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HomeMy WebLinkAbout026-1286-14-000 r — T Wisconsin V eoartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Ss1 ty and Bu ding, Division INSPECTION REPORT sanitary Permit No: 515080 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: S unset Ridge LLC, C/o evering Homes I Richmond, Town of 026- 1286 -14 -000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town /Range /Map No: 34.30.18.1436 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. / 61, 3 Septic Benchmark Dosing �d 1 00 Alt. BIM o/ A&X 1 0A 1 3 Aeration Bldg. Sew D /io.bZ S G / o.�•D et Holding -- - S tJlr j yy�_ 2 1 / / 1 TANK SETB INFORMATION St/Ht Outlet TANK TO P/L WELL BLD Vent to Air Intake ROAD Dt Inlet Septic ` I 1 S , Dt Bottom Dosing , / Header /Man. Z D d.2, Aeration Dist. Pipe 10 �. 3 i l s/o 24 z 106. Holding Bot. System yi -- ;�, ,; /ya,� 3S_ os Ss Final Grade PUMP /SIPHON INFORMATION P - Manufacturer Demand over GPM Model Number �E_V - 71 TDH 1 1-ift TDI� Frict io L s Syste He Ft o � . "S /, 3 r -� • 6a is 7 Forcemain e FV7 ias, Dist. to Wel L r /A) � � Q SOIL ABSORPTION SYSTEM N BED /TRENCH Width Length No. Of Trenches PIT DIME IONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S SETBACK SYSTEM TO P!L BLDG WELL LAKE /STRE M LEAC Manufacturer: INFORMATION CH R OR Ty f System: g �/ r UNIT Model Number: DISTR!AUTIgN SYSTEM J d � Head anifol Distribution x Hole Size x Pipe(s) Hole S acing Ft to Air Intake ,/ ,c / �/ 2 O . �� 51 � Length Dia '� Length Dia�� Spacing "I SOIL COVER x Pressure Systems Only xx and Or At - Grade S fati J Depth Over Depth Over tDepth of O Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges soi , �� Yes 54 0 Yes L" COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 1 /�/1 �- 7 "O Inspection #2: 7 /0 PP Location: 1218 121st Street New Richmond, WI 54017 (SW 1/4 SW 114 34 T30N R1 8W) Sunset e Lot 14 Parcel No: 34.30.18.1436 1.) Alt BM Description br ; 2.) Bldg sewer length )4 B / A--t_ 3- L = /O ? "U n , . - amount of cover = �Z / S / S1'^ B �) if PA Plan revision Required? Yes a No Use other side for additional information. ._ tv.._,� l j - -- �1nsqct&.Sinat.r Date Cert. o. , BD -6710 (R.3/97) I f �. i tj � sec. 3Y 13a ^-�,c' /8 w (' ° �' *• I �k ••• S � fi P , � � ,C' Z yZd72- X41 SeAdtr ws � �f 7 � ro Po S o0 o Go ° a lol- CIA �p k � � w .ao /(7 6 LC co �yj a feh Q� y3� Ja - ^� commerceml.gov Safety and Buildings Division County y F� 201 W. Washington Ave., P.O. Box 7162 t��l. a X i sco n s i n Madison, WI 53 1 Sanitary Permit Number (to be filled in by Co.) Department of Commerce P r 1 5 J5 a O be o Sanitary Permit Application s tate Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental �p unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you ide may be used for secondary i L I ` Z' S 1 • 57 . purp oses in accordance with the Privacy Law, s. 15.04 1 m , Stats. I. Application Information - Please Print All Informat' Property Owner's Name / ��EI� /E Parcel # tl + . oZ / c� � zs c� 41 Coo Property Owner's Mailing Address Property Location y33 / f � ti� o;1 � � �� � ' Govt. Lot City, State / Zip Code Pho ;e 15bl Z XCOUN� FIGE tom, SL v y, Section 3 t~ J C i►�t t J PLp,%t4lW a, ONING �� (circle one II. Type of Building (check all that apply) 6 k Lot # J T -36 N; R Eo $1-or 2 Family Dwelling - Number of Bedrooms R / Subdivision Name ) R- Av...4C � Block # S� - ✓ ❑ Public /Commercial - Describe Use � ❑City of ❑ State Owned - Describe Use 1 4 mber El Village of k S Q✓ CSM Nu 6e IR Town of X C d rr III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to Now List Previous Permit Number and Date Issue Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that appi ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: 4 Design Flow (gpd Design Soil Application Rate dsf) Dispersal Area Require sf) Dispersal Area Prop (s System Elevation So i. v( � Sa 7 TSB 223 �o �. 6 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks y c d y epti r Holding Tank O �.v D sing Ch ber V v VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS sho n the attached plans. bees Name (Print Plumber's Signature M Number Business Phone Number QG L LLS?L 'f 7L -4V 2-1 Plumber's Address (Street, City, State, Zip Code) Z (� 5 / tS© -tti 5=t. �-u l,�-s 518 3 VIII. Coun /De artment Use Onl Approved tsappr Permit Fee Date I uf7/6 Issuing t Signature iven Reason enial $ lr IX. Conditions of Approval/Reasons for Disapproval 3 L O • k o 0- Sl -�.lc. ot� JL �1 �.� •'/` I✓� 1'6t I s { lC1 N t r t to com ete plans for the sy tem and submit to the County only on paper not less than 81/2 x 11 inches in size 1 ^ ' SYSTEM OWNER; n�f ttC✓� 1. Septic tank, of ilit t -tiker and dispersal cell must all be Services / maintained as per macagemot plan provided by plU ntw. SBD -6398 (R. 02/09) Valid thru 02/11 2. AN ssttlick Nhents must be mitt hed as pK eppli0tplt Celt / *dW01M. i Safety and Buildings commerce.Wi.gov 10541N RANCH ROAD K HAYWARD WI 54843 Contact Through Relay i s c o n s i n www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary June 12, 2009 CUST ID No. 222872 ATTN.• PO WTS Inspector JACQUE M HAWKINS ZONING OFFICE HAWKINS SOIL TESTING & SEPTIC SYSTEMS ST CROIX COUNTY SPIA 2659 150TH ST 1101 CARMICHAEL RD LUCK WI 54853 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/12/2011 Identification Numbers Transaction ID No. 1670835 SITE: Site ID No. 748399 Oevering Homes Please refer to both identification numbers, Lot 14 Sunset Ridge above, in all correspondence with the agency. Town of Richmond St Croix County W1 /2, SW1 /4, S34, T30N, R18W FOR: Description: Mound, 3 bedroom residence P Nj .T .S Object Type: POWTS Component Manual Regulated Object ID No.: 1227975 ICI Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), SSWMP Pub. 9.6 P'P pEP NT IVA The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes D1V 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) LORRESP'( referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compli SEE 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: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The bottom of the distribution cell shall be level per the Mound Component. Manual. The "D" dimension shall be a minimum of 12 ". The maximum finished slope of the mound surface shall not have a slope ratio steeper than 3:1 per the Mound Component Manual • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. JACQUE M HAWKINS Page 2 6/12/2009 ' • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. .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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Beginning October I ", 2008, small wastewater holding tanks with estimated flows less than 3,000 gpd that are based completely on approved POWTS component manuals must be submitted to the appropriate governmental unit and will no longer be accepted by the Safety and Buildings Division for review. Please refer to s. Comm 83.22, Wis. Adm. Code for further information. 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 I Balance Due $ 0.00 atricia L Shandorf POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pat. shandorf@wisconsin.gov cc: Leroy G Jansk , POWTS Wastewater Specialist, Y p , (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. I y . • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Beginning October 1", 2008, small wastewater holding tanks with estimated flows less than 3,000 gpd that are based completely on approved POWTS component manuals must be submitted to the appropriate governmental unit and will no longer be accepted by the Safety and Buildings Division for review. Please refer to s. Comm 83.22, Wis. Adm. Code for further information. 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 atricia L Shandorf POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pat.shandorf@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. i i I 1 l ' MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Oevering Homes Lot 14 Sunset Ridge Owner's Name: Oevering Homes Owner's Address: P.O. Box 179 New Richmond WI 54017 Legal Description: W1/2 -Sw1 /4 Sec. 34 T30N -R18W Township: Richmond County: St. Croix ' Subdivision Name: Sunset Ridge Lot Number. 14 Block Number Parcel I.D. Number: 026 - 1286 -14 -000 4 Plan Transaction No.: ; pu t Page 1 Index and title Page 2 Data entry �D Page 3 Mound drawings Page 4 Lateral and dose tank / Page 5 System maintenance specifications Page 6 Management and contingency plan 1 (� Page 7 Pump curve and specifications Page 8 Plot Plan Designer: Jacque Hawkins License Number: MPRS# 2228 Date: 05/24/09 Phone Number. 715 -: Signature: — Designed Pursuant to the Mound Component Manual for POWfS Version 2.0 SDB- 10691 -P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01101) Version 5.1 (R. 06/06) Page 1 of 8 a Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 38 inches. 450.00 Design Flow (gpd) i 7.00 Site Slope (%) 105.00 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd/fe) Distribution Cell Information 76.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpde) 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) C Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest pant. 0.156 Orifice Diameter (in) 2.00 Estimated Orifice Spacing (ft) = 6.25 t12/orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 95.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 6.50 Vertical Lift (ft) 67.44 5x Void Volume (gal) 3.12 Friction Loss (ft) 83.75 Minimum Dose Volume (gal) 0.00 In -line Filter Loss (ft) 38.77 System Demand (gpm) 14.17 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Di ameter _ Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallonslinch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.001 Septic T ank Capacity (gal) Total Working Liquid Depth (in) Skaw Precast Compaq Manufacturer gal/in (enter result in cell dos) Dose Tank Information Effluent Filter information 642.33 Dose Tank Capacity (gal) Best Filter Manufacturer 16.47 Dose Tank Volume (gal /in) GF -10 Filter Model Nt Skaw Precast Co. Manufacturer Project: Oevering Homes Lot 14 Sunset Ridge Page 2 of 8 ,J I Mound Plan and Cross Section Views 1/10 F KK B Observation Pipe 0: J L L'•.•S �1 L L 1 , . . .:';w,igtl'L ti•LL �+••�•L LsL�••L ail �'�.. i .4�� �ti LPL �ti L••.. Ls W B z _- L Mound Component Dimensions A 6.00 ft E 17.04 in H 1.00 ft K 9.01 ft B 75.00 ft F 9.50 in 1 10.30 ft L 93.01 It D 12.00 in G 0.50 ft J 5.68 ft W 21.9$ ft 450.00 (fe) Dispersal Cell Area 1 1222.31 (fe) Basal Area Available 6.00 (gpdtft) Linear Loading Rate 1 7.50 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 107.79 (ft) — --� � fifr�f�ii 2 fff�iff G sfflffff {„� f {f{ F Dispeml Cell 106.50 (ft) Lateral 106.00 (ft)- ►� — Invert Dispersal Cell Cj3, :D Elevation E : :•: AA . - � � }, . ter ; ,,;`•�� .�:�' - ..,,l..Kt , ., ,± ,o �,S ��, x ..C�.� � �' � {',. ��"- t'r.'' .�'Kx-''•C}'.Cx+�'- w i� Y ...� �� •,.' {• �.{ _ " ` ` s 105.00 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key . Dispersal Cell See lateral details on 10 _ Topsoil Cap o "� 1.5 ft ..: ..• : • : f, f,;,. Page 4 for number, size, o ff:ff Subsoil Cap a 5 • `:: and spacing of laterals. ee r s.s' Laterals are eq ual ly ASTM C33 Sand fl `° :4. "••L• s� a "�: F �1 IY Tilled Layer 0.5 ft rypicai Lateral R +�;.r : spaced from the ti 0 ":'" : •tti " "ti ° : tir: r 5 distribution cell's Ego t. A g9 eg r ate a "� :;�•r. .f. ; f..�, t centerline in the 0 -- A - -* distribution cell (AxB)• Project: Oevering Homes Lot 14 Sunset Ridge Page 3 of 8 i i Center Connection Lateral Layout Diagram Force main connection YM tee or cross to manifold at and point. Laterals are WWnt1c al i P S. 0- Turn -up wrball valve a --�� sit st2� Laterals ti Force make of PVC Soh 10 aleanoutpiuy per C(><++FA Table 84.30 -6 Holes drilled on the bottom of the lateral Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.10 ft Lateral Length (P) 36.75 ft Orifices per Lateral 18 Lateral Spacing (S) 3.00 ft Orifice Density 6. 5 fe /orifice Lateral Flow Rate 9.69 gpm Manifold Length 3. Jt System Flow Rate 38.77 gpm Manifold Diameter in Total Dynamic Head 14.17 ft Forcemain Velocity 3.96 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - -► Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented a Altemate outlet location Foroemain diameter Skew Precast Co. Manufacturer 2 in. Cap acityl 642.33 Gallons Volume 1 16.47 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.91 328.00 B 2.00 32.94 C P ump off elevation ft C 5.09 83.75 100.00 D 12.00 197.64 D Total 1 39.001 642.33 iF - I Dose elevation ft 3" Bedding uncTer tank. 99.00 Alarm Manuafacturer JS.J. Electra Alarm Model Number Tank Alert Pump Manufacturer Goulds r � Pump Model Number IEP �— Pump Must Deliver 38.77 gpm at 14.17 ft TDH Q 3 D Project: Oevering Homes Lot 14 Sunset Ridge Page 4 of 8 Mound Svstcm Maintenance and OPeration SpecifigMtlons Service Providers Name E Sanitation Phone 715 - 386-0114 POWTS Regulators Name St. Croix County Zoning Phone 715 - 386 -461 System Flow and Load Param ers Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 fe Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 efu /100 mL Service ftggencv Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month Pressure System Laterals should be flushed and ressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 ears Other M1sceflaneous Construction and Materiels Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured ,in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ........... err •�������������♦ Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral i Project: Oevering Homes Lot 14 Sunset Ridge Page 5 of 8 • Mound System Management Plan Pursmnt to Comm $3.54, Ms. Adm. Code This system shall be operated in accordance with Comm 82-84 Wis. Adm_ Code, and shall maintained in accordance with its' component manuals (SBE)A0691 -P (N.01101), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD 107WP (N. 01101)] and local or state rubs pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than &inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Secdc Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fiker shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter Is equipped with an alarm, the finer shall be serviced if the alarm is activated continuously. Intermittent filter alarms may Indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump jerk The pump ( dosing) tank shall be inspected at bast once every 3 years. AN switches, alarms, and pumps shall be tested to verify proper operation. If an effluent finer is installed within the tank it shall be inspected and serviced as necessary. Uourid and Pressum i)bdibutioni Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the hAltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may riot exceed 220 mg /L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/I.. SOD 30 nVL TSS, 10 mg/L FOG, and le cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system Is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed It should be compared to the initial test when the system was installed to determine if orifice ding has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. CoMnannev If the septic tank or any of Its components become defective the tank or component shah be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be Irnmedletely repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and related piping, and repledng said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Probubnent Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 8 Page 7 of 8 NGOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and • Farms manual operation. Auto- superior strength and corrosion CxvidianStwxftidsAswdaWn • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "C" or "I"') factory. strength, and durability, SPECIFICATIONS ■ Motor Cover. Thermoplastic Gods Rnp is mo 9001 FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. 1 14" maximum. ■ EPO4 Impeller: Thermoplas- N Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: l 1 W NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104°F (40T) continuous METERS FEET 140"F (60T) intermittent. 10 • Fasteners: 300 series stainless steel. 9 30 5GPM • Capable of running dry without damage to e 25 rr components. 25 ° a Motor: _ • EPO4 Single phase: 0A HP, v_ 20 115 or 230 V, 60 Hz, 1550 5 . - 5 RPM, built in overload with c 5 automatic reset, a a • EP05 Single phase: 0.5 HP, o EPOS 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot 5 standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 ° 0 0 10 20 30 40 so GPM foot length, 16/3 SJTW with three prong grounding plug o 2 a 6 & I 12 rr (standard on EP05). CAPACITY Goulds Pumps 0 2001 Goulds Pumps ITT Industries Effective May, 2001 03871 q a tic u, /7 •c��►►►oN�, w ,5 a�7 t7 _ is a/ C �► o I cs P i P G s ec. 3 t 3 ^-�� i8'^� i P �t I fi� pp •to0 S q Z 2 z 1-9 72- 0 „� 3 - �src1•� �•« I �p wS t t c1.S 7 01, Proposed /oa 60 9a l � 0j. S�o t pra os�d >< 4 61 1 9 �j s u$e,d;N ���s rhsT�a���P�►JS�u.���°'►�'�ht �a Ce��n �� /d Q� y3-� AO Wisconsin Department of Commerce B U J O!L EVALUATION REPORT Page ( of Divisi.,n of Safety and Buildings E `L in accordan V County S, 4- ri Attach complete site plan on paper not less than 8 112 x 11 it i size. Plan must include, but not limited to: vertical and horizontal referen point (` 1 ', directio r�¢¢ Parcel percent slope, sca le I or dimensions, north arrow, and I tion ar�l�i arQeQo 6W[4t road C/ i Re •wed by Date Please print all information. ST. CROIX COUNTY (f Personal information you provide may be used for secondary pt rposes (m)). -- Property Owner Property Location' Z! Govt. Lot W 1/ 1 y 114 S 3 C) T� N R I O E (o W P Owner s Ma Address Lot # Block # Name or CSM# roPertY ng City State Zip Code Phone Number City El Village own N est Road _ Code derived design flow rate "�✓ GPD New Construction Use: esidential / Number of bedroom s _ _� -- _ ❑ Replacement Public or commercial -Describe: - - - - -- - -- - - -- - - -- Parent material __ -_` Flood Plain elevation if applicable General comments / o 6 i , and recommendations: # Boring ng Ground surface elev. f . Depth to limiting factor in. i o pit �- Soil Application Rate _. i - •�xture Structure Consistence Boundary Roots GPD/IF Hodson Depth Dominant Color Redox Description "Eff#1 •Eff#2 in. Munsell Qu. Sz. Cont. Colo' Gr. Sz. Sh. I---- r 3 �� -,.� ✓� �/ we Boring Boring # it Ground surface elev��= F Depth to limiting factor in. �l .cation Rate /- -- Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 �r p 1 -- • EfHuem #1 = BOD > 30 < 220 me and TSS >30 <_ 5: r " Effluent #2 = BOD _< 30 mglL and TSS < 30 mg& CST Name (Please Print) 226900 gna CST Number Bird Plumbing, Inc. Shaun Bird Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, Wl 5401 -'L% 715- 246 -4516 =3 Property Owner _ _ Parcel ID # _ __ Page of Boring -� [] Boring # E4i Ground surface elev. -03,� ft. Dept: J. riting factor _ in. Sai icabon Rate - - Horizon Depth Dominant Color Redox Description Texture cturQ i Consistence Boundary Roots GPD1fF in. Munsell Qu. Sz. Cont. Color r; =_. >h. r *Eff#i 'Eff#2 2 L 6 5 j-1 1 a Boring # ❑ Boring ' ❑ Pit Ground surface elev. ft. Dept i o limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture : >tr jcture Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color f? 3z. Sh. 'Eff#1 '042 Boring _ Boring # Ground surface elev. ft. Dep, - .o limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Descxiption. Texture ^` tr uctire Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color �:,r. Sz. Sh. 'Eff#1 'Eff#2 c ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L > < 0 and TSS >30 150 mo/l s Effluent #1 - 8OD� 30 _ ?2 nrg/L _ mg /L Department of Commerce is an equal opportunity service provider aad employer. If you need assistance to access services or need material in an alternate format, please contact the derarcment at 608- 266 -3151 or TTY 608 -264 -8777. sBD -8330 (IL6100) �X Soil Test Plot Plan Projerct Name Sunset Ridge LLC Shau it Address 838 Summer Pines Circle Hudson Wi 54016 CS Lot 1 4 Subdivision Sunset Ridge Date 4 74226900 /05 W 1/2 S W 1/4S 34 T 30 N /R W Township Richmond ❑ Boring G) Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Nail /Iron System Elevation 106.2' *HRpSame as Benchmark B -2 259' Property Line 0' 45' * 45 , B-3 35' 45' 7% Slope B -1 103.5' 105.5' 214' Property Line Scale is 1 = 40 unless otherwise noted to 437' Property Line sk G � o Z V I I i pal f I I �: ev ® a• V ct — 1– Lu �' u ' N i mi Ei ' I of l E I vi I I 3nrf3nvisizi of I I cil I � I ''I ul > °I RI i- .06'4ZC M.4Z.64.LBN I I I vi I I I i of I I ° M,69,69.69N M n 88 3 I I Rr N 1Eo N ap i V N N 8515'11' E v� 1 � YL \ WW f 1 I A � I 3evazae o E E o v1 + •SS n �l . s Yn �.aaz „$81 �'Oml I h o rp 1 1 alm - ' y'ff4yy Z am ° I 3 ° 1 e t r I - I I w w a I m S. a l I I I 15 H10L1 z , N • I V 0 I ,Beat 3 � bS OS. 6H N SONVI 03llVIdNA IV— )� ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer �� �✓ �� �� Mailing Address `y33 L�re�v�uu�c /74 ��� - � TYO - _ Property Address (Verification required from Planning & Zoning Department for new construction.) City /Statetirw le Cti 111" ,- d �,c�,' Parcel Identification Number LEGAL DESCRIPTION Property Location ate. �L , S� '/4 , Sec. T N R / 8 (g, Town of & C A) Subdivision Plat: 5L,5" R, � E , Lot # . Certified Survey Map ,# , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house yes Xo Lot lines identifiable Xyes 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 ( I ) 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. 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 returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms J 4_l1 3/ o `j F A NATURE OPPLICANT(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. (REV. 08/05) 2 6 6 0 1 3 5 -7 74940 ;2 STATE BAR OF WISCONSIN FORM I - 1999 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIK CO., WI This Deed, made between Herman W. Keller, Sr., Herman W. RECEIVED FOR RECORD Keller Jr. and Karen M Keller, husband and wife 09/21/2004 10:25AK Grantor, and Sunset Ridge, LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT i the following described real estate in St. Croix County, State of Wisconsin REC FEE: 13.00 (the "Property") (if more space is needed, please attach addendum): TRANS FEE: 1440.00 See attached Exhibit A COPY FEE: CC FEE: PAGES: 2 Recording Area Estreen & Ogland 304 locust Street 1 � q Hudson, W! 54016 �rrj Together with all appurtenant rights, title and interests. 026- 1098 -20 -000: 026- 1098 - 30-000 Parcel Identification Number (PIN) This is homestead property (is) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, resttric and reservations, if any,, of r ecord. r Dated this !/'f day of V 7 2004 * Herman W. Keller, Sr. * Herman W. Keller, Jr. 4 Kr a n M. Keller AUTHENTICATION ACKNOWLEDGMENT Signature(s) Herman W. Keller, Sr., Herman W. Keller, Jr. STATE OF WISCONSIN ) and Karen M. Keller, husband and wife ) ss. ST. CROIX County ) authenticated this 7 da of �� 2004 - - -- - -- Personally came before me this day of , 2004 the above named Herman W. Keller, Sr., Herman W. Keller, Jr. and Karen * Kristina Ogland M. Keller, husband and wife TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same, THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland, Estreen & Ogland 304 Locust Street, Hudson, W154016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, w1 STATE BAR OF WISCONSIN 800 - 655.2021 WARRANTY DEED FORM No. 1 -1999 r U 2660P 30?- EXHIBIT A Located in part of the northwest quarter of the southwest quarter, and the southwest quarter of the southwest quarter of Section 34, Township 30 North, Range 18 West, Town of Richmond, County St. Croix, State of Wisconsin described as follows: Commencing at the southwest comer of said Section 34; Thence North 00 degrees 08 minutes 04 seconds East along the West line of the southwest quarter of said Section 34 a distance of 484.66 feet to the POINT OF BEGINNING; Thence contiue North 00 degrees 08 minutes 04 seconds East along said West line of the southwest quarter 2157.27 feet to the West quarter comer of said Section 34; Thence North 89 degrees 50 minutes 54 seconds East along the North line of the southwest quarter of said Section 34 a distance of 1018.75 feet; Thence South 00 degrees 08 minutes 04 seconds West on a line parallel with the West line of the southwest quarter of said Section 34 a distance of 2007.79 feet; Thence North 89 degrees 59 minutes 59 seconds West 694.55 feet; Thence South 00 degrees 08 minutes 04 seconds West along a line parallel with said West line of the southwest quarter 164.50 feet to the northeasterly corner of a Certified Survey Map recorded in Volume 5, Page 1400; Thence North 87 degrees 49 minutes 24 secons West along the northerly line of said Certified Survey Map 324.40 feet to the POINT OF BEGINNING and there terminating. St. Croix County, Wisconsin. COUNT( PLA o0-- SUNSET RIDGE Located in , c of the Nortnwest Quarter of the Sout, wes� the s SOuthwe t �.�jarte r of the Southwest Quarter of Sectl ' o� '. ' North, Range 1E West, Town of Richmond, County of St. crci." " tz - �e , . sc-'nsin ------------ ad N 89'50'54" E '71 /z IcT 5 2M L - - - - - - - - - ad e - Sect/an 34. r,30M. RISW 6 263 d LEGEND C�) St. C'.1. County S.'W' Corn.. 1. N.!'d 200.23 0 S6t 2 and 3/8' (O.D.) 30 P; 6' 0 d9JX'C' 1-106,04,1 R. - - - - - - 12' unary E ... —t 7" - 20 --tr q '16-do, 9 0- a, V. 21 271 1 Ae -.1 -1-, 1­ J, - Y 4 � ,a 9 WH L7� 12 Id' o S'-za;'. ILC ceal 54o 6 a 17 .ere umve 1. a.- -.1, 100 0 100 200 SCALE lk FEET 12- 'ad 16 Id' — - - - - - -- 12 15 14 '003 LOT 18 LOT 17 13 1 6. 6 694.55' P N87 49 24"W 324 40' I Zl 5_T-AVFN_QF_ (S 8757'56' J' j2,3j) P -ag ��5? L2!- L LOT As MELCHERT WALKKY I..d-.p. rchit.cittr. I Hl 1 5 2 4.10 .4... wl civil engineering 1 7 ) 154 8 38 -T734 Sheet 2 of 2 Sheets lond surm) ;:: cl 0-7889 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 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 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 cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; 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 products; 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 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 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 material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant 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 infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. • A suitable replacement area is not available due to setback and /or soil limitations. Barring 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 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 soil absorption systems may be reconstructed in place following removal of the biomat 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 POWTS INSYALLER POWTS MAINTAIN R Name c Q ►�, n r s Name G C. 7 w c�, tis Phone L Z L/ Z_/ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name �t5 tai Name J of o "'X Phone Phone U This document was drafted in compliance with chapter Comm 83.2212)(b)I1)Id) &(f) and 83.54(1), 12) & (3), Wisconsin Administrative Code. , POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 6 IWI f- S Septic Tank Capacity / 0 ,0 0 a l ❑ NA Permit # Septic Tank Manufacturer 15-4 k, w ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer iSfS "`�" ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model �t�t �d ❑ NA Number of Public Facility Units '0'F!A Pump Tank Capacity o p al ❑ NA Estimated flow (average) al /day Pump Tank Manufacturer �' ul ❑ NA Design flow (peak), (Estimated x 1.5) `j j gal /day Pump Manufacturer o u �� S ❑ NA Soil Application Rate g al/day/ft' Pump Model P d ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit 2<A Fats, Oil & Grease (FOG) :530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L 11 WA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L 1 1!:�NA ❑ At -Grade .Erm Fecal Coliform (geometric mean) _ <10' cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. 94A Other: ❑ NA Other: Ll,-KA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ❑ month(s) (Maximum 3 years) ❑ NA ears) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 0'2 ❑ month(s) (Maximum 3 years) ❑ NA -i3 year(s) Clean effluent filter At least once every: / to - 2 - month(s) e h ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA j 8-year(s) Flush laterals and pressure test At least once every: ❑ month(s) El NA 71 El"year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ 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 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 chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 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