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HomeMy WebLinkAbout040-1324-29-000.sconsin Departmem of Commerce PRIVATE SEWAGE SYSTEM Safely and Building Dr lion INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal imomiabon you prowoe may be used for secondary purposes (Pmacy Law, s.15.04 (1)(m)] TANK INFORMATION TYPE MANUFACTURER .^ LS4 CAPACITY Septic J J -( z %Dos Dosing Holding TANK SETBACK INFORMATION TANK TO PfL WELL BLDG. en Air Intake ROAD Septic DO" r AW Aeration Holding PUMPISIPHON INFORMATION a.1/ Manufacturer -Z'NJ Demand / GPM Model Number 13 7 TDH Lift Friction Loss Systam He TDH / , 3 IG b O Forcenuin Length , 1M. r Drat to weld 1A z SOIL ABSORPTION SYSTEM ELEVATION DATA STATION BS HI I FS ELEV. Benchmark IWAI Aft BM I.b\k. o � �• � /OS7. Bkig. Sewer 4.6 /6s5. a St/Ht Inlet %,(a /2iS/• St" Outlet Dt Inlet Of Bottom 13.7 % 4(7• 91 Header/Man. 2.3 /d59•0 Dist Pipe Z , 3 5p /0 5 /. Bot. System .I /dS4. Final Grade iss o 5r BEDlTRENCM Vwdtn Length No T PIT DIMENSIONS No. DIP in Dia Laud Oepin DIMENSIONSg S7 �e SETBACK SYSTEM TO PA- JBLDG JWELL LAKE/STREAM I LEACHING k/anuNclwar WORMATION TYDe _ GJ T2 1� , r,t /v AT— CHNUNIT OR UNIT Model Nrrrrtier DISTRIBUTION SYSTEM Headw/Mmiktd if IF r • f x Hole Size r f x Hole Spetmg/ verlg to Air In e Lerrgln�Dle Z IDsvlbut— P9Nw �`� Z Length Dia Sparing 3 /(,./ Z v SOIL COVER v Prouure SrMems Oniv as Mound Or At!Grade Svstenrs ONv " •�` .-.."�� Depth Over BeNfmnC Crrmx g Depth Over Bed/french Edges n Depth of Top" I xx Seeded/Sodded n MukMd / Yes I No Yes to COMMENTS: (include Code discrependas. persons present. etc.) Location: 575 GERMAN CT / 1.) AN BM Description 2.) Bldg sewer length = /sf- 36 7 N - amount of cover Plan revision Required? [ Yes -eNo 1 —7 I Use other side for additional information. 1 _ Z' I / SBD-6710 (R.3517) Date Inspection i1. c' . Zd i—; Inspection 82 1 �'Ipf 66� 4, Jsec� '.` $ ` Safety and Bindings Divisbn G� VFW County (a , ; : 201 W. WBshiVor, Ave., P.O. Box 7162 5370sz Spry Pamir N■aba (m be filled m by Co.) RemJ :�I %yea _ ■ �7 SawTaasa >im Number st.c eimit Applicanw.. `Zae e Fs a) m 36321 . wu. Adm coat, abmissioc of this fu®m the appraluiae an..._ ,iv rail is mgovod prior to otmmae a SIMHWY P®u_ Nam: Appliouw faces fat scot nv d POW S Ad&= (ifditia- 9- mace{ aft=) 4<Depsrbmt ofSafety atd Fmfasionel Savirs. Pelmet offot mm ym provide may be urea fa seoon PUIPCOal ID sem*=nA the Privacy Law, s. 13. 1Ym Stall. 1 Application lnformatioa- PleasePrintAll low Property osmn's Naze: Pi p e-'er,,, 0qo- 139y-oi`1-000 Psapaty Ooaa's Mailing AAt + 0 >"anylasso■ 01. 2g. I r � Goat La r y,. / /' %Y\ Section L T Z" N; R E W e■y Stans n 9 Lip Cade < Pl os N ®ba IL pe of B■ildiag (rheck all that ap -2 Subdiv Naox q 2 Far+j Dwellma-Number of LY Bkeb PubtirM..a®.W-Dsen'be Use Ciyd CSbm Owvyim -Dabe Ufa 0Vdlaaed CSM Numbs x 5 0,, (`R*-d v ,_ Ill. Type of Parnell: (Chat only one box on line A. Complete line B if applicable) 1 A. Sy..m —� ❑ R.*ccan t sym® ❑ Ttom.tar BDI&u■ Tank Beplacmd Only � 0 OPua 1.Sodifmoao m EtistiaE Syaaa (,Via.) B- ❑Permit Revision ❑Cbage ofPtumbc � o Traafaa7:ew� i List usPcmh Nurnbar anDme honed ad rv. 7'_ efPOR'1'SS cam eaoa/DerYe: Clecic.0 skatapply) :Aso-Ran■iad mduoved ❑ Preaavad m-Gamd CM -Grade ❑ Masnd> I4 rt dutiable sail <24 n dmiaNe sal ❑ Noldmt Took ❑ Alba iwpasal C'�mt (e,� ) ❑ Preaea®mt i Tr<(=5d>m) V.INs rea eH Ara Inform Id, - t ' Disposal Arn Req=-WA�r-/� �Dspasal Ato syn. k7evaboo do s✓ a VL Taak ldo ' Cpdty a Tout a d Mawficma Galbas Gallaas Unit Nw Task Exitmt Tatlo ¢ a CS $$ Iy sepoe-Hatdiut Tmk / 7 _ 1 D.. t(2mba .-� ) VIT. 3Bity Ste ' 1 'b. oder*-A d Lr mu4tlaa chat Pown same a the aaaehd s Name (Piiot) PI WMALEC NO A(tdte�s (Saa4 City, State. 7 p VMLowattv/Douartmeat Use Only D 7 I ��t 5 b � In t zoanne _�-L• I1L Co■dm�ns, . , I& PA*Pprovw _ 3 so AeL,.e_1 'iib pm::m tell must all be sa_k>s ! r., s pa gyray■rnen! plan p oa erl WW plumber: t'10M� %N'CI" i 7a �Kh TUaLbe f:1. N.E� ,hn . t✓b f'filaA •"--"'-' —` f /1 / 'dA , � vpFIwA de / I as rose l.raknarrwa. /1{�(�y�'i tl ZA Aoad bonyleb laW fnr eke ayms nW mM�Camp/�wppc ant les a�eetnsll brieu 6e SBD-6399 (R I In1) Q,(� to N/1 F'aarl Y pp��•r• l �- s� 51�td i Z6A, ;s 7 3oa R� 4- 61-j n9 4t 6e_ 4 116, ooe C� System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cemohous Ave Suite A New R ichmond Wi 54017 NE 1/4 NW 1/4S 1 /T 28 NIB 19 w TowN Troy COUNTY ST.CROV SYSTEM ELEVATION 1057.8 1.3' below grade 7/12/17 3 DATE BEDROOM CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK. MOUND )00( SEPTIC TANK SIZE 1000 gallons LIFE TANK SITE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 #x of chambers none _kLBENCHMARK V.R.P. Top of rebar ASSUME ELEVATION 1056.71'Filte[ I.tfetitne Filter ❑ BOREHOLE O WELL •H.R.P. same as benchmark Tank is to be properly bedded and provided with lockdown covers with approved warning labels Scale = 1 /4" - 10, 2 acre lot Grading is to be done to divert run-off away from system Area 15' below system is to remain undisturbed Property Line Well is to meet all WDNR setbacks Huffcutt Combo Tank B-4004 B-4003/ //// B-4005 `/ 2% Slope 1 057' 1056.5' n 1056' �D- 428' Property Line B.M.' August 14, 2017 CUST 1D No. 226900 SHAUN R BIRD 1432 120TH ST NEW RICHMOND WI 54017-6409 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/14/2019 SITE: Oeverine Homes 575 German St Town of Troy St Croix County NE I /4, N W t/4, S 1, T28N, R 19 W Lot: 29, Subdivision: Cottonwood South FOR: DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay hftp://dsps.wi.gov/programsfindustry-semices www.wisconsin.gov Scott Walker, Govmor Laum Gu06rrez, Secretary AT77V: POWTS Impectar ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD f' HUDSON WI 54016-7708 _ !//►• Sct CC:: Identification Numbers Transaction ID No.2978756 Site ID No. 841292 Please refer to both identification numbers, above, in all correspondence with the agency. Description: Mound System (J Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1720852 Maintenance required; 450 GPD Flow rate; 22 in Coil minimum death to limiting factor from original ¢rode; System(s): 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.01/01, R. 10112); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • Divert surface water from POWTS 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 prepareIf it crumbles site preparation can proceed If the site is too wet to preparedo not proceed until it dries. I SHAUN R BIR❑ Page 2 8/14/2017 • 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 (1 I)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: I. The bottom of the tank is located more than 15 feet below the elevation where the servicing oad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(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 reduce the amount of soil available for proper treatment. If no other site is available. trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual andlor owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Tim Vander Leest Private Sewage Plan Reviewer, Division of Industry Services (920)492-2214 , Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Payment Submittal. WiSMART code: 7633 SHAUN R BIRD Page 2 8/142017 • 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. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing mad is located 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located • Verify property line(s) prior to installation. • Pump Floats to he set and verified per approved plan Anv chances may result in pump resizine to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state smts 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, dent T/.a�iw e�"Cv7 Tim Vander Leest Private Sewage Plan Reviewer, Division of Industry Services (920)492-2214 , Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Payment Submittal. WiSMART code: 7633 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 7/11 /17 Owner:Oevering Homes Location: NE1/4 NW1/4 S1 T28 N,R19W 575 German Court Troy 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 7-8. Maintance and Contigency plan 9. Filter Specifications and cross section Attachments: Soil Test /1 Shaun Bird Signature License nu 2269( RECEIVED JUL 17 2017 iNOUSTRY SERVICES Page 1 of 9 i VLIIiV ?��J 4a7 oLNCE System PLOT PLAN PROJECT Oeverinc Homes ADDRESS 1433 Cemohous Ave Suite A New R ichmond Wi 54017 NE 1/4 NW 114S 1 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 1057.8 1.3' below grade 7/12/17 DATE 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 g of chambers none IlL BENCHMARK V.R.P. Top Of rebar ASSUME ELEVATION 1056.71'Fijter LifetIIDO Fiter ❑ BOREHOLE O WELL -H.R.P. same as benchmark Tank is to be properly bedded and provided with lockdown covers with approved warning labels Scale = 1 /4" - 1 ph 2 acre lot Grading is to be done to divert run-off away from system Area 15' below system is to remain undisturbed Property Line Well is to meet all WDNR setbacks Pro 3 Bedroom House Huffcutt Combo Tank B-4003 1057' 1056.5' 1056' B-4004 ( B-4005 2% Slope 428' Property Line �� Mound System Cross Section and Plan View :3 - Topsoil Cap Material Gootextile Fabric U11 El= ASTM C-33 = Clean aggregate O = 4 in. sch. 40 pvc sand fill Y2 to 2 Y3 in. dia. observation pipe 10�-4r.5--Ft Contour E Slope Direction H GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x w) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a % inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Spacial 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. 10/07 lgj Page ot� Pressure Lateral Layout Two Laterals — End Manifold Manifold T Force Main g 0 i ;4'[.R4 sit° r Distribution Network S tioni Lateral Diameter Z 'In. in. Manifold Diameter Orifice Diameter 3� in in. Ft. Ft. In. X orifice S L ral M old Force Main Diameter Force Main Length Ft. �- Threaded Cleaaout Lateral Turn -up --► Plug ui L Long sweep 90 Bend Pressure System Construction Laterals arc constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down Lateral um -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 's 000 ������• 6-8 Inch Pawn yyy���111 Sprinkler Valve Box \ Page 4 of L 03/05 li j tR a 0 lij 1v 4- max .� 10.IrIA tv � N I pt It FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • ,raw daa:g prat evalelle �. - • Elactrlcal dlernam. for dupar syslems, are available and sup m with in rams • VarbLle lsvd [arid swhc has ae r adaue for con6cang drylaphase • Oolbe piggybedr Weeklies level 000 swskllea am avab* for variable level lag ad shod cyde controls. • Sealed Qwik43ac avalahle for cudoor inswiaeons. See FM1420. Qver 130'F. (54 C.) special Quotation required. i10153 Santa �'��7r1e�L7E'�7t�7 imll®lllll0l©lsl� r.;�I�ft■ttt�tr>��>�ss�a N bdealdee d All d efMeddabbe *Amid 4wrme and e*Amidbeos d de 6I a et ken"elelkN len. ecldral ant soft soda eefeM MhMow met aesed Ydop Me ro reed a W ee 89011k Qede p1Eq ad 1M 000Mloed eddy ed HUM Ast paNA} vm TOTAL DYNAMIC HERD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING MODEL 152 153 Feet Meters Gal. titers Col. Liters 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 4.6 53 201 61 231 20 6.1 44 187 52 197 25 7.6 34 129 42 159 30 9.1 23 87 33 125 35 10.7 -- -- l 22 85 40 12-2 -- -- 11 42 Lock Volvo 138.0 F. (11.6m) 44.0 Ft. (13.4m) SELEMIIN4 GUIDE 1. SegbpippyheavaNbbbvdfloatswadhadohlbplagytreotvrbbblave)for ftW RdwbFMD477. 2 See FW712 for onema model of ElackiolAbrroV EAl I Vadebblemaltwad s ith104MufedeemadaMab,lDerif ARln l3) or (4) fbasydem. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered intD the design of every Zoeller pump. LIAK.IIY. P.O. B07( 1b7Q LQWrAlk TQ:3 KY402RwRc yWMirapRd.. SMO70: 6649Qee 9neod f e Loubi. KY 40711-1961 .•�L717'f%aT .SfeS �I />I�YAewwsd.aereaeh PUMP !O. MMn4 0 Copy¢ght 2000 Zoeller Co.All rights reserved POWTS OWNER'S MANUAL & MANAGEMENT PLAN P.06 w FILE INFORMATION •rani: It . 1C/,F'srI 1C�.1 MAINTENANCE SCHEDULE Vakm typirah nor domestic (non� Mast aw •nd asps Unk •ek. ." Vokm typicW roe pretreated wasbwater- Service Event Service Frequency Inspect condition of tank(s) At least once every 0 months r(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sledge and scum equals one-third (Y,) of tank volume Inspect dspersat c*s) At least once every ❑ months s) (Maxbnum 3 yrs.) Clean effluent filter At least once every /!❑ months s) Inspect pump, pump controls & alarm At least once every ❑ months s) 0 NA Flush IatErals and pressure test At least once every 0 mon s) ❑ NA cero. At least once every ❑ rthontiic ❑ year(s) ❑ NA Dent At least Duos every ❑months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shag be made by an individual carrying one of the folbwng licenses or Boris: Master Phunber Master Plumber Restrict@d Sewer POWTS Inspector POWTS Mantatr r. Septage SerVk*V Operator. Tank inspections must Include a vLAW Inspection of the tank(s) to identify any missing or broken hardware. identify any cracks or teaks. measure the volume of combined sledge and scum and to check for arty bade up orpordirg of effluent on the ground surface. The dispersal ce0(s) she/ beivisuafly inspected to check the effluent levels in the observation pipes and to check for arty ponds g of effluent on the ground surface. The pordirg of efluent on the ground surface may indicate a failing condition and requires the Imrnediaterw lication of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals oneahird (Y� or nave of the tank volume. the entire contents of the tank shag be removed by a Septage Servicing operator and disposed of in accordance with ch. NR 113, Afiscorsn Administrative Code. The servicing of effluent filters. m �nicai or pressurized POWTS components. pretreattment components. and any er othmaintenance or monitoring at iritervats of-12 months or less shall be performed by a certified POWTS Maintainer. A service report shag be provided to the local regulatory authority within 101 days of completion of any service event. STAE2iUP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) tor the presence of paintrkq products or other dhemkats that may impede the treatment process and/or damage the dispersal ceil(s). If high conAtrations are detected have the contents of the tank(s) removed by a septage servicing operator priortouse. pop -of-. START UP AND OPERATION « outran ahernl� For new Canatrurtbn, prior to use of the POWTS check treatment tank(s) for the presence of painting Produota may Impede the treatment process ardor damage the dispersal cell(s). If high ooncentratiais are detected have the contents of the tank(s) rernoved by a septage servicing operator prior to use. System start rip shall not occur when sdi conditions we frozen at the Infiltrative surface. During pourer outages pump tanks may fill above normal highwateT teveis. When Power is restored the eoess wastewraier will be discharged to the dispersal cei(s) In one large dose, overloading the cell(s) and Tay result in the backup or surface discharge Of effluert. To avoid this situation have the contents of the pump tank retrtoved by a Septsge Servicing Operator prior to restoring Power to this effhrent pump or contact a Plumber or POWTS Maintalner to assist in r eratelly 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 wuerin 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of tia following from the wastewater stream may improve the perbmance and prolong the i(e Of tte POWT$: anitblotics; baby wipes; cigarette butts: condoms; Cotton swabs; dagrasaara; denial floss; diapers; dunf9cWft; fat: foundation drain (sump pump) water fruit and vegetable peelings gasoline; greeeei herbicides; meat scraps; medications; ell; painting VWuc*: pestiddes; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls andor Is permanently taken out of service the followinglateps shall be taken to insure that the system is property and safety abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Alt piping to tanks and pits shall be disconnected and the abanrlahed pipe openings sealed. • The contents of all tanks and pits shall be removed and propedy disposed of by a SOP" Sarvk:ug Operator. • After pumping, all tanks and pits shall be excavated and removed Or their covers removed and the void space filed with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaved the following measures have sheen, or must be taken, to provide a code corrtpTMnt replecernard system: O A suitable replacement area has been evaluated and may be utilized! for the location of a replacement soil absorption systefrr. The replacement area should be protected from dauxbonce and mmpacdon and a xxM not be k *VW upon by requkled owbacks from ehdsting and proposed structure, Id lines and wells. Failure to protect the replacement area wit revolt In the need for a new ace and site evaluation to establish a suitable replacerttent Area. Repfeoernent systems must corntply with fhe nrieel In eliect at that time. ❑ A suitable replacement area is not aysiiabie due to setback and/or soh Ifni t bons. Barring advances In POWTS technology a ng tank miry be installed as a last resort to replace the failed POWTS. eke has not been evaluated to identify a suitable replacement area. Upon fstlure of ee POWTS a sot and site evaluation rout be performed to locate a suitable replacement area. If no replacement area A available a holding tank may be Installed as / a leaf resort to replace the failed POWTS, nd and eNrade sell absorpion systems may be reconstructed in piece fdtoWng removal of the bionret at the infiltrative surface. Rernratnx:tlons at such systems must comply with the rules,in effect at that time. «NIARNING>> 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 & A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS _ POWTS INSTALLER POWTS MAINTAINER � Nerne Name Phone r _ C, Phone SEPTAGE SERVICING OPERATOR UMPERAUTHORITY Name !� / / Phone 7.1 �rl(1 h —�/ - --- This document was drafted in ccmpllence with aspbw SPS 3e322(2)(b)(1)(d)L(f) and 3a3.540), (2) a (3), W400rein Ad iroln m Code. 20140048A 1.19t1 r ?A3U 6 6 _.5;4 ' & BUILW4GS SECTION A -A eu Ann a.101wl wle MA I MDAM L PROrERIY AOOR91 M:µC: IMO LOUR! ! ® MIMORWMMe 0 RI 100 LEGEND X wwoo urn aR rM ouo lCr �' ® •woao lul eer Ar la OIRET. 16 CifQT. d10N IUIDW F%1B161011 � iOlM au'rax MRCR NNJT® i TAP, mravw IWEEI aA RM 1 F ro.r.. rove waR ore elevArroR rr r�onr \ Mrssn•w Mass' � x M]E n•Ruw \ � rov Rlalnrl,M..lr \ _ II � . • I r.o.R..�u.M ryy \�. � 11i ii LW 29 I O2 I I � �g :s.m \ \ \ k i1•��i� Srbro,:noRRez,MS. Q \ ns Y l I IIMY1/111.Y' G � � 7 aw / ♦ o t r€ .YQ�"„' o 1. rr,. u.N.. W—. 1e ssw lU.e w.mw. n.na Ou,INq <® ne l.ed �o.ww... .wi.a.•e Mlwl. S mr x 07/10/17 IOIA1 1 OF 1 S�p�•'c� y o00 53f� 9,`a' EN SPACE � o I m ' SOODWE 121Aa I� GERMAN COURT,. I mN� Sg � O 532'E 71OW El SOCr28'3rE 1327.8C' UNPLATTED LANDS LODE ?°Nr Z9O SO -AWE 190.50 m m y YI —. t;; l I I mm I I I I w'b�0E31VW1: �l I I L ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Deue/ Mailing Atldrei /� Property Addre'� (Vad City/State LEGAL DESC ON Property Location Nil %, Subdivigion Certified Survey Map # Ll Parcel Identification Number d qO — 13I 1d7 on Soc Tz'3NI,& Warranty Deed # I V —) I I Slow house/yes/no Town of Volume , Page # —,Volume Page 1�ot lines identifiab ye no IISTEM_MAINTIJi NANCE AND OWNER CERTIFICATION ,Ps huVrop-r we mambemnce consists aad maintenances f your septic system could result in its premature failure to handle wastes. Proper the system can affect the fnmction of the EeP� tank every tluee years Or sooner, if needed. by a liter PonPer'- What you put into r septic tank as a hutment stage in the waste disposal system. Owns maintenance eepoosihilities are specified in §Comm. g3.s2(t) and in Chapter 12 - St. Cmix County Sanitary Owner The property owe agrees to submit to SL Croix Corm[y pLmniug & Zoning Detrer�ent a ccrrification f owtra and by a masher phunher, journeyman Plumber, restricted plumber or a licensed �4 signed by the wastewater rivpo W syeteru is in Proper operating condition and/or 2 after ' Pumper verifying that the on -aide less then 1/3 full of sludge. () tffipection and P�PmB Cif necessary), the septic tank is ata d8 h by � the above requirements and agree to maintain the private sewage disposal system with the Department of Commerce and do Department ofNahmat Resources, State of wiscousin. Certiticatien stating that your septic system has been maintained must be completed and ret®ed to the St - Zoning Croix County Planning B: Department within 30 days of the three year expirabon date. Uwe certify that all statements on this mi are true to the best of my/our knowledge. Uwe arr✓are the owners) of the property dearrtbed above, by virtue of a winrs(ify deed recorded is Register of Deeds Office. Number of bedrooms •V// X Pl�S�� DATE ***Any information drat is rrdarepresentednay result in the sanitary perraot befog revoked by the Planning &Zoning Department luehtde 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. 88M5) LV V o> pn ao aO JA I H4aonsh DepwY,.tdt arms a DkisionofSaaelyand Buadkgs L16 4/ SOIL EVALUATION REPORT Paps l d 3 Aw Mary omniplefe aft I - than 812 x 11 trem In afm. Plan naW stts+de, bd not Fyflaa hmrtrontal rubtance point (BM), mrection rd POW, t slops, ae�a'3T . noM umv, and location and distanme t0 nareat mad. Please print M kdb m don. i}Imw lnlwrrwknym perWemq Wewafm NOY+duypurp aM(Prk,@WL�...i&o4o)(m)). C•�M -./�/ ST. CROIX alp Prmpervowner KERNON BAST/DQNALDA J. SPEER-BAST property Location 1N GoK. Lot — NB V4 NW 19 S I T 28 N R 19 or) PmPery OwWs Mlaitp Addrms 948 LaBarge Road 110 20 tilodlf SLbd urns or CSMs — I- COdonwood South Coda Hudson. WI): 54016 651 324-1147 Vllape Lip,,n Nearest Rood SchvAlkn Drive 0 New Construction W&M Residential / Mm9 wd tedmon 4 Code dwMd destan flow Me 600 GPD © Replaartwi Q " Pnbk or cawareld -Describe: Parpar1WA __. glacial till Flood Pldn Wmation I Wpk" NA a Genew cc and re MOUND SYSTEM —1.17 ft, sand fill — 0.4c keeling rate ara id moanrr mnwarnsndalfmnc • L System contour and desiggo to be fmiabed before bldldmg peml3t is issued (4jS ova•A dew2� P/f1/f i (6-8. ) — 2� Borkv e 0 Bong El PR Gmune surfaa slw NA It. Depth to 1mlry f dmr 11 e1 Sme our liorimn Doplh In. Daminwrt Muroea Redo: Desorption Du. Sz Cora. Color Texture struct" Gr.SL Sh. Dorarisbna Boundary Rods 'EW 'EM2 1 0-11 IOYR3)2' — sil 2f-ma&sbk mvfr ea 2vf-f 0.6 0.8 2 11-16 10YR4/4 flf10YR" sil it4 mvfr w lvf-f 0.4c 0.6 3 16-24 I0YR4/4 mld10Y2Wd10Yad2 aicl 1Sbk raft Ivf-m 0.2 03 some rk frog f3 LJ ft s BoriV 0' Pit Ground sur4a alar. 1057.1 a Dagh tokn&Q WN � hi Sme Race Herb= Depth In. Dmmeera Color Muse) Rodcx Description Gu Sz Cod. Color Tezlus I ttucos Gr. Sa SR Cotsicterm Boundary Rods GPM! —EW I 'EM2 1 0.9 7.SYR2.5/2 — an IIpI mvfr as 2vf-f 0.4c 0.6 2 9-19 73YR3/4 — all I&bk mfr a 1vf-f 0.4c 0.6 3 19-22 75YR3/4 — s1 Ifsbk mvfr aw Ivf-f 0.4 0.7 4 -22-30 7.5YR3/4 f2f73YRSM 81 Om- mfi — — 02 0.6 4 bas ��T•=1[i�_ia3�"rLfr`!i•'i _I. l--y � �LI:•ni�yr'3ili:w}�3•�>,*rtiaw'��_•� CST Nmnw W9875 690th Avenue, River Fall; WI 54022 12 - 01 - 13 715-426-1775 y BA. g=m (1.0128) Prod N)f (PenduW P� 2 of 3 q B,iv s U BaYp _ PN laud euAeos dsv. 10563 R DVM to krAp babor 36 h - Bol Rees i MUD Deem kL Dommrt AFu�sl Pad=Daea"m Qu Sz. Cat Color T04" I 9tratne tr. 6z &h CauJelenoe I BaRtlry I Rnob GiPLM 'F.11f1 I 'HIFl 1 0-13 75MY2 _ eil 2f-mi&.ebk m,* I u I 2vf-m j 0.6 0.8 2 13-14 4 sl lfpl mvfr m lvf-f 0.4c 0.6 R =80' eAr•rwiwaab ,seS&TH ►.a 3 of s Pr \ I e a Baakhpa Ph All benchmark, top of mbar — 1 D5�A- • - 381.34`— 47.36 —N89050231E.428.69' T � Vie\ ..,,. �S \ •, I XN.a? W I 105 I LOT z \ 2.00 ACRES d. 8- 0 io57 QO I N 0 3 o�G \ � 05s.0 X o �. Z C7 N89°50'23E 368.18' — . — a . 1(