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HomeMy WebLinkAbout004-1028-50-100Wecon sin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT Saritary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan 10 No 645440 Personal information you provide may be used for secondary purposes [Privacy Low, s 15.04 (1)(m)] 102202421-C Permit Holder's Name City Village Township Parcel Tax No Tucker & Brook Benjamin TOWN OF CADY 004-1028-50-100 CST BM Elev Insp. SM Elev: BM Description Section/Town/Range/Map No 12.28.15.192E TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMPISIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist to Well STATION BS HI FS ELEV Benchmark Alt BM Bldg. Sewer St/HI Inlet St/HI Outlet DI Inlet DI Bottom Header/Man. Dist. Pipe Bot System Final Grade St Cover BEDITRENCH DIMENSIONS Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth SETBACK INFORMATION SYSTEM TO Type Of System. P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer Model Number slk*t d.] I :11111k it falr�yW.wit:1r,i HeaderlManAdd Distribution x Hole Size x Hole Spacing Vent to Au Intake Pipe(s) Length Dia Length Dia Spacing Srlll Cr7VFR . D.n.....n Q... rnm. AM.. rr u..und nr At-rZrAA. Svatoma only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bad/Trench Center Bed/Trench Edges Topsoil - Yes - No Yes No COMMENTS: (include code discrepencies. persons present. etc.) Inspection #1 Inspection #2. Location: No Address Available 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? C Yes No Use other side for additional information. Date Insepcior's Signature Cent No. SBO-6710 (R.3/97) -d < a- _' I - n n-R A I -% -. -va — 9 11 r Kew . / • v Ot `• to as/��'t. indushyServias C°�q }fill /W Modism Yards WaySr . 6,�a x � Madbo% WI 53705 = j Petbek" oo i&Co.) +a _. ;, 0 C T 66 2022 P.O. Box 7162 .-� btadisoq W1 162 st. AWlicati Smbenxmgm mNtaabw is amada weME2 I (]Z z OZq Z / - L ,abmb d=of.i halls m. tk k Pdwb aI a raisry Pot NOW Appimbois hem Br Re febulteed to A4&w *=ad � ) Ib fSihty m p ' ' 3 1" hmri babumdm be erPqwM lm Po'ibmW uW In seaoadey aca am PtapertyOwalelrmISA40ft Lip-I�- trrt y7S 32S-�'` ST Paod Is TuGCE P �tooK En+?Aor/N 00 `�' /o.?d- SD - /oo Ptoperty Owrter'e � Addros GI O I/S7dQ .ZB• .I97,6 cky. sum71P cod,SyoPbow N mb er PaEsco,T w .t1 65/ B9o-7' Nov SE w Section /07 u. TYPO of Bidder (dw* A that appW Lot a T �B N R /S ptor3PrmityDwd t-NanbRofBedwatu 3 a Nawie [Y"DCammatdai-Daambeire BINko Dks"Ovanod-oselaRmUn of CSM Number //- 3440 P.i of z VK4e ( Oowa Of LAa Y ]II.TYPO OfP0W18PWUft (cW*ddw-xawwor-Rgke sla rMAoverMffBmbaMEaA. Cbv&w.b@xMl♦aazz.w av=c oeov tl �0 1�'wa leoddlwboa to Sysi a (tsWNN) Pra 7A.E L[bOeod �ttfCoda M°wad lodi�idaalSMDmip Tyr(dBeAtta ❑� ofPbaabw taoettbNew P►wefowPsekNabareleDeeals.ed 1V. Ana Md Tolsk 1dbOtc ✓n DeaDt set Applieara Dbpond Area (1A � y Ams (SO trPJa..k. S'So /o `/So Z '/So 7.5 Cry r Tow i of Tads Infaema4ab NOWTWMa.Bmt Teala aalleo. Unft F-10 I1kc E] Sapda or D�OAO I 4)/-rnu L'4j c- v � GDD v BlabfMt-1. tbf �ifea`we.111t�e Item Pow 13 fbewa Ott 1b atdebi pram. NftaO (Pr1et) a MUMMA MNowbis Pbttbe Ntanber EtK n.?J/lf� S 6T�- ?ll fetdtd: Arleta. (Sleet Coy, zip caet:) 98 Sr. s JWN u1O ❑ Drappwirsd ova Daa roved robs Attu fG OwaROhaaRae 111!, /S. ! r3 Conditiaat otApPtovaYRa„aeo he Db>appA.a1 ,( �tyl SYMM OWNER-- I. Septic tank, vuent filter Ono /� .L L r pawl cell must «` !!l tt`/ / / as as per management plan provided by plum t ��S �% t h' - D/�, { i`{j�tt 4ess�Y1 LP L T. All Wback requirements must be maintal "V 7 `�l✓,h all par aupltcabN cods/ordinances I L44.P( - After r eatapltr ft�a atrs►ealeaf� ale fea�tte it C1tba9' eeb ov p+v ub it ibb a Ina 11 lnbea r itr UD•6390 (R- 0341) YJ5 p rtAri CLAN �Ll LKE ( G7 EnJ iAr1hJ- y.TS 325- tN Sr /VL.J, S£, 1,7, ,78N, /SGJ jr' a.r ZAd y Sr C.ceix Co. T N N /=30 O /5 3a C : //rsi ..?-0. YS Rt.tE LnY Atc Si°S 3$3, Y3 Se-r.6,4,:,tS MCC FAAw flic0 G X 73,ROCx CEtL Ideirs t 9 SYS. Ea. - /oa. G O,r /co. a ��a•, aai �J 8a f fitxo .� Pv! Sca,9o Ftlli �./�/•D?y��%/OUf- 6ELu/� rAs8y . re `. j �r r/nv��ey /oo76` f4A'dr a AM11 '4/ !u)6�/ Coo , 'Jr4,jK x=/oG.c� I i /'RoioslD /die/oJlO { ® 4JC« A I I r ra OL /''/ C AvAr C/il"Ae. c . p /oa .a t r fl Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 October 3, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-10-03 Plan Review: PWTS-102202421-C JOHN PELKE N6298 State Highway 25 Durand WI 54736 SITE: Tucker Benjamin 425 - 325th ST Town of Cady St. Croix County NW, SE, S12, T28N, R15W Total Amount: $250.00 co.,.mion•1ly nro+ n n oonaccn., �� c SERVICES �� •�riir�i7iir [FF CnRRFSRmmn FN[F Phone:608-266-2112 Webi hnp dhp. Email: l,p", •., n.• i,.u. Tony Evers, Governor Dan Hereth, Secretary FOR: Description: Three Bedroom Mound System 1 Sloping site Mound Component Manual - Version 2.1 (May 2022-2027), 450 GPD, 29" depth to limiting factor, Maintenance required, Effluent filter, New construction The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec.145.19, Wis. State. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, i Gerard M Swim POWTS Plan Reviewer WI DSPS - Division of Industry Services (608)789-7892 jerry.swim(o)wi.gov vv uJLI.Vf iULUI i 1t:dLIllClit J)'JtGlll Wdex and TIdc Page Project Name- -- T,cx€,c X c., I5A. Owner's Name: —_ � �� 0 A-t—do Owner's Address: t.i /%OS i y . '=v uE _ Mr f IrbIV Y LV - --- --- ncor nc [At:r v eun DDncce[Inue, T !L� ,/ f'OJI - RI\.IC In IJ nC 1\Inl-ICTDV [CD\/1/`CC LAgai Ltcscrtpt:ar.: - id��•f %c. ;�,..� q,ti. 4Sunicipality. i lovm. V44eg-. (.4P. n! _ •:•'' - - County :5;. �.co.A Lot Ntunber Mock Na+nbrr CSM'Jamtxc //- 3c 93 Subdi.-7von Pamei 1 D Nornber. — GoY /0,28 -S6- /00 -- -- _ _-- __- Page 1 index an(! Titic Page rl age Pag:: 3 Cross -Section & Pion Vic'X Page 4 Pipe Latmai Laycu; t'sge 1 Crpiic Tar- Pump Cha^.:5rr'-:.,�� gel unn e lx;aii,ati,>rl. Page h Yurnp Perforninnrr. info -nation Page 7 POwTS & Mrnao'cmenr Pian Pa8c' }"J\;GCS r•tinc-'v 11:tmai X- �,Wnagcmc,u Plan Page 9 Filter Informatior Vame e;t Des,rnc,. .� ' / i;1 L,cen.+;e Signature — �.212 _ L-I L Date: � �)W lti omnone_m Manuni tilu DSP$ 3�::y5: ";v(uund Component Marvin; for PtiXlsy'_L'�' �02' -Pressure Distribution Componcra'Aamad for t'tj%A, C`;" Ven,ent 1.i itriuy' IU�l-�lll: 1 A..azhincnt: Suil L•vah:ar.on R-;ti�r [Y;.f 3�5Ld Sr. YLOUY PLAN /ULKE.[ ,BE,JlArsi.J- yis 3,7SrN Sr, Nam, 5,C j 1,71 .78N, /sw r aF ZAOY .Sr. 'C'ed"K 6, T Po/.;'ode 9 N -- — jo O /5r 36' A[[ SOS 383.'/J Sfr4/[ks plfr `AAIV I G '[ 7.7 [ eocx c f[c �•7,�'{ 97.8'i'7ou.�0 /ears a..A f PL rr .? Pvc Sc[r. yo t fa<c0r a ar dsu Old i. I Yo"Pie y� 0 1 /I tlusu �Y Cary,So tA.r,r MO",O .ede C/y n 3031 p /aa .d I Q I ®ur« D • . G ft E _ IN ft r = 9 ft IQ = ._ ft $=eft A = _�_ ft $ r Zf ft I a. / ft J = `/..f ft K = B.? ft L = 92.8 ft M = a.2 G ft 4" soh. 40 PVC obswwd n Pipe 1.5ft 0.5ft CROSS-SECTION Page 3 OF MOUND of 9 UPTURNED LATERAL NI ACCESS BOX I OBSERVATION PIPE & WATERTIOW CAP TOP SOL GEOTEXTILE FABRIC COVERING DI8meuTION LATERAL ( / s In. sch. 40 PVC 132M) ASTM C-33 SAND FILL Lateral Invert EI.= /01 / ft / TOP SOIL N TOE F ., ,;' System EI.= /ae. 6 ft Contour EI.= /Go, p ft • r !, '•• r' _ • : ' = : .: "1Z PLOWED SURFACE ' ': . �. :... - .. s •. - % SLOPE R oRCE NAIu (r ach. 40 FVC o2t)e6) IHSTRIBU?ION CELL =_� ft x r it = f5a W (W-2W ooregaM) Min. Required = 0"d + Zo - fSO its Obeerva0w pipe 73' r Observation Pipe t r K y S � 8. 9 OX G+ A ox DisMbUdDn CeA DWilbutbae n plp ft (%-2K'aggregate) ft x 71 (� in. sch.40) OXa Upk mad Lateral with Access Box If Prohf* distubNoo and vetdde Vaftic witMn 15 ft of downaiope toe. , I L 91.8 Bald Area = /B / ft x Y It = /3S7 fe lAn. Required = Yso + y //,t'S fe r Farce mein M@nNd (,& in. sch. 40 PVC 02086) Y/ HOLE DIAMETER in. LATERAL DIA. _ Al in. (sch.40PVC MANIFOLD DIA. _ in. pipe D2665) FORCE MAIN DIA.- �_ in. p = . ft. s 3 ft. X 7 ft. Y y ft. ANIFOLD ( / > in. sch. 40 PVC D2665) PIPE LATERAL LAYOUT OF MOUND (End Manifold with Aggregate) \ ee 0\05 ee'j JP a\U9 s FORCE MAIN (2' sch. 40 PVC D2665) rAccess Q\ Minimum Number of Holes = YS6 ft2 + 12 = 38 Holes Page of HOLES LOCATED EVENLY ON BOTTOM OF PIPE. 1? Holes/Lateral x 2 Laterals = 38 (3/16') Holes x 0.66 gpm / (3/16') Hole = WS.08 GPM = SYSTEM FLOW RATE PIPE VOLUME = /`iy ft. Laterals (totan x 0.092 gaVft. = /315' x 5 = L:• 2r GAL = MINIMUM DOSE VOLUME PIPE INVERT ELEVATION ft. Page S of 9 COMBINATION SEPTICIDOSE TANK CROS"ECTION (DRAWING NOT TO SCALE) GRADE _ ,• a ww oo.1 BUILDING SEWER r (W SPS 3esao(l I)) sfroft r MANHOLE RISER & COVER (W SPS 3e42" i (e� op1powod lodbw 1- Or . i w o h Sabot End nwtm* dew a rwwwNy.) 4' 14K tick 40 PVC Ton* Vwd badied t or 2C above � f� graft m Y2 . ass-/e u Samoa* ft, an t�~%OnQrat 4- lit Sdt 40 PVC TMA Va,t ELECTRICAL epb t � eReed*BraW JUNCTION BOX {oo � �s300) I ' FORCE MAIN ,+- OPTIONS ram ( Mai, II . Tool Ae,a k 1 � _ _ \\ c MINIMUM OF 7 OF SUITABLE BEDDING BENEATH TANK 6 MA)Cf1igN BURY DEPTH OF W ArichartV of tank may be required per SPS 383.43(8)(9) Tank Manufacturer %i/EJ&A lodc.cc rE Daily Wastewater Flow (DWF): 41IS6 GPD Septic/Pump Size: /4000/4co6 alions Number of daily doeea: S.3 Or %) Alarm Manufacturer. S. T. E• /?4"A s Model Number. rifwK AxgAr / Switch Type: &j,4 4,jic,r ,L Effluent Pump Manufacturer. Zoscuu Model Number. /S/ Minimum Discharge Rate: ?S. O8 GPM Vertical lift (pump off to lateral invert)............ 4 ,1 ft System head (distal pressure x 1.3 ft): 3.3 ft JaF Force main volume: o?O ft x . A an = 3.3 gal Actual dose volume: 88.8 gei - 3,3 gel = SS. S gal (total dose vokui - volume of force main) DOSE TANIS CAPACMES: Reserve above alarm .?0. 7 in = 3YZ. 9 gal (D) Alarm float above on float a in = 315' gal (C) ONOfffloat measurementS.3 in= 888 gat(B) Off above tank bottom 8 in = / 3f / gal (A) pros man x _ f _/100 mcbon fedor 3 ft D03E TANK DIMENSIONS: Rtter friction loss ...................................... _ ft Length /SO in Width 8,Y in Total Dynamic Heed (TDH): 7 ft Outlet height ^ 34_ in Gallons/inch /l.74 r r •C ti FI■■■■■■ ■ ■■■■ ■■■■ �■\`\\■ENE ■���08■■ ■ \��■■ ■■■■■■■■■■ "'�'° 4 • • tll t• 303 7r3 310 >m 1sa FLOW PER NBRITE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for oontrolling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls - • Sealed Qwik-Box available for outdoor installations. See FM 1420. • Over 130°F (54`C) special quotation required. t51�t�ia3.; 1sinma AN)OBf I conow ew scon mom v brill MaM 1#151 115 1 Non U 1 2or3 f1N161 116 1 Auk U kdrdad 2dr3 E151 23D 1 NM 32 1 2or3 SE151 230 1 Ards 32 YridN 2rr3 11152 118 1 NM 6.5 1 2or3 8N152 115 1 AdD 115 1 4.3 - Yrbd3d 1 2a3 2er3 OR 230 t 1Ahuft 4.3 Uckd3d or Nt tl 1 Nan 10 a BN163 E153 116 1 2X 1 Auto 103 krdudid 2a3 2or3 Non 5.3 1 OEM 23D 1 Auk 5.3 bdadad 2ar3 u SELF_— - 1. Single pggyback vwi" kvel 6oa1 switch or double pwyback variable level foal switch Refer to FM0477. 2. See FM0712 for correct model of Becfrtcal Allemator E4ak, 3. Variable level control switch 10-0743 used as a eon" activator, specify duplex (3) or (4) float system �, r53i3�G: a" ]_ _.:. _.. -. i CH':.`5 t'r. .: ,.'•:uL s Yn! Tf 1 Q�d iorrrs eecukka Ai 3iee*o ams y .r �. an sicJo a tdo.c rrsd.q b WAR •ece•r moilont twervo Gear 91K. 3wa 'Ar avowwwral Sam awd Belli 1ro1405"k TOTAL DYNAMIC HEADIFLOW /4. ` 6f 9 PER MINUTE EFFLUENT AND DEWATERING E!®E70o0OD rani©r:���moo■ r0TA)zmrtDN©©"0m rt•�0r���©�o� nms�m©®©0 ome o 00 o�s�is�■ioo o®a�sas�� Model 151 arm 37/ + 4E08 ' 374 4 3 ra 3n Models 1521153 3 .Easy W ("V d orange Poe not+z►ded) - 4_ DUMP STAND orN 0-2'?4"1 Reduces polerltlal clogging by debris. Replaces rocks or bricks under the pump. Made of durable, noncorrosive ABS. Raises pump 2' elf bottom of basin. Provides fhe ability to raise intake by adding sections of 1 %i or 2' PVC piping. Attaches securely to pump. Accorr odales sump, dewatarirlg and effluent applications. NOTE: Melee sure Moat is Ins From obstruction. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered km Ile dewp of every Zoeller pump, 0 Copyright 2008 ZDollor Co. All rights nsaved. POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION oww�i[K d QEN if m) Permit # DE'SI[.1[ Pali eitrtpDe Number of Bedrooms I Number of Commercial Units Estimated ow (average) 300 Design flow �t estimated x 15 y o Soil Application Rate 0 Influlmt/Etiittwt Qusiity(❑ NA) Moathiy Average Fats. Oil 1 Grease (FOG) _< 30 mg/L Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) - 220 mg/L c 150 mg/L Pretreated Eff]umtQuality (® NA) MoolhlyAveraQe Biochemical Oxygen Demand (BODs) 5 30 �L TOW Suspended Solids MS) Fecal Coliform (geometric paean) 5 30 ttrpll Maximurn Effluent Partick Size 40 efir/100ml I/g ink diem ref F f�lt047 Y'.' ally r.r . Scpdc Capacityeo0 Na Septic Tank Maw>>sdurcr c✓iEsu NA Emuent Filter Mmudacmrex Fs r NA Effluent Filter Model -/O Q NA Pump Tank Pipwity Go 21111 E3 NA Pump Tank Matmfacwrer ,,sea NA PUMP Mmufaicturer I ZOdnCI&C NA PUMP Model / f / NA Pmtrtatmpot Unit ( RNA) ❑ SandKhzvel Filter p past F&W ❑ Mil Aeration In Wetland ❑ Disinfection ❑ Other. Manutfachuer. Model: Soil Absorption Component (p NA) ❑ 11178mund (gravity) ❑ In-gtotmd (pttssluizern ❑ A"rade III Mound Drip4ine 0 Other ❑ Dispersal Units — Mmnrfacurer ❑ Aggregate Cell(s) Model Soil Dispersal End Cap (Dispersal Unit EISA) or ]Zn+ rateAMLIUMimd - ESA + (D=Ch Width) _ # Units or Total Leneth of Trenhr 1 ❑ "Design of Prsasltre Distribution Networks for Septic Tank -Soil Absorption Systems" Publication 9.6 (SSWMP Manual) O "[CC Flowtech Mood Component Mannar Version 1.2 ❑ Mallow MouW Component Manual' Version 12/15f2017 ❑ SBD - 10954-P (R.1/12) "At -Grade Coenponent Manual Using Pressure Distribution` Version 2.0 ❑ SBD- 10705-P (N.01101) "In Ground Soil Absorption Component Manual" Version 2 0 W SBD - 10691-P (N.01101) "Mound Component Manual" Version 2 p ❑ SBD - 10657-P (R.6f99)-Drip.ime Effluent Disposal Component Mannar ❑ SBD -10706--P (N.01101) "Pressure Distribution Component Manual' Version 2.0 MAINTENANCE MONI'[iORING SCEIKDULE - AND MANAGEMENT p� $ - Servlce Frequency inapect s dean filter At least once 13 months 3 p Other _ act twit At least once ev ❑ months ®3 ears NA Flush and test laterals = At least Once every: months 3 years ❑ NA START IIP A1� OPF RATTON: For uew coavtruction, prior to use of the POWTS check trtatrtrent tanks) for the presence of P�ti Prom's or other chemicals that tray opede the treatment process and/or damage the dispersal cali(a). If high concentrations are detected have the contents of the hrnk(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative stuface Ile property owner is respormble for the operation and maintenance of the POWTS and submission of requited reports. The quantity and quality of the wastewater strearn win affect the performance and longevity of year POWTS. The installation ofwata�aving appliances end fixtures along with prompt repair of leaks reduces the wastewater volunme. Also the brine or waste from water sofbeneM iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not inchrde laundry waste, showers, dishwater, etc This system is designed to handle doetestic strength wastewater. however the of food based �k and Ada. and food solids such dspoaal greases and oils, vegetable/fruit produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the ryseem_ Other non -biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs sbould not enter the system_ Chemicals sacb as petroleum products, paint Page 7 of? disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the weep. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. INSPECTIONS & MAINTENANCE: Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Tank inspecdm must include a visual inspection of the tank to identify any missing orbroken hardware, identify any cracks or leaks, treasure the volume of combined sludge and scum and check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms. Any deflects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry the tanks. When the combination of sludge and scum in any tank exceeds one-third (1 /3) or more of the tank volume, the entire contents of the tank shall be removed by a Seplage Servicing Operator and disposed of in accordance with Chapter NRI 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to rwove any accumulated solids according to manufacturer's specifications. Solids washed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Alarms should be tested on a regular basis by the home owner. Iran alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve tinder regular operating conditions, however water should be conserved until any problems wi th the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT: When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPS 383.33, Wisconsin Administrative Code. All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed - The contents of all tanks and pits shall be removed and properly disposed of by a Septagc Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covets removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been, or mutt be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells_ Failure to protect the replacement area render it unusable. Replacement systems must comply with the rules in effect at the time of replacement ❑ A suitable replacement area is not available doe to setback and/or soil limitations. Barring advances in POAFTS technology a holding tank may be installed as a last resort to replace the failed POWTS. X The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. X Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biontat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name -TO" /,fZAr /!/-wili,14 Name Pdrzxx <4.vLwe Phone ir I Phone /T 1 - J1144 SEPTAGE SERVICING OPERATOR LOCAL REGULATORY AUTHORITY Name Agency Sr. eA j r ry Phone Phone yif 32 - flte Page 9 of 9 A- 9 ofy Installation Instructions for the GF10 Filter i Stop 1: Locate and remove the septic tank cover, on the outlet side of tank. Step 4: Out the finer use onto the outlet pipe. Insen the Idler cartridge Into the case. IMW* sure the filter is completely Inserted Into the case.) EST _�/sY Step 2: Before Installation, Place the Aker case on to the outlet pipe. Make sure the case Is positioned so the filer can be removed from the tank for mainte- nance and service stops: Folnstdladonsthat require or desire additional support. Of sciditional support Is not needed, go to Step 4) Glues section of I' Sch. 40 pipe to the two hubs located on the bottom of the case and the hub located on the side of the case. step 3: For Installations whereR WId bedNticult to reach the handle, piece 1'Schedule 40 pipe into these on the handle and extend It to height that wife make It easy to remove the filtar. 1E n $ seer 11 uo AY cane car sus Lw t , M0 V l r-r t: r Y 1 11 "t. roe r'A� V Installation of an S,m,s„ner,aatetnm,,yehe,apek,,,tl, A existing system. nws<bopurapodprior tobutallation. 9 Ib w ra , arm mu r r-. L.-, p-n NJ ._, Ll n = La.rw Mrs vy v Raw tc. na Maintenance of the GF10 Filter A time home In which septic tanks are serviced Is sat by sate and local codes. Although they may be different, most requis" agencies suggest hero to five years. We recommend the GF I O Idler be cleaned when the septic tank Is normally cleaned and pumped, or as headed. WARNING: If the liquid level In the tank is above the top of the filter, pump the tank prior to removing the filter cartridge. ACAUTION: USE RUBBER GLOVES WHEN HANDLING FILTERSI Step 1: Remove the septic tank cower and pump the tank N necessaryto prevent any skids from escaping to the field when the Aker Is removed. k&Yltitpl!`. 9 sup 2: ha the filter handle and "the filter out of the case, Step l: While hold1N the Aker cartridge over the access open tg of the tartlt, ranee theortridge off with fresh owner. Take ore to make sure all soaks material falls back Into the tank AVIW OFEW _V,AW TECHNOLOGY 2 FohMld Blvd. WaNlrrglad, Car tk92 1417.716e/IB Fax: M01-11614 Sup 4 kwart the cartrldge best Into the case making Rare that It Is properly ailpnd and caryktely Inserted kao the case. WISH - - Wlaeonln DePartritart of safety ud Probesional ser*" pace 1 of 2 Division of hn&Aky serAcm SOIL EVALUATION REPORT in s000rda ncewah sP33%, ws. Adm. Code County Attach camovis oft plan on pow Holt lees than B 1!2 x 11 Ynclw in etas. Plan must include, 8T Crobt but rot". W veryool and IKwkawtW mlerence point (BM), aYedfon and percent Mope, Parosi I.D. ash or dlmereions, north snow, and bMon and dietarnce to naareat rood. 004-1029-WIOO Plteaae prim ant MrbrlMalfoa Reviewed by Date Property, Ovrrer Tudtor Beryfwnin Property LowaYon: OWL Lot NW Y. BE % 812 T 26 N Pis W Property Addrs@4 Let a Blodt i Subd. Name a CStrti 425 325TH ST 02 CBM 11-3003 city SteltM Zip Code Piwre Nun*w ❑ Cay ❑ vtaaq 0 Tarn Nto" Rood Kropp i JWI 54740 1 (651)00.7110 1 1 Cady 325TH ST ® N@' C&Uftr$Cn Use: ®RMWWtW / NMber0lbadroore 3 Codo delved d=r lbw rate 450 GPO ❑ Replacernsit ❑ Public or oarenwaW — Deww": Parent malatlal _ Pbodplabn slavatbn it appfoabla NA a. Gw orel comnm* end reoormtartdetlorne: Rro•erxnrl r ft'"m 7• and•! MMM mo.d m i0000 ou . de apnea b.ue r•r. LP - 2V (R•dorerserpW Yrexesi t1-1 Boring i ❑ Boring Pk Ground eurbm Slay. 98.00 6. Depth to yodync bcW 29 in - Z Horizon Do"m*kwd CoW mur"l R*Wx Deaw"on 0ru. Az Cord. Color Terdue Struaue Or. Sz. 3h. Co swenoe sougivy Root oo AODNO@UM fob GPD/W 1 •E1M2 1 10YR 3/3 I MW m* ae 3" 0.6 0.8 2 018 1OYR 514 fill 2mabk ds-dah pa tm-vf OA 0.8 3 1 1CYR 516 Ifs 099 dl ew if-vf 0.5 1.0 4 10YR616 Qd7.5YR5baioYRtv2 if 4W 0a2-0m mbmfi 02 0.6 2 1 Boring i Cl BOA Pit Cwou d nx/aoe M•v. 100.00 ft. Depth to Ln tiny %cbr U in, Iry ■o■i���r.�■ - . - .: , - ©�®ail■ : ■� �$ T^:;if?•'•�Sc:7ir:.�T. .71�1+r.•t•a�.-.►zr_------ --Lana CST (Plaaoe Prt q Sbtakra 155>30a 150 FTWIL Ben" Ryon Ben" CST Number 1330832 Address 779 Spdnp (reek i 5. Rod VAm. MN 56M T Delta Evmkof w Condudod 06MOM Telaphore Nunber (661) 327-W4 sou-osau (Haul a) O Born 9 Boring t ® Pa Ground aurfaoa aw 100.90 ft. Depth to limiting factor 32 in i i CnY CerJriliev� Z Horizon DtO Dominant Color Nkfeen Redoa DMcr"on Ou. Az. Cont. Color Te>Que Structure Gr. Sz. Sh. ConsiWnot Boundary Roots GPDTe •ERtt •Elft2 1 0-8 10YR 313 ad 31gr mfr ca 3o-vf 0.6 0.8 2 17 tOYR 5/4 1 2f-mbk dah 98 2cM 0.6 0.8 3 1 32 1OVR 4X fat 2mabk mfr gw 1 m-vf 0.4 0.8 4 2 1 OYR 416 12d 7 SYR 5na tl 1 OYR an fal 1 fabk MfI 1 f-vf 0.2 0.6 El Boring t ❑ Boriri; ❑ Pit Ground suAaa alev. R- Depth to I*Mng factor _ in. ❑s Bo" t El Boring Cl PM Grand &AIM elev. R. Depth to linking factor _ In. ' Effluent 01 - EIDD, a 30 s MO mg/L and TSS > 30 s I W mgeL ' Elfluenl t2 - SOD, - 30 s 220 mg/L and TSS > 30 s 150 mg2 Ovelpr. Ram Dadlel C 2022 Advanced / Deiper Enginew" Sy�iterna 0 2263-7. _- ... All r is resented. �' ''f ' BM 1 = 100.00 OQ� � "Top 111 PVC pfik (14" above §fade) : BM2 = 108.00 'M propInes not BencNmfk Y1"S'TEr" N(/TLti erty Crawn are 10M frorr � • 'Irylk Tank: ryatem AIN sod Bong Top. nail in 40" Pine (25" above grade) --------------------- "Well to be located >50ft`\', Field from soil treatment area 81 rroo edge >25ft from tanks" 3: 98 0 poi l� ��\� l `^, T D BM 2 , C to west P.L./ Q ! 325TH ST C/L — — — — f--, Current grade I �---- New I z 106.65 j 3BR f 1145 1-, 0'i BM 1 lop go e3 N Sf.AI.F ; Home I �� Fence line drr wAft ft load ewm No Men deetvwd wed wedmed as eee«ew ee am 1mM turd lore aeda Tao " wooev" ores nora '.rasa, pwrr row a"dswaw wryer e.g - wwo W4 Add wwww aa. M wtwm a WIN ntg M Mill1 MLLLL omnllMt 70 Aft7 tr ►w"W "" e,A a_P�'_a�!�. Ibd- IW VVIEWS rah 4 00 for tYwnrlm Epp. m. d-- Pump Teak: i W Treatmewt Area: lkcoddow4 drew" T mdta POWIS enwdw 1 OD tl0 ura■r.M a tiler ks6y dad Diptn le rorlatm = tY howl -9dpe -11% alrlbulkra: Sfstan ee repot Preware aradorn LOCATION IMP W to wrdl 45TH AVE E ry ll�� M 1 PR WAKED FOR I` Tatra BWWM I-- — - ---S16AAdrew 1 45 325TH ST PID: 004-IWS-SD-IW 20.45 Atfm'• Legal: Lot 02 CSM 11-3W3 NW1/ SE1 41 S12 t1N R1 fjW Tom of Cady Scale: ]' = 31Y Deft: VIOM __J ST. CRo UNTY SANITARY SYSTEM File #: I Office Use Only OWNERSHIP/ADDRESS FORM crwftd212021 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer Tucker or Brook Benjamin Mailing Address W11052 - 457th AV City/State/Zip Prescott, WI 54021 Phone Number (required)651-890-7110 Email Address (required)tucker.bcca_gmail.com Parcel Identification Number 004-1028-50-100 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location NW y. SE 1/a , Sec. 12 . T 28 N R 15 W, Town of Cady Subdivision Plat: , Lot # 2 Certified Survey Map #3093-CSM 11-3093 004-96 , Volu Page # Warranty Deed # (before 2006)Volume , Page # Number of bedrooms 3 Spec house O yes ■ no Lot lines identifiable ■ yes E3 no OFFICE USE ONLY New Property Address 2�/ 2S 72, F A! U Ili (Verification of new address required from Com unity Developf eyk Department for new construction) Z0/ ZI 022 (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center cddGv5ccw1 gov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax 4YbY �Y. S ((',yl (I oV FRONT ELEVATION - W--- - - Ria� rr•1'r PORCH SIDE ELEVATION r K.rr REAR ELEVATION i K. rr ( ARAGE SM ELEVATION 1a i U j � a zaara:aer I 1 i , x �w sae PROPCMO MAIN LEVEL FLOOR PLAN iCK u•.Ip 1%,AM�lOA ,OYd1IgpR aY�Y11r I lul s I i ---- - - ----- - ----- ------- PROPOSED LOFT LEVEL FLOOR PLAN �.... wx� w-.ro rw..�marr a0M1r uora 3- X Wisconsin Division of Attach complete site but not limited to: vet scale or dimensions, 7palW.- 1�1MIsionalS� � SST-aoaa -a3� Prdiices ee Page 1 of 2 022SOIL EVALUATION REPORT ac rnce1ndU1SPS385.Wis Adm. Code County ST Croix 44airPlD nches in size Plan must inctu 1e.ce point (BM), directbn and percent slope, Parcel I.Dcation and distance to nearest road. 004-1028-50-100 Please print all information. Revited by 1 J / Dat' I Property Owner Property Location: Tucker Benjamin Govt. Lot NW V. SE Y. S 12 T 28 N R 15 W Property Address Lot # Block Subd. Name or CS M# 425325TH ST 02 CSM 11-3093 City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road Knapp IWI 154749 1 (651) 890-7110 I I Cady 1325TH ST Q New Construction Use: M Residential / Numberof bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement ❑ Public or commercial - Describe: �`l.( r/ Parent material Loamy dint andlor loess over loamy till (Santiago sit) Floodplain elevation if applicable NA ft General Comments and recommendations: Recommend minimum Y uM lift POWTS mound on 10000contour win 049pd,2 loading nine LF = 29- (Radoximorp0ic rsatuna) ❑ BOflflg ❑ 1 Boring # ❑] Pit Ground surface elev. 98.00 ft. Depth to limiting fac ror329 2 Snil Annhration Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 EfffF2 1 0-8 1 OYR 313 1 3fgr mfr cs 3m-vf 0.6 0.8 2 8-18 1OYR 5/4 is] 2mabk ds-dsh gs tm-vf 0.4 0.8 3 18-29 10YR 516 Its Osg d1 cw 1f-vf 0.5 1.0 4 29-46 1 1 OYR 616 c2d 7.sYR sr8 a 10YR rue Ifs-fsl I Osg-Om ml-mfi 0.2 0.5 ❑ Boring 2 Boring # Pit Ground surface elev 100.00 ft Depth to limiting factor 34 in. Cad AnnOrofinn Gofn Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 'Eff#2 1 0-10 1OYR 3/4 1 3fgr mfr rs 3m-vf 0.6 0.8 2 10-23 1OYR 5/4 1 2f-mabk dsh gs 2m-vf 0.6 0.8 3 23-34 1OYR 613 Ifs Osg di gW 1m-vr 0.5 1.0 4 34-42 1 1 OYR 6/3 Jf2f10YR518&10YR&2JIfs Osg ml 0.5 1.0 CST Name (Please Print) Signature CST Number Ryan Bethel 1330832 Address Date Evaluation Conducted Telephone Number 779 Spring Creek RD S, Red Wing, MN 55066 08/10/22 (651) 327-W74 non noon .nnu•c ❑3 Boring # ❑ Boring ❑� Pit Ground surface�lev. 100.90 fl. Depth to limiting factor 32 in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots GPD/F1' 'Eff#1 'Eff#2 1 0-8 10YR 3/3 sit 3fgr mfr cs 3c-vf 0.6 0.8 2 8-17 10YR 5/4 1 2f-mabk dsh gs 2c-vf 0.6 0.8 3 17-32 10YR 4/6 - fsl 2mabk mfr gw 1 m-vf 0.4 0.8 4 1 3242 1 10YR 416 fed 7.5YR &8 a 10YR 611 fsl 1 %bk mfi 1 f-vf ❑q Boring # ❑ Boring ❑ Pit Ground surface elev ft. Depth to limiting factor _ in. Soil Application Rate Dominant Color Munsell Boring # ❑ Boring ❑ Pit Ground surface elev. fl- 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 GPD/FI2 'Eff#1 'Etf#2 Effluent #1 = BOO, > 30 s 220 mg1L and TSS > 30 5.150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 305 150 mg/L ❑3 Boring # ❑ Boring ❑� Pit Ground s6rfacillev.100.90 ft. Depth to limiting factor 32 in. c..ii Q.t. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' 'Eff#1 'Eff#2 1 0-8 10YR 313 sil 3fgr mfr es 3c-vf 0.6 0.8 2 8-17 10YR 514 1 2f-mabk dsh gs 2c-vf 0.6 0.8 3 17-32 10YR 416 - fsl 2mabk mfr gw 1 m-vf 0.4 0.8 4 32-42 10YR 4/6 rzd 7.5YR 5/8 a 1aYR 6/1 fsl 1 fabk mfi 1 f-vf 0.2 0.6 4] 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 GPD/Ft' 'Eff#1 'Eff#2 aBoring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ in. e..;i e....r^mi. oste Structure Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 s 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 9 150 mg/L Designer Ryon Bechei © 2022 Advanced Crllfled Sol Teeter: 1330832 Environmental LLC. Designer of Engineering Systems: D 2263-7 AN rights reserved. ADVANCED 'All propertydrawn are >110011 from Q° ines notBenchmark Septic Tank: SYSTRM NOT ES E N V I R O N M E N T A L system $ Sal Baring BM 1 = 100.00 %Tops" PV/C pf�e/ (i ali&e 6F.adey Opp %BMY;= 16 .0(� Top, nail y 40; pin��25';pbov gr��e) \\ 1 **Well to be located >50ft —.L/—.1 /— —/1 — from soil treatment area & ro I ` 3 11\ >25ft from tanks** '� � i 98 o' 106 �\� \n` 1 � O\ e� �PpO -J s. 1 ' O BM 2 i U \ 1 � to west P.L./ Q , 325TH ST C/L r— ------ I I ' New i i 3BR f 1145' SCAHome i i LF. I � i 15' L----1----- 0' 30' Field edge � 9J Current grade 106.65 QO V MAP / I Fence i line I � I OIBM1 Corlitled er.lMr_ lli yarn hm kaan doWM sd wakdM ti a®rdry ash MuM err! WW m0a no ed beetrrrrd ama nut ianwkr Praerkrd ham Ikrer "Wor serapes. bell" rd air asrlrdlrr. lD UWVXN a IMM MR nee kl'a1Eat teu CCtlteeJE na Ae4 FM ee>Ee�eMY aratrn mad kn PraPry mrnlubmet analm ran. nPrn'a r�as.rma�for krvpwon an�a.e .d wwhd rss Pump Tank: %all Treatment Area: Ram m erd nrerm r saimt Powis mwra m 10000 calve an 0 Op* ba" rae 00 to redden = 2!r (Aedopmapra leatrn) -sbpe =1111 Distrlbulion: -S"em as regale Peace ddlhem LOCATION MAP &at to en ) 45TH AVE ,y SITE M PREPARED FOR: Tucker Benjamin Site Address: 425 325TH ST Knapp, W1 54749 PED: 004-1028-50-100 20.45 Ac Legal: Lot 02 CSM 11-3093 NW 1/4 SE 1/4 S12 T28N R15W Town of Cody Scale: 1' = 39 Date: 8/10/22 s ewdmaoeN. 645440 CouNn NO. STATE�S�Al�IT���Y PERMIT UeRll**�A AL P OUS PLUMBER TOWN OF 6 SEC /Z 9T AND/OR LOT Z BLOCK SUBDIVISION Zom x CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations In force on the date of approval. (c) The unitary permit Is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit wW be based on regulations In force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit Is transferable. History: 1977 c.168; 1979 c. 34,221; 1981 c. 314 Note: If you with to renew the permit, or transfer ownership of the permit, please contact the county authority. [ING OFFICER - DATE UNLESS RENEWED POST IN PLAIN VIEW ZZ THAT DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI1/20)