HomeMy WebLinkAbout026-1139-03-000 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law. 5.15 04 (1)(m)].
Cade & Aliesha Heiberg TOWN OF RICHMOND
lei
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Dosing
Aeration
Holding
PUMPISIPHON INFORMATION IF'r 01i --4Sn--7-4-
Manufacturer
r ! J
Gl�, I0!5
Demand
GPM
Model Number
p` to
(
I
TDH
LjR J
Fric ion l,os
Slystem arm
Tp �Fl t
Forcemain
Lenathh
Dia. 1I
Dist. towell
JUIL ABSORPTION SYSTEM
BED/TRENCH Width � Length
DIMENSIONS
SETBACK SYSTEM TO V
INFORMATION
Type Of System:
o Y
DISTRIBUTION SYSTEM
M
YZ� I I L" 1117 '
ELEVATION DATA
STATION
BS
HI
FS
ELEV.
Benchmark
. 93
' of Dtl
'O 1 .
AIL BM
Bldg. Sewer
Q t�V1�i
V 1
!S 4J
S H Outlet
♦ of AL+
NS
A3
(P ,
to
.10
Dt Inlet
Dt Bofto�
L-A'
Z . 3
Header/Man. Jn
T
Tz
.13
,
98, -7
Dist. Pipe
hi•
T3
.2Y
`j$ -69
Bot. System
r411
7.0o3
`lP.oc
Final Grade
00.
St Cover
CHAMBER OR
UNIT
Header/Manifold �
I Vl �,
Dipe(s) lio
Pipe(s) J. r
� �
x Hole Siz@
t x�
x Hole S acing
�tP 1`
Vept toIntake
lib
Length Dia
Length Dia � Spacing
!8
K
J VIL V V V CR x Pressure Svstems rinly — Un... A n. A,-P—A- c...,e...e n..r..
Depth Over
Bed/Trench Center' #7 _ I_/ fu x
Depth Over
Bed/Trench Edges / l �,
xx Depth of
Topsoil
xx Seeded/Sodded
'
xx Mulched
- Yes No
5 iF No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: Q Inspection #2:
Location: 1402126TH AVE 3013q ob1&va c%^
1.) Alt g s Description = 5 `, t_ .J, 1 Na �✓''F Qt fit p h �s �-
2.) Bldg sewer length = LxI7U"i •,.1•�� �,tlrti eC/L�
-amount of cover= ✓ 0�V44tty, (", e� � `JC,t'1-}S 104 jbi.
Plan revision Required? [Yes I''ISNo
i� i )
Use other side for additional informatiW 10 V
SBD-6710 (R.3/97) Date Insepctor's Signature
cyd
Ced No
c04 N -.20let -- tl e-t
✓I
E�
Safety and Buildings Division
County
St. Croix
201 W.Vashingtori Ave., P.O. Box 7162
Sanitary Permit Number (to be filled in by Co.)
•1 DEC 05 2019
Madiso 15 07-7162
`ls" f /
ounce
Comm ° it Applicat10n
State Transaction Number
In accordance with SPS 383.21(2), W is. Adm. Code, submission of this form to the appropriate governmental unfit
big 1 Z' Sd 25 i -• C
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to
Project Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
ty
purposes in accordance with the PrivacyLaw, s. 15. 1 m Stats.
,�' ' 1
Same T /yQ� /�p ,„,�
L Application Information lease Print All Information
Property Owner's Name '
Parcel #
Cade & Aliesha Heiberg
026-1139-03-000
Property Owner's Mailing Address
Property Location ,
1402 12e Ave.
Govt. Lot
SW ''%, NW '/4, Section 36 .
City, State
Zip Code
Phone Number
(circle one)
New Richmond WI
54017
952 378-0
T 30 N; R 18 w
11. Type of Building (check all that apply)
Lot #
4
®I or 2 Family Dwelling - Number of Bed;, , aet,
03
Subdivision Name
Block#
❑ Public/Commercial -Describe Use
Na
Plat of Torey Pines ✓
❑ City of
❑ State Owned- Describe Use
'❑ Village of
CSM Number
`42b "' /b EZ ft is
Na
®Town of Richmond
III. Type of Permit: (Check onl line A. Complete line B if applicable) z.
av
A.
❑ New System <
Replacement System
Treatment/Holding'rank Replacement Only
❑ Other Modification to Existing System (explain)
B.
El Permit Renewal
❑Permit Revision
❑Change of Plumber
❑ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Owner
514918 issued 7/07/08
IV. Type of POWTS System/Con Check all that apply)
❑ Non -Pressurized In-Grou ® Pressurized In -Ground At -Grade ❑Mound> 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ e Dispersal Component (explain) ❑P7treatment Device (explain)
V. Dis ersaUTrea ent Area Information: 30 EZ- to EZ1203 dispersal units
Design Flow (gpd) Design Soil Application Rate(gpdf Dispersal Area Required (sp
Dispersal Area Proposed (st)
System Elevation
600.0 Gpd 0.4 Gpd/Sq. Ft. 1,500.00 sq. ft.
1,500.00 sq. ft.
98.00'
VI. Tank Info
Capacity in
Total
# of
Manufacturer
Gallons
Gallons
Units
New Tanks
Existing Tanksi
L 41 is1
Al
a
Septic or Holding Tank
1200
1200
]
Wieser Conjrete
X
Dosing Climber
800
1
Wieser Concrete
X
VII. Responsibility Statement- 1, the an cmigned, assume responsibility for ins lotion of the POWTS shown on the attached plans.
Plumber's Name (Prim)
Plumber' Signatures
MPA PRS Number
Business Phone Number
James K. Thompson
X` /
MPRS 30021
715 248-7767
Plumber's Address (Street, City, Stale, Zip Cud!)
340 Paulson Lake Lane Osceola, WI 54020
VIII oun /De artment Use Only
pproved
❑ D'
Permit Fee
Datesued Issuin gent Sign u
• ao
Owns en Reun forDl5e^
=77L��
DL Co QlURessons for Disapproval
1. Septic tank, effluent filter and 3� t.ena� r i'forv4
�
dispersal cell must bg gerviced /maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code/ordinances,
R
t7sa�
Attach to complete plan for the system and submit to the County a* on paper not less than 8 1R all inches in size
SBD-6398 (I- 11/11)
�� Ssl� t�Y+�rat�rSw+ p�bydJl'd M:Q
. jP)a's+it+q l)n+fc clot.
Index & Title Sheet
In -Ground Pressure Replacement Dispersal Cell
Project Name: Heiberg 4-bedroom Repl In -Ground Pressure Dispersal Cell
Owners Name: Cade & Aliesha Heiberg
Owner's address: 1402 126th Ave., New Richmond, WI 54017
Site address: Same
Project location: 1402 126th Ave., New Richmond, WI 54017
Subdivision: Lot 03, Plat of Torey Pines
Legal Description: SW i/4 NW 1/4, Sec. 36, T.30N, R. 18W., Tn. of Richmond, St. Croix Co., WI.
Parcel ID #: 026-1139-03-M
Page 1
Index and Title Sheet
Page 2
Septic Tank Maintenance Agreement
Page 3
Existing Septic Tank Ceritification
Page 4
Parcel Map
Page 5
Warranty Deed
Attachments:
Sanitary Permit Application
State Approved System Design
Mater PI er Restri ed Service; James K. Thompson, DSPS Credential #30021
Signature: Date:
Pagel Of 5
Design pursuant to In -Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
Index & Title Sheet
In -Ground Pressure Replacement Dispersal Cpfl
Project Name: Heiberg 4-be om Repl In -Ground Pressure Dispersal Cell
Owners Name: Cade & Aliesha Heiberg
Owner's address: 1402 126th Ave:, New Richmond, WI 54017
Site address: Same
Project Location:
Subdivision:
Legal Description:
Parcel ID #:
1402 126th Ave., New Richmond, W 14017
Lot 03. Plat
026-1139-03-000
Mater Plumber Restricted Service:
Signature:
WI.
Page t Index and Title Sheet
Page 2 Septic Tank Maintenance A eement
Page 3 Parcel Map
Page 4 Warranty Deed
Attachments:
Sanitary Permit Application 1\
State Approved System Design
l
Date:
Page 1 Of 4
Design pursuant to In -Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
December 4, 2019
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2021-12-04
Plan Review: PWTS- 121902519-C
JAMES K THOMPSON
340 Paulsen Lake Ln
Osceola WI54020
SITE:
Cade & Aliesha Heiberg
1402 126th Ave
Town of Richmond
Saint Croix County
SW, NW, S36, T30N, R18W
Total Amount: $250.00
DIVISION OF INDUSTRY SERVICES
2850 MIDWEST DR STE 104
ONALASKA WI 64650
Contact Through Relay
http://dsps.vA.gmlpmgremsiDefault.aspx
www.wisconsin.gov
Tony Evers - Governor
Dawn Crim - Secretary
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
FOR:
Description: Four Bedroom Pressurized In -ground System \ Sloping site
In -ground Component Manual - Ver. 2.0, SBD-10705-P (N.01 /01, R 10/12), Pressure Distribution Component
Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10/12),100" depth to limiting factor from original grade,
Maintenance required, Effluent filter, Replacement construction
I
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 any 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,
starts.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with
the requirements of Sec. 145.19, Wis. Stats.
• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches.
Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil
moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire,
the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not
proceed until it dries.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be
made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis.
Stats.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also
receive a copy of the appropriate operation and maintenance manual(s) and be responsible for
ensuring that POWTS is operated and maintained in accordance with this chapter and the approved
management plan under s. SPS 383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a
health hazard, the property owner must follow the contingency plan as described in the approved
plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
A copy of the approved plans specifications and this letter shall be on -site during construction and oven
to inspection by authorized representatives of the Department which may include local inspectors
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state scats 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 provide a copy of this letter and the POINTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POINTS.
Sincerely,
G�u.�d M.. Sw�.►+.
Gerard M Swim
POINTS Plan Reviewer, Division of Industry Services
(608)789-7892 — voice \ (608)785-9330 — fax
im.swim(¢.wi.eov
Index & Title Sheet
In -(ground Pressure Replacement Dispersal Cell
Project Name: Heiberg 4-bedroom In -Ground Pressure Dispersal Cell
Owners Name: Cade & Aliessh Heiberg Conditionally
Owner's address: 1402 126th Ave., New Richmond, WI 54017 APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
Site address: Same SERVICES
DIVISION OF INDUSTRY SERVICES
Project Location: 1402 126tlr Ave., New Richmond, WI 54017 l
Subdivision:
Parcel ID #:
Signature:
Lot 03, Plat of Torey Pines
SEE CORRESPONDENCE
SWl/4 NWIA, See. 36, T.30N., R. I8W., Tn. of Richmond, St Croix Co. WI.
026-1139-03-M
Page I Index and Title Sheet
Page 2 Site Plan
Page 3 - 5 Design Calculations
Dispersal Cell Sizing Calculations, Pressure Distribution Network,
Lateral Details, Pump Chamber Calculaltions
Float Settings, Septic/Pump Tank Cross Section
Page 6
Pump Curve
Page 7
Existing Filter Specifications
Page 8
Diversion Valveing Detail
Page 9
System Management Plan
Attached: Soil Evaluation Report
County Inspction Report - Existing POWTS installedon 2008
Service: James K. Thompson, DSPS Credential #30021
Date: f /ri9
Page 1 0f 9
Design pursuaat to In-GrouRd Soil Absorption Canponrnt Manual for POWTS, vasim 2.0 SBD 10705-P (N.01/01)
Ca.rJiaG:6-to .e a rips'
/AQC.�/M EV.n IM'K S1Q/ta'M.ji Yt _
a*wzo / er/' deic
sysEE.K.
o!d' —
I
I
r
r•� ' I
I
1�
P�opscd FK-Gro...d P�sriw+�d
d,�-11.o,�q., Gc!/.77i ne.(�) •4y.rsd
tiw.la,r.E 3',r.�ot!'twn,!lr�ofsaf �4
TR,p/ian.da.iE•FIa fi/!/I,s,;d.Y�ssbadrw,.
it dkt �•rCi/Fiwl7X S LeAc< cAeA . 4
6*iw_ ARM. /Jr,/'%.ivr.Cs [obctf.�+u�de.d
ad r8 .
Se;/ eYicfma.%tw, p,t byWrd s{ia
Alhoshi -J
/i0.t-/26 ,jrt.
ace, 36, rdo,t., G M.0y 7-4.
LOY ac4W
070 :-Ifo r
s.r.�� �. �,% •tea �� � �'�
,w-s2s.aLim.AAI� All
6,.A�, alc a lir cFclw., 6
1il ber, tlFJW.ef pwp,r•
fo rcr�aVn.
mra'
Heiberg Pressurized Distribution Dispersal Cell
Replacement Dispersal Cell - Residential POWTS
In accordance With In -ground POWTS Component Manual. Verswn 2.0, SBQ10705-P (N.01101)
& Pressure Distribution POWTS Componem Manual, Version 2.0, SBD-10706-P (N.01/Ot)
JOB DESCRIPTION:
A 4- bedroom residential POWTS was designed and installed in 2008 to serve a newly constructed single-family residence.
The system design was approved and installed under Sanitary Permit #514918. The dispersal cell is hydraulically failing as
evidenced by back-up of effluent into the structure and discharge of effluent to the ground surface.
PROPOSAL:
The existing septic tank and pump chamber will be left in place for reuse with the new dispersal cell. A valving system
constructed with 2" ball valves will be installed in the existing forcemain to divert effluent away from the existing dispersal
cell and into a new pressurized dispersal cell constructed using EZ-Flo distribution media with pressurized distribution
laterals. The existing dispersal cell will be left in place, allowing for future re -use.
Dispersal Cell Calculations:
1. Design Wastewater Flow: = 600.00 Cod as per code
2. Proposed Infiltrative surface elevation = 98.00'
2. Infiltrative capacity of natural soil = 0.4 W&SQ. I
3. Absorption area required: 1,500.00 sa ft 600.00 Gpd/0.4gpd/sq, ft.)
5. Proposed absorption area; 1515.60 so.ft. (30 EZ-flow EZ1203 bundles at 50.00 soft, Perlmit)
Number of trenches: 3 trenches with (10) EZ1 rich
Trench width ! W' t ulna 3 U" X lU 0' bomdle).
Trench length: 100.00'
Total system area w/ 6' trench spacing: 21'x 100,00'
Dispersal cell infiltrative surface elev.: 98.00'
Pressure Distribution Network:
1. Distribution pipe sizing:
Laterals per cell:
Lateral spacing:
Lateral length:
Lateral size:
Orifice size:
Orifice spacing (x):
Orifices per lateral:.
Network discharge ride:
2. Manifold sizing:
Location:
Lengtb:
Diameter.
3. Force Main:
Diameter:
Length:
3
9.00'
99.00'
1'/."
1/
48" (1 st hole at 24" Irom manifold entrance thmugh end dap)
25
30.75 eau./minute (3 lateralsx25orifices/lateralx0.41 gal/orifice)
End
tea_ 18,
2"
2"
50'
Pg. 3 of 9
4. Total dynamic head: 13_28'
Nfin- supply pressure: 5.00,
Vertical lift -M$ 04A manifoldelev. = 99.001, pump off= 9322')
Friction loss (2" Fmrerain): - 2 T (50)(4.99 MON.)=2.495 ft _�—
Total dynamic bead: 132r 35
5. Fluid Flow Calculations: Pump will disehuge 55 Limn as installed = 5.61 fusecond
Effluent velocity = (.408)(55 anml = 5.61 Useeond (flow through PVC pipe to be 2 - 10 IL/sec.)
4
6. Branched pressure distribution network to be otmttrutted to equally distribute effluent to distribution laterals.
Lateral Construction Detail:
1. Pressure distribution laterals to be installed in accordance with mamuilift eYrecommendations within
"Installation Instructions for EZ-Flow Distribution Systems".
2. Distribution interal to star at entrance dwough end-porL 1" orifice located at 24" from entrance through end -
last orifice located at 24" from and of dispersal cell
3. 1' laterpL4ta"eeved through 3" EZ-Flow corrugated distribution pipe.
4 orifices 4 "",so& drilled at 12 o'clock position with every 5e orifice drilled at 6 o'clock
effluent drainage upon completion cycle.
5. 1'/." lateral claaout extension to be brought to finished grade by use of long sweep 900 elbow. Cleanouts to
terminate with 1'/1' ball valve within valve bore.
e'.YrMYw,YwMMA 11es �4ev►„IanllwMa.M�iaMllr/y
+----- P
AaMrpbal.Idba*W
w�"b"o
OrDO�.M� elw T
ww.�d.a,ewwl�..l.ww�.r r...reYR."!►ems
Orifice diameter:
1/8"
Orifice spacing (?i):
49"
Lateral Spacing (S):
9'
Lateral Length (P):
98.00'
Manifold Diameter:
2"
Manifold length:
is,
Lateral Tura -no Detail:
Finished •...........
Grade \ tt
W Diameter 10
Lawn Sprinkler f
Distribution
Lateral
Lateral Turn -up Detail
..............
Threaded
Cleanotut Plug or
weep Two
45 Brids
Same arneter as
Lateral
Pg. 4 of 9
IN -GROUND PRESSURE DISPERSAL AREA
Uniform Elevation Trenches with EZ1203HP Bundles
3-ft Trench (down -sizing credit)
C� TYPICAL TRENCH
SOL COVER 17 CROSS SECTION VIEW
Min. bwMhi�i�i•i•i�i•i•i•%�i•:•i'i •Scale)
System Elevation •' 1
Provide
Lateral Invert Elevation 1 ft separationbetween
TYPICAL TRENCH (Show force main, manifold, and flush valve locations on plan view.)
PLAN VIEW
(No Scale) 11/4 "0Schd140 °b*erve^Poe° aptokwww
PVC Lateral •1"ffl 'bet~
t•o unBE.
(typical) Observation ,
1�Nf •�•�N N
L_— -----,�------------
B = 100 ft
(ty"o
INSTALL PER TRENCH:
10 10-ft bundles Q 50 fl EISA/unft- 500 }p
+ 0 5-ft bundles @ 25 f! EISAlunit = 0 ft
10 ft
(typical)
A = 3.0 ft
A(tyocgo
EZ1203H Bundle
(typal)
(mfd by Intltatm Systems, Inc.)
Install pursuant to mamrfacturWs Instructions.
= Proposed EISA per trench . 500
ft' Required Infiltration Area =
1,500
ft
x 3
trenches = Proposed Total EISA =
11,500
ft'
Existing Dose Chamber Capacity & Demand Dose Setting9:
Manuf wturer & Capacity: Exist' p Wiper Concrete WLP1200/800-MR (36.0(" Q 22,24 gal./inch = 800.64 asl. actual)
Control Panel: Existing weather pmdjunctikm box
Effluent Pump: Exjgft Goulds PE41
Puma Tank Sizing
A) One Day holding capacity: 18.00" = 40038 aal.
B) Alarm setting: 2.00" = 44.48 aal.
C) Dose volume + flow back: 5.00" — 111.20 aal.
(6W pUS dose per day) + (.163X 50') = 128.20 gal. maximum dose volume
(.064 Wineal foot of 19" IawralX100.Ox3) = 1920 gal. min. dose volume
D) Reserve storage: I1.00" = 200.16 gad,
TOTAL: 36.00" - $00.64 aal.
Pumn sclection:
Manufacuaer Con
Model number. PE 41
Min. discharge rate required: -4&" gran Ceti 12.33' TDH (30."5 ,, pm) —
Pump will discharge approx. 55.0 gpm @ 13.28' TDH or 5.61 tUsec. now rate
Dose Tank Inforrttation
8ectrcal rn per NEC3110 and
Cn
nm ttt28 VW4C e
-
._� Cbeornect
Tads component M property v~
Ur""WI 0=
•:.:
# :.
Ew-m-NIM'
WT." ".T.".
w7WITZ01
OEml
: ee
SKM'',
0EEMEEM
�NNMEKFM
0'
m
r.
:ee
i B
C
Alarm Merwafacturer I LovelArm
Alarm Model Ntwtber DLV
Pump Marwfachxer GmAds J Ptatp Model NLwrber PE 41
Locking coverwahwartip
M»I and bekkp dwbe and
.sealed w aim W
4 in. rm.
Foreeman diameter
---1 2 in
Weep hole or wti-
sk*m device
owwanon tt
93.22
Pg. 5 of 9
1
RGOULDS PUMPS
APPLICATIONS
Specially designed for the
following uses:
• Mound Systems
• Effluent(Dosing Systems
• Low Pressure Pipe Systems
• Basement Draining
• Heavy Duty Sumpl
Dewatedng
METERS FEET I
40. PESt
35 }.
j 90
L-
v �.
2n'-__—
o h
15}:'
In
SPECIFICATIONS
Pump — General:
• Discharge: 11h" NPT
• Temperature: 104OF (400C)
maximum, continuous when
fully submerged.
• Solids handling:'h"
maximum sphere.
• Automatic models include a
float switch.
• Manual models available.
• Pumping range: see
performance chart or curve.
PE31 Pump:
• Maximum capacity: 50 GPM
• Maximum head: 25' TDH
PE41 Pump:
• Maximum capacity: 60 GPM
• Maximum head: 29' TDH
PE51 Pump:
• Maximum capacity: 70 GPM
• Maximum head: 37' TDH
Submersible
Effluent Pump
,t
PE
MOTOR
General:
• Single phase
• 60 Hertz
• 115 volts
• Built-in thermal overload pro-
tection with automatic reset.
• Class B insulation.
• 011-filled design.
• High strength carbon steel
shaft.
PE31 Motor.
• .33 HP, 3000 RPM
• 12.0 Maximum amps
• Shaded pole design
PE41 Motor:
• .40 HP, 3400 RPM
• 7.5 Maximum amps
• PSC design
PES1 Motor.
• .50 HP, 3400 RPM.
• 9.5 Maximum amps
• PSC design
IM00ELS: PE31, PE41, FES
iM►.33, .10..50
—► 2 GPM . I f
1
1 � ,
,
i
l
5 �..__.._._ ._... .. _1
0 00 10 20
0
Z� 2002 Goulds Pumps
Effect" November, 2002
BPE31/41
.. _ r
30 40 50 60 70 GPM 90
5 10 1 15
CAPACITY rJRGPM: 3"W.j
FEATURES
■ Corrosion resistant
construction.
■ Cast iron body.
■ Thermoplastic impeller and
cover.
■ Upper sleeve and lower
heavy duty hall bearing
construction.
■ Motor is permanently
lubricated for extended
service life.
■ Powered for continuous
operation.
• All ratings are within the
working limits of the motor.
■ Quick disconnect power
cord, 20' standard length,
heavy duty 16J3 S1TW with
NEMA 5-15P, three prong,
115 Yoh grounding plug.
■ Complete unit is heavy duty,
portable and compact.
■ Mechanical seal is carbon,
ceramic, BUNA and stainless
steel
• Stainless steel fasteners.
AGENCY LISTINGS
CRUS
Tested to UL 778 and
CSA 22.2108 Standards
By Ceradlrl 5tarlda ds Assodatial
Ede *LMS49
Goulds Pumps 4 ISO 9001 Registered,
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Goulds Pumgs
& ITT Industries
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PL-525 Filter
PL-525 Effluent Filter
The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has
525 linear feet of 1/16' filtration slots. Like the Polylok PL-122, the Polylok P1525 has an automatic shut-off hall
installed with every filter. When the filter is removed for cleaning, the bal I will float up and temporarily shut off
the system so the effluent won't leave the tank. i
Features:-
* Rated for 10,000 GPD (gallons per day).
• 525 linear feet of 1/16" filtration.
• Accepts 4" and 6" SCHD 40 pipe.
• Built in gas deflector.
• Automatic shut-off ball when filter is removed.
• Alarm accessibility.
• Accepts PVC extension handle.
PL-525 Installation:
Ideal for residential and commercial waste flows up to
10,000 gallons per day (GPD).
1. Locate the outlet of the septic tank.
2. Remove the tank cover and pump tank if necessary.
3. Glue the filter housing to the 4" or 6" outlet pipe. If
the filter is not centered under the access opening use a
Polylok Extend & Lok or piece of pipe to center filter.
4. Insert the PL-525 filter into its housing.
5. Replace and secure the septic tank cover.
PL-525 Maintenance:
The PLr525 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
cleaning.It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If the installed filter contains an optional alarm,
the owner will be notified by an alarm when the filter
needs servicing. Setvxing should be done by a certified
septic tank pumper or installer.
1. Locate the outlet of the septic tank.
2 Remove tank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed.
4. Pull PL-525 cartridge out of the housing.
5. Hose off filter over the septic tank. Make sure all
solids fall back into septic tank
6. Insert the filter cartridge back ittto the housing making
sure the filter is properly aligned and completely trisected.
7. Replace and secure septic tank cover.
1/16" Filtration Slots
Accepts 4" & 6-
SCHD 40 pipe
Outdoor SmaRFittm® Alum
Potybk Lobel & ll at filters accept
the SmariFilterW switch and ahem
Alarm 5witich
(mi)
Accepts 1" PVC
Fxtaukm Handle
Raced for
10,0M GPD
525 Linear Ft.
of 1/16-
Fohatim Skits
Carow t o
MOPAMIM 86modwd A
Gm Deflector
Aufnetatic
stmt-0ff Ball
Erimd & Loki'
Easily Wabus
into Odsting tanks.
Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 loll Free: 877.765.9565 Fax 203284.8514 www.pobdok.com
Prj. 70,09
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In -Ground Pressure Septic System Management Plan
Pursuant to SPS 383.54, Wis, Adm. Code
General
The septic system shall be operated in accordance with SVS 392-384 Wis. Add. Code, and shall be maintained in accordance
with component, manual SBD-10705-P (N.01/01) and SOD-10706-P (N.01101). All local and/or state rules pertaining to
System mamtmance and maintenance reporting shall be complied with. all m"emon and memtenXace activities shall be
perlmfuOd by a registered POWTS Maintober in aocordance with SPS383.52 (31 Wisc. Admin. Code. Questions on the
operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the
St Croix County Zoning Department at (715) 3596.4680.
Seutie Tank
Septic tank servicing mechanics comply with SPS 383.54(lxe). The septic tank is located within 150' of service pad, with
the bottom of tank s 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every three years by inspection. The septic tank contents shall be removed when the shidge and scum
in the tank exceed 113 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of Use tank
are not removed at the time of a biannual assessmeM maintenance personnel shall advise the owner of when service will be
heeded to maintain less than 113 scut and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The fiber cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the fiber when removed from its enclosure. if the fiber is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes risers, access risers, and covets should be inspected for water
tightness and sonmdness. Access openings used for service and assessment Mall 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 proven accidental or unauthorized entry into the tank
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Coming3.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used, they "I be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Pump Tito
The pump (dosing) tank shall be inspected annually. All switches, alarms, and pumps shall be tested to verify proper
operation. Distribution lateral pressure shall be flushed every three years.
Soil AMprption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and mound the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrativesurface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October -March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mgjL FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent poling annually. Pending levols above 6 inches
indicate an impending hydraulic failure requiring additional, more frequent monitoring.
RMUnt dlwr *02 be altetnaW between dispersal tab by use of diversion valve on a two-year schedule or as
required by inspection. Effluent to be diverted font new cell to aid d.gtmfield at 3-year anniversary of new system
installation. Old drainfield to be utilized for a 1-yearpet od. Effluent dispersal to be alternated between systems on a 2- year
rotating basis or as required by annual inspections thereafter.
Coatimeencv Plan
If any POWTS component becomes defective, the component shall be repaired or replaced to keep the system in proper
operating condition. Excessive pending within the dispersal cell will be eliminated by ahemating the diversion valve
between dispersal cells to bring the system into proper operating condition. If aheanadN cells does not result in a properly
operating system, a new dispersal cell will be installed.
Pg. 9 of 9
In -Ground Pressure Management Plan
The owner of this in -ground pressure system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisp. Admin. Code, this system shall be
considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore,
all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS
383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 600 gpd; BODE 5 220 mgL"'; TSS 5150 mgL''; FOG 5 30 mgL'
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
o material fatigue (i.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s) and any distribution appurtenarroe(s) (Le., distribution t drop boxes)
o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities (i.e., pump re -cycling, float switch settings, etc.)
o electrical components (i.e.. wiring, connections, switches, controls. tamers, alarms, etc.) .
o distribution lateral or lateral orifice plugging (measure lateral distal proms —compere to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o septic and dose tank(*) shall be pumped by a certified septage servicing operator licensed under a. 281.48 Wis.
Stets. when the volume of solids In the tank(*) exceeds one-third (113) the liquid volume of the tanks) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wiw- Admin. Code.
o Effluent flltertsi shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months
o Diallributlon laterals shall be flushed once every 3 years or when necessary.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.66 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: James K. Thompson Phone: (715) 248-7767
Local goverment unit St. Croix County Zoning Dep'. phone: (715) 386-4680
Local government unit address: 1101 Carmichael Rd., Hudson, WI Zip: 54016
Any defective pan of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), VV=. Admin.
Code. Repair or replacement of failed or malfunctioning components snail comply with SPS 383, Wisc. Admin. Code.
No product or chemical or physical restoration of the POWTS may be used unless approved by the departrnent in
accordance with SPS 384, Wisc. Admin, Code.
Contingency Plan
In the event that any failed treetrnent component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be
abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383:33, Vftc. Admin. Code.
Pg. 9A of 9
Owner/Buyer
Mailing Address
Property Address
City/State
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Cade & Aliesha Heiberg
402 126th Ave., New Richmond, WI 54017
Same
(Verification required from Planning & Zoning Department for new construction.)
Parcel Identification Number 026-1139-03-000
LEGAL DESCRIPTION
Property Location SW ''/" NW ''/4, Sec. 36 , T 30 N R 1 8 W, Town of Richmond
Subdivision Plat:Torey Pines
Certified Survey Map #
Warranty Deed # 915475
Spec house ❑yeslZto
Lot # 03
Volume Page #
(before 2007)Volume Na Page # Na
Lot lines identifiable ❑+ yes❑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 §SPS. 393.52(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 verifying 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.
Uwe, 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 Safety And Professional Services 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.
I/we certify that all statements 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 warranty deed recorded in Register of Deeds Office.
Number of bedrooms 4
�T7(' ii_lr
SIGNATURE OF APPLICANT(S)
11/19/19
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. 04/12)
�. 24s
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) 1402 126th Ave., New Richmond, WI 54017
located
at: sw ''/4, NW '/4, Section 36 , Town 30 N, Range 18 W,
Town of Richmond , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service October 24, 2019
Did flow back occur from absorption system? Yes X No
(if no, skip next line.)
Approximate volume or length of time:
Tank Capacity: 1.200/800 gallon
Construction: Prefab Concrete X
Manufacturer (if known): Wieser concrete
Age, of Tank (if known): 11 years, installed August 27, 2008
(if known) 514918
20 gallons 75 minutes
Steel Other
r. James K. Thompson
(Lensed Plumber Signature)
MPRS
(Title)
November 18, 2019
(Date)
(Print Name)
MPRS #30021
(License Number) MP/MPRS
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
P5. 3 orr
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M06e 9 p -- 39
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N89°47'37-E 330.00'
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2.29 ACRES $
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2.08 ACRES
90750 SO. FT.
STORM WATER
RETENTION AREA
I H.W.L a 1009.0
L.-.._._._.a_—._.-.-.I
IN WITNESS WHEREOF, THE SAID ALLIANUS BANK
HAS CAUSED THESE PRESENTS TO BE SIGNED BY PHILLIP REIM
VICE PRESIDENT. AT
,..�[AND IT!,CORPORATE SEAL TO BE HEREUNTO AFFIXED
DAY OF_ _________• 20_OL__:
IN THE PRESENCE OF.
BAD ________ -_________
I
VICE RESIDENT
STATE OF A•_w\h.' 3SS
BENCHMARK COUNTY OFU�-2 o:,L
TDP OF 1• IRON RPE
ELEVATION -10BB.11 PERSONALLY CAME BEFORE ME THISS�n- DAT _ _ __
PHILLIP REIM' VICE PRESIDENT . OF
THE ABOVE NAWD CORPORATION, TO ME KNOWN TO BE THE;P SONS WHO
EXECUTED THE FOREGOING INSTRUMENT, AND TO ME KNOWN SUCH VICE
PRESIDENTS OF SAID CORPORATION AND ACKNOWLEDGED E L_ XECUTE➢
THE FORGOING INSTRUMENT AS SUCH OFFICERS AS TH S
)RP®TON. ITS AUTHt1RITY.0 ` -___
_ ______ PUBLIC ,:��
MY COMMISSION EXPIRES �1E_Qyy�pyLw, Zi'�gL3
„,PJ�¢__
OFWI eam"
. CORPORATE OWNER'S CERTIFICATE OF DEDICATION
iO l� AMES INVESTMENT LLC, A CORPORATION DULY ORGANIZED AND
EXISTING TINDER AND BY VIRTUE OF THE LAWS OF THE STATE OF
WISCONSIN, AS OWNER, DOES HEREBY CERTIFY THAT SAID
CORPORATION CAUSED THE LAND DESCRIBED ON THIS PLAT TO BE
SURVEYED, DIVIDED, MAPPED AND DEDICATED AS REPRESENTED ON
vO �� THIS PLAT. AMES INVESTMENT LLC, DOES FURTHER CERTIFY THAT THIS
PLAT IS REWIRED BY S.236.10 OR S.236.12 TO BE SUBMITTED TO
THE FOLLOWING FOR APPROVAL OR OBJECTION TOWN OF RICHMOND, THE
5555��''''777777 DEPARTMENT OF ADMINISTRATIONI AND THE ST. CROIX COUNTY ZONING OFFICE.
U IN WITNESS WHEREOF, THE SAID AMES INVESTMENT LLC, HAS
' CAUSED THESE PRESENTS TO BE SIGNED BY JEFF SOVADA, AT NjyayM>`___
1 . e -•
i 1HIM.
•� • TH1S_5-.i!^_=-DA_DAT OF _, 200L-
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IN
la '
THE PRESENCE OF.
AMES INVESTMENT LLC.
JEFF SOVA
STATE OF y�W�epLw�L�A•a_-)
COUNTY DF-htj .m0c-_)SS.
PROPOSED TOWN ROAD
(NOTE
NO OWNER OR RESIDENT SHALL DO ANYTHING WHICH
WOULD INTERFERE WITH OR CHANGE THE OPERATION
I
OF THE APPROVED COMPREHENSIVE WATER DRAINAGE
p
AND SOIL EROSION PLAN FOR THIS PLAT. THIS
'y
I
INCLUDES BUT IS NOT LIMITED TO BUILDING UPON,
OBSTRUCTING, ALTERING, FILLING OR EXCAVATING. OR
IPLANTING
III
IN ANY POND EASEMENTS, WATER
s
_
DRAINAGE DITCHES, WATER RUNWAYS, WATER
PERSONALLY CAME BEFORE ME THIS.St^_DAY OF
200L_, JEFF SOVADA, MEMBER OF
THE ABOVE NAMED CORPORATION, TO ME KNOWN TO BE THE ERSON
WHO EXECUTED THE FOREGOING INSTRUMENT,„,AND40-ME KNOWN TO BE
MY COMMISSION
COUNTY TREASURER'S CERTIFICATE
STATE OF WISCONSIN)
PUBLIC
08'26'E 277.9
THENCE ALON
TO THE POINT
DATED THIS_-
DOUGLAS Z
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212 WALNUT
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GENERAL INFORMATION
PwwiW iftanubm you Kwste may be used for sam dwy Pspom
11
TANK
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
(ATTACH TO PERMIT)
IPnvacyLww, s.1Q0s (1xm)j
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TYPE
MANUFACTURER , d,
CAAACITY
septic`
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TANK SETBACK INFORMATION
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Manufacturer Demand
at
Model Number PE At l �5 O
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SOIL ABSORPTION SYSTEM
im
ELEVATION DATA
STATION
BS
HI
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ELEV.
Benchmark
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COMMENTS: tlndude cads d4crepandea, parsons present. dc.} Inspection #1:_ I__I_ Inspection
Location: 1269 14M SV" 1N" Fddanond, WI U017 (SW t/4 NW 114 36 T30N R18W) Toney Pines
Lot 3 P I No: 36.30.18,998
1.) Ali BM Description • 1i". s.� iw,� j+�, W C11616rj
2.) Rig sewx wv s 3 s �Z %} t a•d. dw.J / 5�.(t'3e.J�5
- amourd of cover - N v [[
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plan revision Regtdred9 0 Yea wNo Q +p� �
Use other aide for additbrW inknnabon. G• iO Q Os
SeOdrto (R.7re7) DaleMespuor - - — - Cart No.
wbaoe.+n o.v.n,,.,a d Ca - - SOIL EVALUATION REPORT
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7U Deparlmnt ofComme= is w eggt appmmnity am m prmdec and "foyer. If you axed vad0tsce to seem nwvica Of
need mdorW in w akenwft A mat. pkme caravel da: depuu=t at 608-260313E aTTY W464-M.
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