HomeMy WebLinkAbout010-1096-03-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM -ouny St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 633834
Personal information you provide may be used for secondary purposes [Privacy Law, s 15 04 (1)(m)I
Permit Holders Name City Village Township Parcel Tax No
Patrick Olsem I TOWN OF EMERALD 1 010-1096-03-000
CST BM Elev IIn861 Elev� IBM Description /j�a ko Sechon/Town/Range/Map No
//�/z{U/ L TT I33.30.16.569
TANK INFORMATION ELEVATION DATA S, 2 0)9,q'5 941. 25
TYPE
MANUFACTU ER
CAPACITY
\a ")
Septic
'tom
41
3r
Dosing
V TQ —
A
Cij kV
H ing
TANK SETBACK INFORMATION I
TANK TO
P!L
WELL
BLDG
Vent to Ad fi
ROAD
Septic
-7 /t � \
�J
Dosing
-716
r .
W
Aeration
Holding
PUMP/SIPHON INFORMATION \J
Manufacturer "ee1 ✓ 1 Demand
GPM
Model Number
i
TDH Lift Fdctio Lo System Head TD Ft
Forcemam Lengl t Dia. it Dist to ell
SOIL ABSOR TION SYSTEM
DIMENSIONS
DISTRIBUTION
STATION
L BS-z—
eI`l
FS
�EZVS
Benchmark
Alt. BM
Idg. Sewer
a
�y
SNHt Inlet
r7.
SVHt Outlet
Dt Inlet
Dt Bottom
Header/Man.
Dist. Pipe
Bot. System
J
�!' 26
Final Grade
C ver
Q 2 • ^\
CHAMBER OR
UNIT
Header/Manifold
Distobuhon
x Hole Size \.
x Hole Spacing
Vent to Air Ileatsntake
Length i�'a
Length)_�pD Dia `�_ � Spacing
5
-)' it
SUIL GOVER ,• L_ x Pressure Systems Only vx Mnund Or At_r;rada Svstems nniv "I / 171....... h. ✓
Depth
r
I I
Depth Over
xx Depth of i
xx Seeded/Sodded
xx Mulched
Bed
ench Cen er
BedfTrench Edges
i
TopsoA
L/, Yes
U No
X Yes
Q Na
COMMENTS: (Include code discrepencles, persons present, etc.)
Location: 1228 240TH ST 1.) Alt BM Description =vJI)LL
r , (w(J
2.) Bldg sewer length =W615, - amount of cover = 7 q ,1 Y ,
Z's•5
Inspechi p' 01 Inspection#2: PJQw //✓�Z�
-SotlS �t tlrod{ I06IIVI la�s,I�ill�ld���a��Id
Plan revision Required? Yes SL.No
Use other side for additional information _ I _a �_l '
Date s or's Signature Cart No
SBO-6710 (R.3f97)
�Jvlll� ;,1' 1 s n
Rio
-
.•, �� .-.
.,
Bui dings Division
Safety and l
County
Q�
9
\ S P APR 22 2021.
201 W. Washington Ave, P.O. Box 7162
Madison, WI 537 777162
Sanitary Permit Number (to be filled in by Co.)
& 33 g--�q
_ - Sanit i it Appli ion
5t
D
In accordance with SPS 383 21(2). W is Adm. Code, submasan of this form to t to ap[y1t�e goverrnnental un
Project
is required prior to obtaining a sanitary permit Note Application forms for steteowned PO"'submitted to
the Depanment of Safety and Professional Services. Personal information you provide may be used for secpndary
Address (if different than mailing address)
purposes inaccordance with the Privet l Law, s 15 04 I m , Slats
L ✓
Asse 2-y µ% c&�
Please Print All Information
1. Application Information -
Property Owner's Name
bps
Parcel k
63-aao
Property Owner's Mailm ddress
Property Location
33.3e)A ,Sb4
Govt La
I/a�-I/4 Section33
City. State Zi Code
p
Phone Number
�' S O'
"�1 +3 8
Ici le one)
T � N; R Jr West
il. Typical? Building (check all that apply)
1 or 2 Family Dwelling — Number of Bedrooms
Lot d
3
Subdivision
_
Public / commercial — Describe use
L
C 41q Ev 5
Block a
❑ City of
Village of
State owned — Described use ___
No
CSM Number
_-�
�I0t,k s �onc- x
wn of
S 111, Type of Permit: (Check daily one box on line A. Complete line B if applicable)
A.
New System
Replacement System
'rreatmenUHolding Tank Replacement Only
O Other Modification to Existing System (explain)
B.
❑ Permit Renewal
❑ Permit Revision
Change of Plumber ❑ Permit nsfer to New
ElTra
List Previous Permit Number and Date Issued
n
Before Expiration
Owner
IV. temlCamponebt/Device: (Check all that apply)
Non-Pressurimd in -Ground ❑ Pressurized In4iround Ar-Gradc Mound> 24 in. of suitable soli Mound <24 in of suitable so IT, _ J ss
Holding Tank El Other Dispersal Component (explain) El Pretreatment Device (explain)_ �n _ I V
V. DispersaVrrestmentArea Information: Hx
ZO 0 CC
P
Cn
2. 8
S Design Flow (gpd) Design Soil Application R e(gpdst) Dispersal Ana Requi Ist) Dispersal Area Propo' (sf) System Elevation
Aso s 3
so 1 0,2 WCo zZso 225o
VI. Tank Info Capacity fit Total a of Manufacturer 8 s 9 _
D Gallon. Gallons Units si_-1 Cif'-)D �1�� ` U e.
New Tank E,rsring Tanks
4
�0 co�,ha
CoVvt
Se tic Tank
Lift Tank
TAW ViApifs.
a VII. Res nsibili statement- 1, the undersigned. unit v Iliry inaMll 'on of the POWTS shown on the attached plans.
MP/MP" Number Business Phone Number
T Plumber's Neme (Print) ruuure
I 25397 715-231-7375
Lewis Bork
Plumber's Address(Strat City, State, ZipC (o vidi VS'%gfQ'AaV-dh "4 s�
--yy E7819 Coun Road E Menomonie. 54751
t
i Vill. CountyMepartment Use Only rswt ^4' h '
>> Permit Fee Dategent aIssued Issuing ASi ne
Approved ❑Disapproved S / � - 73 2
�O 60 /
F El Owner Owner Given Reason tot Deal - -
p IX. CapftillaV (fldsprovaUReasons for Disapproval V
S 1, septic tank, effluent filler and
df sperun cell must be taroleedrmahttskiad
as per management plan provided by plumber.
2. All soback requirements must be malMtbntd ,I d 7iO•ri O' �__^_
go
is par appllcabla ttltla/ortllnerKHl, T) �(00gi n .-,l S�5C
()A-U (or�pdrQ�r'a-.S/I /In)71lt Cpar{'�lfol rv�ie5/of P/ior % Sy1f�Hr /n�r+4//Q�ibar:
, IG.W3981 ( I%i%��H 10 r ter. ZCr r r r) 5, r �✓n �r la ✓e Jt(di S�l �iN� ✓her artrc 1 r1%a r/vca�
,j
o Act — ZZ�3 ZOO f+-i <L i' Ay
� O}• �t�ih`�
498401 o zn
y
4y.a 41f, 9.4,t #GZS397e_
-}o z�tp+ti
-� 4E6dES
. —b 93•Z
s
`
33
f t .`
r- r-- Soil
470.72
The at teat- Bey
r� Sys. p,Pa _ y D-2GGS 9�t. zs'
Z _ �" p•ZGFS
0 20 40 Soft
Dfsc"M R_TMs mapy P�e,MnoCb De
�.� o �5 P5 Gf�1" 136cu. T!E6�
July 16, 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023-07-16
Plan Review: PWTS-072100069-SSD
LEWIS WORK
E7818 Cty Rd E
Menomonie WI 54751
SITE:
Pat Olsen
1228 2401h Street
St. Croix County
Town of Emerald
NEX-SEY44-S33—T30N—R6W
FOR:
Description:
REVISION - 3 bedroom Mound — 450 GPD —
New Construction - 6" to limiting factor —
Effluent Filter- Maintenance required
DIVISION OF INDUSTRY SERVICES
10541 N RANCH RD
HAYWARO WI 54843-6462
Conrad Through Relay
http l/dsps m g0v/progrrem5/1ndWtry-eennt05
www.wsconwn gov
Tory Even - Dovemor
Dawn CNm - Secretary
REVISION to PWTS-042100609-C
COA'DITIO.VALL,Y
APPROVED
DEFT OF SAFETY AND PROFESS:JNAL SERVICES
DIVISION OF INDUSTRY SERVICES
_ &6 4 Ck,
SEE CO ESPONDENCE
I FO`;vIED
JUL 19 2021
Mound Component Manual)4Vi?f,2L0Y rSBO- I
10691-P(N.01/01,R 10/12)
Pressure Distribution Component Manual — Ver.
SBD-10706-P (N.01/01, R.
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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:
Reminders
a This approval is for a revision to a previously approved plan for this site — PINTS-042100609-C.
The mound location is moving outside the originally tested area. All other conditions of the
original approval remain.
a This approval is subject to the conditions of the Interpretive Determination approved for this site
on July 16, 2021.
e A sanitary permit must be obtained from the county where this project is located in accordance
with the requirements of Sec.145.19, Wis. Stats.
0 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.
• A state approved effluent filter is required. Maintenance information must be given to the owner
of the tank explaining that periodic cleaning of the filter isrequired.
• 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 rnav include local
inspectors.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also
receive a copy of the appropriate operation and maintenance manual(s) and be responsible for
ensuring that POWTS is operated and maintained in accordance with this chapter and the approved
management plan under s. SIPS 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.
The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
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 responsibility 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 above left addressee shall provide a copy of this letter and the POWTS management plan to the
owner and any others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely,
Cec� RGLdt2"C l
CeCe (Elizabeth) Rudnicki
Wastewater Specialist/POWTS Plan Reviewer, Division of Industry Services
(608)400-3186
elizabeth rudnickiCw-wisconsin.eov
PAGE 1 OF 6
Mound Plan
Index & Cover Sheet
Component Manual Design References:
Version 2.0, SBD-10691-P (N.01/01, R. 10/12) & Version 2.0, SBD-10706-P (N.01/01, R. 10/12)
Pg 1 of 6 Index & Cover Page
Pg 2 of 6 Plot Plan
Pg 3 of 6 Mound Cross -Section & Plan View
Pg 4 of 6 Distribution Network Specifications
Pg 5 of 6 Pump Tank Specifications
Pg 6 of 6 Management Plan
Pump Curve POWTS Application for Review
-nLmu- Soil Evaluation Report & Site Map
Project Name if Description
4 Olsv-� —
Owner Name(s): _ PA+- OtSV-1 _ _ Phone: IS 39$_- 3s-yg
Owner Address: gy% WYIOWonc� WSIJQ�L—Zip;__SY10lG
Project Address: 1-4ZZ5 L" U)+1 VM teA4(A
Govt. Lot: 3 MF— 114 of 51~ 1 /4. Section -63 , T_{tN-R L ro E ❑ or W X❑
Township: EWtEIZA� Q _ County: 5k•
Project Parcel ID #: OIO - to96 - 03 -Oco
Designer Information
Designer Name: 1n6A) l6b 'Aw _ Phone:TIS .a1a3� `�
Designer Address: �i "%;, WZ Zip�S
E-mail: I or� REVISION to PWTS-042100609
License Number:
—_ DCVr BF SAF: I A!, i •,y nl_ c-p VICES
Remarks:
31VZ510N ni -jar 5:�•.': ;�fl5
Signature: Date:
r
Onginal mgneture gwed on ch submMed copy.
ZOO '4" 5�r« • ' I A t
GS y 3of- 3
— --- -- s1 a}• ��d'nl� 498,01 �fh 2of(i
qy.a %�AS�IC R,,4,t, -}0 7 qO+4,
LTN C--)_
.LO .` 93•z
33
�� '•Cltµc.w� f�r'a d�flJ
Z� QZ•a 470.72 --�
a�
i9 c as B�
y" D•zc;,S
rj�o E = Z�bD ��..a yvtw�n• _ �" O•ZGGS
Z%
0 20 40 50R
pt$CtM R TM mep n •u pxv.rYeO ro Y
o �5 P5 Sir 13 6
0.5- TO 2.5' WASHED AGGREGATE
(min, 6.0- beneath distribution pipe - min.2.0-
over distribution pipe and covered with
approved synthetic fabric)
0 ASTM G33 SAND FILL
Plowed Surface
SINGLE -CELL
MOUND DISPERSAL AREA
MIN. 6.0' OF TOPSOIL COVER
min 1.0It
min. 0.5 it -
r-->/ —
I cI
L -77
A=—T
Ij (typical) E
Surface Contour
Elevation = 9�_ it
(Stow force main manifold and flush valve locations on plan view.)
5_ % Slope
O = 7 f tt
E= -Z--7 ft
System Elevation = 9 a • 3 ft
Lateral Invert Elevation = q5. $ It
jllt", CROSS SECTION
9z 8
Z. 5'
PLAN VIEW
(No Scale) Cr 5L 3
' ' 0 Schdl 40 � _ � ,a; h IZry
PVC Lateral -"F typ1ca4
(typical) r
---- -- -
-----------------------------------
r - — — — — — — 0eservaem
Z9 2 ftF L----- �- ----- -----�
W_-------es12d ft
-----
�I I) -1t
= ft
Bend as necessary to follow contour
DOWNSLOPE TOE
L = IW& I it
Prohibit disturbance and vehicular traffic
wlthfn 15 feet of downslope ice
Reset Page
v
D
0
m
W
O
n
m
DISTRIBUTION NETWORK SPECIFICATIONS
(No Scale)
Laterals to be level •�+ Fist Od Ice .,� �-0 Schd140
Schd140 PVC Lateral 0 = •�J in (h'I) may' / (ape to purr manta k
FLUSH VALVE DETAIL (typical) Ile to,ionat) fordran-back)
(No Scale) \ii /
Orifice in — — Valve Box
Center of Threaded Cap (insulation optional)
for Head Testing
(optional) \ \
f ) \
Ball Valve I ) \ \
(optionall / \
Onfices egta>ey spaced
a) St a) OR b) below) _� \
ating bottom of lateral
b) al"top of lateral Flush Valve
in fwk Assembly
with every — (typical - see dotal)
facts down
LATERAL INVERT ELEVATION = .
(typical)
stueld orifices roc
graveiess apphcabores
Last OrYke
(typical)
OBSERVATION PIPE DETAIL
(No Scale)
Screw -Type or . W
Finished Grade
Sip Cap (loose) + .`
(mulched 8 seeded)
4ro PVC Pipe ; ,-
Topsoil Cover
(can. 1 foot)
Top of pipe to terminate
at or above finished grade
(4) 114 112' x 6' SbtS
'0 apa t
Anchoring Device
Infiltration
Surface
orifice Spacing (X) _
(typical)
.I Jai
24 in
Lateral Length (P) - 131_ft
Number of Orifices per Lateral = - a—
OrfNce Discharge Rate = .11311 gpm
Number of Laterals - 2
Lateral Discharge Rate =1(0' Z. gp 1m
TOTAL DISCHARGE RATE = 3—
GPM
Orifice Diameter = to
(typical) Fist orifice
(typal)
END MANIFOLD
(Npicii i) ❑ CONNECTION
Check
applicable box. Mang
Fist Odke (risor pipe optional) ^D
(typical) rl
m
F- x—xn x)2—x A
(typical) (typcal) O—ic
ENTER MANIFOLD `n
Mangold) CONNECTION
(riser pipe optional)
PAGE 5 OF 6
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
aro VMI Pipe
>,0 a from
Bolarg Eleclnrai mua, WMPIr vmr
,?' MM. or 2 01 aMs SPS 316 aid NEC 300
Emoltsned Floyd Ele vbw NaelMrNop1 E❑Md na, 11.4 nser as necessary.
(rypnll Jun bon boa
yO� AWOd Lofkmg Mar y"
IMPORTANT ON win Wemng Label AILWwl
Anchor tank(s) as necessary flydcall
pursuant to SPS 383.43(8)(g) ConOa�r .• N01 or 2.01 above
/—Established Flood r'eva w
T/ Inokn
FhlsMc Grada
CAPACITIES (§ IG� gin
Depth (In)
Volume (gal)
A
1
,31L.93
B
2.0
Z
[c]
.5
ftz&5►
0
13.57
?.ZZ.
r
. .
i • i
-*T
IA
I I
T111-
a rrr
PJmp
*Pump Tank Liquid Level = .Sc) in
0
`Force Main Diameter
D Force Main Length �ft 3 A°P°"°d Bede,
t SS
Force Main Void Volume = ) a -7 9 gal
T1
[C] TotalDose Volume (TDV) _ _]y . I gaUdose
TL (5X�lotal lateral void volume S TDV < 0.2X design flow)
+ (force main drainback volume)
MIN. PUMP DISCHARGE RATE = Z. Ljgym
PUMP TANK:
Volume = (441. 33 Dal
Manufacturer.
Pump Manufacturer. 2P1r]1l�-
Pump Model'
(See alYelvO pump pin!
Controls/Alarm Manufacturer. STF404006
Controls/Alarm Model:
Float switches containing mercury are Prohibited.
,,�AeOyN seal
r5• S
83.1
Guk+D�ru�nep
tJ
aM•
0ypu,1
Weep
Approved Jums +am
HOW
Approved Pipe 3 0 rmto
Solid Grour•d
8rpw,0
� Alarm
PUMP -OFF
_Gp
ELEVATION
cpn:rMh
INSIDE BOTTOM
4"°
ELEVATION- �Z_ ft
Maleeal aerwem -enJ
D Vertical Head = 2 ft
1 + Min. Supply Head = s ft
+ FM Friction Loss = I '' ft
+ Fitting Loss' =�ft
'(min supply head x D 3)
= TOTAL DYNAMIC HEAD = tg=tt
SEPTIC TANK(S):
Total Volume =IWD� gal
Manufacturer(s):
Install approved effluent filter at the septic tank outlet
immediately upstreamof the pump tank inlet.
Filter Manufacturer: Me NXD
Filter Model: FT- dgZZ I 1
PAGE 6 OF 6
Mound Management Plan
IMPORTANT:
The owner of this mound system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admen. 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 Malntalner in accordance with SPS
383.52 (3), Wisc. Admin, Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 45b gpd; BODs S 220 mgL"; TSS 5 150 mgL"'; FOG S 30 mgL"
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i,e., pumps, valves, switches, floats, etc.)
o material fatigue (r.e., leaks, breaks, corrosion, etc.)
o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
c neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
o extent of ponding in distribution cell prior to dosing
o dosing irregularities (i.e., pump re -cycling, float switch settings, etc.)
o electrical components (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 tank(at shall be pumped by a certified septage servicing operator licensed under s 281 AS Wis.
Slats. when the volume of solids In the tank(s) exceeds one-third (M) 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 Fluent filter( sl 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-
0
Wstribution laterals shall be flushed once every 3 years or when necessary.
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 orcompanyltr ietA �i3r(/ Phone:�as Zat-?a75�
/, Pho ( r"
Loral government unit: �•I�l) ESL (� ,�yy/ (�
15
Local government unit address:-CAUV^ WJWA ZIP: 5 moo ^
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 384, 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 mound dispersal component may be
re -constructed within the onginally approved area after removal of all failed components.
System Abandonment
if use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
I50 Senes 1.111aent Pumps Awller Pump C on,pdm
hapN. www.ttxlletpump, cum co-naprodui is wrap-0111tcnt-pump+cl .
lw
W r
r W
UJ w
LL
50
14 45
12 I 40
rd
2
35
30
20
15
10
5
0-1---
GALLONS_
L IT E:RS
10 20 30 `40 50 60 70 80 90 lOG
4U 80 - --120 160 200 240 280 320 36C
FLOW PER MINUTE
2 21 ?'II S. IU Ot U1
_ A'ARMNG DEA rN NAY OCCUR IF'AYN IS EN CREC
WI TNOU T PROPER EO PNENT
0
No TESEE INNER WALL PNO TO W THE'"CkU VEL Y A T SKA WS' PA GE
I�4
xxa —� `" _��_ OUTLET END VIEW OF TANK
'_1I—�� x4m— xf rA
ero
Ala xa _
MET r000I—_ L W�
r i--j'{L
. mA;N PRFSS xp)- ,.Oa II FNfs,
SEAL GASKEr SELL
INS rALI EO GASAf T
L_- RAFFLE
riLrLR
) x J SECTION VIEW OF TANK AND COVER--t--,m
Model Nurnber 1000 i 600 SKAW PRE -CAST Phone. (715) 967-2277
Approved SEP-IUSEPTIC.SEPTIQPUMP.SEPTIC/SIPHONOR HOLDING 26255 105th Street, New Aubum TOII Free, 1-800-924.8625
Welgfri n VTZY
u f Im Uq Depib Gal IIn NOm. C.ep. W,s,;onsm 54757 Fax: (715) 967-2707
13, 050 lbs. 44• /2" 39, 16 47 642 33 gd wew akawprotesf <om
8-in. to 15-in. Dia, Biotube Effluent Filters
Applications
Orence 8-inch to 15-inch Biotube' Effluent Fitters are designed to
remove solids it m effluent leavng commercial septk tank they can be
used :n new and existing tanks,
General
Orenco' 8-Inch to 15-inch 84eio O Effluent Filters• ere used to Improve
the 4'xa k of WWI aRflino a commercial SepdC tank. The Broit100
cw'6%e fits snugly in the vauft and is removat!le for maintenance, In
handle assembly snaps into ft nolc'he9 in the top of the vault, and Cte
tee nandle can be extended lot easy ren wal of the cartridge. A *Use
Inlet' model (see p. 2) is available for low -profit tanks. M optianai side
,all system, available on larger models, simplifies insullaucin and prwides
lank access for smvlcing.
Nanme assembly
Alarm hula assunibly
(wend separetetyl
Rps moing
Bivivoys
support cmioling
�I
I
upon•! bracket
Cufiv7ay view
Sbr vl6w
bwiJ b6ir flnnn F1'ryr! M <snwf.r,tl.- nYtWI LLS. YId hMNM'IdPlaY4.
Standard Models
FT0854-36, F 1254.36, M 554-36, FTO822-14B, FT1254-36M
Product Code Diagrams
F
T� T I __ IY.4b,Y1M.,MYM W'a
to • wNIbW�
yy��//��11��P brlYf
i 7 . it B 0 4'IYO
u . Nui,e
o • Nnael
n. nar
I,
3. 5OM
essr`a'+Ya++r
N�h Pliewq'O,W tl VU d ll.0 Y ,M01IN nn;
S.�n nui�,t' Y+crU r Vll d ki�N R 1,tpliCpUr�y
axn nNF.n.Y.nlr Yudw.N �raa.,.u..r
a4Y (Nreen bdp rYlL daL nlRR,a:.latl �•Y
r. 1lW 13�t pfo- N PO.m �Y� dr M V'
�rrgtM V..•awYY.UMW WW
FT 72-UIB
-rod nen vn.,•.dw.
rm viYlY.Vs wdae
y ne �'me
14 14q n,n Ync
I�,vvrtl ^rYKn Rr
1) i
li. 'i?L
MYTM�tl�
Materials of Construction
vedt Fvc
pipe coupling T'vC- -- - - —
i'dnft comwea!s RVC
supporl tolaxn9 SW bracket _ P4C'_
rYuw,w�ranr.•r,,n ____._.-PuiyY_..p.�eno .v,a nnHn.ny:wY
rroav:AramcnYaaW ery suPr•,ex.n ✓n a,aN!Y w i;!Y w,3 klm.7 e*,
w a�aarlaaa�
omN aveWwo- b& , see M M AW baarre% ON 07416 Uba • bb0-40411641i • 54140 N6 • vwrr oralcR.00ra mp-Ps.rt-z
Pa 24OU"7
Page i of a
Maintenance Instructions
Biotube9 Effluent Filter
How to Clean Your Effluent Filter
To ensure your effluent filter is functioning properly, it should be inspected every year. Under normal conditions, your
effluent fitter will function for several years before cleaning is necessary. The fitter should be cleaned when it becomes
clogged enough to restrict normal flows out of the septic tank. At a minimum, the filter should be cleaned whenever the tank
is pumped.
Most people prefer to have a septic tank service provider take care of fitter maintenance and cleaning. You can find a
septic tank service provider in the Yellow Pages, under'Septic Tanks & Systems.' Or you can contact your county health
department for a list
If you wish to inspect and/or clean your effluent filter yourself, be sure to dress properly. Wear full-length pants and shirt,
shoes, gloves, and goggles or glosses. Then follow these instructions:
1. Remove the access lid to your septic tank by unscrew-
ing the stainless steel lid bolts with hex head wrench
provided. If your lid is above ground, it will be easy to
find. If it is buried below ground, find the marker that
indicates its location.
2 Remove the filter cartridge by grasping the tee handle
and lifting it out of its housing Isee photo N.
3. Spray die cartridge tubes with a hose to remove any
material sticking to them Isee photo 2). Ensure the three
orifices in the optional flow modulation plate inside the
filter are clear of any debris. Make sure the rinse water
runs back into the tank, but do not allow solids material
to fell into the open filter housing.
4. Firmly place the cartridge beck into the housing.
b. Some effluent filters come with an alarm that activates
when the filter needs cleaning. It you have an alarm,
check to make sure it is working by lifting the float
with a stick An audible hom should sound. The alarm
panel is normally mounted on the side of the house or
in the garage.
Note: If your effluent filter doesn't have an alarm system
and you would like one, call your local septic system
installer.
6. Record the date thatyou inspected and/or cleannd
your fitter on the form thatfoeaws. If You checked the
alarm or made arty other observations about the tank
or system, include that information under'Notes'
7. Attach access lid by placing it on the riser, matching
the openings in the lid with the bolt catches. Insert lid
bolts into catches and tighten with hex head wrench
provided.
photo t. Remove the filter cartridge by lifting it out of its
housing.
Prom Z spl. rho 10/ odvs wbas with a ROso.
NXfWi 1
s... 72 7M
►W7ar4
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3
Division of Safety and Buildings
in accordance wnn wiinn od, vvrs. ndm wan
Attach compels site plan on paper not lass than 8 1/2 x 11 inches insize Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
Personal inform you provide may be used for secondary purposes (Privacy Law s 15 Oa (11(m))
County Skis cicd�
Pyric" Q 4
(��O - II (�7 ^ os—
Reviewed by Date
Property (honer
?A - OIS<<J
Property Location
Govt. Lot NE 1/4 SE 114 S 33 T30 N R t E( )W
Property Owner's Marling Ad ress 00j L
Lot
Block It
I Subd. Name or CSNWZ �O
City w5tate Zip Code Phone Number
a tar tits • 394 S
ity Village • Town Nearest Road
Z 10•
0 New Construction UseE] Residential / Number of bedrooms _ Code derived design flow rate S GPO
Replacement Public or commercial - Describe:
Parent material 10-loft Flood Plain elevation 1f applicable R
General comments
and recommendations: —1Z 1'0"1V � M„ Y S .i �64 0� JA- o vill Nw,' rnaowsDl�
a-1
Boring# ❑ Boring ry� q
El Pit Ground surface elev. , f� • 8 R. Depth to limiting facto 1 in.
Soil Application Rate
Horizon
Depth
in,
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Colo
Texture
Structure
Gr Sz. Sh.
Consistence
Boundary
Roots
GPD
'Em#1
'Eff#2
-P
"4CA45US
i
LW
B-2
Boring # ❑ Boring Pit Ground surface elev. 17, ai N. Depth to limiting factor in,
Soil Aziplication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz, Cont. Color
Texture
Structure
Gr Sz. Sh.
Consistence
Boundary
Roots
GPDO
•EB#1
'Efdt2
3
Y%JA.
C
. G
ltri(
ZP
c
t
• 8
Emuent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Emu 2 = D < 30 mWL and TSS _< 30 m&2
CST Name (Please Print) _ _ _ CST Number
Lewis Bjork L . E3jo 153976
Address Date Evaldaton CorrXected Telephone Number
L•7818 County E Menomonie WE 54751 715 231-7375
Property Owner. () 15FPl
Coo- WA6 -03 -000 =
Parcel lD# Page of
-31
PB ?
Boring # U Boring
pit Ground surface elev. 19 ft. Depth to limitingfactor—I_in.
Sod Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Ou. Sz. ConL Color
Texture
Structure
Gr. Sz. Sh
Consistence
Boundary
Roots
GPDIff
'Eff#1
'Efl#2
'k'43-
CAt 10%K411
51
—.
ZF
_
1-1 Bonng # BonrV
Pit Ground suAaceelev. ft. Depth to Writing factor in.
Sod A4.4Aication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Ou. Sz. Cont. Color
Texture
Structure
Gr Sz. Sh.
Consistence
Boundary
Roots
GPD/fF
'Eff#t
'Eff#2
aBoring Bong # Ground surface elev. ft. Depth to limiting(odor in.
• Pit Sod Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Ou. Sz. Cont. Color
Texture
Structure
Gr Sz- Sh.
Consistence
Boundary
Roots
GPD/ff
'Eff#t
'Eff#2
—+—+7t:::i=
J
Merit #1 = BODE > 30 < 220 M9L and TSS >30 < 150 mg L ' Effluent #2 = BOD; < 30 rrxyL and TSS < 30 mg/L
The Depart nent of Commerce is an equal opporlun ity 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.
566emLmpi iR i�: Im
— o i- ACJ -• ZLS ZYO 41 SKI 4-
498501
4 Ztjo+A,
�5
Uk
.� 93•ti
33 0. t�ropow (Oo�l6o0
Zx q�.a 470.72 --�
8�
TOP of PFeaa Bed
�OPE • �'zo ' loo
Z Flo
D 20 !o son
DWMMER Tlw mep n nd puns d b De
ca sa w�i'°nm ::wa�roMname O 5 V, TIE& AG
��, Ps sir 13�c. -'
,. Otr �A nUl
r
-;0
�gP$
a
SFr StilOy ��
April 21. 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023.04-21
Plan Review: PWTS-042100609-C
LEWIS C WORK
E7819 County Rd E
Menomonie WI 54751
SITE: Pat Olsen
Town of EMERALD
St. Croix County
Total Amount: S250.00
Description: 450 GPD (J Bedrooms)
Maintenance Required
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY WI 54304-5211
Contact Through Relay
hftp.?Idsps.wi.gov/progremstindustry-services
www.wsconsin gov
Tony Evers - Govemor
Dawn Crim - Secretary
Cond,tionally
APPROVED
DEPi OF SAFETY AND PROFESSIONAL
SERVICES
DR'ISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
Pressure Distribution Component Manual - Ver. 2.0,
SBD-10706-p (N.Oli01, R 10112)
Mound Component Manual - Ver. 2 0. SBD-10691-P
IN,01101, R I0r12)
The submittal described above has been reviewed for conforiance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be
constructed and located in accordance with the enclosed approved plans and with any component manuals)
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.
slats.
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 constriction
products shall not be discharged into the drams discharging to the private onsite wastewater treatment system
(PO TS). 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 hater 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 of the soil. Proper soil
moisture content can be determined by rolling a soil sample between the hands. If it rolls into it 1 r4- 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 184.30-5
• Insulate building sewer beyond 30 feet per SPS 382.30 (1 I )(O
• "'ell setbacks to meet chs. NR 811 & 812
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(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.
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 system. Owners shall receive a copy of the appropriate operation and
maintenance manual and'or owners manual for the POWTS described in this approval SPS 38154(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 -sue 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 municipality shall be obtained prior to commencement of
constructs on'installalton; operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary tier code compliance, As per state stars I01-12(2), nothing in this review
shall relieve the designer of the responsibility 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 above left addressee shall provide a copy of this letter and the POINTS management plan to the owner and any
others who arc responsible for the installation, operation or maintenance of the POWTS.
Tr�h-�aa-nks../J
.J��n 7Jaa�r.�rra�
POWTS Plan Reviewer - Wastewater Specialist
Department of Safety & Professional Services I Division of Industry Services
1",l•: 'r i%❑•,k: chi"fit'.,. 111Pl .
Cell: 608-516-6134
File #;
ST. CROI- LINTY SANITARY SYSTEM Office Use only
� OWNERSHIP/ADDRESS FORM cremea2/2027
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.
OWNER,/BUYER INFORMATION
Owner/Buyer Pq , 2
Mailing Address 7
City/State/Zip--
Phone Number (required) 7
Email Address (required) i 172iz!K � � s c c /' �� r� . Z
Parcel Identification Number D
(found on the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
Property Location _ 1/4 , _ 1/4 , Sec. _ 33, T -3 ' N R-1-W, Town of Ch e-, �- yam/
Subdivision Plat: 1 � : { ra Cr- Cteck Wca-)S Lot #
Certified Survey Map # Volume Page #
Warranty Deed # i1/& 26 Z (before 2006)Volume Page #
Number of bedrooms 3 Spec house E3 yes O no Lot lines identifiable O yes O no
OFFICE USE ONLY
New Property Address !y28 7-40i1\ S�
(Verification of new address required from Community Development Department for new construction.)
%/Z31Zl
(Staff Initials) (Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) 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
ci asccwig-ov- 1101 Carmichael Road, Hudson, WI 54016
715-245-4250 Fax
www.sccwl.aov
1 ...- -
I/ i
ni u
4—
n�.+pmxa z
a
! j sn flaTM
tlESdt.
_ Ig1E
i
CfiH � ' �gy w,.°rnra°N
MAIN FLOOR PLAN
wt &
V.LP MR mrtW C
b:•biC 9! Nlld I.1 /I\ 3f RK'MLL YMYE 411.0.
sruW•ry
� ibnas itdns KlTI1¢p)1W�0u40.
M W RS 5' /!O GMM RP}M (1) NMItl 4 V.'.
plmaawswemnomn»en
��fiNGE/Vf[tlrvalMB Sf'
''^l thracat wuu�nemv.�roramnnmc
q veen.0 wvmx uo xw iew arhers
� ooe mrsmt-nR I
A
;trtsi �u.�i
DIVISION OF INDUSTRY SERVICES
10541 N RANCH RD
D
HAYWARD WI 548434462
-
Contact Through Relay
�aP8
MIRI/dWsw..govipWams/ineusby-eennces
www.wisconsin gm
Tony Evers - Goveriwr
July 16, 2021
CONDITIONAL APPROVAL
SOILS SATURATION DETERMINATION
Plan Review Number: PWTS 9-SSD
LEWIS WORK �
E7818 Cty R �� 10D COADITIU.\ALLY
Menomonie 547510-i9 APPROVED
JJ DEPT OF SAFETY AND PROFESSIONAL SERVICES
DIVISION CF ;hU,iSTRY SERVICES
SITE: st C' oe�e
Pat Olsen coc""-
1228240`hStreet
St. Croix County SEE CORN EE PONDENCE
Town of Emerald
NEX-SEY.-S33—T30N—R6W
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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:
• Approval is hereby granted pursuant to s. SPS 385.60(2), Wis .Adm. Code, to estimate the depth
of seasonal soil saturation based on an interpretive determination process completed by Lewis
Bjork, Certified Soil Tester (CST) and his recommendations.
• This approval is limited to the soil characteristics within the tested area. This approval is based
upon best management practices and does not warranty the functioning of the system. Water
conservation, wastewater disposal practice and system maintenance will aid in the longevity of
the system.
• On -site visit was conducted by CeCe Rudnicki, DSPS on July 12, 2021.
• The estimated highest level of prolonged soil saturation approved under this determination is 6
inches below grade. At least 30 inches of sand lift on top of 6 inches of unsaturated, in -situ soil it
required for adequate treatment and dispersal.
• The basal soil application rate for the mound shall be 0.2 gpd/sf, and the linear loading rate 4.5
gpd/ft.
• 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 of 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.
• Chisel plowing to a depth of 12 inches immediately prior to sand placement is required to
improve vertical water movement into the soil solum.
• Landscaping up slope of the mound shall be incorporated into the POWTS design to prevent
surface water from concentrating along the up slope edge of the mound and to divert surface
water drainage away from the system.
• This approval shall remain valid unless the site is altered in such a way that the depth to soil
saturation would change or if saturated conditions are observed for seven consecutive days at
depths less than 3 feet below the infiltrative surface of the POWTS distribution component.
• This approval in no way relinquishes the use of color patterns to estimate the depth to high
groundwater on any other parcels or portions of parcels.
• A copy of this approval letter and attachments must accompany the mound system design for this
site for purposes of plan approval and sanitary permit issuance.
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 municipality 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 responsibility 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 above addressee shall provide a copy of this letter and the POWTS management plan to the owner
and any others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely,
C" /CGLdnid,[i
CeCe (Elizabeth) Rudnicki
Wastewater Specialist/POWTS Plan Reviewer, Division of Industry Services
(608)400-3186
elizabeth rudnicki@wisconsin.gov
INTERPRETIVE DETERMINATION REPORT
Property Owner: Pat Olsen
Mail: 847 Wyldwood LN Hudson , WI 54016, Phone 715-308-3548
Site : 1228 240`h street , Emerald WI
NE -SE — 33-30N 16W TOWNSHIP OF Emerald
ST CROIX COUNTY WISCONSIN
This report prepared in accordance with Wisconsin department of
Commerce Administrative Code. 385.60 (1) (7)
Prep Le ('ork, C T # 253976
Lewis Bjork LLC
E7818 County Road E Menomonie, WI 54751
Phone: 715-231-7375, cell 715-308-2173 Fax: 715-231-7376
E- mail lewisb or�yahoo.com
CONDITIOAALLY
APPROVED
DEPT OF: SAFETY AND PAOFESSIONAL SERVICES
DIVISION OF I:40-:STRY SERVICES
SEE CU 'ESPONI FENCE
Conclusions, Recommendations why this proposed mound
system will treat and disperse residential wastewater on this
site
1. This site has supported cultivated agricultural crops in past years , most
resent ( last 10 ) has supported agricultural hay field non- hydric type
plants .
2. Seasonally saturated soil conditions do not occur in the upper 6 inches
of the soil profile as indicated by the absence of redoximorphic features.
3. The A horizon in the proposed system area is Munsell color 10 YR 3/2 to
10 YR 3/2 which indicates an organic matter content nominally of 25
g/kg in the range of 20-30 g/kg or 2.5 percent. This level of organic
matter is indicative or relatively good drainage and aerobic conditions.
(Tyler presentation, Reading shallow Soil Saturation, Chippewa County)
4. The relatively low level of organic matter indicated by the Munsell value
of 3 would facilitate observation of high chroma redoximorphic features
in the A horizon. The general lack of observation of these features in the
A horizon is strengthened by the low organic matter content which lends
further evidence to a conclusion that at least six inches of soil is present
which is not periodically saturated for more than six days.
5. No hydric soil indicators are present in the observed system area soil
pits; this conclusion is based on particularly careful review of the
indicators for silt loam Soils. There is no hydric vegetation in our
proposed area, when in lower elevation areas hydric vegetation is
present closer to west where the elevation drops of.
6. System area pits demonstrated root penetration to depths of 10-12
inches; such depths are not expected in soils which remain saturated for
significant time periods.
7. The small-scale cross slopes of 2% is better than none for lateral
movement of effluent down -slope via the more permeable upper soil
horizons and away from the mound system without surface ponding or
surface discharge.
8. The available length is 150 ` allowing for a lower liner loading rate and
enhances the ability of the system to allow effluent to infiltrate the in
situ soils along a contour without a surface discharge.
9. The site is acceptable for a mound septic system with a minimum of six
inches of unsaturated soil for treatment and dispersal of treated
wastewater effluent as allowed by Comm 383.44 (3)(b)l.
10. The observed 6 inches of redoximorphic-free natural soil will allow
treated effluent to be assimilated into the subsurface without ponding
on the ground surface.
11.Site preparation requires mowing and removal of as much vegetation as
possible followed by deep chisel plowing to at least a 16- inch depth.
12. Additional fill landscaping soil shall be added to the up- slope area of
the mound structure filling the concave, upslope area behind sup slope
the mound non collection of surface waters
13. Mound construction requires 4" of sand lift placed on the basal area
then plowed into the grounds surface and then more sand added to 30"
depth. Construction must take place under relatively dry conditions.
This 30" depth of sand creates an effective sand filter and can be
expected to produce a treated effluent with less than 30 mg/L of both
BOD and TSS and fecal coliform concentrations of <10,000 cfu/100mL
14. The rock cell in the mound structure shall be 4'x120' for a linear loading
rate of 3.75 gallons per day per foot for a 3- bedroom residence.
15. The sand basal area loading must be a maximum of >0.2 gallons per day
per square foot.
Wisconsin Department or Commerce SOIL EVALUATION REPORT Page I of 3
Division of Safety and Buildings
in accordance wnn weon oa, en& num. s.une
Attach complete site clan on paper not less than 81/2 x 11 inches in site. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road
Please print all Information.
Personal Information you provide maybe used for secondary purposes (Privacy La H, a 15 Oa i l) (m)).
County• �d�
p��pO I �Q� ^ 1
t ( Off•Coo
Reviewed by Date
Property Owner
?A- d5 t.�
Property Location
GovL Lot #45- 114 S 1l4 S M T •0 N R W; E❑(or)W
Property Owner's Mailing Ad G +
o pG11 "0
Lotg
ir
/
Block #
Subd. Name a CS µ0 `1
VT
City Srtatee Zip Code Phone Number �/ p
gut6p) V"! l•-S I./A � a
ity ❑ Village • Town Nearest Road
I2MIAft
E] New Construction UseO Residential! Number of bedrooms _ Code derived design flow rate S GPO
Replacement Puplic a commercial - Describe
Parent material LhS Flood Plain elevation ti applicable R
General comments
and recommendations. .S.1i�wt 0�
J,r�,4- 0 i,,i+tl Qn-o -� D2 c,c. ( 1�
e-I
Boring # ❑ Boring Q Q Pit Ground surface elev. CM • 8 fl Depth to limning facts I in.
Sod Applicabon Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Ou. Sz. Cont Cola
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPOM
'EfWl
'Eff#2
a
3
;
Z Aldi*A.
JIM „ 1 IS
C-0
zY
46
B-2
Boring # ❑ Boring
lPit Ground surface elev. �Z "I fl. Depth to limiting factor 10 In.
Shc Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Ou Sz, Cont. Color
Texture
Structure
Gr Sz Sh
Consistence
Boundary
Roots
GPDRF
'Eff#1
I 'Ef#f2
31Z.c
.a
ID tl�
2�
e
1
• 8
Effluent 4l = BOD > 301220 220 mg& and TSS >30 < 150 mgll-' Efflue = < D 30 mWL and TSS < 30 mglL
CST Name (Please Print) _ _ - CST Number
Lewis Bork 75�L' j,° 253976
Address Dada E atxxt Con ad Telephone Number
E78l R County E Menomonie W 154751 7 l5 231-7375
Property Owner
olsFd.l
do - Wq6 -03 —0= = ;
Parcel ID Page of
Boring # U Boring
Pit Ground surface elev. Z. 9 ft. Depth to limiting factor �^ in,
Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDM
'Etf#1
'Eff#2
O"1
It7yYt y
t.I
Zr-%qp
mallL
A.%
. 8
4
Lf 10*14k
So
-.
❑ Boring # Borg
Pit Ground surface elev. ft. Depth to limiting facto in.
Sod lication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDlff
'Eff#1
I 'Eff#2
1-1Boring # BoringGroundsurface elev. . ft. Depth to limiting factor in.
Sod Mdication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz- Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDffY
-Efl#1
'Eff#2
Effluenl #1 = BOD, > 30 < 220 mgrL and TSS >30 < 150 mgrt - Effluent #2 = BOD, < 30 mgll 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.
ieLMmwrcni iR 01.®.
—V°wb.j c+ 498,01 DF y 3ef- 3
c 5 z o3
_
9y.a AkJA 0,,4,t 4o
3
Qs fropOW fMol6Oo
33
9� Ift MA�W1 t.--b
470.72 --�
Bm
TOP of N*aa Banc
94.W
= 7 ` D• 7-0
�o�E • y'zo ' lb�
II 004
0 20 40 6011
DISCWMER The mop h.q waukteod IQ Dc
vPxWMn�•dmnNe pwl•.ymfWvd 0 ( _ PL T r/ _v - T
��, '•
commerce.wi.gov
isconsin
Department of Commerce
Date of Inspection: April 08, 2004
Project Name: Christensen 3 Lot CSM
Use: Residential New 34 Bedroom Home
Legal Description: SE-SE-33-30-16W
Site Number: 670155
Subdivision: Proposed CSM Lot 1
Municipality: Town of Emerald
County: St Croix
Plan Transaction Number: 963425
Sanitary Permit Number: NA
Wastewater Flow: 450-600 gpd
Persons Present: E Gottfried, Owners
P Qum
INSPECTION REPORT
SAFETY AND BUILDINGS DIVISION
Integrated Services Bureau
13 East Spruce Sheet
Chippewa Falls WI 54729
www commerce state m,ue/sb
(715) 726-2544
Plumber Name and Address:
NA
Certified Soil Tester Name and Address:
Ell M Gottfried, CST 221981
PO Box 1645
Eau Claire WI 54702-1645
Owner Name and Address:
Kurt and Elizabeth Christensen
877 Benoy Road
Hudson WI 54016
(715) 386-6340
An onslte soils verification was conducted at the above referenced site as per district policy for all sites
with less than four inches of unsaturated soil below the bottom of the A horizon. This is a follow-up
investigation subsequent to one conducted In February when sod conditions were largely frozen The
Intent of this Investigation is to confirm Initial observations by the certified sod tester (CST) relating to the
presence or absence of redoximorphic features in the A horizon and/or subsoil In -situ soil texture
structure, and consistence factors were atso reviewed as they relate to wastewater application rates
Other site conditions such as percent and direction of slope, landscape position, land surface contour
length, and surface water hydrology may also be noted and their effects are factors considered in the
recommendations and conclusions portion of this report
A typlca d profile could be described as follows
CST B- OT 3 /
00-04" 10YR 3/2 sil, 1 msbk. mfr, as.
04-08" 10YR 312 sit, lcsbk, mfr, cs
08-10' 10YR 312 sit 2msbk, mfr, as, wr f2d 7 5YR 416 rmfs
10.18" 10YR 513 sit 2msbk mvfr, w/ m3d 10YR 416 and 518 rmfs
CST i LOT 3
00-07" 1IIYR 3/2 sit. 1msbk, mfr, cS.
07-10' 10YR 2/2 sil 2msbk mfr, as w/ c2d 7 5YR 4/6 rmfs
10-14" 10YR 5i3 sil, lini mfr, w/ m3d 10YR 416, 5/6, and 5/2 rmfs
CST B-2 LOT 1
00-07" 10YR 812 sit, lmsbk, mfr, as
07-08' 1OYR 3/2 sil, 1fpl, mfr, as.
08-10" 10YR 5/3 sil, 1mpl, mfr, cs, w/c3d 7 5YR 516 rmfs.
10-16' 7 5YR 4/4 sit, 1 m csbk, mfr, w/ m3p 5YR 5/2 and 4/G rmfs
611 M cio I-FYR111)
Page 2 1 n-
A copy of the approved plans, spectGcabons and this letter shall be on -site durntg construction and open to
inspection by authonrcYd representatives of the Department. which may tact tide local inspectors If plan index
sheets were mhn fitted in lieu f additional full plansets, a cup% of ttus approval letter and index shed ,hall be
atciched to plans that correspond wth the copy on file ts%h the Department .Alt permits rcgwred by the state or
the local municipality shall he obtained prior to commencement of con5trudion/insCillation/operdnon
In granting thm approval the Dietswn of Safett K Btuldinga reserves the right to requite lunges or additions
should condmous arise making them necessary for code compliance As per sate slats 11)i 12(2). nothing in this
reN iew shall rehese the designer of the responstbl]ty for designing a sate buldm¢, strucmre, or component
Inqumes concennng this correspumdence map be made to irk at the telephone numbci lisicd bclou of at the
address on this letterhead.
((Smeared}',
l.cros G .lamky, ;utcwa r Speaab,t
bneg::ned Services Hweai
(' I' 1'.26-2544 \'uicC
Mans}.) acmuniel.,r state Nu us
Fee Required S I WOO
Fee Reverted 5 I DO On
Balance Due 5 () On
WtSMART code. 7633
i
I i
April 21, 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023-04-21
Plan Review: PWTS-042100609-C
LE C BJORK
E7818 unty Rd E
Menomo WI5475I
SITE: pat Olsen
1228 240th strcel
Town of EMERE
St. Croix County
Total Amount: $250.00
Description: 450 GPD (3 Bedrooms
Maintenance Required
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY WI 54304-5211
Contact Through Relay
httpJldsps.wi.gov/programsfindustry-services
www.Msconsin.gov
Tony Evers- Governor
Dawn Crlm - Secretary
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF 114DUSTRY SERVICES ,
SEE
ofe Distribution Component Manual — Ver. 2.0,
10706-p (N.01101, R 10/12)
Mound Component Manual — Ver. 2.0, SBD-10691-P
(N.01/01, R 10/12)
The submittal described above h en reviewed for conilblirlance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The §l#5mittal has been CONDITI LLY APPROVED. This system is to be
constructed and located in a ordance with the enclosed appro plans and with any component manual(s)
referenced above. The o er, as defined in chapter 101.01(10), consin Statutes, is responsible for compliance
with all code reauiremal ts.
/stats.
a ge in or work at plumbing in the state unless license o do so by the Department per s.145.06,
onditions shall be met during constructionor installation and prio o occupancy or use:
ispersal area prior and during construction to avoid disturbance, compa on and use of the site.
onstruction; it is recommended not to activate the pump in the dose tank until the tanks are
or 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
(PO)&TS). Waste generated shall be properly disposed of on -site or off site.
• Any tell 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 inches.
Smearing and compacting of wet soil will result in reducing the infiltration capacity of 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 SP Table 384.30-3 and SPS Table 384.30-5
• Insulate building sewer beyon 0 feet per SPS 382.30 (11)(c)
• Well setbacks to meet chs. NR 8\ancture's
• Tank Installation to follow all mrecommendati• Verify property Hue(s) prior to in.
• Pump Floats to be set and verified per a roved plan. Any changes may result in pu resizing to meet
TDH and GPM Specifications.
• Areas that are occupied with rock fragmen\,whe
ts, stumps and boulders r cc the amount of soil
available for proper treatment. if no other siable, trees m the basal • ea of the mound must be out off
at ground level. A larger fill area is necessary of the above c pionsare encountered, to provide
sufficient mf:ltrativc area.
Owner Responsibilities
• The current owner, and each subsequent owner, shall cei a copy of this letter including instructions relating
to proper use and maintenance of the system. O rs shall ceive a copy of the appropriate operation and
maintenance manual and/or owner's manual f e POWTS cribed in this approval SPS 383.54(1).
• In the event this soil absorption system or y of its component rts malfunctions so as to create a health
hazard, the property owner must follow
ollo a contingency plan as cribed in the approved plans.
A copy of the approved plans, spe icanons and this letter shall be on -site Vag construction and open to
inspection by authorized represe fives of the Department, which may incluN local inspectors. All permits
required by the state or the loex municipality shall be obtained prior to comm cement of
In granting this approva a Division of Industry Services reserves the right to requ a changes or additions should
conditions arise maki4 them necessary for code compliance. As per state stats 10 1. 12), nothing in this review
shall relieve the desi er of the responsibility for designing a safe building, structure, o component.
Inquiries cone ng this correspondence may be made to me at the telephone number liste below, or at the address
on this letterhold.
The abov e$ addressee shall provide a copy of this letter and the POWTS management plan he owner and any
others so are responsible for the installation, operation or maintenance of the POWTS.
Thanks,
r%im eaa�a.�Pn�ea,;�
POWTS Plan Reviewer— Wastewater Specialist
Department of Safety & Professional Services ( Division of Industry Services
email: um.vanderieestfawisconsin.soc
Cell: 608-516-6134
PAGE 1 OF 6
Mound Plan
Index & Cover Sheet
Component Manual Design References:
Version 2.0, SBD-10691-P (N.01/01, R. 10/12) & Version 2.0, SBD-10706-P (N.01/01, R. 10112)
Pg 1 of 6 Index & Cover Page
Pg 2 of 6 Plot Plan
Pg 3 of 6 Mound Cross -Section & Plan View
Pg 4 of 6 Distributi Network Specifications
Pg 5 of 6 Pump Tan Specifications
Pg 6 of 6 n Ma�g t Plan
I 1 M 1�.
Attach ents:
hiclosures:
Pump C e
licatip6 for Review
'1Mwt�
Soil Evaluatiory4eport & Site Map _
Name / D9cription
Owner Name(s): ice- Orb Phone: I S -30B- 3SYB
Owner Address: 917 W VJOtilZip: "64-101G
Project Address: I Z28 Z � t,rAA
Govt. Lot: -3 NE 1 / of SE 1 /4,%ction3, T3N-R 16 E ❑ or W0
Township: MV1 ounty:Project Parcel ID #:
Designer Informathon
Designer Na ilwi P� _ hone:76,R3l -7375-
Designer dress: -7,oia L- Zip:94'S i
E-mail: ov. cona;rrina;ly
APPROVED
Lice a Number: DEPT. OF SAFETYPROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
T
SEE CORRESPONDENCE SP
Signature: Date: �_ J-Z-OZ
Original signature filquired on rh submitted copy.
L-04 S
C4ECK BOX AS APVLICABL_.
HLC K &jX AS APPXsELE.
WAGE z O
SOIL
EVALUATION
Srale: t 30'
SYSTEM
D
SITE MAP
45
60 /PLOT PLAN
PROJECT NAME:
75'
DESIGN FLOW'—GPD
Air bt.CAa
Attach design flow calculations for commercial plans.
PROJECT ADDRESS
2.2 is Z� }N tr
``
N
Pipe Material ! ASTM Stan and (Tables 3 .3 r0-5)
SanttarySewer / Zlt J
BM Symbd. .4.
BM Eieoallon- 91 FT
Face
Maln
BM DaScdptlal ��
Chok $ W
Slope Gradient (%�
WNI -rod H a urable7
I pN O
nd..0 wnr by
m.winp •^+��°^
IMPORTANT:
Stow ground elevation contours at suitable IORrvals.
of Tested Area
on tn..pp-opH^. Inc
�hSfE2 ti �39�6 �� 2 Ise PI�� Y >1
s - 01 .,
d P Is 0
(3) Im
/ Elang
v
Lo 3 0�
CpeN alas -
P i2
q�'�
qow s 661- RR ck � w
LJ.L Il
W =
0.5" TO 2.5" WASHED AGGREGATE
(min. 6.0" beneath distribution pipe - m1n.2.0'
over distribution pipe and covered with
approVe4synthetic fabric)
aASTM C-33 SAND FILL
Plowed Surface
SINGLE -CELL
MOUND DISPERSAL AREA
D = Z• � r;
MIN. 6.0" OF TOPSOIL COVER E = it
min. 1.0 ft System Elevation = 9 Q • 3 1t
Lateral Invert Elevation = q5.48 it
min. 0.5 ft
r--/i o
I
} A = 4 ft—
I (typical)
Surface Contour \
Elevation = q_ 6
% Slope
t
9z S
Z. 5-
PLAN VIEW 3
(No Scale)
/7--P
40 J= �2 ft
eral inypica0l)-------—-------------------- ---------°senaoon 0—--------------------------------�
B =12a It
14.75 ft
K= 13.Z ft
I = ft Iti)
Bend as necessary to follow contour
OOWNSLOPE TOE
Prohibit disturbance and vehicular traffic
within 15 feet of downslope toe.
Reset Page
D
m
W
O
n
O)
nJ Plat- QIAv,
576.76 dls�A, - �lO�
4(�-18 ZZ8 1J-t0�h s--
R C EEK WOO
TM�J�/. Han
Ow«
33
p
P.rs Conpw
4r loaTy ter: a�
'}T.Ba_ 4N.Ls Plr_
498101
1
4 20
DJS IAIMEF. Ws mep is ral iryeleliO4ar! to Ee
e ,.W conatl, oor l,ammWrqbte.r
mndoelanabwn are aw respaugay of tM
user.
5�-- CrO' X COUNTY
NO. 633834
STATE SANITARY PERMIT
OWNER Pa4n4cK Olsewt
PLUMBER ZCWI'S A 4or k- LIC.# 253�j%(o
TOWN OF
SEC 33 9T 3 N, R E
AND/OR LOT 3 BLOCK
THIS PERMIT
POS
SUBDIVISION
E
CHAPTER 145.135 (2) WTSCONSEN 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 maybe 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.
CER - DATE 7/ Z 3/ZJ
RENEWED
VIEW
T DATE
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R11/20)