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HomeMy WebLinkAbout030-2052-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 567278 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: Schettle, Orville B. I St. Joseph, Town of 030-2052-20-000 CST BM Elev: Insp.BM Elev: IBM Description: Section/Town/Range/Map No: /DD f3/1/\ 27.30.20.524 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ti CAPACITY STATION , BS� / H I L FS ELEV. Septic Z p,^ Benchmark 55 7 LJ� e /&30 Dosing �OO Alt.BM ro 111L e,pert � �v� Bldg.Sewer � Q C g,7' t .1 Q �P Holding j St/Ht Inlet 7.5 9s . o \ TANK SETBACK INFORMATION St/Ht Outlet TANK TO j& i WELL BLDG. Ven Air Intake ROAD Dt Inlet Septic N Dt Bottom f7O . Dosing �.. / Header/Man. 1S / z $51 3.0112*Aeration Dist. Pipe Holding Bot.System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover v 2GPM Model Number I S tq,7 D TDH Li ro. Friction Loss System Head TDH Forcemain Length I Dia. :.It Dist.to well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No.Of Trenche PIT DIMENSIONS No.Of Pits Inside Dia. Liqui a th DIMENSIONS e SETBACK SYSTEM TO I P/L JBLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O System: /Z,3+— Z, CHAMBER UNIT OR Model Number: DISTRIBUTION SYSTEM Header/Manifol q'�L// Distributi`o'ns x Hole Size �� x Hole Spacing Ve t Air Inta Length Dia /'w Length /3 (o Dia /• Spacing a ( $ 3 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only •"'v Depth Over Depth Over xx Depth of xx Seeded/Sodded flu x Mulched Bed/Trench Center LI - BedlTrench Edges \` Topsoil ' � �P 7N, es No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / 40/ Inspection#2: I-e5� Location: 1364 HWY 35 ai n Str et)Hoult/9n, I54 82(SE 1/4 NW 1/4 27 T30N R20W) Villa`g'e of Houlton,�t 2 I Parcel No: 27.30.20.524 1.)Alt BM Description= ` 1� I�7 r� v �dl 2.)Bldg sewer length= 7Z SyS�C,�,� CL16X. JO QQ-amount of cover= ( J �_. � 1--- Plan revision Required? Yes �No � z Use other side for additional information. - SBD-6710(R.3/97) Date Insepctor' ignat Cert.No. W Z M t-- 0 Ct3 ' LO 6 t _ d 0 co L E z: o c) W 0) c U") U) �f LO d- CN CO CO LO CN Lo 4`4 LO t� V Q/ m cw LO C w LO `! c M. ( ' LO CN LO LO U') a. g M co LO co CV fir- L J ry c t - L -�� _ "IN k 1, • 3 g' + P�BO�(pGCS-alb ,Ya use �B� k 5s �4 _ _ I { ��� �4 ."" County_ (4.*�� °� Safety and Buildings Division ,V o t .,_.;: o 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) ., Madison,WI 53707-7162 �` 5(/-7 2. 72 y' OstoKpti NO 11 'lu s ', State Transaction Number Sanit �rmit Application Z3 1 S/ U Co In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. I. Application Information-Please Print All Information ,,.!<1 Property Owner' Name * Parcel# Property Owner's Mailing Address 00- /� Property Location •r s / — --, s} L /it<nt v Govt.Lot City, .to a� �) p Code Rhone NuifiBe _--ft-, /4, �(/(,t '/., Section 7 cOU (circle one) 'a L.. r ∎�, A,. %: T „Yo N; R,-�D E or W II.Type of Building(check all •rt :7".;:7".;ly Lot# 01 or 2 Family Dwelling-Nu 5!; :e... ms Subdivision Name v Block# Ptak 4 Villa/4e dfii'd t( jt,, - ❑Public/Commercial-Describe Use !/ ❑City of J CSM Number ❑Village of ❑State Owned-Describe Use ,----- 0 Town of JA/ III.Type of Permit: (Check o' • . 'x on '.e A. Complete line B if applicable) A. ❑New System Zi 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 System/Component/Device: (Check all that appl ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade Mound?24 in.of suitable soi ❑Mound<24 in.of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain)_ / /j/� retreatment Device(exp n) V.Dispersal/Treatment Area Information: i/O / mourn C-e�C.r � r vs •g f VV 7 6m`.d Design Flow(gpd) Design Soil Application te(gpdst) Dispersal Area Required(sf) Dispersal Area Propos d(sf) System levation -�s' ,�- /., 4-/( 960 yam' 'i-7�,`S-0 ' -i - ,9 ✓ VI.Tank Info C acity in Total #of Manufacturer Y Gallons Gallons Units a :'. _° New Tanks Existing Tanks 0 5. N '2 I R y W 0 R, C YH,(� Septic or Holding Tank Dosing Chamber ! /90 oM v✓/P/y/01 5 ZS /ls VII.Responsibility Statement- I,the undersigned,assume resp.. sibility for installation of the POWTS shown on the attached plans. Plumb r' ame ' 'nt Plumber' Sign. ^ MP/MPRS Number Business Phone Number P umber's .ddress(Street,City,State,Zip Code) / I .5.-%9 35eYd, e21-d VIII County/Department Use Only Approved ❑Disapproved Perrmitt Feee' 0 Date Issue Iss ' g Agent Si ..ature ❑Owner Given Reason for Denial $&GiS , o' '12//�(3 / vt.r;,, IX.Conditions of Approval/Reasons for Disapproval 0,4 s , ait. ( ' SYSTEM OWNER: � 144 i 4 ,/ /1014-�t�'► dii 1.Septic tank,effluent filter and `� dispersal cell must be serviced/maintained ..;,QfI�Q./G 02, 7b' S?5 3(3. 3i. as per management plan provided by plumber. � / y 2.All setback requirements must be maintained ( // R- 6d /Vi7bw, Lll� ��'' . as per appficablekt:tiwhn tans for the system a submit to the County only on paper not less than 8 rn x 11 in es. e ee-3► 6A,t. Pei{( Qo ►tic o PwtiuQd 4e O,:fly- P Ga- fyeh a-sae a • soarzag2, DIVISION OF INDUSTRY SERVICES oP t2 7'0 10541N RANCH ROAD f ;Sa a r " Contact Through Relay •; p� www.dsps.wi.gov/sb/ TIL_114;4-11 { www.wisconsin.gov -cssroNn'. Scott Walker,Governor Dave Ross,Secretary October 07,2013 CUST ID No. 224263 ATTN:POWTS Inspector KIM A OCONNELL ZONING OFFICE KO CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/07/2015 Identification Numbers Transaction ID No.2315106 SITE: Site ID No. 796091 Orville Schettle Please refer to both identification numbers, 1364 Main St/Hwy 35 above,in all correspondence with the agency. Town of Saint Joseph St Croix County SE1/4,NW1/4,S27,T3ON,R2OW FOR: C(�rID Description:Mound,3 bedroom residence Object Type:POWTS Component Manual Regulated Object ID No.: 1451624 AP Maintenance required; Replacement system; 450 GPD Flow rate; 29 in Soil minimum depth to limiting factor from O DEPT original grade; System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12),Pressure $S Distribution Component Manual-Ver.2.0,SBD-10706-P(N.01/01,R. 10/12),SSWMP Pub.9.6; Effluent Filter PROFS pNiS10N OF 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. SEE No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) •. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans.In addition,the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the mound component manual are complied with.A copy of this information must be given to the owner upon completion of the project. 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. • 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 KIM A OCONNELL Page 2 10/7/2013 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis.Adm. Code. • Insulate building sewer per SPS 382.30(11)(c). 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. Sincerel Fee Required$ 250.00 Fee Received$ 250.00 Balance Due $ 0.00 Patri Shan•• POWTS Pl. Revi: er,Integrated Services WiSMART code:7633 (715)634- 10 ax:(715)634-5150,M-F 8:00 a.m.-4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm Note: Effective January 1,2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Orville Schettle Owners Name: Orville Schettle Owners Address: 1364 Main ST Hwy 35 Houlton WI 54082 Legal Description: SE-NW sec27-T3ON-R2OW Township: St.Joseph County: St Croix Subdivision Name: Lot Number Block Number: Parcel I.D. Number: 30205220000 'Ttptt►ALLY Plan Transaction No.: DROVED ND SAFE7Y AND 1 Index and title ONAL SERV�CE� � Page 2 Data entry NDUSTRY SERV i(. Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specification Page 6 Management and contingency pla �RRESPON'� Page 7 Pump curve and specifications Page 8 Plot Plan I5 0 Designer: Kim Oconne License Number. 224263 Date: 09/16/13 Phone Number: 715-381-7917 /4.Signature: Designed Pursuant to the Mound Component Manual for POINTS Version 2.0 SAD-10891-P(N.01/01, R. 11/12),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,R.10/12) Version 7.0(R. 11/12) Page 1 of 8 , Mou nd and Pressure Distribution Component Design Desian Worksheet Site Information (R or C) �� � Ri Residential or Commercial Design Note: Sand fill(D)calculations assume a 300.00 Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil tn3atment for l 1.501 Peaking Factor(e.g. 1.5= 150%) fecal colifomt of<=36 inches. 450.001 Design Flow(gpd) 10.00? Site Slope(%) i 95.801 Contour Line Elevation(ft) 29.00 Depth to Limiting Factor(in) �^ M 0.501 In-situ Soil Application Rate(gpd/ft2) Distribution Cell Information im 75.00 Dispersal Cell Length Along Contour(ft) = I 6.00ICell Width(ft) I... 1.001 Dispersal Cell Design Loading Rate(gpd/ft2) i 11 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) i E Center or End Manifold I 3.00 Lateral Spacing(ft) If N above,enter the elevation(ft) 2 Number of Laterals of the highest point. r 0.125 Orifice Diameter(in) 3.191 Estimated Orifice Spacing(ft)= ' 9.38 ft2/orifice 2.-601 Forcemain Diameter(in) 38.001 Forcemain Length(ft) Does the forcemain drain back? Y , 91.503 Pump Tank Elevation(ft) Enter Y or N 6.50 System Head(ft)x 1.3 6.20 Forcemain Drainback(gal) 4.88 Vertical Lift(ft) 67.53 5x Void Volume(gal) _ 0.34 Friction Loss(ft) 73.73 Minimum Dose Volume(gal) 0.00 In-line Filter Loss(ft) 19.77 System Demand(gpm) w _ 11.72 Total Dynamic Head(ft) Lateral D iameter Selection 1 Manifold Diameter Selection in dia. options choice in dia. options 1 choice 0.75 1.25 x x... 1.00 .f 1.50 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank Information 100000:= Total Tank Capacity(gal) x1000.00: Septic Tank Capacity(gal) 36.00 Total Working Liquid Depth(in) Weiser i Manufacturer I 27.781 gal/in(enter result in cell B49) Dose Tank Information Effluent Filter Information R 600.001 Dose Tank Capacity(gal) PolyLok Commercial Filter Manufacturer 16.76; Dose Tank Volume(gal/in) 525 Filter Model Number Weiser Manufacturer Project Orville Schettle Page 2 of 8 Mound Plan and Cross Section Views ':•:• • : : -, :1/10 B :-:-..-:•:•:-:•:-:-:-::::::.:.:.:.:. J .. Observation Pipe - -fl _ill♦ r r r t. .r r r s r r. �_ K i. A W - 1' B r • 1— • L • , Mound Component Dimensions A 6.00 ft E 14.20 in H 1.00 ft K 8.03 ft B 75.00 ft F 9.50 in i 10.61 ft L 91.05 ft D 7.00 in G 0.50 ft J 4.33 ft W 20.93 ft 450.00 (ft2)Dispersal Cell Area 1245.54 (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 98.18 (ft) --► . ..,..�.. ..• ♦ H e ......,,.,.jam,,,.,:.,,r G 1 isfrriZZZAI ..l4l iMI,Ariiii.i I F Dispersal cell 96,88 (ft)Lateral 96.38 (ft)--► :� . . . . Invert Dispersal Cell :[:: : : _ :ii. :::: Elevation D []a:;-•• "1::x.::::: :2; } - { 7 5 95.80 (ft)Contour Elevation 10.0 %Site Slope #- Geotextile Fabric Cover Shading Key a. 1-1 I Dispersal Cell See lateral details on 0 Topsoil Cap o c 1.5 ft °r Page 4 for number,size, Subsoil Cap and spacing of laterals. © �......... p _ Laterals are equally © ASTM C33 Sand 4; ` F spaced from the f 1 Tilled Layer d 0.5 ft Typical Lateral Y a distribution cell's © Aggregate er c l centerline in the distribution cell AxB . Project: Orville Schettle Page 3 of 8 End Connection Lateral Layout Diagram Laterals centered over the A tz B dimension •=Turn-up Ina'ball valve or cleanoutplug A P< P I • All laterals are identical IE-X--j1 Holes drilled on the bottom of the lateral S equally spaced y • Force main connection via tee or cross to manifold at anti point. Laterals&forcemain Sch 40 PVC per SPS Table 384.30-6 Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing(X) 3.20 ft Lateral Length(P) 73.60 ft Orifices per Lateral 24 Lateral Spacing(S) 3.00 ft Orifice Density 9.38 ft2/orifice Lateral Flow Rate 9.89 gpm Manifold Length 3.00 ft System Flow Rate 19.77 gpm Manifold Diameter 1.25 in Total Dynamic Head 11.72 ft Forcemain Velocity 2.02 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 '1 I L 4 in.min. iDisconnect �.,r____.___ ij Tank component is properly vented `, ❑e <--- Alternate outlet location I F- _ Forcemain diameter Weiser Manufacturer __t_ Q 2 in. Capacity 600.00 Gallons Volume 16.76 gaUnch A Weep hole or anti- Dimension Inches Gallons B siphon device A 23.40 392.19 B 2.00 33.52 C d .------ ` Pump off elevation(ft)____t_ C 4.40 73.73 1 92.00 D 6.00; 100.56 D Total __ 35.801 600.00 Dose tank elevation(ft) 3"Bedding un er tank. 91.50 Alarm Manuafacturer SJ Electro Note: Switches Alarm Model Number [HW 101rn vtt., . containing mercury _ may not be used in Pump Manufacturer Goulds p this system. a Pump Model Number ?PE 51 Pump Must Deliver 19.77 gpm at 11.72 ft TDH Project: Orville Schettle Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Kim Oconnell Phone 715-381-7917 POWTS Regulator's Name St Croix County 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 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 every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect forpondmg and seepage once every 3 years 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 _ _ _ r -_._.:..-• Threaded Cleanout •. . .-.-. . .• Sprinkler Valve Box Plug or Ball Valve Distribution 45 D ree Bends same Diameter as Lateral Project: Orville Schettle Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54,Wills.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.11/12),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 POWfS 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,Spats. 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 c fu/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,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically dogged 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 POINTS 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 8 , . eq. 7 e.- ' g GOULDS PUMPS Submersible f„ Effluent Pump T MODEL PE ..,,,,-.-„. - ,- i'FLUENT PUMP SPECIFICATIONS MOTOR FEATURES General: •Corrosion resistant Pump—General: • Single phase construction. - • 4 • Discharge:i'h NPT • F(40°C) • 60 Hertz ■Cast iron body. maximum,continuous wh en . 115 volts •Thermoplastic impeller mpeller and • • Built-in thermal overload pro- cover. fully submerged. tee with automatic reset a Upper sleeve and lower �' • Solids handling:W' r maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models indude a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel •Motor is permanently • Manual models available. shaft. lubricated for extended Specially designed for the - service life. following uses: •perfo range:see PE.3 Motor. •Powered for continuous n9 performance •chart or curve. • .33 HP,3000 RPM operation. • Mound Systems • 12.0 Maximum amps PE31 Pump: Shaded pole design ■All ratings are within the • Low Pressure P Systems • Maximum rapacity:50 GPM • gn working limits of the motor. • Low Pressure Pipe Systems • Maximum head:25'TDH PE41 Motor disconnect power • Basement Duty Draining • .40 HP,3400 RPM '� • Heavy Duty Sumpl PE41 Pump: • 7S Maximum amps cord,20'standard length, Dewatenng • Maximum capacity:60 GPM • PSC design ps heavy duty 16/3 SJTW with • Maximum head:29 TDH NEMA 5-15P,three prong, PE51 Pump: PE51 Motor: 115 volt grounding plug. • Maximum capacity:70 GPM • .50 HP,3400 RPM •Complete unit is heavy duty, • Maximum head:37'TDH • 9.5 Maximum amps portable and compact. • PSC design •Mechanical seal is carbon, METERS FEET _.,_ 1 ceramic,BONA and stainless ao t �" : - ; .11MODLS:PE31.PE41,PE51 t steel. PE51 .. )H HP:.33,.40,.50 ■Stainless steel fasteners. 35: i 10- r f --0.- 2 GPM AG ENCY LISTINGS 30 I--PE41 i.:- ..� 1 FT . t i-. 3 ( i v .: r 4 I C US E -. 1. -' - :- : } Tested to UL 778 and a i us Standards ra f e ; •O . . . f IF t_s. , god Pumps is 60 9001 Registered. 10 _. ___�i _ —• 0' 0 U ...�.:_.1 o ;0 30 40 50 60 X70 GPM 80 5 0 10 15 m3/h Goulds Pumps CAPACITY . ...,n.,,,rr ....Inc ...iric Pt r .. .. , ,. , . iol„,- /344 ID e -Fs ,1 e no // ce ni/ ", _ , .4 „,-,-*.A4.*_,„,,,9 7- Tae.Al-X-7-7ck) 121-j/ /.eA43_4.7 <,-5-**-;? l ci Li- 2, 8toc ) - 41-7PWato4- 1 /60.4 ___JC--- " --- • ( ` _ _ —1 A‘ii- 1 . . _ . . ii_______ Ii151.."4"4"eg'A ) ile' — -J I a fa& M.P01) 3g1 -....... /Me 97'75-7-5 3 wih, Oi.86-Le li . , 1 . ,o „).g,..4;i 1.'illi4r7 1 1\ .., 0:607 n x, elsigIVAIM lifik - ' 1 " .----*----‹ ‘ x I' ?. > .t. e ' "t1(1) 1,1ki i - NV "k 1 - . 1 1, 1 1 A Wis.Dept.of Safety and Professional Services SOIL EVALUATION REPORT Page / of 5 � Division of Safnd Buildings in accordance with SPS 38 Wis. Adm. Code ,i, County J Attach m e s' plan on paper not less than 8 1/2 x 11 inches in S+¢ must � ��`�°X include, off ited to:vertical and horizontal reference point(BM),dire � Parcel I.D. per 4s pe, cale or dimensions,north arrow,and location a�1¢.distance to ne5�1)road. �/�,�rl;`.0Gv!v?G' Please print all information. CII�J 7 34 9 R sewed \ Dat- • .4.al information you provide may be used for secondary purposes(Privacy Law, . . 4(1)(m)). `- V` i-7 Property Owner ° 7 erty Location 1(54/1//6 ,J a./.nZ Govt.Lot S 1/4 AV/1/4 S77T 3Q N RAC; E(orkdr Property Owner's Mailing Address Lot# Block# Su N me r CS /37P°�//.72 ,) sr — �, ,,' Z �? �'1�. �l 4: -lov l City Stat Zip Coder 7 Phone Number ❑City. ❑Village EITown Nearest oad 6 �( n, i/ i,) It IL" k5,k g-.7 I ( ) r/i�,E,y--/ I ,; / 35- ❑ New Construction Use:Ia Residential/Number of bedrooms ._3 Code derived design flow rate /�/� GPD gl Replacement Public or commercial-Describe: Parent material 77/ Flood Plain elevation if applicable /V1- ft. General comments ,1 �/77 / /� and recommendations: ..S F,n �C>j:5F_,o On) a-J 4,e'�,w).g - 9'''9 // / "I A/0 iaArrk:111-47)ka 0 Boring / Boring# ® Pit Ground surface elev. 9.5.- 9 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots , GPD/ft 2 in. Munsell Qu.Sz. Co t.Color Gr.Sz.Sh. *Eff#1 *Eff#2 / /9---.< /4 Se:/.6 /!/i /*(: l f / e, _ ,S� /c (->9 .3'/7 ;. "':e,._-// , O /A (1.7, m,)r,� (.,,ii _3r. ,,s' //9 / )7-?C 75°,e I% N/ s/ /2�1,� .77-x// . Frt ,-/ , 7 / `=l6 76- 1- (I_,Ip.- d.1--A-7J4 �.1-5 / �l-.„ ,9.4-.-. - /- . 37 ,e Boring# ❑ Boring ® Pit Ground surface elev. V/ ft. Depth to limiting factor ,.30 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *EMI *Eff#2 31-,3t, 75`K's ly ,lilt /fs ( , ,,),,Z, n_u,, /rr� , /.D 3 :3,n--7. 76-411 <4, sx'G%:s-e7h kfi rfIL, ,,,,, - /,c , , , l *Effl -nt#1=BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L CST Na - . 'nt) , S / , CST Number Address 11 Date Evaluation Conducted Telephone Number �'( /,.34° �),f /9Te�ia/ Zf/,1--- /P g-/5- ZS 7,v`'._58/- 79/7 SBD-8330(R11/11) Property Owner ac2.11 4- Parcel ID# 634--,?(.7 Page of -� Boring# ❑ Boring ko Pit Ground surface elev. �„� ft. Depth to limiting factor ,'/ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2 in./ Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *'Eff#2 t`7 ` /05e--> A/ � L`�i)1 r _ 7/ 0.5 Jv.” /CI , /Z Zs-X-4 /2, c,� ���, •-/ , 7 Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture ` Structure Consistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *`_ff#2 ❑ Boring Boring# ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPD/ft z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1 =BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330(R11/11) 7-'3 -r3 nrii ii c./,� .Z s,�/i AA,1 f,s-6, 4' a ) e - / . s - ,46,,,,,/ /rd./74.A, 0_L ..- - 0 - iser .:a,E 41.0.4'-'.. lone ii - , ,/ 7`zIs /N ,G' 4-1C I 14 - Sys 46:1.1 //a--4- \ ge I l dF,r f A/ c4v6, ' 1 Le 1,--44 69' x19' > "C; '4/ F NHS us,.- 17,,7 / t. 7m ;e>7e 1,:%e// 14 5c 24f o `47_ pp/c. C 1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM NOV L u ST CROIX COUNTY Own.erBuyer 641y :11 Mailing Address /_?(;/--/ Property Address }7mv� L (Verification required from Planning&Zoning Department for new construction.) City/State Parcel Identification Number 0 ?v LEGAL DESCRIPTION Property Locationf 1/4 , JY 1/4 , Secc 7 , T .2° N R(.0 W, To of SI. a.1/9,5-t9°l Subdivision Plat: L. 7- 2) 13 Loc.k. 2- Plaf©F , Lot# Certified Survey Map # , Volume , Page # Warranty Deed # 3c7 / 6 3 (before 2007)Volume 6 7) , Page# 4/g . Spec house 0 yes ao Lot lines identifiable yes 0 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. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein, as set by the Department of 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. I/we am/are the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number if bedroom SI A ' 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. 04/12) . ._ ,''' /rts0. ! _ STITe 8AR n} 7hhCOSSIN-FORM 2 ._ 3 c-0 1 6 3 1 _ "" - its SPACE AESttRwEO FOR eEGOitgt/iG OJ7/' e - "- : -'--- _ - . /Diary A. Sci_ettle K+ct3rf TERS OFFICE y ST. C.IROLX CO., W . - --- Reed.. ftx Record this ?LC'a . c�+tevess Fwd ai^. rr�.s.0 Orv?i1E B_ ste le andl He.a_*^y �i: day o :'`a A.D. z fnf • t9 /e: Sc itle r bus 1 s f.+Te:as joint t enan is .1 c_., f-, r, Ark. J° - i - .i � 4. . rat ►vir:saW d +`6x49 Peal efaate ia:-� S't- Cx 13C -Geero.y. - �a of�`i aas ia° i Lot 2,� Block '2 of Plat.of Village -of tioul ton- Tax Key No. ,. This deed is between husband and wife for the purpose oP crcaat.::ng a joi.nt, tenancy b z tiween the grantees. , i F .r' ;r'1T' F Tl4,:s i riO t,homestead pco rJ y. - (ts� (ig twt) `t Exception to a Sf+rnt:OR: t` y_ - June i9 78 `[sated this tiVa - _.. '-s<?�'bi , (ZEAL.) ,4241'4, 4 - L2 (SEAL) Ma A. Schettle (SEAL) (SEAL} i 7 AUTHENTICATION ACKNOWLEDGMENT . i Signatures authenticated this 30th 'lay of STATE OF WISCONSIN ff June a 14 78 (S as County. ) I = -e:::;:-."-`• Personally came before me, this day of j s ue l R. Cari. _the above named TITi.E- MEMBER STATE BAR OF tilSCOP.SIN 'a — eR3t *. iZ3PO**4$ !y'tid gat*?}X _ _ T1-..'s iasirumeni ivar. drafted by BEYWOOD .AaSiD CARL ,by Samuel R. Carl - to me known to be the pe.-son_r_ who'executed the fore- - Hudson, FF1scons1T1 :_ 54015 going instrument and acknowledged the same- . - (Signatures may be authenticated or acknowledged. Both — ----- are not necessary.) Notary Public-,— County, Wis. My Commission is permanenL (if not, sale expiration date: _. 19_.) 1- _ _WARSAaTY OEEO—STATE BAR OP WtSCOFr5raa . PORY. NO. 2-4977 5 LU Z r) N 0 to o I Lf) x T.- N.- If 0 CC ) Ln zf 1 LI) `i 1 :`.i u r` col 1 co N o o CO o °O °O ! '`n Cr) LC) LC) L ) ., L( (co ) CCII NI- Cr) N it 01 1 Q N CO i , LW Ln ; N CNd 4\I 1 LO I ' N d- Lf7 . 0 N i I. N N N N LO � Lc) � 1� gym$ M CO 0 Q. 1 I 1 g.. t t') O .- : IQ 0 MI Iii) �� n 3 3 ... V"' CO r,, Q g� t d (r) Lf? � 0 4"s X € 1 r V _ 68'41 (Si 1