HomeMy WebLinkAbout020-1491-10-000 (4)M
- - -3
q3
Wrl
County /
fety and Buildings Division
%O 14
1 NOV ]4 2919
1400 E Washington Ave
Sanitary Permit Number(to be filled mby Co.)
P.O. Box7162
53707-7162
G)6 —IL-RI _10-_000
Denadison,Wl
De:, ,lrjnlTlmt
Sanitary Permit Application
Sate TrnNmmber
04
NN
m iss in accordance with SPS 383 21(2), Wis. AdCode, submion of tlus form to the appropriate governmental unit
Project Address (if different than mailing address)
ism tarod prior to obtaining a sanitary Permit. Note: Application forms for state -awned POWTS are submitted to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
ourposes in accordance with the Pnvac law, s 15.04 1 m Stats.
9 �� /
1. Application Information- Please Print All Information
Property Owner's Name
Parcel # r
fQ�
O/YI 00d
GAO OOGS
Property Owner'sMailing Addresst
Properly Location
4_1 i
Ll1
J %} C fl /J / It) AJ
Govt. Lot
/ y,, Section %
City, State
Zip Cade
Phone Number
(circle one
T oc �% N, R � / E o65
H.'Sype of Building (check all that apply)
Lot #
Subdivision Name
-or 2 Family Dwelling -Number of Bedrooms_
/O
.�
/
///o/ L LJSONt
Block
❑ PublidCommercial- Describe Use
Elcityof
/
❑ Owned Use
❑ Village of
C SM Number
Skate -Describe
Town of S r7 ti�
7-pad- w /d,$� /6.S
`_
yC/i�
III. T it: (Check only ork box on line A. Complete line B if applicable)
AN. System
❑ Replacement System
❑ Treatment/Holding Talc Replacement Only
❑ Other Modification to Existing System (explam)
B. 1, ❑ Permit Renewal
❑ Permit Revision
❑ Change of Plumber
❑ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Owner
e of P Component/Device: Check all that a I c
XNoo-Pressunzed In -Ground Pressurized In -Ground ❑ At -Grade ❑ Mound> 24 in. of suitable soil ❑ Mound < 24 in. of Mutable soil
o cr Dispersal Component (explain) Pretreatment Device (explain)
V. Dis ersal/Preae ent Area Information:
Desi n Flow (gpd) Design Soil Application Rate( s0
Dispersal Area Requred (so
Dispersal Area Proposed (s
System Elevation
V1. Tank Info
Capacity in
Total
# of
Manufacturer
Gallons
Gallons
Units
// /1 / /'
�
'.a•
w B
�
v
n �
o
2
.o:
�
Ncw Tanks
Ezanns Tanks
�
Septic or [b13 ank
/ So
_—.
-2.Jb
//Co 5�
Dosm� Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibilityfor installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Plumber's Signature
MP/MPRS Number
Business Phone Number
WADE RUFSHOLM
(��(/J �-
C-r-�
227691
715-349-7286
Plumber's Address (Street, City, State, Zip Code)
PO BOX 514, SIREN, WI 54872
VITI. County/Department Use Only
❑ Approved
❑Disapproved
Permit Fee
Date Issued
Issuing Agent Signature
❑ Owner Given Reason for Denial
1 IN. Cor Nf( ffyaI/Reasons for Disapproval
1 Septic tank, effluent filter and
dispersal cell must be selvlced 1 maintained
as per management plan provided by plumber
2 All setback requirements must be maintained
Atb< to imp Poi tbe.gstem and submit to the County only on paper not lso Nan 8 iR x 11 indhc, m siu
SBD-6398 (R0313)
CONVENTIONAL IN -GROUND POWTS DESIGN
Residential Application
Index and Title Page
Owner's '.dame: J c f 7 // l o r dI
owner's Address:
dqd Scii Jr y?%6
Site Address: I G' G l fi NnL_ /17'�l
Legal Description: S �% 3 % W % /V /( / 7 C,-"
Town: it ( c#-S 0 "I'll
County: S> , C... die% i e
Subdivision ctm::L C i�/}1V' e / l J (-_f #0 JSe)Ai of No. 11 � Block No.
d Page index
Plumber Name:
Plumber Address:
Telephone:
Signature:
Date:
Page 1 Index and Title
Page 2 Plot Plan (may include septic tank and filter specs)
Page 3 Distribution Cell(s) Cross Section
Page 4 Maintenance, Management and Contingency Plans
WADE RUFSH®LM
P.O. Box 514, Siren, WI 54872
715-349-7286
Credential No. 227691
Finis,
Orig
Top
System
Grow -section of a single cell EZ Flow In -Ground Dispersal Geli
Slope
I I,
%�P eotextlfe f�bricto meet Comm 84.30(6)(9)
RA in im um of 12" of cover overtop of cell
l : Two ObservationNent pipes provided per cell
Ac�r4a�te 3nnd7ri,
FBi;'r�rucr Btnxllrs
EZi 2o3 H Top View
ICierml couplerca trims
The Tice Pipr Bundl-
;fie
e Fa-mc
Page ? of
PRi'VAT , VI) S= WASTEWATER TREATMENT SYSTEM MANAGEMENT >PLAi�I
SEPTIC TL CK AND GRAdIlTV DN-GROUND SOIL ABSORPTION COMPONENT
Pursuant to SPS 383.54 WI §, each Private Onsite Wastewater Treatment System (POWTS) shall include
information and procedures for maintaining the system within the parameters of SPS 383 and 384, and the
conditions of approval by the department, agent, or governmental unit. The approved plans and permits
for the system are of ffle at Mlle county zoning office.
This management plan complies with SPS 383,54 WI § and the In -Ground Soil Absorption Component
Manual for Private Onsite Wastewater Treatment System SBD-10705-P (N. 01/01: R. 10112).
Table 1. System Desian Specifications
Sanitary Permit Number
Number of Bedrooms
Design Flow —Peak d
�C c
Estimated Flow — Average d)
0
Septic Tank Capacity al
5 �3
Soil Absor "on Com onent Size (ft
C� G -z -J
T 'e of Wastewater
nip e-- �i C
`1'sibie i° Soil Absorption Component — Limits of Reliable Operation
Septic Tank Component
Soil Absorption Com onem
Design Flow —Peak d)
Maximum Influent Particle Size (in)
N/A
1/8
Maximum BODS m L
N/A
220
Maximum'ISS (m L)
N/A
150
Maximum , OGl
N/A
30
;Cable 3-
Tank
Uutlet P Ilter I snould inspect once a year ana clean once every year
Soil Absorption Component Inspect once every 3 Years
SEP'TIC TANK
!�n individual certified to service septic tanks under s. 281.48, Stats, shall maintain the septic tank. The
contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing
Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage
Trenches, Privies or`Poeta"y1eiRestrooms).
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 operation. The filter cartridge
should not be removed unless provisions are made to retain solids in the tank that may slough off the filter
when removed from its enclosure. If the filter is equipped with an alarm, the filter 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 is contents removed when the volume of scum and sludge in
the tank exceeds 1 /4 4�el liquid volume of the tank. If the contents of the tank are not removed at the time
of an 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.
13RECE1V'ED c5T-3o- 90q
Lir,con,m lRpsnmcnt nl4 umnR•rce SOIL I-VALUA I ION RFPOR'1' hago _ 1 nl 4 _
l nannnt of Sattl1, and Building, G. fin 4 v"W'Inu „Ith (umn: N]I At, 1dnl loch'
lu) 4 tint.
V14.h 0"n l '11,;1npofk)kjb l , II m.hn :n ,v. I'hmml{r SL C�rotx
buludr: hW nor linulc•fali1c `Q Ly�,�Li(>)8>e,1dN3:,. {rrnnU14M11 .wr(yrld � � r I'vtx' I l p
?; nenl ,lope ,c. , r . vrt!: muH. end 1411 :vlcrrn:..,l Ir I� • rr �V q _ Ix
■Y If r, cJ hS Dmc ---
Plrasr print all ,dm, ola 4PR•ZXv� �e
Verovml in:irtmsenn.ru pnluJe nte5 he ::,rd tier v�tonJ:ut '-„.r F
RDlllne Ridges I.L('. I.I s I i l 29 N R 19 w
1'mpem f) ,n,, , Mahn¢ Addre11 at Y F41,k 1. P tiubd Name In l WIN
965 Alexander Rd.
t it, Slnh lint .Jx pl:,mt ❑ (}Ix ❑ �llLlkc 0 I own _ _— _ N„uc,l Road
udson I i4 Ai'016 6i1-24R-O I 191) Iludson AlextmderRd.
2 Kcw Construction I Ice 0 Rcsideflllal : \umber of l-lCdnwnls Codc dcrlocd design flow rate GPD
❑ Replacement ❑ Public or Commercial 1lcstrlbc
Perenl Material I.or., oxer f hdwasil I food Plmn Clcsau(n If applicable V.`A_ _ It.
General comments and recommendations
rinnnP 't 0 Pit
( 01allId
Sit IIdtl Ilex-MIMI 99.6 It
Hor,zon Depth Dominant Color Re'dox Description Texture
:n Monsell Qu Sz Cori Color
1 0 15 10YR313 LS
2 15 30 10YR4i3 - SC L.
3 30-90+ 10YR4l4 S
❑ Rorinc
7
(iurin}i, BPir Ground fur late I Icxation 99.
u I II.
Horizon Depth Dominant Color Redox Descnpion Texture
in Munsell Qu Sz Cent Color
1 0-11 10YR3l2 SIL
2 11-33 75YR414 - SICL
3 33-43 5YR414 - VGRS
4 43-86+ 10YR414 - ` S
1`
q• - 1t 4
I fthicia : I - III 111 n, _ -,u n:-I and I15� •V I,.I ru:'J
c SI N:nnr I1•Iraw Print ��/ Srnnnlury
Mark 1�crson
lddre+,
P.O. Box I ii Hammond, WI ?401 S
I)Cplll to I unitin lata)r --90 In-
Sol Appl"t,on Rate
Slrunure
Consistence
Boundary
Roots
GPDIfl`
Gr Sz Sh
"EfrM1 'EBN2
2-f-bk
mfr
gs
3 f-co
0.7 1 16
2 m bk
mtr
gs
2 1-co
04 06
0-Sg
ml
it
07 1 6
Depth in
I iminoe factor -86
Soil Application Rate
Structure
Consistence Boundary
Roots
GPD/R'
Gr Sz Sh
'E"I •Ef#2
2-m-gr
mfr gs
2f
06 0.8
2-m-bk
mfr gs
1 f
04 06
0-sg
ml gs
-
07 1 6
0-sg
ml -
-
0 7 1 6
'r 011"m e!- IN11)• IlI andISS- ❑)met
l ',I Nall
40672
I- I IItIILIII I I mtlt;.ItJ
\uutnt +I.20I7
71i-796-i664
Rojjjll� ili&cL LLU.
PnlpC rty Uwner_
I'.uul
ElBoring
i
Bonne
OPit Ground SulhtCC1 claut❑
IIh. It
Horizon i Depth
Dommant Cc or Redox Descrpnor
Tr'xC.IrV
nl
Munsell Ou Sz CrI Coax
1 0 10
10YR312
SL
2 10-20
7 5YR414 -
SL
3 20-96+
10YR4l4
S
❑ Bunng
❑ l3otim_- OPrt (bound Sllrla,C f CVItl IJtI ___ II
Horizon Depth Dominant Color Re'lox Descrl Ion Tex•ure
Ir Munsell Ou Sz Cont Color
❑Bonin
ftrxin Olht (art ttl l ld Surla(-C I In anon n
Honzon Depth Dominant Color Redo x Desr. I[Ill nn Texttre
In Munsell Ou Sz Coral Color
'I III mN �I It, )DI 'iI, ,211 a\:':I .III,I I�� In I, I. :m1
Z:
; it
of f
_
1Ilaec
OcInth to
I Imiliml Ltilur :-90
in,
Soil Apphaahon Rate
Stnu'ttre
Camislence HnLndary
Hoots
GI
Gr Sz Sh
'FH#1 'ER#2
2-f-bk
mfr gs
3 fco
06 1 0
2-m-bk
mfr gs
2 f-m
06 1 0
0-sg
ml
11
07 1.6
DhI to I inulint, L¢tor in
Sod Application Hate
Structure Corsislorcc Boundary Roots GRU:ft'
Gr Sz St 'Eff#1 'Eff#2
Depth to Llnulun_ IdOot _ _ _ _ m
Soil Applicatton Rate
Stricture Consistence Boundary Roots GPD/ft'
Gr Sz Sh 'ER#1 'Eff#2
'I Illuvnl n+ III N, ll; nnil and Iti1. +It n..I
lhr D7p.trlmcnlul l urllmiRc 1, un:yual rip:wrl111II". l: pgnld.. ;l.d:mpw'..� 11''Ill tlC,ll ll.`I\lure: lo.IL-'11 LL..Or
%1rd IIIar11.11 in .111 :Ihcnl li IiI'-nat l .f11' ii:IIA Ill .IT 611.N-'M'-,I; I .n I I \ (,I IN-?I.I-a-,
Page 3 of 4
Lot # 11
BM#1 - inp W 314'PVC Pipe
1a1 5'
B-1
7 gr1 �
i
i I ,
B3
1p23� \
�O-
c'-
on Zan 40n soe
(N)
B-1 198,
99 1 13M#2 - Top of 3%4"PVC Pipe
98 3 100 0'
• = Ground Surface Elevation
BPAN & Oesrr.p6en�
Eevatio� =Bench Mark
Owner Rolling Ridges I. LC
965 Alexander Rd
Hudson, WI 54016
Phone 651 248 0390
B-i = ioo Boring Location & Elevation
Site Information Completed By Mark Iverson
114 14 S13, T29N R19W 617 Cty Rd J
Town of Hudson Roberts, WI W15
St Croix County 715-684-9125
CST# 46672
SEPTIC LOCATION
FOR: CRANE HILL OF HUDSON
f
DENOTES SOIL
r RORING LOCATED
ON9-1.3-17
T-Tnl
NORTH
100 700
CORNERSTONE
I ANf7 SURVEYING. INC
Wisconsin Department of Commerce
Safety and Buildings Division
GENERAL INFORMATION
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
(ATTACH TO PERMIT)
versonai imormauon you provice may De useu ror secondary purposes [Privacy Law, s.15 04 (1)(m)).
Permit Holder's Name: ❑ City ❑ Village Town of:
Girl Scout Camp of St. Croix Valley, Town of Hudson
CST BM Elev Insp BM Elev.: BM Description
&e , t) I m .31 = C ST- gwLZt�
ELEVATION DATA�fa q(4 i- ) r 3. L`i, t9, 13
I ANR INrUKMAIIUN
TYPE
MANUFACTURER
CAPACITY
Septic
3 51 5 '> a p tSp✓
/ , ,
Dosing
1256
Aeration
/
Holding
TANK SETBACK INFORMATION
TANKTO
P/L
WELL
BLDG.
Ventto
Au Intake
ROAD
Septic
yzoo
>207)`
SZ
`_
NA
Dosing
NA
Aeration
NA
Holding
PUMP / SIPHON INFORMATION
Manufacturer Demand
Model Number GPM
TDH I Lift Lriction Syestem TDH Ft
Forcemain I Length Dia. az n' I Dist To W0
County.
St. Croix
Sanitary Permit No.:
353118
ate Plan ID No: ,,tt��
2 o =TrouSa*" /A#
,Parcel Tax No :
020-1016-60-000
STATION
S
HI
FS
ELEV.
Benchmar j
�DO
(D�,D
/�. d'
Alt. BM
Bldg. Sewer
St/Ht Inlet
f
y}.zG
St/Ht Outlet
19
9-7, oZ_
Dt Inlet
I�.4B
`j3.2Zr
Dt Bottom
le •• �-`f
�' li 3-L /
Header/Man
Dist. Pipe
yf
8
95-.66
9G.y
Bot- System
See
Final Grade
%.0
1B4O
St cover
f �10
99.vo'
SOIL ABSORPTION SYSTEM rl(o r._&_ l,e, �n,A_ 4,—.,U
$EB TRENCH
Width f
Lengt
No Of Trenches
PIT
No Of Pits
Inside Dia
Liquid Depth
DIME
2
DIMENSIONS
SETBACK
SYSTEM TO
P/L
BLDG
WELL
LAKE/STREAM
LEACHING
Manufacturer: r
io
INFORMATION
CHAMBER
System CoglJ,
>2�
>Zoo
--
OR NIT
U
-Ncm Qrti
DISTRIBUTION SYSTEM �
Header/ arkifold
stnbution Pipe(s)
xHole Size
xHole Spacing
Vent To Air Intake
zn
Length t4 Dia
Length Dia Spacing
�-
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over
Depth Over
xx Depth Of
xx Seeded/Sodded
xx Mulched
Bed/Trench Center
Bed/Trench Edges
Topsoil
❑ Yes ❑ No
❑ Ye5 ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:0V/ /y/oo Inspection #2: —L--
Location: 965 Alexander Road, Hudson, WI (NEIA, NEV4, Section 113/ T29N-R19W) - 1329.19.73 - Ulf F
DT-
3j SfcQy a-t-
Plan revision required? Yes ❑ Nc
eothersideforaddi onalinfi; ion. bS 6+ Co
SBD- 716 0 R /9777) Date Inspector's Signature Cert No
Safety and Buildings Division
SC SANITARY PERM[ CATION 201 W. Washington Avenue
`epirsconsin In accord with Co B�OI O, i _ �Eo. P O Box 7302
4� . 0- Madison, WI 53707-7302
'X
• Attach complete plans (to the county copy only) foi`the'syst*, ,%paper not I�ss
County
than 8 12 x 11 inches in size. j r t,UF;1
State Samta ry Permit Number
• See reverse side for instructions for completing tEsis applicCt�ti on ,OQ�
r
�_
Personal information you provide may be used for secondary purdose5 C ` - (
3 (/
OWX -
[Privacy Law, s. 15.04(1)(m)]. - '' E+j .�Ntis-tCi
�-`f
❑check it revision ID Previous I Edon
State Plan LD. Number
I. APPLICATION INFORMATION - PLEASE PRINTA•LL IN ATION,
3I *d
Property Owner Name - _
_ .Property'Location
ei L ® % , C
i/a 1/4, S 13 T � , N, R E (or�%
Pro erty Owner's Marling Address --
at Number
Block Number
�i 0
City, State
Zip Code
Phone Number
Subdivision Name or CSM Number or- Z-
L97510
2)
L• -
II. TYPE ❑ BUILDING: (check one) State Owned
D it� / k `%
VII
Nearest Road
�---�
Public 1 or FamilyDwelling- No. of bedrooms
❑ age
Town of D
GE 4
III. BUILDING USE: (if budding type is public, check all that apply) Parcel Tax Number(s)
I -;. ui • t5
1 ❑ Apartment/Condo —Al
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on IineA. Check box online B, if applicable)
A) 1. New 2_ ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an
-____ System_ System ____ Tank -Only -- Existing System _ Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one) 3 4rj¢7'111& M ,AGQ6:X — PELF
Non -Pressurized Distribution Pressurized Distribution Experimental Other
11 Seepage Bed 21 ❑ Mound 30 El Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy
13 Seepage Pit .7 X r-KW. %S 43 Vault Privy
14 ❑ System-In-FillrS-rj),E`
r
VI. ABSORPTION SYSTEM INFORMATION:per/
1. Gallons Per Day 2 Absorp. Area 3. Absorp. Area 4. Loading Rate 5 Perc. Rate Systelr59ev. 7. Final Grade
equired (sq. ft.) P oposed (sq. ft.) {Gals/day/sq. ft.) Min./inch) / 9>. B /�' Elevation
So .S 2 .Q �iFeet rpN Feet
VII. TANK
Ca aclt
INFORMATION
in gallons
Total
Gallons
# of
Tanks
Manufacturer's Name
Prefab.
Concrete
Site
Con-
Steel
Fiber-
plastic
Exper.
App.
New
Tank
Existin
Tanks
structed
glass
Septic Tank or Holding Tank
❑
❑
❑
❑
Lift Pump Tank /trpherri! in, b2
VIIl. RESPONSIBILITY ATEMENT w/ ��L Z7W%ZS
lithe undersigned, assume responsibility for in_s&Iation of nsite sewage system shown on the attached plans.
Plumber's Name: (Print)
Plum r'S Signature Sta
•MP/MPRSW No.:
Business Phone Number:
r 4
ill 9,
Z 2 /� SO
Plumber's Address (Street, City, State, Zi Code):
Ol
IX.COUNTY/ UEPARTMENT USE ONLY
❑Disapproved
Sanitary Permit Fee (includes Groundwater
Burchargereel
Date Issued
Issuin gent Signature(No Stamps)
Approved
❑Owner Given Initial
y
m Z- Z-� ul%
V Z }
Adverse Determination
X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: j
slt�r�u'/ � � �trarzi,.�vnrG+r frr t�i%
SBD-6398 (R. 4/99) DISTRIBUTION. Original to County, One copy To: Safety a Buildings Division, Owner, Plumber
isconsin
Department of Commerce
August 04, 1999
CUST ID No.267341
WEGERER SOIL TESTING & DESIGN
421 N MAIN ST
PO BOX 74
RIVER FALLS WI 54022
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 08/04/2001
SITE:
Site ID: 178033
Safety and Buildings
2226 ROSE ST
LA CROSSE WI 54603-1905
Too #: (608) 264-8777
www.commerce.state.wl.us
Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
IIrn�i�li�WA119-TeireJ7
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
St. Croix County, Town of Hudson
NEIA, NEI/4, S13, T29N, R19W
Facility: St. Croix Valley Girl Scout Camp - Bathroom Facilities
FOR:
Description: Dosed Non -pressurized In -ground System
Object Type: POWT System Regulated Object ID No.: 483570
Identification Numbers
Transaction ID No. 239170
Site ID No. 178033
Please refer to both identification numbers,
above, in all correspondence with the agency.
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
• Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the
the Zabel filter is required. Access to the filters for cleaning must be provided per Comm 84 product approval
conditions.
• The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan
approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the
manufacturer's instructions and the plan approval, the plan approval and code requirements will take
precedence.
• This approval does not include plans for the general plumbing systems or sewer piping leading to the
septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to
determine if plan submittal and approval is required.
A copy of the approved plans, specifications and this letter shall be on -site during constructionand open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
WEGERER SOIL TESTING & DESIGN Page 2
8/4199
Inquuzes concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely,
4
yard M. Swim
POWTS Plan Reviewer - Integrated Services
(608)785-9348 , Mon - Fri, 7:15 AM - 4:00 PM
jswirn@conimerce.state.wi.us
DATE RECEIVED 07/27/1999
FEE REQUIRED $ 240.00
FEE RECEIVED $ 240.00
BALANCE DUE $ 0.00
WiSMART code: 7633'
DOSED CONVENTIONAL SOIL ABSORPTION SYSTEM Page \ of -1
FOR
evt�ol�,�s-
LOCATED IN THE NE1/4 OF THE NE 1/4 OF SECTION l_!> T29 N, R 19 W
TOWN OF u�s�r� ST • C\moo lK COUNTY, WISCONSIN
INDEX
PAGE
1
of
7
TITLE SHEET
PAGE
2
of
7
PROJECT DATA
PAGE
3
of
7
PLOT PLAN
PAGE
4
of
7
PLAN VIEW -CROSS SECTION
PAGE
5
of
7
LEACH CHAMBER DETAIL
PAGE
6
of
7
PUMP CHAMBER
PAGE
7
of
7
PUMP PERFORMANCE CURVE
PREPARED FOR
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T
vF"
S4E
PREPARED BY
WEGERER SO2L TESTSNG
AND
DES2GN SERVSCE
F.O. BOI 74 421 N. MAIN ST:
RIVE? FALLS. 1154022
AR lup L
YY53_B£
Pali V
suswcwnl,
�ESIGI;F't�i
_7. l --C3
JOB NO. C 9-1%� T
PROJECT DATA Page I- of
This system will serve 3 bathroom buildings at the St.Croix
Valley Girl Scout Camp. The anticipated use is a maximum of
40 persons per day per bathroom with 1 floor drain in each
building.
System sizing is based on 5 gpd/person (outdoor sports facility)
which appears to be the most logical sizing criterea.
ANTICIPATED WASTEWATER
40 persons at 5 gpd =---------------- 200 gpd
1 floor drain at 50 gpd'=------------ 50 gpd
Total per building = 250 gpd
Total effluent from 3 buildings = 750 gpd
SEPTIC TANK
250 + 750 = 1000 gal. minimum capacity req'd.
A 1000 gal Wieser Concrete septic tank with a Zabel Filter
will be installed at each building.
Effluent from the 3'buildings will flow by gravity to a 1250 gal
Wieser Concrete pump tank which will then dose the proposed
trenches.
2 trenches, each 3' wide by 93.75' long with'High Capacity
Sidewinder leach chambers are proposed.
750
gpd
- .8 =
937.5
sq.ft.
absorption area required.
2 X
5 X
93.75
= 937.5
sq.ft.
provided.
--
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H4avdu� CAP
Sots- FLu
La. C�-). o'
a1S�(t\evlZuTfiu�S
EZCV _95.0'
f�l
THE
Chamber
High Capacity Model
End View
34' 'f
o I
SYSTEMS INC '
Leading Ilia way In septic and slormwatot chamber systems
4 Bw.Yl ss Park Rnad • P.U. Box 765 Old seybruok CT 06475
B00-390-6639+ B00-2214430• fax. 06P3B968 10
Side View
754
11
r
tol
III
Product Features
• Lightweight units offer easy assembly and installation.
• Fully -louvered sidewall provides maximum infiltration.
• Open chamber bottom allows additional infiltrative area.
• High -density PolyTufl'" polyethylene construction guarantees
strength and durability.
High Capacity SideWinder Chamber
Specifications
Size (W x L x H) 34' x 75` x 161
Storage 115 gaIJ15.3 W
Weight 32 lbs.
u n roan.. n+w +ur w s.YN.+L1.uv.+Mt•.e 4YL.5+.lan+Y sva rn. un+an n..n• . mA+t w m G�..a.•s...�.+ W+.vn, aux.fe ta. us ,os." as NnV• w+.Nsw.•
N+V.- I<.'a+a. +rt SNtYJn V..i.uaf VM•Nb W n. 1•+^•�9 ••�++V7Y a.:rt4..r S/•nv H' G•H:". A4v.•Pr.l.YM.+ Nca:.t•p. \'r4t NraN:4 wl S.":4rt+
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PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAGE 6 OF %
VENT CAP
'{C.Z. VENT PIPE
WEATHER PROOF APPROVED LOCKING MANHOLE
JuucTloW Box
�10'FROM DOOR, 12'MIU COVER WITH WARNING LABEL
WINDOW OR FRESH
AIR INTAKE
GRADE
w b 4' MIW.
CONDUIT
18•MIN. v�t; __________
11�
INLET PROVIDE
AIRTIGHT SEAL I III
/r` I I v
APPROVED JOIAITJ A Tank construction shall comply I III APPROVED JOUJTS
with ILHR 83.15 and ILHR 83.20 1 III
I I I ALARM
a 1 II
I I
1 I ON
+ I I
LLEV.B9 17 FT �{
PUMPS OFF
TD
-� nv a.S� COUCAETE BLOCK__J
RISER EXIT PERMI7rED ONLY SEODINr, IF TAWK MANUFACTURER HAS SUCH APPROVAL 3 AP,ISi4
5PECIFICA7I0NIS
DOSE
TAWKS MANUFACTURER: ` ��� ^�'-���C NUMBER OF DOSES: 3 ' 3 PER DA.i
TANK :,IZE: \ZSO GALLONS DOSE VOLUME 1
ALARM MANUFACTURER: S �L• ��`fRD S`-S�`rf_3 INCLUDING BACKFLOW: � �-6."1 GALLONS
MODEL NUMBER: LOCAPACITIES: A= �.2_IUCHESOR 22L'f GALLOWS
SWITCH TYPE: 1"lE1z.CVR-�/ Z 53-3
B = INCHES OR G�LLOUS
PUMP PIAWUFACTURER: GOV Ca I RUCHES OR �'�6'� CALLOUS
MODEL NUMBER: 3`8Z1 EPQ4 D- fE INCHESOR 7.13'Y GALLOWS
SWITCH TYPE: W1�2 °W R''I DOTE: PUMP AND ALARM ARE TO OE 6.8
MIWIMUM DISCHARGE RATE Ll6.8 GPM INSTALLED OW SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEW PUMP OFF AN0,0I5TRI6UTIOU PIPE.. 7' FEET
+ MIWIMUM NETWORK SUPPLY PRESSURE .. . . . .. � FEET
+ L4() FEET OF FORCE MAIN X �I' I y F jo Fr.FKICTIOU FACTOR.. �' 6 FEET
TOTAL DyWAMIC HEAD = 4'y'9 FEET
DIAMETER
IWTERNAL DIMENSIOIM1 OF TANK: LENGTH —' ;WIDTH ,LIQUID DEPTH `„1124
BOTTOM AREA - 231= - GAL/INCH
AS PER MANUFACTURER = Zb.6-)' GAL/INCH
P GVP-V 1F
E c' —7
APPLICATIONS
Specifically designed for the
fallowing uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
• Water transfer
• Dewatering
SPECIFICATIONS
Pump: EP04
• Solids handling capability:
1W maximum.
—� • Capacities: up to 55 GPM.
• Total heads: up to 24 feet.
• Discharge size:11h" NPT.
• Mechanical seat: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
1040F(400C)contnuous
140OF (60°C) intermittent.
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Pump: EP05
• Solids handling capability:
'/4 maximum.
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet.
• Discharge size: l'A' NPT.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
1040F (40°C) continuous
140OF (60°C) intermittent.
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Motor.
• EP04 Single phase: 0.4 HP,
115 or 230 V, 60 Hz,1550
RPM, built in overload with
automatic reset.
• EP05 Single phase: 0.5 HP,
115 V. 50 Hz,1550 RPM,
built in overload with
automatic reset.
• Power cord: 10foot
standard length,16/3 SJTO
with three prong grounding
plug. Optional 20 foot
length,16/3 SJTW with
three prong grounding plug
(standard on EP05).
METERS, FEET
Goulds
Submersible
Effluent Pump
3871 EP05
• Fully submerged in high
grade turbine oil for
lubrication and efficient
heat transfer.
Available for automatic and
manual operation. Automatic
models include Mechanical
Float Switch assembled and
preset at the factory.
FEATURES
■ EP04 Impeller Thermo-
plastic Semi -open design
with pump out vanes for
mechanical seal protection.
■ EP05 Impeller: Thermo-
plastic enclosed design for
improved performance.
■ Casing and Base: Rugged
thermoplastic design provides
superior strength and
corrosion resistance.
>C aJ
■ Motor Housing: Cast iron
for efficient heat transfer,
strength, and durability.
■ Motor Cover: Thermoplas-
tic cover with integral handle
and float switch attachment
points.
■ Power Cable: Severe duty
rated oil and water resistant.
■ Bearings: Upper and lower
heavy duty ball bearing
construction.
AGENCY LISTING
SP- Canadian Standards Association
(CSA listed model numbers
end in "I"' or "AC'.)
—►�-6 GPnn
I
-'L25Fr
0
I
I I , I
E
0
i,
5
I a
EPo5 —
I
I
°
;a.y
EP04
s
,
00 10 20 30 40 50 GPM
0 2 4 6 6 10 12 m'/h
CAPACITY