HomeMy WebLinkAbout014-1017-80-000
county: St. Croix
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM SanitaPrylan PermID No:
Permit No:
Safety and Building Division INSPECTION REPORT 563851 0
GENERAL INFORMATION (ATTACH TO PERMIT) State
Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Parcel Tax No:
Permit Holder s Name: City Village X Township 014-1017-80-000
Anderson, Andrew F. Forest, Town of
Section/Town/Range/Map No:
CST BM Elev: Insp. BM Elev: BM Description: ^ 1 08.31.15.118
1/•`!J` ELEVATION DATA
TANK INFORMATION
FS 'Ob
MANUFACTURER n t CAPACITY STATION BS ELEV.
TYPE q/HI
G J U Benchm
ark
Septic D , 11 ~ I Q~
J
;1 yz
BcsTR'9 Alt. BM
8 Gam' Bldg. Sewer
~s
Aef*M J o YAP
D&Ie St/Ht Inlet r,
SS
Holding
St/Ht Outlet ,y yZ
TANK SETBACK INFORMATION
TANK TO R UL WELL LDG. Vent to Air Intake ROAD Dt Inlet . tJ A/Z
a C- Dt Bottom $7
Septic $7 2 1 I /Z
Dosing ~J Header/Man. 3
9s.G
ration Dist. Pipe f j 5
Bot. System
[HIding
• G
Final Grade its
PUMP/SIPHON INFORMATION Y
A
Manufacturer Demand St Cov~if
G GPM f(~I
3 ,i C 60.
Model Number ZF
~ • TDH L
ift ` ystem H TDHForcemain Leng
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Qf~Trenc PIT DIMENSIONS No. Of Pits Inside Dia Liqui=pth
DIMENSIONS 7 116 P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK SYSTEM TO F CHAMBER OR
INFORMATION Type O~tem: 346/ 5~ y~ I UNIT Model Number:
DISTRIBUTION SYSTEM d 1i, x Hole S acin l Ve o Air Intake
Header/Manifolf Distribution x Hole Size _ pg QS ✓
/ L Pipe(s) Z
3
Length ~ Dia ~ J Length Dia It 5 Spacing 5"
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only xx Mulched
Depth over xx Depth of xx Seeded/Sodded
Depth Over Yes No
Bed/Trench Center Bed/Trench Edges Topsoil ' Yes No
/ Inspection #2:
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Z,6 1-13 ..1'
Parcel No: 08.31.15.118
Location: 2711 CTY RD Q~CI~Iar Lake, WI 54005 (NW 1/4 NW A 8 T31N R1 5W) 40 acres Lot
ttit~,25 a ~
1.) Alt BM Description = / Dw r J✓t~
= ~ eafi~~, 01I` A~ v~
2.) Bldg sewer length A
- amount of cover = r f
Plan revision Required? Yes X No E-7
Use other side for additional information. 1 Insepc s Signat Cert. No.
Date
SBD-6710 (R.3/97)
X ~jyl a i ~C
Am. U County
~4 f ' Safety and Buildings Division ~ - C Q d
201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) pSI Madison, Wl 53707-7162
P 56 3 ~S 1
State Transaction Number San' Permit Application a a 5~9 -7 &3
In accordance with SPS 383.21( 1 Code, submission of this form to the appro,% ttal unit
is required prior to obtaining i pe ' . Note: Application forms for state owned POWTS tad to Project Address (if different than mailing address) the Department of
S essi Servies. Personal information you providq/rp IT be used for se .Mary
purposes in actor e " c Law, s. 15.04 lxm), Stats. UU -0
~Y~--- 1. Application fiJiniffiativK_ -Please Print All Information Z -Z-7711 Property Owner's II A) ST CR Parcel # L l
Property Location Property Owner's Mailing Address
3 -7 Govt. Lot ~ t)
City, State Zip Code ~ Phone Number J w ya A44t./ y., Section 0 ~S
LEA l00 ~~S"c~~ 'o~~lua T N, R 1 c1Eon~w H. Type of Building (check all that apply) Lot #
Subdivision Name for 2 Family Dwelling - Number of Bedrooms
1 G CA G Block #
❑ Public/Commercial - Describe Use _ ❑ City of
CSM Number ❑ Village of
❑ State Owned -Describe Use J 'Town of -rU ?_E 577
III. Type of Permit: (Cher i A. Complete line B if applicable) A. C1 New System eplacement System El Treatment/Holding Tank Replacement Only ❑ Other Modification
to Existing System (explain)
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal 11 Permit Revision 11 Change of Plumber El Permit Transfer to New Before Expiration Owner
IV. Type of POWTS S stem/Com onent/Device: Check all that apply) O tj
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil i&' Mound < 24 in. of suitable soil
❑ Holding Tank ❑ er Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rat gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
S . Q
0D ,6) 112-5 2.~
VL Tank Info Capacity in Total # of Manufacturer w Gallons Gallons Units n 2 ° U
New Tanks Existing Tacks c U -
LC r- J _ . a. U rn rn v. C7 G.
Septic or Holding Tank U <_1 l O LVO ' iCJ C_L__T_r y-k-
Dosing Chamber / U u V
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signa a MP/MPRS Number Business Phone Number
_Z~ (E,L-r- c-~►q e ~1~~ tS~~ ado
Plumber's Address (Street, City, State, Zip Code) ~S 7 / - SD 9
w 4 1/77 / 7~7'f ,4v6 Tu tTtz 1,4A
VIII. Coun /De artment Use Only
X-1Cpproved ❑ 1sa ve Permit Fee Date Is ed Issuing A t Signature $ G 7,5 ' 'Z--) 7 z-- L3
❑ -ven eM r€er Denial IX. Condit- #yeasons for Disapproval r6,)
6J. 1 atQ i 1. Septic tank, effluent filter and 3 e A5 1
dispersal cell must all be services I maintained t t/ ~tn`'S e
as per management plan provided by plumber. G 6 2. AN stack 'requirements must be maintained L~
es , icabiscode /ordinances. q 61A dirt,, tXA Attach to complete plans for the system and submit the County only on ppr not less than 81/2 a I l inches in size
Ga cti ,
SBD-6398 (R. 11/11) .~10 r Gh Y4
/1101,,.", A- l J T
INA SEPTIC SYSTEMS
MPS/CST 824825
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;A b ~ I 61
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~~A.RT.NF 1 DIVISION OF INDUSTRY SERVICES
10541N RANCH ROAD
HAYWARD WI 54843
Contact Through Relay
(3 ! S www.dsps.wi.gov/sb/
P S www.wisconsin.gov
-461
JUL 9 Scott Walker, Governor
l 9 13 Dave Ross, Secretary
C/?C~X cD~NN
May 30, 2013
CUST ID No. 824825 ATTN. POWTS Inspector
BOB J HARDINA ZONING OFFICE
HARDINA SEPTIC SYSTEMS ST CROIX COUNTY SPIA
477 170TH AVE 1101 CARMICHAEL RD
TURTLE LAKE WI 54889-9187 HUDSON WI 54016
CONDITIONAL APPROVAL Identification Numbers
PLAN APPROVAL EXPIRES: 05/30/2015 Transaction ID No. 2252763
Site ID No. 791142
SITE: Please refer to both identification numbers,
.
Andrew Anderson above, in all correspondence with the ac
2711 CTH Q
Town of Forest
St Croix County
NW 1/4, NW 1/4, S8, T3 1N, RI 5W cot4D~
FOR: AP
Description: Mound, 3 bedroom residence
Object Type: POWTS Component Manual Regulated Object ID N 1430086 EP-T QF
Maintenance required; Replacemen 450 GPD Flow ratexin Soil minimum depth to limiting factor fro ESS'
original grade; Syste : EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Man~OF
Ver. 2.0, SBD-10706-P (N.01101, R. 10/12), SSWMP Pub. 9.6; Effluent Filter DIVIS10t4 OF 1
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above.
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code SEE C
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Key Item(s)
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• The 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.
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.
BOB J HARDINA Page 2 5/30/2013 1 y
• 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.
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 Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
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
This Amount Will Be Invoiced.
When You Receive That Invoice,
Patricia L S and rf Please Include a Copy With Your
POWTS Plan Re ' r,-Integrated Services - Payment Submittal.
(715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633
pat.shandorf@wisconsin.gov
cc: Charles L Bratz, POWTS Reviewer II, (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 Industry Services (formerly
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
"SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
BOB J HARDINA Page 2 5/30/2013
• 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.
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
constriction/installation/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
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
This Amount Will Be Invoiced.
When You Receive That Invoice,
Patricia L Shand rf Please Include a Copy With Your
POWTS Plan Re ' tegratedServices------- - Payment Submittal.
(715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART Code: 7633
pat.shandorf@wisconsin.gov
'dc- Charles L Bratz, POWTS Reviewer H, (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 Industry Services (formerly
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
'SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
EZflow® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: ANDERSON
Owner's Name: ANDREW ANDERSON
Owner's Address: 2711 CTH "Q"
CLEAR LAKE W1 54005
Legal Description: NW,NW,S.08,T.31N R 15W
Township: FOREST
County: ST. CROIX
Subdivision Name:
IfONALLY
Lot Number: Block Number: ---------TROVED
Parcel I.D. Number: 014-1017-80-000 SAFETY AND
)NAL SERVICES
S RVICES
Plan Transaction No.: IDUS
Pagel Index and title
Page 2 Data entry
Page 3 EZflow mound drawings lyp CE
Page 4 Lateral and dose tank RRES
Page 5 Distribution media
Page 6 System maintenance specifications 5~7 co 3
Page 7 Management and contingency plan'
Page 8 Pump curve and specifications
Page 9 Plot Plan
Page 10 Filter Maintenance
Page 11 Soil Data
Designer: ROBERT HARDINA License Number: 824825
Date: 05/15/13 Phone Number: 715-986-2508
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, R. 10/12)
EZflow Mound Version 3.0 (R. 3/1/12) Page 1 of 11
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) r Residential or Commercial Design
300.00 Estimated Wastewater Flow (gpd)
1.50 Peaking Factor (e.g. 1.5 = 150%)
450.00 Design Flow (gpd)
5.00 Site Slope
93.42 Installation Contour Line Elevation (ft) 120.00 Contour Length Available (ft)
16.00 Depth to Limiting Factor (in)
0.40 In-situ Soil Application Rate (gpd/ft)
Distribution Cell Information
7.00 Cell Width (ft) ,3, 4-5 6, 7 8 9 or 10 Only 65.00 = Dispersal Cell Length (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft2)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(c or e) a Center or End Manifold
4 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)
2.00 Estimated Orifice Spacing (ft) = 7.11 ftz/orifice
2.00 Forcemain Diameter (in)
60.00 Forcemain Length (ft) Does the forcemain drain back? ~Y
82.00 Inside Pump Tank Elevation (ft) Enter Y or N
0.00 Forcemain Filter Loss (ft)
4.55 System Head (ft) x 1.3 9.79 Forcemain Drainback (gal)
12.59 Vertical Lift (ft) 58.31 5x Void Volume (gal)
1.50 Friction Loss (ft) 68.10 Minimum Dose Volume (gal)
18.64 Total Dynamic Head (ft) 34.46 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
Gallonslinch Calculator (optional)
Treatment Tank Information 627.00 Total Tank Capacity (gal)
1000.00 Septic Tank Capacity (gal) 42.00 Total Working Liquid Depth (in)
huffcutt Manufacturer 14.93 gal/in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
627.00 Dose Tank Capacity (gal) BEAR Filter Manufacturer
14.93 Dose Tank Volume (gal/in) 10~ Filter Model Number
huffcutt Manufacturer
Project: ANDERSON Page 2 of 11
Mound Plan View
T
. . . J
;1/10 B
Observation Pi
l. pe
K A
5
.
I
.
_L L
Mound Component Dimensions
ft
A 7.00 ft E 24.20 in H Aft ft K Aft
B 65.00 ft F 12.00 in 1 ft L ft
D 20.00 in G 0.50 ft J W 455.00 (ff) Dispersal Cell Area 1261.76 (ft) Basal Area Available
6.92 (gpd/ft) Linear Loading Rate 6.50 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
EZflow Dispersal Area
Finished Grade 97.09 (ft) 00
,.,,,.,,i ♦ H
G
I F t " Dispersal Cell 95.59 (ft) Lateral
95.09 (ft)-6. - 6" Invert Elevation
Dispersal Ce:.-
D
Elevation
93.42 (ft) Contour Elevation
5.0 % Site Slope
Typical Dispersal Cell
Shading Key See Page 5
V
2 Topsoil Cap a
a Subsoil Cap o •Q 7 Approved Geotextile Fabric Cover
y c 2.0 ft
ASTM C33 Sand m :e . r.f;e• I
4 Tilled Layer
5 EZflow Media °
cn 0 0.5 ft
-4 - 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.
Project: ANDERSON Page 3 of 11
End Connection Lateral Layout Diagram .
Place Appropriate Lateral Diagram From Right Below
Turn-up vdball valve orcleanoutplug
P
Z -31 1 st orifice located at Z If X--}` Orifices point up except every 5th S
one points down for drainage.
Force main connection via tee or cross to manifold at any point. Laterals & force main of PVC Sch 40
AN laterals identical with orifices equally spaced. per SPS Table 384.30-6
Number of Laterals 2 Orifice Diameter 0.156 in
Lateral Diameter 1.50 in Orifice Spacing (X) 2.05 ft
Lateral Length (P) 64.28 ft Orifices per Lateral 32
Lateral End (Z) 0.73 ft Orifice Density 7.11 W/orifice
Lateral Spacing (S) 4.00 ft Manifold Length 4.00 ft
Lateral Flow Rate 17.23 gpm Manifold Diameter 1.50 in
System Flow Rate 34.46 gpm Forcemain Velocity 3.52 ftlsec
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and No 1111~~~~
SPS 316.300 WAC 4 in. min.
Disconnect
Tank component is properly vented 'E Alternate outlet
location
Forcemain diameter
huffcutt Manufacturer 2 in.
Capacily. 627.00 Gallons T
Volume 14.93 gal/inch A
Weep hole or anti-
Dimension Inches Gallons B siphon device
A 23.43 349.88 C
B 2.00 29.86 Pump off elevation (ft)
C 4.56 68.10 83.00
D 12.00 179.16 D
Total 42.00 627.00
Dose tank elevation (ft)
Bedding And Backfill As Per Manufacturer 82.00
Alarm Manufacturer SJE RHOMBUS 1
Alarm Model Number 101
Pump Manufacturer ZOELLER
Pump Model Number BN 152
Pump Must Deliver 34.46 gpm at 18.81 ftTDH
Note: Switches containing mercury may not be used in this system.
Project: ANDERSON Page 4 of 11
Uflowe Distribution Cell Media Layout
7A0 Cell Width (ft) 1.50 Sidewall to Lateral (ft)
Distribution Cell Cross-section Arrangements
7 ft Wide
Component Legend
® SR1JA 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 @XM SR3-12H in 5 ft or 10 ft lengths
Q 4" Perforated Distribution Pipe With Pressure Lateral Inside
Turnup Enclosure - - - - - Pressure Lateral
Bundles are covered with approved geotextile fabric as per the their product approval.
Distribution Cell Plan View Layout - Typical
7.00 Cell Width - A (ft) 65.00 Cell Length - B (ft)
Center Connection Lateral Layout Dia rain
Force Main
7 ft Wide
End
Manifold
Page 5 of 11
Project: ANDERSON
Mound System Maintenance and Operation Specifications
Service Provider's Name ROBERT NARDINA EEEI Phone 715-986-2508
POWTS Regulator's Name ST CROIX ZONING Phone
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 455 ft2 Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 ML
Service Freauency
Septic and Pump Tank Inspect and/or service once eve 3 ears
Effluent Filter Inspect and clean as necessa at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test periodically
Pressure System Laterals should be flushed and pressure tested eve 3 ears
Mound Ins ect for ondin and see a e once eve 3 ears
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, 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 SPS 384, 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 • . • •
Threaded Cleanout
6-8" Diameter Lawn Plug or Ball Valve
Sprinkler Valve Box
Lateral Ends at Last Orifice Where
Variable Length Cleanout Begins
Long Sweep 90 or Two
45 D ree Bends Same
Diameter as Lateral
EZflow S nthetic Media 1.95 Feet
Distribution Lateral - Lateral Cleanout -
Project: ANDERSON Page 6 of 11
Mound System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals (EZflowMound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101) 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 SPS 383.33, 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 fifter 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 filter when removed from its enclosure. If the fitter is equipped with an alarm, the
fitter 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 o 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, ft 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 BOD5, 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.
Project: ANDERSON Page 7 of 11
tY
W W PUMP PERFORMANCE CURVE
u-
MODEL 15111521153
50
14 45 153
12 40-
35
U5 10 152
30
Q
a 8 25 1.51
6 20
15-
4-
10-
2- 5-
0
10 20 30 40 50 60 70 84 90 100
GALLONS
LITERS 0 40 80 120 160 200 240 280 320 360
FLOW PER MINUTE 014508
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9Z8VZ8 .LSD/", d1I
SWgISAS 3LLdgS VNICIgVH
ONSf~
FILTER CARTRIDGE INSTRUCTIONS
_200'9 /TM
Installation
STEP 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.
STEP 2 While the case is still dry fitted on the outlet pipe, measure the length
of 34-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.
STEP 3 For installations utilizing the optional supplemental side support:
solvent weld the V4-inch pipe onto the filter case. If side support method is not
utilized, proceed to step four.
STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter
cartridge into the case, pressing down until the filter locks into the bottom of
the case.
STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning
clockwise 900.
Maintenance
1. The effluent filter should be cleaned every time the septic tank is
serviced.
2. Open the outlet access opening to inspect the tank and filter. ry, : *,,1~ y"
3. Pump the septic tank completely, making sure to remove the sludge k4 r } .c,
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
cartridge from the case.
r. .
5. Slide the cartridge up and out of the case for cleaning.
6. If a VRS switch connected to an alarm is present, the switch y
should be removed by turning counterclockwise 900 and cleaned,
with water only.
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.
8. If VRS switch is utilized, replace by inserting into filter and '
turning clockwise 900.
9. Insert the filter cartridge back into the case, pressing down until
the filter locks into the bottom of the case. K"
10. Replace and secure the access opening on the tank.
BEAR ONSITE " FILTER CARTRIDGE F"iVE-YEAR. LIMITED WARRANTY hon .f:e. ;fare ret
(,,tar r~nsrte `'filter nr>noges are evarrante.[i to ne fieii, of defe=ety ul olaL gnat and 1; rrkol inl,hrp for ti,¢) y'r.~ r,
BEAR ONSITE111 Filter Case -Lifetime, limited Warranty
Befa ")rsde wai rarlt9 the filter case will he; free of detects in latH11,11 1' d kir l,+sfl{p dUrTg norrnril ul,tr lot the Ir i i';:d of how
they ne}.ttal purr•h a,: lw s the prodw t.
it z tote :t is fonricl in nofm7t se, Rear Onsrte will ,at its Q(ecilon, leptiu };rover t i replaeu meilt l.a(t or product. ) nr eke.
arp or rate arllust me1nt Damage to .t f roduct r,iu cd by .ar udent, mist ni, abuse r5 nuet coveted C'ey tins + art lnty Improper
void the warr.arcti oi, 1'; scrlhnq firm) amts not rn_>tahed, Caper atui, of mauatamed m a rdancr With insU Ur trons IrroV dec., vJdl
- nry f ,>ot of hair hale roe crlnal safes te,_erpt most be provided to Beat Onsde gait at! warranty CI our Lear
,_")SItu rit re- 1 tensible for Iabot r_hu re^5: rem,lval ,ha,gi' a %tallEal rte ~ r u'I'dental of cons Lqw"-n' I cO sC.
ire t 'Pill shall the iiAU' ty of I.rila1 Grtsite t.xr'eed
U"., ) 1 e I,er I the ,,l duet } e
rr ~I i
7
' q W111"W
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Pc, v
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer A N,P Rk W &
Mailing Address -271/ Cou wr o UfAt~ l.Ake tut S6.,5-- i'fProperty Address _<a1kh-9 .
(Verification required from Planning & Zoning Department for new construction.)
City/State- Parcel Identification Number a IO17 - 000 1
I.~IKc l~l piy-tor -90-oeu
LEGAL DESCRIPTION
W /v
Property Location NW '/4 , Nt,J 1/4 , Sec. T 3 i N R_S W, Town of F 2c'S I
Subdivision Plat: d-cluv , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # (before 2007)Volume , Page #
Spec house ❑ yes o Lot lines identifiable C] yes ❑ no
SYSTEM MAINTENANCE 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.
I/we, 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. I/we am/are the owner(s) of the
property described above, by virtue of a warranty dee recorded in Register of Deeds Office.
Nu ber of ed oo , j
p~ /.2/ /'aoa
SIGN T RE 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)
DOCUMENT NO. QUIT CLAIM DEED 63.61 1
Vol. 1574PAGE REGISTER OF DEEDS
ST. CROIX CO., WI
Felicitas V. Anderson quit claims to Andrew F. Anderson the following RECEIVED FOR RECORD
/
J _
described real estate in St. Croix County, State of Wisconsin: 01-10-2001 2.30 PM
QUIT CLAI11 DEED
'T% tY EXEMPT # BM
CERT COPY FEE:
COPY FEE:
The West Half of the Northwest Quarter (W1/2 NW114), Section 8, Township COPY FEE FEE:
31 North, Range 15 West, St. Croix County, Wisconsin. RECORDING FEE: 10.00
PAGES: 1
This deed is given by and between the parties pursuant to the terms of the
Findings of Fact, Conclusions of Law and Judgment of Divorce, held before L J t a,,. GQ kcx :y r is rc
Honorable Scott Needham, Circuit Court Judge - Branch III, in the City of Hudson, 5 cro u 5+~~'N~
Wisconsin, on December 20, 2000. ao 8 4 S
o $c„t 33'7
DSceola W I .S ItCdto
014-1017-
014-1017-90
Parcel Identification No.
This is homestead property.
Dated this 201" day of December, 2000.
Felicitas V. Anderson
ACKNOWLEDGMENT
State of Wisconsin )
) ss
St. Croix County )
Personally came before me this 20 day of December , 2000, the above named ' to me known to be the person who executed the
7 ing instrument and ack wiedge the s e.
Molly E. Gale V rick - 010 1442
Notary Public, ate of Wis nsin
My commission s permanent.
This instrument drafted by:
Attorney Molly e. GaleWyrick
LUDVIGSON & GALEWYRICK, S.C.
208 Cascade Street, P.O. Box 337
Osceola, WI 54020
Wisconsin Department of Commerce SOIL EVALUATION*ORT Page / of3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. e &un
ROM
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 14 1017-
80-000
include, but not limited to: vertical and horizontal reference point (BM), direction aft .percent slope, scale or dimensions, north arrow, and location and distance to neareslp"fi
Please print all information C Re ed by Date /I
Personal information you provide may be used for secondary pu s cY Law, s. 15.04 (1) (m)). I d9
Property Owner Property Location
r) W
ANDREW ANDERSON Govt. LotNW 1/4NW 1/4 S08 T31 N R15 o■
Properly Owner's Mailing Address Lot # Block # Subd. Name or CSM#
2711 CTH "Q" N/A WA NA/
City State Zip Code Phone Number ity ®viIlage [H ]Town Nearest Road
CLEAR LAKE WI 54005 775-263) 2162 EST
El New Construction UseD Residential ! Number of bedrooms Code derived design flow rate GPD
El Replacement 17 Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ft
eneral cwmmen s r17it/1~ y '~U Z r' Q Shc M in&YLc/
nd recommendations:
1 11 Boring 16
❑ Boring # Ground surface elev 93.25 t Depth to limiting factor in.
Soil A lication Rate
Pit
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
1 0-12 1 OYR3/3 -0- SIL 2MSBK MFR W 1 M .6 .8
10YR4/6 -0- CL 2MSBK MFR CW .4
3 -25 10YR4/6 C2D5YRSL414 S CL 2MSBK MFR CW 1 F .4 .6
25-38 5YR4/6 SIL 2MSBK N/A N/A N/A /A
Boring 93.42 16 J
Boring #
• Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHf
Horizon Leth
Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 1OYR3/3 -0- SIL MSBK MFR CW 1M .6 .8
MSBK FR CW 1F .4 .6
2 10YR4/6 -0- SCL
OYR4.6 C2D5/YRSL4/4 SCL MSBK MFR CW 11F .4 .6
q YR4/6 F2D10YR7/2 SL MSBK MFR NIA N/A N/A N/A
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = SOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Si nature CST Number
ROBERT HARDINA 824825
Address Date Evaluation Conducted Telephone Number
77 170 TH AVE TURTLE LAKE W154889 5-7-13 715-986-2508
ANDERSON 014-1017-80-000
Property Owner _ Parcel ID # Page of
r - Li
Boring # Boring 92.75 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
1 -13 1 OYR313 0- SIL 2MSBK MFR CW 1 M .6 .8
2 0YR4/6 0- SCL MSBK MFR CW IF .4 .6
3 OYR4/6 C2D55YRSL4/4 SCL MSBK MFR CW 1F 4 .6
4 - YR4/6 F2D10YR7/2 SL MSBK MFR N/A N/A N/A NIA
Boring # Boring 92.25 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/IF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 'Eff#2
1 -12 10YR3/3 -0- SIL MSBK MFR CW 1M .6 .8
2 12-16 1OYR4/6 -0- SIL 2MSBK FR CW 1F .4 .6
3 16-28 0YR416 C2D5YRSL4/4 SCL 2MSBK FR CW 1 F .4 .6
4 28-40 YR4/6 F2D10YR7/2 SL 2MSBK FR N/A NIA NIA N/A
Boring
F-1 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
Effluent #1 = SODS > 30 < 220 mg/L and TSS >30 < 150 mg A- ' Effluent #2 = BODS c 30 mg/L and TSS < 30 mg/1-
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.
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