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HomeMy WebLinkAbout231-1047-70-035 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT sanitary Permit No: (ATTACH TO PERMIT) GENERAL INFORMATION state Plan ID No: 567221 0 Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)]. ­W_ Permit Holder's Name: X City Village Township Parcel Tax No: Deiss, Larry City of Glenwood 231-1047-70-035 CST BM Elev: Insp.SM Elev: BM Description: Section/Town/Range/Map No: I G 27.30.15.754H TANK INFORMATION �`✓�- ELEVATION DATA TYPE MANUFACTURERS FAPACITY STATION j3s HI FS ELEV. 't 3 Septic ,t I �aOU Benchmark / L� Dosing t Alt. BM on Bldg.Sewer c� Holding , t/Ht Inlet c� �v 1 �• 7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. ent to Air Intake ROAD Dt Inlet \ Septic 7 56 �-• Z) Dt Bottom Dosing Ise / Header/Man. Z y Z f 15Z N Z, Aeration Dist.Pipe t' Holding Bot.System Z •� /1S ! • 7 PUMP/SIPHON INFORMATION Final Grade Manufacturer Z, M.3. Demand St Cover / {i GPM w}-- tcl v t�. /l• �.3 • (o Model Number IG/� . 1 1 � z3• �� / N i f 3, TDH Li�t�• Frictio Lo System Head TDH // t 0 , Forcemain Leng�� Dia.Z Dist.to well SOIL ABSORPTION JYS TEM BED/TRENCH Width Lnn No.Of T ies PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth_ DIMENSIONS a _-`` SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O�j y�►tem: nil!O ✓ �� , 56 UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifyld L Distribution L x Hole Size x Hole Spacing / Vent t r Intake ��J Pipe(s) Length Dia Length Dia 1'6 Spacing 3 3„!J � SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges ` Topsoil No "-�ea Ed No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: -71 Z 4/ ! P ��spction#2: Location: 150 Surrey Ridge Trail lenwood Cit,WI 54013(SE 1/4 SW 1/4 27 T30N R1 5W) A Lot 8� — '—'parcel No: 27.30.15.754H 1.)Alt BM Description= �~l Iles r 2.)Bldg sewer length= 2-�. / G'• ,,� d-- � Q v a Y`, -amount of cover= Plan revision Required? Yes No Use other side for additional informa4io . — - -- SBD-6710(R.3/97) Date Insepct— or's ature Cert.No. Co IQ cl- 4Z OA COU t r Industry Services Division C.rO~ r ct t ton Ave Sanitary Permit Number (to be filled in by Co.) OEWashing 140 a•i P I-i P.O. Box 7162 S ' Madison, WI 53707-7162 ~ '2 - ..~x Y~ i% . State`Transaction Number Nermit Application 136 In accordance with S 3. ,Wis. ode, submission of this form to the appropriate governmental unit is required prior to ob , a s permit. Note: Application forms for state-owned POWTS are submijtgEo Project Adf different than mailing address) the Department of Safety and rofessional Servies. Personal information you provide may be used for sec ur oses in accordance with the Privacy Law, s. 15.04(1)(m), Stats. / <O _ 7r 1. Application Information - Please Print All info, n S el # ~a I Property Owner' me uNr1 231- /10 hl7. 76 - 35 Property Owner's Mailing Address Property Location ari ~ ~ &0 Govt. Lot n Section O` City, State • / Zip CodPhone Number L DO~ [Y ~~V 3 7 7v~- T 6/ T ?110 N: R __,~lE one II. Type of Building (check all that apply) Lot # - Subdivision Name or 2 Family Dwelling - Number of Bedrooms 6,4- a Llock ❑ Public/Commercial -Describe Use tO-f lage of / r 5 O Z_] ❑ Vil State Owned -Describe Usel own of G ~ 75 S/ 30441 III. Type of Permit: (Check only one box on line A. Complete line B if applicable A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Pen-nit Renewal El Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground 11 Pressurized In-Ground. ❑ At-Grade Mound > 24 in. of suitable soil ❑ Mound < 24 in. of sui ble soil ❑ retreatment Device (explain) i ❑ Holding Tank ❑ O er Dispersal Component (explain) V. Dispersal real ent Area Information: Dis ersal Area Proposed (sf) System Elevation Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Re uired (sf) P / .yo (7 l/.1,tI 1. Tank Info in Total # of Manufacturer y c Capacity V Gallons Gallons Units o ~ „ V ~ ❑ 33 A New Tanks Existing Tanks t c. U v) ii C7 0- w Septic *wwiiot~ank 4A - , I /7w Dosing Chamber G ' ®d VII. Responsibility Statement- I, the undersigned, a me res on ' i for installation of the POWT w o Nhe attached plans.usiness Phone Number Plumber's a (nPrint)/q Plu s ?-Jr- Plumber's Address (Street, City, State, Zip Cgt~e) i L~ .00 IF 70 4f VIII. Coun /-e artment Use Only Issuing A t Signature d Permit Fee Date issued g Approved iven Reason for Denial t!' p~ IX. Condi*tg'j#pAV{I 0p Reasons for Disapproval • x ~j tLQ• ('0-U ~G 1- Septic tank, effluanfi fNter and t X~ / / ~ g r~ . ~ ~ dispersal cell,must all be servits / Mjhtart14Q e- as per management plan provided bypw r. / I Al selpapk 0 . emectts must be r ontiblio x I t inches in size Attach to complete plans for the system and submit to the County only on paper not less then 8 in SBD-6398 (R0313) s ~ y Q~pkRTM DIVISION OF INDUSTRY SERVICES e ~oA PO BOX 7162 Uo~ P MADISON WI 53707-7162 i 3 S _ Contact Through Relay 9~ l P S www.dsps.wi.gov/sb/ Qw www.wisconsin.gov Q ~o sSIONALSw Scott Walker, Governor Dave Ross, Secretary September 24, 2013 CUST ID No. 139462 ATTN.• POWTSInspector TODD L SINZ ZONING OFFICE TL SINZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751-5520 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/24/2015 Identification Numbers Transaction ID No. 2309415 SITE: Site ID No. 795771 Larry Deiss Please refer to both identification numbers, S y Ridge Trail above, in all correspondence with the agency. of Glenwood t Croix County SETA, SWIA, S27, T30N, R15W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1450358 Maintenance required; 450 GPD Flow rate; 27 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Distribution Component Manual - Ver. 2.01 SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). All industrial waste shall be properly disposed of onsite or offsite. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch COND wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. APP • The tall grasses, shrubs and leaves need to be cut short and removed prior to plowing the surface for DEPT OF installation of the dispersal component (drainfield) to prevent matting under the dispersal area. PROFESSt0 • The area within 15' down slope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavaWSION OF 1N or soil compaction is prohibited in this area. SEE ~ORPJ TODD L SINZ Page 2 9/24/2013 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Fee Received $ 250.00 ance Due $ 0.00 Bal Sa4Sh~# Engineering Consultant, Integrated Services WiSMART code: 7633 (608) 264-7782, Monday - Friday 7:45 am - 4:30 pm sally.shumaker@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am to 4:30 pm TL Sint Plumbing Inc A~j r ,i 7 ae TODD L SINZ Page 2 9/24/2013 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Fee Received $ 250.00 " - Balance Due $ 0.00 Sally jShakAWk Engineerin g Consultant, Integrated Services WiSMART code: 7633 (608) 264-7782, Monday - Friday 7:45 am - 4:30 pm sally.shumaker@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am to 4:30 pm TL Sinz Plumbing Inc n 43"~ y~Lrl'ir. t~tW~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Deiss New Sewer Owner's Name: Larry Deiss Owner's Address: 2515 130th Ave Glenwood City Wi 54013 715-308-4692 Legal Description: SE 1/4, SW 1/4, Sec. 27, T30N, R15W Township: Glenwood County: NA Subdivision Name: NA Lot Number: NA Block Number: NA Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Tank specifications Page 9 Site plan 1" = 30' Designer: Todd L Sinz License Number: MP139462 Date: 09/07Ywfz Phone Number: 715-235-2644 Signature: ZONALLY LOVED Designed Pursuant to the >AFETY AND Mound Component anual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 10/12), and both JAL SERVICES SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and USTRY SERVICES Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 :SPONDENCE Mound and Pressure Distribution Component Design Design VVorksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 450.00 Design Flow (gpd) 7.00 Site Slope 101.00 Contour Line Elevation (ft) 27.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft ) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (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) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 10.23 ft /orifice 2.00 Forcemain Diameter (in) 150.00 Forcemain Length (ft) Does the forcemain drain back? L- Y 85.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 24.47 Forcemain Drainback (gal) 16.38 Vertical Lift (ft) 67.44 5x Void Volume (gal) 1.88 Friction Loss (ft) 91.91 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 23.69 System Demand (gpm) 22.80 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (,optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Huffcutt Concrete Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 640.00 Dose Tank Capacity (gal) Orenco E4Bk:_E] Filter Manufacturer 15.23 Dose Tank Volume (gal/in) FT0822-Filter Model Number Huffcutt Concrete Manufacturer Project: Deiss New Sewer Page 2 of 9 Mound Plan and Cross Section Views t . 1/10.6.. . J Observation Pipe K:~. . •5, A W ;E. t. B . • • . . . . . . . . . . . . . . I L Mound Component Dimensions ft K 8.26 ft A 6.00 ft E 14.04 in H Eilft B 75.00 ft F 9.50 in 1 ft L 91.51 ft D 9.00 in G 0.50 ft J ft W 20.41 450.00 (ftz) Dispersal Cell Area 1151.11 (ftz) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.54 (ft) -i ♦ H G j I F 102.25 (ft) Lateral Dispersal Cell 101.75 (ft) - Invert Dispersal Cell © t Elevation IE D t 4 F 101.00 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key m 2- Dispersal Cell See lateral details on 0 Topsoil Cap c a 1.5 ft :Page 4 for number, 2 Subsoil Cap c size, and spacing of ASTM C33 Sand 5 ° laterals. Laterals are Tilled Layer d 0.5 ft Typical. Lateral. equally spaced from the W distribution cell's Aggregate o centerline in the i - A distribution cell (AxB). Project: Deiss New Sewer Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over the & dimension 0 = Turn-up Ydball valve orcleanoutplug p .I All laterals are identical IE X~I Holes drilled on the bottom of the lateral S equally spaced Force main connection via tee or cross to manifold at anu point. Laterals Morcemain Sch 40 PVC per SPS Table 384.30-6 Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.50 ft Lateral Length (P) 73.50 ft Orifices per Lateral 22 Lateral Spacing (S) 3.00 ft Orifice Density 10.23 ft2/orifice Lateral Flow Rate 11.85 gpm Manifold Length 3.00 1 ft System Flow Rate 23.69 gpm Manifold Diameter .50 2 in Total Dynamic Head 22.80 ft Forcemain Velocity .42 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented E Altemate outlet location Forcemain diameter Huffcutt Concrete Manufacturer 2 in. Capacityl 640.00 Gallons Volume 15.23 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 23.49 357.72 B 2.00 30.46 C Pump off elevation (ft) C 6.03 91.91 85.88 D 10.50 159.92 D Total 42.02 640.00 Dose tank elevation (ft) Bedding under tank. 85.00 Alarm Manuaaacturer SJE Rhombus j Note: Switches Alarm Model Numbe Tank Alert 1 containing mercury may not be used in Pump Manufacturer Franklin this system. Pump Model Numbe SE-40H Pump Must Deliver 23.69 gpm at 22.80 ft TDH Project: Deiss New Sewer Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name T L Sinz Plumbing Inc. Phone 715-235-2644 POWTS Regulator's Name ~St Croix Co. Zoning Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 f:2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once every 3 ears Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound Inspect for pondin and seepage once every 3 years 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 mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 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 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution` Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Deiss New Sewer Page 5 of 9 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 [SBD-10691-P (N.01/01, R. 10/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with 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 filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L 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 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continuency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 9 SE-40H Series 4/10 hp Submersible Effluent Pump - High Head, 3/4" Solids FLOW - LITERS/MINUTE 0 50 100 150 200 250 Motor Housing Epoxy Coated Cast Iron 35 10.0 Impeller Material Polycarbonate 30 Impeller Type Closed Vane 25 8.0 Volute ABS Power Cord SJTW 20 6.0 Mechanical Shaft Seal Nitrile with Carbon s and Ceramic Faces 15 °a Fasteners Stainless Steel 4.0 = Shaft Stainless Steel 10 Upper - Sleeve Bearings 2.0 Lower - Ball Bearing 5 } Q 0.0 ( J 0 10 20 30 40 50 60 70 FLOW - GALLONS/MINUTE 11.65" 5.65" X1-71- I " ;A41.5'DISCHARGE 9.30 7 O 9.00" 3.91' Aljl~~ r SCREEN TO PASS W SOLIDS 55.0 41.0 32.0 13.8 20' 24.0 1,750 SE-40H-AF 1 50509341 9361 1 4/10 I 23230 0 I 1.5" FNPT 6.5/1000 70.0 1 664.0 4.0 1 55.0 f 41.0 132.0 113.8 I 20' ( 24.0 1,750 Franklin Electric 400 East Spring Street, Bluffton, IN 46714 Tel: 260.824.2900 • Fax: 260.824.2909 02011 FranMin Electric Co., Inc. 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CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Deass Mailing Address' Property Address J 5C5 6u rre /G `d~ ra o0 (Verification required from Pla g & Zoning partment for new construction.) ` e""(~• City/State Parcel Identification Number ~C LEGAL DESCRIPTION Property Location CSC 1/4 , cSW11a , Sec. T 30 N R~W, Town of Subdivision , Lot # Certified Survey Map # 3C~ y , Volume , Page # 30. Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe 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 deed r orded in Register of Deeds Office. Number o edr om °S4NATURE 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. 08/05) Aug.29, 2013 1,46PM ALBRIGHTSON EXCAVATING INC No,3367 P. 1 3 a s 8 Tx64 38226 7 '71 a 982041 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WY 07/11/2013 12:33 PM EXEMPT*; N/A REC FEE: 30.00 TRANS FEE: 90.00 I)MUMNCNO• STAT'H BAR OF WISCONSIN FORM 1.2009 ~vAxtt,uv tY n mo TATS DEED, madcbetween liruco U. Husby and Connie J. Husby husband and wife CkCka tlor:' w5cthar one or more) convoys and wa,ranis to T.Arey T. Delas C 'Grantee', whether mie or wore), the Wowing described red estate in ST CROIXCouoty, State ofWisoonsin: Lot S of Cardfled SuvveyMap, filed.l'anvary" 30, J996tin'Val, 11 or C.S.M., pg. 3049, as Doe, No. 5399 7, Iocited.in the SE'.G'of the SEY, and. part of the MV14 of the SEX, Section 27, Townsblp 30 North, Range 15 West, City of Glenwood, St. Croix County, Wisconsiu, RETUMTO St. Croix Counb• Abstract & Title Co. (r)c, 219 S. Knowlcs•Avcnuc TpvRiormond, WI $4017 " . Ta..P:ucetVe: ?~1-1047-70-075 ' This is not homaetead property Exception to walTelitteA. Municipal and zonluz ordinances end agreodtents entered under Ihern, recorded easements for Qte dishibiWon of utlllty and mynlcipal servicea,recorded boding and use restrlc(lons and covenants, and further excep12013 real cs[ate' W!tos. Dated this 9th day of July, 2013. . Bruce t. Rujbv Connie Y Ffusb) AUTHENTICATION ACK1 O OLEO GNIENT Sipotureg authenticalod this day of STXrB OFNIft,11,C230A, 201 . ss. COUNTY OF TfaR MEMBERSTATE DAR OF WISCONSIN personally cama before me this 91h day of July, 2013, tho above (If not, named Bruce R. Ilusl)y and ConnleJ, Husby, husbitnd and wife authorized by § 706.06, Wig. Stats•) a known to be dte person(s) who axecured the foregoinz instrument and acknowledge the same. THIS WSTRUMIDITIVAS DRAMD BY Robert L" Y„ oberg I Loberg Law O(Ticc r N t Iic Co , MN 1314945/sip 20l b1y Corntxtission is peitnancut. (if not, state expiration da(e) ~ti✓• (Signatures maybe auibenliciled or eckno\vlcdged. Both are 001 necessary.) CHRISTOPHER J. RAMMAKERS ~N,r:, orpe wJ, ytr~ m ~y csy~ty jep rtf ae gped a prmrd bcln* Jxv rsx•enr NOTARY PUBLIC - MINNESOTA 1 of 1 watt &NI necu a My Coomissloa Expires Jan. 31, 2017 fwm gyp. 1.700.1 FORM NO. 985-A Stock No. 26273 ED 4mo- r9i ~ 539Ok 0 1996 s 11 01 Deeds CERTIFIED SURVEY MAP NO. 3049 ' VOLUME 11 , PAGE 3049 THE SOUTHEAST 1/4 OF THE SOUTHWEST 1/4, AND PART OF THE SOUTHWEST 1/4 OF THE SOUTHEAST 1/4, SECTION 27, TOWNSHIP 30 NORTH, RANGE 15 WEST, CITY OF GLENWOOD CITY, ST. CROIX COUNTY, WISCONSIN OWNER: SCALE: 1"=300' AMERICAN INVESTMENT CO. 1873 13 1/2 AVE. HWY 8 E P.0.8OX 99 BARIUM. %M 54812 O' 150' 300' 600' DRAFTED BY : I DONALD M. CLARK UNPLATTED LANDS / L18' I N 89'13'35' W 483.57' N 89.33'10' W ae vrsv v~ s¢ r, 1313.31' 433.04' S N N LOT 7 I 1Z* 515,221 SQ. FT. (11.83tACRES) ~a S 78• 495,905 SQ. FT. SI o1• g (11.381ACRES) LESS R\W a' s LOT S 1412.46• 1443.73' I / ao _ a 499,133 SQ. FT. / o NI (11.46tACRES) 33. cal a 491,739 SQ. FT. ¢j (11.29tACRES) LESS R\W JI ~ a ZI N 89.35'20' E 1384.00' ¢ w Lj I 1351.00' 3 LOT 9 Fal ¢I $g 414,904 SQ. FT. Hj di o A (9,52tACRES) 405,217 SQ. FT. _i bo (9.30tACRES) LESS R\W Jj b{ ►m I w ao y N 89'35'19' E 1383.54' a_ _ 1350.54' :DI co N - 6 W s LOT 10 W - WSW 9 470,355 SQ. FT. eI m co to (10.80tACRES) 8 458,791 SQ. FT. 5.5' <10.531ACRES) LESS R\W 38.71 mnN Lae W se 1/ ~ L< sec. [l S 89.34'53' E 1311.30' 1.70' 2550,54. 1 S 88.55'42' E N 88.55'42' W 2622.24' SOUTH 1/4 CORNER SOUTHEAST CORNER UNPLATTED LANDS SEC.27, T30M R15W SEC.27, T30M R15W ST. CROIX CO. MONU. ST. CROIX CO. MONU. G 0 h S~ DONALD M: * LEGEND g1ASR~K 2 GOVERNMENT CORNER W140MONIE, (AS NOTED) SET, 34 WEIGHING-1.502 RU3S. R PER UNEAL FOOT. ~etsci~l~ /!7 CEDAR CORPORATION 604 WILSON AVENUE MENOMON/E, W! 54751 (715) 235-9081 PAGE( OF--Z- Wisconsin Department of Comm SOIL EVALUATION REPORT Page of Z Division of Safety and Building~~ in accordance with Comm 85, Wis. Adm. Code v r County Cr Attach complete sl Ala n p r not less than 8 1/2 x 11 inches ir~iEag' ,r/`j) ~ include, but no it to: v ical and horizontal reference point (BM), directio +a~(e Parcel I.D. percent slope, U0 or ' ensions, north arrow, and location and stance to nearest road. 231-10-17- - - a3 Please print all information. ACT Q 4 t3 Revie d by Date Personal information you provide may be used for secondary purposes (PrYtcy Law, s. 15.04 (1) (m)). Property ° 41-- ocation Z?- LL Q` s Govt. Lot .14 1/4 1/4 S Qf~ T O N R E (or) Q( Property Owner's Maili dress Lot Block # Subd. Name or SM# 122 6/ ;f U-No- City State Zip Code Phone Number ❑ City ❑ Village a Town Nearest Road 942&1 5YO13 1 64 ~e a.1 t.,) o oalill' 'S (A- 10 V%, 14 W-New Construction Use: Residential / Number of bedrooms Code derived design flow rate YT d GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material e &L AZ~J. V1+w~ Flood Plain elevation if applicable tt -Ss General comments ~ll r o and recommendations: r(~ LD/M'►l~Y► ~ .S d. tF ~ I'►''hD w/kT Vi 7 0 s ate, / GJ 5v~i~ ✓ /OJi I Boring # Boring - P/1 ~ pit Ground surface elev. _:7~ ft. Depth to limiting factor(Q?!7 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 o-/0 31,ZE -;4/-- s 3-~ o ill"ID-M A9 3 3 ~ 5 Ana ~ D- D-~l VW,% 0 C C- -e 57 C-- boll lpr~~ Boring # Boring ® Pit Ground surface elev/PA ! O ~ft, Depth to limiting factor C;", 0 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 0 17V p-5 'o /Wrip, 0 o~ oy r3 s lift s tur•-P~- o- 6."01, 0 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 rrjp/L Effluent #2 = OD < 3 mg/L and TSS < 30 mg/L CST Name (Please, Print) Si atu CST Number ~L Address Date Evaluation Conducted Telep one Number ~~D~ Page ~t Property Owner Parcel ID tt _ Bon F31 Boring # Pit Ground surface elev. 9 h Depth to limiting fador inSoil Application Rate 0 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF Gr Sz Sh 'Ef $1 'Etf#2 in. Munsell Qu. Sz. Cont. Color 00 C" 6. D mat S elk Boring Bonny tt ft Depth to limiting factor in. Soil licabon Rate HPIt Ground surface elev. Hohzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots EttGPDIffEL r. Sz. Sh in. Mansell Qu. Sz. Cont. Color - I Bonng Buiurg tt Ground surface elev ft. Depth to lirniuny facto( _ in F Pit ff# MlE Application Rate /ff Horizon Depth Dominant Color Redox Description Texture Structu e Consistence Boundary Roots f#2 in. Munsel l Qu Sz. Cont Color Gr Sz Sh _ Effluent #1 = BOD, > 30 < 220 rnglL and TSS >30 < 150 mq/t. Effluent #2 =HOD. < 30 mg L and TSS < 30 mglL The Department uf'(ununerce is an equal oppornmily service pr- idcr and emplovCr 1 t v,iU need <JSSi,t;rnco to access srn ices or need material in an alternate t6rinat, plctusc contact the dcparunent at 6021-200-3151 or I-hY 008-204-8777. SU1933M-1 rK unitiq 00, \ Page ~f Property Owner , S J Parcel ID # Bon n a Boring # Ground surface elev ft Depth to limiting factor C in. Soil Application Rate Pit . Roots GPD/fg Horizon Depth Dominant Color Redox Description Texture Grt SzuSh Consistence Boundary 'Effai Eft#2 in. Munsell Qu. Sz. Cont. Color 6. D ~ s ~S I J o n 1 '00? M~ mat s pcei C. Boring # Boring fl. Depth to limiting factor n Soil lication Rate Pit Ground surface elev. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Sz. Sr) ftg1 Gr. in. Munsell Qu. Sz. Cont. Color ❑ Boiuig # Boring Ground surface elev, ft. Depth to limiting factor in. Soil lication Rate Pit GPDff Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Effrt1 Eff#2 in. Munsell Qu. Sz. Cont Color Gr Sz Sh Effluent #2 = BOD. < 30 mg/L and TSS < 30 mg/L ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L The Department of Commerce is an equal opportunity service pn,vidcr and employer. it ~uu necd assistance to access services or need maieria in an alternate lbrmw, plcrLS: contact the dcparurnent at 6118-266-3 1 S 1 or 1-1-Y 608-264-8777. SBD4 3301 ni (k 1)7AX)) C ~ 0 b~ V W Olt=. d s ~J cr V a ~ Q I o 0 INA ~ o i M C Q