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Home My WebLink About004-1053-70-105Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM V�•" St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 624928 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15 04 (1)(m)] Pertnrt Holder's Name City Village Township Parcel Taz No: Anthony Ninneman I TOWN OF CADY 004-1053-70-105 BM Elev Elev TANK INFORMATION o ,_ TYPE MANUFACTURER CAPACITY Septic V Dosing �Krai'cn D �J Holding TANK SETBACK INFORMATION (BOG k5 �A TANK TO P/L ffW WELL BLDG., Vent to Air Intake ROAD Septic L'� >�5 I Y01, Dosing 7 261 26 \ "4 1 Z Y Aeration Holding PUMP/SIPHON INFORMATION Rut C ' ZZ-6 Manufacturer Deman OV S GPM O Model Number FPOS TDH Lift ^ , FrictiT l- System �d� TLl . z5 L3 Forcemain L� SW �/ Dia_-„ Dist to Weil \� T &1011IF_1-1;'111]:121G]!I&V&iI 1, ELEVATION DATA STATION B 317 ) ol) FS / DO Benchmark`jj • 6`6 Ob.O d Alt BM AL"! ga.ys Se Bldg Se r 3.70 0 6.5 SVHt Inlet I J L St1Ht Outlet Dt Inlet Dt Bottom Header/Man. /4(9 Dist. Pipe 3.�-/ s Bot. System y 33 79 Final Grade Cover d ? LO) ? P Cb E. itG SEDrrRENCH DIMENSIONS Width Lenggth 1 5/ ZS bb /_ IAL_ I_ vBILDGI PIT DIMENSIONS No Of Pas Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO T e Of S lain P/L / 1 f 3� WETLILCS r LAKE[ REA L CHING CH BER O NIT anufa turer. Model N mb DISTRIBUTION SYSTEM HeaderlMandold u , / 7i Distribution , Pipets) % 7 '�� I Z x Hole Size ! 7 x Hole S acing % �• '^ Ve to Air Intake Length Dia Lenglh,'"37 Din Spacing L 3Z �� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only ep.p CY-- r Depth Over xx Depth of xx Seeded/Sodded xz Mu ched nler Z Bedrrrench Edge Topsoil 7 l Yes C No Yes F_I No COMMENTS: (Include code discrepancies, persons present, etc.) Location: No Address Available / 1.) Alt BM Description -4\) "P'T 2.) Bldg sewer length = 1.1 - amount of cover = -? I81\ 701 Inspection #1. Inspection #2: Plow /) ZI Plan revision Required? I- Yes j�.�j�No 7-1 rf Use other side for additional informatioh. 0/ ,%Qdy yK 58D-6710 (R.3l97) Date Insepctor's Signature Can No commerCe.WI.yOV Safety and Bwldmgs D ..slon � 201 W Washington. ve , P.0 Box", 162 sconsin !;Ulu 04 262Q9adaon, WI 53707-7162 Department of Commerce h r Sanitary Permit Application .i In accordance with s Comm 83 21(2), Wit Adm Code, submission of this from to the appr to govern❑ unit is required prior to obtaining a sanitary permit Note Application forms for state-owme WT submitted to the Department of Commerce Personal information you pro, id may be used for sec u: v ses in accordance wnh the Pnaes Law, s 15 04(I m), Slats 1 A2elication Information- Please Print All Infor Proper-. O,wer s Name Al �%i t rr.. A� ✓1 ✓1 o mr, , are po be lilted :n by Cu t Number Trotect Address (itdiFlerent than trading address �J3ti 3ath!}c-e I Par;ei Ocy -10'1 l�-3Wp , icy Fropent Location Properp r,ncr'IMal rigAddress lJ IL'A16 )'--A IIIIIo., .l Secti.r.'13 Coo, State Zip Code Phone Number IS •� �� O�� `��(/' �� Q' I �!l � rcle on N R %"u II Ts pe of Building (check all that apply) X0: 2 F3mi6 Dwelling Lot o Subdtsuion Name - ,Number ofedr ins ai y„,�� ❑Public Commercial - Describe Use ) Block k City of _ ❑ State Owned - Describe Use ❑ Village of CSM Number ❑Town of 111, Ts pe of Perni (Check only one box on line A Complete line B if applicable) > Nerr System ❑ Replacement System ❑ TrealmenVHold ing Tank Replacement Only ❑Other Modification to F.xnUng Sr stern irs plo vn � B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑ Pertnn Transfer to New List Previous Permit Number and Dale Issued Before Expiration Owner IV. Type of POWTS S stem/Coin onent/Device: Check all that apply) �1 -- ❑ N'on-Pressurzed In -Ground ❑ Pressurized InGround❑ At -Grade ❑ Mound 1 24 in .(suitable soil1-4 Mound < 24 in of suitable snit _ nmmng inn, a vmer uispersal Componen�xplam) Ll P reatment De"Ze IevDlam)____ k D soe s T t t o I f t h7 r s Design Flo,, tgpd} Design Soil Applicaiion LgpdsQ Dispersal Area Required (sl') spersai Area P•oposed rsil System E!es utmn 40 70541 S 1. Tank Info Capacity in Total k of Manufacturer 7 Gallons Gallons U.n Ir Nc.. Talcs Eusung TeNcs !e r I Dosing cnan,.e, Alt. Responsiblbty Statement- 1, the undersigned, assume responsi biltp for mstallaoon of the POWTS shoran on the attached plans Plum 's M1ame (PnnO Plumbe 's Signature MPMIPRO Nwnber Business Phone Number 'r 72-•-3ZIy I �d� ;;,?Ae�tti - I I,('.I 15Pvi Or 1 / `A ro. ea Permit Fee ate Issued ssu 4 ern Si nature -� pp C,`�rse rove g g g }.f1 CZ•t ner G: - r Denial $��t/— I.\ Conditions. S STEM OWNER 3�P71ht.¢IU)�PAaC f�0 Q�"wM0.4 •' 1. ept'c tank, effluent flterand ispersal cell must be serviced /maintained Sr s per management plan provided by plumber U �},��t 2. oQ L �6. C t H. (�tx• OWE k as per applicable codelord>ri"a`ic6empie c plan, ror In, ,rrtr an'r= �rhe co��.kgnpt k„ no s v, ii,r e, i.,i,e SBD-6398 (R 02/09) P L' fa viol � o� J' I �p.59w aoo�A tar wv L /' /y n �eVagw��9�r t'Sa1 C'� F 1 i� ----- ---- � tam n 0S PS luh1- 1010 C UN DITION41 AI11'RO\ AI. PLAN \PI'RO\,\I, F\PIRF.1, ,II„-O--I, Plan Re\Ie)): P\1'I,, Il;^UII I c()')-C ROGLk L I I\INI SI F F : Anthony Ninncman ;OtlI A St. C loll Cad\ FOR: Oblcct I ypc Oblcct Fvp(. Uecu'rprCrnr: dNr (,PA Maitenance Rcgmrcd DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN DAY VVI 543D4-5211 Contact I nrougn Rclay 5ttp ttdsps wI govtprogram�lrndustiy-.rrvii.es. wvAv wuvansr gav Tony Evers - Governor Dawn Cnrn -Secretary Co„dmo,ally APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Nlanual Ver.21), SLID-1(hd)I-I (N.01/01. R IR/12) Pressure Distribution Component Manual \-ct 2 0, SBD-10700-P(N.01/01. R 101r12) the UhIriIt,Il de',ctIhed above heti hecn Icsie"cd forconforrnance with applicable Whcumin AdministratlVc t O&d :utd \\luon,ln 1i,dulr. I he .uhm Wal Im, hcrn CONIATIONALLY APPROVED. Thia aystcm Is n, he conshucted and I1rcet2d III ❑cconl.lnce with the enclosed approved plans and with am, component manual(,) rePorcnccd ahme the ownct I, Ichutcd ut chapter 101 U It ill). Wisconem Statutes. Is responsible for c nmphamc „rill all UIiIC ICyUnclnrnr, No Del win UwN :ne.i c In nI ,)on k nl plumbura in the state unless licensed L, do tin hN the I )cp.ut ncnt per ,nr� I he IOJIWu Ina cnndltloro 111,111 h: [net during u,PSULl1t1on or lnamllatlon and pnnr to occupanc; of Ire • 1 III, t,m to be cnmh u�0.d and IUCnUld In .tCcnrdence ,rich the apprmed plans and Ihc' MRnlnd C (1111 pr anent IN TOO1,11 101 1'[ rvdtr U11v11 Y\ stems Vernon ' o" SBD- I nn') I -Pl \ I i l n l I • I he [,I:, uwc m.nvnl. [, to b; cnnso uued In accol dance �+ th pubhcattnns ',BE)-1,1-1 I(,-I'I\ULU11 '1'1 v,,ill c 17)I>111huu Un C onlp-menl \IJ ILI'd bn PI ante Or.arte \\ aste,�ater Ircatmcnt L, .t: mu - Vern i,n _' n" ,Intl or the s171T_ mctpodc of \,II' Pnblicnhrlu y 6 Der iYn of Pres_;urc Dr,olhutron \ch,nrl.s Ion ', -'S I ill SI)" A copy of the ,y)pn lvcd pl,ni `Pc, it Icetlonn and thu letter shall be on -site Lim nou con trUtTIOU and open to ul spccho❑ h� moi n Li I plc,enixnes of the II mien[. which may Include local tnspcctUl ;\11 pcl nrtl< I quo td bN the uI Ihc (wal nnmlclp:d P\ ,hell be obtained prior to COPULDencemcnt of umstructlnn Immllntlnn:olm'ItInn In bran tin this approval the I)n is ion of Industry Services Ieserees the right to icyuu e chances of additions should coed it ions arise making them necesscu for code enmpI iance A; per state snits 111 12( 2). nothim, in this review shall relieve the dctiigner of the Iespon>ihi I ny for de,ipnine a path build in structure, ur coin ponent. Inquiries conecrnm this enrresponden,e may he made to me at the telephone nwnher listed helow, or at the address ,in this letterhead I he ahove left addresser shall pi cl idc a copy of this Inter and the POW IS ivanZeement plan to the owner and any otheis w hu ,u c responsible for the mstaIIaion, upei ation uI maintenanc e of the P( )W'TS. '`incei ch Matthew Allen Ian7en Wa tew ater Specialist, Divi>wn of Industry Services ( 71 s ) 3,40-0407 In atthe\\ an Len ROWI eov Project Name Owners Name Owner's Address: MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Coodmonally APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Legal Description: Township: County Subdivision Name: Lot Number: Parcel I.D. Number Plan Transaction No.. Anthony Ninnmen >t/, r1l 7'//-�,ra, W 10415 860th Ave SEE CORRESPONDENCE River Falls WI NE / NW S23 T28 R15W Cady St. Croix NA NA Block Number: NA 004-1053-70-105-359A-05 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 Designer Roger Timm License Number 226524 Date 07/07/20 Phone Number. 715-772-3214 Signature Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N 01/01, R 10112), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Pressure Distribution Component Manual Ver. 2 0 SBD-10706-P (N. 01/01, R 10112) Version 7.0 (R 11112) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet (R or C) Site Information 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/ft2) R 300.00 1.50 45000 6.00 97.00 14.00 6.00 (C or E) Distribution Cell Information 56.25 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information C Center or End Manifold 267 Lateral Spacing (ft) 6 Number of Laterals 0.156 Orifice Diameter (in) 4.00 Estimated Orifice Spacing (ft) _ 2-00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) 82.801.Pump Tank Elevation (ft) Head (ft) x 1 3 Vertical Lift (ft) ASystem Friction Loss (ft) In -line Filter Loss (ft) Total Dynamic Head (ft) Lateral Diameter Selection in dia options choice 075 x 100 x 125 x 1.50 x x 200 x 300 x Note Sand fill (D) caiculabons assume a Table 383-44 3 m-srtu soil treatment for fecal coliform of ¢ 36 inches Check maximum soil application ra 8 00 Cell Width (ft) Are the laterals the highest point in the distribution 0 network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 0 10.71 ft'/orifice Does the forcemain drain back? 0 Enter Y or N Forcemain Drainback (gal) J2262 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) Manifold Diameter Selection in dia options choice 125 x 150 x x 200 300 Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000 00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete Prod Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 603 36 Dose Tank Capacity (gal) Poly Filter Manufacturer 16.76 Dose Tank Volume (gal/in) IPL525 Filter Model Number Wieser Concrete Prod Manufacturer Project Page 2 of 7 Mound Plan and Cross Section Views 11 1.0_B Observation Pipe L3J K 7 0 Qall I B 0 A 800ft B J25 ft D 22 00 in L Mound Component Dimensions E 27 76 m IF9 50 in G 0.50 ft 45000 (ft`) Dispersal Cell Area 8 00 (gpd/ft) Linear Loading Rate 11 Aft ft ft J K 1160ft L 79 44 ft W 29-13 ft 1191 88 (ft`) Basal Area Available 5.63 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.63 (ft) 98 83 (ft) • F Dispersal Cell Elevation Shading Key Topsoil Cap 0 Subsoil Cap 0 ASTM C33 Sand 141 Tilled Layer Aggregate ❑a G " 11 Dispersal Cell 99 33 (ft) Lateral - Invert 97.00 (ft) Contour Elevation 6 0 % Site Slope /-'� Geotextile Fabric Cover y 7 Dispersal Cell 11,511 T p nj f( �T�al Lat� F i 0 A— +i See lateral details on Page 4 for number, size, and spacing of laterals Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax B) Project Page 3 of 7 Center Connection Lateral Layout Diagram Fpc....0 n <rnnecrrw, w a. o, c ros s to m W old +t xy ports I+ P ••Torn p»Iba l l verve or �X—c 1"12 xl: yl Gran out pi up Hol.s ba.d or. lt, bolt orr. of ih. I+r.r+1 Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 6 1 50 in 27.37 It 267 ft 3.77 gpm 22 62 gpm 21.57 ft L u..ak ar. rd.nc rJ Laterals S. forcernam �<h 40 PVC per SPS Tebfe 384 30-5 Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemaln Velocity Dose Tank Information Electrical as per NEC 300 and -0 SPS 316.300 WAC Tank component is properly vented Wieser Concrete Prod Cap2CItyl 603.36 Volume 1 16 76 Manufacturer Gallons gal/inch Dimension Inches Gallons A 2053 344.12 B 200 3352 C 547 91 64 D 800 13408 Total 3600 60336 3" Bedding Alarm Manuafacturer ISJE Rhombus Alarm Model Number ITank Alert 1 T__ A B C D Disconnect Pump Manufacturer Gould I Pump Model Number J EPO 5 Pump Must Deliver 22 62 gpm at 21.57 ft TDH 421 Ift 7 1071 ft`/orifice 5.33 ft ib7nRi' i;tilfir=: Locking cover with warning label and locking device and sealed watertight 4 in. min Alternate outlet location Forcemain diameter 2 in. Weep hole or anti - siphon device Pump off elevaLon (ft) 83.47 Dose tank elevabon (ft) 82 80 Note Switches containing mercury may not be used in this system Project Page 4 of 7 Mound Svstem Maintenance and Operation Specifications Service Provider's Name Roger Timm Phone 715-772-3214 POWTS Regulator's Name St Croix Co Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peakffi30 gpd Maximum Influent Particle Size 1220mg/L in Estimated Flow - Averagegpd Maximum BODS Septic Tank Capacitygal Maximum TSS mg/L Soil Absorption Component Sizeftz Maximum FOG mg/L Type of Wastewater Maximum Fecal Coliform 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 month) Laterals should be flushed and pressure tested every 3 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 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 Dispersal cell aggregate conforms to SPS 384.30 (6)(1), Wis_ Adm_ Code. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm Code Tillage of the basal area is accomplished with a mold board or chisel plow. 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 \ 6-8" Diameter Lawn Sprinkler Valve Box Distribution Lateral C Threaded Cleanout Plug or Ball Valve 3 Sweep 90 or Two 4J L)egree Bends Same Diameter as Lateral Protect Page 5 of 7 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with ds' component manuals [SBD-10691-P (14.01/01, R 10112), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver 2.0 SBD- 10706-P (N 01/01, R 10/12)) and local or state rules 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 users, access nsers 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 8-inches in diameter shall be secured by an eRecfive 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, 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 filter shall be cleaned as necessary to ensure proper operabon The fitter 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 fitter 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 firne of a finer-mal 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 fitter is installed within the tank d shall be inspected and serviced as necessary Mound and Pressure Distribution System No trees or shrubs should be planted on the mound Planhngs 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 sail compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter well 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 mg/L BODs, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg1L BODS, 30 mg1L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent- Influent flow may not exceed maximum design flow specified in the permit for this installation The pressure distribuhon 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 clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell Observabon pipes within the dispersal cell shall be checked for effluent ponding Fondling levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become detective 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 selecWe 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, a will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged 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 Wastewater METERS. FEET 10 k CAPACITY MODEL INFORMATION 10 12 Order Number HP Volk Mps Minimum f�adt Breaker Flort Plow switdi style Cord later Cotrtectlou Mitimua On Latel Min{ne+nt OM la+wl MY�imunFS-;d: Basin4Vnlyht Diareater16SAg Shlpptng -EF'0411 FP0411A - EP0411F EP0411AG EP0d12 l 4' I 715 12 i 20 Plug/ No awrc Piggyback Wide -Angle Plug/ No Switch Piggyback/ Ydde-Angle 1 Plug / No Switch Plug / No Switch Plug/ No Switch — VJ de Angle Plug / No Swlt_h 10' 1 -A'w ' Manual Manual 15" _ _� 20/9.1 2119.5 10' 1 20' 1 12' 6' Manual Manual 20 191 21/9.5 20' 12" 6' 230 66 10 10 Manual Maral 20 / 9 I EP0412F 20' Manual Manual — — 12" Manual 20/9 1 EPOSI7F EPOSIIAC i 1115 5 230 i 73 20P,g 20' Manual 22/10 20' 6' --- <3/104 22 / 10 EN512F 6S 10 20' Manual Manual P46F 3 /, r11 11) rill I. 1-11 NE/4/zj Se, , 3 r zopL t� . Town off' S/-r 6`0'.c CL,uInAy r scrcte V � r o �v' 49 t;! 17y-1d'3 -70-/05 U I o o-�� goo/ bw 6arob Q \/v 1 A �5�►1 , , 1 b � � I Brn £Ltc�,o Wisconsin Department of Safely and Prolessional Services Drvrwn of Industry Services Page / of 3 SOIL EVALUATION REPORT In accordance with SPS W5, %Ms. Adm. Code Attach complete site plan on paper not less than 6 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference pan (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print alf information. Personal information you provide mayrysPrivy Law, s. 15.04(1)(m)).ed p Property Owner Property Location AJ o n e—m Govt. L l N k A Property Owner's Mailing Address Lot # Block # ( 4 ) /C.Y/(- Y,Gr,-/-h "fl vv County Parcel I.D. 00 y_ /05--3 - /0 - / 6 S - Reviewed by Date c� ❑ Lc % S� 3 T ram( 9 N R /S E Subd. Name or CSM# C" State Zip Code Phone Number I ❑ city Village 0 fovm Nearest Road /r,r'r-lc�l� ILr7LI'zi(�3Jk I I I(-,xhV I ?T./i A,," aConstruc hon Use: Residential! Numberof bedrooms =� Code derived design flow rate 5�M GPD ❑ Replacement ❑ Pudic or commeraal - Describe. Parent material t-, l % r'l - % / Flood Plan elevation if applicable � applicae Lfl. .G�c1f eneral c«m nnis and recommendations: �_- c�.^ o r- /. 8.1 ' o�,� �.� �f rv. c .��. —IV VjC JL) 6'' 0.a5 Cr(( o� .'c5nfcc�r C/Z-0. Sss", E%o, FLI Boring # ❑ Boring Ground surface elev. it. Depth to 6mibng factor -'� C' in. c..a e...a�n..., acre Horizon Depth In. Dominant Color Murrell Redox Description Qu. Az. Cont Color Textum Stricture Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe •Etf#1 •Elf#2 % �./R t S L 6h Wt� w oYP F F-F � El_ _t#Ej -1 CJ Boring If ❑ Boring Ground surface eleO. '? R Depth to l mrting factor L rj in. Vlv A.II(Slfmn k.te Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cant Color Texture Structure Gr. Sz. Sh" Consistence Boundary Roots GPD/Ftr •Eff#1 •Etf#2 -�� _ _ If - Z _ 1 0 2 �( ('34 oy ' Effluent #i - BOD, > 30 5 220 _ and TSS > 30 5 150 m ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L GVPame (Please Pnnnt�) I Signature CST Number Ad ress Date Evaluation Conducted Telephone Number i f, / A C U/c`f /(� 1. � t -5 � 7'C. 7 SBD 8330 (R04/15; Boring # Boring M_PFi ( Ground surface elev.��, Y ft. Depth to limiting factor in. Sal Aonlination Rate Horizon Depth In Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh- Consistence Boundary Roots GPD/FP •Eft#1 'EfW to -/ rf--t✓ L O 75 I Y 7 -- ❑ Boring # ❑ Boring ❑ PR Ground surface elev. _ ft. Depth to limiting factor _ in. Sod Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az CorrL Color Trotters Stnicture Gr. Sz Sh. Consistence Boundary Roots GPDlFtz •E1191 •Etf42 I� Boeing # ❑ Baring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Sal Annaration Rai Horizon Depth In. Dorninant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Flu •EtHl1 'Eff#: • Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOD, > 30 s 220 rng/L and TSS > 30 S 150 mg/L C�'C'-�----1��n cliff -�r', Lc�.•, :1 .,�'<i2f�.1 LL6 Cc" -:E7)CCLA T-i- �- E7 � 1 03 II i� ('.M IC(-'),c c, . 5t, Inc iv\ W, i'�«. 4 Trees To{, �C -i qU e :lt cpj qY, ✓L WLP1000/600-MR TANK SPECIFICATIONS DIMEN SIOP6 WALL J" BOTTOM', }' a a COVEP 5" MANHOLE: 24" 1.0, PRFCAST CONCREIE RISEP =I HEIGHT 56" 0 D. LENGTH 150" 00. TI WIDTH B 4 " O I), ' �, r — — — _- __ — _. — k_ — __ __ __ �, BE LOW INLET 42" 00, - LIQUID _EYEL 36' - C45!-A- Jr.A, WEIGHT 14,970 LBS. c R1LE1 ANC O11T1_ET'. 4" CAST -A -SEAL BO(H OR EQUAL GASKET, CAST -A -SEAT_ BOOT OR e"'.a1AL P Yz o _ INLET AND OUTLET BAFFLE AND FILTER > e it WISCONSIN, SEE DETAIL #IO (DTHER STAIFS SEE C114RT I SAFFI_E— LIQUID CAPACITI2788 GA -/IN (SEPTIC) LaJ „ - — -. .... T — - V 16.76 GALj IN (PUMP) LOADING DESIGN. 8' 0" UNSATURATED SU!I Q TOP VIEW C V m z oC 6J TANK CAN BE USED AS: C= CA SEPTIC/SEPTIC, SEPTIC/PUMP rD OR SEPTIC/SIPHON W ` r 4' 'JFkT O COVER: MIX DESIGN 8 ((NO'JFIBER TANK: MIX DESIGN N 0 ZRCTURAL FIBER) W ,�CC CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WiESER CnNrP.EIE INLET - OU1LE7 Z Q I _m L---L o Z o a 5 F `-PUMP DRAWINGS SUf3MITTED� n. HAD FOR APPROVAL JIL'E ', IEi( APPROVED a,' EEI 'I,_, APPRJVA', CAT" TANKS ARE MANUFACTURED TQ MEET OP EXCEED ASTM C-1227 REOUIREMEN TS PRODUCTS NEEDED 9, .-- --- ilF OLYAWK Zabei� A KYilm.le VroJu[}r ♦P.nw of VaYbY uc_ PL-525/PL-625 FEATURES & BENEFITS o Ali PL-525 PL-625 INSTALLATION INSTRUCTIONS PL-525/PL-625 FILTER The PL-525/625 Effluent Filter should operate efficiently f:)r several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped or at least every three years If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer RECOMMENDED PRODUCTS Risers & Riser Covers ,'r)iylck rsers bring ycur epfic tan' cover to grade 1 his allows locating and servicing your filter easier and time saving by el mi- nahng digging to find tank ntran-e. Extend & LokTM Polviok Extend & LokTM is a simple, easy to use solution that can extend the inlet or outlet pipe and make filter and/or baffle installation a snap. Fits 3" and 4" pipe. Features & Benefits: . Rated for 10,000 GPD e PL-525 = 525 Linear Feet of 1 /18" Filtration PL-625 = 625 Linear Feet of 1/32" Filtration .Accepts 4" and 6" SCHD. 40 pipe . Built in Gas Deflector •Automatic Shut -Off Ball when Filter is Removed *Alarm Accessibility .Accepts PVC Extension Handle Riser Safety Screens Polylok safety screens prevent tragic accidents from happening by children and pets falling into open septic tank entrances Polylok PVC Filter Extension Handle Filter Alarm Panel and SmartFilter TR Control Switch Polylok filter alarm panels and switchs provid a visual and audible notification of impending Titer and tank seracing. Fora full list of Polylok products please visit our web site at: www.polylok.com --- 6 1,L' BALL CHEC>. I � C�. fl�i' ialll j C HEiAINING CLIPS PREVENT FILTER FFJ41 FLOATING ACCEPTS 6" SCHD 40 FOR INLET EXTENSION — OUTLET BUSHING ACCEPTS 4" SCHD 40 & 6 SCHD 40 .I i { i PL-525 -625 FILTER HOUSING PART NO. - 30142-525 MATERIAL - HOUSING - POLYPROPYLENE OUTLET BUSHING - PVC 65' BALL - HDPE 1159 III �/ J1 1294cmJ1, 20.6 cm 1 U.52 126.7 cm 2 rr n 5 1 cm i 36,4 cm I — --- OUTSIDE DIAMETER ACCEPTS 4" SCHD 40 SOCKET OPTIONAL BUSHING (FOR 4" THIN WALL PIPE) FART NO. 30', 42-R CR FOR 110I,!%I, PIDE PART N0, 30142-EUR 5.23 ' 13 3 cm I LI_ yooA •o xaaeu� '_IJ LL'�� Juan S}.ita I I I E-117= IEll ,9cml f' t — I �L�/.9]C,, INSTALLATION INSTRUCTIONS �y, Za PL-525/PL-625 FILTER E w,n..n.,Roem: V nu,,.m-o�v��Nn e. INSTALLATION INSTRUCTIONS Step 1: (A) Locate the outlet of the septic tank. (B) Remove tank cover and pump tank if necessary. MAINTENANCE INSTRUCTIONS Step 1: Locate the outlet of the septic tank �DV NV I VtiC I'WMtlINU WHEN FILTER IS REMOVED USE RUBBER IGLOVES WHEN CIL ANING FILTER Center filter with opening t Additional pipe or Polylok Extend & Lok^ for centering Step 2: (A) Before installation, place the filter housing on to the outlet pipe. (B) Make sure that the housing Is positioned so the filter can be removed from the tank for maintenance and service. Step 2: (A) Remove tank cover and pump If necessary (B) Pull the filter out of the housing (C) Hose off the filter over the septic tank Make sure all solids fall back Info the septic tank. Step 3: (A) Glue the filter housing on the outlet pipe (B) Insert the filter cartridge in the housing, making sure the filter cartridge is property aligned and completely Inserted in the housing. Step 3: (A) Insert the filter cartridge back Into the the housing making sure the filler Is properly aligned and completely inserted. (B) Replace septic tank cover Easy -to -install liquid level alarm system for indoor use. I This alarm system mondors liquid levels in lift pump chambers, sump pump basins, holding tanks, sewage, agricultural, and other water applications _ I The Tank Alert- I alarm system -ai serve as a high or low level alarm depending on the float swrtcn model used �t►• •We The alarm hom sounds when a potentially threatening liquid level condition occurs The horn can be silenced, but the worming light remains on until the condition is remedied A green "power on" light indicates power to the alarm panel SPEaRICATIONS JF NEt.M 1 enrinsure des;1nec'or ease of installation rated'cr indoor VOLTAGE FOR 120 VAC MODEL use PPrim_c,_ 120 VAC, 50/60 Hz, 5 v: efts mar jr Red 'alarm" hgnt, oreen "power or" light, alarm'test" switch, and (alarrn cnndi inn) horn "silence" switch Sgcondary 12 VAC AV Alarm horn sounds at 86 decibels at 10 ft•et (,3 meters). VOLTAGE FOR 230 VAC MODEL: AF Can be used with any UL Listed / Recognized switching mechanism (not UL Listed or CSA Certified) rated to include 1 amp, 12 VAC load Pnmaty 230 VAC, 50/60 Hz, 5 watts max AV Alarm system (when installed on separate circuit) operates even if(alarm condition)e ❑ddry 12 VAC the oumc craut tads AV Complete package includes standard SJE Signalldastere control ALARM ENCLOSURE: 6 x 4 x 2 5 inch switch with 15 feet (4 57 meters) o` cable (other lengths available) If 5 24 x 10 16 x 6 35 cm), NEMA 1 metal and mounting clamp / Switching mechanism operates on low voltage and is isolated from ALARM HORN 86 decibels at 10 feet the cower line to reduce the possibility of shock (3 meters) AF UL Listed 1` WsmOc CSA Certified C, UL POWER CORD 6 foot (1 8 meted AF MAX Three-year limited warranty FLOAT SWITCH CONNECTION TERMINAL: tjyPllCfujlC For float switch connection only Do not apply power (Voltage across fenn;nals is 12 VAC Maximum line, impedance 6ir KII 4 1 111 iinifiratinq device 5 ohms) When ordered with the alarm, this system is available with, FLOAT SWITCH, SJE SignalMaster° control switch with mountng clamp AF alternate float switch mocels for high or low level warning Cable. 1 ` feet (4 57 meters), flexible 18 / 120 VAC primary voltage or 230 VAC primary voltage 1230 VAC gauge, 2 conductor (UL) SJOW, water- model is not UL Listed or CSA Certified) resistant (CPE) Float:: 74 inch diameter x 4 83 inch long (7 crn x 12 3 cm), high impact, corrosion resistant polypropylene housing for use in sewage and non -potable water up to 1401E (601C) RhSIES us PO Bo, 1708, Detroit Lakes, MN 5650- 1-888-DIAL-SJE • 1-218-847-1317 1 218-847-4617 Fax SEE BACKSIDE FOR ORDERING INFORMATION. email pe,@slerhombus com www.sierhombus.com 77 �7 J,0,0 z £ I = x zZ Jv� r"IH Flu n4pq urn [�rnu�uUl q/ 71/1 uy J'o.f 14rn7e vo y ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND // OWNERSHIP CERTIFICATION FORM OwnerBuyerhy LmL4 A/41,Iel a/1 Mailing Address /_h Property Address '% 1�y , V� V A'< .-0 (Verification required from Planning & Zoning Department new construction ) City/State 61 LcJ Parcel Identification Number DU/1-/�J� ' 70 LEGAL DESCRIPTION Property Location � Y< , /V '/< , Sec. a;3 IT 62& N R W, Town of Subdivision Certified Survey Map # 1-, 19.7 &4- - , Volume , Page # Warranty Deed # -/ '�'t 7 a' / , Volume , Page # Spec house yes CO) Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # "— 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 (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. Uwe, 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. Uwe certify that all statements on dus form are true to the best of my/our knowledge. I/we anvare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office Number of bedrooms 3 ✓� V SIGNATURE OF APPLICANT(S) Yl 3 -n7D DATE 'Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. "' Include with thts 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) �_ &5r--ZDZO-IcQ5 Wisconsin Departme .-� f;es �+ P of 3 Division of Industry S L� L' 1 JJ t/ EGO — d6 2020 SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code county c Attach complete site pla on papWtnottass Ova 8,112 x 11!inches in size. Plan must include, `� / but not limited to: vertical anQgetsoptal reference:pced B ), direction and percent slope, Parcel I.D. 0 �/- /GAS 3 - JO - � BS scale or dimensions, n a r-- to nearest mad. - Please print all information. rersonar imormaaon you pruv�ue may oe useu mr secoraary purposes iffnva raw, s. �a.ua i m - Property Owner /' /i ✓i ��h /j /I /v/°��m�r� Property Location GwL Lot A)E%I%0%sa.3 ❑ TDS NR IS E (or W Property Owners Mailing Address w I6 /S goo Ju . Lot # Block # Subd. Name or GSM# C' State 11 tvT Zip Gode Phone Number O ❑ City ❑ Village own Nearest Road Ab 3 ew Construction Use: Residential/Numberofbedrooms .3 Code derived design flow rate -�ISn GPD NtC ❑ Replacement ❑ Pudic or commercial - Describe: 54 ,.'f'l ay0 l s�� &" Sys Parent matenal ./- E)Z:�s c i`) l lit,- %f i Flood Plan elevation if applicable It ,General comm is and recommendations: G! 5 �.� ' c r" /. 83 ` o f -..,. c� a o� ��- �-p e lUICLtU(� S' '5 C'�It on cchfn i- �7eo, s E/e�- 98-s3 Boring # ❑ Boring Ground surface elev. it. Depth to limiting facto d C' in. Soi ADolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' 'EtF#1 'Eff#2 - � � YR � `- S L r 61- w1 �7 �- w � � � • Co 1._ Boring # ❑ Boring R Ground surfaceelev.1Z a, 0. Depth to limiting factor 3 in. Soi Anull ;ration Rate I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' 'EfI#1 'E111#2 J F Effluent #1 = BOD. > 305 220 mall- and TSS > 30 5 150 malL ' Effluent #2 = BOD. > 30 5 220 m0/L and TSS > 30 5 150 ma/L CS ame (Please Print) Signature , /.- / CST Number _ Ad ss Date Evaluation Conducted Telephone Number `7/5 -I-)-=/-aU -/-)69 S )pun c, UP ��27 �rsuu�w(Huan�l Boring Boring # Cam" y _. Ground surface elev. =�+R De to UrnMMi Sal ADDlication Rate I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az Cont. Color Texure Structure Gr. Sz Sh. Consistence Boundary Rods GPD/Ft' ,Eff#1 'Eff#2 y s, {^ r (� v �4IoY 5Y 7 s `( L.J 3 > l r 3 At3 , ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ tt Depth to limiting factor _ in. SM Ann ication Rate I Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots GPD/Fe 'Eff#1 'Eff#2 FEM ❑ Boring ❑ Pit Ground surface elev. _ IL Depth to flmiting factor _ in. ,W Annli hon Rate '. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots GPD/Ft' 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30 5 220 mglL and TSS > 30 <_ 150 mglL ' Effluent #2 = BOD, > 305 220 mgiL and TSS > 30 5 150 mgfL Boring # C1 Boring )Qg� �:) of 3 Ground surface elev.�ft. Depth to limiting Sod Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe 'Eff#1 'Eff#2 o f y I F vLakG 3 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. —ft. Depth to limiting factor _ in. Sod ADMication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Fe 'Eff91 I 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ R Depth to limiting factor _ in. Rod Annlir tion Rah Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDJFt' 'Eff#1 'Eft#2 ' Effluent #1 = BOD, > 30 2- 220 mg/L and TSS > 30 <- 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg1L and TSS > 30 5 150 mg1L 1a�� 3 6f 3 _3c fh Xi , G I)- oe,y-icS3-7o ins— �s a3 i ' I /Cc�,«y�/ ' 1 C4 CADY _ u2 Sc c , 3 - --