Loading...
HomeMy WebLinkAbout231-1047-70-040 F Wisconsin Qepartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Divisioq INSPECTION REPORT Sanitary Permit No: 404994 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: y— M Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. � /K Permit Holder's Name: X City Village Township Parcel Tax No: Mueller, Kenneth I City of Glenwood 231 - 1047 -70 -040 CST BM Elev: • 0, Insp. BM Elev: t BM Description: CA .O kV Q& GiT Igo t TANK I FORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS H FS ELEV. Septic r� qq Benchmark q r �J �.SE =Q. Z� `� • 1 D — C7- . u Dosing l Alt. BM �. Aeration v7 np Bldg. Sewer �( O O' �g� 1 y Oq Holding St/Ht Inlet LA 11.00 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic loo 2-2 , Dt Bottom t 5- 2 Do k ti 1 0 -13 sing u l y Header /Man. ' �.- 3( Aeration Dist. Pipe /a 9!0 Holding t. System r •�} .Z3 _ it Final Grade N PUMP /SIPHON FORMATION !G IP 5 .,� �,;L I.L i Z + - -aa J Manufacturer emand St Cover L Model Number M '1� /� p DH Lift Friction Loss System Head TDH Ft � ,� •o t 3,�- 120 .9!; remain Leng h t Dia. r l Dist. to well �♦ W 2. SOIL ABSORPTION SYSTEM BED/TRENCH Width Length INO. Of Trgn PIT DIMENSIONS No. Of Pits Inside Dia. IlLiquid Depth DIMENSIONS /_ / (Or f SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHI nufacturer: INFORMATION T e Of S stem: f CHAMBER YP Y l S t (_ � � / U umber: DISTRIBUTION SYSTEM Header /Manifold Distribution 1 x Hole Size x Hole Spacing Vent to Air Intake 3 t �' Pipe(s) ' 1Z - 5 ' 0 Length Dia Length Dia Spacing '1p 1 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only j Deth Over Depth Over xx Depth of xx Seeded(Sodded xx Mulched B.d1Tr.n.h Center Bed/Trench Edges Topsoil i Yes No 1 Yes No (9 COMMENTS: In d o e crepen ies, per pons present etc.) Inspe do 1: O +/ l / e Inspection #2: — 7 Loc tion: Glenwood C[t , WI 5 3 (SE 11 SW 1/4 2 T30N R15 Glenwood Meadows Lot Parcel No: 27.30.15 1.) Alt BM Description = L"_�_ et�ef� 2.) Bldg sewer length = 22 / X [� tl,,,, - amount of cover = ? 2 S°' 3. Contour = 3, (0 444 �- -loo CFA• ��(• -- - -- -- -- - -- - - q - -2 i - -- other side for additional informati n. 1 2 ' J O- _ P n revision Re wired? xrl Yes 1 - Cert No. No Date Insepctor's Signature 710 (R.3/97) f I H Safety and Buildings Division County All 201 W. Washington Ave., P.O. Box 7162 5 j ! , C cp 1 N V&4�onsin Madis n, WI 53707 - 7162 ' Address De artment of Commerce et 113 SAddr Sanitary Permit Ap li `ar Pe Num m In accord with Com 83.21, Wis. Adm. Code, personal i rmatiREGEWED � may be used for second oses Privac Law, 15.04(1 (m ❑ Check if Revision I. Application Information - Please Print All Information State Plan I.D. Nwnber PR 0 4 XM91 Property pwner's Name Parcel Number 2--, gp • (5- ST. CROIX COUNTY 2 (_ M1 _ 1-0 _ 040 Property Owner's Mailing Address Property Location 0?9� w A 11 34 r 5 0 %,S 7T DN RIS A0 City, State Zip Code Phone Number Lot Number Block Number 10" 44.0004 C 1 (•mil 5-Y, 13 Subdivision Name CSM Number /� V / !i )en w.�,jQ Xe - , 1 1W. 4 '� 0 V 1 P y H. Type of Building (check all that apply) pker S wb ww ln, G tPzl -or 2 Family Dwelling - Number of Bedrooms __ / ❑Village ❑ Public /Cotmnor ' - Describe Use ❑ State Owned C( �,� R • $0 Township Nearest Road ' � K/ 0 Mv. -J t tW = (o.g 5 fA T v A fir M. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete lid B if app cable) A. 1 �PIew 2 ❑ Replacement p For County use p System 3 ❑ Replacement of 6 ❑Addition to System Tank Only Existing S stem B • ❑ Check. if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(nutnbering scheme is for internal use) 44 ❑ Non - Pressurized In•Ground 2J-Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min. /Inch) Elevation ,,/, &D 4 to . a9 88. Z yo. L / VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks I Tanks Septic or Holding Tank Dosing Chamber ©a 4 ��- VII. Resp onsibility Statement- I, the undersigned, assume respans bility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signature MP /MPRS Number Business Phone Number e ,�� .e o Plumber's Addr (Street, City, Sta 'p Code) L O r -r ; VIII. County Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse . ! — Determination 32 . 2,tv IX. Conditions of Approval/Reas for Disapproval V1n,LtMwUAV%. `0 .�` ` 5 0�0� n w C s �" &a.." w{Dt A op � Count only) for the systemloii paper not less than 8112 x It inches In size SBD -6398 (R. 05101) �z 1 loo ! cl^ jQ s J 9 fA i i a a L14 9 �T4 t A . ♦ r : C4 r LA ao 9 IT _ o y 3 s IP I d 3 -4 tj go Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 �sconsin www. w ww.cornmerce.s tate.w i .us/sb wisconin.gov Department of Commerce Scott McCallum Governor Philip Edw. Albert, Secretary March 08, 2002 CUST ID No.225094 A7TN.• POWTS Inspector ZONING OFFICE MICHAEL P ROGERS ST CROIX COUNTY SPIA N4563 320TH ST 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/08/2004 Ide ID l) 1 ' rs Transaction o. 71118 SITE: Site ID No. 6417 Ken Mueller - Surrey Ridge Trail Please refer to both identification numbers, Town of Glenwood City above, in all correspondence with the agency. St Croix County SETA, SWIA, S27, T30N, R15W Subdivision: Glenwood Meadows - lot 9 FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 831578 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. P O. �Qritl n Co al l .v ' MICHAEL P ROGERS Page 2 3/8/02 Owner Responsibilities Continued: • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim@commerce.state.wi.us Ken Mueller - Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01/01) Location: Lot 9, Glenwood Meadows C/f SE 1/4, SW 1/4, Sec. 27, T 30 N, R 15 W City: Glenwood City County: St. Croix ,, z Date: March 7, 2002 Q Owner: Ken Mueller tJf Address: 294 Magnolia Glenwood City, WI 54013 ; Plumber: Mike Rogers Signature: License # MP 225094 Attachments: 6748 -Plan Approval Application SBD -8330 page 1: cover 2: design criteria & calculations 3: plot plan "`PA RTMENT OF O r OIVISIgN MMERCE 4: system cross section SAFETYAND BUILDINGS 5: plan view, lateral detail iir 6: pump tank exit detail SEE CO RE 7: pump curve NDENCE 8: system management page 1 of 8 LL Design Criteria Y trS Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 l°' " 0 gallons /day hydraulic load Design Calculations In situ designed loading rate - L -t gallons/sq. . ft. per da g g g q P Y Depth to estimated high ground water z a in. Depth to bedrock > IA in. Cross slope at system (9 •$ % Force main length tsY ft. of Z in. Manifold /header length 3 ft. of in. Drain -back 16 gallons Lateral length @ S+b . o ft. of Z in. Lateral elevation ft. @ bottom of lateral 3 - Lateral hole size 1 6 in. @ 4r % • in. ( g'• ft.) Spacing % holes /lateral holes total Lateral volume • 4' gallons Total lateral discharge rate ' gallons /minute @ Z '�� ft. head Network pressuror compensation losses �� ft. Elevation difference ft. Friction loss ft. @ 3 � gallons /minute Total dynamic head ft. Pump / sioon Sa gpm @ z ft. of head Manufacturer �� • �-� Model # S 14 Or— S n Dose volume q gallons Lift /siphon tank gallons Septic tank Z'b gallons Effluent filter Measurement um on and off � in P P Height alarm from tank bottom in. Reserve capacity 5' gallons specs.calcs.res Page 2 — of %f s .� t o c t cl • F-- ' e d ; L14 to d � � •l� nn'' � V M v • Ir Lb y 9 �/► '" 0 � � . ��"� C� e�'L .� t — � ; o 0 + CA d J � 9 Y-c Sc r 4L (L CNN w.�. ��.►N• J c8 $ Z / 1 Mom" \ 1 r� f C O ti o �- . 4 �t4b' N o �. L •. � � 7 �" �1 �. T �. w •. v� w. ?4 �^ � 'nH v+ `�^�"1 O � ♦ � C 1Y 1d w : T p . 4� �- 4 � 1p •.�. (� v C o �o l �r v � •+: o ti �..'a l` � i-o b . •L � o .. O � r o c. k �O �•�. N • C. Oya. 4 •�LIt �F 7Z 10�(.O� `o..� `� �172m e 6 r N 2 '1, S � o�p �•�c AA� � �1n � 1 w.1c ` � � w ► ` S ts, No oo W4 3.0 1 4 :.c., X.0, o l C 4 o �� O,•r T ' �S L > � • In b ••., , 3 4 .3 2.. .•., � � ...1 � �.e� � 2 .� � � e-.�C. otter k ► ti TVA 1 L . WEATIIERPROJC UNCTION LOCKING COVER J "U t,,w, A 711771777 MMMJMrJF �IIICK p1�GO�IY�GT""1 4 P P�v� 3' ,np NpISTUABED SO IL 24" � d YENT Nuwu0LE w �w[tc ppPltovt.c A �` P v � I I 6KET 3bJIJfJ WFLE 1 AL &W.T 3' owo .I. PIPS d ON „ �) w4>4T% iRb )" ECTI OK4 —�— —/ - z- ` s . 1 . ' - \ O \ (j RDu►i0 I F ow PtxyP � BIZ.. aq.q �•� b" C L7V. 6coc�C E TIC i S E G I IJ o P P IF Q S S DOSE TANKS MALJUFACTURER: W e1Rk QUPACER OF DOSES: PER DAZ TAWK SIZE: GALLOWS DOSE VOLUME ALARM M WUFACTUKER' S,� FI "'��O INCLUDING BACK /LOW: GALLONS MODEL WUMDEK: lo CAPACITIES: A= 32.b 11JCHES OR GA LLOWS SWITCH Ty /L: :b wpb 9 c '{ IWCHESOR � z GA PUMP I\AQUFAC.TUAIR; `��`'" " C ■ ��� IQLHE$ OR 1E9 ° GAL6. OU5 MODEL WUMOER: S \4V Sb 0� 6 INCHES OR Ct GALLONS SWITCH TYPE: __ "1 O WOTE: PUMP AMD ALARM ARE TO bC MINIMUM DISCHARGE RATE 34.4 INSTALLED O SEPARATE CIRCUITS G1/1 VERTICAL DIFFEKE i 1, 'Q�� f OETWEf►J PUKP O F F AUO OIS RI�UT N PIPE.. T T 10 P E.. FEC 1 + MIuIMUM NETWORK SUPPLY PKt&SUR .. . . Z.J FCCT O ' +l C + ISg IFFY OF FORE[ MAIIJ X �' � F /poFxFRICTION FACTOR._ FEET 3�� TOTAL OyWAMIC HEAD = FEET IQTERWAL. DIMEW61OWS OF TANK: LENbTH__,_;WIDTH � � ;LIQUID DEPTH DET AILS ENGINEERING 1 11 4 Performance Data 30, 100 Pump Characteristics 24 80 Pump/Motor Unit Subesetdblo j Naetnl64odels'SO M1 M2 N3 Ma NS w SNEF100 AciowtKModels At A2 ! 60 -... fdl Love A s 15.0 7.611J 1.2 0 SHff50 Motor T YP* Co ii!9r NO 3 6 = 12. % 440 R.P.M. 4 3 SO R IP , hose 1 8 3 B Vitha g IIS 2C4.230 208.230 460 SIS 6 20 Mwwel AWil 0 001 M4 A3 1 M4 11 j I A vatic Meeois A2 Y I Hmse wtr 1 Q j full land AM s I t 14, 12.1 a.e /sa 2.8 1.9 Capacity-U.S. G.P 1( C 20 40 60 80 100 Mesa ! Co eater Start 39 RPM 3470 Lilers/Secord 0 2 4 6 Photo 1 0 3 0 Total Hood (Iret) 1 25 35 45 55 65 15 90 Moir a 1 206 - 230120-2X1460 1 575 (n) 4.9 1,6 10.1 13.1 16.94 19.8 22.5 21 Vert 60 1/2 HP (US GPM) 63 SS 41 35 18 Teivomiure 140 f Max FIUI T6n . -- - -•- WAA Des n l 11 /1) 4.0 3.5 3.0 2.2 1.1 — — — Lewlctton Class 1 1 HP (US GPM) __ 81 81 1 14 65 50 3 0 Disdior situ 2" NPT S td. (1/ — t 53 I 5,1 1 4.1 4.1 3.2 Solids Hordilli i,iit Witit S 1bi.15o1 65 16. 11 00) Dimensional Data Fower Cord 1 SV, 14/3, 51TWA; 230V, lo, 16/3 ST1V•A; 3a 16/4, STW•A 1 All d,mvneions in rncnes. j All cords 20' $td, Kltls 30' opt, 2, Component c1 nansions ma very +I. 1t8 mch. 3. Not for construction purposas unlvst CCnai6c Materials of Construction 4 Dimensions and weights are apc _ 5. W4 +ecsrvs the •ighl to intake revisions to our pruduas and tnoa Hande Steidess Steel spoeifl "ItlarG wilrrpu; 'tutiCtl 6. r switch ?,eiutrmat:r. mare's Only; Lub icminy Oil pialactru 011 1-4 Moia HousieS Carr Irol r" I Puny Casitp Cmt iroe ' ' _ ' I S++efr Staidni Steel ..f..... Jb MS��• . Yserhaexel Seal locos: Corboe /Caetaic Shaft Sec! Seel Body: Bross Sprfel: Sreltdess Steel it n BaNaws: bu►a -N krpoler En5lnor►o ThrmePiestii +. �cuuec ! Upper Beonng j Simla Row Ni Benaieg lows &acing I Sinlik Row W116miey ►sham P410 Poiyeslaa (weed Steel laS'l11215 Slairdfli Steel y _..- ... i J I lags En;ineree Therttteplestir SHEF54 SiHEF 100 Sh ay 1840 Bane Road �T �a Iri HYDROMATIC y x ` Led Ashland, Ohio 44805 '� ' ire.... T w \ System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715 -235 -1132, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water- saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. , 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. I f the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 t Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code '74 County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. --l0 -7e — O Q Please print all information. viewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). R Property Owner Property Location C D M e O Govt. Lot SC 1/4 5(,) 1/4 S e7 P T 3o N R OW) W Property Owner's Mailing Address Lot # 1 Block # I Subd. Name or CSM# IV q G e tti&v Af e,447kr CW V State Zip Code Phone Number City ❑ Village ❑ Town Nearest Road Sf Plf 4 1 // t 1,57) - AW G &-ea eal G/ 7' I Swix e l , Il [$I New Construction Use: W Residential / Number of bedrooms Code derived design flow rate L/. SO . 1 GPD ❑ Replacement Public or commercial - Describe: Parent material L-T�'4 C/ .4 L / �t / Flood Plain elevation if applicable ft. General comments and recommendations: ST C�p►X F/-] Boring 2 Boring # ; Pit Ground surface elev. . ft. Depth to limiting factor — � in. Pi Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 AM &A S L 6 ME 4S a l" -.2f o S_6 A,d CS s 6 a 3 6�•� R 3 c ah,6 M LG V .d o 10YR AZq 6 Ch 6 MV ®Boring # FA Boring ff � FA 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 2- JAI- /6 -? S' j 7,1- dMAJ if A4 - C S - 2 3 o - s S M - 9 -6 M M 6 yM C 3 0, -W M y ,t' . z C� 1r s Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gi4,C G� SN/ w 7�" l v .12 - :D 3 Address Date Evaluation Conducted Telephone Number SO 2 Property Owner e /em e iy ` 6 o lh e e Parcel ID # .23Z- &k — / e1 0l/ AO Page of 3 FT Boring # ❑ Boring ® Pit Ground surface elev. b ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 l o- l 3 S /,G .2M s6 Mr= A S A 8 .2 4. A6 r F 2 At 1 P , C 6 k MI/Fs S eh / S a Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 E3 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. 11 pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOD4330 (8.6/00) zo o 1 C7 7a fik ol ----- ----- - -- - -- 1-7 -L-2- { I i � I I ! i I I I I � � � I L _1 _ - J-1 I� - I I � l_ I L I I � -� - -; r--, 1 I !- � � I I , i rs I 1 I I ! � -- _— l i p___ - - - -- �_ ' -__ - -I - -- -� -' - -- _ _ _ - ; --- � - - - -I� - - - - -- I ' - :_ I F-7 POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner t . Z l �G�- Septic Tank Capacity a 49,P gal [3 NA Permit # Septic Tank Manufacturer. �,vi sr ❑ NA DE' Effluent Filter Manufacturer /� ❑ NA SIGN PARAMETERS Effluent Filter Model E3 NA Number of Bedrooms 100gpd/bedroom y ❑ NA / ma Nmmercial Units NA PUMP Tank Capacity pv gal E3 NA umber of Co Estimated flow (average)* lot) gal/day PAP [3 NA T� Manufacturer , ,e .,..- [3 NA Design flow. (peak), estimated x 1.5* oa gal/day Pump Manufacturer , Pump Model o ❑ NA Soil Application Rate j, 9 gal/day fr Pretreatment Unit ❑ NA Influent/Effluent Quality (NA 0) Monthly Average ** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) 5 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) ::5 220 mg/L [3 Disinfection ❑ Other: Total Suspended Solids (TSS) Manufacturer: Model: 5 250 mg/L Dispersal Cell(s) Pretreated Effluent Quality [3 Monthly Average * ** E3 In_ground (gravity) E3 h1 ground (pressurized) Biochemical Oxygen Demand (BODs) 5 30 mg/L ❑ At-grade 44Mound Total Suspended Solids (TSS) 5 30 mg/L ❑ Drip -line ❑ Other. Fecal Coliform (geometric mean) 5Wc fu/100ml ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate _gp olft 2 Area Req. (Other than bedroom based) Absorption Area Credit per unit Minimum Number of Chambers ❑ Aggregate Design Flow/Loading Rate= fe min * * Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ . "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 ❑ SBD - 10570 - (8.6/99) "At Component Manual Using Pressure Distribution" ❑ SBD - 10567 P (8.6/99) "In Ground Absorption Component Manual" ❑ SBD - 10705 =P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD - 10628 -P (N.6199) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656 -P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD 10572 -P (86/99) "Mound Component Manual" ❑ SBD - 10691P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD 10595 -P (R -6/99) "Single Pass Sand Filter Component Manual ❑ SBD - 10657P (8.6/99) "Drip -line Effluenf Disposal Component Manual" ❑ SBD - 10573 P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD - 10706 -P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months o1 -year(s) (Maximum Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume InspRf dispersal cell(s) At least once every ❑ months tayear(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months )ZLyear(s) Inspect pump, pump controls & alarm At least once every r_3 months J&year(s) ❑ NA Flush laterals and pressure test At least once every ❑months ❑ year(s) E3 NA Valves At least once every .❑ months ❑ year(s) ❑ NA Other: At least once every p months � ❑ year(s) ❑ NA Page of ❑ Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Baring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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 CONTIAN 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 M t,ec Keo .e r S Name Phone 7 1 z Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name Agency Phone Phone KAWPDATM1EMPOWTS OWNER'S MANUAL.doc Page of I WART UP For new construction, prior to-use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents 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. OPERATION The Pr P o erty owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/frait peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ❑ Valves Valves shall be operated in the following manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) "more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NRl 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. ' 171 mvity Component Dispersal Cells shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any uface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory ading at depths greater than 75% of the height of the component may indicate overloading or impending lure necessitating more frequent monitoring. Page of a Y RF cF Private On -Site Wastewater Treatment System (P c Index and Title Sheet ° tii ° %� 0� tiC° CO Owner: �Q�►�' Project Name and System Type: Location: _ L� -w" 9 Street Address S Slv 47 30 Zs - 4 ,2 Legal Description , Township /County Contents: Page 1: &n Sz Q,au Page 2: _ Am 04 9u Page 3: Page.4: Page 5: ��n• .�, �� o Page , Page 7: Page 8 A /1. .. Ole 1',� s A Page: Attachments: r' Date: • ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND pp OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address %. e, 10;�d 12, 41 Q'('tm� a, erification required from Tanning Department fo w co truction) City/State Parcel Identification Number LEGAL DESCRIPTION 0A f7,4 Property Locatio ' y �1L /., Sec. ,�, T�N -R�W, Town )of of Subdivision ► fQ�(��I 1�� Lot # Certified Survey Map # , `� , Volume _ Page # Warranty Deed # Volume , Page # Spec house ❑ yes I no Lot lines identifiable ❑ 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 masti;rplumber, journeyman plumber, restricted plumber or a liceasedpumper 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 that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the thr year expirati 3 2c o / / I NATURE d94AI&ANT DATE ^ OWNER CERTIFICATION I (we) 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 prop d ri d above Virtue ' of a warranty deed recorded in Register of Deeds Office. 3 / 2g / oz NA F ICANT 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 03/28/02 THU 13:30 FAX 713 386 4687 RE OF DEEDS PA6t: nn�� f�J002 • 'vtti, 647r=71 STATE BAR ap 1V69CaNMN r0RM a - i999 yy��Egg pooesteat Nernber WARRANTY DEED�ISTE 6 DEE S ST. CROIX CO., Wl Thh Deed, =cW batwean Clearest P. CwMro and Gayle J. WMI90 FOR RIM Gathm husband sod wl% and se h" 06 -47-Mi X1000 AM t OMM OEFD Grantor, and KenBeth S. ddue ow mo Sup T. Musibr, husband and CRT MPY FEE. W& _ COPY FEE: Til#IM FEE. 63.00 � txu6 FEE: 1 .00 t"riustee. Granrar, for a valuabb eottsideradon. conveys to Grantee the foltowing desexibad real 4MG In St Croix _ County, State of Wisconsin (if mote spat+ is needed, please attach addendurn): Rerardla0 Amu Name and Raatrn Addret L pf Cse U$d Survey h4ap, MGd January 30 1996, In lrune l o of �, Y% 6- ;-i {,� edified Sumay Maps. PIM 30499 a s Document No. 3 9027 locate d in the Scetthaast % *row Scu*wed IA and part o Southwest `A of the Southeast t4 of Section 27, Townohip 30 Nerth, Range 15 West; City of Glenwood City, SL Croix County. Wisconsin, together with a private road ettaeaaent fbt• in8rM and esgness as shown on the recorded Certified Survey Map thereo f 231 -1Od7- 70.040 Parcel ldw0fkation 1 haabcr(PIN) This is not twnwrolea+d pruperir• Oil (is coca Exceptions to wu andes: Easements, restrictions and rights -af -way of reeord, if Vey- Dated this , dAY of l4ltty 2001 � �* hmeat P. Gu*m + r• AUTHENTICATION ACKNOWLEDGMENT 5isnature(a) STATE OF WISCONSM ) County } ahttlhentieate d rh' .- ._— pentilly came befom me this day of rsa Ma , a00t the strove named c lesaent P. Guthn and Calte.l. Ghhthro, lausbend sed wih sad Stafe of Wisconsin + Mae D. ScIrwab TITLE: MEMBER STATE BAR OF WISCONSIN t me known to be the tlera0n(s) who executed the foregoing (if not, instrument and adtsowledged the same. autherind by 1 706.09, Wts. Stars.) TNiS INSTEWME:VT WAS DRAFTED BY � � 1.A.� -` — — Attorns+I+KrtaWa 29AMd Notary tic, State of Istwnsin H udson, My Commission is permanent. (If not, saute expirarLon date: (slaaawM any be sethanaaaead or acknow4ed8ed- Both are car necessary.) • ruses dipetsont signiag any capecdy mast Wined or prided below their &WIMua. waeKeieh,ar ea+ae+r, Fmd SPATE UR 0p ISCOMIN WARRANTY DEED FORMNO-2.12" \ 11.G L e .p. ...... ,..... . . . .. A 1 • Z! 1384.00' J 1 1351.00' C A l o U wl � ?,� L 405,217 SQ. FT. - (9.30*ACRES) LESS RAW ..,.� 1383.54 Z 1 1350.54' 3 ' :D 1 10 -•',. N :Q. FT. RES) o 458,791 SQ, FT. (10.53:tACRES) LESS R \W 38 # 7 0 SE 1/4-SW 2/4 = P7 1311.30' 1970' 2550 S ' 88'55'42' E N 88 w SOUTH 1/4 CORNER SOUT LANDS SEC.27.. T30K R15V SEC.c """ ST. CRCIX CO. MONU, ST. C A. . �► LEGEND GOVERNMENT CORNS (AS NOTED) s w s` 1 c: _ H1NM NO. 985-A • N Stock No. 26273 539o27 S CERTIFIED SURVEY MAP NO 3049 VOLUME 11 , PAGE 3049 w N THE SOUTHEAST 1/4 OF THE SOUTHWEST 1/4, AND PART OF THE SOUTHWEST 1/4 OF THE SOUTHEAST 1/4, SECTION 27, TOWNSHIP 30 NORTH, RANGE 15 (PEST, CITY OF GLENWOOD CITY, ST. CROIX COUNTY, WISCONSIN OWNER: SCALE: 1"=300' AMERICAN INVESTMENT Ca 1673 13 1/2 AVE, HWY 8 E. P.O.BOX 99 BARRON, WI 51812 0' 15V 300' 600' I DRAFTED BY : DONALD M. CLARK UNPLATTED LANDS �18' N 89;4 W 483.57' / N 89'33'10' V m u, w g tl+-w V4 s¢ !/ 1313.31' .04' _ fU N LOT 7` 515,221 SQ. FT. (11.83tACRES) S �' 495,905 SO. FT. S1'p1• E (11.38tACRES) LESS R \W 3 141 1440 � LOT 8 499,133 SO. FT. / o w w <11.46tACRES) AI b 491,739 SO. FT. ¢I C11.29tACRES) LESS R \W I A� FE JI ZI n N 89'35 E 138400 �I w F G11 ,0 135L00' z LOT 9 0 � AI 3 ai f o $ 414,904 SQ. FT, I F N N (9.52tACRES) 405,217 SQ. FT, x r 'i g (9.30tACRES) LESS R \W �. -j u w N 89'35'19' E 1383.54' OL I �� x 1350.54' 3 =)I 8 c+ LOT 10 W - w� N . < W W 470,355 SQ. FT. oI m m (10.80tACRES) 8 458,791 SO. FT. _• (10.53tACRES) LESS R \W 38,70, =m roc QaV�wV4smn , S 89 E 131L30' L70' 2550.54' ' • v S 88 E H 88 W 2622.24' SOUTH 1/4 CORNER SOUTHEAST CORNER UNPLATTED LANDS S ECR7, T30N R15W SE C27 T30K R15V -- -- - ST, CROIX CO. MORII. ST. CROIX CO. NONU. .�►� Ce ti `. * LEGEND DONALD M. 4 $ C LA RK ' G OVERNME NT CORNER MENOMONIE, I Q i • SET, 3/4 "X24' REBAR WEIGHING 1.502 LBS. PER LINEAL FOOT. 8ruq��d CEDAR CORPORATION 604 WILSON AVENUE MENOMONIE, W154751 (715) 235 -9061 PAGE-1—OF-J. ��a.00 -fed, • 1 it 1