Loading...
HomeMy WebLinkAbout042-1039-40-020 (2)M TYPE MrUrFACTU ER 11 ��iYsJ CAPACITY Septic Dosing � r Aer Ho TANK SETBACK INFORMOTInlid TANK TO P/L WELL BLDG- Vent to Air Intake ROAD Septic Dosing l( t I Ae ' n ding PUMPISIPHON INFORMATION - 45 Manufacturer emand GFtM Model Number "A TDH LiftFriction Loss System H, fad TDH Ft loaf .2- T(I �l,.za Forcemain Length , Dia it Dist to well \� too Z �C .EVIL AdaUK1- I IVN STs I EM Wisconsin pepof Commerce PRIVATE SEWAGE SYSTEM Safety and Building ding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes (Pnvacy Law, s 15.04 (1)(ml Perrnil Holder's Name City Village Township Kathy Williams & Jon Besser TOWN OF WARREN CST BM Elev Insp. BM Elev: BM Description Iob,D tO.Df gf— TANK INFORMATION ELEVATION DATA County St. Croix Sanitary Permit No 645463 Sta!e Plan ID No Parcel Tax No 042-1039-40-020 Sect ion/TowniRangerMap No 15.29.18.231 B-20 STATION BS HI FS ELEV. Benchmark 2D JOD D Alt BM Bldg. Sewer-20 `jLf- 2D St/Ht Inlet Q SUHt Outlet DI Inlet DI Bottom Header/Man. Dist. Pipe 2. D Bot System Fill/Grade 2 't- s _ mac, St over _ r ' �t _r2 fD�, fDr 3.(D 3't. qg Id SEDfrRENCH DIMENSIONS Wdth 12 / Length I No Of Trteaekes-- PIT DIMENSIONS r /I No Of Pits inside Dia Liquid Depth lI I SETBACK SYSTEM TO P/L BLDIG WELL LAKE/STREAM LEAC G ufacturer INFORMATION CHAMBER Type Of System: r j -' I Z! p� O W I * U Mode bar nserorer rTr�sr nvnf�.. Header/Manifold lit Distribution f I t x Hole Size rr x Hole Spacing Vent to Air Intake Pipe(s) i /3 q rr Length Dia Length_ Dia ` Spacing �[ 2 T SOIL COVER x Pressure Systems Only xx Mound Or At -grade Systems Only Depth Over joepth Over xx Depth of xx Seeded!Sodded jxx Mulched Bedfrrench Center Bed/Trench Edges Topsoil 1 Yes No Yes No .j LMpENNTB�'. (Include ode discrepancies, persons present. etc) Inspection #1 7 l� [2.0 2:,7 Inspection #2 Location: 957 120TH ST 1.) Alt BM Description = 2-) Bldg sewer length = 36, - amount of cover = ;, tW k Plan revision Required? ❑ Yes NoZ�/ Use other side for additional Information. f0 is t� SBD-6710 (R.3(97) Date Insepctor's Signature J Cert No 2. iNA Industry Services Division 4822 Madison Yards Way County - r+ J� Sanitary Permit Number (to be filled in by Co.) Madison WI 53705 M MWED , Sanitary Permit Appli In atiorbCT 17 2 Stale Transaction Number accordance with SPS 387.21(2), Wis. Adm. Code, submission of this f to the appropriate governmental unit Project Add tf diffe-ertt than ntaihng address Lj 7- 12C l is required prior to obtaining a sanitary permit. Note: Applkatlon fortis f the Department of Safety and Professional Services. Personal information purposes in accordance with the Privacy Lew, a. 15.0I 1 m , Slate. r state-owned POWTS are submitted to u provid*m�jF' Iis�W;kondary communityDevelopment I. A Ucatlon nfotvnation - Please PMnt All lntortnatlon Property Owner's Name t �,1-44,cJr j T� VA Parcel M O t 9— -2* (� o Property Owner's Mailing Address Property location Govt. Lot City, State I Zip Code Phone Number %S SeetitTn A0, Jt� LA L�z� -,2�, 6-) I ^ 2. �6 II. Type of Building (check offthat apply) l at A T N R r w I or 2 Family Dwelling- Number ofBodroo Subdivision Name Block H Oublic/Commercial - Describe Use ❑City of Otate Owned - Describe Use 1J6C um '�3 l illage of 4, l✓O / ` G j Q own of _ 111. Type of POWTS •Hermit: (Che elther"I+New" or "..R placement" and other le on line A. Check one box o line B. Complete line C if -REP Ile A. System Deplaeernent System ❑Other Modification to Existing System (explain) Additional Pretreatment Unit (explain) B' nFlolding Tank ❑In•Ground t-0rade Mound DIndividual Site lkaigo Other Type (explain) (conventional) lo C• 1011crirwalBefore Revision nge of Plumber 13fransfer to New Owner ist Previous Permit Number end Date Issued Expiration FIC'm / N, - - . IV. Dies ersaVI'reatment Area and Tank Information: - Design Flow (go) Design Soi Application Rate(gpd/af) Di 1 Area Required (sf) Disp'rsal Area rropu"cd (s Systen evetV - I zaz:,D Tatilt Information Capacity in Gallons Total Gallons M of Units Manufacturer �l New Tanks Esisting Tanks Septic or Holding Tank y 7 Isi Dosing Chamber v V O 0 1Tv-71 IS V. ResponalbWt . Statement- 1 the undersigned, assu sponslbtllty for •installation•of theYOW75 also wa on the attached planill Plumber's Name (Print) Plum Signature MP/MPRS14ymbor Business Phone Numw. lumbe7(Stret, d s City, Sta ip C / �- S .4 Vl. CounllD artmentUs Ont t ❑ Approved 0 Disapproved Permit Fee S Date Issued Issuing Agent Signature O Owner Given Reason for Denial Conditions of Approval/Reasons for Disapproval 3 , ! f 0 c ? CPU L D�S J�? J �•`��LL���p,rn�� t�►,�, SYSTEM OWNER: t� . , Septic tank, effluent filter and dispersal cell must be serviced 1 maintained as per P �- t^;`"�-`�J✓ '� management plan provided by plumber. i At.W ra {� pvap��r► . t r Q— 1 e&ack requirements must be maintained as per eppll( cie C0aelp or twwwans for the system and submit to the County only on paper not Ins than a 14 s I t Inehet In size SBD-6398 (R. 03/21) q System PLOT PLAN PROJECT Kathv Williams ADDRESS 957 120th st. Roberts Wi 54023 SW 1/4 NW 1/4S 15 /T 29 N/R 18 W TOWN Warren COUNTY ST.CROIX SYSTEM ELEVATION 98.2' DATE 10/5/22 BEDROOM 4 CONVENTIONAL AT -GRADE %00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE DOSE TANK SIZE 800 HOLDING TANK SIZE LOAD RATE .6 BENCHMARK V.R.P. Top of steel fence post ❑ BOREHOLE O WELL •H.R.P. same as benchmark 120th St. Property Line Scale = 1 /4" = 10' Well is to meet all WDNR setbacks 0' 40' 80 Grading is to be done to 98' divert run-off away 98'2 98.5' from system B-3 Area 15' below system is to remain undisturbed Wieser Combo Tank 2% Slope Pro 4 Bedroom House ABSORPTION AREA 1000 # of Chambersnone ASSUME ELEVATION 100' Filter Lifetime (Driveway Property Line -ao,f y Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Sox 7302 Madison, WI53707 October 17, 2022 CUST ID NO.: 226900 SHAUN R BIRD 1432 120TH ST NEW RICHMOND, WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/17/2024 MUNICIPALITY: TOWN OF WARREN ST. CROIX COUNTY SITE: KATHY WILLIAMS 957 120TH ST. ROBERTS, WI 54023 SW I A NW I/4 S 15 T29 N,R 18 W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 40" Maintenance Required: Effluent Filter Phone: 608-266-2112 Web: hitn:lldsosmi.¢ov Email: dsns(a wisconsin.¢ov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS- 10220258 1-C Application No.: DIS-102249653 Site ID No.: SIT-108086 Please refer to all identification numbers in each correspondence with the Department. cwximanAxy APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES .11-- L__t SEE CORRESPONDENCE AI -Grade Component Manual - Version 3.0 (May 2022-2027) Pressure Distribution 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: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. + With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. + Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a IM- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to beset and verified per approved plan. Any changes may result in pump resIAng to meet TDN and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 393.54(1). • In the event this soil absorption system or any of its component pans malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. 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 383.540). In the event this soil absorption system or any of its component pans 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/i nstal lation/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, Fee Required: S250.00 Fee Received: $250.00 ZW V4� , / Balance Due: $0.00 Tim Vander Leest Refund Expected: $0.00 POWTS Plan Reviewer Division of Industry Services Phone: 608-516-6134 Email: tim.vanderleest@wisconsin.gov Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Date:10/6/22 Owner: Kathy Williams Location: SW1/4 NW1/4 S15 T29 N,R18W 957 120th St. Warren Manuals Used: At -Grade Component Manual version 3.0 (May 2022-27) Pressure Distribution Manual version 2.1 (May 2022-27) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Rher Specifications 8.4 Maintance and Contingency Plan Attachments: Soil Test P Shaun Bird Signature License number A ..,,4-1 ,fit SEE CORRESPONDENCE Page 1 of 9 System PLOT PLAN PROJECT Kathy Williams ADDRESS 957 120th st. Roberts Wi 54023 SW 1/4 NW 114S 15 /T 29 N/R 18 W TOWN Warren COUNTY ST.CROIX SYSTEM ELEVATION 98.2' DATE 10/5/22 BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE DOSE TANK SIZE 800 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 ff of Chambersnone IL BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime ❑ BOREHOLE O WELL • H . R. P. same as benchmark 120th St. Property Line I Scale = 1 /4" = 10' Well Is to meet all WDNR setbacks 0' 40' 80 I � J Grading is to be done to 98 288, divert run-off away 98.5' \ /\ from system Area 15' below system Is to remain undisturbed Wieser Combo Tank 2% Slope Pro 4 Bedroom House lDrivewa Property Line �� y At -grade System Sloping Site Cross Section and Plan View — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - ` E i � L,L••••L•L•L•} L.L•L•L L•L L•L•L•L•}•L•L.L L.L.L.L.L.ti.L.•..L.L•L•L•L•L•ti•L•L•L•L ti t I F•J•r r•r J•r t J �•r•F•r•F•r•r•r• r•J•r•r•t•r•�•rti?•rtir+rti {J{r{J{rtir;�{r;:tip{�{ I } L.� L.i•L•} { � } } L L.L L ti.ti�ti�{.ti ti ti } r 4 :tiff{L:4:ti:tirL?tirL:ti�}Ftif}rti�S�{:{:{.{:{:{�i:S�F{r�:{:tiftir•.fti{ti:ti:tiJ•�ti�Lr�:;:'r':ti I r•r•r•r■f•r•r•r•r■r F■r r■r•r r•r•r•r•r•F•r■F {F r• r•rtir{{ti?Yr.S�r•r;J•�•r F ;% I r•} } } }'}•�,} �F}r}F�}S}J F �y}}}.i.i f.r} ? r J I ti..{•ti.{{{r}ti1L�L ti?ti{rti ti•}•}•} .�}•S•ti•L•ti•{•ti-};?i�; I f•r•r•F•r•r•r J• r•r• r•J• J r r �7�+ :': •r rti ti�y+ryf L.L.ti+1•t L• ( L. t•L•L• ti,.L•L L L ti ti L ti L.L • I J J}F J.r r}}}F�}�.r. �.' F•F}�} •F•F}r.J'1}.�J{rr{�{for{iitirtrtirtirl:ti'lL W A ; L } L•;•L•L•L ti ti.L�{ L;ti ti•ti 't } }F}F}f}•tiftir rL%}r r•f r J•r•r•r•r•r•r•F•F•r•r• I 1 t•f F r•r t 1•r J r•r•r• J•r•F ; �•�•�.�.�•{ L•L•ti•L•L•ti•L.L•} }•L I ti•{•}•� �•ti bti. L.L•1��ti•ti t ti 4 ti ti ti ti�h {'�iti•ti�ti�iti.L�{�{�ti1•1iti�L I }Fy .r• F r•r•r• r•r•F• r•}•F•F•r.J.f}r tr ! J it r• r• ti.;{ti. ttit { .{ w }.ti?{ ti•ti•ti �• � L• L } } } � ; {.}•�'r'��J}}.}�r r}i r r { r•J r J•r r•r•r+ r• r•r` � �� L �ti�+titi L ti � ti• {. ;.{.i•{.�� L.ti.L {i{.ti.{�{•ti.L ti { ti{ ti r r•r t t • ••r•J•r•r7t•t�f■r7t?r■t•r•r♦■t.t■r•r■t■}■t•t•t•hr•r•}•r}•}•r}}•FY} I ti L,ti. ~.}fL •� L .L•L L ti tit 4•L•L• S•L■L•L•L•L•ti•ti•4■'.•ti■S 1 •},i} } y}F} r.} } ; J r }•r ?•{}f;{rti:tii{{{: '� ti•}•L S. L.L.L•L1'ti{ti3L.L ti.L { { { {• rLFL �r{�{?ti? .r.Jtirtir.J.�. {r..?•}{3 J{? J r ; r�r�:{:{:ti:ti L:{J,Z{;{{:{?+rti{fti Z ?"f C; {•ti {• C {{.{•{•�{ti.ti ti. J: } r r•J• I r{f;�;{f•?•f' ?;tier;Jtif}tiKx:S ti�{{{rti};rsr;f{i'r {{J{ { ? {•ti.ti•ti ll 1✓ �� 1 /6 B *--——————————————————————— — — — — —— --- E B L — 1 = Plowed M Clean aggregate 0 = 4 in. sch. 40 pvc _ .1 basal area '/� to 2 '/z in. dia. observation pipe Geotextile Fabric Lateral with 2" aggregate over pipe 1• G Topsoil Cap Ft Lateral Invert , 2. Ft Contour ~ Slope Direction r� 1 IF I % Slope Observation Pipe With Cap __E� Topsoil Cap Plowed Surface C GENERAL INSTALLATION; The at -grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a '/4 inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After -the topsoil cap is placed, the entire at -grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/0519) Page of Fc Pressure Lateral Layout One Lateral — End Manifold ..— — , Distribution Ndwork cations Lateral Diameter In. Orifice Diameter 5 Z. In. X Orifice S in In. L teral Len Ft. Force Main Diameter Force Main Length In. -5-0 Ft. 03/05 lgj ♦— Threaded Cleanout Plug ,ong weep 90 lend- Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. orifices arc drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral turn -ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. Grade •••••• 6-8 Inch Lawn Sprinkler Valve Box C Page o — Se tic -Pose Wank Cross Section And Pump Performance Specifications P Tank Manufacttnnr a �� Tank Mode, Number 1 a Total Tank C.etpaaity/9170 Max. Butt' Depth = _ F"tlter MatwfaCUCar r Filter Mosel Numb Inlet outlet Manhole Kfin. 4" Above Grade With Looking Device. Inlet Manhole < 6" Below Orade Sealed Watertight putld Filter �� -- Wet Boma Switch 3 and Re®erve Capswit,v Tank Volume — d-0--?_, 2, OR Dimension, Inches Volume Gal. (gym) A, Z alarm B 2 7` (dose) C ; / (dead) D -S Total g� iUMZE)= l Number Alarm Manufetoturvr Alarm lViodal Number Switch Type l Total Dynamic Elevation Hoed Distal Preesare Network Loss Force Main Loss Total Manhole Min. 4" Above Grade With Looking Device , Disconnect Means Bottom Elevation F1 GIEN RAL INSTALLATION: IU septic/doae tmk is bedded and back filled in accordetrm with the manufaatumr's product approval spooifieadons. Maximum depth of bury as spooified by the manufiWurer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and'outlet is of approved material, connected to the tank with wat"ght fittings, and laid on stabl soil to prevent settling or sagging. Tho force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation abd the sleeve is sealed watertight. Electrical �pQT mlpmplies with NEC 300 and Comm 16.28. 02/05 U Page 0 % 280-SERIES 1/2 hp Submersible Effluent/Sump Pumps The Liberty 280-Series provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. Designed around Liberty's unique'Uni-Body" casting, the 280-Series will provide years of reliable performance, All Models Feature; • Vortex style Impeller permitting passage of solids uptoW • 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball bearing • Epoxy powder coat finish • All fasteners -- corrosion -resistant stainless steel • 1 %4 Discharge • Stainless steel bottom screen — easily removable • Maximum fluid temperature: 140' F. 280-Series Cord Lengths Model 10' 25'(-2) 35'(-3) 50'(-5) 280 Standard Optional Optional Optional 281 Standard Optional Optional OpdorW 283 standard Optional Optional WA 287 Standard Optional N/A WA 10' cord length standard on all models. For optional lengths, add "-2, -3 or -5" suffix to model number. Example: for model 280 with 35' cord, order 280-3 Motor Specifications A hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Pemlanent Split Capacitor 8.0 amps (115V) 4.0 amps (208/230V) ■■■■:\■■■■■■■1■■■■OEM ■■■■■■■ ■■■■■■i\!■s�■■■■■■■■■■loss!■, '■11100111.■!■■■■■■l■■l■■■!' ■o■■%■■■■■■■■■■■■■■■!. ■onsoo■sll■■►5■1l■olsllls■■■' MEIN ■■■■1NEN11■ter■■■■■■■#NONE . „ 1111111111111�11`11111111111 ' --_-------.--r.... '!■■■■■�■■lO��■w■■■■►�■■■■■■■ '■■■■■■■■■■■■�■■■■■■■■■\\ills ■■■N■■■O■■■■f1O■■N■■■■■■1�■■■ r NON��������f�r�re��;w������� , p 38 78 114 15e 192 228 270 Liters Per Minute Dimensional Data: Weight: 29 lbs. Height:13" Major Width:10" (model 287) Minimum Sump Diameters: Model 281, 283... 14" Model 287 VMF...10" Factory switch Model 281, 283 Model 287 settings VMF Turn on level 13" 9.5" Turn off level 7" 4.0" The Model 283 features at fully adjustable wide-angle float. Differential adjustments can be made easily by tethering the float to the dis- charge pipe or other mounting point. vertical float model 287 Is not adjustable. odel 280 Model 281 Model 283 Model 287 VMF-Series anual, Wide angle Wide angle float switch Vertical mag- switch Iwo float switch with quick- with series netic float for disconnect (piggy -back) smaller pits — will operate in plug a 10' diameter sump SSPN k S �• c us Certified ep"t" Wy M. MyWU to ch.nq. wNhoul notk•. Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York f 4416 • Phone 800-843-2560 Fax (586) 494-1839 Www.lJbertypUmps.COm cop^m a ub"" t�wnps. Im. 2017 AN eggs reserved. LL rr 2D00 B06117 W a POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE INFORMATION Owner Permit _pESIGN POAMETERS Number of Bedrooms ❑ NA Number of Public Facility Units .LNA j Estimated flow (average) Yd Ugall/day I I Design flow (peak), (Estimated x 1.5) abda Soil Application Rate 114 gaUdeol? Standard Influent/Effkreni Quality Monthly average, Fats; Oil & Grease (FOG) Sap mg/L Biochemical Oxygen Demand (SOD.) SZ20 mg/L. ❑ NA Total Suspended Solids (TSS) !Pretreated 5160 mg/L Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) sap mg& Total Suspended Solids (TSS) 53o mg/L Fecal CoNform (geometric mean) S10' cUl0orN Maxlmurn Effluent Particle Size )6 in dla. Nq Other. NA 'Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity 0 NA Septic Tank Manufacturer0Nq Effluent Fer Manufacturer0NA K'-, Effluent FilterModel 0 NA 'Pump Tank Capacity Gal ❑ NA Pump Tank Manufacturer 0 NA Pump Manufacturer ❑ NA Pump Model ❑ NA Pretreatment Unit ❑ Sand/Gravel Filter ❑ Peal Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection ❑ Other. Dispersal Cell(s) ❑ NA ❑ Irt-Ground (gravity) ❑ In -Ground (pressurized) J3gQ-Grsde ❑ Mound ❑ Drip -Line O Other Other. ❑ NA Other. ID NA Other. 0 NA INTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: eaMa s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA knaped dispersal cell(s) At least once every:month(s) (Maximum 3 years) ❑ NA es a Clean effluent filter At least once every: ❑ ❑ NA A8�(s) Inspect pump, pump controls & alarm At least once every: T3 o(a) ❑ NA Flush laterals and pressure test At least once every: '� month(s) a s a NA At least once every: 0 montyear(h(s) NA r. NA MAINTENANCE INSTRUCTIONS llnspectlons of tanks and dispersal cells shall be made by an Individual carrying one of the following licenses or certlficaWns: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank Inspections must Include a visual Inspection of the tank(s) to Identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be .visually inspected to check the effluent levels In the observe lon pipes and to check for any ponding of effluent on the ground surface. 'The ponding of effluent on the ground surface may Indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum In any tank equals one-third (ib) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of In a000rdanee with chapter NR 113, Wisconsin Administrative Code. AJI other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at Intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION For new construction, prior to use of the POINTS check treatment tank(s) for the presence of painting products or other chemicals thrl may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thh tank(s) removed by a septage Servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the Iniiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cefi(s) in one large does, overloading the cell(s) and may result In the backup or surface discharge of efflue0, To effluents puhis mp sor alJon contactave the a Plumber fents of the pump or POINTS Main ainert to ssistt In manually operatinge icing g the puumpocont controls to restore normarior to restoring rto l levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area, RedUI Wn or ellminaWn of the following from the wastewater stream may improve the performance and n lrlpfolongltth the fe f8tfo f thendaoOWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental foss; dla rS; dmin (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produc*; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POINTS fails and/or is permanentty taken out of service the following steps shall be taken to insure that the system is props y and safely abandoned in compliance with chapter Comm 83.33, HVIs3consin Administrative Code: 6 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 property 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 another inert solid material CONTINGENCY PLAN If the POINTS falls and cannot be repaired the following measures have been, or must be taken, to provide a rode complislint 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 compadbn and should not be infringed upon by requ*d setbacks from existing and proposed structure, lot lines and wells. Failure to proted the replacement area will result In the the tn0ed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply eil in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soli limitations. Barring advances in POINTS technology a holding tank may be Installed as a last resort to replace the failed POINTS. The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be Installed) as 1 a last resort to replace the failed POINTS. XL Mound and at -grade soll absorption systems may be reconstructed in place following removal of the biomat at the Infiltra)Ive // surface. Reconstructions of such systems must comply with the rules In effect at that time. <<WARNI NG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN, DO MOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Ol= A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR 1MPO3510LE. ADDITIONAL COMMENTS `— POINTS INSTALLER Name Phone POtlIfT8 MAINTAINER Name Phone J = SEPTAGE SERVICING OPERATOR (PUMPERI (PUMPERLOCAL REGULATORY AUTHORITY Name Phone Ntama u Phone This document was drafted In c:ompilanos with ahspter SPa 383.22(2)(b)(1)(a)d,(f) and 383.Wl). (2) ✓i (3). Wisconsin Adminbtrative Code. �,nwt DgWOY ent of Carrrteroe SOIL RIALUATION REPORT Page a DhA>tlua of Safety and Buk*Vs in so=tanm vm Comm as, w Aden. Code Comity c Aaanh oomplste site phn on paper not lees *an a 1/2 X 11 moose In size. Plan must Include. W not 4rnhed lo: vertical and hortsWW Alamitos Point (W. tfkidlon and Paroel I.D. percent slaps. scale or dimensions. north arrow, and looadon and dMo nae io neaneat rood. v Pieaae prim( al! infhrm&ftn. Reviewvd by Dom Naaaw i ".. aeon you prorw mey be and for Nooedr) rurvom "egq Law, 2. ISA4 (1) (m)1• Owner I Property Location? L /• % Govl L eS�-(/ i! S T N R E( W E y MsWV Addren Lot IF Btoek N Stbd. or CS�ii CKY so* 23P code Phone Number f ❑ cityvim- Town Rood IOC o..2 c- 2-3,Y` t'"� Co�seuc0o,M toe: Raaidentlaf / hkanber d bedroorns Code dorh+d dettipn low rob -_ v GPD Replsearrtr>t Public or mrtvnera(sl - Describe Pare'R rrtaOerW[ Flood Plain elevation If applicable 041Msl CONKIM s and fflawwww"ons: Q7 Sysism 1Ty"— System Ebvatbn fcS t I Borty i ❑ amtq 1" Onound surface elev. it. Depth b ".MtQ (color-qA In. Sol Aodlmdon Rage :i = M/ CJ ` �'� a ❑ eoetr� ❑ / pit Ground etufaoe elev. n�T R' Depth IQ Wn" fecbr InSat Aodicadon Rate r FA �■R, �rAFIrAl ►AF= FAM MM MWAR EfkM N'l • KU. 7 30< M) rr "♦� L &W I SS J-M < 7 - t"LMM JFZ s Duw. 1 au 11 %pu w s+ I w _ w .. y. CST Name (Please Print) CST Numbu ignature Bird Plumbing, Inc. Shaun Bird 404226" Address Da E ConductedTdhorM sPNmtw 1432 120th St, Now Richmond, WI 54017 � 715-246-4516 property Owner. FS so"/ Parcel ID p �j Borkq '7>".Pit GMUM sutf M NwL-1— ft. Depth to lin tirg factor in. pope of Sol /lppecaeon Rate MIRA © te r Mr, M. MM -I= FIMMA WAaM � � r1��1►�'ll� � r � �C�ii'��7 �T� �WR71-1 WAN E AwN 01 ■ BOD, > 30 < 220 nVL and TSS 3-30 < 150 mall ' Effluert #2 ■ BOD. < 30 nv& and TSS < 30 mplL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to attest services or need material in an alternate format, please contact the department at 6W266-3151 or 7TY 609-264-8777. sea-4330(RAM) Soil Test Plot PI Project Name Kathy Williams Address 957 120th St. Roberts Wi 54023 Lot 2 Subdivision SW 1/4 NW 1/4S 15 T 29 N/Ri8 W Boring Q Well PL Property Line BM or vRP Assume Elevation 100 ft. Bird 169TM #226900 Date1015/22 Township Warren County ST. CROIX Top of steel fence post System Elevation 98.2' •HRPBame as Benchmark Sc ST. CRO - �j NTY SANITARY SYSTEM File#; '6 �.,•r,iu�.��,r�- Office Use Only OWNERSHIP/ADDRESS FORM crwtedZa027 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 Mailing Address City/State/Zip Phone Number (required) �S Email Address (required) Parcel Identification Number (found on the property tax bill) OWNER/BUYER INFORMATION NEW SYSTEM: LEGAL DESCRIPTION Property Locatioa�/a , Sec. T �N RW, Town of 1 ��N " Subdivision Plat: Lot # Certified Survey Map # �g� �3� Volume a 6 Page # Warranty Deed # �1'��PZ� (before 2006)Volume Page # Number of bedrooms Spec house O yes no Lot lines identifiable yes 13 no New Property Address (Staff Initials) (Verification of new (Date) OFFICE USE ONLY !/ required from Community Development Department for new construction.) 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 o copy of the certified survey map if reference is mode in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd0sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi.gov semsb /ow..>td by 4fGCS ST. CRO-' NTY,(http://www.sccwi-gQHhp.Nwww.gcssoftware.com) !l,SCO/ist/t 1111 St. Croix County Web Portal Tax Year Prop Type Parcel Number Municipality Property Address 2022 v Real Estate 042-103940-020 042 -TOWN OF WARREN 957 120TH ST Tax Year Legend: Property Summary Parcel #: Att. Parcel #: Parcel Status: Creation Date: Historical Date: Acres: *$ = owes prior year taxes Property Addresses Primary AL Address 957 120TH ST ROBERTS 54023 Owners Name BESSER,JON WILLIAMS, KATHY BRZOZOWSKI, WESLEY BOYD, ROBERT J & LORRAINE Parent Parcels Parcel Number 042-1039-40-000 Child Parcels No Child Parcels were found Abbreviated Legal Description (See recorded documents for a complete legal description) SEC 15 T29N R18W PT SW NW LOT 2 CSM 26-5956 N= not assessed 042-103940-020 15.29.18.231 B-20 Current Description 8/26/2013 2.250 Status CURRENT OWNER CURRENT CO-OWNER FORMER OWNER FORMER OWNER Creation Date = not taxed Ownership Type Billing Address JON BESSER KATHY WILLIAMS 1839 KATHRYN CIR EAGAN MN 55122 Delinquent Current Interest Public Land Survey - Property Descriptions Primary Section A Town Range Qtr40 Qtr 160 Gov Lot Block/Condo Bldg 15 29N 18W SW NW District Code AL Description LOCAL ST. CROIX COUNTY 2422 SCH D ST CROIX CENTRAL 1700 NORTHWOOD TECH Associated Properties No Associated properties were found Type # gMrCh pwaenw by LOT 02 4&(j!jj LgtS013 Category (hftp://www.gcssoftware.com) OTHER DISTRICT REGULAR SCHOOL TECHNICAL COLLEGE 2 = p Ln �i Illlllllfllllllll ����''� ' '—'" IIIlllll� flllllll I�i �i��a I �IIIIII� ICI JJ"ii 99 117 1 iScs ¢ _ - • Yr I -,I ,1 �IIIIII IIIIIII�I � Lill. � - , ill.I BE-1 1 III �I((�:'ILLl ,III '° oZ III Q a • ' IR! �1 � i9 Jul J W 0 g t 0 r�R Ln U- 1 Y r ° o- z s _ IAP1�10 R�1 I • IAP1�10 R�1 I • tu, ' tn 0 LLJ n 0 4 LD I QI Zi oz Lj!; zi QI "V ��j U 5 20Z2 WAaconsrDeparvrerr,of rce SOI EVALUATION REPORT Page o� D"sior o` Satety irk^ B:mdim �ovnty stir, 4U—& compote Bite plan or x - � ink it Sze Plan r-Iust rnNude. bug not frnitec tc verb and honzorua reference M R !BM, direction anc F Parma Deroern slope, scale or dimensions, nortt. arrow. anc location an; d+stanoe tc nearest read. l O Ap Om o ! Please print all information. Re ' wed ry Date Lh I P.r� Mrb-UtW vOq; VrOv*4 -11 ' be �Mw t0( 860MOOr) DAM O'fwsc! LJw. f :..04 Prop" Owner i Property LOCar*r i l CL f 1, % Wvt. Lodi ' r C S T N R E f Property Own ty ! Aaifing Adores Lot # siock # f Subd_ or CSKO -I—- o G �s >y state Zip Coact Phone N[Fnber n Cit}• ❑ Village IS ; own rest Road i LJ � Construaian � sE �Res+oentra: ' umber o' bedrmrrk �ieRia.•�ement Pubti;. COrtN'�e-aai - Parent ntawlal 5 ; General corrments S AM reooffvrandabons: System Type /7- 7' - Code derived design, flow' rate 3p D Flood Plait eievation r' applicable _-4 . ---- - -- .. tt Systerr Elevation `{� Pgi Ground sur aos elev. n IZI� # fr--'k Gep[h gu I�nibnB factor in. ..e'er 7:r:'7 MM Mont o - MEN E�0119MMAWffA �is�.r�rr■�ra����w�c���r EflkMnt 01 a BOO. > 30 5 220 mgrL and TSS >30 c IW9&' Eftkient #2 a SOD, c 30 _ mVL ana Tss 1 3o r„grL CST Name (Please Print) Ignature CST Number Bird Plumbing, Inc. Shaun Bird 2-26900 Address 7�z Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 14 —715-246-4516 PrFS perty Owner _ Boring # Parcel iD # RiBo%L16 o itring Ground surface eleva_1 '�� ft Dept to ^9 factor in. Page Sol Application Bate MMMIMM � " ®M MWIN MMr[� •1 �rI�I�� 1.� � /, Maim ! .V M®WAS F7l�n# ❑ Borng ❑ Pit Ground surface elev. ft. Depth to limiting faclor in. Soil Application Rate • Etlk�ent #1 = BODs > 30 c 220 mg1L and TSS >30 c 150 rng1L ' Efiuent ttrl = BQD, < 30 rnglL and TSS 30 mglL 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 608-266-31 S 1 or TTY 608-264-8777. SaD.t330 (R.U00) Property Owner Parcel ID # Wng Boling IN i!pit Ground surface e3eY� R Depth to limiting factor in. Page _—Za —3-- SM Amli-nfirm 5.re ©►M..r 1� C•il� ...M1,Wfi7�1 MFIAWAMlU, �� W' t�ll/�i'att�®==W' UMP71 .,~M���r �MUNIM M®M7 Boring Boring F-1❑ Pit Ground surface elev. ft- Depth to kniting factor in. St Ar"Vn it P.fo • Effluent #1 = BODE > 30 < 220 nV& and TSS >30 < 150 mg4. . Effluent #2 = BOD, f 30 mg& and TSS < 30 mg1L 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. [:?3 iITTi=try ail Soil Test Plot PI Project Name Kathy Williams S n Bird Address 957 120th St. Roberts Wi 54023 WTM #226900 Lot 2 Subdivision ------- S W 1 /4 N W 1 /4S 15 T 29 N/R1 8 W ❑ Boring Q Well PL Property Line (PM or VRP Assume Elevation 100 ft .,.. qR 9' Sc Date 10/5/22 Township Warren County ST. CROIX Top of steel fence post * N n aSame as Benchmark r_3 J3 M ko kD • 0 • O 4 a w � o ° a p '� w �• a p o S L Boa H 7 i IL` is .; � •. Y 0 0 6 ��Ea���voanQci w Y w� �� OG `J a�"as IIqr F C6 7ABoGaEF Z' Fs �a 9 rwe .a L� V C R r C� A r� Ua Z a H O a