HomeMy WebLinkAbout030-1029-50-000 (3)Ac"I'll
PRIVATE SEWAGE SYSTEM
e r INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
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SBOb398(RO 14)
SYSTEM PLOT PLAN
Sommer a Betlroom Septic Syabm
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CONVENTIONAL COMPONENT DESIGN
Resiuenral Application
INDEX AND TITLE PAGE
Phiject Name Sommers 4 Bedroom Septic System
Owners Name
Marc &Sheila Sommers
owner's Morass
JOBS Golden Oaks Lane
Hudson, Wl 54025
Legal Description.
NW1/4, Pi SJ, T29N, R19W
Township
St Joseph
County
Subdivision Name
Lot Number 12 Black Number
Parcel I D Number 030-1029-50-000
Plan Transaction No.
Page 1 Index and title
Page 2 Plot Plan
Page 3 Septic Tank 15peci0catlons
Page Existing Tank Certification
Page Sept2 Tank 25peciflcanons
Page Effluent Filter Information
Page) System Sizing &Cross Settlon
Page EZ Flow Information
Page Management and contingency plan
Page 10 Script Tank Maintenance Agreement
Page 11 Warranty peed
Page 12 CSM W Plal
Attachment) Sail Evaluation Report
Designer: John Schmitt Umese Number. MPR522370
Date: 7/4/2020 Phone Number 215-0600496
Signature ��&
InGround Soil Absorption Component Manual Verson 2.0 SB0-10705-P (N. 01/01)
SYSTEM PLOT PLAN
Sommers 4 Bedroom Sepbc System
NMAwlowordu.
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me".wlgov
I�S�COMI�SIfI
Fed 16. 2010
WEEKS CONCRETE PRODUCTS
MV W EEKS
1832215TH STREET
NEW RICHMOND WI SW17
SAFETY AND SJILDINOS DNISM
Furrow ream wwe
PO BarM
NMnon, Wisconsin W70I 26M
TTV Cmx.n moyalw
JIm DaYk.Oevwnw
6JCµeJ. YlnwwrgM.6srwry
Re Deecnow SEWAGE TANI CONCRETE
Manufacturer WEEKS CONCRETE PRODUCTS
Product Name SEPTIC, HOLDING, OR PUMP
Model Numteds): I WO
(491N L L.21 76 GALRN., 64 IN Ml DEPTH OF BURY 511 G.P.D. WHEN USED AS A
SEPTIC TANK BASED ON A 3 YR SERVICE INTERVAL FOR RESIDENTIAL
WASTEWATER, TANK DIMENSIONS IN. LX IN. W X 491N. H)
Product I No. 20100040
The specitcetl0ne anchor plena for this plumbing product have been Mewed and dmermlnM to be In compliance with
chapters Comm 82 through 84, Wisconsin Adminrsoanve Code, and Chapters 145 and 160, Wisconsin Statutes
The Department hereby Issues an approval based on the Wisconsin Statutes and the Wisconsin Adminlahstive Code. This
approval Is valid until the and of JUNE 2015
This approval is contingent own compliance with the following stipulations)
This tarts must be designed t0 virtual the pressures to which it mil he subjected,
The manufacturer must fend at the manufachunn0 plant a set of Plans and swilicallons bearing the department's
stamp of yprovat The plans and specifications must the open to Inspsymon by an authorized representative 0 the
department
When this product receives wastewater from promote ane o used as a septic think, It will produce an effluent Worry
with a mmrmum monthly average value for SODS of greater than 30 myL and Was than or equal to 2201 Tss. or
greater than N mill or Nita than Or equal to 1 W 1 T93, and F O G 01 Was Nan 30 mi
Approval is Issued for this product as being younwam to a beer outer water chisel when the fixture drain is installed
in the vpical povition The design maker the Intent of s Comm 62.32 (5) Net and So 20 (5) (n). Wi6. Min Codewhkh
repmres water closet to discharge through a minimum diameter 3-drain pipe or f0mir and the [Owl to conform 10 ANSI
eel of line code Is met since this product prove es the same Numbers' performance as water
closels that meet ANSI Slam AI1219 2M
BEOWNO: Bedding MotorMl eNll be uW to provide a undkem Beefing plan. A min. of 4-inch base of
sl by granular b on lop of a form and uniform W" IF mcomm W. The lank should not bear 0n rocks. Sites
with high ground water MOIp should hove 8p iWly designed bedding. Sell should to comps under the hour.
This aWoM suWrs d s the approval issued on 4R12005 uner pMuct file numther 20050106 This approval Inver shall
he incmmoral with your previously acOroved plans Mason spectral Approved under product file number 20050106
As DI May 15, 2006, a espy 01 a Soe eful water tlghtnM tM sport br this product mWl bs AVAILABLE FOR
INSPECTION AT THE MANUFACTURER'S PLANT prior to this product being used as a ROWS h0 ing or ireetmont
tank In Wtaconeln.
The department Is in no way 6ndoreing this product or any advancing, and is not responsible for any airual pn when may
result from he use.
Sincerely,
Jean M M¢Cubor CST
Engineering Consultant -Plumdry Product Reveri
Comment, Salary 6 Sulldirgs Div., PO Box 26M 201 W Washington Ave., Madison An 5370SNN
Phone. 608-266DONS: Fee'. 601,283-7456, EmaJ Jean.Ma uWllnowiswnsing
Sao lO -E IN marl FWM rIXNWLCCC
Pap 3
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that 1 have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) 1096 GoNen Oaks Lana located
at: Nw �/, NE Y., Section m , Town 29 N, Range 19 W,
Town of St. Joseph , St. Cron County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes_ No
(if no, skip next lui
Approximate volume or length of time gallons minutes
Tank Capacity low
Construction Prefab Concrete x Steel Other
Manufacturer(ifknown): weekaconcrete Produare
Ageof Tank(lfknown) 4/2V1969
Pe it vumknown)
ber f own) 119378
y?� John Schmid
mensed Plumber Signature) (Print Name)
MPRS 223760
(Title) (License Number) MP/MPRS
8.13-doaa
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s 145 06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
A cAST-A-yA
r ( GSI-A-SEAL
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TOP NEW
MILT
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$ � i
W320-MR
TANK SPECIFICATIONS
pYEN9WS
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MM461: S
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o]A s. O D BnnW NIET I/r D.D
ups 1£`h1 U
Mali: ].B9D IAS
NIET ANo WTIn
e GSI-A-S B T M EWAL
D ET. CAST -A- F WT M EWAL
NaT ADD WTFT BM AND DIIEA.
(tt STATES Y MAR 0n
UWD l AaI a D C AN
L ADMD KSIM BV UNSAMRAIED S(AL
TARN CM BE USE➢ AS
3 =/ H(MAW/ MW M MPH(Al
COTER' NIX CE9Q1 /B (ND twt)
TIAK YIX CE9d PO (SINICMtAL ttB )
WSIORF➢ TAKKS
Cfl CUSTW TNRS L TR Y CM W
FOR APF
mNTs IrEMD n.
PAL ZA,r
°»m so" �' P4525 Effluent Filter
Arms.,
PL525 Filter
The PL-525 Filler is sled for 10,000 CPS (gallons per day) making it one of the largeat filtere in der class It W
525 linear feet of t/16" filhanon store Lke the Polylok PL-la Me Polylok PL525lasso auMmahc ahubf! WII
handled with every filter When Ne filter is remaved fin cleaning the ball will float up and temporarily shut at
the system so the effluent won't leave the IaN
s 1/I6" Filtration Slots
• Rated
Retell for 1o,00Bcro (gauo,u per day). mamswlw
• 525 bnezr feet on/16' bitumen 101000 GPD 1mPBaaml
•Accepts 4"arM 6"S DW pipe. E,<e�pta I' PVC
• Belt A gas deflector
• Automatic shutoff hall when filter Is remained!
Alarm am" ib,hty aoWs,
Accepts FTC extension home WGPo
I•I 525 mrwlm,mn
Ideal for resideproffial and wmmercial waare flaws up to sit LlmrR
1g00B gallons per day (GPD) nl/ls-
ans sent
t Lxa1x We omlet o(Bresepfic conk
z Remove the tank cover and pomp tank it neceswy
3 Glue use filmy here at to the 4" or 6" on Fee pipe If
the Mter us not contuses under the access opening use a
rollick Extend & Lok or piece of pipe to center filter
4 basert the PL525filtm nto,k Foumng
5 Replace and secure the septic tank cover
1'Li15 Ma role neon
The PL525 ElFluenl FYMn will operate efficiently for
several years under pound! conditions Mom requmng
cleaning It is recommended that file filter be cleaned
every time the tank is pumped, or at Team every three
years If Fire installed filter contains an optional alarm,
the owner will b, notified by an alarm when the filler
needs morning Servicing should he done by a remfied
dephr lank pumper or de aller
L Ircme the omlC of the septic ttook.
2 Remove tank cover and pump Gnk d naemary
3 Do not use plumbing when fiber is removed!
4 Full K 525 cartridge out of the housing
5 Hose off filter over the sept¢ tank Make sure all
solids fall back into crepe mrrk.
6 Fewer the filter cartridge back into fire housing making
wre be filb u properly shipped and comple,ely orsrtN
Replare and savre septic time cover
yk
SCHo o pip,
altomp
a�
BI,utON BvII
II�
y,oklahl knBd Xlnnamp, got mmAs
Ne bweNai ew,W aW A. min..wins miss
Polyluk, Inc 3Favbeld Blvd Wallingford,C W492 NII Free 871.7659565 For 203,284,1M 14 www.potylotcom
gavefi
IN -GROUND GRAVITY DISPERSAL AREA
Stepped Elevation Trenches with EZ1203HP Bundles
3-ft Trench (down -sizing credit)
anirtCRTOYSPSI SECTION VIEW
HgM1 tTr li Lar tTm^ (�aprlEaHE) OGSERVAiM PIGSC AIL
System Eleyetb -915' ry 905' fl 89F ry fl, n vouow.I
�W
TYPICAL TRENCH
laaw lwauon NmMl�a�alN Pw �wo.moowgm.ewl ^"•°°""-"�'-'
PLAN VIEW q-p
(NO Scale) PeRmatee Lateral "'—m nw� 10
'N I.
lbPge9 aim�I ms+mll
-- A=30fl
1
_____—__ INpol D
B= 1W ry — m
am W
INSTALL PER TRENCH: E21 l del iqe O
10 1aK eumNa®SOK EIS4vY•50D fl, (we Mean gym. kl T
wr Prswn�.m.en.ewrva A
♦ 0 NbwAas�25K EISMna•0 M
+Repro] EISA peravcry+= a' Repulretl lnfia aMn Ns= 1 11' D'S"utpn MHh
v? trenches = Prapo To EISA=1500 fl. branchetl manftM
Installation Instructions for
EZJlow Systems in Wisconsin
.......................... 4.6................
Wucnan Department of Comments, Wary and Eltailgs
Deane. Iva reNevrea Me spedficall al pens for this
product and Mtemmad It to ber to mmowce AM teeplew
Germ M Through 84, Mormsln Men, G end phacoa;
145 and 1 W, Mccrwn staves, As sites must meet Me $ye
g u mndnr.+. if Local a later,m debdes for noted In
III mourners
The Worked pm]ucts are 12MH (3-12- grad es e+M of an
center bundle 115or 10' ksg6s) and 1 r HP(3-17 gvgyy
with lope In each bundle m 5' or 10' MgMs
A single piix ounce contains a from inch combated of sur-
rounded by EP3 aggregate atl is held bacMw wan poy-
ehlfahe neMng A angle aggregate bundle cwtare aggrgate
moo ends held Icemen rnM excretdykne "i
Miami am Equipment seemed '.
• Ezhwm 0.mmrm
• E2nw 6eolemk Fabnc
• Uflo.. [memo Fine Coopers
• Rpe for Heeeo and Inkl
• 8ackhx/ExraMw
Me fretful for Inwa
m Of EZpodur
accordance
ma gin m
MW iFie onor ilmuralMmMt roxict wokslab
nuketral m Naplers Comm 14 and 1f B4, Women M-
msVa mill so and Gaplers 1 depos anot NSswnt cause
Wes. as mill az Me local hrsM Ceprlment's current desgn
manuL
t After the areal hal denial If dommmM sung,
cenfiguraton, and about for Me Unch, my,l,mm, shake
or m nk yim pant the traYn of Ver4n and ern fY
cal to act correct Wk. nerd scou hracer Ie or do.
thol ax and trench athvn elMlkns afore b¢W-
labm Of of bundles
9 Remure drum Ediow shrygng saga prew to awing
anbks in the sentence). Fence wry qua III in they
trench before ayarem Is mfento
3 The pm]uct must have globs llb heard Mat meet ne-
qunements of s Comm 64 W (6) to). My Abe Cone,
instapk l cancer on by of the product and ex[eMrrg
dorm eMg Me sees of the prol to a pant at kut sou
inches from me amom of product
4 Men ordered in a trench, the trench should a dust b
a froth of 36 inches. TMs net enty saves labor in exume-
ton, back also provides sector load -Mating recall y offer
backfilling is mmpbce
MAEVo ww
W IMBafIYi01r
5 The Pbswptbn arm (SF) for a guru add shal
be store bead m m s ernium aalry sewage my (DPD) and
Me Forrestal for Me she If cartoon oteria Is met, Me
EII slung can da used in Wlxmsin, rmul in s 40%
smal oriental
5 Piece Uflow ahhdMal an Me Ezgnam mnrqumbon end
pmvM by system design pemrA smoked Iw Me partla-
W site The I% on canter -mast whose mnlanng lope
re paned and to end with an internal lope cw{ler Arty
screened aggregate only bundles Mat may be r cured.
mould lu united egsnet Me omen a0rmsta my Wn-
dks and do not require my AM of ¢nnecTm
9 The top of reach C£D cylinder cmtans a fHa home pre-
.nulactuhm ir. between merrelmq.ra.gyeyte The
boom Is rourn ed to prevent sou women The mswkr
snau make sure the the DEG a, lulaimed upward cad,:
ttnect wok the fa[M cmfrnM m The mosecent cylio-
der before Saarhnahg
3. The EZhrx GWfeU Systems mould he homed m a
MI beah kr Y arspxhs (wlh across and a" me
scarf amen) and showed foMv led cmtwr of the ground
swece el I (umfomh depth), won of m.
weaker IW I crammsl WNkaboards pend to cad?
y.M eel Mdk drsmaM lope mterconern ed.
wmwt any came slepbxns or Omer union steps
9. They beach Icq shad be cooked suer That ware Irks not
peaks Eackfiu should be seeded or sahed rmmeduvNy
after compebcn to nodded erosion,
t0 Harbor, EPS Woks we IbM4 and can of an waked
IrerKhes as may be revenues to m d flees, a khrom, by
other obstanea.
I I EPS aggregate rs IigMer than embr. Merelwe, d might
b selected that naNN banner forces mal two to
cause Uffe, usemb"concedeo Mbu
t et of Midi va erh
pihd'mg beech FW emenexa has shove, Iwwerer,
Mat are an not a Dormant wren sytwos home a minimum
of 6' of sal carer as recommended by manufacturer.
120311-0EO
lnhr M1Yknal
hP
H
.............................................................................. 6...........
Page 8
PAGE 4 OF 4
In -ground Gravity Management Plan
IMPORTANT:
TM owner of this Innground gravity system shall be responsible for Its parpea l operation end meiMe w pursuant to
regmnmenM of BPS 3112-381, WSac Admm Code Pull M BPS 30352(2), Win Admin. Opera this Moen shall
be Considered a human troalm NSaN if not maintained In accordance with this appmvad management plan.
Furthermore, all inapMmn and maintenance activities Shall be performed by a ragietarad POWf3 Malntalmer In
accordance with BPS 383 52 (3), Mi Admm Code
Maximum Dleonaal Area Owmeno Limits:
Design Flow 600 gpd: BODe 5 220 ml TSS 5180 mgL''; FOG S 30 mill.^
Inspection Checklist INSPECT EVERY 3 YEARS
type d use
c we of Sall
nuisance laden p a odors. fear Complaints, etc)
mecharvW malfuMlon if a, pumps, valve;, swatches, flwte. etc I
mai IN [ague (r e. want, bread Cturmi, etc.)
o a dldsvdueinanaercOe Veanemtank(s)aMaMdMnbutiMaWunenanmpl(ie, dinbWmldmp ")
o negled Of mproper use (r a. mic ceding deeien c itm. prombned address ere I
0 WI of lx'Mmg in matrbution cel prior to arming
o dean; megull if applicable(le. pump nlwcng noel switch settingsere)
o el l components. It apdicade (r a, wri cpnMchms. switches. consols. tin , alarms, M.)
o mdnbutim lateral or antra price sugpnq(messure weral diem pressure- Wnpare W deal apeclfialpn)
o wrfxe discharges Of emuwn of sewage baps upmlo structure served
Maintenance Call MAINTAIN EVERY 3 YEARS (or when nice q)
Baltic and apse OnW$l Mall ce pumped by a Carol sewage Serv,dr g Coeralw lie W under s. 281411 We
Buts Cohn the volume of INSIMS In Me lank(s) exceed@ mMhlyd (in) Me liquid volume of the Inds) a
as required by locy ordmance annual of canmma shall be pursuant M NR 113. Conic. Admm. Code
o ERluent lit 0s s l be inapnted every 3 years and Mall be demand Mrn vesseary to remove arty
mUIMW lldsn din0tomanNmturersa ,f, bona Aarwunp penM willYwry; Mgredtt gwn l2
months
System malnYnance MPOM Mall as SUMnIM W the PMW loin gmemmem unit In accordance with
SIPS M."Shut. "min coda, Ral arty cmnponant hilun or mS1fmcMdn to.
NemedlMnteuddmmpam Schr&Sons Excavating, Inc pappp 715-760-0486
Leal government fret St Croix County Community Developement on,. 715-3864680
I government fret Wdmw 1101 Carmichael Road, Hudson zip 54016
Any defMrve pan of this system shall he repo ist mphice], or Sunni pursuant to BPS 383 51(1), 1Nn. Adnin.
Code Repah or repinemanlolklted or mellunGlomrp components shall compgwed BPS 383, Wiss Sol Code
No Product let chemical of phll national d Me POI may be uSW unless approved by the dapamnanl In
accordance with BPS 384, Wise Admin Code
Condnbencv Plan
In Me event that any failed treatment Component of this PCVTS cannot be npslrad, It shall be mot pursuant to
a plan submitted to the approprlete agency Cr m iew and nprovtl. A felled in -ground dlsmml mmpormst may be
abandoned and replaced by a eMxomplymp dspersal component In a pre dearmlned area of suitable Colin
System Abandonment
If use of this PONrts IB discontinued, It Mall be abandoned In accordance with BPS 303 33. Mae "min. Odds
KLCp(MT(vlLY
SFPTKI TAN[ MAIN I I NANCE A ilk"AIP NT
AND
OW NFKMIIF ( EAT IPII'AI K^ T I1pM
Marc & Sheila Sommers
Ma,l,nI,\mN., 1096 Golden Oaks Lane, Hudson, WI 54016
I,,,.,I,A, 1096 Golden Oaks Lane
O m4uun r[paM F..n %wM A /anJ ik(.waM H sn ....
r,t.-s,1feHudson, WI Par[aleeletrn,lln.nuer,u[.030-1029-50-000
Fn yt•.,ernNlR „r. NE 07.1 29%A 19x.Iannri St Joseph
sawamwt NA
Vemi4d Sunn Map • _ . \'o:wm .Pare n
NamRn fill __. iAt:ne:U\:Iv'u:uf� . P.Ee a_ _
1 a�lz"l. Ia 1:m nYeurr04 eleQ.a.
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