HomeMy WebLinkAbout040-1310-00-022 (2) Wisconsil, Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
• Sah^ry and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 514884 0
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)j.
Permit Holder's Name: City Village X Township Parcel Tax No:
Cook, Eric & Shannon Troy, Town of 040 - 1310 -00 -022
CST BM Elev: Insp. BM Elev: BM Description: nn Section/Town /Range /Map No:
9 Z . 2 ,J 1 G5T 17.28.19.2009
TANK INFORMATION ELEVATION DATA
Oq
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV.
Septic � (.�Jr Benchmark 5 9.�y..7 [v -n �Y 7Z � Z1 Zoo / Z •
9esrrrp Alt. BM , g �,
rr';t df 48. H
Aeration e Bldg. Sewer 9 &V
Holding St/Ht Inlet
/A45 y(0 . Z
St/Ht Outlet
TANK SETBACK INFORMATION \
TANK TO P - /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic hX � / r� $� 1 94 Dt Bottom N g 919,
Dosing / , p / 'l Header /Man.
Aeration Dist. Pipe V• 947•
to.
Holding Bot. System
PUMP /SIPHON INF ORMATION F'nal Grad T T 7, ,.7 q�7• a
Manufacturer Demand St Cog�v r
ZC1 `, GPM C1 • 5 9!0 • S7
Model Number 1 &5 r $ y (v ` - 7 1
TDH Lii , , ^ Friction; ohs System Head. )A [Dt Ft ��, /(� 9 3.57
Forcemain L h / Dia. Z t! Dist. to,Well 9103,
c.�p LOWt �.
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length No. Of Tren PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS :3 4,6 �{ l /• ms , ,� J�
SETBACK SYSTEM TO P/L JBLDG ! WELL LAKE /STREAM LEACHING Manufacture,: (�
INFORMATION CHAMBER OR I 01 /•�
Typ e Of System: / UNIT Model Number 1 '57 : ;1 : ^
DISTRIBUTION SYSTEM 7,,4. 1Z, 4 - If Z = 3 (40 -All
Header /Manifold # Distribution x Hole Size x Hole Spacing Vent to Ak Int
� t ' Pipe(s)
a to
Lengt Dia 4 Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only / S 4, o..
Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed /Trench Center 1 Bed/Trench Edges Topsoil
J , � � � Yes 0 No Yes � No
COMMENTS: (Include cod di crepencie persons p resent, a .) Inspection #1: / / Inspection #2:
lo. !te,� 6 M Q.� P o Z Low". - rtw�.�..� I�•a.ut. S;JALb
Location. 313 Meadow Rid e Court Hu WI 54016 (SW 1/4 SE 1/4 17 T28N R19W) Meadow Ridge of Troy Lot 22 Parcel No: 17.28.19.2009
1.) Alt BM Description
2.) Bldg sewer length =
- amount of cover = ��
Plan revision Required? ❑ Yes ><'No - --
Use other side for additional information. �� � L_.—
SBD -6710 (R.3/97) [} Dat Inseyrr'si ature Cert.U (Ie,Au e oQ,f` ��l b�^: S m. V
corrtmeree.vtrl.gov Safety and Buildings Divis n County _ �(
a 201 W. Washin j O"x -� 1 • i" 1 f
sco n s i n Madison, Sanitary Permit Number (to be filled in by Co.)
nlepa.tir nt of Comm neroa 11!i 7"T
Sanitary Permit Application State Transaction Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental
unit is required prior to obtaining a sanitary permit. Note: Application forms for s - S are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal inforrna r+xs d for condary
p urposes in accordance with the Privacy Law, s. 15.0 1 m , Stats
1. Application Information - Please Print All Infor
Property Owner's Name 2 00q Parcel #
ERIC -A. � S kixA3mwa 1,_ c ooK MAY 3 0 ( UU Q4c 13io- -�z�
Property Owner's Mailing Address pe /
ST. CrR�G O�FICEY Pro perty Location
0 W\Ot 5 C' L ZO Govt. Lot NA
City, State Zip _ Code Phone Number SW y,, Section � 7
:NAMF�sow A1 I 0 (Circle one
H. Type of Building (check aH that apply) C� Lot # T _ N; R j� E o>
1 oi• 2Family Dwelling - Number ofBedroOrris ZZ
Subdivision Nana
stock AEAMW Kk0&:;& OF T1Z_0/
❑ Public /Commercial - Describe Use 1r' b cc� ❑ City of
1) State Owned - Describe Use
CSM Number ❑ Village of
n 1 � '/� d Town of "iRL�
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
New System y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain)
B. ❑Permit Renewal ❑Permit Revision ❑ Change of Plumber ❑Permit Transfer to New
List Previous Permit NWvber and Date Issued
Before Expiration Owner
IV. 1Xpe of POWTS System/Component/Device: Check all that appl
Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. ofsuitable soil ❑ Mound < 24 in. of su e s
❑ Holding Tank El Other Dispersal Component (explain) _ ❑ Pretreatment Device (explain) r
V. Dis erssVMeatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdst), Dispersal Area Required (st) Dispersal Area Proposed tem Elevation �• �Qw
dr7 ✓ 8 5 57 X 3 et. 75 $� _ 60 y(a6.Od �o
Vl. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units u U y j JJJ
New Tanks Existing Tanks w i'
o . 3„ n;
W J 6E FILTER a V v,
Septic or Holding Tank (LO O J7 tl d l:' dmq5o Dosing Chamber co �O� 4— FF1 I
VII. Responsibility Statement I, the undersigned, assume responsibility for in allation of thp4r o WTS slWwn on the attacked plans.
Plumber's Name (Print) (umber's Signature P PRS Number Business Phone Number
�1M KL-kRttiklZ_T �'l Z. 2.7- 1 ? 97 �'�15 ev - g
Plumber's Address (Street, City, State. Zip Code)
/V aGo C T t4. p �R U ra ptf�ir \vi t f 7 3 7
VIII. Count /De artment Use Onl
Approved Disapproved Permit Fee Date stied Issuing, em Signature
❑Owner Given Reason for Denial /`-�
IX. Conditeasons for Disapproval
1. SWic,t a lUW alftb and / ma 3� /Vd �it.r%3 d l •'�.
atrper management plan provided by oWber. �ra.t a�i5 P�oPe
2 AN s IMR tbtjt 9mW is must be mWntaiited
r
Attach to complete plans for the system and submit to the County only on paper not less than 8 14 a I I inches in size
SBD -6398 (R. 01/07) Valid thry 01/09
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Wlsconsln Depstrient of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings
ante ' Comm 85, wis. Adm. Code
County St. Croix
Attach complete site plan
led on pa than x 11 inches in size. Plan must
include, tart not Limi to: vertical n Parcel I.D.
t � r �. .�.� w .e� I � v _ O 2
rsene pnnr an f anon.
Personal Information you provide may be used for ry purp FAI�1-012 90 04 (1) ))• 3 d
Property Owner Property L tion El
DCCI Land Planners Inc ST. CROIX CO Lot SW 1/4 SE 1/4 S 17 T 28 N R 19 E (or) W
Property Owner's Mailing Address # Subd. Name or CSM#
I 1505 HWY FS I 22 I ( McMow Ridue M'Tmv
City State Z4 Code Phone Number []City []MIlage ■ own Nearest Road
New Richmond I WI 1 54017 1 ( TXQY I East Cove Road
I la New Construction UseE] Residential / Number of bedrooms 3 to 4 Code moved design flow rate 450 to 600 GPD
n Replacemrerd _ Public or commen:w - Desaft:
IP arwnt mahvial Loess over glacial till Fkwwi Plain aelwvahnn if annliraNp w.. e I
General comments ^a " e
and recommendations: G
f t ... E:
Pit Ground surface eiev. 971.77 ft. Depth to limiting factor > 102 in.
Soil Application Rate
Horizon Depth Dominant Cokxj Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont- Color Gr. Sz. Sh. 'Eff#1 " EW2
1 0-8 10yr3/2 sil 2msbk dsh as 2f .6 .8
1 2 1 8 -24 1 1 n—A Id I - I sil I l mcbk Idsh I d w 11 If 1 .4 I .6
3 2 7.5yr4/4 - s 099 dl _ _ _7 1.6
2
F Boring
# El Pit Ground surface elev. 969.13 R to limiting factor >105 m
Soti Rate
Application
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPDW
I I in I Mrar m I (err R, cent t`tinr I I Cr R, Rh I I I - FfW1 i -MV0
1 0-28 1Oyr3 /2 - sill 2msbk dsh as 2f .6 .8
2 28 -32 1 4/4 - sil lmsbk dsh cW If A .6
3 32-60 7.5yr4/6 - s Osg dl cw _ .7 1.6
u►_ lnc _
' Effluent #1 = SOD. > 30 _< 220 mmn: and TSA >30 < 150 mall ' Effluent #2 = BOD_ < 30 malL and TSS < 30 mdL
f:RT Nmrw mwmp Prirm Rinnahop — - MT hhrnhnr
Thomas C Nelson 4 Z� 227387
Address Date Evaluation Conducted Telephone Number
1432 120th Street, New Richmond, WI 9/18/05 715- 246 -2454
Property Owner. � DCCI Laud Planners Inc Parcel ID # Pending Page 2 of 3
Boring
❑ng # S Pit Ground surface elev. 966.55 Depth to limiting factor > l00 in.
Soil Application Rate
Horizon Depth I Dominant Colod Redox Description Texture Structure Consistence Boundary I Roots GPD&
I I in. I Munsd I Qu. Sz. Cont. Color I I Gr. Sz. Sh. I I I ! - Efr#f I '002 I
1 0 -8 10yr3/2 - Sil 2msbk dsh as 2f .6 .8
2 8-23 1 4/4 - 0 lmsbk dsh cw if .4 .6
3 23 -100 7.5yr4/4 - s Osg dl - - .7 1.6
I Boring # l t "l a ly
L_J U Pit VrWrq surtme el 1< r#eprn W 11111111119 >matx ln.
SW Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDO
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `EfF#2
F -1 i i i i i I I 1 I I I i
Boring # Ea i�Pit 9 Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPDMe
I I in. I Munsell I Qu. Sz. Cont. Color I I Gr. Sz. Sh. I I ! I -Efr#1 I - Eff#2 I
' Fflb mrN M = R1111 > An < 77n " and TGR >-n < 15n nwtn ' FM mnt L = RM < An mnA anri TCq < An nw,n
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.
S11"Wral M07M)
DCCI LAND PLANNERS, INC. 8 • •
SOIL BORING
RIDGE # 22 - MEADOW RIDE OF TROY
♦ BENCHMARK
T I K4F
SW 1/4 OF THE SE 1/4 OF SECTION 17, T28N, R19W, TOWN OF TROY, ST. -TOP OF CONDUI CROD( COUNTY, WISCONSIN. ALT BENCHMARK \ / -TOP OF CONDUIT TOM NELSON CST - Lic. #
227387 N NOTE: THE CONTOURS IDENTIFIED
ENVIRONMENTAL B1( DESIGN ARE PRIOR TO CONSTRUCTION. CONSTRUCTION GRADING WAS DU IN 1432 120TH ST. PROCESS RING SOIL TESTING. NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED
TO ph. # 715- 246 -2454 CONFIRM FINAL CONTOURS DUR TA G IINSTAU ATION.
SCALE IN FEE 1- f 4W •
6i" iiia
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1 100 0 100
s°
82
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Tile Sheet for New Se, ptic System
Residential Application
Conventional Septic System
Owner's Horne
Address 2L- --
Legal Description w g►- Akemo w Rum of MEW DF - nAL , �7 TzW I -g
Township Ng
county a. egMX
subdivision MeA UW-k of ISJOy
Lot Number .ZZ, -
Parcel LO. Number o40 X310 - a� _ 0 z a
p�r�rrrrr��
P /ark• &n Humber; VV
�.•� : '• , •.�� Page 1 ........ ............................... Title Sheet
•
NO `�R ; Page 2 ......... ............................... Plan View
S ? Page 3 ........... ..........................Plot an
g
• 1 FP .
Page 4.a, b & c Maintenance Plan
40 Page 5 .............. ..........................Pump specs
Page 6 ......... ............................... Tank Specs
• D �G •`
Designt V+'�'o License Number Lt22= oo'Z
Date a. -i-L-01 Phone Number
Signature �✓��.�5�
Design Information: In-Ground Comp0nentManua / Mal 0TO.5-P/N.01 /01]
Page L of-fa-
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a0SER18fxtiL7J ssu:SPE�TtO.IJ
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42_ W31T5 3 i (y UtiITS pER TREa3�{1 REput
Fay E1uD }�� 5g ! ea - V7eNG}I 3 T C,���cK U c-fa ..r�..or� r a A k BR
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I
POWTS OWNER'S MANUAL AND MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner CMK Svr 5}I NO Septic Tank Capacity 12-0 D gal 0 NA
Permit # S eptic Tank Manufacturer WkEse Z 0 NA
DESIGN PARAMETERS Effluent Filter Manufacturer G
- 5 ❑ NA
Number of Bedrooms 100 d/bedroom 4 0 NA Effluent Filter Model 1 0-9 D NA
Number of Commercial Units NA P u m p Tank Capacity 100 ❑ NA
Estimated flow (average)* yp p g al/da y Pump Tank Manufacturer w v es C- O NA
Pump Design flow (peak), estimated x 1.5* (� ® gal/day Manurfachuer 2-0G 1z ❑ NA
Soil Application Rate 0 ga l/day Model 0 NA
.Influent/Effluent Quality (NAC1) Monthly Average ** Pretreatment Unit O NA
❑ Sand/Gravel Filter ❑Peat Filter
Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration 0 Wethmd
Biochemical Oxygen Demand (BOD5) .c 220 mg/L 0 Disinfection 0 Other.
Total Suspended Solids (TSS) Manufacturer; Model:
<- 250 s
Pretreated Effluent Quality ❑ Monthly Average * ** Dispersal Cell (� 0 In -ground (pressurized)
<
Biochemical Oxygen Demand (BOD 30 mg/L 0 At-grade ❑ Mound
Total Suspended Solids (TSS) 5 30 mg1L ❑ D - 0
Fecal Coliform (geometric mean) <10 cfu/100ml ),Leac er 2S
Maximum Effluent Particle Size 1/8 inch diameter Model v g Length/Chamber
*Wastewater Flow Verification and Calculations: Soil Application Rate O�f� Area Req. 3 , 7
(Other than bedroom based) Infiltrative SurfaceIC'hamb rr -ESIA fl
N Minimum Number of Chambers 25
❑ Agggate Design Flow/Loading Rate= N Pt min
** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code
and septic tank effluent. COMM84 and be installed per manufacturers specifications
** *Values typical for pretreated wastewater. and approval letters.
DESIGN CRITERIA
E3 "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Mannar (Converse et.al.1990)
0 "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler.
Publication 15.22
0 "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6
0 "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual -
Onsite Wastewater Treatment and Disposal Systems ". EPA 625 /1- 80-012 October 1980
0 SBD - 10570 -P (8..6/99) "At -Grade Component Manual Using Pressure Distribution"
❑ SBD - 10567 -P (8.6/99) "In Ground Absorption Component Manual"
I SBD - 10705 -P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0
C SBD - 10628 -P (N.6/99) "Recirculating Sand Filter System Component Manual"
Q - 10656 -P (N -6/99) "Split Bed Recirculating Sand Filter System Component Manual"
0 SBD - 10572 P
6/99 Mound
(R- ) Component Manual „
0 SBD - 10691 -P (N- 01101) "Mound Component Manual” Version 2.0
0 SBD - 10595P (8.6199) "Single pass Sand Filter Component Manual"
0 SBD - 10657P (8.6/99) "Drip -line Effluent Disposal Component Manual"
0 SBD - 10573 P (R 6199) "Pressure Distribution Component Manual"
0 SBD - 10706 - P (N.01101) "Pressure Distribution Component Manual" Version 2.0
0 Drip -line Effluent Dispersal Component Manual for Multiflo Onsite Wastewater Treatment Units
0
MAINTENANCE AND MANAGEMENT
MAINTENANCE MONITORING SCHEDULE
Service Event Service Frequen
Inspec condition of s) At least once every 3 ❑ months s 3
Pump
out contents of s When combined stud a and scum equals one -third 1/3 of tank volume
Inspec dispersal cells At least once ev 0 months IX
yeWs) 3
Clean effluent filter At least once eve / , j 0 months s
Inspe pump, pump controls & alarm At least once every A ! p months W s ❑ NA
At least once e very
Flush laterals and ressure test At least once eve ❑months
Valves 0 s NA
❑ months 13 s I�NA
Other: At least once every ❑ months ❑ s NA
r - -- 4 z w
I
START UP
For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are fiozen at the infiltrative surface.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of wafter- saving
appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water
softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc.
This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetablethuit
peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only
paper that should be discharged into the system Other non biodegradable items such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, dental floss, -and cotton swabs should not enter the system Chemicals such as petroleum products, paint,
disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compaction of snow over the dispersal unit may cause it to freeze up.
p Valves
Valves shall be operated in the following manner.
Alarms
Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any
problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing.
INFECTIONS
Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Phimber, Master
Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule).
`1 Septic Tanks Component
Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks
or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground
surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any
defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective
locking device to prevent accidental or unauthorized entry into the tank.
When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents
of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin
Administrative Code.
The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's
specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more
frequent intervals than stated in the maintenance schedule to keep the system operating.
Purrip Chamber/Treatment Tanks Component
The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters.
Any service needs or repairs shall be promptly taken care of.
In- Ground Gravity Component Dispersal Cells
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding at depths greater than 75 %.of the height of the component may indicate overloading or impending
hydraulic failure necessitating more frequent monitoring.
46 of
START UP
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water- saving
appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water
softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc.
This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit
peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only
paper that should be discharged into the system Other non biodegradable items such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint,
disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compaction of snow over the dispersal unit may cause it to freeze up.
p Valves
Valves shall be operated in the following manner.
Alarms
Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any
problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing.
INPECTIONS
Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Phm bet, Master
Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule).
'] Septic Tanks Component
Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks
or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground
surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any
defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective
locking device to prevent accidental or unauthorized entry into the tank.
When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents
of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin
Administrative Code.
The outlet filter(s) shall be inspected and cleaned to remove an accumulated solids '
Y according to manufacturer s
specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may b necessary at more
frequent intervals than stated in the maintenance schedule to keep the system operating.
Puir� Chamber/Treatment Tanks Component
The inspection must include a test of all electrical rent such as
�P pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters.
Any service needs or repairs shall be promptly taken care of.
In- Ground Gravity Component Dispersal Cells
The inspection shall include recording the levels of pondWg, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending
hydraulic failure necessitating more frequent monitoring.
I �
❑ Mound, At- Grade, In- Ground Pressure
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure
necessitating more frequent monitoring.
The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals
should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to
ensure that equal distribution of effluent is occurring to promote the longevity of the system
PORTS
Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative
Code.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is
properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code.
- All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
- The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
- After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or other inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption. system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the
need for a new soil from existing and proposed structure, lot fines and wells. Failure to protect the replac ameat area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems mist
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
holding tank may be installed as a last resort to replace the failed POWTS.
The site has not been evaluated to identify a suitable replacement area Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed
as a Last resort to replace th failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES
AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREAD
TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE
INTERIOR OF A TANK MAY BE DIFFICULT OR aeOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name AIM R uRC4,u Name �I A k4 �1 Ri-13� tzT
Phone
(its z-%3-LA-%5 Phone '1 t5 Z g 3-
SEPTAGE SERVICING OPERATOR u r LOCAL REGULATORY AUTHORITY
Name TFU - CAu s.a vT/4ttp A U6 10
Phone ('1157) 72 30 Phone
IW2006 K: \WPDATA\EH\POWTS OWNER'S MANUALA.,
Paee %G of to
W tj HEAD CAPACITY CURVE
30 MODEL °98" 4 5/8
e
= s 20
3 5/8
0 0
J ! -
4 )
o
10 f ° 4 3/16
-- 2
'TNt
0
1 1/2 -11 1/2 NPT
U.S. GAL LONS 10 TFLW
0 50 60 7 0 so LITERS 160 240
NUTE
MODEL 98 60 CYCLE
Feet Colons Meters Liters
5 n 1.5 27 3
10 61 3.1 2 31
15 45 4.6 170
20 25 fir 95 12
Lock vm.c 23-
ea9971
4 3/16
s1c 1102
CONSULT FACTORY FOR SPECIAL APPLICATIONS
Electrical altematom. for duplex systems, are available and - Variable level float switches are available for controlling single
supplied with an alarm, and three phase systemm.
• Mechanical alternators, for duplex systems, are available - Double piggyback variable level float switches are available
with or without alarm switches, for variable level long cycle controls.
SELECTION GUIDE
Standard off models - Weight 39Ibs. -' /z H.P. 1' Integral float operated2polemecha�iswt, rg " r ed.
98 aeries "/,. H. 2- Single piggyback variable level float switch or double piggyback variable level.
That switch. Refer to FMO477.
Modal Vohs -Ph Mode Si— Duplex 3. Mechankel actor 10-0072 or 10 -0075.
M98 115 1 Auto 9.4 1 or 1 &7 — 4. See FM0712, for correct modd of Elactriral minnator.
N98 115 1 Non 9.4 --g -or 2 _ &G 3 or 4 & 5 5• Control swilich 10.0225 used as a control activator, specify duplex (3) or (4)
D98 230 1 Auto 4.7 1 or 1 & 7 6. Four (4) hole J- Pak, junction box, for watertight connection or wke"
E98 230 1 Non 4.7 2 or 2 & 6 3 or 4 & 5 or dept apet 0002•
7. Two (2) hole J-Pak, for wtight connection or splice.
CAUTION
F,r W,"Ofim on adt l>odLxffi teW to catft oo Ptgbexic Vadabte Larel &Afthes. All installation of controls, protection devices and hiring should be done by a qualified
R" 77' 6ecfliwlMrlWW ,FM1N86; Meehm3eaW OWW.FMOM'.&MVMewage8w=,Frr OW licensed electrician. All electrical and safety codes should be foUovied including the most
Sm&Phaw3m#aPunpCo*d . FM1916:A1amlSysleras, FMOM recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA).
RESERVE POWERED DESI
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
IUIrt TO. P.O am 16347
L' --Lotdn KY
WO 4 147 Ma> r lsd
O �f Lot Taft, KY 40211 -1961
hUp:/i mailer com AIIA- p - �y- tW4 778.=-1(ft RF -PU1iII ✓ice ,� Y
FMffiO4774,W4
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r
Paae Of
SEPTIC TANK t PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
4" CI VENT PIPE 12" MIN. ABOVE GRADE E HEATHERPROOF
? 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
FRESH AIR INTAKE WITH CONDUIT MANHOLE COV
W/ PADLOCK
FINISHED GRADE _ WARNING LAB
t;; lm" - .nw i+ . __ 4 " MIN.
IN
NS --
INLET WATER TIGHT SEALS �P D
F1�TER JOINTS HITH
LM APPROVED PIP
APPROVED B ' ON 3' ONTO
PIPE 3' - 'F — + SOLID SOIL
ONTO SOLID C -
SOIL PUMP OFF ELEV - %3.6 -- — OFF
D
r
3" APPROVED BEDDING UNDER TANK
CONCRETE PAD
SPECIFICATIONS
SEPTIC / DOSE
NUMBER DOSES PER DAY:
TANK MANUFACTURER _ V�11>✓s S• 3
TANK SIZES SEPTIC 2.00 GAL, DOSE VOLUME INCLUDING
DOSE - -1- GAL. FLOWBACK: ll7-.. GAL.
ALARM MANUFACTURER: CAPACITIES: A = 1_ INCHES = _�fCO7 G/
MODEL NUMBER:
B = 2 INCHES
SWITCH TYPE: rn ct•a°G�*�� = _/{�f µ�C�
PUMP MANUFACTURER: C = S INCHES = 1 // , ZD G�
MODEL NUMBER:
SWITCH TYPE: 1) _ INCHES =G+
REQUIRED DISCHARGE RATE ^)C GPM PUMP K ALARM HARING AS PER I LHR 16.23
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE Z.$J FEET
+ MINIMUM NETWORK SUPPLY PRESSURE - - - . - - - - - - - - - FEET
+ 3$ FEET FORCEMAIN X lli r T/ 100 FT- FRICTION FACTOR . _ . ,'137 FEET
TOTAL DYNAMIC HEAD - "9 FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH
d ; WIDTH ?(p
LIQUID DEPT !
8W CAL ZZ. Z4 iti
• sses d
J , t�RO.vrCT : (—DoK, ek[C F P4 `
FAC : to o-F
1 1!1111 IIIII lull IIIII lull lull IIlI 1111!11111 IIlI
* 8 6 2 4 3 7 1
862437
STATE BAR OF WISCONSIN FORM 2- 2000 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Document Number ST. CROIX CO., WI
RECEIVED FOR RECORD
THIS DEED, made between DTeamstructure, Inc., a Wisconsin 10/15/2007 02:50PM
Corporation, Grantor, and Eric A. Cook and Shannon L. Cook, husband WARRANTY DEED
and wife, as Survivorship Marital Property, Grantee. E%ENPT
Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00
the following described real estate in St. Croix County, State of Wisconsin: TRANS FEE: 375.00
Lot Twenty-two (22), Plat of Meadow Ridge of Troy, in the Township of PAGES: 1
Troy, St. Croix County, Wisconsin.
' ea
METP,O LEGAL SERVICES, INC.
330 SOUTH 2ND AWNUE, SUMS 150
Exceptions to warranties: MIMEAPOLIS, MN 55d01 -2217
Easements, restrictions and rights -of -way of record, if any. f 842743
040 - 1310 -00 -022
Parcel Identification Number (PM)
This is not homestead property.
Dated this 26th Ay of September, 2007. Metro Legal Services
EDIRET 84743 A
Dre c e, .,a W' cons' C rporation 774805 WD 461378
B
* n Pre t
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
ST. CROIX COUNTY.
authenticated this 26th day of Septembere grown
vv b'�C Personally came before me this September 26, 2007 the
Alnt Pu above named Jason Johnson, President, Dreamstructure, Inc. a
Wisconsin Corporation, to me known to be the person(s) who
TITLE: MEMBER STATE BAR OF executed t e foregoing instrument and acknowledged the same.
(If not,
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY *Cheri Brown
Notary Public, State of Wisconsin
Peterson, Fram &Bergman — Steven H. Bruns My commission is permanent. (If not, state expiration date:
50 East Fifth Street, St. Paul, MN 55101 2/27/2011 )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
*Names of persons signing in any capacity must be typed or printed below their signature
WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000
1 of 1
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
��' I S� to n 0^ OC-0 k
Owner/Buyer .
Mailing Address / Y IS ro oJ&t-Jr% 1J S C
Property Address 3!3 /W o J2e e„ a v/4 C 14cisc/t (41 ` S Y j fo
(Verification required from lanning Department for new construction.)
City/State � �/sdn Gt�i Parcel Identification Number n �O — 1 0 C oa•�
LEGAL DESCRIPTION
Property Location SW %4 , %4 , Sec. l=7 , T ;I-$ N R__Lq_W, Town of t ra
Subdivision /7Zrjow 9i d e- Y— — ),-c) Lot # X:k.. .
Certified Survey Map # , Volume , Page #
Warranty Deed # g co a-y , Volume , Page #
Spec house yes no Lot lines identifiable yes o
• SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle waste 3. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner ma' itenance
responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Zoning Department a certification form, signec by the owner and
by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site 1 vastewater disposal
system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is 1 ss than 1/3 full of
sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, Stat of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning
Dep within P days of the ee year expiration date.
SIGN APPLICANT DATE
OWNER CERTIFICATION
I/we certify that all stater nts on this form are true to the best of my /our knowledge. I/we am/are the ov mer(s) of the
prop describ A a of a warranty deed recorded in Register of Deeds Office
SIGNATURE OF APPLICANT DATE
* * * * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning eparhment. * * * * **
Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certifi d survey map if
reference is made in the warranty deed.
i