HomeMy WebLinkAbout026-1121-09-000 i
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Cou
Safety and Building Division
INSPECTION REPORT Sanitary P
(ATTACH lt0 P�'��11T) 453150 0
GENERAL INFORMATION 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:
Halle Builders Inc. I Richmond Township 026- 1121 -09 -000
CST BM Elev: Insp. BM Elev: BM Description Section/Town /Range /Map No:
raa iJv ZT trc - 60vitj S 05.30.18.724
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic { Benchmark
Dosing / ' t � A�It. BM - Sc- noC.w,- 2
b bc7 a «, 41 : d�2 ,
Aeration Bldg. Sewer
Holding
St/Ht Inlet ,/S 9 3 • (,5
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \
Septic ' Dt Bottom � • 3 S 9. "J6
Dosing Header /Man. 9 IS Z %
Aeration � Dist. Pipe O
73 cl T. Z -
Holding Bot. System < 6 •,a 9�
Final Grade , V
c� 1�
PUMP /SIPHON INFORMATION 4. lot, Z 2)
Manufacturer J De St Cover
d
Model Number �. al, 7./ JO
TDH Lifl., �/1 Friction Loss Syste Head TDQ ' a Ft
�D / d o
Forcemain Length ) Dia. rt Dist. to Well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width ' Length f No. Of Trenches t , PI D7 IMENSIONS No. f Pits Inside Liquid Depth
DIMENSIONS Ge.`\ J \ \>
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: 1
UNIT Model Number:
DISTRIBUTION SYSTEM
[ r /Ma nifold/ Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) gh Dia "► Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx De of xx Se ed /Sodded No
xx Mu ched
Bed /Trench Center Bed/Trench Edges Topsoil
No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 1713 106th St Unknown (SW 1/4 SE 1/4 5 T30�N R18W) Partridge Run Lot 9 Parcel No: 05.30.18.724
1.) Alt BM Description = 2 - 45 h7DTtbr air ( - e J TX
2.) Bldg sewer length
- amount of cover
5
Plan revision Required? Yes No b
Use other side for additional information.
(R.3/97) Date Insepct jSigure Cert. No.
Safet an � County
201 W. W hingt I ` �t � 6 t
` Ma iSon, WI r537t 7 — r / t Sanitary Permit Number (to be filled in by Co.)
i S�Di�S,i� d (608) 266 -3151
Department of Commerce
State Plan I.D. Number u
Sanitary Permit App cation 3 , fvC Z
In accord with Comm 83.21, Wis. Adm. Code, persona OM
may be used for secondary purposes Privacy s Off ICE Project Address (if different than mailing address)
IV'I T
I. Application Information — Please Print All Information mi ee
Property O wner's Name Parcel # Block #
Property z���� 1 �t°�s
6 n
Property Owner's Mailin Address ayS 0 Property Location
/ a ov to approval shall be
1 ( 3 ` C 4 V G null end void S� y., �i, Section 7
City, State / Zip Code Phone Number , // /
?CS '2 1VI T � Q N, R L EorW e)
II. Type of Building (check all that apply) �� • t t a
S+Ox 4vision Name CSM N
9 2 Family Dwelling — Number of Bedroo '
❑ Public/Commercial —Describe Use ��
❑ State Owned — Describe Use Za ❑City_ ❑Village �r ship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) f � � r t
A. El- ew System ❑ Re "" stem ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal Permit Revision ❑ Change of LE]Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber
IV. Type of POWTS System: at appl
on — Pressurized In -Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter
ttructed Wetland El Pressurized In -Ground ❑ Holding Tank El Peat Filter ❑ Aerobic Treatment Unit ❑Recirculating Sand Filter El
Recirculating Synthetic Media Filter N6.eaching Chamber ❑ Dri Line ❑ Gravel -less Pipe ❑ er (explai )
V. Dis rsaVrreatment Area Inf rmation:
Design Flow (gpd) Design Soil Ap lication Rate(gpdsf) Dis rsal Area Required (st) Dispersal Area Proposed (sf) System Elevation
/ 25 w3 . 9
VI. Va nk Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks, Tanks r
Septic or Holding Tank GG(� [.t/ �
Aerobic Treatnxnt Unit V l
Dosing Chamber Ll GU I
VII. Responsibility Statement- I, the undersigned, assume nsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumbe Signature M MPRS Number Business Phone Number
�� S� �Z3�(�
Plumber's Address (Street, City, te, Zip C e) r
VIII ount /De artment Use Onl
Approved El Disapproved Sanitary Permit Fee (includes Groundwater Da `e Issued sluing Agent pignatute (No mps)
Surcharge Fee) <#-� ,
11 Owner Given Reason for Denial
IX. ('onditions of Approval /Reasons for D iisappproovvaal p )I
Attach complete plans (to the County only) for the system on paper not less than 81/2 ill inches in size
SBD -6398 (R. 01/03)
of 1 ?��G�► Htond
l ot
9 G� �AQt r ��Of � �K ✓l � ..�`Y� J
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1000 Ili l JL t C 7%
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-••• �.•..�,aa LaOSS SECTION AND SPECIFICATIONS
4" Cl VENT PIPE 12" MTN. ABOVE GRADE E WEATHER PROOF
!25' FROM DOOR, WINDOW OR JUNCTION BOX
APPROVED
FRESH AIR INTAKE
WITH CONDUIT MANHOI
FINISHED GRADE 4" CZ RISER M/ PAD LO(
7 6" MIN. WARNING l
A80VE G ADE _ - MIt
Is" IN. 6" MAX.
INLET f
WATER TIGHT SEALS GAS_
4"
TIGHTS
BAFFLE A SEAL - B APPROVED
cr PIPE - ; LM JOINTS W/
3' ONTO �
SOLID PIPE 3' 0 - 'T' - � ON
SOIL PUMP OFF ELLV . SOLID S0I FT- -�- OFF ** RISER
D PERMITTrD
IF TANK
MANUFACTUI
3" APPROVED BEDDING UNDER TANK HAS APPRO'_
SPECIFICATIONS CONCRETE PAD
EPTIC / DOSE -
TANX MANUFACTURER: �` NUMBER DOSES PER DAY:
TAN SIZES: SEPTIC tB G 0 GAL.
o DOSE VOLUME INCLUDING
DOSE
GAL. F'LOWBACK: GAL.
/ALARM MANUFACTURER: CAPACITIES: A :
MODEL NUMBER: INCHES
SWITCH TYPE:
e = ? INCHES = G
!''UMP MANUFACTURER:
MODEL NUMBER : - C = INCHES =
SW ITCH TYPE: -- - •- -`.•
D = INCHES = C
REQUIRED DISCHARGE RATE �� GPM pUKp 6 ALARM WIRING AS PER ILHR * 16.23
VERTICAL DIFFERENCE SMEEN PUMP OFF AND DZSTRIBUTION PIPE . .
• MINIMUM NETWORK SUPPLY PRESSURE - �' FEET
• ` _ FEET FORCE MAIN X - 5 FEET
,FT/ 100 FT. FRICTION FACTOR
TOTAL DYNAMIC HEAD o FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH �o FeET
WIDTH— DIAMETER
LIQUID DEPTH
�I :IGNED:
LICENSE NUMBER..
n ••ww.
GOAS
/;_4 Submersible
Effluent Pump
C�
.h
3871 EPO4'
EP05
• Fully submerged in high ■ Motor.Housinq: Cast4ron
APPLICATI •Fasteners: 300 series rode turbine oil for for efficient heat transfer,
stainless steel. g
Specifically designed for . Capable of running lubrication and efficient strength, and durability.
following uses: dry without damage to heat transfer. ■ Motor `Cover. Thermoplas-
• Effluent systems components. ti cover with Integral handle
Homes Available for automatic and and float switch attachment
• Motor: manual operation. Automatic po
Heavy sump • EPO4 Single phase: 0.4 HP, - models Include Mechanical
115 or 230 V, 60 H, - 1550 z Switch assembled and E Power Cable Severe duty
• Water transfer Hp�p, built in overload with Float rated oil and water- resistant
• pewatering preset at the factory.
automatic reset ■ Bearings: Upper and lower
SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty b�a11 bearing
115 V, 60 Hz, 1550 RPM, construction.
Pump: EPO4 built in overload with m EPO4 impeller. Thermo-
Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING
Ve maximum. • Power cord: 10 foot with pump out vanes for
• Capaci>ies: up to 55 GPM. standard length, 1613 S,ITO mechanical seal protection. Q W Stanaaros annodOw
} • Total heads: up to 24 feet. with three prong grounding m EP05 Impeller. Thermo- CSA listed model numbers
• Oischarge size: 1I NPT. plug. Optional 24 foot plastic enclosed design for end in "1"' or "AC ".)
• Mechanical seal: carbon- length, 16/3 SJTW with improved performance.
rotary/ceramic- stationary, three prong grounding plug m Casing and Base: Rugged
BUNA -N elastomers. (standard on EP05). thermoplastic design provides
• Temperature: superior strength and
104 (40 °C) continuous corrosion- resistance.
140OF (WC) iriterrnittent.
• Fasteners: 300 series METERS FEET
stainless steel. to
• Capable of running
dry without damage to 9 30_
Components. 8 s '
pump: EP05
Solids handling capability: a
Ve maximum. W
• Capacities: up to 60 GPM. e
• Total heads: up to 31 feet. - 0
• Discharge size: l'N NPT.
5
• Mechanical seal: carbon- 0 1
inDtarykeramic- stationary, a a
BUNA -N elastomers. ►-
• Temperature: 3. 10 - -
104 °F (40 continuous
140°F (60°C) Intermittent. 2
5
0 -
0- 0 0 10 20 30 40 50 GPM
C 2 4 6 8 10 12 mi/h
Eft M
I
Safety and Buildings Division Count)
201 W. Washington Ave., P.O. Box 7162 l•
l Visconsin Madison, WI '53707 7162 Sanitary Permit Number ( to be tilled in by Co )
Department of Commerce r r _
)�S3 15
-'
Sanitary Permit Appfica' ion State Plan I.D. Number
T
In accord with Comm 83.2 1, Wis. Adm. Code, personae information ouro d
may be used for secondary purposes Privacy L w, s150 n) V 004 Pr oject Address (if different than mailing address)
1. Application Information —Please Print All Information 4 KiiC� % U ` l+ '�T 19" 3 0 J�
ING C)FFICE�
Property Owner's Name Parcel # Lot # Block #
2 jeX
cl fit, t c I dle- P S
Property Owner's Mailing Address Property Location r ,
/ L
I , 1 3 j — / r^. � v s 11j 'A, ' / <, Section
City, State Zip Code Phone Number s
t
(� C 4/ C��'r,� *1 C W t S L �k G` G ��3 T `3(J' / Pc
�or W e)
II. Type of Building (check all that apply) o6 S� "
ubd is'on Name CSM Number
® for 2 Family Dwelling - Number o edrooms
/ rc rt c l r /?4
❑ Public /Commercial - Describe Use
❑ State Owned - Describe Use t/ ❑City_ ❑Village WISIu Of
III. Type of Permit: (Check only one box lin A. Complete line B if applicable) �{ 21 — inej - Gds -
A. �
1;�1�ew System ❑Replacement Sys te ❑ Treatment/Holding Tank Replacement (�hly ❑Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision Change of ❑ Perin it Trans r to New
List Previ ennit Number and Date Issue
Before Expiration her Owner
IV. Type of POWTS System: Check all that appl '
x El
on - Pressurized In- Ground _ E l Mound < 24 i,Fl. of suitable soil 11 At-Grade El Single Pass Sand Filter El
Constructed Wetland ❑Pressurized In- Ground ❑Holding TanV, El Peat F'Ite�f' ❑Aerobic Treatment Unit El Recirculating Sand Filter
Recirculating Synthetic Media Filter eaching Chat ber ❑ Drip ine .4ravel -less P ipe ❑ Othe (explain)
V. Dispersal/Treat ent Area Information: V / /4- C6-' /
Des' n Flow (gpd) Design Soil Application Rate(gp ispersal a equired (sf) Dispersal Area Pr I ea ystem Eleva
VI. Tank Info Capacity in Total Number � Manufacturer Pre Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank o o o [Al i C r 2 ✓.
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, as me responsibility for installatio of the POWTS shown on the attached plans.
Plumber's Name (Print) Plum 's Sign re MP/MPRS mber Business Phone Number
o-e 2
Plumber's Address (Street, City, State, Zip de)
VIII. County/ )c artment Use Onl
Approved El Disapproved Sanitary Permit Fee (includes Groundwater at Issue I suin Agent Sig t ant (No Stamps)
Surcharge Fee) tt �� try `
❑ Owner Given Reason fl/Denial
IX. Conditions o Approva 3 \
SYSTEM OWNER: ) /
1 Septic tank, effluent filter and a, ViAj" zed ?aSS&
dispersal cell must all be serviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinances
Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 01/03)
N a IIG
SW C-t30 N Igo 3`I S'-
t & w., a R,'c..4 M -On j
Lot '
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lot
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Na fle, 84t +' / c r /34
Lem ,S�/� /
S % �- r- t 3 / N t {l 'fit
PP 0 3,/ 7 S- f, ,.
Lot y G r
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3 Rt tire- U t° p 1 t l
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RECEIVED
Wisconsin Department of Commerc
FEB 13 2 gbIL VALUATION REPORT Page of
Division of Safety and Buildings
�NG O k4ftTLomm 5, Wis. Adm. Code County
Attach complete site plan on paper not less than x n size. Plan must S+ Cra l X
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. pat::j — i i ,a 1 -- (a
Please print all information. Reviewe Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). a
Property Owner Property Location
H a Ile & M ers Govt. Lot SW 1/4 SC 1/4 S S T 3 0 N R 19 E (o
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
M3 Aw y q 1 Pakrtrihe Rw
City State Zip Code Phone Number ❑ City ❑ Village [Town Nearest Road
Alto Ric� W! 9I0 17 (11 ) '�y6- bS%3 R; C.�Vnav a -," st .
New Construction Use: Residential / Number of bedrooms Code derived design flow rate Lisa _ GP
❑ Replacement ❑ Public or commercial - Describe: I Z S b
Parent material 4 L. , { Flood Plain elevation if applicable 3 E3
General comments arm J11. ' r a ,3 — i� '!s LG 1,5
and recommendations:
Al I rv� � � � se- � - h' 9737
Boring # ❑ Boring
IN Pit Ground surface elev. 1 00-73 ft. Depth to limiting factor / QC> in.
Soil Application Ra e
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
0-6 1044, - L. I F& 9 dsh as a F • 10
cZ 6 -10 In y 3 1 4 L- FP L— il)-SVi CW 1 F
3 16-11s 104 L aFs 3s�N CW luF
q I5 -34 '75W SL I F5 V, 6 1 st, QW W to
t ,
pfd - 3z. � -3 1
Boring # ❑ Boring f�
Pit Ground surface elev. 9 9 + 7 ft. Depth to limiting factor QD in.
Soil Application Ra
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -� 101R31a L I FUR ds� as aF A 6
a W -9 wk Sly L 1 FP4- dsVi CW 1 F , W
9-110 10yR4 Iq >i eL— a 8 0, CW I V
y 16 -36 PSG IF SQK 3Sk, cW 1v r-
- ? ,SIR 4 116 J`s a rssK ds aw
14 goo s yR "Iq I 5L rsm 3 SIB — . q . 6
ockefS o-� - 1 .5 k (o FS
* Effluent #1 = BOD > 30 _<72 and TSS >30 _< 150 mg /L * Effl ent #2 = BOD < 30 mg /L and TSS < 30 mg /L
CST Name (Please Print) Signature CST Number
1 - s 5 L 3 aV ?44 6
Address Date Evaluation Conducted Telephone Number
a ?� Zo o s ' s . 5 +ar PfA;r� � S40a 10 -ay -oi 715 - 0141 --358's
SBD -8330 (R07 /0 )
r
Property Owner H al k (3u Iaers Parcel ID # Page <�— of
13 -1 Boring # ❑Boring Q9 V Pit Ground surface elev. � ft. Depth to limiting factor /0 D 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
O -ky IOyR Ila L I FPL y •(P
oZ W -19 trm `i: aCS69 dsl CvJ IF •5 .8
3 I9-36 , ,S1K 4 1q SL )F a
3b -loo SI 414 ,y .10
F41 Boring #
❑ Boring
Pit Ground surface elev. ft. Depth to limiting factor I b y 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
a -io tioyR L irPL O's a,c ,b
! U -I OR 5 13 L d s\-, cw F ,
3 1 -d3 IoV ' Nt V d M5 6K Iv P ,5 ,$
y a3 -ya - 7,5 1R qIq SL / C5 .4 b
S eta 5 4 1y SL JFS8K
I
� z
❑ Boring # ❑ Boring
Ground surface elev. ft. Depth to limiting factor in.
❑ Pit
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
I
I
I
* Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L
i
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.07 /00)
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POWTS OWNER'S MANUAL & MANAULMtN I f'LAN Page ' of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner J 11 Septic Tank Capacity U G G a l O A
r i'S
Permit /r '� Septic Tank Manufacturer &J" is z �' O A
DESIGN PARAMETERS Effluent Filter Manufacturer 217f, /D b A
Number of Bedrooms 3 3 ❑ NA Effluent Filter Model /,l - / 0 4 , O A
Number of Public Facility Units "A Pump Tank Capacity al A
Estimated flow (average) 3 ° ° gal/day Pump Tank Manufacturer A
Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer A
Soil Application Rate , ` gal/day/ft'- Pump Model
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit
Fats, Oil & Grease (FOG) 530 mg /L O Sand /Gravel Filter O Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA O Mechanical Aeration O Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection O Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) O
Biochemical Oxygen Demand (BOD 530 mg/L W' - Ground (gravity) O In- Ground (pressurized)
Total Suspended Solids (TSSI 530 mg /L ❑ NA O At -Grade O Mound
Fecal Coliform (geometric mean) 510 cfu / 100ml O Drip -Line O Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other. ❑
Other: ❑ NA Other: ❑
"Values typical for domestic wastewater and septic tank effluent. Other' O
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: �j O earls)(s) (Maximum 3 years) 13 N
Pump out contents of tank(s) When combined sludge and scum equals one - third %) of tank volume O N
❑ month(s) (Maximum 3 years) O N
Inspect dispersal cell(s) 3 At least once every: 3 ayear(s)
❑ nth(s) O N
Clean effluent filter At least once every: 2 - 3 p- -ear(s)
O month(s) O N
Inspect pump, pump controls & alarm At least once every: ❑ year(s)
O month(s) O
Rush laterals and pressure test At least once every: ❑ year(s)
Other: ❑
At least once every: ❑ ye �I ❑
Other: O A
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certificatiC ns.
Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. T ink
inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or lei ks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surf ce.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pon ing
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 (Y or more of the tank volume, the en ire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
AN other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, Pretreatirent
units, and any servicing at intervals of S12 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page Z of 2
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other 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 cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting P P
aintin products; sanitar pesticides; sanita napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter 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 properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS 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.
�� T
alua ' a o ing ank
e a� � 17i� �D12 /1/ L'ONS77e(I�TtON
b tZ�N
❑ 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 INSTALLEIN POWTS MAINTAINER
Name Name
Phone
Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name S ( !�(
phone Phone /S— 3gf!O— !O
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)IM &(f) and 83.5471, (2) & (3), Wisconsin Administrative Code.
04 / ^ ^/ ^004 13:50 715 2467227 HALLE SUILDEPS Dram PAGE 02
SEMC T.AW MA1N EMATSZM AGREEMEW
AND
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city/state f n11jfA � [ garceq n TdentW(at N ber I
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Subdivision _ . Lot #
Certified Spy map # __ _ _ volume ___ -- . .Page V
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warranty De �
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04/2- 1�; 0 50 7 1 5 - 2 4 6 7: 22 7 HALLS BUILDEPS 1141", PAGE 07
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04-27-1"9 4t15 An
WRRANTY DEED
EXMT I Is
Halle and Linda R� HQII�, lra.-sband' CFRY rtIpy FFFt
MPY FFF-
antl Warrant to Halic I�Uljda h)-c-, a NVISCOnSin corporatioliL, the TRANSFER FEE.
follow 9 d c - scribed real estate in. St, Croix C<pujnt7y, Ivisc VJ.00
1 1- 4 Hi-ghway 64
Th Soutbwest Quarter Of the SOUthCOSt QUATter (SWI/4 ofSEI/4) cpfS _ti nFj -vim f5),T_ S hi p p Thirty
(30) 114'orfn, Raagc Eightccrt (IS) I vVest, E.&C-r-E vonurie 728, pa-ge 1_I_I as Dcrcument 140. 407700. now
known as Lots I — 26, Plat ofParttidge Run- in the Tovqi, ofRicb-mond,
i rus is not homestoacl property.
.Exception to warranties rnurmc3pai and zoning ovamanc;&5, casoments and restnelio ofrccord.
Dated this- day of August, 1999.
ee
STATE
CR47"N COUNTY
Personally came before me thi-AIC- day of
THES DOC 1
INT-4 Mj B:Y�
- Wezley - W. HaIlle and
R° Hade tie, Eme known to b� the germ n —her
Judith A. Remington - ' - 4txNbqtcd the foregoing instwx=at and acknowledgz
LAW OFFIFTCES & 4?__ Z
P-0, Box 177 1 "134 N _ WI7.
.L�e.w RicbmamICL wl 54017
(715) 246-5422
4 OF Nm
• NE
343.27'
LOT UNE — — M
1
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33' 1 33'
�
O : 1.065 ACRES
O 46.370 SQ. FT
M N89'55'31" 341.43'
M
W 1
w
18
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UNPLATTED LANDS �
, 1A r - 1.090 A RES
------------------------------- - - - - -- Q 47,496 SQ. FT.
' O
N89'55'31" 339.53'
iD
co
so
S 8908' 47" W 660.00' 323.37' 17
220.00' 162'19 627.00 1 024 ACRE
S89'08'47 "W 705.56' 44,582 SQ.
clq
STORM WATtR 1 8 0�O
RETENTION Ii REA '\ ^ � '
\ 7 N 1.014 ACRES ry� N89 5 31 E 2
MINIMUM BLDG. \ N 'Sc 44,147 SQ. FT. •w
ELEV. = 978;7 9l 6)
04 1.017 ACRES
�•�1�' ; /'� 44,277 SO. FT. �? �' ° 16
1 OD i ' �, o
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000 1.004 ACR
N77• r' C �. ,714 SC
28 o " Iq \
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1.617 ACRES N89 \ 5 31 E e
701430 SQ. FT. I 1 9 • / 5
80' I !
j
1.009 ACRES
• I / 43,948 SQ. F'
N89'55' • "E 220.02' \� __ __ / 1.061 ACRES N6g2
195 nn o� 6 \ _ .. _49,21 SQ. FT.