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Home My WebLink About018-1018-40-110Wisconsin 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 TANK INFORMATION TOWN OF HAMM TYPE MANUFACTURER CAPACITY Septic Dosing J� Aeration Holding TANK SETBACK INFORMATION TANK TO I P/L WELL BLDG. Vent to Air Intake ROAD Septic C' Dosing Aeration CI�r 46 Holding PUMP/SIPHON INFORMATION Manufacturer // Demand `r 6.Ew GPM Model Number Zeo ,t L10 TDH LiQ� Fric4ci Los ^ Syste Head TD !,V ft Forcemain Len tth Dia,Zx� Distto well156 )) SOIL ABSORPTION SYSTEM State Plan ID r Parcel Tax No. qND Section/TowNf I1L11fl_1 St. Croix 018-1018-40-110 09.29.17.135C I['fr] STATION BS 1.8 HI loi, FS ELEV. vo. Benchmark 3.(a 03. (vv Alt. BM Bldg. Sewer SVHt Inlet St/Ht Outlet Dt Inlet Dt Bottom l3,Z qQx 41 Header/Man. Dist. Pipe 8 T 1V� Bot. System / Final Grade St ov r A � ,"d 3. 3. I bo, Z BED/TRENCH Width v Lengg� 1 No. 9f-Traaehes PIT No. O Pits nside Dia Li i Depth DIMENSIONS �7 TENSIONS SETBACK SYSTEM TO P/LS BLOGC 1WELL LA /S RE V.LEA ,IIN ar durer INFORMATION E OR Typ Of System: o el Numb : _ -�bx I 10 I NI UW I KIOU! I IVN,YS I t_M 1 A hCftW Header/Manifold y t Z I, Length Dia Distribution Pipe(s) sy 7— 1• I Length DiaSpacing / x Hole Size 3 ,. /� x Hole Spacing , Vent to Air Intake 'f 1p r VKJO A VIL V V V i x Pressure Systems Only xx Mound Or At -Grade Systems Only a. BedfTre�yh Gpgter ' t` D�j Bed/Trench Edges Topsoil 1 Yes 0 No ,® Yes ['�, No n W —y� COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 3 4 Zg2q --K4 Inspe Lion #2: y'231 �OZ� � Location: No Address Availaale 1 [•.L n.h S r h I.� 'f►1+i1 C r 1- /� u P��% LC_ 1.) Alt SM Description = �1 Co VK.0 7 7 w / Ntf(/(/(„(y J'T'/' you T_1/ 2.) Bldg sewer length = 07� ` Doz., L N, / rnn. �4ol-j 1�1 -amount of cover = (ovtt*dT"t •") /-P"'r�2 t,/'Z�/ I")I VLA i.4 i✓ljff&hlOh Plan revision Required? C Yes No q Z -Z Use other side for additional information. I (S� SBD-8710 (R.3/97) tptylons w/ �,g53�3ate�O�r „��` an�pctor's Signature Carl. No. " Safety and BuWinp Division U , ,� . \lVlf � WED 201 W-WiaskngWn Ave., P.Q. Banc 7162 �y pq= Number (to be Medm by Co.) K` Madison. WI 53707- 162 P X'I-D r +8 t•� 3 2020 Permit Application-(ot smT"°°�'"°� aaaoad t, s�� ,+ Code, wbmissicn of this fca m the appopneme g� a � — ream Note: Application farms for stne•owned PQWfS are mi nud to ofance wty and a Privacy L w, S.15 Personal infamaiim you provide may be nad far secondary PIRPOW in eacardaoce with the � Law, S. LS. 1 m Smis. Pmjea.. Ad= (if diffeleffi�thjan marling address) 7. F �a r �� r ! L 'cation Information Please - Print Alt Information 1 Property Owner's Name Pamd e 6e�� Pmpary tTmer's Addtefa / 3 ;� e � ZI Ptopaty, Laaatton Gav Lu Lay' sinme zip Coder FbmeNtwba 1 N; or W II Type of BaildmQ (cbeelc all tbat apply) —� tat Lac S 12 Family Dwelling -Number oor Subdivisim N®e ❑ YublidCOmmumal-Desmbe Use tfUt f t*5 —� lock a ❑ (Sty of ^---- 13, ❑Sam Owned -Describe Use ❑Yabege of CSMNNumtw .. C) of III. Type of Permit (Check only one box on line A. Complete Mae 1 V 1 B if applicable) A. synaa D RWffaDcmSystem O Tmaotwm/Hol Tack dm8 Replac®em (Aly ❑ Otba Modidintim to 5daimg System (aplam) B. ❑PetmitRenewal 'Fwision ❑cbmgc ofPtumber ❑Pamir Tmosfum New List Prt o Pemtn Number and Daft Issued Befae Ekpira4m �,� N.yw of POWTS S stem/Com nent/Devite: Check an that 11DIDIVI It a4A t ❑ Nm-Prasmmed 10-Cndmd ❑ Pressurized b-Grc ad ❑ AI -I a' >_ 24 u ofswc*k soil 24 is of winble soil ❑ Holding Tank ❑ OPoa biX ( Into Ikvicc (nrplam) V. Dia refitment Ara Fbw(gpd) Design D' Ana R"wed(st) Amer Proposal( S U , o—Z7 VL Tank Id'o Taal tl d _ Gallons ` u Na<.lai , Tado r- s m '• m ii � G Septic or HoWmaT k D-4-9 3 D 30 DIL RespombdAY StMzMCW F. then ssibBity forimtamsioa dike POWTS a►owa as the atmehed plan Plumber's Name aNim) Mp/MPRSN®brr Basiors PhrneN 1Aa,-- / z6 rr� 7rs-a Phnber's; z (Straf, Cay. Cads, Cowry est Use ISi'e........_. 0m,.d Pewit Feci./� - rgmftSi lv�lvv,-• ❑ Owm Given Reasm for Deaml 5 O� LY. Conditions of Approval/Ressom for Disapproval 1 ((�� 3) uLa� SYSTEM OWNER: Klv�u•- r2V tS te-r, arn4atf 1. Septic tank, effluent filter and q a f ,-� — --Q_,, ,, Q dispersal cell must be�aNiCed /maintained f''' [y.,�Q yTJ �`'ts. Ji�'�Gla"'�+"�y'� as �4, per management plan provided by plumber Tt f�- �'[�,Lg tser -1 _.., a►L "''r �C`�'•W^l w>va play 1�0av8L1i111BU61i 9Qe as per applicably code/ardinances. 4M P- Z40- � SBD•6399 (R I l/11) � ,p•JL•L?'hp� u>` l S C/ � M R.t ►'� bgt:.Q System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cemohous Ave Suite A New Richmond WI 54107 NW 114 SW 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 99.8' DATE 2/29120 BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of telephone box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL sH,R,P, same as benchmark 2 Acre Lot Q 40' 80' I I 1/4" = 10' Scale Property Line Grading is to Pro 3 be done to Bedroom kHu divert run-off House away from system � Well is to meetutt combo tank all WDNRsetbacks B-3 _ it fM 98, 7B- 49%. Slope B - 18. M.' Area 15' below system is to remain undisturbed 170th St. Mound System Cross Section and Plan View TT-- . — — — — —,— — — — —.— — — — — — — — — — — — — — — — — — — — — — — — - - I — = Topsoil = ASTM C-33 F ,a Cap Material El sa 4 nd fill — a Ft Contour E= Clean aggregate %x to 2 ys in. dia. Slope Direction Dimension Feet A 5 /. 0J A , $ D E F G H /. J I g R q` Z L j, `�' Z6c/ z 19, 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'/4 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 Tandured in place with rebar or a closet flange. 10/0719j Page o Manifold I Force Main Distribution N Lateral Diameter Force Main Diameter Force Main Length 03/05 lgi Pressure Lateral Layout Two Laterals — End Manifold Lateral Turn -up M X L _ Z_ In. �. In. 3!/6 In. Ft. 4 Threaded Cleanout Plug Long Sweep 90 Bend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral tum-ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. ••••• Grade "910* 6-9 Inch Lawn Sprinkler Valve Box Page 1ofl f i Septic -Dose Wank Cross Section And Pump Performance Spxificadons Va��h...�c� �. • • ,� a �l''�Il� �Vimm-4 �ir.. ... ��' L=I Outlet Manhole lain. 4" Above Grade With Locking Devioe. Inlat Manhole < 6" Below Grade Sealed Watertight switch S T and Rer�<3d Tank Vo - Dimension: Inches reserve A: , S (alarm B 2. (dose) C : s ( D Total Z mirm-myr-m=d _ ..�. Total Dynamic Head (TDH) - Fat Elevation Head !J Distal Pressure C7 Network Loss Force Main Loss Total /s, Manhole Min. 4" Above Grade GENERAL INSTALLATION: The sepWdose task is bedded and back filled in accordance with the manufacuuer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not to have an effective locking device (padlock) be exceeded without prior approval. Manhole covers exposed grade fittings,and installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight laid on stable soil to prevent settling or sagging. The force main is sleeved With r Sob. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical wrvicneomplies with NBC 300 and Comm l6 2x. Page � ov_ 02105 lJ Ft 2so-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 Y" " 416 stainless steel rotor shaft " Permanently lubricated upper and lower ball bearing • Epoxy powder coat finish " All fastener; - corrosion -resistant stainless steel 1%" Discharge • Stainless steel bottom screen - easily removable • Maximum fluid temperature: 140'F. 280-Series Cord Lengths Model 10' 251-2) 35'(-3) 50'(-5) 280 Standard Optional Optional Optional 281 Standard Optional Optional Optional 283 Standard Optional Optional WA 287 Standard Optional WA WA 10' cord length standard on all models. For optional lengths, ado "-2, -3 or-5" suffix to model number. Example; for model 280 with 36' cord, order 280-3 Motor Specifications %hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (115V) 4.0 amps (208/230V) Performance Curve: 280-Series L3iGii�000GGGGiiGiGiGiGGGiiiGia Eli iIMEMO MEMO CiiME;;; o 5 in t5 9n 95 nn 35 An Ar. fin rv; An Rf, m U.S. Gallons Per Minute I I F I I I i 0 38 78 114 166 192 228 270 Liters Per Minute Dimensional Data: Weight: 29lbs. Height: 13" Major WkIIIh:10" (model 287) Minimum Sump Diameters: Model 281, 283... 14" Model 287 VMF... 10" Factory switch Model 281,283 Model 287 settings VMF Turn on level 13" 9.5" Tum off level 7" 4.0" The Model 283 features a fully adjustable wide-angle float Differential adjustments can be made easily by tethering the float to the dis- charge pipe or other mounting pant Vertical float model 287 is not adjustable. odel 280 Model 281 Mtldei 283 anual, Wide angle Wide angle switch float switch float switch tno with quick- with series disconnect (piggy -back) plug cuous c Certified ew�sw."re wgMr m �+Mro""mo„c "oats Model 287 VMFSedes 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 800-543-2550 Fax (585) 4941839 www.liberbWmps.com r-opy,gM o Liberty P" mlrw 2017 n Ae n"M MV & LUT=0 PMM7 wil'ol PROJECT Oeverino Homes NW 1/4 SW 114S 8 /T 29 System PLOT PLAN _ ADDRESS 1433 Cernohous Ave Suite A New Richmond WI 54107 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 99.8' DATE 2/29120 BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 If of chambers none IL BENCHMARK V.R.P. Top of telephone box ASSUME ELEVATION loo' Filter Lifetime Filter ❑ BOREHOLE O WELL •H.R.P. same as benchmark 2 Acre Lot 40' 80' q' I i 1/4" = 10' Scale Pro 3 Bedroom House Well is to meet all WDNR setbacks Property Line Grading is to be done to divert run-off away from system Huffcutt combo tank B-3 99, 98.8' 98, B-2 4% Slope Area 15' below system is to remain undisturbed 170th St. B- 1B.M.* 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: 012000108-C Location:NW1/4 SW1/4 S8 T29N,R17W Lot 1 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. Fitter Specifications and cross section 8-9. Maintance and contingency plan Attachments: soil test 2 / Shaun Bird //I Signatu License 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 till 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 scats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Thanks, POWTS Plan Reviewer — Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email: tim.vanderleestawisconsin.eov Cell: 608-516-6134 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay hitplldsps.wi.govlprogmmslindustry-services www.wisoonsin.gov Tony Evers - Governor Dawn Crlm - Secretary March 2, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-03-02 Plan Review: PWTS-032000017-M SHAUN R BIRD 1432120th St New Richmond W154017 SITE: Oevering Homes Lot 1 170th st. Town of hammond Saint Croix County Total Amount: $80.00 — Revised POWTS Dispersal Area Location 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 a.145.06, stets. The following conditions shall be met during construction or installation and prior to occupancy or use • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, 20140048A . '9 21 SECTION A -A Fn E INFORMATION POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page Hof_ SYSTEM SPECIFICATIONS DESIGN PARAMETERS Number of Bedrooms ❑ NA Number of Commercial Units NA Estimated flow (average) oafiday Design flow (peak), (Estimated x 1.5) !f aVd Soil Application Rate i v aVda /R' Inffuenl/Effluent Quality Fats, Oil & Grease (FOG) Biochemical Oxygen Demand (BODJ Total Suspended Solids (TSS) MMV* average - S10 mg/L 5220 mg/L 5150 /L Pretreated Effluent Quality NA Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) Fecal Coliforrn (geometric mean) Monthly average" :5W mg/L 530 mg/L 510' ctu/tooml Maximum Effluent Particle Size Y. Inch diameter MAINTENANCE SCHEDULE Valuas typical fof dcmestr (nonCOr Mull), Wastewater and septic tank affluent Vahma typical far pf "ated W Ste ter. Service Event Service Frequency Inspect condition of tank(s) At least once every 2 O months earls) (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_, ar(s) (Maximum 3 ym.) Clean effluent fitter At least once every / (--O months r(s) Inspect pump, pump controls & alarm At least once every ❑ monthsZ140ar(s) O NA Flush laterals and pressure test At least once every J ❑ month r(s) ❑ NA W1°r' At least once every ❑ months ❑ year(s) NA ogler. At least once every ❑ months ❑ year(s) 0 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, POINTS Inspector, POINTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) 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, pretreatfinent components, and any other maintenance or monitoring at blervals of 12 months or less shall be performed by a certified POINTS Maintainer. A servicd 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 POINTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal oell(s). If high conoecitratlons are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. <6 D4 % Page _ of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank($) for the presence of painting products or other cherMcels thrlt 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. 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 cell(s) and may result in the backup or surface discharge of eHluerdt To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to 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 compel, the area within 15 feet down Mope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the oerfomiance and prolong the life of the POWTB: ardlblotkw, 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; meat scraps; medications; oil; painting produc1s: pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly 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 shell be removed and properly disposed of by a Seplage 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 material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must he taken, to provide a code comprirnt replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be inhinged upon by requiged setbacks from existing and proposed structure, lot Imes and wells. Failure to protect the replacement area will result in the noad for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruleti In effect at that time. ❑ A suitable replacement area is not available due to setback and/or soll Ilmitabons. Baring advances In POWTS technology a holding tank may be Installed as a last resort to replace the felled POWTS. The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and aka evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be Installed) as a last resort to replace the failed POWTS. Mound and at -grade Sall absorption systems may be reconstructed in place following removal of the Nomat at the infiltrative urface. 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 _ POWTS INSTALLER 11% Name �� Phone POWT8 MAINTAINER Pram lj-�9 SEPTAGE SERVICING OPER'AT�OR f MIPERI LOCAL REGULATORY AUTHORITY Name I 9-awi4t ? Fma, Phonar _ 6--<lV / /.T 31l6 This document was drafted in Compliance with chapter SPS 383.22(2)(bH1)(d)&(I) and 383."1), (2) a (3), VVlwon•In AdmtrYtril" Cede. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _of_ Division of Safetv and Buildings in accordance wah r.;onm 80, WIs. Mom. Woe Me& complete she plan on paper not fens than 8 112 x 11 Inches in size. Plan must Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, soak o dimensions, north arrow, and location and distance to nearest road. Please print all information. pWWW Mlonrnatron Ya Graves M" W UW for raconeary DX"" (pmacy Law. s. 15.01 (1) (m)). county J Parcel I.D. Reviewed by Date Pit, Dwrur Property location Govt. Lot �Lt/ 1/4,> ( l4 S(J T N R E ) W Property Owners M s,S C/i 7 Lot I( / Block # Subd. Name or CSMM City tale 'p Code%e N ❑City Village Nearest Road Z IQ New Construction Use:�dendal I Number of bedrooms ❑ Repkcement _ JJ// //,, ❑ PubNc a commerdal • Desaibe. Parent material �Sr Y�1J General oamments and reccinmendatiorls: System Type Ii: 11 L Code derived design flow rate ,b GPD __—__.— -- Flood Plain elevation # applicable N ! R R� System Elevation ' BorMq # ❑ Boring Pit Ground surface slay. 4 B R. Depth to Ivn" facto In Soil iration Rate Florizon Depth in. Dornant Color Munses Redox Dssatpuon Qu. Sz Cont. color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 'Eff#i •EfW2 . r V O iY7 l� L r' ® Bolsg # ° Boring Pit Ground surface slev! Q r R. Depth to Urn" factor n. Soil icabon Rate Horimn Depth In. Dominant Color Munses Redox Description Ou. Sz. Cont Color Texture Stnxdtxe Gr. Sz. Sh. consistence Boundary Roots GPDRF 'Ert#1 'Ee#2 1 o-S �- ^. s . - Eflluard #1 - BOD. > 30 < 220 MWL and 155 >3U < 1tiG CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 540 a — 715-246-4516 fJir.�u Parcel 10 It Page , of __ 0 VA •.0 .. • lM i7m ---_ ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to liatl8rg factor In. Sod A..[ m I Bourg # ❑ Boring ❑ Pit Ground surface olev, ft. Depth to Imiarg factor In. Shc Effluent 01 = BODE > 30 c 220 mg+L and TSS >30 < 150 mot . Effluerr #2 = BODr < 30 a9t and TSS < 30 m92 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. Project Nami Address Soil Test Plot Oevering Homes 1433 Cernohous Ave Suite A New Richmond Wi 54017 Lot 1 Subdivision _ NW 1/4SW 1/4S 8 T 29 N/R17 W ❑ Boring Q Well PL Property Line I% 4 WM #226900 Date 2/29/20 Township Hammond County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of telephone box System Elevation 99.8' 2 Acre Lot 1 /Uth St. *HRPSame as Benchmark Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page I of 3 in accoruance wen k m oo, vvia. ^um. k Attach complete site plan on paper not less than 8 1l2 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. Persmal mformao ym iowv may be, used nor saomdary purewes(Privacy Law, a. 15.04(1)(m)) Coun ty '^ ° x Parma J.D. evt by` /I ,t Date .Jp�tl�-yV�a•-� 3 O Property Owner Property Location � t� GoA. Ld �/� 1/4s(,(/1!4 Sj T N R E r) W Property Owner's M " r y33 6-,r Lot Block # - Subd. Name or CSM# City State Zip Code ) e ❑ City Wage Nearest Road Pl�tlew Construction Use PResidential I Number of bedroom) Code derived design flow rate ]b _ GPD ❑ Replacement_ JJ ❑Public or cpnmerclal • Describe: Parent material �LX � Find Plaint elevation if applicable �✓ ` ft. General comments recommendations: ///j (U't"S t5 Z�J �B.I 1�'^ ,'o^� —i4� L;�OA System Type �TY System Elevation Y% n / Boring # El Boring 0pit Ground surface elev. ft. Depth to limiting factor in. Soil ination Rate Horizon Depth in. Dominant Color MunseN Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots I GPDhY •Eff#1 •Eff#2 -f - 4;, r�-- - ti i �ZO j C ^ s /�? L / Z ®Boring # ❑ Boring yn r Pit Ground surface elev! � ' !] ft. Depth to limiting factor Soil Application Rate Horizon Depth in. Dominant Color Mansell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM 'EB#1 I •E1f#2 r -1/ 14 S - Effluent #1 = SOD. > 30 < 220 rngrL and TSS >30 < 150 AZ• Effluent #2 = SOD, 130 rngrL and TSS < 30 mg1L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 540 a —I;_; 0 715-246-4516 t4 , Property Owner _ Parcel ID # Page _of Boring ❑ Boring # ❑-Pit Ground surface elev. ( L ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Roots GPDM 'Eff#1 'EEff#2 kBmndary - Lj - �- A n/ P ,P%jo ■ ■E. �". Boring Boring # Ground surface elev. ft. ❑ Pit Depth to limiting factor in. Soil Aadication Rate Effluent #1 = BOD, > 30 < 220 mg,L and TSS >30 < 150 mglL ' Effluent #2 = BOO, < 30 rr9L and TSS 130 mg1L 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 TfY 608-264-8777. sao-owfs.sm) Soil Test Plot Project Name Oevering Homes Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 Lot 1 Subdivision --------- N W 1/4 S W 1/4S 8 T 29 N/R17 W Boring O Well PL Property Line BM or VRP Assume Elevation 100 ft. Da__ Township Hammond County ST. CROIX Top of telephone box System Elevation 99•8' *HRPSame as Benchmark 2 Acre Lot 170th St. SAN —QGo — o IS y _r -- County` L. • f 2 0 �OCO Sanitary Permit Number (to x filled in by Co.) JAN t �Qb,p('pz CDmmaniN iistZSff In eccotd 5383.21(2), Wis. Adn is required prior to obtaining a sanirery, perm L / State Transaction Number l 1 Zd0 O 16m - C_ project Address (if different than mailing address) of rdSafety and Professional St the Departposes in entaccordance purposes in accordance with the Pri law. n(�, ( i - /03 / 176 k` 5 L Application Information - Please P. Property Name 'amel a Owner's �. Oej e �rnl� t t ol8- 10►4�-46 -�1No Property Owner's Mailing Address ,(U V j ,mperty [.potation of , 1 . `r city, Sun iov1. L (� %./., Section 7 ( mle o N; R E W IL T otBuilding (check all that app.;; \` Lot a ///'� or 2 Family Dwe g - Number of Bedrooms l l 7 / Subdivision Name Qk t� k ❑ Public/Commemial - be UseM1• ❑ Ciry of e ❑ State Owned - gibe Use CSM Number e )1l$cj/'574 ❑ Village of (6 0e, in. Type beck only o boz on line A. Coralpte line B if applicable) New System ❑Replace yskbarri mrnNFlolding Tank Replacement Only ❑ Ot11er M nation to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision of Plumber it a to New List Previous it Number and Date Issued IV.T ofPOWTSS atemlCom onenUDkallt to❑ Non -Pressurized In -Ground ❑Pressurized InAt-G > 24 in. ofsuit pound <24 suireble soil ❑HoldingTank ❑ 'spersdComponent ❑ tce exp V.DisipenaVrIneat ant Area Informatio Design Flow (gpd) Design Soil Applimil te(g sf) Area qw (sf) I Area Pr ed $y ovation ,v o. \ / VI. Tank Info C iry in orel Manufac[ r Pill ns r �= `� ii $_ .4 g g b y New Tanks Existing Talks Sepde or Holding Tad Jr A Dosing Clamber VU. Responsibility Stateme the undersigned, as ponslbiliry for Iinstallation of a POWTS shown on the attached planer Pluy6tt' Name (Print) PI S- tore MP/MPRS Number Business Phone Num 01 Pim s Address ( Creel, C , S . Zip C / VIII. County 1De artment Use Only PPro ❑ �� Permit Fee Date sued Issuing Signature s �41� • 00 � t9 20 Owntt rn Reason for ial IX. Coo jj#j"A)tpgppWeasons for Disapproval .{l 3 Y.! t P� 1. Septic tank effluent filter and dispersal cell must be serviced ! mainfa)ed �„e O,,Jgy� g IWA f�_O as per management plan provided by plumber. 2. All e 1 A rokak�a setback requirements must be maintained fie I a. r. t 'AYUHlVY&mY1W F91he system and submit to the Count' only on paper entras than B 112. 11 inch" in sire n�4a+V LG of err. i A, Ja& - w/ � /ier,N: �- SBI)•6398 (R 08/14) ( ! 'rMSA, DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 K Contact Through Relay P $http:/Idsps.wi.gm/progmmsrindustry-services w www.wisconsin.gov Tony Evers - Governor Dawn Crlm - Secretary January 27, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-01.27 Plan Review: PWTS-0 I 2000108-C SHAUN R BIRD 1432 120th St New Richmond Wl 54017 SITE: Oevering Homes Lot 1170th St. Town of Hammond Saint Croix County Total Amount: FOR: Mound C ponent (N.01/0 10/12) uescn Eon: 9Jo v�u J oearoonrs—wew a )erocaoE Maintenance Required The submittal described above has been r/er and Wisconsin Statutes. The submittal ha constructed and located in accordance wit referenced above. The owner, as defined iwith all code requirements. No person may engage in or work at plum stats. The following conditions shall be met *ing construction or Manual — Ver. 2.0, SBD-10691-P •e Distribution Component Manual — Ver. 2.0, 0706-P (N.01/01, R 10/12) itallaV and prior to occupancy or use: • Preserve dispersal area prior Iduring construction to avoid dist ante, compaction and use of the site. • With new construction; it is r ommended not to activate the pump i he dose tank until the tanks are pumped prior to homeowner o upancy. • Wastewater generated fro ontractors 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. C7 • 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 I/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 fine(s) prior to installation. • Pump Floats to be set 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 NdLl" the amount of soil available for properireauncnl. I I' no olhcr site is as ailable. Woes in the basal area ul'the mound must he cut off at ground los-cl. A imber lilt area is necessary A� hen any of the above conditions Lire encountered, to provide softicient 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/instal lation/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, p ��/ 1 U.t9/ v oe POWTS Plan Reviewer— Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services entail: tim.vanderleesuFu+visconsin.gov 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 Owner:Oevering Homes Location:NW1/4 SWi/4 S9 T29N,R17W Lot 1 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 Attachments: soil test Shaun Bird Signature License number Page 1 of 9 PROJECT Oeverina Homes NW I/4 SW 1/4s 9 System PLOT PLAN _ ADDRESS 1433 Cernohous Ave Suite A New Richmond WI 54017 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 100.9' 1.9' sand Ilft DATE 1/16/20 BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE. DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 If of chambers none BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION I00' Filter Lifetime Filter ❑BOREHOLE O WELL •H.R.P. sameasbenchmark Area 15' 1 to remain Huffcutt Comt 170th St. /T 29 1/4" = 10' Scale e to divert system Well is to meet all WDNR setbacks 0' 40' 80 2 Acre Lot Property Line Mound System Cross Section and Plan View -------------------------- --------- J I 1 I � 1 1 :� I 1 c2yt y? +y n. i s f�.ttxudtSxs} <xT <� t S ctctz? z.i? ? c Su ..S�zSiS3 :.y ct �y ti� x x r. 1 �i' 1 l{ 1j Z—T I � � I ` - — — — — — — — — — — — — — — — — — — — — — — — — — — — — = Topsoil F7771 = ASTM C-33 Cap Material L_. LLJ sand fill = Clean aggregate /3 to 2 'h in. dia. ' Slope Direction �� Dimension I Feet A ! E 2 2J pl �� y F G x L 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 (I. 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. 10/071gj Page 3 of7 TMI rul�c iviaul e zr, Distribution N Lateral Diameter Manifold Diamei Orifice Diameter X Orifice S aca L (Lateral Lenatl 03/05 lgj Pressure Lateral Layout Two Laterals — End Manifold In. I ded out 8 rig sweep 90 Bend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral tum-ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. ••••• Grade • • 00 00 6-8 Inch Lawn Sprinkler Valve Box Page q of �— Septic -Dose Wank Cross Section And Pump Performance Specifications Tank Manufacturer c Tank Model Number Up Total Tank Capacity 7or0 g .7 Max. Bury Depth Filter Manufacturer Filter Model Number j �� Minimum Ptnnp performance Required ICJ GPM 1@ 1 /5-,7 Ft TDH Outlet Manhole Min. 4" Above Grade With Locking Device. Inlet Manhole < 6" Below Grade Sealed Watertight � .- — -- 4 — Finished Grade - - ?r I Outlet Filter Inlet Inlet Bale Switch &tt4np and Reserve Capacity Tank Volume = .j GPI Dimension: Inches I Volume Gal. (reserve) A .'-r 3 ?• (alarm) B . 2 _ 7 (dose) C C. � 7 (dead) D 3� - Total Z_ 3 Total Dynamic Head (MM - Fat Elevation Head ) Distal Pressure c (7 Network Loss Force Main Loss Total Manhole Min. 4" Above Grade Securely Mounted with Locking Device Weather-proof Junction Box —► t' — Vent Min. 12" Disconnect Above Grade Means With Vent Cap GENERAL INSTALLATION: The wpde/dose tank is bedded and back filled in accordance 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 affective 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. Elearicaiservice Toppties with NEC 300 and Comm 16.28. 02105 Ll Page 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 fl" • 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball bearing • Epoxy powder coat finish • All fasteners - corrosion -resistant stainless steel " 1%" Discharge • Stainless steel bottom screen - easily removable • Maximum fluid temperature:140' F. 280-Series Cord Lengths Model 10' 25'(-2) 35'(-3) 50'(-5) 280 Standard Optional Optional Optional 281 Standard Optional Optional Optional 283 Standard Optional Optional WA 287 Standard Optional WA WA 10' cord length standard on all models. For optional lengths, add 1-2,-3 or -5" suffix to model number. Example: for model 280 with 35' cord, order 280-3 Motor Specifications %f hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (115V) 4.0 amps (208/230V) Performance Curve: 280-Series 2 LL 2 v = 1 iii/MiiElong IN■iiE/ENOOR■iEiE�Ei/i/iiNiINiE .1102i// INENEIN►c\/ 00500 U.S. Gallons Per Minute 38 78 114 156 192 220 270 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, 283 Model 287 settings VMF Turn on level 13" 9.5" Tum off level 7" 4.0" The Model 283 features a fully adjustable wids-angle float. Differenft 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. odel280 Model 281 Model 283 anual, Wide angle Wide angle switch float switch float switch tno with quick- with series disconnect (piggy -back) plug C us Certified aoeanutgmsueagx*roche,u".nmmsm . 6 o-E ) Model 287 V611F-Series 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 8004643-2560 Fax (585) 494-18" www.libertypumps.com copr+uht0Ubwtyr ^Im".x 7 All dghte maerved. L1r 2000 RDSn7 v a 2.01 4 0 0 4 8 A SECTION A -A i921 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page—_ol— svcrcu QPrilIFICATIONS FILL mrvrcesw nvr. — — -- Owner , Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer 0 NA • VaWs typical for domestic (noMo Idal) wastewater and septic tank eflluenL .•• Valves typical rw pretreated wastewater. MGINTFNe NCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every S ❑ months-Ayear(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 0 months lb years) (Maximum 3 ym.) Clean effluent filter At least once every , ❑ month ear(s) Inspect pump, pump controls & alarm At least once every ❑ months ar(s) ❑ NA Flush laterals and pressure test At least once every ` 0 months earls) O NA Oawr. At least once every ❑ months 0 ye r(s) NA Other. At least once every ❑ months ❑ year(s) NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an indivkfual 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 oll(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, m"nical or pressurized POWTS components, pretreatFment components, and any other maintenance or monitoring at i4ervais of 12 months or less shall be performed by a certified POWTS Maintainer. A servigg report shall be provided to the local regulatory authority within 10 days of complefion of any service event 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 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. Page _ of _., START UP AND OPERATION For new construction, prior to use of the Pi check treatment tank(s) for the presence of painting products or other chemicals thsil may impede the treatment process andlor 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. System start up shall not occur when soil conditions aka frozen at the infiltrative surface. During power outages pump tanks may fill above normal highweler levels. When power is restored the excess wastewater will bee discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and they result In the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to 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 mile. 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 pertormance end prokxig the Me of the PO WT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fait foundation n (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; pal nting pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails 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 a3.33, Wisconsin Administrative Code: • Ali 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 shell be excavated and removed or their covers removed and the void space filled with sudl, gravel or another Inert solid materiel. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the folhowing measures have been, or must be taken, to provide a code complipm replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. 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 neled for a new soil and site evaluation to establish a suitable replacement area, Replacement systems must comply with the rulail In effect at that time. ❑ A suitable replacement area Is not available due to setback and/or soil limitations. Baring 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 soil and site evaivaton _must be performed to locate a suitable replacement area. it no replacement area is available a holding tare may be installed as a Ias1 resort to replace the failed POWTS. �Mound and at -grade soil absorption systems may be reconstructed in place following removal of the blomat at the infiltrative urface. Reconstructions of such systems must comply with the ivies In effect at that time. <<WARNINO» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O� A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. COMMENTS POWTS INSTALLER POWTS MAINTAINER Name 73Name r LPhonePhone SEPTAGE SERVICING OPERATORI LOCAL REGULATORY "AUTHORITY Phone This docisrwa was drafted in ovmpllarim with chapter SP8383.22(2)(bX1)(d)&(r) and 383.54(1). (2) & (3), Wiscansin Administrelive Code. • C ST -aG I q —,)d I =mstomeannsirimid ( Wlti=un not sonvidos per SOIL EVALUATION REPORTi arcurdarca wdh SPS 385. We. Adm. CodeAttacheomplIhan B 2 x 11mdtes in size. PW,must imkdeWI not hmead(BM). direction and percent Slope. scaboroimeOn end dibtams le meanest read. q6 /e —. Pleaaa print all Information. Doi Personal Infarmation yW._W_avide may be uaad for aemndary purpoaea (Privacy Lew_c, IS,egjl ltM& �prapanyy pwrw Rap" LocationO GOAL ,A- —'/ �V/N's� 7 E («) w prperty s Meding Addrrrsa Lot N Black V �Iry Stfo Zip Coda Phan^ Numhof ❑ City ❑ V.Oge 0 T Nsaraet Rmp� (�f N"Consuucbon Uxe.®RaaidonuatlNumborofbadmwns%•_ Code derived design flow mteR_ZGPD 6,14: ❑ Roplacernenl 19 Pubic w cwnmrrroat - Descnhe _ .. parent material ;7.11 Flood Plan elevaliunI applicable A4� R. Ga,«ar mmwm ona woomnendauons. soring a ❑ Petrie P:t Ground sudaw oiev. h. Depth to limiting facto _[zin. Sal Application Rate lbdxon ----[Depth Dortlrtare CobrFx Doscnpt.on ToxWm Siruclwe Cmsist«ma Baurd«y Roos _GPp1Ft' In. Muragz Coot Color Gr. Sz. Sh 'E11N1 • •E«2 N ❑r�a Baring tp.Pit Gnxmd xuAace aiay.,G{r.1y II. tkplh alMraling lad« .� � m. SoilAppilcation CH«Izon Depth ht. Dominant Color MtaeteN Redpx Daed,p101 Ou Az. Con_ColaL TexWm Suix:wra 3h Canswenoe Boundary Roots OPDIFI' EMt ? 'ENaR I / — , ._�_/ _G_Sz L -.._.._01 .DOD.—e SO S M mYLL rM rs9 ioja<Q9 m(sI .-- [ffkm / r CST N _grmJ♦•1 Signewre` Address o / '3LL/ice/, If!)/_ •%1 / f I Dow Evalwlion Conducted _ CST Number Telephone Number 7301 s slot ♦• 7 I Boring a Dxput to limiting faclo, _Af in. � Sal A_aplkaegn RAW IlOdian j DepM I DwinorA Color Redox Geacriptm lexlwe SWclure Conaslerx:e Boundary " GPGf 1, In. Mnitell Cu. At, Conl. Color (i. S. Sh. .'ERat 'EBM2 613 ® P't G"MI'd uwl:tur "Al Gawp a ❑ Boring ❑ Pi Ground sunacx yr v It Manton Deiah Daminent Color Itu x Gosa:ytan 1047 st'ni w ca h. Munsee W. At. Cant. CWw W, 9< Sh. 1 ❑ Ornhtg ❑ Pt Qta ,,d wdaat alev. _ h. Depth to Amting factor _ M. So% Boundary 1 Roots I CM*t' Depth to Umithg factor Sail Appir#Ian RNa H mn DOO Dominm Color Rodox Deacllpta 7exlUre Murrell W. At. Cant Color i SVY7Sh C S BoudaryIn. i Rawls C'ftuF1' •Eclat •EBY2 EaarMel NODD,>309220ngl. mw 199>305 1S0niWL •ChNmd 02•001),>3:1 S 220 mg+L and TSS>305ISO MG& //7'. spa 9-7 i/✓ �'i�ti' e � fvf 1 e_//./r.:sc:�'- iy>a �7.tlit•�! 98..2s" n it _ �� :�.. 4-J �* t � _ .� ----- . . - _. ��i '/ I- �,��'�O II it I� ', r/�`��I � ��'�� - 'i '' • n ' �. I r Owner/Buyer Mailing Address. Property Address City/State ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM a 7-/4 S (Verification required from Planning & tar new construction.) Parcel Identification Number o f 5- ld i $ -GIo - // a LEGAL DESCRIPTION (� Property Location'/n , �%, , See. ( T �N RL:j_W, Town of _ 1 Subdivision �— Lot# / Certified Survey Map # Qom! l �� /? �I Volume J 1/ Page # 7 a13- Warranty Deed # / (� / L/ % , Volume Page # Spec house no Lot lines ident&ab ye no SYSTEM MAINTENANCE AND OWNER CERTIFICATION brgrroper use and maintenance of your septic system could result in its premahne failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years m 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 rnaintanance responsibilities are specified in §ComuL 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 1 /3 full of sludge. 1/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 Reaourcea, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the SL Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/aie the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms IGNA OF APPLICANT(S) DATE *"Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. •** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. [f 7 AKII.?SF�. Attach complet site but not limited : vet scale or dimen one' ��( �l�d �y�f �� nal Services SEP 3 2019 SOIL EVALUATION REPORT I accordance with SPS 385, Wis. Adm. Code County / % gVIlldss than 8 12 x 11 inches in size. Plan must include, �f n . "pLglypfeW* oint (BM), direction and percent slope, Parcel LD. on and distance to nearest road. Please print all information. Revie y • C5T ,AOJQ -aol • .� Page of 3 i noinlinl - , I . '/6 - /ec> rersonal lnrormauun you prowoe my oe useo ror secanuary purposesYIWa L2W, S. ld.U. l m v� 14AWT1 I Property Owner Property Location ❑ Rf GovL Lot (il Y. d 1/. S N R E (or) W Property Ownel's MailiAddress Lot # Block # Subd. Na l r CSM# city, State Zip Code Phone Number ❑ City ❑Village T�wn Nearest Roe ®New Construction Use:®ResidemiallNumberofbedroomsy�f Code derived design Row rate J QGPD :�00 ❑ Replacement �9 Public or commercial - Describe: Parent material ,LI Flood Plan elevation if applicable W� ft. General comments and recommendations: 7 Boring # ❑ Boring L-l—t Pit Ground surface elev. &cft. Depth to limiting factor �in. Coil ArvJil ration Rat. ®®® Redox • Description Cant Color �IA�, ,WA ®Boring # ❑ Boring capit Ground surface situ.% R. Depth to limiting factor � in. Soil Aooll ication Rate t Iuent Fl = ROD. > 3n 5 YYn and/L and TSS > 3n 5 1 M nvAll - Fmunnt W a ROD. >.W) 5 JJn mnlL and TSS > 311 5 1Mt mall CST N lease r led Signature CST Number Address Date Evaluation Conducted Telephone Number ,5/Gry-4o JtlU-e (KUW1 D) �ot� • n.s Boring # ®PR Ground surface elev. $/,eft. Depth to limiting factor _Z4— in. aM enn�nrannn Rnfo l �r F.EsW-rrsrea■�■Fa ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ In. c U e.�— u�nx�� ome Horizon Depth In. Dominant Color Munsell Redox Description Ou. 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. AM a ni 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 5 220 mg/L and TSS > 30 5 150 mg/L • Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg1L Boring # ® Pit Ground surface elev. &!Oft. i/ Depth to limiting factor In. c.,u A--1l i� 0..e I ®®®....: �IMol �, �MA NWM WA�QR� ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ in. car e.,� a,. 0— os e Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr, Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 'EfW ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ In. c,.0 ems, Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ftr 'Eff#1 'Eff#2 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L