Loading...
HomeMy WebLinkAbout030-2131-37-000 (2) =pr_-le. e PRIVATE SEWAGE SYSTEM I' St. Croix Sete[: and a-i ding ri:'is lpn $:mil P,n, I NO. INSPECTION REPORT :,ty SAN-2019-129 GENERAL INFORMATION AT-ACH PLRI-Al 1 i St.ee ph. Ic vo Pe-sr,-ul mlann:h.:n qw. In s.o:in rnui =c sec'w 1,.: u,L1:y i:.np:;e.ns [Pvn s 15 0< It::"III pcRni' Ipnors'.arnn !xr , ape Tennship ln,li a. No Michael Puhrmann TOWN OF SAINT JOSEPH 030-2131-37-000 -RVF1 ,¢p tat.l ne, 1 n'd ❑er'e r:uc ecLC^il C.nlRan" hh,p Nn 23.30.20.1091 TANK INFORMATION ELEVATION DATA Ivor l,IiANU=AC I., RI-R 'Y STI,TP^N BS HI -s ELL,i Sephd f':cnchrlua I I:ISrtIg All 1410 ACt'allon l bV Se:,er Molding S:2 let SL'Ht Outlet TANK SETBACK INFORMATION TA',K TO PIL I- ULDii. 'lent tc Air I-tabs ROAD DI Inlet Septic DI Bottom Dosing Headedhtan. Aeral,on OS. tripe Holding rot Syslem F val Grade PUMPISIPHON INFORMATION Manufacltucl Donnnc Sl "ovw Gw" tviotkY. N. uDc-r TDH . dl nc;ion Loss Salem -cad TDH Fl Forcemai-i ength Din. I:.:: -II SOIL ABSORPTION SYSTEM RED,TRENCH M;th _rngth OlTmnches PITOIMFNSIONS No. O'Fi'- I^SIce Did. qwO Gcp:` DIMENSIONS , SETBACK SYSTPd TO °rL ULDG LA{irS1 REAM LEACHING h0a,0aet_rer INFORMATION CHAMBER OR I~pe O: Sys'em. UNIT Nadel"umber DISTRIBUTION SYSTEM yeader'Nan'cIC 7istr tnarn: ^nlr. Sze x-de Spat ^p ve^t tOAir httabc -enpth t SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depr^ r:eer Ocnr O'e• Dept- s xx Seedea $od:h:C 'nuichrt^ li 1,ern:h Ccn'or IS>d! I ranch l_dgc, Tap=oll , r•._ - COMMENTS: 1 n 1. i:c roue dlSuCpencies. persons preserr etc i Inspeclion ut: yy IIvspecn-ll #2. Location: 1412 SETTLER'S-Aii :~JI rK,1J'~'tt01r~ L6.4, ! it- t Al: UId Descnption D , 2 j Bldg sewer length = sl A~71,~ /~0AC~ J - amount of cover = / Plan revision Required? Yes No Use other sice (or addd:onal i'lformallon T r l/ l V i _ Date Insepct signal CeN N. S13D 6710 LR.3:0.• j ,y G' I I d .i I ~G P ~ M~ S Jp Z s 'G g Q i 6m , x o£F c N 2 Z n D C ~ D G = A g - 2 V z C b C c t M± y O I F L J A unty SanitaV PermU A~ppUc'f'^° ST. CROIX COUNTY WISCONSIN pW~ In lien, in r ah Cl a:r l 12 -t. Cioi> ounly Samr r~ W ra n a PLANNING & ZONING DEPARTMENT ,,lcr6Tt.onal in rt;+hor ,uu pr.: 'ide may be rscd for:. rrda•y pup:°e" ST. CROIX COJNTY GOVLnigm1 7CENTLR Ci t, Ynoa Liw. S. 1504',tp;.n' 't Dl Carnrel,ae R ad - Hudson WI 54316 -7711 ~'0 7'5i18' ti89 Fax i. rS'1786-~"086 ,.,q" 6) complete clans ter the sys'mr nr pair' r,:I ess thin 8-12 x 11 r;he:: 1• size. - _ rf,~•y,S `an Iary Pernvi A rl Gherk J rc'vis on to o'evraus aPPI c3'.ion r" 5 I. - 2-p l " 1. Application Information • Please Print all Inl ation Location: P; opert'! Uvma• Na•ne / rCr- 14 SDI 1!4, Bee o 3 /l/(4At e 1 v,/I/SAN n,c% 1 _~7,61 N. R 26 Eior! Poperty ':{men's M11admy Aadross / Lct N "7- Block N,unher c P/, Sa:n Zip Cad, P-10 1-1 Nome• Su I,I- Name or CSIJ Number s/- y7-2 -3<r3t7 II Type of Building: (check one) [C P/ ❑ Village 1~3own of 1 o' 2 -ar-nly D1,011ing - No. of 8edumn's. Lgl~ F: W.hiic-0o~'na•a al (oe;::nhe r.scl uvmed Nearest Road(J j l "r/7 ~r6 Uln II. Typo of _ mrR ~Cnoca Orly one box on I re A. Cnocn box or 6na D f ap0 rca:a«<) I - Pa°:rl fax \~mhe•(si _ C;', IU 1- *P,epair 20 Reoornedirnt 3.[Nurr~lumorg ❑Hel,roenatcn 7C Sarr tio9 ~ormit NuI _:ate Issued / 700 3 B) ~':a[r- S,:nary 'ennC vra5 previa.sly msued4 I r_ O (aSa % Z L3 IV. Typ _ apply} _ ZdY-t n/ `n.r prrsrurz d n-g•crrd 171 I/ound r linableSOd F1 ftrnmt 24 In v -bILsoil ❑ Wound A." San] Ifte - - - C CoastnrctKd Wcljat o ❑ Pea Ftlter ] Drp tIr.e ❑ prnssi.nmc lr graand -.:anq lank ❑ Sngle Pars ❑ Ctner n At q•a ❑ Aornr, C -reatrnenl Un 1 C Hcertcula:inq V. Dispersal Treatment Area Information: 1. Uasign F-v ig::dl 2 Disperse Area 3_ Drsp^•sal Area t Su I Appl cation Rale 5 PereclaUnn Rate 6. Syslecl C'e•rahon Z F inal Grace / Regr.rre!: P+ele"04- Gals : day'sgJ1.', W11.!mcn: Fevahnn i-2~~~/ ~z r3 Gl ~t~ VI. Tank Information capai0ty in Gall::ns Tulal .'o' h'an,ractdrer Prefab SI e on. Steel Fiber- Plastic Now Fxisli'tq Gallons Tank; con W'ete °.In¢ICd Mass leeks Tan', I~N - - rt ^:.r<t.rG- >.Ca wi '.vSa_• /270 ra.! n.'r+n 3.. Id O ❑ ❑ .7 ❑ Ll ❑ ❑ VII. Responsibility Statement I, f•re enders ~gred, assume resporsiO l ly for •r=pa urer..u viers°iomrEjuvenalioNinsla lalion o' nor plumo ng f-a 9rc POVI shown on the allarhed plars A 4Cen56 is nUt rCQU red `Or terrahlt repa r o' [hc irie131lrLinn n' err. plenl9 rg Sari'atlOn :iys'~.;Pr Plumbers Narne :pant) Pluir.- . r la: 1,10 St' psr MPr'MPHS No. H isiness Phone Number Pldmber s Address Strore City, 4talr. Zp Cod-- n /<r✓i':L K?/S VIII. County Use Only o doo Sanitary Perm t Fee a.5 a.eu Issu Agent S n, a ihh e',~r•,µ,;i i npar:;.;e:: ~ O,,•rcr c :e .,e ~ ZCjb . 00 5/ 31 /l Ier 1 I IX. Conditions of Approval; Reasons for Disappr^^ovallL L f / yr\5~a~la-{~`a-rl vF" C~ t1C-:tR'fr~~:o/~ ILK ~ ~Jv~..L2-. oL,J ST CROIX ('01INTY REPAIR DRAIN FIELD IIEADER PIPE REPAIR FORA FOLR BEDROOM RESIDENCE Owner's name Michael Puhrmann 1544 Rivercrest Rd Lakeland. NIN 55043 Located in the 1432 Settlers Wav N 1.1 ''A of the SV4' of Section 23, T30N, R20W. TONN N OF ST JOSEPH S'l CROIX COLNTY NVI Parcel # 030-2131-37-000 Lot # 37 INDEX Page 1 Index & Title Page 2 Information and repair scope Page 3 Pipe repair detail Page 4 Septic tank maintenance agreement Page S Septic tank Certification Page 6 Aerial Photo kith approx. locations Page 8-1) Manual and Management plan Attachments: Bird inspection, Permit Filc cI)'V/ 2v i' CT Prepared BY Michael Rodcwald 285 Count% Road SS River Falls W l, 54022 71-6zz1) M I' " 931384 Signaturc_ i 285 couNrv ROAD ss EXCAVATING RIVER FALLS. WI 54022 800828.3723 ?15-425-62C~n 715.425-8466 FAX ~ .>tq,,'e '7 Z019 Michael Puhrmann 1433 Settlers av Toren of St Ioscpll Septic permit 44.10188 1110; Reason for repair: Intlallation of a distribution box to promote equal distribution. Upper trench is ponding, middle trench is kin, logver trench shoti pondinp only on the cast end (drN on the heatler end inspection). I ? 1 ~P61 f i t~( Mel- lee- ~r51 GnX ?("doe- Q ~ ~Nsl~ lr E P J~sF~ f 9o 0 7rH s S7. CIMIX CUIiN IN SEPTIC TANK MAIN' I F.NANCP AGRF.FMEN:• ANO OWNERSHIP CltR I'11-WATION FORA Owner1'1311yer feilingAdtlress~ ^/SN~ n',uP~L'iesf CAAellivvp irJr/ 55Q~J3 Property Address , ILMY 7Q (j IT Sf J ay , r (Veril cation raquir •d Font P!:mninq $ Zontnc Ucp:uuruv u r nc•.w c rsnncliu::.j City-Slalc L'✓,~~ Pans:I~cntitic:uiuaVrunbct 030'21.31_37-Q4(~ LEGAL DESCRIPTION Property Location N _ !'s , cl ;ti , Sec. I ( IN R_ ) W. i uwn of S _ 4>r Subdivision Plat: tfle/~ G2 den/ ~y5 03C.l -613 Lot 4 37 . Certified Survey Map # _ Volume. Pagc Warranty Deed # (before 2001 Volume . Pagc a Spcc honsc❑yes2~:o Lot line, iden6fmhle&es❑t,, SYSTEM MAINTENANCE AND OWNER CERTIFIC• FION Improperaw and maintenance or your scp+ic. syste.nr could !esull :n its premature fanure to handle wastes. Pr^pcl r: ;:intcnanee eie:si5ls of punapbtg act tl-,e sgrfc tm:k every lumr :leers of •oo:uer, i1 nccakJ, by a 6censcrl pumper. V:I:at ynn p::' late dm system can atfecl ilte function of the septic tank as a tn•.n:roent stage a: the waste disposal ayslcm. Owncr maiwcndmo res,r~mibililies are speci!ied iu gSPS 333.'2{I1 and in Chapter 12 - SI (kotc County Sanitary Orlinuncc. The properly uwnur ttgrccs to sabmil to SL Croix Couny; Planning & Zoning Dcpawncan a certi:lcariun form. signed by a c. ovmer and by a mamcr plumber. iourncyman plumber, raluUCd plumber nr a licenscd pumps; -ecidyiug iha: (1) the on-site nalstewaler disposal system is in proper oper.ning condition ati&ot (2) at" I in pecbon and pnmrx.g (if necessary), 1:^.c septic tank a: *;+:han II? full ofsludge. IAve, the undersigned have read the.lmre re.p6mments act. agree to maintain rac priva:c sewage aixpusal system with fac str Aiids ,et forlh• heacin, as set by !hc. Department of Smciy Aim Professmna: Scrvires And the Dep onienl of N, :oral Resomncs, tilelc of q'laconsln. C.rti I-Xc:inn StAing Il:al your septic s•istcm nas been :vaauainel must be completed and mlun-od to the r_::. f annDa Planning & Zoning Della: Intent voldill1 39 days of the three :•ear expr.aBun dale. I etc artily th+t all stalelln r IS un I n r I ^ :uc l I: 1 11 r I .Iq;. I: ;c .mr'a:e th I ^ :.Isle pngr ay dcser6cd abwo, by s irlue of a war r c : to I I -!cr Number of but Irolons t SIGNA I'I'RF OFAPPLICANI+.SI DA:1: --:'v; in!G::maiun that is Iaisrepresetncd may tcsull m the a:r...:.u y pew.i: tieing revoked by the Pkuming & Zoning Depmw:en:, lnclu'e will'. :ppim:mm,.1 r .,1,.Cd .:a e I,iced 1 . i PVe PC'1 1I P! ,17: I'.ll .e:,nd a, : ac ce:. I::.I :rcev map is .aulcncu thr (REV. 04121 i ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that 1 have inspected the existing septic andi or dose tank presently serving the frllowing residence: (Streetaddress) /y3Z- ^ cttlel- C"!r located at: Section Town _ N, Ran-,c 2e X1% Town of M. roix County Wisconsin. 1')011 inspection, I W-titq that 1 have firu11d the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to he tiurctioning properly. 41ost recent date of inspection or service- pomt, /lIzz17 Did flow back occur ti-om absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: /..1-5v Pd(et - : N _ M Construction: Prefab Concrete _ Stec] Other- ylanutacturcr(ifknown): ijic*,e,t - u a,_,. A,,e of Tank (if known): 1 .7"C y Pcl'11Ll mmlber (Ifkn)wn) 4/,?O y U 7/3~ z 3 (Incensed Plumber Signature) (Print Name) g313Sy, (Title) (License Number) NI MPRS 5 7,/2u j (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06. Wisconsin Statutes) or licensed disposer (NR I I Wisconsin Administrative Code) Rev. 22012 , i~ y r Ilk. w 4 Lk y _ ~ ar l b J J w jw~I.I~ ~ ~k r. F -9e 12 Vr ~ '~al f POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner lf~le 4 y `rn.r A-rt ll Septic Tank Capacity el ❑ NA Permit a X30 j ~JtJ t' Septic Tank Manufacturer ❑ NA 55 Effluent Filter Manufacturer Z. C3 NA DESION PARAMETERS Number of Bedrooms ❑ NA Effluent Filter Model a\ 00 ❑ NA Number of Public Facility Units O NA Pump Tank Capacity al O NA W a C) NA Estimated flow `average` 00 alloy Pump Tank Manufacturer Design flow (peak), (Estimated x 1.5) p allda Pump Manufacturer Cs O -k\ f~^ ❑ NA Soil Application Rate al/de /ftz Pump Model ❑ NA Standard influent/Effluent Quality Monthly average' Pretreatment Unit NA Fats, Oil & Grease iFOG) i 530 mg/L ❑ Send/Gravel Filter ❑ Pest Filter Biochemical Oxygen Demand IBOD6) 5220 mg/L ❑ NA 0 Mechanical Aeration ❑ Wetland Total Suspended Solids ITSSI 5160 mgiL ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dleparsal Call(s) ❑ NA Biochemical Oxygen Demand (BODr) S30 mg/L `-Ground (gravity) ❑ In•Oro~ un~ d Ip~e~wutedl Total Suspended Solids iTSS) 530 mg/L NA ❑ At-Grade ❑ Mound Fsoal Collfonn Igeometric mean) 5104 -cfWIPOM1 ' ❑ Drip-Line ❑ Other: Maximum Effluent Panicle Size Y, in die. r ❑ NA Other: ❑ NA Other: ❑ NA Other. ❑ NA •Value$ typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency month's) Inspect condition of tank`s) At least once every: 3 ear s Pump out contents of tank(s) When combined sludge and scum equals one-third (Ys) of tank volume O NA ❑ month`s) (Maximum 3 years) ❑ NA Inspect dispersal celltel At least once every: 3 ear(s) ❑ month`s) O NA Clean effluent finer At least once every: I . year`s) ❑ monthls) O NA Inspect pump, pump controls & alarm At least once every: ❑ ear(s) ❑ month(s) DNA Flush laterals and pressure test At least once every: ❑ ear(s) Other: ❑ month(s) ❑ NA At least once every: ❑ oar(s) Omer; O NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintalner; Septage Servicing Operator. Tank inspections must include a visual inspection of the rankle) 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 beck up or ponding of effluent on the ground surface. The dispersal collie) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IYa) or 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 NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ~l Page G ot START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(81 for the presence of painting products or other chemicals that may Impede the treatment process and/or damage the dispersal cel Is), if high concentrations are detected have the contents of the tanklo) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cattle) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells, Do not drive or park over, or otherwise disturb or compact, the area within 16 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (SUMP pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scrape; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Cade: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption 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 replaoement 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. E3 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. W/^ 13 ; site t ,An If on FAA!ft^~~~ -'194A A tit, tank O Mound and at-grade soil absorption systems may be reconstructed In place following removal of the biomat at the Infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time, < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name /ylifC- l~) rtLJ/ f y'cf~ L Name Phone '715_ 2S c, Phone SEPTAGE SERVICING OPERATOR (PUMPERi LOCAL REGULATORY AUTHORITY Nams f /tf/~ Sr Name S i . (k16) k ~U . N i Ji Phone r5 Phone This dooumsnt was drafted in compliance with chapter Comm 83.22(2)(br(t)(d)&(f) and 83.64(1). (21 k 13), wisconsin Administrative Coda. Septic System and Well Inspection Report Bird Plumbing Inc 1432 120th St. New Richmond Wi 54017 715-246-4516 sbird@frontiernet.net I Shaun Bird, certify that on 5:19119 _ I XXX Inspected the Septic System (PO , TS) XXX Inspected ;he Woll XXX Obtained a drinking water sample FroPertY Owner/Buyer Mike Puhrmann Site Address 1432 Settler's Way Houlton Wi As a result of my inspecton, I certify that: XXX In my opinion, the septic system was, on the date of my inspection, in working order and in compliance with the standards set forth by the Department of Safety and Proffesional Services. Any exceptions or needed repairs will be listed below. Last date of pumping 11/22/17 System appears to be sized for _4_-Bedrooms XXX In my opinion, the well at the date of my inspection, is in good condition and complies with all WDNR standards. Water sample sent to Quality Water Testing Lab Somerset Wisconsin. See attached Property'[ ranster Wells form. Any exceptions or needed repairs will be listed below. In my opinion, the septic system or the well is not working or not in compliance with the Departmot of Safety and Public Services or WDNR. See attached Property Transfer Wells Inspection form. The pressure switch is out of adjustment. It needs to be set to 60/40lbs. Currently set at 35/18lbs. Next time the septic, tank is pumped, the filter handle needs to be extended. The header for the drainfield appears to be needing to be redone. Currently all the water flows to the lower trench first, then fills the upper trench. The lower trench will overflow before the upper and middle trench are full. The middle trench was completely dry. Septic System maintance information: Pump tank every 3 year*.~nd clean effluent filter if installed once For further information. contact your local zoning office. Disclosure: This test is not a guarantee of future performance felt a proffesional opinion. Usage can c; different owners. This is not a warranty of this system. I discl m all liabrtfy for any loss caused by reli cerfication. Past problems with this system,( if any) need to be'disciosecl by the seller. Shaun Bird MPRS.!CSTM tt226900 DNR# 7640,_ Date__ 5;'91 Nucirnsin DePadmunt cf Co-nrnercu PRIVATE SEWAGE SYSTEM County Safety and aviding C,v •8u~ St. Croix INSPECTION REPORT Sanitary Permd NO GENERAL INFORMATION (ATTACH TO PERMIT) 430188 0 Sae Plan D No r'ersoaom iNOnri9HOn )~ou,vuvWe may be used :or eondary purposes IP[V2Cy Law, s 15 Os ; ):^i St Joseph Development ph Cay Village X 1o.nship Parcel Tae No St Inc St. Joseph Township CST 8A1 Llev. Insp. BL1 Elnv 11" Cescnphon. ( m .fl r Sec[ioMn.nlRanga.lAap No TANK INFORMATION 23.30.20. ELEVATION DATA TYPE ldANUFACTURER CAPACITY STA1,ON' BS HI FS ELEV. Septic ~)£-(56{2- tZ~ Dccchrnark r I Dosing ~.tf•snti no 6~+ All. HM 0• u t~•YJ ~.OO a P•v Aeration W Bldg. Sewer I Holtling SI!Hf Net r - k!e/'i t TANK SETBACK INFORMATION SUHI Outlet 1ANK TO P!L WELL BLDG. Vent to Air Intake ROAD Dl Inlet SepCC r . 5D j y Ot Bottom ttY~~ g Dosing U Tl I O f He3derilda RI •I p-r•a~s Aeration t• S•~ ~(.~f Dist. Pipe, / r Holding _ Bet. System 5~ 4.9 2 3' + PUMP/SIPHON INFORMATION Final Grade Mamrtacturer Demand ve ST. w.e,,, tM+O' r„x c.ea.aie~~ Model Number GPM - ti ~ 5 , 7DH LiN I Foci, on Loss CPO System Head TDH Ff Forcernain LengthV0l DIa a Utsl !p Well 2 5 r SOI PTION SYSTEM 9 DIM rTRENCH Lenypt No 01 re jvs PIT DIMENSIONS No OI Pils Inside Duti S LiOLi9 Depth 3 @.zS ex) 3) SETBACK SYSTEDA TO PJL BLDG WELL LAKElSTREANI LEACHING IAanufa ur r. INFORMATION Type C`Sysler CHAMBER OR S l.BL1N 2S t ~ 9/ ~ /p~ UNIT MudOl Numtx~r. lr DISTRIBUTION SYSTEM 2 Header'Ma-ifoc it U,stt bug.or. 2 S :,pelt,,, ' It - x HOW Spacing VWI W Air lnfai Lengni I Die Spacing 4D 'SOIL COVE., x Pressure systems Only xx Mound or At-Grade System Onl Depth Car Deptt C+or xnCe y Bexl?tench Gunter HrrlTrencn Ed P[ y " Or u Scnded+Sodded xx AfurUed Des hgsoil Yes No Yes No COMMENTS: 'Include code tlisaepencies. persons present, e:c.) inspection p1: D Inspection LoWlion: 7432 Settlers Way Hudson, WI 54016 (NE 1!d SWGV.4'23 730N R20`.N rxWers Gten Lot 31 F~arcel No: 23.30.20. it A 1.) Alt BM Desenolion- S~ L, K:qua•~pr 9ui' S `~U .pwAA~,N{~ ~Z +-~•ryu•C !r ~p 2.) Bldg sewer length - ?mount ot rAye,•' I r ~ .2 6 c ` IrX) ~IAAY.~ 'i~ . ol~,wnmF~e- ~~1rts es 2~-~R 1 AMOCO `"20~ S Ra c9 ~eua. ~«t iS JeQ Plan mvisldn HequhcC'. Yes /('to ~ 0 se oR,er side for additional intormaUon ~f 2 -D1a e -~M+~~_ SBOX.710 H 3:371 _j- ( T~VJ~.~ % 4+S xSns pture UJQ~Si C.~4AC PL y NoA rtAi 1 We P- c~ U• •f I wtiKLL _ 1 bounty Sstely and Buddirgs-Dlvlslur. , 201 W. Washington Ave P.6. Box 1i62 ,7 her Yn (t Madison, WI S37U7 - -tary Sam Permit Sum yo b p! filled is by Co.) 11 Vsconsin' (E'8)266.31 51 3 0/0 p, a artmeut of Commerce L___.--•-.- ---1 1 sue PIU LD. Numbet Sanitary Permit Application dIA i In accord with Comm 83.21, Wu. Adm. Cade. personal mfmoranon )uu provide , Project Add~taa (if different than nredmg address) ma be used for sacadary purposes Privet) law, $15 040)(m) 1. Application Information - Please Print All Informatlbn parcel X Block X proper0' owner's No me _ ,ToSef'~ .e vL/tNi✓✓ 1-:- - ✓ P LTF n~ f Property Location ~ropcrty Gwnm'9 isi stung Address - ~ i' a,Socbon oZ.p ' r Zt Code Phone Number Cl/y. state ~ (C1t6e WK) N: R 11-Bat lT N4 r~ S O I 0.a, *re I; Type of Building (check all that apply) Subdivision Name CSM Number PCI or 2 Family Dwelling - Number of Bedroom .l PublicfCommem"I - Describe Ussc'j~ w - DCitY_~Vtilage SC~TowmldD of 57-.TiSlf~'J~ L State Owned - Uestribe Use 3 y 1~ - one'box no Bne A. Complete Bne B if applicable) III, Type of permit-. (('heck daily D Otber MiAifladon to Existing SysKm A _New System s Repla:emem Systen D Treatmer,VHotd:ng Tank Replocemem Otsly List Previous Permit Number tind Date issued f B. [1 Plant[ Renewal I D Permit Revision ❑ Changc of I Permit Transfer to New I Marc Expiration I Plumber Owner , I I _ IV. Type of POINTS Svstem: (Check all that apply)" ❑ Pus Sand File Non -Prcssurittd [n-Ground Mound > 24 in- of sutwbie sod L~ Mound < 24 m. of surab:e sot: 7 At-Grade Single Prcasuriud io-orouod _ Hotdmg'(ank D Peat Filter C aerobic Treatment Unit Recirculating Sand Filter r Constructed Weiland Oil !ea I in) ❑ Recrrwtadn Synthetic Medre F'.:mr - eattsi Chamber rC~ D Grav:t-less pi 3/ V. Dk ersaVl're"Went Area Infor atlo-, n___.~- Dn [sa: Area ?topes; (sf; S)atem Efcvatior. sin A Design Onw (BPd) Design Soil APrrDliatl . Rate(gpdsf) i Dispersal to Required (s f, /a r 3 I 3, g,0 I Z t Gj .0 J ✓ Prefab Site Steel Fiber BSt: C VI. Tank Info Capacity in :oral Number Manufa<w;r. Grass A Cos:re Commaded Gillons Gallons o(Unis A Ncw ~ { I }----rte I Tanks , } I I -T luLr SAY 1 Scptic or Ilo.ely Tank netabic Trertnsrax Una i ~ - . Dos q Chamber K ~ ~Q I. Responsibility Statement- 1, the uoderstaed, asstune respondbWty for taBation of the POINTS shown on the attached plans. I MPRS Number 9utitxss Phone Number Plumber's Na me lPrlnt) Plumbers Si grmmre - I _ ~~ifl/Q _ Sc~ras,..l~d'r 1 Lt/.%~=.~_~1~ • Plumber's Addre u lSoec6 Qty, Smo, Zip CudU VII t Count )DI artmertt Use Only - permit anitary m.luds Groundwater IDate Issued lnuing A rat Signistue.Irr o Stamps) S g Approved I Dlsapprovco I Su[chargc Fee) e2 ' G ' ~v )Date L Owner Given Reason for Dental 1X- C,onditfone of ApprovaUReasons for Disapproval o ` f7~ ~ / app /LON ^ xA~/O fj 4~ ' s G /L~' ~mcaxo O t1Guf> J /07CU' r , 3. q3- 5 ? 740 ge ,mar: 2 S s4 ~ f 0~"C~2~ ~a rh~va. fn c! 3606 tlf /d a~wh: L~'k`t?tn_ J 1 y h etas a(i2 07/ uI`- 81"It 11. -4 3 ramp~4f {}tar's A la tt:! Coev y ocl re 9 DjPt t It" I x ~ a SBD6398(R.Ol/U3} 449i) 1Xt Ydla:-svs ^^~LP2 6142W»- 0 ter. `i` Q ~ ~ -c • - ~Y: U C Ltl~ / 5 (1 31 t~Ci Mb.a v,, Ta~~ o-3k P1TY ak~.s ~pt~ G 0 Y Az, OSC G CO e SP ~ y I Sc•yCe. ~~'0~ l ~mz a;doa ~G-3° _ NIl'$G ~I I `r r 7P-J 5 i 3t tiCi inb..e v.E' Ted ~ ~`f b i L JJ 2F:Z ,'F^_ T <•~.~i ~J.•r. 4" CI VENT ?IPE 12" MIN. ABOVE GFi.4JE E 25' FROM DOOR, W:NDv^W OR WEATHERPROOF FRESH AIR INTAKE JLINC:IO;i BCX APPROV'cD WITH C:NDUIT XfiNF!OLE COVER F:NISHEL ;RAI£ W/ PADLCCK E 4" CI RISER If WARNING :ABEL aiN. 6" MAX. M.N. WATER T-^'•^ i ♦~n. SEALS SAS- T T:GY•T' ' PPROYEO A SEAL j ) vJ D~ r ( JOINTS OINTS W.SJ 'IPE 3' I B ► J-'ALM f APPROYEO PIPE 3N70 S'ILID ~;1oON 3' ONTO SOLID SOIL W.L pyup OFF ELEV. FT.--~~ ak RISER orr ` D I PERMITTED ONi.Y ZF TANK MANUFACT.JRER 3" APPROVED BEDDING UNDER TANK `i APPROVAL SPECIFIC CONCRETE PAD SEPTIC DOSE AN)( MAh1+'FACT•JR£R: %f Ccw 1wN.B£R iOSES PER DAY:/ :'SN! Si.^.ES: SEr^.IC~~d GA2. DOSE vCLumE I1CL'JDIVG DOSE moo SAL' FLOWBACK: i59 ~4L. ALARM MEL CTUR?R: 4.egg ~ CAPAC:TIES: A MODEL NUtlBE.R: pc u a~ :NCHf.S = •~`gAL, SWITCH TYPE: `tj? rr~ B = ? INCHES r _y,____GAL. PUMP MANUFACr.RER: MODEL NUMBER: C : INCHES . GAT SWITCH TYPE: _ INCHES = 2.G GP.L. R.QUiRED DISCHARGE RATE GPM pUMp E ALARM l;:R:NG AS PER ILYR 16.23 wA" VERT:CAi DIFFERENCE BE:''h'EEN PUMP OFF AND BUTION PIPE FEET + N.INZMUN. NETWORK SUPPLY PRESSURE STA.I FEET FORCEMAIN X 2<D F.. . F. .FRZCT:ON FACTOR • ~-73 ~ rlnrT T FE^ TE T.:TAL DYNAMIC HEAD 41 7 F~ RNAL D.'ME1°: i.\S Ci PL'?1? TANK: C:AN.rmER ; IGNED: ~C 7 CEhSE W-- Submersibie Effluent Pump 3871 EP0 APPUCATIOIIt • Fasteners: 300 series • Ftdly submerged In high ■ Motor HowNrg: Cast Iron stalnlesssteel. gradeturbtnooilfor foretficlenthodtrarWer, Specifically designed for the . CeDa~ of Nnrinp =and and efficient strength, ehd durability. following uses dry without damage to at transfer. ■ Motor Ww. Thermoplas- • ENluam systems components. for automatic and tin cover with Integral handle • Homes Motor. Available and float wAtch atlectiment • Fams 0.4 HP, manual operation. Autotttetlc points. • Hash duty sump • Ep04 Single phase: models Include Mechanical • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled ad M Power Cable: Severe duty RPM, built in overload with preset It IM tatdory. rated oil and water resistant ' Oewaterlnp automatic reset ■ Burtape: Upper and lower • EP05 Single phase: 0.5 HP, hssvy ball bearing fPECIRGATION= _ 115 V. V Hz, 1550 RPM, FEATdaEi coon. Pamp: EP04 bush m overload with ■ EP04 Impeller. Thermo- Solids handling capabAr automatic reset plastic Semi open design AGOY Ut M • Power card: 10 toot whit pump out vanes for • CCapacitl pto 55 GPM. standard length. 16/3 SJTO mechanical seal protection. ceumwawmbsKmdeeca • Total heads: up to 24 feet. with three prong grounding s EM Impeller: Thermo- (CSA listed modeE numbers • MecMroe se: ce - length, Optional T20 fact plastic ancload design for and in'F• or'AC".) • Mechanical l seal: carbonbon three with ,rnproyed performance. BUNA- olost snary. three prong ng grounding plug M Cealag and Base: Rugged omermers. standard on EP05). thermoplastic design provides • Temperature: superior strength and 104°F (WC) C) continuous intermittent corrosion resistance. . 140°F 60° • Fastarers: 300 series F&MRa FEET stainless steel. - L-~ • Capable of running dy without damage to o ass-- components. a Pump: EP05 • Solids handling capabl*: 7 Wmaximum. Tp upt 331 feet. ° , - -a • mschaige stre:1'h' NPT. ss 5 i • Mechanical seal: carbon- a , a rotarykeramic-stationary, 4 BONA-N sgttomers. 3 to • Tempersture: 1049f (40'C) continuous 140•F X-C) ottarmhtent z i t 5 I ' ~ 4o ao OPY } 0 Oa t0 30 tz mint ' o s e a. ~o CAFACm e snwnwwr. ion ,aaa am" Norm , PAGE__3 OF 3 iE Sotih~on LOT#S:4- 1 F ;AL )FS 'RIPTION ~1./~ 12~ 1'3'G LI B LT! FdQi SCALE: 1"= ND - - BM 1 ELEVATION /[b. o i BM I DESCRIPTION '6P oL-- oc 5d l BM 2 ELEVATION BM 2 DESCRIPTI 4oP c.G 2 OPT F~ e - - - SYSTEM ELEVATION SYSTEM TYPE Con ✓er1-{tu na 1 I } ~ ~ CONTOUR ELEVATION fi/Ia 7 2.3 rLlhr-- fw- ~k 7 i 7 a~o3 f Aso `1 t bey 4° ,eA~/Nt \ l: Syt-~ vrudwa~-1' q -2 's~ 5y SIGNATURE ? DATE ' ~ 3~ ~ ' wrate.MJevadnn of C~~ SOIL EVALUATION REPORT Papa ~ a~ Division of Safely and BUN" in aomrdance with Contra 85. Wb. Adm. Code _ fFercel AtWch rornpiete sb Man en paper not tans than a 112 a 11 in Mdd e, but not limited W verecal and hoAnrgal "Mai (9M): and ED. percents", scale or d[mansions. moral arrow. and location id dblencetonwmestroad. - Data pfewe pnW ail Inflormatlion. ;1,; 'i . ) "il i RMta/t/ved 7 PscM arerrmarbn yw War~ea ^wr M urge N saedidery Prava Privacy Lev. s. 15.01(1) (m)). rnwanyLow~'t - ProPenEy r L - GDVtl'bT iV' 1A 11/114 STj T •30 N R ZU E (oi Ii Me" ° tat a Block a Srbd. Nana or CSMa Property Owi?, 't, Addy 3 S4_ 't/S ~f e Y~ ~ U I t CRY p Cms Plante raxniber ❑ Crty ❑ vtm9e ®Town Neaeat Road New Construction for ® Residential I Hi of bedrooms Code derived design flow rate of GM Rectsosment ••tt~ . ❑ Pubac or corrnnnerciel - Oeapba: _ Food Plain elevation f appaceda k' Parent material - v, y 3' 8v. ~ Nr.wrrwns: SY 5 .1 e/< nng # [9 Pit Ground aurfaoa elev. 9S_tih. Depol teihtaMg tacror_05..__M. Sol trition Rae r ° Horizon Depth Dornxi Color Rsdoa Deersyacn Texbae Sbutlurs Conshtanae BaurdaY Roots GP DM 'Efar1 •Effa2 M. Mansell Du. Sit. Cant Color Gr. Si. Sh. I a-lo la 3 3 - L s.h~ / GG/ 1►~ r S Z. 3 /o v - S 6s YYl W j, L, Z Boring f Boring © pit Grated surface elev. 9, Q R. Depth b rmhMg favor S M. sw Rate Horn Depot Dominari Color Redo; DmaWw Tempe Sbuchrm CanabWn Boundary Roots GPDIfF in. MunseN Gil. St. Cmt color Gr. Si. Sh. 'Efwl 'EM2 a-n )o y,- 3 _ SL Z1rt5 !r ! GS d1 s - 2 N Z D - 5 YY ---I c,~u 03 Cw - >a -5 G _ G vy\ 4V P •FlliIn•Bm>30<Z20 mgrt and Tss>30_150 ri #2=BOO <30 ai ad TSS 30 mP't CST Nun *w CST Hama (Plmm - : Q - - Date Evaktaaan - Tabpllme Num6a Address -pz j 1~' S t~n.SJ 1, oz - 7 - I (p D iS - 76o n J C)h rl sc) Parcel 100 ~a< 3~ Pgs z of property O~ e« ~1 aa:q a ❑ in. 3 Gb Pit Ground sinfwm elev. q! SL n. Depth to rai8rp NOW Sol Rats HrxQOru Depth t anlnad Redox Dssaplbrr TOM" Strurchas Corusktwee Boundary Ram GPDRF in. Manes Du. Sz Conl Color Gr. Sr- Sh. T M1 'E1M2 o 3 1~ ~3/ - L Z14 C fnw vI , s. ❑ P'rt Growl surace elev. h. Depth b Writing factor n. $ol Rara i Hcdxcn Depth Dominant Color Redox Deetrpbon Twduae StrnrrbJl6 Constance Boundary Boob GPDAF in. MLmsa Du. Sz Cad. Color Gr. Sz Sh. •EIM1 j •E=2 . _ I Bonn90 ❑ 8ang ❑ Pft Cxornd surface elw. R Depth to liniliug factor in. Sou tim RataRare Horizon Depth Dominant Color Redox Description Texaae Strumrre Coneees,xa Bourndary R[wb GPDIIF iu. Marvell all. SC ad. Color Gr. Sz Sh. - 'EMI •EfW I E®uaa in = BOD,> 30 270 ffw_& and TSS>30 < 150 mVL • Eflkwt 02 = 8005 < 30 mglL and TSS 30 wq4- The Department of Comnteme is an equal uppotomity servim providcr and employer. 1 f you need assistance to acceaa a iecs or need material io an alt=am format, please contact the department at 608-266-1151 or TTY 608-264-8777. • . PA(+, 3 OE 3 NAMF Soo NCO1_ JDT#a-:~- LEGAL 4ESCRYnOhLO-_~-Y4..S,-I T3a .N.R.2r! )~c74 SCALE: I` yo, BM I ELEVATION /Lb.y BM I DISCRIPTION,op oy BM 2 ELEVATION 33, 50 BM 2 DESCRIPTION,6P C-G Z " 012- C, - SYS`T'EM EI.E.VAT'ION 93 oo f SYSTEM TYPE- n rc~~o I F CONTOUR ELEVATION 6-/a I -a ass ~ SIGN'A'i'[JRE DATE ;7 ~ r f sr i, ~~G,~i c ~e ~e T 37 l?f , sr 1 N 1-11 / %D~eF! N n a1y, a 91-17 IAIJ a ea'V s ✓ , + fa F-0 ' -3K P?Traoek4- 0 Zp b~. ~ 2or q ~ 9~ 5~ Sp . ~ ~_y~~'~ - ~ ST ~Gu~~,,~ a~ ~ ~GC --ec,,~/SW ~O -tom nay, Wisconsin Departmento(Commeroe SOIL EVALUATION REPORT Pape of-a Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code County 0 i C. Attach complete site plan on paper not less Man 8 1/2 x 11 inches in size. Plan must C-Y ) include, but not !united to: vertical and horizontal reference point (BM), direction and Parcel I,Q. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ; Please print al! inf rma7 on. Data Personal inknowtipr you provide may be used for ry IxxtKt5B5 (Privacy La::: s. 15-041(1) (m)3 I I^ - Properly Owners _ P Location l_UY 3 G r-, " yG 114 Stj vs S Z T o N R20 E (or)e Property Owners Mailing ress Name or CSKO 12-C : II ,Cr ? flo F4 r\ 5e Gry 1 State 21p Code Phone Number ❑ Village M-Town /rest Road } II Y N r.r ~L MCI 1y51-2`I14 ~Z k ''x_ />w 3S' New Construction Use: ® Residential / Number of bedrooms - Code derived design flow rate 'i' S O tT O GPD ❑ Replacement ❑ Public or commardal - Describe: Parent material E. I Flood Plain elevation if applicable R General comments .5 )t e- Il J . 7q ST% and recommendations: Ccn~u~r -awl. q~po 6!/Ceti-- ~91.J i ) I Boring If Boring 1 1 G~--Pit Ground surface elev. 7 U fL Depth to RmiMg factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W i in. Munsell Ou. Sz. Cent, Color Gr. Sz. SK 'EfWl 'Etf82 I C>-Ili l - Srl 2n•-t~k rr,ir r I~- ,~5 'k`J tL~ • f5~b C2 r\ .S 'l to S ~rti r~ ( ~o Boring If ❑ Boring > ( Pit Ground surface elev. 0 q' it. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description TuxWre Structure Consistence Boundary Room GPDW in. Munsell Ou. Sz. Cent Color Gr. SL Sh. 'Effa1 •Etfp2 c_`~ I )r~`> <5 ! I.Z. I~ --czP~.s '11('D t > I n4 Effluent ill = SOD, > 30 < 220 mglL and TSS >30 150 mg/L ' Effluent 82 = BOD, < 30 myl- and TSS < 30 nWL CST Name (Please Print) S Lure CST Number Address Date Fvalualion Conducted Telephone Number