The URL can be used to link to this page

Home My WebLink About026-1161-16-000 Wisconsin Department of Commzrce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488205 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: Posel, Rich I Richmond, Town of 026- 1161 -16 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /Z)v 15.30.18.1239 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER K n t CAPACITY STATION BS HI FS ELEV. Septic I ,Z5v Benchmark /� / 3 3� D3.3 Dosing C Q�w�Z> 75d _ j Al BM ftaf • 6004-,— �y�• �� 9 • ZL Bldg. Setver Holding J SUHt Inlet y-r- 39 .� TANK SETBACK INFORMATION St/Ht Outlet INS TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 5aoA, Septic 16:5 73 • 2 3 1 Z 3 / Dt Bottom � r ' i3. 9� Dosing / ► Header /Man. 5 Jas / 93 23 23 Z.7(p /00• Aeration Dist. Pipe • s Holding Bot. System 1 9q• g f /� {�� 5 � 6 PUMP /SIPHON INFORMATION Final Grade . f' A_ Manufacturer Demand St Cover GPM mber �/ s ?l ci q Model N lb .4 -1 I 9 O 2� COv�� L, ` . TDH Lift 17, 641 Friction Loss System Head TDH� . 4P 0 Forcemain Lengtth Dia. 2 , Dist. to Well • SOIL ABSORPTION SYSTEM BED/TRENCH Width + Length r No. gahes PIT DIIVtENSIONS No. Of"' its Inside 61ia. Liq id Depth DIMENSIONS Cr / {Z ` \\ SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type OAlstem: r (� � / + / JI UNIT Model Number: \ DISTRIBUTION SYSTEM 10.0"x_ Header /Manifold Distribution Z IL x Hole Siz�11 { / x Hole Spacing / Ver/[`(o Air Intake Pipe(s) 5'� $' , 1 - J Lengt Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over / Depth Over I xx Depth of Ix Seeded /Sodded xx Y Mulched Bed/Trench Center Bed/Trench Edges To soil (r � 11 Q I Yes No es No g p COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / �� / �° In ction #2: Location: 1534 127th Stt New Ichmond, WI 54017 (NW 1/4 SE 1/4 15 T30N R1 8W) Cherry Knolls 1st Add Lot 16 Parcel NIQ 15.30.18.1239 1.) Alt BM Description C�,' LOJ-tJ� G�g.� A.5 �, CGk ar• S� �. (r t�W n = � C • � p � `+''`C�1' 2.) Bldg sewer length = Z 3 �+ low o4c. - amount of cover = -4 r Plan revision Required? Yes No r Use other side for additional information $ 1(0 D - 2 ,5 _— � _ _ _ Cert. _ L _ Date Insepctor's ignatur . No. SBD -6710 (R.3/97) Wisconsin Department of Comme,ce PRIVATE SEWAGE SYSTEM County: St. Croix Safely and Building Division INSPECTION REPORT Sanitary Permit No: 488205 , 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you p9ovide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's N tme: city Village X Township Parcel Tax No: Posel, Rich I Richmond, Town of 026- 1161 -16 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 15.30.18.1239 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer o ding St/ Ht Inlet S t /Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WEL BLDG. Vent o Air Intake ROAD Dt I S ept ic Dt b ottom osing Headertman. era ion D ist . Hipe H olding o . ys em Ina ra e PUMP /SIPHON INFORMATION anu ac urer Demana bTuover GPM o e um er I nc I n oss 1 5 yst ern mea t-orcema I Leng ma IL ABSORPTOITSYSTEM DIMENSIONS INFORMATION CHAMBER OR I ypu 01 System. UNIT IvIarjel JIU11113M. MeaderlMallifilld Pipe(s) Length Dia Length Dia Spacing x Pressure Systems Only xx Mound Or At - Grade Systems Only Bed/Trench Center Bed/Trench Edges Topsoil L] Yes ] No ]Yes 7JIN COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ! ! Inspection #2: Location: 1534 127th St New Richmond, WI 54017 (NW 1/4 SE 1/4 15 T30N R18W) Cherry Knolls 1st Add Lot 16 Parcel No: 15.30.18.1239 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes ] No - �- Use other side for additional information. - -- ---- tnsepctor`sS 9nature - - -- — SBD -6710 (R.3/97) k Safexy rmd Buildings Division County 201 W. Washington Ave., P.O. sox 7162 C ,_ I vscona n .-O Madison, WI 53707 - 7162 Sanitary Permit Numb (to be filled in by Co.) — Department of Commerce (608) 266 -3151 " 1S Z OS Sanitary Permit Application State Plan ID. Number In accord with Comm 8321, Wis. Adm. Code, personal information you provide 1 B may be used for secondary purposes Privacy law, x15.04(1 xm) Pmject Address (if different than mailing address) I. Application Information – Please Print All Infortin ion s3 !.t 7 ' sr. Property Owner's Name w AUG 0 7 2006 � � 'Vy> �!� B L Property OwntesUading Address Prop" Location �J ST. CROIX COUNTY r "z - . �–` �u1 /., PE Section City, State Zip neNumber T 30 N; R E H. Type of Building (check al at apply) 6k a0 Sub rr.' �^p � Subdivision Name CSMJJjlrrrber Vf or2 Family Dwelling - Number ofBedroom y dils0 y ❑ PublidCommerrial - Describe Use / � C /C��rts State Owned - Describe Use 7 �z - r ❑City ❑VillageCROwnshipof C Ill /•t�D III. Type of Permit: (Cheek only one box on fine A. Complete line B if applicable) A. pRew System ❑ Replacement System ❑ TreatmentlWding Tank Replacement Only ❑ Other Modification to Existing System -------- B. ❑ Permit Renewal ( B'I�ermit Revision amp of 11 Permit Trmsfer to New list Pang Number and Date Issued Before Expiration Plumber owner y�S IV. Type of POWTS S Check an that a pply) ❑ Non - Pressurized In Gromrd ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable so 8 de Single Pass Send Filler ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Fiber ❑ Aerobic Treatment Unit Recirrulatarg Saari Filter ❑ Recirculating Synt Media Filler ❑ Leaching Chamber ❑ Drip Line ❑ Grmrd -rasa Pipe ❑ Other (explain) V. Dis rsal(I matment Area Information: Design Flow (gpd) Design Soil Application Rates Dispersal Area Re7 d (sf) Dispersal Area Proposed (so System Faevation ✓ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Wed Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass Now Ex6tiqg Tanks Taolm Lr� Pz C C Septic ore& ✓ 71�rabre�flaelneeliLri4• d Dosing Clunber r VIL Responsibility Statement - I, the as ed, assaaa r htstantion of the POWTS shown on the attached plans. Plumber's Name (Print) Pl 4 h'��RS Number Business Phone Number o TiS- 6- o�av Plumber's Address (Street, City, Zip 173 7 ,fir rF � - o !- �lTv- VIII. Coon artment Use On ,,_, / Appro pp Sanitary Permit Fee (mcllu�des Groundwater Date Issuing t Signatu (No ,� Reason for / 5 - c) � $ g a IX. Conditions ofApprovaMemons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent filter and dispersal cell must all be servit:es / maintained as per martayernertt Plan Provided by P lumber. 2 AN adback requkwn Ms must be rraintained as PK eppl , t h Code / ordklartces. Attach eonpkee pram (to me Comty only) for me srstmr en paper not'm and 8112 s 11 lathe is sime SBD -6398 (R. 01/03) Site Plan Page 8 of 8 For: Rich Posel Lot 16 Cherry Knolls 1st Addition NW1 /4 - SEl /4 Sec. 15 T30N -R18W Town of Richmond - St Croix County 153 rd Ave. p 25 50 M- ---� a-Pbb &We (fit) 1 inch - ao tt 1.81 Acn Parcel #1 ABM = Top ofIhm Plpe SWLot Iron Elev. 100.00' #,2 ABM = Top of con" Pipe Ew. 99.96' 1 100'Batldi�g SetbackLina I Proposed 4 Bakw n Home P I Proposed 4 "BvU tsg Sewer Proposed Wieser Concrete I 1250 -750 GaLCombinadon Tank 127 th w/a PolylokPL -523 Effluent FUter pmposedZ "Sek 40 Form Main FN# 1 53 4 98.00' 9% I 4% I /B #3I Proposed 95c112'At -Grade Mound Cell 100 E i v,� a System Elevation of 9980' #1 cop��. A m Note: Slope parcentage var*W by Lave F'o8aty Site Plan Pw 8 of 8 For: Rich Posel Lot 16 Cherry Knolls 1 st Addition NW1/4 - SE1 /4 Sec. 15 T30N -Rl8W Town of Richmond - St Croix County 153 rd Ave. 0 25 so a -pble &Ab ONO i imt, - ao w 1.81 Acre Pmael #1 ABM - Top of Iron Pipe SW Lot Irm Elev. m 100.00' #2 A BM = Top of Condwit Pipe Elev. 99.96' 1 100'Butldit Se6w*I the I I Proposed 4 Bedroom home I P I • fELL Proposed 4 "Buildtng Sewer I Prgwn d Wieser Concrete ' 1250-750 Gal. Combination Tank 127 th Sb d w/a PolylokPL -525 Effluent FlUer p 2° Sch. 40 Form Main FN# 1534 98.00' �- 9%� 4% i I B pal Proposed 9'xl12'At-Grade Mound Cell 10000 B #i with a Elevadm of 99.80' #1 #2 PA A BM BM Note: Slope percentage verified by Davy Fogerty Safety and Buildings 10541N RANCH ROAD commerce.Wl.gov HAYWARD WI 54843 TDD #: (608) 264 -8777 isconsin www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 01, 2006 CUST ID No. 221180 ATTIC• POWTS Inspector DAVID B FOGERTY ZONING OFFICE FOGERTY PLUMBING & PERK TESTING INC ST CROIX COUNTY S 28288 MCKENZIE RD 1101 CARMICHAEL RD SPOONER WI 54801 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/01/2008 Identification Numbers Transaction ID No. 1294407 SITE• Site ID No. 715734 Rich Posel Please refer to both identification numbers, 1534 127TH St above, in all correspondence with the agency. Town of Richmond St Croix County P NW1 /4, SE1/4, S15, T30N, R18W Lot: 16, FOR: Description: New at grade system, 4 bedroom residence 1 Object Type: POWTS Component Manual Regulated Object ID No.: 1087308 Maintenance required; 600 GPD Flow rate; 92 in Soil minimum depth to limiting factor from original grade; S System(s): At -grade Component Manual, SBD- 10570 -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: Key Item (s) Y O • In the event this soil absorption system 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 the At Grade Component Manual are complied • The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total,p dynamic head increases, the proposed pump must be reevaluated and may be inadequate. `Ci • The designer proposes to install an effluent filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. Reminder • The orientation of the at grade system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • DAVID B FOGERTY Page 2 8/1/2006 • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). • Insulate building sewer per COMM 82.30(11)(c). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall prod opy o this letter to the owner and any others who are responsible for the installation, operation or mai nance of e PO TS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L POWTS Plan Reviewer, Inte ted Se ices WiSMART code: 7633 (715) 634 -7810, Fax: (715) 4 -515 , M -f 7:45 am - 4:30 pm pat. shandorf @wisconsin. gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 I RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project Rich Posel 4 Bedroom At -Grade Mound Owner Rich Posel Address 835 East 6th Street New Richmond WI 54017 (715) 246 -8641 Legal Description NW1 /4 -SE1 /4 Sec. 15 T30NR18W Township Richmond County St. Croix.��" ,. I Subdivision Name Cherry Knolls 1 st Add. Lot No. 16 Parcel ID Number Plan Transaction Number Index sheet Page 1 Calculations Page 2 At -grade drawings Page 3 C� Laterals and dose tank Page 4 Specifications Page 5 I Management & contingency plan Page 6 Pump Specifications Page 7 Plot Plan Page 8 Designer Dave Fog erty License Number MPRS #221180 Signature rr Phone Number (715) 635 -9609 Date 07/09/06 Designed pursuant to: At -grade Component Manual for POWTS SBD- 10570 -P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 3.11 (05101) Page 1 of 8 PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (gpd) 600.0 Design wastewater flow (gpd) 9.00 % Site slope 99.80 Contour elev. below lateral (ft) 75.00 Depth to limiting factor (in) 0.60 In -situ soil application rate (gpd /ft ^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 5.40 Linear loading rate gpd /ft 9.00 Effective absorption width (ft) 9.00 Max. effective width permitted (ft) 112.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0.125 Orifice diameter (in) e.g. 0.188 Not a final 1.75 Estimated orifice spacing (ft) calculation 2.00 Forcemain diameter (in) 2.70 Forcemain flow velocity (ft/sec) 125.00 Forcemain length (ft) y or n y Does forcemain drain back? 91.00 Pump tank elevation (ft) y or n y Are laterals at highest point? NA 6.5 System head (ft) x 1.3 20.4 Forcemain drainback (gal) 8.30 Vertical lift (ft) 50.5 5x Lateral void volume (gal) 1.91 Friction loss (ft) 70.9 Minimum dose volume (gal) 16.71 Total dynamic head (ft) _ 26.4 System demand (gpm) Lateral Diameter Selection Gallonslinch Calculator (optional) Pipe diameter I Design options Design choice Total Tank Capacity (gal) Designer 1 in Total Working Liquid Depth (in) must select 1.25 in x Galfin (enter result in cell G46) one lateral 1.5 in X X diameter 2 in x Treatment Tank Information 3 in x 1250 Se tic tank capacity (gal) Wieser Concrete Manufacturer Effluent Filter Information Dose Tank Information Pol lok J Filter manufacturer 773.8 Dose tank capacity (gal) PL -525 Filter model number 16.11 Dose tank volume (gal/in) Wieser Concrete IManufacturer Project: Rich Posel 4 Bedroom At -Grade Mound Transaction Number. Page 2 of 8 AT -GRADE PLAN VIEW D 1/68 Observation pipes (2 typical) B 112.00 ft 116 6 18.67 ft C 11.00 ft W D 5.00 ft E 2.00 ft L 122.00 ft B W 21.00 ft AxB 1000.00 ft^2 L Cap Typical obs. i YP pipe. = Total aggregate cell A x B slotted in the lower = s and anchored Plowed area L x W s 6 ,. AT -GRADE CROSS SECTION Svnthetic fabric cover 101.59 ft Finished grade Lateral elevation invert elev. 100.30 ft �._ Observation pipe at aggregate toe E 9 % Slope Surface contour 99.80 ft C A and system D elevation = 12 in. topsoil and subsoil Plowed layer ® n tapered to toes. over aggregate and 999 Pe below L x W = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Rich Posel 4 Bedroom At -Grade Mound Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Canter Connection P - X --4x12 I xf2 +l Laterals & Force main of PVC Soh 40 Last hole drilled nest to end cap (per COMM Table 84.30 -5) Holes drilled on the bottom of the lateral, • =Turn -up wf ball valve or oleanoutplug equalig spaced Lateral Specifications 0.125 Orifice diameter (in) Center Lateral connection point X 1.74 Orifice spacing (ft) 2 Number laterals 32 Orifices /lateral P 54.81 Lateral length (ft) 13.2 Lat discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 26.4 Sys. discharge rate (gpm) 125.00 Forcemain Length (ft) 16.71 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather-proof warning warning label and locking device box Final grade junction 4 „ Tank compon disconnect ent is Altemata properly vented 'N.„ outlet ^ location 18" min. Electrical as per NEC 300 and A( ' outlet Comm 16.28 WAC joint Tank full C inches Gallons JA Provide 114" C A 29.7 477.5 Alarm on weep hole or Cf antisiphon C 4.4 70.9 Pump on B device. G D 12.0 193.2 92.0 ft C Totals 48.1 773.8 Pump off D 3" Bedding under tank 91.00 ft Goulds Pump manufacturer ISJ. Electra Alarm manufacturer EPO-4 Pump model number 101 -01H Alarm model number Project: Rich Posel 4 Bedroom At -Grade Mound Transaction Number. Page 4 of 8 At- arade System Maintenance and Operation Specifications Service Provider's Name Tn- County Sanitation I Phone[ 386 -0114 POWTS Regulator's Name St. Croix Co. Zoning Phone 715 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1000.0 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 du/100 mL Service Freauency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month Pressure System Laterals should be flushed and pressure tested ev 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the at - grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All rav' and piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 9 �y pressure P P 9 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -qrade component manual SBD- 10570 -P (R. 6199). Lateral Turn -up Detail Finished •............ 000000000006009 Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral �y Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Rich Posel 4 Bedroom At -Grade Mound Transaction Number. Page 5 of 8 Page 7 of 8 e, GOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: • Effluent systems g Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion csean sta wwds ftum tt • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efticlent heat transfer, in "C" or "F ".) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Gaft Putlps M 90111 Restated FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. "/a" maximum. ■ EPO4 Impeller: Thermoplas- 0 power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1 NPT, seal protection. • Mechanical seal: carbon - rotary/ceramic stationary, BUNA - N elastomers. • Temperature: 104°F (40 continuous M FEET 140°1' (60%) intermittent. • Fasteners: 300 series 10 stainless steel. s 30 • Capable of running 1 -4- [ 5 dry without damage to 8 z 5 Fr components. 25 o 7 Motor: • EPO4 Single phase: 0.4 HP, v e zo 115 or 230 V, 60 Hz, 1550 RPM, built in overload with 5 automatic reset, o 15 • EP05 Single phase: 0,5 HP, o 4' EPOS 115 V or 230V, 60 Hz, 1550 '' 3 to RPM, built in overload with automatic reset. 2 EPO4 • Power cord: 10 foot s standard length, 16/3 t S1TOW with three prong I grounding u Optional 20 0 0 0 9 9 9• P � o to zo so ao so FPM foot length, 16/3 SJTW with three prong grounding plug o 2 a 6 a t o t t MI A (standard on EP05), CAPACITY Goulds Pumps E 2001 Goulds Pumps ITT Industries Effective May, 2001 83871 At -grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [S13D- 10570 -P (R. 06/99) and SSWMP Pub. 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. SeWc 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 finer shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filer cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At -arade and Pressure Distribution System No trees or shrubs should be planted on the at- grade. Plantings may be made around the at- grade's perimeter, and the at -grade 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 at -grade 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 at- grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg /L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg /L TSS, 10 mg/L FOG, and 10 du /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine N orifice clogging has occuned 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. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade 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 renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Rich Posel 4 Bedroom At -Grade I Transaction Number: Page 6 of 8 1 FOGERTY PLUMBING & PERK TESTING ;A(_ y6r-G 28288 McKenzie Rd. Spooner, WI 54801 (715) 635 -9609 (715) 749 -3656 Fax (715) 635 -5286 DATE: 6 -29 -06 TO: RYAN YARRINGTON FROM: Dave Fogerty RE: Rich Posel /Tom Nelson soil evaluation Ryan, Thanks for sending your onsite determination report. Based on this report, the customer has now asked me to design an at -grade site. I need to clarify a cou le of items to system for this s y P make sure we are all in agreement. You indicated we needed to increase the proposed system size due to horizon #2 being a weak structured silt loan. Correct? Elevation differences between borings remain the same, so that a is not a reason for the need for increased sizing. Correct? R Not noted was the incorrect boring elevation for bd'ing #3. It is closer to 101.9- 102.2. For the record and for design pur- poses, I'm going to modify Nelson's contour to reflect the cor- rect elevation and scale. Hopefully the state will allow these c hanges and not insist Tom Nelson sign off as a condition of approval. Please call if you have any questions, 1- 715- 416 -0000. Sinc Dave Dave Fogerty T'd 98ZSS69SiLI 9NIawn1d A IN 390A e9S =90 90 OE car ST CROIX CO AA U A#4k PLANNING &. ZONING MEMO DATE: June 23, 2006 To: Dave Fogerty CodeAdministra FROM: Ryan Yarrington, CST #683475 715 - 386 -4680 RE: Soil Evaluation Report for Rich Posel Land Information & Planning Town of Richmond, Sec. 15.30.18 Lot 16 of Cherry Knolls 1 st Add. 715 - 386 -4674 Real Prop During excavation of the basement for this site, the soils were questioned for 715 -3 677 suitability in use with a conventional POWTS system at a 0.6 gallons per day /ft loading rate. I conducted a soil on -site determination on 6/23/06. Weather was Re cling - 386 -4675 clear, sunny, and in the 80's at 9:00 a.m. Three backhoe pits were completed adjacent to the soil borings completed by Tom Nelson CST #227387 on 4/1/04. Soils are consistent with descriptions provided by original soil tester. However horizon #2 has a weak structured silt loam instead of a moderate structured silt loam. Due to elevation differences between the pits, a loading rate of 0.4 gallons per day /ft must be used for sizing the system. The original system elevation of 97.8 and 97.2 ft. should still be used. A copy of my on -site report is attached for your review. Cc: Rich Posel, property owner ST. CRO /X COUNTY GOVERNMENT CENTER 110 1 CARM/CHAEL ROAD, HUDSON, W/ 54016 71X386 FAX PZ @CO. SAINT- CROIX.WI.US WWW.CO.SAINT- CROIX.WLUS ST. CROIX COUNTY WISCONSIN ZONING OFFICE N N N M N N M N Noted ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road �. --- --�-"' Hudson, WI 54016 -7710 ,. (715) 386 -4680 FAX (715) 386 -4686 COUNTY ON -SITE VERIFICATION FORM Propedyowrw D roparty ocation G.A. Lot N-� 14 1/4 S 15 T 36 to R /$ E (or)@ Properlyowwrs Mailing Address nn Lot Blou4c# Subd.NameorCsw n - 9 5 E G K.- Sd-. NerJ Q;�,.w•��•dJ 1 , k.-,b City SM Zip Code Phone Number []City ❑Village Neared Road NewConstruclion Use: ❑ Residential J Number of bedrooms -----Code derived design flow rate -- -- - - - - -_ GPD ❑ Replacement ❑ Public or commercial - Describe: ------------- ___•-- - -- -_— -- Parent material ---------- - - - - -- _ -- Rood Plain elevation if applicable - - - -- - - - - -- and rommmendations. Rya, P ...� 6 b� » �.: : Qyww Y aff CGau ' Fr 0 -st , 6�,4 � Being # 0 Baring 97.1 P I�1 R9 Pit Ground surface abv. _J ? • /� ft. Depth to limitirg facicr-- -� - -- in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Strackrre Coisidence Boundary Rods GPDM in. Mumsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'F491 'Eff#2 6 -10 16 M A)A- g; Z G 2 16-30 1byA, fv N 5 i 1 1 #L%6hL d k o JI o.�e - o - q% AD YQ `t Nl- 1,:5 o '/ f v C_ .7 /' (0 8 - 7 SY 3 A)k 5 L 1 C_ — 0.z 5 76 Z Being ft anng Q9.��0 1 lI/ Pit Ground surface &v, _ —"—_ lt. Depth to finning factor in. Soil Applicat Rye Horizon Daplh Dominant Cobr Redox DoscriptiQn Texture Structure Consistence Boundary Roots GPD1P in. Mtnsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'EM '0102 /oYa s Alk 5.` 1 1 C. 1 'I � o. 6A 2 z 3o fc fo y 3 �- D-4 1 364% . !o YL N L-5 o s rw%4r e- S - 754'R L o ng #�d�n9 /- 3 pit Grounds,rfacc?eb, �0.� *ft. Depth to limiting factor in. gal Application Rade Horizon Oeplh Don Color RedoxDe=iption Texture Structure 7CaisiLs-4te Bou ndary Rods GPDW in. Munsdi Qu Sz. Cont. Color Gr. Sz. StL 'Effd1 'EM2 o -i0 /oYR s N A. c. 1 4- o. o .$ 2. /b 30 /o Q 't NrQ. c, % ✓�- 3 30 -50 YQy 4 -S rA ❑ Boring ff C3 Baring ❑ pit Ground strrkrca elev. _ —� —_ ft. Depth to Amiting factor _ —_ -- In. Scil Application Rate Horizon Depth Dominant Cobr Redix Description Texture Structure Consistence Boundary Rods GPEW in. Munsdl Ou. Sz. Cont. Color Gr. Sz. Sh. 'FM Safety and Buitdmgs county 201 W. Washington Are, P:O. X 7 ST r`zD.ZY i seonsirt , WI 53707-71 Sanitary Permit Number (w filled in by Co.) Department of Commerce ()-3151 zbs Sanitary Permit Application S 0 Plan LD..Number In accord with Comm 8321, Wis. Adm. Cade, personal information you provide / may be used for secondary purposes Project Address (if different than mailing address) I. Application Information — Please Print All Info ' n y f3 U ' Property owner's N MAY 2 6 2006 Pared Black # 9A.MmMIL � Property OwneesMailing Adkm Y Property Location le w/ Ri %. 5,E V.. Section City, State Zip Code Phone Nunber O 3a N; RZ E ( i Z 3 U. Type of Building (check all that ap ) gk b 5t 4`or 2 Family Dwelling - Number of serener Subdivision Name CSM N her ❑ PublicfiCommtercial - Describe Use E i ❑ State Owned - Describe Use Z , C p V L✓ Z f Z�o L 4 e f 5 ❑CA) ❑Village Bownshipof M. Type of Permit: (Check only one box on " Complete line B if applica ) n 7j / l A view System ❑ Replacement System \fttmentffiloldnigTarik Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ of . Transfer to New List Previous Permit Number and Date Issiced Before Expiration Phu► IV. Type of POWTS S Check all that a pply) Pffon - Pressurized M- Ground ❑ Mourd ? 24 m_ of suitable soil omd <24 in. of suitable soil ❑ AvGrade ❑ Single Pass Sand Fildx ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank Filter ❑ Aaobic Treatment Unit ❑ Recirculating Sand Filter Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Lis avd less Pipe ❑other (explain) V. D' vestment Area Information: 0C 40 /_X?X Aelf — I O Design Flow (gpd) Design Soil Application Area ltexry (sB Dispersal Area Proposed (sf) Systan `� 2 VI. Tank Info Capacity in Total NaliPer 'fad Prefab Site Steel Fiber Plastic Gallons Gallons o nits Concrete Constructed Glass New Exisft Tanta Twits OL Septic or46dd* T#A*- ., _� 2 ✓ Aerobic Treatment Unit Donna Ckember VII. Responsibility Statement - 1, the an asseme responsibility fo ilastatlaffootiftbe POWTS AN-- the attached pons Plumber's Name (Print) Pl s Si e/MPRS Number Business Phone Number ::z� t o w Pllum Address (Street, City, W+ Zip .C. Q Lo F VIII. Chan artment Use On Approved D Sanitary Permit Fee (inLcluddeess Groundwater Date Issuinl0vat Sigma o ) for Denial Surcharge Fee) IX. Conditions f of A rrovaUR ns or Disapproval , srsTewlS'Cv�lr 3) rAW a C�r l'G.� low; I . septic ark, eA nd depersal cell mud IM be SWAM / mmilliffilMd d� as per mats pment plan provided by p1UQdW. 2. AN setback rsgttirentertts trust be rnaktakisd (4kr C V-\. - Jet i as per appkable code / ardilwX s. Attack eampkre picas (to ak Coawp �) s m psi" i man 3112 x 11 iacba is (mac_, l'Qr u; P o l' (,nr�wt.e SBD -6398 (R. 01/03) UU x { r f ✓ F x' M3!2y2 rN TnP o f x2oKi / f7r�P / /o ®.D / Dos L } G -/ 97,8 WF r G1 GK�u i j I ` I �( —� -_ - -- ---ill F✓L'GGGN /ZCE�'" f.�- rRsjCk' f— i F -. _ -- - -- - -- IV7 y 1 r S 3 r '� .fir/• P i /vo.D iD °g L o Fmcnv /J /OT lbiz �M covco rrF 2s0/7so C -( 97- C'-Z g7�2 G,-,�GKt'ur �1 n 1 y1 Fe'- it rt p [T I ex WF t/s7r- w c -- c'/ CEIV Wisconsin Department of Com C SOIL ALUATION REPORT P 1 3 Division of Safety and Bufldings � p bt i�'}r a Jai0e pomm 5, Wis. Adm. Code County St. Croix Attach complete site plan on pa 11 inches ' size. Plan must include, but not limited to: verti I and h Tplbint (B ),direction and Parcel I.D. Pending percent slope, scale or dimension , n and (stance to nearest road. Please print all information Re ' by D alq Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.14 (1) (m)). ` i� Property Owner Property Location t O Steve Derrick Govt. Lot 1 /4 SE 1/4 S 15 T 30 N R 18 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1438 County Rd G 16 - Cherry Knolls 1st Addition City State Zip Code Phone Number []City []Village ■ own Nearest Road New Richmond I WI 1 54017 1 ( I Richmand I County Rd G El New Construction Usee Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD 0 Replacement ® Public or commercial - Describe: Parent material loess over glacial outwash Flood Plain elevation if applicable M A - ft. General comments This site is suitable for a conventional below grade system and recommendations: A da �' � ;7''uk^ *Wlor ^ � gmJentS ba a4ld FTI Boring # ®�ng El Pit Ground surface elev. 100.11 ft. Depth to limiting factor >96 in. Soil � lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0 -9 10yr3 /2 - sil 2msbk mfr as 2f .6 .8 2 9-40 - is mvfr if .7 7.5 4/4 Osg cw 3 40 7.5yr4/4 - vfsl* lmsbk mvfr cw - 2 . 4 62 -96 7.5yr5/6 - 1 s Osg ml - - .7 1.6 ,'0 Z 2 ' 2 Boring Boring # 99.06 X92 El Pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#1 'Eff#2 1 0-12 10yr3/2 sil 2msbk mfr as 2f .6 .8 2 12 -29 1 4/4 - sil 2msbk mfr cw if .6 .8 3 29 -59 7.5yr4/6 - is Osg mvr cw _ .7 1.6 4 59 -92 7.5yr4/4 - sJt Om mfi - - .2 .6 LA I Z r ' Effluent #1 = BOD > 30 220 mg/t. and TSS >30 < 150 mglL ' Effluent #2 = BOD < 30 mg/(_ and TSS < 30 mgR CST Name q%ase Print) Signature E CST Number Thomas C Nelson �� 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 4/1/04 715- 246 -2454 r• Property Owner Derrick Parcel ID # Pending page 2 of 3 Boring 3 Boring # Pit Ground surface elev. 100.96 ft. Depth to limiting factor >96 in. Sal Appl Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence E Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10yr3/2 - sil 2msbk mfr 2f .6 .8 2 8-25 1 4/4 - sil 2msbk mfr if .6 .8 3 25 -52 7.5yr4/6 - Is Osg mvfr cw _ .7 1.6 4 52 -96 7.5yr4/4 - sl Om mfi - - .6 Xl ICIV 7 � ❑ Boring #ng Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rabe Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/IP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 l apit Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 * Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L • Effluent #2 = BOD a 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 altemate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SM- 8330Tea (8.07/00) � . Cherry Knolls 1st Addit Lot 16 Scale 1" = 30' BMl Top of iron pipe 100.00' BM2 Top of conduit pipe 99.96' B1 100.11' B2 99.06 B3 100.96 $2 4% -- slope 46' - 147' B3 B1 23' 100' g i AIL BM1 --a-- 27' —► BM2 SW lot corner Thomas Nelson 227.387 2 8 7 ? P 0 T � KATHLEEN H. WALSH State Bar of Wisconsin Form 2 - 3 REGISTER OF DEEDS WARRANTY DEED ST. CROIX Co. WI Document Number Document Name RECEIVED FOR RECORD 08/29/2005 02:00P?f WARRANTY DEED FEAENPT z THIS DEED, made between Steven J. Derrick and Margaret M. Derrick, husband and wife REC FEE: 11.00 TRANS FEE: 149.70 or more ("Grantor," whether one , COPY FEE. and Richard L. Posel and Ashley N. Andrews CC FEE: PAGES: 1 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space Estreen & 091Wd is needed, please attach addendum): '• 304 L OCust Street Lot 16, Cherry Knolls. St. Croix County, Wisconsin Hudson, W1 54016 026 - 1045 -90 -050 Parcel Identification Number (PIN) This Is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if Dated (SEAL) ( AL; * *Steve Derrick i (SEAL) (SEAL) * *Marg t M. Derrick By: S even J. Derrick, Attorney. in Fact AUTHENTICATION ACKNOWLEDGMENT Signature(s) Steven J. Derrick and Margaret M. Derrick, By: Steven J. Derrick, Attorney in Fact STATE OF ) ss. authenticate on 4 COUNTY ) Personally came before me on *Kristin O land the above -named TITLE: MEMBERS ATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Notary Public, State of Attorney Kristina Otgland My Commission (is permanent) (expires: ) Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 ' Type name below signatures. INFO -PROTM Legal Forms 800 -655 -2021 www.infoprofonns.com ,�, .o 6 ry o, %� %� • 2 212 •o �o 2.39 • CO' 9. ' . --15 i � >5 A LOT 28 N / LOT 25 V V i •` 82,148 s ft. ao ( 79,95 7 sq. ft.' G __ 89 acres I 1.84 acres s L. B. O. = 975.0' G L.B. 0. = 97,5.0' N��i 2J Z r \ iU') o N N89'48'27 "E • 8� �3 N o \ss \ ,/ M o 22.84' N7834'03 "£ 1 B OD �• ss p� o rn 4812 / J w • ° o o — Drain age U •o � '�� ry 80' r . Z N • —�' H. W.E. = 973.0' \ 8• to be •� �'S' \Ex ten Eosemen t R o 50.81' 12 /2',, 61 �� / o � • ' 2. L.B. B 9 +<vl _ � � , �' h°'• X64 •? h S st \ Easement "� • • ' EAT M ,,h`'/ �t .,�• , 93,166 sq. ft. l LOT 17 / ' 2 14 acres 82,198 sq. ft. acres cV ' J L.B. O. = 975.0' LOT 18 ' 1.89 „^ ° ► / -ri L.B. O. =9 2 78, 85i sq. ft. % o �JO' Drain a 1.81 acres 99' v o �' 379. 1 Easement g L.B.O. -975.0 �� N$4'47'1 7 "W 004.98' : 479.73 I ' / f i l l U, •- 639.73'- i ' CH[ 207.21' 256.96'. ' ss ' T 9 '39'45 "W 706.72' o .99 ' LO 0 _ _ _ — _ 8a5 LOT 8 � 33' 33• / / i -- L �Y ,KNOLLS I I � ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address A1 44-TC fh /C/j f-4Ar- Property Address ' ` `� a 7tA }� (Verification required from Plannin & Zoning Department for new cons tion.) City /State Parcel Identification Number Bz LEGAL DESCRIPTION Property Location +fZkl 1 /4 5 1 /4 , Sec. � T ?z> N R_If W, Town of Subdivision Q6C Id - , Lot # a Certified Survey Map # , Volume g age # — Warranty Deed # FA f! ° Va , Volume �� 77 , Page # 07 �- Spec house yeses Lot lines identifiableye 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 versifying 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 stating 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. Uwe 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 SIGNATURE OF APPLICANTS) 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) C m�C ` IN #� c a I . i co °o n N N D w U ca ♦� 7' m f. OFI ' • 0 V ;" �+ 1 ' 4 T = • - m U!) Z V Oo RR to : as i .fl � o 4-o LD 0 ' Combination Tank Component Cross Section Approved Manhole Covers With Warning Labels and Locking Device / 4" Min. Above Final Grade Weather Proof Junction Box Electric per NEC 300 & COMM. 4" Sch. 40 Vent 16.28 WAC > or = to 12" Above Final Grade %Disconhect Alternate Outlet Location W /Approved 4" Sleeve _ Inlet Approved Force Main Diam. _ Effluent Filter < or = to 1/8" Weep Hole or Anti Siphon Device Baf116k Particle Size A v . B Pump Off Elev. C Tank Mfr. D Dose Tank Elev. Vertical Difference Between Pump Off and Distribution Pipe = Minimum Required Supply Pressure ....... ............................... = --- .bra FT. of Force Main x L- > Friction Factor /100FT.... = Total Dynamic Head .................... = • 3 Number of Doses ... = t � Per Day Gal. Per Day / #of Doses= /-:;O'Gd. Volume of Backilow .... 4W ..a..(.- ,A -A # .................. =1k Gal. Total Dose Volume ...................................... ............................... = Gal. Pump Tank Capacity 7X0 Gallons Dimensions Inches Gallons Pump Tank Vohme f y " GaVInch A B Pump Mfr. 9tv ee 4 C _- ,(6 Pump Model D Minimum Discha& Rate = GPM Alarm Mfr. .S, / A65VP & Total= ,-i 7 �� Alarm Model ie Bed Tank per COMM. 83.45(5) Anchor Tank as necessary to negate buoyant forces per COMM. 83.43(8)(8). i M ODEL DVP03 MO •04 •0 Su bmersible P ump r GOULDS I i rSX: ,_Pump Specifications METERS FEET ,.. / aHP Up t0 40 GPM �" ` ' 10 MODEL: 3871 Discharge size 1'/: NPT , . 9 30 Solids: y: maximum 6 Motor 7 26 I Single phase: 115V W 6 zo Materials of Construction - - Brass/thermoptostic a 6 15 EPOS Features and Benefits ° •Top suction eliminates a 3 '° impeller clogging. 2 5 EM • Corrosion resistant i construction. o • Float actuated switch. ° +0 2 so ° o so us6PM 0 2 4 6 6 10 12 mVh CAPACITY METERS FEET MODEL DVP03 Pump Specifications Features and Benefits 0 6 ° /16 and 1 /2 HP • EPO4 impeller - semi -open design Up to 60 GPM with pump out vanes to protect 5- 16 Maximum head to 32' mechanical seal. ° Discharge size 1 NPT • EP05 impeller - enclosed design 0 3- Solids:' /:' maximum for improved performance. 2 • Rugged.glass- filled thermoplastic 1 6 All motors feature ball casing and base design provides 0 00 6 16 16 zs u.s.6rM bearing construction. superior strength and corrosion resistance. L -L Single phase: 115V ° 2 CAPACITY 6 8 10mOpv Materials of Construction • Cast iron motor housing for Cast iron efficient heat tranAfer, strength, Thermoplastic and durability. Stainless steel • Corrosion resistant threaded i stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. All Models are designed for continuous operation and feature stainless steel hardware. E3 000 EB a e D DD aD D O in -4 Rl I F A �< " D - -t ' O m Z I _ o m m m -0• 30' -0 lot - s•_nr• . r.aw• iuncw u.r d I h ! d Ix b Ib I} , �o• . to• .•-r.• . row• I � .s r V a ' I! Ik ------ -- I I I N -- - - -- -- -- I - ------ - - - - -- - ». -- I 4 3b '� YAIIT �• • Y4lT I g' {" s I s r au PIMPLACE TV O TV D I. l ot � . i Y O Y E 2Y {° 30' -0' SY-b' I ol 5'1'•b" ,0" 90• -0" qt 's { xX t is 6 { ; 6-1 • , { 1 10 1 = ___ ------ - »_--- -i { s • = i• ; m_ y okx ,22• FLOOR ,RUeeEe . Mr o.c. _ 1 i �2Y FLOOR TRUBOM • M2 '_O.C. ! = J • = VVVV� � � .. �� i 1 5'1'b"