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HomeMy WebLinkAbout022-1011-70-050 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 463115 0 GENERAL INFORMATION 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: Westhoff, Jeffery & Me an Kinnick Township 022 - 1011 -70 -050 CST BM Elev: 1 Insp. BM Elev: BM Descr tion: Section/Town /Range /Map No: (,;, ?� 05.28.18.71 B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION EIS HI FS E 3 6'3 Septic — obt� Benchmark ~ '' Dosing C' ^� & S'0 Alt. BM Aeration Bldg. Sevyer 3 Z Holding St/Ht Inlet o9 GJZ.`Is � TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet / Septic / Dt Bottom IWO z )� Dosing +0 Header/4a n. 3 - �P• � Ivry Aeration Dist. e 3. SS 1 � Holding Bot. stem y z yq 7 ,�-- PUMP /SIPHON INFORMATION Final Grade Manufacturer GPM nd �'� St Cover ��� � ? 83 � 14 A r7 Model Number O �"• �� / TDH Lift Friction Lo System Head TDF�, "`��� 6 (, Forcemain Lengty,, Dia. Z ti I Dist.towell SOIL ABSORPTION SYSTEM BED/TRENCH Width G ✓ Length D No. Of T hes� PIT DIM No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO IWELL LAKE /STREAM L Manufacturer: INFORMATION CHA OR Type Of S ' UNIT Model Number. DISTRIBUTION SYSTE SGT ykG, , s S jZ /Q Header anif, 15istribution 1� / l x Hole ize x Hole Spacing Vent to it Intake r Lengt Dia t�_ Length �� " ' Dia / •5 Spacing 3t7 » 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 A) 7 ' �\ /& y (((��� Yes ] No U Yes D No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1,9 1 2-2 7-0 Inspection #2: / z° r,� Location: 571 County Road SS River Falls, l Parcel No: 05.28.18.71B 54022 (SW 1/4 NW 1/4 5 T28N R18W) NA Lot'[ , re Q._ . 3 V / �" 1. Alt BM Description .) Bldg sewer length = Z <4-- tW 4w-4Xk4I R - amount of cover U Plan revision Required? Yes , Use other side for additional information. b ZL SBD -6710 (R.3/97) Date Insepctors Signatu a Cert. No. L - i ,..ie Nye CO Subject: #463115 Schumaker / Westhoff - PLOW Location: Kinnickinnic, Lot 1 Start: Fri 10/22/2004 9:00 AM � End: Fri 10/22/2004 10:00 AM Recurrence: (none) 022- 1011 -70 -050 05.28.18.71 B Pam do final at 2:00 I w i Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 N y f s c lOnsin Madison, WI 5370'7 - 7162 Sanitary Permit Number (to he filledd in by Co.) Dep art 7ient of C ommerce ( 608 Sanitary Permit Al i ati ' �- State Plan 1. D. Number .1t. In accord with Comm $3.21, Wis. Adm. Code, Personal in ormation you p v e 4!_na ` j may be used for secondary purposes Privacy Law, s15.44 � ? 004 f different than mailing address) 1 1 1. Application Information - Please Print All Informa o rtu i � ONING OFFICE � 5 ( CTS _ rjs Property Owner's Na me - Parcel # Lot # Block # Property Owner's M ailing Address Pro Location �ff'' Property �'- 1rJC'O � A City, State Zip Cale Phone Number -=-i'— '�'�Q148�_'�.tiPCtion 5% ,rte 1 ,,y �� �� II. T G 5713 C � (circle o ne) ype of Building (check all that apply) �% (� T o2O N; R_�E otdd oc 5 w.t J ake•- blDl�1.AQ I �1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number ❑Public /Commercial - Describe Use 1 � ❑ State Owned - Describe Use -' -� !- "- '/ � - �FJCity_ ❑Village .township of III. Type of Permit: (Check only one box on line A. Complete line B if appl icable) OZ 2�1 o11- - Z - o5i7 g New System Replacement System ❑ Treatment/Holding Tank Replacement Only, Modification to Existing System B• ❑Permit Renewal ❑ Permit Revision Change of J Permit Transfer m New List Frev[ous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of P OWTS System: (Check all that apply) ❑ Non - Pressurized In- Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. i n of suitable soil ❑ At -Grade ❑Single Pass Sand Filter f ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching ber B ❑Drip Line ❑ Gr vet -less Pipe ❑Other (e lain) V. Dispersal/Treatment Area Information: X 0 Design Flow (gpd) Design Soil Application Rate( gp f) Dispersal Area Required Dis ( persal Area Proposed (sf) System .ovation �/ 0 s�� , 9 , _ I VI. Tank Info Capacity in Total umber I Manufacturer efab Gallons of Units + Pr Site Steel Fiber Gallons J Pl astic I I Concrete , Constructed Glass New Existing I I Tanks Tanks I ; Septic or Holding Tank Aerobic Trea[ment Unit Dosing Chamber VII, Resp onsibility Statement I — the undersigned, assum respons for u . allat of the PQWTS shown on th attached plans. Plumber's Na me (Prinl) Plumber's Si gnature P MPRS Number / __-Business Phone Number � � -�?'7 _ S C�ltt •�G'Y' Gt/ - C 1 07:7 / Q � Plumber's Addre ss (Street, City, State, Zip Code) VIII. Count /De artment Use Only I Approved ❑ Disapproved Sanitary Permit Fee 'ncludes Groundwater Date Issued Issui Agent Signature o Stamps} Surcharge Fee) ❑ Owner Given R eason for Denial ��� IX. Conditions of Appr /alvo Reasons for Disapproval � - SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained i as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances Attach cwmplete plans (to the County only) for the system on paper not less than 87 /2 x 11 inches in size SBD -6398 (R. 01/03) 14 101;0a. 1 �p o�'/'�YC. GO 3 /l. 4L' . � 1 o c 1 li 1 � Pro osed i••lounda� /9. 3G /o 7.so' 1� 1 I 1 H I V. r lr ► d, sCrl'buE%on /at�r,�/so� /Y=X88ss' o A JPQcedde ZS3. 1 ! c• 11 W 1 wl 1 I 1 1 Q� , Proposed wje6tr'Cc"cic r J c.�cA�aX1 /46'n -ink CeW+blila6 :tn d r 54,E,c�+�/Pk..lp c1,.Ln76G --w/ " � l �bc.J i4-/o eFFlcccnE /[; 1 "gC,1,. P. ✓.c, 6k;�d;,� scwt� 0 w cp jO V - ✓o G, 36 �OJC P. ✓,e. C I�roPostol Pr'oposc will �a r�aBC M ' ^/ 12 10 lolA P O, ' S �f✓a lu s f i- , " lo' E CO *? � E,tiSfin �rad� e It ✓a��n Safety and Buildings +, 4003 N KINNEY COULEE RD commercemi.gov LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 It isconsin www.w www.coe.wi.gov/s / isconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary September 23, 2004. CUST ID No.227990 ATTN: POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/23/2006 Identification Numbers Transaction ID No. 1063575 SITE• Site ID No. 689855 Jeffery & Megan Westhoff Please refer to both identification numbers, 571 County Hwy SS above, in all correspondence with the a enc . Town of Kinnickinnic St Croix County SW1 /4, NW1 /4, S5, T28N, R18W Lot: 2, FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 982107 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". 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. COIZdItIi No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. A P The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTMENT 01 N OF FiEI General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRESI "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST SAS (01/81) • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. Stat + WILLIAM C SCHUMAKER Page 2 9/23/2004 • 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 Responsibilities. 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. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 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 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893, 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 F MOUND AND PRESSURE DISTRIBUTION COMPONENT DE 6'<7 o Residential Application! INDEX AND TITLE PAGE `O� VV Project Name: Jeffery A. & Megan C. Westhoff 3 bedroom residentail m ound Owner's Name: Jeffery A. & Megan C. Westhoff Owner's Address: 989 Englewood Ave. St. Paul, MN 55104 Prop. Add.: 571 Co. Hwy SS Legal Description: SW1 /4NW1/4, Sec. 5, T.28N., R. 18W. Township: Kinnickinnic County: St. Croix Subdivision Name: CSM Vol. 17, Pg. 4482 Lot Number: 2 Block Number: Parcel I.D. Number: 022 - 1011 -70 -050 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications QIy Page 6 Management and contingency plan Page 7 Pump curve and specifications EU n Page 8 Site Plan COMMERCE Page 9 Soil evaluation reports D1NGs 'ONDEN Designer: Bill Schumaker License Number: 227990 Date: 09/14/04 Phone Number: (715) 386 -3121 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R) Residential or Commercial Design Note: Sand fill (D) calculations assume a 300 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of — 36 inches. 450.00 Design Flow (gpd) 3.001 Site Slope ( %) 98.50 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) _ _.__.-.-------- 0.501 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 5.00 Cell Width (ft) 90.00!, Dispersal Cell Length Along Contour (ft) _ 1.00; Dispersal Cell Design Loading Rate (gpd /ft - 1 influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y 7_ 6 r_' or N (c or e) e, Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 0_.1_251 Number of Laterals of the highest point. i Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 20600, Forcemain Length (ft) Does the forcemain drain back? _ Y 86.50] Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 32.62 Forcemain Drainback (gal) / p 9 12.50 Vertical Lift (ft) 81.25 5x Void Volume (gal) 3.80 Friction Loss (ft) 113.87 Minimum Dose Volume (gal) 22.80 Total Dynamic Head (ft) 29.66 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x - 2.00 x 3.00 x - Gallons /Inch Calculator (optional) Treatment Tank Information 646.001 Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 38.001 Total Working Liquid Depth (in) Wieser Combination 'Manufacturer 17.00 gal /in (enter result in cell B49) Dose Tank Information E Filter Information 646.001 Dose Tank Capacity (gal) ;Zabel - ,Filter Manufacturer ... 17.00 Dose Tank Volume (gal /in) A100 'Filter Model Number Wieser Manufacturer Project: Jeffery A. & Megan C. Westhoff 3 bedroom residentail mound Page 2 of 9 I f j Mound Plan View F J 1/10 B •' ' •' : ::. : ::.:.:....... .. 3 '. . Observation Pipe KK 'b A W L. .. . ' B . '. . . ....'. '. .. ........... I . '. . L I Mound Component Dimensions A Al2.00 ft E 13.80 in H 1.00 ft K Aft ft B ft F 9.50 in 1 8.05 ft L ft D in G 0.50 ft J 6.31 ft W 450.00 (ft Dispersal Cell Area 1 1174.45 (ft Basal Area Available 5.00 (gpd /ft) Linear Loading Rate 1 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.29 (ft) G H I F ; ::: ; Dispersal Cell 100.00 (ft) In L ateral 99.50 (ft) —► Dispersal Cell 3 Elevation E 98.50 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on [] = Topsoil Cap o a 1.5 ft ;;. Page 4 for number, �] 11111 Subsoil Cap 'A 5 size, and spacing of ASTM C33 Sand " + ©: •�:(��,: �, :� � ��•.' ••'•�" F laterals. Laterals are d 0.5 ft Typical Lateral equally spaced from Tilled Layer c " q Y P 0 0 Aggregate v o the distribution cell's --- A centerline in the distribution cell (AxB). I Project: Jeffery A. & Megan C. Westhoff 3 bedroom residentail mound Page 3 of 9 I `I End Connection Lateral Layout Diagram Laterals centered over the A & B dimension = Turn -up vWball valve or olesn out plug ` I gF P rals are identical I<- X _41 Holes drilled on the bottom of the lateral S equally spaced main connection via tee or cross to manifold at any point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30.5) Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 88.55 ft Orifices per Lateral 36 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft /orifice Lateral Flow Rate 14.83 gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 22.80 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -► Comm 16.28 WAC fts in. min. Tank component is properly vented Alternate outlet loc ation main diameter Wieser Combination Manufacturer 2 in. Capacityl 646.00 Gallons Volume 17.00 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.32 311.48 C B 2.00 34.00 P ump off elevation (ft) C 5.68 96.52 87.50 D 12.00 204.00 D Total 38.00[ 8.00 646.00 iF Dose tank elevation (ft) 3" Bedding un er tank. 86.50 Alarm Manuafacturer LevelArm Alarm Model Number DVL Pump Manufacturer Goulds Pump Model Number 3871 EP05 Pump Must Deliver — 2 - 9 - 67 gpm at 22.80 ft TDH Project: Jeffery A. & Megan C. Westhoff 3 bedroom residentail mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker Phone (715)386-3121 POWTS Regulator's Name St. Croix County Zoning Dep't Phoned (715)386 -4680; System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft Maximum FOG 30 mgA_ Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every . 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Jeffery A. & Megan C. Westhoff 3 bedroom residentail mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General i This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' compohent manuals iSBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking devics to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for Vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and-any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system In proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Jeffery A. & Megan C. Westhoff 3 bedroom residentail mound Page 6 of 9 V GOULDS PUMPS Submersible Effluent Pump 387 EPO4 1 EP05 Ii I APPLICATIONS • Fully submerged in high ■ EPOS Impeller: Thermoplas Li Bearings: Uppe! card !-..t grade turbine oil for tic enclosed design for heavy duty hall :)tz :r, ^,� S.ecifically designed for the lubrication and efficient improved performance. arnstruc?ic I c owing uses heat transfer. • ffluent sistems ■Casing and Base: Rugged �Cmies Available for automatic and thermoplastic design provides AGENCY t.! • -arms superior strength and corrosion manual operation. Auto resistance. • I.avy cvy sump matic models include • "eater transfer Mechanical Float Switch ■ Motor Housing: Cast iron �eWr,tenf�C G.)Ldds PumFs I, ISO SJO' Ieya;nc. 1 assembled and preset at the for efficient heat transfer, factory, strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • �oiids handling capability: float switch attachment points. max:n um: ■ EPO4 Impeller: Thermoplas- ■ Power Cable: Severe duty • Capacires: up to 60 GPM, tic Semi -open design with rated oil and water resistant. • oral heaos. up to 31 feet, pump out vanes for mechanical • Discharge size: 1'12" NPT. seal protection. • '.1echancal seal: carbon- : otaryJcerz.rnic- stationary, .;UNA -N elastomers. • emp 04 ' ;,0 C) continuous METERS FEET ' 40 160 .Q Intermittent. 'I •Fasteners: 300 series 10 !_ _ -_ _ - - - ,taimess steel. 30 • paule of running L_ vriti, out damage to $ - - s F ornponer'ts. 25 '- — O O ¢ ^' r. roto ._PO4 Single phase: 0.4 HP, L) 6 201 5 or 30 V, 60 Hz, 1550 , ,PM , hcilt In overload with o 5 5 _ . — ----- utomanc reset. - • tPC` EP05 Singe phase 5 : 0.5 HP, ~ 3 V or 230V, 60 Hz, 1 550 ; - - -- :P 'A i;uil( in overload with - - EE>oa :u,oniatic reset. 2 .:'ower cord: 10 foot 5f -- 1 - �tandaid length, 16/3 'JTO` ) wi'h three prong uroi plug. Optional 20 0 0 0 10 20 GPV 'Dot Icnym, 16/3 SJTW with '.`ree prong grounding plug o 2 a t, o stan on EP05). CAPACITY Goulds Pump; 'J2 ,u., s Pur„ �✓ ITT Ind striUS p - Sc ;:l ,I !,er, 2002 9. r P,✓.C.���C. ,Qssccmed elcv�= / 00,60 311. /1' I ' 91.0 �Cnn�AK r- � I I � I Proposed rrloccno/a.t /9. 36 '*- 107, so � ij �. �3 S /AiOt '� %8' "o/ 3PacCdaE: 2 � A I Q u o I proposed W i e5 ;r Carc/cic I J tiLA /,cry 1450 -moe CombiilaE %ew) ' r I �bc-1 � - /r/U eFfJacanE I Seo f."G fP•� Ko w� /rt . 1 "5C o Ito . IV. C. Scwcr.. 0 w � � c 36 <dJ�d 0 ry Cf 1� /oPOS�.o/ Pro ° scd wctf z S caA �SAi /F /ua� i vnlOiE eIt ✓af�n �.8oF9 vWsoonelp Departirm"t of cortxnerce SOIL EVALUATION REPORT 1 of 3 Division of Safety and Buildings . . • in accordance with Comm 85. Wiis Adm. Code ' county . C Attach complete site plan on paper not was than a in x 11 bras in store. Man mist Include. but not Wrilled lo: vertical and hortzontal reference point (BM): direction and Parcel I.D. percent slope, scale or dnnenslons, north arrow. and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you prwWde maybe used for seoondery purposes fWaq Law. s. 15.04 (1) (m)). Properly own>ar . L gs�,r\ GovL Lot Set 11411W 114 S T Zr N /g E (or)O Property Owner's Mailing Address Lot # Block # S Name or CSM# OW S tate Zip Code Phone ❑ aty _: ❑ VMP O Town Nearest RaMd ( ) �c .�c .'G CL S Ig New Construction time: El Residential / Number of bednoo ns 3 - '-f .. Code derived design Clow rate q 5 GPD ❑ Replacernerd ❑ Public or cocnrnerdal - Describe: Parent material �.� Food Plain elevation if applicable fL GWWW er� and rec«nnendations: sysflr>1 . �a• S0 Co�-fo � r et ev- 9 # . ❑ 8aing pK Ground surface elev. / 0 ft. Depth to Ruining factor ���J In. Application Rate Hart= Depth Dominant Color .. Redox Description Txture Structure Consistence Boundary Roots GPIW in. Mtrnsefl MI. Sz Cont. Color Gr. Sz Sh. 'Eff#2 I — as D soft Pit Ground surface elev. O' . Depth to Running factor �� / f in. Sof Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary lv� GPD/W In. Munsell Ou. Sz. ConL"Color Gr. S7- Sh. 1 •Eff#2 , � • $ Z 12 -2 1 _ 3 f c.1 c-5 — H I. 4 3 Z4- C ZP -7 5 xi Effluent #1 = BOD > 30 < 220 mg& and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 3 mg/L CST Name (Please Print) ignature CST N urdbu jj�io .S� a ---) L S - - 5 0 q Address Date Evaluation Conducted Telephoe Number 1 Property Owner P n P f"� Z . Parcel ID # Page 2 of a �# ° ® Pit Ground surface elev. ft. Depth to Irniting tactor Z ` in. Sa'I Application Rate tiortmo Depth Dominant color Reedwe Desaip" TeAure St ucfiue Consistence Boundary Roots GPOW In. Munsell Qu. Sz. Con. Color Gr. Sz. Sh. •Eff#1 - •Eff#2 3 - 41Ln F-1 B oft # ❑ Boring ❑ pd Ground surface elev. ft. Depth to limiting factor in. soil Appilcation Rabe Horizon Depth - Dominan', Color Redw Desaiption Texduwe _Strtrchue Consistence Boundary Roots GPM 6r. Mrmse,.l Qu. Sz- Cant. Color Gr. Sz. Sh. •Eff#1 'Eff#2 a# ❑ ❑ Pa Ground surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPDO in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BOD > 30 220 mglL and TSS >30 < 150 mgll. • Effluent #2 = BOD, < 30 nV& and TSS < 30 mgll 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. seos0weR.enaor �I PAGE OF'� R. NAME I h e A 1.01#2 &EGAL D : " 1 l SCALE: I"= y0 _ BM I ELEVATION /QQ_ O BM I DESCRIPTION of l Ov�� BM 2 ELEVATION ff. y BM 2 DESCRIPTION I , w_e �: Dom_ _ SYSTEM ELEVATION �q 0 Sd I SYSTEM TYPE M OU A d CONTOUR ELEVATION l { I 0 D S SIGNATURE DATE 39 Wisconsin Department of Commerce SOIL EVALUATION REPORT (� Page � of Division of Safety and Buildings A �J In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 812 x 11 inches in size. Plan must C roix include, but not limited to: vertical and horizo �]ipt� Parcel I.D. percent slope, scale or dimensions, north anea t road. Z Uf — - 7 0 - 0,� Please print r Date Personal Wariiation you provide may be used for (I y t 15.04 1) (m)). y 0 Property Owner . Location t ry ST `'UiX C ()U _ ovt. L SW 1 /4,Uw 1/4 S T Ze N R Igj E (or)� Property Owner's Mailing Address Block # Subd. tU me or CSM# 226 \ e cck. City State Zip Code Phone tuber ❑City _ ❑ Village Town Nearest Road ( ) } New Construction Use: Residential / Number of bedrooms 3 - `f . Code derived design flow rate 5 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material �� I I Flood Plain elevation if applicable A ! Z j ft. General and re commendations: C i rn ele • (0 ,1-�o L) v - e.[ e v Boring Boring # ❑ o� Pit Ground surface elev. ! / / fL Depth to fcmiting factor �� in. Soil Application Rate Horizon Depth, Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f1 In. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sti. 'Eff#1 'Eff#2 --I Z l Z �. c 5 I 5 Z 0 -- cJ bk mi r C C /(o 2.msb L nn-L- _ . L4 - Co F 2--1 Boring # ❑ Boring GG ® pit Ground surface elev. O' fi. Depth to limiting factor Z 4 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z 1 - -- i LI c 24 Lf "7 5 scl 2rn,. 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) i CST Number M a 2 S -330 Address Date Evaluation Conducted Telephone Number Q �>< - �vh,�i �� u /l• �yO�S` — /0 — 0Z C`�iS�z�/'� —y�r✓ Property Owner p..nP� Parcel ID # Page of F Boring # ❑ Boring ® pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz- Sh. 'Eff#1 _ 'Eff#2 5.1 Zrrxrabk c S l 5 , c� 3 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth . Dominan, Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz In. Muns(.l Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # Boring ❑ ❑ Pif Ground surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 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 mgll- 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 - 2648777. SBD -8330 (807/00) r w < PAGEOF NAME he h e T. I ON 5u NWY ,S 5 T Z�I ,R, /�f E(or� SCALE: 1 "= �O BM 1 ELEVATION /QCI. O y BM 1 DESCRIPTION 4o aL J yc ®� �- j'' BM 2 ELEVATION Q f (p y BM 2 DESCRIPTION S pv C- f SYSTEM ELEVATION �9 p Sd SYSTEM TYPE M OO A d sd CONT EL EVATION I U o� v 1 S b -1 SIGNATURE DATE �`� , i LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF KINNICKINNIC COMPUTER NUMBER 022 - 1011 -70 -050 Parcel Number 5.28.18.71 B OWNER NAME: First JEFFERY A & MEGAN C Last WESTHOFF PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 571 CTY RD SS SECTION 5 TOWN 28N RANGE 18W 1 /4160 1 /440 Line Description Line Description TOTAL ACREAGE 2.600 PLAT CSM 17 -4482 022 -03 LOT02 BLK 01 SEC 5 T28N R18W PT NW NW & 15 02 PT SW NW (2.6 AC) 16 03 CSM 17 -4482 LOT 2 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit r ST CROIX COUNTY SEPTIC TANK MAIN'MANCE AG"BMENT AND OWNERSHIP CERTIFICATION FORM r r Owner/Buyer L E Mailing Address OW L 0A Q. Property Address 'S 1 �'� `SS ✓ (Verification required from Planning Department for new construction) City/State Parcel Identification Number 40 o ZZ. - ! 0 / 1 - 70 - o SU LEGAL DE3�RII'�ON Property Location r0., -,'W %., Sec. 1 -F N- R -Zf_W, Town of Subdivision Lot # ?— CertMed Survey Map # 11q3/Z— . . Volume ? . Page # �V x/ z Wan -arty Deed # _ 7.2 LL Z f Volume 2 p 3 f , Page # 4 P r Spec house 17 yes 0 no Lot lines identifiable 40 yes © no Improper tree and Maintenance of your septic system could result in its premature failure to handle-wastes. Proper maintenance consists of pumping out the septic rink every three years or sooner, if needed by a licensed pumper. What you put into the system can affeet the faaction 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 tt3a8terplt1mber, 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 I/3 full of sludge. Uwe, the undersigned have road 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, $fate of Wisconsin. Certification Mating that your septic system bas been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of dip. three year ex irad date. C7 / 4IAJ4 OF APPLI DATE QBMR CERTIFICATION I (we-) certify that all statements on this form am true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office, SIC3N OP PLI 101 4109 0 DATE •• * *** Any information that is ads- represented may result in the sanitary permit being revoked by the Zoning Department. '• Include with this application: a stamped waranty deed from than Register of Deeds office A COPY of the certified e strcv y map if rofotwnoe is nude in the wamnty deed J 223 °i 088 - 7 ia! J- :L t,t KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 - 1998 REGISTER OF DEEDS WARRANTY DEED ST- CROIR Co., WI RECEIVED FOR RECORD Document Number 05/13/2003 09t00Ari This Deed, made between Frederick G. Lenertz. single , Grantor, and jeffiq-TV A. Westhoff and Me an C. Westhoff. h sband and WARRANTY DEED wife , Grantee. EXEMPT N Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00 described real estate in St. Croix County State of TppySFFEE: 134.70 Wisconsin (the "Property "): CC FEE: PAGES: 1 Recordln Area Name and Return Address s J e. A Was off & (. ff Y c Lo e ,nit Ywp Myer Faffu.-Wt-� OZ2_ - -7o 0221 00 Parcel Id cation N tuber 9 N This is not m teed pro (is) (Is not) of 2, rtified Survey Map flied in Vol. Page Document No. /Y3I a /4 , located in part of the NW ' of the /4 , and that part of the SW 4 /4 of the NW '/4 of Section 5, T 28 N, R 18 W, Town of Kinnickinnic, St. Croix County, WI. Together with all appurtenant rights, title and interests. none Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this day of , 2 (SEAL) (SEAL) A --- W1 y Ffe Ick G. L (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, WENDY SWAT ZIIN , A ) ss authenticated , NOTARY St. CroixCounty ���� Personally came before me this 30th day of April 2003 the above named Frederick G. Lene to me known to be the person wh a ecu the foregoing instrument TITLE: MEMBER STATE BAR OF WISCONSIN qnd ack wledge the sam (If not, �Q authorized by §706.06, Wis. Slats) w THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin Coldwell Banker Burnet 1301 Coulee Road My co m fission is permanent. (If not, state expiration date: Hudson, WI 54016 G� 3 -27883 `�� ) (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons sioning in any ca ci must be tyeed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1 —1998 Milwaukee, Wis. 3 ? 1 4 3 1 2 VOL 17 PAGE 4482 KAT({LEBII' H. WALSH REGISTER OF DEEDS NW COFt ------------------------ - --- --- ---------- - - - - -- _ — — ST. CROIX CO �tECORD SEC. CERTIFIED SURVEY MAP 03/24/2003 01:OOPM LOCATED IN PART OF THE NW1 /4 OF THE NW1 /4. AND PART Y MAP TIFIED SURVEY OF THE SW1 /4 OF THE NW1 /4 OF SECTION 5. T28N. R18W, CE RE R FEES SURVE TOWN OF KINNICKINNIC, ST. CROIX COUNTY. WISCONSIN. COPY FEES PAGES: -- 2 - - ° -- 'Q Wp`1 NOTE: DRAINAGE EASEMENT SHOWN HEREON IS CREATED TO MAINTAIN EXISTING SURFACE QD DRAINAGE. IT IS THE RESPONSIBILITY OF LOT OWNER TO STABILIZE AND MAINTAIN APPROPRIATE VEGETATION ON SAID EASEMENT. PREPARED FOR: FREDERICK LENERTZ 220 LIVESTOCK 6; � >p 9 `� EXCHANGE BUILDING ST. PAUL, MN 46 0.3 q - 55075 1 ° Il a 1 r EASEMI`N� . - - �� SURVEYOR: g THOMAS M. HEALY S & N LAND SURVEYING, INC. �1 ( i r �UrrV G S �y ii 2920 ENLOE STREET HUDSON, WI 54016 U r ! LOT BpC KCIN / i U mm 8,2 % 3.00 ACRES `+N E tt i O � 0 + ° - n ` (130,842 SO. FT.) INC. R/W Iv S 1 i 2.43 ACRES coo ry �l m r (105,745 SO. FT.) EXC. R/W W A r 11 Z i ' . C9 �5?7 o S > O3r 00 ° 46 3 Y 0 +v E sot r3' UDSON, r ur g - -10 0' NW 1 /4ofT 1/a ~ O SURV� w f t W. SW1 /40 HENW1 Cr RN 'i�INZ p; LOT '1 ��C�❑ ..G ° S Z : 2.60 p C (11 30,4 FT ) INC. IN yC HI �o m u ' 2.33 ACRES �' I � (101,494 5O. FT.) EXC. R � Ln Co RAN ' ..a f N C � Gd i� ° SCALE IN FEET 1 " = 100 i c ,z N m 10 Q O 100 "� + r[ m o I IF' 6.7 8.50' ! �(� ��m T N89 °35'25 "F 475 -26' rn 1 APPROVED 1 m rn 1 n ST. CROIX COUNTY + m + V� LOT 3 Pfannlnn 7nnlnn end Parks Committee �► + ��} Z cz-i I O 2.17 ACRES 4 20D3 rn MAR 2 (94,312 SO. FT.) INC. RNV ro N m -# Q p1 2.02 ACRES n O 1 (87,874 SO. FT.) EXC. P"ot record" wahin 30 days of g m I c j approval date approval $hail be - + nun and void 37.3 I r -hJ D 444.03' 584 °2'E 481.41• t r?� 33. 33' 6 6' FOUND ALUMINUM ST. CROIX COUNTY ' Sa ro n LOT 4 SECTION CORNER M ' Lw� m 2.23 ACRES MONUMENT D (97,038 SO. FT.) INC. RAN SET 1" OUTSIDE 2.04 ACRES r , DIAMETER BY 18" m (88,832 SO. FTJ EXC. RM/ Q O LONG IRON PIPE, + WEIGHING 1.13 LBS. 1 PER LINEAR FOOT I i DIRECTION OF 37.7 444.27' DRAINAGE p o S88 "E 481.99' 66' WIDE JOINT MMr LI�E!,I'D f�: I�IFT&3 0` NIN0R -M9D 1:3W lr��:� 1I1 :70111 DRIVEWAY EASEMEN W1/4 OCR. U' THIS INSTRUMENT DRAFTED BY: WILLIAM KANE SHEET 1 OF 2 SHEETS SF0. 5 JOB NO. 6000 -17 DATE: 09/19/2002 REVISED: 12/12/2002 _. Vol. 17 Page 4482