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HomeMy WebLinkAbout004-1041-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567236 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: Riek, Brenda L. C/o Jon Amundson Cady, Town of 004-1041-40-000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town/Range/Map No: bc), 0 j (b 18.28.15.278 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER •~~3 CAPACITY STATION BS HI FS ELEV. 3. / A3~ /GIG Septic Z /did Benchmark 2 SS ~a3~ 5 Dosing L-0-06 e"LUN 13 660 60 Alt. ~t-l 1aZ Aeration Bldg. Sewer Holding St/Ht Inlet • 2 f -,z 1, Is .O 9S• ~ TANK SETBACK INFORMATION St/Ht Outlet J_ TANK TO P/L WELL BLDG. Vent to . Intake ROAD Dt Inlet Septic T7 Dt Bottom Dosing / Header/Ma ~o0 72, 197 9tS U"VT -L." 4." Ps S 10L,41 Aeration Dist. Pipe Z, 211 - Holding Bot. Syste PUMP/SIPHON INFORMATION -J (-1 ►LC`'fl Lys ?c Gh 'l. Final Grade S 7 Manufacturer -116 01 1 t Deman 4 St Cover Model Number c 4.S°n>" ~~~ovT 4 3.ss iad TDH Litt / Fri~io ~ n "s System Hemet DH Ft I ' hJ L ' Forcemain Lengt r' t Dia j, Dist. to Well SOIL ABSORPTION SYSTEM w1t EZ~/v_ BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth < DIMENSIONS 30 SETBACK SYSTEM TO P/L BLDG WE LAKE/STREAM ING Manufacturer: INFORMATION HA OR Tyrvq"4'44 ystem: UNIT > 17 I ID01 Model Number: I I C 1 , DISTRIBUTION SYSTEM , A / j c ' /0--pi Ll' Heade Manifol Distribution x Hole Size tx Hole Spacing Vent to Air Intake? Length Dia l- ngth-TL Dia Spacing ` g 3, $ 7 91d 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 a] Yes g] No ~ Yes E No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /d / Z-l / /3 spe~tion #2 / 13 Q 1~!- o if-'~-a o U Location: 356 Cty. Rd. NN Wilson, WI 54027 (SE 1/4 NE 1/4 18 T28N R1 5W) 40 acres Lot Par I too: 18.28.15.278 1.) Alt BM Description = {HOC 2.) Bldg sewer length = = _t - amount of cover Cat ~n g~ Q D Plan revision Required? ~ Yes o Id I/ Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Si nature Cert. No. LL S s. - `I 7 - ,t / -Y i r ~7~. 44 I A l r 21 4 - is Zo 4 ' r t9 ~ t- _ © i. r 9 - 't Clarence Glotfelty Enviro-Tech Systems & Services ` N4955 Sunny Hill Road- Weyerhaeuser, WI, •54895 Engineering Data I 9.15' I S Rim 9.60' 9EN-CIA-SFS 9EN-CIA-RF 960' 4,6T --I 9.15' GO, VL 9EN-CIM Performance GPM @ Head Dimensions Solids Size Running Amps/ 5' 10' 15' 20' 25' Shut Off Cord Weight H X L X W (in) Item Model HP Volts HZ (dia.In.) Watts (ft) PSI Length (Ibs) 509260 9EN-CIA-SFS 4110 115 60 3/4" 9.0/920 80 70 60 45 25 32 14.1 20' 27.5 10.76 10.45 8.07 509261 9EN-CIA-SFS 4/10 115 60 3/4" 9.0/920 80 70 60 45 25 32 14.1 30' 28.5 10.76 10.45 8.07 509209 9EN-CIA-RF 4/10 115 60 3/4" 9.0/920 80 70 60 45 25 32 14.1 20' 27.5 9.15 9.6 6.8 509210 9EN-CIA-RF 4/10 115 60 3/4" 9.0/920 80 70 60 45 25 32 14.1 30' 28.5 9.15 9.6 6.8 509207 9EN-CIM 4/10 115 60 3/4" 9.0/920 80 70 60 45 25 32 14.1 20' 26.5 9.15 9.6 6.8 509208 9EN-CIM 4/10 115 60 3/4" 9.0/920 80 70 60 45 25 32 14.1 30' 27.5 9.15 9.6 6.8 509219 9EN-CIM 4/10 208-230 50/60 3/4" 4.0/800 80 70 60 45 25 32 14.1 20 27 9.15 9.6 6.8 509221 9EN-CIA-RF 4/10 208-230 50/60 3/4" 4.0/800 80 70 60 45 25 32 14.1 20 27.5 9.15 9.6 6.8 • • Performance . Cover Epoxy-coated cast iron Flow - Liters/Minute Motor Housing Epoxy-coated cast iron o 50 100 150 200 250 300 Impeller Material Thermoplastic elastomer 35 11.0 10.0 Impeller Type Non-clog 30 Volute 9.0 Epoxy-coated cast iron 6.0 Power Cord SJTW 25 7.0 m Mechanical Shaft Seal Nitrile with carbon and ceramic faces 1i 20 6.0 d Fasteners Stainless steel - 2 a 15 5.0 Shaft Steel a a10i 4.0 Bearings Upper sintered sleeve and = 10 3.0 x lower ball bearina 2.0 5 1.0 0 0.0 Franklin Electric o 20 40 60 80 P.O. Box 12010 Flow - Gallons/Minute Oklahoma City, OK 73157-2010 Phone: 1.800.701.7894 Fax: 1.800.678.7867 www.LittleGiantPump.com Form 996193 - 04/13 • Little Giant 9EN Series Effluent Pumps are rated for continuous duty in dewatering, water transfer, and effluent wastewater removal applications M • 4/10 hp PSC motor with thermal overload protection • Energy saving low amp draw • Cooler running motor which extends the life of the pump • Cast iron pump housing with protective epoxy coating for corrosion and rust resistance, polypropylene base F • Stainless steel screws, bolts and handle 5 x • Mechanical seals (stainless steel spring, nitrile parts, carbon and ceramic faces) • Upper sintered sleeve and lower ball F; bearing • 1-1/2" FNPT discharge j9EWC1A-RF • Fully submersible • Handles liquid and solid waste materials up to 3/4" diameter • Available in manual or automatic operation: • Piggyback mechanical float switch • On level 9" - 14" • Off level 2" - b" • Integral Float Switch • On level 7" - 10" • Off level 2" - 5" • Two year warranty -U S C 9EN-CIM Little G IAIN T Wastewater - Water Systems HVAC Industrial - Engineered Products -i =43OEyARTAtCounty V Safety and Buildings Division 201 W. Washington v , P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) $ Madison, W~74 62 _ ~JSION Or r 1 -7 2 3 b , 11-1 a it Application , f>o t State Transaction Number /A In accordance with SPS 383fo m. Code, submission of this form to4l~er~ opriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owtx° 4'4 66 'S are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be rte' for secondary l purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. 71 t I. Application Information - Please Print All Information ?N~ f ' Property Os Name (t a ~i~/ Parcel 109 14 Property Owner's Mailing Address Property Location City, State Zip Code Phone Number L /a i': , 40 ~.~y.L Section -7 to (circle on II. Ty of Buil tng (check all that apply) 7 / Lot # T~N; R E o W Y 2 Famil]y~Dwell'ing-~Number of Bedrooms Subdivision Name l ,0tJ/4LA_,) I~dq.. Block d V ❑ Public/Commercial - Describe Use . ob. , , in C& ❑ City of El State Owned -Describe Use CSM Number El Village of A •ASTown of III. Type of Permit: (Check only one box online A. Complete line B if applicable) 4 New Syste ' ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in.,of suitable soil Mound < 24 in. of suitable soil ❑ Holding rank ❑ Other Dispersal Component (explains' r i I` mo' '4-6retreatment Device (explain) V. Dispersal/Treatment Area Information: vt1' zf ' v iii; XT/ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st19_ Dispersal Area Propose (sf)' System Elevation VI. Tank Info C acity in Total # of _ Mwiufacturer e Gallons Gallons Units New Tanks Existing Tanks o " 2 v y N n` U v~ H to is. C a or olding Tank V r Dosin hamber t a l~ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of to POWTS sh vn on the attached plans. Plumber's Name (Print) P b Signature M PRS Number Business Phone Number _ l"- SaB -553 _CJ re. 11 C4E, CA 04DO-7aS -7 Plumber's Address (Street, City, State, Zip de) i 1( % e_~- ~'A OL Q k A VIII ount /De artment Use nl Permit Fee Date Issued Issuing Agen Signature Approved ❑ Disapproved $ t r Ile, p i ✓ 7 f. 1 ❑ Owner Given Reason for Denial" IX. CeGIFM @pval/Reasons for Disapproval 1. Septic tank, effluent filter and, dispersal cell must be serviced / maintainedL rs as per management plan provided by plumber.` , ` 2. All setback requirements must be maintained 'iZ/11~ 1 yr r,i j'~ Attach to complete plans for the system and su mit to the Copnty only on pJ er not 1 ss than.$ 1 x I l inches in size r GYf (✓v t SBD-6398 (R. 1 r/I) otipnxr.►rF,~ DIVISION OF INDUSTRY SERVICES yti ~o~ 10541 N RANCH ROAD P HAYWARD WI 54843 3 S Contact Through Relay P K ~ S www.dsps.wi.gov/sb/ o`' www.wisconsin.gov Scott Walker, Governor A~O~SSfONAls~ Dave Ross, Secretary October 15, 2013 CUST ID No. 220728 ATTN.• POWTS Inspector CLARENCE L GLOTFELTY ZONING OFFICE ENVIRO TECH SYSTEMS & SERVICE ST CROIX COUNTY SPIA N4955 SUNNY HILL RD 1101 CARMICHAEL RD WEYERHAEUSER WI 54895 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/15/2015 Identification Numbers Transaction ID No. 2319844 SITE: Site ID No. 796593 Brenda Riek Please refer to both identification numbers, 358 CTY NN above, in all correspondence with the agency. Town of Cady St Croix County SE1/4, NEIA, S18, T28N, R15W FOR: Description: Mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1453809 Maintenance required; 450 GPD Flow rate; 15 in Soil minimum depth to limiting factor from original grade; Sy('IT~ON EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P APPROV (N.01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter DEPT OF SAF The submittal described above has been reviewed for conformance with applicable Wisconsin Adminis" P OFESSIONAL S and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be conk and located in accordance with the enclosed approved plans and with any component manual(s) referenced a The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all co requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06EE C RES N stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval, and SPS 383 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. CLARENCE L GLOTFELTY Page 2 10/15/201'3 • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved specifications and this letter shall be on-site d py plans, urmg 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. Sincer Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shand POWTS Plan R viewe , Integrated Services WSMART code: 7633 (71 S) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shaffdorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Note: EffvcUve January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. I EZFLOW MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Riek Mound Owner's Name: Brenda L. Riek Owner's Address: N6425 Hwy 40 Elk Mound, WI 54739 Legal Description: SE 1/4 NE 1/4 Sec. 18 T28N R15W Township: Cady County: St. Croix Subdivision Name: n.a. Lot Number: n.a. Block Number: n.a. Parcel I.D. Number: 004-10414-0000 ALLY :D Plan Transaction No.: TY AND SERVICES Page 1 Index and title SERVICES Page 2 Data entry / Page 3 EZFIow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media TENCE Page 6 System maintenance specifications Page 7 Management and contingency plan 19 Page 8 Pump curve and specifications Page 9 Plot Plan Designer: Clarence Glotfel License Number: 220728 Date: 09W/13 P one Number: 715-868-5831 i` Signature: Designed Pursuant to the EZFIow Mound Component Manual (N. 06/03), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) EZFIow Mound Version 1.2 (R. 02/04) Page 1 of 9 ~I EZFIow Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 8344-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of - 36 inches. 450.00 Design Flow (gpd) 4X9 Site Slope 100L00 Installation Contour Line Elevation (ft) 100.00 Contour Length Available (ft) 15.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 1 6.00 Cell Width (ft) 3, 4, 6, 7, 9, or 10 Only 75.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution EY Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation IT 4 Number of Laterals of the highest point. L 0.125 Orifice Diameter (in) (e.g. 0.25) Estimated Orifice Spacing (ft) ft2/orifice 2.00 Forcemain Diameter (in) 0.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.50 Inside Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 13.05 Forcemain Drainback (gal) "Q,.75 Vertical Lift (ft) 67.44 5x Void Volume (gal) 1.52 Friction Loss (ft) 80.49 Minimum Dose Volume (gal) 17.77 Total Dynamic Head (ft) System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. o tions choice 0.75 1.25 x 1.00 x 1.50 x x 1.25 x R 2.00 1.50 x x _ 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information j 600.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) r 42.00 Total Working Liquid Depth (in) 'Huffcutt ~ IManufacturer 14.29 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.OOi Dose Tank Capacity (gal) Best Filter Manufacturer 14.29; Dose Tank Volume (gal/in) 'GF 10 1Filter Model Number ._,_.____-e i Huffcutt _ Manufacturer Project: Riek Mound Page 2 of 9 Mound Plan View J 3 1/10 B Observation Pipe 0 FK A W B r~ I . I . Mound Component Dimensions A 6.00 ft E 23.88 in H Elft ft K 11.61 ft B 75.00 ft F 12.00 in z ft L 98.22 ft D 21.00 in G 0.50 ft J W 26.60 ft 450.00 (fe) Dispersal Cell Area 1342.33 (ft2) 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 10.75 (ft) ► H G ♦ F 1 A!i! !i!i 01. Dispersal Ce11 102.25 (ft) Lateral 101.75 (ft)~ - 6 : . Invert Elevation : Dispersal Cell:::::__;;; E D€ Elevation 100.00 (ft) Contour Elevation 4.0 % Site Slope Typical Dispersal Cell Shading Key See Page 5 7 Q [ Topsoil Cap 2 c Geotextile Fabric over Q Subsoil Cap ° 2.0 ft © ASTM C33 Sand ~ F Tilled Layer a c 0.5 ft 05 0 EZFIow Media See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: Riek Mound Page 3 of 9 Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below Force main connection via tee or cross to manifold at any point. Laterals are identical Orifices point up, except every 5th one K- P points down for drainage. S Turn-up Ydball valve or X--+ IFKr2 I W2~l Laterals & force main of PVC soh 40 cleanoutplug per COMM Table 84.30-5 Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) A.97 ft Lateral Length (P) 36.75 ft Orifices per Lateral 1.0 Lateral End (Z) NA ft Orifice Density /.25 ft2/orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate gpm Manifold Diameter 1.50 in System Flow Rate . P gpm Forcemain Velocity .7,. ft/sec Dose Tank Information Locking cover with warning label and locking device, and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC Disconnect ~4 in. min. Tank component is properly vented Alternate outlet location Force-main diameter Huffcutt Manufacturer 2 in. Capacity 600.00 Gallons Volume 14.29 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 22.35 319.45 C B 2.00 28.58 Pump off elevation (ft) C 5.63 80.49 92.50 D 12.00 171.48 D Total 41.99 600.00 Dose tank elevation (ft) Min. 3" Bedding under tank. 91.50 Alarm Manufacturer S $ t;=,. W? Alarm Model Number„ C~ Pump Manufacturer t- r- LA ~ g6jJ-1 Pump Model Number Pump Must Deliver gpm at 1,77 ft TDH Project: Riek Mound Page 4 of 9 EZFIow Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Drag appropriate drawing to space beion,I. 6 ftWide Component Legend ® 6" EZFIow Bundle - EZ0601A, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203H, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203HP, 5 or 10 Ft Lengths O 4" Distribution Pipe With Pressure Lateral Inside Turnup Enclosure - - - - Lateral Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 75.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Drag appropriate drawing from left to space below. Force Main 6ft Wide Center Manifold - - - - - - - - - - - - - - - - - - - - - - - .j $ 9 Mound System Maintenance and Operation Specifications Service Provider's Name Kolve Exc. & Septic Phone 715-425-9188 POWTS Regulator's Name 1 tY Zoning Phone 1. 71 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 fe 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 every 3 Years C"ther 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 EZFIow mound component manual. 2. Dispersal cell media conforms to EZFIow products approved for use with the EZFIow Mound Component Manual approved 6/3/03. EZFIow media is covered with an approved geotextile fabric. 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 . . . . . . . . . . . . . . . . . . . . . . . - - . - . - . - \ Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZFIow Media 0 9 ; Diameter as Lateral 1.24 Feet - Distribution Lateral Lateral Cleanout Project: i Mound Page 6 of 9 Mound System Management Plan ° Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [FZFIow Mound Component manual 6/3/03 and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, 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 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 10° 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. 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, alarrn or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: '~i Mound Page 7 of 9 Franklin Electric INSTRUCTION MANUAL Upper Volute Seal: Vellumoid gasket INTRODUCTION Power Cord: 16 AWG 3-conductor copper stranded Franklin Electric Submersible Effluent Pumps are designed for Cooling: The motor housing contains a cooling use in normal sump and general dewatering applications where oil to provide cooling for the motor and higher pressure is required. The pump is designed for pumping to lubricate bearings and seals. These non-explosive, non-corrosive liquids with up to 3/4" spherical pumps are capable or operating with solids. Do not use for raw sewage. the motor housing partially exposed Automatic operation can be achieved with the use of the RFS for extended periods of time, providing Remote Float Switch. Other accessories such as basins, check sufficient motor cooling and bearing valves and covers are also available. lubrication, however, for the best cooling All models have a 1-1 /2" NPT discharge. Do not over-tighten and longest motor life, the liquid level being pumped should normally be above discharge pipe into pump volute discharge. the top of the cast iron motor housing. UNPACKING: SAFETY GUIDELINES: Franklin Electric pumps are carefully packaged, inspected and tested to ensure safe operation and delivers. When you receive MMN(a your pump, examine it carefully to determine that there are no broken or damaged parts that may have occurred during Risk of electrical shock. This pump is supplied with a grounding shipment. If damage has occurred, make notation and notify the conductor and/or grounding-type attachment plug. To reduce firm from which you purchased the pump and they will assist the risk of electric shock, be certain that it is connected to a you in replacement or repair, if required. properly grounded grounding-type receptacle. SPECIFICATIONS: Read all instructions and safety guidelines thoroughly. Failure to Discharge: 1-1/2" NPT-vertical follow the guidelines and the instructions could result in serious bodily injury and/or property damage.t dandling Capabilities: 3/4" screened opening Your effluent pump is equipped with a 3-prong electrical plug. Housing: Cast iron The third prong is to ground the pump to prevent possible Volute: ABS plastic electrical shock hazard. Do not remove the third prong from the plug. A separate branch circuit is recommended. Do not use an Impeller: Closed design with stainless steel wear extension cord. ring When a pump is in a basin, etc., do not touch motor, pipes Motor: Single phase induction 1750 RPM, or water until unit is unplugged or shut off. If your installation with automatic reset thermal overload has water or moisture present, do not touch wet area until all protection Hardware: 300 Series stainless steel FIGURE 2. Bearing: Ball FLOW - LITERS/MINUTE Radial Bearing: Sleeve - Permanent lubrication o loo zoo 300 Shaft Seal: Mechanical, spring loaded, stationary 10 carbon with rotating ceramic seat - 30 Impeller Seal: U-cup, Nitrile :J 8 Volute Seal: O-ring, formed Nitrile w w a: Motor Housing/ " W 20 e ~ w FIGURE 1. y~ 2 0 02 0 I TFFT VTF - 0 I _ »3 r~ 0 20 40 60 80 FLOW - GALLONS/MINUTE 9 + r-r: > r _ p n . Tl- T. ~ t _..n.. .......n tt a; 14 ` / J 5 Clarence Glotfelty " Enviro-Tech Systems & Services . N4955 Sunny Hill Road- Weyerhaeuser, WI, 54895 r w t 1 Wisoofrsin DepaMWt of Commer% SOIL EVALUATION REP..OT, Page of 3 Division of Safety and Buildin' in accordance with Comm 85, Wis. Adm. Code ,rj ST. CROIX Attach complete site p1hri on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 004 - 10414 - 0000 .percent slope, scale or dimensions, north arrow, and location and distance to nearest road. R iewed by Please print all Wormation. ~-2- Personal information you provie maybe used for secondary purposes (Privacy Law, s.15.04 (1) (m)). Properly Owner Property Location BRENDA L. RIEK (Buyer: Jon Amundson) Govt. Lot SE 1/4 NE 1/4 S 18 T 28 N R 15 E (or) W Property Owner's Mailing Address ;ilty Block # Subd. or CSM# N6425 Hwy. 40 own e 7p Phone Number []Millage C.T.H NN Elk Mound, WI 54739 ( ) 3 450 GPD LNew Constructi on UseEl Residential /Number of bedrooms Code derived desgn flow rate acement Public or commercial - Describe: aterial loess over till Flood Plain elevation if applicable *TA General d reommmeMs Mound System 1.75 ft. sand fill 0.4 loading rate /ll Z01.2- Off` an and recommendations: Zoning Specialists f1 0" Soil on-site with Ryan Yarrington and Pam Quinn, St. Croix County~ g w I IO6f C,SI-PAW#Lt SAS - Boring Boring 16 # Q in. Soil ication Rate ■ Pit Ground surface elev. 100..72 ft. Depth to limiting factor /PF Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Ei<#1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i 0-8 10YR4/2 GPD*011112 sil 3f-ma&sbk mvfr as 2vf-m 0.6 0,8 sicl 2fabk dh cs lvf-m 0.4 0:6 2 8-lb 10YR5/4 ~ ivf-f 0.4 0.6 3 16-20 10YR5/6 m2d 7.5YR4/6&10YR6/2 cl 2fabk deh some gr; cobs. I 2 Boring # Boring 98.29 16 Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP #E *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-7 l0YR3/3 sil 3f-ma&sbk mvfr as 2vf-m 0.6 0.8 cis lvf-m 0.6 1.0 2 7-16 10YR4/6 sl 3fabk ds m2d7.5YR4/6 sel 2fabk deh - lvf--f 0.4 0.6 3 16-22 10YR5/6 some gr; cobs Effluent #1 = SOD > 30 < 220 mglL _ and TSS >30 < 150 mg/l- Effluent #2 = BOD 5 30 mg1L and TSS _5 30 mg& CST Number CST Name (Please Print) S 07 t. M Jo Hu rt ollister's Soil Testing & Desi 224832 Date Evai Conducted Telephone Number Address W9875 690th Avenue, River Falls, WI 54022 10 - 30 - 12 (715) 426 - 1775 fTT t,~nn TMNV\l Property Owner RI)K, Brenda Parcel ID # 004 - 10414 - 0000 Page 2 of 3 Boring 3 Boring # Ground surface elev. 99.12 ft. Depth to limiting factor 15 in. Pit son ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence !Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-8 IOYR3/3 - sil 3f-ma&sbk mvfr as 2vf-m 0.6 0.8 2 8-15 10YR5/4 sicl 2f-msbk ds cs Ivf-m 0.4 0.6 3 15-20 10YR5/6 m2d 7.5YR4/6 scl 2fabk deh Ivf--f 0.4 0.6 one gr/cobs/ stones. E Boring # Boring Ground surface elev. ft. Depth to limiting factor in. Soil -AppWSW Rate Pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/if . Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 Efr#2 in H Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 Etf#2 * Effluent #1 = BOD5 > 30:5 220 mg/L and TSS >30:< 150 mg/L * Effluent #2 = BODS < 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. 8=4330rast (S.OM) i Plot Plan for Site and Soil Evaluation Page 3 of 3 ~ Property Owner ~7REkDA L . R,K 1"=40ft l3 ayym: ~Tm1 AM m.dsoni Legal Description (except where noted). '-kj5w. -rQwJO or AJD ra = Backhoe pit (~~OS~D 5 }4ce~~ North y0 ,~c~s ~ Fens cE uN E a 1 (NOT f~ ~Z bK115 Y Fo ~eu~ tZq~p ~ 357 c:r+H . NN ! F ~ f ~~c pia' o °0 of ~~0 6 h 0KZ ~ Site Location: o ° ` so ~ws. i S D - V~ ~ !K~ N1llilZOk~ 19/ , _Qk be wt-J fad e vtWcn Pkyte uw/~ gM 2 7p Sou-rft Oct 31 12 03:0Gp Hollister's Soil Testing 715-426-1775 p.2 1 J , Plot matt for Site and Soil Evajuofion 2~a~-~ 3 of 3 Property Owner P R EtiDA z-. R, ,,i day -vHy Amw sions I» = 40 ft. Legal Description y ~q°or Twe f, y4 56,c, /8 7z" O xcept where noted) ?Zasw, -rawN t)F cAnyf ~r cV61x 0L5cWA3 ; JU = Backhoe pit North FC+sCE LINE (NO r N (G CC ~ i~t►~ RpMj bR~vEWAy Gn 35'7 c r,+i , nIN At'` r I 00 wix ~ a o, 9 jt ~ /~/S//L CO~t~~Y 0~1-5~ so~~/Ue✓i'~t~.rfj`Q-~-~ ~x ,Q~~ JDl.✓G? ,,I Site Location: o~~~- lip ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/ uyer V ~R L R he L Mailing Address ~J Z 0 1G OtJnC~ IN -I- Property Address C K N iQ 42 (Verification required om Planning & Zoning Department for new construction.) City/State V v t_150 VJS Parcel Identification Number LEGAL DESCRIPTION 1 d , T 2 N R S W, Town of Property Location JOE 1/4 , C 1/4 , Sec. Subdivision Plat: L f6 , Lot # Certified Survey Map Volume , Page # Warranty Deed # L/ 0 / (before 2007)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 §SPS. 383.52(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 Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF P ICANT(SX DATE C viii ~ y3~ * * *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. 04/12) ,f n y+ } h . .,+Y. ~F'A-ice 1Gk . +~wyt+lt~ xa`.' .ace r l 1. yf t; Oct 31 12 03:06p Hollister's Soil Testing 715-426-1775 p.1 M Company Name Hollistees Soil Testing & Design W9875 69& Avenue River Falls, Wl 54022 Phone Number. (715) 426-1715 Fax Number same Email: holllistedesign@att.net FM TMNVMI-rTAL FORM To: s'` CAID9L CO. Z.ryVINCy Date Sent ~I Name: TKY^M CC: Number of Pages: 2. Phone: Fax: 71 -3 - ~}b i~~o Message= 114 Q S~ A// ao b o ~ R ~ w w L8 u r a r Iwo ~ - a o^ o RI to C .Y i w N C x► or c w y w ~ ~ w a ~I T (y t!~ h' 41 ~,ry z z w q~ -n 40 T y m s s kIL Ube= R CA ~d ~ \ J G G' L IV r~ Q~` FAIRCHILD LAW OFFICE 11 111111 508 Wilson Ave. Menomonie, WI 54751 $ x4001200 B QUIT CLAIM DEED 918513 DOCUMENT NO. BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 07/01/2010 3:39 PM EXEMPT 8M Ronald R. Riek, quit claims to Brenda L. REC FEE: 30.00 Riek, a single woman, the following PAGES:1 described real estate in St. Croix County, State of Wisconsin: RETURN TO Michael J. Fairchild Attorney at Law Parcel Identification Nos. 004-1041-30-000 004-1041-40-000 The South one-half [S of the Northeast Quarter (NEW) of Section Eighteen (18), Township Twenty-eight (28) North, Range Fifteen (15) West, TOWN OF CADY, St. Croix County, Wisconsin. This is not homestead property. This deed is given pursuant to the divorce judgment entered in Dunn County Case No. 09FA332. Dated this day of ~n Q 201C. (SEAL) *Ronald R. Riek ----------AUTHENTICATION-----------------------------ACKNOWLEDGMENT-------------------- Signature state of Wisconsin) ss. County) authenticated this day of Personally came before me 2010. this day of 11~,/w 2010. the above named pig n11 Q QiP~ ` (Ronald R. Riek) TITLE: MEMBER STATE BAR OF WISCONSIN THIS INSTRUMENT WAS DRAFTED BY ~•~PQ1• FA1RC Michael J. Fairchild, Attorney 508 Wilson Avenue Notary Pub~.i , Menomonie, WI 54751 t1 QCouii is2~, n My commiss- iea p~xeta e • +s. If not, state f 1 expiration jL~~ e: y~ a a o 7-o~L • :gip .srq rE• of I$\ Parcel 004-1041-40-000 02/15/2013 03:13 PM PAGE 1 OF 1 Alt. Parcel 18.28.15.278 004 - TOWN OF CADY Current OX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner 0 - RIEK, BRENDA L BRENDA L RIEK N6425 HWY 40 ELK MOUND WI 54739 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 SCH D BALDWIN-WDVILLE SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 18 T28N R1 5W 40A SE NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 18-28N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/01/2010 918513 QC 04/02/1991 467812 897/123 WD 2012 SUMMARY Bill Fair Market Value: Assessed with: 173131 Use Value Assessment Valuations: Last Changed: 04/23/2012 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.000 8,500 0 8,500 NO 05 I UNDEVELOPED G5 1.000 100 0 100 NO AGRICULTURAL FOREST G5M 3.000 5,000 0 5,000 NO Totals for 2012: General Property 40.000 13,600 0 13,600 Woodland 0.000 0 0 Totals for 2011: General Property 40.000 13,200 0 13,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00