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Wisconsin Oepartment of Commerce PRIVATE SEWAGE SYSTEM County: St. C roix Safety anrf Bu ✓ division INSPECTION REPORT Sanitary Permit No: 429923 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan IQ No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. ; Permit Holder's Name: City Village X Township Parcel Tax No: Hoitomt, Bad I Forest Township 014 - 1076 - 20-000 CST BM Elev: W • J Ins M Elev: BM Description: Section/Town /Range/Map No: eo .0 1 jC0 • o' S:e�•S Qt"^ I = q.. of 35.31.15.568B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS 9a HI FS ELEV. Septic Benchmark (we A 30 Dosing � �1 / - Alt. BM Aeration Bldg. Sewer 0.I0 Holding St/Ht Inlet p 1 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 1-- t Dt Bottom > 50 >Ivo 39 9Z6 Dosing i tc „ 50 t Header /Man. �,V 5' l �• /�l Aeration Dist. Pipe .(�� 5 / q/• S r I Holding Bot. System Z .35' Final Grad PUMP /SIPHON INFORMATION ua wry Manufacturer Demand St Cover ( -r✓(Z GPM �. Model Number TDH Lift Friction Loss System Head TDH Ft • .9 3.30 IZ -83 Forcemain Length r Dia. Dist. to Well � wW Z lt - If3D SOIL ABSORPTION SYSTEM = 3.4 2Z,? , 5' % E l)"~ Width � Length � No. Of Vfenea ec _ n PIT DIMENSIONS No. Of Pits Ins L' MENSIONS S 5"} C-4 1__oLS SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING anu urer: INFORMATION CHAMBER OR Type Of System: , ry ► 7 ' t / UNIT M de DISTRIBUTION SYSTEM Header /Manifold Fistribution � x Hole Size x Hole Spacing Vent to Air Intake ��.(( alt r Length -f• of Dia Z rI L ength s 7 a' / Dia 2 Spacing 0 3 110 of -2 &f to SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only T Depth Over Depth Over xx Depth of xx Seeded /Sodded j xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [� No Yes EN] No COMM ENTS: (Include di r ncies, persons present, etc.) Inspect` ���P^r'�'e 'On Location: 1829 Highway 128 Glenwood City, WI 54013 (NW 1/4 SW 1/4 35 T31 N R15 ) NA t arcel o: 35.31.15.5688 1.) Alt BM Description = r 2.) Bldg sewer length= .0 7 S amount of cover = +Z Z " }- �.�.av cy�q - - ear r*-�.o Plan revision Required? V,V { /3 j �I Use other side for additio SBD -6710 (R.3/97) ate In sepctor's Signature Cert. No. Safety and Buildings Division County J 201 W. Washington Ave., P.O. Box 7162 v "/ ,)__ V � Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co. (608) 266 -3151 Z Z q a 3 Department of Commerce State Plan I.D. Number S anitary Permit Application r In accord with Comm 83.21, Wis. Adm. Code, personal information you prov Proj Address (if different than mailing address) may be used for secondary purposes Privacy Law, s15.04(1)(m) J I. Application Information - Please Print All Information i S - Parcel # # Property Owner's Na me t � lo Zo• oW Property Owner's M ailing ddress 1 Property Location 2 -2 0 P Z ,Ctk,Section Ci �Iate / Zi p Code Phone Number E or II. Type of Building (check that apply) ✓ Subdivision Name CS M Number 2 Family Dwelling - Number of Bedrooms "�- ❑ Public /Commercial - Describe Use — ❑ State Owned - Describe Use ❑Ciry_I Village) wnship o l III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, ❑ New System eplacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ermit Revision D Change of ❑ Permit Transfer to New �/ �� U -2 Before Expiration Plumber Owner 7 _0 1 IV. Type of POWTS System: (Check all that apply) ❑ Non - Pressurized In- Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank El Peat Filter ❑ Aerobic Treatment Unit ❑Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Ar a Proposed (sf) Syste �Elevati� L2 12 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing "ranks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement I, the undersi assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's nature MP /MPRS Number Business Phone Num er �� 2_ 6 - d r's'2 �' J" Plumber's Addre ss (Street, City, State, Zi e) 1 VIII. County /De artment Use Onl Sanitary PermitLee (includes Groundwater Date Issued Issuing ge Signature (No s) ❑ Approved ❑ Disapproved Surcharge Fee) - ❑ Owner Given Reason for Denial W IX. Conditions of Approval /Reasons for Disapproval lam. S a� rece t,r2d/ Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size Safety and Buildings •� , 10541N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 1eonsin www.commerce.state.wl.us /sb ,•tment of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary July 23, 2003 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/23/2005 Identification Numbers Transaction ID No. 887159 SITE• Site ED No. 657669 Brad Hoitomt Please refer to both identif cation numbers, 1829 Hwy 128 above, in all correspondence with the agency. Town of Forest, 54013 St Croix County NW1 /4, SW1 /4, S35, T3 IN, RI 5W FOR: Replacement mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 898709 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ,`''q chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. C 3 e It The following conditions shall be met during construction or installation and prior to occupancy or use: �.. General Approval Conditions: t, " • This system is to be constructed and located in accordance with the enclosed approved plans and with the i5, . Of SAFET "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691- (N.01 101) and SBD - 10706 -P (N.01 101). G ' ��- EE GORRES • 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. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. 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. 4W SHAUN R BIRD Page 2 7/23/03 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 60.00 Fee Received $ 60.00 " f Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Integra ed Services WiSMART code; 7633_ (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pshandorf @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 i i s � t Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 7/2/03 Owner:Brad Hoitomt Location: NW1 /4 SW1 /4 S 35 T31 N,R 15W 1829 Hwy 128 Forest System type: Mound System (Revision) Manuals Used: Mound Component Manual version 2.0 (01/31) Pressure Distribution Manual version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan `•'�• 3. Mound Cross Section ---� 4. Pipe Cross Section /Pipe Layout A' C ERC 5. Pump Chamber Cross Section ND cs 6. Pump Curve 'ONDENCE 7 -9. Maintance and Contigency plan 10 -12 Soil test Signature License number 226900 PLOT PLAN PROJECT Brad Hoitomt ADDRESS 1829 Hwv 128 Glenwood Citv Wi 54013 NW 174 SW 1 /4S 35 /T 31 N/R 15 W TOWN Forest COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/2/03 BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND xxx SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none IL BENCHMARK V.R.P. Top of foundation ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Highway 128 89.6' Scale = 1/4 = 10' Old House and System was Well removed prior to new testing 300' Pro 3 Bedroom B. M. House Tank is to be properly bedded and provided with lockdown Area 15' below system is covers with approved warning to remain undisturbed labels Huffcutt Combo tank Grading is to be done to B-1 divert run -off away from sytem 13% Slo e B -3 0 CD 1< B- m 8888.6' 86' No Designer Date Non -Woven Filter Fabric 4" Observation Pipe Perforated ,Distribution Pipe Below Filter Fabric AM C -33 Sand II Topsoil l� 7. Slope bed Ot !�- 2 %2 Force Main Flo*ed From Pump Layer Drain Rock i Cress Section Of A Mou System u sing F r A Bed For The Absorption Area G A Ft. t; - -'— 1 g j Ft. Z Ft. KI� Ft. L ), Ft. Ft. l L 4'Observation PiPe --,,,\ � � ---------------------------------- - - - - -- _ n A '' Force Moin —° - - -- -------- - - - - -- --------------- - - - - -- I From Pump W V' l° _ ---- - - ---- L ° Distribution Bed Of / — 2 i 0 Pipe Drain Rock I 4Observation Pipe Permanent Marker Pipe or Rods Plan View Of Mound Using A Bed For The Absorption Arco PAGE OF Perfor0led Rip! Detail ~i E tV'!st /// �Gerloratta �/` PvG P,pe Holes LDiateC On Got: sn+. Art tiRupl}y $00tea t�1 t PVC torte Mair►� FtltST }tOt.L pjT. Y,�' T6 C.Or1AtG fCf L / l PVC Monitold Pipe � Cistnauton Pipe , `vov i4lribufiQ Pipe LaVQ Ft. R Fj. X � inc�es Y� Inches Hole Diameter" Inch Signed: Lateral "_ Inch(es) License Number: Manifold C;� Inches Date: Force Main Inches # of holes/pipe d Invert Elevation of laterals �� ( Ft.' A� ;B SPwCxT iCAZ Zc714� SEPiiC TANK E PJMP Ct;AMS£R CROSS SE4 1C�• VEATHERP90OF APPROVED 4 1 , Cl VENT FTP£ ) L" 3�?�i • Ado= � GRADE „"NCTLON BOX } 25' FROM DOOR, "TNDOW OR WITH CONWIT W/ P 7 L CO�Fi � / PAD K � FRESH AIR INTAKE WARNING LAB£' FINIS GRADE --- _ �.., MTfl. � ai +n• ZY X. sl °• C.Z. 41siL '` a t$ MStf rift ! LET G s- a APPRA1tEo WATER TIG i% SEALS ` TIGi `? t JOINTS WITH 7 LT ER "" _.s•"_ �' =Ai.M APPROY£J) PIPE t = 3' ONM s s •- ON SOLID SOIL APPROVED ` PIPE 3° C ' OFF OgTo SOL ID FT. -' -- SOIL i AMP ^FF ELF ` D BED C?NIDEs2 iANY- E PAD 3" .AFFROV £a �. CONCRET / :1sf A s pEr~TFZCATZONS S ES BAY = 1-- --- -- SE PTIC ! DOS£ LHDER DO TAivK MANUFACTURER: i3C5E v �3T.UYiE ZI`iCLt1 GAi.L- GAL. LL11iSAC i< i TAtiK SIZES = SEPTIC GAL. !NCRE A _ _ t t J S aye -- f-ESoil: --- r , CAPACITIES- _ GAL. A1.AR24 MANUFACTURER'. �' 6 $ _ �� INCHES � MODEL I+U14SER � � � /n _ - INCITES = SWITCH T PL . _ -_ G F. Pum iIANUFAC F GA MODEL NUMBER �!` � LHR 15. wAc SWITCH TRIPE" � v � ALARM W'R-c NG AS P� r� - GLZM c EET L - D DISCHARGE RA =E ` IWj -r1ON ? = ?£ - �-� FEET REQUTA OFF ANB Di S`I'R _ - FEET �ggTyCAL BIFF£RENCE 3£';"s,J£PR IRiC'Ilp2it FACTOR FEET S UPP LY PRESSURE _ �- MI NIKui� NET3rI0RK S' 3 t FT 1 GO FT T , DYNAMIC t? zh►D - /---_"� --•- F ORCEmA.IN •F% TO �r�s- BTU', D?AM£TER - ST£R NA L DIM ENSIONS LI�UIII DATE 7 TOTAL DYNAMIC HEAD/CAPACITY PER MiNuTE HEAD CAPACITY CURVE EFFLUENT AND DE'd1ATERING MODEL 152/153 I I t52 ,53 � I MODEL w 4 LL Feet Meters `' Go!" I Liters 50 Liters 50 261 77 291 5 1.5 '1 69 153 10 3. • 6 231 70 265 12 40 152 15 4.6 53 I 20' I 61 231 o ` 2 ' D i 6 ` 44 167 52 197 i, 6 34 42 1 J° = 25 31 30 9-1 23 l 87 33 125 8 3 5 10.7 — ' 22 8 20 40I 2 ? I _ _ 11 42 o Lock Valve 38.0 r (1�;.6m) 44.0 F t . (13.`4m) r" ��.- -- G545Ga 4 I 10 0 20 40 60 80 100 GALLONS I 4 5% LITERS 0 80 16G 240 320 - 3 27/32 I— --�" FLOW PER MINUTE 3 27/32 ONSULT FACTORY FOR SPECIAL APPLICATIONS e _ C o s z7/3z - f I • Timed dosing panels available. supplied with e • Electrical alternators, for duplex systems, are available and an alarm. I switches are available for controlling single phase contro • Variable level systems. I'I I • Double piggyback variable level float switches are available for variable decontrols. level Ion and sh Y • Sealed Qwik -Box available for outdoor installations. See FM 1420. • Over 130 ° F. (54 °C.) special quotation required. 1521153 Series I t onrol Selection � I 1521153 MODELS C s 1/9 Model VoRssPh Mode Amps Sim Iex Du tex I Non 8.5 1 2 or 3 � _ (_ 54 N152 115 1 2or3 t I 8N152 115 1 Auto 8.5 Included E152 230 1 Non 4.3 i 1 ! 2 or 3 BE152 230 1 Auto 43 Included 2 o�3 SELECTION GUIDE N153 115 1 Non 10.5 1 back variable level float BN153 115 1 Auto 10.5 Include . ded 0 3 1 Single piggybac BE1 switch. Refer to FM0477. k variable level float switch or double piggy 230 1 Non 5 . 3 BE153 230 1 Auto 5.3 Included 2 or 3 2. See FM0712 for correct model of Electrical Alternator E-Pak. p CAUTION All installation of controls, protection devices and w 3. Variable level control switch 10 -0225 used as a control activator, specify duplex wiring should be done by a qualified or (4) float system. electrical and safety codes should be f i the most licensed recent National El electrici a n. ctri (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256 -0347 Manufacturersof. . SHIP ?0: 3649 Cane Run Road QurrurrPu�vs �ycE /��� a Louisville, KY 40211 -1961 z 502 778-2731 1(800) 928 -PUMP Z _ Q� /� ,/ /ff// ) d ( 1 �Q- FAX (502) 774 -3624 hnp / /www.zoeller. com (, - t,r )nnn 7nPller Co. All rights reserved. Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715- 246 -4516 Pumper: Tom Mondor 715 - 246 -5148 St. Croix County Zoning 715- 386 -4680 P age of WTS OWNER'S MANUAL & MANAGEMENT s PO SYSTEM SPE CIFIC ATION . Septic Tank Capacity - 9 D al ❑ NA FILE INFORM) Septic Tank Manufacturer Permit #. Effluent Filter Manufacturer ❑ NA DESIGN PARAMETERS 3, ❑ NA Effluent Fitter Model ❑ NA Number of Bedrooms Tank Capacity � �' � al O NA NA Pump Number of Commercial Units ❑ NA aUda Pump Tank Manufa�rer :.GL' Estimated flow (average) Manufacturer NA � al/d Pump I Design flow (peak), (Estimated x 1 .5) Model '.s o` ❑ NA C/ aVda /ft� Pump Son Application Rate � Monthly average- Pretreatment Unit s C] Sand/Gmvel Filter ❑Peat Filter Influent/Effluent Quality �i0 mg/L ❑ Wetland Fats, Oi18� Grease (FOG) ❑Mechanical Aeration [I Other en Demand (BODs 420 m9� ❑Disinfection Biochemical OxY9 ) Manufacturer Total Suspended Solids (TSS) 51so m /L ANA Monthly average" Dispersal Cell(s) In jig and (pressurized) pretreated Effluent Quality - S30 mg/L ❑ In - ground (gravity) ound Biochemical Oxygen Demand (BODs) ❑ At -grade 530 mglL ❑Other. Total Suspended Solids (TSS) ❑ Dri ine n) 510 cfu /looml Fecal Coliform (g eometric mea Values typ for domestic (non canmerciao wastewater and Y inch diameter septic tank effluent L MEm�um:Effluent Particle Size .� Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event ❑ months ar(s) (Maximum 3 yrs.) At least once every � y) of tank volume Inspect condition of tank(s) When combined sludge and scum equals o ne-third ( , Pump out contents of tank(s) ❑months ear(s) (Maximum 3 yrs.) At least once every � ear(s) Inspect dispersal cell(s) ❑ months At least once every Clean effluent filter — ' ❑months ar(s) ❑ NA At least once every earls) ❑ NA Inspect pump, pump controls & alarm '7 ❑ months At least once every ❑ NA Flush laterals and pressure test At least once every ❑ months O year(s) other. ❑ months [I year(s) ❑ NA At least once every other MAINTENANCE INSTRUCTIONS n one of the following licenses or ins pector POWTS Maintainer, Septage Inspections of tanks and dispersal cells shall be made by an in d i v idual carrying miser or broken Sewer POWT certifigtions: Master P i ns pe ctions r must include a visual inspecti° of the tank(s) to identify any 9 Servicing Operator. and scum and to check for any back up hardware, identify any cracks or leaks, measure the ls l ce11( ) f�elY�g ally inspected to check the effluent levels round surface - dispersal ( The ponding of effluent on Me or ponding of effluent on the g ponding of effluent on the ground surface. wires the immediate notification of the local regulatory authority . in the observation pipes and to check for any ground surface may indicate a failing condition and requires eq ual one -third (4) or more of the tank vol the ed accumulation of sludge and scum in any tank II be removed by a Septage Servicing Operator and disposed of in accordance with ch. N When the Combin entire contents of the tank shall nents, and any 113, Wisconsin Administrative Code- onents. pretreatfinent comPo rformed by a certifi other maintenance or monitoring POWTS Maintainer. The servicing of effluent fns nn m at ntery l Is of pre ssurized 2 months orless sha l be pe comp le tion b Geri of any service event A service report shall be provided to the focal regulatory authority within 10 days o Ce of painting products or other START UP AND OPERATION for the p resen tons are For new conStrucbon, prior to use of the PO o and/or damage the dispersal cell(s). If high concentra chemicals that may impede the treatment p oved by a septa9 e servicing operator prior to use - detected have the contents of the tank(s) fen -1 Page of sta u shall not occur when soil conditions are frozen at the in fi ltra tive enPower is restored the excess System P fill above normal titghwater le er outages m ay and may result in the During pow tes Pump tanks rsal cells) in one large dose, overloading the ceum en s) tank removed by a wastewater will be discha�9ed to the dispe backup or surface discharge of effluent. To avoid the th have the contents of the P P Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to Septage Servicing urn controls to restore normal levels within the pump tank assist in manually operating the p p Do not drive or park vehicles over tanks and dispersal cells. soil absor park over, or otherwise disturb or compact the area within 15 feet down slope of any mound or at-� Reduction or-elimination of the following from the wast ewater stream may improve the performance and prolong the life d arette butts; condoms; cotton swabs; degrease; dfloss; rbicides meat of the POWTS: antibiotics; baby wipe um water, fruit and vegetable peelings; gasoline; greas disinfectants; fat foundation drain (sump PUMP) des; �� napkins; tampons; and water softener brine. scraps: medications; OR; Painting products; 1 - ABANDONIAMENT taken out of service the following steps shall be taken to insure that the When the POWTS falls and/or is permanently taken and safe doned in compliance with ch_ Comm 83.33, Wisconsin Administrative e: system is properly openings sealed. Ail p to tanks and pits shall be disconnected and the abandoned of y Septage Servicing Operator. • The contents of all tanks and pits shall be removed and property After pumping, all tanks and pits shalt be excavated and removed or their covers removed and the void space • filled with Soil, gravel or another inert solid material, CONTINGENCY PLAN repaired the following measures have been, or must be taken, to provide a code If the POWTS fails and cannot be ent soil compliant replacement system: and ❑ A suitable replacement area has been area should be protected ect om disturbance and and compaction and should not absorption system. The repiacemen lot lines and wells- Failure to be infringed upon by required setbacks from existin g and proposed structure, protect the replacement area will result in thenee a new soi (e � t a thatttirne�blish a suitable in replacement area. Replacement systems mus c ompl y O A suitable replacement area is not available due last resort to replace it li failed pOWT-Sng advances in pO VVTS technology a holding tank may be installed as n failure of the POWTS a soil and luated to identify a suitable replacement area. if n o replacement area is available a 76—The site has not been eva site evaluation must be performed t ort to pla the fated PO rWTS f n olding tank may be installed as a Mo und and at -grade soil absorption systems may Reconstructions nstructed in pith the f ollowing i n e ff� at t time. at at the infiltrative surface. Reconstructions of such systems must comply <<WARNING>> - TANKS MAY CONTAIN LETHAL GAS SES AND /OR INSUFFICIENT OXYGEN. MENT SEPTIC, PUMP AND OTHER TREATMENT CIRCUMSTANCES. DEATH MAY DO NOT ENTER A SEPTIC, PUMP OROM o�KY BE DIFFICULT OR IMPOSSIBLE. RESULT. RESCUE OF A PERSON FROM ADDITIONAL COMMENTS POWTS MAINTAINER POWTS INSTALLER Name _� &,u� ENe f i u ,� � Phone -t � � �'., �.._ � S'� LOCAL REGULATORY AUTHORiTY 7P7 77::] Agency Phone �J,j � .�� This document meets the staffs of the Green , tte and Waushara County Zoning and Sanitation age of This document was drafted by GMW in'imum re uirements of ch. Comm 83- 22(2)(b)(t)(d) &(f) and 83- 54(1), (2) & (3 ?. 1N- isconsin Adminl5tlat3ye Code- Use of this document does fro them 4 guarantee the performance of the Powl's. � DAID Wisconsin Department of Commerce SOIL EVALUATION REPORT Page division of Safety and Buildings L in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. / percent slope, scale or dimensions, north arroyu@nd location and distance to nearest road. Please print allnfortQtt awed by CZat /gjb Personal information you provide may be used for dary purposes (Pnvacy , s .1 �4 (1) Property Owner Property Location Gott. Lot 14,� /4 S j, 5 T 3/ N P s E (or) Property Owner ili Address !� Lot'# Block # I Subd. Name or CSM# State , ode Phone Number ~^ City Village Town Neare t Road &'b 'SZO — 4 ❑ New on use Residential I Number of bedrooms Code derived design flow rate S'L7 GPD eplacement ❑ Public or commercial - Describe: i Parent material Flood Plain elevation if applicable General continents and recommendations: Boring # Boring I W Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 0 . - •�--- ?^ ice, S' ' / L. Boring # Boring ;• Pit Ground surface elev — 1W ft. Depth to limiting factorin. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 3 IZA 3 S 2.i r , 3 tt� G� / Effluent #1 = BOO > 30 220 mg/L and TSS >30 150 ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg(L CST Name (Please Print) Si CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �-rar v3 715- 246 -4516 x Property Owner _ Parcel ID # Page of Boring # E:] Boring C Pit Ground surface eleg, © ft. Depth to limiting factor ( in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a 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 'Ett#2 F-1 Boring # ❑ El Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil ication 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 - BOD. > 30 < 220 mg/L and TSS 30 _ 150 mglL 'Effluent #2 - BOD 30 mg/L and TSS 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD -9330 (R.6=) Soil Test Plot Plan 1 Pr�oject Name Brad Hoitmot sha i 'rd Address 1829 Hwy 128 Glenwood City Wi 54013 cs M #226900 Lot - ---- Subdivision - -- - - -- Date 7/2/03 NW 1/4 SW 1/4S 35 T 31 N/R 1 5 W Township Forest F1 Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Foundation System Elevation 89.6' *HRPSame as Benchmark Highway 128 I Scale = 1/4 = 1 old House and • -'—� S S �� System was L� x`/24/0 3 removed prior t Well �"' `�`'�'¢ new testing O e I 300' Pro 3 Bedroom B. M. House A new soil and revi on done because prior soil test was not accurate, and previ usly t ted / area was found to suita le for �"° holding tank only! I B -1 E3 13% Slope p B -3 0 CD 0 CD B- 5 CD gg 88' 90' tt , + '- D ar'. -...- of � r. ;�',r rA .�+. �T`ET ": a•5.. +�•yj,� y: �':.. �'. `��..�,..�.,�. d�fv,.Siit fir, �. .Tii ....,., i.r .. - • -:. k. t.k 569043 4 STATE BAR OF WISCONSI�i :fOR41 2 - 1982 WARRANTY DEED DOt;vMENT NO i Karen A. Wienke, a single individ _ � REC 5ftr 7, -1' 7 i ICF- S T. rR0iX w(... `.yI . .j _ NOV 2 6 1997 t� conveys and warrants to Brad A. Hoitomt, a sing e t individual j 9:30 A Ro I•ter of Deeds it THIS SPACE RESERVED FOR RECORDING DATA I NAME ANO RETURN ADDRESS t the following described real estate in St. Croix _County, ` State of Wisconsin: ; The South 20 Rods of the West 40 Rods; of the - Northwest Quarter (NW 1/4) of the Southwest GJL S .21 '. Quarter (SW 1/4), Section 35, Township 31 North, _ - _ Range 15 West. : k;5 _ _ 014- 1076 -20 .. PARCEL IOENTIFICANON NUMBER E w' a y y - ► 1z � TRA NSFER �r 5 00 V; 57-,/7 /77- - T - r R: t. This 18 not homestead propertyt _ (is) (is rot) " Exception to warranties: Subject to easements and rights of way of record, if any; r municipal and county zoning ordinances. ' Dated this _� day of November , A D , l9 97 . s A i' (SEAL) - C (SEAL) ' 1 . to i Kaked A. Wienke j (SEAL) (SEAL) s 4 AUTHENTICATION ACKNOWLEDGMENT- S gnature(s) State of Wisconsin, 1 II I� County. J I� � I authenticated this day of • 19_ Personally carte before me this day of I� November 19 97 , the above named` Karen A. Wienke TITLE. MEMBER STATE BAR OF WISCONSIN *,- j (If not, ( h autorized b 5706.06, Wis. Stats.) I� Y to me known to I)e the [rrs who executed the [ongoing { i� instrument sr td ecktio�. trde tT;ame._+L . j .......... ........................... ................................. ...... ....................... ...... - - --- ------ -- ............... ......... ................ T ROIN Y SEPTIC TANK MAINTENANCE AGPI'EMENT A.14D F, MARIE -31UP ("ER.TIFICAT101`4 PD M Pro],): .. ..... . .. . ..... . ..... ........ (Verffica.ion required from Planning Department for new Parcel Identification ta-t T -3i NR_ W, Town Of' -S w '/4.. SM 3 IV Ceri'Cied 'sire y Map - H "VOlumv page W.a•�' 111t IN! -P, 5(o 0 Volume g � �... _..._.. . spec, louse Kno fXt UnCS idf,-l3tlfiab1C Kyes C no Impro DO r i ne and .mai[nitenatice of your septic system could result in its premature Wture to handle Wastes. Pratwr consiv; of puzapi;it z out the sayitic tank every three years or sooner, if needed by a iieemedoumptr. What you put: into tho system can. at..ct the fill i';�rtan of the vlptic tank as a treatment stage in the waste disposal systern, The p'm'x::%'V owner agrees to subrait to SL Croix toning Depaitruent a certification form.. signed by t4e.01-vner.-Akrid by a ; sy ste m ma.ste, Plumbe,., i u i. plumbor. itstrictodpluzubcr or a liccused.puniper verifying that (1) the on •site wastowate.rdis Pos �i. Y is in P )per op ig condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 113 1W of 'Audge. Uwe, -:. ie undersi)!):i -d have reac the above requirements and agree to maintain the private sewage disposal system with the,- -,tozdards set foi heiki�.*li- by the Dep:trtmeritof Commerce azd the'Departmcntof Natux-al kesowrces.- State of'Wisconsin. Cer, kcation been maintained. ust be completed and returned t the St. (,'rt,)jx Zoning, Offllce�w6;hin 30 (i a v o c eo:-, - a t • Ir DA11- i4v'le 7 "'V ".."I Gyt-li 'T I (wc):o!,•iify that all t•tements on this form are true to the best of my (our) knowledge. I (we) am (are) tare owaorfs) of the pr. ierty dvs(, i! izd above, b y virtun of a warranty deed recorded in Register of Decciss Office N A.Yay ir&ir()ation that i.; nijs- .represented may result in the sanitary potmit being revoked W Zoning Xim.:.ude with h 1i applicati-iin: a stamped warranty deed from the Register of Deedi office A copy of the certified sw vey map if reference is made in the wvm2nry deed Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department Of Commerce (608) 266-3151 Z `j92 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide 'Em. c{�I.D.# may be used for secondary purposes Privacy Law, s15.04(l)(m) ject Address (if different than mailing address) I. Application Information - Please Print All Information _ Property- Owner's Na me �M y Lot it Block y 72 o I Property Owners M ailing Address ` _ pO - /� y Prqe Location i City, State Zip Code ne Nu�ber„ _�� tton circle II. Type of Building (ch that apply) 0,S S T ✓� N; J E W or 2 Family Dwelling - Num f Bedrooms 13 Subdivision a CSM Number. w.ts ❑ Public/Commercial -Describe Use Ce(cswe* R9• 0 ❑ State Owned - Describe Use 57 l! SD �g t 0 illap�Township of S III. Type of Permit: (Check only one box a A. Complete line - D if applicable) A ' ❑ New System Y merit System Treatment/Holding Tank Replacement Only Other Modi to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ e of ❑ Permit Transfer to w ist Pr ber and Date Issued Before Expiration Plum Owner IV. of POWTS stem: (Check all that a 1 ) IV ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil Mound < 24 of suitable At -Grade and Filter ❑ Constructed Weiland ❑ Pressurized In- Ground ❑ Holding Tank Peat F' ❑ Aerobic Trffftt Unit ng Sand Fil ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip L' Gravel -less Pipe S V. DispersaMeatment Area Information: / Des k Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area (sf) D' Area posed (sf) S VI. Tank Info Capacity in Total Number Manufactu Prefab Site Steel ' r Plastic Gallons Gallons of Units Concrete Construc New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undei d responsibility for installation of the POWTS sh on ed pleas, P lumber' � Na me (Print) Plumber' i MP /MPRS Number Business Phone Number 7 _u ' Av ����� ✓� oz - `� Plumber's Addre ss (Street City, state, e) �J� VIII. Count /De artment Use Approved ❑ Disapproved Sanitary Permit Fee (includes Grotuwater Date Issued Agent tgnature (No Stamps) Surcharge Fee) El owner Given Reason vial JL IX. Conditions of Approval/Reas r Disapproval AA Attacd complete plans (w the County only) for the system on paper not teas than 8112 x 11 inches in size 3BD -6398 (R. 01103) ± PL T PLAN .ad Hoitomt DDRESS 1829 Hwv 128 Glenwood City Wi 54013 /4 SW 1 /4S 35 /T 31 R 15 TOWN Forest COUNTY ST. CROIX 4/8/03 3 MPRS Shaun Bird 226900 DATE BEDROOM CONVENTIONAL AT -GRA CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1 000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of 6 " wood post ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL 'H. R. P. Same as Benchmark Hwy 128 SYSTEM ELEVATION 100.9' Existing 3 Old tank to be Bedroom House to a collapsed and be tom down and buried after replaced with a 3 cD pumping Overflow bedroom house sr Huffcutt combo d tank, to be properly bed • c and provi with Well lockdow vers with oved �� war g labels 218 Hen r House 1 9 9' B -2 98' Building sewer is to be insulated as per code, and clean outs shall be installed as needed Grading is to done to 7% divert run- away Slope from syst r B -3 m Area 15' below system is to remain undisturbed B -1 Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 www.commerce.state.wi.us/sb www. wiscon s in.gov wisconin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary April 22, 2003 ," CUST ID No.226900 ATTIC• POWTS Inspector r SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RIC OND WI 54017 HUDSON WI 54016 CONDITION PROVAL PLAN APPROV IRES: 04/22/2005 ntificaton Numbers Transact' ID No. 855952 SITE: Site ID ' . 657669 Brad Hoitomt Plea refer to both identification numbers, 1829 Hwy 128 abo , in all correspondence with the agency. Town of Forest, 54013 St Croix County ` G- NW1 /4, SWIA, S35, T31N, R15W FOR: Replacement mound, 450 GPD Object Type: POWT System Regulated Obje No.: 89870 The submittal described above has been reviewed for co with applicable Wisconsin Administrative Codes �jlj.T- and Wisconsin Statutes. The submittal has been CONDIT LY APPROVED. The owner, as defined in �'® chapter 101.01(10), Wisconsin Statutes, is responsible for co iance with all code requirements. Gm ditiO t l The following conditions shall be met during construction ns tion and prior to occupancy or use: splENt OF General Approval Conditions: G;. D;V! _ AfE7Y • This system is to be constructed and located in acc ce with the en sed approved plans and with the "Mound Component Manual for Septic Tank Effl nt for Private Onsite tewater Systems" SBD- 10691 -P (N.01101) and the "Pressure Distribution Comp ent Manual for Private On Wastewater Treatment SEE CORRES Systems" SBD- 10706 -P (N.01 101). • In the event this soil absorption system or an f its component parts malfunctions s s to create a health hazard, the property owner must follow the ntingency plan as described in the appro plans. In addition, the owner must insure that the operation, tenance and monitoring duties as describe section VIII of the mound component manual are compli with. A copy of this information must be given a owner upon completion of the project. Key Item(s) • The scale on the plumbing plot plan* 1 ":40' per designer. Note • The designer proposes to install a to approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet fi r product approval stipulations, maintenance information must be given to the owner of the POWTS expla' g that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall to ' ate at or above finished grade with a watertight cover. Reminder • The orientation of the mound sys em must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. SHAUN R BIRD Page 2 4/22/03 . • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. Y P g P P • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Abandon failing system per COMM 83.33. 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 appro the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise ' g them necessary for code compliance. Asper state stats 101.12(2), nothing ' this review shall relieve the de er of the responsibility for designing a safe building, structure, or comp t. Inquiries concerning this con ondence may be made to me at the telephone number listed belo or at the address on this letterhead. The above left addressee shall prove a copy of this letter to the owner and any others w e responsible for the installation, operation or maintenance a POWTS. ....: Sincerely, Fee R fired $ 175.00 Fee ceived $ 175.00 G ! /B'Ince Due $ 0.00 u Patricia L'Shandorf POWTS Plan Reviewer, Inte rated Services WiSMART code X633, (715) 634 -7810, Fax: (715) 634-5150, M -f 7:45 am - 4:30 pm pshandorf @commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 r' r/ ,h �I Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 4 /8/03 Owner: j 13 P_,AS� o iTO MT Location: 1829 Hwy 128 C� �' °` r'VC System type: Mound Syst N W �/� '/y Manuals Used: Mound Compone anual v sion 2.0 (01/31) Pressure Distribution version 2.0 (01/31) Page# 1. Cover Page '• �a� � 2. Mound Plot Plan �y 3. Mound Cross Section ERCE 4. Pipe Cross Section /Pipe yout su►►.o► 5. Pump Chamber Cross ection ENCE o , 6. Pump Curve 7 -9. Maintance and C tige cy plan 10 -12 Soil test Signature License number 226900 4/8/03 PL T PLAN PROJECT Brad Hoitomt DDRESS 1829 Hwv 128 Glenwood Citv Wi 54013 NW 1/4 SW 1/4s 35 /T 31 R 15 TOWN Forest COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/8/03 BEDROOM 3 CONVENTIONAL AT -GRA CONVENTIONAL LIFT HOLDING TANK MOUND )()p( SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none IL BENCHMARK V.R.P. Top of 6" wood post ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Hwy 128 SYSTEM ELEVATION 100.9' Existing 3 Old tank to be Bedroom House to a collapsed and be torn down and = buried after replaced with a 3 pumping Overflow bedroom house ST Huffcutt combo Shed tank, to be properly be d p and prov' d with Well lockdo covers with proved 218, w ing labels Hen House 100, 99 2 98' Building sewer is to be insulated as per code, and clean outs shall be installed as needed Grading is be done to 7% divert r -off away Slope from stem CD r B -3 m Area 15' below system is to remain undisturbed B -1 Date Non -Woven Filter Fabric 4 Observation Pipe Perforated ,Distribution Pipe Below Filter Fabric AsTK C-33 Sand Topsoil a 7. Slope ti B ed Of {j0 2 1 Forte Alain -,,,__Plowed Drain Rock From Pump Layer ID � Cross Section Ot A Movnd system Usin A Bed For The Absorption Area G -_�— 1 A 4 0 Ft. g Ft. Ft. K .,�Ft. - - - ,Q Ft. r` w.31 L p bservotion Pipe -I _ K V A - - - - - -- 1 Force Moin -- - - - - -- ----- - - - - -- - From Pump z l o iribulion Bed Of Z t d Pipe Dram Ro cK I , 4 servation Pipe Permonent��Morker pipe orR Pton View of Mound Uitn A Bed for The Absorption AreO FAG &,,,. Perforated pip* 0 01011 0 i End View ' Perforatsa �' PVG P.pt e Are T LOCCIO oA f3ottau. Jam► . A E4�ffy Sf►*ced k v /1 a r PVC Face Mai% e 5 T t tg� H01.e. etsxt to Cenetisc�mn VC mor if Pipe ) �c Sfl� vie, Oi6lriout,an :1 Pipe �, J ,r Distribution Pipe 1-0yatt p Ft. R .. R. ` X Inches Y hes Hole Diamet Inch Signed: a Lateral Inch (es License Number: % Manifold " a ches Date: Force Main " In es of hol eslpi peea Invert Elevation of laterals Ft. SEPTIC TANx £PUMP CHAMBER CROSS SE CTi ON RND SPECIFICATIONS GRADE "EATWRPROOP APPROVED y .. CI VENT PIPE 1 KIN • ABO JUNCTION BOX HOLE COY ER gg* FROM DOOR. WINDOW OR WITH CONDUIT MA PADLOCK 6 FitES H AIR INTAKE WARNING LABEL FINISHED GCE MIN. • S.O. �. :- 1wfi1• am 18" IN • nm , 1' INLET • • GAS- WATER TIGHT SEALS "�" TIGHTS • TH A SEAL �1tNTS PIPE FILTER ...!_- LM 8 ' N 3 SOIL APPl10YED "� ' PIPE • C t am SoLlo OFF SOIL Pt)MP OFF ELEY . ! �i fF D 3 � a ROVED BEDDING UNDER TANK f CONCRETE PAD S PECIFICATI ONS SEPTIC / DOSE NUMBER DO PER DAY: TANK MANUFACT HOSE V ME INCLUDING 7• ✓ SEPT GAL. -.1 � GAL. GAL F LO►C ..1-- ---- -- +�' TANK SIZES : Z1' 2 • ✓ GAL D OSE ITIES = !► _ �' INCHES = Cwvt -2 Y1LCt1ES s GlIL. ALA1W riANa7FA B ,..,_..,.. MODEL. 1uK8ER= `; G.r S iNCHES S� 6AL. SWITCH TYPE : �� C = � FACTURER: L- ----"� L PUMP D : � INCHES a 140DEL SW ITC H TYPE: I r1G AS PER I LHR 16. 23 WAC !f PUMP ALARM � FEET REQUIRED DISCHARGE RATE E FEET Hp O DISTRIBZITION� E 8.TWEEN FF AND FEET U E C VERTICAL D2FFFItENC ppLY P - - . FRITION FACTOR FE !' ♦ M 2MUM !NETWORK SU F£ET FORCEM �FT/ 100 FT r M A" TOTAL DYNAMIC lr1EADi LENGTH � ID�H INTEttNAL DIt'lENSIONS OF 14P TANK= LIQUID -.•�-+ DATE= LICENSE NUMBER' SIGN ED: 1/88 i TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AN DEWATERING („ MODEL 152/1 i 53 MODEL 152 153 W :2 L- 50 Feet Meters Gat. Liters Gal. Liters 5 1.5 69 261 77 291 153 t0 3.1 61 231 70 265 12 40 152 15 4.6 53 201 61 231 20 6.1 44 167 52 197 = 30 25 7.6 34 129 42 159 S2 8 30 9.1 23 87 33 125 0 35 10.7 -- -- 22 85 2D 11 42 0 �- Lock Valve: 138.0 ft. (11.6m) 44.0 ft. (1 4 er4soe 10 0 40 80 100 GALLONS 6 1/4 LITERS 0 80 160 240 320 - 3 27/32 45/9 ft PER MINUTE 3 22/32 CONSULT FACTORY FOR ECIAL APPLICATIONS 4 _ ® 3 2 • Tuned dosing Panels avadaie. t • are avail and supplied with • Bed ical attemators. for clupleX systems. an alarm, are avaitacle for con phase • Variable level OWW SwltrM system y variable level "switdms are av able Wei long and short cycle oorl ds• � • Sew OVA-BOX avallMe for WWW installation. See FMi420. I • 13VF. 5M) spedd re0red. Over ( u 1/s 15M53 Series" s 1/e 1 llbdei Voge -Pb Modg 1 2or3 $ Noo &5 rrmst N152 115 1 BS Yrduded 2tr3 &1151 115 .1D 43 i 2or3 F152 230 1 Non _ 3 M►dided 2m3 BE152 230 1 AIM 1 5 1 2or3 SELECTION GUIDE 0153 11 i Non y or d 10 5 rr�uaed BN153 115 1 AWD 50 1 1. Sb* vadaw level that swhdt ar101e Pi89yb level float E153 230 1 Nan 5.3 Ne *ided 3 w*h. Refer b 77. BE153 230 1 Auto &3 Flame! AWISW E-PaIC 2. See FM0712 for A c N should be dooe by a riable I Va level wr*d used as a wntd adwaW, specYY duplex (3) ° �y Heft A dtS� (4)t SYSISM 'Wed No*" Bedft coft vim RESERVE POWERED DESIGN safety faCWr is engmet� red into the design of every ZOder Pump. For un conditions a reserve IWA trx as scut 1 6347 Lmtvft KY 47 Alarxfadwers &W d.. 3 StlPTO: �9C8r19RMP LgrKY 407111961 Q rSa TM2T3t • I ON 926•PIAIAP 7&Mo �jj Fi+xr ►n4 4 htfp !/www zoe8� COn' r Co. Pail rights reserved• 0 co pyright 2000 ZceNe Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump without float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, refill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715 - 246 -4516 Pumper: Tom Mondor 715- 246 -5148 St. Croix County Zoning 715 - 386 -4680 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pie or SYSTEM SpECIFiCAT10NS FILE INFORMATION r Sic I'antc CapaY at NA Owner Tank Manutadurer e 13 NA Permitt F� Me O NA DESIGN PARAIiRET 3 p NA FMer Model Ot7 p WA Number of Bedroom Tank al 13 NA WA Pump- Y Number of Conm Urns �d pub Tank Marwtadurer O NA tkret () pump Ma r! i] NA Dew flow (IedO. (Fstmabed x'1.5) J a ..•. _ pmt Model � /.S 0 NA Soft Apps Rate Unit Monthly average s. mgA � F� C] Pe Filt irhfluent/Etlumhl ► & grease (FOG) p � Aeration p Other: B Oxygen Demand (800 mgA p Disinfection Total Suspended s (TSS) 5150 �u bcbKw Preheated Eft tluaW ; � - S) Cl in�ruund (pr"suri�) Mond Demand (BODE S3i p In'9� (gra+�Y) � Bioct. Oxygen 53 p At -grade p ���.. Tatat Suspended Solids (TSS) p Fec i CoflfOrm (9�e� mean) 51t00m1 Y inch diarmeter V h = typi for d onesW (� W"te"'W °1`r Maximum Effluent Particle StZe .. f r ". MAINTENANCE SCHEDULE service Frequency Service Event 13 months ear(s) (Maximum 3 yrs.) Inspect condition of tank(s) At least once every .f pump out contents of tank(s) When combined sludge and scum equals one -thi r d (X3) of tank volume lttspect di spersal cell(s) At least once every � D m,year(s) (Maximum 3 yrs.) At least once every �. ❑ months s) Clean eftiuent f ilter inspect � pump controls & alarm At least once every J O months O NA �s and test At least once every (3 months;Fj °' s) p NA Flush s At least once every O months (3 year(s) ❑ NA Wa At months p years) O NA 01fo r. At least once every MAiNTI f orm of and dispersal cells shall be made by an kvfwMua l cwft am of the f 9 O p : pia�e tnspet Plumber' Master Plumber Restricted seMrer: pOWTS Insp� Maartain Se � �� �y m or broken mss' � amens must include a visual �spe� of the �} scum and to check for any back °p measure the volume of combined sludge ntffy any hardware. We ffkmrd on the ground cracks or leaks. s be sp to check the effluent levels persal rface. The dis cell() of effluent on the o and to �'� for any P of effluent on the g rhdrfiradon the re9utabory a�,orrtl,_ indicate a fa�n9 conddion and requires the hnmedtate Wound =face may one-third (l.) o r mom of the tank volume, the accu m ulation of sludge and scum in any tank one and disposed of o accordance with dh_ NR When the combined Slog b remoa+ed by a Septage Servicing 0f�W 113. ent , Wisconsin contents � � �e its and any 11 filters mechanical or pressurized POWTS camp . a cer pOWTS Maintainer' . The servicing of effluent shaft . O th er mairdenance or m at i of 12 months or less 0 P of any service eve A s report doll be provided to the Iocal regulatory authority W ithin 10 o f t ai n brig products or other START UP AND OPERATION trea tment tank(s for the P to use of the POWTS check trey ms if hl9h tratior►s are chemicals that may humped the I �� t press and/or damage use. detected have the conten of th ts e tanks) removed by a septage P rior to Page of ootnditions ace frozen at the l nMradW SOrce System start up shad rat occur- when sod is restored the excess hi During pow o pump tanim Way above WN wag call(s)-and May MMA in the to the dispersal cdKs) in one large taNk retrtovr�d by a situation haw the contents o f th pump wagtai,,ater VA be bacMJp or at e m the effluent Prune 'Or Sepwe Servickv P ccontact a or Nlaint to �� to restore normal levels win the pump tank.. asses in marMW OPOM overlanksarodispersal cells. Do not drive or b over. or olhetwise distwb or compact. Do not drive or park Vellid" the area within 16 (feet down dioW of any mound or at -grade sod absorption the crud prolong the rite Re * or t� of the fmrn the wastawgier stream may imps dental boss; diapers: of the PO1W� � � butts: condoms. cotton swabs; degr+e meat wort Willi PUM) water: >rr vegetable pee disinfect '. o$ products; Pte' san � acrd weer soger>er twine. scraps; ABAIWONSU M' tatmct out of service the following steps shad tts taken to i� gat the When the POW MW with ch. Comm 83.33. w system is proper�l and the abandoned pipe sebled. AN piping to tanks and PIS strait and properly disposed of by a Septage S The of ad tanks and pas and removed or their removed -and the void space Ater PmVktg. 81 tanks and shM be wmvated filled with sod. 9raW or another inert solid nudmial. CONTINGENCY PLAN t be repaired the fodowi<ng m have been. or must be taken. to Provide a code if the POWTS falls and canno compliant reptacement sys and may be utd'med for th e l of a replacement soh area has been uca�ated and c ompaction and should not O The rat area should proms �sbvcdrre li and weds. Failure to Setbaq from a ds*v anti proposed be infringed upon by evaluation to a suitable � � t ee � the need for a ne w soa and site ewe � t1 ma the terms must oomph► � the ruies i n effect tepiaoetnent area. Replacement system due to setback and/or sod limitations. Baring advances in pOWTS a A suitable r�eP t area is rat a last resort to replace the faded POWTS. ted nolog ► a holding tank may be installed area Upon failure of the POWTS a sod and , =T he has not t>sen eva<t to identity a suitable replacement arr:a. If no re area is available a ` must be d to locate a suitable r ' be as a W resort to the failed POW TS. removal of the biomat at tank and at-9 pb°n rnafl reco n structed ust comply v� enac t at that tune. the kdam&e sudece. Rctions of such systems <<WARNING» MAY CONTAIN LETHAL- GASSES ANWOR INSUFFICIENT OXYGEN. SEPTIC. PUMP AND OTHER �pTMEW TANKS TANK UNDER N CIRCUMSTANCES* DEATH MAY A SEPTIC, PUMP OR OTHER TREATMIENT TOR DO NOT ENTER FROM THE INTERIM OF A TANK MA RESULT.. RESCU E OF A PERSON ADE)MONAL COLUKENTS . Pours awAMwTAa'I� . POWYS INSTALLER Name Name �� Phone Plane LOCAL REGULATORY AUTHORITY SEPTAGE SERWCING OPMT A t JC Name Ptwne � masts twos. FAs° a"d Wausl'ar' Cou�Y and San» 71ds doe Tres doe gre stags of We Green curd 83.54(1 }. t2) � t). �onsln A� t Code. ties of Ws doa� does run wa: dra�d pen► wort me MWMUm tee or CIL Car■n 83.Z�x xdltrm of the POWs guarata� �e � ' Wisn D4partment of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page —L of Division of S and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in ize. FRE I V E D Co my include, but not limited to: vertical and horizontal reference point (B diredti`on and 0 percent slope, scale or dimensions, north arrow, and location and dis nce to nearest road. Pa el I.D. # APR 2 5 2003 APPLICANT INFORMATION - Please print all inform ion ST. Ciiolx COUNT)' Re i y Dat Personal information you provide maybe used for secondary purposes (Privacy w, s. 15L"M)4gq)I9FFICE Property Owner Property Location Govt. Lot 1/4 jj1/4,S3� T 3 ,N,R �3 i)�r) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# /fi y /.2 City / State Zip Code Phone Number Nearest Road [T DOO f O/ � 2/ ) 26 •S ��o�oZ El city f �Vill . � .Town o? ❑ New Construction use: ❑ Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flo gpd Recommended design loading rate e �j bed, gpd/fi _'S trench, gpd/ft Absorption area required bed, ft trench, ft 2 Maximum design loading rate _ bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) , 9 9. ft (as referred to site plan benchmark) Additional design/site considerations O � .S tions L3 B � n'I VX .,,c gAd / do, Parent material (� L / G / L Flood plain elevation, if applicable N ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank u= unsuitable for system ❑ S 0 u WS ❑ u EIS O u I ❑ S 0 u 1 ❑ 1 ❑ S ER u SOIL DESCRIPTION REPORT Cali¢,,, J1 1, - uw Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench l o- a 3 �- 2 q -21 — s C- s , f Ground Alk 1V'4 elev IF 9 _ Depth to limiting fac ipir ; Remarks: Boring # ,S // Sdk RG C S Ground elev. /e , Depth to limiting factor -L&JR. Remarks: CST Name (Please Print) Signature Telephone No. SM "�"� �i� ;2 1,3-- Address �p Date CST Number SOIL DESCRIPTION REPORT 2 PROPERTY OWNER n Q> Page of .� PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Geptft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground el ev Depth to limiting factor 4in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; 11- y Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) i — o� o - -- - -- -- -- es PA iL - -- - - 6--e -- I -- - I- -- - I i �,