HomeMy WebLinkAbout026-1135-05-000 pr I
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
399506
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:
P.C. Collova Builders, Inc. I Richmond Township 026 - 1135 -05 -000
CST BM Elev: Insp. BM Elev: BM Description:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic wp ASO Benchmark pp
—
Dosing Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht o tIy
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic r, 3 2 1 Dt Bottom
C7
Dosing fjL.\ t LI 30► Header /Man.
Aeration ) Dist. Pi
c �q,a "rd9•�oo
Holding Bot. System
►° •�S Z I
Vi �e5 v '. $� •8$
Final Grade ,
PUMP /SIPHON INFQRMATION
Manufacturer C Demand St Cover
` GPM G�CO J
Model u M' _' ,•(p) q(S'.(oA C� , a ►
TDH ft �` Friction Loss System Head TDH Ft
� 3.
N Forcemain Length i Dia. , Dist. to well t
45 1 SOIL SORPTION SYSTEM (S
RENCH idth Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIME - ?jt o l3 c2
SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufact re
INFORMATION CHAMBER OR
Type Of Syste V. N 0 i S-/ t
� � � f UNIT Model Number: u ° n
DISTRIBUTION SYSTEM s 40 awx
Header /Manifold tt Do le Size x Hole Spacing Vent to Air Intake �� " Pipe s) / O I
Length Dia Length Dia Spacing " to
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 0 No Yes No
COMM (I de code discrepencie � e " rsons present, t In spection # Y:J / 2* 1 A�gq spection
A\ c.a• StC wts ws%t ..•. :as + , t a1•k�• • ' �i —
OV Locbtion: 1442 141st Avenue New Richmond, WI 54017 (SE 1/4 SW 1/4 24 T30N R18W) Ev rgreen Overlook Lot 5 Parcel No: ��av
1.) Alt BM Description tpr 4-wdk — 1 {AO • S�.
2.) Bldg sewer length
- amount of co )ts °-i ��� ► ate SAS. e Fptei� �.
LL
aN AA
ev, sibn Required? Yes NO - y
Use other side for additional information. •
Date Insepctor's Signature Cart. No.
SBD -6710 (R.3/97)
1
`NAN S�Gye iC
20 W, Waswastor. Ave. • Y.0 Sax 7.62
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Wisconsin Department of Commerce SOIL AND SITE EVALUATION 3
Divtsion of Safety and Buildings Page _L of
Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code
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 �ro
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. #
APPLICANT INFORMATION - Please pr \aN 10dr R v ed b Date
Personal information you provide may be used for seco �fiy�poses (Privacy tyr; s04 (1) (m)).
Property Owner operty Location ,,,��
RkA �1j1 ; vt.
Lot 1 /4l 2 t 1/4,S 4( T Z ,N,R r E (o (
Property Owner's Mailing Address i i 5 , _,fit # Block# S Name or CSM#
j � , � {, „ 220 � �-e,� reen QV2r ►cam k
City State Zip Code Phone *ft r g � Town Nearest Road
City ❑Villa e n
UC_I Son W1 UI ?/ c� O r -
® New Construction Use: [�PResidentiai / PTurr rAf. ooms _5 Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow e U U gpd Recommended design loading rate .5_ bed, gpd/fl trench, gpd1ft
Absorption area required /ZUC) bed, ft 100 ttrench,jt Maximum design loading rate ..gy bed, gpd/fl . trench, gpd/ft
Recommended infiltration surface elevation(s) bl ft (as referred to site plan benchmark)
Additional design /site considerations A-t
Parent material 4o-4"c -- 5 Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system I ®S ❑ U I E�ps ❑ U [�PS ❑ U P ZS ❑ U I [Is ❑ S 1R'U
SOIL DESCRIPTION REPORT ---
Boring Horizon Depth Dominant Color Mottles Structure GPD/ft
g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench
Zrr&bk r4r C S V J • 5
Z 173) n -)-Pr CS — �5
Ground L C S
elev.
9 3.9v ft.
Depth to
limiting
fa for
� in.
Remarks:
Boring # ° ,.
�_ s _
Z 3s ) 5i I Z mcxbi< r cs
3 -�o Its Nr 4 .5 (o y
Ground
elev.
Depth to
limiting
factor
min. Remarks:
CST Name (Please Print) ignature Telephone No.
11d ool SC b e ( C7�s Z4 7 -yoog
Address Date CST Number
PROPERTY OWNER SOIL DESCRIPTION REPORT page 2 of 3
PARCEL LD.# �pf
g Horizon Depth Dominant Color Mottles Structure 2
Boring # P Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
3 k o -ii 10 Z 2 rYl �r �s 5
Ground 3 -9.v lv )(0
elev.
Depth to
limiting
factor
S lq_in. 3 - Z 3.2-
Remarks: a
Boring #
6 -. l Z S' c
2 B - W 10 4 ly 5� I ? � bk mfr c
5
W- 941 ip r L 2 mcb k rte; c s
Ground
elev.
Depth to
limiting
f for
�in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring ..# I _I i� IZ S�1 Zm�hl� Apr CS �v — ;
1b 14 C3
Ground ,
elev.
C? yO tt.
Depth to t `
limiting ;
fa
Z`i in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
' Remarks:
SBD -8330 (R.9/98)
PAGE�OF
NAME (o D LOT# 5 LEGAL DESCRIPTION
SCALE: 1"= �(?n
BM 1 ELEVATION
. V
6
BM 1 DESCRIPTION n i n ZO " .c ( v✓\ J/ p
BM 2 ELEVATION
BM 2 DESCRIPTION 7 fats
SYSTEM ELEVATION I ��
ALTERNATE ELEVATION (• (y y(
CONTOUR ELEVATION z j!
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Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity in- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number 395
Number of Bedrooms 3
Design Flow - Peak d)
Estimated Flow - Average (gpd)
Septic Tank Capacity (gal)
Soil Absorption Component Size (ff)
Type of Wastewater DdYnestic
Table 2: Soil Absor tlon Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak ( d) 514 . pw
Maximum Influent Particle Size (in) 1/8
Maximum BOD (m /L) 220
Maximum TSS (m /L) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic nd outlet filter shall be assessed at least
once every 3 years by inspection. Th filt shall be cleaned as necessary to ensure
roper o_pM tion. The filter cartridge =rn removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
r
f ' Management Plan for a Septic Tank and SoV Absorption Component
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 scum and sludge in the tank
exceeds 103 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shell advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
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 Unc hes In diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry Into the tank.
No one should enter a septic or other treatment or holding tonk for
any reason without being In full co npilance with OSHA standards for
entering a confined quo* The is tmosplars within fife septic or other
trosintent of holding tank may contain to ial uses, and moue of a
perieon Abaft the interior of the tank may be difficult or Impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a PCWTSS component,
t
gall ,Ali aMga� onent
The soil absorption component serving this structure Is designed to accept domestic
wastewater from a residenttat facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reilabie operation. Good water
conservation practices by all occupants and the Installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption oomponent's operation must be assessed by inspection at least
once every three years. The Inspection shalt Include recording the levels of ponding, if any, in
the observation pipes, and a visual Inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be Identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system Is prohibited and considered a human health hazard,
Traffic around or over the soil absorption component should be avoided particularly
during winter months, The compaction or removal of snow cover over the component may lead
to hydraulic failure by free=ing. This type of failure is usually temporary, but is difflcult or
Impossible to repair until weather conditions Improve, in general, soil compaction over this
component will reduce diffusion of oxygen Into the soil and dispersal cell, Which may lead to
more Intense, and earlier, organic clogging of the soli.
2
r
a
Management Pien for a $optic Tank and Sall Absorption Component
Plantings of deep-rooted trees and shrubs directly over of within ten feet of the component
should be avoided since root intrusion Into the component may obstruct wastewater flow,
Contingency Plan
In the event of system failure, a new system could be Installed in an alternate arsa. With the
InstallaWn of a diverter valve, the existing system could also be reused attar a period of three to
four yearn
ft Is the property owners responsibility to maintain the alternate area free from any plo t ng of
trees, shrubs, sto, in case of failure of the original system, the alternate arse will be needed. 9
any frets, shrubs, stc. have been planted on the alternate area, they will have to be rsrnovsd et
Property &* expense,
If aiterrmats area is destroyed, there are other altsrnstive systems that can be used, in which,
could result In added exparne to the property owner,
Any tank abandonment shall be done In acoardanp with Wino. Code 93,33, Any questions
regarding this code, please contact your loco) Zoning Office or contact the installing plumber.
Co s %ef ('1 I t„ — % tp$ O
FRtW P C COLL.OUR azRS, INC PHONE NO. : 715 549 591 Feb. 02 2001 id r : MW Pl
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnertBuyef
Mailing Address 7 0;= 0, . If d . rr
Property Address — + � L f 4 D
(Verifica(ion required from Planning llepartrnent for new cony vetion) M C
City /State 112 61611001* Pared Identification Number
WTl�
LEGAL DESCRrP77QN
Property Location Ivan ;�a, N 'i; Scc.o24, ' (_R W, T OWII O f _1_13C-
Subdivision C.. Loo
Certuicd Surric-v "Aar, if �— VOlu-me na g � , it
(� 2 3 %�
W arranty Deed I �GJ V 5 Volume P3"c Y . ��
SCeC house �YCS 7 1 P.0 �t dui. :f;'c1i1133UI✓ w no
SYSTEM MAL`ITEXANCE
Im and ttsaiateaaccc of your scYuc system could remit is its Frcnature failure to i:aadic write s. i roper=aintc^.accc
:assists of pumping out the septic ttak every tic year: or scener, if accded by a ltceased ptunccr. What you put into the system
=a affc-- ties funetiaa of ;tie septic tank as a tmatment stage in tha waste disposal sy;tcm.
IIu property o7mcr a;rt:cs to ni6sit to St. Croix Zoning Departnact a cartiiicatioa form, cigncd by the, owt= and by a
masterpiumbe4 jour=eysrsnph=b =tr'ctcd plumber or a licensed ounnper- e. -ify=g that (1) the on -site wastewater disposal systc=
is in proper operadag condition attd(or (2) afar is pectioa and pumping (if aeu : -7), the septic tack is less than 1/3 full of sludge.
Uwe, the uadcrsiped have read the above requirements and tgrce to =intatn 1c private sewage disposal system with the standards
set forth, herein, u set by the LDepartir -rat of Commerce and the Dep=ment of Natursi Retourcta, State of Wiscansia. Certification
stating that your septic system bas bcea maintained must be completed and rerimed to urge St. Croix County Zoning Office wittti : 30
days
cruise thrd y ar P", U' ton aata.
AV
� 7 J a
F APPLIC. - T LATE
OWNER CERTIFICATION
I (we) certify that a1I statctneats on this form are tart to the !.ast of ray (cur) knowledge. ? (we) ant (are) the ownetf3) of
e d a abov¢;'oy virtue or� warranty dczd recorded in Register of Deeds office.
0 /
ItxA • OF APPLICANT DATE
"' "�•t information that s mis epresentedma result in die sanity •••'••
�Y y ry permit being revoked by tltc Zoning Dcpartmcrt.
•' Inetude with this applicatten: a stamped warranty dccd from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty dccd
III
FROM P C COLLOVA BURS, INC PHONE NO. : 715 549 5911 Jul. 21 2001 01 :54PM P1
02/03/00 TUE L1:33 FAX 718 384 468 ``7qq Rgrt19TER OF DEEDS
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(7T.il .. tncmnm sad udh0.rluJrcd uw nasa
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WARRANTY PLOD aTASivLutOM1M19+Q0i+6i11
IOOY Vs. Z. 10"
L
ro� S89'40'38'E 291. 0' S 9'40'38 "E 292.00'
o
N LOT 11 1 , r 1 LOT 8
S 43800 SQ. FT. 0' °0 43 SQ. FT.
1.01 ACRES 1 �I + I ° 11 o
. ACRES
12' 44 , r , I
EASflMENT - , i I •�
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S89'40'38 "E 292. 0' o f- g 9'40'38 "E 292.00' I z
1 01 w a '0 1
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o LOT 12 0I N LOT 7 0 o W
43800 SQ. F 7luu SQ. FT. u0, N 1.01 ACRES I , , 01 ACRES ° O O
co
1100' I 100 1 1 M
S89'40'38 "E 292.60' i r r S 9'40'38 "E 292.00' N �
LOT 13 1 - w cM I
43800 SO. FT.I I ' �- I LOT 6 (° `
° 1.01 ACRES 1 0 0� 0 0 1 °o . N
BENCH MARK TOP OF 33' 33' d I ° 43800 SQ. FT. � ` W
1.01 ACRES V)
3/4' IRON PIN ELEVAtION (^ 1
996.51 (ASSUMED) I 1 o w
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o LOT 14 J 1 a
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458 05 ACRES °I tn 43800 S0. FT. o TEMPORARY
C ES 1.01 AC R S _ CUL —DE —SAC
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EASEMENTS
I REMOVED UPC
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16 SW40'38"E
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— 141ST 1 AVENUE M
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r Goulds e� Submersible
Effluent Effluent Pump
C�
3871 EPO4
EP05
APPLICATIONS • Fasteners: 300 series Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficierit heat transfer,
• 'lubrication and efficient strength, and durability.
following uses: Capable of running
• Effluentsystems dry without damage to beat transfer. ■ Motor'bDver. Thermoplas-
components. tic cover with integral handle
• Homes Available for automatic and
Motor. and float switch attachment
• Farms manual operation. Automatic p oints.
• EPO4 Single phase: 0.4 HP
Heavy duty sump 115 or 230 V, 60 Hz, 1550 , models include Mechanical
•
Water transfer float Switch assembled and ■ Power Gable: Severe duty
n over
• RPM, built in with rated oil and water resistant
Dewatering preset at the factory.
automatic reset Upper • EP05 Single phase: 0.5 HP, ■ Bearings. and lower
SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing
Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- construction.
• Solids handling capability. automatic reset plastic Semi -open design
3 /4 maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SA• CaragmSu danbAssoftion
• Total heads: up to 24 feet. with three prong grounding 9 EP05 Impeller Thermo-
• Discharge size: 1 NPT. plug. Optional 20 foot (CSA listed model numbers
• Mechanical seal: carbon length, 16/3 SJTW with Plastic enclosed design for end in °F" or "AG".)
rotary/ceramic- stationary, three prong grounding plug improved performance.
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 continuous superior strength and
140 °F (60°C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel. 10
• Capable of running i
dry without damage to s 30
components.
Pump: EP05 a
• Solids handling capability: 0 25
% maxmum. a
• Capacities: up to 60 GPM. s
• Total heads. up to 31 feet
• Discharge size: I NPT. z 5
• Mechanical seal: carbon- o I
1s
rotary/ceramic- stationary, a 4
BUNA -N elastomers. o
• Temperature: 3 10
104 °F (40°C) continuous
140OF (60°C) intermittent 2
5
} ,Y
OL 0
0 10 •. 20 - 30 40 50 GPM
0 4 6 8 i10 12 tnytt
M Y
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
I I N 1 II N N N ■ ST. CROIX COUNTY GOVERNMENT CENTER
- 1101 Carmichael Road
Hudson, WI 54016 -7710
s (715) 386 -4680 FAX (715) 386 -4686
i
Friday, November 22, 2002
P.C. Collova Builders, Inc.
1442 141st Avenue
New Richmond, WI 54017
Regarding septic inspection for P.C. Collova Builders, Inc..
Location of Property in St. Croix County:
Municipality: Richmond Township
Subdivision or Plat: Evergreen Overlook
Certified Survey Map:
Lot: 5
Address: 1442 141st Avenue
Dear Applicant:
A septic inspection of the above reference property was conducted on November 19,2002.
This property is located in the SE 1/4 SW 1/4 of Section 24, T30N R1 8W, Evergreen Overlook (Lot 5 ),
Richmond Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was
found to be code compliant for a 3 bedroom home.
If you have any questions regarding this, please contact our office at 715.386.4680.
Si n rely,
Kevin Grabau
Zoning Staff
cc: file