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HomeMy WebLinkAbout008-1011-60-330 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPnvacy Law, a 15 04 (1)(m)I y t� cnarity lyer I TOWN OF EAU GALLE (TANK INFORMATION I L .4t4 ; i r 14t�r` 1 ELEVATION DATA TYPE MANUFACTURE 1 nx CA ACITY Septic e-3t-t` Cvwi�o G Fd- 3 !Boo Dosing Wieser- B onwll L o Aeration W yzoa Holding92" w kl' R kj / 1'/�L 1t � L TANK SETBACK INFORMATION TANK TO PILL I WELL BLDG. Vent to Air Intake ROAD Septic > Z5 , �5O 3 _ , J , Dosing > ZS . %tJD� 37 t 50 1 Aeration ZS 1 i JO t y/ ' V3, Holding PUMP/SIPHON INFORMATION Av - Demand k Manufacturer / ZGIe /[i GPM Model Number 1 e/O Z } y `� TDH LI([� Z Fnch� L�ss. 1 System He d�� Tp N ForcemaLLin Len 1 Dia. z +. Dist to Well >� , SOIL ABSORPTION SYSTEM STATION BS 3,7 HI Iola FS IL VV 160 Benchmark ) 183 101.93 1 AIL 8M Ti'Kh orwlt� ` -7I l D Bldg. Sewer 58 p7 61 O��,q SUHt Inlet 13` I / St/Ht Outlet 13 7b SZ 73 9FM4et— Tr r it n � otir \ 4 Z Z. T 7,.1e. 14.4 7. L 3 9 -75 9Z Header/Man. 3 ,C l00. l Z Dist. Pipe 3. 65 !o0 , b 5 Bet System f� ?Q Ja 6y 3Z (G Final Grade St Cover 6.1S 41,.09 115A a -lo.q 33 `7 7. 5 s J 65 2. o, 7 SI-J gs .6, 63.) BED7TRENCH DIMENSIONS Width r LengthQO r 11 Ne-6h1'�r c i) a �� .�lerp PIT DIMENSIONS No Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAK /STRE LEAC ING Me acturer INFORMATION CHAMB R OR NN Type System � .rl/ 0Vx t y7 I q! ��O ` Model Number. DISTRIBUTION SYSTEM \.rj� Header7Manifol` ` .x 11 Z Distnbutio I Ir 1 Pipe(s) Z x Hole Size ` t 7�� x Hole Spacing + y Vent to Air Intake %YOl �eh Length Dia 1 Length Dia__/ Spacing J SOIL COVER x Pressure Systems Only x Mound Or At -Grade Systems Only rl?r / �VWt r Deft*15 r� / ter Z/ +r Depth Over Bed(+rench Edges xx Depth o ++ Topsail ! Z xx Seeded/Sodded xx Mulche...d���iii �� Yes r' No Yes❑ No 79 .V1, V tK�- COMMENTS: (Include de.(rriipscr pen�cli_es-, persons present, etc.) Inspection #1. /y, s �%% u Inspection 42: o1„ J Location: 525 233RD ST �7` • ` I , I1" Fi 1 �r � ,-- IS IV / 1 ) Alt BM Description =� GT y�L�O/'f'V.-Ill 2) Bldg sewer length=��5 .1L'?4h pr+T uq lbo` a�VlC. < Iev kr2 'q!5' /o r s -amount of cover =)G�Z ,FO,,,, JJJJf,,,,'//// kOt&k, 7�{Z� —/ I'O d l Plan revision Rfor iredo ❑Yes �jJ No -7 1 -7 Use other side for additional informati r _ G SBD-6710(R.3/97) Date nsepctors na ran No C, Cont Industry Services Division St crow Ave a L $ P APR 26 2021 \l\ 1400 E Washington Sunnary Permit Number ([o he filled in by Co) Po. Box7162 $ Madison, WI 53707-7162 Z 3� unitary-PerrnitApplication 0 state t ransaction Number In accordance with SPS 183 21(2). Wis Adm Code- submission of this form to the appropri _ vcm rental unit mlS-042100023-M is required prior to obtaining a sanitaq permit Note Apphcution forms for statetsm(ncd POW fS arc submitted to the Department of Safely and Professional Services Personal mtbrmation you provill m he for mdary Project Address (if drtterent than mailing address) purposes in accordance with the Prix acs 1 ass s IS 04(I i(m). Staa 525 233'a St I. Application Information- Please Print All Information!T Property Owners Name p�N C! Andy ]yet Parcel = / (1 r�.J}i 008 ' /O /f -(,p -3„3 ti Propem Ouner's Mmhng Address Property I ocation 2281 Woodcrest Or Gott. Lot C ny. Stets Zip Code Phone Number SE '/.,. SW' Sa. Section 4 W oodbun %IN 55129 (circle one) F28N _ R16LorA4 IL Type of Building (check all that apply) I I ota or. amdV Dwelluig-Number of Bedrooms - Subdoision Name j ® Public'Commercmal - Describe (.-se Block ❑ City of ❑ State Owned - Describe Use ❑ Adlage of CSM \umber ZONE X_ 20-5006 ® l own of fau Galle 111. Type of Permit: Check only one box on line A. Complete line B if a licable A ®New System ❑ Replacement Svstcr ❑Treaturcnt'Holdmg'1 ank Replacement Onlh I❑ Other Modification to Existme A stem levplaim Co.x.l�dr = �j, 5 B ❑ Permit Renewal emot Res urn ❑ Chan_ec of ❑ Pcrnut Fmnsfer to \ew List Pros ions Permn Number and Date Issued 13clbre Expiration Plumber Owner 7 d U IV. Type of Pi System; Component, Device: (Check all that apply) vt d _ l ❑ Von-Pressunied In -Ground ❑ PreSSnrricli In -Ground ❑ AI -Grade ❑ Mound > 24 in of suitable sod ❑ Mound <24 in of suitable soil ❑ Holding Tank ❑ Other Dispersal Component Iesplam) t retreatment Denec (esplain) / 1 a( t 44-1 t l0/ 7t� !u'6 T� A. Dispersal/Treatment Area Inform 'on: q,X 160 Ill i Resign liow (gpd) Design Sod pplication Dopers, rea Required ( Dispersal Area P posed ) System Elevation gD0 Rate(gPds VI. Tank Info Cap' ny m Gallons total d of Manufacturer New lan6s 6-Gallons Units Septic or Hefdmgdank ,90n6 /(yob zv U 70 ❑ ❑ U ❑ Dosmlt Chamber 41 U (/ f�j918'� 11 ❑ ❑ ❑ VII. Responsibility Statement- 1, the undersigned, assume respo rill ' or i I on of the POWTS shown on the attached plans. Plumber s \ante (Print) Plumber s Signat e MP MPRS \umber Business Phone Number Todd Sine 139462 715-235-2644 Plumber\ Address (Street, C m. State Lip Code) r c G %i-� Cori / 2� Ili� S ' ` f;5609 708ih Ace 11 77'1 Mononi Ne 154751 4rY !h e GfL✓ a�� Thlj' L'�'In,r ! Vill County/Department Use Only rAooL9ySd L Disapproved Permit Fee Date slued Issrung Agents lure bYJ l tM 4J R ea on him Denial S ZS 0, Da S ZO Z IX. CdN6 oalalcLN. pp6tst / 9®1� (Qtl3/IT!@p@{_�val j {viSiot-, �o tale)L) vi i ; as per managementy pl plan provided bumber. Ltl t� h {t �Y,�(y}gjyt w.rhf �rr/r�ICS H-a.yl hof ex(e 2 All Woack I requirements must be maintained JJ J' _l ,v.5 / as per applicable codeiordlnances. IS oaf {h✓°r Pfer 1 Z ✓r'Jf'1t5, r l ��,� s darts fir rhr a..r tin.uhmuminn!n a tin nnl,n oI.—lha.a V>. 1inohn. in<im Anah to romplehl • Fn5%/�i�vn� RC�yrdi-� f-ti eXCee� SHD- 398 R03'14 ` �00 �e9o(e I 7L4,4 A- ah T� 0.�.9✓Lgal l� �hvl va�Gy . G `y,Paa LNEgT _ I , t DIVISION OF INDUSTRY SERVICES or 2331 SAN LUIS PL GREEN BAY WI 54304-5211 sI Contact Through Relay P @ http Udsps w govlprograms/industry-services '��' •1 w .wisconsm gov Tony Evers - Governor Dawn Crim - Secretary April 19, 2021 CONDITIONAL APPROVAL PLAN .APPROVAL EXPIRES: 2023-04-19 Plan Review: PWTS-042100023-M Dale A Schlieve 312 Conro St Rhinelander Rl 54501 SITE: IYER REVISION 233, RD STREET Town of EAU GALLE St. Croix County Total Amount: $80.00 FOR: Description: 1800 GPD (Reviser/ to Pretreatment) Maintenance Required Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE The submittal described abote has been res sewed for conformance with applicable P isconsin Administrative Codes and Wisconsm Statutes The submittal has been CONDITIONALLY APPRO\ ED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction: it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy • Wastewater generated from contractors cleaning of equipment and tools and or left over construction products shall not be discharged into the drams discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properIN disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall he cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS .Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity (if the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands If it rolls into a 1!4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries • All piping shall conform to SPS Table 384.30-3 and SPS Table 384 30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations • Verify properhline(s) prior to installation • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied vvidt rock fragments. tree roots. stumps and boulders reduce die amount of soil available for propel treatment If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infilti'am-e area. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the s}stem Owners shall receive a copy of the appropriate operation and maintenance manual and; or owner's manual for the PO\i'TS described in this approval SPS 383.54(1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. .All permits required by the state or the local mmntcipality shall be obtained prior to commencement of construction'installation/operation In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibiluy for designing a safe building, structure, or component Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The abov e left addressee shall provide a copy of this letter and the PONk TS management plan to the owner and any others who are responsible for the installation. operation or maintenance of tile POW'TS. Thanks. q /� dt/R 7/ii G�/P3 �CCP24.% POW'TS Plan Reviewer— Wastewater Specialist Department of Safety & Professional Services', Division of Industry Services email: um under eesra %uscon,m _,m Cell: 608-516-6134 BM, I`/� GT O fC.. b7o APPROVED S �1.00�. DEPT. OF SAFETY AND PROFESSIONAL C6 3 / smviags M(>oPvs�A.oP�cG�1=4i��l��i.. � D1� �I '\�7 �POVL�i/n��+w(y.rSjTLAp�r_�1J'+l�o��,•�EP:�L�Plg.y,25 9}-I I , ��� DIVISION�ISIO, N 7O/Fe.INDUSTRY f SERVICES c Cfve5F CLL�J4T}} C`5 SEE CORRESPONDENCEr�4(r) 5 %ENcI7l-0pC.06+Ip)_ LC. ) (L)Icca (2 xglA �cIZ�.a �3znl !�� M��oCtiIP774; Fi\,-T res. �>Ps�o(�L 5 pex ray oP�92Z l do t3�r< � �waSuSPE 1,3(22-Ham+.S)lzz = !'.S AL.li G"Z14r �apoo Inc Per, /NZsA\ Iboo _I]L tF L.S j�-=ZZSo 5r- lozzr' I'oc> x r Ca + 43.'S 1 = Z259 TaP o�Fvc. Pi p¢ 12'S •a z'0 I y� ' 1 !- T/O i LLl�=V�SLaPC or_ CGI-�- A�LG n-l'9 `"17"S CA,.,Tou fi.. x ,THzcE.AflE-o, 24\ppGZ)S T L,��/�ct z; r- i )"e C.uuy- aLITS _O�Se�u�1�oJ 13S LL�.l-6� INxx OF � 1 f 34 B 9b4'o —� 4 4"1 l00 Soo �• 10cx� DwF- l.�,s.yca2 �_•. boob/`gib z33�-o S TLI;�T. 6G'r4Sw�g54i29>21bW I�wmoo,=Gq�6C �jco �o�•j1 P� I PDT P/iPLAN *CA, LCuLbTIotz --i .�� L_.; F-lo„wo T L±I�7 LFT to-I1-Zo LOTS GSP Zo• oo� oo • oii (x33 I'I_Q ')- -J-9_ 11 P. POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATIONS col (dU 53 SYSTEMSPECIFICAT101 Owner: & septic Tank Capacity — Permitg � Septic tank Manufacturer DESIGN PARAMETERS Effluent Fiber Manufacturer Numberof Bedrooms NA j Number of Public Facility Units D..GG ❑ NA Estimated flow (average) uC.7 SaVday. Design flow (peak), (Estimated x 1S}j50 O gal/day Solt Application Rate gal/day/ft' Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) 130 mg/L Biochemical Oxygen Demand (DOD,) 5220 MG/L ;I NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BON) ! >30 mg/L j Toni Suspended Solids(TSS) 530 mg/L ❑NA Fecal Coliform (geometric mean) { 5104 mall Maximum Effluent Particle Size i NA ❑ NA j Other: ❑ NA 'Value typical for domestic wastewater and septic tank effluent. �of gal Pretreatment Unit U NA ❑ Sand/Gravel Fiber ❑ Peet fiber Mechanrml Aeration ❑Weiland Disinfection 0 Other: _ Dispersal CeNls) ❑ NA ❑ in -Ground (graoty) ❑m-Ground(Pressure) [:]At -Grade ;/ Mound ❑ Drip dine ❑ Other: iOther. ❑ NA Aber: Other: ❑ NA ❑ NA conditions of tank Is) At kastonce every: 3Inspect L moan isl (Maximum 3 years) El NA y.a (s) Pump out contents of tank(,) When combined sludge and scum equals one-third(1/3) oftank volume Inspect dispersal cell(s) At least once every: oanffi is) (Maximum 3 years) [I NA Clean effluent filter At least once every: month is) ❑ NA yea s Inspect pump, pump controls & alarm Atleastonceevery: month (s) ❑NA latemis _ A[kVs[oncl ,O ar a) month (s) NA Flush and pressure test every: y� s) Other: ' cI r 14 L✓ � At least once very: I O months) e�w�t ❑ NA Inspections of tanks and dispersal calls shall be made by an individual carrying on of the following licenses or certifealiens: Master Plumber, Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual Inspection of the tanks) to identify any mlasing or broken hardware, Identify any cracks or leaks, measure the volume of combined sludge and sum and a check for any back up or pending of effluent on the ground surface. The dispersal cattle) shelf be visually inspected to check the effluent levels In the observation pipes and to check for any polling of effluent on the ground surface. The pending of effluent on the ground surface may Indicate a falling condltion and requires the immediate notification M the low( regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third (1/3) or mom of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of eMuea Rltere, meohemcal or preesurmed components, pmtraatmaM units, and sny eervioog at ireervale of -12 months, shall be performed by a cemmed POWTS Malmainer, A service report shall be provided to the local regulatory authority with 30 days of completion Many service event STARTUP AND OPERATION 2/ 3 For new construction. prior to Use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals flat may Impede the treatment process and/or damage the soil dispersal Dellis). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface During extended power outages pump tanks may fill above normal hlghwater levels. When power Is restored the excess wastewater Wit be discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result In the backup or surface discharge of effluent. To avoid this snuation have the contents of the pump rank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POWTS, antibiotics; bay vWpes, cigarette butts; condoms, cotton swabs; degreasers, dental floss, diapers: disinfectants; fat; foundation dram (sump pump) discharge, fmlt and vegetable peelings; gasoline; graces, herbicides; meat scraps; medications, oil; paining products; pesticides; sanitary napkins, tampons; and water softener brine. ABANDONEMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that ht system is properly and safely abandoned In compliance with chapter SPS 383.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the Vold space filled with soil, gravel or another inert solid materials. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide the code compliant replacement system. ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a now soil and site evaluation to establish the suitable replacement area, Replacement systems must comply with the rules in effect at the time. ❑ A suitable replacement area Is not available due to setback andlor soil limitations. Barring advances in POWTS technology, a holding tank may be Installed as a last resort to replace the failed POWTS ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Ar Mound and al -grade soil absorption systems surface. Reconstructions of such systems mu «WARNING» ��,tt SEPTIC, PUMP AND OTHER TREATMENT TANy61 ENTER A SEPTIC, PUMP OR OTHER TREATMI PERSON FROM THE INTERIOR OF A TANK I*ER Neme ICr>0 Z' Z _ _— .etq;,.,. 11 In place following removal of the biomat at the infiltrative in effect at that time Name Prone AND/OR INSUFFICIENT OXYGEN. DO NOT ICE. DEATH MAY RESULT, RESCUE OF A SEPTAGE SERVICING OPERATOR(PUMPER) LOCAL REGULATOR AGENCY Name _ Nemi /f ,r' al�fll' Phone Phonet Thic tlocvment was tlraf[ed In complianrewith chapter SPS 383.22f2)(bl(1)idAm nd 383 .11). (1) & (3), Wicromin Ad—f.,atwe Code. R,tkd 3/29/13 1 v rP, , Ro . T — M4�z G iP��� S`Sr-+T�aejlc �32c. 4 3 I 4 LLAY "C33 �4 Pam en L4�rt2IV �PT T"k ; ( , �s (, q 2�0 �� s — - DPP `Z'F� Low51w�(� J Cow rco�; S3Z/Z64OWG,5 P31-S°, D PLc� lire DosC �I `M�ti, o Pew zo�� 14� 3uT10" P' Pr a S�w4o r�iC Pi ni5 f-c P, Z - I T I�oo D� ,rpp� I _ 3' Li�jC1Lq� S zE t /z z�+o� s sz 95 Olscu�rc�� 2���; 3 S S�Sj--M l l�ca CA-/4oLf- TcqA�--t4eAo; S-rSTc,.-. 14L-,,�cx I tot s Fsz RP�-- PZz, P, !3-S; GPrn L r-7 ` 9.77 F «-p0,-) 95-x?2-2' = lvtl �rzCFiMtn J+ a D QO `Y, GpPM DA,\V,Gls4z zie RLTE-m- > T\f? za-" l «ram ¢ Mrs s�`� fr,�clSn - FLTrrz L rcT L� 5'if3 -- - - �zu�r- F72 P3 WHITE KNIGHT MICROBIAL INOCULATOR/GENERATOR 3/3 1- 110 VOLT POWER SOURCE IN HOUSE 2- DIAPHARAGM AIR PUMP WITH WEATHERPROOF BASIN 3- W' SCHEDULE 40 PVC AIR SUPPLY LINE- R-zx, O,P 4- 24" LOCKABLE MANHOLE RISER AND COVER l 5- WHITE KNIGHT MICRO INCOCULATOR/GENERATOR 6- IN TANK EFFLUENT FILTER IN TRASH TANK Q1 4 z 4 F 3 S MAINTENANCE SCHEDULE: 6 MONTHS - CLEAN AIR FILTER AND CHECK IF DIAPHRAGM PUMP IS WORKING BY CHECKING IF LIQUIDS ARE BUBBLING IN TANK. 12 MONTHS - REPLACE INOCULATOR MATERIAL, CLEAN AIR FILTER AND CHECK IF DIAPHRAGM PUMP IS WORKING BY CHECKING IF LIQUIDS ARE BUBBLING IN TANK. MANUFACTURER: KNIGHT TREATMENT SYSTEMS 281 COUNTY ROUTE 51A OSWEGO, NY 13126 800-560-2454 SUPPLIER: FIRST SUPPLY 5852 FOREST LOOP ROAD RHINELANDER, WI 54501 715-362-7824 i YSTEMS "Guardians of Water Quality®'' 281 Cc Rt, 51A, Oswego, NY 13126 1-800-560-2454 / 315-343-8521 / Fax 315-343-2941 www.knighttreatment corn March 29, 2021 Mr. Dale Schlieve CEC Plumbing Design 312 Conro St Rhinelander. WI 54501 Re: White Knight MIGTM Sizing & Suitability Confirmation / Andy & Charity lyer POWTS Design To whom it may concern: I have reviewed the Onsite Wastewater Treatment System Design that would serve the lyer's proposed 5 Bedroom Residence & Event Hall. Town of Eau Galle, St. Croix County WI, which includes the use of (1) White Knight Microbial Inoculator GeneratorT"^ Model WK-150 with WI Licensed Designer Dale Schlieve of CEC Plumbing Design. Based on the information provided and with a design flow value of 1800 GPD, I am pleased to confirm that the proposed number of units (1-Model WK-150), installed in combination with the residency time provided by the 4200 gallon pretreatment tank complies with our manufacturer's sizing parameters and guidelines to achieve highly pretreated effluent. It is important to acknowledge that each onsite wastewater treatment system will develop its own individual and unique operational personality and characteristics that will continually evolve with time and fluctuation of user input. With that said a change of intended use, increased hydraulic or organic loads or other operational change may require the use of additional White Knight MIGTM units in the future. Please feel free to contact me directly with any questions or concerns. As I am frequently out of our main office calling my cell phone at 315-575-4676 is the best means to assure a prompt reply. Thank you for your time and consideration Respectfully, Mark C. Noga, President Cc: File 12132020 ZoWw Pump Company 1140 Senor Effluent Pumps 20 16 16 14 f f 65 60 55 50 45 40 35 30 25 20 15 10 5 1451 4145 1401 4140 10 20 30 40 50 60 70 60 90 GALLONS LITERS - - �- 0 80 160 240 320 FLOW PER MINUTE 150090 tlaps./Aw toe0erpumps.m en-isfpn urtsJsump-M"t-pumpstaffi t/140-sene&#Ue ival4 22 12M020 2oallo Pump Company 1140 Series ElMu Pumps 20 18 ill 14 8 0 4 �< 2 In GALLONS 65 60 55 50 45 40 35 30 25 20 15 10 5 145/ 4145 1401 4140 10 20 30 40 50 60 70 80 9( LITERS 0 80 ZC7,o -2. Toro I 1 1 160 240 320 FLOW PER MINUTE 150090 nitmJl .m lerpumps.m /en WprWmtL%s effluentyumpNaMue Ui40-saneeWertmkeWeta 117 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ _A NAN n � C HA P- S T y T )IEP Mailing Address 2 ZS/ wOLtDc:-�ESr pp , w00D/-.jbf P-y MN 5,5712 Property Address 5 Z i / y s 6 Lclr Mtn fN3 s4 DO (Venftcation requimd fmm Planning & Lonhrg Ikpwwni hx new construction ) City/State '� ALPWWV i tJ3 parcel Identification Ntfmber Ubg ' /o d 60 - 330 LEGAL DESCRIPTION p Property Locations /..34/ %, Sec. �, T 154 Rj.�_W, Town of 4i%✓ & g!l r Subdivision Plat: p `� Lot # Certified Survey Map M�/7 f O —7 7— J _,volume Zd Page # S o6 (', warranty Deed H &��jjP ".�// /3 / % ' L- (before 2007)Volurne�/ Page # Spec house dyesa<- Lot lines identifiable afy cno SYSTEM MAINTENAN E A OWNER CERTIFICATION Improper use and maintenance of your septic system could mutt in its premature failure to handle wastes. Proper mainteomce 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 arc specified in §SPS. 393.52(1) and in Chapta 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. Owe, 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 DepaMsent of Safety And Professional Services 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 this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 5- SIGNATURE OF APF14C IZ �o9�2n DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ••• Include with tbts application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey asap if reference is made in the warranty deed. (REV. 0U12) 1T5 T j I I � 1- -�- Ilj II 1 ILI -I --�i r- �I-r-Ir _i� L- _ J L.l 17' 5 uiui�utiituwutuut uuuwu' `uNuwuunnu�ui�uuuN�u�nu�umiuuii - -iuuuu OPIUMNINNNINININNIININNNNNNNNNNNNINIINNNNNIN ��: ININIIINIIWNNIIIINNNN i 10'4' 1 to 4• 1 0' 4 T t0' 4 - - T 10 1/27 ; TO"1 8' 0" I' TO"1 I. 60' 0" ro- I I I 8' o" 44 7' 0" -_1 7'110 1/2" L �-T 10 112 B. 0" 8' 0" t 8' 0" 8' 0" } 8' 0" 8' 0" 8' 0" } 8' 0" } 8' 0" 8' 0" + 8' 0" fi 8' 0" + 8' 0" T 10 1 /Z°� " r -- -- - - - - - - 120' 0" - - -- - - -- --- ---- - C �V,{�� _- _ _ 0 (V N b0 O Qo N O O B I I EO O 60 Zo_ 00 zo -11n" — 710 1/2" I a' o" 24' 0" I � p7'101n° � t 7' 101n' - - � r s sla^ 16' 4 tn" 7' 8 1/4" — 4a a' _ �c -Pr A. Wei oi, si AANz i SWEST END HLEVATION +IMAINTAIN LEVEL APPROACH TO WALNDOORS" N11 8 DJOR & WINUOW eCHCDULf ID, XX SS WIU XO]P eKx CifxMF. o IF .,ffi Walters Buildin r ePEw. o� r�,,,.,,aoffx., 1 gs �„� 11 IAI a wox •.• �[Prn nM'�m A, —ICI tow OW ® ct0 'GN FFI CC PINPol F111 'm- L� \NDY •i CHARITY IYER mono PEct -- � Wr.LPA coWXmWn e w-G 1HIU \ PEa -_ •PNNwLH ` •• ��i _ xrnuMuiI aim { � i- � vvi Irnl �Y-#rie SOU rH SIDE ELFVATION A2 r_o- -1 IS I .,,.P „ oee R. P..Crvry .,�rrTU , I I OF MAI Rw.,,HH. PA.rv. aExxLIEPC.L1i u HE ITS. I oUxp OnWISTES -11 GwMgA L1 T] arn.+sn,ws1rL ,.R mr.nu II it il, CC — orav:o n�aca m, R." o, US 11 es .N•�@ NORTH END ELEVATION Az sse,z ve _ (_p "MAINTAIN LEVEL APPROACH TO WALKDOORS•• ..11 srta ear`—Ia - ' ./ wnre>m e s�.re wni Pewiunm OVER B ./kPR- !,� AU. ID SELL u"i KHI RI III i lumn�mmnnimn nummnmmmmn�nn�mmmmnmmmi �a J ll ,,, ll .,. 11.1. b .,. — — — ,,. — 11.14' NLtiI SIDE ELEVATION IL g CT rt wrvo SCHEDULE[ _ _ 77 Walters + Buildings va l� ANUYB Cr4RITY IYER HIS .L " \SD1� 77 60-09LI3 INO IN 1 0, 1Ill.NOS A � r�;1LI. NI;'milON Il OF of (1111 f --MAINTAIN LFVEL APPROACH TO WALK000RSm1 wlPf° er LS_NNx xwf Vhv..wr. 1•I 1 I, - VVEPXwC GIONN11 m 1. A.S,1xX Cv P. i a, wAL7R- -r, - OR P,u LI ' rRlrrm nb 1001 A.' 011 SOUTH HND El EVAI ION TN1-0 aw � Aala mew IR l INOFA7 m 'I, •= •or �,,,-il it Ij Ali ��� �� III _' II I'I al� �la'� fill, rh_ i ii.� J .,. z' ,,, 4 4 , kl m,. J , �\ FAST SIDE EI EVATION 1 SCPLE I/B 1-0" L[-��Vhvv6 P Z' -7 Walters Buildings 0 J NO �� -J ..:.... •. ANU7 3 CII \RITY I7ER All L 6U-0929 ,< a.VOII, OF x.I�.EA:, I,: l I'4----------- -----------lF 1 w - WIII I' yI v ITe r] �. A scowr f �•: ;_i. r� EP �- ^ o �wu I FIRST FLOURPLAN on,w & wwonw salmwe -- -1 ,�,,,,.,,x oM�. -E.�.� Walters Buildings r TITE �n. - ¢m FIT I I£ © i.ow- Q 1[E �I �— I" "Ir FIF-r llL arrrr�r..v i a:._ .i io JJ. AMYB ,mE �.n CHARITY Ivry �'0Ill —I :.. � 3 L l" .lIA 60-0 9 A3.1 uii ona::x� a. 'a — fNA r a,� w xw�� — I - -- --- L -- ------- ------ ------ ...... ..... A, Ir a v C3J i a w" .o# —alxoln ANY mxcmIox Gil1SPI D FLOOR PLAN 3� scna I/e'-i-o oaoa � valloow scNmuIr —, . 2 * Ic Walters w.wx�� Buildings c xi FILFDVANDAIN DO Cm LLo`ewN YV .., x. m ..,,,.. .,. I'll , ANDY& — of — '� CHARITY IYCR j L �� L� B anun�I eo Bf rac NAI AN 60-0929 A3.2 x �aL,x{,F�.�✓ ..1nw1-x �.�...,_- n.x-= n.Lnxs sILL ANEI, I'll, \ fEl Ltit E I CJ \ I — 91w i}i M L Y .. .. .� Dot ._. .. }.fir♦ ,n,l FAST END ELEVATION "MAINTAIN LEVEL APIR04CH TD WALKNORSr ,...x ex.w rrr.�� i n,cxs ooxrvwwrs n nv-,: ,nr r ILx�M�rzxcax..x \ <D —IRNQRTH SIDE ELEVATION 4^1 WA. .e I -o - DDiP 8 'NI. TID'h iCH7LI'l` -- --7.w ITI i - sn.w oiWx � 6II RISE, I-LI /ry 11, ,11- OWUT� -- Walters 1.1 - RI Buildings -- -fl— IAl 14 ILSLIDE LEN - ® a ...,,.... AK FWFIII RID �Ld--- �� AID NDYS CHARITY MR B Il'i\ AI IIII ILL .�...t., LLB A2.1 11 III Ilipll\IS Trillll NrN1M. Il ill ll N(uMC li rll lI N�N1A4 O r rollI IRW fs Rnl 1.1 vC9ac Ell • s FLOOR PLAN I'¢rs-a .s wnu nn�n �ixEH Walters BI UlClI0a5 � ' K v[W� .. .1 °� a) './'• .rvry r mw r AIILII�-I. ICI l.s i' n i --- -____.__ _1_, 4NDY 5 CHARITY IYFR rvl�uulvc v[�r r 6\WOIN NI so nl.esc E. I I �sln Department of fBty and Professional Services Page 1 of 4 find D gnat try nt, Q r I 1 SOIL EVALUATI REPORT CST- ZoLo- 3 y43 In accordance with SPS 385, Ws Adm. Code County St Croix Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size Plan must inGude, but nottimited fol-eteF4161 and horizontal reference point (BM), direction and percent slope, Parcel I D sE.alttiondn-Ah� , and location and distance to nearest road 008-1011-50-330 Please print all information. by Date /Z /,71 Property Owner Property Location `� ❑ Andy & Charity lyer Govt. Lot SE Y. SW % S 04 T 28 N R 16 E (or) W Property Owner's Mailing Address Louz Block # Subd Name or CSM# 2281 Woodcrest Dr 5 CSM 20-5006 City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Woodbury MN 55129 If i I Eau Galle 233i° Street ® New Construction Use ® Residential / Number of bedrooms 5 Code derived design flow, rate 750 GPO ❑ Replacement ® Public or commercial - Describe Event Hall Parent material Loess over glacial till Sxvt i S, )-} LoKr Flood Plain elevation if applicable NA It Z oRA)_ X General comments and recommendations. A mound system using 21 inches sand fill will provide treatment. Plowing to a depth of > 14 inches to disturb the larger peds possibly associated with a plowpan and assure a soil application rate for a moderate grade of blocky structure overall The area near B-3 needs to be avoided because of soil compaction The lower lying area around B-1 is not suitable for a mound due to saturation that may occur in the A horizon 1❑ Boring # ❑ Boring ® Pit Ground surface elev 90 56 ft Depth to limiting factor 0 in Sal Annhratinn Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu Az Cont Color Texture Structure Gr Sz Sh Consistence Boundary Roots GPD/Ft2 •Eff#1 •Eff#2 A 00-08 10YR 3/3 -- $u 2msbk mfi aw f 1 0.6 1 08 B 08-21 10YR 4/4 f3d 10YR 516 & 6/3 sit 2m-csbk mfr air --- 06 0.8 2C 21-28 7 5YR 414 f3d 7 5YR 5/8 sl tcsbk mvfr --- - 0.4 07 �j^NNOOTE: Horizon 2 has common 10YR 6/2 silt coatings on ped surfaces that are not considered indicators of seasonal saturation However, there are redox features present as well Cy Boring # ❑ Boring /I ®PR Ground surface elev 98 16 ft. Depth to limiting factor 22 in Soil Application Rate Horizon Depth In Dominant Color Munsell Redox Description Qu Az Cont Color Texture Structure Gr Sz. Sh Consistence Boundary Roots GPD/Ft2 •Eff#1 •Eff#2 Ap 00-08 10YR 3/3 - sil 2m-csbk dish aw 2f 06 0.8 E 08-12 10YR 6/3 -- sit 2msbk parting to 2m I dsh cw - 06 0.8 B 12-18 10YR 4/4 -- sil 2msbk dsh cw -- 06 08 2C1 18-22 7 5YR 4/6 --- sl 1 msbk ds cw -- 04 0.7 2C2 22-44 7.5YR 4/4 f3d 7 5YR 518 sl 1 csbk ds -- --- 0A 0.7 NOTE: The soil structure in horizon 2 is compound The blocky peds part platy when disturbed The major structural unit is blocky and in my opinion, the soil application rate for moderate grade blocky is applicable • - Gnn � Qn a 01n —A —A Tee � an e . An —11 • Cf .—# *1 a ann > zn < tin mna nnA TRS > 3n < 1 rin mn/I CST Name (Please Print) Signature CST Number Leroy G. Jansk- 71599 Address Date Evaluation ucted Telephone Number 12758 43rd Ave. Chippewa Falls WI 54729-6610 9/25/2020 715 723-0408 h 715 829-6571 c JCU-t3SSV (KU4ll p1 Page 2 of 4 f/�,{ Boring# El Boring lec xxc ® Pit Ground surface elev 98 65 R Depth to limiting factor 0 in Rnil Annlicnfinn Rnfn Horizon Depth In. Dominant Color Redox Description Munsell Qu Az Cont Color Texture Structure Gr Sz Sh Consistence Boundary Roots GPD/Ft' 'Eff#1 'Eff#2 Apt 00-03 10YR 313 --- sil 2fgr mfr aw 2f 0.6 08 Ap2 03-10 10YR 3/3 f62J3 d 7 5YR 5/6 & sil Om mf aw - 00 0.2 B 10-15 10YR 4/4 -- sil 2msbk parting to 2m I mfr cw --- 0.6 08 2C 15-24 7.5YR 4/4 f3d 7 5YR 516 sl 1 csbk mvfr --- -- 0.4 0.7 NOTE: Horizon 2 was apparently compacted by farm equipment and the redox concentrations observed were induced by physically reduced permeability This pit is outside of the suitable area for the mound ID4 )� Boring # El Boring ® Pit Ground surface elev 96 59 ft. Depth to limiting factor 22 in Rnil Annlirfinn Rafe Horizon Depth In Dominant Color Munsell Redox Description Qu Az Cont Color Texture Structure Gr. Sz. Sh Consistence Boundary Roots GPD/FN •Eff#1 'Eff#2 Apt 00-03 10YR 3/3 --- sil 2f-mgr mfr aw 2f 06 0.9 Ap2 03-08 10YR 313 --- sil 2msbk mfr aw 1f 0.6 08 B 08-16 10YR 4/3 -- sil 2msbk mfr cw -- 06 08 2C1 16-22 7 5YR 4/6 -- sl 1 msbk mvfr cw --- 04 07 2C2 22-40 7 5YR 414 f3d 5YR 5/6 sl 1 msbk mfr --- --- 04 07 NOTE: Horizons 3 and 4 also had common 10YR 6/3 soil coatings on ped surfaces although fewer in horizon 4 InBoring # ❑ Boring ® Pn Ground surface elev. 99 00 it Depth to limiting fac r 15 In Snd Anni.,,Mn Rafe Horizon Depth In. Dominant Color Munsell Redox Description Qu Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 'Ef#2 Al 00-04 10YR 3/3 -- sil 2f-m gr dish aw 2f 06 08 A2 04-08 10YR 3/3 -- sil 2csbk dish aw, if 0.6 08 B1 08-15 10YR 4/4 --- sil 2msbk mfr av — 0.6 0.8 B2 15-20 10YR 4/4 f3f 10YR 516 & 613 sil 2msbk mfr cw --- 06 0.8 2C 20-35 7 5YR 414 f3d 5YR 5/6 sl 1 msbk mfr --- -- 0.4 07 Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOD, > 30:5 220 mg/L and TSS > 30 5 150 mg/L I m ANDY & CHARITY IYER PIN: 008-1011-60-330 LOT 5 CSM 20-5006 n PART OF THE SE 1/4, SW 1/4, SEC. 4, T28N, R16W TOWN OF EAU GALLE, ST. CROIX CO., WIS. 4.23 ACRES BM #2 = 102.21' TOP OF 3/4" PVC PIPE BM #1 = 100 00' TOP OF 3/4" PVC PIPE 0.67' ABOVE GIRD 280 t TO c OF 233RD CT _ R -_-- Q AW #1 AW #2 B-2 97.00" GRID98 . / /'9600" x 98 82' B.5 99.00, F i 6 B3O , 98.65' 98.001, 5.7% \\co B-4\\ G> m - - ------ - /'" N m 0 SCALE: 1" = 20' �- 260} TO 4 OF 233RD IT ANDY & CHARITY IYER PIN 008-1011-60-330 LOT 5 CSM 20-5006 PART OF THE SE 1/4, SW 114, SEC 4, T28N, R16W TOWN OF EAU GALLE, ST. CROIX CO., WIS. 4.23 ACRES BM#2= 10221TOP OF 3l4' PVC PIPE O AWC1 GRD x 98.82' 98 00" 57% N A 73O ' <o >F _mm N N < J O D i O A � BM 41 = 100 00' TOP OF 314" PVC PIPE 0 67' ABOVE OFF R AW Y B-2 9] W 96 / N SCALE. I 1"= 20' 0' 5®' " �'"Depnrh "1of1M1 80�• SOIL A UATION REPORT oLamhoproan d aReisen 1 __- / F v� IIJiRE , s Ar1rn Code - - - ---I p��,t 3 �,. D �.`; COUNTY Attach complete site plan on paper not less 112 X,4' as m a. PI Include but Si+C7 1 PAROELIA. a not anneal to vertical and farizordal relate epptM (BAA), dIr,;W= of scale or dimensioned, north arrow, and location _ "a 00 D DATE APPLICANT INFORMATION -PLEAS T ALL IA N °' �i y 3 {� PAOPERIYOINtiEk �''EMY %' LOCATION •n v fdA14)T E V4Sk3114,S T 28 NA 16 E( tY PR(TT2OWNEASS ADDRESS. - -- lAT agca sun0.NQECRCSN CS 2 S� CITY, STATE ZIP CODE PRONE WMER u.AGE CNIN ' NEAREST RK W1Ar W I S wz- ("tl5) 68y= 7z93 GPrLL zaa ^ sr, pq New Coretrudon UseM ReddefrM/Number ofbedrooms 3 I) Add1JTbsldstingbuiI* I I Redacemart I I Pubk or comrarclal desrnDe Code dewed defy flow yS_ gpd Recommended design bedkV rate_ -6ed, 9PdYft�=aend4 9D AWaplon area rmpdred 3-15 bed, hg YI S hnch, R2 Mawum de* baling rate , S bed. gpdAt2_ �trerclr, gp W Remnmarded W W m sure sievadon(s) 98.0 4 (as referred b site plan bendmwq Additional desO/Site cornideradars*'>,bnw w/8'sr $EO- MsAarrumyeor= SPow RLL, parent material Lness ovjr2 CaWR ftt 11" Flood plan elevation, fa*abb ►-3A R u:U ❑sue® �s ❑u ❑S C§UPr>�ssus ❑SS RU ❑S IOU I ❑S ®u 98 It, Depth to flailing laabr Z6' Ground elev. LltL Depth b lindrlg hoot 304 SOIL DESCRIPTION REPORT Hodzon Depth In. Dominant Color Munsef Mottles Qu. Sz. cad. color Texture Structure Gr. SL Sh. Cos>atence &ur-dey Roots GPD/ Bed anrh 0-1. Lo•t.tz317- sit Z11361z wtfr oS •5 .6 2 -1-ty Lt.Ntz s/L S 1 .L+Sbk tuft• as 3 ty�L Z•S 1e 3!y _ L' y 26--so . S Ll jiv 5't¢ Ve. L o.. wtyi 3 •Y 0-8 tD�T:3lz Sit ZPsbk mf>w as - s .6 2 -16 . !b `fe 9!L — si I L F sbtc qt(1 cS 5 •6 L 11% nru A cs _ y S 3b-3Y 5 Yn-'Si� L ,.S �r¢ 5✓8 L Remarks: Arthur L. Welterer ""'"' 715-425-0165 ter Soil Testing6 Design Service-P,O. Box 74 River PallsrWI 54022 a` Doss- 1 " y_6-oo I"a°bi2o2s4 IV PROPEMYOWNER �'iY�V�. SOIL DESCRIPTION REPORT PARCEL I.D. r1 00 2; — l O lj - 60 Boring 8 Ground elev. °LS.b it. Depth to limiting factor zz5 Boring N El Ground elov. Depth to limiting factor A i Pape Z of Horizon Depth in. DominantCotor Munselt Mottles Qu. Sz. Cont. color Texture Structure Gr. Sz. Sh. Cor6istence Bouffiy Roots GPD/ft Bed rrmrKb 'i a_g 10`m 31Z - sib Z`P3bit h1'F1- CS Z 8-W Lb-flz 316 Sit zY3104 mew oS s Iv-za -1-S `U 3/y - L t CAtz >«\ t, cs - y s y z.a-3b S Lm MY 4 I-SLtfz 5I8 Remarks: Remarks: -- Boring # Ground elev. _tL Depth to tlmlting factor 3oring N ;round dev. it. 3epth to miling Ictor RemarKS: __,_ PLOT PLAN SCALE 1"- 40 ' 14l'' --_� Ncnx.�sr LUr Uu� Fi pLp DRI�r_ hi au�ItuN'i� Loa° ZSo' rj a 0 ae.o � b Page -s of -s 8M*Z �z b9 �LS bR a�31'vRa Tt{ls prltl'A . Y36 . %M*1 - t5L.too.a'L*j S'thatf, 31y`bfA P'vC PtP.E...WL!wPYt 1 VtO jse -M %E M U."RsT 'LS ' Pop-ovi hW t-b-- W O-L 4 ♦ ♦ Sc, < y pp.Ss-I p ZZ02S'j CST3ignature �'Date Signed Telep neNo. T l- C� - - = 5r�' q j } L-L1 L-�-za - 44C bb 1:5, ✓-� �-ad� -�� i� Z�d N,o-!� ��6 v3d CJ b � r L f 117 ri�rLj=7J5�J� yzxz-"?%l - Z-9C�L NzI -- - lL�'3j •'HNCTc�a - ��'� i Ic- zs (A�? I � �� , � . \' � \ j � 2 •, 7 d , 2 NR' Q � t 1 , �`—fir•-� t� ���il� rJ _. Conditionally , Igo bG�i- 1_Z� L �,ll+✓e� 1=��c.To2 (,70 �uoP� a�q��� �3 °�i�.e '7EPT. OF SAFETY AND PROFESSIONAL < < l S.! SERVICES CC1 _ iZ� 1 Q i I� �- %C �.� 1 I ► �:iC i L DIVISION OF INDUSTRY SERVICES Pit._L_ CE,� �:���✓ �a, 1 _ i� ,'� Z"C=� ' 132 C IEL'6- e 1 4 \ �� � �L p j )c- pT " 1' �sii p ot„ -H) � �� ' I I SEE CORRESPONDENCE n-+i.�j kol.OtiCk`C4� I�N�7LppP�-j�I �f ' A- Z.o 4co �rvG4 A�7F loo.o' �I r L -i�-' 1' t,v r Ca, T v2Nc,r� �- �'/!�cu;�,IL (T/C.� V ScI j L4o f lvc. I Kica,x 54. 9 6:7`} i I 4k 1 N4uL-/�, �jG�� `o Soli :Zaw knv C) 5 G �� ,...o Nei, "It's "Cia DALE A. CC2LIEVE i ail nfi� w it PUT 1 FD Z,' I Do s �2 tCrJ 5aC7 Tk l b': 1r�r 4'�� 5r'%4 6W�4 7� r�RU iC pLQ 1 t�ln.�r01-- LA�Lo l7�Ll.� �; CiZOI X cc \1 P� ► PL - 6TPLA�� Mbutia PLJC�,4 C�LQ -j LAJ '�Qtz S 1457 -j L. t tiz. PLa, I o-t )-Zp LO 5 / w tv l_ 7 .ems 9 n —I ILJ 9 U `1 v vni r� �1 c� Co., �� ,��' �� Industry Services Division o ty r Sanitary Permit Number (to be filled in by Co.) _ y { ' • Y I' DEC 21 1400 E Washington Ave P.O. Box 7162 2020 vR.nwnev" Madison, W1 53707-7162 3 I Z 2j JL SI leation O In accordance with SPS 383.21(2), Wis Ad Code, submission This form to the State Transaction Number -assi-7 7 �� of appropriate u �� Z t.1/ 008 / -C is required poor to obtaining a sanitary Petri it Note: Application forms for stateowned PO S are subnullM m Project Address (if different than reading address) the Department of Safery and Professional Services. Personal information you provide may he used for secondary _ imposes; in accordance with the Privacy Law, s. I5,041 m Slats. SZ 5 Z 33`� 5 �-- 1. Application Information - Please Print All Information ' Property Owner's Name Al D -,- ah Parcel H Property Owner's Mailing Address Property Locatio Goof Lot . yrJ � 5� '/., SW '/., on TW City, S le Zip Code Phone Number DDt� SIZ`I T AS?N R!,(c vle`J It. Type of Building (check all that ly) 2 Family Dwelling Lot u c or - Number of Be ins J Subdi ion Name tgrvbhcrCommercial -Describe Use _ ❑ State Owned - Describe Use ❑ City of El Village o ��// Z VAJ E X CSM Number749 Z U. 2.o 4. 6' t�� a-Ti;wn of ill. T e of Permit: Check only one box on line A. C lete line B if a licab A ew System ❑ Replacement System ❑ Tre enu'Holding Tank lacement Only ❑ Other Modification to Existing System (explain) g ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type ofPOWTS S stem/Coin nent/Device(Check that 1 ❑ Non -Pressurized ln-Ground ❑ Pressurized In -Ground ❑ -Grade ts/t ❑ Holding Tank ❑ Other Dispersal Component ex lain) - ICI Mound < 24 in oswtable oil P Po ( p ❑PreVea nt Device (explain) �/ f L 1 v V. Dispersal/Treatment Area Information: 005 Design Flow (gpd Design Soil Application Dispersal Area Required is Dispersal Area Proposed f) I S stem Elevationt /%no Rate(gpdsf) to zr , r'S7s" oo �lZ 3t 1'i , 98 3!L VI. Tank Info Cap in t lions Total Gallons # of Units anufacturer' 2 �atz U 0 � o Nov, 7 Ex�sMg Tank' n` in vri iZ J Septic o•-ti iATe 049 406 ! Dosing Chamber o �' VI1. Responsibility Stat ent- 1, the undersigned, ass a respo ' ' ty for installation of the PON"FS sho on the attached plans. Plumber's N rind o Plumb i S� MP/MP Number Business Phone Number �r✓t- 39 Z �!f Plumber's'Address treet, City, State, Zip Code) r Fia % 7&e />vc GdG si/v) Co /De artment Use Onl C( d l f 41 5 AgozoV4 ore tVIIII. Ipl Ap vecl 1 ` ❑ Disapproved Penn it/Fee Date Issued -Z Issuing Agent alure ElOwner Given Reason for Denial $ (p7fz .d 0 IX. Conditions of Approval/Reasons for Disapproval 3)lJo Coo i Ns of d IS� Wo�S1�� {µ �1 ACC, r SYSTEM OWNER. J J !� yy .1 1,SepticLink effluent filter and 0.6Ls(;cv- �rVL�ZC11 �[S I"^ wc,mot Jes7 n-Cd 1'u.-g dspe t_�l rr.11 m ist he serviced )maintained t as 1,,.r Ire. �;: IP I Ian provided by plumber. �QCQ(� ��� t✓+�C✓'✓IVk!✓['f RC �r va1$ NR YIo %r ar r 'io p e e p�avn. e� pr1the e0atem and submit to the County only on paper not Inc t n 9 x 11 iechn little - �Z d' Ili..]J II�CS�r'/'r,7 5\/j rn�.Y.IJ/ 1 rtgvi r �)tol rai enkrn,�a yt? Cot dl�Po�ot u5c �Yrm /S /�uo6e:4r-t f1rj1r;7oe-s x a�XGe� /OCR o��e l djsv r) 114 5 9 nn� � 1 -s -flA, �c(eco� 15 am DS � PS December 8, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-12-08 Plan Review:PWTS-122002817-C Dale A Schlieve 312 Conro St Rhinelanber WI 54501 SITE: Andy and Charity lyer 233 rd Street Town of EAU GA E St. Croix County Total Amount: S325.00 FOR: Maintenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Tony Evers - Governor Dawn Crlm - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORREyPc Mound Co ponent Manual — Ver. 2.0, SBD-10691-P 01/ P ssure Distribution Component Manual — Ver. 2.0, BD-10706-P (N.01/01, R 10/12) The submittal described above has been r iewed for co ormam and Wisconsin Statutes. The submittal as been CONDI NAI constructed and located in accordant with the enclosed ap vei referenced above. The owner, as dtied in chapter 101.01(] 0 V with all code requirements. No person may engage in work at plumbing in the state unless stats. with applicable Wisconsin Administrative Codes _Y APPROVED. This system is to be plans and with any component manual(s) isconsin Statutes, is responsible for compliance to do so by the Department per s.145.06, The following con ions shall be met during construction or installation a prior to occupancy or use: • B-3 s an isolated compacted area. Soil tester as a small isolated ar • Prese a dispersal area prior and during construction to avoid disturbance, mpaction and use of the site. • W' new construction; it is recommended not to activate the pump m the dos tank until the tanks are ped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 i)eches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Pro/Cr soil moisture content can be determined by rolling a sod sample between the hands. If it rolls into a inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulat%building sewer beyond 30 feet per SPS 382.30 (1\)(c) • Well setbRion meet chs. NR 811 & 812 • Tank to follow all manufa u 's ine(s) prior to instal i • Pump Floats to be et and verified peed plan. Any c TDH and GPM Spe\area • Areas that are occuck fragments, tree routs, stumps ax atlable for proper tf no other site is available, [rocs i at ground level. A laa is necessary when any of the sufficient mfiltran%c Owner Responsibilities result in pump resizing to meet boulder% reduce the amount of soil basal area of the mound must be cut off conditions are encountered, to provide • The current owner, and each subsequen wner, shal eceive a copy of this letter including instructions relating to proper use and maintenance of the syst . Ow rs shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual Nr e POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any its component parts malfunctions so as to create a health hazard, the property owner must follow the c6raftency plan as described in the approved plans. A copy of the approved plans, specificatio and this letter s II be on -site during construction and open to inspection by authorized representatives f the Department, wh h may include local inspectors. All permits required by the state or the local mum pality shall be obtained p r to commencement of construction/instal lan on/operahon. In granting this approval the Di Sion of Industry Services reserves the IN It to require changes or additions should conditions arise making them ecessary for code compliance. As per state [ats 101 12(2), nothing in this review shall relieve the designer o e responsibility for designing a safe building\nb'cr , or component. Inquiries concerning th' correspondence may be made to me at the telepholisted below, or at the address on this letterhead. The above left ad essee shall provide a copy of this letter and the POWTS manageme Ian to the owner and any others who are sponsible for the installation, operation or maintenance of the POWTS. Thanks r/ �,na n �.erat PO TS Plan Reviewer— Wastewater Specialist partment of Safety & Professional Services I Division of Industry Services mail: tim.%andcrlccstL POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INF.(ORMATION 036 - 1OI 1-1d0- >31ti SYSFEM SPEafICATIOI IP1 14r,-rT` 52Ptk TankCaPacRy Ib-j Permh g=d==� 5eptjc TeN[hpnufacthrer i OESIGNPABAMUM EttW mi FptrJ MenofaRuuer Number of Bedrooms ❑ NA NumbwcfpuwcF UNfs - QNA Estimated ftow(average) O eaU Defignflow (peak),( Estimated s l.S i O son A pcadan Ram gaUday/Ba staoderd kukient/EAlueutQuafxy Ntomhlva.erage• Fats, Oil &Grease [FOG) 4W mg/L Biochemical oxygen nemmd(BOV4 s=MG/L [)NA Total SusPOOd-d SSIWA JaW L Mamhie suerage en Demand (RON) pended Sods (TSB) s3a mg/L ao m&/L �NA (geometric mean) NOthw: SriN me%L Sze tf (neap} NA fY1 -Value, PrCLealmem unit ❑ Sand/Graacl Filter Q Meclankal Aerehan Page I _ of Z rn ❑ NA ❑KK ORA Inspect conditions, oftank is) At lit dNCe amy,njo manar�ta{ (atiapaam Syetxt) ❑NA Pump Out contents of tm *(T) aly5i3eandacpdt Ku" one-third (1(3) fd tank volume Impectdispersalcell(S) At .every: smrtth:A) PAwd"an 3yeam) DNA clean effluent fBrer At an ry: w eA DNA Inspect pungt, putnp tmteels&abuTp ,stoominie mdrah(s) DNA Flust hbmle arMPtesavafeSt Atleaseaxeavery: t §amh(s) [INA Other. Atleast once every: 'manth it) a ❑fW Inspecpona o1 to itsVn�, isperad cane be made by an indOR mft om the folkawng Itcenael Plumber: Mestur Pluearitl0d PDVVT$ krspBclPr, P(pgd,N* ; Sell Serviejdg Op—b incWde a v�iml knepf are. lenk{9 idanBfy any miedng ear tirdvr a, 1dm'afY. erg Cs m hapcombined s"o anrc) a ch any back up orpondhg oon the gnwnd . The dispariinspec(ed i0(tedttunt i@VVaLS �ObSarV"d1(OaPI{ms hdr etty pofa&nj af(1 On 111ag1pof etAueM co eats Qrbmce faditaie,a4eWirgcdrri7Kark and anti mtedlale the maWhen me combined tar of sludge and scum in airy inusewequaw ono4hod (1/3) ar m f mcontents of the tank oved by a SCH)UP 84"VWhg opadisposed'-of In abc ,dance Admbdstrab" Code, All other services, int not limited to the wnidrrg of oMmml, remre, maoinankal o preasurimd coupon, and any servi mqt atof = 12 months. Shea be pedormed by a .rdf®d POWTS W Imefkrer. A sewkat report shag borovided to the local mguMvy aulborhy with 30 days of completion of cry aerviae avenL or camftcafi s Master Twat haseddots must measure irre. Nfhnne or d W11(s:) stud be visually, od surfaos. The pondrrg regudl ov auBtority. Wit I,olwre, the entire tiler NN 113, Wisconsin probvetmerd unite, START UP AND OPERATION For new construction. prior to use of the POUTS check treatment tank(s) for the presence of painting products or other chemicals that MY Impede the heatment process and/or damage the sod dispersal cell(s). If high concentrations are detected have the contents of tie tank(s) rentoved by a septage servicing operator prior to use. System start up shall not occur when soli conditions are frozen at the infiltrative surface. During -Mended power outages pump tanks may flit above normal higfnvater levels. When power is restored the excess wastewater will be discharged to the dispersal caff(s) in one large does, owdoading the cet(s) and may result in the backup or surface discharge of effluent. To avoid this situation haw the contents of the pump rank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POUTS Maintainer to assist in manually operating the pump contr/Iningproducts; levels within the pump tank: Do not drive or Dark vehicles over tanks and dispersal calls. Do not drive or park own, or otherwise disturb or coin 15 feet dovm skhpe of any mound or at -grade soll absorption aura. Reduction or elimination of the lollovdng from the waeteweler stream may improve the performance and prolong thlifeS: anbbiotk:e; bay wipes; cigarette butts; condoms; caton swabs; degreasers; dental Bass; diapers; disinfectants;ain (sump pump) discharge, fruit and vegetable peelings; gasoXro; grease, herbicides, wheat scraps; med"ratlors; ts; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT When the POUTS fells and/or Is permanently taken out of service the fodowirg -hall the taken to Insu at ht system is properly and safety abandoned in oompdance with dlad 3R3.33. Wisconsin Ain' Code: • All piling to tanks and pits shah bed necl and the a openings sealed./ • The contents of all tent® and pis shall o Clepol;ed of by a Sep Servicing Operator. &mpla� umping, ee tanks and pHs shall be rertgaed or their covers moved and the wit space filed with son, or another Inert add materials. • COY PLAN If ,he Pfalls and cannot be repaired the fit ng measures haw been. must be taken, In provide fhe code compliant replace ❑ ble cement arse has been evaluafed and may be utilized the location of a iaps"no m sad absorption system. pla area should! be protected from dishabanc, and and should not be Infringed upon by required rs from and proposed structure, let lines and ace . Future m protect the replacement area well result in the or a new soil site evaluation to establish the suliable t area Replacement systems must comply with the effect at the tiroble replacement area not available due to setbe and/o soil limitations. Sarong advances in POUTS tachnology, a tank may be installed Last resort to replace feted POUTS. ❑ The aft- has not been evaluated to Identify a sui cement area. Upon fa lua of tro POUTS a soil and site evaluation must be Performed to locste a suitatillerep, area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed S. Mound and at -grade soil at>anpton system* 'y`bq raowgVted in place folbwm ng removal of the bioal m the irKtitrauva surface. RECOnsysteminUCtfona of such system dv rtlJha, in aRec1 al that time. <<WARNING» ti �+rYS _•f SEPTIC, PUMP AND OTHER TREATMENT T ,AQNTAFN L ASSES AND/OR INSUFFICENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREA T TA}1N .CIR STANCE. DEATH MAY RESULT, RESCUE OF A PERSON FROM THE MTERlOR OF A TAN IF IAAIsO3$ i ? it 4 ADDITIONAL COMMENTS: t e 3- Cct,Stze L,ro1-4n�YZ) 8 x Le STM,(f3)lzo 19zo5F (>PswPc P-IL� 14, UA _kov. oLEr Li f"1w,..o �'N; �c.Tn2s. �JPS�o�L .05 ex,..,aSL.oPC 122� � d1w �u 4 Ir.r, -co �t ppc ---- - Bc-c.u.l-tr;p_u.. oo'P^kx ,SGaN . �R � 00.0 �pAPPOVEO To of L Pip ? WiD�i-3 �VwJ} _I.S. 'F �•O -F �•Z i- O I� oo P? ;'• OAL'e w�ff.w,m.mnQ, SC"L E :f � ✓...v.. f.-.Y lozzi' l2 Top oF:FvLP,Fc - 7h 3 M � � �y��t�Tlo-� 6 • wcea R-�Mrt>u-:D ��OF De��+�S�np� I,..� c� �'o So r eV.-. 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I7' N z23 C33 7 LowE,z, 6 ,S-6 16-84 i.e4 RL-p f .1.10, Za% F �_ CIF .20 + IS_4`i _ 1�t5 496� P 5�u 4d i'vc� L, IZA�T�L-42 24 Lxiw� c I I� To�o,� �+14 N -- ---- - -� M 72 F�PT F�w^� -Zc) 4c:> ASS.-ULG Ac> , d 150 •-o Tplc..kL- Cam,-f-s 17' ��- 1 0 49 Z5 \,-ls, , h beo , PufP0.ti ��.,�.. 3,3 M,� 4' D,Se �� ie..�-��.- 5- a S�SjG►-� I-1-�n 32.3 ��-- �-E. _P, r FLa� Prrz Pips. l-b - Mrs^-�` �o�' � (�IP��.- c''-'� �.c,- ,� �( j'�,�,..,�.,.► FrZ. 1 �z" z 23 jM C33 4 how TTNt-- L 1 E,4,0 ; x ► ,'3 x o = � a 6 ,50 �L�r-�' 99.7 - gz� -121G�OAJ �.vSS .9Jx2'..3 = 2,1 i .�>x2_-sb J.e4 j� .�4' zs,� cTpfz. b� SAP C► L.L- DcPTr 4 _CAp DsPT,4 (Cam) .5* H) I L) f2o 4- Z 11.4 .T�res. C. c3wraS4.ot�>s.� uz.. 13 on.Q� pc Ira rE�-c T 1�112'Lt �LA.. =11 tQZ4'? r` _ \ j k,jcL.L_ To 50''r-zow z_e, I I_4 Zsa_CD 11 Ncl -8 Z� — - - r .ir�� 5 1 �;c. 41 17-1 X C/-\�P�� CT/c� oJ 1 "co I bo'"x A�� .,�L�s I r D ti0 iG t3�H-N=1-� `5Mz &M C7. 4 yew 58.I(o' � zryF� cart conamorwq APPROVED DEPT. OF SAFEiY AND PROFESSIONAL SERVICES DIVISION of INDUSTRY SERVICES SEE CORRESPONDENCE Z� I �E4 t � tJ S o i T � l b , wr ® Q F4•� {l-+4 ►�a ,`� L�' �0��/ v,� LLT S►='�4 Snwtf4 S4 T2eQ�2" i 6VQ 1 ot,.,t., o,- G:c�u X C2oI Cow t`1 L�)�. i`^iburvC> PL tV� CLCk,x LArTtQbQ S t✓C G.�w�G �EC. 1e7�J, fjt.,;Tica�J._�S_o��i T0/2 I o-�t 1wZc> T 5 e�54�^ 'z_o- coo oa e► l-C=Y�