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HomeMy WebLinkAbout018-1028-80-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Divis°n INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Wevers, Clarence Hammond, Town of :ST BM Elev: Insp. BM Elev: BM Description: lam, o /oa~o TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ` 1,~11~ U Dosing /1 _ ~ v!(~'~7 j Aeration Holding TANK SETBACK INFORMATION TANK TO P /L WELL BLDG. Vent to Air Intake ROAD /~ ~, ` Septic /~, i / ~ ~ ~ r (1"6a Dosing CSI Iv S (- Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~,~„ , n Model Number U Cam' ~~ ~ ~~I ~~ I 2" AQC/'1DDT1llAl CVCTCM errand PM • SD ELEVATION DATA County: St. CroiX Sanitary Permit No: 506269 0 State Plan ID No: Parcel Tax No: 018-1028-80-000 SectionlTown/Range/Map No 13.29.17.208D STATION BS HI FS ELEV. Benchmark ~•~ /oz~ ~p , U Alt. BM G~ f ~'D / Bldg. Se ~ `r ~ ~ JS .~ SbHt {nietsGE..~ ~D / ~' SUHt Outlet / J Dt Inlet ~ t Bottom ~~ A (~ r b ead Man. ~ /n ~ • ~' S Dist. Pipe ! ~ ~ • ~~ ~2 , ~/ Bot. System S D. 9 Final Grade ~ 70 7 9~0• / / Se St Cover ~ - ~ J ~~.n_ Lin.. On ~L (-0 (/~ BED/TRENCH Width ~ / Length / L No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS J ~ SETBACK SYSTEM TO P/L BLDG WELL LAKElSTREAM LE CHIN Man cturer /_ 5 / ~ GHAMBER R ~ ~/ INFORMATION Type f System: 7 O / ` ~ 1 UNIT Model Number: ~ nICTDID11T1~1A1 CVCTCIIA /~ eader/ anifold Distribution I ~ ~ x Hole Size x Hole Spacing Vent to Air Intake Lj T J y Pipe(s) / 3 acin Di S ~ ~- ~ / Length Dia g p a Length ~~n /~/1\/CD __ n____..-_ c•_._a_.Y_ ~_~.. .... ^..,....a n~ A•_r_r~.~o c..~rome nnw u Depth Over , / ~ t C / Depth Over Bed/Trench Ed es xx Depth of Topsoil xx Seeded/Sodded xx Mulched N Y " er ~5 - en BedlTrench y g (a~~ Yes No -~ ~~ o es y r COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:_~/ Gk~/~ Inspection #2: / / Location: 922 US HWY 63 Baldwin, WI 54002 (SE 1!4 SE~~1/4 1n3,,T29N R17W) NA Lot ~ _ ~/~ ~ Parcel No: 13.29~1j7~208~D 1.) Alt BM Description = 0~ vJ ~ ` ~G1~'b r v0-"r- w t^'~ `" ~.~~,,%/CJy'~~° ~~ -S~y _ ~"' 2.) Bldg sewer length = 301 ,,k'~/G(/~ - amount of cover = Plan revision Required? [ Yes ~; _ o ~ ~ /t~ G~~2~ _ //. ~ ~ ,~ ~__' Use other side for additional information. V ~,~iC~-. Date Insepctor's Sign ture Cert. No. SBD-6710 (R.3/97) comtn~rce.wi.gov Safety and Buildings Division County /~ , S ~ ~ /~~ ' 201 W. Washington Ave., P.O. Bax 7162 1 ~ ~~ ~ c ~ n Madison, WI 53707-7 i 62 Sanitary P 't I~fumber (to be fillod in by Co.) IAepartmertt of ~^ 5b Z ~ Sanitary Permit App i state Trat,sa«io°"Number In accordance with s. Comm. 83.2 t(2), Wis. Adm. Code, submission ofJ'~.r;.;,tnt ~`^'~~ovemttmental / ~ _ unit is required prior to obtaining a sanitary pernmit. Mote: Application forms for state-owned POWTS are Project Address(ifdifferentthantnailingaddress) submitted to the Department of Commerce. Personal information r seco u ses in accordance with the Privac Law, s. 15.04 l m}, Scats. , I ~~ ^ -, l ~i L L ' f 7 A lication Information -Please Prfnt AB Informs Pro y Owner's Name ~l~}2 ~~G ~. C.c.1~u ~r1~ JUL 2 3 2007 Parcel # 1j~8'-/DZSr- ~G -oGa Property Owner's Mailing Address f"~YJC ~ S C~ ~CF,tp~(000~TY~ v ~'f ! te Property Location , ~~ r Govt. Lot I City State Zip Code r ( ~ 1 E , ~A ~dw ,'„ c/ .~ ~ 6 ~ti ~ f s-b~tl--all 5" ~_ , , /., S /., Section T ~g '^~ ~leor~ E or~ N; R L i I I .~pe of Building (check all that apply} Lot # __ ._ _~ , ~ , i N S bdi .IJLLs~t2 Fautily~wellinQ~ ! ~••±ha*~ of Bedroo ame u vms on __ _ _. 4 Block # ^ PubiidCommereial -Describe Use ^ City of ^ State Owned -Describe C}se CSM Number ^ Village of 2- ~ ~ t,,~ ~3 d-i GI~4 ~Townof `~ F1YY1Htvh Ill. Type of Permit: (Check only one oa [iae A. Complete Gne B if applicable) A' ^ New S tern Ys lacement S stem ~ep Y ^ Treattttent/Holdin Tank tacethent Onl g ~P Y g Ystem (explain) ^ Other Modification to E.xistin S B. ^ Permit Renewal ^ Permit Revision 0 Change of Plumber ^ Permit Transfer to New List Previo»s Pemoit Number and Date Lotted Before Expiration Owner io~m'~~! ~, ~ IV. T e of POWTS S stemlCom aent/Device: Check all that a I Non-Prrssu~ f~-Gcomod ^ Pressmaized In-Ground 0 At-Grade ^ Mound > 24 in. ofsuitable soil ^ Moutxi < 24 in of suitable s°i! ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. D' ersal(CreatmentAyea Information: Desi Flow (gpd} Design Soil Application Rate(gpdsf) Dispersal Area Requi (sf) Dispersal Area Proposed (sf) System Elevation V I. Tank Info Capacity in Total # of Manufacturer 8 , c Gallons Gallons Units ~ E ~ ~ New Tanks Fxistiag Tanks ~ a g ~ ~ $ .$ `~ ~ ~ (~ ~~ ~ 4 V y q y , L4 ~ C1+ Sgrtic w HrlMing Taak Y" j (~Gp ~`e SG /J ~(. t)osinb Chamber ~l ~ ~ i ~ ~ VII. Responsibt7ity Statement- [, the undersigned, a ttre responsibi or i"stallation ofthe POvt!1'S sho on the attached ptam. Plumber's Name (Print) ~G e S't r+ h Plum s Signature PRS Number ~23~ eft" Business Phone Number l - ~ ~~ G~~ ~7t Plumber's Address (Street, City, S Zip Code) ~.(/~' / / /~v, i3G d ~~ GGr CG rp! /e m J VIII. Coon !D artment Use Oni Approved Permit Fee Date sued Issuing nt Si a ~ ~ 7 ~1 ~7 Ow ivenR nforDenial IX. Coaditio ppro_ v~„1/Reasons for Disapproval 3~ a~ r~ (~ w~S ' G. a, 1. SuptiC tank.-!fll<tl~ttL tNtK atM ~ O °C-"- . _ dispersal ceq rttttst ap ~,(J~J G-c, ~ ~ _ as per management ph>ul P-pvklad bY;plulnbif• ~~ LLI t t All etb ui et nt ~t~ttlalihttainrwd D e~~' o~ ~ ~~ ~e k 2 s ac rt q r r e s m . r 6 ~° ro• 'r'e^^R1L9L'.6Tif4elYiplllRRfpSt~e~tne system amW snbmu tame t.oa"rv ongr on paper rasa o c ,i, . ,xcuca ~~M1~ 5t , 58D-6398 (R. D1/07) Valid thru 0!!09 ~ .~ r `~~ ~~~~ ~.~~ i ~~ ~~ r \ ~~ ~- ~G _~ Z ------T ~ 7 k ~ ~ ' •~~ i~ 5ca ~ c T~ ~ t a~ ~_ Q-3 ~; ~ ice. ~`' 2 Qo' ~ ~ S~~d ~ Q--Z- s e ~ + a `~o iu ~ /~fl ~. }} ~~ P~ 4 ' ~rKs ~r~° ~ `~~ ~ fl'S ~~bv ~ ~ `a .. ~~ ~~ `` g ~~ 3 a R ~~t7uSL (b O~ NwY 63 \nleve~-s C ~qr erne. ~ G ZZ N wy 63 ~M~ ~ - ~~ ~Z °P ~_~ 9 ~. 05 ~- 2 q b . 5.~ Sys ~~ q~. t 9 ?, ~s~- qd , a ..,,._..T..a.....~.,.~..a. 1_ ~.._C qt , 3` 3~ I~ ~ ~,`~ ~. ~U ~~ ~ ~ ~-~~ Scat t ~ ~ "~, t- C3 - 3 t)'. T~ ~ ~ J~ 5 , 40 ~ S~cd R-: Z r ~ . ~ ~ ~ E s e i ~~9 ~Q /~U i ' ~ ~ ~ ,rv e I ~ L ~~o~ ~`~ ~~ ~ ~ ~vG ~ 4 ~i SV ~ ~ J `'! b kl. S~? ~~~ Q ~ i~ c~ us ~ loo' RWY 63 C ~q~ erce W ev e,c-s ~ zz ~ ~y b3 .~ ~~~ raze- ~~-oac~ ~'. D O ~M#~1 ~'M ~` Z gg,85 -~~.~ ~-~ wets _ t~-1 9 ~. 05 ,Q_.3 q~L q S,yo ~~ ~~-S9~'~, ~~ ~~~ q ?~GS~' c~C.b ..~.~.~_,.W.. a ~ .. RI 3. 3 ~ 3 .-~ .- Wisoor>sin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT ... ~e'a per, 1 ~ 4 m a an rtn ~mrr~ vns. ream. ~.aae ,~.lL..~~ ~u+~Y St. Criox Attach complete site plan on paper not less t x 11 inches in s¢e Plan must inGude, but not limited to: vertical and horizontal . referen~_noio1:i81Al.•diredion and pares I.D. 18-1028-80-000 percent slope, scale or dimensions, north arr~ocation and distance to nearest road. Please print all i Rev' by Date Personal information ou rovide ma be used for CC ~ \ ~ CC nn (1) (m)) Wi~~r~s 15 '7 3 7 Z y p y ry . . . . Property Owner Prope Location Clarence Wavers .IUL 2 3 200 ~. ~ SE 1/4 S 1/4 S 13 T 29 N R 17 E (a~ Properly Owner's Mailing Address of # Block # Subd. Name or CSM# 922 U.S. Hwy 63 ST. CROlX COUN Y Cily State Zip Code P ~Vllage ^ own Nearest Road Baldwin Wi 54002 ( 7~5-684-2115 U.S. Hwy 63 New Constnx:don Replacement Parent material General comments and recommendations: a a f Use Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ~ Public or commercial -Describe: Loess over Glacial Outwash Flood Plain elevation if applicable ft. Suitable for leaching chamber trench system elevation of 91.90 r ~' r / ~` r tl~- ~tS ~ ~~~ a'C ~~ ~ rS ~~~` `~ 5~in/1 ~e . 7 .n~,~tr Boring # ~ Q ring Pit Ground surface elev. 97.05 ft. Depth to limfing factor >120 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ in. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-20 10YR3/2 - sil 2fgr dl as 3f 0.6 0.8 2 20-32 10YR4/6 - sicl lfsak mfr cs lvf 0.2 0.3 3 32-60 10YR5/6 --- scl 2fgr ml as --- 0.4 0.6 4 60-120 10YR4/6 --- s Omgr ~ as - 0.7a 1.6a t ~2 2 Boring# U Boring 96.55 >120 Q Pit Ground surface elev. ft. Depth to limiting factor ~• Soil liptan Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *E1f#t 'Eff#2 1 0-12 10YR3/2 -- sil 2fgr dl as 3f 0.6 0.8 2 12-35 10YR4/6 --- sicl lfsak mfr cs lvf 0.2 0.3 3 35-55 10YR5/6 - scl 2fgr ml as ~ 0.4 0.6 4 55-120 10YR4/6 -- s Omgr >~ as --- 0.7a 1.6a 5~ - tmuent ~i = t3vD > 30 < ZZO mglL and TSS >30 < 150 mglL * EflltaeM #2 = B < 30 rng~ a TSS < 30 mg/L CST Name (Please Print) Sgn re CST Number Thomas W, Gedatus `~l~ ~ 962178 Address Date Evaluation Concluded Telephone Number Stang Plumbing & Electric P.O. Box 263 Woodville, Wisc. 54028 1-715-684-516b ~ ? v/l~~ --- ---- ----•--- Property Owner Clarence Wevers Parcel ID # ols-lots-so-ooo Page - ~ - 3 ~„~ Boring ~~ # ~ Pit Ground surface elev. 95.40 ft. Depth to limiting factor >120 ~ Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR3l2 -- sil 2fgr dl as 3f 0.6 0.8 2 10-24 10YR4/6 --- sicl lfsak mfr cs lvf 0.2 0.3 3 24-40 10YR5l6 -- scl 2fg ml as - 0.4 0.6 4 40-120 10YR4/6 ---- s Omgr ml as - 0.7a 1.6a Z Boring l Boring # pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Hor¢on Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPD/fl? in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. *Efl#1 *Eff#2 D ring # ~ Boring Pit Ground surface elev. ft. Depth to liming factor in. Soil ligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft'- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "'Eff#1 "Eff#2 'Effluent #1 = BODS > 30 < 220 -r-9fl- and TSS >30 < 150 mg/L `Effluent #2 = t3OD6 < 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330Teat (R.07J00) /\ ~\ ~L i~ t s~ V i~ s~ V1~ }-- cr tom, 4 - 3 $ Q ~ 2 ~" 30' Scq~ ~ I q0` I ~-- 3,~, s 0 ~t ~ ~ g- t to qa, A2 R ~ ~\ ~i 3 8R l-~ ~ ~.s c, t~~' N '~ Y R-.Z a ~4 ~_s}fl~~ / 5~ v sti~a Stio p ~O 3 C l0.r erce. W ev ers '~i Ztz. N `~ y b3 6c` 1 a w`~^. w CSC- b ~i OD'Z ~/h'#~~ 100,op 9 ~'O°P a{' W e~~ g---~- EL-a~.bS Q- 2- 6>_-gb•5S X3-3-ELF s.yo ~' ~QJ~ 7fa d/~ ~ ~~,~~ 3 o-PLf St. Croix County Land Information. Online Page 1 of 1 _,3 P~uoel CampuEer Nmnber: N/A Y ~ R/a County Home Search Tax Record Documents _ )Map r,,~ i ~Y ~~ Re50~ Tools., ~ ~ .'"'~ c$ ` ~,--~ yew Tools... ~`~ ~ ~l` So~rrJ~ ResuRs -1 MaDdW~y PtoperlN N Return To Search Methods -~ Generate Mailip Labels Grid Oi8-1028-80-000 TOWN OF H11MMf)l® O.ARF.NCF VVEVERS 922 HWY 63, _ Staled"= 110 }p -~., _ _. od.,ed~ cam I http:J/72.21.234.178/website/LRPortal/main.asp _ 7/18/2447 sT. cROIx cotrNTY SEPTIC TANK MAINTENANCE AGREE AND OWNERSHII' CERTIFICATION FORM OwnerBuyer Mailing Address ~ ~ 2 ~ s ~lw~ G 3 Property Address ~ ~ `''` ~ / (/Verification required from Planning & Zoning Deparment for new constructiob.) CitylState ~~- ` c `~ '~ 'T ~ +~ Parcel Identification Number ~ ~ ~ ~ 0 2 ~ - ~i ~ o~ G G LEGAL DESCRIPTION Property Location ~~' '/a , S~ '/a , Sec. S , T ~ ~ N R f ~ W, Town of `~! ~` `''~-- s1'~- o fi Sabdivtsion- - -- - - _-----___ _ ___ _ _ - --___ _.__ --- - - ----s - .• _ _ - - Certified Survey Map # ,Volume ,Page # Warranty Deed # ~ ~ ~ (.r V (~ ,Volume ~ ~~ Page # ~~ Spec house ~rac Lot lines identifiable yes no SYSTEM MAII~ITENANCE AND OWNER CERTII~ICATION Ir~roper use and maintenance of your septic system could resah in its premature faihue to handle wastes. Proper maintenance consists of wing out the septic tank every three years or sooner, if needed, by a licensed pua~er. What. you put irta the system can affect the function of the septic tank as a treatment stage in the waste disposal system. t7wndr responsibilities are spocsfied in §Comm. 8352(1}and in Chapter 12 - St. Craia Camty Sauitazy Ordinance. The property owner agrees to submit to St. Croix Co~mty Plam~ing & Zoning Department a certification form, signed by the awnear and by a master Plumber, joucne}mnan phnnber, restricted phumber of a pumper verifying that (1) the on-site wastewater disposal systeon is ~ proper operating aonditios and/or (2) aver and pamper (if ney~ the septic tank is less than 113 full of shdge. Uwe, ~ undersigned have read the above n~ and agree to ion the private sewage disposal system with the staadscds set forth, her+aia, as set by the Dep~tcttnan of Coke and the Deft of Natural Resources, Sortie of Wisconsin. Cos staTmg that ~ septic system has been mamtamod mast be cQmpkted and retvmed to tl~e 3t. Croia Coanttg PLmniog & Zoning Depertm~ within 3Q clays of the tb<ec year aq~atioa date. Uwe certify that all statements an this farm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the proQtcty dets~od above, by virtue of a warrasay dxd ret;orded in Register of Deeds Office. Nnmbcr of bedro0mt _,~~ SIGNATURE OF APPLICAPTI'(S} ~l ~FJ / ~~ DATE /// '*'Any n that is misrepr+esznbed may r~lt in the sanitary permit being revoked by the Planning & Zoning Deprstment. #** lnchide with the application a rccorded warranty deed fYOnr the Register of Deeds Off>sx and a copy of tht certified survey mapr if referencc is made in the w~arraniy deed. (REV. 08/0 PUMP CHAMBER CR055 SEC T IOW gltiG ~Pl:£IF{CATtORlS ~ 2~' FROM POOR, wli~{DUw OR f'RES>•t AlR UuTAKE 9g i8"MtIJ. l1ULE7 ~L~v ~ ~' ~ FT. ~~;~ v~ uT taP wFATNt:t~tcoor .lUt~1tT1011 90X I L"MtLi. li GitAD£ ~ _____ ~~ counUST ~--- v ~. PROyt 0 E AittTi6H`I' SEAL ~- APPttOVEO t_OCKik1G MA1JtiOt_E COVE R Y' A'kIN. ~____ i~-r~{u. {' tt ~~ ALARM ~° ~ _~ C *APPROYED i i ~ JOINTS YI7H APPRUYEU PIPE _,.! • 3 ` ORlTO ~ PUMP --~„ y ~t'F o SOLID SAIL COlJCRETfi RISER EXlT PERMt7[ED p1,Si_y tc T7-.UK MAtJtFAtTURCR HAS SiJGH APPROVAI•. s~Prtc E SPEGIFIGATIOAtS DOSE ~i`Ga'~C, TA11btS MAttf,lPACTUR£fl: .~:.~.~ (~KYrtOE'R OF 005E5: PER bAs TAAIK 5tZE : -_ G 1J ~ 6ALLp41S D05Q VbWME ALARK MAWUFACTttRCR: S.1 ~ ~ !ttlCLUOII~t6 6AGK/LOW: GALION: MODCL UUMb£1~: ~ ~ ~ ~C i ~'~ - CAPACm~s: w=.1.~{n~s Ire ~_~ 6AU.aus StrflTCtt T':1PE: g =_.,~,_1tJCHES OR ~~S~ 6AtL0lJS PUMP I'SAtJtlt'ACTUKCR: ~ ~~ ['! ~ C z ~ ~ ~ ttJCNES OR ....tom= CsAILOiJS MOOEL UUMbEk: ~ ~ ~ ~,_,,_,,,,~„i,_, D ~ ~inIGNFS tM :.L~.. 6ALLpN£ 8W~CN TAPE: t30TE: P!lltP AtJC ALARH ARE TO iSE Mt1~ItItitUC1 piSt!{A-Rl~E itA'T'E t' d ,~GrM tAiSTAtLED OU SEPARATE CtRCUfTS• HERTtCAL ,DtFt=6REt1CE OirTWT.Cq PttMP Ol<f l1t~} pISTRitS1iTI01J PIPE.. '~ FE£T -!- M1t"~ali~MUM t1ET'WORK St1PPL~3 PRESSURE .., .. , .. ~ . . , 2.5 FEET ~- , ~ v _ FEET OF ~~tCE MAti~1 X ~6 ~FRttTiOki P/4G'tOR._ 1 e1 FEET - TOTAL O`ltAtAMIC K1:AD = .~Ra.i_ FEET Ii~iTERt-!AL Qi EU5tOt~it OF TAt.1K: L~AIGTH ~..._,_._,WlDTH -- --;LiOWa DEPTH _.~..,,_. 3tG{.,1£ O: LICEI-!SE a>urtllER: J` ~'~ ~ ~ OA'TE: t6d i~r~i3~L 3871 ••. :~ • dpA~4K • t~pnpb8s6P~. • ToNIl~~b3t imet _'• tllBdlolg~so~'fil~t'1~`I: • Medr~aie~ ~ ~ ~lN~~pp~lG '~_ . ~~~~ aleel. •~wAfiOUt~ ~ageb ~~ ~_ }QA~P, i#S etZiO .6D Nx t~ Rf~M, btu is e~e~tor! w'Ih C Ie~M. 1 WY~~ii~f~0~. ~~ ~ Q~~ ~~~ ~~ ~~oo~arusa.~~ ~ aoeo •~m~ aa~. ~e~t heatlr~r. Awl~iefrrs~w~ITC~M t^e~t^~i Ratl~iiba~wMeia~i ~'f~ ~IiCdM~ +~ pue~podt+~^~lator al/p ~, ~'~; ^EAi~c'~o- ~~ w oon+~sio®nea~,e. •~w-~ tit i~ tae~ciMt~tt~e6er, sra~h,~d~u~bt. M~rOliw~fi~OplWic I~IiOn~t i~l~gl6in~eid Pow •lMi~C~9e~e~d~ I~dd~11~f1 loArer ~waNCY t~nao ~i~r~~wiei. . ~ air: ~~wr m ° - ~- 4 s $.- ~ s2 wow 07/20/07 FRI 13:22 FAg 715 38B 4686 ST CR% CO ZONING tool POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORM/A7'ION ', ee Owner C. / la ~ ~. y G G tM~4 v~ t$ S Permit ;X DESIGN PARAMETERS Number of Bedrooms 3 O NA Number of Public Facility Units ^ NA Estimated flow (average) L~ Sou al/da Y Design filow (peak), {Estimated x 1.5) al/da Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average' Fats, Oil & Grease {FOG} 530 mg/L Biochemical Oxygen Demand IBOD6) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent duality Monthly average Biochemical Oxygen Demand {8006) <30 mg/L Total Suspended Solids ITSS) 530 mg/L ^ NA Feca! Coliform (geometric mean) 5104 cfu/100m1 Maximum Etfluent Particle Size Y6 in die. ^ NA Other: ^ NA 'Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~ ~ p U al ^ NA Septic Tank Manufacturer („~ r'C,SC? ^ NA Effluent Filter Manufacturer GS1r ^ Nq Effluent Filter Model ^ NA Pump Tank Capacity ~ 5 U al ^ NA Pump Tank Manufacturer W ; C t C~ ^ NA Pump Manufacturer rj. it t` ~ ^ NA Pump Model ~ ~i O ~ ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Rlter ^ Mechanical Aeration ^ Wetland ^ Disinfection ©Other: Dispersal Cell(s) ^ NA In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade Q Mound ^ Drip-Line ^ Other: Other: ^ NA Other. DNA other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s1 At Isast once every: ^ month{s) (Maximum 3 years) ^ earls) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third IY3) of tank volume ^ NA Inspect dispersal cellls) At least once every: ~ ^ anth(s} (Maximum 3 years) earls} ^ NA CEean effluent filter At least once every: monthls- ^ year{s} ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(s) D year(s) DNA Flush laterals and pressure test At feast once every: ^monthls} D year(s) ^ NA Other: At least once every: ^ month(s) ^ yearlsF ^ NA other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying ane of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellls} shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the locaE regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third tY31 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent #ilters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within f0 days of completion of any service event cnnw taro, ) 07-20-0? 15:29 TO: FROM:715 386 4686 P61 07/20/07 FRI 13:23 FAX 715 386 4686 5T CRX CO ZONING Page of X002 START UP ANQ OPERATION For new construction, prior to use of the POWTS check treatment tanks} for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell{s}. If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Saptage Servicing Operator prior to restor'sng power to the effluent pump or contact a Plumber or POWYS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade sot! absorption area. Reduction or elimination of the fo!}owing from the wastewater stream may k'nprove the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump} water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medicatwns; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS faits and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Alt piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits she!! be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not he infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure io protect the replacement area will result in the Hoed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not avaiable due to setback and/or soil limitations. Barring advances in POWYS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed io locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POW'fS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following remove) of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSI$LE. r_f1MMFNTS RAINTS INSTALLER - --Name - J G Cr .~~ J9 ~'1 Phone ~ ~~ ''~ ! ~ fJ,'! ` (j POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR {PUMPER} LOCAL REGULATORY AUTHORITY Name Phone Name ~ Phone 7(S - 38'~ " This document was drafted in compliance with chapter Comm 83.221211b111)Id)&{fi and 83.5411), (2) & 131, Wisconsin Administrative Code. 07-20-07 15:30 TO: FROM:715 386 4686 P02