Loading...
HomeMy WebLinkAbout040-1295-90-000 tNisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 499207 0 GENERAL INFORMATION (ATTACH TO PERMIT) late PI sD NN a Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. � fGJ '(' � S • J ,6 . Permit Holder's Name: City Village X Township Parcel Tax No: Forbra d, Tammara I Troy, Town of 040 - 1295 -90 -000 CST 8 El ev; Insp. BM Elev: I BM Description: I AA Secti /Town /Range /Map No: •�' at 133 _U" - - �.I11� 19.28.19.1701 TANK INF RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �¢- I Z� , LAC 0-t Irf1 99. Dosing t � Alt. E?M ' 1 Aeration Bldg. Sewer • b r Holding St/Ht Inlet 1 ot. 90 /Q �. D • H t TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ti � � 19� / i DtBottom � 11.2$ 0•�t Dosing ti u Header /Man. 3 4 Aeration Dist. Pipe 3-1L t{b3.20, 3.9 Holding Bot. System X .&t 10 Z R I Grade PUMP /SIPHON INFORMATION �+ SID+ Cs+�' 'da _AQ r JUUJH Manufacturer Demand IstZover �( GPM Model Number W 31 I ,1_`.Nq� i /d, al �,.� '[ L- ` TDH Lift, o %N' Friction Looses System Head TDH Ft I O I .g � i -t ( (0 • 7 - t . I Forcemain Leng_th� t Dia. tf Dist. to Well SOIL ABSORPTION SYSTEM = •`I •R / Width r Length t N PIT DIMENSIONS No. Of Pis Insibe Dia. Liquid Depth DIMENSIONS / lZO SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: — INFORMATION CHAMBER OR • ?/'S Type Of Syste I UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold t Distribution t �t x Hole Size x Hole Spacing Vent to Air Intake Pipes) 1 Length3 , O Dia 2.0 Length 4 ` 9 •Z � Dia Z Spacing � - /O I 2.0/ SOIL COVER " Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil I I Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Insp tion #1: 000. 3 1 1 Inspection #2: /VOAI _2-00jo Location: 390 Mitchel Road Huds n, WI 54P16 (NE 1/4 SE /4 19 8N R1 W) Tr�du alley Estates Lot 9 Parcel No: 19.2817D It 1.) Alt BM Description = 1 081 _ D 'co . 4,Jp� 2.) Bldg sewer length = Z o - amount of cover= `q��" "SMrTC / �bK Cet.�/t Ots� S(,trcoflS n �t Plan revision Required? I Yes No ' , O Z __ f T' SZ�� Use other side for additional informa n. t G A D Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) f Safety and Building;; Division County 201 W. Washington Ave., P.O. Box 7162 1*i1 sconsi XF Madison, WI 53707 - 7162 Sanitary Permit Number (to be fi ll ed in by Co.) Department of Commerce (608) 266 -3151 Al 9Iz 6 Sanitary Permit Applicatio State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal informatio rov' / may be used for secondary purposes Privacy Law, sl5. 1 x Project Address (if different than mailing address) I. Application Information - Please Print All Informafign > '3 n ( C1 `1 U Pro PVV Owner's Name `` , Parrrl it Lot # Block # N rc� � r sT I F ° �,i ict 0 k Prope er's Mailing Addres Q Property Location o, +c �p C State Zip Code ne �r -�, �a Section ! 1._ SCE 11 3 � c E.M ! �D SCE T N; R�E o W II. Type of Bul ng (check all that apply) t r pk 0A `n ' or 2 Family Dwelling - Numbs of Bedrooms n itr Subdivision Name CSM Number ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use t a' 00 [&J A. ❑City_❑Village)<Townshi o III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. VNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System 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 S em: Check all that apply) C, w Oct ❑ Non - Pressurized In- Ground A Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground ❑ off (ding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis rsaVPreatmeat Area Information: P r 5 V-*- Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Dispersal Area Pro (sf) System Elevation � ✓ t � � VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks optic HoWing Tank ' ± C, Aerobic Treatment Unit Dosing Chamber ory k e VII. Responsibility Statement - 1, the undersigned, ass risibility for in of the POWTS shown on the attached plans. PI mber's Name (Print) PI u s Signatu MP RS umber Business Phone Number t s3 Z `7I -a S, t0 -S/ Plumber's A Tess ( Cu , State, Zip Code) a of VIII. Coun /De artment Use Onl A pproved ❑ Di Sanitary Permit Fee (includes Groundwater Date Issued Issuin ent Sigma Stain Fee) C� 6c� ❑ en Reason for Dema J IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2 All setback requirements must be maintained as pK applicable cods / ord irtartces. Attach complete plans (to the County only) for the system on paper not less than SV2 x 11 inches in sin SBD -6398 (R. 01/03) ` �' 9�`,�� �K �.� ��Y 'M`T C1 ter': ry'��1C. �� ..• ;� 4 4,: 1. 1. � J {�� tt1l_0.t�Gv� AJ 5 sx R OS Q►, :1�� , m _N SI_f.3 - ,, 0 (A h- f) Cbmloo !` o� y;I ok- Sol -s_ - tv/ -- fo CF _ - - u w. G LLO 1 4's - -- - - - i 1502 SOIL EVAL REPORT At c-- 0 20 $ l Wisconsin Department of Commerce Page 1 of 4 Division of Safety and Buildings in accordance witfC V6 ^Adm !Code; AC.E. Sal & Site Evaluations Opunty Attach complete site plan on paper not less than 8 %x 11 inche st St. Croix include, but not limited to: ve rtical and horizontal reference poin�i� /� p I D percent slope, scale or dimemsions, north arrow, and location a 040- 1078- 20 -000, ID#19.28.300 Please print all information. e , gy Date Personal information you provide maybe used for secondary purposes 5.04 X Property Owner Pro Wation J.T.B. Properties, L.L.P. C/O John W. Nielsen j 4W.IL& N / 1/4 SE 114 S 19 T 28 N R 19 W Property Owner's Mailing Address ... _ . Block # Subd. Name or CSI# 1564 West University Ave n ue ' '9I Trebus Valley Estates City State Zip Code Phone Number ity _j Village e Town Nearest Road Saint Paul MN 1 55104 651 - 646 - 1967 Troy I County Highway T" iV..� New Construction Use: 01 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD I Replacement Public or commercial - Describe: Parent material Glacial drift _ Flood plain elevation, if applicable na General comments and recommendations: Recommend installing mound system at elev. = 102.45' at 6" above 101.95' contour. ,� Baring # --j Boring F -- P' Ground Surface elev. 101.87 fl. lim' i factor — 34 Soil loation Rate it h to it AAA Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz *Eff#1 *Eff#2 1 0 -12 10yr3 none sl 2fsbk mvfr cs 2fm 0.5 0.9 ( 2 12 -24 10yr4 /2 none sil 2fsbk mfr cs 2f,1m 0.5 0.8 ,( 3 24 -34 10yr3/3 none sil 2msbk mfr gs 1f 0.5 0.8 ( 4 3 445 10yr4 /4 f2f 7.5yr4/6 sicl 1 msbk mfi cw 1 f 0.2 0.3 5 45 -61 7.5yr4/6 f2f 7.5yr 5/8 sl 1 csbk mvfr - - 0.4 0.6 — Boring F-1 # ,J � i/ Pit Ground surface elev. 102.91 ft. Depth to limiting factor 52" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft' *Eff#1 *Eff#2 1 0 -12 10yr3 /3 none sl 2fsbk mvfr CIS 2fm 0.5 0.9 , 2 12 -16 10yr4/4 none sl 2fsbk mvfr cw 2f,1m 0.5 0.9 3 16 - 25 10yr4 /4 none sl 2msbk mvfr cw 1f 0.5 0.9 , 4 25 -35 7.5yr4/4 none sl 2msbk mfr gw 1f &vf 0.5 0.9 , ( p 5 35 -52 10yr4/4 none sil 2msbk mvfr cw 1f 0.5 0.8 , 6 5 -82 10yr5/4 m3p 7.5yr 5/8 Is/sl/sil 1csbk dsh - - 0.2 0.3 Fi#6 contains colluvial mmsbk Is, mmsbk sl and 1csbk sil. * Effluent #1 = BOD ? 30 < 220 mg/L and TSS 30 < 50 fFl #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Si ature: CST Number James K. Thompson 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceda, WI 020 12/5/01 715- 248 -7767 i ,Prope►tyowner J.T.B. Properties, L.L.P. C/O John Parma ID# 040 1078 - - 000, ID #19.28.300 Page 2 of 4 3 ] Boring F Ong # 99.40 ft. Depth to limiti factor 42" in. Pit Ground Surface elev. � Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : *Eff#1 *Eff#2 1 0 - 14 10yr3/3 none sl 2fsbk mvfr cs Vm 0.5 70.19 2 14 -25 10yr4/3 none sl 2msbk mvfr cw 2f1m 0.5 , 3 25-42 7.5yr4/4 none scl 2msbk mfr cw 1f 0.4 0.6 4 42-66 10yr5/4 f2f 7.5yr4/6 Sil 1 csbk mfr - 1 f 0.2 0.3 H#4 contain luvial sl and limestone fragements. Loading rate adjusted to reflect reduced permiaibilty associated with abrupt textural changes. F Boring # _ I Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2 *Eff#1 *Eff#2 F-1 Boring # _J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' *Eff#1 *Eff#2 * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employe r. 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. SOIL AND SITE EVALUATION 1502 Page of 4 PROPERTY OWNER: J.T.B. Properties, L.L.P. C/O John W. Nielsen PARCEL I.D.# 040 - 1078 -20 -000, ID# 19.28.300 A.C.E. Soil & Site Evaluations REPORT MEMO Soil evaluation completed for plat review purposes and prior to clearing or lot monumentation. Results indicate that the soils at this location are suitable for a mound septic system. Additional soil evaluation and clarification of system location /design may be required prior to POWTS design and sanitary permit acquisition. At 6'letlabo,, ti ,ALt. P.M.' ao.�( n ee Al ench h- ta.n1' � T aF •� v �eb� -�: A SSG.rnP,Ci t OUTLOT 1 f iNSERVAnON EASEMENT qloo, 732414 SQ. Ft. l 15.81 Ac. fLO T 10 4 149180 S. F\ • 3.42 Ac. �W RAM TEMP�j JEA SEM 11E D uP EAS Y TEWSI f r 4Z LO T `8 o ` 125567 S \2.88 4 / LOT \ \8 109895 S.. . 52 A r / LOT 147698 S.F. I f 3.39 Ac. I r�ac.�• I 989b (5 LL) Xe= • 089ti -98£ (S LL) O LLL-9 L0t IM 'uospnH peon Iaeppiuo LOLL - a31N30 1N31NNH3n0J Ik1Nnoo XIOao '1S - 3JI330 0NIINOZ •••••\ = r • n nn. n n NISNO3SIM A1Nnoo XIO83 1S � ` a 8.Nm £ = h - _ " o o d am �+ z_ m e ym a0 H A O > in fr � •. z c m n s zzs: z ^ Rig!; = J a 3 �e�eea�Y'�Y�1#�eG�G � t �� Z $R y A'A A� �77wyss ssx,ea.stz ", ssscstscue> s " ", ° >.Y:r -- ssgrr," -.qi» =mo R`Y 'Z :k = "imp "4� O 3�� 3 N N n 1fg�YSG�Y CgBk Yrr,s / I DNPUTTED LANDS NEST LINE K THE NE 1/1 OF THE SE 1/1 N 0011'01' E I30&70' " s' f: —� c o a i y \v/ 11QQ • 7' O V /JJ• ��\ � yytf ✓<I � �" � y / ./ / �! i!y "vim `� \. � ' T A ff1f� z IT rA OPEN SPACE S `> _ « O \ •• g: '> \� q s d5 G • I tr7 �x S 00Z7'46 w zezalea' g ,.« EAST LINE OE THE SE 1/" UNPLATI[0 LANDS I �p I y I t Safety and Buildings 4003 N KINNEY COULEE RD commercemi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.w www•commer isco sin.go / Department of Commerce isconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary October 06, 2006 CUST ID No. 220537 ATTN.• POWTS Inspector CALVIN W POWERS ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/06/2008 Identification Numbers Transaction ID No. 1328657 SITE: Site ID No. 719189 Tammara K Forbragd Please refer to both identification numbers, County Highway F above, in all corres ondence with the agenc Town of Troy St Croix County NE 1 4 / SE1 /4 S19 T28N R19W Lot: 9, Subdivision: Trebus Valley Estates FOR: Description: Mound / Four Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1101537 Maintenance required; 600 GPD Flow rate; 34 in Soil minimum depth to limiting factor from original grade; System(s): Ezflow Mound Component Manual, (N.6103), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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: • This system is to be located and constructed in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS 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. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • 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. Access to the tank/filter for maintenance purposes must be provided per Comm 84.25(7), Wis. Adm. Code. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives o e e artment which mgy include local inspectors. • y • -,-) Cara d a'10H 471"J Aft ' P-PRLIV ED DEPARTMENT Of C 1t:6IEUOCE nivisiOh'OF SAFETY AND BUILDINGS CALVIN W POWERS JR Page 2 10/6/2006 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 owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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 Safety & Buildings 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 RECEIVED SEP 2 9 2006 EZFLOW MOUND AND PRESSURE DISTRIBUTION COMPONENT DE GA BVIL DINGS Residential Application INDEX AND TITLE PAGE Project Name: TAMMARA K FORBRAGD Owner's Name: TAMMARA K FORBRAGD Owner's Address: 1312 ROSE PLACE ROSEVILLE, MN 55113 Legal Description: NE1 /4 SE1 /4 SEC19 T28 NR 19W Township: TROY County. ST CROIX Subdivision Name: TREBUS VALLEY ESTATES Lot Number: 9 Block Number. Parcel I.D. Number. 040- 1078 -204M Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZFIow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 PLOT PLAN Page 10 PERK TEST Page 11 SEPTIC TANK/PUMP STATION S PECS Designer. CALVIN POWERS License Number. 220537 Date: 09/30/06 Phone Number. 715 - 246 -5135 Signature: Designed Pursuant to the EZFlow Mound Component Manual (N. 06103), and SSWMP Pubrk ation 9.6 Design of Pressure DWbution Networks for ST -SAS (01/81) EZFlow Mound Version 1.2 (R. 02/04) ('> E Page 1 of 11 SEE CORRE EZFtow Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design Note: Sand fill (D) cala,lasons assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches' 600.00 Design Flow (gpd) 8.00 Site Slope ( %) 101.95 Installation Contour Line Elevation (ft) [ 130.00 Contour Length Available (ft) 34.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd/fl?) Distribution Cell Information 6.001 Cell Width (ft) 3, 4, 6 7, 9, or 10 Only 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gp w) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution E Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = 6.00 if /office 2.00 Forcemain Diameter (in) 20.00 Forcemain Length (ft) Does the forcemain drain back? [ Y 94.00 Inside Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) 8.12 Vertical Lift (ft) 90.37 5x Void Volume (gal) 0.70 Friction Loss (ft) 93.63 Minimum Dose Volume (gal) 15.31 Total Dynamic Head (ft) 41.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 _ 1.50 x 1.25 x e 2.00 x x 1.50 x X 3.00 2.00 x _ 3.00 x Gallonstinch Calculator (optional) Treatment Tank Information 800.00 Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) 1 36.001 Total Working Liquid Depth (in) W I Manufacturer 22.22 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter I nformation 800.001 Dose Tank Capacity (gal) ( POLYLOCK Filter Manufacturer 22.221 Dose Tank Volume (gal/in) I PL525 Filter Model Number WIESER Manufacturer Project: TAMMARA K FORBRAGD Page 2 of 11 Mound Plan View T F 10 6 J : ::: :: :::` : ::: :: Observation Pipe 3 ❑ :- .. i A 5 _ W B ................. z 4� .......... ......... ...... . ... .. .. Mound Component Dimensions A 6.00 ft E 11.76 in H Aft ft K 8.22 ft B 100.00 ft F 12.00 in 1 ft L 116.44 ft D 6.00 in G 0.50 ft J ft W 20.63 600.00 (ft Dispersal Cell Area 1 1578.95 (fe Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 1 10.00 (ft) 1 /10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 104.45 (ft) -► k; • H ,.................. 2 ................. I F t ;':::`.::::::' : Dispersal Cell 102.95 (ft) Lateral 102.45 (ft) ---► — :;; 6" Invert Elevation Dispersal Cell :.:.:.[�.:.:. :.:.:.:.:. ..•.....•...•.- .•.•.. ...... . 1 Elevation - 3 101.95 (ft) Contour Elevation 8.0 % Site Slope Typical Dispersal Cell Shading Key a See Page 5 1❑ Topsoil Cap —° a c 2 0 ft Geotextile Fabric over © Subsoil Cap a � � T ee •r- rc:... .�,:.�, -. �.•.�:..,, . , f .... ; ...... ASTM C33 Sand :a Z Tilled Layer 0.5 ft 05 EZFlow Media 0 See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: TAMMARA K FORBRAGD Page 3 of 11 Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below Force main canection Wa we or cross to rrwHYold at any point. Laterals are ikmiaai Oifitm point up, except every Sth one K--- P points down for drainage. $ 0= Turn -up udball valve or X��E�e12 Laterals t: Force main of M Soh 40 densnoutplug per COMM Table 84.30 -5 Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 49.25 ft Orifices per Lateral 25 Lateral End (2) NA It Orifice Density 6.00 fe /orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 10.30 gpm Manifold Diameter 2.00 in System Flow Rate 41.19 gpm Forcemain Velocity 4.21 ft/sec Dose Tank Information Locking cover with warning label and locking device, and Electrical as per NEC 300 and --► sealed watertight Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented 4E Alternate outlet location Forcemai n diameter WIESER Manufacturer _ 2 in. Capacity 800.00 Gallons Volume 22.22 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.79 439.73 C B 2.00 44.44 P � ump off elevation (tt) C 4.21 93.63 94.83 D 1 10.00 222.20 D Total 36.001 800.00 Dose tank elevation (ft) Min. 3" Bedding under tank. 94.00 Alarm Manufacturer I SPI Alarm Model Number OB SERVER 100 Pump Manufacturer GOULDS 3885 Pump Model Number WEO 311L 7 Pump Must Deliver 41.19 gpm at 15.31 ft TDH Project: TAMMARA K FORBRAGD Page 4 of 11 EZFlow Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross - section Arrangements Drag appropriate drawing to space below. 6 ft Wide (94MOSOO Component Legend ® 6" EZFIow Bundle - EZ0601A, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203H, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203HP, 5 or 10 Ft Lengths 4" Distribution Pipe With Pressure Lateral Inside Tumup Enclosure — — — — Lateral Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Drag appropriate drawing from left to space below. A- - Force Main - - -- — — — — -- — — — 6ft Wide Center Manifold GOULDS PUMPS [� Suawrsit Effluent Pump MODEL 3 88 5 WE Series PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion - resistant, Single phase (60 Hz): can be operated continuously Specifically designed for the stainless steel. Threaded • Capacitor start motors for without damage when fully following uses: design. Lodmtrt on all models maximum starting torque. submerged. • Homes to guard against component • Built -in overload with 0 Bearings: Upper and • Farms damage on accidental reverse automatic reset. lower heavy duty ball bearing • Trailer courts rotation. • STTOW or STOW severe duty construction. • Motels ■ Fasteners: 300 series oil and water resistant N Power Cable: Severe • Schools stainless steel. power cords. duty • ''h — 1 HP models have rated, oil and water resistant. Hospitals ■Capable of running dry • Ind NEMA three prong E poxy seal on motor end y without damage to provides secondary moisture • Effluent systems components. grounding plugs. • 1'h HP and larger units have barrier in case of outer jacket ■ Designed for continuous bare lead cord ends. dam and to prevent oil SPECIFICATIONS operation when fully Three phase (60 Hz): widdng. Standard cord is 2U. Pump submerged. P Optional lengths are available. • Solids handling capabilities: * Class 10 overload protection N 0 -ring: Assures positive 3 /a' maximum. MOTORS must be provided in ding against contaminants ,, • Discharge size: 2' NPT ■ Fully submerged in separately ordered starter unit. and oil leakage. • Capacities: up to 140 GPM. high -grade turbine oil for . STOW power cords all have AGENCY LISTINGS • Total heads: up to 128 feet lubrication and efficient heat bare lead cord ends. TDH. transfer. TOW 10 w. 778 and • Temperature: ■ Class B insulation on Opera � p ratings r �C kl By 1041(40°C) continuous 'h -1'h HP models. On' Pump ratings Assockft► 140°F (60 in termittenrt. ■ Class F insulation on 2 HP within the motor manufat�urer's s tae 9 • See order numbers on models. recommended working limits, GoW& Po"M b 150 9001 reverse side for specific HP, voltage. phase and RPM's METERS FM available. 40 130 sEwES: wE 1 zo srzE: ��.• souus FEATURES 35 110 rtrM: 500 & i 5 WPM ■ 1 1 11444+ Impeller Cast iron, semi- 30 1 00 SFr open, non -dog with pump - out vanes for mechanical 25 so seal protection. Balanced for smooth operation. Silicon 20- TO i bronze impeller available as 60 an option. < 1s so ■ Casing: Cast iron volute ° 40 - type for maximum efficiency. ° 2' NPT discharge. — ■ Mechanical Seat: SILIC J1. . 10 CARBIDE VS. SILICON T D. CARBIDE seating faces. ° 0 0 10 20 30 44 50 60 70 80 90 100 110 120 130 140 150 160 Gaul Stainless steel metal parts, �--' BUNA -N elastomers. 0 5 o 15 20 25 30 35 ff0ft cAPAaW 41- It, Goulds Pumps ® 20M rrr water rechnoim, Inc ITT Industries Effective December, 2004 www gouwcam 83885 Mound System Maintenance and Operation Specifications Service Provider's Name CALVIN POWERS Phone 715- 246 -5135 POWTS Regulators Name ST CROIX ZONING Phone 715 - 386 -4680 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 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 fe Maximum FOG 30 mg/L Type of Wastewater Domestic 1 Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Fitter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound ins for ndin and see a once every 3 years Other 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 EZFIow mound component manual. 2. Dispersal cell media conforms to EZFlow products approved for use with the FZFIow Mound Component Manual approved 6/3103. EZFIow media is covered with an approved geotextile fabric. 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 mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished . .............. •.............• Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where ............... .............. Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZFIow Media Diameter as Lateral 1.26 Feet 4 Distribution Lateral Lateral Cleanout Project. TAMMARA K FORBRAGD Page 6 of 11 Mound System Management Plan Pursuant to Comm 83.54, Wit. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZFbw Mound Component manual 613103 and SSWMP Publication 9.6 (01/81)) 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. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 84nc hes 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, Slats. 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 least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent OW alarms may indicate surge ikrws 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. ff 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 creeds 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 C immerce. Pump Tank The pump (dosing) tank shall be inspected at 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. Mound and Pressure DkOlbut on System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perirhster, and the mound shad be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than far vegetative maintenance) on the mound is not recommended since sod 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 mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODs, 30 mg/L TSS,10 mg/L FOG, and 10 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 it 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 call shad be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 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 shad be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes detective the defective component(s) shad be immediately repaired or replaced with a component of the same or equal performance. If the mound 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 removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the nacre and telephone number of your local POWT'S regulator and service provider. Project: TAMMARA K FORBRAGD Page 7 of 11 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ - -AM A tz.4 j < Ajl laQ / A:AeC_C.J41 —C Mailing Address /3 / 7 2, /eO Sc PLAC.4=_: , / 3 Property Address �`�� ^ -- L- [2-04,0 (Verification required from Planning & Zoning Department for new construction.) City /State ` d S o " 5/x- Parcel Identification Number LEGAL DESCRIPTION Property Location ' 1 9 T !.D N R l 9 W /a, / a, Sec. W . Town of Subdivision VA L Lot # Certified Survey Map # , Volume , Page # Warranty Deed # l — 7 3 - ,Volume ` / , Page # Z �o � Spec house ye no Lot lines identifia yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. 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 maintenance 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 Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on - site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 fall 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 P P the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of warranty deed recorded in Register of Deeds Office. Nu�er-af be rooms ff / 0(.0 SIGNA OF PL ANTIS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warran ty deed. (REV. 08/05) C� J.J w 96 41 .l.w B' i a t t i S \ j s 0 ' ` i Y ' TT C• ii� i J 44!* ` t 1 Lo � � s y � Z ('� a C n a —3 = �f Z a, n n mg ule :a� 3:i�2�w r �� G A D ' N O W 9� —BOO— =O > G Zk �• > O C7 •.. N O $ z '` z c. o o � a n > r j a ° o � Q n m WLPi 200800 —MR 9CJ1LE: i 4 "+�i' REV N0. DAIS O � ORANl1 81f:SMf Z SEPTIC MANUAL wv" us mm u m+ Mr. is 54M DAM JAMJMY toot �t' REV. JAN. 2005 800 - 325 --8456 sm- w.Pizoo 09/2 THU 9 :19 FAX 715 386 4687 ST CROIX CO RHO OF DEEDS _ U002/002 2 X3106,.73 DOCUMENT N UMBER WARR 9 ANTY DEED 6 3 KATHLEEN H. VALSK REGISTER OF DEEDS J.T.B. Properties, LLP, a Minnesota Limited Liability Partnership ST. CROIX GO. VI RECEIVED FOR RECORD conveys and warrants to Tamara Kae Forbragd, 20/31/2005 10:00AM the following described real estate in St. Croix County; State of Wisconsin: 11ARRUTY w DEED al LOT 9, PLAT OF TREBUS VALLEY ESTATES IN THE TOWN OF TROY, RfiC 3 11;.0 � ST, CROIX COUNTY, WISCONSIN. TRANS Ply: 335. COPY Fa: CC Mt PAGES: 1 THIS SPACE RESERVED FOR RECORDINO DATA NE AND RETURN ADD WIN LAW FIR treet N n, WI, - 10 040 -1295- 90-000 PARCEL I.D. NUMBER OR G.I.S. This is not homestead property. (is) (is not) Exception to warranties: TOGETHER WITH AND SUBJECT TO any other easernents, covenants, reservations or restrictions of record, if any, but this shall not be deemed to extend any such other recorded encumbrances beyond the term established by law therefor. ated th day f b , A.D.. 2005 (Seal) (Seal) Jo n W. Nielsen Partn + (Seal) (Seal) y Brad cv S. Diller. Partner ' AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN authenticated this day of etc I% COUNTY } At Personall y came before me AN TITLE MEMBER STATE BAR OF W C I� day of October , 2005, the ove- (if not, �' Q named John W. Nielsen and Bradley S. Diller, atlthoriied by §7066~, V' , S partners Z L' THIS INSTRUMENT WAS DRI to me known to be the sons who executed t e foregqoinl�' at e d acknowledge the Atty. Hugh H. Gavin. GWIN �. S.C. 430 Second Street, Hudson. WT. 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) of Pu St. Croix County, WI. 1 My commission ' p an f not, state, expiration date: .20 q �o' ��� - \° '}�� i �o�