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HomeMy WebLinkAbout026-1142-51-000 Wisconsin Department of Commerce Count Safety aad Building Division PRIVATE SEWAGE SYSTEM r , St. Croix INSPECTION REPORT Sanitary Permit No: 429962 0 GENERAL INFORMATION (ATTACH TO PERMIT) ��� St to Plan ID No� Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. r Tlr`m • ( b Permit Holder's Name: City Village X Township Parcel Tax No: Miller, Sam I Richmond Townshi p a(o 114 9 � ozz) CST BM Elev: Insp. BM Elev: BM Description: LL Section/Town /Range /Map No: p . NL a C S 1 a M� ( 25.30.18. / TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic LZ4rCS 6i(Z_ 1000 Benchmark ) =-o Dosing Alt. BM 1 W 4sl S �'2— T Jam+ 3.0 0 . Aeration Bldg. Sewer Holding St/Ht Inlet 1 g. 1 TANK SETBACK INFORMATION St/Ht Outlet $ si .O TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �• 9 Q p Septic Dt Bottom > So a 12 q . Dosing Header /Man. 4 Aeration Dist. Pipe �fQ3 QI Holding Bot. System ' . Q PUMP /SIPHON INFORMATION Fin y w,U 12f «.64 1 Manufacturer �- Demand St Cover r 1 f GPM 4(o . O p3 • SG Model Number 1 G�• (6,% TDH Lift a , V Friction Loss System Head TDH Ft p•4� •So .o$ orcemain Length / 1 Dia. Z t� Dist. to Well q ' I SOIL ABSORPTION SYSTEM E ?Ti�1f' Width Length 1 No. Of T-wsh -a— PIT DIMENSIONS N . Of Pits Inside Dia. Li uid De th IMENSIONS r O (, .3" m� SETBACK SYSTEM TO P/L 1 BLDG WELL LAKE /STREAM 4OG nufacturer: INFORMATION CHAMBER Type Of System: el Number: DISTRIBUTION SYSTEM Header/Manifold Distribution I x Hole Size I x Hole Spacing Vent to Air Intake Pies (/ �� I 1/ ll Length Dia Length PSia ' 2 - Spacing 2 .� I f� 2 'S3 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over TBedp/ Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center rench Edges Topsoil - Yes [) No i Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection # Inspection #2: Location: 1371 141st Street New Ri mond, WI 54017 (NE 1/4 NW 1/4 25 T30N R1 i e 4orne Lot 51 Parcel No: 25.30.18. 1.) Alt BM Description �oe �� � � \�+ °*� 6-64- 2.) Bldg sewer length= Z O w - amount of cover = '-*2 3.) Contour = ____ —_ -- 1No e,A revision Required. _ - Yes C Jp Use other side for additional information. 4 11, _____ ______� __ f SBD - 6710 (R.3/9 ?) Q ` n � _ Insepctor's Signature Cert. No. cc 1 10 'vo2 ` F i AM up \ 1 NN "1 �- rd 3 a z � � VI -- w •� . N � oQ .� .� C o I 1 I w p � oQ, N °� v �," .p 0 0 U e Safety and Buildings Division County _ , 201 W. Washington Ave., P.O. Box 7162 cons in Madison, WI 53707 - 7162 Site Address De artment of Commerce j 3 f q 1 S�S Sanitary Permit Application Sanitar Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �L may be used for secondary Privacy Law, s15. 1 m C1 Check if Revision ` I. Application Information - Please Print All Informati State Plan I.D. Number Property Owner's Name Parcel Number 4 4�- / �q -7 i ©?,6- //5Y2 -S /-zf;D Property Owner's Mailing Address Property Loca " t'�ion �c �S ST. CROIXCOLINTY u (.V�yyI•S ZS�T 3 ON R City, State Zip C Lot Numbe Block Number Subdivision CSM Number 71 7 0 jf F H. Type of Building (check all that apply) ( ❑City 9 I or 2 Family Dwelling - Number of Bedrooms ku 4Y ❑Village ❑ Public/Commercial - Describe Use ownshi /[� lj We p 11 State Owned r io Nearest Road C// T T III. Type of P t: (Check only one box on line A4dumbering scheme for Internal use). Complete line B if applicable) A. 1 1 2 ❑ Replacement stem 3 ❑ For County use p Sy Replacement of 6 ❑Addition to stem Tank Onl Existing stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)( bering scheme is for internal use) " ❑ Non - Pressurized In -Ground 21 ound ? Zµ 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. DispersallTmatment Area Information: >—* L E -lO0 tL lE Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed ' Rae(Gal� ,Sq. 2) (Min./Inch) — Elevation �Sa 7IF' VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks -� v Concrete Constructed Glass New Existing / Tanks Tanks 7 � Septic or Holding Tank Y 40010 ,• , Dosing Chamber /o / — —+ VII. Respo nsibility Statement- I, the undersigned, assume responsibility for lion of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber''j Signature MP/IviPRS Number Business Phone Number Plumber's Address (Strect, City, State, Zip Code) 4 / 1 AlvAtope" VIII.Counnty /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater � Issued mg nt Signs o Stamps) Surcharge Fee) / ❑Owner Given Initial Adverse t] 00 l � j Determination IX. Conditions of Approval/Reasons for Disapproval s'tatJ k4f V16 Cen /� M -F. Lvh aGvnCi}� u u eQ n� e -d eta e e ��iL l�r, c� Z � �','1,�• lam- f L - �3, s �, �y2 mA-k i�v� ✓i+L �i it � aZt Gr' vw,� _ � 3. 3 - l t Attach comp plans (to the County only) for the system on not teas than :11 a In size SBD -6398 (R. 5 /01 ) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizo cerpoint (BM), direction and Parcel I.D. 62 / /t/2 — S/-CO O percent slope, scale or dimensions, nort w, A ration and,oistance to nearest road. diri j eview by Date Please p nt� mforwaation. , Personal information you provide may bus for se s (Pr'i' a- w, s. 15.04 (t) (m)). Property Owner PropertyLocat Oakwood Land DeVelO ! ¢ ^ Govt. Lot NE 1/4 NW 1/4 S 25 T 30 N R 18 K(or) W Property Owner's Mailing Address ST CROIX^ Lot # Block # Subd. Name or CSM# 1611 HY. #10 NE. courmr `- 51 na Red Pine Corner City State Zip ode Eftf fi ❑ City ❑ Village ® Town Nearest Road s S rin Lake Park Ric hmond E& New Construction Use: CR Residential / Num ms 4 Code derived design flow rate 6( GPD ❑ Replacement , El Public or commercial - Describe: Parent material glacial drift Flood Plain elevation if applicable ft. General comments n and recommendations: Cl mound @ el. 103.00', based on contour line of el. 102.50' /1 ❑ Boring # Boring 1 [� pit Ground surface elev. 103.1 0 ft. Depth to limiting factor _�0 _ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fY in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. r*Eff #1 `E ff#2 1 0 -10 10 2 2 none mfr 2f .8 2 10 -17 10yr4/4 none sil 2msbk mfr 1m 8 3 17 -33 7 5 4 6 n mvfr na 4 33 -90 5 4/4 none Boring # I Boring 102.80 33 F 2 KJ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0 -10 10yr2/2 none L 2msbk mfr 2 10 -33 75. 4/4 none ms Qsq mvf 3 33 -70 5 4 4 none it 4 70 -85 1 7.5 4/6 none ms 0s Effluent #1 = BOD > 30:E 220 mg/L and TSS >30 150 mg/L gffluent #2 = B ,: 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address Date E luation + nducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 8-8-2001 715 - 246 -6200 I l Property Owner Oakwood Land DeV . Parcel ID # Pendinct Page 2 of 3 3 Boring # ❑ Boring pit Ground surface elev. 20 ft. Depth to limiting factor 49 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 0 -9 10yr3/3 - none sl aw mvfr cs 2c .5 .9 2 9 -24 7.5yr4/4 none sl 2msbk mfr qw 1m .5 .9 3 24 -49 7.5yr4/6 none is Osg mvfr qw 1f .7 1.2 4 49 -80 7.5yr4/6 none sil /vf M na qW na 0 2 5 80 -90 10 7/3 none fractured limston na nn 4] Boring # Boring ❑ © Pit Ground surface elev. 100-20 ft. Depth to limiting factor 6 S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 0 -16 10yr3/3 none sl 2mqr mvfr qw 2 2 16 -45 7.5yr4/E none ms Oscr I m vfr 3 45 -65 5 4 4 n .2 .3 4 65 -80 10 7 3 F-1 Boring # ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R6M) STEEL'S SOIL SERVICE Gary L. Steel 1554.200 #h Ave. CSTM2298 Oakwood Land DEv. New Richmond, WI 54017. MPRSW -3254 NE'Nw4 S25- T30N -R18W (715) 246 -6200 town of Richmond. lot #51 -Red Pine Corner This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as sboWn as permanent lot lines mere not establidod at the time the test vas conducted. N 1 =40' BM.= top of 1" pvc pipe @ el. 100.00' alt. BM.= top of survey stake @ el. 96.90' Gary L. Steel 8 -8 -2001. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: 608 264 -8777 isconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary April 21, 2003 CUST ID No.225036 ATTN: POWTS Inspector MICHAEL P MC DONELL ZONING OFFICE MILLER CONSTRUCTION ST CROIX COUNTY SPIA 1070 HUNTER RIDGE RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 ,ttyNq&v CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/21/2005 Identification Numbers Transaction ID No. 861597 SITE: Site ID No. 658045 Sam Miller Please refer to both identification numbers, 141 Street above, in all correspondence with the agency. Town of Richmond St Croix County NE1 /4, NW1 /4, S25, T30N, R18W Subdivision: Red Pine Corner - lot 51 FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 900004 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • 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. • Comm 83.22(7) - 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. comliti P 0 x S. AP n MICHAEL P MC DONELL Page 2 4/21/03 Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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 per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Gerard M. Swim Balance Due $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Sam Miller 3 bedroom residential mound system Owner's Name: Sam Miller Owner's Address: P.O. Box 121 Hudson, WI 54016 Pcl. Add.: 1371 141st Street Legal Description: NE1 /4NW1/4, Sec. 25, T.30N., R.18W. Township: Richmond County: St. Croix Subdivision Name: Red Pine Corner Lot Number: 51 Block Number: na Parcel I.D. Number: 026- 1142 -51 -000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry RECEIVED Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications APR 18 2003 Page 6 Management and contingency plan Page 7 Pump curve and specifications SAFETY & BLDGS 111% ; Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Mike Mc Donell License Number: 225036 Date: 04/15/03 Phone Number: 715 - 386 -8692 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) OENARTMENf Of Coi' Version 3.0 (03/01/01) DIVISION OF ' FETYANDBUILDINGS Page 1 of 9 SEE CORRES IDENCE Mound and Pressure Distribution Component Design Design Worksheet S_ _ite_ I nf or mation (r or c) — RJ Residential or Commercial Design Note: Sand fill (D) calculations assume a 30 0.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 % coliform of — 36 inches. 450.00 Design Flow (gpd) 7.90i Site Slope ( %) 102.50 Contour Line Elevation (ft) 0 — U 7�4 - 'O – � Depth to Limiting Factor (in) In -si tu Soil Application Rate (gpd /ft 2 ) Dist Cell Information 9 Dispersal Cell Length Along Contour (ft) = F 5.00 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd /ft Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c! Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation_ (ft) 41 Number of Laterals of the highest point. _ 0.125 _ i Orifice Diameter (in) (e.g. 0.25) 2.50' Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.001 Forcemain Diameter (in) 35.001 Forcemain Length (ft) Does the forcemain drain back? _Y _ __.-__-. _.__ 95.001, Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 5.71 Forcemain Drainback (gal) 7.50 Vertical Lift (ft) 81.25 5x Void Volume (gal) 0.66 Friction Loss (ft) 86.96 Minimum Dose Volume (gal) 14.66 Total Dynamic Head (ft) 29.66 System Demand (gpm) Lateral Diameter Selection I Manifold Diameter Selection in. dia. options choice in. dia. o tions choic 0.75 - -- 1.25 x 1.00 x 1.50 x x 1.25 x 2.00 1.50 x x 3.00 - - _ - -- 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 750.36` Total Tank Capacity (gal) 1000.0_0; Septic Tank Capacity (gal) 3 Total Working Liquid Depth (in) Wieser Concrete_ Manufacturer 20 28 gal /in (enter result in cell B49) D_ _o_se Tank Information Effluent Filter In_ 75 Dose Tank Capacity (gal) ;Zabel_ _ _ Filter Manufacturer 20.2 D os e Tan Volume (gal /in) fA100 _ Filter Model Number Wieser Concrete - _Manufacturer Project: Sam Miller 3 bedroom residential mound system Page 2 of 9 Mound Plan View T :0. J Observation Pipe 3 — FK 1r'T'_1► 5 + •TA B �. . Z �. • • L Mound Component Dimensions A 5.00 ft E 10.20 in H Mft ft K 7.40 ft B 90.00 ft F 9.50 in z ft L 104.80 ft D 6.00 in G 0.50 ft J ft W 17.58 450.00 (ft Dispersal Cell Area 1 1181.96 (ft Basal Area Available 5.00 (gpd /ft) Linear Loading Rate 1 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 104.79 (ft) —► G H _ F Dis. ... .. ........ .... ... esal eli 103.50 (ft) La I tera 103.00 (ft) — Invert Dispersal Cell t Elevation E D ' J �, J ' J i ] 1, ] ]. i i, • i i, ], - ] J, l ], ], ] ] ] ], ], ] ], ], ]. J, J, ]. .• �i, i, ], i - ]. i, 1, i, 1 ��i (} : J !. J, J, - i i '], ] i 1 i ] i J J, 'I, ] �. f, 1, ,i, ] ~], '] - J ] ,]. ,i, i I J, ]. i i, .{ J, ,I, i, { 1, ,• I i J ] .{ ], j. .. .. .. { �. 1 02.50 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key — T Dispersal Cell See lateral details on ❑1 Topsoil Cap c 1.5 ft •• • •• Page 4 for number, Subsoil Cap '� 4 n •. ' size, and spacing of ASTM C33 Sand "n F laterals. Laterals are Tilled Layer H 0.5 ft Typical Lateral equally spaced from Q5 0 Aggregate 0 5 ;+ the distribution cell's -- A centerline in the distribution cell (AxB). Project: Sam Miller 3 bedroom residential mound system Page 3 of 9 i �r � r TV N A l NO a , G_ O G I r vA � r U r o � :ID e � G 1 o c r L4 r f f Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical will P �k •= Turn -up va'ball valve or IF X{ ­41<-021110241 Laterals & force main of PVC Sch 40 clean out pl u g per COMM Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft /orifice Lateral Flow Rate 7.41 gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head F 14.66 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented F— Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Cap acityl 750.36 Gallons —T Volume 20.28 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.51 375.30 B 2.00 40.56 C Pum off e levation (ft) C 91.14 96.00 4.49 D _ 1 243.36 D Total – 37.001 750.36 D ose tank elevation (ft) 3" Bedding un er tank. 1 95.00 --- - - - - -- Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number 98 Pump Must Deliver 1 29.66 gpm at 14.66 ft TDH Project: Sam Miller 3 bedroom residential mound system Page 4 of 9 I Mound System Maintenance and Operation Specifications Service Provider's Name Jim Thompson #30021 Phone 1 715-248-7767 POWTS Regulator's Name St Croix County Zoning Dept Phone 715_386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft Maximum FOG 30 mg /L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • ............. ............... Grade \ , 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral �,► Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Sam Miller 3 bedroom residential mound system Page 5 of 9 HEAD /CAPACITY CURVE w r 5 W , W' LL HEAD CAPACITY CURVE EFFLUENT MODELS TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE — EFFLUENT AND DEWATERING 63-66 _- -- SERIES 6759 D7 96 137-139 ,81 153 166 156 IBa 1W 1a9 _- FT. M. Gal Lila Gal. Lwi Gal. LVS Gal, Lin Gal. Utr Gal. L9s G.I. Ln. Gal L". Gal 19s. Gat Lts. Gr L." -- 5 1.62 43 183 58 212 72 27J IM 304 106 401 6I 231 61 231 68 220 166 687 166 547 - 10 306 34 129 46 174 61 231 79 300 100 .378 61 231 el Z31 68 220 148 680 151 672. 15 417 19 72 36 133 45 170 64 242 91 344 60 227 60 237 58 220 142 537 135 549. 20 Q10 16 57 26 96 36 1J6 B2 JtO 69 2TJ 80 227 68 223 I 6 1 6 14G SJ] V_ T 26 7.Q B 30 74 280 67 216 ba 223 58 220 30 9.14 66 .246 66 206 64 = 90 -340 56 270 121 468 127 481 40 .1219 46 174 46 .172 66 276 76 2W 68 220 106 197 1,4 ut; 186 50 .1524 21 60 33 126 61 191 66 .'219 6B 220 90 3411 1 3 N: I8.29 16 '67 43 IEI. >d 136 ba 220 71 2691 B6 3L 70 21.34 30 Ila 10 36 62 197 61 193 70 2 165 80 24,36 IA W 45 170 26 105 52 2,1, 90 27.43 32 121 2 B 37 14J 100 X48 1B 66 21 79 163 Ito 3200. 7 J - Lock V" 19.26' 2176' 23' 26' 66' 66' 67 73' 116' 91' 117 EFFLUENT & DEWATERING 65 Warning: Model 185 should not be subjected to less than 30 feet TDH. _ 189 Note: For Head Capacity on Model 112, industrial column- explosion proof pump, see FM 219. 161 T 97 1a8 98 — 5 55. 7,59 1 3 39 — SEWAGE & DEWATERING [ orrs ��• �� 4L)l So 601 70 ea 1 90 loo 1 „p 120 11 140 11 1 WARNING: Model 293 should not be subjected r Da �• 00 160 240 320 400 480 560 640 to less than 15 feet TDH. Q 9• GG P• M ,�� � a s ✓a-z�e r wee of 24 8,0 - - - - -, TOTAL DYNAMIC MEAD /CAPACITY PER MINUTE 75 SEWAGE AND DEWATERING - 22 - - -- SERIES 262 266 267 268 252 264 292 293 294 295 _ 70 FT. M Gal. LIn. Gal LIrs, Gal. L1r6. Gal Ltrs.' Gel Lim Gal Llrs. Gel. LI7s. Gel. LIt3 Gal Los _Gal Ltrs 20 5 t 52 90 341 126 484 128 484 128 484 130 492 180 681 140 530 196 742 225_85 _1 T 65 10 3 37 .05 60 227 69 337 89 337 89 3 95 360 158 598 124 469 181 685 205 _776 15 4 57 22.5 85 50 189 50 189 50 189 63 236 135 511 106 401 130 492 16 5 625 185 70. 18 60 - _20 110 10 38 10 3 8 10 38 33 125 ,06 401 88 333 119 450 1 558 168 6'.c 1, __25 7.62 76 288 68 257 106 40 1 136 515 ,5 3 30 9 14 _ 43 163 47 t76 _ 90 340 121 458 146 530 55 _ - 16 i = 40 12 19 _.._ _ 5 19 50 189 - 94 356 _. J'_ 50 15 24 50 - _ _ __ -_ _ _ - 58 220 85 -397 -1 — T — 60 18. 29 __ 13 49 5S 2); li T 70 21 34 - -- _ - PS 9-__ -. 45 - lock valve 18' 21.5' T 2l 5 -- _21 5' 26' 35' 42' 12 ._ 40 1 l 35 - 30 8 T 293 25 I 6 20 4 zee 10 292 2 5 i 262 266, 267, 268 284 284 285 — 0 GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 220 230 LITERS 0 80 160 240 320 400 486 560 640 720 800 880 it ♦ G /eda� "0� • �.oC�t�d�U/'op. she "/0' 7,, 0 /' O 19 /2' p,;oe • Ass a.nec✓ a lea: = loo w.' Q ■ � r _,o a.s o� s r /03.0' �- P p c4an6u I i� / S 4. S�0 ll � � ✓,C. Farc � o i B� proposed i, ce � o Prop osed,�touadat t —s.r4q j&,6 /C rl 17 5 /05/ e o'w/ 6'x 90' 14-46b e*luc„ 6 dl'5 bu.L'on Cel/. lour( 00; Ctc /a 14 6�G�.I /a 6e.ra s 4 & 0 l x W ' W/ i 1 yB ° o� F ces S,oace S3 garag � � Prop oscd I i 3 be'droor" AO- e$,'de4Ce o •F- pr pose I we Proposed drivcvJO-`� ,z7G.89 .�o I �.B o�9 Mound System Management Plan W 1-12, 9 q & Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet finer shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD5, 30 mg/L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Sam Miller 3 bedroom residential mound system Page 6 of 9 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 7i Number of Bedrooms Design Flow - Peak (gpd)S� Estimated Flow - Average (gpd) 3 Septic Tank Capacity (gal) oeao Soil Absorption Component Size (ft') ,,$D s. Ya, (O_ Type of Wastewater 4Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) / So f.-r- Maximum Influent Particle Size (m) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank In spect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping. Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic JaaLaDd outlet filter shall be assessed at least once every 3 years by inspection. T outlet filter @bIl b proper o ation The filter cartridg of e removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the I r � Management Plan for a Sceptic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 11 s S Cd yr t r 3 ae ema '�� t 3 d es . y k f 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT . AND OWNERSHIP CERTIFICATION FORM Owner/Buyer L L Ey- Mailing Address I -'o '�� S/ HU �s o s • � � ���� � � Property Address I ? r I ( 3 Al w (Verification required from Planning Department for new construction)_ city/state Q i G k 44 0 J Parcel Identification Numb � Z I� �Z Sl — Q'x� wn_sT. n t^R1iPTION Location AE- V, � ' /•, Sec. z �. T N- � own of /�' 1 • o Property etc I Lot # Subdivision k D � / � 3 . Certified Survey Map # 117 3 Volume . Page # $ 7 ( - 7 -? S `� . Volume Z Z y • Page # Z" Warranty Deed # - Spec house Rkyes ❑ no Lot lines identifiable Oyes ❑ no SYSTEM MA6uE could result in its premature failure to handle wastes. Proper maintenance use and mamtenanceof Your septic system t you t into the system Improper Wh consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. Y pu the can affect function of the septic tank as a treatment stage in the waste disposal sys' The property owner agrees to submit to St. Croix Zoning Departm a certification form, signed by the owner and by a 1 the on - site wastea►aterdisposal system mastcrplumber, lourneYmanplumber, restn that ctedplumberoralicensedpumperverifyin ( ) is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is leas than 1/3 full of sludge. have read the above requirements and agree to maintain the private sewage disposal system with the standards Uwe, rth undersigned ent of Natural Resources, State of Wisconsin. Certification set forth, herein, as set by the Department of Commerce and the Department stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Og within 30 da the three year exp ra n date. � DATE ATURE APPLICANT QVM ['FRTIFI[ ATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s of the p described above, ] % virtue of a warranty deed recorded in Register of Deeds Office. 7 O/03 G �A CANT DATE F APPLICANT «« «««• A information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. «• Include w ith this appUeation. a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed J 2 2 10 P 2 0 5 -7 1 -7 -7 a.4 r STATE BAR OF WISCONSIN FORM 1 —1998 KATHLEEN H. NALSH WARRANTY DEED ST. OF ,DEEDS ST. CROIX CO., YI Document Number RECEIVED FOR RECORD This Deed, made between Oakwood Land Develooment Inc.. a 04/17/2003 03:16PH Limited Liability Company Grantor, and Sam E. Miller, a single WARRANTY DEED person , Grantee. EXEMPT I Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00 described real estate in St. Croix County State of TRANS FEE: 508.50 Wisconsin (the "Property"): COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address Sam E. MillAr 1381 1plet Strew N ichqjc,4 WI 54018 /kor Syol� 026 1142 48 000 Parcel Identification Number (PIN) This Is homestead property. (is) (is not) Lot 12, Red Pine Comer and Lots 47, 48, 50 a d 51, R d Pine Corner 1" Addition, Together with all appurtenant rights, title and Interests. none Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this day of Agri! 2003. (SEAL) (SEAL) • Oakwood Lan eveiop t Inc. (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, WENOY !3WATZ ) as. authenticated this �y o Y St. Croix County $ ► C V Personally came before me this day of ApAl, 2= the above named Gregor a s r to me known to • be the person who exec kdthe fore going TITLEC MEMBER STATE BAR OF WISCONSIN inst ment an acknowledge th rr i f not, authorized by §706.06, Wis. Stats) [ THIS INSTRUMENT WAS DRAFTED BY Notary Public, Stat of Wisconsin Coldwell Banker Burnet 1301 Coulee Road My commissio I pe anent. (If not, state expiration date: Hudson, WI 54016 3 -31793 1 (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. F WARRANTYDEED FORM No. 1 -1998 Milwaukee, Wis. 0 f ca / � k � T i Q! § cp ic / 9 0 = k _ r } G) \ N CD \ 0 g - § E § f § § �a) § E O To o E E 9I, / © Q E r g 3 � .. f 3 \ $ $ K CL z ) \ { 0 0 0 ; � w � g J o - ƒ K k k k \ / § i ■ ■ ■ - J E 2 / J § CD \ B 0 CL 0 § _ f „ . k . 0 \ } / § £ � w » z 2 ■ � E - ■ _ R § R / I" T 7 / § E § z k k 7 2 � 2 k � _ > CL 70 q / % ; ƒ � � � 7 � $ � \ § o @ CD % k CD o k �