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HomeMy WebLinkAbout040-1266-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 552313 0 GENERAL INFORMATION 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: 040-1266-40-000 James, Stephen C. & Diana Troy, Town of CST BM Elev: Insp. BM Elev: BM Description: ` Sectionrrown/Range/Map No: /00,0 d O• O G -6" 1 16.28.19.1446 TANK INFORMATION LEVATION DATA /ooU a 3 S/s TYPE MANUFACTURER 3 CAPACITY STAT_ION / as /D ~ I, FS LEV. Septic •r,~, Z Benchmark / t~,eseC / iM 7-- Dosing /m.4 97 Alt. BM ~ Z $z. 77,(.o Co~,,lor~ 3 1 (OW Or' 1'o Aeration Bld . Sewer cS • 7,151 •27 Holding St/Ht Inlet 7.75 '7Z• (,7 TANK SETBACK INFO ION St/Ht Outlet 11-% TANK TO P/L WELL BLDG. V nt to Air Intake AD Dt Inlet Si o Septic G 7 Z~, t Dt Bottom J y ~ .z5 9.17 Dosing Hea a an. - -2b s UL e 57 INK 2.15 Aeration Dist. Pipe I h 4 tti.d 1 Toy apf vto+o e 2-(~ y~'~~ Holding Bot. System 2 41 9~ / /a~ 6 1 I D d 6 ,++,n, PUMP/ IPHON INFORMATION Final Grade eZJ" cturer Demand S Cover GPM L ) ~ 3•4to / Model Number n- r 7 'V ~(~/Lid' TDH Lift Fri tion Loss System Head TDH Ft A , f ^ I W P_ A0 r r 15 1/&./ 5- l "lOVed J4 W 11 WAIL ;VL1 V-60 w, Forcemain Len Dia. Dist. to well eu+ SOIL ABSORPTION SYSTEM CL` L~~i • f / BEDITRENCH Width r Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. iq i epth DIMENSIONS 1_ r c, SETBACK SYSTEM TO P/L 6 BLD ELL LAKE/STREAM C G Manufacturer. INFORMATION CHA ER OR TypAe f System: 1 / (fJ5 Ll Model Number: I X6 it DISTRIBUTION SYSTEM Q5 Q}Pe~ oI Head anifo Distributio/n x Hole Size x Ho re Spacing Vent to Air Intake 11 Pipe(s) 1f7~ S~ r 2 . ) bb-<-PW/ -P, Length is length Dia Spacing j/ 1 SOIL COVER x Pressure Systems Only xx jatknd Or At-Grade Systems Only Depth Over Depth over 436 Depth t Seeded/Sodded xx Mulched Bed/Trenc~ter... Bed/Trench Edges Tops~r L1O /_h s No Yes NNo COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 3 / V/ w.~,WI ection #2: `-/y/ Z' Location: I NW 1/4 SE 1/4 16 T28N UW) ve tatio 5th arcel N : 16.28.19.944 322 Empire Builder Drive Hudson, W 54016 ( if 1.) Alt BM Description = ~d L~ _ ! /G W/t'h. ✓4, C~ 2.) Bldg sewer length If (Z" t GI~VV1~ 11 f1 ~d ~'t!lf i c? t ' SL' if VC~Xti~ :Jw~.WG~ - amount of cover = ~ ~ ~ ~ • nn nn n {'7 1 S rah ~L.~ 4- Plan revision Required? Yes o Use other side for additional information. Date Insepctor's Sig ature Cert. No. SBD-6710 (R.3/97) 3 J t~ \r f 7 N 1 ro LaiborandDepartment Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor and Human Relations tions Division of Safety 8 Buildings in accord with ILHR 83.05, WjB-Adm. GOdeh ~ , : 150UNTY ST' ' 1.1~-0 lX Attach complete site plan on paper not less than 81/2 x 11 inches in size Plan.rnust incftde`,btvr, not limited to vertical and horizontal reference point (BM), direction and %of Mope, scale or PARC L I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PAINT ALL INFORMATION r REVI DATE PROPERTY OWNER: tt!f e ~ZLAS w le- f m) -YDEQ \S S e~iuLl Z 69 EAT f~ " 1 5, jJOT Zj:~,N,R 1C~ E ( W PROPERTY OWNER':S MAILING ADDRESS. L07 # , .;8 4CK# ` E OR CSM # Z S~ l~lU ?S I DIE -D2buE `3 5 C 5mnulu S ~ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE DOWN ' NEAREST ROAD 1Z.1U~`~ ~i l~S w1 Sy,o2-Z.(~LS) ~l ZS- $lbt ~~.p~{ L~1Pllttr 8ully~ D~, New Construction Use Vj Residential / Number of bedrooms (J Addition to existing building (j Replacement [ J Public or commercial describe Code derived daily flow b IZQ gpd Recommended design loading rate-~J_bed, 2 2 9Pdft trench, gpd/ft Absorption area required Sao ' bed, ft2 S)o trench, ft2 Maximum design loading rate _-q bed, gpd/ft2 5 trench, gpd/ft2 Recommended infiltration surface elevation(s) tiotJ, S ft (as referred to site plan benchmark) Additional design / site considerations "M Ut n~ '-,J l 8 'V- 6-1 ' 8 ez) , M Iiv , Z q " or- Sfs, Fr rL Parent material ~ol_35s CsUL2 Fly' uj2.tm Llr-l~sl-or`~ Rood plain elevation, if applicable N~ ft I S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for stem ❑ S OU RIS ❑ U ❑ S ®U I ❑ S ®U ❑ S [9U I ❑ S 211 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft in. Munsell I Qu. Sz. Cont Color Texture I Gr. Sz. Sh. I Consistence IBourxiary I Roots Bed rer>~ j 0-~1 1u~1IZ3lZ - siJ Z,'~Sb m`F~- ew 1~ -S •6 Z ll-Z~ LO`1fz-31 b - s l 2`~sb:r m'F~ es _S ,b Ground 3 2,y-31 -)-S `i2 31 Sz ~J 1 esb lz m elev. ft 31-~l0 ln`22613 `3R _ _ ivP Depth to limiting factor 1z Remarks: Boring # 1-1 tz31Z - sII Z~f-s~k ~'I~►~ eW t~ .S 1.L El 2 $_zZ Z,S`,1R3/y SbeJbk 3 Zz 0 L01-t rz-6 Sze leSblz WrR- C~0s Mme` V Ground elev. R6.5 n ~~Y''11 3o-yb t - si~J lesbh m~~ _ ~z- -3 Depth to v caN niS ? S °1 o Ll M - ~I 'r limiting factor - Remarks: CST Name:-Please Print Phone: Arthur L. We erer 715-425-0165 M e ress. gerer Soil Testing & Design Service-P.0'. Box 74 River.Falls,WI. 54022 . Signature: Date: CST Number.. oo-la3-aS S-q=Ul~ 220254 PROPERTYOWNER_~`lE! SO-ftLrZ SOIL DESCRIPTION REPORT Page Z of s PARCEL I.D. # P~~Al/VG Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft in. Munsell Qu. Sz. Cont. Color Consistence Bour><kry Roots Gr. Sz. Sh. >3:Nl 0-9 10`22 ~/z - S11 Z b Bed Trench z 9 Zo tvVa W/ - s)J ZT34 h~~1 e.S Ground 3 711 Zl, ~.S`tR 0--s -Z- elev. s> cJ 1b~ h~'~. C.S - •3 ct-). 3 It. y 2 t -L/F /oyr Ua, - g . - 1 i NP Depth to limiting factor Z1o`' Remarks: Boring # o-8 t~`1r~ 3~Z si } r:4 : M g -z s o ►z 3 r s; i z f sbk ~F►- s _ s •Z . 3 Ground S 1.(-,j 1~°Sbly hiTi- as elev. i~ 3y-vcl t~~l2 6/3 ~S@12 p,,~, Np (Djg.7 ft. - - Depth to - limiting factor 5 ( Barks: -V - 07 IKIV~Tw~ 13 g # 0-7 17 Y/,- 3 x 7-~3 a 3 4 b 1~ 1 S I +7 rhw Ground e eV. c . It. 0 r 3 y ;C ~ti Cs Dept to I limiting UL, Yv'. factor r I r, ~ " Y Remarks: 3oring # around elev. it. )epth to imiting actor Remarks: - PLOT PLAN Page 3 of 3 SCALE 1"= S~)' i I W~ 3 g't4tr.H PUC mPA21I& PtPN . ~-u~ l-Ihltr b 5 ~ ~ o ~ oT cam aA.-e 3y~ 2) I JU DU i'~0M OF `3Qs::) j oily LZ 5°lo g'y ? ~N i . L1-. Ooo r3 oN 8,!k1.614, 3/tit DIA• OoQ- PlPE II ft'! w/ 3 Z ` H ~ctt Pve M r't jLeZ Pcp~ i I~ N ~0-103- 85 _ _ _ . _ zZoZg . . y (715 ) 425-Q`16-9 - CST Signature Date Signed Telephone No. CST # B- 15 00. .0000 r _ 40.86' 3 - 96 A .101 50! 3 o 6 " 1 3 'W h -13 8g x 2.5270 150' vii o o r 1 - N R c F t 88* 10 3 I ~ y ` 500.0 ► - / x I 12 I /84 20' RAI GE is , • • • ' • f 51 S \88 390.00' r B_ 50' ` 3 100' 3 W B-26 N~ 83 SaB ~ .501 AC 150' 0 2.840 AC ' 4v s 88° 10 6" - . 390.00' o La B-10 ~ ~ ~ ° ~ 150! 2-t COVED vd gov zestywdBa~dwDfvIdM Coudy • a1 1 W W Ave- P_O. Box 71&2 ST 0-(Zee I )L Mh4,~-_ 1r1 Ma~Wt 7162 SammryPamitNamber(tobcWWiabyCo.) afflms fpm to flee appmp~te Roil L b o biz za : 021 V*. Adm. Code; N'Ir MR is itq~feti t m oll~asg a saatay pc ma -Now A iii fN swoomzd rows-at PmgmAd&mpfdammun=oft tldrass) sAmilled to the Dqwftoont of ! Pw ooal irh~ you pmvido may be mod for szcondwy j/~ M $ ~tllC Lnv%a. 15 1 m State. L ~t G. L -f r l.. KJ"~. t.~ P,ape<fyO~as / Pamir Pmpa w owsees Ma~gAddim Pcapff.Y Locadw A?64 C E-eM'P 1 Q l AN C- C I Sectim a t zv Co Nombc (iry V, fu 1._1lsrqJ I IS161 ~ T 29 R a~ It. II. OJI rg Typo ofBuIldlog (check all that apply) Loth _ or2FamiIyD vUIgL-Nbmbcr ok "W" i - ; 5 +2stRYlON YN T aCity - O Stets Owncd-gnaDbeUsC CSIANUMber 0 VMw of -T 2 e~ V G - -13 !S/ L (YI C r ~Toemaf .,Z 31T_ Type afPermift (Cheek only out box on ihae A. Complete lineB ifapplieable) NZwSps6eM 0 R System 0 T " Tadcl gbMMM fO* 0 OffmModiflcxdoafoP Sya~ (~p1 ) B. 0 P=kRmtwzl OPawkRevisin 0ca,H of> ©Peam T tWWN. IastP=imPw*NuIIDeteLsaed i Befte r_Vi shin O+Mer C` IV. T ofPOWFS S (Check allthat Q NII,FMIIM2=d i7 Po=gz=d h G =wd O Az Gta k ElMowd>24 vL efsniable soa <24 ib. o€sait bICSod []Bold:--T'ak II odw (cVj=} O Device V.D" tsal/1i~eatmentAxmIofw=afio~a: Dem Flow (ppd} De sod Arda Sysk-Elevahm r4SCJ e), 4 4:5-D /it 26 Tots} p of VL Tank Info - m t s o 9 l I ~ EmtiogTasdcs a o Y a u WRWTaeta A V v, oa fi+Q 3 ~ I = Irv Sic TTc t 100C -7c-eM VII. Re~gua?a~~is Statement- >z the , assomc respo~ety fee ~ t1e P01'PES am the atlacbed puns. Pis? i (P= Ply s 5 0 $s 1ne Number I .-XFF zz.30 17. IS '66-7LI (o PI.-les Add:= (Stxee-City, SbI,.Z'P -1 J." el Pct. c Sk! S t> nt VI S 4106 (t -*M~CourrtyMepartmenf Use 04W /I 3 { ¢¢-f PecmitFee Ihic IBS s" O forDemial Is 625. ~ -6 IZ L3. Cg h one forDisapproFal S ~e- L 1. Septic tank, effluant filter and dispersal cell must all a Iteta f rpaintaia r as per management plan provided by PINM @FI j 2. Atse{backmquV,ments must be<f►1@ai hold aftrh +rnavplete syst~anasaLmirwaxeoeeg6*eap ~clem,h~ssn:llhlCfia~o J. a, "T - t`,I 2 ? c 9 1 Ull ~ S a 1 n 2 L 1 ZL- Safety and Buildings c QtirAartrE,~ 10541 N RANCH ROAD HAYWARD WI 54843 y ` Contact Through Relay p www.commerce.wi.gov/sb/ 9y ; S www.wisconsin.gov fi SIOINS Scott Walker, Governor Dave Ross, Secretary March 02, 2012 CUST ID No. 223242 - _ - -ATTN POWTS Impector - - - JEFFERY V FOX ZONING OFFICE JEFF FOX CONTRACTING & SEPTIC INC ST CROIX COUNTY SPIA PO BOX 565 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/02/2014 Identification Numbers Transaction ID No. 2060097 SITE: Site ID No. 777130 Steve James Please refer to both identification numbers, Empire Builder Dr above, in all correspondence with the agency. Town of Troy St Croix County NW1/4, SETA, S16, T28N, R19W FOR: Description: Mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1361386 Maintenance required; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.01/01), SSWMP Pub. 9.6; Effluent Filter The submittal described above has been.reviewed for conformance with applicable Wisconsin Administrative Codes V.0 and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed col 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 W?l requirements. N p 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: gE:E G Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. JEFFERY V FOX Page 2 3/2/2012 • 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. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 r' Fee Received $ 250.00 Balance Due $ 0.00 Patricia--Shandorf POWTS Plan Revie~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@wiscoiisin.gov cc: Charles L Bratz, POWTS Reviewer 11, (608) 789-7893, 7:45 am - 4:30 pm Monday - Friday 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. I I i MOUND AND PRESSURE DISTRIBUTION COMPONWT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Steve James Owner's Name: ? Owner's Address: PQ (11526AW UV v J W~ !7 Legal Description: NW1/4 SE1/4 S16 T28 N/R19 W Township: Troy County: St. Croix Subdivision Name: Glover Station 5th Addition Lot Number: 85 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title gU~1p~N 5 Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank SPpND Page 5 System maintenance specifications ~RQE Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 9 Soil Test Designer: Jeff Fox License Number: MPRS 223242 Date: 02/27/12 Phone Number: 715 755 2461 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.0 (R. 04/03) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 8344-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 450.00 Design Flow (gpd) 5.00 Site Slope 98.50 Contour Line Elevation (ft) 20.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 65.00 Dispersal Cell Length Along Contour (ft) = 6.93 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft) 1 Influent Wastewater'Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3.47 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 8.66 fe/orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 11.42 Vertical Lift (ft) 58.26 5x Void Volume (gal) 0.85 Friction Loss (ft) 66.42 Minimum Dose Volume (gal) 16.82 Total Dynamic Head (ft) 28.00 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 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) Mw-t Filter Manufacturer 16.70 Dose Tank Volume (gaVin) te"i ht Filter Model Number Wieser Manufacturer )rj Project: Steve James Page 2 of 9 Mound Plan View B . J 1/10 +777 Observation Pipe - I K {j} A W B L Mound Component Dimensions A 6.93 ft E 20.16 in H 1.00 ft K A24.27 ft B 65.00 ft F 9.50 in z 10.49 ft L ft D 16.00 in G 0.50 ft J 6.85 ft W ft 450.45 (fe) Dispersal Cell Area 1132.15 (ftz) Basal Area Available 6.92 (gpd/ft) Linear Loading Rate 6.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.63 (ft) ♦ H G j I F Dispersal " 100.33 (ft) Lateral Cell 99.83 (ft) Invert Dispersal Cell Elevation D = -•1 !tA~ s~~ J. s , tip. "9".5'0 (ft)~Conto', ~ . ur Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key a a T Dispersal Cell See lateral details on 7(T Page 4 for number, size, 1❑ ® Topsoil Cap o a 1.5 ft andspacing of laterals. 2❑ Subsoil Cap c ASTM C33 Sand t° Laterals are equally F spaced from the 0.5 ft Typical Lateral Tilled Layer a distribution cell's © M Aggregate c centerline in the A distribution cell (AxB). Project: Steve James Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered ovw tha A & 8 dOwnsion *a Turn-u p W bail vaNo or olosnout plug AN Laterals ate sdwmcal If ?4 holes dried on the t+aeom of the tatevN 5 epuaft spaced Fordo mein tOM4Mion via too of (:foss to mamfok) at a" poim Laterals & Fotce mam od PVC Sch 40 (per COMM Tattle 84.30.5) Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.54 ft Lateral Length (P) 63.50 ft Orifices per Lateral 26 Lateral Spacing (S) 3.47 ft Orifice Density 8.66 fe/orifice Lateral Flow Rate 14.00 gpm Manifold Length 3.47 ft System Flow Rate 28.00 gpm Manifold Diameter 1.50 in Total Dynamic Head 16.82 ft Forcemain Velocity 2.86 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - ► 1~ Comm 66.28 WAC 4 in. min. Disconnect Tank component is properly vented F- Altemate outlet location Forcemain diameter Wieser Manufacturer 2 in. Capacityl 600.00 Gallons -T- Volume 16.70 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 18.95 316.48 B 2.00 33.40 C Pump off elevation (ft) C 3.98 66.42 88.92 D 11.00 183.70 D Total 35.93 600.00 IF- Dose tank elevation (ft) edding under tank. 88.00 Alarm Manuafacturer Se tronics Alarm Model Number MJJ 2501 Pump Manufacturer Zoeller Pump Model Number BN 151 Pump Must Deliver 28.00 gpm at 16.82 ft TDH Project: Steve James Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Jeff Fox Phone 715-755-2461 POWTS Regulator's Name St. Croix C Zoning Phone 715 386 4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450.45 ftz 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 Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ondin and seepage once eve 3 ears Other 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 mound component manual. ry f1'...........1 11 i......w I- r.......... OA 9n /C\/•\ \AP.. AA- t--.4- 1W . viaNci Jcu ca,, aggregate wii ~ w vvn n v r. rv \'J/\lh IF r ia, nun 1. vvvc. 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 Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Steve James Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L 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 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continuency 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Steve James Page 6 of 9 W w 2 PUMP PERFORMANCE CURVE LL MODEL 151/152/153 TOTAL DYNAMIC HEAD/FLOW 50 PER MINUTE 14 45 153 EFFLUENT AND DEWATERING 12 40- 35- MODEL 151 152 153 x 10 152 Feet Meters - Gal. Liers Gal. LRers Gel. Liters 30 5 1.5 50 189 69 261 77 291 0 8 25 151 10 3.0 45 170 61 231 70 265 15 4.6 38 144 53 201 61 231 6 20 20 6.1 29 110 44 167 52 197 25 7.6 16 61 34 129 42 159 4- 35 10.7 15 aSht41-offHead: 9.1 - - 23 87 33 125 10 12.2 - - - 11 42 2 30 R. IQ 1.1 38 iL (11.6m) 44 R. (13.4m) 5 0 0145088 10 20 40 50 60 70 GALLONS 80 90 100 LITERS 0 40 ---120 160 200 240 280 320 360 FLOW PER MINUTE 014508A Model 151 Models 1521153 67132 61/4 • Timed dosing panels available. 37/8 4 518 3 27132 4 518 • Electrical alternators, for duplex systems, are available and supplied with an alarm. 43 7718 3322~7/W • Variable level control switches are available for controlling ® 37/a 327r32 single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Cwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 11 11116 121/8 15111521153 MODELS Control Selection Model --V b Ph Mode Am a Sim lex Duplex k1-51 115 1 Non 6.0 1 2or3 4318 5118 BN151 115 1 Auto 6.0 Included 2.0 3 E151 230 1 Non 3.2 1 2 or 3 BE151 230 1 Auto 3.2 Included 2 or 3 SK2444 SK2064 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 -BE-152 230 1 Auto 4.3 Included 2 or 3 N753 115 1 Non 10.5 1 2or3 6N153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2 or 3 1E153 30 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float A CAUTION switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: P.O. BOX 16347 Z ® Louisville, KY 40256 0347 Manufacturers of.. SNIP T0: 3649 Cane Run Road Louisville, KY 40211-1961 50 http://www.zoollercom PUMP !O_ (.21778-2731. 1(800) 928 PUMP QvaurrP~1,PSSvcE 194!9 FAX (502) 774.3624 © Copyright 2004 Zoeller Co. All rights reserved. 3 ~ r ~y r ` N Iz ;y r 5 1 4ZI rid A U ~ A C7 w ch ~ ~~aa oL z U t~ C3 C9 ww0 - W C~li U- s ti (16 ~rfe $ mmm~ IN so 01 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer S d Mailing Address ( ,6QM i 111) -IL), ws /t) t,,/ t a '-Ioi --71 Property Address _ v2 ~ T G 3Z2- 1 re- B to t I r t J e 1Q (Verification required from Planning & Zoning Department for new co struction.) City/State tluOSOIv Parcel Identification Number tDESCRIPTION q _ 12~y R 1 W, Town of lig Property Location N t/4 , Sec. , T Subdivision Plat:' 5 U ~3 D Lot L.6U`~r2 Sf ►`~~'I v Certified Survey Map # , Volume , Page # Warranty Deed # / 5 2667 (before 2007)Volume , Page # Spec house yes j"K01 Lot lines identifiable 1/yes 7.1 no SYSTEM 112AINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a ty deed recorded in Register of Deeds Office. Number f bedrooms 37 SIOTqATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09/07) 1f4'4THE SW 1 i4 SE 1L4 OF $it. V4, THE w rm nra ' THE SW 1/4 OF Tip SE 1/4,. X 1 1/4 OF HE F S ~4 TKE SE 114 OF THE NE 1/4 a SECTION 46, 12M, R1 , t, C1SN OF TROY, ST. XIX uOhl'TY WISCONSIN. r r { 6' - 1 ' f ; 70 / x SOV.E1i19TA1- FM EDTA y~ j y %J IV L6GITILPr IIIAP I M12/1n Cf *LW U. R7 , j 114 t WSK `27a7a4t\~ N erwx SCALE N FEET 73 ZU I' M MOO 1 t - Ulf M, It v , r Cs \.~.~~•A 1 111 , 1 0 75 150 20 45C 4 ~ 5 ru LEGEND I f r ~6 I 93 ( y7j 3 r W / 306 ii i i ! +ri I L'70 4GE3' ary $ y - QUII[ WIN mw nuoi', KIM rrt Um, to rx, no }n t am uc ? n 4 uwlu na, wa 3 N arxr ! >~v a to -by n[x v+ arr r. r110 PFK, fw. - ' r W4➢77 V. I C I ' N«'+4 x•Ir u4lp 1plOt. LOT I., 75 , ® nc a ,ic 85~~ if r u u ane ut m~ea z7uNao % a r'°"~' ' un. r. N ,a' r r H•mlrut[wnKrrµXt~a+1n_ n , - +7 b >,r. s 94 Iv 95 V. r - ~p J 6 - - re,X ncs u uuc «a~ar qeu[~j m to Nt n Al JIM, U0~ 1 ~ ~ ~ ~ ' ~ $ L wlwr v.. ~ ' ~ a7»~u ` ^ u°~Jrr areeA>ranm~ t,«w+cM r tua. X *w 0 1 17rOp M• C 7Rtl C -1 ~ -0 ~ ~ } i f $ M T..,:_>aµ,n u~nm i>o ~tao Kro A.o G UUS w+ml. ~y~ V ~ 4.N i C 700®WovYalg4 32879~D 3 \ `unortra / `84 a r ^i b ..m~oera,wwRm+ o~n u J N ` i 4 m t 0411040 CWTO 1Mn. mn ra WAIL No A 8 f u ar, nAUrauoertlr m«Aaauo« )<OT m 1 k ' ~-,r , { N°" R - O3 ac as Npzu1 a M/ ua 91V V k"s ---aw v o iq4, u4a 74 Naa 114 V* 7 76 ' n ~r $ X3rNrx A 7aor 1 'u° ooa AS ~aw«1wu~ m1«MnWAx I. 7a A ri7]f~ ~ 1: {ML 40lS ' b' •p $ ` 1 ' ~ ~ ~ ~,,,~,•OY.NM[GnOR, IHEHOf YGN; - ' mnau~ 83 y ~9697-~ _..~csvsncal „cManrdw M,NarMam. 3 N yA lsr t 0Wu isv" MIX V : 9 wo 4.11 al ~h _ d cat= 4 t Nl Jl j r roar 1 4+7yN IRrPLAi E ANDS } N Irm a r alum 7,4 • b+tt: K[ i KNt MMIeOrtO «A r« A (N[1i IX Xu07gA C1 Q~ _ NSA Mo kt;MluM Xo[11«YGtR~tt11t51- l 1 me Q r!KIttna1 woaM4w~>tsl - ~ u xt. _ 1. at Nwflr « w M> u 5nucy~xe 1r« el~}, I + I__ r + ]a. NY1«mP1NL. CK.. bm pa x 8 CNITT A - - t % Kun na r bn~aC _°r n, oat X" 0 ~ y. 49 6ETAL OF LriNYEWAY DETA1 OF DRIYEWAY EASEuENT I-'rord Art 5F. FOR LOTS 73 AR 74 FOR LOTS 76 d10 17 ~l r ~ o°° w nr k L r AtUT7 w w+rro. nun ~a75u l9tr~ r ' i e°ui ecu moot, . Sr 75 i @CYE r . 5C 7ur uaar. Nort X, , nix 74 73 Icy 100 9.'~. `-1 1 1 tW 77 '7 102 a711 3!. 11' 47u u \ = f I ~ y Tr- : i F 104 ,R !0~ g7a6) 17 A f 4~ x `x, w~ iIWhTTEO LA'~`~ ~-wvuNd4~~Mdt~{F~,"~'~,. 'tit OPP, / 47 AC ! t r~ ~ ~ 1 i ~ 1 it ~ ~ ~ ~ ~ ~ - I Q , . 5 ? 2.525 150 000, - - - r S 88' 10' 3 1 500. 00 0. 12 _ 4• S '88M0' 36" EC13 \390.00' o W 8-11 50 CL -.f e l • 4A O_t MO ~ W Sal o f vs 1 AC 150' ! ~ v ~ 4t• Ole~a J 12V - ro )x1oN- it 88.10' " E 390.00' N 8-10 7 \ a 5d 15,; 8 50 c 1oG' / r ! : 18.;1 r 2 B- 15 ,i t a 204.9' ~ t6 ;36 40.86' 3 '~~58 2 1 : ► 5' 0' ~l r tr t 0' 3 Q i, Ir 1 . to . _ 2.510 AC v, 3e w h 1 B-2 j' rte: PGA S 88' ' 36' •E - / ' i ~ ~ .fir`"-'- / • • N ~°~,r r • 1 J 0 • O ! _I / ' A X11 a f i l O i 100 A rit , I . - - , /o 2-4 I ~ 524 ' ~O-.,••I 20 RAIN GE EA MEN S O 20.5& • - - / of i in • ` w••••.. G 3.03' 50, 1 50M ib B-2 100' / n B-26 a I i7 Via.: N i7 cl) 3 50'_ 2.840 AC 2.511 AC N E)R 1 O to e o 2.501 AC I r ~ i, 0 ONE II Il lllll111111N1111111111111 8 0 5 1 0 2 4 Tx:4037961 Document Number WARRANTY DEED 952087 BETH PABST THIS DEED made between Brushy Mound Partners, LLP, a REGISTER OF DEEDS Wisconsin Limited Liability Partnership ("Grantor") and Stephen C. ST. CROIX CO., WI James and Diana E. James, husband and wife, as survivorship 03/07/2012 3:22 PM' marital property ("Grantee") WITNESSETH, that the said Grantor, for valuable consideration EXEMPT#: NA conveys to Grantee the following described real estate in St. Croix REC FEE: 30.00 County, State of Wisconsin: TRANS FEE: 210.00 PAGES: 1 Recordin Area Lot Eighty-five (85), Plat of Glover Station Fifth Addition in the Name and Return Address Township of Troy, St. Croix County, Wisconsin ' 040-1266-40-000 (Parcel Identification Number) This is not homestead property. Dated this 2nd day of arch, 2012. ~ S ` na a ck ae R. AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this 2nd day of March, 2012, the authenticated this day of 20_ above named Michael R. Stevens and Ronald L. Derrick, as partners of Brushy Mound Partners, LLP, a Wisconsin Limited Liability Partnership to me known to be the persons signature who executed the foregoing instrument and acknowledge the type or print name same. TITLE: MEMBER STATE BAR OF WISCONSIN (if not, /f/1/L y y (rte V~ authorized by' 706.06, Wis. Stats.) signature ^ type or print name rL II L ' L ayl ~ ~ THIS INSTRUMENT WAS DRAFTED BY Notary Public St. Croix County, Wisconsin. _ A Y Michael R. Stevens My Commission Expires: i2 ;;f`;"r ' Brushy Mound Partners PO Box 445 'Names of persons signing in any capacity sVOCT11 bb; Q~ New Richmond, WI 54017 printed below their signatures. jj.B 1 of 1