HomeMy WebLinkAbout040-1036-70-000 (2)Sal and gold Ing DIVISIOn
GENERAL INFORMATION
LLC
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
(ATTACH TO PERMIT)
19.118B
TYPE
MANUFACTURER
CAPACITY
STATION
ED
HI
R
ELEV.
sepro
.aNj l.lall
12b6
s.nmm°n
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W7
3zo
AR Mt'
3•L8
.o
Ise.s'ZS
EidP .n
;ea,
Homina
SvHtInln
✓
TANK SETBACK INFORMATION
Sl Outlet
4i`
TAINKTO
Pi
AVELL
SLID
1
v
ROAD
sonar
9. Z
/
swoe
39
On Bodo3
6.
HeednlM.rt
-
a/.z
Accident
MIT P,x
oNlg
Bal Real
PUMPISIPHON INFORMATION
anal Can,
11.
.9
noMmre; Depend
stcw°r
3.
Model Nurl
ITNH mmoo Los:
S C*mMof
m.� of Ole.
Iowai
SOIL ABSORPTION SYSTEM
x'AT%pa I
a1TQ4j! oNs
as
eeo�Lq.
DIMe
s
INFOCHAMBEIR
RN.
sysTEMTO'1 IeLDc
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UNIT
au /
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Ideal
DISTRIBUTION SYSTEM J' � /
pa l
ixtnla�
anal
1. gacke
oksue�o
ven(m iri
66 1
xeoil
SOIL COVER /I h
Pn„
U.ak"ook...
a
��
O
A.65
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cal
'aakety
On
IN
COMMENTS: Anal code dBaccap.ncleL, personeponent eM.l
Lrcatlon: 435 M ICK DID Ql ,1 1nl.UY— l�
T) ON Deeclpndian- .may
23 ern '64"'IJ
Plan edge, Rectangle QYnc, 1N, 9 16 li
xo er°ge III ddlWmllnhuntr n!
Call 0IR al AN,
Intel #1 a ion
mvpuonS CM.Po.—
— � IntluYry Servvs¢DlWsm
C'm'
1000E WaMlrglm Ave
smimf YcmnNonly (m YOlbdinyfn.)
j
it li AUG 29 2M9 Ro.ew ns2
4 l f M1kElsdn.'M 53/01 Y,
Connlr
COMM I iit Applic85on
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m azwNuve wiln lmmroue Dwumn ml�wn
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N
applusiame
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Aessli(diHeenrlhunuillRvSdreal
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Yw IXVmn^m ofsandwd Pohssionel servlua. =mW
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p1b10360 a8.d8.19. 118
va) dro l
Prme=m Lmmm
Mail'm6Addrw
INGIwer Rd
421N( l Rd
2
Cvn,lgr
BE9 NW Yn sWiu 00 )
ZipCMe
PMrc NumW
New,
5016
T3sN BI9[
R. iyPe Of DOWIS Neeck AU Name APPFF) cl L'd
J 6
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❑PoL1'v/ ,M,w-Dmaih=UN,
❑Sim Dann—Depwbuse cvMN
0wage r
p;a� r7 E2 Gl. of io z¢
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ILLT eof PxmiC Cha4onl o Iine A. Coat kee Lane BRv Ikvhk
❑ryIM 61Wi(aunm EUOW Nyslen(eedelnl
A. ❑Nw spurn RWNmnan Seem:0 pTrtumWHddme Tut Replvmem WY
NM, Nmril
❑PnmNBcism
❑Chorea of
Pmm ivmf,Nm
Lid Frtruv Meat N�MDme awed
Ecforz ElpdNm
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m
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Nr 3n(o=mad I pB Syvam Blevumn
Meats, P, IN Dlgemu lNvimfNo l0?]s
mw (®d)
450
T"Newd°0 9D
n T..k mat
seplkw Xoldw{iwt 320wP im, 13W 2 Www Ca FdWeekl C PIf
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W L Rdpmnrll Stlkmee - I. the end'i-Il vuum rvpewlhlllb b lmblatlon of Ne Po W le =M1wn an the vNehM pam.
MPMPABNmnMr mat PmneNunb
BII5.]60L66
PvmK'iNm (PdnOIF/
12N3®
John, Pmhmitt
PmmW'lMOess lsmmt SZIPA
586 Valley Vimv Tal,SWOMO4W54M5
vi On Me Meep LoDn S.
Appmed - am
s 5oo.m 9 arft i l9
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2 NaRx%xNle-.mnammtw.r.d.i e:
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SBD-098(BOLII)
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) 435 naa cads located
at: SE 'h NW Y., Section 9 , Town xs N, Range is W,
Town of , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the molds), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appears) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes_ No_
(if no, skip next line.)
Approximate volume or length of time: gallons _ minutes
Tank Capacity: 1260
Construction: Prefab Concrete x Steel Other
Manufacturer (if known): weexcaonvme vmhod.
Age of Tank (if known): zs yeem
Permit nu ber (if known) 31889e
John smmin
(LieKsedPlum er Signature) (Print Name)
Mess szneo
(Title) (License Number) MP/MPRS
`l-jG' iq
(Date)
Form to be completed by licensed plumber (Dept of Safety and professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev.2/2012
SYSTEM PLOT PLAN 4/�ry�1�
Project Name: KP.J 3 Bedroom Septic °e6AlwN"aw' "' 'men �m.bl e
o
hgeu Mons. meNN plw
Wi Syrn :A B Pbe Mvmoei¢ I S7M EWFW Solea"=a]'
BM MC,lwl TwNs9Sa.90.38� Po
SWmlO
BM O¢w' w To c4.l6lQ WSl W W W Ia
ao"wadeMo17nMArer. 0
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ue. SEE CSM Wm M¢p
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ah 8«
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CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
KAI Properties, LLC 4 Bedroom Septic System
Owners all
Michael & Kerry Jacobson
Owner's Address
421 Glover Road
Hudson, Wl 54016
Legal Description:
SE1/4, NW3/4, Site, T28N, R19W
Township
Tray
County:
St Croix
Subdivision Name:
NA
Lot Number: 6 Block Number
Parcel I.D. Number o40-1036-)0-000
Plan Transeptal No.
Page 1 Index and title
Page 2 Plat Plan
Page 3 Existing Septic Tank Spectral
Page 4 Existing Tank Certification
Page 5 Septic Tank Specifications
Page 6 Effluent Filter Information
Page 2 System Sizing &Cross Section
Page EZ Flaw Information
Page Management and contingency plan
Page 30 Septic Tank Maintenance Agreement
Page 11 Warranty Deed
Page 12 GEM or Plat
Attachment 1 Soil Evaluation Report
Designer: Jahn Schmitt Lic Number: MPR52237W
Date: 8/26/20/01199 Phone Number: 215-760-0486
Signature
InGroundSoil Absorption Component Manual Venlon 2.0 SBD-10705-PIN. 01/01)
SYSTEM PLOT PLAN
Project NameK 3 Bedmom Septic
Ppwn.ae„... •AftseJ,M PASS ®mew,e M,
a i
6Mi 6ynn A 6m simile
FlADe,a
v�prvn: TVW1'M nrga e fl3wa em sp
go 120
6MM®m6M. Q em [wen ": 103.5e0
moun TV m
oftz
: mw Km
so.arec mOW 000$4
SEE 'Polm
N,,,s[e CSMf,mMm WIAS; ad
OgiVie cl
P_
q1 88 $
a 55 8y
YY
Minaeeo+e
50.
I I
a' CAST-A-ssAL
____ 0
— 7 4' CAST -A -SEAL
III
LL J
MTER OR GAF RE
np NEW
INLET _ TLET
W320-MR
TANK SPECIFICATIONS
DIMENNONS:
WALL Y
BotTM: r
COMER: r
MANHoOE pC I.O. PRECAST CONCRETE RISER
HEIGHT: 5r O.D.
LENGTH: W 00,
MOTH: W O.O.
BELOW INET. 01/ So.
UOUI0 HEY 43.
%VG T. S.OBO WS,
MILT AND WTEET:
6' CAST-A-SFK BOOT OR EQUAL
CASKET, CAST -A -SEAL BOOT OR EQUAL
INIET AND OUTLET BAESIE AND FlLTER:
WSCWGH. SEE DETAIL PO
(OTHER STATES ME CHART)
UWIO CAFAGTY. SC GAON
LOADING CfGOI: 80' UNSATURATED SOIL
TANK CAN BE USED AS:
SEPTC/ Rg1MNC/ PUMP ON APNON
comm :NI%OE9W 0 NO HBER)
TANK: I% CfSW (IO STRUCTURAL nSER)
WSTCMIID TANKS:
ELM CUSTOM RAMS CONTACT WEME CONCRETE
FOR API
PDl far
PL-525 Effluent Filter
PL-525 tiller
The PL-525 Filler Is rated for 10,000 GPD (gallmu per day) making,t mire of the ragout Nrers in its class. It has
525 River fret of t/W Ntrationslots. Lye Me Polylok I'LiM, Ne Polylok PL-525 has an automatic shut-off ball
rmmlled with every filter. V✓hen the filter is removed for cleaning• due bell will Boat up and temporarily shut off
my system so the effluent won't leave the tank.
Faroe.: 1/16" Fil nation Slule
• batrd for 10," GM (Ripen per day)_ NsmEmam
10,000 GPD i0pd°wt
• 5nlamar fat of l/16'filo-atlon. pazyuPPva
• Accept. 4'•and 6'S Ho 40 pipe.. glowers Rome
• Built in go, deflector.
• Automatic shutoff bell when filter is removed.
• Alarm acmasromry.
• Accepts PVC exmour handle.
PL-525 Installation
Ideal for rendenad and rommmad waste flow, up to
HAD gallons per day(GPD).
1. Lacate the model of due whir lank.
2 Remove the tank rover and pump tank9 necessary.
3. Glue Me filter housing to the r or 6" outlet pipe. If
go filter is not commed under the micros oper0ng use
Polylok Bslend @ Loknr pieceof pipe 0 center fllmr.
4. Insert the PL5M fiber into its housing
5. Replace and secure the septic tank cover.
PI.525 Mointe.....
The PL-525 Effluent Filmn will operate efficiently for
several years undo normal conditions before opening
cleaning, his recommended that the filter be cleaned
every time day road is pumped, or at least every, three
yeas. If me installed filter comers an optional alarvy
the meaner w01 be retired by an alam, when the filter
needs servicing 5ervicup should he dove by a remained
some book pumper or broader.
1. Lmcare the order of the septic Lard,.
2 Remove Lack ewer and pump bard V necessary.
3. Do not use plumbing when from is removed.
4. full 11L525 cartridge on of fire housing.
5. Home off Into, over one sept,c hnk. Make sure all
solods fall back mum septic bard,.
&Inssed, the filter cartridge back him the housing making
sure the film is property aligned and comply madeflL.
Z Replace and secure strike milk cover.
AmySCHDin kPba"
marten
IXlpse e
Flmm,914
a�om .
se=1.II
OutdiwSmaftrll"O
ZeMlh Pevfinenamp X Emilyiasu
rtr Sm.rtFate�m�rcF anawrm. into e,a gnvkc
Pichok Inc 3Fairbeld Blvd W hngford, CT 06492 Toll Free: 87.7659565 base 2032M.M14 wsu.poldidocom
�1iI oil'
� °
IN -GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with EZ1203HP Bundles
3-ft Trench (down -sizing credit)
IL�)m
112!II�
,•.:: ::i i:,-il
00*06*
•••
TYPICAL TRENCH True, ,,I Mmleu nutlet Pepe wanamaa m Plandex.)
PLAN VIEW
Weeks C. P.Meser Concrete
6eplk Trinket Vourt
1260 sN 320 sal _ se 4al
PONIok Effluent Flux Namaaa�c
smam rnm,wmx 525
OBSERVATION PIPE DETAIL
r
Qr
r.:
TV .1rene,
I., Inatome.
(ND Scale) 010
Perfoatetl laterel=Imomeramn npx� (aqu9 f
(typica0 („am.
___J roPea) m
BE ]0 fl W
(VOI 0
INSTALL PER TRENCH: EZt203H Bundle T
(bpiap A
1M bundles @50f EISauuu=350 ft' Gn(n E;IMut evauma. IM)
.. paaa.� wmanrarn.xalro e...
+ 0 5-fl burden @25fir EI5Nurd1=� fl'
= Propped EISA per trees=35U ft' Requireel ItullnMn Area=3fl' Distribution Medhori
x 2 trenches = Proposed Total EISA= 700 ft' branched! manifold
RESET
Installation Instructions for
EZflow Systems in Wisconsin
woconsln oepadmem or commerce, safety and Buildings
Dlvlalm, has reviervW me spectral and/or Mans for into
product and detemrined q to be In compares with chapters
Comm e2 tnreugo M wiscrosm Admen. Code, and mantas
145 and 160, Wisconsin statutes. All sites most meet to S9g
& S911 Cmdfim• 6 Locators & but advances as noted'm
local regulations.
The approved products are 1203H (3-12' bundles with plat in
center bundle In 5or 10' Ieni and 1CuGHP(3-1 Se bundles
with fax in eatli bundle In 5' or 10' lengths.
A areas Moe bundle contains a tour Inch Perini pipe sur-
rounded by EPs aggregate and is held togeMer wig Pi
income netpng, A single aggregate bundle contelrs aggregate
my and is held homes, with polyethylene not".
Materials and Equipment Nxded
• call cancer
• Ezfiow Geotere le Eabrr
• E2fiow lntemal Pipe Guples
Pipe ter Header and Inlet
• Weence/Eem.aer
fi sMletion Instructions
he Inslmctors for Installation of Utley pr oduci are given
Ivlmv. This product mum be installee in accordance smin state
roles deNkd in chapters Comm 82 through 84, Wscemin Ad-
ninlshative Code, and (chapters 145 and t60, Wisconsin slat-
ifies men ai. well as Me Ioml Health department a anent design
I. After Me used hwlM department had determined grang
conferrallon, and layout for the Ullew rystems, sake
or Mark voth part the eaBm of trachea and Iona. Be
careful to set correct tank, Invert pipe, header line or&c
Mbuton bans and french bottom elevations before Inmal-
IAlon of ape bundles.
2. camave ,scene came, shipping bags pnorto placing
bundles In Me trenchms). Remove any plastic bugs In the
bench bH«e system Is severed.
3. This modal must haw gmfpvdle fabric Mat meets re-
quirements of I. Cwnm 84.30 (6) by Ws. Adm. Code,
Ineeped poetry on top W Me pmduc and borehole
down along the sides of the product to a point at least as
inches from the bannm of product.
4. Wnen installed in a french, the bench shwltl be dug to
awldM o1 M inch m This not only eaves omorin eamet
non, but also spaces better load-beanng capacity after
deserting is complete.
1ME46ow-
.al..l.,.....
.........................................
b. The AWorption bass pM) nttessary for a men site shall
be slued based m maximum daly Assets flow (GPo) and
Me Pemaadlliy for to le. It moan regard is met, Me
ESA sizing can be used In Wisconsin, ressuXing In a 40%
smathadminfield.
6. Raze EZflow small in Me E2flaw configuration am
proven by ry9em design count specified for Me pi
or site The pop or center -mom bundles containing pipe
are famed end to end wXM1 an Interval pipe coupler. Any
addNOnal objections only bundles that may be required
should bed butted against the other aggrisateminly bun-
dles and do not require any ben of connection.
Z The tap of such GIW rylinder mnalns a lifter fear: fort
manufactured mbmvree Me noting and aggregate, me
fain: is Ivedm to present boll abuser. The insular
shall malre sure the Me GEO is positioned upward and to
in contact with the fabdo convened in Me adlacenn qlm-
derbeMresold long.
B. The caddy, Downfall systems should be Installed in a
III trench in all dandons (bMM1 across and along Me
trench Wtlwn)andshwNldkwthe commodbejround
surface tlerztion (units" depth), wig all wntinuws
missing 10-imt mundwml bindles placed aid To end,
with cmbal bundle dlatamen pipe Imerttnnemee,
without any dams, srammar or other water seeps.
9, The trench top shall be graded surf that weer wall rot
found mclefill should be seeded or sodded Immediately
after completion to teduw erosiwv
10. borrow EPS bundles are fietide and inn fr in curved
irenehes as may be necessary to avoid tress, boulders, or
oMerobsades.
11. EP5 aggregate is lighter Men water, therefore, It might
be expected that hil l beemnq for world tend to
cause EZfiav assemblies to float out of ground when
pending prars. Fred a@rowers has shown, mower,
Met ths Is not a problem when sym ms have a mnimum
of6° of sou super ae recommended b/ msochis r.
PAGE 4 OF 4
In -ground Gravity Management Plan
IMPORTANT:
Tire Owner of this Ingrourd gravity system Shell the responsible for its perpetual operation and maintenance pubuam to
requirements of SPS 3823M, Wisc. Atlmin. Code. Pursuant to SPS 383.52(2). Mw. Atlmin. Code, this system shell
be considered a human health haaaM if not maintained In accordance with this approved management plan.
Furthermore, all inspection and maintenance ac8vities shall be performed by a ragWoned POWTS Maintainer in
axorel with SPS 383 52 (3), Wrx. Atlmin. Code.
Maximum Dispersal Area Operadifted Undiffil
Design Flow= 450 gpd; Bi 5220 mil TSS 51W mgL 1; FOG 530 mi4
Inspection Checklist INSPECT EVERY 3 YEARS
o typeofuse
age M stem
• Ica factors e. adopt, user complaints, eta)
o mechanical mapurcron (i a pumps, valves, switches, poster, ste.)
messmad fatigue (/.e., Il breaks, corrosion, etc.)
wilds volume in anaerobic trammerd tank(s) and any distribution appurknancei (te., diumbulion / drop bores)
neglect or improper use p.e., exceeding design capacities, prohibitedactivities, all
I accord of pmdsng In distribution call prior to opera
o dosing imagulanues-if applicable (fie pump recymling,flout ewichsatlings, em)
• electrical components if applicable ti.e.,wiring, connectors , swichp, controk, timers, alamrs, el
o distribution lateral or lateral oll plugging (measure lateral distal preaarre—centers to design Modifiation)
o surface diwhage of effluent or sewage back-up into structure served
Maintenance Chen lb[ MAINTAIN EVERY 3 YEARS (or when necessary)
o Seollc and dose tnkt shall W pumped by a deal septual servicing Operator licensed under s. 281.48 We.
Sught when the volume of wilds in Me tanks) excwds onHhlN (1/3) the liquid volume of Me tanks) Or
as repuireb by local ordinance. Disposed of contents shall be pursuant to NR 113, Wisc Admin. Cab.
o Effluent fl drlsl shall be separated every 3 years and shall ba cleaned when mceuery to remove any
accumulated wilds xcoNing to manufacturer s apcibcations. A servicing proM will a'ways be grouts than 12
months.
System maintenance report shalt be Suspended to the proper local government unit In accordance wIW
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name M individual or company: John Schmitt prone, 715-760-0486
tccal government unit. St. Croix County Community Developement Phone. 715-386-4680
local government unit Worse.: 1101 Carmichael Road, Hudson, WI 21p. 54016
Any defective Pad minis system stall be repaired, replaced, Or removed pursuant to SPS 383.51(1), Who Admen.
Cape. Repair or replacement M faired or malfunctioning components shall comply wit SPS 383, Al Atlmin. Cone.
No product for chemand or physical rRAOmtion of the POWTS may be used unless approved by the depadment In
accordance with SPS 384, Wisc. Atlmin. Carl
Contingency Plan
In Me event that any bileo Ireaonent component of this POWTS cannot be repaired it ahall be replaced pursuant to
a plan submitted to the appropriate agency for review and appreval. AbibdingrounddlweroulcommpMmaybe
abandoned and reMxetl by a wdemmpying disposal component In a pre-debrmlmtl area of suibbb tails.
System Abandonment
If use of his POWTS is discontinued, it shall be abandoned In accordance with SPS 383d3, Mac. Admin. CMe.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
ONMERSHIP CERTIFICATION FORM
KAJ Properties LLC
Meiling Address421 Glover Road, Hudson, W154016
Proposal Address 435 Brick Circle
Vermont required fs, Plains a Z'nin& Oryanmvm for na trommachom)
ciyrsmre Hudson, WI Pam] Identification Number040-1036-70-000
R A DESCM"MN
Proprom locution SE no, NVa ts, sac. 08 T 28NR 19 VI Towm of Troy
Subdivision Plat: LaU 6
CerROWSurvey Mapll VoWme ,Pagel
(before 2007)Volume_,
spa horeloyef}to Lot lines bmifint wCno
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and numerous, of .. won ourm can I molt in in pmmuwrt Oil arc to handle wuteo- Pmpe'
aorP"mpins out the Arctic lack eany'1're, years m
Vernon,
If nxded, by a I wash PWOP" WM YOU Pm inm
the system can offers 0, m ntiw of the noun tank as a mal snug, in the wane aspwl system. Owner meimmuce
responsibilities am specified In stay. 383 Small add In Chapter 12-SL CNAX Couny sonlmry OMinutw.
The pmpeur ow,rcraErars to wbmit to SL Cca County pan ... a A rating Me mein semifinalistt(coat sal by they
tt and by a out plumberjoumeyman plumber, woman plumber or a licensed Pumpn wriying thn(1)the stein
ter&spoeal sysem is in proper chromium commom amor(2) mo mention and pump!,&(ifnece ), the Verde tank is
was then W full of treat
low, the undezpped haw read the above resommash and seen to maintain the pnv se sewage dlepovl sysem with or
sNMerds not forth, barren se sea by the Depimment of Safely And Pmfaslawl Smite and ftC ostru eat ofNamml Rewumq
stl ofwis sin. Colhomion sWinetheyom scraftsysMm has been mains iced mustbewmpltlW aMtttumM to Units. Cnix
Counry Planning de some, Generators w,inio30 days ofthe three you caphaliom date.
Vwe ami(y an all statements on batsman, am hue to the bet chapter knowled&,. Pascalme the ownedy) ofthe
property descri nd scone, by issue of a I y deed recorded In Rel of Goods Offl
Number of bedrooms
AWE
9IONATUR V�FT .1 ANT(5) DATE
e*Any i n(rmYion Nat is misrep Mmay result in the estuary Pamir hot mg owled by the Planning R]nine lkNZmar."'
hall with this mind c Sion a recorded court deed Imm the Reeita of Dews 0ff=and a copy of the C miunes survey matt
refw is made in the wvramy and.
(REV. arm)
SAFETY AND BUILMNGB DIV6pN
Plural Prom Free
cpmmerca.wl.gdv
P.O. rm 2au
Mastendee, Wr On wri
'Wisconsin
TTYrConed meagh Henry
DeparYienr W Bonaiwrta
Jim Di anxmw
Natal J. Wankel ra
April 8, 2010
WEEKS CONCRETE PRODUCTS
RAY WEEKS
102215TH STREET
NEW RICHMOND WI U017
Re: Description: SEWAGE TANKS. CONCRETE
Manufacturer'. WEEKS CONCRETE PRODUCTS
Product Name: SEPTIC, HOLDING OR PUMP
Model Numberfis) 1260
(581N, L.L., 21,76 GAL/IN. CYLINDER, 841N. MAX. DEPTH OF BURY, 604 G.P.D. WHEN
USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL
WASTEWATER; TANK DIMENSIONS= BO IN. INSIDE DIAMETER X 581N. H)
Product Fla No 20100129
The specifications and/or plans for this plumbing product have been reveraod and determined to be in compliance
with chapWra Comm 62 thro gh 64, Wismnsin Administrative Code, and Chapters 145 and 160, Wisconsin
Stands,
The Department ready Issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative
Coca This approval Is va1M until the and of AUGUST 2015.
This approval is contingent upon compliance wild Me follovnng s8pulation(s):
• This tank must be designed to withstand Me pressures to which it will be subjected.
• The Manufacurer must keep at the manufacturing plant a set Of plans and specillcabons healing the
departments stomp of approval. The plans and specifications must be open to Inspection by an aWhomed
representative of Me department.
• When this product receives wastewater rom dwellings and is used as a septic link, It wtil produce an emown
quality with a maximum monthly average value for BOGS of greater than 30 mi and less than Or equal M 220
mglLTSS, mgreater Man 30 mphorless Man orequalto 150 real and FO.G. ofless than 30 Mgt.
• This Product is approved th use the following:
-Two Inch schedule 40 PVC cast in riser for elecocal during.
- Pipe materials constructed In conformance with Table 84 30-2 or 84 30-11, Wis. Admin. Coda poured into tank
e Department apprroved effluent filter designed to be installed in a four inch diameter tee with extension and
installed In accordance with are product approval for niter IncludIng a Properly sized and located access
opening for service and maintenance.
- Department approved EZ Set and Pulylok Inc., 24" riser cast into the tank cover.
This approval supersedes the approval Issued on M012005 under product file number 20050675.
SOD real E(NA run Hi Rd MN2002mrm
mem'/e..:w.xem'rawvy PRIVATE SEWAGE SYSTEM
SeNeveMaulminmoleaiun INSPECTION REPORT
GENERALINFORMAMON (ATTACH TO PERMIT)
Iwi' °' ;u"b`aucxNDDz u Tro u vil"All, k 1red o,.
TANKINFORMATION ELEVATION DATA
9T. CROIx
TYPE
MANDFARURER
CAPACITY
STATION
BS
HI.1
6
ELEV,
Septic
1v
st O J
BM[M1marz
Dosing
Mretion
Hidg. Sewer
V.SB
o4. E
Holding
St/Xt Inl%
C &d
Od 9y
TANK SETBACK INFORMATION
SUXt Outlet
C.Y
1oa.16
TANKTO
P/L
WELL
BLDG.
q e
ROAD
Dt Inlet
Septic
NA
M BOttwn
Dosing
NA
Xeatlar/Man.
11 5
s,l
Mrabon
NA
Dist Plpe
q` p
Ndtlirlg
Nor System
'sl,
"e��`,;
PUMP/SIPNONINFORMATION
final Gndt
ms
oast
DemaN GPM
I
E
Fnotim
5 t
TDH Ft
glM1
Did,
we11
SOIL
BED/TRENCH
DIMENSIONS
wlnu
ungm
TA01TI110111%T
n'MFNS'ON%
N, olvm
mal,
ymticegn
SYSTEMTO
P I L
9LW
WELL
LAKE/STVA
LEAOING
INEFOXMATCK OX
vra
CHAMBER
exam r.
5 m,.
OROMT
DISTRIBUTION SYSTEM
m
size
a
openre
•t AAn ma
Xerau
_O
Asim
sa.o.0
SOILCOVER a Pmssurc Systems Only uMOUM Or At -Grade Systems Only
cepnO.b
wmM1om
o1nM
oSidn"Issi
S
aalulMed
eoee<
.ealTrtrtbe<ee
on
Due
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St Croix County, Wl
Conducted by:
Thomas J. Schmitt
Legend
CST 227424
T-
Conducted for:
Existing aid
KAJ Properties, LLC LOT 1
❑..v
435 Stick Circle Proposed orainfieltl Vila
Hudson, WI U016
.v
PIO 040-1036-704100 M t
`4n
t
wx
a1 BV
`5 o SIOPe-..
m
Eaistinp Septic Tank
—uv
g11 b
9Ml
wmuas
BM 1 100.00' Top of tareal lot comer pipe
-
--
�b 2106.50' Top of asking septic fink manuals cover
�*^
102.0- Septic Wnk outlet
ca+.n�ar m
B1105.3]'
1413, n(i
(
N
LOT 2 usaruarag ,en
82103.3]'
�fs
831f153]'
MS
%ell
/it
469.01 = �O
en.'
Y"� aVa
PPPr1CK CIRCLE
P
V
1Properties, LLC
HP1 LOT i�ng 1
Brick Circle
on, W156016 E t infield
M-10 6-70-000 ,
MOTool Orainfl ii
III
m
Existing Septic a fop 2 1 `
M2
BM 11 .00' Top of V pool lot Curran pip Oj
BM 2106 68' Top of existing septic tank in
103 0 Septic tank outlet
111 105.37 1022
2103.37 LOT 2Bp ercar"
3106.2T'
0v Sh �em
469,01 v W 18496
3X {
St Croix County, Wl
Legend
❑st,:
eetIe
stxynge
s We�,