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022-2001-60-000
I Parcel #: 022 - 2001 -60 -200 12/06/2007 10:59 AM P 1 OF 1 Alt. Parcel #: 35.28.18.549B 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/21/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - WEEKS, JOANNE S JOANNE S WEEKS 94 PONDEROSA RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ` 94 PONDEROSA DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 4.000 Plat: 4951 -CSM 19 -4951 022 -05 SEC 35 T28N R18W NE NW LOT 1 CSM 19 -4951 Block /Condo Bldg: LOT 01 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 35- 28N -18W NE NW Notes: Parcel History: Date Doc # Vol /Page Type 04/20/2005 792692 2787/0001 QC 04/20/2005 792692 2787/001 QC 03/23/2005 790288 19/4951 CSM 09/28/2004 775552 2664/538 QC 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/08/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.000 80,000 241,600 321,600 NO Totals for 2007: General Property 4.000 80,000 241,600 321,600 Woodland 0.000 0 0 Totals for 2006: General Property 4.000 60,000 241,600 301,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 06/22/2006 Batch #: 06 -05 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i o v ° 0 CD o a c C C N � � v � v O T C \ O ( v N C (1)@ .. T LL O 5 U v i Q) C O M Z E E z O 0 z > � ° 3 N > d m O rn F Z 0 0 N o z :1 o @ � (D a�i 2 c N y c 7 N N O N 'E N • N @ 0 Z Z O aw o c .. a m E m c N a 'm • ?' a a a @ c IL 0 0 E LO h U m o 0 Z CD Z C. O � N O C fir:+ 3 i O CD O E I � 0 7 o co m co �V N E 00 Co O R f L d @ rrte�• R CL 0 L c .�. U a O fA U /isconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479312 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. I if 5711/ 3 : TVA NS. 19, # Permit Holder's Name: City Village X Township Parcel Tax No: Hinz, Ken Kinnickinnic, Town of 022 - 2001 -60 -000 CST BM Elev: r Insp. BM Elev: BM Description: Section/Town /Range /Map No: 1 (1),E) /OU (�j Y11 1 �,5 1 35.28.18.549 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing I _ Alt. BM Aeration Bldg. Sewer 1• (05 4J . ( Holding St/Ht Inlet I � �, / • Zg / St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic y l � ( � � r Dt Bottom Dosing (A tl Header /Man. � ti � Aeration Dist. Pipe 3.2v 3 0 z o l ob SZ r Holding Bot. System 3. I t - L- Final Grade PUMP /SIPHON INFORMATION as r> up (( t2 .4eiQ – ao Manufacturer Demand St Cove GPM 0 �� •� r N Model Number PG 2 ' Gor.,o�� . 7S 22- S � ;ED Lift Friction Loss System Head r TDH Ft relds /os oq I cc o� i Forcemain Length I Dia. rr Dist. to Well _k ' , n _ /• 30 A I• }' SOIL ABSORPTION SYSTEM ' �t l BED RI!htem Width / Length r No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. ui Depth ENSIONS (04 3 SETBACK SYSTEM TO I P/L J ' BLDG IWE LL LAKE /STREAM LEACHIN anufacturer. INFORMATION Type Of Syster CHAMBER (�R y�^ tcb S \ 1 �^ UN1 Mo umber. DISTRIBUTION SYSTEM Header /Manifold if Distribution x Hole Size 0 x Hole Spacing Vent to Air Intake �,p r / Pipe(s) Length Dia Z Lengt Dia '' Spacing ' SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over TBed/ Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center rench Edges Topsoil Yes �] No L'l Yes �j No C: MENTS: (Include c de r pe ies, persons present, etc.) Inspection #1: 16 1 / ds Inspectio #2: awl 85 / 5 a-� �V � � (i �� .� L on: 94 Pon Drive River FalI7�sWl , 54022 (NE 1/4 NW 1/4 35 T28N R18W) NA Lot Parc No: 35.28.1 1.) Alt BM Description= R� 2.) Bldg sewer length= > S, p - amount of cover = _2� Plan revision Required? [ I Yes No � 'I � � i Use other side for additional information. s �E Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County ` m W 201 W. Washington Ave.,.P Box 7162 St. Croix Madison, WI 5372 Sanitary Permit Number (to be filled in by �Ons,i� J (608) 266 -31'SI /� t Department of Commerce �j (,tJtS► Sanitary Permit Applicati r ^ Stare Plan I.D. Number hi accord with Comm 83.21, Wis. Adm. Code, personal info you aRTde . / r may be used for secondary purposes Privacy Law, s15. (1)(m) Pmj Address (if different than mailing address) 1 dero Road �'�� I. Application Information - Please Print All Inforlation 1 f j ) Po ` Property Owner's Name / S 1. 1.; O I X t O i ) N ! ; Par 1 # Lot #/f Block # Kenneth Hinz & Joanne Weeks ZONING OFFICE 9d6t.? �f k�fc5 Property Owner's Mailing Address perry Location �� 110 Ponderosa Road City, State Zip Code Phone Number h, _ %, Section River Falls, WI 54022 715 -425 -9526 28 1 rr(circle one) T N; R 6 r o II. Type of Building (check all that apply) p 5 e ,( - or" Subdivision Name CSM Number c,� Z J _ /� 1 or 2 Family Dwelling -Number of Bedrooms � 1 _ . ,I 1 _ _ n«r� �At//rL.tj.• Public /Commercial - Describe Use ❑ State Owned - Describe Use � ,� ��, e� 6 u( c OCity []Village �Iownship of Kinnickinni III. Type of Permit: (Check only one box online A. Complete line B if applicable) - A. ❑ New System 0 Replacement System ❑ TreatmentfHolding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal 0 Permit Revision 0 Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Pl Owner 463087 October 5 , 2004 IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil © Mound < 24 in. of suitab soil ❑ At -Grade ❑ Single Pass Sand Filter 11 Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recircul ing Sand Filter ❑ / Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line 13 Gravel -less Pipe ❑ Other (explain) A 1 1 V. Dis rsaVl'reatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area R I d (sf) Dispersal Area Pro" ( System Elevation 600 0.4 ,�; 600 / y� 600 i 100.67 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units �� / Concrete Constructed Glass New Existing 4 Oe -. k p n t Tanks Tanks t Septic or Holding Tank 1200 1200 1 Wieser x Aerobic Treatment Unit Dosing Chamber 800 1 800 11 1 Wieser x VII. Responsibility Statement - I, the undersigned, aslume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Sign MP/MPRS Number Business Phone Number Roger Nelson MP226497 715 - 2734444 Plumber's Address (Street, City, State, Zi e) 122 East Summit Avenue Ellsworth, WI 54011 VI oun /De artment Use Onl Approved ❑ �nReason Sanitary Permit Fee (includes Groundwater Date su Issuing A Signature Surcharge Fee) ❑ O De nial m IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 3J • v �5 ; e, 1. Septic thnk, effluent filter and l.� e � cell must all be services / maintained /p as per management plan provided by plumber. Y 2. AN setback requirements must be maintained as per applicable code / ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) Kenneth Hinz & Joanne Weeks 110 Ponderosa Road River Falls, WI 54022 SE Y SW'/. , S26 T28 N, R18W Kinnickinnic Township St. Croix County Scale 1 " = 40' Weiser 12001800 tank BM #1= 100.00' top of % " steel pipe BM #2 = 98.12' top of % "steel pipe 40' of 2 "force main ORM 2 3/0 ' 8t it b �o a 133 V% y /1 a JrMa s �'q 2 a Owe/-(. Q A d- � r � 0 9tso' � v x L/pffGre Lot Page 8 of 8 r — Kenneth Hinz & Joanne Weeks 110 Ponderosa Road River Falls, WI 54022 �1 N SE /, SW 4, S 26, T 28 N, R 18 W Vo - tA Kinnickinnic Township A Croix County Scale 1 " = 40' Weiser 12001800 tank BM #1= 100.00' top of %" steel pipe a 7C BM #2 = 98.12' top of Y2" steel pipe 40' of 2 "force main "t• L 3io . _._ BM 2 ism i 091 ,63 / $3 0�.'r Uo4a jr �z �• y AL �riry z`' oi9 �" Hoke f � prvEtL a r h 0 v r L,/Q Ac La >` Page 8of8 Safety and Buildings 4003 N KINNEY COULEE RD commerce .Wi.gov LA CROSSE WI 54601 -1831 4 TDD #: (608) 264 -8777 i sco n s' n www.w www.cammer isco sin.go / isconsin.gov Department of Commerce - Jim Doyle, Governor Mary P. Burke, Secretary July 07, 2005 CUST 1D No.226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 07/07/2007 Transaction ID No. 1151713 SITE: Site ID No. 647421 I Ken Hinz & Jo Ann Weeks Please refer to both identification numbers, 110 Ponderosa Road above, in all correspondence with the agency. Town of Kinnickinnic, St Croix County SE1 /4, SW1 /4, S26, T28N, R18W FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1027133 Maintenance required; 600 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD- 10691 -P (N.01 /01); Biofilter 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. Condit No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, �P, -++� stats. R The following conditions shall be met during construction or installation and prior to occupancy or use: ' DEP ARTMENT , pN FTI Approval Requirements: l< SEE CORRE • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 /0l) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1) • 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 See. 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 See. 145.20(2)(d), Wis. Stat I ROGER D NELSON Page 2 7/7/2005 • 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. 0 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@conimerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Hinz & Weeks 4 bedroom Mound Owner's Name: Kenneth Hinz & Joanne Weeks Owner's Address: 110 Ponderosa Road River Falls, WI 54022 Job address: Ponderosa Road Legal Description: SE 114, SW 114, S 26, T 28 N, R 18 W Township: Kinnickinnic County: St. Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: Plan Transaction No.: 1063896 Site # 6474 Page 1 Index and title Page 2 Data entry 20Qrj Page 3 Mound drawings v t'" a 3U 3 Page 4 Lateral and dose tank , ��rLp = �N Page 5 System maintenance specifications Page 6 Management and contingency plan Z Lclrc Page 7 Pump curve and specifications �- Page 8 Plot Plan P QNDE,N , Designer: Roger Nelson License Number: MP 226497 Date: 06 /27/05 Phone Number: 715 - 273-4444 Signature: , ff,/// 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 4.0 (R. 04/03) Page 1 of 18 i i 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 400.00 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. 600.00 Design Flow (gpd) 3.00 Site Slope ( %) 99.50 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 67.001 Dispersal Cell Length Along Contour (ft) = 8.96 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 2.99 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 4.00 Estimated Orifice Spacing (ft) = 11.77 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 9.33 Vertical Lift (ft) 40.03 5x Void Volume (gal) 0.40 Friction Loss (ft) 46.55 Minimum Dose Volume (gal) 16.23 Total Dynamic Head (ft) 21.01 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800 - 325 -8456 1 Manufacturer ff I gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel 1- 800 - 221 -5742 Filter Manufacturer 22.24 Dose Tank Volume (gal /in) A100 Filter Model Number Weiser Manufacturer Project: Hinz & Weeks 4 bedroom Mound Page 2 of 8 Mound Plan View 1/10 B ... .. : - A J F . . . . • • . . . . • • Observation Pipe — ti•".••. •ti•�•ti•••••.•- .••,••,••,•ti•ti••� •.•ti•'4••,•4••.••.••,•ti ••.• • : �:; r; r• r- :• :•r•r•:•r•r- r•r• j..r':.'.r.r..'..'.r.:•r•r•r• r• :• •� �ti �� �: .5.•. -•.••. •'�!� rte•. �S•ti.ti.•.•1••.•L•ti �1 �•. �•.••.• •'.L• _ ••: r• r•: •:•:•r• r• :•r•r•r•r•:•r•. :.:• ••r•r• . . r�r�r�r,r }� ti ��� •, ftil; j �� :• j. r.r + ��. • � rti fti +; • ,��, rti �� rti ��, r � r � r' jti j W ' .. i s . • - .. . . . . : • • : • • I L Mound Component Dimensions Down slop toe extension made. A 8.96ft E 17.23in H 1.00ft K Ejmft ft B 67.00 ft F 9.00 in 1 13.43 ft L ft D 14.00 in G 0.50 ft J 6.65 ft W 600.32 (ft) Dispersal Cell Area 1 1500.00 (ft) Basal Area Available 8.96 (gpd /ft) Linear Loading Rate 1 6.70 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.42 (ft) ► rfr�f,�r G j rrrrrrf rrr {rrrrJ77r.�rrrr.�rrr�rr�...- I F : : .... . ... . . . ...... r 101.17 (ft) Lateral j Dispersal Cell 100.67 (ft) - ► Invert Dispersal Cell t Elevation E D ' ..... .. .. .. ._...... -- 4 4 99.50 (ft) Contour Elevation 3.0 %Site Slope Geotextile Fabric Cover Shading Key 'a Q, Dispersal Cell See lateral details on 51 Topsoil Cap o a 1.5 ft ti• . ti• Page 4 for number, size, •' }'� Subsoil Ca m c;�' ~' `' r and spacing of laterals. ©0 ASTM C33 Sand `66 Z r "' r• r•. :•r•.• Laterals are a uall ®Tilled La er d 0.5 ft :ti TYPi Lateral ,.:r }; spaced from the Y �. fq ,,, ti.1.1.ti 1.1.1• r•: •r; ; -r•: •:•r•r•r•: distribution cell's ❑5 rtir�r�. �t p Aggregate r: }; •. ti '' �'''''ti'ti' S• r•r•:•:•..:•r•.;: centerline in the A distribution cell (AxB). Project: Hinz & Weeks 4 bedroom Mound Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & B dimension •— Turn -up vdball valves or olonnoutplug f P .1 All laterals are identical I Holes drilled on the bottom of the lateral 3 equally spaced Laterals & Force main of PVC Sch 40 S (per COMM Table 84.30 -5) Force main connection via tee or oross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 4.M ft Lateral Length (P) 66,44 ft Orifices per Lateral 17 Lateral Spacing (S) 2.99 ft Orifice Density 11.77 fe /orifice Lateral Flow Rate 7.00 gpm Manifold Length 5.97 ft System Flow Rate 21.01 gpm Manifold Diameter 1.50 in Total Dynamic Head 16.23 ft Forcemain Velocity 2.15 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 4 in. min. Disconnect Tank component is properly vented F Alternate outlet location Forcemain diameter Weiser 800- 325 -8456 Manufacturer_ 2 in. Capacityl 800.00 Gallons Volume 22.24 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.88 486.57 B 2.00 44.48 C Pump off elevation (ft) C 2.09 46.55 91.83 D 10.00 222.40 D Total 1 35.971 800.00 Do se tank elevation (ft) 3" Bedding un er tank. 91.00 Alarm Manuafacturer IS. J. Electro Systems Alarm Model Number 1101 HW Pump Manufacturer JGoulds Pump Model Number IPE 31 Pump Must Deliver 21.01 gpm at 16.23 ft TDH Project: Hinz & Weeks 4 bedroom Mound Page 4 of 8 Mound Svstem Maintenance and Operation Specifications Service Provider's Name Installed by Nelson Plumbing Phone 715- 273 -4444 POWTS Regulators Name St. Croix County Zoning Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.32 ft Maximum FOG 30 mg /L Type of WastewaterF5om 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 Moundl Ins ect for ponding and seepage once eve 3 ears Other 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 P revent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • ............. ............... Grade \_/4 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: Hinz & Weeks 4 bedroom Mound Page 5 of 8 I Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01181)] 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 device 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, Stats. 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 filter 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 filter 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. Pump 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. I Project: Hinz & Weeks 4 bedroom Mound Page 6 of 8 [( 6�GOULDS PUMPS • Submersible Effluent Pump PE oulaw Now SPEORI ATIONS MOTOR FEATURES Pump - General: General: ■ Corrosion resistart • Discharge; I M" NPT • Single phase construction. • Temperature: 104 °F (4M • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 volts ■ Thermoplastic impeller and fully submerged. • Bti t-in thermal overload pro- cover. • Solids handling: 'V tection with automatic reset, a Upper sleeve and lower maximum sphere. • Class 0 insulation. heavy duty bail bearing • Automatic models include a • Willed de*n. construction. APPLICATIONS float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available, shy lubricated for extended following uses: • Pumping range: see PE31 Motor: service life, • Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■ Powered for comtirwus • EffluenVDWng Systems PE31 Pump: • 12.0 Maximum amps operation. • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design 8 All ratings are within the • Basement Draining • Maximum head: 25` TDH PE41 Motor working limits of the motor. • Heavy Duty Sump) PE41 Pump: • .40 HP, 3400 ItPM ■ Quick disconnect power Dewatering • Maximum capacity: 60 GPM - 7.5 Maximum amps cord, 20' standard length • Maximum head: 29' TDH • PSC design heavy duty 16/3 S1TW with PESt Pu : PE51 Motor. NEMA 5-151P, three prong, • . 70 GPM .50 HP, 3400 RPM 115 poet grounding plug. Maxhum ca 1� • Y• ■Complete unit is heavy duty. • Maximum head: 37' TDH • 9.S Maximum amps portable and compact METERS FEET . • PSC design ■ Mechanical seal 6' carbon, 40 LL mimic, BUNA and stainless fQ51 a MODELS: /E31. . P .. PE41 E4' 33 . ■ Stainless steel fasteners. - t t / ;. t ' 2 GPM 7 AGENCY US111NGS r � a 1 = 25 O 1 Y a ; .. 4 - . 1 ....... : �c u 5 + r r «fi 20 M + ? t i _ ! ;. 1. t ..t.. �.._ TOW Is UL 778 and � . ? . +..�.. ..,:: CSA 222 108 Sfandattls �'[ 15 *- BYCWAdi•o9goA�Ard[Anotwdon _J.. r,Y _. i..l ;._ _H..1' 1 r�l. ArlR3bs�9 •• -r• .. :-. Goulds ►amps is ISO 9001 R•gfgmd + s �.' Y 0 0 0 10 2 30 40 50 60 TO GPM 60 0 5 10 15 rn Goulds "•"'F+o 2 1. 01 C RPACITY R+ 2002 Goulds Pumps +<�ve Nowm1w, z 0o2 IGO RM aPE31 /4' <X> ITT Industries Parcel #: 022 -2001-60 -000 07/1212005 03:32 PM PAGE 1 OF 1 Alt. Parcel M 35.28.18.549 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner HINZ, KENNETH O & BETTY J KENNETH O & BETTY J HINZ 110 PONDEROSA DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 35 T28N R18W NE NW Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 35- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 09/28/2004 775552 2664/538 QC 2005 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/11/2003 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 40.000 2,300 0 2,300 NO Totals for 2005: General Property 40.000 2,300 0 2,300 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 2,300 0 2,300 Woodland 0.000 0 0 Lottery Credit: Claim Count 0 Cert ification Date Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 WisconsiADepartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ,Safsty and Building Division , INSPECTION REPORT Sanitary Permit No: 463087 0 GENERAL INFORMATION (ATTACH TO PERMIT) 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 N1 0 000"' 022-2001-60-000 : Hinz, Kenn h Kinnickinnic Township CST BM Elev: Insp. BM Elev: BM Description: Section/T n /Range/Map No: 35.28.18.549 TANK INFORM ION ELEVATION DATA TYPE ANUFACTURER CAPACITY STATION HI FS ELEV. Septic Benchmark OF Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION SVHt let TANK TO P!L WELL BLDG. Vent to Air Intake ROAD filet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe A , Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System He TDH Ft Forcemain Length Dia. Dist. ell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSION o. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM CHING Manufacturer. INFORMATION CHA ER OR Type Of System: T Model Number. DISTRIBUTION SYSTE Header /Manifold D' ribution x Hole Size x Hole S ing Vent to Air Intake e(s) Length Dia ength Dia Spacing 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 ( Yes [] No Yes [] No COMMENTS: (include code discrepencies, persons present, etc.) Inspection #1: / / Inspection ! / Location: 94 Ponderosa Drive River Falls, WI 54022 (NE 1/4 NW 1/4 35 T28N R18W) NA Lot Parcel No: 35.28.18.549 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = F_ Plan revision Required? [ 1 Yes 0 No �. Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. r ' Safety and $uildema;Uidsion County vkrj 201W J . Q/' 4 ` P.Or Box 782 s `T C X M _ wt , 3j707-7 082 7 SCOfISIIf 082 Sanitary Permit Number to be filled in De artment of Commerce (608) 261 -6546 6 ago , Sanitary Permit Application Plan LD. Number In accord with Comm 83.21 Wis. Adm. Code, pesoha) information.. � • -de . 3 / p. may be used for 1 Proms � 0 ' P Pri i w �y , sis, ►)(in) , �( _ ? �"' Project Address (if d t them mailing address) L Applicatio formation — Please Print Ail Information' - Property Owner's Na 'j e n E2oS A- D k E,#VEY�v lti o, S �. V4,0 /C ��J Parccl Lot# Block Property Owner's Mailing 2 �j • 9 ) //D �ovp + a�D • 3 �. City, State Zip Code Phone Number `V�' /a section f ILL Type of Buildi (c heck all that '!s • ? S • T 2 N; l t . d e n ) S � )94-or 2 Family Dwelling - Number of B sobdivision Name CSM Nnmba ❑ Public/Corumercial - Describe Use ❑ State Owned - Describe Use ❑City ❑Village Orownship of III. Type of Permit: (Check only one box on line A. Co Itgliete line B ppiicable) A. J(Nt w System ❑ Replaoemtent Syst ❑ old' Tank Replacement Only ❑ Otha Modification to Existing system B. ❑ Permit Renewal ❑ Permit Revision ❑ f List Previous �� Expo ❑Pamir Transfer to New Permit Number and Date Isued Plumber Owner IV. of POWTS tem: Check an that a i ❑ Nmr-Pressurized in-'mund ❑ Mound > 24 is of suitable I X M < 24 in. of suitable sod ❑ Si ❑ Single Pass Sand Fi Constructed Weiland ❑ Pressurized In - Ground ❑ Hord' sale ❑ Peat ❑ Aerobic Tmurient Unit ❑ Recirculating sand Filter ❑ Recirculating Synthetic Media > filter ❑ Leaching Chain ❑ ❑ -less Pi r ❑ (explain) V. Die eatment Area Information: O p Design Flow (gPd) Design Soil Application Rat D' Area Required Di Proposed (st) , System Elevation t7v jv ion VI. Tank Info Capacity im T Number Manufatxua Gallons s of Units Prefab Site Steil F7aer Plastic New f&6eA A — roe Conereie Constructed Glass Tanks � septic or i1ol� rank Aerobic treatment unit Dosing dumber 0 VII Responsibility Statement- the undersigned, assume responsibility for installa u tion of the POWTS sho a the attached place Plumber's Name (Print) P ber's Sign s"a"a S Numbs Y7 . / .e P_ � G j , Business Phone Number Plumber's Address (Strea Late, Zip Code) 4 7 7_5 2- f'/ Z.. 1 fl-- ;f Gtr/. 41'76 -7 VIII. Coun arttme use Onl ,m Approved ❑ Di ssp Sanitary Permit Foe (includes Groundwater Date Issued issui t Signature (No Stamps) Fce) ❑ Given Rea for Der Surcharge - a ual 3 n— Q , 0 IX. Conditions of A rovaUReasous for Disapproval SYSTEM O NER: 1 Septic nk, effluent filter and disp al cell must all be serviced / maintained as r management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances Attach complete plea (to tae Casa . A/ ?J ty sly) for the system o sot less than 31/2 s 11 laths la sire SBD -6398 (R. 08/02) � y i I KZY LA € o O V1 3 z jo I t � 1 1 ca - zt ccr CP co co y ga• (f eo � - t , CP C: co co o An ML kA Ch I i - i W t E o • "C3 0 3 c . 1 co { ,K Safety and Buildings PO BOX 7162 commercemi.gov MADISON WI 53707 -7162 TDD #: (608) 264 -8777 ' s c O n s i n www.commerce.wi.gov /sb/ www.Wsconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary September 27, 2004 CUST ID No.226375 ATTN: POWTS Inspector ROBERT W ULBRICHT ZONING OFFICE ULBRICHT & ASSOCIATES CO ST CROIX COUNTY SPIA 2812 10TH AVE 1101 CARMICHAEL RD SPRING VALLEY WI 54767 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 09/27/2006 Transaction ID No. 1063896 Site ID No. 647421 SI TE. Ken Hinz & Jo Ann Weeks - Dwelling Please refer to both identification numbers, 110 Ponderosa Rd above, in all correspondence with the agency, Town of Kinnickinnic, 54022 St Croix County .T /4, S26, T28N, R18W FOR: VEC. NW , SEC 15 Description: New Mound System / 600 gpd Object Type: POWTS Component Manual Regulated Object ID No.: 982341 Maintenance required; 600 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, P ' ( stats. com The following conditions shall be met during construction or installation and prior to occupancy or use: Ar" 1. This system is to be constructed and located in accordance with the approved plans and with the DE p R component manuals listed above. DIVISI N 2. On page 3, Y = 51 inches. SEE LORI 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. 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. _ 1 ULBRiCHT & ASSOCIATES CO. 2812 10th Ave. • Spring Valley, WI 54767 Res. Designers of Engineering systems Private Sewage Consultants 715 -772 -3442 PROJECT INDEX Plan I.D. # /,, D .S /.'1. 000 —_ -4 -b Owner /<9A) &N 2- J0 ,V U ,1641<5, U ,1641<5, - - 71s'• ye • �sz Address 4/0 ? L D ERQS A � r7 .� R VA, F I t W 1 • SW O Z Legal Description ?AR7- O F yQ 4 4tS Sf, 5 40 C. Zlp, T29 0 . R 12 1��JV y o 2Z - io 7 • ya • rya 0 c4 o -1 -1 - tool • (P0 • as a W Town of &i L• % G County S'ft • ��� C.S.T. A1,9R 1 G �.� - 2Z(� 3'7 - Installer R• ZlL(31 T Local Authority/ Supervision 5T. c2 r X cry. z o 4 PROJECT DESCRIPTION 7 / 5 ,- 3 16 J1 X C D�V U�-u 7�i4w�L x`'10 U �D - SYS T n V S i 1J S t� TS+ RD B6P! I Zf L3 R IC [T t Ulbricht & Associates ''p L '¢ly Private Sewage Consultants 2812 10th Ave. 4� Spring Valley, WI 54767 FSA r ..• Pg.1 PLOT PLAN VIEWS .UZ, Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS (REVERSE SIDE Z DETAILS INSPECTION PIPES & FABRIC /TOP FILL DETAILS) �� PIPE LATERAL LAYOUT (REVERSE SIDE SHOWS DETAILS OF LATERAL O CLEAN OUTS) Pg A DOSING CHAMBER CROSS SECTION & SPECS. L Pg.5 PUMP PERFORMANCE SPECS (REVERSE SIDE SHOWS PUMP DETAILS) U Pg.6.OPERATION, MAINTENANCE REQUIREMENTS (REVERSE SIDE SHOWS � ... SITE & SPECIFIC PROJECT DETAILED INFORMATION,UNIQUE TO V LOCALE AND GOVERNMENTAL UNIT AREA) I The attached plans and specifications are based on the following approved manuals: "Mound Component Manual For Private Onsite Wastewater Treatment Systems 11 (Version 2.0 SBD- 10691- P(N.01 /01) and "Pressure Distribution Component Manual For Private Onsite Wastewater Treatment Systems" (version2.0) SBD- 10706- P(NO1 /01). r 1 �zt kA kA C C ILA co f 4 i A � S s_ co v� P �c �l 1 O j f T V/ n p M i l c 0 f co V` CC= co ca _ O O ! 0- -- �s 1� v3 1 1 ti w I t I _,•� d O � t 1 F 40 I o a � t x TI kA r t p Q ON 2 at CQOSS SECT IO&) Or M OU AJ D w i r ti Gee Den OF % " rr - t �, Agg�eeSaT Di ST(Lit3t�T�n,V G, TNe ck�sFSS PiprNG- �� °P So �vl TEiP�1ti -fL- sys p � 0)Jil=0pK Toe N t..i " E PtowEa To P's i..�►— �// �� /I uu i Fo � R 3 % s top s FORCE' Et�vnroa Luc MAW - cNvE:Rr o f 7 IRTiERAts � oL• �$ w Z � G • S T Top OF R O ck /0 rt p FT , ' TO °� � � I ATER A (s PLAN VIEW OF M©uND wi L'EQ_ - � (✓vRcE MAiN I Fr K la Fr 1 B •� i {� �za k -->� � T lS M n :T- 1 Sa o i 2 " Pvc. �ApprmD To ! a. Aq 4 RE'G-�T� dC3SERYhTtO+v n f rfem PEQMA,JE,uT MAeL -ERS ('P) o f G / ,CAW Of sw4"E7�...1'} REOUiRED aASAL, AREA , �At'� Lvh �'! ow &00 tS� C ApAci Ty PR-Op o s E V BAS M ARL-4 = X ( t Observation pipe Distribution cell 6° 6„ Cover material Fill material (ASTM C33, fine aggregate) Aw Tilled area <--Slope Force main Figure 6. Cross- section of a Mound System water tight cap 4" min. rife. Tap of . ieachia9 Re r coup�iags chamber Slat 6" 6" min. min. in . Infiltrative surface Water Closet co liar Bar @// . dia ) Figure 8 — Observation Pipes ph 0 _ ,,fAq, - rYA!/L. fipl el G. Ape � c L C c C �� � 4P �1i,U. 1Jf 5T`- ,3 �sTQ� fO (IT CEOTRAL, MAAn i Fo ,_D \ Iz� P s r \ �Z Z F r R 3 Fr X YZ 6UTRAL FORce MArk EC � a � CEDED ---_ INc ,SD Fr. �� CORK / of P v c ES4C pE -- Iuc SE VARI'Af3LE -TOTAL. V(91D U0jL ' Z GA15 . WS r4X) C ft / N oll~ D "ANE -MR H s OF N&7k o/C k Z CEN 2. TRAL. MAMIFOL� " �7• S ►NCH �s FoRcE MAIN 2 HOIE5/pim I A,GE{ES ZuVERT E LEVATI( or- LA TERAI S sE� PLUEPSE' SIDE J= ��� . l g • T;E_ i "A L C/O b T�4f L , Pis A; U 17Eiy4 L (� (t I'A Fo IR ATE P O f REMauE All DR;�I W 6 j N IOCATE o,J BOTi'oM S AC S ED p 1) STRi Qu r to" 'DISchARv -E RATS Po - ,l R �'A c h L A - r E R q L. PAR Ott GAS TOTAL D DiSctiARC:,E (FATE r Nor woR , 9 k 3Cv � , GA.L M 1 *,k). e a. MI NI MUM ' D E T A t L. 6F L ATE R A t___ C '7 -- � VX/ .R V . z Reti o-3 PUMP CHAMBI =R CROSS SECTIOM AND SPECIFICATIONS P,g of � __�_� VEIJT CAP 4 * C.Z. VENT PIPE WEATHER PROOF APPROVED LOCKtAIG JUMCTION BOX MANROLE COYER 25' FROM DOOR. i w /uirfitN�aGr�AAWI WIWDOW OR FRESH 12MIJ AIP, INTAKE 1� I- 1pnJ GRADE r Ally y � /E b I 4 MIAI. I �. IB 1�lIU. COMDUIT -- ---- -- - - -- /r IV4 i 0 11 .0 v X11 INLET PROVIDE � - - - — AIRTIGHT SEAL I � I APPROVED JOIN'( jA NS �K , W APPROVED /C.I. P PEC %,//C-T. P1PE , �1} EXTEAIDING EXTENDIM& 3' O t ( I ( . SOLID OWTO SOLID SOIL �/��� -3' / Om ELEV, fT. t PUMP,- - -i OFF 2lSE 3 , z� Sit vl> ill BLOCK LI�► � (E VA f � rd' � - RISItR EXIT PERMI - WED OIJL`! IF TAUV. MANIUFACTURE.R HAS SUCH APPROVAL SEPTIC E �tlr SPEC.IFICATIOU DOSE �V� GI,��� TANKS MANUFACTURER: W MBER OF DOSES: PER DAS l /10 TANK SIZE : ♦ d � ��QQ b GALLONS DOSE VOLUME 1.30 ALARM MAMUFACTUR.ER: 4tU�`' INCLUDING BA GALLO MODEL HUMBER: `_ U U . L CAPACITIES: A= '( iWCHESOR t� GALLO SWITCH TSPE: FIok ` $= 2 t INCHES OR 570 GALLO PUMP MANUFACTURER: C= Y *2 jUr-HE5 OR 1 ,3 4) GALLO MODEL NUMBER: l `� �` D- ffi INCHES OR • �'� GALLC SWITCH T`.IPE: 1 ( l Jy c F MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 37- GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTIOU PIPE.. ` FEET -A AA ) /, SPfGS + MIAMMUM NETWORK SUPPLY PRESSURE /........ . � 3Z � FEET EACG1, • OV -,DT - FEET OF FORCE MAIM X 2A'Q F /oQFLFRICTtOil FACTOR. .'. - * _ FEET TOTAL D'3UAMit HEAD = 1 0 -5- FEET J INTERNAL DIMEMSIONS OF TAA1K: LEM&TH " D ; - WIDTH Vo ;LIQUID DEPTH � THIS POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL A goo 16L a Q W HEADI 115 „D ip 5of CAPACI 32 F oo � 30 — CURVE 29 so- 26 l I EFFLUENT 24 MODEL MODEL 188 and a 22 75 , s5 DEWATER/NG 70 20 65 _ d Z 18 60 Y 55 4 18 MODEL F � 183 MODEL 14 188 45 12 ` 35 10 }— MODEL MODEL 137,139 185 8 � SEWAGE and DEWATER/NG 8 20 MODEL 15 MODEL 181 4 7 10 MODEL 5 53, 55, r 57.59 1 i+ M 0 GALLONS 10 2� 30 40 50 80 70 80 90 100 110 24 80 LITERS 0 80 160 240 320 '100 75 FLOW PER MINUTE 22 70 20 t8 M L 295 {p S5 V 6o I 14 M2 Z 12 40 c MODEL 35 O i 293 10 MODEL F 284 8 MODEL 6 20 282 — 4 15 10 MODEL 2 5 287, 288 - - I 1 3280 Old M L9M ° P.O. Box 18347 GALLONS 10 20 30 40 5D 6o To 86 90 100 110 120 130 140 3 50 180 170 180 180 Lout % Kw*icky 40216 LITERS 0 W ISO 240 32D 400 480 Soo 6 720 ( ) 778 -2731 40 FLOW PER MINUTE "137 Cast Iro Series " CAPACITY HEAD UNITS /MM 139 ?! Bronze Series Feet Meters Gat. Ltrs. 5 1.52 104 394 • Automatic or Non - Automatic. 32 • y2 H.P., 1 Ph., 115V, 200 -208V or 230V. 15 4.57 64 242 20 3.10 3s 133 • Y2 H.P., 3 Ph., 200 -208V or 230V. 25 732 a 30 • Non-clogging vortex impeller design. Lock vane: 26' • Passes % inch solids (sphere). • 1'/2" NPT discharge. Canadian Standards UL listed C0 Assoc. Approval • Float operated, submersible (NEMA 6) 2 pole available mechanical switch. • Automatic reset thermal overload protection. i ;g� 137 series SC -2225 • Stainless steel screws, bolts, guard, handle and 0i 139 Sarlas SB -1115 arm and seal assembly. .,nrc. •ice a nc +.nn f— gnn_s)nRv /1 Ph. I Wisconsin Department of Commerce; 86fl. E REPORT Page of Division of Safety and Buildings in Accoklaripe With Comm 85, Wis. Adm. Code Count Attach complete site plan on paper not less than 81/2 x 1 f fir tes irrsize. Plan must s r c a o ` X include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 2Z • py Y - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. p 2 • 2.00 j ' & ' GD'M ) Please print all information. ReyievuecLby Q to Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). juw Property /Owner E��E j N Z s R . -f^4 Property Locati Q 3 0 AN f �- D Govt. Lot �� 1/41/4 S T �`� N R. Nor) W Property Owner's Mailing Address Lot # I Block # I Subd. Name or CSM# r 6F p / 'P ow DE RoS h p+ A kA City State Zip Code Phone Number ❑ City ❑ Village . f Town Nearest Road i2it7�IZ ���� wJ Sgow ( 715) 415 952 Ki.v vi a FbmOCRoS A,– New Construction Use: Residential / Number of bedrooms - Code derived design flow rate _ V.4 Q — Q 6 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material /0 &1 S 00 ge Flood Plain elevation if applicable General comments and recommendation: i A /p T�S�'�D sv�� �'��E �d/� HOOVA r7]Bo,ing # 1na� Boring i 1 ' O !!� pit Ground surface elev. it. Depth to limiting factor in . Sort Application Rate Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Murrell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 •Eff#2 o •/o /o ge G 2 *%. Si x Q s 3 f- . (P . 0 z •o • ?.5YR5 — 54 - / f qA G O- S • y • 7 3 0 • z& /a Y* 5 06 S �t, 5 •7 /• i G c z M s CG. �. • •Z , 3 S Y)t L B or i ng i # erg 7 (• J `� •� 2 S . . LL_—JI 51 Pit Ground surface elev. ft. Depth to limiting factor ` m. R ate Horizon Depth Dominant color Redox Description Texture Stnicture Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 / o• It ib R 5/L 24.1 s s Q, s 3 - f- 2fshk if k a s 2 f • 8 3 Z • io 5 �a�l Mots 5GL 73 /& Effluent #1 = SOD >,,30 << 220 mglL TSS >30 < 150 mg& ' Eifluefd #2 = BOD < 3t) and TSS < 30 mgA. CST R {Z•T � 7 G r'l� M Z Z Ce CST 3 S Adams Date Evaluation C Foducted Telephone Number 9• 4Y . c260 715• 7191. 3ggZ Private Sewage Consultants 2812 1 Oth Ave. Spring Valley, WI 54767 ORIGINAL ��C.Prvv o 444f s Property Owner � Z S iG • Parcel ID # Page 2 of 3 0 Boring Q # fig R. Depth to , s o Z3 ® pit GmM %x1aoe elev. f nMV factor in Rode Horimn Depth Don*wd Redox Desaip m Texture Strucdae C.onsasterice Boundary Roots GPON in. MunseY Qu. Sz Cont. Color Gr. Sz. Sh. 'Eif#1 •E}f#2 / 0-1,6 io S L z f sh s as 3 . & A 0 • 1o' eS s a S 2 •F i N V t3 CG • Z . s F-1 Boring # � ❑ Pit Growid surface siev. ft. Depth to &Tft9 tailor in Soil Appkaft Rate Horizon Depth Dorm Color Redox Desexipilan Texture Strucbre Consistence Borrrdury Roots GPOW in. Munsell ChL Sz. Conk Color Gr. Sz. Sh. 1 *EM ❑ Pit G=1rw elev. & Depth to W � 4 factor In. n P WZ] Horizon Depth Ooh Redox Description. Texture Cons me Boiridary Roots Murrsel au. Sr - Conk Cdor & Sh. •E F �°'`�# ❑ prt Ground wfece elev. Depth to ti n ft factor in Soii Rate Horizon Depth Dornirrant Refloat Desaiplian- TeKU" Skuck a Corrsistenoe Boundary Roots GPM ir~ Mansell OLL Sz. Conk Color Gr. Sz- Sh. 'Eft#, •El's Ettiverat #1 = BOD > 30 < 220 rrV& and TSS >30 1150 nV& • EMuert #2 = 800 <_ 30 nV& and TSS a 30 mglL t 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 - 266-31 St or TTY 608- 264 -8777. 8804M pL+6=) i � 4 3 P s` kA =� A O •\ z k 3 t F f k { 3 � j 1 0 i D i N w o� 't ----�- kA i -o o 4 p, ,,V o/V _ i + Mound System Management Plan 0 .� Pursuant to Comm 83.54, Wis. Adm. Code... I ' 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 filter shall be cleaned as necessary to ensure proper operation. The filter pe a cartridge should not be removed unless provisions are made to retain in the tank that may slough off the filter when removed from its enclosure. if the filter is equipped with an alarm, the filter 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, Safety and BuOdings Division. Pump Tank The pump (dosing) tank shall be Inspected at least once every 3 years. All switches, alarms, and pumps shalt 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 Svstem 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 penetrption. Cold weather Installations (October- February) dictate that the mound be heavily mulched for frost protection. ' influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg /L FOG. influent now 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 shalt be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual (SBD- 10572 -P (R. 6199)} 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 shag be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump lank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be seated 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 device to prevent accidental or unauthorized entry Into a tank or component. _ Conlingency Plan If the septic tank or any of Its components become defective the tank or component shall be repaired or repl- ced to keep the system in proper operating condition. , If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shag 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 blologicaMy clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector. SEE REVERSE SIDE Pg,6 FOR MAINTENANCE REQUIREMENTS SPECIFIC TO T'HiS SITE, DESIGN, AND COMPONENTS I OWNER•s MAINTNINCE--op SEPTIC SYSTEM ''• POWTS (landowner) is re on /P�Piv. ire main P Bible for roe J maintenance of. this system, Regular proper r o p era tion and - servicing is necessary far the safe healthy c operation o ot..thi d s system_ The owner is required: by code to submit all necess_sry Y maintenance /fnspectiori reports the controlling ies: SPECIFIC CONTACT AGENTS * Gov. insp ectors: ernmental authority/ ins • TS S C/�GIX Cr / •. aOA3(A.3 Dpl � * Licensed installer, responsible for providing an maintenance.."Users" manual, operation/ ?fS • 7 7z • 3 7 * Licensed sere *ce / inspection.agent other than ins taller: electrician, for Pump, electric controls, wiring units. nits: Y} cro- IMPORTANT OWNER MAINTENANCE RE UIREMENTS I, Winter iraffic` (sleddin area shall not': be g' shove ring, etc.) across the the cell permitted, or frost can /will penetrate i- n'to-,.. winter freezing up the system. Discontinuos use _In the .- use (a vaeaction.trip, resulting %in no water lead to _ freeze ups. ) can also ` Water conserva.t.ion. needs tb be exercised! hy.drolIcally Overloaded and destro ed, Or system can be design for a maximum wastewater flow This syskem was gals. daily. 3. POWTS are not designed to accomodate wastes from disposal unit, or an Any introduction of suchhKastematerialsuwill °f a waste'agey destroy thi System. Overload and 4• If a power outage occurs, or a pump a t p fa in em P i ls temp orary overload of e , it may result:_ cell, whi fluent be ing w hich ma ad l Pumped 'r int v o Y e th reel e ` Y imp act c ecommended that a licensed P t the cel (leakhgej. It is allowing the Pumper empty the dosing tank, Pump to return to dosing the correct- amounts. 5• Neglect of the ve Consult your installer immediately for advice, erosion preventive) cover (the ce osio traffic preve ntive) can lls insulation & ffic also can destroy lead to failure. Compaction or heavy REGULARLY WATER THE VEGETATIONsyysteste A SYSTEM!! m. It IS NECESSARY TO the stem beneath IS NOT sufficient alone t0 Effluent in TOver. maintain a 6. Periodic inspections by _ necessary, Inspection Pipes annex, or his agents, is Into the P P ports have been incorporated system: on the mound basal area t piPeS), cleanout terminals on 4 pr e s 1ze1 Inspection to the laterals, at each tip - for flushin the pressurized out.- The filter system in the ta g and cleaning the laterals ground cover nks (via a Locked above Person should /ma be hole). Only a l icensed prop & severe safetPerforming this work whicheinvolvesl health y risks. Evidence of System's ef tre ?tment cell shall also beregularindin 9 in the // t Y inspected. 3 ST CROIX COUNTY SEP'i'IC TANK MAINTENANCE AGREEMENT AND r- OWNERS CERTIFICATION FORM Owner /Buyer T1� f�/ /�! Z SR y.�,5' • /�'S�. Co ' Mailing Address //Q Po mo E' R a A, R D R r oe& R<<s S tx Z Z Property Address '-? (Verification required from Planning for new corrsftwsou . IJ�sparttrte»t ) City/state Parcel Identification Numb Qz MAL 49sC PlION ,U � r go •4 art s tip~ Property Location n / +, r / Sec (� , T �'� N -R lg W, Town of Subdivision R,4� r z y0 � Lol # If S V� �• Certified Survey Map # , Volume _ Page # G 1AiA4 War r'Ruty Deed # 7 S Z , Volume page # Spec house 0 yes 9 n Lot, lines identitable { yes O no ST90,51 MAIN #'ENANCIv; hnpropet use and m8iMcnance of your septic system could result in its premature failure to handle wastes. Proper mains consists of pumpiug out the septic tank every three years or sooner, if needed by a licensed p mVer. Wttat ym pot into the cart att"ect the !'unction of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Departtrtcnt a cedifteatioa fotttr, s igned by fire owner a ll master pfumber,ortneymanpttmrber, restrictedphmrbexor a licensedlanMpervedryhngtlrat(i) tbeon -site wastewaterdisposai, is in proper operating condition audlor (2) after inspection and pumping (if necessary), the septic tank is less than 113 fiat of s Uwe, the undersigned have read the above requirenxnts and sgree%th maintain the private sewage disposal system with the sta set forth, herein, as set. by the Departrttentvf Cormtretce and the DepadMent of Natural Resources, State of Wis6onsim Certif !►tafing that your septic system has been maintained moist be completed and returned to the St. Croix Qp mty 7oniug Office wit �( days of the three year ex ' ation date. SIGNATURE or. APPLICA DATE QWN&R t;ERTiI ICATiVIY 1(we) certify that an statements on this form are true to the best of my (oar) knowledge. I (we) sm (are) the owm the prWerty described abov , by virtue or a ;warranty deed recorded in Register of Deeds office. SIGNATURE oP APPLICANT DATE �' ;•' Any in that is gs - represented may result iu the unitary permit being revoked by the Zoning Department. ' •t Include wltlt this ftttptteatlors: s stanched warranty deed from the Register - of Deeds voice a copy of the certified survey map if reference. is made in the warranty deed I I i i I U 2669P 538 -7 -7 ni ZS!� DOCUMENT NUMBER KATHLEEN N, VALSH REGISTER OF DEEDS QUIT CLAIM DEED ST. CROIX CO.. BFI RECEIVED FOR RECORD Kenneth 0. Hinz and Betty J. Hinz, husband and wife, as joint tenants' Grantors, quit claims to Kenneth O. Hinz and Betty J. Hinz, 09 /28 / 2804 04 :30PK husband and wife, as joint tenants, Grantee e o owing escri ed real estate in St. Croix County, State of Wisconsin: QUIT CLAM DEED ✓/ EXERT F 3 — The NE 1/4 of the NW 1/4 of S35, T28N, R18W. REC FEE: I1.09 TRANS FEE: COPY FEE: CC FEE: PAGES: 1 NAME AND RETURN ADDRESS Kenneth C. Pletcher Rodli, Beskar, Boles & Krueger, S.C. 219 North Main Street PO Box 238 River Falls, WI 54022 022- 2001 -60 -000 Parcel Identification Number This is not homestead property. Dated this day of 2004. �Zg0N �J (SEAL) •• .`5� Kenneth 0. Hinz Betty J. H' z (J Co ; 'P AUTHNNTICATION ACKNOWLEDCPSSNT •: ve�•••'.... '. • ( � 4 t e •� Signature(s) STATE OF WISCONSIN ) '' � ST Q01 1, 0 % y ST. CROIX COUNTY ) authenticated this day of 2004 Personally came before me this day of 2004, the above named Kenneth O. Hinz and Benz, Grantors, to me known to be the person who executed the foregoing instrument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) * pp THIS INSTRUMNNT WAS DRAFTED BY: Nota Public County, Wis. My co issi is ermanent. (If not, expiration date: Kenneth Pletcher /lam (? Rodli, Ba akar, Boles & Krueger, S.C. (�� `7 (f > P.O. Box 138 River Falls, WI 54022