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018-2009-15-000
Wisconsin Department of Commerc` e' PRIVATE SEWAGE SYSTEM Safety and Budding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law. s 15.04 (1)(m)I TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER y CAPACITY Septic A IoDO Dosing D7t+ Z ob Y TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic (s, 701 701 Dosing t a 7 39' Aeration Holding PUMP/SIPHON INFORMATION m i„ Manufacturer I L I T�I� i dv1l De and GPM 51- Model Number Q"efA 9EM TDH Lift IS 3 Friction Los 0•tos System He d TDH Ft 1C11 Forcemain Length4,. Dia Z11 Dist to Well �Zr 50IL ABSORPTION SYSTEM SEDRRENCH Width 1 Lengtht� DIMENSIONS -741 74' DISTRIBUTION SYSTEM 7— County St. Croix Sanitary Permit No 645446 State Plan ID No. 102202416-c Parcel Tax No 018-2009-15-000 Sectionlrown/Range/Map No 04.29.17.999 ft" STATION > +p= BS 1.o HI ioz. FS ELEV. 9s Benchmark tr 6welL Alt. BM gr LVial I.a6 lao•toz Bldg. Sewer 4.5 92.5 StIHI Intel q 14 92 2ro StIHI Outlet DI Intel DI Bottom 13.2 11 rT r Header/Man. '[,f� I (� ^ 9 0'J Dist Pipe 2'3 [y.�[ `V Bot System 3r02 fl _3 Final Grade Cover vi r F 70 /00 _ i02. Ge..4si I 1-5f fo-1-sl to-6%.6er Z ' 3 X to— NEW i" we is 82 To X41w --B 1+.74o15a 2.o IDo.o lot 1 &5' JO-1171 1 �r it asavv — /'mlf4 of /a Header/Manilld IDistribution 1 It 1 Pipes) /' x Hole Sore x Hole Spacing Vent to Art Intake Length Dia Length �� Dia 1 .7 Spacing 3 —1 SQif,7OOME61' I TCT. v Draaarrra Cvafuma rtnty .r aanund rb e•_n.=de C aroma An1v Pao }71 iAAQ---V pth Over µ Bed/Trench Center Is Depth Over Bed/Trench Edges xx Depth of Topsoil xx Seeded/Sodded xx Mulched If, yes No yes No COMMENTS: (Include code discrepancies, persons present. etc.) Inspection n1 'iankn 111"J2a7 p Inspection #2 Location: 1133 178TH ST D4 Bµ 1 pemaolco, 45 Srada. 0 18";-5 1 And recslalrl;+kad W 1.) Alt BM Description = Dr cit"n't- — nt" wall At 44a lip •f ?�spacl an 1 2.) Bldg sewer length = W r - amount of cover = ' Is" Plan revision Required? G41s ® No Use other side for additional information. SBD-67101R.3/97) 1 Date Insepctors Signature Don. +^at -}av1k loca:4low cllan..W:� r7d/ �s eke Aq ber11.61 0144 Pviit ca Jwr veh,/f. . G/G12a2a 0 ' {�sa. Conslrua1itd 13ut 7bp oG Dr cwmr Can No See Retcts=U = 9/3/zoz3 -Mown., mound 4,'Ilia east: 5.4V-2022-3t6 �_ .. 0 -C��� *� c� �� !fit Safety and Buildings Division 201 W. Washinaton Ave., P.O. Box, 7162 County Sanimn' Permit Number (to be filled in by Co.) p S Madison, 1M 5s707-7162 p s; '.� MAR 31 2023 ti •1Ch _!nO »p Comm'. 'gip t Application State Transaction Number p�,tsft„� In accordance with SPS 30.2) (2), Rrrs. mission of this form to the appropriate governmental unit PAS � 3Z3 O� 3b2 ` pS Proice, Address (if different than mailing addr ss) is rewired prior to obtaining a sanitary permit Note: Application forms for state-owned POa'TS are submitted to the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privam- Law, s. 15.(14(l)(m), Stats. ` 7 Q e ` J � v r L Application Information - Please Print All Information J Property Owner's Name 0 Q/}' '� I f I- Parcel a U 1 V- 2 —( -6W 3- e M Property Owner's Mailing Address ' / Propem Location `79 er eCle fpe- C� 3 t GnvC Lot y., S' C- 'd, Stction Ci State r Zip Code Phone Number belt one) 1 N R � E o:, IL Type of Building (check all that apply) Lo: � f ` V � Subdivision Name ❑ I a 2 Family Dwelling - Number of Bedrooms Blockk jj % I� ) { 1 Jd L CltH ❑ PubIic/Commercial - Describe Use -�' n Cin' of ❑ State Owned - D=sibe Use CSM ❑ Village of Number �----� TOwz of ^r III. Type of Permit (Check only o-ne box on Gn A Complete line B if applicable) A" ew S} stem ❑ Replacement System ❑ Tretument/Holding TanL Replacement Only ❑ Other Modification to Existing System (Main) R. ❑ Permit Renewal ermit Revision ❑ Change of Plumber ❑ Permit Transfer to New Lis: Previous Permit Number and Date Issued Before Etpiration OWm= ype of POWTS Svstem/Com onent/Device: (Check all that a iv) W. T- ❑ Non-Pressuriz-.d in -Ground ❑ Pressurized In -Ground ❑ Al -Grade ormd > 24 is of suitable sor7 ❑ Mound < 24 in of suitable soil ❑ Holding Tani ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaIlTreatment Area Information: la' v 35 M /' - D.Sl) 6'r Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elev NIL Tank Info Capaciy in Total € of Mantificti= Gallons Gallons Urdu ✓ f 6N u c u o Now Tanks Existing Tanks Septic or holding Tank Dosb* Cnambm 1 (� VIL ResponsibiGh' Statement- L the undersigned, assume responsibility for installation oft OM S shown on the attached plans. Plumb-- Name (Print) Plumber's S guattm WIJAPRS Numb= Business Phone Number �Nkr- �yl -962 9l,S Phsrnb caress (Strom: City, State, Zip Code) '0 , Q ) z) (�� 1 VIII. Countv/De artment Use Only Approved tsappmved Permit Fe 6�� Date issued y!3 Iss ' e Agctr. Signature on o. spin _f)23 A Conditions pprova \ ov lA/ rvte�f�C �ocn`�ttrawt (t �gCe�1�/(� Q/Q�Qr»Ue� SYSTEM WNFR / S R'Q 1}iStB-f� is']D'�WL O�OIu+ OSPS rter; bff ��tt�,�ta rtiettv<�L l�oc��to.. carlG«=`' mMV« "a.a^ am"t'aan«. 2At:sanderrogAe 8.Wbemat*M �r .,,. ,. , q) � Attu it. eomplate plans for the system and submit to tilt County onh antpaper not less than a V ill inches is sae 11J IESOR- ST`D�e:r.•.bo. �� (pn,a+ti �n>��-la.l1 t inSPec�e�. SBD-63% (R. 11!11) 1133 /76 rz Sr. �%/ESf.c /p00�G60 LOrJ.Oo TA.rK .6. q,1 998'T�` C � ZlJt.t Lor / - L�A44 /78 rN Sr. Lar /S X/LtSr��r �/E/CNTS /YE, SEr Y, .79N, /7 4) r' of /�/L�'/�o.✓�� Sr. L.co�r Co. a. 0 U Pror .PI,A G � 75r,co<!c <Ett r la r 9/.?lNlouNo Aarlrs .SYS_ --t.- /01. Sroo /o?.alGawlrcuc L.o r /-emu. /=Ya a ` PirS! ,� rlc�E Ga r ALL. JVS 38), Y3 SErOAcxf A. o-2OF ! CL 0 U 3 &dr0d>*.11lll couNrir RE�� S�atil .� vKoveaQ wt.e u•haQ a� 01-3/Z-2-3) NO. 645446 STATE SANITARY PERMIT n 33 /794-A 5-/- LLYY 2Ai RE PRCV�Bi� OWNER PLUMBER )f-eklL /ikC LIC.# ZZ i19 TOWN OF d ol SEC,T�N, R 7 AND/OR_LOT /� BLOCK SUBDIVISION CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period to) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (Q The sanitary permit is transferable. History: 1977 c.168; 1979 c. 34,221; 1981 c. 314 :Vote: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. �AUTH RIZ D ISSUING OFFICER — DATEWOTHATDATE Z THIS PERMIT EXP S 0 ZOZ NLESS RENEWED POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20) Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 March 30, 2023 CUST ID NO.: 224199 KENT HOKE PO BOX 10 COLFAX, WI 54730 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/30/2025 MUNICIPALITY: TOWN OF HAMMOND ST. CROIX COUNTY SITE: LAWRENCE REIMER 1133 178TH STREET HAMMOND, WI 54015 NE 1/4SE 1/4SEC 4T29NR 17W FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 32" Maintenance Required: Effluent Filter Phone:608-266-2112 Web: http://dsps.wi g,ov i Email: dsps@wisconsm.�ov Sp S ,c� Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-032300362-C Application No.: DIS-122258386 Site ID No.: SIT-107439 Please refer to all identification numbers in each correspondence with the Department. REVISION to POWTS-102202416-C CONDITIONALLY APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Me, 4 �2� ck SEE COORESPONDENCE Mound Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size 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. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • This is a revision to PWTS-102202416-C — the mound has been relocated from original plan • Verify property line prior to installation and maintain proper setbacks from any neighboring wells and buildings. • Care must be taken to set the dose volume as approved in the plan design. If the minimum tether length of a single switch mechanical float does not allow the proper dose volume, two separate floats must be used. • 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 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. • The dispersal cell site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the dispersal cell site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. 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 and Wis. Admin. Code § SPS 383.54(l). • 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 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/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 designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, 1(9 CeCe Rudnicki Division of Industry Services Phone: 608-400-3186 Email: elizabeth.rudnicki@wisconsin.gov Fee Required: $330.00 Fee Received: $330.00 Balance Due: $0.00 Refund Expected: $0.00 Page 1 of 9 iivate Onsite Wastewater Treatment System Index and Title Page Project Name:%wrs Cn1Ft,�) (REu��iva� Owner's Name: Owner's Address: 798 �E�CEGRI�JE tic_ * Ls. W syd.?.z Legal Description: NE ,SIC �/ J 4 N /7 4) Municipality: Town, V4ilage, Gib of '1 _ /►'Anima „r0 County: — r C.toix Lot Number. — JS Block Number: / CSM Number: Subdivision Name: /y/LL S//JE �%E/�,yrs 1/33 178�— sr Parcel I.D. Number. D/8 /S- oao REVISION to POWTS-102202416-C CONDITIONALLY Pagel Index and Title Page DEPT OF SAFETY AND R OFESDSIONAL SERVICES Page 2 Plot Plan DIVISION OF INDUSTRY SERVICES Page 3 Cross -Section &Plan View �nn Page 4 Pipe Lateral Layout CI �C.� k� ,cd� SEE CO ESPONDENCE Page S Septic Tank / Pump Chamber Gross -Section & Specifications Page 6 Pump Performance Information Page 7 POWTS Owner's Manual & Management Plan Page 8 POWTS Owner's Manual & Management Plan Page 9 Filter Information Name of Designer: /�kWr111f K, Signature: License #: /V - Way/p9 Date: IR- 3 "Mound Compon Manual for POWTS" Version 2.1 ,�cia lvianual ants llSPS 381-38 "Pressure Distrlb on Component Manual for POWTS" Version 2.1 ay 0(May 2022 2027) Attachment: Soil valuation Renort 13 S�n4'i%1�S �r5 "rgr So�S 7761 �117 3aad j p `Scr t ` — S1 t°✓li�� 3!/r S 371�j/ S / t %� `t7h - 70f -- / _ 7..F Fn/ 1 Y7 Sl!°74t/ (7r-•r C js/ y Jai x 773 > y rX fpl 17 e r G 'Lbi�(�7 (y •7il7/ 1P ` (vi8tii37YQ� ne. •tl>e• .. _. t Y d' d v 0 a r1St71 j p ?7.701 ZIP, op j r p7 DG'fQ?O� Y.as.�J� hl- - - �O j/.o j p •per` ; .W• ry 9z% 5 ft 16 ft ft 'G = ':Et H = —V :Et A :et B :fft L Iff = d" ft 4"sch. 40 PVC observation pipe fn 2 ca �5 C3 GEOTEXTILE FABRIC CovEpjNG ASTM C-33 SAND FILL TOE 41 TOP SOIL. Page 3 of c? �GRQSS-SECTION �t �r �OF M �OU I V p - UPTURNED LATERAL 11 ACCESS Sid -S I TOP SOIL OBSERVA71ON PIPE & WATERTIGHT CAP ( / DISTRIBUTION LATERAL( A In. sch.40PVC D2865) Lateral Invert Ei.= o R System El.= Lj ,7. 5- fl EContoui-El,= 14.?.o rz/. Y" &OV.- '�71yt PLOWED SURFACE % SLOPE FORCE MAIN (2" sch. 40 PVC D2665) DISTRIBUTION CELL ft x 75' ft = y3�9ft2 (%".2%"aggregate) Min. Required = ✓56 5,0 ft2 t Observation pipe Observation pipe K 7 tox A Ox 1/68 = Distribution Cell v6B= (%'�-2%" aggregate) Distrib ution pipes 112 In. sch.40 OX= Upturned Lateral with Access Box Prohibit disturbance and vehicle traffic within 15 ft of downslope, toe. 51/ .7 aasal Area fe Min. Required = JYSO fie 21 Farce Maln Marffold /Y1 I'l. S'l, 40 PVC D26W (End Manifold with Aggregate) HOLE DIAMETER = i/L in. LATERAL DIA.' = in. WUNIFOLD DIA. = in. (scn. 40 PVC &6 FORCE: MAIN DI,. = in. pipe D2665) toe!". S\ee ,,pe S = ft. \�o q x :Et. / N vz -x p Y 4,1 ,%e I ,ANIFOLD ( /ff in. sch. 40 PVC D2665) .,,Access Box \091L HOLES LOCATED EVENLY CiN* BOTTOM OF PIPE FORCE MAIN Wsch. 40 PVC D2665) Minimum Number of Holes = 4�6 ft2 + 12 = 32 .. Holes 19' Holes/Lateral x 2 Laterals = 3S_ (3/16') Holes x 0.66 gPm / (3/16") Hole = -2.�-,09 GPM = SYSTEM FLOvv RATE PIPE VOLUME = /!Yl ft. Laterals (total) I tal) x 0.092 gal/ft. = 1J.,75' x 5 Rjr GAL = MINIMUM DOSE VOLUME PIPE INVERT ELEVATION = _Ze3.,o fL Page_ 5 of q co SE TANK CROSS-SECI[ON (DRAWINGN , voujill.) FINAI (.,PAne= MANHOLE RISER & COVER (00r SPRNPA 94M A IM 4' Min. Sch. 40 PVC Tank Vent located 12ObOve grade or 24' above Regional Flood Elevation MINIMUM OF 3' OF SUITABLE BEDDING BENEATH TANK & MAXIMUM BURY DEPTH OF 96- Anchoring of tank may be required per SPS 383-43(8)(g) Tank Manufacturer: Septic/Pump Size: 0 allons Alarm Manufacturer. Model Number: Switch Type: Effluent Pump Manufacturer. 41 rne Model Number: "?&e Minimum Discharge Rate: — -1,T 08 _GPM Vertical lift (PUMP Off to lateral invert) ............ .176 ft System head (distal pressure ell Y X 1.3 ft): 3ft ft Force main x _Z. V /100 friction factor ft Filter friction loss ft Total Dynamic Head (TDH): —4)A- 7 ft FORCE MAIN OPTIONS Daily Wastewater Flow (DWF): VS6 GPD Number of daily doses: 5. g -q, T. Force main volume: I/ _ 5 ft x /o/3 gai/ft 7 3 gal Actual dose volume: 93. ? gal - 7.3 gal = 9,./, d gal (total dose volume --Volume of force main) AQKIANC GAP GtTi��: Reserve above alarm , 2 6. q in gal (D) Alarm float above on float_. Al in gal (C) On/Off float measurement_5. G in = 93- '1 Off above tank bottom gal (B) gal (A) DOSE TANK DIMENSIONS - Length in Width in Outlet height 3.9 in Gallons/inch .74 1 EFFLUENT PUMPS 9 9E(GA-SE2 9E(-CIA-W B iL C o 9ECr(IM 9EC-C!A-SfS: 11:8'(300'mN s10 T(21) mm) " fld'(2 mm) . 4EGCIA•RF 11.0'(280mm) 89'(226mm) 84'(I14 9EGCIM - ILO'(28Dmm) 89'0I6mm) I 84-(IMmm) mommmmomw Cover Epoxy -coated cast fro r►,oR.;,,,,1 -17,. Mechmkil Shaft Seal I. Beuings Power Cord ' On SFS eudelt ^ an au xc-cu.�r,�e yrcoy * Franklin Electric HOEIduM784 I wnAMjAw POWTS 0VVNER'S MANUAL ilN MANAGEMENTPLAN Page 7 of q, FILE INFORMATION Owner L.4 cd,eyC�/�R Permit # DFURIGNPADA 7;1YY,-a Number of Bedrooms Number of Commercial Units -- Estimated flow (Ave) (100 gpd/bedroom) Design flow mv-'PN = estimated x 1.5 yr Soil Application Rate In#luent/Effluent Quality (® NA) Monthly Average Fats. Oil & Grease (FOG) <30 mg/L Biochemical Oxygen Demand (B0175) _<220 mg/L Total Suspended Solids (TSS) < ISO mg/L Pretreated Effluent Quality (0 NA) Monthly Average Biochemical Oxygen Demand (BOD$) <_ 30 mg/L Total Suspended Solids (TSS) 30 mg/L, Fecal Coliform (geometric mean) { 10 cfu/j00mL Maximum Effluent Particle Size 1/8 inch diameter Calculations; Dispersal Unit Mfg,/Model Number: Soil Dispersal End Cap DWF - Application Rate = Area Required - EISA .To /, d = Si.So ya1. 13 NA (Dispersal Unit EISA) or (Trench Width) _ # Units or_ Total Length of Trench(s) 6 = 7.5' 0 "At -Grade Component Manual forpOiVW, (pressure or Gravity. Version 3.0 (May 2022-2027) 13 "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems," Publication 9.6 (SSVAV Manual) 13 "EZ Flow Mound Component Manual" Version 12/15/2017 (April 2018-2023) "In -Ground Soil Absorption Component Manual for pOWTS" Version 2.1 (May 2022-2027) 91 "Mound Component Manual for POWTS" Version 2.1 (May 2022-2027) 13 "Pressure Distribution Component Manual for POWTS." Version 2.1 (May 2022-2027) ® Other: least unit — .ss acaaa vuVc GYCr u mOntnS tad 3 ears START UP AI+IA E TFt�1d, 13 NA For new construction, prior to using the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System startupshallnotoccur when soli conditions are frozen at the infiltrative surface. The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports, he quantity and quality of We wastewater stream will aged the performance and longevity of your POWTS. The installation of water -saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume, Also the brine or waste from water softeners, iron removal.urtits, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this donot es include laundry waste, showers, dishwater, etc. This system Is designed to handle domestic strength wastewater; however, the disposal of food based greases, seeds, bones, and food solids, suchas those produced by garbage disposal should beminimized. Toilet oils, vegetable/fruit peels, tissue is the only be discharged into the system. Other non -biodegradable items, such as babywipes, paper that should p tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs, should not enter the system. Chemicals, such as petroleum products, paint, disinfectants, pezfie;des, antibiotics, solventc,etc.,abouldnot beflushed into thesystern becausethey can seriously damage yourPOWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle 'traffrc over all system components. Compaction ofsnow overthe dispersal unit may cause it to freeze up. drinking water supply. Maintain arco )ar steady flow byp spreading laundry Pag--8 of "U washing throughout the week. Ave oid vehicle traff-7ic over all system components. Compaction ofsnow 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: lviaster Plumber, M'aster Plumber Restricted Sewer, POWTS Maintainer, or Scpla-e� Servicing Operator (per the attached Maintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware. identify any cracks or leaks, measure thOVolulne of combined sludge and scull) and check for any backup or ponding of effluent to ill' c ground surrace and test all electrical equipment such as pumps and alarms. Any defects shall be promptly corrected. Exposed openings treater 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 ol'the tank volume, the entire contents of the lank shall be removed by a Septagc&I'Vicilig Operator and disposed or in accordance with Ch. NR 113. Wisconsin Admin. Code. Specific servicing mechanics must be provided if vertical is >1 5 feet or if horixontal�1s >1 50 feet and instructions to be provided beloiv. The outictfilter(s) shall be inspected and cleaned to removeany accumulated solids accordingto manufacturer's specifications. Solids washed ftom 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. if an alarm sounds, contact an individual licensed to service P OWTS, There is normally a I day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABAND ]INVIE- El :1.- When the POWTS fails and/or is permanently taken out of service the 110110Ving steps shall be taken to ensure that ,he system is properly and safely abandoned in compliance with Ch. SPS383.333- Wisconsin Admin. Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings scaled. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel, or other inert solid material. CONTINGENCY PLAN: If the POWTS fails and Cannot be repaired the 110110-ing- measures have been. or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption System. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks l'i'0111 existing and Proposed structure, lot lines and wells. Failure to Protect the replacement area renders it unusable. Replacement systems must comply with the rules in effect at the time of replacement. C3 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technolo.y a holding tank may be installed as a last resort to replace the filled POWTS. 0 N The site has not been evaluated to identify a suitable replacement area. Upon failure or the POWTS a soil and site evaluation must be Performed to locate a suitable replacement area. It'no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 0 Mound and at -grade soil absorption systems may be reconstructed in Place following removal of the biomatat the infiltrative surface. Reconstructions ol'such systems must comply with the rules in effiectat that time. "VARNING1111 SEPTIC, PUIMP, AND OTM:R TREATMENT TANKS iN-LAY CONTIAN LETHAL GASSES AND/OR 1NSUPITICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUWjP, OR OTHER TREATMENT TANK UNDER ANY CIRCUjw-ST'ekNCES- DEATH MAY RESULT. RESCUE OF A PERSON FROM THEINTERIOR OFATANKMAYBED[FFICULT OR iMPOSSIBLE. ADDITIONAL COMMENTS: POWTS INSTALLER blame: �'-' � 5- V—) -- - 1 /-/-40 111"a- ?,? v P � Phone: 2 - 4// 4-C SEPTAGE SER WICING OPERATOR (Pumper) 2 POINTS MAINTAINER Name: /�"� Phone: -zLr LOCAL REGULATORY AUTHORITY Name: Sr LjPhone:� 713- Me B :° I::Effluent . G Oto ilea7: To ensure your effluent filter is functioning properly, it should be inspected eve effluent filter will function for several years before cleaning is necessa clogged enough to re N Year. Under normal conditions, your g normal flows out of septic tank At a minimum, the filter should be cleaned wbeneverthe tank is pumped, rY The filter should be cleaned when it becomes Most people preferto have a septic tank service providertake care of filtermaiMenanceond cleaning. You can septic tank service provider in the yell' pages, underSeptic Tanks & Systems." or you can contact your coup health deparimetrt{�ra lists find a if You wish to inspect and/or clean your effluent %ryourself, be sure to dress ro erl , Wear full-lengthtY hit shoes, gloves, and goggles or glasses. Than follow these instructions p p Y pants and shirt, 1. Remove the access lid to your septic tank by unscrew- ing the stainless steel lid boles with hex head wrench Provided. ifyour lid is abova ground, itwill be easy to find. If it is buried below ground, find the markerthat indicates its location. 2. Remove the fitter cartridge by grasping the tee handle and lifting it out of its housing (see photo 1). S. Spraythe cartridge tubes with a hose to remove any material sticking to them (see photo 2). Ensure the three orifices in the optional flow modulation plate inside the filter are clear of any debris. Make surethe rinse water runs back into the tank; but do not allow solids material to fall into the open filter housing. 4- Firmly place the carhidge back into the housing. 5. Some effluentiutors come with an alarm that activates when the filter needs cleaning. If You have an alarm, check to make sure it is working by lifting the float with a stick. An audible ham should sound. The alarm panel is normally mounted on the side of the house or in the garage. Mote. If your effluentfilter doesn't have an alarm system and you would like one, call your local septic system installer. Record the data that you inspected and/or cleaned yourfilter on the form thatfollows. If you checked the alarm or made:any other observations aboutthe tank or system, include that information under -Notes. - Attach access lid by placing it on the riser, matching the openings in the lid with the bolt catches Insert lid bolts into catches and tighten with hex head wrench provided. housing. �•� •� „net carrrmge by Mpg it out of ft ,,,,.,,p ""urage tubes with a hose. rei".rr4r_j ROW22. M4 Fags 3 at 4 Wisconsin J)QP8TtM0adf Sel* and Profes*nal Services Division of IndLoy Sim = Page of ML EVALUATION REPORT Inaccordancewith SP8386,Ws. Adm. code cou* --I AftchcomPletaolto Plan on paper not [sea than 8 ii2xii Inchas In size. plan must Include, but ftOt UnItted t(Y, Ivattleg and hoftntaii M%11811W point (8q, direction and percent slope, Parcel I.D. scale or dimenalm, north 91TOW, and location and distance to aaamt mscL r 111983-a print all InfoTmau0ii. Rvis P r8on a 11h Tflikont — Drovids i be used for secon'da y osetl Pava Lahr a, 16, Jymp'. awad by We PWpatly (114nor Property Location QovL Lot Y, Y. S 0/ T PtOsdy Own8es M811ingAddress Lot# 810,akg y N R E (or) W -1 Subd. Naple, rosmo, StaL- 7JP Gode Phone Number city WISP ATown Nee oad I Gads derived design ilow rate GpD MCI red recOMM Idatto a Flood Plan elevation it applicabie&L ft "'M Q7, 75c, t (1-n -0- Boring Pit GmUnd surface eley/el-1. Depth tQ JIMItIng factor -EL fn. !!on D'p" Dominant In,. Textureno aietence 80�unO�w �RO DIS 0 soriog it Ground surface eiA4 Do '�th -- Wc)—r-zort T ��j CST Name, seass, -prin Addteaa W3503 Hemlock 7 15) S't 5 8 4 Depth to limiting factor In, latencD 1BOUndary jRoots "r 11umba Telsoholle N Bating 4 M7 Wg PR Dam to IlmitingfRow'. _31Z--ift. Hwlwn DOPfn iAF Damtn= Golor MILlobil Redoxoeure Qu. A---- Cor& o'clar SOIL�an Rob 62 Boundary Roots GPD Gr. Sz Sh, U: 0 C""_ i 671 1/4 Lj Boring 9 L-1 Boeing Ground Sum -ace Slev. —,ft. Dept to Jbiling factor .. j_1r, Horizon Depth Duraluntcolor I Texture Q U=re C nsistermboundary iftot AGPDI* 'Saos QU, ' Ogn4A Boring# Pit Graz nti surfaOs eim _'L. Deptil to 11MIng ft0w_ in,* Pth Red= Descriptiol —taxture Stricture = Gonslutunce Soundaq Roots GPDW In. s xunseli Qv, A7_ Cont. Col., sGr.. SE, OEM 42M - EMUSnt#1:2 SOD,> Mg 22OWqlL jand TSS> 30..; iao mtvii_ ' Efrlu6nt#2 = 800, > 30S 220 rng/L and TSS :, 30S 950 mg& b q T-O? Of AL- Ib Will Heide Soil I-es),ing, 1V3503 Her -dock Road, Mondovi, WI 54755 (715) 57V159�1 e- �56 SA ZOZZ- .51U 1.� 4822 M,msoalY>� Way I� \S�s ` St. Croix County Madison, WI 53705 �- Community Developm t P.O. Box7162 \_ +� Madisaq WR 53707-7162 Sanitary Permit Application In aecordaq with SPS 393.21(2t, wis. Adtn Code, enbmiRion of this gums b tee appoprisee 1po,amt,a,m unit is required prior to obi a smith' Pert Now Application forme for araesowocd Powrs we submitted to the Department of Safety and ProfaaootW Sark« P4saW infametim you provide may be seed lbr secondary �tupow in accordance with the Privacy Law, s. ISAti(1 )(m). Sum f / kyELA XCINZ-A 'Ar'CANE l��- 9IF ? S r, 6AOIX MUCY Paint NUMbc (to be ftlad ie by Co.) G qs q� the rmttaedon Nueber I DZz-o-z q - L *a Addicts (if -M am date mdNoR iadt!7 / 1133 /78 y� 0/8-.7009- /s- scan L z. NE � SE settie. y 11. Type of Band1oR (t3edr all that apply) Lot 0 r 9 R E oM 01 or 2 Femily Dwelling - Numbs ofaedtuoun / ` srrbdi.laim N® f EhmidCommercial-DesrnbeUse Block# ✓ /LLS/OE /vE/liVTS Dude Owned - Describe Use Dayof - ` / CSM Numbs illw of I / I@TMM of III. Type of POWTS PerselC ((beck ehhv "Nara' as "Raplaeao�l" sad ether applicable on Rae A. Cheer one box oar Le IL Cwaplds 6e C U�iA. ew SyMm � rr� System OOWer Mediticatioo to ExisdrK Sys ( M� Pretreatment Unit (explain) Tank 13k1nade Sub Deep I_ IOtber Type (explaiin) C. U Reocwal Before I URcviWon Lhrye of Plumber Qlrsoafa b Previous Pemtit i4-M=and Dab leaned Exp4stion Design Flow (gpd) Dwip Soil Applin - D40MW Ain (d) Diapeeat Area SY.So /. o D• yso 1/ 25 YSc Tank Information &MM Tows of Maouactme G.ttom Ue;a fro. Teaks Exiaiaf Tnim I Septic or ".J:�;� Dmmg Ch.— V- Refnnnd6ilbv Re.�- /�O 00 � • .� _�—.—_� _ _ /coo Goo _ _ _ I l - rri !./ EsE,c Ca.�c.. . a�trQa a— w �v o O. A ex f; as � m v stscsaa pmm MPA�4Nttmba Bsei 74 q,1 �d p Disapproved remit Fin Dan / ►s,ujt��Agj�y�te / ` ❑ Owner Given Reason for Daniel Conditions of Appsovismeasons for D' Leg0/�rbv�t SYSTEM OWNER: 1. Super tank l nxist t filler snd �� t� �I dUpersal cell trn,n pp,�plj(�(mfiIIlliNd a 1'� / e! � C _4 a per managerrxnt plan provkNd by plu 2. An sHbatk rsquMsmsnts moat es maim sa per spPbable coee/ordinarKas. _ % h ��yl, � Je+Y� .. �t / Aaed to eaaplrb pins j"sdd etalents `flat Cotter 0* ea Paper act low date a in 111 lades la SBD-6398 (IL 03/21) 7! "D!4� tY //hJ��Y� l)th1 o oo/ _ 7 •nrr :4v7 >�o1r•r! odd rO s'66 -'L�' rlrod Or'noJ./ � /d tr p`, , o cyj GG�� niYw l�roy 773� a�oY S•$x % r i �os6 a end /S / N a 0 0 1Ji�fil�7! d3t r/i'ias VPT 77P' a07 Jr)y /t 'SII/ =b of �Or O y 003fOO(7/ t'0 arrodoq� Or3i� y �o dod, i I rjNp1Y 77//�/ rT T d Y ,fYro�nrrp O�so�vrd rI/r ; t"lI 'oJ X/ob'� :ls �yroNrry/j1 �0:1' /7L/ Nwbr 6 'Js'3N f/ 107 '1f' Ff 9L/ CE%/ 'y3a/3,y• A7I+3YI9y7 06 0 0 ' 1s g- $Ll W iscgnsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI53707 October 3, 2022 CUST ID NO.: 224199 KENT HOKE PO BOX 10 COLFAX, WI 54730 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/03/2024 MUNICIPALITY: TOWN OF HAMMOND ST. CROIX COUNTY SITE: LAWRENCE REIMER 1133 178TH STREET HAMMOND, WI 54015 NE 1/4SE 1/4SEC 4T29NR 17W FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 35" Maintenance Required: Effluent Filter Phone: 608-266-2112 Web: hup_ Email: J+P.g w ivnn.m gi n Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-I02202416-C: Application No.: DIS-092247108 Site ID No.: SIT-107439 Please refer to all identification numbers in each correspondence with the Department. CONDMONALLT APPROVED DPlr OR SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES C& 2�'a. M COOLSPONDOOM Mound Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size 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. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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 determined by roiling 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. • The dispersal cell site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the dispersal cell site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. • If the force main is to be installed in the downslope area, the trench for the force main may not be wider than 12 inches per the Component Manual. • Care must be taken to set the dose volume as approved In the plan design. If the minimum tether length of a single switch mechanical float does not allow the proper dose volume, two separate floats must be used. 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 and Wis. Admin. Code A SPS 383.540). • 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 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/opemtion. 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 slats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, CeCe Rudnicki Division of Industry Services Phone:608-400-3186 Email: elizabeth.rudnicki@wisconsin.gov Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Refund Expected: $0.00 Private Qnsite Wastewater Treatment System Index and Title Page Project Name: Owner's Name: 4 " W4.v £[.vE,c - 3 - Owner's Address: 7 98 1E,tEe,riaf Li<. ¢ 3 QiuE,c F,o[c s [..1I SYa.7.7 Legal Description y R 9 N / 7 GJ Municipality: Town, Village, Gity of //0fky0,,o County: Lot Number. Subdivision Name: Parcel I.D_ Number - Page I Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Name of Designer. Signature: Page i of 2 C0NDI770NALLP APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CO ESPONDENCE �S Block Number. CSM Number. _ //33 /7.R G� a/a - Joo 9 - /S- oao Index and Title Page Plot Plan Cross -Section & Plan View Pipe Lateral Layout Septic Tank / Pump Chamber Cmss-Section & Specifications Pump Performance Information POWTS Owner's Manual & Management Plan POWTS Owner's Manual & Management Plan Filter Information License #: - ^0- Jay/99 "Mound CPOWTS!* Manual for Version 2.1 (May 2022 2027027) "Pressure Distribution Compone=Muldtl for POWTS" Version 2.1 (May 2022-2027) Attachment Soil Evaluation Report i synod vrnoly 7+� Gr I( , o tbj (G7� riYir !>ro� 0(6 Gd w>S Wye / 1JYtr>/'17t F/i'f8F fps 77Y CI7s/�,101 1V�Y Ir 'fl/i =c o/j �Or O g% / N o. yr►rl M vc.? e 0 iir°YoyO/ is Puy Id , A/t —, o°r-i .49 !°1 °•°Ol at ;y•a o� X.oY� 1s �ryt+oNlr6il> y°, (7LI NbC h 19 S '7IV s.JN°/Y/y vo1177111 s'/ 107 'lf' FfBCI [ill 'r7/r/3y �'r►�Yr'Y% tJ FU T 8 D = . S ft a = .8 ft r = .9 ft d = 'ft H=�ft A = _/V_ ft B=73ft s = 9 ft J = S ft K = 8 ft L = 910 ft N=d_ft 4" sch. 40 PVC obeemsdo tpipe f1.6ft ti 0 ft GEOT EKTILE FABRIC COVERING ASM C-33 BAND FILL TOP SOIL TOE '� • 9 CROSS-SECTION OF MOUND Page 3 of UPTURNED ua>CRAL a ACCEN BOX s / roP BOa. OBSERVATION PM s WATIRMW CAP �,DMM8UTION LAMRAL ( / : in. sch. 40 PVC D2&5) a Lateral Invert EI.= Aa, O A ,, i �. * •• • `. � �• � • � � � . „ � • � �� 4 PLOW®SURFACE r • . •' J! %SLOPE . y FORCE MAIN (Y sah. 40 PVC 132686) DISTRIBUTION CELL w"_ ft x _7.r it = 9321 1e CI _2. appregeN) System EI.= 9f, S ft Contour EI.= 974 ft J OWwvdon pipe t Obesrv"w pips S J 7S aide' Ox G A r�.•ft•Jx�'t}ffti�?YL''tiit}.�y•ti t-r''y`'4:t.':tJ.t'}w2 ' �f:'t.K:,: .J. •�, ,.5;•rt ;�1 /' 7.5�7 :?� , T . ",h:l }J• . { �: �dbJw �'%:R I rf- ,fit?.t1. .t :f�'•: .�l tti;'::'+". _ �;r' ,t' :� ---► I 1MI ■ Dlsbbution Cal n pipes 9 t � ft (x -2K ace►�a) Ar In. J.1S rt L s 7S ( soh.40) OX= Uplumed Lateral YAM Acaes Box ProM * dieturbeim and vWW9 trailo within 16 ft of d"nslops toe. I E L 9/,a' I Basal Area = —Z:E—ft x —7L—ft ■ //aS ft2 Min. Required - Y.So . - Y - //?S fe T Fam Mal" Me" (An. •o. 40 PVCMM) HOLE DIAMETER in. LATERAL DIA, in. MANIFOLD DIA. IY,2 in. (Sch• 40 PVC FORCE MAIN DIA,• in. pipe D2685) p = 7Pt. 8 = .9 ft. / x = 'S/ ft. (\ Y - _ ft. MANIFOLD ( In. Xh. 40 PVC D2665) PIPE LATERAL LAYOUT OF MOUND (End Manifold with Aggregate) FORCE MAIN (2" sch. 40 PVC D2665) htesa� "a�GS`000 A Access rBox Minimum Number of Holes = V-f6 ft' + 12 = dS Holes Page '/ of 9 HOLES LOCATED EVENLY ON BOTTOM OF PIPE. _/ Holes/Lateral x 2 Laterals = 3A (3/16") Holes x 0.66 gpm / (3/16") Hole = .,isas GPM = SYSTEM FLOW RATE PIPE VOLUME = /// ft. Laterals (total) x 0.092 gal/ft. = /.I J5' x 5 = GAL = MINIMUM D03E VOLUME PIPE INVERT ELEVATION = 106.0 ft. Page S of COMBINATION SEPTIC/DOSE TAN RTI OSS-SECON WING NO I TO FINAL GRADE MANHOLE RISER a COVER {roPt tl�af suftot a ly ham ICt1111 M'� a (8)• +st ExW nWrob(t) ra Proptr Anmp) w A a U nK "M erne attlYtolt ftw s tro.ray.t 4' Mh Sdt 40 PVC Talk Vat BUILDING SEWER Ittst•dlTtbppWiftRx- (perBPS382.3o(17)) rn R49krM rdt/ dill [8'WW >18' r kh sat. 40 PVC Tar* vat ELECTRICAL ktaled tY wow Waft or 24• UNCTION BOX ibM R900ntl Fleaf otnron ad mrti� Hs IINS J FORCE MAIN ,r OPTIONS »8r T,\ � 1� t f�L(M[p �II II `�wowvs /4w III �jI.Z C 17 r eeiT /Pt A5~ 0i .tFIV r X/ puler Insert 4p ftdOn Qd �a �r fYWt11 MINIMUM OF 3' OF SUITABLE BEDOM e9EATN TANK a W1t�tIl1M aMtY Dt�rH OF is' Anatoritg Ofit twmey be esgr�9{9 sd perW@ Will Tank Manufacturer. 4/1,c [� �•,dc.cir6 Septia'PumpS¢e: /oad/too gallons Alarm Manufacturer. _ Sf/rA!Wjcf Model Number of TT/ Switch Type: _ /!rr[tAVe.•[. Effluent Pump Manufacturer. Li rru Giw.rr ��(►j�Model Number. /Y 6ainimum Discharge Rate: iS. 08 t3P1iA Vertical lift (Pump off to lateral invert)............ / y C ft System head (distal Pressure AS x 1.3 ft): 3.3 ft 66 ft Farce main x !. f 11oo *k;oon factor 8 It Fitter frictionkm ...................................... — ft Toted Dynamic Head (TDH): ft 0 Dal Ww water Flow (DWFr tSO GPD Number of daily doses: 3- y ( /8.7 i.) Foroe main volume_ ed ft x , /(3 gayry - 9. 8 gal Actual dose volume: 93.9 gal _ _9 gel = g//. / gal (total dose volume - Vahmte of torte main) Reserve above alarm 16. Al In = 'V19 9W (D) Alarm float above on float _ ? In = 33.5' gill (C) On/Off float measurement _,G In = gJ. 9 gal (B) Off above tank bottom $ in = gW (A) DOSE TANK DIMENSIONS: Length /So in Outlet height _J46 it, Width 84/ in Gallons/inch le.7G EFFLUENT PUMPS h. 6 a, 4 9EC SERIES — 4/10 HP 9B-QA-gS 9Et-a" uay:ii�p�f �� 1W-CA-SFS' •- .E1OD • 1QTQ)1 mm) n+n) 9K-0kRF ILO• RaO mm) a.Y W6 mm) ffff flP (2I/ mm) 9-L-m I TUM11O17m I 6Y(mmm) I ar•(214mN Cmw Epoxy -coated cast imry MOtQ WW Cast m wodumat"m 6a6tomer Imoder Nw-dog Motor shaft Steel MaQarai am sew Nitnle with carbon and ceramic twes infWlrs Stainless steel a mm Upper shteredsleeve andIowa u beanrg POWCord WIW••SJTOW -oe9r9H-0LA:�l1(tdr waft a <✓y' 0 Franklin Electric HftLNLV1l1 I .euftwm Page % of 9 POWTS OWNER'S MANUAL AND MANAGEMENT PLAN PILE INFORMATION Owns LArr,c cE E/r/Eit Permit M DMUCW PAIRALteTvnc Nuallier of Bedrooms _ 3 Number of Commercial Units — Estimated flow (Ave) 100 ) Dealp flow MWF) a estimated x 1.5 'YSO gpd Soil AMUcation Rate .O Influent/Effluent Quality (O NA) Monthly Average Fats. Oil & Curie (FOG) 5 30 mS/L Biochemical Oxygen Demand (HODS) <220 mg(L Total Suspended Solids CM :5 ISO mg/I, Preusered Elilpent Quality (M NA) Monthly Avenge Biochemical Oxygen Demand (BODs) <_ 30 =WL Total Suspended Soft (TSS) S 30 mglL Fecal Coliform (geometric man) S 10 cfd100ml, Maximum Effluent Particle Sine 118 inch diameter SYSTXM SPECINCAnONS Septic Tank Capacity I N Soplic Tank Matufac4ua /E Et a.rsn. D N Effluent FMerM uer AEy<e ON RmuentFilter Model 10Cre4122-1116 ON PUMP Tank Capacity I Zoo ON Pump Tank Mauttilacturm Um5me ON Pump M=Dhckww i rrte &*,car D N EL O N AehaMom llnM Unit ( NA) O Sand/Gravel Filter O Mechanical Aeration O Disinfection O PeatFilter O Wetland O Other. Model: Soil Absorption Component (o o (a) O At -grade M Mound D Drip -tine O Other. Vertical Distance TankBouom to SavioePad Horizontal Distance T s to Service Pad: ft ft Calculations: umgmwm Um M1./Msdai Number O NA Soil Dispersal Fad Cep (Dispersal Unit EISA) DWF Application Ram — Area Requited - USA � or (Trerrch Width) *Units or Tend L � ofTxe=Ws) SO /.O SD G 1 — 7.Sr - -- DRg1r.NrRrrP urs O "At -Grade Component Manual firPOWIS' (Preatae cc Gravity. Version 3.0 (May 2022-2027) O "Design of Ptesstm Distribution Networks for Septic Taedt W Absorption Systemei" PuNi ation O "IM Flow Mound Component Manual" Version 9.6 (SSWMP Mantra)) 12115M17 (Apnl2018-2023) O "In -Ground Soil Absorption Component Manual for POWTS" Veafon2.1 (May 2022-2027) iB "Mound Component Manual for POWTS" Version 2.1 (May 2022-2027) O "Presume Distribution Component Manual for POWTS." Version 2.1 (May 2022-2027) O Other: MAIIVTBNANCE MONITORING SCHEDULE - MAIN raNANCE AND MANAGEMENT swwke;vow service ftywonspy s elm filter At last awe riery, 8 13 months R 3 years (3 Other. lank JAllesstoweeverr. Fhmh and PMWM lest 12101112 O months At least omoeeverr, O mouths 03yews O NA tB 3 yan O NA 21MU Ur Ado ursseATloN: For new construction, prior to usimg the POWTS cheek treatment tsmk(s) for the presence of painting products or other chemicals that tray impede the treatment process and/or damW the disperd calks). If high concentrations are defected have the contents of the tank(s) removed by a aaptage servicing operator prior to use. Slssem Am l uPdalastsoene wisest soil conditions are freer at the haflbtntive smiaee. The pmperty owner is responsible for the operation and maintenance of the POWTS and anhminion of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water -saving appliapaes and fixtures along with prompt repair of leaps reduces the wastewater volume. Alan the brine or waste from water softeners, iron removal. units. other clear water treatment devices and foundation drains should be disclungad to the ground surface whenever possible. Note•. this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however, the disposed of food based greases, oils, vegefable/fruit peels, seeds, bones, and food solids, such as those produced by a garbage disposal should be minimized Toilet tissue is the only paper that should be discharged into the system. Other non -biodegradable items, such as baby wipe. tionpons. sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs, should not enter the system. Chemicals, such as petroleum products, paint, disinfectanK pescicida, antibiotics. solvents, etc.. ahmild nnr l,w A...1...1 :..razzh....-......r..--�.�..�.____'_".._.r��vro nw.....,•_n�L� Yy drinking wafer nap !p y. Maintain a regalar steady flow by spreading laundry washing throughout the w*cL Avoid vehicle creme over all syttteon cotrtponeata. Compaction ofsnow over the dispersal urnitmay cause it to A a up. drinking water supply. Maintain aregular stead flow spreading laundry Page 8 et 9 Y Y P g dry washing throughout the week. Avoid vehicle traffic over allsystem components. Compaction ofsnow over the dispersal unit may cause it to fieczr 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 anached Maintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware. identify any cracks or Icaks, measure 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 defects 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 ono -third (1 /3) or more of the tank volume, the entire contents of the tank shall be n:moved by a Septage Servicing Operator and disposed of in accordance with Ch. NR 113, Wisconsin Admin. Code. Specific servicing mechanics must be provided if vertical is>15 feet or if horizontal is > 150 feet and instructions to be provided below. The outlet Rlter(s) shall be inspected and cleaned to remove 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. If an alarm sounds, contact an individual licensed to service P OWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT: When the POWTS fails and/or is permanently taken out of service the following steps shall he taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPS 383.33, Wisconsin Admin. Code: All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel, or other inert solid material. CONTINGENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been, or must he taken, to provide a code complianl replacement system: O A suitable replacement area has been evaluated and may be utilized for the location of 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 renders it unusable. Replacement systems must comply with the rules in effect at the time of replacement. O A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. 9 The site has not been evaluated to identify a suitable replacement area. Upon fnilurc 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. 9 Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructionsofsuch systems mustcomply with the rules in effcctat 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 OVA TANK MAYBE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS: POWTS INSTALLER POWTS MAINTAINER Name: r aKE /rYjO- / 9 Name: 11A11 PLuiv6i✓i Phone: / 6 _ V/sr Phone: i/f 9G?-5//sS SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name: Name: Sr. L.eait' n: O'Oeo a,,,rr Phone: I Phone: 7/5S 3.94- yl8o pc. 9 df Q Maintenance InstructionsCa 01010001 1--600a45.900 Biotube Effluent Filter How to Clean Your Effluent Filter To ensure your effluent filter is functioning property, it should be inspected every year. Under normal conditions, your affluent filter will function for several years before cleaning is necessary. The filter should be cleaned when it becomes clogged enough to restrict normal flows out of the septic tank At a minimum, the filter should be cleaned whenever the tank is pumped. Most people prefer to have a septic tank service provider take care of filter maintenance and cleaning. You can find a septic tank service provider in theYaflow Pages, under'Septic Tanks do Systems.' Or you can contact your county health department for a list If you wish to inspect and/or clean your affluentfilter yourself, be sure to dress properly. Wear full-length pants and shirt, shoes, gloves, and gaggles or glasses. Then followthese instructions: I. Remove the access lid to your septic tank by unscrew- ing the stainless steel lid bobs with hex head wrench provided. If your lid is above ground, it will be easy to find. If it is buried below ground, find the marker that indicates its location. Z Remove the filter cartridge by grasping the tee handle and lifting it out of its housing (see photo 1). 3. Spray the cartridge tubes with a hose to remove any material sticking to them (see photo 2). Ensure the #m orifices in the option at flow modulation plats inside the filter are clear of arty debris. Make sure the rinse water runs back into the tank, but do not allow solids material to fall into the open fitter housing. 4. Firmly place the cartridge back into the housing. 5. Some effluent filters come with an alarm that activates when the filter needs cleaning. if you have an alarm, check to make sure it is working by lifting the float with a stick An audible horn should sound The alarm panel is normally mounted on the side of the house or in the garage. Note: If your effluent fitter doesn't have an alarm system and you would like one, call your local septic system installer. Record the data that you inspected and/or cleaned your fitter on the form that follows. If you checked the alarm or made any other observations aboutthe tank or system, include that information under'Notes' Attach access lid by placing it on the riser, matching the openings in the lid with the bolt catches. Insert lid bolts into catches and tighten with hex head wrench provided. Pheao 1. Remove the Star cartridge by fang it our of its housing. Photo 2 Spray the cartridge tubes with a hose. 7r Mr. 22 7M Pg0]M4 WteMW DePerimentof Canmarre SOIL EVALUATION REPORT Division of Safety and BuilQrg: in a000rdance wait Comm 05, Wee. Adm Code C Attach complete site plan on paper not less Ihen 8112 x 11 kw%n it able. plan must lndt patgrq " but not limited to.Vertical and horizontal rain a ppiq (Buq, tlrecaon and Plop LD ) a slope, scale or dimensions, north arrow, anti location sW dlatanca to nearest road. Please print all informailan. Reviewed by Pueensl lekrmwon Year mate* mar be ese0 br aeaadory 001006" MAnq tee.. a. 16.04 (1) (n))• .opal.Y� r , — en • PopertyLocaoon Gout. lot NY 1/4 -5'r 1M S MIM Pepe — d t71i�^ l��017'� Date I T Vp N R E(o8W Construction Use: tnldenial1 Nun m of bedrooms _ �` Code derived desQn flow rate cacao ❑ RegaosmeM Pubic or commercial • oesab&. Gerona material �� Flood Plain elevation a appkMW /✓/ Y It. General oonsrherde and reaarmrwMevom. J System Type System Elevation_ / � . Bofilp a Iy❑y Bodrp p.pll Ground su(aa Nay. Dees, rn NMW.., r..r,. MEMEL- Iffl nMO M ©I F..u_-�I.07MM, .�JWA P' a ,�ITWOM IyL'���� DFA„ MIR ®�r ©�/p�©© MaRr�a C�AMMMAAA „UMMA WE WAVAII� nMye W1 w< < ow. a .xr morL anti f bb < 3e MWL CST Name (Pies" Print) re CST Number Bird Plumbing, Ina. Shaun Dird 226900 Address Daps Eia*jalfon Conducled Telephoto Number 1432 1201h St, New Richmond, WI 54017 —3—Z.D 715-246-4516 Proporty Owner PRIM WA o ®® ' Elnuent p1 = SODS > 30 < 220 19& and TSS >30 < 150 mg4 ' E8ltwtt i2 = SOD, < 30 mWL and TSS < 30 mgfL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TCY 608-264-8777. �aLLClp II LOCI Soil Test Plot Project Name Lawrence Riemer Address 950 Morgan Rd. River Falls w 54022 Lot 15 #226900 Subdivision Hillside Heights Date 9/3/20 NE 1/4 SE 1/4S 4 T 29 N/R17 W Township Hammond ❑ Boring 0 Well PL Property Line County ST. CROIX BM or vRP Assume Elevation 100 fL Top of 3/4" pipe System Elevation TBD •HRPSame as Benchmark IUNN Et W �EOlpYS _ • � _ I i ��a A� I _ L— I I4�G}•�o.� � ..� ...�. I I I �W lij, n i II II II II II II II II II II I I I I FDATE: I I I I eiie�zz I '�^••^� I I DESIGNER FOUNDATION PLAN I L _"— _ _ _ _ _ _ _ _ = J I sKA SHEET -� A-2 0=TM O T(]MIV1JO. O �SF T�ft, ..,�S �HO�w �ap. misU$ Im Ca.m.Tcos MAIN FLOOR PLAN SCALE: vr. 1'.01, - - --------- 12"M O OWL fil it F07 6/16/22 SKA SHEET 74 EAST 1 /4 OF THE NORTHEAST 1 /4, SOUTHEAST 1/4 ALL IN SECTION 4, WISCONSIN. SCALL: 1" : 100' 0 25 50 100 200 r2 - /.7 �, /G�� �5�, 16 7 2 31-31 S.F. 1.66 Ac. I ���. Ln O 1 0) 15 91873 S. F. O \ 14 0 90140 S. F. 2.07 Ac. \ \� \ \�D B.M. ELEVATION 1119.11 \ 1 13 \ 1 5 5' (30, \ �0 - 65425 S.F. \ \ I 1.50 AC. i ly \ \ — -- -- N---89 06 00" W' I d- _ 367.43' z- S.F. ��s �O�g/ / p 79_18' _ _, 288_25_ LIJ AC. \ ` / �'' / J B.M. ELEVATION = 1125.72 } W i ` 75151 S.F. I co l �, I O 1.73 Ac. ��� � I LL1 66552 S.F. d- r 1.53 Ac. 4, /� W I —� W w 10 17 I �w 68106 S.F. a, f 67565 S.F. 1.56 Ac. � 1 C)I 1 �� 1.55 Ac. a ( O LID i I zl I r--,I ST CRO NTY SANITARY SYSTEM File a: ""OWNERSHIP/ADDRESS FORM �oz z�rUse �� 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 Lawyenceii il.m(ZJ=cr Mailing Addre City/State/Zip Phone Number (required) —1145- L4 alo- I -MS Email Address Parcel Identific (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location /l '/I,//' '/, , Sec. T &_N R �� W, Town of I"}gYY1CM1C� Subdivision Plat: h`��/ ISI /)`fiS Lot # �5 Certified Survey Map # . Volume , Page # Warranty Deed # (before 2006)Volume , Page # Number of bedrooms _� Spec house O yes 0 no Lot lines identifiable O yes O no OFF.K3E USE ONLY New Property Address i 7e5/ (Verification of new address required from Community Development Department for new construction.) (Staff Initials) (Date) This form must be submitted with oil 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 cdd &sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax ��IfluP C"�r- ZUZO - { - SEP 04 2020 FUPQ %AsconsinDepiattmentot Cornim SOIL EVALUATION REPORT l}Page_Of I'j� l�ry _ Division of Safety and Buildings ? 7 > ifl araxdance wdry,CpLrtm �5, Wis. Adm. Code Attach complete site plan on paper not less than B 1 /2 x 11 inches in size. Plan must `>L, include. but not lirnited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. i Please print all Information. Reviewed by Date Porno" iMormabon yw onw may be used for ssecndwy pur9osas (Prev" law. s. 15.04 (1) (m)) % Property owner Property Location Govt. L1,5_ot 114 � 1/4 S 7 T Z� N R 7 E( N Property owner's Mailing Address Lot # lock # Subd. Name or CSM# 5,217l [AY Y M State ZIP Code Number ❑ City ❑ Village NetToll Construction use'9pesidenfial I Number of bedrooms 3 Code derived design now rate `f� U GRID ❑ Replacement Public or commercial - Describe: - parent mate" Flood Plain elevation if applicable /✓% — ZOt t2 tt. General CCfmte1115 and reconrnenddi�oris: (n/ System Type!//,�J .Lc..� System Elevation / / �� 80*V # Ong (7�'yn[ �'/1 I C/ ll Pit Ground surface elevL c�, V ft. Depth to 6rr"factor in. c�AMPjO rfM ;.r�r r��u� WA WMEWM WA �I�Mqm- go- EtlltlenR al � f7(JU, � Jll <_ LLU mglL onto I SS �JV � l - cmuora we � ovv, _ a� „ynr� scar , w _ w „y. CST Name (Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 3— 2,0 715-246-4516 Property Owner _ Parcel ID # Boring it ❑ Borg / �it Ground surface elev.� Depth to limiting facto J % in. 1 Page —_of___ EWA I MPEMMM"M a Boring # ❑ Boring ❑ pit Ground surface elev. fl. Depth to limiting facto in. Horizon Depth in. I Dominant Color Munsell Redox Description Cu. Sz. Cont- Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF 'Eff#1 I 'Eff#2 is ❑ Boring ❑ Pit Ground surface elev. fl. Depth to limiting factor n. Horizon '%epth in Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Stricture Gr. Sz. Sh. Consistence Boundary Roots GPD/fF 'Eff#1 I 'Eff#2 Effluent #1 = BODE > 30 < 220 nglL and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg1 The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266.3151 or TTY 608-264-8777. S9P3330tx aoor 41 Property Owner _ Parcel ID # Page --of 3 1 Ground surface elev./Mr-1-ft. Depth to limiting factor Ong # El Boring Redox Descnp4lion � v�r r.,Mi m � IWOUMN ©MIMEW� ==►"1/t�l�/'1AMAA UAN"I *.� E �r•�1M1UA�i is f '�L1M "Aim! MMM MM Boring # ❑ Boring n ou Ground surface elev. ft. Depth to limiting factor in. o a n�aia Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Stricture Gr. Sz. Sh. Consistence Boundary Roots GPD/if 'Eff#1 'Eff#2 nEl Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit sailication Rate Horizon ')epth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/If Eff#1 'E1f#2 Effluent #1 = BOD, > 30 1220 mg/L and TSS >30 < 150 mg& ' Effluent 92 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or M 608-264-8777. seD tJW (e.&W) Soil Test Plot Pla Project Name Lawrence Riemer Sh ird Address 950 Morgan Rd. River Falls Wi 54022 TM #226900 Lot 15 Subdivision Hillside Heights Date 9/3/20 NE 1/4 SE 1/4S 4 T 29 N/R17 W Township Hammond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation TBD *HRpSame as Benchmark 100, I 3 gedroo0on, 645446 .Cro;x COUNTY No. STATE SANITARY PERMIT n 33 /7B+1, Sf LLlY1�A�5f' RE P V NO. OWNER PLUMBER TOWN SEC IN9 R /7 )/OR -LOT 15 BLOCK s" SUBDIVISION 0 CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the prtvate sewage system described In the permit (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit (e) Renewal of the sanitary 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.168; 1979 a 34,221; 19111 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. AUTH RIZ D ISSUING OFFICER -DATE W&I AC "L THIS PERMIT EXPI + S /0//4/ZgQqtNLESS RENEWED BYFOft THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI1/20)