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032-1066-30-002 (3)
`730 w:5eons:r Denanmonil Commrm:e PRIVATE SEWAGE SYSTEM „ounty St. Croix Sate[y anc 3"Adinp ~ivisinn INSPECTION REPORT rA7TACI I TO PERMI i) 607080 GENERAL INFORMATION Persons! rtforrnan::n •rnv uur:,tlr n.:+y :x _SCC ror selwdif-, pu .o ^s (rrivEr:v Law , :.d 'Jwmil George and Karen Vander Veer TOWN OF SOMERSEt F':,,:el } Na 032-1066-30-002 CS-HN Pr:v Imv Bhl Flev KN :ezcnpb"n eCb9n: 'nwmkangeSUap: r,:. 10 Hpvl~ ppp 24.31.19.328E TANK INFORMATION ELEVATION DATA IYrE IVlANJFACTl1R=p C;APACIT, t; l A'. ION BS III -5 FI FV Ran Septic , a Hencnntwk OO W I Q.SEfr I.5 1 tc t+vn coae- . L7 1014 l I Is TIC A't HM1A e I, 06o toc~ al outc 00 g9.47 rt Deg sev xsl hn Hnlciuw ;UHt Inle•. 1 5, 0 7. e Z 3~ o Sank Sf;H ,;IIIeI p TANK SETBACK INFORMATION glU 14 AV- 51~ lL'Q7 LANK TO Frt. ViFI I hlDc. cnt-c AvI-tarn Jt Inlet Scptl- O 0 ' 15 ~1 /1 nt nottolr: DUS199 I V Headcltlvlan 5. bo ~i.o7 HCraoUn Dirt Pitx: / M 7oldmG Hot Syslen, 45 5.7 Z, Fina Clra!ie PUMPISIPHON INFORMATION n 3 3.30 11.3-7 t.4anutact•'- UctL anti fit CLOOO l•b7 tuto .I Number 1 l b,(~Srl • 7 Z TD ih f 'r_'oun Loss N 8 .m aA ' D- 7 O~Ileh (CO b 9 7•D9 Foroema I e11~II'. JIF. II::I II: '.AI Y. SOIL ABSORPTION SYSTEM v EZ IrID ujS BCD7RENCH 9m:tm "1' t IN, OI Ire c^ee PIT DIMFNSIONS N_ Ivte P-~<:r:1" _0 dC:rrn' DIMENSIONS 3 1 O C>< I SETBACK TI_', WL HLLVd A✓,F: STRFAh! LEACHING tPunutacL:er. INFORMATION >v CHAMBER OR IltOWS Tv::.'!)';• r I OI UNIT Nudel NUveer ~)tvXl-, a l C. 4 DISTRIBUTION SYSTEM ~eaCe iand"id ❑ sllit:uLpr x Hoc S', .1'nle Spz::oinq Van, Ic An Intakt -7 , N to °'f'°::.`_ / a ti all evils SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only :oath 1 Jcp:r F,, rr Dep:li al -edm: C.o"❑eC xx Wild,': COMMENTS: (Include code d:screpencies, persons n:esent rtc l Irspeotion s' Ir.epecoan III Location: 720 72ND ST Ct,1!•.r'~i" P 1 1 All HM L>CSCfIpllOn - 2 i Bing newel Il:nyth - arnouot Of cove, _ ✓ r ppp I Plan revision Requued? yes No r 7 I QI Use etrler sae Tor additional Information / ` ` - - _ - - - - - - - Dil InSOn-rnYr. fJ1U a :.e'I NC SIND-6?10 (R.3re71 ST. CROIX COUNTYZO\ING OFFICE CERTIFICATION STATENIEN'T FOR UTILIZATION OF EXISTING SEPTIC TANK(S) M is is to cerhly that I have inspected ill: exaa h~? Serr, am: or dose lank presently servin the follov inu resice-:t:r: Street address 171!'=' d weer located at: RV'! s'"N'- Section 24 I ,own N, Ram-,e 'S W, 'f oNTl of gum-~s2' , St. Croix Count- \Vsconsin. Cpon inspection, I cerify that I have found the tank(s), to the best ol'mv islowiedge, wail confornh to the requirements of SPS. R4.~ and it (tare') appear(s) to be function'.ng properi%. Most recent dare of inspection or ser,ice Did tlova ba;k occur from absorption system" Yes No iifno. skip nest line.) Approxima:c volume or ler._th of time: gallons minut;-s Tank Capacit.,:='o i <rnstt uctior: Pre fah Concrete x _ Steel Otllc- N'Ian,IfaCtL:fe: (If known): %1,eeks Con:,ete Dmduets A_e -I Tank (if known): 22 Permit member (if know ) 990c5 iLictrbsed Plumber Siunatu,%: :Y:i:l;'_ 1. Number) NIPr'~4PRS i Date i Form :o be cxnhp;eted'ny licer.scd ?lor.i`_~er (Dept of Safeu arid Proiess'orra. , ~crvices Chance-',05 and s. l-1i.00. 1V~:cc il~i:' S:atUICS'or l::censed d:spos~-.r i~R 113 Wit 11OnSir;. r'\Cltll:[Itl<t-2::~: t_6C2i Re\. „?N SYSTEtJ SLOT PLAN Project Name. Vander Veer oesiga Plow• faogacnsmay a~~c. FJ Jress'. v 3rnei /vund.1, ow:9r f uw ealwlationo ror ccmmar_ia roars 6 S n-oul A Lill _levalla 10C.C-D Pon 1laalonms; 0.$TIA $;antlartl $Cal?: 1" a K PA Descllotior. Tvr el::en6c tank insnx c- pipe l ames 3&.3'S-2 5 384.3D--`. - ED SC 12C 3M2 SYntbol. Bid Elevzdw- 95.3 e' SCI+ 40 P'.i, , A3TA! D1&:5 'N Dessmliou Windcw;M o-base"ent ninaon - _ ICUC Gi admml of l cstc_ ,vCa 1"ofl S~n•bot (1' a~?I _adey I'.CIP.S !pCl:'S 2-3'x9_' EZ =iow trenches E: 1. = 95.35' i I PMr 205t^ Avnue I n f.5 7 102 - - gg ~33 L 1D III Existing X 0. ` rock & plpa - _ car' slope a` trench N.Bz . t`•. 7 Proposed 32_ gal N 31 septic tank M Existing 1300ga1----'~-► sel tank ?N1 - \ BM2 / CL i• C Pool } /edrgorii, CL - \~1ousp"= %;arage 1'tileO YL C Prooert , _ire Page 2 11 Industry Se n ~Zti -r~61 v QV \e•` (tool) 'Ll rvices Division \ t rya s D S 1400 E Washington Ave - P O Box 7102 Sworn) Pcnnu Numiscr no he filled in hl co.) pS Madison WI 5 117-7 / C)~ 60 C) Sanitary Permit Application L timlc,ran.:,cnun .\lmltxr Ina r h+ael I SI S Si 1 is . r 'IL . - :1- ",i Ihis I .nn Io Inc Ilppr .pit ne fus enn,cnlul amt i, n gmrad pr r 1 1 to n I I I :I a N r 1• u n fi.rnls (.it sawJ1hsnW P- IN I Sale wbmawd to Ue lkp.L'trrci I l l din n:-,III :.,n d' - \iee . ;n• u l ndI imiin I wa prosule n.n hr used lhr ic,ori 14t .es( Addms of ddleren de,a .Ladle address- Purpuser n a ..ndlu..c wuh the P•nacv aw. , s l.h I nn. Jan. Tit $Irca 1_npplicalion Informnlio _ Icam Prior kit Information Propenl':Ihnc",\aIIK I ,col ra U3.2-11 Y A A::ern vsndcr \1•<: U}-'-IX✓n.I1Hm2 a4, 31 19. ~?SE Pngcm Osrncl's Muihng Address Pm ml, I real or 120 72'a Street Gut. I,a .fin. Slat - - Zip( odc I'hnne Noraher NN'':. Is" "'.ma' 74 Snmcaci 'A f ;g n25 (circle ,net - 'I' 31 N It 141.. oriFl It. lspe of Building (check all that apply( Leta ❑ r: :rnl Ihltiua Vunlh r't F1cW~..nln SuM11vI~ sionNa.•rx ❑ l ul ,nI me ,ml I k h. v ~~'R'-__ _ nlo;A n ~J :-I l*nv ul f' +4r ❑ 1n:k' 1 rwned I:cseri l,e 1 ,e 1 - (S!d Vunlhn C~t uan 0 Somerset I,% It 0 Somerset ~I I II. 1 vpe of Permit- (Check oul line t. Complete line B if a r licable) Z _ - X - \ Ncw \Ulell Replnccmem Sfslem [j l icatnlaaflloldmg IoM Replacement Onis i ❑ Other Sltdi4icauon to 1,xisling System lexplams I If. ] Permit Renewal ❑ I'<nnd Res isiun ❑ C'h:n8n (I ❑ I'cmai Iranfer In Nc% Lnl l1n;%wos pclmil \unite, and Date hsued 'letcrc l-gip rat-, Ill I'Ialnhcr Owner 971135, a`IIIr1987 I '_'I'spe tPF~ stem' ComponentDes ice: (Check all that apple I \,.n f Ic.. n vnl In :[n+un' ❑ I Icaunnd In Grounc ] AtAiradc ] Voind 2.4 to ct o able,,ol ❑ Nand 24ni of si ilable soil ❑ I'..Id.: o,. L_j rIn I ) ,rs .r11 o moment levpl:nnl ❑ 1'mnc:arrem Ills rc ksUl:mlI I, 1 Dispersalr prl'a ntent Area Information: I1L I u 's : •'n h De o S ,\Pp: Cation Dispersal Area Require' sll I'Nrsal.Alca Propn ed lsf, Swem I'ales Inn K 11~nJ,l; Nil 'TIU 9i 75' S L l a n k Info ~ L a p u n:n I ~ - v t dI nv Fl,,taol a of limn u I N ..~.i... , can•c Ilm6 I w P /e,~ SzS j J v. : V L S,pbs of l h,ldm~l anA Lp lL4n 13?0 ? ti ocAs'd'.eser Q ❑ ❑ ❑ Imnt 2 $ f m b 1I. RespOnslblllts Statement- I. the undersigned, assume I r%l o i%ibilin' for installation of the I't N1 I S shoe it o t the attached plans. \amc Iprinl; - Ylw S ;:Ills VI': \7PR1 Sumhe liasness phone Number i-7 (a).11486 I ihuun ~✓C lL-. 213I.I _ IhILI 'r. 1dvr♦ IAIK.1lII 11u1/.p (oucl S86 b .u'.. A i,:, --d._ S. I 1 5402i v\ III : ionls Department I'+l Only \l ,r I'crmn Fee Il;nc l uc I„wr goo Sigum re ` r. n -I I' -..,m I n Demo[ S 5566 I\ C ondit t ~r i~lN aw'~~e s for ?Isappros'aI (CO'r ~ Yc a ten . n 3~ ~..IL.. LGC Ci•R'r F~ f (1 41sper:::a cell carat ed be -i 1-- - d:,. ez , W pK;TW.3 Oman: pli n p•o'lue1 by,I.L.nbe,. 2. Al rle0r*~Kk:IM-'11tH+mwtw r, sr~Y.c:1 So pN N{'Oa Ct*f 1 adwola ena:t ban plrir 0."1„rIhrI\,IrIII andv:M1.m ilu I."l:nm,.III .nP-1'•nut I.." ohanSi.. Il nnhr. m.u. Silt P,; IX H,'. I I i CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Vander Vee' 4 l-edroom Replacement Septic System Owners Name' George Vander Veer Owner's Acdress 720 72nd Street Somerset, W' 5402S Legal Description: NWl/4, SW 1,4, S24, T31N, R19W Township Somerset County: St. Croix Subdivision Name: NA Lot Number: BIOCK Number Parcel I.D. Number 032-1066-30-002 Plan Transaction No Page 1 Index and title Page 2 Plot Plan Page 3 Sept c Tank Specifications Page 4 Effluent ilter Information Page 5 System Sizing & Cross Section Page 6 EZ clow Information Page 7 Management and contingency plan Page 8 Sept c Tank Maintenance Agreement Page 9 Existing tank certification Page 10 Warranty Deed Page 11 CSM or Plat At;acnment 1 Soi i`valuatior Report Designer: John Schmitt Licnese Numbe•: MPRS 223760 Date 4/277201/~9 / Phone Number: 715-760-0486 j'/C//C< ~f Signature: In/Ground Soil Absoro'ion Component Manual Version 2.0 SBD-10705-P (N. 21/01) Page 1 SYSTEM PLOT PLAN Project Name Vander Veer. Designf17w eoog&mscav Proied Actl'es 5'. 5'ic ^ Attnh eosigr few calculations for commercla'• plans Btd' Symbor. A ii!d F_evabon Too Do Pipe evaleral.: ASTr,I Star4ard Sale- 1" = 60' BM Doseriptior. rep of septic tnrt -,p cecn ope 7 ables JFI4 JO -3 & JtlA.yJ 5 C y SO W. 72L BMI Symboi* L B)d E-avation 9973 ' SCM 10 P11 AS TM DM 65 BM DeSviphof Alydon Sid of basenxnt nlndcw ?CiJ >CC rPSTtJ 03034 Slope Gradient cf Tested Area Well Syrrh Dl (if appliranle) Voles Nctes 2-3'x90' EZ Flow trenches El. = 95.35' RPJV 205th Avnue 102 1 98 100 f ~ I V ~V ~ c 63L A \ o Existing 5' X 67' rock & pipe \ .9% slope a trench r-',,a, ~ a Proposed 320 gal septic tank `.,',61 \ C Existing 1000 gat- septic tank BMI d BM2~ Drivewa ( \ CL Pool I ° C Bedr oorl~ / y 0 a douse. ' ' ~Garag %AleI I I Property Line Page 2 in-ctu ~ r 7e M y( NV'6 'Ii1d35 313dO10S b3531 - C :1.. ~ J r J H < i J J rL Z co 0 0 J z Ou m w Y w p O m v~ = s Vl G pp K ° a m N a c (n ~ ~ k' N G W ~ Q z N tto o .J `C a J l7 O d F, ZK LL O a ° om n_aa a u H O o p a -z( z ¢ o chi i Q LL z° < t Q d mN :.:mow Z 1 Lp O ? i U m JQ°~ v o c: o °z D r0 M Q 'O vi Z In paoo°ao vwiN m k o o wo z C6 -0 a = 0 U N~ps WJ(O WQU w` FQ- pJ~ i NZ W~ 8,W ozC u VOA W u W 7 <O z_ u~o°-== our p~r a e m a 2 z o O Q w Z O J J" Z. Q Z i p U Z w x ° u Y o w wow3 da as o a n g `r' 7 Zs: © ul=J MM _ p 7 U Q ~ W ti .J q y F 4 U H w W W K r•. - N i e ~ S ,rl Q W lr ~ U ^ £ X N u JI - w n\ u O z < 7 s a v'. i ~f Page 3 IN 1'I.-ti? 1 ffluLt nt I IIt1,1 Filly, l -525 Filler Is ral: d for Io,110o (_XI) (haIhns pti d,iv) makln}1 kl OuV of lh, IaI, r,l filter. in its Ai,s It has iii i•. ar h~'. u! 1 + Iri' fit tratiur d,dc I Ike [lie Polvlok PI--C2• lhu f t)[vink FI has an automatic+hut-nfl gall m-~L11t•d wi;h VV'.rV flter. 'A hen the filter I, removed for cleanin,;, the hall L% ill float up mid tvinporanl_v phut olf tb • ~;om Ihv r/Ihn•nr •.Noil,t leave the lank. (G Ahrm S,. dch ' iIi-d tur 10.0001 D hallow perd: v- 10,000 [optional} I. near Icvl n, I: In" tiltraltoll - . Ata•pl. 1" PA'l rc its 4" and ti' Y-1 11) 40 pipe. Lalconran Ilandk 1111;1 ill gas dc•rlector. ~d uII ~nfla shut If hall wh,•n lill:,r is removed hatavl fee `.Lum ruossihlfi!)'. In,IRIII CI'D its t v'C c\tonslnn handkc. i 9 12, I:' zs :.I tor residenti t. and ;ot:ilervial waste tluws up to , o :X; I .nrn. FI. nUil I,allons pct day I( Pl), - =-r ---'+i L:Ilranon tilots ate the outlet of Iho +rplir Tank. move the tank uro r and purnp lank I no,os. vv- - a~ 1a i t n - 1Ilan tha tiltcr Luum}. to ihr J" or n , ulk t i. Intel is nct, enten•d under the acre,, npo ilmlG a., .t 1 1, Lnk F\torrd & I_uk .v PIVa e .f o:pv hr u•.dv. I'll..1 1 tin, It the PI -5251 filter into its housing. - Certified io } 1 c and s,. ur.• the+eptic tank I over. NSF ANSI Standard AG II \I Anton, I. 1 I I'I.-525 Filluonl Filers va:Ill operate dlicicntly lot r,Il pears und,-r normal conditions bclora rcyumv l 1 ..Mill,,. 11 is racon'n"loll drd that the filler he eleartai r. I:nn• the tan, is pumped, it it lea+1 evert' Can I I the In+tallyd filty. nmtauns an opnnnal al:u'm. '.li, nor ae.Il by notiheu by an aldrm as lu•n Ow III[,rI ,.I~ s: rviu nf;, Sa I t icinf; +huu Ll h,• done by a arUn. d 1 1 , ~I,. . I,l:, tu) pur.)par,a'uutall:^ III 1-_.I. 1I I.r.~ tic the oallct vl tilt' Wvrc tank hmk r,nrr and pump tank if nec...... _ I hr not use plum bin.4 who n hlto r is r, nv,a', d. - 1.fullIT-525 . al idg. -W 1 h, hvusui}, _ - 1 5 Rosa ,if filter , aor Cto tank Make sit-,'.ill solids tall back into s,-ahc lank. o Insert thv tiller c:u'lr:dpe mark Into the lum,"' j Makin:', san•thafilwri+pr„pcrlV nh};Intl and cullll ~IPlCly illx'h',t •,I 14.. /.d :l >I hL•rrn art rpm E.ilq.... L,. Kuplacc and +ecu IC SCi•.tI' tenkc,-.VoI •1, uC- .,o It, hand Menu ;o1e C~i.r,r.Il 1,, L. P~ irk k. Inc. ? 1 xncck Bl'-d 'iVillrnelord, CI W,44, loll Fwc: n??,?:,j •i~r,: I : III.., 's4.K5la au„ .slkl,,; „n Page 4 PAGE 3 OF 5 d ^ s: o c a i•.; I is o V" a) Y ° - C E d 1 Q 'Z' n (0 O f 2 rt .o E i c 4 Q * o Q o w ^I of Q a. U> r I~ II I w E^ ~I CII ~2^ wz Of - < W O F I LL _ a N _ -j c> e I I 9 2 ~NcwnZ ~3 8 I Ili I = ~ D W C d~ ~n I q jl ~ a; 0 .2 C- 0 c C U d `a r`, t O I d V7 Q ~ O a- y ~ } I I' II ~ m I i N V U w 4 I I u i C) Lo cy) Z, ol (N r) It qq L ^ . r \ \ II II II II x Z Y M C :J IJJ J Lo (r (n O E I^~ r t o Q 4~ k a Ln N l v) 3 $ a U Ud LLI z ~I T w a n I w v fig u a III' Q~ a L ~ d l C ui Z? I F- clot LLI wcz _j + <QZ 1 Page 5 Installation Instructions for ~EZOw~ EZ-",, Systems in Wisconsin JCyGINF1UNATOR eCT, M Ccpa•tmen on, it a -c : af,bf a'al 6u 1 S. The rrh sornt Cn to a gi,~n site ti^tal or. -at, rcnrv,r•d .ho spc:ifcatunu, andirr plans for f i:, _ s: ed based on maaml.rn daily sewage flow (,GPDJ anc -r,uct and cele•m nec it to be in compliance with chaptn th< ~ermeabilty for the site. II certain cilena is met, the -Trim 82 through 84, Wisconsin Admin. Code. arid ClI iA ~sinnq :an be used in Wisconsin, resulting in a 40% 15 and 160, Wisconsin Statutes. All sites must mcct the ,:.allcr drainheld. - -ol Condiiors & Locations & Isolator distances as notrt l~-, - it regula6ans, ; i. 'I. EDIo:•: bundlejs) in :he EZflow configuration ap- nraved by system des-gn permit specified for the parfcu- T, c approved wrrduct; arc 1203H i; 12" bundles witn pine i s4e. The top or center-most bundles cortaining ppe ^ntei bundle u: d' or '0' Icngthsi and 1_203NP t3-12• bundler as jo'ned end to end vilh an internal pipe couplet. Any +:dh oioe in each auroie ir• E or 1C lerg:hs, addi: cna aggregate orly bundles that may be required, • should be butted against the other aggregate-orly bur- it pipe bundle corta ns a four mt.- perforated pipe sur dies and do not require any type of cornecton. ..iced by _PS aq -ega:c and a held tCgetner w,tn poly- b,., 4 -,tile aa~recat, i 1 ; ain =gg'eyat'- : Tne lop of each i cyllyde- contains a titter fahnc p•e- nc i t ,,,:ct'r •,r • r: rr'C q-; manila:-lu'ed in belv.eeri the netting and aggregate. The fahnc is inserted! :o prevent soI intrusion. The :nstaler Materials and Equipment Needed shall make sure the the GEO 15 pcsiti oned upward and is • L-'!l v, it co"lac: with the fabric contaired in the adjacent cyii • I_Zil,r, Gua:::dilr ao•r~ der before oacAfilling. • L 'Iv, Inleiral Pipe le • Pine fcr leader an 1-1e d. The EZ(low Dranfield Systems should be installed in a • Gar~hoe%.arava+.x level tre°ch in all directions iboth across ant along the :wncr ucttarr; and shauld fellow t-e contour of t -c ground Installation Instructions sufface elevation (tinlo'm depth), with all continuous tl~ ~ iu._G_,nL ti _I r•ullahc•, cf EZfryw produ,-is ac given ; adjoining 1C-(oot cylridncat bund'.es placed ene to end, I,.-,. Thu l" d..i:' r.. be r)-stalled in accordance Altn stale ; vvdo certral bundle disliibutlon pipe mterconne_ctod, J rb:hn d it 1 Ir-q;h:rnrn-r R7 through 8• 'Wh i_Qnr yr AJ- w'dhoul a+y Jams, dcpduwns or other water slops. 'istr:_i've Code, and Cf,dp:erz 145 ant. 150,'Wisconsir Slal- ~.it, as well as the local health drpa•1e•e rfr :--.,urenl der.igr the ln•ncrt top shall be graded such that water wiil not d pnnd_ Baccfill sho.:ld be seeded or sodded immediate'y after completion to reduce erosion. frer the local health department ha- detc'rnincd s :n_ r'guration, anc layout for t'ne EZflov; systems. ciakc I0. 7flrnv EPS bundles are flewblc ane can fit in tuned rrs•k m:h paint the Iota:-m• of tier &i ii, and knee.. Lie :rent.:^es as may be necessary to avad teas, boulters. er cful to se: eu••ec tai invert pipe, header Ineor Ji.- otter obstacles. : j:ion box arid tie•rch bottom eievatior.s before i^s 1-bn of pipe bundle t I FFS. aggregate s lighter Irian water, therefore, it might : Lr expected that natural buoyancy forces world tend lr. .ovo piasDc EZfiow s-ippng hags prior to piacrr l : cawsc EZ11tow assembles :o float ou: of ground when _u' arcs in the benches). Remove anv plastic bags in :.re p-ndinp occurs. Field experience has shove, however, 1 , ~-ch tefore system s covered. nips: this is no: a p'cblem when systems have a ri rr,xn "ol r„v cv as re^ontntended t'v menc'ar'._i,.. r,. p•odu:t must have geotextdc labrc :hat meets i, cement= of s. ;cnyn S4.._'i (6j fgl, Vin- Adrr. Cca,~ tallec tiredly on for of L.e 1.....d..-'. :!nr, ir,- 1203H-GEO :n along the s.d~ e c" t^c .:~r_t tc it j,t so het. from the hotto•n cf pi.,:i .rt • VJ'nr ins ailed in 3 trench, h r d-I t ~ di y ~ ♦ j Q 1 A d,u th f 3r3n,.hr:. °3rr:. Page 6 I In-ground Gravity Management Plan PAGE 4 OF 4 IMPORTANT: The ov: ner cf t'iis in-ground gravity system shall oe responsible for 1s perpetual operahon and maintenance pursuant to requrcmems of SPS 382-384, 1V,sc Adntin. Coce Pursuant to SPS 383 52 (2). Wisc. Admir Code, this system shall be corseered a human health naza-d if not maintained r accordance with th s approved management plan. Furthermore, all inspection and raintenance activities stall oe performed by a registered POWTS Maintainer in accordance with SPS 383 52 (3i, Wisc Adm n Code Maximum Dispersal Area Operating Limits: Design Flow= 600 gpd; BOD, 220 mgL'; TSS 5150 mgL'; FOG 30 mgL" Inspection Checklist INSPECT EVERY 3 YEARS type of use age of system nuisance `actors (i e cdcrs, user complaints, etcj mechanical malfunction r, e pumps, valves. switches, floats, etc ) material fatigue ([e leaks. breaks co,rosion, etc i solids volume in anaerobic treatment tank(s'r and any distribution appurtenance(s) ( e. distribution / drop boxes) neglect or improper use (r a exceeding eesign capacities prohibited acbvites, etc.) ex:enl of pordmg in distribution cell prier !o dosing uos•ng irregularities - if applicable (i.e., pu-rp recycling, float switch settings. etc.) electrical components - if applicable ;i a wiring, connections, switches, controls, ur°ers, alarms, etc i oistribulion lateral or lateral. onfice plugging (measure late,al distal pressure - compa-e to desigr specification) ss-face discharge of effluent or sewage back cp irtn structu•e served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) Septic and dose tank(s) sha be pumped by a certlied septage servicing operate, licensed under s 281 48'Jyis. Slats when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local crcinance Disposal of contsws sha I be pursuan: tc NR 113, Wisc. Aentin. Code. Effluent filter(s) shall be inspected every 3 years arc sna'1 Do clcared when necessary to remove any acccrnulated sulius accoro,ng to marcfact_ efs specifications 4, sc% ang period w I always be greater than 12 n, or ~:'r s System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of idividual or company John Schmitt _ Pnone 715-760-0486 !coal govemment uric St. Croix County Community Developement ahone 715-386-4680 focal government unit address 1101 Carmichael Road Hudson. Wl zip 54016 Any defective pan of tnis system shal oe repa-red replaced or removed pursuant :o SPS 383 51 )1), Wisc. Admin Code Repair or -epiacernen! of `ailed o• maifunctinning components shall comp y witn SPS 383 Wisc Aemm Coce. No p'oduct for chern ca or physical -estcra!ion of the POVv7S gray be used unless approved by tne department ,n accordance with SPS 384 Wisc Al n Code Contingency Plan Ir, the ever: tnat any famed lrewirer! comporent of tnis POWTS cannot be repared :t shall be replaced pursuan: to a plan submiCed to the appropr.ale agercy fur review and approval. A fades in-ground dispersal component may be aeandoned and replaced by a ;,cite-rn p'yino c :persal ccmpo,ert n a p-eceterrn ne area of suitable so s System Abandonment If use of !his PO'✓v rS is discor:mued. it shall Le abanco'reu it accodarce w :h SIPS 383 33, Wiisc Adr-in. Code Page 7 I. ( WAX COl `11 Si PI:( I \\h \1.\I\ lF\.\\( I \l,RI 1.\(I.\ I VAD OWNI!I\N1IIP CI -R Ill W\ Illi\ I'OR\I li.t,cl Ctgo:mpm-l6a&nKwonvVender Veer Iv®eteSOMt' 4Met , WI 54025 \ _nn,c Addres> 772C QD<6treet I\ cr:-!"ttp, I r;,JUIC l ling Planning S Zoning Depaluncnt I'l IC„ canstr~.r.:~m Q% Slaly. Soaleryet, WI Parcel ldcmification \umh~r ~O-002 LF(l DESCRIPTION PI.!belly I ocatim, %W , . SW I. Sri. 24 . 1 ~31 \ R TV9 loin of Somerset Sul"Ikision I'I'll. Lo[ Certified Sung' Map Volume . Page t \\arrano Deed- ('beltne2007)VolumePage u St,; r"a'c Dy C'WIo I it lines idan fable Occs❑no Sl S ITNI NIAINTFNANCE AND O\V\ER CERTIFIl I ]ON In-~I'l y+er cec and n'.a ntenane -,,1 ,our ',:pr , 'y't nw <ould rc,r I i.. prcinnturc l3ilurz to handle wastes. Primer •m ;I~n.Ies o' rtPnpme oo. lr: cpvc !Ink Unry Wee jno •r,.Per_ r ncedcd. by a lis•r,cd pentper. What you Dot into w:.• um can affect the function of the septic ink as a treatment stage in the waste disposal system. owner maintenance ~n,ibi l it ies are sll Il ed in SPS. 33,93, 52111 and in Chapter 12 • S. Croi\ C"way Sanitary Ordinance. I II: pramcl I} own el agrees 1I- submit to St- (Un Counh' Pow inp• & Zoning Dcp nMCI a a cenitication Onn. signed by the ~.n. roar and by a nastc: plumber. iowng nm plumber, r amsted m:ur ber or a licensed p rawer ,'erQ mg that (I) the on-she \,a':cwatcr disp?sal summa .,ill proper operating cend'no•, and or!'_i ellcr inspection and pumping lifnecessary I. the septic tank is anan i.9 full of dodge. I we, me IM&MISCS ha,c read the HKINC rayalrernent, and agree m:unain the poking scoage dupo,al iymcin with the oand:uds set Earth. herein, a, sa h. Me Ucpaapmu of Saky And Professional Services and i Department of Namml Resources, s(.:IC of lShuman. (Antie0Mm , m"W dat rata n tie ~),wni has been Maintained InUM he Cnmrletcd and NWnWd to the St Crol\ (:wins Planning \ nine Depm;Ment wrthm in, day, of tae three scar npration d:ae. I we cad§ that all ate-naus on this Qrrn arc true to the heat of my our know Iet1 e, I we am, are the owner(51 of the r- pen, dewnhed aho\c, by t Inuc of a oar-a',I\ deed reavde,: nl RCPI,te' of D,•hi. (all. e. \l n cr a f be roomti 4, zl) `8 I l RI, (A APPI.IC:At~-~ D \ I l •••.\ny in Gn Malin. th rt s :nis: c,nrwnle•:I m.rv result : I d,c ,.Inicc, ,'crin;l?-c.nu rc,"kee he the Planning \ Zoning Depanownt. Irnlnde ,cab this apmli, n on a rr~„r,l I ~.•I ar•y 't "'I ~nmt the l nr Drrb. r olio and a x9" 'I Ow : roil rd 'nrcu n'ar if reference is made in tau warranty ccd IRF.A.114 12) Page 8 oEPARTMLNT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION V.O. BOX 1969 BUREAU OF PLUMBING NIADISON, WI 153107 NEly, M!zi, S24,T31N-R19W 3CJGONVENTIONAL ❑ALTERNATIVE 'Gown of Somerset 17 Holding Tank LI In-Ground Pressure .1 Mound 72th Street NANI Of rFRMIT N OLOEN AUUNI SS Uf rE RN.T.OIDEP In9•f::I IUN Jn II 9I n George IIanDsbur UQ Route 1, Box 21, Osceola, WI 54020 3d_s elJ dCY~ BENCH MAR. IIerm~vnl-I--L-T I1131n1 r II 111 I IIN NI IKON ILA. REf IT ELEV. ST REF IT ELEV is or h._TT,r MliytlPSW no (PUn r - _ UILF1 lwmn no•IDN William Pfannes 6222 St. Croix 99035 T SEPTIC TANK/HOLDING TANK: _ MAN91PACTURER CT 0CAFALTV TANK tV LET E-EV I.%k 0V11 f 111. tV PRNING LAIIFI - LOCKIN4GWLn j 7 / q -t > 6 I UV MED. POVI OEO W^Y-~1`l(J I10 /JJ ~I ) OV !.['J VFS NO ❑VES NNO Ivooixo - aLN1 ne vI VT NA•. NIC.$tTEN NUMBER OF ROAD I11UIEFITI Eu - uurtuln V NT TO INESH J a:nNM fEET FROM -7 11v~ 0 I AIn wLEI GIVES NO -1 ` Yf.S O NEAREST... DOSING L AMBEq: MnNVCnl:lUtNl1 1NI '.1.. 1 ! G I.IV rUTA-MODEL UNI. SN.OV VANLI \I'.1 X111 ~t NARVIN4 LAtll1 NK Vl.(O\ER VvOVInfU IPOVIL[O IJ YES 1]N~ 1__ L L YES ❑NO I YES ; FL F'NO GALLONS PER CVt7LE. 1:ilwv AnnGTVnuniorrnAnD^^' TN R OF Curv WEv1h4rREZN (DIFFERENCE BF TWFFN ROM •t N1n PUMP ON AND UI E) YES NO T SOIL ABSORPTION SYSTEM. Check Oesoll monmreat thedepth ofplowing A SO x1, MAr.Rw. NJMARr. I,;or excavationI If sod can he rolled into a wire, construction shall cease until FOthe soil is dry crounh m coot rue l MACONVENTIONAL SYSTEM: n 11 11I x•'11 ITT :1 915tH IT E nCl.:: tl IVSN:L DIA •r113 IOU EottRENC aDIMENSIONS DIMENSIONS ~1 ENC.1s 1111 Al PIT nfITN DIMEN rill - l T. T1 1 ELT. n I l i s - 111 1.. 1 rmi o1s ~rM A WE nu n, n NUMBER OF IgOa 1v wfu ulnwwc V vT to nusn 'r r,:, IF, etl •N111 IElf . 7 I..I FEET FROM /1 O AIR mLEr ~ !eL •~Y L,. ~ - 21 _ NEAREST-~L.`SL_ I✓-._ to MOUND SYSTEM__ Mound site plowed perpendicular to slope Check the texture of the fill material for I PROVIDE A DIAGRAM OFSYSTEM and fUr10EY3 thrown upslope: mound systems to make eertanl that it ON REVERSE SIDE. SHOW ELEVA. _ meets the criteria for medium sand. TIONS MEASURED. 17YLS LINO IL COVER rExraflf rfRMwlnlNal%fK alisfevA non WCls _ "W6" LJVES NO _ - YES VNO 1:li'11111 \'II ~I tirl Ntnl.ll ..,-I V• IIIFNG-A57 101501L' F lllllll IfUrn 7 YES II EDGES ❑VES ❑N0 LIYE$ L~N0 UYE$ ❑NO PRESSURIZED DISTRIBUTION SYSTEM: 11-1 If V~'.T11 MI OF LA•f RA. SPACING GRnV EL DFITY 9ELUw VIVI - FILL Cf",l A6 V COVER BED/TRENCH uu. vlaas DIMENSIONS n'n I'nn IJMI MANI1111 fl DISTR. PIPE MANIFOLD MATERIAL. VO :Ntiw OIS1R. I UISI~VTtONIIEAIAL O MANKIND ELEVATION AND . r LL( V VIA. EL1 V ZITS ' A DISTRIBUTION Nrn~an nor xra~lNt. r. P.ufn C.nnnrtnv COVER NATtR1nL ' of RT1CSL LIf T CONRLYVNOS TO AlIl 0 INFORMATION ILA.$ EVE El NO IYES I, NO COMMENTS: PERMANENT MARKERS. ORSEAVATION WELLS NUMBER Of IROPFRTY WELL BWLUINF LINT l~ OM ~I_VES 1 110 ❑VES I_~NO NFARIE NEAREST---__ 90 - _S k Sketch System on RnIlain in county fete for audit. Ruverse Side. SII.VATLflE-. DILHR SBD 67101H. OT/BYl ~ / _ -7.oninq Adeii ULaT ~ r 1, Lit -0 Delarlment,d-, 29 201tOILEVALUA u r #1967 _ / Safety and' n, accorded with Canon 85, Wit, Warn Crxfe Page I of 4 = Professional Services Schmid Soil Testing. Inc. County Attach Wmplela site plan on paper not less then a% x 11 inches in size. Plan mull St. Gmlx ~rclJOe, but nor hrnlted to. vertical and horizontal reference point (8M), direcfan and - - - ti,r nl slope. scale or dlrnensrons, north avow, and latabon and distance to nearest road. Parcel I D 032-1 3 002 Please print all information. Rev d By Date q Peauuol ud~xmdtierlyCRr provie)rwvts usrM lm =2(r nary w, .1 1504 (1) IMP property Owner Properly Location Vander Veer, George R Karen Govt Lot NW V4 W1/4, 524, T31 N, R19W Property Owners Maaing Address Lot # BlocL # Subd. No or C'S MN 720 72nd St City Slate Lip Code Phone Number City Village Town Nearest Road Somerset WI 54025 Somerset 72Nd Street New Conshuclwn Use' Residential l Number of bedrooms 3 Code derived design flow rate 450 GPO Replacement Public or commercial - Describe - Parent material Outwash (Chetek-Onarnia Series) Flood plain elevation if applicable n. General commmnis Repl:,,;enleot area is surtable'n: auunvenlronal syslnl Wit 10 7gWrsgfl tale. Syslein elevation fw feplac:emenl area is 9? 35'. Jnd iecomnMndahnns. Siope Cl area is tN.,.. ❑ Boring # Boring PA Ground surface elev. 100J U 1t. Depth to limding factor 98+ m. Sol) Application Rater Horizon Depth Dominant Color Rodox Description Texture Structure Consislent Boundory Roots GPDM- m Munsell oil Sz Cool Color Gr. Sz Sh. I 'Ett#1 •EIff1 1 I. 0-8 I0yr3/3 none sl 2mgr nrrfr as i 2Vf i 0.6 I 1.0 2 8-17 7.5yr4/6 none grsl 2msbk mfr gvv lvf I 0.6 1.0 3 17-25 10yl 5/6 none 9rcos Osg ull cs j 0.7 1.6 -1 4 25-36 i 10yr6/4 note j S 0sg ml cs 0.7 1 1.6 1 36-40 I 1 r5/6 rune I's Osg ml cs - - 0.5 1.0 I I none s NJ ml 0.7 1.6 6 40-98..1_ I0yr6/4 r I ~ Boring # Boring a S~ . Pd .:sound suAace e'ev 98.73 It Depth !u limiting factor 96+ m (S-I Appticaoun Rate Horizon Qpth Dominant Corot Redox Description I Texure Structure Cunsnlrnui Boundary Roots GpryB' in Mull"ll Gu. Sz. Con. Color 1 Gr Sz. Sh. 'Ensl 'Ea#2 1 I 0-10 10yr3/3 i none sl 2mgr mvh as i 2vf 0.6 1.0 2 10-23 I0yr4/3 cane sl lmsbk ! mfr gw lvf 0.6 1.0 1 23-32 I 10y14i4 none gist 2ntsbk mfr I 9w 1vf 0.6 i 1.0 / 4 32-86 IOyrS/6 I orle grcos Osg ml cs - 0.7 1.6 5 86-96 I0yr6/4 none I~ Vfs - -1\ sg ml 0.4 0.6 - Effluent #1 = BOD,:. 30 < 220 mgfL and 1 SS >30 < 150 mgil ' EffWent #2 = BOD, 1- 30 mg.4 and TSS < 30 mg/L C5T Name (Please POW SgnatureF / i CST Number Thcmas J. Schntill 227429 Molest, Semi it Sod Testir.V. Inc. / Date Evaluation Conducted Telephone Number 1595 72nd St Flew Hlcmnond. V.1 `,401: 4/23/2019 715 760-1978 ~eniPgR U'nxn Property Owner Vanoer Veer, George & Karen Parcel ID # 032-1066-30-002 Page 2 of 4 F3 I Boring 11p1d # p.l Ground surface elev. _-1110.10 - R. Depth to em#mg factor 98+ m. -plication Rate - - - - Sod Ap' Horizon I Depth Dominant Color Rwloy Des-rlpfion Texture Structure Consistence. Boundary Roots _ GPDHH _ in. Mwrsuil Vu Sz Cunt. Color Gi. Dz. 31. 'Ena. •Enrrz 1 0-12 I0yr3/3 none sl 2fsbk invfr 2c,2vf 0.6 1.0 it - - - i _ -----I._-qw - 2 1230 :Oyr4,4 cone sl 2msbk mfr gw 2m,lvf _0.6 1.0 3 30 60 10yrS/6 none grcos Osg ml as 0.7 1 1.6 q 600 98 10yr6/4 none s Osg ml 0.7 1.6 f mot, h Boring Boring # pit Ground surface elev. fl. Depth to Omitmg tailor - Rate! _ _ - Soil App:icalion Rate Horizon Deplh Dominant Color Redox Description Texture Structure iConsis!encel 3ourdary Roots _GPDM' in. Munscd Ou Sz Cont. Color Gr. Sz. Sn •Enyr •Ero2 i i 8oring Boring # Pit Ground surface elev. A Depth to umdmg factor ,n, -.Sotl Appilption Ratei Hor=n Depth Dominant Color Redox Description Texture Structure Consistences! Boundary Roots _ GPD_M_' un Munsell Gu Sz Cont. Color Gr. Sz. Sri 'Ffpn •En#2 JII 1 i ' Effluent #1 = BOO,> 30 < 220 mg& ano TSS >30q 150 mgrL ' Etfluen! A2 = BGD, q 3~ ,'ngrL and TSS <.3C mgiL The Dcpanwcnt ol'Comincice .s inn _guul upporlunity sore ice pmt liter an.] em:+lo er. If-.,u need nmtcrial in an ultcrmdr formal. please conta;t the Gellarlnleln at 608-266-1111 .u 1 1' sign., v.«. I i ..ism'.,i ii o} rte. SYSTEM PLOT PLAN /w Project Name Vander Veer reorgn8Karen Vander Ver cif-N' I"roieCI AW(CSS - Addrefls-. 720 72nd Street Soma set. Wl 54026 r RV I Sym of - nD,l h.--vic" 1x' J(I e lsm Descnp6orr. Top of septc tar\ +spemon type PID. 032-'066.30002 Scale: 1" = 60' Lol x 60 91 120 9%Q symecl. p B`.1 Ee<akn 99 73 Legal NEI. Mi. S24. TIT N R109J 21d Des6np6cn Whoow SM o' easement mndow Towiship Somerset i t5' 5lcpc GlaUlent ul le5leU Area. 19';. County St Cols 'A~ V Sywbnl r, applirahle) Notes. Ncies I RiW 205th Avnue 100 102 gg \ 1 \ 83)IN \ c % Existing 5' X 67' r;'•, o eio 2 rock & pipe G IA \ a trench B 1 \ c~ Existirg 1000 m gal septi - s . iB M1 septic tank k \ (D 4 BM2 o Pool) Be drooll~ % Driveway arag~,/ Well 0 Property Line C s a„- ~ k ^y _ U m s N P IF. 4~f r a•, yr y n. L dim M I` ~ rK t c o. ~ ~ } k c 1 Ai ^°s 4 y ~ _ r r yt M WY •r ~ ay 1 a .