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PRIVATE SEWAGE SYSTEM
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31 CTOlx
INSPECTION REPORT
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GENERAL INFORMATION
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TANK INFORMATION
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TANK SETBACK INFORMATION 'wF'a10e1
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PUMPISIPNON INFORMATION
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Plot Plan pw /d of
PROPpttt OWNEk R,;sExr r � s« v a r s 1� i I>J i• = ao cr.
I�I�+c�ordl
I PID�:P e1Sil 56C O N f � Ii=hMtce OH
Dzt-roR'/-4o-OOD / If) crif �, •'���
North
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Site I Ion:
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oIlson of lnoVSTRV SEW5
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GREEN BAY Wl occult
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CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES'. 2021 09 13
Plan Review: PWTSUPILD99C
MARY IO RUPPERT
28497
Drd my1W AVM13
Dainbury W150AJ0
SITE: ROBERT L. S, SRIRLEV M. TRS BOUVIN
1SOSI H 65
foevn of KINNICKINNIC
Saint Croix County
Total Amount 525000
FOR:
Dispersal Mound Component Manual — Edition 1
Pressure D9MWot Component Natural —120,
SBD 107M P IN_0lml, R 10112)
n' 600 GPD /d BeAwnma—Rmbmnenn
Maintenance Raryucd
fire ,bm,tmi described above Lea TOnmai for eonibamenm w1O apphnable Wlscondn Adminlstmtive Codes
nM Wisconsin Slam Ms. The submund W been CONDITIONALLY APPROVED. This rys¢m o to be
Ged and located In pleasure 11O mearclI a moved plain and with any oosm.. ..no
,fwmad above ¢ uwmq as defined In ehaplm 10101Q0), W oCua o Statutes, Is refewouble sot Ciampi.....
With all cWe rtgmaemen6
N. peemn may engaged orw.h at plumbing m Tehran mle s Learned m do so by the Oepedmenl per 1 145 06,
no following conditions shall be met timing mmomdon or Imtalletlo r and press in omupawy or use
• Prcrmx dispersal area peim and during wnsWmi.n to a void disturbari compaction and use of the aim
• Any mil grosses, leaa ad shrubs shall bed It than old removed Prior to tilling OesuAna Er m aimo nto
prevent malting uadm the dispersal stew. All Iome organic maYrivl to be "armed from m.wd area
Peioe to aoml[oefoo of M1edrn veh¢4lhe mntl
a SOL] sample, between the hands. If it to I Is into a 1/4 nick way
a retie emdnm ova
tit.. e o bi
need u. d
• Abandon Eastman System For ADS 383. 33
r a r.ea ahn m= t war
n lad rem Siscliffirld0fls,
• Fallen ,,date n'aM firm POWTS Nra.
• All piping Shall mWnrm in SPS Table 384303 and SPS Table 384,305
• Insulate handing sewer brand JO fen pan SPS 38230 p p(e)
• Tank Installation to follow all tmnafactm, I rttommenaaturre
• Veri, Property ]Insist Met or installOccu,
• Well se,,U to meet arm Nor 811&812.
• Arena that Are compict with rockfmgmm6. nee mots ammps and holden redo¢ the amount hall
wlablefarpmpv Ifnootha w11abla n the basal marftfi, man m,,(1x ut OR
at Pro wd level, s larger fill awn nttevary when any of in' sense condition, are acrunmmd, to pmriae
•uThen ... Glamim area.
Owner Responsibilities
• Thecurrent ownegand each Subsequent nwoer, Shall maws a Copy of his later induding instructions
balance to proper a,, and mabaenm¢ofthe syan+n Owners shall acrnn a oopyofthe appropriate announce
and twlmenanm manual andlot ownefe manual for the POWTS described In this alarmed SPS 383.54(l)
• In the event this wit absorption System or my Attu eampnwnt Parts andfflocOMs so as m Cream A truth
Cannot, the penalty nwncr only follow the coningewyplan AS charged in the approved plans.
A copy of the approved pill, speafi,ationa and lMS Innershall be oroa, timing construction and often to
impwtion by wthatad mpmmourps of the IXpanment which may include localatspnmors. AllpeuNu
mgmmdbythe alate or the local mudelpalya hall be obtained prior meominenwmail of
cau'mmtlaNlnsmlWWASOP nation
lA granting the plarma tho Dnislan oflmlmtry 4enivasoaten the right to realise changes or Millions Solid
conditions arese ranking them asary for I'd' complian . Asper Sell 101. 12(2), motrig h in Ibis review
shall Talent the banner ofthe meponslblIny far designing a safe Wfldingtstmcmto.ormmpoeco
Inquiries mw'mning this wtrespoden¢ may be made to me at the tdnphonc numbtt Ilse d below, 0,at the aldiess
on this lamm,ad.
The al,wh left adamnm shall Put a copy of IM1ss letter and she POWTS management plan to thcowner and any
,then who arc responsible for the @nallatio, opcmtion or maintenance of the POWTS
Thanks,
7 1pl�w%crchxY
POWTS plan Pat Lower —Waste Arm Specialist
Department of Safety & PmfaEonal Services I IJmision of Industry Services
rural dlw con ryggv—
Lw a
Cell'. 608-5I6,6134
Piano HIS to ])a Set a
serified bar mr, ... Sol or,,, An, changes am% train in Dumb "I to
TDH and GP\I Specifies m
• Dimum mother 0 er from POWTS Arse.
• All piping shall wooden m 5P8 Table this30.3 mid SPS Table 38490.5
• Inmlato building aware hyond 30 feet for SPS 38230 Csm)
• Tank Installation to follow all ishoufausure's rwrommaMauotu
• toaster property bar(,) prior to mrallefrw
• Well willmla to meat cle SIR 811 he 812.
• it.... thatoccupied c oohfi'agmo umprmd bouldcS elect At
11 rumored
A,,all Ifoto 1 I. inteemel ...... maderst surd
oPawl of
atgwundlm afipnu roar TwM1en ofineabove umdimm� umwwun¢mlmpoaM
"Hi"i moltmi.+ma
Owner Responsibilities
The chareand owner, roam moutrage.owner, shall these Soft of Its eu rbalmin
reletingm pmpo us and ehuenanee oftbe syebm Owl,n lhall r ell' a wpy ofNeaPPwp 'Wopmmw
aetl rmintoame mmoal and or..noes moral for the POWTS deshola inthia approval BPS 381.
In the Alan this oil absorption - of it comparison par malfunc That, a Palle
Come, m pmpcoy owner must follow the eontmgooryplan as thearr am Car appro
ved Plan
A copy of the granted plan,, IT ... i ahons and mia lino- shall be adults during coneweme end ppan to
inapecfiou Ey anNmisstl reptemntntivea ofthe Depm®aril. x'M1icih may iddn@loesl ivrpectora. Allpermita
required by the sate or the l,ml mobac,"In, Otall be nleaned prim to counterthrust of
masm¢tmn/maWLhaWoperWon
In mooting this approval the Dania m of mau¢o-y Sm ices tomorrow 0e tight to marim changes or nmmdom shoved
wodltlons apse making them befecei tomode, wmplime,c As percale ands 101.12(2), CI on thistetuw
shall mheve We designer of one responsibility for tlaigwng a safe bnildog shot e, or component.
Inqulfies concerning o i, numemmmenm may be made m me at blemmrnumber fisted below, ma the aldase
on ties lrnmhead.
no above let address a shall provide a wpy of me lend and We POWTS management plea to the owner and my
ommwno me responsible for the meanmlan'Person,11meiamnanosofthe POWTS
-
Thanks.p� p �
URFw4•✓L4/
PORTS Plan Reviewer- Wastewater Specialist
Dcpmemad of Safety& Professional seemas 11"lim of lodnany Smiom
mdhlimit, . o
Cell'. wN 516fi136
INDEX AND TITLE PAGE
Owner info
Project Name
ROBERT L 6 SHIRLEr M. TEN BOUVIN _
Owners Name:
(SAME)
Owners Address:
180 S T H.65
RIVER FALLS, W 54ca2
Property Info
Pmpany Atltlress: 180 S T.H. 65
RIVERFALLS, WI W22
Legal Oesclipfron'. NE NW S
W T 28 N R 18 W
Tonveship KINNICKINNIC
Candy: ST. CROIX
SuMlvislm Name: NA
Lot Number NA Black
NumSeo NA 08MM. NA
Parcel l D. Number. 022-1 W]-O9 -9008 022-1089-E-000
Plan Transaction No.:
Index Pages
Page Indexanctille
Page Tank cross sections
Page Dais entry
Page 10 PU plan
Page GeoMal mount drommus
Page 11 Bad Add
Paget lateral and dean tank
Page 12 "
Page 5 O4inputi0n media
Page 13
Page 6 System maintenance speclficatwns
Pala 16 Rental
Page] Management and contingency plan
Pape 15 Map
Page Pump curve and spacifsa6ons
MAR'JO HUPPERT
License Number. 1959,x7
Data owl
bone Number 715 26-1775
Signal
Designer Stamp:
State of Wacommm Approval Saint
«kumn omn.mnw
Synergy Publea L L.6..enesot NarmmIoNr mManual lEalWt,$AS(M.T) an
ssPNPe, DwXlonae Ceslgnat Pressure Ver 20 SnD111m fw01101<ot0trap
vresew.OHNGNon comwrem m.nunl vet. z o saRlvrOSP lu. otrot n.1aIIl
G etald MwM Eckil 12017 Page 10 15
Mould and Pressure Dislnbutlon componaM Deign
nrl6,I'll ON) N ISH RParrw
40o.00 essmalea Wan(ag 1 -nXkk)
r3tl Pe MnB wCae leg rB-r`+A'Y°I
0 Wsigo ill 2600 Sit, Slope
(%)19.1
e
mnfnl
2400 1n Mnog aroln)
to mRah (Opal
1anAn nn mulFngffAu(I)
Distribution Cell Inormatlon
II g vzrkLialMl
ZOO z l:.aam�waaual �lI.MalXn �i rawer I w l waleRea Real m)
n Said Mannole
e nqm.
eII m" -
ldnewpn v
fi
final Oft)
_
an Dameaak(gal)
IfabmeXaaron rt N aae, Saw e
Sin Fifter Wea On
mma a liken Pum
anan mar (in)
Sin ingm(n)
Offs The bmemaln can NtlO: Y
m:p TankEi On
oma(in)ge9 025)
a Onfire soaking lag= Bw drpnnre
I Bz.ul SYSrem eamaM(i
DiameteP Selxtlon
N
075
125
7
50
1 a
A5
0
Mandacturer Information
Trialment Tank lnrorona(on
liffil I h r lnlonnanan
seglc lank atil
ap p
POLYLOK
Water Manurfourar
Blame, Wncrele Prgluga, Inc-MawlxWrer
_
- 1]FIM
MSael Xumper
D[x Tank lnomal GHk,l OkuXba,lwn
BWW Mse Tank Cal lly(gal) Tmal Tank Capacity loan
Rb Lba Tankydume a�InTnl y�nVani Upon Oil (in)
ACowete iOrf<i JMa ula l u gaY, ni I'll In al oobTankvdumn)
Hctecl'. ROBE AT L& SHIRLEY M. TRS BOIMN 6pp]M 15
mmdana Pn�ssmen+smoa+uoa comyoaemoes�n.: ,.. .
r �awar�eal orcemmamMl mlF�
�L�IrsD Rewamv
Estlma4Lawaeafaremr MVI9N1
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� mtaPns=1w^ul
abn Flw:lYVl
u .m�snesaw (w1
poi.-oo� Iwolwo� cpmwr upe oenwrin)
_... uro'. Mp�nro L�lum Paamr oN
Wl lmnlu 9pAPmlNatlon fle@pwYR�
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mmmmin n.aaaae tm
+
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¢e�� waereaerDmlm n an
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uss
zs vamwamw
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(LL) 6h
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81 n m elgep
]231 Syalem CemvW gym(
(abnl WniaMeabcllon
LLn pYmebr BabcWn
�
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m1 tldw
EE
__
1.5g
;W
x —
zoo
+w —'
aoo
noo —_'
TimYiwrl Tank lrrlamuLLan
EIIImMFIMer lMumvtlpn
1](q,pp. SepFCTank GpacMy�ll
IPJLYLq( Manutapurer
IW rGnaTeP�uvis, lm. IManulttWm
'. 1]ilFltler Motlel Numlmr
Dpw4nk lnbrmel�pn 6allarsllzX Dakubbrtroimai
'.., �]W Dsse TanN CawalY lBep TMeI TaMCapmly (Bal)
Ega Mfe ieM Volume) +�l(�nl "TNeI VJaAIm Llpub Mplh lkp
'WlmvDpmtle PrpOWAe lnp. MacuAtlwc ��gaNn (Mer ieauXN¢IlDweianAYalumeJ
Prt{eH ROBERTL 85NIRLEY M. TRS BDIIVIN Pgg2o(15
Mound Plan View
L
Mound Component Dimensions
ftft
ftft
0 50.00 n G 1050fl J Q2.538 W 49.0.3fl
390.00 (fl) Dispersal Cell Area P90.00 a e) Basal Area Available
10 00 (gloci Linear Loading Rate 1 600 pill 1110 B OOs. one Placement
Mound Cross Section View
GeoMat Dispersal Area
observation ripe
12'ASIM C 33sand a:
Genmat
rpoueon cell
nal lfor pro Mat
GmMts1 13"111 C 33 sand
wmponal
I.
a
11121
Fish Grade
-�
6wttsel l
11008
Laderallmert
Elevai
51
109M
rareadal Cell
-
Slope 25.0
E
Ell a
Contour Elevation INN
Till Area
Porwmam
in In, w4l
In situ soil
""��
"" a
Iladrrlg Key
30 ns nc 33 Sand(.)--Iailt ShND+IS P1Pi
40 A TIM C 33 sand (0)
50i
d o Gets Mat
see details nn pool m, nl.no n. we, and waver or minma.
Proletl'. ROBERT L. IS SHIRLE)s 4. TRS BOI Pape 3 of 16
End Connection LnbN Laywl OiagFun
alolur..gwnm.n `TunuPT/IWI vMn or denw
w MIkMlLvudrt
w.rM. a ounce mal. m PAC.xb ao.., SPSTW, �.
xumb.ro Lea reienk aTxe orem.M
z res Zxt ft
Utooll orb Nm A.Wn w4.,lallo 0?30
uwal (z) eon ore®G.nnMou ma'brMe
resinlFa esl sz5n M.mmmb L.ne 3zgn
sz�mwMRIM rnaom F"emal"lvmoon' ronm
oma Tank Inrero anon
nm uu. �..
I III ♦ ...,7 w �..az n.
e,na ou, al mI
_.._ nco�w
Know
evaurw Inc moo p mN
a TVA
Four Motion nwmn
TF IM 1M1
No"Manmawr.r �-
N.nn Model Mumb.rD
r GouakWWrteWW.m
.ryl.m bn __J
or.m Pow Mal xeer wnkn4o
WEO]H
Pump MustOvtmr ognm a,onTR
"tNt RtaI L 85RIRLloo M. T0.5 DOWN PN040i t
-noction.latenllryou[Olagnm.. 5 ..
Llo�mpdm6wn , -Tem'P../eaiiraremeieaw
tnwMee Wrenn
Ysakebrmmaind WCSN Woe.
Nwntx DalaidI fi 0 r 0 %n
bl%1
Legal ay M M1 O N
o vn LIti Siai (S fiN Pn� X
Sysem FLail Viom zeie ij Foumma�n VPiAl
•,
1
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1
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,.m
Flegai deal
2 in
r'1
s,Fvw U26#.
.m
'I
r, nom'in,P. iavp
77 Ra
Peter
_-
Fall FailmNi 5 TF W via
Nnm MarrvhcWm giJE
_Roomam
Nam�MWel NuirEar iPB
Gain u_ia y. aaahm an
Pump MoCel NumDe.
WED 7H
Penn Owm
at0.ois it FON
gal
PT"Pect. aoeewT L. a sruill M. Tics ell Faea 4 of 15
Gaollat obinuumn cell waN Layc ea
Dauwlamlm �saav„nm w.w ad
ola4leuuon all Cmesawlmn AM"arrenm
Componem Legend
•T11.Pe11111.re - -_ -- Pin .i
ce-ma now. Vi Wamd.fain, e.Per mewaani appi.
olalnpotlon Cell plan Vpw Leyoul-Typleal
ssa GI .aim W.W ak lai-aM
-_---------------
Typical Dispersal Cell
oea.mi plans smmnp llov
didid
ye In 1 Q Topsoll Cap
a O sausop Cap
IN,^ 3O panne c 33 sand 1pl
. o Ai i 33 Sand <p>
3' Min 5 Tided Cep met e•
m axermar - n'
P� po3epr v. a srvv Ms S souv�d. m..d>wadaa.ne. paaaamm
Mount System MMntenm and OpBMlbn SpetlIttaRsna
Solv-re Provost¢ Namel RR PTIO LSSESER CE __ P 25-1025
pOWIS Regulators Namel SlC C SPIA 2 OR Pb �]513a&am0
OR
Imsessm Firm AM Last mated
pealptimar Peak Bg0 gM Maxm ium lnfil Pal Sao IIB In
Estenam jFM Average L4 Val MMxlmum BON 90 dqA�
Septic Tank CeWM 1200 gM atimum T53 20 2
Son Amamtian Connotation sva NO K a Maximum FOO M m¢M1
TyceorwaMe.Mm wdmraa ..ammo Feral cwlmim loco nwtm mL
Septic enO Pump Tenk In enNorxrvire��re3 at
Maine other l r aanatlmnae rec —
PomPaMChl"Abi ealonmeve ease mrve
Penn eLweun na Icall
Preaenre symm 1Menk Bnoair
3 am
cennan.a am re realm ram >
Mount Nam afd o^oinB.ane uePWe sr
1. Obm npPoB are ismand and meboels mnlmm b Table $PS]5030.1. have a ethanol Bee ant have, BxuM In as
asked In tlB Syria, Real seven Mend Com{manl Mae0l Vrmon 1, 2017 Gs.:BaHbaund COngMml
2.M Disposal
Vernon 1,201]•VC
Mail Print debt an approved pools Tb imre�•r�9Y $f tone
3 Ay graved and peceure pant melmtls cmdann to ree MUBemenh in Sps Pa, was. Ask Cma.
a. Them 01bad Mal ado YevunpMam vMh a mold LaaN or Chiral Bear
5. TM mound abuclUrt and inner disNRed arts hi, M seeded ant m ukhM to proem hail shared mk nth makEt h0tl
panelMbn.
Lambda Tumup Oat"
� Tnremmcimnnm
Goes, ` Plug ar Pat Valve
piNibu6on lateral ,I IatBlal CleanO
15FM
promal'. ROBERT L a SHIRLEY M. TRS BOOM
Pensacola
Stood Fisca s Name 9hRRpLL'BSEP➢C 'E S -S 5S10g5 _ _ Phone ]1
P0WFS Re9ulam(Shard 51C L- S Z _ OR e - Pnone 1)9 __ �]15 396C69p
llialands NOW old Load
Dorgan Two - Peak WD Was Moral lrTuent dead, SO, 1/8 In
Es4ma150 Flox-Pvends 60p gpE MsvMum BOBS MA
SMIb Tad Convoy 1M0 Bvl Menmum T65 ]0 mqL
Sal PLsdption Canadian so 590 so Menmum FOGLaaa 10 mi
TYneolwesl O Oame Ic MVImum Fecal COlXo'm cil in -
Sal Frog
Samoa and Pumn Tank
Eftena FlXn
occur end LOMmb
1151 were away � year,
Nat
of
Final... Racem
Mount
Misce
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Xown in gre Symsyy diYems Gordon Mocntl Lomnongn Manual Verslon 1, M17.
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