Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
020-1374-24-000
M v1 C O CD C 7 3 CD n A 'B CD d C A 3 .. a� 0 O A 1 i -• �. OD CD a N 0 �y N @ _ = ICI) O ON y Imo+ fl. .w { Ca = p CA _ c\Np a- N N O A C N C O O n CD co 3 0 ° o 7 7 ql J O O ra C7 d A Ca '3 cn CD 1: Q \a 3 O 3 C) N � O O (� i pZ cN\O cN`D = !� C N N C !�f CD C) O a n r N N fD O O N Cn ° C C C Q 0 0 0 �• a c to fA f�A o A n� v CD CD G ^� d v 4 CD °o !+i M .. CS N D �. o O 0 v � m o � �• N N D 6 c N C . 7 CD � Q a 3 a CD ti p Z CD N N C a z Z —1 w T m N N m � Z C 3 A O " Cn NO N Z A CD I Q) v N 0 Z CD N NN Q O � 10 9. = O O O N C O N Q p — 7 CJ7 0 0 n Z Q CD 01 Q d,-C a ° O 3 n 3 7 CD � Z1 o d _0 cn = N <6 CD C/) .0 n -. d ' C rA -° CD 3 Q N CD 3 O = n o 1 o x p.3 a 2. - f 3o� o p a v O NO O _ � co O � b O = b ;< r a 4; L - d as 'MONS '8 I 'bvocl d££ :ZO 90 LL ABA o CO) i g 3 $ � % k k k rk M k E } 2 A 4 § ? C J z/ z °%£ B =r - CD T. E i e 00 § a ' E E e ; @ ■ S ƒ ; E } ® § 2 rQ ; & 2 « f Q t r § 2§ $ B R E%\ t 1 CL 0 a ° E E c & � �U) � ® l y ■ E ƒ = R c E a 7 �; 0 f ® § 8 CD ƒ � \ z' 0 r CA D S § ° @ ® & Z z ( 0 0 i 0 �: ■ . � 0 0 0 % S 0 ) ■ CO) CO) e: k ? } ) { v v � [ \ § CL \ § # f z s z . � \ 2 \ } \ \ . ' o } 1 1 B �LA. � �� � ■2 E 7CD \ o D E_ +�2 � E � f � k z Ch 0 CL \ e R. [ E % 03 M } E (D 2 �_ c f / k z % (D � # � k§ §]k 7 00 k CD /( / \( � ƒ CL \ o a, � ©$§ k CD ) CL &2\ � E © e 2 CN ■ ƒ at . CD § / kj . .. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety anti Building Division INSPECTION REPORT Sanitary Permit No: 488013 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: Nelson, Robert Hudson, Town of 020 - 1374 -24 -000 CST BM Elev: Insp. IM Elev: BM I Description: Section/Town/Range/Map No: d i f5 1 12.29.20.2257 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 3 ^7:5 T.%de Benchmark g I Z50 q /Z. z, //G, Z iO4 (r �t, ,9- /u06 - A B >Q ✓c. 5-6 Aeration Bldg. Sewer . 7 5 /09.515 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing (� � Header /Man. Aeration Dist. Pipe I'7.1'8 9 9 . 6Z- Holding Bot. System 1 . Z PUMP /SIPHON INFORMATION Final Grade 16.85 AV, 5 Manufacturer G e P mand St Cover 3 112 Model Number TDH Lift Friction Loss System Head TDH t Forcemain ength Dia. o Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length , No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 176 ' fr. a> \ SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer,, -� INFORMATION CHAMBER OR Type Of System: nn , i ,, 1 Q_._ A-- UNIT Model Number. J DISTRIBUTION SYSTEM AkC � Z g 4 Header /Manifold �. Distribution x Hole Size x Hole Spacing Vent t take pipe(s) �_ �\ '�� 3�e+c 45 v�- 1 1-ength � Dia Length Dia Spacing '.S SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bedlrrench Edges Topsoil No Yes Q No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 213 Starr Wood Hudson WI 540 (NE 1/4 SW 1/4 2�R20W) Starr Wood Lot 24 Parcel No: 12.29.20.2257 1.) Alt BM Description= 2.) Bldg sewer length= Zt� - amount of cover = �� �1$ Plan revision Required? Yes o 3L Use other side for additional information. Date Inse ctor's S' ature Cart. No. SBD -6710 (R.3/97) Safety and Buildings Division ant' 201 151 P.O. W. Washington Ave., Box Nttmba (to be tilled in by Co.) i8coitsin . 5 - C (6W) 266- A/g a 3 Dep art nent of Commerce I M I.D. Number Sanitary P n QV 2 In accord with Cocain 83.21. Wis. Ad& Cade. Personal mtortpation vide CO (if different than moving address) may be used for saondary p osa 04(1Hm) ST. CROIX I )oct NING OF I. Appli cation Wormation - Please Print AB Iatoraaation Pared x Lux x Block X property Owner's Na me lralQ, o c_ property Location property Owner's M ailing Address City, State Zip Code Phone Number \\ . (t�rck)7 T • A 9 N: RAQ_E � II. Type of B ' g (check A that SPPU') eik as pw ��'"" VVeW f I p ��� Subdivision Name CSM Number ® 1 or 2 Family Dwdliag - Numba of Bedrooms _ / YkAeA Iyd ❑ Pubtic/Comtnercial - Describe Use L, o0 ❑ State Owned - Describe Use v'-� i V t OCity pillage OTowttahip of & &W20 III. Type of Permit: (Check only am box an tine A. Complete tine B if applicable) Q A • ® New Symm ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New Liu Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. of POWTS Check an that ) ® Non - Pressurized ht- Ground 0 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ AvGrade ❑Single Pau Sand Filter Q Constructed Wetland 0 hummed "rotmd ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Rocirc elating Sad Filter ❑ Recirculating S Media Filter ® Leaching Chamber 0 Drip Line ❑ Grad -less Pipe Other ( n) V. ent Area Information: - Design Flow Design Soil Applitxtiou t) Dispersal Area RWuire� (so Dispersal Area Proposed (st) System Elevation "" , VI. Tank Info VGa llons city in Total Number Manufacturer Prefab Site Stud Fiber Plastic Gallons of Units Concrete Constructed Glass Tanks k/ F Septic or Holding Tank Aerobic Treamm Unit Dosing Chamber VII. Responsibility Statement- I, the usideralgis4 assume responsibility for installation of the POWTS shown on the attached Plumber's Na me (Print) Phtmber's i pam a MF/MPRS Number Business Phone Number s PI s Addre a (Street. City. State. Z — ip VnIc Cotmt /)e out Use Only X Approved anitar v S Permit Pee (includes Groundwater ftSwmL Surc harge ` 3� a0 en Reason EK. Conditions of ApprovaVReasons for Disapproval SYSTEM OWNER: t SepW.ta* emmtt Mar and dbpsnal cell must as be 0mvkm / Milnteilted ae psi ettwwq@sm t plan provkled by pM fiber. 2 All sell ck ngttit lvw is must be maiOdned "Per applieable code I ardii 0 Call Atese► mrpleq plans 00 1110 Cottas7 0017) for the 9steo en paper tot less than $14 x 11 itches In she "T & CpM $ECT10N PLN �F' P6111�NIfi 1NiT ... PIP M J was Qa�di � A lt . tr r E[ Svu� a s + t o es A 91 \ �fMtn7�K'•'KE rN Ax /� L►L.�V , / oo. eo' ~ xf Sub AA119tr Ot/uc/F�i tFlc — S1 t JCef /N 1 2 19 b dots- wecur 'kirk T' k cilia V J� J w t!t�w6R 1/� Ew — f1esE�e�a•I P PE ©bs�e��� oR • Mo 6jiso 4e VENT 4AP IiGUM: �rN�Gi�,to� °ATE' . AlAf, 9f &t.,�.�►. The Standad I Ib for Chamber I* Overlap at LMAhiV • � Tf,�kk BdA'� ��V4tiav �� Sac`r 1Z o �m 9g Vo ' stogy V SEW Efhcowe Lenom Wiso[n Department of Commerce SOIL AND SITE EVALUATION .... ., Divlsiori of Safety and Buildings Page ' of Bureau of Integrated services in accordance with Comm 83.09, Ws. Adm. Code 3 5 71 >ll��✓ Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 660 QJ6 APPLICANT INFORMATION - fnt hi timor *tion. Re ' wed b Date Personal information you provide may be u eco ary proses (Privacy 4 , s. 15.04 (1) (m)). Property Owner Property Location /V y A Govt. Lot C 1/45 1/4,S T Z 7 ,N,R Z6 E (or) W Property Owner's Mailing Address C"; Lot # Block# Subd. Name or CSM# �� `J ,.4/t ST CF30iX 24 S '4 iQ IQWC56 City State e� Qi6Wdf3Pber, %' ❑City Village Town Nearest Road g New Construction Use: ® Residential / Number of bedrooms � _ Addition to existing building eplacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate gi bed, gpd/ft 4. trench, gpd/fF Absorption area required _ bed, ft ?S'y trench, It Maximum design loading rate 9 9 0,.,2 . bed, 9Pd/W O• � trench, 9pd/ft Recommended infiltration surface elevation(s) _92- It (as referred to site plan benchmark) Additional design/sitee Ey A7 Nor f1L Rple L / A'r_/ y PAOVA L - Parent material C.� L A C- b 4 ! r LL- Flood plain elevation, if applicable tt S = Suitable for system Conventional Mound In- Ground Pressure — 1 -Grade System in Fill Holding Tank U = Unsuitable for system VS ❑ U %S ❑ u [ s❑ u I X❑ u N s El u EIS K u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ' Trench Y,�3 3 -- SG MIS M CS ,7 :D3 6 s 7 YQ - Cs Ground g _ IAyR _ VZft. , Depth to limiting factor 7 &0 in. Remarks: Boring # 5 8, -z t o Q4 3 — �4 M5 m 6 +-S7 /a Q 4 s Ground 8 7 '" :54 !'Yi5 m ev. �ft. Y Depth to limiting factor > - 7 - 3 in. Remarks: CST Na (Please Pript) Signat re � Telep No. y J A N ^i5ah/ O %, Add Date CST Number 6 l�jNS6A, S r � 6� /2 - aa 2zZ75? SOIL DESCRIPTION REPORT Z - PROPERTY OWNER Page of ' PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 M I in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 6-3 /QYh' 3 / L n rh C S 6 ,4-: S, -54 /avg 4 Ground g ovk S ele loft. S _, ioyp- Depth to limiting # 1 factof ; Remarks: Boring # A 10 iAVlz s 4 I 3 S /0'V43 L- oek cr m I e5 SZ -S D 3 `—' S4 Ms M s — 62:6 X Ground S oN © SG a elev. !L-�Oft. Depth to d limiting in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # �Z !h e s a1 E -11 p' / - L cr rn cs 1 1-5t X24 SG Ms n1 US I a, Ground MS Ll ele II d � , Depth to limiting factor 16-Lin- Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) 1 1,T :tr U � r � u Z � Z � J 2 � 4W — qK Ire S -- w . � M Z �— ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer c7 D - 2 Ne, l s a /J Mailing Address e--H u C1 S a /v W4 5'y 01 G Property Address S 4CA fir LAI 06 -�� A V I S6 (Verification required from Planning Department for new construction) /State T Parcel Identification Number 0 2 1371 0o o LEGAL DESCRIPTION Property Location SE V-, -�X j, Sec. TlIN -RILW, Town of H a A/ Subdivision - 4 �_l g V y W O p �t�{ Lot # '� L , Certified Survey Map # . Volume , Page # Warranty Deed # L 17 S Volume Page # Spec house ❑ yes ■ no Lot lines identifiable Iff yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating tha ur septic system ha been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days a ar pira ' da a /l ? SIGNATURE OF APPLIC DATE OWNER CERTIFICATION Uwe) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the Z sc ibed aY ' a of a warranty deed recorded in Register of Deeds Office. / 17 �- SIGNATURE OF APPL DATE Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 2902P 393 • 8P 8475 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED _ ST. CROIX Co., WI -- Document Number Document Name RECEIVED FOR RECORD 10/05/2005 09:55AN WARRANTY DEED THIS DEED, made between n. Mark M. Erickso a married person EXIT # REC FEE: 11.00 ("Grantor," whether one or more), TRANS FEE: 563.70 COPY FEE: and Robert C. Nelson and Carol A Nelson as Trustees of the Robert C And Carol CC FEE: A. Nelson Trust dated September 7 1995 PAGES: 1 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is PW77-�D g needed, please attach addendum): Lot 24, Plat of Starr Wood in the Town of Hudson, St. Croix County, Wisconsin. 020 - 1374 -24 -000 Parcel Identification Number (PIN) This homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, ifany. Dated L Ll (SEAL) (SEAL) * *Ma?k M Erickson (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF ) ) ss. * L COUNTY ) TITLE: MEMBER STATE BAR OF WISCONi;IY Personally came before me on (If not, �.��� the above -named Mark M. Eric on. a married person authorized by Wis. Stat. § 700.063 \Z' � \ to me known to be the person(s) who executed the foregoing ,,r, Q OCA ins t and s THIS INSTRUMENT DRAF 1 D 1�. I ` ackn g the ame. �SG Attorney Kristina O land -e Hudson, WI 54016 Notary ic, State of My Com ission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) (NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 Type name below signatures. INFO -PRO^ Legal Forms 800-855 -2021 www.infbpmforms.com • POWTS OWNER'S MANUAL & MANAGEMENT PLAN..,L. - . A FILE INFORMATION SYSTEM SPEgtICAT10NS Owner Septic Tank Capacity 1250 0 NA Permit 0 Septic Tank Manufacturer Wieser O NA DESIGN PARAMETERS Effluent Filter MwwfsaWW Zable O NA Number of B edrooms 4 O NA Effluent Rua Model A -1800 O NA Number of Public Fae ty Units ANA Pump Tank C+S►eslty M NA Estmated flow taverage) 400 aft Pump Tank Manufacturer M NA Design flow (peak). (Estimated x 1.51 600 Pump Maevfsctursr M NA Soil Application Rate .7 IW Pump Model M NA Standard MfluentlRQwt Quality Monthly sverags• Pretreatment Unit M NA Fats. ON lh Grease IFOG) 530 mg& O Sen lJOravel Filter O Peat Filter Biochemical Oxygen Demand I9OD 5220 n & O NA O Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 nVIL O DWnfection O Other: Prevented Effluent Quality Monthly sversge Disposal CWK*) O NA Biochemical Oxygen Demand IBOD S30 n*& O kWaramd (gravity) O Iri-Ground (pressurized) Total Suspended Solids (TSS) S30 nVIL O NA O At-Grade O Mound Fecal Conform Igeomstric mean) s10 cfu/100mI O Drip -Line O other: Mmmum Effluent Particle Sine K in dia. O NA Odw. ® NA OW XXNA odw. 8 NA 'Vakm typical for domestic wastewater end septic tank efllumt. Oder: ® NA MAINTENANCE SCHEDULE service Ewnt Service Fro'lwY Inspect condition of tanklsl At last once every. 2 0 rnomffi( A 3 Yearn) O NA veww Pump out contents of tank(s) When combined sludge and scum equals one -third (K) of tank volume O NA I d' cell( At least once every: 2 months) � 3 vows) C3 NA Ins d ispersal sl N nnonthta) O NA Clan effluent filter At best once every: 1.1 L0 Inspect bump, pump control A alarm At least once every: s) M NA O Flush laterals and pressure tees At least once every: 0 mo S) ®NA OOW. At lest once every: O mnamth(s! a NA Odor: W NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal ceps shall be made by so individual carrying one of the fopowinp licences or certifications: Master Plumbs; Master Pkm*w Restricted Sewer. POWTS Inspector: POWTS Maintainer% Sept&ge Servicing Operator. Tank inspections must include a visual inspection of the twills) to identify any rruissing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and sown and to check foc any back up or ponding of effluent an the ground surface. The dispersal call(s) shad be visually Inspected to check the effluent levels in the observation on pipes and to check any pondung of of hoent on the ground surface. The pounding of effluent on the ground surface may indicate a falling condition and ro* ns the imm dote notification of the local regulatory authority. in an tank equals tx►e -third l When the combined accumulation of slaNOs and scum Y eq Kl or more of the tank volume, the entire contents of the tank shop be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113. Wisconsin Administrative Code. to the of effluent "tws, mechanical or preari ted components. Pretreatment services including but not limited to AN other . units, and any servicing at Intervals of 512 months. shall be pwkwnod'by a oetified POWTS Maintainer. A service report shah be provided to the local regulatory authority within 10 days of completion of any service event. Gmw 14/01) � qG� • START UP AND OPERATION p° of —QS. 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 cents). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. ' System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored _the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist 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 lfe 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, most scraps; medications; oil; painting products; pesticides, sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls 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 Odds 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 fined 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: in 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 Ines 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. O 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. d D The site has not been evaluated to identify a suitable replacement area. Upon failure Qf the POWT S a soil an 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. E3 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 oth ) Name C unt Ben Morgan Phone 715- 386 -2850 Phone 715- 386 -2130 !j I SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Tri Coun (Be Morgan) Name St. Croix County Zoning Off& e Phone 715- 386 -2130. Phone 715- 386 -4680 This document was drafted in comp8ance with chapter Comm 83,22(2)1blttltdl &(fl and 83.54(11. (2) & (3). Wisconsin Administrative Code. kL yno IVOPL -t4k,(5 22_sq. 2(1 P, Sum 4 ?f06-7 She - 3w, z 4. . 77 ZA T,� Lima I��d� 23.30,1 �. Izzz fek YMM La Wf4-y vq. 2 F. . ro i A y Uol I kbY &c,z " 36. z� l q 98 0( Vd&, 31.3 /. l - 7. gr s�o► qj 61 L/ �Ki I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division -. INSPECTION REPORT Sanitary Permit No: 488013 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information ybu 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: Nelson, Robert Hudson, Town of 020 - 1374 -24 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 12.29.20.2257 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO PIL BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold IDistribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia I Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/Trench Edges Topsoil �_ ] Yes I , , No � 1 Yes :No] COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 213 Starr Wood Hudson, WI 54016 (NE 1/4 SW 1/4 12 T29N R20W) Starr Wood Lot 24 Parcel No: 12.29.20.2257 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes ] No Use other side for additional information. _ i _ __ — - - - - -� -- - -' Date � Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7 VISConsin Madison, 2 on, WI 5 66- 151 - ``��e� . taq+ ermit Number (to be filled in by Co.) (608) 5/ 8 a 1 3 Department of Commerce PI I. Number Sanitary Pe on �� O I ,9— In accord with Comm 83.21, Wis. A�C,od�e, personal information you rovitl may be used for secondary purposes rdvaer 6""Q 5 ; 04(1)(m) S'(. CRO IX C lea "$ (if different than mailing address) ON1NG OF I. Application Information - Please Print All Information v o A4 S ZO Parcel y Lot N Block X Property Owner's Na me Property Owner's M ailing Address Property Location J 442 u, /9Z, City. State Zip Code Phone Number e) le r T A9 N; R `AQ_ o� C G J II. Type of Building (check all that apply) bk a's fidorft; /,e p � �� Subdivision Name CSM Number ® 1 or 2 Family Dwelling - Number of Bedrooms ou/L ❑ Public /Commercial - Describe Use ❑ State Owned - Describe Use �` 'S► d'W 1V tr ❑City_❑Village ®Township of 11 u,1Lro1Y _ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) OZ 4 — 2 - - A. ® New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑Permit Renewal [I Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. pe of POWTS system: (Check all that apply) ® Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ C onstruc t e d 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. DispersaVrreatment Area Information: l� ' u - - " Design Flow ( Design Soil Application /R mom f) Dispersal Area Requnr (sf) Dispersal Area Proposed (sf) System Elevation �Uc� ✓ Gav, /Y d� O. e ✓ act VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks rt Septic or Holding Tank v Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's i gnature MP /MPRS Number Business Phone Number - PSO Plum s Addre ss (Street, City, State, Zip Cod VIIP Count Re artment Use Onl Approved isapprov Sanitary Permit Fee (includes Groundwater Da Issu Iss ' nt Si (No ps) Surcharge Fee) � oo it zcl O5 en Reason J IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1.. Septic.tank, emus t mer and dispersal cell must all be mantilinild as per management plat[ provided by per• 2. All setback requirements must be maintained n per appkable code I txdirmloes. .. ..- ._...w ,.. __ Attach complete plans (to the County only) for the system on paper not less [Lao 81/2 x Il inches in site �R o Qt� PL OT it CiiOi� zECT10N t+W VATM WPA WM. &WA N 6 UNWA UW ... Pf"cT fw S3 o Q5 A CPS �fAit�rrl�t2K -'� �N - /oZ `of* - re 4v uJ �t�ucPFAt.t?tc -.Si�1� /N /2Se � w�Esrx Sslo►+c'1' K w►Tt1 ��J� P S &CAI QdECJeVA-PalJ P, OPT ©�s�e� I��r,o�l 0 s16NEC: VENr I.Q" rt�� ry�K�4 (oP90f UCEWBE. A A I SO"" "To: rrla�•���, 5r,•r4,�, d/ *A& SKI Vo P The Standa d Ini Ht for Chamber l' Overlap at Latching ... . 0 so o — E�.= goo' SHOE, viEw 75' E c Y itective Length ..PLO 0 7 - PLOT & CPAU SECTION PLN 14' A Q t ZAPPA WM. EXCAVAU4 0 JA C So �cIELSc�vJ a Q — es A wo �faicc�E►��reK ��► - . �aZ �DIWC�Q�' Al - E V , .00.00 � ~ AIC �S V Wes.'. AX � K1 n 44%. loprec T k au��1 JE ' OAW T 0' Z"k A�i n<-IM CL.��, /mil. o</ � "f �� �V% �fGct�E✓vt Li.vE .... • � a S WAI � v�Ew - o,SERVl. dP" P(P, ©6lAc4jkTloJ o2 SOMM VEN r r`N i:S1 Lil�il�OiE OATS: A& y•Aft SDK �/o POW soILTEO sr: The Stanch d In *Iti stor Chamber 7 F l' Overlap at Udch ft ... _ �r p o �fEJ �g 00' slOE. Vic"' 75' Effective Length f Wisc Department of Commerce SOIL AND SITE EVALUATION . Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code c,21 3 Sly �(1Q�✓ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ' ST C96 I X percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 0Z C) -/37� �� -eats ass? APPLICANT INFORMATION It aH information R ed b Date Personal information you provide may be uodlo[s -con ary Aposes (Privacy Law, s. 15.04 (1) (m)). - 1 r Property Owner Property Loca_tio N O Govt. Lot f 1/4 1 /4 T 2� ,N,R 26 E (or) W Property Owner's Mailing Address Lot ## Block# Subd.. Name or CSM# City State Code Y71t er Nearest Road ( p Nearest U Villa soQ Town 5 T 3S I5New Construction Use: ® Residential / Number of bedrooms ��,� Addition to existing building New ❑ Public or commercial - Describe: Code derived daily flow Zoo gpd Recommended design loading rate O. 7 bed, gpd/ff O e trench, gpd /ft Absorption area required _ bed, ft trench, ft2 Maximum design loading rate bed, gpd /ft O•t trench, gpd/ft Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design /site considerations 6jA1_ jA T /On) bo N4_ J�GC # PPA0V,4 L Parent material G LA Ct dL �rj LL Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system VS ❑ U %S ❑ U [A S❑ U [ XS E U NS ❑ U ❑ S KU SOIL DESCRIPTION REPORT Borin g # Horizon Consistence Boundary Roots Depth Dominant Color Mottles Structure GPD /ft ... in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Bed ,Trench 43 3 7, vie 3 s6 ,>7 s Cs 62:6-6 Ground g _ fAYR _ -- S6 M fill Depth to limiting factor 7 [QS�_in. Remarks: Boring # _4 /A +23 cr M I / 6A O.S x m Ground p S 7_73 - q M f'h f� ; ev. , Y S v i Depth to limiting factor > _7'3 in, Remarks: CST Na a (Please Pri Signat re Teleph ne No. 7 V080 t4 N54:n6A/ Add s Date CST Number SOIL DESCRIPTION REPORT '3 PROPERTY OWNER Page of PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 8, 54 /ovk 4 r 5 M nj 6 D o g Ground /Obk S 4 5< 5 6 Z /Ot� ele . ft. Depth to limiting rr j factor Remarks: Boring # 3 L «- M I cs 1-� Ground "l0 S6 �'js �'Li �� & elev. , Depth to limiting f e* '' m in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # I6 1ko SG M5 &I CS I a. Ground S6 MS Al —' 6:7 ele . II Depth to limiting factor T 6- Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) SOIL DESCRIPTION REPORT 2 n •;3. PROPERTY OWNER Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench A 6-3 /6Ye,3 / -- 6 + Ground I&M 5 — J� 5 6 ,g ele Depth to limiting fact ; Remarks: Boring # A -9 lb\IP -S q- Vio- c S L c-r m 1 c s l 0 4 a 8Z -S /b 3 ~ S4 miS M I s 62:15-t Ground elev. t ow, S" SG M S A g ft . Depth to limiting f r 7 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # (�� l'1� 1� 4 V14j— — /h C5 f A- I l Q 3/ — L. e w, cr nn CS m- p'4 3 — SG M 61 Ground - /A SG MS M ft Depth to limiting 4D ; factor Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) I . n V� 4� CY w 2 8, NJ j y Z Y' Q w IV Vi 1 f Ud � 7 � M Q flfMV,[16 _ b1Af�_�u_S �OOQ� ®P7 1 _ A 5T1 W 7. NOVI1'29M 346.56' _ — — NOO °50221N 279.94' N =s$ �BI.eS 15a.7f 115.e9 XU.90 11.10 _ � S � _ W N LL co V >a • to 1 38.06 240.W R. . zr9.ar :Mp$ N cm cm u t i !91'Itlee'E a76A0 I � A I ��� �� 8 06 195.00 K 10021• j \� rA.'%' gNgAY S1� 1e0.b {n00i iW p gOUNDAiIY 7x99• 91aa asz 1 1'�' S01 °15 I 99rterz> +m.er I 1320.58' tz 1eme 1.019a N S assar \ N to �eII $ N .I 51 @z gts �l9e' aoa a+ 1s �� ••. ail $ NM" Z pro 5 gill �� h.9/8 W E91 Z I I / ® it 14 f?�� I I I zl FI z I I ' � of p� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND (( OWNERSHIP CERTIFICATION FORM Owner/Buyer _ C� D.Q ��', �- y�y t 1 Ve, t S a /J Mailing Address U ci s a A/ Property Address 2 J 4 C4 fir W vc7 04 (Verification required from Planning Department for new construction) r r City /Stater U Sv N T Parcel Identification Number _� ` 137 Lt - 00o LEGAL DESCRIPTION Property Location S E %,, %4, Sec. _L_, T-2 IN -R aW, Town of Subdivision � t g V y W o p Lot # 2 Certified Survey Map # , Volume , Page # Warranty Deed # OR L f / S Volume Page # Spec house ❑ yes N no Lot lines identifiable iff yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted.plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating d3 ti septic system ha been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days ar pira ' da a F ( tf NATURE OF APPLICANT DATE OWNER CERTIFICATION Uwe) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the p pe sc ibed above y v' a of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed r 2902P 393 84D84 ?S KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS - WARRANTY DEED - -- ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 10/05/2005 09:55AN WARRANTY DEED tX£WT # THIS DEED, made between Mark M. Erickson, a married person REC FEE: 11.00 TRANS FEE: 563.70 ( "Grantor," whether one or more), COPY FEE: and Robert C. Nelson and Carol A. Nelson as Trustees of the Robert C. And Carol CC FEE: A. Nelson Trust dated September 7. 1995 PAGES: 1 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant �ON77so Name and Retum Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Lot 24, Plat of Starr Wood in the Town of Hudson, St. Croix County, Wisconsin. 020 - 1374 - 24-000 Parcel Identification Number (PIN) This _ homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, ifany. Dated (SEAL) (SEAL) * *Mark M. Erickson (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF ) ) ss. +� COUNTY ) * TITLE: MEMBER STATE BAR OF WISCON 4 Personally came before me on (If not, the above -named Mark M. Eric on. a married person authorized by Wis. Stat. § 70C,�.Ob) ���' �� to me known to be the person(s) who executed the foregoing ins m t and ackn g the same. THIS INSTRUMENT DRAF I'y�aO /� / ®� Attorney Kristina O land \_ V" * (/lam Hudson. WI 54016 Notary ic, State of My Com ission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. INFO -PRO^ Legal Fortes 800 - 655 -2021 www.infbprotorms.com POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page — / — of � FILE INFORMATION SYSTEM SPECOWATION 1 Owner •Septic Tank Capacity 1250 O NA Permit u1 Septic Tank Manufacturer Wieser O NA DESIGN PARAMETERS Effluent Filter Msnufsaturer Z a b l e O NA Number of Bedrooms 4 O NA Effluent Filter Model A -1800 O NA Number of Public Facility Units f3ddA Pwnp Tank Capacity D NA Estimated flow (awrspe) 400 Pump Tank Manufacturer M NA Design flow Ip. IEstimsted x 1.5) 600 Pump MarNrfaaturer DNA �) Soil Application Rate .7 g ayd W M2 Pump Model D NA Standard Intiuent/Effl ant Quality Monthly sversge• prMremnsnt Unit W NA Fats, ON A Grease IFOG) 530 n*ti O Sand/Gr" Filter O Past Filter 8iocher 9cal Oxygen Demand (BOD 5220 n19& O NA O Mechanical Aeration O Wed" Total Suspended Solids (TSS) 5150 mg/l. O Disinfection O Other: Prevented Effluent Quality Monthly average Dispersal Came) NA Bioch micsl Oxygen Demand ( SON ) 530 mgX O in-Ground igravityl O In-Ground Ip ed Total Suspended SON$ (TSS) 530 mg/L O NA O At -Grads O Mound Fecal CoMorm (geometric mam) 510 dull 00m1 O Dd)p4Jm O Other. Maximum Effluent Particle Size Y in die. O NA odd. ® NA Odor. DWA odor` N NA "Values typical for domestic wastewols and septic tank efflum. Diners ®NA MAINTENANCE SCI EDM Service Event Service Fre*mW Inspect condition of tank(s) At Nast once every: 2 m Aw>aisrwm S yam) O NA Pump out contents of tank(s) WMn con MW Mudge and scum equals one-third IYJ of tank vokune O NA Inspect dispersal Ceps) At Neat once every: 2 anon s is pw 3 years) O NA Clem effluent filter At Nast once every: 1. months) O NA Inspect pump. pump controls A alarm At Nast once every: O monthls) ®NA nxm Flush laterals and Pro$=* test At Nast once every: O *l 0 H El rnormis) NA At Nast once every: O s) odor: Q� NA MAINTENANCE INSTRUCTIONS a certifications: of tanks and dispersal cells shall be made by an individual carrying ono of the following following Master Pkunber; Master Plumber Restricted Sewer. POWTS Inspector, POWTS Maintainer% Saptags ServickV OPerstor• Tank inspections must include a visual inspw*m of the tanks) to identify any nvs* g or Waken hardware. Wentify any cracks or leeks. measure the voknno of con bud Mudge and scu and to check fat any back u or pondit of offluent a the ground surface. effluent krale in the observation p an d t chook for my ponding o oho�u ssisal � sl shell �visuslly a pondin of effluent on ground surfma may indksto fsEtng condition and requires the ground immediate notification of the local regulatory authority When the combined scamwistion of sludge and scum in any tank squats one -third (YJ or more of the tank vokow- the entire contents of the tank chap be removed by a Septage Servicing Operator and disposed of in s000rdsnoe with Chapter NR 113. Wisconsin Administrative Cods. AN other services, including but not lirnked to the servicing of effluent filters, mechanical or pressurised cw*wAnft. pntrasMwt units. and any servicing at intervals of 512 months. shag be performed *by s certified POWTS Maintainer• A service report shaa bs provided to the local regulatory authority within 10 days of campWM of arty service event- filMVll 14/00 ' Pegs of START UP AND OPERATION For new construction. Prior to use of the POWTS check treatment tanlsl � f hi9hs'are de�tactad helve the contents may impede the treatment process and /or damage the dispersal the presence of of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During Power outages pump tanks may fill above normal highwater levels. When power is restored.the excess wastewater WIN be discharged to the dispersal cell($) in one large dose, overloading the cells) 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 to restoring the war to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating controls to restore normal levels within the pump tank. Do not drive wn slope of any mound o at-grade dispe sal C ll Doionnot drive or park over. or otherwise disturb or compact, the area within 5 feet do Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the fife of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss, diapers; disinfectants; fat; foundation drain (sum Pump) s�� water, napkins; an tamgetablan� ling softener brinere.�I herbicides; most scraps; medications; oil; painting products; pest 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 Adminlsuative 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 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption by system. The replacement area should be f structure, disturbance � nes and wells. Failure to Protect the replacement u ar w 1 es requi setbacks from existing and Proposed 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. [3 A suitable replacement area is not available due to setback and /or soil limitations. Baring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. E3 The site has not been evaluated to identify a suitable replacement area. Upon failure df the POWTS a soil and site evaluation must be performed to locate a suitable . replacement area. If no replacement wee is available a holding tank may be installed as a last resort to replace the failed POWTS. absorpt systems may be reconstructed In place following removal of the biomst at the at -grade soil rM at that time. E3 Mound and -9 must comply with the rules in effect h s ys t ems infiltrative surface. Reconstructions of sue Y < <WARNING> > NOT SEPTIC. PUMP AND OTHER TREATMENT TANK UNDER LLETHACUMSTANCE8D DEATH MAY RESULT RESCUE OF A ENTER A SEPTIC. PUMP OR OTHER PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MAINTAINER pOWTS INSTALLER Name Name of ) T ount Ben Mor an Phone 715- 386 -21 Phone 715 386 - 2850 LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR (PUMPER) County Zoning O f f Q e Name St. C roix Name Tri County (Ben Morgan) phone 715 - 386 -46 Phone 715-386-2130. Administrative Code. This document was drafted in compliance with chapter Comm 63.22(2)(b)(tl(dl&(f) and 83.54(1). (2) S (3). Wisconsin . Pape - 2 - of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may Impede the treatment process and /or damage the dispersal cell {s)• If high concentrations are detected have the contents of the tank(sl 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; most 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 Ssrvicllg 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 ftom existing and proposed structure, lot lines and welt. 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. O 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. CJ The site has not been ' evaluated to identify a suitable replacement area. Upon failure 4f the POWTS a soil and site evaluation must be performed to locate a suitable.repiscement area. If no replacement area is available a holding tank may be Installed as a last resort to replace the failed POWTS. C] 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 tine. < <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 o h ) Name County Ben Morgan Phone 715- 386 -2850 Phone 715- 386 -2130 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Tri County (Ben Morgan) Name St. Croix County Zoning OffQ e phone 715- 386 -2130. Phone 715- 386 -4680 This document was drafted in compliance with chapter Comm 83.22(2)(b111)(d1&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.