HomeMy WebLinkAbout018-1018-40-200Wisconsin 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)].
Homes
BM
TANK INFORMATION
TOWN OF HAMMON
TYPE
MANUFACTURER
CAPACITY
Septic
QUU
Dosing
v
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO
�Pl•Lt
WELL
BLDG.
Ventto Airintake
ROAD
Septic
V
Dosing
Aeration
Holding
PUMPISIPHON INFORMATION
Manufacturer
Demand
LI C
GPM
1-- 4 D
Model Number
L^ 0 O
TDH
Lif(O
FrictiorrysS
Syste eadd
TDH Ft
II r
L-•
r !
�S. � Z
ForCRmain
Len
Diaz n
Dist. to Well
`
SOIL ABSORPTION SYSTEM I yL I<
ELEVATION DATA (,2
St. Croix
!rmit No:
617812
ID No:
No:
018-1018-40-200
en/Range/Map No:
09.29.17.135D
STATION
BS
HI
FS
ELEV.
Benchmark
Cl
Alt. BM
Bldg. Sewer
9r7
SVHt Inlet
SVHt Outlet
Dt Inlet
Dt Bottom
1,2 ,
Header/Man.
3.3
/o2. g
Dist. Pipe
Dz
Bot. System
�• �
Jc72.
Final Grade
St Cover
h
f 7'
.y
('
)Di. 1
BEDITRENCH
DIMENSIONS
Width
Length x
5
Np,.6f+r9Mes�
PIT DIMENSION
No. Of pits
Inside Dia.
liquid th
SETBACK
SYSTEM TO
1P/Lj<ajBLDG
IWELL
LA !SRAM
A IN
AM E OR9_
U I
tuINFORMATIONTypeOf
System1"6C
w_'K/l
u r:
F
WIZ 1 RIGU I IVN JTD 1 CIYI
Header/Manifold
/� 1 J'
_r L
Distribution
Pipets) `L. v 'Z rt� `
"
x Hole Size
l
� ,
x Hole Spacing
`
Vent to Air Inta/kej
Length Dia
Length Dia Spacing
-Z
V
OVILI VVCM
II Pressure gvsfeme only
. M--A n. e.-r_—we e.... nnl,. J.in /L . 11
Depth Over
YI
I
epth Over s
t
xx Depth of
m Seeded/Sodded
m Mulched
Bedfrrench
ever
x.
C
edrrrench Edges �
To 1'7 ,t
yes
No
X Yes
U No
Lt r
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 31 �) Inspection #2: Y/Z3/20 so ja6
Location: No Address Available i —I T - „ . (— / e ,/ FLOW
I IV\rs !11 kT `I i'"Vt�l��` .� (i�Ct'iC "FGN �+—/—,,[/
1.) Alt BM Description = A-;0 cave./!' � � r L y (n 91 0 I ��'/
2.) Bldg sewer length = 153N l �ut• t^j �' J G �> ?/i5,,, 4 (y' P
-amount of cover= u1S"Iff wi%WO-
%01krCd a) 7n5 ftG}toM. Nb Vsc1l ® iV P're �,(b///./1 0 rt l
Plan revision Required? [Yes �yg��'o '7 //7 I� J
Use other side for additional informatiorS. G� L E'/y0
SBO-6710 (R.3/97) Date Insepctor's Signature Can. No.
�ovtt�l,�5 w� PS d
I!
Canny
CDC+
Safety and Buildi"Mision2D1
Permit Number (m be em by C°.)
W Washington Avmaery
Wl 5-ro�
20Madison,
St. Croix County tary Permit Application an YVMU
SM ansamon Number
—03 200� 16 -M
Nis. Ada- Cod, wbmwim of Ibis form m the apptop+ime Bovemmemal mil
Project (if diffaeatt the marlin$ add=)
is malvired prim to obtaining as any, permit Now Application ibrms for sta c-owned PO WTS ate submumd m
the Depattment of Safety and professional Servies. Petsmal information You provide may be used for secondary -
purposes in accordance with the Priywy law, s.15. 1 m Stets.
rl1�
� 635 1 4
L Application Information - Please Print All Information
Property Owner's Name-7 o ^Q
L
Pucda
- y
a
Prop�y �er,s
Property Location
Oovl. Lon
' yy sects
Cary, Z+aPCode PhoceN
i!
TZ N; RE W
Tot
R
IL Type of Budding (check all that apply)
Subdivision Name
Family Dwellirb-Number of Bedrooms
Bbckg
Lyn, of
❑ PublicJrJommercial - Describe Use
❑ state owned- Desmrbe Use CSM
1o9
of
�,❑,,�� CT?
7[LTown of
,
Number
I S`7
III. T f Permit: (Check only one box on line A. Complete line B if applicable)
A'
99— System
❑ Replsxmem system
❑Treanoem/Eoldmg Tank Replacement Cady
❑ Odw Modification m Existing System(explain)
B.
❑ Pewit Renewal
ermit Revision
❑ Change oMcniber
❑ PennaTrausfc m New
lAA Previous Paw Numbs and Dag LacedBefore
Expiration
0 '
6 /
fir. Type
ofPOWTSS stemlCom nenNDeviee: Check all that
❑ Non-Presmriaci ln-Cmund ❑ Pressotimd In4mand ❑ A14rade d> 24 is of miuble soil ❑ Mound 124 in. unteble sob
❑ Holding Tack ❑ Otha DispasalCompoo tam) Praremne°t Device (explain) i
V.Dis mVfrertment Area Information:
rZNU
Design Flow igpd) Design Soil Application Rdtf&dsp
Disyewm l Amer Required (sf)
Dispersal Ann Proposed (sf)
Elevation
jv 1.
y�
!oa
VL Tank Info
Capacay in
dons
Units
Monitfacmet
c
N.T.I. FrieungTMIM
Septic«Holding Tank
D.� c
6 v
VM Responsibility Statement- L the undersigned, siblib for insmliation of the POWTS shown on the attached plans.
s Nmc (Riot)
`
Pl i
MP/MPRS Number
Business Phone N
-,
«2
2 u�
7✓� --
Phun 's Address (S , State, Zip )
�1 )
L N
Co /De
ant Use Only-
APWovM
Lrtme coved
Permit Fee
s QA
Date Issued
�3�2oza
f Agent Si
OwnerGiv®Reason fro Uenial
DL Conditions of Ap "al/Reasons for Disapproval 3 y1A,.a 4 1 &A l
SYSTEM OWNER: LL
1. Septic tank, effluent filter and ;!h 4O U,Se o-
rwrl
dispersal cell must gservicedj maintained I �L
as per management plan provided by plumber. J
as per
SBD-6398 aL 11111)
19
FUR
Po paper PotieaslWu tn_xll rariesm r,r�
�Q4 Provi dL2 S t^4c�t�pt�lw^tP
System PLOT PLAN
PROJECT Overinc Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 114 SW 114S 8 /T 29 NIB 17 W TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 102.5' DATE 2/29/20 BEDROOM 3
CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 6530
HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none
IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter
[:]BOREHOLE O WELL rH.R.P. same as benchmark
2 Acre Lot
q 40 80'
1 1
1/4" = 10' Scale
�J
�O
Well Is to meet all WDNR setbacks
3 Bedroom
House
1 02'
11
101.5' '
Area 15' below
system is to remain 101'
undisturbed ❑
100' B-1
1701h St.
Property Line
Grading is to be done
to divert run-off
may from system
6,0%
4% Slope B - 3
B.M..
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY WI 54304-5211
Contact Through Relay
http://dsps.wi.gov/pmgmms/industry-services
www.wisconsin.gov
Tony Evers - Governor
Dawn Crim - Secretary
March 2, 2020
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2022-03-02
Plan Review: PWTS-032000016-M
SHAUN R BIRD
1432 120th St
New Richmond WI 54017
SITE: Revering Homes
Lot 2 170th st.
Town of hammond
Saint Croix County
Total Amount: $80.00 — Revised POWTS Dispersal Area
FOR:
Description: 450 GPD (3 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 g 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 (11)(c)
• 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, tree roots, stumps and boulders reduce the amount of soil
available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off
at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide
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 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 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%+� �,a" �&e
POWTS Plan Reviewer— Wastewater Specialist
Department of Safety & Professional Services I Division of Industry Services
email: tim.vanderleest(&,wisconsin.gov
Cell: 608-516-6134
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 2/29/20
Owner:Oevering Homes
Plan Revision: 012000110-C
Location:NW1/4 SW1/4 S8 T29N,R17W Lot 2 170th St. Hammond
Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7. Ffter Specifications and cross section
8-9. Maintance and contingency plan
Attachments: soil test
Shaun Bird
Signatu
License n>LTt`ptSer 226900
/oteq
PROJECT Overina Homes
NW 1/4 SW 114S 8
System PLOT PLAN
ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
/T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 102.5'
2/29/20
3
DATE
BEDROOM
CONVENTIONAL
AT -GRADE
CONVENTIONAL LIFT
HOLDING TANK
XXX
SEPTIC TANK SIZE 1000 gallons
LIFT TANK SIZE
DOSE TANK SIZE 6530
MOUND
HOLDING TANK
SIZE LOAD RATE 1 .0
ABSORPTION AREA 456
# of chambers none
BENCHMARK
V.R.P. Top of survey iron
ASSUME ELEVATION
too' Filter Lifetime Filter
❑ BOREHOLE
O WELL *H.R.P. same as benchmark
2 Acre Lot
40' 80'
q' I i
1/4" = 10' Scale
Well is to meet all WDNR setbacks
170th St.
Property Line
3 Bedroom Grading is to be done
House to divert run-off
away from system
Huffcutt Combo Tank
4% Slope B - 3
102,
Area 15' below 101.5' -
system is to remain 101'
undisturbed
100' B-1
0,Pq7
B.M.'
Mound System Cross Section and Plan View
— = Topsoil = ASTM C-33
Cap Material sand fill
Geotextile
G
Fabric
7
Ft Contour
= Clean aggregate
ri Yz to 2 %a in. dia.
E
Slope Direction
Dimension
F t
A
n
K
'$ L
L
]S,
W
z
---
slo
era
= 4 in. sch. 40 pvc
0 observation pipe
H
1 F1
GENERAL. INSTALLATION: The mound area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or
chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a''/. inch soil wire
when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately
after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot
thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound
is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The
observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange.
10107 lgj
Page -3- oq__
Manifold
Force Main
03/05 lgj
Pressure Lateral Layout
Two Laterals — End Manifold
Lateral Turn -up —10
M
Tf—
L
4-- Threaded
Cleanout
Plug
Pressure System Construction
Long
Sweep
90
Bend
Laterals are constructed of Schedule 40 PVC
pipe. Orifices are drilled perpendicular to
the pipe with a sharp drill bit and face down.
Lateral turn -ups terminate with a threaded
cleanout plug and are enclosed in a 6-8 inch
diameter lawn sprinkler valve box accessible
from finished grade.
• • • • • Grade • • • • • •
6-8 Inch Lawn
Sprinkler Valve
Box
Page _± of �_
Septic -Dose Wank Cross Section And Pump Performance Specifications
Filter Manufacturer i�
Filter Model Number Z .
Minimum Pump Performance Required
YU OPM /-J— 6� Ft TDH
Outlet Manhole * 4" Above Grade With
Locking Devioe. Inlet Manhole
< 6" Below Gritde Sealed Watertight
.► — � � Fuiiehed Grade
I Outlet Filter
Inlet r: �� Inlet Bale
{:
Switch and Reserve Capacity
Tank Volume= S GPI
DimegWon,
Inches
Volume Gal.
,
EVA
2
D
r
/ -r
2
L
Total Dynamic Head (TDH) - Foot
Elevation Head
zo
Distal Pressure
3 C7
Network Loss
Force Main Loss
/.
Total
/ s
Manhole Min. 4" Above Grade
Securely Mounted
With Locking Device
Weatherproof
Junction Box
t
Vent Min. 12"DisconnectAbove
GradeMesas
With Vent Cap
r3mi 31
Off Elevation C
`ice a Bottom
D t EElevaalionn
9,2
GENERAL INSTALLATION: The septic/dose tank is bedded and beck filled in aceoadance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer 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 4r Sch. 40 PVC to bridge the tank
excavation and the sleeve in sealed watertight. El lies with NEC 300 and Comm 16.23.
Page
02105 U o
280=SERIES
112 hp Submersible EffluentfSump Pumps
The Liberty 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 280-Series will provide years of reliable performance.
All Models Feature:
• Vortex style impeller permitting passage of solids
up to %"
• 416 stainless steel rotor shaft
• Permanently lubricated upper and lower ball bearing
• Epoxy powder coat finish
• All fasteners -contusion -resistant stainless steel
• 1 Y2" Discharge
• Stainless steel bottom screen -easily removable
• Maximum fluid temperature:14V F.
280-Series Cord Lengths
_Model to' 25'(-2) 35'(-3)
501-5)
280 Standard Optional Optional
Optional
281 StlexWd Optional Optional
Optional
283 Standard Optional Optional
WA
287 Standard Optional WA
WA
10' cwd length standard on all models. For optional lengths,
add "-2, •3 or -5" suffix to model number.
Example: for model 280 with 35' cod, order 2W-3
Motor Specifications
Y2 hp 60 Hz 3450 RPM
Oil filled, thermally protected
(PSC) Permanent Split Capacitor
8.0 amps (115V)
4.0 amps (208/230V)
Performance Curve; 2804Series
1
......... mmmmmmmmommmmmmmmmm 1
U.S. Gallons Per Minute
38 78 114 IN 192 228 270
Liters Per Minute
Dimensional Data:
Weight: 29lbs.
Height 13"
Major Width.10" (model 287)
Minimum Sump Diameters:
Model 281, 283... 14"
Model 287 VMF... 10"
Factory switch
Model 281, 2113
Model 287
settings
VMF
Turn on level
13"
9.5"
Turn off level
7"
4.0"
The Model 283 features a fulty adjustable wide-angle float. Difterentiai
adjustments can be made easily by tethering the float to the dis-
charge pipe or other mounting point vertical float model 287 Is not
adjustable.
d
Model 280
Model 281
Model 283
Manual,
Wide angle
Wide angle
no switch
float switch
float switch
with quick-
3,
with series
disconnect
19,
(piggy -back)
plug
(� a
c us
Certified
sP.dlk�o„s a..qe,.. ro a,.,p" wmout .
Liberty Pum • 7000 T
Model 287
VMF-Series
Vertical mag-
netic float for
smaller pits -
will operate in
a 10" diameter
sump
ps Apple ree Avenue • Bergen, New York 14416 • Phone 800-543-25W Fax (585) 494-1839
ww%v.Hberfypumps.com Copyright o L ft ty Pumps, Im 2017
6 &9 Ar rlghi• reesved. LAZ=Re5r17
20140048A
ma 5200
198000
I8.0000
1.1921
-40
93759
.01cm between cm am 9.4356
\ ✓A 1
SECTION A -A
POWTS OWNER'S MANUAL & MANAGEMENT PLAN vaga— .f_.
INFORMATION SYSTEM SPECIFICATIONS
FIL E
Owner P P
Septic Tank Capacity
Septic Tank Manufacturer
9ai j[03Permit NA
#
DESIGN PARAMETERS
Number of Bedrooms
❑ NA
Number of Commercial Units
NA
Estimated flow (average)
dipgal/day
Design flow (peak), (Estimated x 1.5)
fJLD gairday,
Soll Application Rate
0 gaVda fle
Influent/Effluent Quality
Fats, Oil & Grease (FOG)
Biochemical Oxygen Demand (BOD,)
Total Suspended Solids (TSS)
Monthly average*
s30 mg/L
420 mg/L
5150 mg/L
Pretreated Effluent Quality ❑ NA
Biochemical Oxygen Demand (BOD,)
Total Suspended Solids (TSS)
Fecal Coliforn (geometric mean)
Monthly average"
S30 mgfL
s30 mg/L
s1W cfu/100ml
Maximum Effluent Particle Size
K Inch diameter
MAINTENANCE SCHEDULE
• Vakxs typical for cf m $ c (nw-0 mroMial) wastewater and
septic tank effluent
Values typkJl for patreated wastewater.
Service Event
Service Frequency
Inspect condition of tank(s)
At least once every
❑ months' earls)
(Maximum 3 yrs.)
Pump out contents of tank(s)
When combined sludge and scum equals one-third %) of tank volume
Inspect dispersal cell(s)
At least once every
' earls) ❑ months
(Maximum 3 yrs.)
Gean effluent fitter
At least once every
❑ months7'CLkear(s)
Inspect pump, pump controls & alarm
At least once every
❑ months s)
❑ NA
Flush laterals and pressure test
At least once every
O month r(s)
NA
Other.
At least once every
❑ months ❑ ye s)
NA
Other.
At least once every
O months ❑ year(s)
NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an Individual carrying one of the following licenses or
certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage
Servicing Operator. Tank inspections must Include a visual inspection of the lank(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) shall 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 local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the
entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR
113, Wisconsin Administrative Code.
The servicing of effluent fitters, mechinlcal or pressurized POWTS components, pretreatfinent components, and any
other maintenance or monitoring at irlervals of 12 months or less shall be performed by a certified POWTS Maintainer -
A ser Aqg report shall be provided to the local regulatory authority within 10 days of completion of any service event
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment lank(s) for the presence of painting products or other
chemicals that may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a septage servicing operator prior to use.
V CD1 /
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 thut
may Impede the treatment process and/or damage the dispersal Cell(s). If high concentrations are detected have the contents of thH
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 highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the oell(s) and may result In the backup or surface discharge ofeftloue
rill
To avoid this situation have the contents of the pump tank removed by a Septage Servicing operator prior to restoring Power
the
effluent pump or contact a Plumber or POWTS Maintainer 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 Partonnance end prolong Hta Ida of the POWT$.
anbblotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat foundation drain
(sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meet scraps; medications; oil; ps'hting producC
Pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails andlor is permanently taken out of service the following steps shell be taken to Insure that the system Is pr0pe(ly
and safety abandoned In compliance with chapter Comm a3.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• 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 filled with soil,
gravel or another Inert solid materiel.
CONTINGENCY PLAN
It the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code Complipra
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement son absorption systan.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the naiad
for a new soil and Ella evaluation to establish a suitable replacement area. Replacement systems must comply with the ruled in
effect at that time.
❑ A suitable replacement area Is not available due to setback and/or soil Iimkall.xre. Barring advances In POWTS technology a
holding tank may be Inatalled as a last resort to replace the failed POWTS.
".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 Installed as
I resort to replace the failed POWTS.
Mound and at -grade ad] absorption systems may be reconstructed in place following removal of the blomat at the Infiltrative
surface. Reconstructions of such systems must comply with the rules In effect at that time.
«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 OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS —
POWrS INSTALLER
POWTS CAAINTAINER
Name
Name
S,( '
Phone
_ — Ell
Phone
SEPTAGE SERVICING OPERATO PUMPER
LOCAL REGULATORY
Name ' '
Ia
GAiiZ//
Phone �_�����_
Phone
This document was drafted In oompllence with chapter SPS 3e3.22(2)(b)(1)(dW1) and 383.54(1), (2) 6 (3), Wisconsin AdnlnlsHaUL Cod•.
9o47
Wlsomm Deparlrtnernt of Commerce, SOIL EVALUATION REPORT Page _of_
DhAson of Safety and Buildings
In accordance wan L.omm Dd, wY15. rwm. W e
Attach compete site plan an paper not less than B 12 inches 11 ves in size. Plan must
include, but not limited to vertical and horizontal reference Point IBM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
PenenM Mtenr,etion Yoe Pro meY W .tied for eecorWary pvmoees (Prhery t.sw. e. IS al (1) (m)).
- /A' C
County `J * / ' fl fix_
Parcel I.D.
Reviewed by Date
Pm ty owner
0Q J P e' ��
Property Locationi
Gcvt Lot A/) 1/6C 4(— 114 S g TZ N R Z E (o)
PropertyOwner's rasa
Lots
2
Block a
Sibd. Nero or tSte t
S e Zip Coda umber
G ( )
❑ city Village T Nearest
i
Conatnucllon Used' Residential / Number of betrooms Code derieed design flow role GPD
❑ Replacement Public Pubic or commercial - Decmbe.
Parent maledd ./.f Flood Plain elevation if applicable y�//`— ,-- If
General.marts
and recommendations. /
System Type z4c System Elevation /n,2• _
a°
Borings Pit Ground surface elevZIM R. Depth to fervting facto C C� n. Sok Application Rate
Hfodzon
Depth I
in.
Dominant Color
Munsel
Redo: Description
ou. Sz Cont. Color
Texture
Struc4ne
Gr. Sz Sh.
Consistence
Bourdery
Roots
GPDIT
'Effp1
-Efaf2
p-
z-
f
Z^
%
m
'If
�
3
s
S
_ -
i
i
Z
C-
F-I
F=F
Boiling a ❑ Boning '� /7'�
,8. Pit Ground surface blev. Z Depth to Inv" factor � in Soil Application Rate
Horizon
ColorRedox
Munsel
Description
ou. Sz Cont. Color
Textue
StructurConsistence
Gr. Sz. Sh.
oBoundary Ros
GPD/ff
'Ertut
-Effs2
�z
6DepthDonnant
,-5
i
Y, -3
Effluent a1 a SOD- > 30 < 220 m1g1L and TSS >30 c 150 ' Effluent 12 • goo. <:w mgrL arc i a - .w -Vq
CST Name (Please Print) elure CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Adtlmss Dg�e valuation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 oV -,2-(-) 715-246-4516
Property Owner— Parcel ID # Pa
Redox Description
Cu. Sz. Cont. Coor
WIMMOMWAII
o� # ❑ eon
❑ Pit Ground surface elev. ft. Depth to Iimifing factor in. Soil Appfication Rate
Rortmn
Depth
in.
Dornunarrt Color
Mrmeetl
Redox Description
Cu. SL Cont. Color
Texhxe
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDM
•Eff#1
'ER#2
Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Ertluem #1 • BODr > 30 < 220 nnWL and TSS >30 < 150 nV& . Effluent #2 • BODr < 30 < 30 rnWL
rtg1L and TSS
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.
ss"JWMR ,
Soil Test Plot Plan
Project Name Oevering Homes Shau
i/
Address 1433 Cernohous Ave Suite A
New Richmond Wi 54017
Lot 2 Subdivision
N W 1/4 S W 1/4S 8 T 29
N/R17 W
Boring Q Weil PL Property Line
BM or VRP Assume Elevation 100 ft.
IL
System Elevation 102.5'
2 Acre Lot
ftM #226900
2/29/20
Township Hammond
County ST. CROIX
Top of survey iron
'HRPSame as Benchmark
170th St. B•M.*
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I If
Division of Safety and Buildings
h Com 5 W
m accordance wit m 8 , is. Mnn. Code
Attach complete site plan on paper notless than B 1 /2 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.
Parsers: inlama4 you yravide may be used for ae dsry purpe (Pme" law. s. 15.04 (1) Im)).
c
Co"ty'1* /x
Parcel I.D. �1
8 — Q �O '- O — 2 Cc
R awed by ,Q
J
Date
'V
Property Owner
oQ J P f i(n
Property Location
Govl. Lot f✓4// 116U-..,114 S g TZZ N R E (a)
Property7Owner's Maili dress
J Z /St A S
Lot #
��--
Block #
—
Subd. Name or CSM#
Ctty S e Zip Code Phone Number
El City Village =Nearest Road'/_
S
New Construction Use. Residential I Number of bedrooms Code derived design flow rate GPD
❑ Replacement Public or commercial - Describe:
Parent material Flood Plain elevatign if applicable y///�/f� ft.
rrrru
General coenls I S \) 2 N SB t I
and recommendations:
System Type ///f%lGr9 System Elevation
Boom ❑ Boring
# pit Ground surface elev 7P i R. Depth to limiting factor in.
Soil iretion Rate
Horizon
Depth
In.
Dominant Color
Munsed
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDIif
•Eff#1
•Eff#2
o---
5
B«irg a ❑ Boring p
�, pit Ground surface elev. /" / R. Depth to limiting factor =-,L in.
Sod Application Rate
Horizon
Depth
In.
Dominant Cdor
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDIff
•Eff#1
•EfW
I
.3l:
--�
01
C;-
z
`f
• Effluent #1 = BOD- > 30 < 220 mg4 and TSS >30 < 150 •Effluent #2 = BOD, < 30 mgll and TSS < 30 mg/L
CST Name (Please Print) ature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Apluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 �� 715-246-4516
Property Owner
Parcel ID #
Page __?, of
•w d•: i
Imo►
•t�Df�ll��'1l�_
'//�Jd��+/:I��JI�!���:�I
N
: �w
El pit Ground surface elev. - ft. .: 55 O cMw
El pit Ground surface elev. - ft. .: 55 O cMw
Effluent #1 = BOD, > 30 < 220 mglL and TSS >30 ! 150 mg& ' Effluent #2 = BODY < 30 mg/L and TSS < 30 rtg&
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.
S.DJ16M nt.6W
p-3t3
Soil Test Plot Plan
Project Name Oevering Homes Shau
Address 1433 Cernohous Ave Suite A i
New Richmond Wi 54017
Lot 2 Subdivision ---------
N W 1/4 S W 1/4S 8 T 29 N/R17 W
Boring Q Well PL Property Line
BM VRP Assume Elevation 100 ft.
M #226900
Da 2/29/20
Township Hammond
County ST. CROIX
Top of survey iron
ystem Elevation 102.5' *HRpSame as Benchmark
2 Acre Lot
C
5AO► a'dO - 401
^aUldIndustry
Services Division
County, C
0400 E Wash�pgton Ave
Sanitary Permit Number (to be filled in by Co.)
•
y
P.O. Box 7162
my
elopment
Madison 537 7-7162
O
� ! 7gl�
m
Sanitary Permit Applica ' L
Mate Transaction Numbe
t
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the vernmental unit
0 ec Address (if ch Brent than mailing address)
is required prior to obtaining a sanitary, permit. Note: Application forms for state-owned POWTS ined to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
Purposes in accordance with the Privacya Law, 15.04 I m Stals. k
_ L /� S I� I ,r,/47/lJ
'�IIZ i
1. Application Information —Please Print All Information
Property Owner's Name
Porcel a'' OI6 —q o -aw
Property Owner's Mailing Address
Property location
?
Go"
Y. /�.,gSection
City, State
Cade Phpre
Number
/(1
-tcle
L/
i N: W
II. ype of Ben"ddi.,1,he.c 1 at apply)
a
Subdivision Name
I" 2Fami1y Dwelling -Nuns ofBedrow�o
sL�
iwR �
r�
Black a
❑ PubliUCommercial - Describe Use
❑ City of
❑ State Owned - Describe Use
❑ Village of
CSM Number
.6
III. Type it: (Check only one box on a A. Complete Iiq;B if app' e)
`t'
New.$ystem
\
❑ Replacement System
❑ Togiment/Holdi T cement
❑Other firation to Existing System (explain)
B.
❑ Permit Renewal
❑ Permit Revision
hange be P mnsfee to Ne
Revimus Permit Number and Diu: Issued
Before Expiration
r
IV.
ofPOWTSS tem/Co en Ice: h k that
❑ Non -Pressurized and -G Mount m. of suitable wait < 24 in. of suitable soil
I
❑ Holding Tank l Com ent xp ❑ Pretreat t Device (explain)
V. Dispersalf1fireatilifent A& Informal o Lf
[last (gpd) i oil ADPlicati SO rsauire ;�d,
Dip 0 A ID�
fJ
S /
/Flow
[/
Elevation
J/
VI. Tank Info
opacity in
Total
s
Manufacturer
Gallons
Gallons
Uni
ro s
u
New Tanks
ExrenBT
Sept. or Holding Tuck
Dosing Chamber
U
1
Li
VII. Responsibility Statement- the undt red, n responsibility for installation of the WTS shown on the attached plans.
ern PI 's None (Plu er' ignaturc
MPIMPRS Number
Business Phone Num
�w
Plum 's Address (Street, City, State./ - ;
'ln'.il•.Jrn�/
our /Dertment Use O 77
Opp,oved Sapp
Permmiit
Date sued
Issuing Sign
`Fee
S �:f n ad
112il-lz
Given n for Denial
IX. Con4W'®ryDWteasons for Disapproval 3 t!
Jt�
1. Septic tank, effluent filter and /
A.
fl'Of i�a wT�
4AA;A
dispersal cell must be serviced _/ maintained W •
as per management plan provided by plumber. y�
2. All Setback requirements must be maintained a}>
rr--WidTn to Whm W e'WdMYrhe system and submit to the County only on paper not I` �n 8 t� a I l iochpjo_sjre
4 re, 1 A. Qit'KK (-A,.I// rl'gt,yl,J
SBD-6398 (R. 08/14)
R
/N.
W%.
System PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 1/4 SW 114S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 100.1' 1.8' sand lift DATE 1 /16/20 BEDROOM 3
CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 0 of chambers none
BENCHMARK V.R.P. Top of 2" pvc pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑BOREHOLE O WELL *H.R.P. sameasbenchmark
Well is to meet all WDNR setbacks
Grading is to be done to
divert run-off away from
system
170th St.
Pro 3
Bedroom
House
4%
Huffcutt
Scale = 1/4" = 10'
0' 40'
n
97'
B-1
Property Line
98' 98.3' N
99'
B 3
Area 15' below
system is to remain
undisturbed
M.. S 0, e 0 0
so, 2 Acre Lot
CpF
January 28, 2020
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2022-01-28
Plan Review: PWTS-012000110-C
SHAUN R BIRD
1432 120th St
New Richmond Wl54017
SITE: Oevering Homes
Lot 2 170th St.
Town of Hammond
Saint Croix County
Total Amount: $250.00_
FOR:
Maintenance Required
The submittal described above has been rcA
and Wisconsin Statutes. The submittal has
constructed and located in accordance with
referenced above. The owner, as defined in
with all code requirements.
No person may engage in or work at
stats.
The following conditions shall be
• Preserve dispersal area pri(
• With new construction; it is
pumped prior to homeowner
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY VA 54304-5211
Contact Through Relay
http://dsps.wi.gm/pmgramsfindustryservices
www.wisconsin.gov
Tony Evers - Governor
Dawn Crim - Secretary
nd Component Manual — Ver. 2.0, SBD-10691-P
1/01, R 10/12)
Pressure Distribution Component Manual — Ver. 2.0,
SBD-10706-P (N.01/01, R 10/12)
ice with applicable Wisconsin Administrative Codes
ILLY APPROVED. This system is to be
ed plans and with any component manual(s)
Wisconsin Statutes, is responsible for compliance
rbing in the state unless
uring construction or inst
duringcj struAtio
to do so by the Department per s.145.0
Q prior to occupthcy or use:
•
f pfu •
disturbance,
lump in that
are
• Wastewater generated from contractors clf�ftg of equiVremed
v and/or left over construction
products shall not be discharged into the drains dischargingte onsite wastewater treatment system
(POWTS). Waste generated shall be properly disposed of ff site.
• Any tall grasses, leaves and shrubs shall be cut short and ior 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 (11)(c)
• 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 �Nith rock fragments. tree roots. stumps and boulders reduce die amount ofsoil
available for proper treatment. If no other site is available. trees in the basal area of the mound must be cut off
at ground keel. A larger 1111 area is necessary when any ofthe ahme conditions are encountered, to provide
sufficient inliltrative 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 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 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,
�7-
POWTS Plan Reviewer— Wastewater Specialist
Department of Safety & Professional Services I Division of Industry Services
email: tim.vanderleesba;wisconsin.go%�
Cell: 608-516-6134
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 1/16/19
21.-.,., .L-,*
Owner:Oevering Homes
Location:NW1/4 SW1/4 S9 T29N,R17W Lot 2 170th St. Hammond
Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7. Filter Specifications and cross section
8-9. Maintance and contingency plan
Attachm
Shaun B
Signatu
License
System PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Camohous Ave Suite A New Richmond Wi 54017
NW 114 SW 1/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 100.1' 1.8'sand lift 1/16/20 BEDROOM 3
DATE
CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND XXX SEPTIC TANK SIZE. 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE. 1.0 ABSORPTION AREA 456 # of chambers none
IL BENCHMARK V.R.P. Top of 2" pvc pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL +H.R.P. same as benchmark
Well is to meet all WDNR setbacks
Grading is to be done to
divert run-off away from
system
170th St.
Pro 3
Bedroom
House
4% Slope
Huffcutt Combo
non
9 7'
Chu
Scale = 1/4" = 10'
0' 40' 80' 2Acre Lot
Property Line
M
a 15' below
tern is to remain
fisturbed
= Topsoil
Cap Material
Geotextile
Fabric
El= ASTM C-33
sand fill
a. =r�- Ft Contour
= Clean aggregate
to 2 %z in. dia.
Plowed Surface
Slope Direction
Dimension Feet
A
13 iy.
D
E Z.
F
G
H
I
J �G
K
r. Qi
w�$� 7
z
Slo �
O = 4 in. sch. 40 pvc
observation pipe
GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or
chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a'''A inch soil wire
when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately
after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care must be used when placing sand of less than one fooq
thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound
is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The
observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange.
10/07 lgi Page 3_ ofl—
zm
rurtic MUM
F
Force Main Diameter
Force Main Len¢th
03/05 lgi
Pressure Lateral Layout
Two Laterals — End Manifold
fications
Z- In.
Z In.
3 // In.
�21_ In.
Ft.
r
ded
out
g
rg
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 turn -ups terminate with a threaded
cleanout plug and are enclosed in a 6-8 inch
diameter lawn sprinkler valve box accessible
from finished grade.
••••• Grade ••••••
6-8 Inch Lawn
Sprinkler Valve
Box
Page �— ofL
Septic -Dose Wank Cross Section And Pump Performance Specifications
Tank Manufacturer
Tank Model Number
Total Tank Capacity ?,
Max. Bury Depth
Filter Manufacturer
Filter Model Number i
Mimmum Pump Performance Required
YU GPM1 @ Ft TDH
PUMP Manufacnm
PUMP Model Number
Alarm Manufacturer
Q C
Alarm Model Number
i
Switch Type
Total Dynamic Hand (TDH) - Feet
Elevation Head,
0
Diatal Pressure
_' c7
Network Loss
`'
Force Main Loss
i
Total
,
Outlet Manhole Min. 4" Above Grade With
Looking Device. Inlet Manhole Manhole Min. 4" Above Grade
< 6" Below Grade Sealed Waterduht Securely Mounted With Locking Device
Weather-proof
Junction Box
Finished Grade - - - - - - - _
Vent Min. 12" Disconnect
Above Grade 7Means
With vow Cap
:r
Outlet Filter �y
Inlet I4 inlet Baffle
X I I
Switch Se and Reserve Capacity
Tank Volume = GPI
Dimension:
Inches
Volume Gal.
(reserve) A
� . -s
(alarm) B
2
3
(dose) C
s
Y-/.
(dead) D
/ S
Total
/ 2-
(3 )
Elliskin
Off EleyationFt C
AMA
Bottom
D 7n Elevp on
a-1=- Ft
GENERAL INSTALLATION: The sepuddow tank is bedded and back filled in accasdance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer 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 and the sleeve is sealed watertight. Elecirtc 11 servicprtiomplies with NEC 300 and Comm t 6.28.
02105 U Page D of
280=SERIES
112 hp Submersible Effluent/Sump Pumps
The Liberty 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 280-Series will provide years of reliable performance.
All Models Feature:
• Vortex style Impeller permitting passage of solids
up to %"
• 416 stainless steel rotor shaft
e Permanently lubricated upper and lower ball bearing
e Epoxy powder coat finish
• All fasteners - corrosion -resistant stainless steel
• 1 y:" Discharge
• Stainless steel bottom screen - easily removable
• Maximum fluid temperature: 140'F.
, 28O-Series Cord Lengths
Model 10' 25'(-2) 35'(-3)
501-5)
280 Standard Optional Optional
Optional
281 Standard Optional Options!
Optional
283 Standard Optional Optional
WA
287 Standard Optional WA
_
WA'
10' cord bngth standard on all models. For optional lengths,
add "-24-3 or-5" suffix to model number.
Example: for model 280 with 35' cord, order 280-3
Motor Specifications
hp 60 Hz 3450 RPM
Oil filled, thermally protected
(PSC) Pemlanent Split Capacitor
8.0 amps (115V)
4.0 amps (208/230V)
Performance Curve: 280-Series
CE
0 1 hL
30
25
`= 20
v
m 15
= to
P. ... ......................r
U.S. Gallons Per Minute
0 38 78 114 156 192 228 270
Liters Per Minute
Dimensional Data:
Weight* 29 lbs.
Height: 13'
Major Width:10" (model 287)
Minimum Sump Diameters:
Model 281, 283... 14"
Model 287 VMF... 10"
Factory switch
Model 281, 283
I
Model 287
settings
VMF
Turn on level
13"
9.5"
Tum oft level
7"
4.0"
The Model 283 features a tiny adjustable wide-angle float Differential
adjustments can be made easily by tethering the float to the dis-
charge pipe orcit er mounting palm. vertical float model 287 is not
adjustable.
Vnoswitch
OM 28O Model 281 Model 283
anuel, Wide angle Wide angle
float switch float switch
with quick- with series
disconnect (piggy -back)
plug
c us Certified
s.amne«.roI.h. xtU,out ratio.
Model 287
VMF-Beebe
Vertical mag-
netic float for
smaller pits -
will operate in
a 10' diameter
sump
Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone Soo-543-2550 Fax (585) 494-1839
www fibergypumps.corn copyright o ubwry Ranpe, IM 2017
AIIrlghtsmeerv.L LUT2000PMM7
WE
20140048A
SECTION A -A
921
Cl�
K
FILE�INFORMATION
POWTS OWNER'S MANUAL & MANAGEMENT PLAN page�of._—
SYSTEM SPECIFICATIONS
%1 C'c �„Q�1
Septic Tank Capacity _
( al ❑ NA
Permit ht` vim. r .
Septic Tank ManufacturerNA
• Values typical for domestic (nonsortunerdali wastewater and
septic tank effluent
Vahros typical for pretreated wastewater.
MAtNTPNANCE SCHEDULE
Service Event
Service Frequency
Inspect condition of tank(s)
At least once every
"> ❑ months ear(s)
(Maximum 3 yrs.)
Pump out contents of tank(s)
When combined sludge and scum equals one-third (Y,) of tank volume
Inspect dispersal cell(s)
At least once every
O months 9,4ear(s)
(Maximum 3 yrs.)
Clean effluent filter
At least once every
/,� ❑ months ear(s)
Inspect pump, pump controls & alarm
At least once every
❑ months )id-year(s)
❑ NA
Flush Wterals and pressure test
At least once every
❑ months t4Kear(s)
❑ NA
Ocher.
At least once every
O months ❑ year(s)
P NA
Other.
At least once every
❑ months ❑ year(s)
NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or
certifications: Master 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 cet(s) shall 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 local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the
entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR
113. Wisconsin Administrative Code.
The servicing of effluent filters, mechinical or pressurized POWTS components, pretreattment components, and any
other maintenance or monitoring at Aervals of 12 months or less shall be performed by a certified POWTS Maintainer.
A serAc.9 report shall be provided to the local regulatory authority within 10 days of completion of any service event.
STARTUP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other
chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a septage servicing operator prior to use.
'�01 1i
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 that
may Impede the treatment process andlor damage the dispersal cell(s). If high concentrations are detected have the contents of tha
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 NI above normal hlghwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(a) In one large dose, overloading the cell(&) and may result in the backup or surface discharge of effiueca.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to ft
effluent pump or contact a Plumber or POWTS Malnlalner to assist In manually operating the pump controls to restore normal leve.s
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 feel down slope of any mound or al -grade soil absorption area.
Reduction or ellmination of the following from the wastewater stream may improve the Perfomtance and prolong the lie of the PO
WT�i:
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation draht
(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 fells andlor is permanently taken out of service the following steps shall be taken to Insure that the system Is propefy
and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed end properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shalt be excavated and removed or their covers removed and the void space filled with: soil,
gravel or another Inert solid matedal.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compf.ent
replacement system;
❑ A suitable replacement area has been evaluated and may be util¢ed for the location of a replacement soil absorption sypleim.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requiiled
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in thelneled
for a naty soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rvletl in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or sod limitations. Saming advances In POWTS technology a
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 sod and site evaluation
must be performed to locate a suitable replacement area If no replacement area is available a holding lane may be Installed as
a last resort to replace the failed POWTS.
Mound and at -grade adl absorption systems may be reconstructed in place following removal of the blomat at the infiltrative
surface. Reconstructions of such systems must comply with the cries in effect at that time.
«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 OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POINTS INSTALLER /l
Name
✓ �� f� � „ I
r Phone
/
POWTB NbdNTAINER
Name S q,« ^--,
PhoneJ'—
i
SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORX AUTHOR_ ITS_
Name 7IA-1 A, 4 ArL�
l�—Phone —.—
Thu document wee drall In compliance with chapter SPS 383.22(2)(bX1 Kd)&rO and aa3.54(t ), (2) 9 (3), Wisconsin Admka81lr8" Code.
CST -ao I -d (,a
Wiarmsnrr���q � o a•Id Pml� W 9omtoe !Ail
P+rBa a
Drvtelan of RPlvides tt
11 �ZQii SOIL EVALUATION REPORT
In ante oath SPS 386, Wis. Adm. Code County
Attach canwdl ae pion ,pharlitC( t ttmcheainsize.Planmusticipa. .
Cut red IiMtad lo: � .� e point (BM), duetbon and percent aerpa, Parcel I 0
foele W dbcation am distance to neared road. 0/1-
., • Q� /�"�
Plena print all Informatian. Rew by Dale
Personal InbnnWbn YOa provide may bo usea IW YaC<mawV ywp0986IPrvaey LBW, e_i5.0e 1 fn )., _ . - _ ..I. /e /
Property Owner Prom-ly Location 03
N R E (orl W
J�Iu��k
.__.._ Piopert fs MMFg ress Lai N SuM. N a '
Clty State Zip Code Phone Number ❑ Oty ❑ Village 01 Neawst
RINaw Con trudion Um o Readenlmi7Nurnbmofbodroome'l_i Coda d0Ave6006lgn flaw race • :f GPO G!'C'
i
❑ Replacement ❑ Put>Ac or fAlMnorOal - Descnba __._ -
parent material '�/�— Flood Plan elo,adon if applicable IL
General canments and rewrnmenpaliorte:
% ❑ Goring
t ® P,t Ground surface elev J�Fjj, PI Depth Ip BmAmg facto
Sae Apptlmo m Rate
H"W Depth OWnlnam Cobr Rod"Doscripw Taxhxe Structure CCnnasiome Boundary ROOM GPD/Ft'_.. ..
M. Munsell Go. Az. Cont. Cola fir, Sz. Sh. I 'EMt EM2
__ ...Ylt .�tSdL—,lti.Zt� --{
/ G
-� sating 0 ❑ Boning
J 0 BP'to Grtrund surlarw .sov. 'B Depth to bmNmg factor 1,� In.
Srxl Application Rate
Nodxen Dapet OWninem IC Redux Description Tenure Swduro CWnuterlce Boundary Roots CPD Ftr
in. Muwell Co. A,. Cont. Cow Gr Si Sh 'EM1 •EM2
�r /
C � 1
teuk.."t BOU, 30s 220 imA and TSS>3051 4 'Elpuont Y2•BOD >30s220mM.�TSS?30sf50 nglL _
CST Na(pN r gesture `;i CST Number
Address 1 I Data EvaMalian Conducted TetepbrMe Number
ST/.�K' 1---.._e°:a7et11 -- —1/, lz3iz- - —J
I BormS 1
Bonny
Pe Ground awlacn ldev.&'bKiL
R"ox Demic-nptlon TeNluro Slruclure Cwtaiatrnce
]u. Az. Cont. Color I GI. Sz. Sh.
Unlxh to NmNnM radar L m.
❑ Boring
❑ Pd Gmund surface olov. _ t. Depth to INnMtM fedor _ In.
_ Sri App�c I— Rma
Dapm Dmmv sal War Ro0ox Descnpawi Texture Smrcture Consistanoe "DuundayTs GPDfft' -
Ttfn
h, Munaoh 19u. Az. Cc�t. Calm I Gr Sz. Sh E011 —
❑ Donny
❑ kidGr W nd surtam aov. , 0 Depth to looking IagOr In.
Sal Applaelion Rate
Iloezon Daph I portinant Color i Redox Doscr lNion teNwn 1 Structure IGmslsterce Damdmy Roots GPDIF'
R Men W A, Conk (bNx ! Gr. Si. Ski •EMN1 EI112
•pinuentet•BOO. -309220AM&NOTSS>305150mryt •Eetuen112- DOD. -30s220nV&vNTSS,3Ds15011-WL
.c�4 1 11rY
.�iCai.J tv� S:✓G`�
N
9
97
i
G5' t
1—
�ca
AL g�i,W.c l f�
.1 f.3;ot !J �e�uoi /CI zz ne
43,7 1
I p ( r
B• 3i'
c .c LAL
I
Owner/Buyer
Mailing Address _
Property Address
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
a 35
OWNERSHIP CERTIFICATION FORM
Planning & Zoning Department for
City/State Parcel Identification Number 401$' INC- i0- zoo
LEGAL DESCRIPTION j
Property LocaU oq4. '/� L l/ '/a ,Sec. T �N R/ Town of
Subdivision Lot # 'e - .
Cert ied Survey Map # /n y/ , > -1 Y __ , Volurne,-� 0, Page # -6 7� -l'-z:>—
Warranty Deed # ' l J q , Voiutne `— , Page #
Spec house no Lot lines identifiab ye 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 §Comm. 83.52(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 l /3 full of sludge.
I/we, 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 Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and retuned to the St- Croix County Planning &
Zoning Departinent 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. Iiwe amlare the owmer(s) of the
property described above, by virtue of a deed recorded in Register of Deeds Office.
Number of bedrooms
IGNA F APPLICANT(S)
L /i--p
DATE
***Any information that is misrepresented may result in the sanitary perwt being revoked by the Plamung &'Zoning Department. ***
Inchide 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. 08MS)
Wisconsin q( o{, �r d fsio al Services V
Division of }des
SEP '03 ZO SOIL EVALUATION REPORT
anti In rdancewith SPS385,Wiis. Adm. Code C�ounb'
Attach complete ile plan g,pfy(RNn x 11 inches in size. Plan must include,
but not limited to: rtical pr9tiR nee point (BM), direction and percent slope, Parcel I.D.
scale or dimensI s, , and location and distance to nearest road.
Please print all information. Revis I
Personal information you provide may be used for sewndary purposes Pdva Law, s. 15.04 1 m .
Properly Owner Property Location
Govt. Lot I Y. I/. S
Property efs Mailing Ad ress Lot# Block# Subd.
cityState Zip Code Phone Number ❑ City ❑ village ®Tol
R) New Construction Use:ja Residendal/NumberofbedroomS3-Y Code derived design flow rate -Z a -
❑ Replacement ❑ Public or commercial - Desaibe: _
Parent material �� Flood Plan elevation if applicable ft.
General comments and recommendations: ,
J I Boring #
❑ Boring
® Pit Ground surface elev;�ft.
CST -aa 1q
Pageof
OR►G►Pu
❑ r �s
N R E (or) W
Nearest
Depth to limiting factor
in.
QN1 e..l r..�..-. owe
�11
MR
nWW�!�.►�RWAR10
-
n
Boring #
❑ Boring
® Pit Ground surface elev. ,2il. Depth to limiting factor J1, in.
cM emml Iwr irv. am.
�1
r�
W.
s■e�■�
�Nmlr���as�
CST a (7 P'
Signature
CST Number
JZL
Address
Date Evaluation Conducted
Telephone Number
vjZ
S-/CLAO aUu-oaau p<uwiai
aBoring #
❑ Boring
® Pit Ground surface elev..
Depth to limiting factor Lin.
Sal Application Rate
Dominant Color
Munsell
Redox Description
Ou.Az.Cont. Color
�WA���Q�
❑ Boring #
❑ Boring
❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Du. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Fe
-Ef#11
'Eff#2
❑ Boring #
❑ Boring
❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cent Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD1W
•Eff#1
I -Eff#2
Effluent #1 = BOD, > 30 s 220 mg1L and TSS > 30 <_ 150 mg/L ' Effluent #2 = BCD, > 30 < 220 mg/L and TSS > 30 s 150 mg/L
Ufa
4 3�
EBoring #
❑ Boring
® Pit Ground surface elev.
Depth to limiting factor � in.
R.dl An..nrsa..., owe
MM
ice®®
lF�J�/1,4�
�
WA-WM��1
W9■L��A�1I
�Ili!NWAI
, �W-W1,�!
MWMR�
❑ Boring #
❑ Boring
❑ Pit Ground surface elev. —ft. Depth to limiting factor _ in.
Sal Application Rate
Horizon
Depth .
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Fe
•Eff#1
'Eff#2
❑ Boring #
❑ Boring
❑ Pit Ground surface elev. —ft. Depth to limiting factor _in.
Gtil Amlirs inn Rwn
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az Cont Color
Texture
Structure
Gr. Sz Sh.
Consistence
Boundary
Roots
GPD/Fe
'Eff#1
-Eff#2
Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 5150 mg/L • Effluent #2 = BOD, > 30 5 220 rn92 and TSS > 30 5 150 mg1L
� I
171
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