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HomeMy WebLinkAbout038-1079-60-115Wisconsin Department of Commerce Safety and Building Division GENERAL INFORMATION Personal information you provide may be used for secondary PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) [Privacy Law, s.15.04 (1)(m)]. BRANDON & MINDY BERREY I TOWN OF STAR PRAIRIE CST BM Elev: Insp. By I BM Descnpti7 �t( t7v G TANK INFORMATION ELEVATION DATA TYPE MANUFACTURT -� S IC CAPACITY Septic 1AAf r rwhr 34 /zbo Dosing Wn,fb D "T 344 (on,; O pO o Aeration ,r 00v "I TANK SETBACK INFORMATION TANK TO P L WELL BLDG. Vent to Air Intake]ROAD Septic 3 5 . N 01 1v 18 , Dosing 5 �� r Aeration Holding v op PUMP/SIPHON INFORMATION /4,7�r ! I vs..L, -27.) `1 Manufacturer 1 11 bvv 1 GS Demand GPM Model Number (Jr r TDH Yo r 3 7b Fricti n Loss System Head TT 'LFt / Foroem/ain LeQcZlh O , MOO Dia y. Dist. to Well Cr SOIL ABSORPTION SYSTEM STATION BS • l 101 .I FS ELEV. 00 Benchmark { ' . 0 Q 1. I /00 Alt. BM,jr" 4tC (O� 43.5(o Bldg. Sewer rZ•(' �� SVHI Inlet l�l- Sq.7 SVHt Outlet Of Inlet Dt Bottom 17.13 SG . 1/7 Header/Man. 7s(- y&,SY Dist. Pipe CL 96 SY Bot. System D O Final Grade c r fasq 93.5ro yr I Is FRENCH DIMENSIONS Width r Length�O 11 Ng,Qj3fCac�as_ Z PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAK AM L CHI Man a er: INFORMATION CNA BE OR V, NI% Tye r• t stern ��� V0, M el Number: DISTRIBUTION SYSTEM Header/Manifold r Z Distributiioonp '1 I D,5� f �Z `i , z Hole Size ) I• z HoleSpacing J. O r Ver��I to Air Intake YO 4l1 Length Dia 1-pegsPpe(s) Length Dia pacin S g B / SOIL COVER <e - nI x pressure Systems Only xx Mound Or At -Grade Systems Only 1 er P) V .-�& t Dolif, 8 c L, �I Bed iheneMCenter Z) / I I Dk Depth Over Bedlrrench Edges 712 1z xz Depth of I Topsoil 7 )-Z ` Seeded/Sodded *Yes ® No zx Mulched )(Yes Q No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / 25' ZOk!_ Inspection #2: Location: No Address Available L OG�5 d- C hq,Y`rJ- I'%t�J 6-.30 --li 1.) Alt BM Description = t N4 Jh 2.) Bldg sewer length = L45/ f -amount of cover = 71/- Plan revision Required? ®Ym '�'-gp'�_No - �—I- 7! .•b 1 � 3 Use other side for additional inforrmation. I C� SBO-6710 (R.3/97) Date Insepclor's Siglillto Can. No. 15wa 1 l (-oo at,-- OAK-2n:20 -1�3 opMiMetla ea r ?g MAY 18 2020 t Industry Services Division 1400 E Washington Ave P.O. Box 7162 Mason, WI53707-7162 County Sanitary Permit Number (to be filled in by Co.) t C-96 � pplieation� 1 In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fold to the appropnate governmental unit State Transaction Number Project Address (if different than mailing address) is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary PlarpMeS in accordance with the Privacy law, s. 15.04(1)(m Stats. I. Application Information - Please Print All Information Property Owner's Name Parcel # Property Owner's Mailing Address Property LocaCom Govt. Lot Sul y yi Section 19 City, State Zip Code Phone Number _ - crrcle one T _ N; R E ` 32-4�"' l ,1,1.. Type of Building (check all that apply) IA 1 or 2 Family Dwelling - Number of Bedrooms Lot # / (O Subdivision Name -�� ' Block# ❑ Public/Commaercial - Describe Use i ❑ City of ❑ State Owned -Describe Use Village of '[a ` —21 r❑� Townof 1t / IQ. Type of Permit: (Check only one box on Hue A. Complete line B if applicable) A lam System ❑Replacement System ❑ TreatmenUHolding Tank Replacement Only ❑ Other Mollification to Existing System (explain) B- ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stern/Com onenUDevice: Check all that a 1 ❑ Non -Pressurized In -Ground ❑ Pressurized Ira -Ground ❑ At -Grad Ma111624 in. of suitable soil ❑ Mound < 24 in. of suitable soil Ki ❑ Holding Tank ❑ Other Dispersal Component ( lain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) B Design Soil Application te(gpdst) Dispersal Area Required (s Dispersal Area Proposed (at) System El'evv lion ? VI. Tank Info Capacity in Gallons Total Gallons # of Units Manufacwm a 2 V c4 R vl imt rnY 'w' C7 s 'a New Tanks Existing Tanks Septic or Holding Tank T Dosing Chamber — VII. Responsibility Statement- I, the undersigned, assume rwpgnsflMty for installation of the POWTS shown on the attached plans. Plumber's e ' t .� Plumber's i t� MP/MPRS Number Business Phone Number s Plumber's (Street, City, State, Zip Code) VIII. Conn /De srtment Use Only 7KAppmved ❑ Disa roved ❑ ve on for Denial Permit Fee Date Issued is g Agent Sigo ture IX. Conditions of Approval/Reasons for Disapproval '3 � pqQ to SYSTEM OWNER: W '�d rrta4� ' t e 1. Septic tank, effluent filter and -4.1 Pl+�� -6 o j 6 - dispersal tall must be serviced / maintained // rtlV?� S Wttu t1 +a+tce as per management plan provided by plumber. `ter) Pf'ltO.Ql OWVAX-. 2. All setback requirements must be maintained as per applicable codefo pA rlatreeslete plans far the system and submit to the County only on paper not less than 8 in a 11 inches in sin SBD-6398 (R 08/14) May 15, 2020 CONDMONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-05-15 Plan Review: PWTS-052000845-C KIM A OCONNELL 504 3rd Ave E Osceola W154020 SITE: Berrey 205th AVE Town of Star Prairie Saint Croix County Total Amount: $250.00 FOR: Description: 600 CPD Maintenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 543045211 Contact Through Relay http:i/dsps.vA.gov/progranr.rindustry-serviCes www.wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01101, R 10/12) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDMONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • It is recommended to fence off 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. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. if it rolls into a 1 /4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • It is recommended to cut as short as possible and remove ground cover prior to tilling the ground surface for the dispersal area. • Remove and maintain woody vegetation on or near the dispersal component to minimize root infiltration into the dispersal cells 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 stets 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Travis Wagner POWTS Wastewater Specialist, Division of Industry Services (608)598-0715 travis.wagne rP wi.gov idMRW X APPLICATION FOR REVIEW !s i:l'�t �1 Completeall pages- i,.' P=% NOTE: Personal information you provide may be used for secondary purposes \� / [Privacy Law s. 15.04(1)(m), Slats.) Private Onsite Wastewater Treatment Systems Division of Industry Services ❑ Plans to be E-filed. Provide SharePo[nt User name below: For plan status, check our websits at htto://dsps.vA.aov Email technical code questions to maiao•DSPSSBPowlsTech0wi.00v Several counties have been delegated certain authi) ty to review plans in lieu of Division of Industry services. For a current list of those Counties and their designation check our website at h :ll .wi. ov 1. Project Information - fill in all known information. Confirmation of assignment to a reviewer. PmjecUSke Name: "E Transaction ID: Location, Number & Street of project (if nearest mad) Previous Related Trans. to: f�urdi�no,ym,' .G� Estimated Completion Date: Assigned Reviewer _ -� Legal Description: YF� ��i-Y- �/ /-,7�lyl,(� ��, 4. ( Assigned Office: Mail to your affice of choice below: La Crosse, Green Bay mom ❑ City view Town of ❑ M 2 After plena are reviewed, Please: (check all that apply) ❑ Call customer 1, 2 (circle number)` NOTE: We reserve the right to redistribute plans to another office if ❑ Requesting party will pick up needed to reasonably balance turnaround times. Check � htta:tld4ps.wi.gov for next available review date f Mail plans io customer 1, 2 (circle numberp 'Refers to customer number from below. 3. Complete the fd1owing deslgnedowneNregtwting information. utiaze the check boxes when desigcer, owner or requesting party is the same to avoid repeating information. Designer IpMtmaliotm (Custprw 7 OSPS Other Please Specify Below (Customer Z) DSPS Fsst N� Em Cu Number Fist Name tit Flame Ctslomer Number y , C./. Compwmy Name Address n Address 9 digits) CIAr State zP+4 (9 dam) XState SS Ptwna Number E♦nad address can owns Phone Number E-rmuil address Cell phone. (area code) - (area code) ,�iix,r�con/.�Ic//.�P �ZZ Check If applicable Check if applicable or speafy telationsW ❑ Owner ❑ Owner ❑ 00w -specify relationship Itdormation and Plan Submittal Checklists. To request electronic plan review =npleto the appropriate application form and e-mail it along with your regisFered SharePoint usemame to DSPSSBPlanSchedule(caW isconsin.aov. If plans are being submitted via paper, they will be assigned to a reviewer after receipt at a DSPS office. Submittal cheddisLs can be found In each applicable component manual e rim on the POYTS program page under Publications POWTS Components Manuals HalmenlOnalaska Area DSPS 2850 Midwest Or Ste 104 Onalaska, Col 54650 608-785-9334 Fax: 608-7ati-9= Green Bay DSPS 2331 San Luis Place Green Say, WI 54304 920492-5601 Fax 920-4925604 Email: DsosSbPlanSchedulekAwl eov Make Checks Payable to: Division of Industry Services OR ❑ Check box to invoice designer and sign below TOTAL AMOUNT DUE 5 Review Code 7633 Designer signature SBD-10577 (R 3119) S. POWTS SUBMITTAL (check all that apply- Incomplete forms may result In processing delays) ® NEW ❑ Aerobic Treatment Unit(s) ❑ Chlorinator ❑ Tank Replacement Only ❑ REPLACEMENT ❑ Commercial system ❑ UV Disinfection Unit ❑ Add Effluent Filter SYSTEM TYPE(S) NOTE: Submit separate sheets for each system If submitting multiple systems on the some alto Enter Fee ❑ Revision to previously approved plan $86.00 [] Miscellaneous Review (i.e. replacement of a septic tank, addition of an effluent filler or pretreatment device to an existing system, ate.) $801hr ® Component Manuel treatmentcomponentsa e previously approved Design At -Grade Component Manuel - Ver. 2.0, SBD-10864 (N.03107, R. Ill 2) Wastewater Flow In under Ir ground Component Manuel - Ver, 2.0, 880-10705-P (N.01/01, R 10112) Gallons Per day Design wastewater flow of the proposed system: Mound Component Manuel - Ver. 2,0, SBD-10691•P (N,01/01, R 10112) Pressure Distribution Component Manual - Ver. 2.0, SBD-10705-P (N.01/01, R 10/12) 1.000 god or lose $ 250.00 ❑ Other- Please specify Goo 1,001 - 2.000 gpd $ 325,00 2,001 - 15,00 d $ 400,00 ❑ Sall Based Individual Site Design* One or more treatment components are not previously approved under s. BPS 384.10 (2) or (3): ❑ At Grade (Individual alto design/deviation from component Non -Pressurized In -ground Design manuals and use of components without product ❑❑ Pressurized In -ground Wastewater Flow In SPprovel): Mound Gallons Per day Design wastewater flow of the proposed system: Drlp4he ❑ Constructed Wetlands GPD 1,OD0 gpd or lase $450.00 ' Documentation must be provided to support treatment and dispereal claims. In a separate 11001 - 29000 gpd $600.00 2,001 - 5,000 god $750,00 statement, provide rationale for the project and attach supporting documents (code sections, test than 5,000 gpd $900.00 reports, technical papers, research articles, etc.) greater plus $0.08 for each gallon over 5000 gpd State-owned feclitles: Design Holding tanks previously approved under a. BPS ❑ Holding Tank Component Manuel, Ver. 2.0, 580-10866-P (N.03/07, R1112)' Wastewater Flow In 384.10 (2)(3). Design wastewater flow of the proposed system: Gallons Per day • Non -state owned Commercial and Residential Holding tanks that completely utilize this manual 5,000 gpd or lose $ 00,00 and have an estimated daily flow of lose than 3000 gallons per day must be submitted to the GpD 5,001 - 10„000 gpd $160.00 appropriate governmental unit for review Instead of the Department. [see BPS 383.32(3Xa)) greeter than 10.000 gpd $226.00 ❑ Holding Tank Individual Site Design', (I.e. site constructed, <5 day holding capacity, Co- Design Holding tanks Including site constructed tanks NOT mingled wastewater, etc.) WealFlow In previously approved under s. BPS 364.10 (2) or (3). Please specify:_ Galllonsons Per day Design wastewater flow of the proposed system: 6,000 gpd or lase $180.00 ' Documentation must be provided to support the rationale for the project. In a separate ststsmenL 6,Ool-10,000 gpd $300.00 _ please include all code sections, lest reports, technical papers, research articles, etc.) OPD greeter than 10,000 gpd $480,00 ❑ Boll saturation Determination Report (using observation pipes) ❑ Interpretive Ostemlhallon $240.00 — ❑ Experimental System (One time additional fee). Submit foe for Individual system as per appropriate above system type) Expsrlmsnl Number_ $400.00 — Priority Review (enter same amount as normal review fee listed above) $ Enter Total (rounded to the nearest dollar) $ �/ sc BPS-10577 (R 4/18) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Berrey Conditionally AFFKOVED Owner's Name: Brandon & Mindy Berreyvrr .�r . OF SAFETY AND PROFES SIONAL Owner's Address: 2123 62nd ST SERVICES ERVICES Somerset WI 54025 Legal Description: SW-NE-sec19-T31N-R19W Township: Star Prairir SEE CORRESPONDENCE County: ST Croix Subdivision Name: Lot Number: 6 Block Number: Parcel I.D. Number: 038-1079-60-115 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 10 ATT soil evauation Designer: Kim A Oconnell License Number: Date: 05/03/20 Phone Number. Signature: 224263 715-381-7917 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01101, R. 11112), and both SSW MP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet (R or C) R Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd/ftz) 400.00 1.50 600.00 6.00 94.00 32.00 0.60 Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 I In0uent Wastewater Quality (1 or 2) Pressure Disribution Information (C or E) E Center or End Manifold 3.00 Lateral Spacing (ft) 2 Number of Laterals 0.125 Orifice Diameter (in) 3.00 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) - 50.00 Forcemain Length (ft) 87.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 D 7.33 Vertical Lift (ft) 1 %D 0.81 Friction Loss Ift) 0.00 In -line Filter Loss (ft) 14.64 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1200.00 Septic Tank Capacity (gal) Wieser Manufacturer Note: Sand fill (D) calmlafions assume a Table 383-44-3 in -situ soil treatment for fecal coliforrn of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest point in the distribution L_ ' J network? Enter Y or N If N above, enter the elevation ft of the highest point. 9.09 ftz/orifice Does the forcemain drain back? Enter Y or N Forcemain Drainback (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) A Manifold Diameter Selection in. dia. options I choice 1.25 x 1.50 x x 2.00 3.00 Gallons/inch Calculator (optional) 1200.02 Total Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) 33.33 galfin (enter result in cell 1349) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) Pol ok Filter Manufacturer 22.24 Dose Tank Volume (galfin) PL-525 Filter Model Number Wieser IManufacturer Project: Berrey Page 2 of 9 Mound Plan and Cross Section Views 600.00 (ff) Dispersal Cell Area 1 138720 (fe) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.29 (ft) —► G H F Dspe sal cell — 95.00 (ft) Lateral 94.50 (ft) Invert Dispersal Cell j~-L t Elevation D 94.00 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover Shading Key m aT t Dispersal Cell See lateral details on 1❑ ®Topsoil Cap c ° 1.5 ft Page 4 for number, size, Subsoil Cap W o © and spacing of laterals. Laterals are equally © ( ASTM C33 Sand -0 0 Z - F spaced from the ® Tilled Layer Y © Aggregate d m ro v 0. ft Tvwcal Lateral distribution cell's in the o i? centerline A * distribution cell (AxB). Project: Berrey Page 3 of 9 End Connection Lateral Layout Diagram • = Turn -up vdball valve or clean out plug AN laterals are identical IEX --- >1 Holes Nded on the bottom of the lateral equally spaced Force main connection tria tee or cross to manifold at anu point. Laterals Morcemain Sch 40 PVC per SPS Table 384.30-45 Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and SPS 316.300 WAC Tank component is property vented Wieser Ca acityl 800.00 Volume 1 22.24 Manufacturer Gallons gal/inch Dimension Inches Gallons A 20.54 456.77 B 3.00 66.72 C 4.43 98.59 D 8.00 177.92 Total 35.97 800.00 3" T A 1B C D Alarm Manuafacturer I SJE Rhombus - Tank Alert Alarm Model Number 1101-01H Pump Manufacturer I Goulds Pump Model Number I PE 51 Pump Must Deliver 27.19 gpm at 14.64 ft TDH Locking cover with waming label and locking device and sealed watertight 4 in. min. Alternate outlet location Forcemain diameter --- 9 2 in. Weep hole or anti - siphon device Pump off elevation (ft) 8-7 Dose lank elevation (ft) 87.00 Note: Switches containing mercury may not be used in this system. Project: Berrey Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name I Phone POWTS Regulators Name I St Croix County Zoning Phone 715-386 4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ........ .............. Grade yr 6-8" Diameter Lawn P Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Berrey Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code Genera This system shall be operated in accordance with SPS 3a2-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD•10691-P (N.01/01, R. 11/12), SSWMP Publication 9.6 (01181), and Pressure Distribution Canponent Manuel Ver. 2.0 SBD- 10706-P (N. 01/01, R. 10/12)] and local or state miss 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 SPS 383.33, 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 a -inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48. Slats. 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 ant outlet fitter shall be assessed at least once every 3 years by inspection. The outlet fitter 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 fitter when removed from its enclosure. If the fitter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filler alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment. maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg1L BOD5. 150 mg1L TSS, and 30 mg/L FOG for septic tank effluent or 30 mglL SODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flaw specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the and 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 dogging 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. Pending levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes detective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it wilt 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 replacing 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. Pretreatment 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: Berrey Page 6 of 9 W CL OV1H PINVNAC W101 N Wisconsin Department of Safety and Professional Services Page of Division of Industry Services SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Cade CMAY � Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must irxitide, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and Ioration and distance to nearest mad. _ _ Please print all information. Reviewed by _ Dale Property Owner Properly Location ❑ -� Govt. L.ot� '/. 41E '/. S J9 T yj N R E (or) W Property Dwnees Mailing Address Lot # 81ock # %bd. Name orb City •� st�e Zip Code Plane Number ❑ City ❑ Village ® Town Nearest Road ®New Construction tIse:®ResidemiallNumberofbedrooms Code derived design flow rate dCW_ GPD El Replacement ❑ Public or commercial —Desrnbe:_ Parent material Z221 Flood Plan elevation if applicable R. xneral corrrrrrertts and recommendations: ,/" 4" 6, L��,�,ira4=d -7e - El , 4"o # Boring0 Boiling ®Pit Ground surface elev.'$& R Depth to WORM feclnr3411. Sail �VIM PAT Boring If 0 Boring; Pit Ground surface elev. R Depth to limiting tacloryJ`- in. SailSati Aoo ®w®wM-12 • r F 05MM. ® �VM0W.-MM t 4 IA��W WH � CST a (P S" CST Number 3 t� Dale EvalMLIlon Conducted Telephone Number A =3 lil Boring # Baring PR Ground surface elev. Wft. Depth to Rmiting factcu- in. ❑ Boring ❑ Pit Ground surface elev. _ fL Depth to Nmiting factor _ in. Sol Aoo6cabon Rate ❑ Boring # ❑ Boring ❑ PR Ground surface elev. _ R Depth to limiting factor _ in. Effluent #1 = BOD, > 30 s 220 mg1L and TSS > 30 5150 mglL - Effluent #2 = BOD, > 30 S 220 mg/L and TSS > 30 s 150 m91L - �ul/90- r-YZJ-X"/-9a/ - - GsTJ� �z�?G.3 � r Ead i�mue 9� Ead i�mue 9� ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Addri Property Address 1958 & Zonine Department for new City/State 16L Parcel Identification Number LEGAL DESCRIPTION Property Location ,,;g� Y4 , _A6c_ t/4 , Sec. 19 , T ��N R4_2 W, Town of Subdivision Certified Survey Map # !J Lot # Volume 2.4i , Page # .J�. Warranty Deed # fiqr�3S`fo (before 2007)Volume , Page # Spec house Oyesoto Lot lines identifiabl4yes0no 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 §SPS. 383.52(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. 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$afety And Professional Services 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 statbments on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of edrooms_ SI A 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. (REV. 04/12) FOR BIDDING ONLY NOT FOR CONSTRUCTION LEFT ELEVATION 1/8' = 1'-0' L III II,III E- 0 I #19-251 = I I a MAIN I L PLAN °6- 1/4- - I'-D° ALT PDRCN PI -AN 9'A' MIJUD WNC. FDUNDATIDN 9' I IV MUNG 0 MAIN LEM 8'-1 IV CDUNGQ UP LEM r ��:e BIDDING ONLY FOR CON5TRUCTION 11 3 FOR BIDDING ONLY NOT FOR CON5TRUCTION #19-251 u 9 9 LOWER LEVEL PLAN IK'= 1'-0" 8+0" FOURLD CONC FCUNDPWK •ew+w FOR BIDDING ONLY NOT FOR CONSTRUCTION N19-nT 147 LAi 2#9, • a_s/4&m>� gy m! e_� qG@Z \ 2'. oppr �rS r . y.• 99 lIFw ' n. lee, . ?.` 0 200 400- DISCV.IMER.Thsmep.isnolgueran -DR ..Me and ct, wr ent, or GOn1W conclusions tlrmvn are Me responsidTity of +^t+:'.'3. FN,N AIL D J^�—�► "�;�1 . Wmeonsin Dep o Saetyand Professional ervices Page —Lof Division of lndu Services JUN 01 Z020 SOIL EVALUATION REPORT` St. Croix County Ina rdance with SPS 385, Wis. Adm. Code County Attach complete sit pla"Mapatpddll 11 inches in size. Plan must include, but not limited to:: onzontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 4 — Please print all information. �2e�riewad by n fDfe/ Property Owner Property Location t ❑ Govt. Lots I/ '/. S T N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or — S9 City Stalls Zip Code I LdJ- �. r-1%�� Phone Number I f 1 ❑ City ❑ Village ®! Tom es� Nearest Roar �. ems! %� "',c I .:VD.S (H New Construction Use: ® Residential/Numberofbedrooms Code derived design flow rate GPD_Ki ❑ Replacement err ❑ Public or commercial — Describe: — 627,01L-D Parent material ; . �� Flood Plan elevation if applicable ft. General comments and recommendations: Boring ❑ Boring Pit Ground surface elev.� ft. Depth to limiting factor In. i TaAjeif .:e 4z L, *ril Sal Aooll ication Rate I ®®® r ®�- M®® =��W-FMWMIWIM�, M��! ��MM W,� Boring # Boring QQQ���JJJ Pit Ground surface elev.-ft. Depth to limiting faaori in. Soil Aonll ication Rate ®®®® • . Description .®®�®® CST a (P a rim Signat ,�%`, CST Number v 3 AddressDate EvaKati6n Conducted Telephone Number ° k 3 onu-aaau tnu�r ,D) 4r,,� c"i Boring # 6drlrfg` , Pit Ground surface elev. 92 Depth to limiting factor Soil Aooll ication Rate ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Rail Annll iratmn Rat. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/FF •Eff#1 •Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Rnil Annlil ration Rate I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/FF •Eff#1 I •Eff#2 . Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30!' 150 mg/L • Effluent #2 = BOD, > 30 < 220 mg1L and TSS > 30 s 150 mg1L .�a PY Boring # RBoring— . .___....,. 0 Plt Ground surface elev.ft. Depth to limiting factor�M in � Anil Annlil ,afinn PM. I ®®® • , • • � , � • ®®�®®®I ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor_ in. AM AnM—tl— Rnfu Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eg#1 I -Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to IimRing factor _ in. Anil Annlirafinn Rafo Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe 'Eff#1 I -Eff#2 . Effluent #1 = BOD, > 30 5 2y20 mg/L and TSS > 30 5 150 mg/L • Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5150 mg/L v ' I I I I �J I I_ I Imo--v I IQZr _ I i i I oLI y I I J y at � — I I �yI I I I � I