HomeMy WebLinkAbout040-1308-00-167
s;oscensir CepartrncntnrCnm^erce PRIVATE SEWAGE SYSTEM C0u-1' St. CrGIX
Salety anc Hr. in ng Jiv s or Sancary Permd No
INSPECTION REPORT 607035
GENERAL INFORMATION (A] 1 ACH TO Pi RN11Tt state van ID No
Pe-sonal irlorrredmr Vou r'e'fine may he Jsco loi auconoor, r ,rpn'.e> [P vacy Ldv S 5 C.4 0: 1 Mtj
Per-,T HornP,rs Nr.--e C,l_; ViM je Tc'u'rSh P Pa'cel Tax No
Bruce Kondro TOWN OF TROY 040-1308-00-167
^ST BPA Lie, lisp. BM Llev 7 riot as Secnon:TOf:n~Rar'gcavlap Nn
166 l.a~- C 24.28.20.1986
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER t L CAPACITY STATION BS HIC FS ELEV.
Sept c Tr Z r Bonchrara I ,9 /d~• l ~d~
Alt BM V
CL I Grl t z •4
Aeration Bldg. Sever 5.O /O f • 9
Holdmg '111 Inlet 144 , /
TANK SETBACK INFORMATION SO It Outlet
G ~`7 Z
TANK TO PA VVELL BLDG Ven: (NA I Intake ROAD Dt Inlet
Septic ' T 9 `D Dt Belloin
Dosing Header.-Man 7.7 cycr
Anratio D'st. P'pe Z
Z,`Z 7
-fold rig Bo: System • 7 `74 2
"I'll' 7
Final Grade -7 /Oz • Z.
PUMPISIPHON INFORMATION
Manufacturer Dcmanc SI Cover Z . /
GPP,1 /6 AA -5
PACne. Nu
TD Lift Friction I oss System ITCH --rt
Forcemain Leng Dia Dist. is v^er
SOIL ABSORPTION SYSTEM
BEDITRENCH Voct'r f Lergth No C' I rrncP=s PIT DIMENSIONS Nu OI Htr. Ins ne C a. Li uic ~cpth
DIMENSIONS 3 z ` e C.-
SETBACK SYSTEM TO Pit. BLDG NJELL LAKEtSTREAM LEACHING tda'.u`ew 7
INFORMATION 1 CHAMBER OR Ill-/.,fir`.
S 1 till '0i-j4- UNIT 1,1cy N.;m r S~
e wJe 7 d
DISTRIBUTION SYSTEM Z.
-Icuce'1Van f9c r I Dis:nowe" x I•c e Sive x Hine Spacing Ve71 to%g Inl r
°T'isj L l/nJl
Le',g:h~_ Dia uengl0__ Dia _ Saac ng -
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only vbJ S
Deplr Over Dc DCr Cver xx Depth cl xx See-netllSOnned ued
Bed+Tencr Carter 41 L 8enrTwncl• Edges Icasoi ~ No Yea No
COMMENTS: rlnccl`.fde cone discrepences, persors present, etc 1 Inspection #I - Inspection #2*
Location: 322 LINDSAY RDC
1 1 Alt BPA Description = l • tL4.'_ 04-4.-
2 i Bldg sewer length = 3eJ4 4- l q= '47 / ill
- amount of cover = _I A.1 ~ Pan •evision Required, es /0 19
6 3~
Use other side for aoditioral infcrraUOn 1 _ _
Ce,l. NO
Dale I-Sep~tc ignalu
56~-G'1?Ilt 319: y
-0 3 S
nq Colanv '
SafeHanc 3dlms Grwsior s'-~'I, l
x` 2J1 ''A. Washin9tor, Ave., P.0. Box 7102 -
rnon Kumbc (to br in by 1
PS I !dadL r. Vrf. 4j37077 7162 SanGa.V % r", Co
- - ? j\
,"rTran, ,i, dxr -
S i ry mit "lpplic
la ...n Cn tq r4 rrJSSnr f 6i rrJ t' L a r - - a IJf,u n
.grua'. I n tc cStatninr 2 samta.7 permit 4",
. pe t .1t ~..Itu 1c u.t< wncd Y J :'I'. arc Buhr m d tc rctAZ/arrps rif d•.7ffaal: merlin?/[f^Mr-~sj 'fit ( I
tr IJ„ artncat f Safc:Y aid "'r t cyst:eu Sc l s t "r':xlal ml In„run _ p +i,i.. ul:* x r <:d Mr sc nEmZ 1y ~G t Gt' °yA- GI)'/
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1 anPlicapon Information -Please Print All Information t
I I ~.r:y O Mcr s Rams Pawl F
U 1Q_
i o erh Cmuer's 4laihn, .dress - Tnnlrert f ]Gill:;al
I 322 ~i
- ~ ~ T tuna v
rn-, .Scetr - - -
Ln.^:.+ •'h,n<Nua.lxr-
1~ . 5F 4 Sxunn
1T / h E i
. 1 ype of 6uildmg (check all that apply
_ F&-aly Dwc ::n~-Nl:mbcl of Hcnuartr_. 1 _ Sutq:+'uwc Name
i^.16ticr:ooLmacial - Usatbc :'r. C7j'°-y-~--` -
L I Suns Ow'w! - fhgcrM CSC SP.f Nyncla Villarc of
`/Uwu cf
,tl. 1 ~ r _ e Z-beck unl_ onx box on line A Complete hue H if applicable:
Vrw $YSICm Rcplacncri ys:nm ii Trcaz nru: _-J :d_n9 Tank Rrplar=c n (mIo [I Orb Moa. irvtmr in xiain, SYst• m (explain:
H. li P<,Zit nnl<w ' Jr-ma ir+ui a ,F:' : r Piunbv I I'crxtlc -:aade 'Jr New Ian Previous Permit ,NUmbc al:d fT.IL. ksuec
ton
iietor Ex-icn'1 ?wva
IS 'fvyr u I 1(1µ'T $vslem. Cnm patient 7/< ire. 1< he k all that rtppll~,1 - n
. V.,a Fres 6t-_rcrpd L P:cssrrle i -mo.q:c .41.-44r Mo:ct:i: ut. of Aatooke sod U M un l = ID. J0 Itabiv wd -Y~JS - 24 f. aur_'sA rilCrr ftt.-Ir_ouT
I; sFt. i:: Ll .rrrm,n Dc,.s laxplain;
S Dispersal Tre_aI ent Area Information - f,
m xl .w rn - - _
F 1~D..1 Cc t ail . p c o I atr rdfj Duppal µ f c uJ r tl/// ry a. _tar (n ed (s11 S•:; :i a p
S'L Tank Info i Cap h"n Iota) of
_ Gall t. al,Uns Cmts c
:•r link. mnF :..r.,
Ll Responsibility. Statement- L Tho_uedr-, ned, ASS AC reSpons_iblhrv for iratallauon of der POW i<showe oa thr attached plans
r IJnxr'z Nam Tlutt P..,._ :rnarte< - - r ';kf?RSNumbc Uus:ness Pbone Nwrbl
tr~ So
~/llllnrv.L11epartmen[Use Only
E CC1
Pc,nit Fee ~u eeu_d tA~'
r ~Jttd uSyarr:rr cell ctra[ all be ss per .aarayemen' plsn ,ue ov twnuc .
2. Ar aeftm* rKLitsl^ens mutA uc r..rt.,l
as pw pKi"m wdo , :rdirmre t, ituu w <r:mVktr P:a~c t.. Ilra ,^Jev..niA a:prnn w tba <b .nl. u Veprl nut Ir. nul ~ V : 1' ie<Lr. m ve
1DJ-G39x iR. I I I I'..
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'`I (~.ty'nrLCD 1~ l fti C.SV~-~61 I
U , ` `t I tt C/ C K,
Wisconsin Department of, merce 19 S IL EVALUATION REPOR Page or_
Division of Safety and Bur ings
in acoordanrx with omm 85. Wis. Adm. Code
r' n t Canty~t
Attach complete site pl on paper not he" thane . ches in size. Plan must
include, but not limted to. vertical and horizontal reference point (BM). direction and Parcel LD.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. G 27 ' 8 ` oil
- 0
Please print all information. R.Zed by Date ~j
perwn4 inlorm~rian you IYMM may tM uwJ tar wcondery parpwe6 (Pnvlay Uw. 6 15 OC (r f Imll V , /
property Owps Property Lecalion
10 Govt. Lot 1?4 S J 1 S T N R wE (o W
Property Owner's Mailing Address Lot u Block rr Subs o CS
14 7 77V
City State Zip Coce Phone Number ❑ City ❑ Village Town earest gpad
41 S`tt ( ) T ~ / L~
tt~-New Construction Use L Xe&cIenoal l Number of bedrooms _ Code derived d sign flow rate U>Z]-_ GPD
❑ Replacement ❑ Pubic ofL/commeroal. Descnbe'
Parent material 0",vtz e1 .Q Yom/ Flood Plain elevation if apPliCahie It.
arWreammendaudns: Z.,
System Type (/Y .SI/t) ~M 'iy Otani Flevahcr ( v1• L
F T] Boring# o Boring r_
Ground surface elev~ L' y ft Depth to limiting factor //S- ai.
Pit Sa; -Applcabon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMr
in. Munsee Ou. Sz. Cont. Color Gr. Sz. Shh 'Eflp1 'Eil
Z - r
a ,l
P,Ong Y n9 /
pit Ground surface elev[ 03! /ft . Depth to limifing factor ((J in. Sod Application, Rate
Horizon Depth Do mans Color Redox Description Texture Structure Consistence Boundary Roots GPD1ff
in. Munselt Ou- Sz. Cont. Colo Gr. Sz. Sh. •Ent •EBF2
I G~~ 0 f /
S Os ~,4 i . -7
+ ix
LLyl
Effluent p1 = BOD. > 30 < 220 rrxyL and TSS >30 < 150 mq,2 VEffluent A2 = BOD, < 30 mg.l- and TSS < 30 rn41-
CST Name (Please Print) Si. CST Number
Bird Plumbing, Inc. Shaun Bird 226900
?ddre5s Dale Cv luatton CondurfP. Telephone Numher
r, 432 120th St. New Richmond. WI 5401 715-246-4516
Property (`Ater Paroul 10 # _ _ Page of
r~ Soong # ] Boring /1
II c {J II t(L~ pit Ground surface elev./Y ~r r ft- Depth to limiting facia / in.
Sod Application Rate
lionzon Depth Dominant Color Radux Description Texture Structure Consistence Boundary Roots GPD#f
m. Munseli Ou. Sz. Cont Color Gr. Sz. Sh 'E##1 'Ef#12
ar
1 - 7-
Boring # ❑ Boring
❑ pit Ground surface elev. ft, Depth to limiting factor in.
Scxl prLcahon Rate
Horizon Depth Dominant Color Redox Descnphon Texture Structure Consistence Boundary Roots GPD/lf
in Munsell Ou. Sz. Cont. Color Gr. Sz, Sh. 'Eff#l 'Efl#2
❑ Boriny
BOnr'g # El Pit Ground surface elev. ft. Depth to limiting factor in. .
Soil Application Rate
l4cozon 'lepth Dominant Colo( Redox Description Texture Structure Consistence Boundary Roots GPDM
,n. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh- 'Eff#1 'Eff#2
'Effluent #1 = SOD, > 30 < 220 mgit and TSS >30 < 150 mgt ' E#iuem #2 = BOD, < 30 nxy'L and TSS < 30 rngl
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access smites or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
See M0 ix awl
fProperty Owner Parcel ID # Page _ or_
_
Bong III ❑ Boring _
Pit Groundsurfaceebv.JY1
~t. f.. Depth to Imling factor ~~in,
Soil Ilcalan Rate
Horlzen Depth Dominant Cokx Redox Dexenpt on Texture Structure Consistence Bourgary Roots GPD#f
in M_un_sell Chi Sz Cont. Color Gr. Sr. Sn •ER#1 •E1M2 j
/1
I•
I
1
i
Bonng # ❑ Boring
❑ pit Ground surfaceelev. Depth to limiting facto in
Soil Apo6:;ation Rate
Horizon Depth Domrtlant Ceiori Redoz Description Texture Structure I Consistence, Boundary j Roots __G_P_Dfff
in. I Munsell CIL Sz. Coot Colo Gr. Sz. Sh. •EB#1 •Eff#2
i
I i
i
I ~
i
Boring # ❑ Bong
❑ Pit Ground surface elev ft. Depth to limiting factor in, Soil Application Rate
Horizon •)epth Dominant Colorl Redox Description. Texture Structure Consistence Boundary Roots GPDAf 1
in. Mt nsell Ou. Sz. Cent Color Gr. Sz. Sh. •Eff#1 •Eff#2
1
I, 1
I I ,
• Effluent #1 = BOD, % 30 < 220 rtgL and TSS >30 < 150 mglL • Effluent #2 = BOD, < 30 mgrs and TSS < 30 mgt
The Department of Commerce is an equal opportunity sen•ice provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-315 1 or 1-1 Y 608-264-8-7.
Sei»uto ra rim:
rlto.n: Bruce Kondro Soil 'l'est and System 1'1.0'1' PLAN
SE 114 SF 1/4s /4s \ppgltss 322 Lindsav Road Hudson Wi 54016
20 ~'I' 28 Nm 20 W 1'owN Troy
1 COL N" TN' ST. CROIX
SI'S'I'I:N1 FLE'VATION 98.4. 7.6 5' helo•,v grade
5/28: 19 3
I)ATI. IIEDRooh1
coNVr.NTIONnI. xxx
CONK` If N'T ION; 11, I,IP'I HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT 'T'ANK SIZI?
DOSE, TANK SIZI,
HOLDING TANK SIZI{ LOAD NA'I'L. .7 AR)SI)RI"fION AI21?:A 651
_ # of chamhers 32
xL;NCnNLvltK v. R.P. Top of survey ;ron
A55tJNtr: 1:1.1•: 'I ION 111().11'
NUNIIIOIP Filter L*Cnx, Diller
O \v Ii1.L «ILR.P. Sameasbe.nchmark
B.N1. Lindsay Road
Property I.me "(Slope
13 Scale = 1/4" = 10'
50' '0. ;o
t3
20' Vem
20 >6" Qmck-t Sla1dard
of C)vcr Leaching Chamber
B-1 wilh 20.0 fit of Area
4 Long 5.6VI/pair of end caps
1_..
10' Grade at SNstcm Elevation
ST
2-3' X 66'cells with >3' spacin_L
I,
33 Pro 3
Bedroom
I foue
All Piping shall be. AST NJ SDR 30/34, within
10' of tank. piping shall be .\.S 1,M FS91
Plainview' Road
'tun,
ss t' Safety eno 3vilol !./1T
r D ys C•ivtsb t 1 -
S P 201 Vv Vdashington Ave:, P O. Box .''162 - I Ll~ ,
7vt;rdi~t.:M Samts~: vrn:rt c weer ;m be w,ed u. by t'o
Cl,' Permit .Applll:fl(1C)Il
1L 3Ciudau. w'rr: ~1 ` A J: ll'~ .Jm f sub n i n ut
die w drc
tt ia1;
y~:i¢ n -_tw.irrr s:c'u~pt-nrt 'PY P gosannicotnl wa:
:c r r. 'd L .a: n P>: ins f slat - _
'r:pa rmc S rr• ar, Lr ic'. a%nm S-r is r wmd } N, S m<sW untied io I Pe: ea AAdrcs -
'n .:a m ac v~ J : rat,,n r>v provi n:ay be "'d I:tt t r mda:~ '.d d;[tvlac Ilan : taiin~ a::iltxsi
~f ° o"' o t.w.c a,b •hc i rnac5' t.., _ r'.1.1 t ,o ci
L :1piiltc3uon Infnrm3n<o - YJlra_i Ynol All Informant,,
P" P=y Jwr s M;dmC Addr
C, n!.a'1jr
t iro L
Je 'heme luutber 7 ~
Cam, _ st_nm: a _ .11
ll 1 'pe of Budding (dlafe all that a 1 • - - - - t IC one
yt„ r ? ~an:h I7w'dhnr Number of P2d:oams I / ✓ F- - - -
OK'.. / Sil.'nll 1sirJ t\anrc - _-1
! n.biiu'Gn~c,c:al- rksribe (Ae 31:d:~ - __-~~CC>
Jkrl
rLl
$21e OuJCd ll~cna ; sr CSAA ~ - -
f~ - - - - _ - I ❑ biilagc of -
JrS~,5-f! C
❑f h5'p' fYermi(: H.hrck only une ux - TS -
nn line,A C omplele Luc 11 ifaPP e) ff-
r
I as S ,tnr Repl3taarrt wY;cn I~ T -
unlq
r ~ _ - - I I I L I rds M1todrpcNim tc xsnng Sysrem fexp,ainj 1
R I Fcns.t ncnrual ❑
9rlca 'xp: aor vac '~~r c Lvs M';evionr ?:rr,u. Fwl:M1a and
! 1 T':..'; y~.tfa :o Dic.A' 0181[ 15SUCd
t R' Typt nfP N'r~S~siemrC omLinoent UeSice: i( r - _ _
mph;
~~°~r"Pcsu <ul r-
:rd Arai 11-•:vi- -
I I I ` Ln. of wiea5le eod l
i ,@ Momrl :24 in. cf ui'i Ir soil
~ xta LI 'rsi , -n:P n n csplvm '
1)n ,ei sal ]rear - - - Prcoamnrnt Danz { xolam•
ment.lrea lnformenun _ - - - - - -~y _
cr Fiou kT t j fr.:Zn S :I .,.ylicatl .o rcu 1cr
l u a . -~1
/Rp pcr5al ) Area ~T
6' / f I;spe~ d ca py,MKed (sl? ~Svytc,r Llermor. - IN .0 ;L al -~-7 1J
auk Info - I
I ~ d11 .115 ~ F1ann:3 Y1,('er '
I ~ Sew lazhs - Gal'm:s ~ ]mtc
Y
ln-
([1 Heypungtrlhn Stairlu - - - _ - i T J
- L nee /d,. fur nvagI fao o of tl,r FONTS nn the evat6 plans. LIF l °Rr Numb, ?hem N er
.r Statc. dip
r1'QI County UcP~nmeul Ca pniv - - -
(r pQp1ouN I 9 apPrm ~ Farcn Fe- T T)ek LtSurv.J -T.. - _ - - - _
JNN~ ~()55 ST~~/,r5}~~'~r~~ .asu : A~,en Si_nanre
Lt((oudi6n11s of Xppmv;l.Rcesuns for
I 1 `Fph. la" k
tl : ,Alt 1
:h {rt~ni: tlf u_t be d'°t itlt+n-'~i ~ ~(wl-(.".,~ IwS~C~t,O V1 ,
ocrn>ar'1~1 n 'r'r + ~ ';1.-,, fl,.n:bcr. U l '
rl:--,:16uJt n..(};:u`:n:.n1:~u.::L1:•~ulditlia.nrsi. _ _
f . IL.:C ~Ur 1 . 1:!e CtrQai~luxn5 for dx S.~rru J. un:an r ,1 r. np o -
- Pap-: nn' Ir.
SIM-63981k 11;111
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 3/20/19
Owner:Bruce Kondro
Location: SE1/4 SE 1/4 S24 T28N,R20W 322 Lindsay Road Troy
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintance an ontigency Plan
7. Filter Cross S?c n
Signature
License number #226900
System PLOT PLAN
rRU.wc r Bruce Kondro ADDRESS 322 Lindsav Road Hudson Wi 54016
SE j/4 SE vas 20 /T 28 NrR 20 w TOWN Troy COUNTY ST. CROIX
SYSTFNI ELEVA•TUrN 885.0.885.5 5' below (irade 3120119 BEDROOM 3
11A'1'I•:
CON VENTIONAI, XXX CONVENTIONAL LIFT HOLDING 1ANK
MOUND SEI91C TANK SIZE 1000 gallons LIFT 'T'ANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers32
BENCHMARK V.R.I'. Top of survey iron ASSUME ELEVA HON 897.16' Filter Lifetime Filter
❑BOREIIIH.I? O WELL x11.R.11, sameasbenchmark
Lintlsav Road
Scale = 1/4" = 10' 247' Property Line
vent
>6" Quick4 Standard
of Cover Leachinsi Chamber
with 20.0 ft2 of Area
S.Gft^2/pair of end caps
4' Lone 3124" Grade at System valionL
i~
Pro 3 890,
Bedroom
house 2-3' X 66'cells with >3' spacing 6% slope
vents
30 B-167B - 6613
'T 100'
35'
All piping shall b ASTNT SDR 30/34, within 60
10' of tank, piping shall he AS NI F891
892'
muB-167C B.M.*
Plainview Road 5 50' 10
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 0.0 lit of Area per Chamber To be >1' above grade
5.6ft 2 pair of end plates
Finish grade elevation
/ Typical Installation 890'
Vent i Grade Vent
3 x/30/34 Septic Tank 3
5' Lone I 5' S' Long I
Grade at System Elevation
.4 -PP 36" Grade at System Elevation
Spacing_ 5'
2-3' X 66' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
16 chambers per cell
System elevations:
A-885.5'
B-'885.0'
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIMATICN FORM
Owner/Buyer Mailing Address
Property Address
(Verification required from Planning & "Coning Depantrcent fur new conshuctionJ
City/State- _ Parcel Identification Number
LEGAL DESCRIPTION
Property Locations i/. , Sec,~L, T Z_ Y N R2_~2W, Town of - -
Subdivision 7!c>~
"t#
l~
Certified Survey Map # _ _~1 ~l - - - Voltrtnc Page #
Warranty Deed # _ I l l I Voltmte _ ' - Page #
Spa house yes no Lot lim•: ideunfiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Tmproper 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 stroner, it needed, by a licensed pumper. What you put into
the system can aflirot the function of the septic tank as a treatment stage in the wash: disposal system Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance.
Ate property owner agrees to submit to St Croix County Planning & Zonng Department a certification frum. signed by the
owner and by a master plumber, 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 113 fail of sludge.
Uwe, the undersigned have read the above requirements and a6mc to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Departrreent of Natural Resouroea, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to ibc St. Croix County Planning &
Zoning 1)epartmcut within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my/our k aowledge. Itwe am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Dmis Office.
Number of bedrooms Brooms 7 _
Q ,n ~1//~
SI I A ' OF APPLICANT(S) DATE
"'Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department
Include with this application a recorded warranty deed from the Register of Deeds Offict: and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _ at_
FILE INFORMATION
Owner SYSTEM SPECIFICATIONS
Pennit # Septc lank Capacity
- Ca - ~ - ~al_ 0 NA
Septic Tank Manufacturer L NA
DESIGN PARAMETERS Effluent Filter Manufacture-Z
Number of Bedrooms - O NA
_ 1 NA Effluent =liter Model O NA
Number of Public Facility Units -
CL NA Pump Tank Capacity
Estimated flow (average) - - dal-I NA
_ 9~ (peak), (Estimated x 1.5) 3~Vday Purnp Tank Manufacturer NA
Design flow - -
- y-y-_ _ gauaa Pump Manufacturer NA
Soil Application Rate I - _
Standard InfluenUE?guent Quali T -yaoayi Pump Model NA
lY Munthly average' Pretreatment Unit -
Fats, 0il & Grease (FOGi 130 rn iL A
Biochemical p g SanalGr-ave! Fitter p Peal Filter
xygen. Demand (SOD;; <220 mg/L NA O Mechanical Aeration 0 Wetland
rotal Suspended Solids (TSS) I x150 mgr]_ _ ,7 Disinfection O
_ _ Other
Pretreated Effluent Quality Monthly average Dispersal Cell(s) - -
Biochemical Oxygen Demand (BODs) I ;3o mglL ❑ NA
Iota' Suspended Solids n-Ground (gravity) ❑ In-Ground (pressurized)
(TSS) --30 mg/LNA. G' At-Grade ❑ Mound
Fecal Calrfonn (geometric mean) :10` cfu/100m1
_ _ ~-1 Drip-Line 0 Othl
Maximum Effluent Particle Size d, in dla. Other. - - -
Other: ❑ NA
- - n NA
'Values `-J NA
typical for domestic wastewater and septic tank efeuew. O'Ser:
❑ NA
MAINTENANCE SCHEDULE
Service Event
Service Frequency
'Inspect condition of tank(s) _ At least once every. month(s)
years _ (Maximum 3 years) NA J
Pump out contents of tank(s) - - - TVVhen combined sludge and scum equals one-third (h) '
of tank volume J NA
inspect dispersal celi(s) _ At least once every: r1 D month(s)
- year(s) (Maximum 3 years) 0 NA
-lean effluent filter - - II At least once every: ~ nfh(s) - - - - - -
ear(s) ❑ NA
'.aspect pump, pump controls & alarm At least once every: 0 month(s) - -
A
'lush laterals and pressure test - - - 0 Year(s) LjLJN
At leas
t once every: ❑ month(s) Other - - U year(s) A
At least once every: 0 month(s) OherA.
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or ceruficatk:ns. Master
Plumber, Master Plumber Restricted Sewer; POV,r7 S Inspector, POWTS Mantainer, Septage Servicing Operator. Tank inspections must
include a visual inspection of the tank(s) to identify any :pissing or broker hcrdwaie, identity any cracks or leaks, measure the volume of
.ombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal tell(s) shall oe
visually inspected to check the effluent evels in the obsotvafun pipes and to oheck for any ponding of effluent on the ground surface.
the ponding of effluent on the ground surface may indicate a fading amd`:ioc and requires the immediate notification of the local
-egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of
he tank shall be removea by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
administrative Code.
,411 other services, including but not limited to the servicing Of e7!uent filters, mechanical or plessurzed components, pretreatment units,
rind any servicing at intervals of _12 months, shall be performed by a cerified POVJTS Maintainer.
A service report shall be provided to the local regulatory authchty within 10 days of completion of any service event.
Page - of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thr4t
may impede the treat,, am process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may 511 above normal hlghwater levels. When power is restored the excess wastewater will be
discharged to the dispersal calls) 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 pacer 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 vetude$ 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 s& 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; dgarette butts; condoms; cotton swabs; degreasers; dental floss; diapers: disinfectants; fat; foundation drain
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting pmduc#s;
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 safety abandoned in compliance with chapter Comm 133.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls 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 systelrn.
The replecernent area should be protected from disturbance and compaction and should not be infringed upon by requhled
setbacks from existing and proposed structure, lot lines and welts. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area, Replacement systems must comply with the rules in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Saratg advances in POWTS technology a
hang tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluapon
must be performed to locate a suitable replacement area. If no replacement area is avaiiable a holding tank may be installw as
a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltralve
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 Name
Phone
i
SEPTAGE SERVICING OPERATOR PUMP R LOCAL REGULATORY AUTHORITY
Name
Phone
► Ptta'e I -
r Y f
This document was drafted in corpliance with chapter SPS 383.22(2Kb)(1)(d)&(f) and 363.54(1), (2) & (3), Wlsoo re Administrative Code.
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46,304 S.F.r W
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E 319.38'
Lam.--.~.
56
200.00' 119.38' ~T BEGINNING "8" °f~/11.024 ACRE
T 16, TROY VILLAG FIFTH ADD/T/ON 6
2 \ \ / POINT OF
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g 168 0 _ 167 166
1122 ACRES Nn 1.140 ACRES r r 1.419 ACRES \
48,887 S.F. o • 49.644S. F.
\ \
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z S33.51'08"E 53. g
200.00' 118
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ffi~I__---_- W -
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' X14.1------
-I_ - - - - _ - 8131 N 88057'18" W 2656.68-
SOUTH LINNEJ OF THE SE' 114 - 'I---- '---~f 1
X58 j LOT 11 -C.S.M1 VOL. 6 1 LOT J _C. S. M. VOL. 6
PAGE 177J DOC.-
_J~21950 PAGE 1777, C. 21950
v:lscpt+sm. L:o~a:nrnnr at':~mmen;e SC:IL FVALUATION REPORT I'ega of
~IN9'G~ Of SsrBDi and Bwld'.ngs
in a rdei wall, CJmm 85•'Me. Adm. Code
Cwnry ST CKolx
Ati Odr119:619 Miff Dian On Raper IN loss Nan B b2 x ' 1 Ineres .n sIZ . ?Ian c
1Cu f,.b noU'mna6:0-+ edlurl and nnr2orltmole!ante point ;0M1, ra- CEIVFO&,o
:wrCBnt SIDDe,S:.alew:impns:pns, noon 8rtpw. arrd lOpBbon and dlsle to neareft road. r~ r
?BNnwBd
Plaaae print all Information. Ma
11e11a+44,r bri veu c+"We may cousei vi c~:.+••+W arv 'e..
%ar•JDa.ry Vwna PrppwtyWWllCn
~DNTINT✓A~/~l- UEVF~ilP•v~E NT COKE' Lpft`.•!cx--`-,b. rs St ? 7.S rl R •'_p 'N
+
•.Pmper G' nor s Mailing Addmss Iota IilorJC a W C'SWIN
~joO Ec~Et1 ~T.. ,v61 SUITE BOO _ IG 7 - j TfZS y V,c~AC 6 - ~,hr~oo; _
C:y, ':Lir:e ZD code Phone Nvnbar City _ village JC Tovm `•'eares: Hoed
4v I U.UDSA `ZOA1II I.
_J
pQ~
No. GN91NCion 1i56./y ResWenCalr Vuaa>x UI SWrooms ~ Code penvad design lOw taro :;?D I
I ~OrRepswrri J '~.buo or mrrveyrnBl•DesGiCO- - d -
Parent malenal L____._ t=1o0d G~aln utavaaun it nnd~~Ow _ ~}'y,'_--_. _-__Y.
GeneralL .irrnNs
-GK-03.sn)U -TR6NCNGS I
and recpmmondauons'. COrJ J 6tiT'1 WAL ZI3
Ali O,~ f,i)ADtN4~ IZAT6 I
(fit B l~ 31 rI
'z oq Ground sunace elev. L , r. Depth :o Imdtng taclor. Lb _ n
$OII Apolucatic" Rate
j 'iii Oeptr Domnan[COlor ,tadpx 7 ~pxture 3uoi i Conststenrel Boundary ) Is
r. Mimse: Co. ` Gr. SL Sn 'EtW, 'Egg2 _
o _ 3QVtiLiz faa.y q P '~G-- d- ~e~_~ o's
7-f CQj f' obKj 3,h Q, Z J' 0.5 0.3
_ I0\4(4 aVz - _ 7J Z=_m, Lh C3 - 12 - ~T-
II =iu
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L ' 3N-9zj IOYrZ't/f
f 7 ~IL"~(> l0 v- /LUI}T - ~5 rJSN
~ t tt(•przi/., 1 rti -1 c "1 H0i4 HAS V\ANI lat 14ce-i dar S HJNS ZS C/o 01 1
/ms~/ss~ ~I Baing r
don
I n q
q P'r il'r'J!W ell/t!C! fllpV `?,J • I_. T Dep1n IO IL•tuunq factor 145- n, I•-
I._ 2
kslion Rate 1 r 1
.wnxar' Japm 0anmax.Col Rrwox Oasmplon I -oxruro Stn.•ctso Corvlswncel Bourdaryl :4wi !3PCiN
n raunseuCu. :;2. Cunt CC:or :;r. 4:. S. IEtr i f~
I p_ i lov2~e 3 =m Y _ 3s ~b 3. ca, .5 CA
Z 7-13 IUY2~=~ - L ZFina ~.4, Ii b 'c
3_T'?"ZZ~L7t L Z= tn< d (jyi__ Zu+-m 0.3
4 ~2Z 0 51, _ - Is Im. 3~ S 07 Lz
5 I -57 .S4214 1 _ s 04 a e ~Ivf-i .7 ; I.Z
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' E'1uonr q: a BCC 33 < 2y0 ng't. arU -SS-30, '.50 mq/u ' E?i 42 • 800, _ 30 mgA and TSS 301
Name 'weaso Pant) Iranaturs 1 (S rdrxnow t r
i~ n``19s2-
I Ad"" '.ate Evelueaon Conducted 'Bleprono Number r
W98i5 1c'~Ade,~IV E.~ i-AtJ'JS 40~' Y_015
3 ~ •
%bAlr~w•,G.ITr~I~ C~6~1L-11)P-SOIL DESCRIPTION REPdFT ' Z`u 2S
ID.rt racn.,.~r_l ~nPJI' Coiep• Fi2C,^n v^'R\C~WhL 'R.orzlN~~~
ECT CowA_071ED T34 UWEFILJ<EAs ClZEAj E,u6c.uEEf1N6
inant Color I Utz" I Structure yGnssartr~l8n+*yYtgoots GPOP04
MunseN Cu Sz.Cont Caar Texture Gr. SL Sh. Sea Tnstn
x MnA
2fsblc mfr 3f 05 IO.I 3/4 1 R.4i4 sil 2msbk mfr
I I- cs Zvf 0.5 0.55YR 4/6 cbsY 2a-csbk mvfr cv 2vf 0.10.6
R R h!6' Osg a1 rw 1vf 0.? 0.8 i
1vf 0.7 'J.d
m YR 5%6 gs Oeg ml
ea"
a :1emarta:
x 1 10-L8 ':OYR 3i' si if-msbk lmfr 9w 2vt 0.5 0.6
2 2 18-30 LOYR 3/' si -csbk imfr cv Zvf 0.5 O.o
1 30-54
2 ,54-66 lOYR 4/2 Inil Zaabk afr cv lvf-m 0.5 0.6
yN) x IOYR 50 ~sil 3mabk Ituti Ics if 0.5 0.6
Gtottd
74.5 IL
-1 1 I66-72 LOYR 5/6 gsl lcsbk mfr Igm jlvt 0.4 0.5
Oeptl ro
inrlr9 2 2-85 7. SYR 416 ~ s Os ~ ai :vt 0. ? 0.8
hCta
Horizons Al and A2 a ear to be fill
~~.5 ?emarks:
Boring n 4 0-9 IOYR 3/3 t 1 !2msbk Imfr !av 12vf-tj 0.5 0.6
Y,.
331 B-;6 iOYR 4/4 1_cl, 2mabk mfr cv 2vf 0.4 :).5
;a p
CI 16-43 10YR 5/6 tads Ong ml v lvf 0.7 0.8
Grano
elev. C2 43-80 ~loyR 5/5 I s IOs MI I--- 1vf X0.7 0.8
892.Oh.
090:0
WMnq
80
9emarks:
8arht9 ►
A I0-9 iOYR 3/3 ~ 2mabk j mfr lav 12vf-f ;)-5-0.6
32_ 3 9-12 :OYR 4/4 Isi ~2msbk mfr cv IZv - 0
C 0.6--
111-84 1 a R
_
dw. I
893. Sit
DW to 11
~ndr+4 i -
> 84"
aemarxs:
~p.eaaocwaer~
C,CIiS1XIr:5,UTAL Oe\ALWf,MENI CCt~t~.
LOT 10, TKCV V t tLtN : , OF
TKCV 5~•LKO~X CGllh+~, v.;l_`~Cr.:`~~~% 5~8 SROa_~~f?E'~
- 1
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81678 B166B
ELEV. 890.2 cLE ®9Z 'C
_892
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8 16 A 8166C
ELEV 887.4 g167C ELEV. 897.2
® 218.15' ELEV. 895.1. -
~H-Cy c~
Parcel 040-1308-00-167 °2'0` 2~" 10
PAGF 1 OF 1
Alt. Parcel 24.28.20.1986 04(.- T-1,I` N OF TROY
Current X ST CRCiX COJNTY, 'v','IS;:ONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
02:1012004 00 0
Tax Address: Owner(s): 0 = Caveat Ov nur. C = Cut,ert Co Owner
O - TROY DEVELOPMENT CORP
TROY DEVELOPDAFNI CORP
11806ABERDFFN ST NE STE 290
BLAINE MN 55449
Property Address(es): ' = Pnrnarv
' 322 LINDSAY RD
Districts: SC = School SP = Special
Type Dist # Description
SC 4893 SCH DIST RIVFR FALLS
SP 0100 CHIP VALLEY VOTECH Notes:
Legal Description: Acres: ".140
SEC 20 T28N R20W PT SE SE. BFING 1 ROY
VIII AGC 6TI1 ('04) LOT 167 (1.140AC) Parcel History:
Date Doc # Vol/Page Type
0211012004 753934 091100 PLA"
Plat: - - Primary Tract: iS-T rt 4D-m 16o%. BlocklCondo Bldg:
' 09-100-1 ROY VILLAGE 6Tt I ADDN 146:168 24-28N-20W SE SE LOT 16
2013 SUMMARY Bill Fair Markel Value: Assessed with:
236824 65,800
Valuations: Last Changed: 11r09r2009
Description Class Acres Land Improve Total State Reason
RFSIDENTIAI G1 1.140 75.000 C 75,JJ3 NC
Totals for 2013:
General Property 1 140 75.000 0 75.000
Woodland 0.000 0 0
Totals for 2012:
General Property 1.140 75.000 0 75.000
Woodland 0 000 0 0
Lottery Credit: Claim Count: 0 Certification Data Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0 cc 0 cc
• I~ ~ NNf*1
OD C)
I II U 66' WIDE l NGL1L S.S
C AJPD~Z_97ESS EA$E•[ZrN_7
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Q) I
4.27' 200.05' r v - - -
I 4 I
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I~IO I-W7Drk- ° O i ncDj Qp I o I
I I va
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I I I, ° I~
N 01°02' 20" £ m III
v I I I ` 244.35' u IZ
I~k?z I I~ I I~ I
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M "00,00.90 N
VARIABLE rn
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0 1 /
r I m,~ o
a CP tt
I~10 I I I
Ic~l~l Z 100' ono Tm m
0 t '
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101
ICI . I .
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0) w
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V
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00' 00" 11' > m
r` I~IO I II ~ I ICI WIC _ 312.65=- tO_ '
02 AO N I ~O
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I`_n I ~I v I T~ I O c7 V' D 1 p I l1'/' W N
~no
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ISM I I~~ I~~I ; 21 N 00°31' 46" E ~tmn /G4
v I I - -325.00'
Wsxcrsfn Doronn~int of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3
Labor and.Haman Rslabom
Dvisi--n of Safoty R Buildings in accord with ILHR 883.05, Wis. Adm. Code
• ~C'J'fTY
Attach complete site plan on paper not less than 8 v2 x inches in size. Plan arfst inc:udo, but
rot limited to vertical and horizontal reference point IBM), direction and of slope, scale or FARCEL LD.. tZ~,f C,I j 6.
dimensioned, north arrow, and location a :id 6stanco to nearest road.
APPLICANT INFORMATION-PLEAS'c PRINT ALL INFORMATION RF+''•FNEDBY DATE
PROPERTY CVVT:ER: RC=ER7
'/(IX:A"C)'1
CO V`jl l.I tv'1~7CPt'L 11kZtJ~f•'1l~VT Cor-p• -~•'b lit SC+i4.SZy 7 -Z-~S N,R Z_0 E(- W
P9CPcRTYCWt,ER':S S!-J-1'JC ACCRESS i CCK e SJ20. XNAVE OR. CStJ a
\ Z? 01 LSIJ\laiC. ~NU~E Q.t`. L3cV - ^ U"• %J V't.hG4~ u►- . / 6'~
CFY S-A.:E y,~, ziP cc -DE P~CNE 10.1H R
J~fCV/"! Sr ROAD
LA. LtC1)V~ I"rv ; Lt!.,OS1~''f 124 M~
I%L New Corstr[cllcn Use (~Q Residential i Nimter ci bedrooms Ac-.S n lc existng bu di.ng
j ( Replacement Pubt- or ocmmercial describe / I k ' ~I l'_ 0 T < =
Code dc7rfad dai'y flow boo gpd Re cmrnencec desigr Icading rase - t[d, gpolf12Yench, gpd,' 2
Absorption area required bS B bed. lt2 -15o rerch, l;2 Ivtx:-u- desier'oadine rate . • 1-_bed 9?d;ft :ranch, cpd.',t2
R[wmcended irFli atom su ace e'.evationrsl &3 T. O - 60d.o h ias referred 's sire plan benchmark)
Additional design l site ccnsideratons t✓J C l O Ire T tr'-Lzl ofJ - ~ t\Ge 3
Parent material ~o~s9 oy~2 G~rtetRC. t>uTfNr~SN Flxdplaine:raa;icn,ifaaplicab'e tiA h
J= Slalatleh)t System CONV--%MQNA- t.1G_NJ ' IN-nRa."; L. ~FC'SC r_ 'TC0.A".= SYSTEtd NFILL F-ctoitr. TANK
U = Unsjilib'. for system Lk1 S ❑ U L'1 S ❑ L' ! (RS ❑ L I ?a S ❑ L Ms L] L I ❑ S RI u
SOIL DESCRIPTION REPORT
Depth Dominant Color .to-n- Structure GPDiftz
crin # Horizon exture C rssance Fbr~"~y Roots -
3 in. Munsell Cu. Sz. Con!. Color Gr. S::. Sh. Bed IT,~:
6 )D~1v 31Z '\rI nl - S I
A : I o-1
L .6-3Z l0 ~h.3/f~ 6rSfl Z'rn S'd'¢ O Sh CS - S .h
-
Ground 3 zao7 ~_5 iR 31~ I~dur pS9 d 1 - •1
eev.
:i'3s_S 1t
Depti, to - I ------I
IiTidng
factor i
i i
Remarks:
~3qn g #
: ; ; J o -l o L' H tz 31 Z ZM 3 Vir" s \1 tA.j • S - v
'b to-zy lwiR 3/6 Zm 3V" vS°,1~ eS I - S ; -u
.<-w~, . 3- v_lo7 ~.S`/a 3yy _ _ I Sol st- o S9 d 1 - ':..x
Crcund
Cev. I L I
C9v.~,t. - I I -
Depdt 10
lir...tng 1
factor - • - - -
> lOl` i I ~ I
Remarks:
C-S Namo:-PleasePrnt Arthur L. Weoerer Phone. 715-425-0165
vegercr Soil Testing 1& Design Service-P.O. Box 74 River Falls,Wl 54072
SicmC:e:- ^~~'!^"~'~'~►C--- - -j9-Z47 _ 138 gate; ~Z- lE-Q~ CS7`-:rber'. 0 5-r-
PROPEBiYOWNERCttiIJM.Itx1Z'td U`L. SOIL DESCRIPTION REPORT
~~NL~IlvL. _ Pa9e?of PARCELIDp-
Do,i9q _
8 Horizon Depth Dominant Color Motu Structure
in. tvtunseII Ou.Sz.Cont.Color Texture Gr.Sz.Sh. CoosistenooDourclay Roots GPD/it
C o-L, lb-AVZ '3/t - - 1 _Led )Ttmdt
2 z3-t(L I iO`iR 3/f, i- - - 6-
f _ _s I 2 wt S b4c_ wt (1 _rc g _ S b
n;cnutd 3 Iy2-fU3 ~ 5`/(z 3/y - S Gk
E9UAp.
limilirt;j 1 -
Iarlor -I - - _ - - - -
> 103" -
s.: ~ 0-11 Il~`itr 3r t- -
A 2 -32 tO Y2 3I'G -
2~sbk ash cs •S •6
7 Ill
G:uund Y S Gr O S9 OZ,
e`>6 91t - _ -
Lle:Ti to
14oibna
t~rclor - I - _ f
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