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004-1032-30-200 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may t>e used for secondary purposes [Privacy Law, s.15.04 (1)(m)J Pennil Holdefs Name: City Village Township John W. & Patricia J. Miller I TOWN OF CADY Insp. BM Elev: BM Descripttion: I 162.• 2.1 / I RVW TANK TYPE MANUFACTURER CAPACITY Septic Dosing _ G Aeration Holding TANK CFTRACK INFORMATION TANK TO PR WELL BLDG, Vent to Air Intake ROAD Septic Dosing > 5'r)1 Y I ep t 1 [act >2001 Aeration rolling PUMPISIPHON INFORMATION "Z.0 441 j r r .ov I �••.V I t•-•- Forcemaln Len lh 1 Dia. / Dist. to Well } (� r e•A•. •�CA� TI 1 CVCTC\■ FI FVATION DATA �MINEw= �MIF�� a m ' a -,. B D Width Length No. Of 109PM % PR DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ENSIONS Ci' %7, tByr SETBACK SYSTEM TO PIL WELL LAKE/STREAM LEACHING ufacturer. INFORMATIONType CHAMBER OR Of System: , 5�/ 93 r ` I Cro / / U-0 If Mod her Header/Manifold / DDistnb ion / l 11 / x Hole Size x Hole Spacing Vent to Air Intake t I# D I °e( I Dia l 1i Spacing �• I / 0� 6 Length . Dia. Length Depth Over Depth Over xx Depth of xx Seeded/Soddad xx Mulched Bed/Trench Center Edges Bed/Trench�NO Topsoil .a� Yes No [u� Yes [©] No I COMMENTS: (Include code discrepancies, persons present, etc.) Inspection/q1: p��g12p22 Inspection #2: t)-, Location: 3125 CTY RD N1.) Alt BM Description = / 2.) Bldg sewer length = \ - amount of cover = j� asp' C-tb&S "ti I L a Plan revision Required? [V] Yes )eNo Use other side for additional information. , O 1 .�[� Dale Insepctors Signature Can. No. V 0941 lit 7 A7 1 7—industry Services Division h 16s" 4822 Madison Yards Way County St.Croix so filled in by Co.) *kr5 Permit Number (to be fi SEP 2 101. Madison, WI 53705 P.O. Box 7162 tA WI 53707 LF_994��t'+Apphca 5t. crox CC,,-t Madison, w195LL4 I Fion SwftM1hmsaction Number in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the ap opriate govImental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (it different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes m accordance with the Privacy Law, s 15.04(1)(m). Slats. 1. ApplIC60111i Worimation — Please Print All Information Pfopcily Owner's Name Parcel 00 004-1032-30-200 John Miller Property owner's Mailing Address Property Location 3125 County RD N Govt. Lot 02 SW NW Section 14 T28 N R 15 EorW City, state Wilson WI Zip Code 154027 Phone Number 715-977-0954 IL Type of Building (check all flat apply) Lot 0 Subdivision Name FV]l or 2 Family Dwelling -Number of BedrGoms ablic/Commercial - Describe Use Block N []City of aState Owned - Describe Use 71illageof CSM Number OTown of Cady 115/4141 and Ill. Ty Replacement" le on line A. ('heck one box on line B. Complete line C ff Type of POWTS Permit: (Check either "New" or �Rep a other applicable applkable.) bile -) A. 1E]New System eplacement System er Modification to Existing System (explain) DAdditional Pretreatment Unit (explain) B, laoldingTank FlIn-Ground t-Grade RIMound I Individual Site DesignType (explain) (conventional) C. Renewal Before EIRevision an of Plumber 1st —previous permit Number d Dale Issued Transfer to New owner 00� 1E] Expiration 4W 2f IV. Mmqieml/TroaFm� Area and Tank Information-. : N Design Flaw Wd) Design Soil Apation Rate(gpd/st) Dispersal Area Required (sf) DispersILArea Pr d (sf) System EI Design Flow 1 ? 1151 1 6 ( Tank Information Capacity in Gallons Total Gallons 0 of Units Manufacturer -1 ANkg� 7miL Now Tinto; ExistintiTanks . too it G Septic or Holding Tank ICLV jr Wle� C Li Donna Chamber V. Responsibility statement- L the undersigned amAmie realponalliff" for Installatlon of the po,"-M shownon the attached plan I RS Plumber's Name (Print) Psribe) Signatur lP'%lPNumber Bimne's Phone Number Damien Oberle '05r,�Ll 690121 715-505-2865 Plumber's Address (Street, City, State. Zip Code) 802 550TH AVE Menomonie WI 54751 ountyID"Rrtmmut Use 0* Pcrnot Fee D I'suSignature Si"ore log Aif Approved C1 Disapproved $ 0 Owner Given Reason for Denial 4 AColizitibm.ot'Approval/ReasoFi,, for Disappr C*ry A^ Anarn to crompletepims 1""3 - SBD-6398 (R. 03/2 1) ier. Rym Be" ied Soil Taster- SP-111500001 to of Engineering Systems: 0 2263--7 SCALE Ai E + + + to north P.L -T- Tree line L + Ai E + + + to north P.L -T- Tree line L + 'AN property lines rot Oo Bsnctmnark SYSTEM NOTES drawn are > 100ft from 9yown SW Baring Septic Task. amirg Weft IDW pkin I-cmipimlimen! Ink + -t- + + + Appm weladiti, ard Waito bxbmwq to be + + + sailed by itlirberk3talff mn 4- abom kW Fade -J- + + E=" arlium (W*0 ID te mmwdoper Sps J, .4- + t 4- AM @ 13TDH AvalaciL t + I 4- + i 4KdDM pareFn*n Lm W TDH mW oM + + + 4- STA: i -ivz.6 Mud -luawomaim -i r dam saw Mt (Cm C33 wd t I + 4- -CJ situo kih to WUJ4 ayod OM Tree line 95-55— 1 1 \ . . k Amo nahaapI mmabdeodr-r -DRutwbmoawmwfmmnabm 4)ep1hkD=k1cb + zmdod z SM T L20' 2� 4- + Distr8mitim Huffcutt 600 w/ It Slut -Tall 100 -4- 4- -4-- -4- + + V -4- 3mi =a00. + :6470'44- 40 PVC I )p (?f (deapouis 1Vansfb 'red LOCATION MAP (not to made) every 4- 4- a4.MiNMjM) 4- + + WeR b(Isting, trer ich In �SySiflTfA� + B142 4- -4- ToR-of mr��Tet e pad \; \\ at Shop NW combir + + + BM3 1D3.35 + + + + + + + + Top of wild amvu MEPARID RVIL, 4- + A + + + + + X11111 Miller --T- �F 10 Site Addiress: 325 Cry RD N Extsting wkm W1 54M + -4- + Weeks 1,000 gal + + -1032-3G-200 1639 Acr PfD: 004 4- + + + + + Ems0fig "ipe Legal: Lot ()2 CSM 15/4141 4- + + v* dew*uts ft" rAed 4- + + + SW 1/4 NW 1/4 S14 T28N R15W y 115ad gtdmffdrt: ME ej hu bW -A,, e;vdu �In saccaftme aft State and Lad codma, Thm so I sa - orme WON mmdh W41M mn"Imm hobo ad Town of Cod July 8, 2021 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2023-07-08 Plan Review: PWTS-072101557-C RYAN GARY BECHEL 779 Spring Creek RD S Red Wing MN 55066 SITE: John Miller t 125 CT RD T Town of CADY St. Croix County Total Amount: $250.00 FOR: Description: 450 GPD (3 Bedrooms — Replacement) Maintenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUI5 PL GREEN BAY WI 54304-5211 Contact Through Relay httpJ/daps. wi.goviprog ramsii nd uslry-services www.vAsoonsin.gov Tony Evens - Governor Dawn Crlm - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01101, R 10/12) Pressure Distribution Component Manual — Ver. 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. T}tc following conditions shall be met during construction or installation and prior to occupancy or usc: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left oN er construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic mnterial to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be dctemlined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. if it crumbles, site preparation can proceed. if the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & R 12 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied wit:- rock tragmerns, uve roots. >:ump; arai hould ns ndt:ce the am>un' of soil availahlc =or proper trealmwn-,. if no othe-„Ae is availahle, trees in the basal area %- the ;.Hound trust lx: cut etI a-, ground level \ frg r Ti area . recessary when any of the •rhove k,vilditions are. Clwounte.- rl. Ic; P7-ovide suftirient lnfillran.vI area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the 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 SPS 383.54(I). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of con structionlinstal lotion/operation. in granting this approval the Division of industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for desigming 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 arc responsible Ibr the installation, operation or maintenance of the POWTS. Thanks, Ye-;av i"14.44wee-', POWTS Plan Reviewer — Wastewater Specialist Department of Safety & Professional Services I Division of industry Services CllSati: `.an.valit�el'I6]itL'T v: IiC�'n4118^' Cell: 608-516.6134 p�Duuiilumuimu I,,,. ,����� ���III'I' I����II I���� III IIIIII�I '' iiiiiiiiii u�iiii��i iiiiiiiii lii Ili, IIII III 'ill IP ��i IIIIIIIII III��I III. I ����,,,� I�Illllllll ��� IIIIIIIIIII IIIIIIIII IIIIIII I �IIIIII� I I• III IIII��� lay Id�lllllllllllllllllll�ll�l���ll IIIIII��� I������I II III I I".1 lil 'i 1 . k, II,,.II IIIIIIIII III011� Property Owner: John Miller Site Address: 3125 CTY RD N, Wilson, WI 54027 INDEX Page: 2 Site Plan Conditionally APPROVE[) Page: 3 Management Plan DEPT. OF SAFETY AND PROFESSIONAL SERVICES Page: 4 Management Plan ulynouRMF-MUSTRY SERVICES Page: 5 System Design Summary1 �r„" .... w!" Page: 6 Mound Design Worksheet SEE CORRESPONDENCE Page: 7 Mound Design Worksheet Page: 8 Mound Design Worksheet Page: 9 Pressure Distribution Design Page: 10 Pressure Distribution Design Page: 11 Pump Design 01luu/Lr,,,l ```'kNI NS�N Page: 12 Dose Tank ,�`�N��`��S Page: 13 Tank Specifications =RYAN G. 6ECHEL Page: 14 Mound Material Estimates - D-2263-7 RED WING Page: 15-17 Soil Test, MN Page: 18-22 Existing System Permit ''1��''r£S Page: I m n u 0 Component Manuals: SBD- 10691 -P Mound (N.01/01; R.10/12) SBD-10706-P Pressure Distribution (N.01 /01; R.10/ 12) lf 'r 1 1 �''Nr r,:� 7�'1!I::`"... ALE:....• Designer Signature: '' -' Date: 6/1912021 I'll.:FAC'11;Ill:;CI F.1-..A.411.I..Lt. I I ..::� I:r r r {,n;ulJ: Piri :, � r�.lata 7r Irpa h: h, �ii':iCNiNii Opw- Ryw Be" tified Sol Taster. SP-111500001 ikpw of Dighearbg Systems; D 2263-7 lines not (E) Beirdwiffark -All propertySIMMM NOTES Wp=:Lz drssysism Sad Boring " are >100ft from Septic Teak: 41% I -Ext Weeks 1000plbn 1-wivali4m is t SCALE 25, Nr to north P.L. -Bring users Vabove W Fade 50. -H -Exd% P/MbefIV44 bbe abandmal per SF 3B3X Tree hne Pump YAwL: 6,q wis 4' atem W grade 4W*A* wm F fdon Lm am MH are odd STA: -Ift45 Mud 02 Tree Ine 95. 55 tj b gmund, avoid &QM Que, wines abiwobion aw and qvirove dMeep -Roupm absMbw aiei ki &* d T-Ir J -Dartwriacetaw may from Mew 0ep1h t m Oxkn= IT T6ilkwmni i 95 *20' 24 -U nbw z 96.55 sch-40 PVC-1 4Ar& b be Vieeid 17 hm am of bad s 2,r fo odes HuffoA 600 w/ 4Aral rMaki T 9059 Sarn-Tech ST11--100 k 43, 1 t sm 40 pvc Wriss wM Mwvws�w Wyfkkr p resture fi& k -1 j teller end -fed neiwod. j'ohfioes @ 3.0 spKing "70'4!-- 31411 =_1Gc.0L 4%w 15 dwislox AwDhon am Ilium e Sdi 40 AMC Top 91' liecbvicaf (deanouts required transdfoMw 4)emwd ra I= se" par design MV Zft L ery LOCATION MAP (mt in @we) . . . .......... CTY Existi w a so- RD N trench F- + BM2 = 102.25 Ln Topof mrvete Ro at VVp kw- comer BM3 103.35 Top of me" M r "o PREP 4REL) FOR: + A 4- 4- Merl MMw Site Address: Bsting 3225 CTY RD N Weeks 1,000 gal WkDR W1 M27 4- bdstft ipe 4- Ni� PID: 004-1032-30-200 16-39 Acre Y* dex*uts every 75-feet Legal! Lot 02 CSM 15/4141 SW 1/4 NW 1/4 ;wu-dd %ana.,& TN. 2900 hu bw a ano evasudeis M deeapespen aft Sbft ,,d Lead 00ML Pee, me buiennient Main Ei@dW Wbftwm wid MVOMM offie, alk, onae wmd me w seem is life, 6 W S14 T28N R15W Town of Cody Management Plan This management plan identifies operation and maintenance activities necessary to ensure long-term performance of your septic system. Tasks that should be performed by the homeowner are identifAvd. Professional management tasks must be performed by a Inensed septic maintainer or service provider, however, it is the homeowners responsibddy to ensure au tasks get accomplished in a trnely manner. ► Keep this Management Plan with your Septic System Owner's Guide. ► Keep copies of all pumping records, maintenance activities and repair invoices with this document. ► Review this document with your maintenance professional at each visit; discuss any changes in product use, activities, or water -use appliances. Management Frequency My system needs to be checked Designer Required Frequency Check every 36 months every 36 menth5. State/Local Gov't Req Frequency: Check every 36 months Design Parameters I Svstem Snecifications Number of Bedrooms 3 Septic Tank Manufacturer Weeks Design Flow pd 450 Septic Tank Capacity 1000 Soil Loading Rate (gpd/ft') 0.6 Effluent Filter Manufacturer Sim -Tech A-100 Standard Effluent Quality Effluent 1 & Model Biological Oxygen Demand (BOD) 220 mg/1 Pump Tank Manufacturer Pump Tank Capacity Huffcutt 640 Total Suspended Solids (TSS) 150 mgn Fats, Oils, Greases (FOG) 30 mgr't Pump Manufacturer & Model Per Installer Treated Efttuent Quality Biological Oxygen Demand (BOD) - moff Dispersal Cell Type Mound Total Suspended Solids (TSS) - mg/I Fats, Oils, Greases (FOG) mg11 Pretreatment Unit Description NA Max Effluent Particle Size (in) 118 Homeowner Check (listen, look) for lea Repair leaks promptly. Regularly check for wet or spongy soil around your soil treatment area. Contact service provider if issues arise. Control burrowing animals (gophers, groundhogs, etc.) Keep bikes, vehicles, snowmobiles and other traffic off treatment area. Alarms - Contact your service professional if any alarm signals. Lint Filter - check for lint buildup and clean when necessary. If you do not have one, add one after washing machine. Eflibir't FINr IIIS:JtJCt �.:nd oew; Pr:rce per b,o Dr at a trl; ;'rlrrl. ......._.............. Caps - Make sure that all caps and lids are intact and in piece. Inspect for damaged caps often. Fix or replace damaged caps. Professional per levels - Check sludge/scum/effluent levels in all system Recommend if tank(s) should be pumped. Pump all every 36 months at a minimum. Inspect tank inlet and outlet baffles (if applicable) Check drainheld effluent levels (if applicable) Verify pump and alarm system functions (if applicable) Inspect wiring for corrosion and function (if applicable) Clean drainfield laterals (IF applicable) Check event counter/elapsed time meter and evaluate water usage rate compared to system design flow. Check dissolved oxygen and effluent temperature in tank Check for surfacing of effluent or other signs of problems. Verify inspection pipes are capped and intact. Provide homeowner with list of management results and any action to be taken. system replacement area: Protect secondary system site from traffic, compaction, etc. MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an appropriately licensed individual or business. Tank inspections must include a visual inspection of the tank(s) 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 on the ground surface. Access openings used for service and assessment shall be sealed watertight upon completion of service activities. Any unsound/defective access openings must be replaced immediately. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. Ponding of effluent on the ground surface may indicate a failing condition that requires immediate attention by a licensed septic professional. Tanks must be pumped when sludge accumulation is within 12 inches of the bottom of the outlet baffle, or whenever the scum layer is within 3 inches of the bottom of the outlet baffle. In no case shall total sludge and scum volume occupy greater than 25% of the tanks liquid capacity. The effluent filter shall be cleaned as necessary to ensure proper operation. The filter should not be removed unless provisions are made to retain solids in the tank that may slough off the filter during removal. If 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. Pre-treatment components shall be maintained and serviced by a licensed septic professional according to the manufacturer's recommendations. START-UP & OPERATION For new construction: prior to system operation, check septic/pump tanks for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cells. If high concentrations are detected, have the contents of the tank removed by a licensed septic professional prior to use. System start-up shall not occur when soils are frozen at the infiltrative surface. During power outages, pump tanks may fill above normal high water levels for system utilizing pumps. When power is restored, the excess wastewater will be discharged to the dispersal cell in one large dose potentially resulting in overloading the cells. It may also result in backup or surface discharge of effluent. To avoid this situation, it is highly recommended to have the contents of the pump tank removed by a licensed septic professional or have a septic professional manually dose the system to return the pump tank to normal operating levels prior to restoring power. Do not drive or park vehicles over any septic system components. Do not drive, park over, or otherwise disturb or compact the area within 15 feet downslope of any mound or at grade system or secondary septic system site. CONTINGENCY PLAN If the septic tank, or any of it's components, become defective the tank or component shall be immediately repaIreU or replaced according to the original system design specifications. If a dosing tank, pump, pump controls, alarms, or related wiring becomes defective, they shall be immediately repaired or replaced with components of the same or equal performance. If the soil treatment component fails to accept wastewater or discharges wastewater to the ground surface, it shall be repaired or replaced by; increasing basal area (if toe leakage occurs), rebuilding the component at the secondary system site, or removing and replacing biologically clogged absorption and dispersal media and associated piping. ABANDONMENT If the septic system fails ariftr is permanently taken out of service, the system shall be abandoned according to approved abandonment regulations. These include: - All piping to tanks shall be disconnected and abandoned pipe openings sealed. - The contents of all tanks shall be removed and disposed of by a licensed septic professional. - Tanks shall be crushed & filled, or removed. - A septic system abandonment notification shall be submitted to the appropriate local governmental unit. WARNING!! SEPTIC, PUMP, AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC TANK, PUMP TANK, OR OTHER TREATMENT COMPONENT UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ALWAYS CONSULT A LICENSED SEPTIC PROFESSIONAL BEFORE DOING ANY WORK. Page 4 System Design Summary Property Owner/Client: Joh'1 Miller Parcel 10: 004.1032.30.200 Site Add re": 3125 CTY RD N, Wilson, WI 54027 DESIGN FLOW, WASTE STRENGTH, TANKS A. Type of Wattewater. aasNantial Treatment Level: Effluent 1 Residential Design Flow • not Bedrooms 3 X 100 GPD X ISM . 450 GPn Commercial Design Flow (datalcalCulations attached): ❑ f4eaw,ed GPD ❑ Esamaled 1,P0 Oesian Flow: 450 GPD Comments: Existing 3811. home; No home business; no sewage ejector/grinder B. Septic Tourists): Minimum Capacity - Design Flow X 2.088 Wastewater received by: Gravity Code Minimum Septic Tank Capacity: 940 Gallons. M 1 Tanks f Comparlmeritts) Designer Recommended Tank Model(s): Existing Weeks 1,000 gal and new Nuffatt 600 gal Effluent filter It Alarm: Q Flue © Floor Alarm Effluent Filter Model! Skin -Tech A-100 C. Pump Tank Code Minimum Capacity. 483 Gallons Pump Tank 2 ICode Minimum): NA Gallons Designer Recommended Min. Capacity 640 Gallons Pump Tank 2 (Designer Req): NA Gallons Pump 30.D GPM Total Head 12.7 it Pump 2 14A GPM Total Head NA it Holding Tank Only: U Minimum Capacity: Residential • 2000 gallons, or Sic estimated daily wastewater flow; whichever is greater Minimum Code Required Capacity: Gallons, In Tanks Holding Tank High Level Alarm Type: Designer Recommended Capacity: Gallons, in Tanks DISTRIBUTION AREA Soil Treatment Area Type: Mound Distribution Type: Pressure Distrtbuticn•Lai Benchmark 1 Elevation: 100.00 if Benchmark Location: SEE SITE PLAN Component Manual 1: S8D-10691 •P Mound (N.01101 ; R. 10/ 12) Distribution Media! Q OruMeld Rod, ❑ APerwed P Ra Component Manual 2: SBD-10706-P Pressure Distribution (14.01 /01; R.1011I) 112' - 1 1/ 2 Aggregate SITE EVALUATION DATA Depth to Limiting Layer: 19 in 1.6 it Soil Texture: Silt Loam Contour Elevation: 96.55 SHLR; 0.60 1 GPD/ft Elevation of Limiting Layer: 94.97 Perc Rate: MPI Minimum Required Separation: 36 in 3.0 ft Soils with 402 Rock Fragments Present? ❑ yes © No Madman Depth of System: Mound in 11 yes. describe % rock and layer thickness, depth of wit Ireatment needed per SPS 383.44-3 and any additional information for addressing the rack fragments Measured lard Slope: 3.0 % in this design. SOIL ORGANIC LOADING RATE 1. Organic Loading ro STA/Pretredlment Unit • Design Flow X Estimated 800 in mg/L in theeffluent X 8.34 f 1,OD0,000 450 gpd X 220 mg/L X 8.34 a 1,000,000 - 0.83 Ibs BODlday a. Pretreatment Unit Information (If applicable); Not Applicable to. Organic loading A&[ Pretreatment (if applicable/ - Design Flow X 800 In miff L in the pretreated effluent X 8. iA : ' ,000,000 gpd X mgfLX8.34. 1,000,DD0• Ibs BOD/day 2. Organic Loading Rare to Soot Treotmen: Area l(bslday/ t 1 : Suit Treatment Bottom Aim ftr • Ibs/day/ftr toomri anq/n'i e,.r 0.83 IDs BOD/day a 896.3 (t, . 0.00092 Ibs/day/ft1 :Ls I+xl'b, Caiiilnem: n A N Nln' Mound Design Worksheet SYSTEM SIZING: Parcel ID: 004-1032.30-200 Design Flow: 450 GPD Soil Loading Rate: 0.60 GPD/ft2 . ...... Depth to Limiting Condition: 1.6 itIII INlii�i�'lll Nil 41 Percent Land Slope: 3 .. .... . .. .... - NNE Design Media Loading Rate: 1.0 GPD/ft IIIOlin ...... DISPERSAL MEDIA SIZING Dispersal Bed Area (A x B) = Design Flow + Design Media Loading Rate 450 GPD 1.0 GPD/ft 2 = 450 ft, If a Larger dispersal media area is desired, enter size: ft, A. Select Dispersal Bed Width (A): 10.0 ft Can t exceed 10 feet Linear Loading Rate - Bed Width X Design Media Loading Rate 10 ft X 1.0 GPD/ft 2 10.0 gat/ft Can't exceed Table I B. Minimum Dispersal Bed Length (B) - Dispersal Bed Area + Bed Width 45C ftz + 10.0 ft = 45.0 ft DISTRIBUTION MEDIA: ROCK Rock Media Depth Below Distribution Pipe 0.50 ft (Estimated material quantities found on Mound Materials page) DISTRIBUTION MEDIA: APPROVED TREATMENT PRODUCTS: CHAMBERS AND EZFLOW 1. Select Dispersal Media: If. Enter the Component Length: ft Width: ft Depth: ft fil. Number of Components Per Row - Bed Length + Component Length (Round up) ft + ft - components per row iv. Actual Bed Length - Number of Components per row X Component Length per row X ft = ft V. Number of Rows * Bed Width + Component Width ft + ft - rows Adjust width so this is a whole 0. vi. Total Number of Components = Components Per Row X Number of Rows X Components Page 6 MOUND SIZING D. Fill Depth Below Upslope Edge (D) = 3 feet - Depth to Limiting Condition (6" Min.) 3.0 ft - 1.6 ft = 1.4 ft Design Sand Lift (optional): in E. Fill Depth Below Downslope Edge (E) _ [Bed Width X Land Slope . 1001 + "D" 10.0 ft X 3.0 % + 100 + 17.00 in = 20.6 in F. Distribution Cell Depth IF) = 8" + Nominal pipe size of distribution lateral (12' for approved products) 8.00 in + 1.50 in - 9.50 in (Nominal Pipe Size adjusted an Laterals sheet) G. Cover Material Depth at Cell Edges (G): 6.00 in 1?6"Min.) H. Cover Material Depth at Cell Center (H): 12.00 in (z 12"Min.) I. Downslope Width (1) - (E + F - G) x (horizontal gradient) x Downslope Correction Factor 3.01 ft x 3.00 x 1.10 = 9.92 ft Or ft J. Upslope Width (J) - (D + F + G) x (horizontal gradient) x Upslope Correction Factor 2.71 ft x 3.00 ft x 0.92 ft = 7.45 ft Downslope Correction Factor: 1.10 Upslope Correction Factor: 0.92 Endslope Horizontal Gradient: 3.00 (usually 3.0 or 4.0) K. Endslope Width (K) - [(D + E) + 2] - F + H x Endslope Horizontal Gradient 37.60 in + 2 + 9.50 in + 12.00 in + 12 x 3.0 ft = 10.1 ft L. Mound Length (L) - Endslope Berm Width + Bed Length + Endslope Berm Width 10.1 ft + 45.0 ft + 10.1 ft = 65.2 ft W. Mound Width (W) = Downslope Berm Width + Bed Width + Upslope Berm Width 9.9 ft + 1D.0 ft + 7.5 ft - 27.4 ft Verification of Minimum Requi ._..._................_._........._......................_.......... "• Sloping Sites - B x ( A + I ) MINIMUM - 45.0 ft X ( 10.0 ft + 9.9 ft I - •• Level Sites = B x W MINIMUM = - ftt ft x ft - ft2 Basal Area _..._........................................_........_......._..._....._... 750 ft= (Min. - GPD + Loading Rate) 896 ft= ............... (Min. - GPD + Loading Rate) Papa 7 0 I MOUND DIMENSIONS I i A 10.0 ft B 45.0 It D 17.0 in E 20.6 in Obs. Pipes (1/10[h of B) TOPE 0IL K SUM L F 9.5 in J 7.5 ft G 6.0 in K 10.1 ft H 12.0 in L 65.2 ft 1 9.9 ft W 27.4 ft 4.5 ft Absorption Width (A+I) 19.9 ft DISTRIBUTION AREA CROSS-SECTION 99.76 98.59 PII. IIiJ ��FIRIGa i 97.97 q:.....f II War!Is�aellv� 'f - J R'STylr l7ldr } F -, F i i i� l: d I l Y Zrq• � l ? � 4F *'F�7 n #;�o w . � r.. I .. f_ ..........._ _ L �.... PLCKN n #I [stet l 96.55 3s PHIOR TO RACING SM D OBSERVATION PIPE DETAIL Screw-lype or Finished grade slip cap.,y, .� Topsoll cover 4" SIC 40 PVC pipe Top of pope to terminate at or above tirllstwd grade 4° - ;" x 6" slots spaced 60 degrees apart I• - r; Infiltration Toilet .. �''� :. sur}eee Flange Pressure Distribution Design Parcel & DD4.1032-30.200 Bed Width: 10 ft Manifold Connection; End Preferred Orifice Spacing: 3.0 Minimum Number of Laterals in systemizone =[[(Media Red Width - 4) + 3] . 1] X # of zones (Round up) zone(s) • 3 laterals Designer Selected # of Laterals loptwiaq: laterals *Can't be less than 2 (enept In atyradea) Min. Lateral Spacing: 3.s It Designer Lateral Spacing(aptmau: ft Min. Manifold Length: 7.0 ft Designer Manifold Diameter (see table s): 1 1/2 in Selected Orifice Diameter Size: 3/16 in 10ruices mist be a 6- a � r rro urea edael Lateral Length = (Media Bed Length . 3 Feet) + # of zones 45 aft + 1 42.0 ft Orifices Per Lateral = Lateral Length + Preferred Orifice Spacing -1 (0.5 for center feed manifolds) 42.0 ft t 3 ft 1 ft = 15 Orifices Orifice Spacing - Lateral Length + X Orifices Per Lateral -1 (0.5 for center feed manifolds) 42.0 ft t 14 Spaces = 3.0 ft (2' Max Orifice spacing for At -Grades) Total Number of Orifices • Number of Orifices per Lateral x Number of Laterals 15 Orifices Per Lateral X 3 Laterals - 45 Total Orifices Recommended Orifice Density is 4.11 ft 2 per orifice; can't exceed 11 ft2 Orifice Density • Bed Area + Total Number of Orifices (Does not apply to At -Grades) 450 ft1 + 45 Orifices ■ 10.0 ft'/Drifke Lateral Diameter (See Table 6): 1 112 in Minimum Average Head: 2.5 ft Orifice Discharge Rate: 0.66 GPM per Orifice (eased on Tabir 41 Tlll.w a IAw RnIF a." 1L. :ru PUM IIN Ur•n n1 a• rn wu rin_.......I. .. ...,.. ___. ...._. ......... �� � 1 IN 1'NiaY.. Y oat C. SI i I If l'N-- ...... NN .. :. I I _ fIN.. u uYu Pk i I1 ... a;i ............. 0.n—�7,y—, 1 "t 1( tor I n .... .... I1- . IN.i1N.;�n<ITI+I 'rr al•.r IYaM�NYI �.h AIYrnN•alln•I� YP rrrrrrrr NrM I.:IrrrNM Page 9 Pressure DistriiIt.0it::' 1 �.-,risign Lateral Discharge Rate (GPM) = Orifices per Lateral x Orifice Discharge Rate Check Table 5 to make sure maximum meacer length is not e.Ceeoea. 15 Otif ices Per Lateral x 0.66 GPM per Orifice = 9.8 GPM per Lateral System Flow Rate - Total Number of Orifices X Orifice Discharge Rate 45 Orifices X 0.66 GPM per Orifice - 30 GPM Distribution Piping Liquid Volume Per Foot (Table,): 0.092 Gallons/ft Volume of Distribution Piping = [^ of Laterals X Lateral Length X Liquid Volume Per Foot of Piping] 3 x 42.0 ft X 0.092 gal/ft 9 11.6 Gallons Minimum Delivered Volume Volume of Distribution Piping X 5 11.6 gals X 5 - 58.0 Gallons PRESSURE DISTRIBUTION LATERAL LAYOUT P 42.0 ft P/2 ft X 3.0 ft X/2 ft Manifold Length 7.0 ft Lateral Diameter 1 1 /2 in 5 3.5 ft Y 3/16 in Manifold Diameter 1 1 /2 in P T� ... n........ ..... ..... .... ...... . .......... ............. ' .. l S Page 10 Pump Selection PUMP CAPACITY (GPM) Parcel ID: D04-1032-30-200 Distribution Method: Pressure If pumping to gravity enter the gallon per minute of the pump: GPM (10 45 gpm) Minimum system flow rate: 30.0 GPM Dosing method: Time Dosing Soil Treatment TOTAL DYNAMIC HEAD (TDH) Elevation Difference: 8.6 ft Ibrtwrrn pump Arta nlp/wa1 Nscaarpa PdMI M, 11 .pll !jl io-nx xl a.,•.xy Distribution Head Loss: 3.25 it Additional Head Loss: D.5 ft ldm to speaal equipment, etc.l Forcemain Diameter: 2.0 in Forcemain Length: 20 it Forcemain Friction Loss - Friction Loss in Plastic Pipe per FT of Forcemain (from Table 6:) X Forcemain Length Forcemain Friction Loss • 0.39 ft Add Equivalent Pipe Length from pump discharge to soil dispersal area discharge to account for fitting loss if needed. (Estimate by adding 25% to supply pipe length for fitting loss if desired. Forcemain Length X 1.25 • Equivalent Pipe Length). Use 1.0 for standard systems. 0.39 ft 1t 1 0.39 ft Elevation Difference . Distribution Head Loss + Addtional Head Loss . Forcemain Friction Loss . Total Dynamic Head (TDH) 8.60 ft 3.25 ft 0.5 ft . 0.39 ft • 12.7 it TDH PUMP SELECTION A pump must be selected to deliver a minimum 30.0 GPM at a minimum 12.7 TDH Pump Model Option 1: Zoeller 98 Performance Curve 1N I PUbi MRFOR IC - CURVE DEL98O J I'1 1sl U"I ..........15'.I � 7d11 rl.::AW %'Eilq All `a.l Ili Pump Model Option 2: Zoeller 151 Performance Cwve PUMP PERFORMANCE CURVE MODEL 151M62,1153 i 7 "J MI y; U :.0 N: iJ Xb al IJr .. �........._L... ..... LI......... ............ i,..........L..... ....-..........-................ IX0 340 310 1'q 3w 0AWVE.NIOWIN. W+ Demand Dose Pump Tank TANK CAPACITY AND DIMENSIONS Parcel ID: 004-1012.10-200 Design Flow: 450 GPD Code Minimum Pump Tank Capacity: 483 Gal Designer's Minimum Capacity: 640 Gal Tank Manufacturer: Huffcult Tank Model: 600 Capacity frotn manufacturer: 640 Gallons InWrtantl: Dose design calculations ore based on this specific lark. Substltuttng a dffererx tank rnodei may alter the pump float Gallons per Inch from manufacturer: 15.1 Gallons Per Inch selt'rys. Contact designer if changes we necessary. Liquid depth of tank from manufacturer: 41.0 inches DETERMINE DOSE VOLUME Calculate Volume to Cover Pump 1-he inlet of the pump must be at least 4-inches from the bottom of the pump tank li 2 inches of water covering the pump is recommended) Pump and block height . 2 inches X Tank Gallons Per Inch •Addlne 2 mchc% eruures pump a cvmred by effluent during operatfm f 10 In + 2 inches) X 15.3 Gallons Per Inch 183 Gallons Minimum Detveled Volume - 5 X Volume of Distribution Piping: (From Pressure Distribution worksheet) = 58 Gallons iminimum dose) Maximum Pumpout Volume - Design Flow x 20% 450 GPD X 20% = 90 Gallons (maximum dosel Select a Pumpout volume that meets both Minimum and Maximum: as Gallons Doses Per Day • Design Flow + Delivered Volume 450 gpd + 98 gal - 5 Doses Per Day Drainback: Diameter of Forcemain • 2 inches Length of Farcemain . 20 feet Volume of Liquid Per Lineal Foot of Pipe • 0.163 Gal(onsfft Drainback . Forcemaln Length X Volume of Liquid Per Linea( Foot of Pipe 20 ft X 0.163 gal/ft - 3.3 Gallons Total Dosing Volume • Delivered Volume . Drainback gal + 3.3 gal = 91 Gallons Minimum Alarm Volume - Depth of alarm 12 or 3 inches) X gallons Per inch of tank 3 In X 15.3 gal/in - 45.8 Gallons 't inch Nm apapal recormevtded to prevent wrbulencere%Atngunrrerftwy wnpcyd,ng FLOAT SETTINGS Float Separation Distance for Dose: Total Dosing Volume + Gallons Per Inch ;y 91 gal + 15.3 gal/in • 6.0 Inches Floe[ Distance Settings (measured from bottom of tank): Distance to set Pump Off Float . Pump . block height . 2 inches 10 in 2 in - 12.0 Inches Distance to set Pump On Floa[ in FFFF Reserve Cap. 21.0 I, I A I.g •Distance to Set Pump-Oif Float + Dose Separation Distance Alarm Distance 3.0 ;n i 12 in 6.0 In = 18.0 Inches a i'i 45.8 Pump On Distance 6.0 1n Distance to set Alarm Float -Distance to set Pump -On Float . Alarm Depth .. E i31 1>.7 Pump Off Distance 12.0 ;n I 18 in 3.0 in 21.0 Inches D 183.1 �.i I Mrirr Pump Off Elev. 91.3 ft 'I TANK SPECIFICATIONS • Minimum cover = 6 inches; Maximum cover = 8 feet (unless specified by manufacturer) • All manhole covers shall extend 4 inches above final grade • If the tank is within 2 feet of final grade, insulate the lid to an R-Value of 10 • Quick disconnect (Cam -Lock) reachable from final grade (24 inches max) required for pump installations • If forcemain will have a "1-Hook" assembly, drill a weep We in the "hook" • Building sewer: No 90's, keep 3 feet between 45's, maintain 1 inch in 8 feet (1%) slope, install cleanouts at the building connection and every 100 feet at a minimum • Insulate building sewer if less than 2 feet from final grade and under all high traffic areas (driveways etc.) 103.33 wate"Ishtconlrol boa with separate 97.00 pump and alarm circuits �l / 101.55 94.25 1%Minimums1o" ll.•I �""� kph I I f..i �yQ�CA i., _._... ............. ♦i- 170' 90.00 VS it:a vLIiri",3ra. KRIS SI.1 [*Yr'Ifall� ........ �'i:IkL:I ctt.rs x iPtic r, : IIF[.LBIG.' LCC$ R.'a Ifi I AW 4" Pwtw lock SMava 7" SCH 40 lorcemam in 4" SCH 40 pipe MOM tank excavation to prevent pipe settling tarn lock .� Float Tro : Instal l floats separately from PUMP on a 1" to 1.51 PVC pipe Weep nola I&W... LlML r' 4X40 aikSA11:n: F11xHIf11 ..I:1 rr" OP.:C' IraMc lace, TOP, t atVEvc.R7 ... Mound Materials Estimate Parcet IF- 004.ID32-3D-200 A. Rock Volume: (Ruck Below Pipe - Rock to cover pipe (µpe ala • r wh, ) X Sea I ength X Bed Width - Volume (f t') ( 6 In 5 io) « 12 X 45.0 it X 10.0 It = 412.5 ft' Divide Its by 27 4t'lyd' to calculate cubic yards: 412.5 fir . 27 15.3 yd] Add 30% for cons rruc tabit try: 15.3 yd' X 1.3 - 19.9 yd' For systems using Approved products: Volume = Product Height X Bed Length x Bed Width Approved Product: if of Components needed: (See Algmd Design page for detailed summary of • components needed) B. Sand Volume: Volume Under Rocx bed: Average Sand Depth x Bed Width x Bed Length = cubic feet 3.1 It X 10.0 It X 45.0 It - 1410.0 111 Upslope Volume: (Upsiope Sand Height x Upslope width x Bed Length) . 2 - c.sbic feet II 2.3 It X 7.5 X 45.0 ) r 2 = 391.3 ft' Dswnslope Vclume: (Downslope Sono Height x Downslope Absorption Width x Bea Length) * 2 = cubic feel U 2.6 It X 9.9 It X 45.0 ). 2 = 587.6 It, Endslepe Volume: Downslope Sand Height x 3 x Bed Wioth - Cubic feet ( 2.6 It X 3.0 It X 10.0 it = 79.0 it, Total Clean Sand Volume: Upslope Voiume - Downslope Volume - Endsione Volume - Volume Under Bed 391.3 f[ ft 79.0 � 587.6 � 10 , 1410.0 It'= 2468.0 It, Divide }t' by 27 ft'/yd' to calulate cubic yards: 2468.0 ft' 1 27 91.4 yd) Add 30% for corutruclability: 91.4 yd' X 1.3 = 118.E ydj C. Topsoil Volume: Distribution Box Cover Volume (aoprox7: D'str+bi Vcn Box Length X Wdth X Average Topsoil Height ('8) 10.0 ft X 45.0 It x 1.5 It 675.0 it' Downslope Berm Cover Volume: Downsiope Berm Length X Width X Depth (12 ) 9.9 ft X 45.0 it X 1.0 it = 446.3 ft' Upslope Berm Cover Volume: Upslope Berm Length X width X Depth (12-) 7.5 it X 45.0 It X 1.0 it - 335.4 11' Endslcpe Berm Cover Volume: Endslope Berm [Length X Width X Depth 11 2')) X 2 (2 Berms) 10.1 It X 27.4 It X 1.0 it X 2 551.5 ft' Divide it' by 27 ft'l yd' to calculate cubic yards: 2008.3 11' ♦ 27 = 74.4 yd3 Add 30%for cons rmctabillty: 74.4 yd' x IA - 96.7 yd' ••For rough estlmatlon purposes only. final mate rtol rstimates should be calculated by the plumberlirlstalterss Wisconsin Department of Safety and Professional Services Division of IndustryServices SOIL EVALUATION REPORT In accordance with SPS 385. Wis. Adm. Code Attach complete site plan on paper not less :ban 8 li2 x 11 inches in s ze. Plan must include, but not limitee to: vertical and horizontal reference point (BM), directior and percent slope, scale or dimensions, north arrow, and location and distarce to nearest road. Please print all Information. ersonal in'omiatlon you provide n-ay be used for seconds pu'poses IPni La Page 1 of 2 County SI Croix Parcel I.D. 004-1032-30-200 Reviewed by Date va w, s. 15.04 1 m Property Owner Property Location John M Iler Govl. Lot: SW V4 NW V S 14 T 28 N R 15 W Property Address Lol K Block d9 Subt1. Name or CSM# 3125 CTY RD N 02 CSM 15/4141 CRY State Zip Code Phone Number ❑ City ❑ Village Q Town Nearest Road Wilson IWI 54027 Cady CIYRUN ❑ New Construction Use: 0 Residentiab Numberof bedrooms 3 Code derived design flow rate 450 GPD Replacement ❑ Public or commercial — Describe: _ Parent material Loamy drift over loamy till (Amery 1) Floodplain elevation if applicable NA ft, General comments and recommendations: Recommend m l'rum • 7' sa-NA PO.VTS mound or 96.55 co^tour wit^ r,.6gpcotuicwri ate LF • 19' (Reooxmorphic features) UBaring it ❑ Boring ® Pit Ground surface elev. 96.55 ftDepth to lim4,ng factor 19 in. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Ctior Texlure Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPDlFI` 'Etfki 'Effg2 1 0-8 tOYR 3 3 sil 3fgr mfr cs 2f-vf 0.6 0.8 2 3 8-19 19-28 10YR 5/4 10YR 44 - f2d 7.5YR 5r6 8.OYR 5 2 sil cl 2fabk 2mabk mfr mfi gs cw 1c-vf 0.6 0.4 0.8 0.6 4 28-38 10YR 4r6 c2d 7.5YR 4,e s 10YR 512 sl 1 msbk mvfr D.4 0.7 2 I Boring # ❑ Boring Pi: Grouno surface elev. 95.85 ft. Depth to lima ng factor 20 in, Horizon Depth In, Dominant Color Munsell Redox Description Qu. At. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft' Ef i 'Effg2 1 0-1 D 10YR 12 1 3f-mgr mfr cs 3m-vf 0.6 0.8 2 10-20 10YR 5/4 - sil 2fabk mfr gs If-vf 0.6 0.8 3 20-25 10YR 4-4 f2d 7SYR 5,6 a I OYR 5,2 cl 2mabk mfr-mh gw 0.4 0.6 4 25-32 10YR 4.4 o2d 7.5YR 4v6 s IOYR 5,1 scl l mabk mti cw 0.2 0.3 5 32-48 1 OYR 4; 6 CIO 7.5YR476 8 7.5YR 5t2 sl l msbk mvfr 0.4 0.7 Effluent #1 = BOD. > 30 5 220 moA anrd TCC > -4n c i to ...,.n �....__. ----- - w v. - V V- LL V n l L anu r A J f J U S IOU m L Ryan Bechel CST Name (Please Print) Signature CST Number SP-111500001 Address Date Evaluatio Conducted Telephone Number 779 Spring Creek RD S, Red W ng, MN 55066 06101/21 (651) 327-0074 3 ] Boring # ❑ Boring ® Pit Ground surface elev. 96.55 ft. Depth to limiting factor ?4 in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots oouApplication Kate GPD/Ft' Eff#1 •Eff#2 1 0-10 10YR 3%2 Sil 2fgr mfr cs 2c-vf 0.6 0.8 2 10.16 10YR 4,'4 sil 2fabk mfr gs 1m-vf 0.6 0.8 3 16 24 10YR 3,6 sit 2f-mabk mfr gs 1 of 0.6 0.8 4 24-35 10YR 4/6 flu 7.5YR 5A a ' 0YR w2 cl 1 c-mabk mfi cw 0.2 0.3 5 35 52 10YR 8,16 c2d 7.5YR 5,6 6 10YR 6,2 fs Dsg loose 0.5 1.0 4❑ Boring # ❑ Boring ❑ Pit Grounc surface elev. ft. Depth to limiting factor _ in. Horizon Depth In. Dorrinant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Sell A IICal ion Kate GPDrFe Eff#1 •Eft#2 Boring # ❑ Boring ❑ Pit Grounc surface elev. Depth to limiting factor__ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color TeMure Structure Gr. Sz. Sh. Consistence Boundary Roots SOII Application Kate GPDiFV 'Etf#1 'Eff#2 Effluent #1 = BCD. > 30 <_ 220 mg/L and TSS > 30 <_ 150 mgil- ' Effluent #2 = BOO. > 30 5 220 mg/L and TSS > 30 <_ 150 mglL an Bethel A A p�=mga ij 0All property Inn nol Teeter. SP-111500001 IrED (DBmwtwnwk Enghwering Systems: 0 2263-7 drawn are >100(t from syslarn SON BMng .LE t to north P.L 4- so, -H -A �1� w Tree One t Tree km 95.55 t 83 I 4& SMI: = 100bo Top of ekctic&— tMnstoroW 7- BM2 102.15 so, blisting Toa NIN p of cm&etecomer WeLL diob t BK3 = 103.35 TOP of outlet A Dover Emsting Weeks 1,000 gal EidstlN PVCpipe wF dear*& every 75-lleet 4- AMOft This ad.n INS IMMM and Sabobd In OOMMOwee an 910110 Md Lead ocilm The ack ftftnmt sue wand Mush Waindrid lure fthwhows Wulls, esuls"m wis, 411111 drr SAMM NOTES septa Funk: -Eaft Weeks 10 galks lank Appear; wab I# I XW popsy Jfteow+e¢ III be veriliad by Oxnbarkstaller ZVSkV WY AM (Plbd) In be abariItm) par SPS 383.33 Pump Tusk: - SrA: Melon-M mrinwIrsn"PONTS.KuWan 9655 wnims we D40 beft raw - 4)"L) Ir. MSMAn - IT IRadmrwphc intm) -rVIDUr = *55 SW=3% Distribudips: ,4sern we mom Penn deawlrm I OCATION MAP (not to on") C7-Y RD N� Ln PREPARED Frill: 101111 mow Ste Addmgs: 3125 CrY RD N WIMR WI 54027 PID: 004-1032-30-200 16.39 Acres Legal: Lot 02 CSM 15/4141 SIN 1/4 NW 1/4 S14 T28N RISIN Town of Cody STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS 3) �t :6 SUBDIVISION / CSNI r!7 Ae, LOT 1 A] A SECTION / Y 26 TN'R /5 W, Town of ST. CROIX COUNTY, WISCONSTN SHOW EVERYTHII t Ex�s�w. el r[cs� 5�007� TI 4�L T� qZ.L [THIN -100 FEET OF 3-70" ,%r 8M � � N I� INDICATE ija.pi'H AFRi)t< Provide setback and elevation information on rev�tse of this form. Provide 2 dimensions to renter of seat_ is tans; u:,3nl ::l C.c��!'r BENCHMARK:_ /6-b ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturers � Liquid Capacity: /b Setback from: Well 7_ House 3.;L' other Pump: Manufacturer IVA Model# Size Float seperation Gallons/cycle; Alarm Location SOIL ABSORPTION SYSTEM Width: ,S Length -7'5 Number of trenches Z Distance & Direction to nearest prop. line: /oG Setback from: well: 37o-vo"House 33W' Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off. Header/Manifold Bottom of system Existing Grade Final. grade DATE OF INSTALLATION: _ Ip ;Ld - P5 1 1,11MRER ON JOB: LICENSE NUMBER: ]NSPE:CTOR: / ry Wisconsin Department of Industry, Labor and Human Relations Safety and Buildings Division GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) Permit Holder's Name' ❑ City Village Town o !MILLER, JOHN X CST BM Fiev : Insp BM Elev.: ]BMDescription i /00• i OJ. .S+t�rr�e TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic r Dosing Aeration Holding IANK 3t FBACK INFORMATION TANK TO P/ L WELL BLDG. ventto Air Intake ROAD Septic 7a S ' c{ a Ya S NA Dosing NA Aeration NA Holding PUMP / SIPHON INFORMATION Manufacturer Demand Model Number GPM TDH I Lift Friction S stem TDH Ft Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA ST. CROIX ax No.: STATION BS HI FS ELEV. Benchmark,{ sf. Bldg. Sewer St / Ht Inlet gg 0 L St / Ht Outlet / ! Dt Inlet Dt Bottom Header/Man. "'�3 ./ 93'B9 c- y Dist. Pipe /U'97-- /0. rY rr3•cb QV. Rot. System I'd '" !r 9'' 5� -/ Final Grade AR p BED / TRENCH DIMENSIONSDIMENSIONS Width Length No. No. O�enches PIT No. Of Pits Inside Dia Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER anuacturer: ype a um r: uu t plow I tun � T] I em Hea er IMani o Drstn ufion Pipes x Ole Size x Hoe pacing Vent To Air Intake Len Length Dia Length___ Dia. Spacing bUIL CUVLK x Pressure Svstems Only xx Mound O►At.Grado tvctsmc Only Depth Over % Depth Over \ Yyt xx Depth Of xx Seeded ISodded xx Mulched Red ITrent h.Center Bed f Trench F dges `' \I Topsoil ❑ Yes ❑ No ❑ Yes n No a.vmttnctr t �: iinclLoecocie,0iscrepancies, persons present, etc.) LOCATION: Cady.14.28.15W, SW, NW, County Road N / 7 lI/it.:y,J�a.ta �!,JC�Ii �- ' v��j•!i ;,. ; i -. '-- 3 � �; , '/. „ ,ayd Plan rm risinn ronui rort� (i Via p1 htn �—', �� I IYI114 t`IJI VIIIVIyMIIVV `r ICJ V ITV Use other side for additional information. Pd. 17S ��r?�t �•�. � � < f_y .y c., ! (� 'o SBD-6710(R OSf91) Date ��—tnwcctor'sSignature eft No A �4ffer AANITAAV DFRUIT ADDI I[_AT1n1J In accord with ILHR 83.06, Wis. Adm. CadeTF STATE &ANITARY PERMIT N —Attach complete plans (to the county copy only) for the system, on paper not less than a g 3�� 8Ni x 11 Inches in size. Cbek It revision previous application -See reverse side for Instructions for completing this application. STATE PLAN I.O. NUMBER L APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER Ain z Z �tsy V PROPERTY LOCATION V- /� %'I v j,1�a W.,� %, S To2S , N. R or PROPERTY LING�ADO „, LOT1► BLOCK �I 1Cq•ZIIP /410 CITY, ATE CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER b} s'i c. 1 11. TYPE OF BUILDING: (Check one" RAREST ReA od A ! State Owned VILLAGE 'V []Public N 1 or 2 Fam. Dwelling-0 of bedrooms #RGEL FAA NUMUERIS) Or 01. BUILDING USE: (If building type Is public, check all that apply) 1 n Apt/Condo 2 ❑ Assembly Hall 6 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School B Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel B ❑ Office/Factory 13 U Other: Specify IV. TYPE OF PERMIT: (Check only one In line A. Check line B if applicable) A) 1. 9 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair o1 an System System Tank Only Existing System Existing System B) LI A Sanitary Permit was previously issued. Permit# -- . Date Issued V. TYPE OF BYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 � Seepage Bed 21 ❑ Mound 30 [1SpecityType 41 - HoldingTank 12 Seepage Trench 22 ElIn-Ground42 Pit Privy 13 ❑ Seepage Pit Pressure 43 Vault Privy 14 ❑ System -in -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3, ABSORP. AREA 4_ LOADING RATE PERC. RATE B. SYSTEM ELEV. 7. FINAL GRADE 15. REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/daylsq. it.) (Min.iinch) j 1 93.4, ELEV14TION S/ 7PO7 7 Tt ,X/bFaet Feet VII. TANK CAPACITY In Gallons Total ly o1 Prefab, Site Fiber- INFORMATION Hew Cisllans Tanks Manufecturei s Name Concreteglass Con- Steel Plastic App. App. `... Tanks Tetlks airucled Septic n Holdina Tank /CSGiJ (, Lit Pump Tank/Siphon Chamber Li I VM. RESPONSIBILITY STATEMENT I, the undersigned. assume responsibility for installation of the onsite sewage system shown on the attached plans. PI is PYrna (Prinfl: Plumber' Signature- (NoSt MP/MPPR+S�W No.: Business Phone Number. r/r/'� ? / 7/� i 7A � X21 um s Address i=ulty, stole, ZIP ) UL COUNTYIDEPARTMENT USE ONLY Olsapprow0 ry ermlt ee (Includes am 1)dvr.t.r • s leaving nt gnalur. o m Approvad Owner Given Innlai / /r/,.p/ aurensrw r~i 7 X. CONDITIONS OF APPROVAUREASONSS FOR DIWPROVAL 21 cam a 10 MM% NCT0,01 Mrw. thin! .l MJ iu M.l`rn. T, 0# N A rk.. Wi. riivlelnn Mw", pfifmh I AIL ST. CRo NTY SANITARY SYSTEM File#: "rr'rr nly OWNERSHIP/ADDRESS FORM ae&� ce 120 7 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. OWNERIBUYER INFORMATION Owner/Buyer 01A►� Mailing Address - 1ZS Govnj" (2ip tiJ City/State/Zip ►-i I IScrj w I 51402i Phone Number (required) 115 971-o95q Email Address (required) 9 ifhl ller© W W4', r%AA- Parcel Identification Number 004- l032- 30 -.2oo (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location 5--W— t/4 , tW 1/4 , Sec. _ 4 , T 2g N R15 Q Town of LADY Subdivision Plat: Lot # _ Certified Survey Map # (a!;;t 5 34 Volume l5' Page # 4�4t Warranty Deed # 10211:3 $ (before 2006)Volume Page # Number of bedrooms -3 Spec house O yesO-tQ Lot lines identifiable O yes O no �+,�,ee OFFICE USE ONLY New Property Address `mod 1/vim (Verification of new address required from Community Development Department for new construction.) (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. y �l l.�I •�' -y 1 4 Community Development Department - Land Use Division 715-344680 St. Croix County Government Center 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 wwwsccwi.gov Wisconsin Department fFrio Exl T Page 1 of 2 Division of Industry �/ EVALUATION REPORT 3I Z5 GT! Rp nl th SPS 385, Wis. Adm. Code County Attach complete site plan onhan 8112 1 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope. Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road 004-103230-200 Please print all Information. Rev d by Dal Personal information You Provide may be used for secondary purposes Priva Law. s 15.04 1 m Property Owner John Miller Property Location: Govt. Lot: SW % NW Y. S 14 T 28 N R 15 W Property Address :02_ # Block # Subd. Name or CSM# 3125 CTY RD N CSM15/4141 City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road Wilson 1W 54027 Cady CTY RD N ❑ New Construction Use: X Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD ® Replacement ❑ Public or commercial Describe �( Parent material Loamy drift over loamy till (Amery 1) Floodplain elevation if applicable NA ft. Z>DµL J General comments and recommendations: Rac rows minimum 1r aarid-lift POwTS mound on 96.55 contour with 0 6gpsst4 loading rats. LF = 19' (Rsdoxxnorphic fsarurss) 1❑ Boring # ❑ Boring r Pit Ground surface elev. 96.55 ft Depth to limiting factor 19 in. � Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots soil ADDliCation Rate GPD/Ft2 Eff#1 •Eff*2 1 0-8 10YR 313 sil 3fgr mfr cs 2f-vf 0.6 0.8 2 8-19 10YR 5/4 sil 2fabk mfr gs 1c-vf 0.6 0.8 3 19-28 10YR 4/4 2d TSYR 518 8 10YR 52 cl 2mabk mfi cw 0.4 0.6 4 28-38 10YR 4/6 c2d 7.5YR 4/6 a 1bvR 5/2 sl 1 msbk mvfr 0.4 0.7 I 2 I Boring # ❑ Boring �J ff Pit Ground surface elev 95.85 ry Depth to limiting factor 20 in. Horizon Depth In Dominant Color Munsell Redox Description Qu. Az Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots sun ncanon Kate GPD/FI2 •Eff#1 'EfF#2 1 0-10 10YR 3/2 I 3f-mgr mfr cs 3m-vf 0.6 0.8 2 10-20 10YR 514 Sill 2fabk mfr gs 1f-vf 0.6 0.8 3 20-25 10YR 4/4 2d 7.5YR SIB 6 10YR 5/2 cl 2mabk mfr-mfi 9w 0.4 0.6 4 25-32 10YR 4/4 c2d 7.6YR 4/6 6 10YR 511 scl 1 mabk mfi cw 0.2 0.3 5 32.48 10YR 416 eld TSYR 416 8 7.5YR 52 sl 1 msbk mvfr 0.4 0.7 •FFR. ., Bl -C n CST Name (Please Print) _ __ _- _ r...vv..,—--, Signature -W -'cv II iL aI'-IJ--- --J rT1IL CST Number Ryan Bethel SP-111500001 Address Date Evaluati Conducted Telephone Number 779 Spring Creek RD S, Red Wing, MN 55066 06/01/21 (651) 327-0074 atsu-dcau (Kugflo) ❑ Boring 96.55 Boring # 0 Pit Ground surface elev ft Depth to limiting factor 24 in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh Consistence Boundary Roots GPDlrt' *Eff#1 'Etf*2 10YR 312 10YR414 10YR 3/6 1 DYR 416 10YR 8/6 - f1d 7.5YR 518 6 10YR 512 c2d 7.SYR 518 d I.YR e 2 sit sit sit cl Ts Ngr Nabk N-mabk 1 c-mabk Osg mfr mfr mfr mfl loose cs gs gs Cw 2c-vf 1m-vf 1vf 0.6 0.6 0.6 0.2 0.5 0.8 0.8 0.8 1.3 1.0 1 2 3 0-10 10-16 16-24 4 24-35 5 35-52 nBoring # ❑ Boring ❑ Pit Ground surface elev. It Depth to limiting factor _ in. u Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh Consistence Boundary Roots GPD/Ft2 •Eff#1 'Eff#2 U ourny 5 Boring # Pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDlFt' •Eff#1 'Eff#2 Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L Boring # ❑ Boring ' -- ❑� Pit Ground surface elev. 96.55 ft Depth to limiting factor 24 in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate GPD/Ft' •Eff#1 •EB#2 1 0-10 10YR 312 sil 21gr mfr cs 2c-vf 0.6 0.8 2 10-16 10YR4/4 sit 2fabk mfr gs 1m-vf 0.6 0.8 3 16-24 10YR 3/6 - sit 2f-mabk mfr gs lvf 0.6 0.8 4 24-35 10YR 416 f1d 7.5YR 518 610YR 5/2 cl 1 c-mabk mfi Cw 0.2 0.3 5 3552 10YR 8/6 c2d 7.5YR 5/8 8 IOYR 6/2 fs Osg loose 0.5 1.0 aBoring # ❑ Boring ❑ Pit Ground surface elev. Depth to limiting factor _ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil lication ate GPD/Ft2 -Eft#1 •EfF#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor_ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots Soil lication Rate GPD/Ft' 'Eff#1 'EtT#2 Effluent #1 = BOO, > 305 220 mg/L and TSS > 30 s 150 mg/L • Effluent #2 = BOD, > 30 s 220 mg/L and TSS > 305 150 mg/L DakJrr. Ryal Baehel C�1T� Sel Tester: sp-111500001 A DVA N C E D *All aroMmy, lines nDt o SYSTEM NOTES Designer of Engineering Systems: D 2263-7 drawn are >100R from s Be^chm°rk Se system Soil Bw n9 prk Tank: {xsdg Weeks 1000 Salon 1-mnparanent tank SCALE I AppeasraleAgNand propedykndmq to be '} I + I , l ' + + + + + + + wr6edbypkrr,*AnSt % 0, 25' so.* to north P.L. I + + �i i I + + + + + + + s{eadq'�en Igor dell to be abandoned per SPS 33 + + , I+ + + + + + + +++ + + + + + + + + N + + + + + + Tree line I + + +' I I + 4- + + + + + Pump Tank: O + + I I+ + + + + + + i +++I + + +Q C + + +I I .+ + + p + + +- + +�+ + + + + I j I - t. 4. + + + d STA: I.` + + ♦- + + -+ + R«amnru m naenI r Ada POWTS word on l 0 I 96 55 Catou een 0 + I 1� + 4- + + + 6�" bWr rae Tree line 95.55 � — 9 OOnka = stndun = 19 (Reearrro Prar kraes) _ BgsaS + + + + + corsar=s655 + + I + + + + + + S10Qe' + + , 1 \+ + + + + + + + + I 1 1 �'}` t + + + + + + ; + + + Distribution: + + + + + + + + + -{ + + + 1 ( ; + + + -System as regae pre etaant on + + + + + + + + + + + + + sMt- 112160 + I { `I + + + + + + + + ? + Tdp of e*ctricaW— + + - T 1 + + + + + + + + + + + + 4nSforcper + + ++1. ; �t �� . + + - + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + `�� ` I LOCATION MAP (not to some) + + + + + + + + + + + + + + + + + + + + + + + + + Elm2� 1024 �5 �i/ �_ �. CT Y RD N �\ Exl OC jog of `oncretL�� -- + + + tre Ch + + +,A1 3 + Tat sh NW cTxner + i� / — �� veil ^\� +/*Sten+ + + V� + + + + + + + Shop `^ \\\ + + + + + + + + + + + + +I + + + + + + + + + + + + + �� \t \� + + + + + + + + + + + + — �e?� 11 rh + \\+ ``\+ + + + + + + + + + + + + + +\ BM3 = 103.35 — + + \\ f\\ + + + + + + + + + + + + + + Top of outlet cover + i\\ �')j, + + + + + + + + + + + + + + PRIEPARED FOR: / )ohn Mier + + + + + + + + + + + + + + + + + ExMng 3125 CTY RD N + + + + + + + + + + + + + + + + + + +� 111 Weeks 1,000 gal Won, WI 54027 + + + + + + + + + + + + Exisuhg pVClpipe + + + + \ + PID: 004-1032-30-200 16.39 Acres + + + + + + + + + + + + + Legal: Lot 02 CSM 15/4141 kv�ckan#uts e%*y 75�eet + + + }� + SW 1 4 NR15W W 1//4 + +s + + + + + + + + + + +- + + + + + + + + 4- + + S14 e plelearet ne ns nann d argue anawarred nn aeewdara aM sae ad nma aedew The ad b.ammt a x, Tart mart pmsess man AeOehasaaapeaeer arse and aAw Town of Cad eMeAb�r n0 wpaarrn"raisy r sits nw ne ssltm ell OMMAX To nwnow snesnaY. �a ns=r ` paply rr=kNrted. lads, rue OWN rrwn.p.rrt shin farnrdanreIm an preps can, Out Scale: 1' = 5W Date: 6/1/21 546 COUNTY (we STATE SANITAR � 7!5 (NI,� QOa s ae!vewnL eus OWNER :!F#Dk A- A'&r PLUMBER TOWN NO. 64542E Y �ERMIT VIOUS.01we -BLOCK SUBDIVISION CHAPTER 145.135 (2) (a) The purpose of the sanitary permit Is to allow installation of the private sewage system described In the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and maybe renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the unitary permit will be based on regulations in force at the time renewal Is sought, and that changed regulations may Impede renewal. (f) The sanitary permit Is transferable. History: 1977 c. 169;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. ISSUING OFFICER - DATE /O SUNLESS RENEWED BED` POST IN PLAIN VIEW DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20)