HomeMy WebLinkAbout024-1010-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division INSPECTION REPORT
Sanitary Permit No:
499107 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 No
Liddle, Wil liam I Pleasant Valley, Town of 024- 1010 -70 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No
I oo g,l�l� l C_ S 07.28.17.54A
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
/ Alt. -P BM
,�- • z X07. GS
Dosing C avw�d P N g00 � aF �e1t.Q�
Bldg. Sewer
" Pa l ak l �_t' '� l �l• y5 y5 , ys
Holding y St/Ht Inlet Y j
.�
TANK SETBACK INFORMATION St/Ht Outlet 1
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
/ 1
Septic 7 5p ' 1 7 i ' IN 1/ — Dt Bottom l5 • ° J S9 � �
Dosing i 1 / Header /Man.
- 7 5� 1 i/� 1 �� �• l� 9�• 3
Aeration Dist. Pipe
�o fS • 35
Holding Bot. System • $ 4 7
Final Grade 5 b� ��j , 3 5
PUMP /SIPHON INFORMATION
Manufacturer ! o v S Demand St Cover p 7. 1 7. 3
(� GPM 1l Goy
Model Number n 2-7-0 / �� r 7 f
TDH l l_if � . Friction Loss f System Head TDH Ft C . �
Forcemain Length 1 Dia. i t Dist. to Well 9 7 • Z_
- 7 Z l �� f Slnel �� Iz• 7
SOIL ABSORPTION SYSTEM
BED /TRENCH Width i Length No. Of Tr nche PIT DIMENSIONS No. Of Pits Inside Dia. Liq�D h
DIMENSIONS /10 Az \
SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer \
CHAMBER OR
INFORMATION Type Of Systerrl: r 7 UNIT Mode; Number
J 'r l l / 9 �
DISTRIBUTION SYSTEM
Header /Manifold Distributi ` t t I x Hole Size I x Hole Spacing Ve to Air Intake
P ip e (s)
e � 1 + IT Z r
Length - Dia Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over i Depth Over xx Depth of xx Se eded /Sodded xx Mulched
Bed/Trench Center / • 5 Bed /Trench Edges \ Topsoil l N es No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: � 6 / z (o / + e Inspection #2: !
Location: 1495 County R oad N Unknown (NW 1/4 NW 1/4 7 T28N R17W) NA Lot 5 e• CIA,- Parcel No: 07.28.17.54A
P, • Co vu O Imo,
1.) Alt BM Description =
2.) Bldg sewer length = � 146 JSQ,. + - o
- amount of cover
fQ ka
03 I t f2 - b _ � t -
Us l
e other� Required? Yes No
side for additional in 7 �
formation.
Date Inse 's Sign r Cert. No.
SBD -6710 (R.3/97)
Safety and Buildings Division County
i 201 W. Was Ave., P.O. Box '1162 ..S��
� VVIsconsin Madison, WI 5370 - 7162 Sanitary Permit Number (w be filled in by Co )
(W) 266 -31
Department of Commerce
1 Sanitary Permit Applicato State Plan I.D. Number
]n accord with Comm 83.21, Wis. Adm. Code, persutlyl intarrnsW you vide l_ � 7 (o Z_
may be used for secondary purposes Privacy Law, slS.04(1)(M) Project Address (if different than maili ad ress)
1. Application Information, - Please Print All Inforr tion R CEIVED �
± Property Owner's Na me Parcel d Lot x Block a
/ AUG 0 3 2006
Ye 5'
! Property Owner's M ailing Address ST. CROIX COUNTY Property Location
City, State Zip Code Phony Nturiber
1 Y - -� (circle . \
�� N; R Eor Cv
II. Type of Building (check all that apply)
n
1 or 2 Family Dwelling - Number of Bedrooms Subdivisio Name CSM ?cumber '
T I
PubliciCommercial - Describe Use el) /C E}e J a
f ':)State Owned Describe Use ❑City ❑Village ,Township of
1I1
� 'T of Permit: (Check only on e box on line A. _ .___. �'�
Type 1. Complete line Rif applicable) __ 1
Vew System F Replacement System Treatmemt/Holding Tank Replacement Only Other .Modification to Existing System
B LI I Ytrntit Renewal Permit Revision ❑ Ct>ange elf ~ t l l Permit Transfer to New List Previous Permit Number and Date Issued
S Before Ex iratian
p � ,Plumber Owner —�
IV. T of POWTS System: (Ch eck all th a 1 }
�. _ - . Y _ ___..._ r _ _. N P.P
.; Yon - Pressurized In-Ground I ' Mound > 24 in. of suitable soil T � Mound < 24 in. of suitable soil I ❑ Single Pass Sa ui Filter
-� Cutstructed WedanJ D Pressurized In- Crtvund a Holding Tank ED Peat Filter 11 Aerobic Treatment Unit Recirculating Sand Filter
�.i Recirculating Sy nthetic Media Fi lter ❑ Leaching Chamber Drip Lure El Gravel -leas Pipe � l Odwr (explain) t� - [
---at .- (a
_V Dispers /Treatment Are Information: _
Design Flow (gpd) Design Soil Application Rate(gpdsO - Dispersal Area Required (sf) Disposal Area Prop Of) System Elevation
e oo -T- - —_-;
VI. 'tank Info Capacity in Total Number I Martufacturt;r Prefab �Sice Steel ,Firer ,Plastic
Gallatts Gallons of units ( Concrete C answucted Glass !
New Gw>t
stir
i Tanks i Tanks t !i 4tJ BKT r�
Septic or Holding Tank
Aerobic Treaunent Unit
f
I
Uosing Chamber
Vl t. Resp Statement- 1 , tho undersigned, aisumt re_ spolinibil lty for L aUatitiv of the PO W'TS shown on the at tached plans.
r Plumber's Na rile (Print) Plumber's Si gnature — Pf PRS Number Business Phone Number
Plumber's Addre ss (Street, City, State, Zip Code)
V_ 11.1, Count /De artment U Chill
y _ -
Approved trap : Salutary Permit Fee lilt I oos Groundwaier j Surcharge rile) Date ssu Issuing
SJ Q - 0 b t Signaa're + aSta i
'
�_______�� ❑ liven Reaso for
M Conditions of Approval/Reasons for Disapproval
SYSTEM OW WO
1. Septic tank, effluent finer and
! dispersal cell must all be services / maintained
as per management plan provided by plumber.
7. AN setback requirements must be maintained
as per applicadle code / ordinances.
{ - �� Attach cornplete plane Ito the County only) - for the system on piper not Nss than 8t>2 x t 1 inches In size - -� - —
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer K�11�11�zoz z l )rAe s
Mailing Address �,'v ct �'� -�
Property Address S LLQA " 1
(Verification required from anning & Zoning Department for new construction.)
City /State Parcel Identification Number lelO •- 2,0 - 066
LEGAL DESCRIPTION
Property Location �,� f,� 1 /4 , !y U) 1 / a , Sec., T N R�W, Town of ��C'6' s�;o
Subdivision ��'"� �� e v , Lot # '- -
Certified Survey Map # , Volume , Page #
Warranty Deed # (� -�, , Volume ! ,FS7 , Page # 1�7
Spec house yes no Lot lines identifiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification staring that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I /we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
SIG TUBE OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
Safety and Buildings
- RECEIVED 141 NW BARSTOW ST FL 4TH
commerce.wi.gov WAUKESHA WI 53188 -3789
isconsin JUL 19 2006 Too #: erce. .gov /sb
vuvvw. com merce.wi.gov /sb/
Department of Commerce www.wisconsin.gov
ST. CROIX COUNTY
Jim Doyle, Governor
Mary P. Burke, Secretary
July 13, 2006
CUST ID No. 220673 ATTIC• POWTS Inspector
CHARLES L WEBSTER ZONING OFFICE
WEBSTER SOIL TESTING & DESIGN SERVICES ST CROIX COUNTY SPIA
N5815 770TH ST 1101 CARMICHAEL RD
ELLSWORTH WI 54011 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 07/13/2008 Identification Numbers
Transaction ID No. 1288762
SITE• Site ID No. 715376
William Liddle Please refer to both identification numbers,
Cr N above, in all correspondence with the agency.
Town of Pleasant Valley, 54015
St Croix County
NWIA, NW1 /4, S7, T28N, R17W
FOR:
Description: At- Grade, 3 Bedroom + Bathrooms for Owners Use in Horsebarn & Garage
Object Type: POWTS Component Manual Regulated Object ID No.: 1085789
Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System(s):
At -grade Component Manual, SBD- 10570 -P (R.6/99), Pressure Distribution Component Manual, SBD - 10573 -P (R.6/99)
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with the component manual(s) referenced above.
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,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
This system is to be constructed and located in accordance with the approved plans, and with publication SBD-
10570 -P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite
Wastewater Systems ". The pressure network is to be constructed in accordance with publications SBD- 10573 -P(R.
6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the
sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS
(01/81) ". (NOTE: The At -Grade Component Manual does not allow for utilization of the Version 2 Prespre
Distribution Component Manual.)
This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/boldml
tank that maybe required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if'p*fh> e " J
submittal and approval is required.
r .
In the event this soil absorption system or any of its component parts malfunctions so as to create a he ltOhazard, the
property owner must follow the contingency plan as described in the approved plans. In addition, the oAer must
comply with the operation, maintenance and monitoring duties as described in section VIII of the at -grade
component manual. A copy of this information must be given to the owner upon completion of the project.
CHARLES L WEBSTER Page 2 7/13/2006
f ,
Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is
required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions.
A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the
designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
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.
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.
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.
Sinc r ly, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Julia Lewis - Osborne
POWTS Reviewer 2, Integrated Services WiSMART code: 7633
(262) 548 -8638, Fax: (262) 548 -8614
julia.lewis@wisconsin.gov
Webster Soi! Testing Et Sewer System Des' v
Charlie £t Kris Webster, Owners V
N5815 770 Street, Ellsworth, WI 54011
Telephone: (715) 273 -3430 Fax: (715) 273 - 4181": ? ";
WI Licenses: MP220673, ST220673, ST 261669, PEI 8803 .
POWTS Index Sheet Page 1 of 8
At -Grade System Designed for a 4 Bedroom Residence
Property Owner/Project Name: William Liddle
NW 1/4 NW 1/4 S7 T28 N R17 W
Town of Pleasant Valley, St. Croix County, WI
Contents
Page 1 of 8 Index Sheet
Page 2 of 8 Plot Plan
Page 3 of 8 Plan View Cross Section
Page 4 of 8 Distribution Pine Layout
Page 5 of 8 Pumping Chamber Layout
Page 6 of 8 Pump Performance Curve
Page 7 &8 of 8 Management Plan
\ S C O ly `" .,
= wE8=R
S E48M 4
« 9 s
O ELLEMlIoRf}4 =
•� X
s♦ONAL E� �••
Com Q onent manual used:
Name: At -Grade Component Manual for POWTS
Version: SBD 10570- P(R6/99
Date: 6/99
Nam�e�. Pressure �tribution Manual for POWTS
513 10473-P c l
J
A'JD SsL-k)m 9.6 ( ot/rc� A,
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A f Gad. d , -- PlaL, Pai- K / ili( FYI l(Y fL L 3 6
J? 0 s.S s E C 7 / o N
r
SA-
ch a•. b er -
' �+-tt psel.J7
A� Feet C-L ,1+04, _
13= / Fe e t
Linear Loading Rate= C " " GPD /LN FT
L= �.� Feet Design Loading Rate= „�„(;pD /SQ
feT�e Feet
' `
Distribution Late al
Observation- �nvej El=
Well
a 06 P c k s a /c ca V Ova
4"c 7
s . CC417.,,.04- 3v cA"_ co
-
Distribution Pipe Layout o C
Place the holes at the bottom of the distribution pipes
at equal spacing. Remove all burrs from the pipe and holes.
�dcad tic end of a Gh Iate�I tsn wiry the oflonl from or 43° ft mg to &point wid a sx '
inches of the final grade. T=Min= the cads of the ]==Is with a valve; Cd c� ar
. threaded Plug- Provide ae; fiu= faW FWc fcr dw valve, dircaded caw or phl.
•�ccEss �sx:_
p►� A L �_ttOS N
P% C �vC
L!
T Y 1 i fV2 7{Q Y Y f x
8ACt}I +
LUWWLi
IS�R�!!hQ
�.... ----------
�terh J7`2
�F x,mN
P ¢ Ft. Hole diameter S " 'a Inch
t lateral � Inch(es)
X o�`!� Inches .
Force brain " � Inches
I of holes /pipe . -L
G_ s 4 -� f� Invert Elevation of- Utera% Ft.
5 Co-s-4)
A t 6� i, d W / ld ,� poi^ kl i i 'd ,., 4 i0gl e Page Of Cq
ck 1 Ai6eM
(No Scale) 7i- req't P� e
Approved Locking Manhole Covers ��
With Warning Labels Attached
Weatherproof Approved
,;, t ;,��`�✓ �` c17-- Ju
''T nction Box Vent Cap —�
12" Minimum
F:�i/G.adQ %7�►�fn;murn — 4" Minimum
Quick
18" Minimum , Disconnect
1/4" Wee
B,.,, A,,4 ,��,,dlPe Ards 00119 , p
1? 73.S Baffle i Hole
Alarm _
On B
I C t t er.,� -Pre
w,'tl,•;,� &,��� *APPROVED Off 6' �`!"► Q d -O
opC.Y0� *0 JOINTS WITH
d °cs APPROVED PIPE D
3' ONTO Conc. Block
SOLID SOIL
3" of Bedding Under Tank:f
,�r�� �w�mP �c1~I 'a.r^m v�! Se.�e+ �i�atY'� �i r'esci'7•S
Number of Doses: S =3Per Day
Gallons Per Day / o1 - Doses : III- ¢Gal 1 ons
Volume of Back flow: 3� —Gall ons
Tank Manufacturer: � � �� � "'k�% Total Dose Yol ume ......... _ / s- Gallons
Tank Size-Septic/Pump: I Z 5 75 Ga ons
Alarm Manufacturer:
Model Number: Capacities: A-),0 inches or IS-/ Gallons
Switch Type: 'If r-, + B w inches or 3a Gallons
Pump Manufacturer: 6 p + C� 9 inches or 14,E Gallons
Model Number: A�e po 4 j + D or l Gallons
Minimum Discharge ate: a 7• o UPF Total ..... - Z inches or ?•; 7 Gallons
Vertical Difference Between Pump Off and Distribution Pipe: 8./ Feet
Minimum Required Supply Pressure:.. 3 < <3° �'��. ?....... + S Feet
,2 Feet of Force Main x Friction Factor /100 Feet: +eet
Inch Diameter Force Main
Total Dynamic Head:.. Feet
Internal Tank Dimensions: Length / sue ; Width ,�96' ; Liquid Depth 17
l � Y t P r m;-
t
11
3871 EPO4
EP05
APPLICATIONS Fasteners: 300 series Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas-
o Homes components. tic cover with integral handle
Farms Motor. Available for automatic and and float switch attachment
manual operation. Automatic points.
EPO4 Single phase: 0.4'HP
e Heavy °duty sump models include Mechanical �
• Water transfer 115 or 230 V, 60.Hz,1550 float Switch assembled and In Power Cable, Severe duty
RPM, built in overload with
• Dewatering preset at the factory, rated oil and water resistant:
automatic reset.
EP05 Single phase: 0.5 HP, ■Bearings: Upper and lower
SPECIFICATIONS •
115 V, 60 H7,1550 RPM, FEATURES heavy duty ball bearing
Pump: EPO4 built in overload with ■ EPO4 Impeller Thermo- construction.
• Solids handling capability: automatic reset. plastic Semi -open design
%" maximum.. . • Power cord: 10 foot with pump out vanes for AGENCY LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. C• Cali SWrAuft Association
• Total heads: up to 24 feet. with three prong grounding
�"' • Discharge size: 1 1 /2 " NPT. plug. Optional 20 foot m EP05 Impeller Thermo- (CSA listed model numbers
• Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC".)
rotary/ceramic - stationary, three prong grounding plug improved performance.
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
•' Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60 °C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel. 10
• Capable of running
dry.without damage to 9 30
components. i
Pump: EP05 a
• Solids handling capability: 0 25
%" maximum. w 7
• Capacities: up to 60 GPM. _
• Total heads.: up to 31 feet. g 6 20 �
Discharge size: 1 NPT. z 5
• Mechanical seal: carbon- >_ 15
rotary /ceramic- stationary, a 4 ,
BUNA -N elastomers. 1 ,
• Temperature: ° 3 10
104 0 F (40 °C) continuous
140 °F (60 °C) intermittent. 2
5
al
`•�'� / rf. 0-
0 0 10 20 30 40 5o I GPM
L L ,
0 2 4 6 8 10 12 ma/h
CAPACITY
®1995 Goulds Pumps, Inc. EffecWe May 1995
B3871
r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page cst
FILE INFORMATION SYSTEM SPECIFICATIONS
er L Se tic Tank Capacity I �� 0 ca = "Y
1 c . 'Id l p
Permit # Septic Tank Manufacturer CV,' Co r ci It
DESIGN PARAMETERS M ° ws C , "� syr p0` Effluent Filter Manufacturer ! o l /, k ❑ '`-
Number of Bedrooms ❑ NA Effluent Filter Model L NA
Number of Commercial Units XNA Pump Tank Capacity ca l C NA
Estimated flow (average) +a Ca g al/day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) 0/-00 gal/da . Pump Manufacturer 0 NA
Soil Application Rate 0- al/da /ftz Pump Model E PCB` + ❑ NA
influent/Effluent Quality Monthly average' Pretreatment Unit XNA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (6013 _220 mg/L ❑Mechanical Aeration ❑ Wetland
❑Disinfection ❑Other.
Total Suspended Solids (TSS) 5150 mg/L
Manufacturer
Pretreated Effluent Quality . ❑ NA Monthly average" Dispersal Cell(s)
Biochemical Oxygen Demand (BOD 530 mg/L ❑ In- ground (gravity) ❑ In -ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L At -grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu/100m1 ❑ Drip-line ❑ Other
Maximum Effluent Particle Size Y inch diameter * Values typical for domestic (non- oommerciao wastewater and
septic tank effluent
*+ Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every ❑ months Kyear(s) (Maximum 3 yrs.)
Pump out contents of tanks) When combined sludge and scum equals one -third (Y) of tank volume
Inspect dispersal cell(s) At least once every ❑ months Xyear(s) (Maximum 3 yrs.)
Clean effluent filter V- At least once every 3 ❑ months )(year(s)
Inspect pump, pump controls & alarm At least once every ❑ months ❑ year(s) ❑ NA As /l/e c u4d
Flush laterals and pressure test At least once every ❑ months ❑ year(s) ❑ NA A Ale, th
Other At least once every ❑ months ❑ year(s) ,ANA
Other At least once every O' months ❑ year(s) >( NA
lr�-P 9• ccesr,.r.oR e/sc %�a,hfs A /frr OhCG�Ver 3Y��`r- 4veLecvnk�ud t4 +'f
MAINTENANCE INSTRUCTIONS y ou, c /ery, r114ex every A,) /l to , v•/ a. P -° >�+•' du r� fhe "')& 6 '-
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 Maintainer, Septage
Servicing Operator. Tank inspections must include a visual inspection of the tank(s) 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 back up
or ponding of effluent on the ground surface. The dispersal cell(s) 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 %) 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 ch. NR
113, Wisconsin Administrative Code.
The servicing of effluent filters, mechanical or pressurized POWTS components, pretreattment components, and any
other maintenance or monitoring at intervals of 12 months or less 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
START UP AND OPERATION. or other
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products
chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess
wastewater will -be discharged to the dispersal cell(s) in one large dose, overloading the oeil(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 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or. 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
scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONM
When the POWTS fails and/or is permanently taken out of service the following steps shall betaken to insure that the
system is property and safely abandoned in compliance with ch. Comm 83:33, Wisconsin'Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
+ The contents of all tanks and pits shall' be removed and 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 fails and cannot be repaired the following measures have been, or must be taken, to provide a code
compliant replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil
absorption system. The replacement area should be protected from disturbance and compaction and should not
be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to
protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable
replacement area. Replacement systems must comply with the rules in effect at that time.
• A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
• The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and
site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a
holding tank may be installed as a last resort to replace the failed POWTS.
Mound and at -grade soil absorption systems may be reconstructed In place following removal of the biomat at
the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY 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 6t,, /f o ovvpi POWTS MAINTAINER
Name Name
Phone Phone
SEPTAGE SERVICING OPERATOR PUMPER U,, LOCAL REGULATORY AUTHORITY
Name Agency /P,e, Ce �o,nf z�o�,�
Phone Phone - 71Y - Z7-?7C 7 +-7
i his document was dratted by the safis of the Green Lake, Marquette and Waushard County Zoning and Sanitation agencies. This document meets
the minimum requirements of ch. Comm 8322(2)(b)(1)(d)&M and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not
guarantee the performance of the POWTS. GMW (2/01)
Safety and Buildings
141 NW BARSTOW ST FL 4TH
commerceml. oV
g WAUKESHA WI 53188 -3789
i TDD #: (608) 264 -8777
www. commerce.wi.gov /sb/
isconsn
l t
Department of Commerce www.wisconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
July 13, 2006
CUST ID No. 220673 ATTN.• POWTS Inspector
CHARLES L WEBSTER ZONING OFFICE
WEBSTER SOIL TESTING & DESIGN ST CROIX COUNTY SPIA
SERVICES
N5815 770TH ST 1101 CARMICHAEL RD
ELLSWORTH WI 54011 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 07/13/2008 Identification Numbers
Transaction ID No. 1288762
SITE: Site ID No. 715376
William Liddle Please refer to both identification
Cr N numbers, above, in all
Town of Pleasant Valley, 54015 correspondence with the agency.
St Croix County
NWl /4, NWl /4, S7, T28N, R17W
FOR:
Description: At- Grade, 3 Bedroom + Bathrooms for Owners Use in Horsebarn & Garage
Object Type: POWTS Component Manual Regulated Object ID No.: 1085789
Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from
original grade; System(s): At -grade Component Manual, SBD- 10570 -P (R.6/99), Pressure
Distribution Component Manual, SBD- 10573 -P (R.6/99)
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY
APPROVED. This system is to be constructed and located in accordance with the enclosed
approved plans and with the component manual(s) referenced above. 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, stats.
The following conditions shall be met during construction or installation and prior to occupancy
or use:
This system is to be constructed and located in accordance with the approved plans, and with
publication SBD - 10570 -P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution
System for Private Onsite Wastewater Systems ". The pressure network is to be constructed in
accordance with publications SBD - 10573 -P(R. 6/99) "Pressure Distribution Component Manual
for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication
"SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ".
• CHARLES L WEBSTER Page 2 7/13/2006
NOTE: The -
( e At Grade Component Manual does not allow for utilization of the Version 2
Pressure Distribution Component Manual.)
This approval does not include plans for the general plumbing systems or sewer piping leading
to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis.
Adm. Code, to determine if plan submittal and approval is required.
In the event this soil absorption system or any of its component parts malfunctions so as to create
a health hazard, the property owner must follow the contingency plan as described in the
approved plans. In addition, the owner must comply with the operation, maintenance and
monitoring duties as described in section VIII of the at -grade component manual. A copy of this
information must be given to the owner upon completion of the project.
Maintenance information must be given to the owner of the tank explaining that periodic
cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84
product approval conditions.
A Sanitary Permit must be obtained from the county where this project is located in accordance
with the requirements of Sec. 145.135 and 145.19, Wis. Stats.
Inspection of the private sewage system installation is required. Arrangements for inspection
shall be made with the designated county official in accordance with the provisions of Sec.
145.20(2)(d), Wis. Stats.
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.
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.
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.
CHARLES L WEBSTER Page 3 7/13/2006
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
Julia Lewis - Osborne
POWTS Reviewer 2, Integrated Services WiSMART code: 7633
(262) 548 -8638, Fax: (262) 548 -8614
julia.lewis @wisconsin.gov
Wisconsin Department of Commerce
p SOIL EVALUATION R�ORT Page of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0-�4 - jp 10 - 000
Please print all information. Reviewed Date
Personal information you provide may be used for aw, s. 5.04 (1) (m)). ,; ! /
M 1= Property Owner P perty Location
vt� ; � h dl d N W 114 j`,(M14 S7 T.2,6 N R` 7 ={er) yA/
Property Owner's Mailing Address - L # Block # Subd. Name Or CSM#
A LE G'.'�,sr �r. S�-f- NTY QT CRnlx
City State Zip ne umber City ❑Village ,Town Nearest Road !
Ft'o 6e. rs Cv� S 6 ? 7/ .lS 8� 6 3 j�I e ') s .
a" -t V d // •• -
New Construction Use :'9 Residen I / Nu ber of bedrooms Code derived design flow rate t U U GPD
❑ Replacement ❑ Public or commercial - Describe: 4
Parent material 4 / r _) c ,',4 / 7 - 1 1 ' Flood Plain elevation if applicable IVA ft•
General comments Vie' /e 11" X k . pe �' c r e+fa �t ' / o% t/ 'rc We e . -rks Tc•�
and recommendations:
A, ro? e • R
Boring
F- 1 Boring #
Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Diiscriptiob Texture Structure Consistence Boundary Roots GPD /fF
in. Munsell Qu. Sz nt. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
�
o- / %P '6l' e / Ca-
•� � � � to v .C' -> / 3 S / .� C, 4',a:� a(� � � � � G � �- •G
/ r 1' �� i "� `° �" a� /� _•' S " r ' � Z s•�, d jo l� C! � � .� 2 �' �i _ � ? _ � .
Boring # Boring
F I vj Pit Ground surface elev. 9 °Z ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz: Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
>' 1 S /4',v 516' s i 2 M. K
' Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name .(Please Print) Signature CST. Number
C /1aa /Ps W Z Z o r - 73
Address Date- Evaluation Conducted Tele
• phone Number.
/V' - its 7741-1G 5t �'f1�,/'d� 71 S
l
f
Property Owner tW ,, a L, Paroel 1D# o -. zU - c oo per of 3
Borhv # ❑
Pt . Ground surface elev qs • 7 ft Depth b limiting factor _ tn. Sol &qftation Rate
Hoc¢on Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'EWI 'Eff#2
4 67
"o q4M 4 ' I / C9_ 6 0-6
F—I�# ❑ erg
❑ pt Ground surfaoeelev. ft Depth to BmiBng factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Din Texture Shicture Coansebwice Boundary Roots GPD1W
in. Munsell Qu. Sz. Cont. Color Gr. 87- SIX `Eff#1 •Eff#2
# 0 E3'()ft
Grourdsurfaceelev. ft Depth to faaOor
❑Pit Sod icatior► Rage
Horizon Depth Dominant Color Redox Description Texture Structure Consisteince Boundary Rods GPDM
in. Murrell Qu Sr- Cont Color Gr. Sz Sh. `EW 'EfUQ
" Effluent #1 = BOD > 30 22D ffVIL and TSS >30 _S 150 mglL ' Efttuent #2 = BOOD, <_ 30 rr>gIL and TSS _< 30 mall-
The Department of Commerce is an equal opportunity service provider and employer. If yon need assistance to access services or
need material m an alteanate fob please contact the department at 608- 266 -3151 or TTY 608- 264 -8777.
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DOCUMENT NUMBER 6 "7 1 2 :23 :23
.si i i -iLEEN H. WALSH
WARRANTr D ZZD REGISTER OF DEEDS
:.. cku: x CO., WI
RECEIVED FOR RECORD
John Z. Sao, Grantor, conveys and warrants to W1111am F. Ltddla and 0r - 1$ - 2002 9:00 AM
penny L. Liddle, husband and wife as suvv1voreh1p marltal property,
Grantee, the f ol l owing described real estate in St. Croix county, State WARRANTY DEED
g
of Wisconsin: EXEMPT d
CERT COPY FEE:
,-OPY FEE:
The South Half o£ the Northwest Quarter of the Northwest Quarter (S -2 TRANSFER FEE 180.00
of NW 1/4 of NW 1/4) of Section Seven (7), Township Twenty Eight (28) ?ECORDING FEE: 11.00
North, Range Seventeen (17) West, Town of Pleasant valley. PAGES: 1
NAME AND RETURN ADR S
DS
LFS rt x A PA , 2
024- 1010 -70 -000
Parcel i entif cation Number
This is not homestead property.
Exception to warranties:
r i g hts-of-way of record, if any.
ri
All easements, restrictions and g
Dated this j Li day of � 2002•
(SEAL)
(SEAL)
r7 Sae
(SEAL)
(SEAL)
AUTHENTICATION ACKm0VLEDGb=NT
Signature of John E. See STATE OF WISCONSIN )
as'
COUNTY )
Personally came before me this day of January, 2002
authenticated this y of Jareaef -'Y, 2 02. the above named John Z. See
• ss nacure to me known to be the persons(s) who executed the
foregoing instrument and acknowledge the same.
J h D. Boles Name P iced o� T ed si nacv :.
TI E: MEMBER STATE BAR OF WISCONSIN
(If not, (N� Pzin�d oc TvPedl
authorized by $706.06, Wis. Stats.)
THIS INSTRUbWNT WAS DRAFTED Br: Notary Public County, Wis.
My commission is permanent. (If not, expiration date:)
Joseph D. Boles
Rodli, Beskar, Boles 6 Krueger, S.C.
P.O. Box 138
River Falls, WI 54022
f -
o 837 168
DOCUMENT NUMBER 6 7 1 2 3 4
i' :r. i �it-EEN H. 'dALSH
TROSTEx's DEED REGISTER OF' DEEDS
RO.IX CO., WI
RECE1�`EU FOR RECORD
Viola Liddle, as Trustee of The Viola Liddle Faaily Revocable Trust _
Agreement dated December 29, 2000, for a valuable consideration conveys ?- i_, - c('Jr ':8U AM
without warranty to John E. See, Grantee, the following described real
estate in St. Croix County, State of Wisconsin: TduSTEES DEED
eXEMPI A 17
CERT COPY FEE:
THE SOUTH HALF OF THE NORTHWEST QUARTER OF THE NORTHWEST QUARTER (S +2 COPY FEE:
OF NW 1/4 OF NW 1/4) OF SECTION SEVEN (7), TOWNSHIP TWENTY EIGHT (28) TRANSFER FEE:
NORTH, RANGE SEVENTEEN (17) WEST, TOWN OF PLEASANT VALLEY. RECORDING FEE: 11.00
PAGES: 1
Said deed is given in satisfaction of the Land Contract between the
parties recorded in Volume 1417, pages 143 -144 as document number
600876.
NAME AND RETURN ADDRESS ./
,fit^ oL; ,3� s,�'Ae, > /�ku�yr
/?,r A tj i -fF
�LtJF,k' LR ��S', Ll��s�?ZyCr1 -Bna3
i
°70 - GYRO
Parcel Identif cation Number
Dated this 7 day of February, 2002.
(SEAL)
(SEAL) e e
ola Liddle,
ACKN0VLEDGbW.NT
AVTHENTICATION
STATE OF WISCONSIN )
Signature of Viola Liddle ) ss.
COUNTY )
Personally came before me this day of
authenticated thist day of February, 2002• T February, 2002 the above named
to me known to be the persons) who executed the
B U J' _ foregoing instrument and acknowledge the same.
o eph
D. les
LE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by 5706.06, Wis. Stats.)
Notary Public County, Wis.
THIS INSTRt7MENT WAS DRAFTED 13Y: My commission is permanent. (if not, expiration date:
Joseph D. Boles )
Rodli, Beskar, Boles & Krueger, S.C.
P.O. Box 138
River Falls, WI 54022
i�
Parcel #: 024 - 1010 -70 -000 08/07/2006 01:26 PM
PAGE 1 OF 1
Alt. Parcel #: 7.28.17.54A 024 - TOWN OF PLEASANT VALLEY
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
WILLIAM F & PENNY L LIDDLE O - LIDDLE, WILLIAM F & PENNY L
465 DIVISION AVE
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description
SC 2422 ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 20.510 Plat: N/A -NOT AVAILABLE
SEC 7 T28N R17W NW NW EXC PARCEL 54B Block/Condo Bldg:
TOWNSHIP PLEASANT VALLEY
Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
07- 28N -17W
Notes: Parcel History:
Date Doc # Vol /Page Type
02/15/2002 671234 1837/168 TD
02/15/2002 671233 1837/167 WD
04/07/1999 600876 1417/143 LC
07/23/1997 703/523
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 06/03/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 18.000 2,500 0 2,500 NO
AGRICULTURAL FOREST G5M 2.510 1,100 0 1,100 NO
Totals for 2006:
General Property 20.510 3,600 0 3,600
Woodland 0.000 0 0
Totals for 2005:
General Property 20.510 3,600 0 3,600
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
l