of al tacks and pis shall be removed and properly disposed or by a Sentage S--v,nr.g Ope-a:or (pcmpeQ.
• A tor oDmpirc, nl: tanks and pits shall be excavated art' ie•nove: o' their :mnrs removad and tie void space tilled %4th soil, -
❑r_ive: or a,tothe: T:e-t solid mate.'s:.
CUNTINGENCY PLAN
if tI-:e POb°dTf: fags ape: cannot be ropaired the folow.ric measures have been. c' must b,: taken, to p-ovice a rode compliant
D-.D cerle:ii system:
P: suirab!e rep,aa:•me-.t area s been evaluated and :nay be U'iJlZ8d for thn Ic; tior o` a -eplace-nwr soil absorption System,
're :eplarernent waa snou:d De ;;tctectea --on, uuP.+rl:~:an^:~ a^d rnmparron anc x.'gold ro: be raretgec upon by a-x:ure:
-::r:aes< f'om ex:sing and p'apesnd strnccu-r..ot Iris anc •vveLs. =ailuie t prolog: ti-,e repiaoe.ment area'.vi9 resglr in the need
for re"", soil anc art= evaica'ion to es'-?blis". a ::vitabla -_placement area. Rcp,acemen: sy scans must cornp!v wiir.. Cie rules in
tart a: the time o'. their permit iss.:ance.
i. 3.iiiablc replaccnont arc:: to not n'vailahe duo to setoack and+or soil limitations. If the sail nosorption system cannot be
than Aafed and barmy advances in I'O'v1++TS terhnoJoay, a hold:rag Tank may Cs ins7al:i-d as a last resort.
_j The s'te ha riot aeen evaluated to identify n suitable mpinonmerrt area. Upo^ failure of the POA'TS a sail anc site evaluatior
Trust be perfo-mod s IDCate a suitable -np.acare-t area If nu :eplacerren, area is avniiabe a nc:circ tan,: may be installed as a
last resort to :eplaoe the faied POVvTS.
fel r::inc. and a.-ara-r soil <^.b orpfi im sy ;tams :nay ha re<xmsLucte~ pace fylo:vine re'ncv-ri ^f thc• nio'nat ar the ir6ltiative
sure . . Rc.r.^n tru iins ct u: . *,=rir must crrr', Vtr the tul_ in effe . a: th r iinr^
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER FN (FR ANY TANK UNDER ANY GIRCUMSTANCF. DEATH MAY
V_.Y RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER
SEP T AGE SERVICING OPFP,ATOR fPUfviPERi LOCAL REGULATORY AUTf IORITY
..Gin'
'hnne Rrr:-: - - -
Tr'- .fucurtuul d'td1~:c L I m _.to l_ : N L. k : M::
'o
SI'. CIMI\ COI'N7l'
sd III 1C I;\\I: NMINI'I NANCI AGRI:IAII.\1
AND
U\1'\II:RSI IlP CI R'I it R A] ION IORNI
(ytsn:t ltu~cr~~ph Un~{yA
\~lailin, Adders. n /V Ezvn~/~ks ~'V •;J ~17
I'ropCtty Address "S -7
15Zn~C Ax, K •
(Verification rcrlnired I'n:rr Plara rt- & /ruing Depa,mcnl for rrew cnnanrction_)
C'itV State I'auccl Idcntifiauion Nuntbcr_ d2i~o •~3a(Q -
LEC:AL DESCRIPTION
Propem Location ' 4 . :!r , SCe. s h ` 4' N R y_\1`, l own (it'
s , /p
Subdivision flat: Lot ±l.
Certified Survey Map 4 \'olunte - Pa to a
Narranh, Decd P 63 (liehor 2O07'I Voluntc Page ii
Sliv,- ho.l,c ❑yv!0tto Lot line i&II(iliahlc II/)~cs[fnr.
SYSTEM NUNTENANCE AND I)~'~'N6:R CI•:10IrICA]ION
Improper use and nmiamtancc of your septic s}iIvrr,ould read: in its prcmamrc It it to I:andIc wastc•s_ Pwilct
nrrinte n.im c emlaisrs of'pumpm mil Ow ,ti: lank every three years or sooner. if ncedcd, by :r lieeruua pungrer. what you put into
the svstcu can alko the lumlion of d,: scplic tank :is n treatment sta~,,c in the waste disposal s}stem. Other maintenance
responsibilities are specified lit 'SPS 8'.i'( I I and i n ('haplcr 11 - St. Croix County Sanitary Ordin;uuc-
t he properly m%mcr rarer, to submit to St.( roix ( aunty Planning K Zoning Department a cc I t iticaIion form, sil:nc;I by Itic
owner and by a master plumber. journeyman plumho, restricted plumber nr a licensai pumper ycritving that t I ) the on-site
wastewater disposal cy u, Ill is in proper opcralim; cundiliun and kit aticr inspection and pumpio-.l it necessar}'I. the scplic tank is
less than I: lull of slud,c•.
Ir\,C, the undcrsiencd have read the above re'llmerucnls u:d agree to maintain the private sewage disposal system with the
standard< set birth, herein, ac scl by the Dcparlnlclrl ul'S:dily And ProkasionaI Scrv ices and the Depart meat of Natural Resources,
Slate of \Visconsiu. ( crtitication slating that your septic system has hecn maintained inner be completed and returned to rile St. Croix
County Plannine A. /oninr, Depar'tmew within ;o clays oflhe three year cepiraliun date.
I \ve cenifr Thal all stalemcrh on t is form are true to the best of my call- knowledge Vwn am are the owneris) of the
property described above. by virluc ol'a w, ranty decd recorded in Revister of Dec& Office.
Numbej-of hedroottts 3 p
SKIN,\ I tIRE 01: APP[ ICANI(Si DATF
try "'Iinaution that is misrepresented stay result ir: the ;aritarp permit being revoked by lire Phuming & /oning Department. r•'
Ilwlude with till, tppli, alien a wcurdvd warranty decd 'ram d. R .~,igcl ol'Dccds l)i fire aa;'. a enpy .I the ermined ,never trial, it
rctucncc is nta do n I:nc warranty deed.
(REV. 04?12)
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`-ISCORSNI SOIL EVALUATION REPORT #1504
Department of Commerce in accordance with Comm 85, Wis. Adm. Code _1- of 3
Division of Safety and Buildings Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8%: x 11 inches in size Plan must County
SL Croix
include, but not limited to. vertical and horizontal reference point (BM), direction and - -
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel LD.
64
Please print all information. Re; Ii
r By Date
Pwsonal information you provide nkly be used for snttfnUa7 purposes (Privacy Law. s 1500 (1) IF Property Owner Property Location
Sienna Corporation RECEIVED ovt. Lot NEt/ , SE1/4, S18, T30N, R18W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
4940 Viking Drive Suite 608 SEP 64 ! The Glens Of Willow River
City State Zip Code one tvukil6er City Village 'l own Nearest Road
Minneapolis MN 55435 ~.:I?i ii Richmond 10Orh St.
New Construction Use _ Residential! Num e s 3 Code derived design flaw rate 450 GPD
Replacement Public or commercial - Descnbe*
Parent material Outwash Flood plain elevation, if applicable na ft.
General comments
and recommendations Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area 1
is high trench 104 5', low trench 102.7'.
Borng # Boring 4
Pit Ground surface elev- 107.96 ft. Depth to limiting factor 110+ in. 'Soil Application Rate
Horizon Depth Dominant Color Redox Description 1 exture Structure Conslstencri Boundary Roots GPD+ft'
in. Munsell Qu. Sz. Cont. Color Gr Sz. Sh. -Efhrt •Lna2
1 0-9 10yr3/3 none sr' 2mgr mfr as 2m,2f .6 1.0
2 9-14 1[hi none grsl I 2msbk mfr as lvf .6 1.0
3 14-23 10yr6/4 none grs Osg ml as 3 1.6
4 23-51 10Yr6/4 none grcos 059 ml cs .7 1.6
1 I,
5 51 71 10yr5/4 none vgroos Osq IT) Cs .7 1.6
6 71-110 10yr6/4 none cos Osq ml .7 1.6
~ 11
❑ Borng # Boring - 41
Pit Ground surface elev 102.55 it Depth to limihng factor 108+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description texture Structure Consistence Boundary Roots GP MI
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh -Ff ' •Ef`dz
1 0-7 1Dyr3/3 none I grs! 2msbk mfr as 2m,2f 6 1.0
2 7-21 10yr6/3 none grcos Osg ml qw lvf .7 1.6
3 21-34 I 10yr6/4 none s Osq ml gw 7 1.6
4 34-81 lGFI none I vgrs i Osg ml a .7 1.6
t
5 81-108 10yr5/6 none s Osq ml I - / 1.6
1
Effluent #1 = BODS> 30 < 220 mg-'L and TSS >30 150 mgiL • Effluent 02 - BOD_ 5 30 mgiL and TSS <.30 mgiL
CST Name (Please Print) Signature- - - CST Number
Thomas J. Schmitt - 227429
Address Schmitt Soil Testing, Inc Date Evaluation Conducted Telephone Number
1595 12nd Street New Rlchrnond, WI 54017 9/1612006 715-247-2941
Nn- 1[
Property Owner Sienna Corporation - "arce~ ID # 64 Page 2 of 3
Boring # Boring
Pit Ground surface elev. 102.55 ft. Depth to limiting factor 100+ in Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD'ft2
in. Munsell Our. Sz. Cont. Color Gr_ Sz. Sh. 'Eff*l •E(r#2
1 0-8 10yr3/3 none grsl 2msbk mfr as 3vf .6 1.0
2 8-24 10yr5/4 none rcos Osg ml as lvf .7 1.6
3 24-51 10yr5/6 none Cos Osg ml gs .7 1.6
4 . 51-100 10yr6/4 -__none s Osg i ml .7 1.6
❑ 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 2
in. k1unsell Qu. Sz. Cont. Color Gr Sz. Sh I •Etf#1 •Eff#2
I
i
i
❑ Borng # Boring
Pit Ground surface elev. ft. Depth to lording factor in. Soi Application p,1 cation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDft7
in. Munsell Qu Sz. Cont Color Gr. Sz. Sh •Eff#1 •Eff#2
Effluent #1 = BODS> 30 < 220 mgI and TSS >30 < 150 mgrL ' Effluent #2 = BOD. < 30 mgr l- and TSS < 30 mg: L
The Department of Commerce is an equal opporumity service provider and employer. II'you rated ;vcsiamrce to accev services nr
need material in an alternate tirnra. please contact the department at 60.4-266-1151 or J I Y 608.2(,4-877
93D N Y! ~ H n9;N ,
ScemM `lrl Te-1i,KJ, inr
Page 3 of
Conaucled by: COMILICled For:
. Schillitt Soil Testin€, Inc. Name: Sienna Corporation
Thomas J. Schmitt. CSI' 227429 Address: 4940 Vikine Drive Suite 608
t595 72nd St. Cit}. Slate, Zip: hlimleapolis. NIN 55415
New Richmond. W9. 54017
Phone: 715-247-2941 Subd.Name: The CClens of Willow River
Lot No.: /C V- -
ueio: 4' Legal Description: /!/E 1!4 SRU4 S18 *F30N RIMY
M Backhoe pit Township. County: Richmond. St. Croix
A Bench Mark F.I. 100.00' Top oft" pvc pipe
0 Alternate Bench Mark P.I. fop of / Sle. C
Slope- /5 Contour Line F.I. iY14 Contour Line Length
N~ 4/ ICu I
Scale 1"-40' TR/;IL 3 1,.'~~
/z7'
71
i
i
c \
it
2 ~L 3 I.~l l~ ,,u~ '
Pr
C+4( I
G~ <GGG
ZVI S
This Soil and Site Finhmlion was complo"I to IitItiII a >onin➢ rnptirenxan. 11 nwy or Ina) 1101 be Ilia location suitable fm You ux.