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HomeMy WebLinkAbout028-1039-60-000 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Cou ty: so" and Buildings Division' INSPECTION REPORT S Croix GE ERAL INFORMATION (ATTACH TO PERMIT) Sa 38Z214 erm Peroonal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (t)(m)l. Permit Holder's Name: ❑ City Q Village Town of: State Plan ID No.: ede, Beth Rush River Township CST SM Elev. - , Insp. BM Elev : BM Description- Parcel Tax No.: (� o� �d� 028 - 1039 -60 -000 TANK INFORMATION EL VATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic i Z e6l Benchmark- Dosing It. BM Bldg. Sewer mng & /Ht Inlet Tt IJ K SETBACK INFORMATION ,NK TO P / L WELL I BLDG. Air Intake ROAD net Air p j ,.tic f �L' /y NA Dt Bottom .ing L p p Z Z -� Z� I NA Header/ Man. Z • 99� -- NA Dist. Pipe M din Bot. System 9 9 JMP /SIPHON INFORMATION ,Pd Final Grade over anufacturer S k Demand , 03 model Number E �� 3t;, `GPM P✓ S Q DH Lift Friction System TDH 22.3Ft Loss e orcemai n Le �Z � Dia. // Dist. To Well SOIL ABSORkffdN SYSTEM BED /TRENCH Width Leng � No. Of Tre ches PIT No. Of Pits Inside Dia. epth IM EN DIM N HING NwwiOacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/ STREAM bEA • e Number: INFORMATION Type , / =� OR NIT System: Z 7 DISTRIBUTION SYSTEM, vo Header/Manifold 4 , Distribution Pipe(s) /+ 9 ' 3 x Hole Size x Hole Spa ring Vent To Air Intake Length Dia. length � Dia. Spacin Y 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 [] r ❑Yes No COMMENTS: (Include code discrepancies, persons present, ec ion / / / Ins ection #2: /Z p/ / q Location: 82 185th Street, Hammond, WI 54015 (N� 1/4 NW 1/4 34 T28N R1 )� 1.) Alt BM Description = �7 S Wcre p c�..yde� 4 A W 2.) Bldg sewer length = Seeps - amount of cover = �� �h "� 1 °rcc rv�ai►� (��s ��t Gem {r a'� �"`�/ 3.) contour = l f, f = 0, y5- �tl S e e mAe s ML 4&r-k Plan revision required? ❑ Yes No Use other side for additional informAVion. Z SBD -6710 (R.3197) Dat4 Inspector' ignature Cert No. r � �I 9 kcr��' ���� A � I� s� Iv � �� ���� ��� �� . C e� 2f� � T �� �,c�C y �,�c/ �� �` �� ��.�) ,�� �a ,� �,- s . o �� `' � � � C, ,� r �1 2 P, Cr 7 , YC6i4-., Alec . Safety & Buildings Division 1*6Sa ta Permit A lication 201 w. Washington Ave. �' PP PO Box 7302 consin In accord with Comm 83.2 1, Wis. Adm. Code Madison, WI 53707-7302 Department of commerce Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy La state owned. Attach complete plans to the county co foeixhe•s on er not less than 8 -1/2 x 11 inches in size. Count _ S y tate S . Penn t Num N ' Ch if revisio 48 pr e 'ous application State Plan . D. 3 S� I. Application Information - Please Print all Inforlilaton . Location: Property wner Na e p Property Location _ / Z 1`� ��p7 r�- N 1/4 (y't 1 /4,S T,N,WIt or Property Owner's Mailing Address 5 V Lot Number Block Number I � I �� 11 - . C• , State Zip Code a Phone Nup*e� Subdivision Name or CSM Number 5 ll 1<' j, 1I Type of Building: (check one) ❑ City ❑ i or 2 Family Dwelling — No. of Bedrooms:_ ❑ Village ED Public/Commercial (describe use): Town of I El State-owned 1 `u S L gbr' III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road A) 1. ❑ New System 1 2. IR Replacement 1 3. ❑ Replacement of 4._ ❑ Addition to tPamel Tax Nun*a O) ` r ( r System Tank Only Existing System U 0 O d $) Permit Number 1,03 Date Issued 1:1 A Sanitary Permit was previously issued IV• Type of POWT System: (Check all that apply) -I r • Non - pressurized In- ground `Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line • At -grade r t _ . (1 n ❑ Aerobic Treatment nit Recircul ❑Other: / Y 6 0 ut G�) LL D lip lq� • Dis ersa Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Propo Rate (Gals./day/sq. ft.) (Min /inch) l C� El evation VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ot 'SeV tc ❑ ❑ ❑ ❑ Ul i A ��� ❑ ❑ ❑ ❑ ❑ VII Resp nsibility Statement I, the undersigned, assume responsibility for i stallation of the POWTS shown o e atta ed plans. Plumber's Name (print) Plu ignature (nos s): M /MPRS Business Phone Number 219 7v� Plumber's Address (Street, City, St e, ip Code) G� Z �) % '� � ter J �� �� *' 5 VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued s ing Agent Si a o stamps) J. Approved ❑ Owner Given Initial Adverse Surc a Fee) Determination 325 = ` tw�.� 20� IX. Conditions of Approval /Reasons for { _ D�isapprovak U. C-0 . I PLOT PLAN Scale 1 X10' Page of 7 cr1'�l _ �L: ��0 •o' Ors — f0 P of e.0�.1 C2•'�',T� Lftr`�p1.�.G___ ... -- _ s�Zl -C %o Q s 0 a" S 'or y" p� � qv1 �- . BD Vz-M G Mt zaS' of k M "PVC FK7. 3Z I � '�c�'n�wi of ° dQ_L ETL 4 (C. s �s I D� r.,pT Cbar�c�- I r III otZ Q LS1v�3 I L lj .s' gI.Z zs LINE of NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( 2 required). 3. Septic tank to be 1,2go Sop gallon capacity manufactured by W 1 t1Z l C� ? - v-J / Mo�m N 1 300 ZpMV'Z Sr UST F L� _ 4. Bench marker Ste— p�3� �. Divert surface water around system to prevent ponding at the uphill side. Safety and Buildings e 401 PILOT CT STE C T WAUKESHA WI 53188 -2439 TDD #: (608) 264 -8777 N *isconsin www www•commerc .wis c ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Brenda J. BI , Secrgtary May 24, 2001 D ECEIVEO n CUST ID No. 1 7 69 72 ATTN: P PO Inspector R .� Y / ARTHUR L WEGERER ✓ ZONING OFFICE c%' KAY 2 WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA ~ -, ST CROIX PO BOX 74 1101 CARMICHAEL RD ATV RIVER FALLS WI 54022 HUDSON WI 54016 - %)N*GOFFlCE `G CONDITIONAL APPROVAL f 7 t PLAN APPROVAL EXPIRES: 05/24/2003 Identification Numbers Transaction ID No. 644133 SITE: Site ID No. 630322 BETH FOEDE Please refer to both identification numbers,' ST CROIX COUNTY, TOWN OF RUSH RIVER above, in all correspondence with the agency. 82 185TH ST, HAMMOND 54015 FOR: DESCRIPTION: MOUND, 4 BEDROOM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 794118 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. 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 enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10691 -P (N.01 /O1) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10706 -P (N.01 /01). 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 insure that the operation, maintenance and monitoring duties as described in section VIII of mound component manual are complied with. 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 ermit must be obtained from the county where this project is located in accordance with the ry ty P J 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. ARTHUR L WEGERER Page 2 5/24/01 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. Sincerely, FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 JULIA A LEWIS - OSBORNE POWTS REVIEWER 2, INTEGRATED SERVICES WiSMART code: 7633' (262) 548 -8638 FAX: (262) 548 -8614 JLEWIS @COMMERCE.STATE. WI.US Safety and Buildings 401 PILOT CT STE C f WAUKESHA WI 53188 -2439 fi� e. TDD #: (608) 264 -8777 visconsin erce.state.wi.us/sb ti �� �' ,�~ www.comm r ,r , wwwmisconsin.gov Department of Commerce Scott McCallum, Governor `• >, j.� ? Brenda J. Blanchard, Secretary May 24, 2001 CUST ID No.691727 = -... : "fiOWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/24/2003 Identification Numbers Transaction ID No. 644133 SITE: Site ID No. 630322 BETH FOEDE Please refer to both identification numbers, ST CROIX COUNTY, TOWN OF RUSH RIVER above, in all correspondence with the agency. 82 185TH ST, HAMMOND 54015 FOR: DESCRIPTION: MOUND, 4 BEDROOM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 794118 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. 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 enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10706 -P (N.01 /O1). 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 insure that the operation, maintenance and monitoring duties as described in section VIII of mound component manual are complied with. 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 igipe 9vr, hall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d I tss!�6it . &/ % , ON SF4� s� c� ARTHUR L WEGERER Page 2 5/24/01 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. Sincerely, FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 JULIA A L WIS- OSBORNE POWTS REVIEWER 2, INTEGRATED SERVICES WiSMART code: '633 (262) 548 -8638, FAX: (262) 548 -8614 JLEWIS @COMMERCE. STATE. WI.US r • i t TITLE SHEET Page of 1 MOUND SYSTEM FOR A � BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P (N.01 101) (N.01 101) LOCATED IN THE SFr 1/4 OF THE I 1/4 OF SECTION 3� , T Zt' N, R 0 W, TOWN OF LZLVEa ST - 0 _2WLX COUNTY, WISCONSIN. I INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR MAY l_ 6 2001 - B�TbI F= LT_ - - - -- S ��ia & PREPARED BY WECCERER St3I L .TEST 1 NG AND. DES I GN SERW S CE P.O. Box 74 421 I1.ilain St. �Mo'se'�41%, River Falls, WI 54022 Phone 715 - 425 -0165 � Fax 715- 425 -6864 $' Z AATf l i WE3 FiER `• oe1s v GLLSWORTo. W l es. � W1 Gr1 4 E NG�� ✓cF -8 JOB NO. 7 Mound System Management Plan Page Z of Pursuant to Comm 83.54, Wis. Adm. Code Seotic 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 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, Safety and Buildings Division. Pumo 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L BODS, 150 mg /L TSS, and 30 mg /L FOG. 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 testis performed it should be compared to the initial testwhen 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 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. 6/99)] arid 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. 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 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 adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning at X15- 38b- Y 65 S T. CQp1x The system installer at - 1 LS- qu - q (is f3 k1 VIT)v They tank manufacturer at g 00 - 3ZS - $ q S 6 !mi L�'R l S The effluent filter manufacturer at rr%�AeZ The pump Lip - g2p _ L1 g GOUL-DS PLOT PLAN Scale ��0 - page -3 of 7 . 1 "= ' cr'l -1 - �L. i�o •o' Ot`J �0 P of � C2't T'�Lf'p��pit�.G__ -___ -- -- Sync V . S N Q q BD - hiort e G em 2.3S� of wCLL aawoml_ EL q 6 • u S' T of dAV_L fit. 4 (�, .9,s U r - I 0 LINE olZ O LSlv�t3 t I i l I III p t Ili I i ls' Brz zs I o NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( 2 required). 3. Septic tank to be 1zj4o Soo gallon capacity manufactured by W IZ 12W hl / M ot� L N 4. Bench marker SQE� "6Ve �. Divert surface water around system to prevent ponding at the uphill side. Page L1. Of - 7 Approved Synthetic Covering ASTH C33 Distribution Pipe. Medium Sand :J1 H I G Y.t Js Topsail - --- F Elev. g 6 . a 5 —I E D 3 - u e Z. % Slope Distribution Cell of Force Main Flowed z" to 2- Aggregate From Pump Layer 0 o -S Ft. E © .1 Ft. CROSS SECTION OF A MOUND SYSTEM F o. b Ft. G o_S Ft. A ti0 Ft. H 1- O Ft. Linear Loading Rate= tirJ , O GPD / LN FT B 6 Ft Design Loading .Rate= o- q3GPD /SQ FT j 13 Ft. J S Ft. K `a Ft. •, tern___ - Fos _ n - 7 Ft. -e*— -i; W Z 8 Ft. L j - Observation Pipe � � K Aa-4 - $ - - -- --- - - = - -- -------- - - - - -- --- - -- yy o-- + -- 6 - - -- - -- - - -- -- - - - - -- - -- Farce Main —� l:N��S Distribution ., Pipe 2 Cell of 2 to z a ggregate Obserntion Pipe (anchor securely) PLATT VIEW OF A MOUND SYSTEI4 Distribution Pipe Layout Page 5 of Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of Iona turn or 45° fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valvp,:threaded cap or threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. -P c Fu C Lateral Manifold M L �_ C Lateral x x x x x!2 I x!2 x x x x Lateral Length — Lateral Length — P Distribution Line tftc Z� soy, h 7°s1.11 t-0 � S PVC wQC, n fl1N P ' 9 Ft. Hole Diameter ' Inch S 3.33 Ft Lateral U 1 Inches) X Inches Manifold Z Inches Force Main " Indies # of holes /pipe ZS Invert Elevation of - Laterals Ft. �s xk), q1 = 6• Ls x 6 = a6.9 6 V*i '.* .. _. Combination Septic:Tank and PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE OF NEWT CAP I WEATHER PROOF JUIJCTIOIJ BOX -(C.1. VEWT PIPE APPROVED LOCKING 1 10' FROM DOOR, MANHOLE COVER wIV %nW00W OR FRESH 1 wAR1.IIWG L1�6EC.. t+�3P Q>J P IPE A�INTAKE cor.,cu�r - w lrYtcLTI s ttT � � t , Ft N lsR I xlu. G�h'DE I v 18'hllll. c \ WLET PROVIDE - --_ •• �� - TAIRT16HT SEAL I I Approved Z�-� -' l Approved joint w/ P�_ )Boo I IC I joint w/ PVC pipe ALARM PVC pipe - C ow-2 FT __J PUMP -� OFF r D - COLICKETE �I D,oQ 5LOCK RISER EXIT PERMITTED OIJLy IF TAW MAWUFACTURER HAS SUCH APPROVAL 3"AFPRat<D SEPTIC F SPEC-IFICATIOUS DOSE TAWK MAWUFACTU;LER: wI� Z-, cwo -�T� 1,JLlMgER OF DOSES: S • ! PER DAW TAMK SIZE : 800 GALLOWS DOSE VOLUME t ALARM MAUUFACTURCR: S' T. - JW S `J3 - rL•+ S IUCLUDI OACKFLOW: - 1Sq•5 GALLON: AC)DEL LIUMBER: L131 HI.J CAPACITIES: A= lq 1 I Z pJCHES OK L IU 1- -7 GALL0IJ5 SWITCH TYPE: e�zCUR -L/ 8 - Z IIJCHES OK L I l' Z G(�L10U5 PUMP M MUFACTURER: GAUL .b S C= i l l Z ILICHES OR 151S GALLOWS MODEL 1JUMBER: 3g� EPOS 0= IMCHES OR 1 & 5 GALLOWS I 5WITCH TYPE: — (HN— ZCU� MOTE: PUnP AWO ALARM TO 6 Z• a MIIJIMUM DISCHARGE - RATE 3 _ b-q GpM INSTALLED OA1 5EPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEW PUMP OFF AIJO- DI5TRIBUTIOW PIPE.. ^,� • FEET + MILIIMUM NETWORK SUPPLY PRESSURE . ; --6---SD— rs . UX + FEET OF FORCE MAIN X Z• SS F T / fIFRICT1oW FACTOR.. � aS FEET TOTAL OyWAMIC HEAD = 0 o FEET As per manufacturer ZO, GO gal /in. Liquid depth 3 8 i Goulds Submersible � Effluent Pump 38 EPO4 EP 5 0 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. P • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermo las- • Homes components. A vailabl e for automatic and tic cover with integral handle • Farms Motor: and float switch attachment • EPO4 Single h 0.4 HP, manual operation. Automatic points. Heavy duty sump g phase: models include Mechanical • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty RPM, built in overload with • Dewatering preset at the factory. rated oil and water resistant. - automatic reset. ■Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: RP , FEATURES heavy duty ball bearing - 115 V, 60 Hz, 1550 RPM, Pump: EPO4 built in overload with construction. ■ EPO4 Impeller: Thermo - • Solids handling capability: automatic reset. - plastic Semi open design AGENCY LISTING a 3 /a`:maximum. •Power cord: 10 foot with pump out vanes for Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. 0 Canadian Standards Association - ,btal heads: up to 24 feet. with three prong grounding EP05 Impeller: Thermo - Discharge size: 1 " NPT. plug. Optional 20 foot plastic enclosed design for (GSA listed model numbers Mechanical seal: carbon- length, 16/3 SJTW with • improved performance. end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 0 C) continuous superior strength and 140 °F (60 0 C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 5 components. ' Pump: EP05 e ; 4 = FT • Solids handling capability: c 25 114maximum. ' - W • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. g • Discharge size: 1 NPT. z b5 • Mechanical seal: carbon- c 15 rotary/ceramic- stationary, _j 4 BUNA -N elastomers. • Temperature: 0 6 �404 (40 °C) continuous s io 140 °F (60 °C) intermittent. 2 Poo 5 , 1 LJ 0 0 t. p _ 0 10.. 20 30 40 ... 50 -GPM 0 2 4 6 8 10 12 m °/h CAPACITY ®1995 Goulds Pumps, Inc, Effective May, 1995 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ' i of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code ST- C2(1 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and Pa I.D. rce percent slope, scale or dimensions, north arrow, and location and distance to nearest road. OZ$ -- Q of Please print all information R iewed by Date 'Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) Property Owner Property Location g v"'Q 46GW -Lot- N E /4 W 1/4 S 3 '4 T 28 N R 1 E (olcw Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# (6 - L L$ ni-- Sr. — I �F - --- I City State Zip Code Phone Number E] City ❑ Village a Town Nearest Road '�l^'Iuh11> I 1-ii I S I ( 713 ) 68 `f - RLj 21V IZ)Z 1 8 T - l- ST- ❑ New Construction Use: ® Residential / Number of bedrooms �_ Code derived design flow rate 6 0 0 GPD ® Replacement ❑ Public or commercial - Describe: Parent material LO ESS O V QNZ 5 Flood Plain elevation if applicable - ''' W " "" ft. General comments �' • ' ' and recommendations: 1 N��UtVD W / lD� K lj o • �� j�l j3U til COIL. b of s F)AA Fil_c._ . ,4,,. ❑ Boring # ❑Boring C. r 1 g ® pit Ground surface elev. q ft. Depth to limiting factor_ in.� i ADD -1 tion Rater Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary F;2`p GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '� ,'Eff#1 'Eff#2 O —9 1 t2 3 i Z; s l S ? - VZ Z 9-L9 lb`-t rz 31b — s i Z`�sb�r m - • S - B bq 30 L0`1 VA. W1 U `Q� y a-39 ��KRSl6 eLA - z.s�t2s�g 7s ovj m v — -q a Boring # ❑ Boring ® pit Ground surface elev. 6 o ft. Depth to limiting factor 3p , in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 u4 1 - Z — SL 1 Z`Fs61z r>-i. C- LA-1 1 v gyp- • S - S 3 zi! jf34VL316 - sit Z>12Sb1Vt m'�1 cs , s • 0 30 -L3 1 1 RVl6 el 1P •SLifzsl8 �s o m v 'P►- - .� .6 • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) - / /► gignat� O l CST Number Arthur L. Wegerer C fi a 220254 Address Wegerer Soil Testing & Design Service to Evaluation Conducted Telephone Number 421 N. Hain St. River Falls, WI 54022 1; 715 -425 -0165 Property Owner Parcel ID # — () Z - % So/ _ 60 Page 3 of 3 F a-1 Boring # Boring ® pit Ground surface elev. ft. Depth to limiting factor 3 3 n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 o-9 to-trz 3j — 3LI z bk m`F►� ery v f • S ,� Z q -Zz tZ70 -NI s' Z� sb�z wl +1- 3 ZZ -3 3 to R vt 6 m y t - y 33 'j 8 1 17`t t2s1 L ctf 4 rzsIS � o�. ► V-N ., F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. • Eff#1 • Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L 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 -3151 or TTY 608 -264 -8777. SBD -8330 (R.6100) .° P Page 3 of LOT PLAN 3 Scale 1' =y / Fm �h - EL..Ioo;a`oN- m PoF_�A�.I C2�T L J1_, - -- � 6w1. tf Z = L . °l9. _�� ' �►`1- 1ip1"CC11N1: -::OF _S r D -t rv� _� .. - -- - - -- - - -- s�Z1C ` � N N Q 6 j �I k w�l 4D 3zXTx5m ., ca�rNu2 et . a 6 • y, S' � 6 � t of d$L FrL 40.95 el l (`gig �• I I � r cS�Z. p Lsly� i3 � `Rfil. S V�RL� 'ZL s,3 i I i s N �Zzm - r L WE nr- 715- 425 -0165 220254 01 - CST Signature Date Telephone Ito. CST No. Job NO. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGRPPMENT AND dD ,� OWNERSHIP CERTIFICATION FORM 6t Owncuycr e � ' Mailing Address 0 fS�A Property Address (Wtificatioa required from Maaiag Department for new construction) (;sity/State A 1117 t j d� gel Identification Number f - I - LEGAL DESCRIPITON Property Location Ac %, <, Sec. 2 T ( , P N - R22—W. Town of )(44 S '1 I& Z Subdivision Lot # - Ctriif ed Smey Map # Volmne , i'agc # Wamnty Deed - olmne pag # Spec.bouse ❑ yes a no Lot fines id fifiable yes ❑. no ZMANCE ' ofy uP coaldtemkIftift ooasistsof P ' tobandiewastcs.PropermamteaanCe cm a the o of tfLe ar, if a cd by s[ ecasod t yna pa�t.mW the syrtcm �s -a stagean IIa; aias6eduposalcy�m- 1ha FWperty owner ap= to mbaz t to St. a Zocrmg , fours, sigaod 6q tdae csen and by a • �Podpl�rbaor =luxa9odpaarperv�ifyimg> bit( 1��coa�itcRn�tcwazorcfisposaisysl PrOPa��gooaaadlar(2) a& rias �oQ�g .( kss�aa If3fa11 of'siudgc. Ulm the Und=kmedbave =ad dycabm=gr and gp=tomaiuftiat�c ��' vz �b'� Hof Gbrnauroeaadiba > �10e 6ic:tasdands ��hasbocamaimd�dm,astbe ofNa�6�scslR� , as;S'cateofFT�oot�n.. �t"ficafioa daps-of &c 6WC year aTkatioa date, oompktodand ietum,od to �c St: Qroix County Zoning Oice witbia 30 SIGNATURE OF ApPI1cwr DATE OWNER CERTrCAON I (wc) certify that all sut=cuft on thus foaa ace t me to the but of my (out knowledge, I (we) am (arc) the ownct(s) of &C pmperty de=%ed above„ by vict= of a wumaty doed =m ded in Register of Dcods Office, SIGNA OF APPT.LCAh1T S`' !-3l / � DATE ssssss A"y iafotmation that is nds•tepnxeatod may reatit is the sadtuy Pmt beitig tevoked by the Zoning Depa Wmt. ss` "' ss ladadc with this application: a tWupod wumty deod fmam the Reghim of Dodds office a Copy of the cWiGod survey map if mfcmacc is made in the warranty dcod I M to 63071 Es STATE BAR OF WISCONSIN FORM 2. 1999 KATHLEEN H WALSH Document Number WARRANTY DEED REGISTER OF DEEDS 5T. CROIX CO., WI This Deed, made between Richard L, Hurtgen a/k/a Richard RECEIVED FOR RECORD Hurtgen and Audrey L. Hurtgen a/k/a Audrey Hurtgen, husband and 09 -28 -2000 9:15 AM wife WARRANTY DEED Grantor, and Charles E. Hanson III and Beth E. Foede + g both single EXEMPT M CERT COPY FEE: persons COPY FEE: TRANSFER FEE: 645.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in SL Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address W 1/2 of SE 1/4 of SW 1/4 of Section 27 and North 60 rods of NE 1/4 of NW 1/4 of Section 34, all in 28 -17. First National Bank of New Richmond PO Box 89 New Richmond, WI 54017 028 - 1038 -60 & 020- 1039 -60 Parcel Identification Number (PIN) This is homestead property. (is) 0 XOO Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this Q a , a day of September 2000 + Richard L. Hurtgen a/k/a Ric an H urtgen • Audrey L. Hurtgen a/k/a Audrey Hurtgen AUTHENTICATION ACKNOWLEDGMENT Signature(s) Richard L. Hurtgen a/k/a Richard Hurtgen and STATE OF WISCONSIN ) Audrey L. Hurtgen a /k/a Audrey Hurtgen, husband and wife ) ss. 75 f C 'T County ) authenticated this day of September 2000 A Personally came before me this �l day --;e ; ` tb6i * naeaed `./ ' v • Kristina Ogland _ k o 0L vJk TITLE: MEMBER STATE BAR OF WISCONSIN — 4 If not, to me known to be the person(s) who executeith fotpgoii g ( instrument and ac W gcd the same. authorized by § 706.06, Wis. Stats.) �r� �. _ (fi g _Aj THIS INSTRUMENT WAS DRAFTED BY hQ 2 k. Attorney Kristin e Ogiand Notary Public, State of Wisconsin Hudson,Wl 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) A01 + i s Names of persons signing in any capacity must be typed or printed below their signature. inronn. lion Frotuaionab company, Fond ��s�W1 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999