HomeMy WebLinkAbout020-1439-43-000 (2)snn.�e aim o�i�m�
I GENERAL INFORMATION
Michelle Gierke
PRNATE SEWAGE SYSTEM
INSPECTION REPORT
(ATTACH TO PERMIT)
TANK SETBACK INFORMATION
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PUMPISIPHON INFORMATION
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YSTEM 00l MERfAPP a"I/Bwe^ne far o,saPPwvel 3 r eA}l %V.5 Ml3 A m
iIapl6 lank, to,ent filter and [ p�
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SYSTEM PLOT PLAN
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TANK SPECIFICATIONS
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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
(Streetaddmss) 896HInaVndr Tull located
at: NE �/, NE �/, Section 35 , TaWn 39 N. Range 19 W,
Town of Wyi Or , St. Croix County Wisconsin.
Upon inspection,) 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 line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: 12W
Construction. Prefab Concrete x Steel _ Other
Manufacturer (if known) wbser0onc w
Age of Tank (if known): 13 Mix
Permit number (if known) scsisi
jam S&Mift
(L rased Plumber Signature) (Print NameID
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MPRS 2237M
(Title) (License Number) MP/MPRS
(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
S
Step 1
Locate the outlet of the septic lank
and remove Me pink cover
local code.
i
Step g.
Remove the tank cover and pump Me
tank R necessary to prevent any scktls
from escaping to the the drain field
when the filter is removed
While holding the catlntle over the Insert the filter cartridge back in ty carthe
wlthfreabM1water, beinga�treful to nose case,
perty alignSure
dthe
antllcompletele
all eeplaga material bck into Me tank, neeltaU In Nil case. ReplaceMesei
tank cover
PAGE 3 ar}
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Step g:
Firmly pull the fiber handle and slide
Me wMtlge out of the case
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•�i-677-765-95651 www polylok. com paee5
SteppedIN-GROUND GRAVITY DISPERSAL AREA � Twk(s)
Elevation Trenches with EZ1203HP Bundles
3-ft Trench r.
Label
O)_ 00
CALTRENCH Provide minimum 3ft
Highest Trench
mums[ TrenOmr; applicade)
OBSERVATION PIPE BEiNL
Svsmm Elevations; =94.44' fl. 93.44 k
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fl X s,ovorcdn
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TYPICAL TRENCH (stow losamn orlmvto�ov Pw cane
non Plan,.') ^^•°^^°'^°=n^
PLAN VIEW 4.0
(No Scale) Perfambed Lateml
` oe..muwrpe 10 X -
(typical)
= �
INpmll INP�I
_____________
B=90 X
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INSTALL PER TRENCH:
EZ1203H Bundle
0
("Ka)
9 10.fihuMi EISWWt=450
ft.
(mktr/IMEYU Syrsbrv. MK•)
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A
+ Sfl bungles ®25ff EISMmn=O
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= Prowaed EIM per trah=450
fl`
Required! lnfilVaOm Ares =058 M Distribution
Meflmd:
x 2 trenches = Proposed Total EISA= 900 X= branched manifold
RRE
Installation Instructions for
EZJIaw Systems in Wisconsin
.............................................
wlawoin oepanmem of Commerce, 3afhy and BuIlElgs
P.ism. may rexexed the specllluYorts and/" plans for this
product and determined n to be in commands elm mepars
Comm 82 though Be, wrsconsm Aamin. Come, and Crafters
145 and If, Wiscrosm SNtufes NI sites must meet he $ore
6 W [mdtm= IF I ors d lastrabdown mode s say noted in
loess rguletlms
The appored products are 1M3X (3-12- WrNes vAm pre In
center market, 5w 10' lengths) and 1: l (3-12' Wnaka
hen qce rn each WMIe m 5' ar 10' angles
A single I bundle cmluns a four M pedonted fps sun
muMN by EPS aggregate end is held together wth dry-
dri noting A single aggr gale ounce contain sggregate
my Fund I hud coal min yryemybne nerong
MCWNN fund Fqulgrrml Pleaded
• Uflow BUMles
' Ur GroteMk Feeler
• EZflmv Intema I Cmwlem
Face for Human and of
eaemnoe�r.ra.-.m,
IneGINEm inaamenta e
The m amccons for innnabm of Einflar, products we game
Maw Then pm]utl must as "staled of accordance wM seats
m'a defea rn doe tns Comm I Through IF deem Ad.
man ubhur Cote, and enapte2145 and INO, wiacMsm Sed.
Nei as vid as the bug hollh delsa "s comet but
maraud
t Ater he ivy hat depanmml Ms determined marg
configuration man 4pw M the FSAav systems, stile
Oo mark wM pith IM Icubm of menthes and Free Ee
oreWl to set mum hem,,rear pp, nester me or des
mdAan Wa and met bmF ee aeou before Iaslal-
is on of pipe buMes.
2 Rmwve prowl 22floor hat lugs poor to pNbng
Wntlles m the mench(ed Femwe at Assoc bags m he
minch before system es comred
3 The pMuct must have Head le f Wrc Nat mesh m.
guummu is of s Comm M M (6) [g), Vita More Cade.
nstalkd areal, an tap of the product and m nagng
amn along me sides of the product to a gym N kavl am
Inches from he your of pound
d Men seat in a Irczh, he trench should he dug to
a width of M Inches, This not only saves labor In excays-
ban but also powaes but Ica-behat cal after
becmflmng is cbmpine
.............................................
4*EZflowm
........................................
5 The Adsorption area (SF) necessary for a gtmn des shall
he deal based an mulmun daily sewage flow (GPO) and
the Partial ku the site If certain uteru is met The
EISA sinng can be used in V aconsm, resulting In a ao%
smaller @unM1eld.
fi Piece EZPow Wndlelf) In the FSflax configureLon ap
proved by system design permit outcome for the perrim
W sate The turn or center -most bundles ccntaning pipe
sae pnad and to eM orm an Internal pre crack, Any
s ddlraaaa' aggregate only Wicks Mat may be ,epueed.
should be Full agunst the bMar eggregateonM bm
des and do Out more any tya of connection
i The top of each St cri cmlans a Mier other men
a,umnuredlnbetweentheneWNg daNrgate The
fal a in5ened 10 prGnt has ammsm The Installer
00 home sum the From GEO rs gsaucnM ul "is
in cmNcl wnh The falvac economic In the Fuji cre n-
bar at bacmflleg
e The Ufldv Dammed Sporms should da imoWlGa in a
and bench in al deacuons Nam across and wart the
Bench Nnwn)aM shwtl mlluvthe cmkura Me grwM
sunue elneam (umnorm march. wM ON conbmmus
Wpnig III cyrnarrzl Wicks pat I t0 and
v.Ma central WMIe dastnbuom I interconnection,
vAMd any dams, samovar or one, »ale tape
g The trench lap s1W be graded exit That water will not
of eacmfiu Faced ce sanded o' madder ammeda:efa
after pnpklKn to redutt music,.
10 UZ EPS Wicks are Ilerl[4 and can fit in cement
trenches as mess ber rccessary to food trres, biuken, Or
other absence
11 En aggrgate'a FgMn Orion water, therefore, d nal
M expected Nat nail buoyancy house work boo b
cusubs, Utah, thereof to float out of ground wnw,
earl occurs Field sediments has shorn, Farmers,
Pat his a col a prodbm when systems have a minimum
of G' of sal mein, as recommended by manufacturer
1203H-0so
GwWeb
Oves
..w.mane
� Rim, Mebnel
ell
........................................
PAGE 4 OF
In -ground Gravity Management Plan
IMPORTANT:
The miner of the Ingrwnd grevity, system shall be comparable for in perpetual operation and maintenance Ivreuanl to
requirements of SPS 382-384, Whic Admin. Code Punuent to SPS 383.52(2), Wisc. Admin. Cotle, this system shell
be mneldered a human heats hazard it not measured In accordance with this approved management plan.
Furthermore, all Inspection and maintenance sell shall be pader ned by a mglstam l POINTS Melntalner In
accordance with SPS 383 52 (3), Wiac Admin Circle
Maximum Dispersal Again Dominion LIMIthe
Design Flow= 600 gpd, BODs5220ml TSS5150mgC'; FOG 530 mgL
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
• age of system
nuisance• factors pa Odom, maker complaints, etc.)
• mechanical malfuncOm(t a pumps, valves, switches, finds, etc)
ocoastal fugue pre. leaks, breaks, corrosion. etc)
aside voters in anaalcb¢borrowed tsink(e) and any dlmnbubm appurtenance(s)(I.e, dinnbuuon l drop bnees)
in neglect or Improper use (I e, exceeding deign wpeddes, proMsted advWes, etc)
• extent of pending In dlsNbutlon call prior to dosing
O dosing eregulardlds -d applicable if a pump reaycbng, float switch settings, are)
I
lecmwl components - If applicable (Lis whi connections, like Ghee commie theirs, alarms, etc)
disnbuaon lateral Or lateral onfice plugging( measure lateral distal pressure— compere to design speclriw0on7
o surface discharge M effluent or sewage beck -up into structure saved
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o seotle and dace tinkle shell be pumped by a cenNed viongs servicing operator licensed under a 28148 Wis.
Sets when the volume of solids In the tanion exceeds onHhlM (tit) Ike liquid volume Pf Ma tank(c) or
a requoadleylocalonYnance Olet of contents shall be pursuant to NF 113, Wil Atlmin Code.
o Effluent Blter6) shall be inspected every, 3 years and shall the tleanetl when necessary to remove any
accumulated sdida according to manufacturers specifications. A awnsce g period wit always he greater man 12
months
System maintenance happens shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Cade. Raped any component failure or malfunction tb:
Named individual or company. Schmitt&Sons Excavating, Inc. Phone. 715-760-0486
Loral government unit. St Croix County Community Developement Phone, 715-386-4680
Leralgmerimenturitaddress 1101 Carmichael Road, Hudson 21p 54016
My real part of this system shall be ro rated, imposed, Or removed pursuant to SPS 383.51 (1), Wisc Admin
Code Repair or replacement of failed or magunctlgning components shall comply with SPS 383, Wisc Admin, Code,
No product for chemical or physical restoration of the POWrS may be used unless approved by the department In
acwMance with SPS 384, Wisc Admin Code
Contingency Plan
In Pe event that anyfalled treatment component 0 this POW S cannot be ordelred, it shall be agreed pursuant to
a plan submitted W the appropriate agency for review and approval. A failed imgmund clusters mmrenent maybe
abandoned and replaced by a wee-complNng national component in a pre -determined area of wbables soils.
Sargon Abandonment
If use of We PO4NS Is discontinued, it shall be abandoned In accordance wits SPS 383.33, Wisc. Admin. Code
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
O0.'NERSHIP CERTIFICATION FORM
0r,nerlenyerJohn A. Ristad & Michelle L. Gierke
Mailing Addreaa 895 Highlander Trail
Property Address 895 Highlander Trail
ICennt matured trim Pi onmg 4 Zoning Department lot nex eoniwm:on I
GM State Hudson, W1 W16 Percel ldentttieanon Numbfr020-1439-43-000
LEGAL DESCRIPTION
Property LoaatfonNE,,_NE see 25 T29 Eda19 A. Town of -Hudson
Sol men Plat Indigo Ponds Lot # 43
Certified Survey Map # Volume . Page #
\carranrc Deeds 951 4135 (before ?00]I\'plume .Paged
Spec house OKSIZ311. Lel lane, idemrrabIe o xesOno
Imprnner andm of Nearxpna onto rtmh: Is pre no total, to handle, Proper
seofpumpina out the domrank ...I three Nor, oranooe if rnial br a boomed pnnion Wu: YOU put "to
me to' fact me pal or in, omiia lank of a treatment o6e in the Nunn d:apmal Is seem 0, net maintenance
,loner b:lino vol rymtled In 65P5 tot i}I) andm Car:a 12—S ( m4 Cauma Samruy Oramal
The piano, Nonor apecs to abnul to No Can Co unp Planning of Zoning Domma m a cemfwuon form, signed he the
chair and on a master plumber initial ilia n plumber contend plindoor at a honed pumper sup nip that I l 'he on site
¢t disposal IN new to 11 pricer local Notation and or Ct after mspnnan and pumping (it n..farm ), the septic ank is
Ipvs than 1 3 Nil of sludge
1 vx Ilse undenegrol be%C rend the afoot¢ requirements and agree to uamum the pol notes disposal sysum moth the
mndards It or heretp as set NI the Department of Safep And proof oe:out 5a Noes and the Deputill of SaNml rural
Sate of R tsmnei it Cannot ion sandy that ¢our upow ss stem hey been minimal mug be completed and reamed to me A Cr,,,
C onrds Planting ar Zoning Dec,mmem nuLtn tO do)a of the three war expiration due
I ere feel is that an Neutral oil tin, man m,lme ra to, aloft at ml .err 4nmamge I,, on are the octal o of The
pmpcm described goof¢ by mole et a ,if to my dead worded ui Roemer of Deeds Of fin
Nurldser uIJl �ms4 _
7 09 23 20
SI NATURE OF AP LICANTISI DATE
e"Am mommalimr Joel rt an rurarcsrn¢d rim reulun the uimun com at being rtmked his the Pluming @ Zoning D prime nl "'
w1m, slug this application,mmduMl( ,w used trot. the Roguirof Deed, Office tad a cops ofil eed to mop _ it
reference is made in the eal dxd
IREV, W/131
e
5.n..m Nmaimn..0PRNATE SEYYAOE SYSTEM
"m Br Croix
INSPECTION REPORT
GENERAL INFORMATION MTTACN TO PERMIT)
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am pro sued , _n-,i-wiemask ue. sCxlmaa r..mg,ln(
u a�m310 an _ r s oa,
o rwo. 0. dime.rora 1-lm d ado mane to aareslo eras
Phal Port nbneInd aarnu m 020d
Ano•Mo..e�ry n weo.Mlwmm
Hared JoNn6Mr[AeIletaer One M NE114, ld sib TNl RI9W
Prod Oemi ii Ayres[ Led V
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