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HomeMy WebLinkAbout034-1040-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538897 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: city Village X Township Parcel Tax No: Wollack, Edward F. & Donna Springfield, Town of 034-1040-30-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: (3 f1r~ 1 G 17.29.15.267 TANK INFORMATION ELEVATION DATA '011 14C~, TYPE MANUFACTURERS CAPACITY STATION BS H FS ELEV. r Septic ~ ~ O✓~ / ~ Benchmark ~ ese~ Dosing Go,,~„bo , Q Alt. BIM ~ _ ~ b e~~ • g 1- Bldg. Sewer Pal to Z Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO PWELL BLDG. Vent to Air Intake ROAD Dt Inlet k t' Septic 1 4 3Z Dt Bottom J JZ. t q 5 Dosing i / .4 - Header/Man. / ~O 7 $ 13Z 4 eration Dist. Pipe A X61. 7 1 -0 Holding Bot. System X J6 • og Final Grade PUMP/SIPHON INFORMATION J~Z QE Manufacturer y Demand StCover G n6 GPM. 1✓►f CEO - 6 Model Number AJ 3"2 A 71 6g TDH Lila Z FrictioLoss System Head TD7 ~ -IFA .9 13 7-1 Forcemain Lengthy IDia.Z Dist. to Well f SOIL ABSORPTION SIPS TEM BED/TRENCH Width Length No. O Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 11-1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of ystem: /66 I / / UNIT Model Number: DISTRIBUTION SYS M Header/Manifol5 Distribution 1f If Ix Hole Size Ix Hole Spacing VP o Air Intake Pipe(s) Length _3 _ Di Length 7 r Dia Spacing- ! I 3.5d/ v SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ®•w Depth Over Depth Over xx Depth of~ xx Seeded/Sodded U Mulched Bed/Trench Center 1 , / Bed/Trench Edges Topsoil / ~rj •f Yes 0 No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:-&-// Location: 2816 90TH AVE Woodville, WI 54028 (SW 1/4 SW 1/4 17 T29N R1 5W) 40 acres Lot f •s7+ Parcel No: 17.29.15.267 I"~t~,a- Gibe- O,n,~ 1.) Alt BM Description = 2.) Bldg sewer length - amount of cover = PIbv1 jq2 GN R.C.1C. 0 Plan revision Required? 0 Yes 'No Use other side for additional information. I~ Date Insepctor' ign a Cert. No. SBD-6710 (R.3/97) Qcertnrena~rd.®atr Saddjr a.a COMMIty 201 W. V e hm Ave- P_0. Bag 7162 l~0 ~ X I t4a~a (a►be Mod in W CO.) sconsin M"Sop, wt 5370''/^9162 Sulk" 3 Stare Tiaawetiaa I~bri Sanitary Fernk tion 11 '5 '6 5-?7 7 " to awe wi& s. Comm 63.21(2), Vrm Adm. Code. ' 207 15 > Adidreaa(ifadiaQe~tE.. addnss) rmh is negaired pdw b obaieiog a 3MANY Perdu- taar Mal s Anmd to die Depwftwnt of Comex „~,nn i - ,ou '°°oedes'` Z81 /6 4ue- PMMOM soowdrnoa via the ftivow talk s. 15_ t L A 19bnostim - Plesse PrbIt AN NON - /A Pwperw Owner's Nawe t ! ~ Parad f 034-1,6 Propedy Ounces MwU* Addrhs ~'L7►~~~ T PMPvMY Loearim 7 1 ~ = Goat fit C , C*, Sure ZipCode PhowftwW" 7L .5d Sts -~j~ Y, S-coi. ..J-H 1.- 6rdCOMML ca ' Ile Y 157qo715 -65-2 -aooi Ta9 It R E; IL Type of Bollblog (cbwk A dual air) Lot • ~t or2 Fanny Dwdliog-NmbrrofBoirooaes eioariie Biodr 6 PublreJ( aaoraeeteid - t tse ❑ City of ~ Q sane Owned- Dexnbe flee CSM a 0 v~ ~ n Toiweof_hCa t-iC (n - - Lg"-- ~W- 9 v x HL Type of perrnie (-'b k only use boz on Um A. Cunpiele Em E dsppNo6k) A- ❑ New &Jsrm kwma t Sysles a TrdmcWdlIWdiog Tank ReOwcwea! O * Q OOM bftMC dAW ID Edging SYriMI ( ) s. D Pamit R®ewai P.Mt RMN. ❑ avow ofrtawba D Pewit UNION b New List pnvioan Persil xuwber aad Dale iuwd Before Expeatian Owner IV. T avow n Cbwk AS flat ' ❑ Noa-Pvc=,,md I -Cr ❑ Pruned Ia Gnv=d ❑ At4Uo& ❑ Momd > 24 in. of=d" sots P1 Mx ad <24 a ofusbWo sob ❑ Hoidmg Tank D Orlrer Dispersal Cewpou®t 1-16-1 ❑ Plover De.toe {esgagto V. pbpcnal/T~ Area labrt,rsdow t Design Flow (gpd) 4 twign, Sod Appbcob a Rarejgpdsll Depamol Aran i (S1 Dmpwa,l Araa hoposcd ®t, . 4 600 0 07 VL Tank Iris C ~ in Tbw tt ( o ti CIAM NarTa.ta >~aE~ 0. ~ ~ ~ $ tr, o a of T"t IoZO ``e 2 er Dodn CbMbw 1N vn. RwpowAdfty sftae.e*- >t, At K~ rOWTSarw... ne atlMereit ~,s Neme) s MPIMPRS Nawber tlworrma Pbwre Nwebor 05 3q-IG 705-a31-13 5 Plumber's Addnas ( CMIy; SINK ZW C-k) E-77$1'q C /Pload C M~•,c+~~,oi, (J Z cS~ l Vm. tTse OMY n~re Drs s few Dc gal n 1 Ix. C iW3~ ~t o lS A (b J~a.~. h I 1: Septli; tank. eMu6nt 61br and dispemW cell must au be feet/. M;I axe- i A e.t t ock- a as per management plan provided by plumber, 2: ANtackt~4u~rnents,mbs:raaintanlid as per 11PpNct~Ie ebdt / otdkaAOM. eE= ~ Asaelr N ~ Ptst trr tie and saMiiitM +mly.a Papa ant kat rhas s vE = i iaettes is aFae SBD-6398 (R. 02/09) Valid tlau 07JI I LU ~ to rb .4) CC Z n `v QCs '3 ~SZ%T. O Fr ~9 - r vJ s 0 C5, . X ~ f OOC)V, AR TirvT°~ Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 g S` Contact Through Relay P .S www.dsps.wi.gov/sb/ www.wisconsin.gov A~OF~ssrONt+tis~~ Scott Walker, Governor Dave Ross, Secretary May 01, 2012 CUST ID No. 253976 A77N.• POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/01/2014 Identification Numbers Transaction ID No. 2078151 SITE: Site ID No. 778594 Ed Wollack Please refer to. both identification numbers, 2816 90TH Ave above, in all correspondence with the agency. Town of Springfield St Croix County SW1/4, SWI/4, S17, T29N, R15W FOR: Description: Mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1368134 Maintenance required; Replacement system; 600 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System(s): Ezflow Mound Component Manual, (R. 8/07), Pressure Distribution Component Manual - co Version 2.0, SBD-10706-P (N.01101), SSWMP Pub. 9.6; Effluent Filter 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 Si0 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. SEE 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 gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval, and SPS 383 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • 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. LEWIS C BJORK Page 2 5/1/2012 J Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • 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 SPS 384.10. 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. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Provide frost protection per SPS 383.43(8)(c). • The existing septic/ holding tank(s) must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of SPS 383, Wis. Adm. Code. If it does not conform a state approved tank must be installed. 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 responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 >Patrici ando POWTS PlanRe ' er, Integrated Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Charles L BratzPOWTS Reviewer II 789-7893, 7:45 am - 4:30 m Monday - Frida , , (608) P Y Lewis Bjork LLC Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety& Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. LEWIS C BJORK Page 2 5/12012 I I i Reminder I • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • 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 SPS 384.10. 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. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Provide frost protection per SPS 383.43(8)(c). • The existing septic/ holding tank(s) must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of SPS 383, Wis. Adm. Code. If it does not conform a state approved tank must be installed. 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 fox 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 .V others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 >Patrici ando POWTS Plan Re ' er, Integrated Services WSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer H, (608) 789-7893, 7:45 am - 4:30 pm Monday - Friday Lewis Bi ork LLC Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. a ~ EVIdw® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Ed Wollock- Replacement Mound Owner's Name: Ed Wollock Owner's Address: 2816 90th Avenue Woodville WI 54028 Legal Description: SW SW 17 29 15 West Township: Spring Field County: St.Croix Subdivision Name: na Lot Number: na Block Number: na Parcel I.D. Number: ,rditiona Plan Transaction No.: PROVED Page 1 Index and title 4OFSAFE b Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank ~CORRESPONDF Page 5 Distribution media Page 6 System maintenance specifications ZCY-I S 1 S Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Septic and Dose tanks Page 10 Plot Plan Page 11 Soil report Page 12 Effluent Filter Designer: Lewis Bjork License Number: 253976 Date: 04/ Phone Number: 715-231-7375 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) ICC Flow Tech® Mound and Pressure Distribution Component Design Site Information r Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150% 600.00 Design Flow (gpd) ) 2.00 Site Slope 99.40 Installation Contour Line Elevation (ft) / 125.00 Contour Length Available (ft) 106.00 Depth to In-situ Soil l Application oRate (gpd/ft) / Distribution Cell Information 6.00 Cell Width (ft) 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpr/ftz) i 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? c Center or End Manifold 3 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.75 Orifice Spacing (ft) = 11.54 ft2/orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.50 Inside Pump Tank Elevation (ft) 0.00 Forcemain Filter Loss (ft) 3.25 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 10.40 Vertical Lift (ft) 90.38 5x Void Volume (gal) 2.45 Friction Loss (ft) 106.69 Minimum Dose Volume (gal) 16.10 Total Dynamic Head (ft) 34.08 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 _ 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer ( gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) Bear Filter Manufacturer 22.24 Dose Tank Volume (gal/in) ML3-916 Filter Model Number huffcutt Manufacturer Project: Ed Wollock- Replacement Mound Page 2 of 12 ICC Flow TechO Mound Plan View .:..:_-:1/10 B - : : : Observation Pipe : I-f . K 5 A -40 W I. I.:..:._. B . . I 3 . ♦ L Mound Component Dimensions A 6.00 ft E 21.44 in H 1.00 ft K 11.18 ft B 100.00 ft F 12.00 in 1 10.49 ft L ft D 20.00 in G 0.50 ft J 8.96 ft W 600.00 (ft) Dispersal Cell Area 1648.94 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 103.07 (ft) H F Dispersal Cell 101.57 (ft) Lateral 101.07 (ft)-► 6" Invert Elevation Dispersal Cell t Elevation = D 3~ 99.40 (ft) Contour Elevation 2.0 % Site Slope Typical Dispersal Cell Shading Key See Page 5 Topsoil Cap > d c. 2 ® Subsoil Cap o o Approved Geotextile Fabric Cover 3 ASTM C33 Sand d ° 2.0 ft 8 Tilled Layer 75:5 > F 05 EZflow Media c - ~t -1111-- 0 A - ~ See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. ICC Flow Tech® Center Connection Lateral Layout Diagram Foic« m.irn connection vi i ew) of ctoa;° to mand(>9d p any point Late r4' it-, tdenhc rI a Orifice_ point up, except every 5th one P point clown for drainage S ♦ = Turn-up vdb3li valve or IF X -y ~r:;ff::f2 al Laterali o force main of PVC Sch 40 claanoutpiu~) ! . , prr COMM T kit 4 20 5 Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1750 in Orifice Spacing (X) 3.94 ft Lateral Length (P) 49.25 ft Orifices per Lateral 13 Lateral End (Z) NA ft Orifice Density 11.54 ft 2/orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 8.52 gpm Manifold Diameter 1.50 in System Flow Rate 34.08 gpm Forcemain Velocity 3.48 ft/sec I Dose Tank Information Locking cover with warning label and locking device and sealed watertight i Electrical as per NEC Wo and - ► Comm 16.300 WAC 1 4 in. min. Disconnect -t- Tank component is property vented LForcemain Alternate outlet location diameter huffcutt Manufacturer 2 in. capacity 800.00 Gallons T Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 21.17 470.91 B 2.00 44.48 C Pump off elevation (ft) C 4.80 106.69 81.17 D 8.00 177.92 D Total 800.00 JF Dow tank elevation (ft) Bedding And Backfill As Per Manufacturer 90.50 Alarm Manufacturer SjE - Rombus Alarm Model Number 520-002A Pump Manufacturer Zoehler Pump Model Number 152 Pump Must Deliver 34.08 gpm at 15.70 ft TDH Project: Ed Wollock-Replacment Mound Page 4 of 12 EZflow® Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall tq,~ateral (ft) Distribution Cell Cross-section Arrangements (0(1~8@qn Component Legend ® SRI-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or QW" SR3-12H in 5 ft or 10 ft lengths O 4" Perforated Distribution Pipe With Pressure Lateral Inside • Tumup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) r- Force Main 6ft Wide Center Manifold Project: Ed Wollock- Replacement Mound Page 5 of 12 Mound System Maintenance and Operation Specifications Service Provider's Name Lewis Bjork LLC Phone 715-231-7375 POWTS Regulator's Name St.Croix county Phone 715-386-4804 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean as necessary at least once every 3 ears Pump and Controls Test once eve 3 ears Alarm Should test periodical) Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years Call Lewis For your Pumping 715-231-7375 Miscellaneous 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 EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 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 6-8" Diameter Lawn/ Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins - Long Sweep 90 or Two 45 Degree Bends Same EZflowSynthetic Media Diameter as Lateral 1.25 Feet 'f- Distribution Lateral 00- Lateral Cleanout I Project: Ed Wollock- Replacement Mound Page 6 of 12 disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. INSPECTIONS & MAINTENANCE: Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, 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 one-third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NRI 13, Wisconsin Administrative Code. The outlet filter(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 POWTS, 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 be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPS 383.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a 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 be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area render it unusable. Replacement systems must comply with the rules in effect at the time of replacement. ❑ A suitable replacement area is not available 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 POYM. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <-WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Loo- `3 K Name Phone °715 - Q?) - 3 75 Phone d3A -73 75 SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name Lew.-; 3So. e 1-LC A enc Phone ?t5- a3,'- 7375 ~ Phone ~ Page of l' 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 [EZBow Mound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. 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 filter shall be assessed at least once every 3 years by inspection. The outlet finer shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter 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 as to 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 Wisconsin Department of Commerce. Pump Tank The dosing (pump) 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 filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death. 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 BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 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 3 years. 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 4 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 clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. 11 Fof all of your pump'ulg na40ii, c81715-231-- ~ 2 BN = w/ Float In Box PUMPS M = Auto Float Attached (vertical) N = Non-Auto (manual) p(//~JP [Q E = 230V Non-Auto (manual) "FLOW-MATE" 98 Ordarl MOM HP- vow TM*- O"Ouft ust- ZBN98 BN98 1/2 HP 115/1 Automatic Cast iron 1/2" Solids, 1-112" Disc. Tethered Float (151 358.95 ZN98 N98 1/2 HP 115/1 Manual Cast Iron 1/2- Solids, 1-1/2' Disc. 319.45 FEATURES: I DEAD cAPAWY CLIME The 'Flow-Mate" is constructed MODEL -W 112 iP BN98 of durable cast iron, carbon 'D ceramic seals and a non- clogging vortex impeller. 15' Cord 20- APPLICATIONS: 15 The `Flow-Mate" is ideal for septic tanks, dosing, low 10 pressure pipes, large mounds and step systems 5 0 o 10 2q 30 w 50 eo m eo "DOSE-MATE" 151,152, 152,153 MAW' Stt x _ !ice Ys . TIM_ - 1 ZBN151 BN151 1/3 HP 115/1 Automatic Cast Iron 1/2° Solos, 1-1/2- Disc- Tethered Float (201 322.08 ZN151 N151 1/3 HP 115/1 Manual Cast iron 1/2' SoW 1-1/Y Disc. 281.16 ZBN152 BN152 4/10 HP 11511 Automatic Cast Iron 3/4° Solids, 1-W Dire. Tethered Float (201 355.08 ZN152 N152 4110 HP 115/1 Manual Cast Iran 314" Solids, 1-1/2' Disc_ 314.16 ZBN153 BN153 1/2 HP 115/1 Automatic Cast Iron 3/4" Solids. 1-112" Disc. Tethered Float (201 496.95 ZN153 N153 1/2 HP 115/1 Manual Cast Iron 3/4 Solds, 1-12- Disc. 46200 ZE153 E153 1/2 HP 230/1 Manual Cast Iron 314 Solids, 1-1/2- Di§c. 462.00 FEATURES: P"Pr NMCaW The -Dose-Mate" is constructed of M0°~ tslrts~r~ BN152 durable cast iron, carbon ceramic x s seats and a run-dogging vortex ° impeller. 20' Cord APPLICATIONS: The "Dose-Mate" is ideal for septic s tanks, dosing, km pressure pipes. - mounds and step systems s e w w» w s w emu= w w o s s ae U a6 3k nowrairure aa~ 14-2 z 53" AS 96" D rrn 41 » READ ~ z r C ~ D 4i n m 0 o UP 40"~ - m 4" CAS s D m cn ~ I 3" 44 r,r 6" *t D ~ I m m m 36" I - r- rn r- v rn N 4 :V mm UP 38" 4" CAS , z Z3 O C K D o ~ 39" c -z+ n m D I D i 1 N G D O z z 0 r z z > 0 0 C3 ~o EM ~mz z~x O 0 Z> oz ~ppCCrozmD00C0--~~DQ~ ~r Am Xx ln~~ 0 ~<n m I il 1ocA o 0 oiia~Sm^Fma 11 ;o ` C~ cmo0 mnm *X Ln D mooo mD 1 f.. to Z -40 iz zz -0m 3: -gzFJ0Dmopr~j~+t~oiw ~ 0 v a o 1N m roA0 D Co NW mRlNil ~Qr-~O sO~ (70 -itn <D o v 1 u z Q2 cDa 0 cnmD I' a,rgt°obr m 00 O~ m u !'l O Z lea Lm A j0~ D~ o- o f b, O O r m m w -Ni W n DD =1 z C) C) m,F m0 00 o 'p D 0 K3 m oo D D w m Z m 2 ~m n m 0< > =~z r1 ~O 0 I m < o m H D mz 1 f~1 z z >lk0 cp y 0 Z f z... V! D zJO 23O 8 :b N A 'TI -0 r, -4 rTi 20 til CA - 3 N O In vA 2D Z > ;o O A r M m z 2 F ,+N P,ZOO,BOO_MR NIENER CONCRETE DRAWN BY: SME SCALE: 1/4'-l'-O' PRE-POUR: ° -mi SEPTIC MANUAL REV. \ z W3716 US HWY 10 MAIDEN ROCK, NA 54750 DATE: JANUARY 2010 DATE:. POST-POUR: ° REVISED JAN. 2010 800-325-8456 FlLE;~ I 3 ~ 4 ~ a ~ tea. - If Q T IL 4 s r ~ s y ~ O x f Plot Plan Legend O1 4" PVC ASTM D 3034.42"Min. Cover where snow is not removed. 24" inside diameter concrete manhole brought min.4" above surrounding grade. Concrete covers chained and padlocked . Precast concrete septic tank. O Effluent filter location. S~ 4" PVC ASTM D3034. 18" Min. cover. Effluent piping or building sewer where tank is within 30'. O Precast concrete dose/pump/filter tank. O 12-2 OF-B Power conductor. 14-2 OF-B alarm circuit conductor. Both wires are UL listed A-2057 O8 2" PVC ASTM D-2665 -09 Schedule 40 Pipe Force main. O9 4" PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. 10 Carlon All weather pvc junction box. UL listed # A-241 11 Ez- Flow Cell treatment/dispersal cell 12 Inspection wells Project 0 0C' Page Wisconsin Department of Comore SOIL EVALUATION REPORT Page l of 3 Division of Safety and Building in accordance with Comm 85, Wis. Adm. Code County St. Croix Attach complete site pla M p r not less th 8 1/2 riches in size. Plan must include, but not limited to: vertical and horizon I re fs M), direction and Parcel I.D. W) -36 percent slope, scale or dimensions, nort h am w, and to ce to nearest road. 634 - Q - db~ Please print l information. Revie by `Date Personal information you provide may be u for secondp(j~po s (Privacy Law, s. 15. (1) (m)). t0 Z Property Owner ✓C~Pr rtyLo SW /17 T 29 N R 15 E (00® Ed Wollack G(sZ CCU / . Lot 1/4 1/4 Property Owner's Mailing Address of # Block # Subd. Name r CSM# 2816 90th Ave CRY State Zip Code Phone Number ity O Village ■ Town Nearest Road Woodville WI 54028 ( 715-698-2001 280th St New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD El Replacement ® Public or commercial - Describe: na Parent material Till Flood Plain elevation if applicable Aa ft• General comments Install standard component manual design mound on the 99.4 Contour. and recommendations: P-1 Boring # 11 Boring El Pit Ground surface elev. 99.4 ft. Depth to limiting factor 16 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A-1 0-6 1Oyr3/2 sl 3fgr mvfr cs 2f .6 1.0 A-2 6-10 10 3/2 grsl 3msbk mvfr as 2f .6 1.0 B-3 10-16 10yr5/4 - grfsl 3msbk mvlr as 2f .4 -8 B-4 16-21 7.5yr4/6 c2p5yr5/3 scl 3msbk mvfr s If - - C-5 21-36 7.5yr4/6 c2pyr5/3 scl Om mvlr - - - C-6 39-47 5yr5/3 S osg ml - - - [7-21 Boring # Boring 99.4 16 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate ■ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A-1 0-5 10yr3/2 sl 3fsbk mvfr cs 2f .6 1.0 A-2 5-8 1 3/2 grsl 3msbk mvfr as 2f .6 1.0 B-3 8-16 10yr5/4 - grfsl 2msbk mvfr as 2f .4 -8 B-4 16-21 7.5yr4/6 c2p5yr5/8 SO 1 msbk mvfr - - - * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30:5 1 mg/L Ofiu t #2 = BOD < 30 mg/L and TSS 30 mg/L CST Name (Please Print) ure CST Number Lewis Bork 253976 Address Date Evalu on Conducted Telephone Number E7818 County Road E, Menomonie, WI, 54751 12-12-11 715-231-7375 n..r neon mnn,nn. Of 3 Property Owner Ed Wollack Parcel ID # Page 2 o P-3 Boring # 11 Boring 99.1 17 ~ ■ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A-1 0-5 10yr3/3 - grsl 2fsbk mvlr as 2f .6 1.0 A-2 5-9 1 r3/2 - grsl 3fsbk mvlr gs 2f .6 1.0 B-3 9-11 10yr3/2 - grfsl 2msbk mvlr cs 2f .6 1.0 B-4 11-17 10yr5/4 - grfsl 2msbk mvlr as if .4 .8 C-5 17-25 7.5yr4/6 c2p5yr5/3 scl lmsbk mvlr - - - 17 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 GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 Boring # H Boring F-1 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 " Effluent #1 = BOD, > 30:< 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD5 < 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. SBD-9330Test (R.07/00) - 2 I~ 1 a e0 2 to 4 V) rb 'A t Z g ,"---ter f r i Installation ',~~a S ° ro 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. S7EP 2 While the case is still dry fitted on the outlet pipe, measure the length of ~-inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. 7FP : For installations utilizing the optional supplemental side support. solvent weld the 3/s-inch pipe onto the filter case. If side support method is not Y LL._ utilized, proceed to step four. Solvent weld the filter case onto the outlet pipe. Insert the filter ? a, cartridge into the case, pressing down until the filter locks into the bottom of the case. If a VRS switch is utilized: insert into the filter and lock by turning a~ clockwise 90° , Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. t 2. Open the outlet access opening to inspect the tank and filter, ssi 3. Pump the septic tank completely, making sure to remove the sludge 1 layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the 1 cartridge from the case. S. Slide the cartridge up and out of the case for cleaning. b. If a VRS switch connected to an alarm is present, the switch should be removed by turning counterclockwise 90° and cleaned i ` with water only. 1 ~ - 9.C.(4~. 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. 4 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 90°. s', 9. Insert the filter cartridge back into the case, pressing down until the filter locks into the bottom of the case.. 10. Replace and secure the access opening on the tank. www bearonsite.com 8??-MLFILTERS (653-4583) /2 I W. Wadbom Ave., P.O Box 7162 I SIC n s i n Mefson, WI 53707-7162 Sammy Pa®it Number (1o be lod in by Co.) r~ pfica t1M In acwrdemcc with s Comm a3SC~e T unit is required prior to t N06M Appliicatim fix= for stdDowned are Projm AAddmw (ifdir~atd m mnl~io* a. ~dd~ress) submitted to tiro DeparOmeet Personal coon you provide may be used for seoa~y punnos in ~P~~ ' `t ~ acconlmrx w ith the L aw s 15. i m StatiL v L leformadoe -Place Print AH Property owner's Name / Pascd # EA Lt, l one N Qo 0 3 L/-/O YO - -50-W O Pmpertty Owner's Marling fropeay Location -7/ 08t Gevt Lot C city, state Zip (',ode Pbooe Number_ yti snaaon ! L _ ODA kh ~ ~ t W~' (r~rdeoee ~ 7_N; R_Eor Type of Balding ehe& in that apply) Let # Al or2 Family Dwdiing-Number of Bedrooms Sub~ves+ooName 1O&# N 0 a =nUsc ❑ City of ❑ Static Owned - Desk Use CSM Nu ben ❑ VNW of 56. a ` ►X. l A VT- Of n... n HL Type of Permit: (t~heek any am box an fine Campleie lit B ifappliable) A- ❑ New, System syA. eg Repiacmomt OdY ❑ Otbrx Madilication to Exia~g Systsm (Cqdain) B. D Pe®it Renewal ❑ Permit Revision ❑ Change of Plumbs ❑ Perm t Traod'c to New List Previous Peffout Number and Date I= W Before Expiration Owner IJn IV. Type of Pow n tlDerice: Cbe& all that ❑ Nm-Pre=== d k-Giouad 17 Pressrw=W M-Cuamrd O AWrade ❑ Mound > 24 uL of =W* sea ❑ Mound < 24 of sable sod Tang ❑ Other Dispersal Component (explaw) ❑ Pretroatmeet Device (cq*m) reatmeet Area Ira w aetiaf: Design Flow (gpe) Uft igu Sal AppticaGion Rate(gpdsit) Dispersal Area R-Mued Dispersal Area Proposed (st) Systrm Etevatiaa VL Tank Info Capacity in TOW # of ?Amwfictmw Gailaos Gallons Units New Tanks Est Tasks l' c °fl °a~ 0.U as w and W t5 is. Sapoc err I§ddi*Tam Z aL . Dosing thsmber articled !f~ VII. iW.y state®e t- 1, the of tfre PQ%M Aw" w ft e Mumber ,s ~M~ "b~ 7 J/'7L ~7 N mtber's Address ( City, Staff ZW ('.ode) J 5- It 7 Use Permit Fee Date Lssuing 1461 signamnre z 5~ l~ ~z ll Lc, couditiow of u bar Diprpprwai ca° SYSTEM dWNEFt; 1 Septic tank, effluent filter and 4 G L t~AAL dispersal cell must all be serviced/ maintained' as per management plan provided by plumber. y~~ c.. Tr✓rM. G4~• 2. All setback requirements must be mqint24nPd as per applicable c6ntgbji'C114~ for the system sad saboR to the comfy only m net kss 6ae s x 11 inches is sae ;A6~ cc r SBU-6398 (R. 02/09) Valid ttnu 02/11 P r1of o~n~ k)o~JaCA _ a , I a 1 t 4 r4 9M.100, 4~' t n P„ ~ 4 of74m a C s r• K oe Q CONCRETE HOLDING TANK DESIGN Single Combo Tank Option INDEX AND TITLE SHEET Project Ed and Donna Wollack Owner Ed and Donna Wollack Address 2816 90th Avenue Woodville 54028 Legal Description SW SW S17 29 N15W Township SPRINGFIELD County St. Croix Subdivision Name Lot No. Parcel ID Number Plan Transaction ID Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Maintenance and contingency plan Page 4 Designer wis rk Signatu Phone No. 715-231-7375 License Number 253976 Date 11/30/11 Designed pursuant to: Holding Tank Component Manual For POWTS (Version 2.0) SBD-10855-P (N. 03/07) Version 6.0 (04/08) Page 1 of 4 HOLDING TANK SPECIFICATIONS Number of bedrooms 400.0 Non-residential estimated flow (gpd) 2000.0 Minimum holding tank volume required (gal) Side A Side B Total 1250.0 750.0 2000.0 Proposed tank capacity (gal) Wieser Tank manufacturer 1250/750 MR Tank model number unknown Alarm manufacturer unknown Alarm model number Tank Dimensions and Data Tank Anchor Calculations X for round tank 14860 Ibs Weight of tank and cover 48.0 Liquid depth below inlet invert (in) 1.50 Safety factor Maximum depth of soil cover (ft) 32795 lbs Weight of anchor required 66.0 Height (in) Outside 37.0 in Soil cover req. for anchor or 155.0 Length (in) Dimensions 8.1 yd' Concrete counter weight 86.0 ]Width (in) Only HOLDING TANK CROSS SECTION Electrical complies with NEC 300 and Comm 16 optional vent manhole cover with vent pipe pipe ~ finished location EL&-;- locking device and grade junction warning label box 4" min. ~ 4" min. 23 in. conduit 18" min. thether - weight Note: All tank joints, and joints - between tank openings and piping building sewer service inlet blind plug alarm on are sealed watertight. All pipe to seal and vent materials comply with outlet Comm 84. Manholes with locking 90% Full 40.3 in device are typical for each manhole opening. Side A 1250.0 gal Side B 750.0 gal 3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy. Project: Transaction Number: Page 2 of 4 bT ~14h ~ ~O~ ~ ,~a ~t Is G x(,10 ~ f u c Zg 0 A--,/c Gt/oa 4~'/Q k syv2- g N Pali } O 4y' s mm of , 9s ~ . f i r Ave- HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to Comm 83, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07), and the St. Croix County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 600 to 0.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and Comm 83 and 84 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 30 days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with Comm 83.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons may be contacted: a. Installer Lewis Bjork Phone: b. Service Provider Lewis Bjork Phone: 715-231-737 c. Co. Zoning or Health Dept. St. Croix County Phone: 11. Project: Ed and Donna Wollack Transaction Number: Page 4 of 4 D 66" AS 86" D REQD m ~ 53" _ D Z z r m c: N ~ A m o t4" 52" 1 m CAS m -A 57" 6" N D, m D 0 N 48" p m m~ 00 m \ D < 1 v 0 I N 4 Z1 N I I / UP 50 m 4" CAS I / m \ m 06 O z z _0 cz 0 51" D m ~ I D I m m D r c Zo Z Z O D ? 2 5 -4 -4 ;a o m D Z Z A O~Z D~Z AE'mro Zmy00D5 C cm° °x c/) ~ oo ° rN °m v ~c~i° ~p° xo~ -xx~o~V) N cn~ mm m o m = 0 n ~zp m>o r 2-10 F; CT1 OD aOn =f N c r D Vc --c mZm ~rnmrn O X ~ zZ n m M z ~?m o > m ~~m N W\ m y -IN Z CDC Z OD ~N DN I -1 OF -io 1l o z rn u n U O x T. m m 0 N~ Nm~ DD -o%t! v~o O (n Z °z m :5 a a' V)0-n r ca n 0 I W ~o D Z Z D NQ, o _0 z m z 2 O c-n o --4 N ry myrn DO N b D v m a H -Zi nW r~O D =FZr0 m~ n -_I m Z ~.'~i C I~ i-. O v p A n NI O -n X _ D 'Z. o z -n _0 r -0 ;o oc z U) F5 0 rn F' 3 rn o -mi o v n D 0 ;v ;u mr ;u 0 r cD rr* I..I z o r O 0 ;u r~ cn z Z ; r m \ N W1250/750-MR x DRAWN BY: SME SCALE: 1 4"=1'-0" PRE-POUR: ° m MIEBER conCBETE REV. ~t m SEPTIC MANUAL DATE: JANUARY 2010 DATE:. POST-POUR: Z W3716 US HWY 10 MAIDEN ROCK, WI 54750 ° REVISED JAN. 2010 800-325-8456 FILE: wlzsonso-MR ~4) Nov-30-Ml 09:27 M St. Craix Caurty ~t~~ >Za'a Wq 715-396-4686 111 SEPTIC or HOLDING TA1"`EVIG'Il`+TG CONTRACT Contract Date 11-30-2011 This corftwt is made between the Tank Owner(s) Name(s) and Purnpefs Name QAJI '5 We aaknowiedge the lnataltetion o (ta ttWdholeitg tank(s) on the MuM properly: (Provide fto demcriptbnx I. The ownw agrees to file a *W of ibis ecnitract with the local governmental unit (St. Croix County Planning & Zoning Department) to docimtant maim mane by a cad septage servicing operator as required in Comm 83.591Xc)2. Wis. Adm. Cade and the approved Component Manual. 2. The owner agrees to have the vVdcrUldiug tank(s) serviced by the undersigned pumper and guar to permit the pumper to have access and to aster upon the property for dye purpose of servicing the septiotholding tank(s). The owner agrees to maintain the aexxss road or drive so that the pumper oa n service the se pticibolding fault(s) with the pumping equipment. The owner fortber agteea to pay the pumper for all dyer gas Murred m servicing the septidholding tank(s) as tnutusAy agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local governmental unit (St. Croix County) a report far the servicing of the septielholding teak(s) on a monthly basis. The pumper Au Cher agrees to include do following in the monthly report: a. The name and address of do perm sesponsiblc &r aeniaing the 5optic/hotding tank; b. The name of the owner of the se pticlholding M* c. The kwdon of the property on which the stptic&olding tank is installed; d. 7 be sanitary permit number issued for the septiclhatding tank (if known); e. The dates art which the septic/bolding tank was serviced; L The volume in gallons of the contents pumped froze the se ptic1 holding tank fbr each setvk g. The dbpoW sitar to which the co nw t< from the septiWholding tank wise delivered. 4. 71do agreement will ruin in offoct until the owner or pumper to rnimates this contra Z In the event of a change in this contract, the owner agrees ref file a copy of any changes to this service commot or a copy of a new swvi& contract with the local governmental unit na within ten (10) busiueas days from the data of change to this service contract. Ownetfs) Neme(s) (Ptiat) OWnees sivisture(s) Subscrlbad and sworn to me on s date: Todagfs DOW i rl PumWs Name (Print] P er's Sin Notary bHc re Sam IZ LL.e PumWs Reglstratlon Number Commiselon Expiration Oct-20-2010 0810 AM St. Croix County Plan/Zoning 715-388=4686 1/1 ST. CROIX COUNTY SEPTIV TANK MAINTENANCE AGREEMENT AND O ERSI P CERMFICATIONFORM Owner/Buycr Cri ~~,►-~.~n _ ( of l ar k . Ma"""S Address 25((a - . - 401 4v e 4 J6e14 ,i.'//.zr - 4/1 _9aW 91. Property AddrM (Verirl atlon rcqumd from P ing Departmew ibr now c omtructiou.) City/State 4 %idif Parcel Wentiffcadon Number 0 Y0 - ~D- 0~6 LEGAL D~SGR PTION Property Location _&L L Sec. _,1L T sDLN R,. /LW, Town of subdivision Plat: /v Lot # CertfSed Survey Map # . Volume z Page # . wttrminty Deed 6 S~ 0effi re 2W7)Vbumc 1 , Pale # I Spec hom • yes r10 rot idenimaft ~ q-,=, vo sir RNMNAMM AND 02M CECATIM Improper use and MlkftnW= of your SRI& ayatM result is its pMe+o MUM to ltendle way Proper mainEenanae conalos of pumping out tin septic tank every tbm yaws or soenw, itmWeci, by a UcouW pumper. Wbat you put into the system can afeet rite iiutadon of ft mpdc tank as a treatment stage In fhe waste 6lspand syet+am. Owner nuftea x responsibiltiea are specifnd in j CwvL 83541) and in ChepW 12 - St Ocoix Cow* Saar Ordinance. Ile PAM orvt .t spa w submit to St. Cmix Citrtrty Flat bg & ZW0ij, DWOUMt a cWnc uicm lbrm. st' by the cnvnar and by a 11MM plumber. journcynw ptumber, TestricW urs tke =d p vri"S met (1) Ilia on-ft watewatet dirt t htys exn is in probe operating condkion u, d kw f2) -afteritrsliect'ion and pumlft fif thereat"). the sptir tank it tees theft t?3 foil afsfu*, Ywe, the armed have read dw abase requites aadAM to minain the prsvata sswsgo dlepoaal systems with the sandar&.24 hrtkhmiv~nsd by to Dqmftag of sad a ofi3s►uursl ~ .&~a of Wkm ad& CaOwAlon sk ft OW yow septle h bae boon waihtashiml marsh be cowpWW and reed to di* 3L Croix C4=W Pb & Zoning Department wltlua 30 dayat offt►e dm year tnghk Wan date. Uwe cexdfi► that all ststementa on this form sae true to the beet of my/bur kww16dge. Ave am/are the own&W of the prmierty described above, by vi ty dead recorded in Regisor of Deed Dim Number of bedrooms SMNAMM Of APnXANT'M DA'I E ***Any information that is miweptesa od may result in dte sanitary permit bdrtg mmked byte Plmft & Zod* Depawtertt. •'e* Include with this appl'toatiora a mcohded waemmW decd iiew the [teSW& of Deeds Office and a dopy of" eadW surm map if reference is mode in the waTrartty deed. (REV. 080) ~v Vol 1441PAGE 191 60Es6.50 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Robert L. Dorwin and Shirley P. Dorwin, husband and wife, 07-12-1999 10:00 AM as joint tenants, conveys and warrants to Edward F. Wollack and Donna K. Wollack, husband and wife, the following WARRANTY DEED described real estate in St. Croix County, State of CERT CORY FEE: EXEMP Wisconsin: COPY FEE: TRANSFER FEE: 537.60 RECORDING FEE: 10.00 PAGES: 1 Recording Area Name and Return Address Thane A. VICCOrMaCk LAVU fla, r!rE 740 Main Street Baldwin, Wi 54002 034-1039-79; 034-1039-90; 034-1039-95; 034-1040-20; 034-1049-30; 034-1040-40 (Parcel Identification Number) The Northwest Quarter of the Northwest Quarter (NWY4 of NWY4) except Lot 1 of Certified Survey Map in Volume 2, page 303 recorded in the Register of Deeds office, the South Half of the Northwest Quarter (SY2 of NW%), the South Half of the Southwest Quarter (S'/2 of SW-1/4) and the Northwest Quarter of the Southwest Quarter (NW'/4 of SWY4), all in Section Seventeen (17), Township Twenty-nine (29) North, Range Fifteen (15) West, subject to easements and, rights-of-way of record. This deed is given in fulfillment of that certain Land Contract between the parties dated September 29, 1984, and recorded in the office of the Register of Deeds for St. Croix County, Wisconsin, on October 1, 1984, in Volume 697 of Records, at Page 275, as Document No. 396679. Exception to warranties: all easements and restrictions of record, and except any liens or encumbrances created or suffered to be created by the acts and defaults of the grantees, their heirs, successors or assigns. This is not homestead property. Dated this 9_11*~_ day of~. 1999. "Robert L. Dorwin *Shirley P- Dorwi AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this O 1999, the above named Robert L. Do(?'~ authenticated this day of D Twin to me known to be the person ted t6- , f r oing instru e t nd ackno g ' !5+0 3'S v t to -L'S Tir signature , signature type or print name type or print name TITLE: MEMBER STATE BAR PF WISCONSIN Notary Public St. Croix County, Wisconsin. (If not, My commission is permanent. (If not, state expiration date: ) authorized by §706.06, is. Stats.) O-Z THIS INSTRUMENT WS DRAFTED BY 'Names of persons signing in any capacity should be typed or ormack printed below their signatures Thomas A. Mc Baldwin, M 54002 Information Frofessionats Company Fond du Lae. wisconsln 800-6552021