HomeMy WebLinkAbout020-1439-10-000 commerceml Safety and gs Division County
201 W. Wash' ., P.O. Box 7162
i sco n s i n a , 53 7 -7162 Sanitary Permit NNuumberr (to be filled in by Co.)
Department of Commerce C 7w
Sanitary Permit ation
State Transaction Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to a gove ntal
unit is required prior to obtaining a sanitary permit. Note: Application fo a -owned POWT a Project Address (if differ t than mailing address)
submitted to the Department of Commerce. Personal information yo y be used for, ��� �'q,.rr ,{
uses in accordance with the Privacy Law, s. 15.04(1 (m), Stats. �JA
I. Application Information Please Print All Inf tion
i ,� t� G O`1 O Parcel #
Property Owner's Name � � s � I09 � ` �ZO - MCI - `b -
S OOdb
Property 7 Owner's Mailin Address ' M/+� j Property Location
Joe V YI~ W rLot --��r + `�'•
City, State /7 pp `` r Zip Code
2. Phone Number ix 1f Y �/, /�G �p14, Sect i on T
(circle one)
avV C AI R - �V 1 1 ;Z 7 fUJ T I N; R 1 E 0
H. Type of Building (check all that apply) Lot #
/ D Subdivision Name
P:l.or 2 Family Dwelling - Number of Bedrooms ` 1 O � O t N ' �
�ro- T► Block #
El Public /Commercial - Describe Use /Q «dG El city of
G ; ; CSM Number ❑ Village of
❑ State Owned - Describe Use Q►Town of *u0s
III. Type of Permit: (Check onl one box on line A. Complete line B if applicable)
A, New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
List Previous Permit Number and Dat I ued
B. ❑ Permit Renewal Permit Revision El Change of Plumber 11 Permit Transfer to New / G
Before Expiration Owner 5'3M 3 ✓ //.Y
IV. Type of POWTS System/Component/Device: (Check all that apply)
PLNon- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/Trea ent Area Information: r
Design Flow (gpd) Design Soil Application te(gpdsf) Dis Area Required (sf) Dispersal Area Proposed (sf) System Elevatio
bbd , $5�. r �! 58 q8• '�•
VI. Tank Info Capacity in Total # of Manufacturer �2
Gallons Gallons Units 2 U ti N
New Tanks Existing Tanks i-iMe6 P � o
`(�.
Septic or Holding Tank O '
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POW TS shown o attached plans.
Plumber's Name (Print) Plumber's i ature MP RS tuber Business Phone Number
Z" I; FP - FoY , v 2232
Plumber's Address (Street, City, State, Zip Code)
too. zbti
VIII. Coun /Department Use Onl
Permit Fee 0 Date Iss ed Issuing nt Signa e
Approved asap $ �— y
er Given Reason for ial k 24 J., 7
IX. Conditw easons for Disapproval R0 "I* ... 4� �/e,N �+ or
1. septic tank, effluent filter and 1
dispersal cell must all be servtces mmaintained C ;mac, •
as per management plan provided by plumber. J J
Z All so k req *ements must be maintained Leax. �t� p c,� C t o
code I ordina
Attach to complete plans f the system and submit to the County only on not ►ess than /2 x 11 inc sin size 50. V L— ;
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INDEX AND TITLE PAGE
Project Nam
Owner's Name:
owner's A ddress :
acv UAI(L v� t
Legal Description:
,vW gE f/4r S 2s 721 NIP, AW
TOWN"P: 4U &% ti
County: ,T Mi tC.
Subdivision Name: l R)RM
Lot Number: Block Number:
Parma I.D. Number
Plan Trion No.:
Page I koeq- - v'T('[TLJ�- S•N�
Page z � SIr LrtlO tJ
Page 3 s YSC��n
page is
Page 5
Page 6 nna N AG . r %et-1
Page 7 {' pw fl 6R.IGE rrtiEN`�
vu A
License Number:
Desrgrter Phone Number.
Date: 04103/x3
Sig
DesWad pumard to the
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UATIC?IV REPORT
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VVISconsin Department of Commerce
I?ivislon of safety and Sulldinys in ccord a G ��omm s5, Wis. Adm_
plan on paper not
County "7
Attach Complete site less t l f x 11 inches in , Pi m Parcel ► D — / D' D�
include. but not limited to: vertical and hOiizOnt I reference point (6M),
d, �
percent slope, scale or dimensions, north arrow, and location and Bare Revi ed by Date
please pwrnt all i'nforntation. . :5/Z3 // ,
Personal Informatloe you provide may be used for soccndsry purposes (Privacy law, e. 15.04 (1) (rn)).
Pro wner Property Locatiio((n t l � p
• s . L L-. 1313010t. Lot 1'r 1 " 114 N t. l S )ST (�9 N
:E li
n Lot # B lock # Subd, Name or CSW
tty
Pro n nrt aili dre �, C., I D � r C. ) p h
— I— Zip Code Phone Number Q city ❑ Village Gd Town earest Road
c,�►`r"o "9 ra r ( , , r�►� +Pr',
mew Construct Use; Residential 1 Number Of bedrooms �3'_ L _m _ Cnde derived design flow rate r �� __GPO
Replacement Public or commercial - [')pporiba, ft.
Parent material d
Flood Plain elevation if applicable
A V � yj y\ 1 [�
General comments :' Sp 5 SC 5rt — _ -f a trG1�► , / I F p r GaG 1, s ; C3 b
and recornmendations' 1, Q V . 9 1
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Borino # V; Boring „� ' j�
f
r�1 v ' f t Depth is limiting actor F � I^ $oil bCatlan Rate
1 I iJ Fit CUrouncl9urraceelay.
t HO Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *F_ 1 PD/ *E
I . tvlunsoll Q, 6a. Cont. Color Cyr. Si. Sh.
aFSb k lh Fr aw rv\
IS -3C to
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Baring # Boring
Pit Ground surface elev. q , 8 a ft. Depth to limiting factor _ J o O in, SoilApplIcatio n Rate_
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rooks fiE GPDM"Eff#2
_ {n. Munsoll Qu. Sz, Cont. Color Gr. Sz. Sh.
-�t f� .- ..,.... --- S F s s k �1,� r M
" F -
Effluent # 1 800 ' s0 � 220 mg1L, and TSS >30 = 150 m ° Effh [Anr #2 ra Bt7D c 30 m4A_ and TSS < 30 mg/L
Name (Plesse Print) T nature CST Number
O° .r'
AddrMs t Evaluation Condurded Telephone Number
nr,r, ryy�n mnnrnA♦
uotiz)/zeal '1i:58 7154859246 POLK ZONING FAX PAGE 02'02
Page of
Proporty owner Parcel lD # _____ _
Boring #
El Boring �..
3 Cl.._Pit
Ground surface elev. X Pt: ,. CSeepth to limiting factor in. 80i1 A lication Race
Horizon 6epth Dominant Color dary Redox Description Texture Structure Consistence Boun Roots GPEW
in. Munsell Qu. Sz, Cont. Color Gr, Sz. Sh. *Eff#1 *'BfF#2
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Boring # ❑ Boring _
❑ Depth to IimiUng factor 'n
Pit Ground surface elev. —ft Soil Ilcation Rate
Horizon Depth Dominant Color Redox oesc Texture S re ConsiNit nC:e Egoundrary Rasta *E GPO/fF
In. Munsell tau, Sz. Cont. Color
s
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8onng Ground Surface elev. ft. Depth to limiting factor F� Sol q c2tion Rate
. ❑ Pit
Horizon DcNlil Dominant Color Rodox Moecriptir n Texture SStnicture Consistence Boundary Roots GPD/ff
� *E"2
in. Munsell Qu. Sz, Cent_ Color Gr. Sz. Sh_ _
"
Effluent 91 = BOD a 30 72o mgIL and T55 P30 �a l en my/l. " [{fluent #Z = SODS -a 30 mgA_, and TSS ;S 3n moll
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commercemi.gov Safety and Buildings Division County `4 C
201 W. Washington Ave., P.O. Box 7162 S�
't i s c o n s i n Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce 5
Sanitary Permit Application State Transaction Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this f to the appropriate governmental 7
unit is required prior to obtaining a sanitary permit Note: Application rms ed POWT Project Addt (i different than mailing address)
submitted to the Department of Commerce. Personal information you p vide �• �`�INr
purp oses in accordance with the Privacy Law, s. 15.04(1 )(m ), Stats. �/1 A n
I. Application Inform 'on Please Print All Information ' ,/
Property Owner's Name koecm MAY r Par cel LJ 3( V 10 0 v
'� 'v
Property Owner's Mailing Address ' / pV4NNlA�r Property Location Z 7
2� 'K l0 1 1 oci Y 1E w �V�� "'� Govt. Lof —��
City, State Zip Code Phone Number N 1( � y, IU Cs ' /a, Section 25 ;
27A. 1 n LA 1 ko W/ 11 p circle on
V l-• Y T Z/ N; R �� E or®
II. Type of Building (check all that apply) Lot #
O NJ or 2 Family Dwelling - Number of Bedrooms I Subdivision Name
J. Block
11 D Public/Commercial - Describe Use /�- g . 4 ❑ City of
r
CSM Number ❑ Village of
❑State Owned - Describe Use
to 'own of U �� - L - �6 L — j C41 ( .9 k
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. New System ❑ Replacement System p y ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑Permit Renewal El Permit Revision ❑Change of Plumber ❑Permit Transfer to New
List Previous Permit Number and Date Issued /
Before Expiration Owner
IV. Type of POWTS System/Component/Device: (Check all that apply)
❑ Non - Pressurized hi- Ground ❑ Pressurized In- Ground ❑ At -Grade 0,Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) U Pretreatment Device (explain)
V. Dispersal/Treatiptnt Area Information: ~
Desi Flow (gpd) Design Soil Applicati p. Rate(gpdsf) Dispersal Area Requir (sf) Dispersal Area Pro sed (sf) iSystem Elevation
{� I X 50 �r25 �(� /IZ6.� �.9 ✓_
VI. Tank Info 4japacity in Total # of Manufacturer
Gallons Gallons Units 0 d °
New Tanks Existing Tanks �/ R
Y 1. a U S,
Septic or Holding Tank I wo ' 4 t V I E
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for i allation of the POWTS show he attached plans. V Plumber's Name (Print) lumber's ature RS
tuber Business Phone Number
��r= r"- yZ I ?15 2'J61 AJ X�e
Plumber's Address (Street, City, State, Zip Code)
Pkj. (fi)c SGS 1bi z,e -5< vV/ s yab9
VIII. County/Department Use Onl
Permit Fee Date Iss d Issuing A Signature
Approved -12e a rven Reason for Denial $ (Q(' ✓
IX. Conditi asons for Disapproval 3
1. Scpt�i tank ef}l��nt fine[ ane( )
dis t � G
as li"N( P !f B1HR1F
2. AN s 1E MIAt 00, M*91@09
Attach to complete plans tor ke system and submit to the County only on paper not less than 81/2 x 11 inches in size
SM-) t wj /j mc.''1y S ss - f 01 R t� 1�
273 Pi i-�C VI G W R AD
(�47
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WMC-
Safety and Buildings
10541 N RANCH ROAD
commerce HAYWARD WI 54843
Contact Through Relay
i sco n s i n ,�,,,yw•commerce.wi.gov /sb/
www.wisconsin.gov
Department of Commerce
Scott Walker, Governor
Paul F. Jadin, Secretary
April 27, 2011
CUST ID No. 223242 ATTN: POWTS Inspector
JEFFERY V FOX ZONING OFFICE
JEFF FOX CONTRACTING & SEPTIC INC ST CROIX COUNTY SPIA
PO BOX 565 1101 CARMICHAEL RD
DRESSER WI 54009 HUDSON WI 54016
CONDITIONAL APPROVAL Identification Numbers
PLAN APPROVAL EXPIRES: 04/27/2013 Transaction ID No. 1927337
Site ID No. 766088
SITE: Please refer to both identification numbers,
Sean Sinett above, in all correspondence with the agency.
Prairie Meadow Rd
Town of Hudson
St Croix County
NW1A, NE 1 A S25, T29N, RI 9W
FOR:
Description: Mound, 3 bedroom residence P.0
Object Type: POWTS Component Manual Regulated Object ID No.: 1310019
Maintenance required; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; Sy
stepn
Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), SSWMP Pub. 9.6; Effluent Filter �
�EPPRZ
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 10 ��
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 gE G
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:
Key Item(s)
• 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. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation
of float switches or relays that contain mercury.
• The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle
size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to
service the filter shall terminate at or above finished grade with a watertight cover.
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along the surface
contour per COMM 83.44(6)(a)2.
JEFFERY V FOX Page 2 4/27/2011
• Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual.
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
• Materials shall conform to the requirements of COMM 84. Comm 84.10. No fixture, appliance, appurtenance,
material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,
unless it is of a type conforming to the standards or specifications of chs. Comm 82 and 83 and this chapter and
ch. 145, Stats.
• Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for
well setbacks and other regulations and exceptions.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any
others who are res.p le for the installation, operation or maintenance of the POWTS.
Sincerely,- Fee Required $ 250.00
��, Fee Received $ 250.00
�i- Balance Due $ 0.00
Patricia L Sh dorf�
POWTS Plan 'Reviewer , Integrated Services WISMART code: 7633
(715) 634 -7810, Fax: (715) 634-5150, M -fr 8:00 - 4:45
pat.shandorf @wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828-5902, Monday, 7:00 A.M. To 3:30 P.M.
Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in
Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings
Division of the Wisconsin Department of Commerce.
"Construction business'." means a trade that installs, alters or repairs any building element, component,
material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform
dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to
87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the
delivery of building supplies or materials, or the manufacture of a building product not on the building
site.
For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildingContractorProc-Tam.html
I .
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: S ean Sinette
Owner's Name: same -
Owner's Address: 2736 Pine Veiw Road
Eau Clair WI
54703
Legal Description: NW1 /4 NE1 /4 S25 T29 N/R19 W
Township: Hudson
County: St. Croix
Subdivision Name: Indigo Ponds
Lot Number. 10 Block Number.
Parcel I.D. Number. Q
Lan' lly
Plan Transaction No.: O ID
, M *
Page 1 Index and title
Page 2 Data entry
page 3 Mound drawings GE
Page 4 Lateral and dose tank �
Page 5 System maintenance specftations
Page 6 Management and contingency plan
page 7 Pump curve and specifications ci Z,
Page 8 Plot Plan
page 9 Soil Test
Designer. Jeff Fox License Number. MPRS 223242
Date: 04107/11 Phone Number. 715 755 2461
Signat
Designed PwsuWd to the
Mound Component Manual for POWTS Version 2.0 SD &10691 -P (N. 01/01), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)
Version 4.0 (R. 04/03) Page 1 of 9
Apr 26 11 09:50a Jeff Fox 1- 715 - 755 -2464 p.3
z
Out. Mound and Pressure Distribution Component Design
��4 Design Worksheet
Site Informati
(r or c) R Residential or C ommer cia l Design Note: Sand fill (D) calculations swumea
300.00 EstimaEed WasteWSW 1 (Qpd) Table 934" i -MU soil treaftrM or
1.50 Peaking Factor (e.g. 1.5 00 %) lead ao l lloim of <= 36 inches.
450.00 Design Flow (gpd)
6.00 Site Slope (%)
98.40 Contour Line Elevation (ft)
36.00 Depth to Limiting Factor (ill)
OAO in - situ Soil Application Rate (gpd/
Distribution Cell Information
85.00 Dispersal Cell Length Along Contour (R) = 8,g3 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft
1 influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution I Y
Pressure Disribution Information network? Enter Y or N
(c or e) a Center or End Manifold
3.47 Lateral Spacing (ft) If N above, enter the elevation Ift
2 Number of laterals of the highest point.
0. 156 Orifice Diameter (in) (e,g, 0.25)
2.25 Estimated Orifice Spedng (ft) = 7.77 felorifice
2.00 Forcemain Diameter (in)
120.00 Forcemain Length (ft) Does the forcemain drain back? Y
85.00 Pump Tank Elevation (ft) Enter Y or N
4.55 System Head (ft) x 1.3 19.57 Forcemain Drainback (gal)
14.48 Vertical Lift (ft) 58.32 5x Void Volume (gal)
2.51 Friction Lass (ft) 77.89 Minimum Dose Volume (gal)
21.54 Total Dynamic Head (ft) 31.23 System Demand (gpm)
Lateral Diame S election Manifold Diameter Selection
in. dia. I o Botts choice in. dia. options choice
0.75 1 1.25 x
1.00 1.50 x x
1.25 2.00
1.50 x x 3.00
2.00 x
3.00 x
Gallons/inch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1000.00 septic Tank Capacity (go!) Total Worldng Liquid Depth (in)
Wieser Manufacturer gal /in (enter result in cell 1349)
Dose Tank Informlitbn Effluent Filter Infomultion
600.0o Dose Tank Capacity (gal) 1139st Fitter Manufacturer
16.721 Dose Tank Volume (gelVin) BTG -10 _ Filter Model Number
Wieser Manufacturer
Project. Sean Sinette Page 2 of 7
Mound Plan View
1
Observation Pipe :.: _ J
K. A
W :l.
Mound Component Dimensions
Down slo a toe extension made.
A [ Ain ft E Aft in H fl ft K gift ft
B ft F In T ft L ft
D G J W
450.45 (fe) Dispersal Cell Am 1 1125.001 (fe) Basal Area Available
6.92 (gpd/ft) Linear Loading Rate 1 6.50 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 101.69 (ft)
f/ffflfififffl %/i�iii/Iiiiii�..
100.40 (ft) Lateral
F f srsal Cell
99.90 (ft) .......... — Invert
Dispersal rsal Ce
II
P :CI
D
Elevation
A
a a q '
9 .40 (ft) Contour Elevation
8.0 % Site Slope
Geotextile Fabric Cover
Shading Key g Dispersal Cell See lateral details on
10 — Topsoil Cap 1.8 ft Page 4 for number, size,
Subsoil Cap and spacing of laterals.
ASTM C33 Sand .!!gg Laterals are equally
its ' _ F spaced from the
7•' Tilled Lateral Layer 0: fl yplcal
y e distribution cell's
Aggregate `' centerline in the
A distribution cell (AxB).
Project: Sean Sinette Page 3 of 9
Apr 26 11 09:49a Jeff Fox 17 1- 715 - 755 -2464 p.2
�
End Connso#fon Lateral Layout Diagram
�rahrc� averth4 3 brlrtrrutfT •= TUrn �wltsttvatwo i
- -- P
All faassyl, yte l deertical I� 3� "�� MW+ra deFed ewrehi totreue�of h.tat..nal S
*q#J*hj
�Exe�m�e neernna. Ntoawatyvatare €sf�if�ariMot�ararigpcnr�r tmaat+&iarcrmiMnoiPVC Sets 4o
fW COMM Tablo $ 4.30.51
Number of Laterals 2 Orifice Diameter 0.156 in
Lateral Diameter 1.50 In Orifice Spacing (X) 2.27 ft
Lateral Length (P) 83.66 ft Orifices per lateral 29
Lateral Spacing (S) 3.47 !t Orifice Density 7.77 if /orifice
Lateral Flow Rate gpm Manifold Length Aft/sec ft
System Flow Rats gpm Manifold Diameter in
Total Dynamic Head L Aft Forcemaln Velocity
Doss Tank information Lock ing cover with warning
label and locking device and
f sealed watertight
Electrical as per NEC 300 Wd �� f
Comm 16.28 WAC Dleconrtecx 4 in. min.
—
Tank component is properly varded C. Alternate outlet
location
Foraemain diameter
Wieser Manufacturer 2 in.
Ca ci 600.00 Gallons `�—
Volume 16,72 gaVinch A
Weep hole or arM-
Dimension Inches Gallons g siphon device
A 18.23 304.75
B 2,00 33.44 C Pump off elevation (ft)
C 4.86 77.86 I 85.92
D 11.00 183.921 D
Total 36,89r-- 800.00 1121 nose tank elevation (R)
Q uncT ta nk. 85.00
Alarm Manuafacturer Se tronIC11 _ �__ T j
Alarm Model Number IMJJ 1 2501
Pump Manufacturer JZoeller
Pump Model Number I BN 157
Pump Must Deliver 31.73 gpm at 21.54 ft TDH
Project: Sean Sinette Page 4 of 7
Mound System Maintenance and Operation Specifications
Service Provider's Name Jeff Fox Phone 715- 755 -2461
POWTS Regulator's Name t, C roix Cty ] Phone 715- 386 -4686
System Flow end Load Parameters
Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L
Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L
Soil Absorption Component Size 450.45 fi Maximum FOG 30 mg /L
Type of Wastewaterl Domestic 1 Maximum Fecal Coliform >10E4 cfu /100 mL
Service Freauencv
Septic and Pump Tank Ins3 a an /or service once every 3 years
Effluent Filter Should h9po nd clean at least on every 3 years
Pump and Controls Test once every 3 years
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Mound Inspect for ondin and see a g once every 3 years
Other
Mlscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap,
and are secured in as shown in the mound component manual.
`t ual
2. VIJpG13Q1 Call aggrcyuic CO- fv�ini �a to COMM V w -�r.vv w j�i�, iiYi: Qd� i �. Code.
3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn -up Detail
Finished •..��.......••� •••••••••.•••••
Grade v1
6 -8" Diameter Lawn B o
Plu r II Valve
Sprinkler Valve Box u a
Distribution
��► Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Sean Sinette Page 5 of 9
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and
maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet finer shall be
assessed at least once every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the
filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products
are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent rifler is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test
when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any
levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically cogged absorption and dispersal
media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: Sean Sinette Page 6 of 9
08/16/02 07 FA X 651 7 9 Jili SAL $S COMPANY PREFERRED EAU G WJUUZ /UUJ
TOTAL DYNAMIC HEAD/FLOW
PER MINUTE
} Li PUMP PERFORMANCE CURVE EFFLUENT AND DEWATERING
MODELS 151/152/153 152 153
so
MODEL 151
153 Foot Mele(s GOL Liters Go►. liters G;OL users
12 40 5 1.5 45 261 69 261 77 29 t
jjj
s 1 0 3.1 42 231 61 231 70 265
201 61
30 15 15 4.6 36 201 5-3 167 52 ; �97
c 20 6.1 18 167
6 t 51 25 7.6 20 129 34 129 42
20 30 9.1 - -- 23 87 33 125
10.7 -- --
11 42
E2 35
10 40 12-2 -- --
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utE RS 0 80 160 240 320 M odeI151
FIN PER MIN= •+ +
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ST. CROIX COUNTY
• SEP. TIC TANK MAINTAMANCE AGREEMENT
AND
OVVNME11P CERTIFICATE FORM
Owner/Buyer A SIA , ✓ .emu /) /.Se c �' %"�° %�'Z
Mailing Address Z 7 3 < �'- •�"'� µ'P �a� e0a - C'l ,u_ W/
pl Adder IV ?e4 ^"6 �� a a/e �+s 402 r yrE' � G
/ (Verificatim regscedfron Pl- ningDgmtn" fornew omstructim)
City /State 9 / s. a2 W ( Parcel Identification Number D7 tl
LEGAL DESCRIPTION
Property Location '/4, '/a Sec. Z S T_ -R� W, Town of
Subdivision f L v /— #
�O Lot r O
Certified Survey Map# 7 2 / p fi , Volume Page 7 (
Warranty Deed# Volume Page
Spec house yes _)Lno Lot lines identifiable _X yes no
SYSTEM MAINTENANCE
Improper use aadmaintenance of your• septic system could result its premature failure to handle wastes.
Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed
pumper. Whatyouput. into the.systemcan affect the fimction of the septic tank as a treatment stage in the waste
• disposal system
The property owner agrees to- submit to St. Croix Zoning Department a certification form, signed by the
owner and by a mastesplumber, joumeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-
site wastewater disposal .systemisinproper.operating condition and/or (2) after inspection and pumping (ifnecessary),
the septic tank is less than W fill of sludge.
I/we, the undersigned haveiradtheabovesequirements and agree to maintain the private sewage disposal system with
the standards set forth, herein, as set by th Department of Commerce and use the Department of Natural Resources.
State of Wisconsin.Ced ifizatioa stating that your.septic system has been maintained must be completed and returned to
the St Croi ounty Zoning Offs 10 days of the three year expiration date_
SIGN OF APPLICANT DATE
#of proposed bedrooms
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge I (we) am
(are) the owner(s) of the pr described above, by virtue of a warranty deed recorded in Register of
Deeds
SI TURE OF APPLICAW DATE
Any mfermation that is mimvpremmtod may rack m the sanitary Pormet besig revdked by the Zan-g Departmat'
include with this application a stamped warranty deed from die Rogow of Deeds aff
. a copy of the certified survey m+p if ro(w oe is made mib. wanv ty deed.
II IIIIIIIIIIIIIIIIIIIIIIIIIIIII
8 0Tx ?4019588 8
STATE BAR OF WISCONSIN FORM I - 2000 936154
BETH PABST
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
THIS DEED, made between Rosamji, LLC, a Wisconsin limited liability 05/12/2011 1.00 PM
company, Grantor, and Sean H. Sinette and Becky J. Sinette, husband and EXEMPT #• N/A
wife as survivorship marital property, Grantee. REC FEE: 30.00
Grantor, for a valuable consideration, conveys to Grantee the following TRANS FEE: 117.00
described real estate in St. Croix County, State of Wisconsin (the PAGES' 1
"Property "):
Lot 10, Plat of Indigo Ponds, Town of Hudson, St. Croix County,
Wisconsin.
Itecordina Area
Name and Return Address:
St, Ar
Together with all appurtenant rights, title and interests. 020 - 1439 -10 -000
Parcel Identification Number (PIN)
This is not homestead property.
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
Easements, Restrictions, Reservations, Roadways and Rights of Way, if any, of Record.
Dated this qth day of May, 2011.
Rapainji. LLC
* Sandra M. Gehrke, President
r
AUTHENTICA N NQ �—, x ACKNOWLEDGMENT
Signature(s) L,IC 2 TATE OF WISCONSIN )
T. CROIX COUNTY. ) ss.
authenticated this 1 Ith day of May, 201 T G 4 Personally came before me this Rth day of May, 2011 the
�F WAS above named Sandra M. Gehrke . the President of Rosamji.
LLC, a Wisconsin limited liability companv, to me known to
TITLE: MEMBER STATE BAR OF WISCONSIN be the person(s) who executed the foregoing instrument and
(!f not, acknowledged the sam
authorized by § 706.06, Wis. Stats.)�
THIS INSTRUMENT WAS DRAFTED BY
Notary Public, State of Wisconsin
Larry Mountain, Attorney at Law My commission is permanent. (If not, state expiration date:
2200 W. Co. Rd. C, Ste 2205, Roseville, MN 55113
(Signatures may be authenticated or acknowledged. Both are not necessan.)
*Names of'persons signing in any capaciq must be typed or printed below their signature
1 of 1 NVARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000
q! a " A .r .
�
W0014 ON 31 �•
, ❑ 1 18.34'
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Wisconsin Department of Commerce SOIL EVALUATION REPORT 1311
Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
Attach complete site plan on paper not less than 8 %x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix
�f / //'' te r/
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 20� " —< V &.t
Please pi l t j� eview y Date
Personal information you provide may ucondary pu IC Law, . 15.04 (1) (m)). a
Property Owner P+`t' Property Location
ROSAMJI, L.L.0 3 2003 Govt. Lot na NW 1/4 NE 1/4 S 25 T 29 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
'T Ci�OIX COUNTY
2141 Cty Rd. C - ZOWINr, 10 na Indigo Ponds
City State zip Co e __j City J Village 10 Town Nearest Road
New Richmond I WI 1 54017 1 715 - 248 -7071 Hudson I Prairie Meadows Drive
0 New Construction Use: yJ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
I Replacement J Public or commercial - Describe na
Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na
General comments �)
and recommendations: mound design, system elevation 100.40 ft, based on contour line 99.40
❑Boring # J Boring
e Pit Ground Surface elev. 99.80 ft. 96
Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/(ts
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EfW2
1 0 -9 10yr3/2 none I 2msbk mfr cs 2c 5 8
2 9 -14 10yr4/4 none sl 2msbk mfr cs 2c .5 .9
3 14 -26 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
4 26-41 7.5yr4/4 none Is osg mvfr cs na .7 1.2
5 41 -72 7.5yr4/4 none cos osg mvfr cs na .7 1.6
6 72 -96 7.5yr4/6 none ms osg ml na na .7 1.2
Boring # J Boring
Pit Ground Surface elev. 99.80 ft. Depth to limiting factor 96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -24 10yr2/2 none sil 2msbk mfr cs 2c 5 8
2 24 -36 10yr4/4 none sl 2msbk mfr gw 1 c .5 .9
3 36-48 7.5yr4/4 none Is osg mvfr cs na .7 1.2
4 48 -96 7.5yr4/6 none Is osg ml na na .7 1.2
- LL -- F ---
* Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg /L
CST Name (Please Print) Si�: CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 5/10/2003 715 - 246 -5085
Property Owner ROSAMM, L.L.0 Parcel ID # pending Page 2 of 3
3] Boring # J Boring
✓J Pit Ground Surface elev. 98.00 ft. Depth to limiting factor 36 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -6 10yr3/2 none sil 2msbk mfr Cs 2c .5 .8
2 6 -16 10yr3/4 none sicl 2msbk mfr Cs 1 c .4 .6
3 16 -36 7.5yr4/4 none sicl 2msbk mfr gw na .4 .6
4 36 -51 10yr6/4 c2d7.5yr5/6 sicl 2msbk mfr Cs na .4 .6
5 51 -72 5yr4/4 c2d7.5yr5/6 scl om mvfr na na 0 0
❑ Boring # Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP p
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = 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 TTY 608 - 264 -8777.
'
STEEL'S SOIL SERVICE INC.
Page 3 of 3
David J. Steel 1564 Cty Rd GG
CST - ROSAMJI, L.L.C. New Richmond,Wl 54017
Lic. #2248956 48956 NWl /4,NE1/4,S25,T29N,R19W Bus.(715) 246 -6200
Town of Hudson, St. Croix Co. Fax.(715) 246 -9372
Indigo Ponds Lot 10
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
1 = 40'
♦ =Benchmark Ele. 100.00Ft
Top of 1/2" pvc pipe
• = Alt Benchmark Ele. 100.00Ft h!
Top of 112" pvc pipe
❑ = Borings
Boring Elevations
B 1 = 99.80Ft
L, B2 = 99.80Ft
B3 = 98.00Ft
B4 =00.00Ft
-
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