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HomeMy WebLinkAbout004-1077-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567225 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Greiber, Kenneth &Carla I Cady, Town of 004-1077-10-000 CST BM Elev: Insp.BM Elev:� BM )gcription: _ Section/Town/Range/Map No: rQI b3, VL, !✓/V 1l 32.28.15.498 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 1 CAPACITY STATION ' 0 1bF�1' FS ELEV. `� 3 id Septic ,n Z JZ 150 Benchmark LJ G , /6,3. 3 , es� �{ Dosing Alt. BM � , p /6:3 , 3y Go vw o 7vr0 �'� � Gd A-attars Pe !7 Bldg. Sewer �1 Holding St/Ht Inlet 3 TANK SETBACK INFORMATION St/Ht Outlet TANK TO �LA WELL BLDG. Vent to Air Intake ROAD Dt Inlet Se p tic \ I Dt Bottom 7 1,66 ��iZ 37 -- Dosing l / 3 Z, i Header/Man. C 7 60 l 9 y G•z5 /a3 . a Aeration Dist. Pipe Holding Bot.System 7, Z �pz- ot PUMP/SIPHON INFORMATION Final Grade Manufacturer V S Demand St Cover GPM Model Number 6P D TDH Lift 'iS Friction Loss System F{ead ITDIJ S l Forcemain Len)thy Diaz Dist.to well / / SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No✓ . Trenc s PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 4/ e 1--- SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Ty ystem: CHAMBER OR Model Number: a 7)66 Sy / 45 DISTRIBUTION SYSTEM Header/Manifold / Distribution �[ x Hole Size / // x Hole Spacing / Vet Air Intake Length•73 Dia + ' L ngth � r '� Dia /� Spacing Z 3 3 Z SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only a Depth Over / Depth Over xx Depth of ��++�� 1xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges To soil ' 1"C' g � p ��. (es 0 No Yes � No COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1:�/ � Inspection#2: Location: 2879 10TH AVE S rip ng Valley,WI67(NE 1/4 NE 1/4 32 T28N R15W) 40 acres Lot ` Pargel No: .28.15.498 1.)Alt BM Description= t^ r� �J f •r+ J 2.)Bldg sewer length= (QQ I �r -amount of cover= > 1Z a _n Plan revision Required? 7 Yes " No '3 b Use other side for additional information. _ Date Insepctor's Si ature Cert.No. SBD-6710(R.3/97) • �urs.�xr���• If t vt° 9 y _ ri 1/2 All- rorc� irra�,.� toy., ls`" / i commerceml.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 Cra~`.~ i sco n s i n Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co ) Department of Commerce S (Av 7 2,7_ S ary Permit Application State Transaction Number In accordance with s. M. Wis. Adm. Code, submission of this form to the appropriate governmental 55 ary permit unit is require ng a it . Note: Application forms for sta %owned POWTS are Project Address (if different than mailing address) e o mmerce. Personal information you provide s ubmitted t ent may /Qed for secondary G ~ ur oses in nce w' e Privac Law, s1 1 in Stars. e Z~ I vf(~- e 1. A lic I rmation - Ple a Print All I ation Property Owner's Name d- ( 0.r / Parcel # OJT ~ 09 ~ f S &41- A0 1-7 454qO Property Owner's Mailing Address / Property Location / 7 "yam Govt. Lot City, State Zip Code Phone Number A/0 'A Section 715--772.- ?,574!P T~-N; R~IEon'V I . Type f Building (c eck all that apply) Lot # / XI or 2 Family Dwelling - Number of Bedroo /(/,4 Subdivision Name /7 ' ❑ Public/Commercial -Describe Use 464 N/1.1°. Block # 4/h ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of is 11 Town of 5, a T4111 6ec 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) B. El Pegnit Renewal ❑ Permit Revision ❑ Change of Plumber List Previous Permit Number and Date Issued ermit Transfer to New Before Expiration TOqw:n er IV, Type of POWTS System/Component/Device: Check all that apply) OV ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: l Design Flow (gpd) Design Soil Application Rate(gp 0 Dispersal Area Requir (s Dispersal Area Propos (s System Elevation ,t,2 ow 6 IN-66 VI. Tank Info Capacity in Total # of anufacturer Gallons Gallons Units _ New Tanks Existing Tanks v U Septic or Holding Tank Dosing Chamber VII. Responsibility StatemJnt- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plu 's Name (Print) Plum is Signature l MP/MPRS/Number Business Phone Number Io 70~ 7! -`772 - Plumber' Address (Street, City, State, Zip CZ-e- W VII ount /De artment Use Only Approved ❑ Permit Fee Date Iss ed Issuing ent Signature even Reason for Denial 41 13 IX. Conditi!~OYIMtOIRt:asons for Disapproval ~ is Sepfi tank, effluent fitter and 3, t!o , 1-►`o>n !'o tfisperwill pellmust all be services / maintained w' as per management plan provided by plumb. I ICr emen mtxtba,triaintalped` (~.w. d- ffe Cale 1 airrfrit~s: Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I1 inches in size SBD-6398 (R. 02/09) '9gpART1Tp~21 Safety and Buildings \N 3824 N CREEKSIDE LA D 9~ HOLMEN WI 54636 3 S P Contact Through Relay S www.dsps.wi.gov/sb/ 20 www.wisconsin.gov 16 ~O sstoNP, Scott Walker, Governor Dave Ross, Secretary October 24, 2012 CUST ID No. 226524 ATTN: POWTS Inspector ROGER L TIMM ZONING OFFICE TIMM EXCAVATING ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/24/2014 SITE: Identification Numbers Kenneth Greiber Transaction ID No. 2165576 2879 10TH Ave Site ID No. 785302 Town of Cady, 54767 Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NW1/4, NE1/4, S32, T28N, R15W FOR: Description: Four Bedroom Mound System / 10% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1397772 Maintenance required; Replacement system; 600 GPD Flow rate; 17 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01101), SSWMP Pub. 9.6; Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed 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 P. 0. W requirements. !oIZ L• Cunt No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.0APPRO, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: D!V!SlON OF SAFETY AN Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the EE CORRESp N requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The existing POWTS shall be properly abandoned per SPS 383.33, Wis. Adm. Code. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. ROGER L TIM" Page 2 10/24/2012 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swi.rn@wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. ROGER L TIMM Page 2 10/24/2012 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov I Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future Jta reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE ~CEIVEa Oct 82012 Project Name: Owner's Name: Kenneth Greiber Owner's Address: 2879 10th Ave. Spring Valley WI. 54767 Legal Description: NW/NE S32 T 28 R 15 W Township: Cady County: ST. Croix Subdivision Name: 40 Acres `S• lly Lot Number: NA Block Number: NA it Parcel I.D. Number: 0041077-10-000 --1` ILDING$ Plan Transaction No.: Page 1 Index and title FENCE 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 P~~lppd~~f PJA,M T So~1 ~>r~~ ~ rl Designer: Roger Timm License Number: 226524 Date: 10/14/12 Phone Number: 715-772-3214 Signature: '4~ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) s R~ Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for fecal coliforrn of 36 inches. 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 10.00 Site Slope 100.50 Contour Line Elevation (ft) 17.00 Depth to Limiting Factor (in) / 0.60 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 110.00 Dispersal Cell Length Along Contour (ft) = 5.46 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 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) C~ Center or End Manifold 2.73 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.1561 Orifice Diameter (in) 4.00 Estimated Orifice Spacing (ft) = 10.73 ftz/orifice Forcemain Diameter (in) 120.00 Forcemain Length (ft) Does the forcemain drain back? 98.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 19.57 Forcemain Drainback (gal) 3.92 Vertical Lift (ft) 99.59 5x Void Volume (gal) 2.35 Friction Loss (ft) 119.16 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 30.16 System Demand (gpm) 10.81 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options- tions choice in. dia. options choice 0.75 1.25 x 1.00 ~ _ --__J 1 1.50 x x 1.25 x - 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) 1250.00 Septic Tank Capacity (gal) _ Total Working Liquid Depth (in) Wieser Concrete Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.00 Dose Tank Capacity (gal) Poly Lock Filter Manufacturer 16.12 Dose Tank Volume (gal/in) PLC 525 ) Filter Model Number Wieser Concrete Manufacturer Project: Page 2 of 7 Mound Plan and Cross Section Views 1 1/10 B • J Observation Pipe K - T 5 A W t. .l: - i.................... B I • L Mound Component Dimensions ft A 5.46 ft E E25.55 in H Eaft ft K [aft B 110.00 ft F 9.50 in z ft L ft D 19.00 in G 0.50 ft J W 600.60 (ft2) Dispersal Cell Area 2213.36 (ft2) Basal Area Available 5.45 (gpd/ft) Linear Loading Rate 11.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.88 (ft) ---0 G ♦ H I F 102.58 (ft) Lateral Dispef5al Cell 102.08 (ft)-♦ - Invert Dispersal Cell Elevation D J. J 1 J{ J J J ` 100.50 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key ' $ T Dispersal Cell See lateral details on 1❑ _ Topsoil Cap o c 1.5 ft y:i:::• r: Page 4 for number, size, Subsoil Cap a;z, and spacing of laterals. ::r:::::•.: ASTM C33 Sand ' Laterals are equally Tilled Layer m 0. ft Typical Lateral spaced from the © distribution cell's Aggregate 0 ~ centerline in the in the A distribution cell (AxB). Project: Page 3 of 7 Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifold at any point. Laterals are Wentrc al 14 P S • = Turn-up wf ball valve or 1E X +ml2 0291 Laterals & force main of PVC Sch 40 cleanouLplug per COMM Table 84.30.5 Holes d""d on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.02 ft Lateral Length (P) 54.27 ft Orifices per Lateral 14 Lateral Spacing (S) 2.73 ft Orifice Density 10.73 ftZ/orifice Lateral Flow Rate 7.54 gpm Manifold Length 2.73 ft System Flow Rate 30.16 gpm Manifold Diameter 1.50 in Total Dynamic Head 10.81 ft Forcemain Velocity 3.08 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and i Comm 16.28 WAC 4 in. min. Disconnect ~1 -ice Tank component is properly vented E-- Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacityl 750.00 Gallons _r Volume 16.12 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 29.13 469.64 C B - -2.00 32.24 Pump off elevation (ft) C 7.39 119.16 98.67 D _ 8.00 128.96 D Total 46.53 750.00 Dose tank elevation (ft) 3" Bedding un er tank. 98.00 Alarm Manuafacturer Se tronics Alarm Model Number 2501 Pump Manufacturer Gould Pump Model Number EPO 4 Pump Must Deliver 30.16 gpm at 10.81 ftTDH Project: Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name Roger Timm Phone i 715-7_72-3214 POWTS Regulator's Name ST. CRIOX Phone(_ 715-273-6747 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.6 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once even 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • . • • • • • • • • • • • • • • • • • • • • • Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Page 5 of 7 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Hera This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01 /01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective hocking 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, Slats. 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 fitter 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 fitter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter 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 104cfu/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. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, 4 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 7 ~GOULDS PUMPS Submersible Effluent Pump MODEL - EP04 & EP05 Series APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion Canadian Standards Association • Heavy duty sump matic models include resistance. SA. File # LR3s549 Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron Goulds Pumps is ISO 9001 Registered. Dewatering assembled and preset at the for efficient heat transfer, factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Solids handling capability: FEATURES cover with integral handle and • g cap ty: float switch attachment points. /a" maximum. ■ EP04 Impeller: Thermoplas- 0 Power Cable: Severe duty • Capacities: up to 60 GPM, tic semi-open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/z" NPT. seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) Intermittent. METERS FEET • Fasteners: 300 series t o stainless steel. 9 • Capable of running 3o 5GPM dry without damage to 8 - - - - , 2.5 Fr - - components. 25 ° 7 a - - - - - - - Motor: Lu x • EP04 Single phase: 0.4 HP, u 6 20 115 or 230 V, 60 Hz, 1550 a RPM, built in overload with } 5 automatic reset. ° t s J 4 • EP05 Single phase: 0.5 HP, o ! - - - - L.- EPOS 115 V or 230V, 60 Hz, 1550 ~ 3 10 RPM, built in overload with ! • 5 - _ ...i. EPOa - - automatic reset. z Power cord: 0 foot standard length, 16/3 1 -----------------t SJTW with three prong T... - grounding plug. Optional 20 ° % to 20 3o ao 50 GPM foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). o z 4 6 8 10 tz m3/h CAPACITY Goulds Pumps 2003 Goulds Pumps ective July, 2003 Eff ITT Industries _ yo AmrtJarc/ a I c^ >a ' 9 J j CGi~t h~ ~r,.h L ~ CPrGC i!'Intil je ! 4l? 16N 1 19 ~y,r A(c 4L = X03.3 W1250/750-MR TANK SPECIFICATIONS 155' DI TENSIONS WALL: 2 1;r BOTTOM ' COVER: 6' MANHOLE 24' I.D. PRECAST CONCRETE RISER HETGHT: 66' O.D. LENGTH: 155. O.D. WIDTH; 66' OD. / \ BELOW INLET: 5r OD. 4' 'AST-A-SEAL LKIUD LEVEL: 46' 4' CAST-A-SEAL WEIGHT: 14.660 LBS. SEPTIC n1 1 INLET AND OUTLET: 0 4* GASKET. CAST-A SEBOOT OR EQUAL AL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: FILTER OR WISCONSIN. SEE DETAIL #I0 BAFFLE / (OTHER STATES SEE CHART) UQU1D CAPACITY: 27.66 GAL/IN (SEPTIC) 16.12 GAL/)N (PUMP) LOADING DESIGN: B' 0* UNSATURATED SOIL MN TANKS WILL HAVE ONE VENT OVER OUTLET AND WILL HAVE TWO VENTS IN COVER OVER INLET TANK CAN BE USED AS 4' VENT SEPRC/SEPTIC. SEPTIC/PUMP OR SEPTIC/SIPHON COVER MIX DESIGN # (NO FIBER) TANK: MIX DESIGN /10 (STRUCTURAL FIBER) CUSTOMIZED TANKS L, - - FOR CUSTOM TANKS CONTACT WIESER CONCRETE 2r t, fi PUMP PAD TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM 0-1227 REQUIREMENTS ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ILA n 6 Mailing Address -7q 10 t '/71/1 7 i Property Address (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number 066 1_ /O 7`7 - j0 - 660 LEGAL DESCRIPTION Property Location A/k) AJF '/4 , Sec. 3 Z , T Z0 N R_Z~LW, Town of Subdivision Lot # Certified Survey Map #UG . , Volume , Page # Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable es 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 of bedrooms SIGNATURE 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) U 1886P 5 2 3 6'7840 STATE BAR OF WISCONSIN FORM 2 - 1999 XATHLEEM H, WALSH Document Number WARRANTY DEED REGISC Co., TTEEIRxOF DEEDS This Deed, made between Kenneth A. Greiber and Carla J. RECEIVED FOR RECORD Greiber, husband and wife 05_08_2002 9--30 AM WARWNTV x~T 0M 1 Grantor, and Kenneth A. Greiber and Carla J. Greiber, husband and wife, holding as survivorship marital property REC FEEL 11.00 TRANS FEE: COPY FEES CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Northeast Quarter of Northeast Quarter (NE 1/4 of NE 1/4) of Section Recording Area Thirty-two (32), Township Twenty-eight (28) North, Range Fifteen (15) Name and Return Address West. Thomas A. McCormack 2120 S THIS DEED IS EXEMPT FROM TRANSFER FEE AND RETURN PO Box Baldwin, , WI WI 54002 PURSUANT TO SEC. 77.21(1), STATS. 004-1077-10-00 Parcel Identification Number (PIN) This is homestead property. oboxg) Exceptions to warranties: Easements and restrictions of record. Dated this day of G", 2002 ' • Kenn e . G fiber _ R ZA~ • + Carla J. Greiber AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSE4 ) )SS. St. Croix County ) authenticated this day of /j~ P rsonally came before me this day of _ / / 2002 the above named Kenne A. Greiber and Carla J. Greiber TITLE: MEMBER STATE BAR OF WISCONSIN - ([f not to me known to be the person(s). ho executed the foregoing authorized by § 706.06, Wis. Stats.) instrument `acknowledged t sam P Mi i~ THIS INSTRUMENT WAS DRAFTED BY « ) - U .y Thomas A. McCormack Notary Public, State of Wisconsin - i Baldwin, WI 54002 My Commission is permanent. a Eic0iwt7l n alit-6 - - (Signatures may be authenticated or acknowledged. Both are not necessary.) ) • Names of persons signing in any capacity must be typed or printed below their signature. trtormat ngvly. Fans du lac, WI STATE BAR OF WISCONSIN eoo sss z°zr WARRANTY DEED FORM No. 2 - 1999 f ~ 91 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8'/s x 11 inches in size. P~+/~Ian~It ielv St. Croix Include but not limited to: vertical and horizontal reference point (BM), ction and - Parcel I.D. 004-1077-10-000 Percent slope, scale or dimensions, north arrow, and BM referenced to n 2f! R iewe Please print all information p~ sr Date/ r/ Personal information you provide may be used for secondary purposes (PrA~- e~(1) m)) L~N,V'~- Zd / Property Owner Property FFjCE Kenneth Greiber p I Govt. Lot NW NE v, s 32 T 28 N R 15 w Property Owner's Mailing Address -Tr Lot # Block # Subd. Name or CSM# 2879 10" Ave City State Zip Code Phone ❑ City ❑ Village Q Town Nearest Road Spring Valle WI 54767 Cad 10°i Ave. ❑ New Construction Use: Q Residential / Number of Bedrooms Code derived design flow rate GPD Q Replacement ❑ Public or Commercial - Describe: Parent Material Loess Flood Plain elevation if applicable N/A ft. General comments and recommendations: + 1 Boring # Boring Q Pit Ground Surface Elevation 100.0 ft. Depth to Limiting factor 17 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell u. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10YR3/3 - SIL 1-m-bk dsh gs 3 f-m 0.4 0.6 2 5-10 10YR3/3 - SIL 2-m-bk dsh CS 2f 0.6 0.8 3 10-17 10YR4/4 - SIL 2-m-bk dsh gs if 0.6 0.8 4 - 0+ 10YR4/4 5YR4/4 c-1-f SIL 2-m-bk mfr - If 0.6 0.8 2] Boring # ❑ Boring QPit Ground Surface Elevation 101.5 ft. Depth to Limiting factor 20 in. Soil ADDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR3/3 - SIL 1-m-bk dsh CS 3 f-m 0.4 0.6 2 10-20 10YR4/4 - SIL 2-m-bk dh gs if 0.6 0.8 3 -30+ 10YR4/4 7.5YR4/6 & 5YR4/4 f-2-d SIL 2-m-bk mfi - 1f 0.6 0.8 • Effluent #I = BODS> 30:5 220 mg/L and TSS > 30:5 150 mg/L ' Effluent #2 = BOD, 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) Signature CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 September 24, 2012 715-796-5664 Property Owner Kenneth Greiber Parcel ID# 004-1077-10-000 page _Z-of 3 P1 Boring # ❑ Boring ®pit Ground Surface Elevation 100.0 ft. Depth to Limiting factor 19 in. SO Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color *Eff#1 'Eff#2 1 0-5 10YR3/3 - SIL 1-f to co- on gs 2f-m 0.4 0.6 2 5-12 10YR3/3 - S I L -m-bk dh cs if . 0.6 0.8 3 12-19 10YR4/4 - SIL 2-m-bk dh gs 1f 0.6 0.8 4 - + 10YR4/4 5YR4/6 f-2-d SIL 2- -pl mfr - 1m 0.6 0.8 O Boring 4 Boring # 0pit Ground Surface Elevation ft. Depth to Limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDte in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 70#1 'Eff#2 a Boring # 0 Boring OR Ground Surface Elevation ft. Depth to Limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKe in. Munsell u. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 * Effluent # 1= BOD3 > 30:S 220 mg/L and TSS > 30:5 150 mg/L * Effluent #2 = BOD5 5 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. Page 3 of 3 0 ft. 24 ft. 40 ft. 80 ft. N Well is northeast of house and all property lines are greater than 200' from the proposed system area. Q U C U O ~o W B3 • e Co P %JW 112" 100.0 di Z09 B-2 gM#1 101.5 103' 102' 101' B-1 100.0 100' 99' 98' 97' BM# t'o Eleva on W = Bench Mark 00, = Boring Location & Elevation Owner: Kenneth Greiber Site Information: Completed By: Mark Iverson, PSS #197 2879 10th Ave NW1/4, NE1/4, S32, T28N, R15W 680 Larcom Street Spring Valley, WI 54767 Town of Cady Hammond, WI 54015 St. Croix County 715-796-5664 Phone: CST# 46672 -0 C) M ° 6 d O tl 41 0. N I', N I ~ I! I v I I CF) c H d ayi ~ c Z N Co c LL c O O ! II 3 ~ 3 ! 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