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Home My WebLink About020-1123-40-000 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 633362 Personal information you provide may be used for secondary purposes [Privacy Law, s.15 04 (1)(m)) Permit Holders Name City Vdlage Township Parcel Tax No. Bradley & Gretchen Folczyk TOWN OF HUDSON 020-1123-40-000 CST BM Elev Insp BM Elev BM Description // p SectionrTown/RangelMap No � • 73 %P 07.29.19.551 TANK INFORMATION I I ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic r- /OD L) 4/cLj bj7f 2•6f4 ei Fi! r dz /a1-- 5ZS '? 3zo Holding TANK SETBACK INFORMATION L.Cr-1,-, d- TANK TO P/L WELL BLDG Vent to Air Intake ROAD Septic °o- az Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GP Model Nlnnb;rZ Z i ) TDH ift Fn tion L s Syste He TDH Ft Force ain Length Dia. ist Well SOIL ABSORPTION SYSTEM STATION BS HI FS ELEV. Benchmark 2 3,1 Qg D7 1 95. 37 3ZO ib. r.� G va*' �� 116, 78 Bldg. Sewer SUHt Inlet � 1 SVHt Outlet t q-11q 13,13 iA 3i-n%r� o.yt- sog �'Z. 9y Header/Man. / • p -7 Ak6 g5 Bot. System 7• ve (0• y % Final Grade 3,8 q L�, St Cover 129 ' 4 r 7 8 VOL Ve 5r)7 9Z.cl `wm Fz Pvt 1 BEDITRENCH DIMENSIONS Width ` Length �0 ` No. Of Trenches '7 PIT DIMENSIONS No. Of Pits Inside Die Liquid Depth SETBACK INFORMATION SYSTEM TO JPIL 41kJBLDG IWELL LAKEISTREAM LEACHING CHAMBER OR T N UI Manufacturer.y(, .r., 1 r r Tye Of System or`µc s1,x >50' ZZ irj0 — Model Number' Fe— r—ic+ DISTRIBUTION SYSTEM HeaderlManifold 'y1 I` Distnbution Pipe(s) x Hole Size x Hole Spacng Vent to Air Intake C �! be Length Dia / Length Dia Spacing X15 1 S SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over . Bedrrrench Center C .� I 1 r ` .7 x'i J Depth Over \ BedrTrench Edges / Z 1� xx Depth of Topsoil xx Seeded/Sodded xx Mulched es No es - No — COMMENTS: (Include code discrepancies, persons present, etc Location: 425 KRATTLEY UN 1.) Alt BM Descnptlan = 3 ZO T^r �` �oYcT' 2J Bldg sewer length = L x is f - amount of cover Plan revision Requiredv F-1 Yes No Use other side for additional informati S (� Date SBD-6710 (R 3197) Inspection #1 Inspection #2. — toe vi fis O yX So w a a, E-V\J Oh P. Insepctoes Signature Can No 'CY14 -�Anl --)o Q I — �� , , , -� Industry Services Division Counts - StCrotx 1400 E Washington Ave P 0 Box 7162 Sandar% Pern Number do be filled in by Cut Madison, VVI r7A2 Jr 33362 mit Application State IransactionNumber In accordance �r (2). WIS Adm Code, submr5sion of this form to the appmpnate go is required prior to obtatmng a samtary perms Note Application fors for statco%ned POW "IS are submitted to the Department of Safety and Professional Services Personal information )uu pros Ode may be used for secondary Project Address pf different than mailing address) u oses in accordance with the Ptrvacv Law, s 15 04 1 ro . Stats 425 Krattley Lane i. Appication Information — Please Print All Information Property Owner's Name Parcel A Bredlay & Gtelchea telczvk 020-112340410 Pmpem Ow nets Sludmg Address Pmperty Lueatron 425 Krattley Lane Goal Lot CIE), Sure Zip Code Phone Number NF. 'A. SC. '.1. Section 7 Hudson. WI 54016 (circle once 129 N R 19 h orotr IL Type of Building (check all that apply) Lot Y Subdo mon Nantc ® I or2Famdx Dwelling Vumhcr of Rcdnwms 3 22 Eagle Ridge ElPuhhd('nmmeretal - Desenhr t t<e Block a ❑ Crn of ❑ State Owned - Describe Use ❑ Village of CSM Number ® Townof Hudson 111. Type of Permit: Check only one box on line A. Complete line B if a livable S El New Ss stem Replacement Svs4m ❑ lreatmentilloldme Tank Replacement Only ❑ Other Modification to Evshng System (explain) R. ❑ Pern Renewal ❑Pern Rey iston ❑ Change of ❑ Permit Transfer to New List Prevmus Peru Number and Dale Issued Before Expiration Plumber Owner i S4910, 6/19/1984 IV. Type of POWTS SS stem, Com nent/Devi .SL Check all that a I Non -Pressurized I n4 Ito Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 in of suitable sod ❑ Mound < 24 in of suitable suit LJ Holding Tmrk LJher Dispersal Component (explain) ❑ I' etreatment Device Iexplmm / V. Dis ersal/Treatment Area Information: Design Flow Igpd) Design Sod Application Dispersal Area Required Isq Dispersal Area Proposed (sf) System Flevatmn 45u Rateigpdsl) Wld X 910' O s VI -Tank Info Capann In gallons ❑aai a of x Neu tanks tvshng Ianks Gallons Units f�M ufacturcr _ f ts v LL i Septic or Holding Tank 320 1000 1320 2 N' Ieser Concrete ❑ El I Dosing Chamber VIL Responsibility Statement- 1, the undersigned, assume responsibility for installation of the PONN'TS shown on the attached plans. Plumber's Name IPnntt Plumbs' 'ign rr ,[1 MPiMPRS Number Business Phone Number John Schmitt 1 L %IZ'L � 22116(l 715-760.6486 Plumber's Address (StreeL Ca% State Zip Code) 586 Valley Vic% 7-rail. Somerset. W'I 54025 CDunt dDe artment Use Only ,CVill. UCI Approved ❑ Dts size Permit Fee Date Issu d I g AgeQt Stgnan c ❑Owner Given e , atpr Denml IX. Conditions o pprovaV proval 3� 1 'saoueulpfo/apoo algeogdde Sad se AL 5_�I `Xr• 1 R�J ' pawelulew aq Isnw sluawannbad sloeq)as IIV-Z�� lagwnld hq papinad ueid luawa6euew jad se aisle uiew aolAlas a - snw aoesaadsl pusda !�'YMtlb$rei b3NMO W31SAS SD 6398 (R03iI4) J t>tY'1`�l'S 5) � a -OUP-C- 2 1 �0. 4-o txAt(t`2 p�� yRSF'l) � t C r SYSTEM PLOT PLAN Folczyk 3 Bedroom Septic System project Address. 42a "toy Lane BA/1 Symbol AL BM Elevation. 91 00' BM Desufpbon Bottom of &long m fie garage 3M2 Symbol: A BM Elevation 95 73' BM Deaodptbp Top of vent pipe on existing d.n eeid 31opa Gradient of Taster Area: (7%) Was Symbol (Heppticeble) OPY Design Flaw' am GPD Attach, design now celculatrona fm commerolal plena' Pipe M.Wials / ASTM Standard Tables 364.30-3 a 384 3 5 4'SCH 40 PVC pipe ASTM.D2rie`- 4'31D4WCpre ASTM-133IX T1- 3S60' EZ Flow trench El --91 00' T2- 3'x90' EZ Flaw trench El.-91.00' Exlsung Nell IsM 1 .1 •1 1 IIVJJ IDriveway Ezlatmg Deck 3 Bedroom House Garage 95' 95' BMd Exisbng 1000 gallon \ \ Septic Tank Proposed W320-MR --- - • Septic Tank wlPolylok 525 m \\ \ 4 xMin j = ♦\ \\ j 8'x36' 11 I 11 11 111 ad 11 II 6102 I I 1W 7%Slope � � I Tt � I T2 B1 -97. 99' 97' / r 95' property Line Z c18.o 7 8v,�A rU q.clq Sza Iry — Ll.g6 93.11 0 UT- 6-'Os 92.4q 2.tD ql. 87 DiS�P. G Zz I'1.85 F9y-Z7 COv-t,- l l G . 7 $ 320 S%? 92 q rSiheJ 50, / irc r 115 - ••15' %f4- �4,cier CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Folczyk 3 Bedroom Replacement Septic System Owners Name: Bradley & Gretchen Filczyk Owner's Address 425 Krattley Lane Hudson, WI 54016 Legal Description: NEl/4, SE1/4, S7, T29N, R19W Township Hudson County: St. Croix Subdivision Name: Eagle Ridge Lot Number: 22 Block Number Parcel I.D. Number 020-1123-40-000 Plan Transaction No. Designer Date: Page 1 Index and title Page 2 Plot Plan Page 3 Existing Septic Tank Specifications Page 4 Existing Tank Certification Page 5 Proposed Septic Tank Specifications Page 6 Effluent Filter Information Page 7 Bull Run Valve Page 8 System Sizing & Cross Section Page 9 EZ Flow Information Page 10 Management and contingency plan Page 11 Sanitary System Ownership/Address Form Page 12 Warranty Deed Page 13 CSM or Plat Attachment 1 Soil Evaluation Report John Schmitt Licnese Number: MPRS 223760 5/2/2021 Phone Number: 715-760-0486 Signature: I I '� LJ[-j/" -1 / In -Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Page 1 SYSTEM PLOT PLAN Folczyk 3 Bedroom Septic System Project Addrea, 425 wem.y Lane BMt Symbol, . BM Elevation. 91 O0 BM Demripbon Bonom of Wing of to garage 8M2 Symbol L BM Elevation g5 73' 8M Deacnptkm Top of vent pipe on exwabng drawn geld Slope Gradient of Teated"a. (T%) Well Symbol la appbcable) Wee See Plat map for complete IOI Damgn Flow, 450GP0 ACach doing, i caWafnts for Commartl8l plane Pipe Matenals I ASTM Standard Tables 394 W-363843 5 4 SCH 40 FVC ppe 45TM-D2fie5 4' 3m4 PVC pipe ASTM-03034 Kramey Lan, T1- 3490' EZ Flow trench El =91 CO T2. 3'00' E2 �Imx trench EI =9' CO Scale: 1" = 60' 0 60 90 120 152 • BM1 Exomng Nkll Cnveway, ExraLng Oeck 3 Bedroom House 1 Garage 95' 95' BM1 Eclsting 1000 gallon Septic Tank \\ -- \�� \I \\ Proposed W320-MR / \ \ Sepbc Tank wlPolylok 525 Property Line 2 4" -AST-A-SEAL WLP 1000—M R TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1 /2' CAST- A-SFAL BOTTOM: 3" COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53 1/4- LENGTH: 8'-8' WIDTH: 7'-2" BELOW INLET: 42' LIQUID LEVEL: 36" WEIGHT: 6,790 LBS, INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.83 GAL AN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1.085 GALLONS LOADING DESIGN: 8'-0' UNSATURATED SOIL a h �J w INLET --I - -�- - - - OL,nF, PUMP PAD JD LTANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS TANK CAN BE USFD AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY APPROVAL DATE: _ PRODUCTS NEEDED BY: ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 425 Krattley Lane located at: NE /4, SE %4, Section 7 Town 29 N, Range i9 W Town of Hudson St. Croix 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 property. Most recent date of inspection or service s - / - A l Did flow back occur from absorption system'? Yes_ No x (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: 1000 Construction: Prefab Concrete x Steel Manufacturer (if known): Weiser Age of Tank (if known): 6/19/1984 Permit number (if known) 54910 John Schmitt Other (L' ensed Plumber Signature) (Print Name) MPRS (Title) (Date) 223760 (License Number) MP/MPRS Form to be completed by licensed plumber (Dept of Satety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 Page 4 TANKS W320—MR TANK SPECIFICATIONS a DIMENSIONS: a , WALL: 3" a BOTTOM. 3' COVER: 4' MANHOLE: 24"I.D. PRECAST CONCRETE RISER k _ i- L" _ HEIGHT 58" LENGTH: 4'-2" 4" CAST -A -SEAL -� -4" CASI-A-SEAL WIDTH' 4'-2" ' BELOW INLET: 48 1/2" LIQUID LEVEL: 43" rr--_-_ _ —,1 WEIGHT: 3,880 LBS. INLET AND OUTLET: 1 4" CAST -A -SEAL BOOT OR EQUAL GASKET v t I � I -- INLET AND OUTLET BAFFLE AND FILTER. WISCONSIN, SEE DETAIL #10 2q --- (OTHER STATES SEE CHART) W FILTER OR RAFFLE-' LIQUID CAPACITY: 8.00 GAL/IN W S TOP VIEW LOADING DESIGN: 8'-0" UNSATURATED SOIL TANK CAN BE USED AS: O� u SEPTIC / HOLDING / PUMP OR SIPHON w ,r COVER: MIX DESIGN y8 (NO FIBER) _ o TANK MIX DESIGN /80 (STRUCTURAL FIBER) W 9 1 a CUSTOMIZED TANKS: r 0 _ �0 -- FOR CUSTOM TANKS CONTACT WESER CONCRETE 4Ja f _�Ua 3 INLET f�4_ REVIEWED BY 0 n c� " REVIEW DAIL 3 a w SIDE NEW DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: SHEET NO APPROVAL DATE: j 1FACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS PRODUCTS NEEDED BY: OF / J paL� �x PE-52.5 Effluent Filter PL_-�_'5 1 ilter The PL-525 Filter is rated for 10,11110 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/1fill filtration slots. Like the Polylok PL-122, the Polvlok PI.-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporardv shut off the system so the effluent won't leave the tank - I vitures • Rated for 10,000 GPD (gallons per day) • 525 linear feet of 1/16" filtration • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed • Alarm accessibdnv. • Accepts PVC eNtension handle Ill -;2; 1netaihinun: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing 5. Replace and secure the septic tank rover Ill-;2= Va ni,nw,c The PL-525 Effluent Filters wilt operate efficiently for several years under normal conditions before requiring cleaning It is recommended that the filler be cleaned every time the tank Is pumped, or at least every three yearsif 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. 1. Locate the outlet of the septic tank 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5 Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properh• aligned and completely inserted 7 Replace and secure septic tank cover l'lb' Filtration `•lutti Alarm s,aAd, 10,000 GPD (OPNnnal) Accepts4" & 1. c� SC}ID 3o pipe t_ is Ilvpis 1" r%C .tension Handle Rated for m00i crD 525 Linear Ft W I/lb, rdtrahnn Slots Certified NSFlANS1 Standard 46 Gas DcOirtor lutomatic Shut-(ntf Ball , t aid Ja,- ill Jl. l ; lb . , i'.",, ,. Id .I114,, Polylok, Zabel & Best filters accept F."!N III the 5martNterU switch and alarm. into existing tanks Polylok, Inc. 3 Fairfield Blvd. Wallingford, C"I' 06492 Toll Free: 877 765.9569 Fax 203,284.8514 w��.polylok.com Page 6 Home About Site Map Order Info Videos 8 Literature Contact Drip Systems Treatment Controls Products Download& Desion Guidance e a-' The Bull Run Valve'" is designed to split flows to septic fields or systems. In addition to the advantages of longer life and easier installation it is the most public health safe alternating device available for wastewater disposal applications. The use has absolutely no contact with wastewater due to the valve's leak -proof and external operating characteristics. The change over from one drainage field to another can be accomplished in less than a minute by simply turning the valve without digging or contact with wastewater. eld Field Field o 2 No 1 No 2 Valve P Positioned y cn No 2 dunng O Septic EvenYears Tank ITEM DESCRIPTION BRV4 BULL RUN VALVE 4" BRVBULK BULL RUN VALVE & KEY ONLY BRVCIRiSER BULL RUN VALVE RISER W,/ CAST COVER BRVKEY28 BULL RUN VALVE KEY 28' BRVKEY36 BULL RUN VALVE KEY 36' BRVKEY48 BULL RUN VALVE KEY 48' Pt RI SE CAP ADAPTER RISER TUBE 4" OUT PORT HATER -TIGHT ACCESS CAP VALVE DIRECTI ON I- ANDLE 4" OUT PORT 4' IN PORT The Bull Run Valve is available in 4" sch 40 pvc and is suitable wherever septic disposal systems are used - in commercial, industrial, and residential applications. OPERATING THE VALVE The direction control handle should be rotated periodically to direct effluent to one or the other of two septic fields. After removing the screw cap at the top of the riser tube, the valve handle can be turned with the valve key furnished. BULL RUN VALVE Complete Valve Kit Contains 1. Bull Run Valve body 2. 28" Valve Key 3. Riser Cap Adapter 4. Watertight Access Cap BRVCIRISER - 4" ADJUSTABLE TO 28" IIIGI I Page 7 p.iim I! iill�lll� IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down -sizing credit) Geotezlile I49q mn 17 Cover 0 0.32W.F511005 MR TYPICAL TRENCH CROSS SECTION (No Scale) Septic Tank(s) Manufacturer: Weiser Concrete Septic Tank(s) Volume(s). 1000 gal 320 gal gal gal Effluent Filter Manulacturer: Polvlok Effluent Filter Model # 525 System Elevation91.0 tt. ' s' (typical) Provide minimum 3 ft Separation between trenches TYPICAL TRENCH (Show location of Inlet / outlet pipe connection on plan view ) PLAN VIEW OBSERVATION PIPE DETAIL (No Scab) Snnw-type nr Slip Cap (loose) 4'0 wC i�pe — Toa of papa to termnate at or above linisneo gage (a) W-1/''h6-Sots 19 A, apart Anrl,onng Dace, 4• 0 Cbservebon pipe shall be naralpxl (No Scale) Perforated Lateral att,ncbonbeheea�unts 10 It observation Pipe (typical) (typical) — — — — — — — — — ----- 7�1 --------- I= B = 90 ft (typical) INSTALL PER TRENCH: Jo9 10-ft bundles @ 50 fe EISA/umt = 450 ft' r. 01 + 0 5-ft bundles @ 25 ff' EISA/unit = 0 ft, = Proposed EISA per trench = 450 ft= F M1Gr,e(1 Gri1(1P (rnulchee & serJe+ll — 1 wsod Cover (mn 1 trot) n00abon SA., IN A=3.O ft G) J (typical) m � W EZ1203H Bundle (typical) - n (mftl by Infiltrator Systems, Inc) Install pursuant to manufacturer's instructions Required Infiltration Area = 900 x 2 trenches = Proposed Total EISA = 900 RESET ft' Distribution Method: ✓ ft' branched manifold El Installation Instructions for EZflow Systems in Wisconsin Wisconsin Department of Commerce. Safety and Buildings Division, has reviewed the specifications and/or plans for this product and determined it to be in compliance with chapters Comm 82 through B4, Wisconsin Admin. Code, and Chapters 145 and 160, Wisconsin Statutes. All sites must meet the Site & Soil Conditions & Locations & Isolation distances as noted in local regulations. The approved products are 1203H (3-12' bundles with pipe in center bundle in 5' or 10' lengths) and 1203HP (3-12' bundles with pipe in each bundle in 5' or 10' lengths, A single pipe 'ounale contains a four inch perforated pipe sur- rounded by FPS aggregate and is held together with poy- ehtylene netting. A single aggregate bundle contains aggregate only and is held together with polyethylene netting. Materials and Equipment Needed • EZflow Bundles • EZflow Geotextiie Fabric • EZflow Internal Pipe Couplers • Pipe for Header and Inlet • Backhoe/Excavator Installation Instructions The instructions for installation of EZflow products are given below. This product must be installed in accordance with state rules defined in chapters Comm 82 through 84, Wisconsin Ad- ministrative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design manual. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake or mark with paint the locaton of trenches and lines. Be careful to set correct tang, invert pipe, header lire or d's- tntuhon boy and trench bottom elevations before instal- lation of pipe bundles. 2. Remove plastic EZflow shipping bags poor to placing bundles in the trench(es). Remove any plastic bags in the trench before system is covered. 3. This product must have geotextlle fabnr that meets re- quirements of s. CarTlrn 84,30 (6) (9), Ws. Adm Code, installed directly on top of the product and extending down along the sides of the product to a point at least six inches from the bottom of procuct. 4. When installed in a trench, the trench should be dug to a width of 36 inches. This not orly saves labor in excava- tion, but also provides better load -bearing capacity after backfdhng is complete, a*EZfowTM by INFILTRATOR 5 The Absorption area (SF) necessary for a given site shall be sized based on maximum daily sewage flow (GPD) and the Permeability for the site. If certain criteria is met, the EISA sizing can be used in Wsconsin, resulting in a 40% smaller drainfield. 6. Place EZflow bund;e(s) in the EZflow configuration ap- proved by system design permit specified for the particu- lar site. The top or center -most bundles containing pipe are joined end to end with an internal pipe coupler. Any additional aggregate only bundles that may be required, should be butted against the other aggregate -only bun- dles and do not require any type of connection, 7. The top of each GEG cylinder contains a filter fabric ere - manufactured In between the netting and aggregate. The fabric is inserted to prevent soil intrusion. The installer shal make sure the the GEO is positioned upward and is in contact with the fabric contained in the adjacent cylin- der before backfilling. 8. The EZflow Drainfield Systems should be installed in a leve 'rench in all dir=_ctio-is (both across and along the trench bottom) and should follow the contour of the ground surface elevation (uniform depth), with all continuous adjoining 10-foot cylindrical oundles placed end to end, with central bundle distribution pipe interconnected, without any dams, stepdowns or other water stops. 9. The trench top shall be graded such that water will not pond. Backfill should be seeded or sodded immediately after completion to reduce erosion. 10, EZflow FPS bundles are flexible and can fit in curved trenches as may be necessary to avoid trees, boulders, or other obstacles. 11. FPS aggregate is lighter than water, therefore, it might be expected that natural buoyancy forces would tend to cause EZflow assemblies to float out of ground when panding occurs. Field experience has shown, however, that this is not a problem when systems have a minimum of 6" of soil cover as recommended by manufacturer. 1203H-GEO ,- '-rt [ r Material Page 9 In -ground Gravity Management Plan IMPORTANT: PAGE 4 OF 4 The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc, Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BODS <_ 220 mgL"; TSS 5 150 mgL'; FOG 5 30 mgL' Inspection Checklist INSPECT EVERY 3 YEARS o type of use age of system nuisance factors (i.e. odors, user complaints, etc) o mechanical malfunction (i.e, pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) c extent of bonding in distribution cell prior to dosing dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) * electrical components - if applicable (i_e., wiring, connections, switches, controls, timers, alarms, etc,) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tar l shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids In the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. c Effluent filterlsl shall be Inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Schmitt & Sons Excavating, Inc. Phone, 715-760-0486 Local government unit St. Croix County Community Developement Phone: 715-386-4680 Local government unit address: 1101 Carmichael Road, Hudson ZIP: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383,51 (1), Wisc. Admin. Code Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc, Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 364. Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33. Wisc. Admin. Code. Page 10 S"1: CROJ-' QUNTY SANITARY SYSTEM FileOffice Use Only OWNERSHIP/ADDRESS FORM C> ted 212027 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer Bradley & Gretchen F Mailing Address 425 Krattley Lane City/state/zip Hudson, WI 54016 Phone Number (reaured)602-412-8439 Email Address (required)9foiCZyk@hotmai1.com Parcel Identification Number 020-1143-40-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location NE X, SE 1A , Sec. 7 T 29 N R19 W, Town of Hudson Subdivision Plat. Eagle Ridge , Lot # 22 Certified Survey Map # Warranty Deed # 987935 Number of bedrooms 4 New Property Address (Staff Initials) (before 2006)Volume Spec house O yes ■ no OFFICE USE ONLY Page # Page # Lot lines identifiable ■ yes 0 no (Verification of new address required from Community Development Department for new constwctjon) (Date) This form must be submitted with all Private Onsite Water Treatment System (POINTS) applications. New System: Include with this form 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 Community Development Department- Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax c0d^^_ccvi gq: 1101 Carmichael Road, Hudson, WI 54016 - r,n. u_ Page 11 1 11 I t.l. It If, tl-d I or b Idley & Greicntl' f-ol,-zyk -V!, k r ittley t 'inc I iod 'ull M , 401G Pit 0 - �0 I WO of "2 — t-ag1t, Rudy_ o- Wl/d SE'/4 Si I 'M P—AN 1 0� HUI'4501, 'J 4- W', 1t 11 1, 3onnm of th, 'd,,g on tl). 'J'vAq, RM 2 il5 -3 Top of V,nt pp, oil Ill, Dlamtehf W1 it)' jil"k - LOT 2-2 Oil 0 r"It !AN ',I cfIC IANK r IS ( IN( \11-VAINF ELL I RIA 2 i'l OPY /* ;01 1, St Croix County, W1 Legend II St Croix County, WI i egend Fu rm- S1' C- 104 AS BUILT SANITARY SYSTEM REPORT OWNER ��- V11, �C Y 'COWNSHIP �+'"��.. ti SEC, 7_ T Z% N-R�Wj h ADDRESS 'r,.�'(i k �ccd ST. CROIR COUNTY, WISCONSIN Z f � ' 2 c y u�5r L: �yOIG 1 SUBDIVISION Ta J K LOT Z �_ LOT SIZE.; % 7 PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Lot Lorna r �T 1-�T4d? �Fnsr 4{� k. 31 i l b�/ 133 - - 3 0 T N INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used -'- ;„/1 ,� T�1y', 3.... ."T Elevatiqn of vertical reference point: Proposed slope at site: S_- %,`SF — SEPTIC TANK: Manufacturer; -,a, Liquid Capacity: / DO Number of rings used: (' Tank manhole cover elevation: 'N Z S 'funk Inlet aevatiun: �j 3, j�`_ Tank Uutlet 1!11v..t luu: Number of f•tet from nearest Road: Front,®Side 0 Rear,0 feet From nearest property line Front.0 Sidc o Rear,O feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER //'' Manufacturer: 1/ 14 Pump Model: Elevation of inlet: �r Liquid Capacity: Pump/Siphon Manufacturer: Pump Size Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Near, O Ft._ Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORBTION SYSTEM Bed: ftj lUai.t ', ., dl Trench: Width: q Length: 3 " Number of Lines: _3 Area Built:( L/& Fill depth to top of pipe: 9 Number of feet from nearest property line: Front, O Side, ® Rear, O Pt O Number of feet from well: Z —Z Number of feet from building: y 7 (Include distances on plot plan). SEEPAGE PIT .. Size: Number of pit.: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK ' Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt._ Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: 7 Inspector: Dated: t Plumber on job: "L License Number. C 3/84:mj DEPA ENT LABOR & HUMAN INDUSTRY, INSPECTION REPORT FOR LABOR &HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS P.O. BOX 7969 MADtSON, WI 5_`07 r IUCONVENTIONAL ❑ALTERNATIVE ❑ Holding Tank ❑ In -Ground Pressure ❑ Mound SAFETY & BUILDINGS DIVISION BUREAU OF PLUMBING s. a:. PM.. LD Numlw, aif=gnMl A NAME OF PERMIT HOLDER ADDRESS OF PERMIT HOLDER IN$PECTIONO iE Sam Mitt" Tfuoutbnooh Rd, Box 282, Nucleon, W1 BENCH MARK 111. n.d'mn FI...... pomp DESCRIBE I F D6FEnENT FROM PI AN NE SE, See.7,T29N-R19W, Lot#22,Eagle Ridge, Town o6 Nudeon REF PT FLEV STEEP PT FLEV Namr of Plumne. %.7` Douglas S.tAohbeen MP'MPRSW Nn 5432 Cl—",, St. C2odx .... Perm.ryuE 54910 SEPTIC TANK/HOLDING TANK: MANJf ACiUH ER LIU..IO CAPACITY TANK INLET FLEV TANK DUT:Fr ELFV WARNINGLABEL LOCI,INGCOVER PROVIDED PROVIDED BEDDING VENT UTA VEN'MATT 1 .:I ,y WA It ALARM / r NUMBER OF mu AD r_.YES ""NG PPryfiE ER II WELL _YES :—NO 9VILDIY/i FRFSH n VES i �NO ., r-r 1— FEET FROM n it ,? l 1 r XLJJ /w �VENTTO ' / ° R'NLET L_,YES .ENO NEAREST a-J MANV F4CTURER •, ^BENDING /� f IOJ:LI I.AFA,IIt F�VV M(aUEL PUMP.SIP 110N MANLFACfL NER 1— WARNING LABEL TOCKING COVER YES ❑NO PROVIDED PROVIDE. ._I GALLONS ❑YES ❑NO DYES ❑NO PER CYCLE PVMp ANO CON] HoTS OPERATIONAL IDIFFEq ENCE BETWEEN NUMBEROF Rrmf Hrr wE�T. aunDlVn vENr TO FRESH PUMP ON AND OFF) ❑YES LINO FEET FROM LP'° �: �7 n �r 'R 'N LET SOIL ABSORPTION SVSTEM.Check"IN $oli moisture at the depth of plowing NEAREST IENI.rH iA•ef rz� uATIVIA1ANDsv,HK1NI- or excavation lit loll can be rolled Into a w.e, construction shall cease until FORCE I the sod is dry enough to continue) MAIN CONVENTIONAL SYSTEM: BED/TR£NCH WIOTHI l` LENC-T 1' NC OF 1)S1H 11PF SPALINb <OV EH rswf Din - - T� LIOVIO DIMENSIONS T TRE%CWS ^dry,{pIAL '''"� PIT DEPrH GRAVELDCVTH eELow PIPES I LI FrLI DEPrN AR;ccvE 1 T IPF E .1 r Jls PIPE .isrR VIVE NATEmAL LEL END ND.srR NUMBEfl OF PROPERTY L'"i WELL euILDINc VENrTDFRESH AIRrv1,E,T FEET FROM nr. _ NEAREST ^ i v aT arum: [ 1 Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA.� meets the criteria for on dwm sand. 710NS MEASURED. ❑YES LINO I YES V LCHED EYE! BED/TRENCH I'AL sPACT NCB aH AV E I DEPTH Bf LLIY PILL - - - FILL DEPTH A3ovE covfR DIMENSIONS REVCHCS MANIFOLD P.VP ELEV IytGVIG(1LD DIS-R PIPE MANIFOLD MATERIAL NO fISTH DISTH PIPE � 1111I,UHIIUNPIVf VATELIAL&MARKING ELEVATION AND.... A ELEv PIPES OmA DISTRIBUTION 11n INFORMATION HOLF SIZE HOLE SPACING ICILVI. MATFHIAI 1 11— 1., T 11. u..e,,., r.. ... ............_ PLANS Sketch System on Retain in county file for audit. Reverse Side. DILHR SBD 6710(R. 01182) E$IG.NrTURE / TITLE I / 1 .", r Department of EE - Safe and SOIL EVALUATION REPORT _) Qni�''PrSi q #2101 ►E ry irr�llydance with Comm 85, Wis Adm. Code age 1 of 4 Professional Service&r IN *A% . Qlh— 1 c, a re.r,.,,, in, Attach complete site Ian on a r not IeSs than fi'Aa 11Inphasln ize Plan mus P P P include, but not limited to. vertica and horkonfal referent'-pekrt (WAL.direction and percent slope, scale or dimensb , rigrtloa " 6cation and dlqance fo R iltry rem Please print all information. 7 Y /, Personal information you provide may be used for secondary purposes (Priv 4 Law, s. t5 04 1) rn)). County St. Croix - ---- Parcel I D 020-1123-40-000 a By -Da �Z( Property Owner Folczyk, Bradley & Gretchen Property Location Govt. Lot NEt/4, SE1/4, S7, T29N, R19W Property Owner's Mailing Address 425 Krattley Lane Lot # 22 Block # Subd. Name or CSM# Eagle Ridge City State Zip Code Phone Number Hudson WI 1 54016 1 _ city Village - Town Nearest Road Hudson i Krattley Lane I New Construction Use: _ _'�'Residential / Number of bedrooms 3 Cade derived design Flow rate 450 GPD I, Replacement _ I Public or commercial - Describe. Parent material Outwash (Antigo Series) _ .._ Flood plain elevation, if applicable _____NA ft General comments Replacement area is suitable for a conventional system with a 0.5 gpd/sgft rate. Possible system elevation is 91.0', Slope of area is and recommendations 1%, --�' 17 Boring # Boring Pit Ground surface elev. 94.42 ft. Depth to limiting factor _ 96+ in. Depth Dominant Color Munsell Redox Description Texture SWcture Cu. Sz. Cont. Color ! Gr. Sz Sh Consisten Boundary Rootsin, 1 0-10 10yr3/3 none sit 2mgr mvfr as 2m,2f2 JA4pplicationHorizon 10-28 10yr5/3 none sit 2fsbk mfr gw 2f,2vf3 28-53 7.5yr4/6 none grsl 2msbk mfr gw lvf 4 53-82 10yr5/6 none grs 05(1 ml cs ------ 0.7 1.6 5 82-96 10yr5/6 i none fs 0s9 ml - j ----- 0.5 1.0 ❑ Boring # Boring Pit Ground surface elev. 93.52 ft Depth to limiting factor _ _96+ in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz Cont Color Texture Structure Gr. Sz. Sh I•Elf#1 Consis(enoe Boundary Roots GPD/ft' •EM#2 1 0-4 10yr3/3 none sil slid 2mgr mvfr as 2m,2f 2 4-25 10yr4/4 none 2msbk i mfr gw 1vf 0.4 0.6 3 25-50 10yr5/4 none ffs lcsbk mvfr a — 0.5 1.0 4 50-96 10yr5/6 none 9rls Osg ml ---- ------ 0.7 1.6 ' Effluent #1 = BODS> 30 < 220 mgfl- and T55 >30 < 150 mg/L 'Effluent #2 = 8QD5 < 3O mg/L and 155 <, mg/L CST Name (Please Print) Signature CST Number Thomas J. Schmitt— 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 159572nd St New Richmond, WI 54017 4/16/2021 715-760-1978 S13D8330(R07MI Property Owner Fo1Cz)k Bradley & Gretchen Parcel ID # 020-1123-40-000 Page 2 of 4 Boring 3 Boring # Pit Ground surface elev. 94,82 ft. Depth to limiting factor 96+ in. Soil —Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fR 'E#xi •Efr#2 1 0-4 10yr3/3 none sil 2mgr mvfr ml as 2vf 0.6 0.8 2 4-12 7.5yr5/6 none grcos 0sg a M 0.7 1.6 3 12-47 10yr6/4 none grs Osg ml Cs -- 0.7 1.6 4 47-96 10yr6/4 none Ifs Osg ml ---- -- 0.5 1.0 Boring ❑ Boring # Pit Ground surface elev _. ft Depth to limiting factor in. - Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Du. SZ Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDjW 'ER#t •EtF#2 l I l l I Boring Boring # �. Pit Ground surface elev. ft Depth to limiting factor in. Sod Application Rate Horizon Depth in, Dominant Color Munsell Redox Description Qu Sz. Cont Color Texture Structure Gr Sz Sh. Consistence' Boundary Roots GPD/ft' 'Etf#t •E1f#2 i I • EfFluent #t = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = B005 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SaD-8330 )a 07M) ShcirW Solt TeSbrq, LK. St Croix County, WI Conducted For Bradley & Gretchen Folczyk 425 Krattley Lane Hudson. W154016 PlU 020-1123-40-000 Lot 22 Eagle Ridge li SE1/4 S7 T29N R19W Town of Hudson Conducted By: Thomas J. Schmitt CST 227429 4-16-2021 (483') 41W 100 0' Bottom of the siding on the garage BM 2 95.73' Top of vent pipe on the exisiting Drainfield 95.39' Top of septic tank manhole cover 93.30' Septic outlet pipe LOT 22 GARAGE 95' 95'• •\ EXIS\ING 1000 GAL •\, XjtE `R SEPTIC TANK '\ \• E STIN \ 18 X 36' 1 �DVAIN t ; t ; BM 2 t I t 1 r % 5LOPE � 81 / / / s9' 97 j 1" = 60'� 258'95' WELL EC HOUSE •1 \ B3 \ t 99 � ; I B2 98' i 7% SLOPE 47 \ 123' \ 97' \95 (88') 274' 1"=40' Legend Lakes ertl Rivers Rivers arN Snearm Intarstams US Hgbways Slate Highways County Highways Law[ Roads Rusts; Roads Ramps Road RgM of Way 9oC Raitroaes N 0 20 40 601t DISCLAIMER Ibis map is not gwranmsd b be accuratfi woad, currant, or wmptete and wndusons drawn are tM responsibility of Ina user. i A"Iewjwasr- 41#7- izw4o 5re WYCOUNTY1 633362 STATE SANITARY PERMIT PREVIO L 112121�1:7 PLU TON SEC AND/OR LOT BLOCK SUBDIVISION NO. SIM0 CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations In force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. AM, and A ED ISSUING OFFICER — DATE 2t PERMIT EXPIRES "4 3 UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)