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HomeMy WebLinkAbout040-1310-00-004Wisconsin 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, s. 15.04 (1)(m)I Permit Holder's Name. City Village Township KMW Associates LLC TOWN OF TROY CST BM Elev Insn. RM Flew I RM n>77 — TANK INFORMATION TYPE MANUFACTURER 2 tphA�J r Septic 1 t Vffw* t Y;/t �I Dosing Hold•rtg TANK SETBACK INFORMATION Irf�Z�j al� PUMP/SIPHON INFORMATION Manufacturer Model Number TDH Lift 5 • ) Friction L 7ss Sy Forcemain Length�t Dia.ZI) SOIL ABSORPTION SYSTEM DIMENSIONS Ty DISTRIBUTION 12 r __Ioo1 EM TO LJ Demand GPM Head Il toTDHII Ft :t. to Weil re � No. f lt-e�c e j Ix I '/L BLDG WELL 10.V IZnI IPTI u ELEVATION DATA STATION BS HI FS ELEV. Benchmark �.� J0f•� �0A0 Alt. BM Bldg. Sewer LI •s 1 U8 . 8 St/Ht Inlet Ht Outlet O Dt Inlet Of Bottom �, n L n 3 `j.,n, Bader/ an. Dist. Pipe Z•y q, Bot. System Final Grade St Co'ver �►� I2. I►3. . to U1.2 del CHAMBER OR UNIT Y HeaderlMankWIPIRW iDistribut,on Pips)9 0I tl � xHole Sizj' 52II x Hole Spacing Veto Air Intae Length Dia Length Dia Spacing �11- e 7ntivm JVIL l V V QM x Pressure Svsteme Only r Mound fl. Al-rtr-.dn C., ern...e n-1 /In-/ N1, u- % -, i Depth Over \ Ir eed/Trench Center I Depth Over Bed/Trench Edges > I�i t/ xx Depth of Topsoil I q •l xx Seeded/Soddetl Yes ] No Mulched - es ENO COMMENTS: (Include code discrepencies, persons present, etc.) Location: 462 MEADOW RIDGE TRL 1.) Alt BM Description = Y V IVY / Wei- 2.) Bldg sewer length - amount of cover . ► ► ` �j CL (D W1104 ?Al- l >HI"0�COVU,onCAI I Of Plan revision Required? 0 Yes Ix No Use other side for additional information.f SBD-6710 (R.3/97) Date Inspection#1: 5)1/r Z02C> Inspection#2: �y rah Or WOL CU 1MOWL d jog I� *lnspc1.1en re Cen. No I t 4 k +- r441ac c%a I� SAW_, ►S -a4 9 D Safety and Buildings Division County �• )l 201 W.' Wastdngton Ave., P.O. Box 7162 Saohmy Permit Number (to be filled in by Co.)EC 16 2019 Madison, 0 ss7o7-7,62 �� -7 7 St. CrCq ,$e it Appl ratio State Transaction Number In sued Vdre Code, subtvissiw of this tsar to the aPreP r 9 - C— jax Address (if diHetent than mailing ad&=) n regairM ' o o ' ' a smimy petmn. Now: AppHcatron tams for sbxowced PO,VTS are slkbtmaed m the Depmbxd of Safety and Professional Ses im Personal information you provldc may be used for sit in accordance with the Law, a. 15.04t1 m Stars. �Aa,,..st'� 1 -r ut y d a lddw R l j J L Application laformation- Please Print AH Information Property Owner's Name Pacd # Property Owner's Mailing "dies �p-66N � 1-7, ail ,19 . 111 o- (�t., �1 lr Govr. La Vh•SE y,' City: Zip Code Ph=Number M10D`i� sseugteeeeonLL TZN. R ; f II. Type of Btrildistg (ehxk all that apply) Lot d Sub^' "ion N I a 2 Family Dwelling -Number of Bcdms on bjc a,D Block# pw ❑ PuNirrY',o®ercial - Descnbc Use ❑ City Of CSMNumber ❑ state owned- Describe l sic ❑ village of xx lZ �, U6 Tessa of III. (Check only one box on line A. Complete line B if applicable) A. System ❑Replaommr Spstem ❑Tmuceot/Hold'ing Tank Replaoatant only ❑ Other Modiicatimm Ebastan; Syutem (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑Permit 7raosfer m New List Previom Permit Number and Dine Issued Before Erpindim owner f IV. OfPOWTSS 'COE y ❑ Noa•Rmmiad lollrouod ❑ Preasavcd 10 Tirade Momd> 24 m of auidble soil ❑ Mound <24 in. of soil ❑ Holding Tank ❑ 09a Dispasal Contoonem (exptaio) Pretreahneat Device (explain) V. DisperadaYrree eM Arm Information: ' Flow (Vd) Desiew Soo Application Disposal Axe Requnad DisPasal Ace+ sr) Syat<m VL TankInfo Capacity in Total i # of Meoufecnnc Gallons odlom Unit d J xaw raalee Eaioag raeta �• �' s oo' � � 3 l'✓ � e� in iC G Septic a Boldi gTaok / Doeng Chamber VIL Responsibility Statement- 1', the aadersigned, t responsibility for imodiation of the POWIS ahowa on the attached plead. p4off" Name (Riot) PI igoaaIIe MP/MP(tS Number Bosircat Phone N plaw �t) ' 7 /M his —a Phmtber's Address (Strek, Zip l VM !De ent Use oily ❑ p�pwecad Pamir Fa Date Issuing Signanve g b� 12 �� l `t DL for Disapproval 1. Septic tank, effluent filter and •J { �I _. �r3 Lw dispersal cell must be. serviced / maintained ►•ntMQ. �, j,)vp,V W, ' �� as per management plan provided by plumber, t 2. All setback requirements must be maintained ► �� r 10 A�.• to y ZIA • - -��__icy-minlapl�'ptlaetat'OtagNaW7 tlroC'.//oCav(r�aMP•rmtlsrb�e81nx11�ve/testes@ (.ew��'�oK� iti t7r tOa►G� SED-6398 (R. 11/11) 4Q, A. System PLOT PLAN PROJECT KMW ADDRESS 8807 Uocer 7th Place N Lake Elmo Mn 55042 NW 1/4 SE 114S 17 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 98.5' 12/3/19 4 DATE BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255. gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 It of chambers none BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL +H.R.P. same as benchmark Ridge Trail Well is to meet all WDNR setbacks 1 Acre Lot Pro 4 Trading is to be done to divert in -off away from system Property Line 0' 40' 80' 1 1 Scale = 1/4" = 10' Huffcutt Combo Tank gn am 12% Slope Area 15' below system is to remain undisturbed 130, DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY vvl 54304-5211 Contact Through Relay httplidsps.wi.gov/progmms/industry-services www.wisconsin.gov Tony Evers - Governor Dawn Crlm - Secretary December 16, 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2021-12-16 Plan Review: PWTS-121902555-C SHAUN R BIRD 1432 120th St New Richmond WI 54017 SITE: KMW 462 Meadow Ridge Trail Town of Troy Saint Croix County Total Amount: $250.00 FOR: At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, R. 1/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10/12) Descrmdon: 600 CPD (4 Bedrooms — New Construction) Maintenance Required 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal ' Area Divert surface water from all POWTS Areas. • 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. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11Xc) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to beset and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tme roots. sumps and boulders reduce the amount of soil available for proper treatment. If till other title is mailable. trees in the basal area tit the mound most be cut off at ground level. A huger fill area i, necesstuy when an; of the above conditions are encountered, to proritte sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval 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. 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 Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stets 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 POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Thanks, r%ixr �.ea� r �eaf POWTS Plan Reviewer— Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email: tim.vanderleesttdwisconsin.eov Cell: 608-516-6134 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:12/3/19 Owner:KMW Location:NW 1/4 SE1/4 S17 T28 N,R19 W 462 Meadow Ridge Trail Troy Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specifications 8.-9. Maintance and Attachments: Soil Tj Shaun Bird Signature License ndm6er 226900 Plan Page 1 of 9 PROJECT KMW NW 1/4 SE 1/4S 17 /T 28 System PLOT PLAN ADDRESS 8807 UDoer 7th Place N Lake Elmo Mn 55042 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 98.5' 12/3/19 4 DATE BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL. LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL sH. R. P. same as benchmark Ridge Trail Well is to meet all WDNR setbacks 1 Acre Lot Pro 4 Bedroom House Grading is to be done to divert run-off away from system Property Line 0' 40' 80' Scale = 1/4" = 10' Huffcutt Combo Tank B-11 1 00' 98.5' 9 8' B-2 M B-3 12% Slope Area 15' below system is to remain undisturbed 130' At -grade System Sloping Site Cross Section and Plan View .--------------------------------- E 1 t 1 1 b 1 W A t F I 1 6 1 1 I 1 1 1 1 1 1 1 I I E %% �— 1/6 B 4 11 E1------------------------------1-' Geotextile Fabric L = Plowed = Clean aggregate Q = 4 in. sch. 40 pvc basal area t'c1 %s to 2 %sin. dia. observation pipe Lateral with 2" aggregate over pipe 0 Topsoil Cap 'a4 Z� F;tal Invert _ A� rY }R. LaterV•rY Ft Contour r.r.r.. :r: � 1•\•tip Plowed --r-vy C `--- Slope Direction y 1 1 Slope / Observation Pipe With Cal) Topsoil Cap GENERAL INSTALLATION: The at -grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a'b inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. Afteithe topsail cap is placed, the entire at -grade is seeded and mulched to promote vegetative gtov✓ h, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inehes and secured in place. 03/05]gj Page 3 of Force Main Pressure Lateral Layout One Lateral — End Manifold 1 Threaded Cleanout Lateral Tum-up —► Plug Distribution Nethwork Sp ecifications Lateral Diameter In. Orifice Diameter 5 In. X Orifice Spacing In. L Lateral Le Ft. Force Main Diameter Z In. Force Main Length j Ft. 03/05 lgj Long Sweep 90 Bend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral tum-ups terminate with a threaded ceanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. •* 9 e• Grade * 0 * * 9 0 6-8 Inch Lawn Sprinkler Valve Box Page ofl_ Septic -Pose 'Wank Cross Section And Pump Performance Specifications Tank Manufacturer Tank Model Number _ v 7 Total Tank Capacity i 1 - -7 Max. Bury Depth Filter Manufacturer Filter Model Number __ J Minimum Pump Performance Required GPNL1 Ft TDH Outlet Manhole Min. 4" Above Grade With Looking Device. Inlet Manhole < 6" Below Grade Seated Watertight -. � — — -1 — Finished Grade Outlet Filter Inlet I.� Wet Baffle Switch 5ettptgs and Reserve Capacity Tank Volume = GPI Dimension: Inches Volume Gal. (reserve) A, I 7. ' (alarm) B 2 (dose) C . • 5 - (dead) D 1 5_�� Total i Pump Manufacturer Pump Model Number Alarm Manufacturer il GG 5 — Alarm Model Number _ Switch Type 1pe Total Dynamic Head (TDH) - Feet T i Elevation Head 0 Distal Pressure Network Loss A Force Main Loss TOta! L% /S - _ Securely Mounted Weather-proof Junction Banc Vent Min. 12" Above Grade With Vent Cap Manhole Min. 4" Above Grade, . With Locking) Device � i Y Disconnect Means A 04 _ Weep B Hole Off Elevation C J F Bottom D Elevation GENERAL. INSTAILLATION: The septicldose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as speoified by the nanufactamr may not be exceeded without prior Approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation " the sleeve is sealed watertight. Electrical serviopcomplies with NEC 300 and Comm 16.28. 02105 U Page _'7 ° 280-SERIES 112 hp Submersible Effluent/Sump Pumps The Uberty 280-Series provides a cost effective "mid- range' pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. Designed around Liberty's unique "Uni-Body" casting, the 280Series will provide years of reliable performance. Ail Models Feature: • Vortex style impeller peniMng passage of solids upto%' • 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball bearing • Epoxy powder coat finish • All fasteners - corrosion -resistant stainless steel • 1 y," Discharge • Stainless steel bottom screen- easily removable • Maximum fluid temperature; 140' F. 280-Series Cord tenths Model 10, 261-2) 36'(S) 50'(-5) 280 Standard Optional Optional OpW" 281 Standard Optional Optional Optional 283 Standard Opdonal Optional WA 287 Standard ciptionai WA WA 10' Cord length standard WWI models. Faopaond Ien00he, add'-z a or 5' auft to model number. Example: lur model 280 with 35' ocrd, order 2W-3 Motor Spermcations A hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (115V) 4.0 amps (20a(23oV) O Model 280 Model 281 Manual, Wide angle no switch float switch with quick - disconnect SSPNj4 s�• c us Certified Ibn N•LP-fib tl,a9• W1,YRMIFI. Performance Curve: 2804%des MENU U.S. Gallons Per Minute 0 38 78 114 158 192 228 270 Utem Per Minute Dimensional Data: Weight 29lbs. Height: 13" Major Width: 10" (model 287) Minimum Sump Diameters: Model 281, 283...140 Model 287 VMF... 10" Factory switch Model 281, 283 Mode1287 settings VMF Tum on level 13, 9.5" Turn off level 1 7' 4.0' The Model 283 teatime a hay adlustabie wldaanple float Ditterantlel ediusanents can be made easily bytwitwirry the twat to the dis- charge pipe or other mounting point vertical float model 287 Is not adluatede. Model 287 VMF-Series Vertical mag- notic float for smaller pits - will operate in a 10' dlarneter sump Liberty Pumps • 7OW Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Far (585) 48418= WwwJHAW4'pumPs.oam cop Wd oraxmy Pwnp•. ba=7 ,vnyea,ewrwd. 11r200Reen7 POWTS OWNER'S MANUAL & MANAGEMENT PLAN one _of TILE INFORMATION { Owner u2 XA,rr 1 c u--�_ � jtll Permit # ESIGN PARAMETERS Number of Bedrooms ❑ NA Number of Public Facility Units Am j Estimated flow (average) i Ira 6 galtday Design flow (peak), (Estimated x 1.5) al/da Soil Application Rate al/da me Standard Influent/Effluent Quality Fats. Oil & Grease (FOG) Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Monthly average' 530 mg/L 920 mg/L ❑ NA 5150 mg/L 'Pretreated Effluent Quality Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Fecal Coliform (geometric mean) Monthly average 53o mg/L 530 mg/L 510' cfu/100mi iMammum Effluent Particle Size Is In die. ❑ NA Odtar. A 'Values typical for domestic wastewater and septic tank effluent AINTEll SCHEDULE SYSTEM SPECIFICATIONS jSeptic Tank Capacity /p2 ❑ Septic Tank Manufacturer ❑ Effluent Fitter Manufacturer /, ❑ JA Effluent Filter Model ❑ t+A Pump Tank Capacity i ❑ NA Pump Tank Manufacturer ❑ Pump Manufacturer ❑ Pump Model a �J ❑ Pretreatment Unit ❑ Sand/Gravel Fitter ❑ Mechanical Aeration ❑ Disinfection ❑ Peal Filter ❑ Wetland ❑ Other. i Dispersal Cell(s) Ground (gravity) ❑ A - race ❑ Drip -Line ❑ ❑ In -Ground (pressurized) ❑ Mound ❑ Other: oNer. ❑ Other ❑ Other. ---- ❑ NA Service Event Service Frequency j [Inspect condition of tank(s) At least once every: f ❑ month ar s(s) (Maximum 3 yaw) ❑ (Pump out contents of tank(s) When combined sludge and scum equals one-third ()S) of tank volume ❑ NA Inspect dispersal call(s) At least once every: 3 ❑ o h(s) (Maximum 3 yaw) ❑ NA Clean effluent filter At least once every: ear(s)(s) NA Inspect pump, pump controls & alarm At least once every: Clear s(s) NAI Flush laterals and pressure test At least once every: ❑ month(s) ❑ year s ❑ x At least once every: El 0 m ark 8's) ❑ hher. MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made -by an individual carrying one of the following licenses or certifications: Maste Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer, Septage Servicing Operator. Tank Inspections must include a visual Inspection of the tank(s) to Identify any missing or broken hardware, identify any cracks or leaks, measure the volume of Combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shaft be visually Inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the I regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (%) or more of the tank volume, the entire contents the tank shah be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconalrl Administrative Code. i Ag other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units.) end any servicing at Intervals of 512 months, shall be performed by a certified POWTS Maintainer. [ A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page _ of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals theft may Impede the treatment process andfor damage the dispersal cell(s). If high concentrations are detected have the contents of 4hp tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal hlghwater levels. When power Is restored the excess wastewater will, bis discharged to the dispersal cattle) in one large does, overloading the cell(s) and may result in the backup or surface discharge of efflu9rd. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to effluent pump or cooled a Plumber or POWTS Melntainer to assist In manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POVV76: antibiotics; baby wipes; cigarette butte; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation don (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting prod Pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is prope(ly and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: j • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.'. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filed with fietl, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code complaint replace ant system: suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systeim. Th replacement area should be protected from disturbance and compaction and should not be infringed upon by requirled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area wi l result in the for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rut in effect at that time. ❑ A suitable replacement area Is not available due to setback and/or soil limitations. Barring advances In POWTS technologya holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be Installo as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in piece following removal of the blomat at the infif"live surface, Reconstructions of such systems must comply with the rules in effect at that time. j «WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O* A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE POWTS INSTALLER /1 Name •� ,^ '� LPhone POWTS MAINTAINER Name Phone i SEPTAOE SERVICIN60PERATOR PU ER LOCAL REGULATORY AUTHORITY "Ne�� ,'/i eklU- %/f�"rN`'h �/v,� —c This document was drafted in compliance with chapter SPS 383.22(2)(b)(%d)8(f) and 383.54(1). (2) a (3), Wisconsin Administrative Code. Name I 1 Phone W, I 2014004aA SECTION A -A Wisconsin Department ofCanmerce SOIL EVALUATION REPORT Page _of_ DtYlsim cf Se" and Buadlnpa Afladl mmplab alto plan m paper red Isas Itiari a 1/2 x 11 Inches In size. Plan onus! trairtds. W not 1m11W to: vertical and horizontal reference point (BM), direction and percent elope, anise dlmanabns, naafi snow, and location and distancelo nearest mad. Pluae JOHM all InfolnNNon. PenenY WWWAxen You movies meY ee eeW far raoonaery purpwe(R sglaw. n. 15.04(1) Im)l. Cox" '51 In Parcel IM Reviewed by Date r Q- e.t S• Property Location Oovl. 114 114 S/ 7 T Z N R E (c6W Pmpedy s MOM Address � Lot 017 Block a Subd. Name a CSMp "' late P e 6y2 I YC'5-3 ❑ City VIIWga §gTovm Ns real d C.anutructlon Use: ssldenlial1 Number of bYeooms 7 Cafe dad design ilm rate 664 GPD 0Replagnwnt _- /l� Pudic or comnwrcal- Describe: Pamt mfftw l flood Wain elevation If applicable General tarrattanaa and System Type � System Elevation To5) _ Seeing Babe M �. Pit Ground surface elev, � � 0. Depth to OWVV factor it. Shc RaOe Horizon Depth In. Dominant cola Munsel Redox Description Du. Sz Cont. Color Texture Structure Or. Sz. Sh. Consistence Boundary Roots •Efe11 I •Eff02 aaangBortv �� a pit Ground surface elev. A. Oapm to Ihxtlre factor In. Sall icetran Rate Hodzm Depth In. Dominant Color I Munael Redox Description Cu. Sz. CaiL Color Texurre Stnclure Or. Sz. Sh. Conalateilcs Boundary Roots GPDIR •E"I •E —1 l / Z v G i 3 It - E11tUYd 1117 . BITo, > 30 < 220 mp'l anti 755 a30 _< 150 T• Effluent 02 a BOD, < 30 melt. Yid T55 < 30 myL CST Name (Please Print) re CST Number Bird Plumbing, Inc, Shaun Bird 226900 Address Date Evaluation Candu too Telephone Number 1432 120th St, New Richmond, WI 54017 � _,, n 715.246-4516 ixJ perm) ID a Page _ of ©FMffffl. /©rZAPMMI MSVMMMWA!!! Berl g fi o Somw ❑ pit Ground surface elev. ft. Depth to limlf&p factor in. Sall Application Rate ON ■ ■ . ..w."P.^T,. -I ©w ®®®©©� Ef wd N1 a BODE > 30 c 220 mgY and TSS 40 < 150 mQ& - More N2 • BOD. 130 nV& and TSS 130 rW& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to acceu services or need material in an alternate format, please contact the department at 608-266.3151 or TTY 608.26e-8777. a 0,1130RAe01 Soil Test Plot Plan Project Name KMW/Precision Builders Shaun Al Address 8807 Upper 7th Place N / ` �� Lake Elmo Mn 55042 QS #226900 Lot 4 Subdivision Meadow Ridge of Troy Date 11/15/19 NW 1/4 SE 1/4S 17 T 28 N/R19 W Township Troy ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 10o ft. Top of 3/4" pipe System Elevation TBD 'HRPSame as Benchmark Owner/Buyer it l Mailing Address Property Address (Yt City/State LEGAL DESCRIPTION ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATIONFORM from Phtnning & Parcel Identification Number Property Location d�&A ,ZL '/4 , Soc/_L T` b N R�W, Town of Subdivision Certified Survey Map # Volume Warranty Deed# / o/ 30 3 Volume �— Pap# Spec house no Lot Imes iaardiflabl l/ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper me and marnOmna._ of your septic system could result in as premature failure to a wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed mupa. what You pm udo,. the system can affect the function of the septic tank as a treatment stage in the waste disposal system Ow�rer mamkoaxro responsibilities are specified in Women- 9332(1) and in f %n 12 - St Croix Courdy, Sanitary The property owner agrees to submit m St crom County Pluming & Zoomg Dapartrnemt a cad cation far{ signed by tbe.. owns' and by a'master plumber, journeyman plumber. restricted plumber or a licensed pamper verifying at (1) the ou-site wastewater d VOW system Is in proper operating conditiem andlor (2) after inspection and pmwmg (if ), the septic tank is less than 1/3 full of "go. Uwe, the mideraivr bavo read the above roquiremews and agree to maintain the private sewage disposal system with the standards sat fortb, herein, as act by the Department of Commerce and the Departmem of Namaal Pascxtrc as, Sate of Wisconsm. Cerufirsaou SII7mtg that your septic sysmm has been inatmamed must be completed and returned to the St. Croce County Planning &. Zoning Department within 30 days of the Ohms year expiration date. Uwe Certify that all etaharteatsform are true to the best of my/am knowledge. Uwe ant the Ownra(s) of the propety destnbed above, by virtu of is deed retarded in Register of Deals Office. Number o bedroom c SIGNAT6163 OF APPLICANTS) I�DATE� "*Any information that is misrepresented may result in the sanitary permit being revoked by the P & Zamng Department.'a' Include with this application a recorded warranty deed from the Register of Deeds Office and a copy ofe a anti reference is made in the warranty dad (REV. OW5) MD MEYER DGN c PRECISION BURDEIL9 162N WR E iRM., NIRISON. WI 31R16 HBPR IP1 pII LARCH-I]0 b=^T NAAApCfL Il-�1 t i nMRO, TR_Dd AN Fwwiv Wvdvr /.M LYs Wmwa V wu Y =L 4�• CROS .0 F wr_�r �M� eti 4 CROSS SECTION u�_1•� CROS1 MD MEYER DESIGN sEnnvcE u.c PRFL I(M BIN pBR$ �cxuv+,00w nmce iBAB. NBD90N.M Sb�6 dccr M+ A-5 FRONT ELEVATION -A 19-1W ysw� 4P Y MQ MEYER DESIGN SENtCE LLC P8EC ON BULLDFAS G6R MEADOW R 1FNL•NUI6 WI HO16 a=T qmp . Q-2 n•• 11 fo millill"'!j"Il �y1t ?�ii•I!R � ei e 1 i��► it's► { �J { slid� �ttt {{ ��► ,�► 1 ire► { !i!�► !tR �!�!?! 4�R?! liiiR?� !iR?I i.illpi i!R $; l►�R?f !e� 0 0 O O O O 0 0 0 O Wlscomun Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildirx%,- I Y m a W RnC wlul W rlm aJ, rYC . Wnl. IiOOC Attach complete site plan on paper than 8 12 x 1 q,0 include, but not limited to: v d horizontal referee print 5�- ' percc•A•1-w =!-- -- n nA pease prim am mi ormaoon. i n Q � Personal information you provide may be used for secondary purposes (Pmrary Low, s. 15.04 (1) (in)). Coirty St. Croix Parcel I.D. O 1�- f L ZCf �7 Property Owner jl. CRO DCCI Land Planners Inc ZOnllnl FA)plMl)ILbcaLo "`�r❑NW SE 17 28 a 1/4 1/4 S T N R 19 E (00 W Property Owners Mailing Address I SOS 1TW V 65 I Lot # IBlock# Subd. Name or CSM# 4 I I M"dow Rirfm Of Tmv I City State 2-rp Code Phone Number New Richmond i WI 1 54017 1 L Ocrty El village � own Nearest Road IEast Cove Road E] New Calstnlction UseQ Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD n Replacement n Public or commercial - Describe: I Parpnf mat r l Loess over elacial till Fk A Plain plpvatinn if nrwJk 4P. e I General corrxrlents 3 C6&4t�r and recommendations: m U �%«�ww- Rco,�,w,Q.Sv�-� cQremiAry I orb; � 400W- 5L "A Q - J �y j Boring Pit Ground surface elev. 947.39 ft. Depth to limiting factor >96 in. Soil Applicafirin Rate Horizon Depth in. Dorninant Munsell Redox Description Ou. Sz. Com. Cobr Texture Structure Gr. Sz. Sh. Consistence Boundary Rods GPD11F 'EtHtl 'ER#2 1 0-9 10yr3/2 - sil 2msbk dsh as 217 I 2 19-19 I ln.-AIA I I Sfl I Imsbk I dsh I rw I If I 4 I .6 I 3 19-24 1Oyr4/4 - sicl Imsbk dsh cw If 2 3 4 24-72 7.5yr5/4 - s OSg dl ew - .7 1.6 5 72-95 7.5yr4/4 - Sl Om dh - - ..2 .6 _1 Boring # ❑ ling 947.73 >90 Qpit Ground surface elev. R Depth to limiting factor in. Soil Application Rate Horizon Depth in Dominant I MIMM" Redox Description I Oil Sv cnnf rw,r Texture I Structure I rr Ss Sh I l:onsisterrce Bouxlary I R I GP 'F##1 1 0-9 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 9-14 1 4/4 - Sil Imsbk dsh ew If .4 .6 3 14-28 1Oyr4/4 - Sicl Imsbk dsh ew I f .2 3 y I 24 on I 7sy,s;4 I I is LEI Eikiem #1 = BOD. > 30 < 220 moll- and TSS >30 < 150 moL ' Effluent #2 = 1300a_<,X nglL and TSS < 30 mo/L rST Naha fPbr+vp P,"M Sinnahlrp i r_CT N. rr,fr•r Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, W1 9/18/05 715-246-2454 Property Owner DCCI Land Planners Inc Parch ID 9 LJ Boring 3 Boring # ElPit Ground surface elev. 950.44 R Pending Depth tb IimNng >90 factor in. 2 3 Page —Of — Soil Horizon 1 Depth in. 0-6 Dominant Cok r Munsel 10yr3/2 Redoz Description Qu. Sz. Cont. Color Texture sil Structure Gr. Sz. Sh 2mshk Consistence dsh Bociodary as Roots 2f GPDM -Efr#1 •Efr#2 .6 .8 2 6-12 1 4/4 - sit Imsbk dsh cw If .4 .6 3 12.48 7.5yr9/4 is Osg dl cw 1.6 A �1_i-9_ n_ 7 G.—Am r—i ri Be"# Wl rnrvy !—J i__l Pit ulourlu eunece env. n �reper w mlmmy raaw rn. SgI�Aoditation RaY� Boring ❑# g� Pit Ground surface elev. R. Depth W limiting factor in. Sol Application Rate Horizon Depth in. Dominant Munad Redox Description I Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/IF 'Ef #1 I •Efl#2 • FiPo r 91 = Rrlrl > An < "n r .,A nM TRR >A < 1 Sn mM • rfs, w i = Rr)n < An . A nM TCC < An Mutt The Departmentof Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBPxiJOTm ra(f%riel DCCI LAND PLANNERS, INC. Lot # 4 -MEADOW RIDGE OF TROY NW 1/4 OF THE SE 1/4 OF SECTION 17, T28N, R79W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. TOM NELSON CST - Llc. # 227387 N NOTe THE cONralRs IDENTIFIEDENVIRONMENTAL BY DESIGN ARE PRIOR TO CONSTRUCTION. CONSTRUCTION GRADING WAS IN 1432 120TH ST. PROCESS WRING SOIL TESTING. NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED TO ph. # 715-246-2454 CONFIRM FINAL CONTOURS DURING INSTALLATION. SCALE IN FEET 1- IO' 100 0 100 �v IDD� DD 1- 31.;k NOV 27 2019 Wisconsin Department of Commerce SOIL EV�LUA �;O� Page of Division of Safety and Buildings -,;_. C::. , rs.mUAnl9ccpf9ar4rAe M,wv wvrn oo. vvrs. mum. wan Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Panonal bdorma0 you provide may be used for secondary purposes (Pnvary law, a 15.04 (1) (m)) County , PSI I,p� Rev a by Date Proper/� !� _ L(J r Q.-1 5 ` Tj < �a Property Location Govt. L 114�'G 1/4 % T 2 N R E ( W Property is Mailing Address © Lot # Block # Subd. CSNW city State p Cocle Phone Number G (6L2)J'oi-3_ ❑ City ❑ Village KLTown Ne rest d —rpti Construction Use: esfdential / Number of bedrooms I Code den/design flow rate G� _ GPD ❑ Replacement _, /11�j❑ Public or commercial • Describe: _ ___ __ _ Parent material •6(X�-n, Flood Plain elevation'd applicable General comments and recommendations: System Type System Elevation Boring ❑ Boring tt// �� # Pit Ground surface elev. � ^ ft. Depth to limiting factor D in. Soil AkPiplication Rate Hoaon Depth In. Dominant Color Munsed Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIIF 'E##1 •ER#2 -r3 v r3[L zr " c , Z 3 3 3- J G/ Lf Boring It ❑Boring _ L Pit Ground surface elev. l�f-00--Z R. Depth to limiting factor � in. Sod Application Rate Horizon Depth in. Dominant Colo Munsed Redox Description Ou. Sz Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fr 'Eff#1 I •E Efduenl #1 = BOD. > 30 < 220 mg1L and TSS >30 < 150 T' Effluent #2 = BOD. < 30 mg/L and TS5 < 30 Mg(L CST Name (Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 /'/ 6"� 9 715-246-4516 Aid Property Owner _ Parcel ID # Page —of ❑I -I Boring # &pit Ground surfaceelev. ` r R. Depth to limitirg factor 1!f3 & in. To imdon Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIff 'ER#1 *Eff#2 L 3L—S� 5- rc /yn; ill �� [> 0-70 1 1-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM 'Ef#11 'Eff#2 Boring # 1:1❑ Boring ❑ Pit Ground surface elev. R. Depth to Ivrvtirg factor in. Shc Replication Rate Effluent #1 = BOO, > 30 < 220 rng1L and TSS >30 1 150 mgA. ' Effluent #2 = BODr < 30 mglL and TSS < 30 mg7L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB6t3N1rKA 1 Property Owner Parcel ID # /Page —of ❑ Boring J Boring # [,pit Ground surface elev. v r ft. Depth to limiting factor � in. Soil ligtion Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD#F 'Etf#1 *EEffff#2 Z. 3L-S� .S r lrn, G —Yh� x L ❑ Boring# ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth in. Dominant Cola Munsell Redox Description Qu. Sz. Cont. Cola Texture Structure Dr. Sz. Sh. Consistence Boundary Roots GPDITF 'Eff#1 I 'Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon 'lepth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIff 'Eff#1 I 'ER#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mglL • Effluent #2 = BOD, < 30 mgiL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. seae»u laeaol Project Name Soil Test Plot Plan KMW/Precision Builders Shaun Address 8807 Upper 7th Place N Lake Elmo Mn 55042 Lot 4 NW 1/4 SE Subdivision Meadow Ridge of Troy Date 'TIM #226900 11/15/19 1/4S 17 T 28 N/R19 W Townshi Troy ❑ Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft. System Elevation TBD p County ST. CROIX Top of 3/4" pipe *HRPSame as Benchmark