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Home My WebLink About014-1025-60-000Wisconsin 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 [Privacy Law, s 15.04 (1)(m)] hip Permit Holder's Name: City Village Towns Richard & Vonette Heibel TOWN OF FOREST CST BM Elev. P. BM Elev: BM Description: r •, eot / Qo.o' C Tg14k*I = 11: PV't- TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic SKCLVr ++n�i+ LZ S, Dosing Ti Aer ' Ho ' TANK SETBACK INFORMATION TANK TO PL WELL BLDG. Vent to Air Intake ROAD Septic r 7 s0 / N > IOU, Dosing 1 t Aer Hol ' g -/ PUMPI9-P'HON INFORMATION C f4- Manufacturer E LLjf,-R GPM Model Number n - r [FoIrcemain Friction Los System H jcl.Z; TDH� 3o Ft S . Length �i Dia. a Dist. to well SOIL AAkORPTION SYSTEM RENCH Wdth Length I No. Of Tra\aehn DI d ( / lai0�i lj SETBACK SYSTEM TO P/L D LL INFORMATION 7 SD STATION BS HI FS ELEV. Benchmark All. BM Bldg. Sewer t SUHt Inlet Q� SUHt Outlet Dt'Inlet pp �•f Dt Bottom Header/Man. -3.3 b Dist. Pipe 3.3 System `f•Sa 8.2..f F' I Grade Lt S over /r+�J „�,, (, �Jt S�� •� /�. s� • s� SV DIMENSIONS INo. Of CHAMBER UNIT,, neaaenmansoia 11IrViDullOn 1 4w x Hole Size x Hole Spacing \ Vent teAir Intake Pipe(s) j_L011J, Length Dia Length--1-L Dia Z Spacing V• !� 7 SOIL COVER Y Prnaaurn Rvctama nnlu . es ....A n. et-a.a.ta a a•e a n..e. Depth Over Depth Over xx Depth of .r xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/rrench Edges Topsoil 0 Yes E] No 0 Yes 0 No 12f �) COMMENTS' (Include code distxepencies, persons present. etc.) Inspection #1: �� 2B Z Z Inspection *2: �� 4� 20 � No w!0#41 — Location: 3048 C D O 1.) All BM Description 2.) Bldg sewer length = 2� amount of cover = Ti r'�. Jo r 3� 3•a rr.�a- e,�, ��,lQ.t' �no�►4►e dd at.re_ t Pan revision Required? 0 Yes (No Use other side for additional information 7 Z SBO-6710 (R.3/97) Dete Insepctcr's Signature No. 2 as per applicable code/ordY *W.0rt'plete plans for the system artd suh to the Co only on pa root less than 8 i x 1 inches in size ,, n SBD-6398 (R03/14) drr u County w 'ar, — I Industry Seyices ST. CROIX : 16 2022 1400 E Washington Ave MAR p s P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) 'a 53707-7162 , WI County Madison 6 (L / ?03 (I St. Croix � nt om Permit App anrtary lication State Transaction Number In accordance with SPS 383.21(2), Wis, Adm. Code, submission of this form to the app407ital unit FUSTj - t)32.2sa -� is required prior to obtaining a sanitary permit. Note: Application forms for state-ownearesu d to of dress (if different than maili as) the Department of Safety and Professional Services. Personal information you provide may be used for secondary Pumoses in accordance with the PrivacyLaw, s. 15.04 1 m Slats. C Q C �4 L Application Information - Please Print All Information Property Owner's Name Parcel RICHARD & VONETTE HEIBEL �E 014-1025-60-000 Property Owner's Mailing Address Property Location 3095 CTH Q Govt. Lot SW '/,, SE'/4, Section 11 City, State Zip Code Phone Number CLEAR LAKE, WI 54005 (circle one) T31N R15EorW IL Type of Building (check all that apply) Lot # Subdivision Name ® 1 or 2 Family Dwelling -Number of ooms ❑ Public/Commercial - Describe Use 4 S far 0 teroatc4 Block # ❑ City of �— ❑ State Owned —Describe Use ❑Village of CSM NutitlreF— ® Town of FOREST III. Type of Permit: Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ® At -Grade Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Compone explain retreatment Device (explain / 1 V. Dispersal/Treatment Area Information Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) Dispe# Area Proposed (sf) System Elevation 600 Rate(gpdsf) 600 600 98 CONTOUR 1 VI. Tank Info Capacity in Gallons Total # of Units Manufacturer New tanks Existing Tanks Gallons U Septic or Holding Tank 1250 1250 1 SKA W Dosing Chamber 750 750 1 COMBO Lj VIL Responsibility Statement- 1, the undersigned, assume responsibility fo installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum r MPIMPRS Number Business Phone Number ROBERT HARDINA 824825 715-491-5039 Plumber's Address (Street, City, State, Zip Code) 477 170TH AVE TURTLE LAKE WI 54889 VIII. Coun /De artment Use Only %Approved ❑ Di oved Perulit Fee 12 Iss d t g Agetti Sign ElOwner iveno for Denial S 6 f 4 z� IX. Conditions Approv so+is fer-Bisappreral 3\ -) J l3 �;, DS d�/�2- Lw STEM OWNER. ma`s" f Septic tank, effluent filter and VrJ^ �►� dispersal cell must be serviced /maintained as per managementt plan provided by plumber. `() yu,t.y�T-- d ✓�� 5 W�t� All 6M CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. SOIL EVALUATION o scale: V4� 40' so eo ❑ SYSTEM PAGE 2 OF SITE MAP PLOT PLAN PROJECT NAME: , DESIGN FLOW: Oft (Poo GPD (iottgo) io HE�BEL Attach design flow calculations to> Commercial plans. PROJECT ADDRESS: 3048 CTH Q -A# Pipe Material ( ASTM Standard (Tables 384.30-3 & 384.305) Sanilery Sewer. � 34 BM Symb BM Elevation: FT Force Main: Zl SGN 44D BM Description: 1 1/2 INCH PVC PIPE pe d ant(%) trKrmate north by IMPORTANT: . otrSloestedGraArea: 3.5 Well 0 drawinganarrow Shaw ground elevation contours at suitable intervals. on the approprite Rte. �,1zdv 7�E capdo-ro .7V- Sk.c, �? 1 � y9 _ a; ras SC.ICa pY DIVISION Or INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 Contad Through Relay hitpildsps.vn.gov/progromshndus"-services www,wiscongin.gov Mo Tony Even . Governor Oawo Crlm • Secretary March 7, 2022 Conditionally CONDITIONAL APPROVAL C PLAN APPROVAL EXPIRES: 2024-3-7 APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Plan Review: PWTS- 032200343-C 3"" ;a*+ Bob Hardina SEE CORRESPONDENCE 4771701h Ave Turtle Lake, WI SITE: Richard & Vonette Heibel County Rd D Forest Township St Croix County SW X SE Y4 S11—T31N — R15W FOR: Description: At -Grade Component Manual — Ver. 2.0, SBD- 4 Bedroom At -Grade — 600 GPD —42" to 10854 (N.03/07, R 1/12) limiting factor— Effluent Filter - Pressure Distribution Component Manual —Ver. Maintenance required 2.0, SBD-10706-P (N.01/01, R. 10/12) 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 The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the At -Grade site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. Components and soil removed from an existing drainfield shall be properly disposed of so that there is no risk to public or environmental health. • 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. • 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 is required. • 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. 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. 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. • 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, imh,uwlzoj l Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715) 813-9111 Joshua.rowley@wisconsin.gov /fir raktr�\ die �` APPLICATION FOR REVIEW Private Onsite '-' Wastewater Treatment • Sp )-i Complete all pages- \z,� S s NOTE: Personal information you provide may be used for secondary purposes Systems �tr [Privacy Law s. 15.04(1)(m), Stats.] Y Division of Industry Services ❑ Plans to be E-filed. Provide SharePoini User name below: I For plan status, check our website at tgRD /dsps-wi.aov Email technical code questions to mailto:DSPSSBPovrtsTech9Z i.00v Several counties have been delegated certain authority to review plans in lieu of Division of Industry services. For a current list of those counties and their designation check our website at http://dsos.wi.00v 1. Project Information -, JFill in all known information. Project/Site Name: H 6 t 3F L Location, Number & Street of project (if fuunknown, indicated nearest road) Co , ro Legal Description: '!;1'EA $E, f County []City ❑ Village ® Town of S 2. After plans are reviewed, please: (check all that apply) ❑ Call customer 1, 2 (circle number)' ❑ Requesting party will pick up ® Mail plans to customer 1, 2 (circle number)' 'Refers to customer number from below. Confirmation of assignment to a reviewer. Transaction ID: Previous Related Trans. ID: Estimated Completion Date: Assigned Reviewer: Assigned Office: Mail to your office of choice below: LaCrosse, Green Bay NOTE: We reserve the right to re -distribute plans to another office if needed to reasonably balance turnaround times. Check http://dsps.wi.gov for next available review date 3. Complete the following designer/ownerrrequesting Information. Utilize the check boxes when designer, owner or requesting party Is the same to avoid repeating information. Designer Information (Customer 1) DSPS First Name Last Name Customer Number ROBERT HARDINA 824625 Company Name HARDINA SEPTIC SYS. Address 477 170TM City State Zip+4 (9 digits) TURTLE LAKE WI 54889 Phone Number E-mail address Cell phone (area code) Other Please Specify Below (Customer 2) DSPS First Name Last Name i Customer Number j Company Name ---------- -------- ---- - Address City State Zip+4 (9 digits) - Phone Number E-mail address Cell phone (area code) 715-491-5039 Check if applicable Check if applicable or specify relationship ❑ Owner ; ❑ Owner ❑Other - specs relationship _— Information and Plan Submittal Checklists. To request electronic plan review complete the appropriate application form and e-mail it, along with your registered SharePoint username to D,SPSS3PIanSchedu ,9_16sconsin.gov. If plans are being submitted via paper, they I will be assigned to a reviewer after receipt at a DSPS office. Submittal checklists can be found in each applicable component manual f appearing on the POWTS program page under Publications POWTS Comoonents Manuals _ Holmen/Onalaska Area OSPS 2850 Midwest Or Ste 104 Onalaska, WI 54650 i 608-785.9334 f Fax: 608-785-9330 Email: DSpsSbPlanSchedute wi.00v Green Bay DSPS 2331 San Luis Place Green Bay, WI 54304 920-492-5601 Fax 920492-5604 Email: DsosSbPianSchedule wi.00v Make Checks Payable to: Division of Industry Services OR ❑ Check box to invoice designer and sign below j TOTAL AMOUNT DUE +_ Review Code 7633 I Designer Signature — SBD-10577 (R 3/19) 5. POWTS SUBMITTAL (check all that apply -incomplete forms may result in processing delays) ® NEW ❑ Aerobic Treatment Unit(s) ❑ Chlorinator ❑ Tank Replacement Only ❑ REPLACEMENT ❑ Commercial System ❑ UV Disinfection Unit ❑ Add Effluent Filter SYSTEM TYPE(S) NOTE: Submit separate sheets for each system if submitting multiple systems on the same site T Enter Fee ❑ Revision to previously approved plan $85.00 ❑ Miscellaneous Review (i.e. replacement of a septic tank, addition of an effluent filter or pretreatment device to an existing system, etc.) $80/hr ® Component Manual Design All treatment components are previously approved ® At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, R. 1/12) Wastewater Flow in under s. SPS 384.10 (2) or (3): ❑ In -ground Component Manual - Ver. 2.0, SBD-10705-P (N.01/01, R 10112) Gallons Per day Design wastewater flow of the proposed system: ❑ Mound Component Manual- Ver, 2.0, SBD-10691-P (N.01/01, R 10/12) ❑ Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R 10/12) 600 1,000 gpd or less $ 250.00 250 ❑ Other - Please specify GPD 1,001 - 2,000 gpd $ 325.00 _ 2,001 ^5,000 gpd S 400.00 ❑ Soil Based Individual Site Design' One or more treatment components are not previously approved under s. SPS 384.10 (2) or (3): ❑ At Grade (Individual site design/deviation from component ❑ Non -Pressurized In -ground Design manuals and use of components without product ❑ Pressurized In -ground Wastewater Flow in approval): ❑ Mound ❑ Drip -line Gallons Per day Design wastewater flow of the proposed system: ❑ Constructed Wetlands GPD 1,000 gpd or less $450.00 Documentation must be provided to support treatment and dispersal claims. In a separate 1,001 - 2.000 gpd $600.00 statement, provide rationale for the project and attach supporting documents (code sections, test 2,001 - 5,000 gpd $750.00 I reports, technical papers, research articles, etc.) greater than 5,000 gpd $900.00 plus $0.08 for each gallon over 5000 gpd Design State-owned facilities: Holding tanks previously approved under s. SPS ❑ Holding Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03/07, Ri/12)' Wastewater Flow in 384.10 (2)(3). Design wastewater flaw of the proposed system: Gallons Per day Non -state owned Commercial and Residential Holding tanks that completely utilize this manual 5,000 gpd or less $ 90.00 and have an estimated daily flow of less than 3000 gallons per day must be submitted to the GPD 5,001 - 10„ 000 gpd $150.00 appropriate governmental unit for review instead of the Department. (see SPS 383.32(3)(a)) greater than 10,000 gpd $225.00 ❑ Holding Tank Individual Site Design`, (i.e. site constructed, <5 day holding capacity, Co- Holding tanks including site constructed tanks NOT mingled wastewater, etc.) Design- Wastewater low in previously pp oved under s. SPS 384.10 (2) or (3). approved Please specify: Gallons Per day Design wastewater flow of the proposed system: Documentation must be provided to support the rationale for the project. In a separate statement, 5,000 gpd or less $180.00 5,001 - 10,000 gpd $300.00 — please include all code sections, test reports, technical papers, research articles, etc.) GPD greater than 10.000 gpd $450.00 _ ❑ Soil Saturation Determination Report (using observation pipes) ❑ Interpretive Determination $240.00 ❑ Experimental System (One time additional fee). Submit fee for individual system as per appropriate above system type) Experlment Number _ $400.00 Priority Review (enter same amount as normal review fee listed above) $ — Enter Total (rounded to the nearest dollar) $ 250 SBD-10577 (R 3/19) RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project HEIBEL Conditionally Owner RICHARD & VONETTE HEIBEL APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES Address 3095 CO. RD. Q nR4Cl/1N AC Mn11CTRY sFRVICES CLEAR LAKE Wl 54005 Awg&d Legal Description SW,SE,11,31N-R15W Township FOREST Subdivision Name SEE CORRESPONDENCE County ST.CROIX Lot No. Parcel ID Number 014-1025-60-0000 Plan Transaction Number Index sheet Calculations At -grade drawings Laterals and dose tank Specifications Management & contingency plan Pump curve & specifications PLOT PLAN FILTER MAINT. SOIL TEST Designer ROBERT HARDINA License Number Signature _ Phone Number Date 02/02/22 Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 824825 7154191-5039 Designed pursuant to: At -grade Component Manual for POWTS SBD-10570-P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 4.0 (04103) Page 1 of 10 PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (gpd) 600.0 Design wastewater flow (gpd) 3.50 % Site slope 98.00 Contour elev_ below lateral (ft) 42.00 Depth to limiting factor (in) 0.60 in -situ soil application rate (gpd/ft^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd/ft rT 10.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 100.00 Aggregate length (it) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0.188, Orifice diameter (in) e.g. 0.188 calciNot i final 2.00 Estimated orifice spacing ft 2.00 Forcemain diameter (in) 3.37 Forcemain flow velocity (ft/sec) __40.00 Forcemain length (ft) y or n '� Does Forcemain drain back? 8.001 Pump tan a eva 10 (ft) y or n y Are laterals at highest point? NA [Al System head (ft) x 1.3 6.5 Forcemain drainback (gal) Vertical lift (ft) 80.0 5x Lateral void volume (gal) Friction loss (ft) 86.5 Minimum dose volume (gal) 1< Total dynamic head (ft) 33.0 System demand (gpm) Designer must select one lateral diameter Lateral Diameter Selection Pipe diameter Design options Design choice 1 in 125 in 1.5 in 2 in X X X 3 in X Gallonslinch Calculator (optional) i 754 Total Tank Capacity (gal) E 47 Total Working Liquid Depth (in) 16.0 Gatlin (enter result in cell G46) Treatment Tank Information 1260 Septic tank capacity (gal) swka—�— Manufacturer Effluent Filter Information Dose Tank Information Zabel ]Filter manufacturer 764.0 Dose tank capacity (gal) A440 L-- r Filter model number 16.0 Dose tank volume (gal/in) skaw IManufacturer Project: HEIBEL Transaction Number: Page 2 of 10 AT -GRADE PLAN VIEW Iff Observation pipes (2 typical) B 100.00 ft 116 B 16.67 ft C 12.00 ft WC D 5.00 ft E 2.00 ft L 110.00 ft B W 22.00 ft A x B 1 1000.00 ft^2 T L ,E� Cap Typical obs. pipe. = Total aggregate cell A x B Slotted in the lower and anchored se = Plowed area L x W securely. -1 6" AT -GRADE CROSS SECTION Svnthetic fabric cover Lateral f invert elev. r 5, r / �'I E Surface contour 98.00 ft C A and system elevation = 12 in. topsoil and subsoil over aggregate and tapered to toes. �—] = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: HEIBEL Transaction Number: 99.83 ft Finished grade elevation .— Observation pipe at aggregate toe 3.5 %Slope D Plowed layer below L x W Page 3 of 10 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection It I� x-+-Y12.1 %12-;1 Last (tole drilled na;;t to end c ap Holes drilled on t he bottom of the lateral, equally spaced Lateral Specifications 0.188 Orifice diameter (in) X 2.00 Orifice spacing (ft) 25 OrificeMateral 16.5 Lat. discharge rate (gpm) 33,01 Sys. discharge rate (gpm) ✓1 13.67 TDH (ft) Final grade _'�, Weather-proof junction box Laterals & lone main of PVC SO 40 fper COMM Table 18410-5i i = Turn -up wiballvaheporeleanoutplug Center Lateral connection point 2 Number laterals P 49.00 Lateral length (ft) 2.00 Lateral diameter (in) 2.00 Forcemain diameter (in) 40.00 Forcemain Length (ft) Typical Pump Chamber Layout Tank component is properly vented Electrical as per NEC 300 and Comm 16.28 WAC 2 Totals Inches Gallons 27.7 443.5 2.0 32.0 5.4 86.5 12.0 192.0 47.1 754.0 Tank full JA Alarm on Pump on B 89.00 ft I c Pump off C zoeller Pump manufacturer bn 152 m— I Pump model number disconnect Approved manhole cover with warning label and locking device 4" Alternate If--. outlet location 18" min. 1r^Approved outlet joint Provide 1/4" weep hole or antisiphon device. 4 88.00 ft Isle r� hombus Alarm manufacturer tank alert Alarm model number Project: HEIBEL Transaction Number: Page 4 of 10 At -grade Svstem Maintenance and Operation Specifications Service Provider's dame Robert Hardina Phone; 715 491 5039 POWTS Regulator's Name SLcrorx Cowl' Phone, 715386�680 I System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1000.0 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tani Effluent Filte Pump and Control! Alarm Pressure Systerr Mounc .w,-l:ei Service Frequency Inspect and/or service once every 3 years Inspect and clean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years __ _ Inspect for_pondin9 and seepage once everx wears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code, 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD-10570-P (R. 6/99). Lateral Turn -up Detail Finished • - Grade 6-8" Diameter Lawn — —i . Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution 98.50 ft 10 Project: HEIBEL Transaction Number: Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Page 5 of 10 At -grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shalt maintained in accordance with its' component manuals (SBD-10570-P (R. 06/99) and SSWMP Pub. 9.6 (01181)1 and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83,33, Wis. Adm. Code when the tanks are no longer used as POWTS components Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Arty opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at feast once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosureif the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected a1 least once every 3 years. All switches. alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At -grade and Pressure Distribution System No trees or shrubs should be planted on the at -grade. Plantings may be made around the at -grade's perimeter, and the at -grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at -grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the at - grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg/L BOD5 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed 0 should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: HEIBEL Transaction Number: Page 6 of 10 I r n PUMP PERFORMANCE CURVE . ; MODEL 1 y. A 9 1� i 30 S Aq a - 20 A ;h E} i 1 -. A C„ 0 4 i i _ — - — .xs6 Atl►A CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. ❑ SOIL EVALUATION Scale: T' 40 ❑ SYSTEM PAGE 2 OF o SITE MAP so Bo PLOT PLAN PROJECT NAME: KezzZI(10ftgrid) 10' j DESIGN FLOW: VUJ GPD HEI BEl_ Attach design flow calculations for commerclal plans. PROJECT ADDRESS: 3048 CTH Q Pipe Material / ASTM Standard (Tables 384.30-3 $ 384.305) BMSymbq D-*r BM Elevation:1QO `— FrSanitary Sewer: �Y1 Force Maln: 7r / 5� }�D BM Descdotion: 1/2 INCH PVC PIPE SlopeGradent{°k) cf Tested Area. Well 15 Symbol (if applicable): 0 Indicate nonhby drawing an arrrnv IMPORTANT: Show ground elevation contours at suitable intervals, on the approprite line. _'j G'ri +AW Y 47,E 20940048A ,r Sk ... 4. 37es ?� U ' �cr' �'= 2�`t'yi '�T''�3 F, r.r, r• 6• it � 1',�� ;�i , w�i,. installation and Maintenance Instructions installation Slept Dry fit the filter case onto the outlet pipe going to the drain bend. Ensure It is i8t tared directly under the l access opening. (if outlet pipe is already in a fixed position, additional pipe may need to be added) Stop 2 If utiRring the additional single side support and the two bottom supports, While the case is sWI dry Otto the ouiJetplpe, measure and mitt rschedule aopvcpipe to thelength needed to extend from the hubs that are pre -molded Into the case to the side wall and the Inside hoot' of tank, solvont weld PIP4 into tine hubs that are pre -molded onto the case. Step 3 Solvent weld the case to the outlet ptpe. insert the filter cartridge Into the case pressing down on the cartridge until It locks Into place at the bottom of case. . Step 4 t(utlifzing a vertical read swath: losert switch Into Use hole pre -mottled Into the top of the filter, Press straight doyen until tt tocks tnts Qlace Maintenance 1) Rern we the access lid of the tank. Note: To ensure undesirable solids do not etdt the tank and into the drain field, the tank should be pumped out until the level of effluent is below the outlet level of the to;& 2) To remove the fllter cartridge from the After case, pull up firmly on the handle of the cartridge dislodging it from the case. (if utillxing a vertical read swltcits removal of switch Is optional) 3) Ustng an ordlifa(y garden hose, rinse the fitter Cartridge ensuring all visible septage. material is removed. 4) Place the filter cartridge back into the fitter case pressing down an the cartridge until It locks into place. 5) Place the access Rd back onto the tank ensuring it Is secure, R--Cr jV)=-t, j FEY 6 4iN t.Hednrntatcr has a lUethae ttmitod warranty: firollwc Nnor UC warrants tiro nitert'A:i ba tree of tmanufacturkip and wnr rYransblp defatts dnringnrnmai use for the period of time the original purdtarer owns the product. Etfeiime Hoer wilt provide a reptarantant Niter ht ttra avert that tho origlrrat Nltor was ant damgrod durft rho lostaMon or maintenance procem oamapa to this product caysed by acddem misuse or abase Will not be coveredtinderthbwarranty,tmpropmcare oraiaifur atomsresrdnngfrompmdvctnotbeGtpinsWed,operatedorr"Dtaiaed properly wal void Us warranty, t tfethe Nter asmumes no responstbtiny for tabor C.haraes, removat charges, 4tstaitauon or oilier inddanW of eonsequanW corn. Contact: p�li Re fadmgll tgjr Mom SU-72Q•22at: 4�T �,Ols 15 zio t I u)ni �. •.�w�4�+��nrny�i vh�i^i.drs�r�W�r m '11GLLD 10 f1ooft wm GHY '91YQt�M9 iIIP'1'/71111J'lY'ON4Ldf1uF mo.xsun� mn � ra n .unsrenat� aw au Tma raona.c� rpv.w nv- wawawa nr .parr. Txw roa�ra.ro� ru awvra rru.aw oa \uicq tnaav 0 -4k i7,fs 49�iR<. NOR'O. -M NOT YAV OgA•Y'!6 -Mn ODNTRADfPQ µW,l, y�wY ALL OMli9✓JN8 -ACTUAL TFU" DOMAN ENAL L IK R TLdNPAOMR On Tft" M,*,� -ALL rWAn9 NOT ONWN Wh 9n Ti IVIMONn'B ::TT' Ow T1N P:NtIY AND cONI•UC�.^4 93MBNb. 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'JNI 8@iV'd S1213cii.10"I NV ci WO-1:J N ,VW ( Fri, a A r- X a u „ l ti a F i lrf yy 4 y File #; ST CRo NTY SANITARY SYSTEM Office Use Only -0 OWNERSHIPIADDRESS FORM Created 2/2027 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. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer RICHARD & VONETTE HEIBEL Mailing Address 3095 CTY RD Q City/State/zip CLEAR LAKE, WI Phone Number Email Address 54005 Parcel Identification Number 014-1025-60-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location SW �/4 , SE t/4 , Sec. 11 T 31 N R15 W, Town of FOREST Subdivision Plat: Certified Survey Map # N/A Warranty Deed # 936107 Number of bedrooms 4 New Property ddress ( taff Initials) Volu Page # Lot # (before 2006)Volume Page # Spec house O yes E no Lot lines identifiable E yes 0 no OFFICE USE ONLY / d � PbQ /a,(,C� (VeZific ion of new address required from Community li (D e) for new construction.) 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 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.gov WARNING DEATH MAY OCCUR IF TANK IS ENTERED WITHOUT PROPER EQUIPMENT NOTE: SEE INNER WALL PHOTO ON THE "EXCLUSIVELY AT SKAW'S" PAGE. 3.0E 4.00 11 27-00 I 27.0E 27.0E 1 i 24. ov 2a.00 2a. oo _ a00 h— U t�::j 1- 16.00 100 -' F200 —1 11 —200 _.. rrdLET� ^ 900 "'� OUTLET Z.00 � � 7ti 00 4-INCH 4 INCH PRESS I PRESS SEAL GASKET SEAL INSTALLED I _-U / GASKET WHEN POURED L� RAFFLE FILTER / 4700 l 30vi SECTION VIEW OF TANK AND COVER Model Number: 12001750 for., SEPTIC/SEPTIC, SEPTIC/PUMP, SEPTIC/SIPHON OR HOLDING 16,1001bs. Liq. Depth I Gat / In. I Nom. Cap. 47" 16.05 754.35 gal. — 3.00 OUTLET END VIEW OF TANK SKAW PRE -CAST 26255 105th Street, New Auburn Wisconsin 54757 www. skawprecast. com Phone: (715) 967-2277 ToH Free: 1-800-924-8625 Fax: (715) 967-2707 Dod a cs�-��- gay Wisconsin and Professi al Services Page of Division ofI ices - LO,t2 MPR SOIL EVALUATION REPORT t County o x CouloPmen6i ordance with SPS 385, Wis. Adm. Code ST C O1X Attach complete s e plan o`ir an 8 1/2 x 11 inches in size. Plan must include, but not limited to: rtiog ontal reference point (BM), direction and percent slope. Parcel I.O. scale or dimension , orth arrow, and location and distance to nearest road. 0141025 60 000 Please print all information, a awed by Oate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04j1xm))._i tgAM6.- Property Owner Property Location ❑ RICH & VONETTE HEIBEL Govt. Lot SW '% SE % S 11 T 31 N R 15 E (or) W Properly Owner's Mailing Address Lot # Slocic # Subd. Na a or CSM# 3095 CO. RD. Q ^ 0 0 CAE_ PA'ad City State Zip Code Phone Number ❑ Cit y ❑Village ®Town Nearest Road ' CI LEAR LAKE W1--- - 154005 f ) I I FOREST CTH Q ® New Construction Use ❑ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material OUTWASH Flood Plan et&,'oii�/Aft. General comments and recommendations: AT GRADE(0CL —� 1 Boring g # ® Pit Ground surface elev. 22 ft. Depth to limiting factor 46 in. l i Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture I Structure Consistence Boundary Roots _GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. EN#1 •Eff#2 1 0-10 10YR313 -0- SIL 2MSBK MFR GW 12M .6 .8 2 10-30 10YR4/4 -0- SIL 2MSBK MFR CW 1M 6$-,g 3 30-46 10YR8/4 -0 LS OSG ML GW NIA .7 1.6 4 4 o 10YR814 F2D5YR4/4 LS l OSG ML CW N/A .7 1.6 -- i I i ❑ Boring I Boring # ® Pit Ground surface elev. 98 ft. Depth to limiting factor 42 in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. •Eff#1 I 'EffA l 1 0-8 10YR3/4 •0' 'SIL 2MSBK MFR GW 2M 6 8 2 8-28 10YR4/4 -0 -- - SIL 2MSBK MFR CW - 1M .6 r 10—; 3 28-42 10YR8/4 -0- LS OSG ML N/A N/A .7 1.6 4 42-62 10YR8/4 F2D5YR4/4 I LS OSG ML NIA NIA J 1.6 - _ . --- i _ Effluent #1 = BOD. > 30 s 220 m /L and TSS > 30 s 150 . g/L Effluent #2 = BOD, > 30 s 220 m /L and TSS > 30 s 150 mg/L CST Name (Please Print) 1 S e CST Number ROBERT HARDINA a' �. 524825 Address Date Evaluat n Conducted Telephone Number 477 170r" AVE TURTLE LAKE WI 7-15.21 _ J 715491-5039 I 3 i Boring # Boring ®Pit Ground surface elev. 98 ft. Depth to limiting factor 46 in. I ,20C--� GM Annliratinn P. l 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 1 0-8 10YR314 -0- SIL 2MSBK MFR GW 2M .6 .B 2 8-30 10YR4/4 -0- SIL 2MSBK MFR CW I .6 .4-8 3 30-46 t0YR8/4 -0- LS OSG ML WA N/A .7 1.6 4 46-65 10YR814 F2D5YR414 LS PSG ML N/A NIA .7 1.6 ❑ Boring # ❑ Boring ® Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Snil Annlirafinn Rafe Horizon i Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1Ft2 •Eff#1 "Eff#2 f i ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor _ in. Soil Annlication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ftz -Eff#1 -Etf#2 v { Effluent #1 = BOO, > 30 5 220 mg1L and TSS > 30 s 150 mg1L ` Effluent #2 = BOD, > 30 S 220 mg1L and TSS > 30 5150 mg1L -z*ka Qjy 3 ok�-3 CHECK BOX AS APPLICABLE. [] SOIL EVALUATION SITE MAP PROJECT NAME: HEIBEL CHECK 90X AS APPLICABLE. Scale: �"=4°' ❑ SYSTEM PAGE 2 OF o ao so ao PLOT PLAN (10 ftgnd) t0' DESIGN FLOW: 450 GPD Attach design flow calculations for commercial plans. i PROJECT ADDRESS_ 3048 CTH Q Pipe Material ! ASTM Standard (Tables 384.30-3 8 384.30-5) $M Symbol: tSr t �. BM Elevation: 100 FT Saniary SewerForce Main: J BM Description �. 1 1/2 {NCH PVC PIPE Slope Gradient (°ki I-dcate nwlh by Ala 3.5 Well Symbol applicable): dra%wng an ancwv or Tested on the aap..mprtie 8a. 51*PF— a x. ras5 56.1 a4ea = T � Q 0 -� \ a � �i a I a 65 IMPORTANT: Show ground elevation contours at suitable intervals. aoQ�� NO. 641903 STAT4 SA ITAR ERMIT L PREVIOUS NO, rV OWNER 1 MAM NviTe &Iwe CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a PLUMBERrAWb,#AC,# specified period. (d) Changed regulations will not impair the validity of a TOWNOF sanitary permit. (e) Renewal of the sanitary permit will be based on SEC ��,T N, R�_S regulations force at the time renewal is sought and that changed regulations may impede renewal. (f) The sanitary permit is transferable. AND/OR LOT BLOCK 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. Oat SUBDIVISION ., _ 4&k"�VZ? ISSUING OFFICER - DATE 20/16W26L RMIT EXPIRES LESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)