Loading...
HomeMy WebLinkAbout018-1082-10-050/* wisoonsln papartmertt of commerce PRIVATE SEWAGE SYSTEM seatety ar'd 9uTd~ngs oi"san INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice maybe used for secondary purposes [Privacy Law. s.15.04 (1xm)]. a~~r'~u"l rr~s 1'nc:, ~ C`ty ~ami~ionc~°~"ownship CST BM Elev.:- insp. nrvi r:iev.: tA~ , r t~O.c`~ r TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ Qbo ~6tz~ Dosing ~ ~,,,,~,~ , Aeration Holding TANK SETBACK INFORMATION r ELEVATION DATA STATI Benchm `~ 01 ~ , It. BM o ty: ~. Croix ~384y216 it No.: S to Plan ID No.: Parce Tax No.: 018-1082-10-050 3p.~~.l7.,$"G8 BS HI FS ELEV. Bldg. Sewer CJ $.bS 9rD.Oto r St / Ht Inlet q • ~~ ~ 5 •6 6 r, St! Ht Outlet Dt Inlet of Bottom (J 13. o ~ - . ~ Header/Man. i 2•~O i~ l~•~ Dist. Pipe 2 ~ /~ ~ ~ sot. System 3; i3 9q ~ S3 Final Grad-~ ~,,, (,(~ Z`I ssx -~ ba ove Pv~e~w. ~ S c,~. 3.40 9$: g~' r~~ C~-~ll c l) `T~ ~ .~~ TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic > So' .~. 5- ! --~ NA Dosing ~~ ~ II -. NA Aeration NA Holding ~'`~q PUMP /SIPHON INFORMATION piT' NoF Of Bits Inside Dia. ~ Liquid Depth r SYSTEM TO P / L BLDG WELL LAKE /STREAM ~v-,~^' SETBACK CRAM , INFORMATION Type ,, ~ r -3 Z` ~•~--- O NIT System: DISTRIBUTION SYSTEM L'~ ~~ r~-Ic~°.el~(ni °'~'`""'~ Header / Mani ptd tt Distribution Pipe(s) 1 ~ x Hole Size ~ ~ x Ho a Spay _l o ~ 21f~" Length • ~ Dia. ~ Length ~~'~ia. 1 Z Spacing 3 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No C ME TS: (I clud c ediscrepancies erso resent, ection #1: /ID / Inspe Lo n: 726 16 th Street, Hammo d, 154015 (SE 1/4 SE 1/4 30 T29 1 ) - 302! xx Mulched ^Ye ^No In # ~~'/ t~ 01 9568 Ridge -Lot 5 'f 1.) Alt BM Description = ~DC~` ~~~~ s`~ •`j0'"`~ 2.) Bldg sewer length = t 5 ,o ` ~ 3 . ~v ' ~'~~'~`- < ~~ -amount of cover =~ 5 p" 50 ~~ Cot><~~ r / 3 ` 3.) conto r = cj9.c~(s~~ ?.zs-,~ ~ - lag-~~ g5 - ~• S ~/ ~an re~s o~quired? ^ Yes No Use other side for additional information. O ~~ ~ Date Inspector s Signature C No S80-6710 (R.3/97) SOIL ABSORPTION SYSTEM ~~ ~~ ~~ 9 Safety and Buildings Division County ' ,~ 201 W. Washington Ave., P.O. Box 7162 ST . CROIX ~seonsin Madison, wi 53707 - 7162 Site Address # ~ ~~ Department of Commerce ' ~Zlo b~ . Sanitaf~ Permit A lication ` ~ Sanitary Peprmit Numfber ~ o ~ 2 ` 2 ,Wis. Adm. Code, p onal iafo~n you provide In accord with Comm 83. ~ ^ Check if Revision tna be used for seco ses Privac La s1S.: . L m ` I. Application Information -Please Print All Informations''' State Plan I.D. Number I ;nom TRANS. ID # 644091 Property Owner's Name ~ _ , ~,Ii ~ ` ~~~ Parcel Number 34 . ~,~] ~ / ? HALLE BUILDERS INC ~ 018-1082-10-050 Property Owner's Mailing Address ~, ~, _ i ~ '~ ~ Property Location , I 1113 HWY 64 ' ~`~`~~~ ~?~~ . ~ SE ~k SE ~,t; s 30 T 29 N R 17W~/ City, State Zip Code Pho ,~1Lunber , ~ ~~ Lot Number Block Number ~ £ M 5 NEW RICHMOND WI ~ 54017 ' .,; ' ' ~1i5,/Z~+fi=~~,1.3 Subdivision Name CSM Number '-~ ~- ~~- MEADOW RIDGE II. Type of Building (check all that apply) ~ ~ s ~ ^Ciry s ~ ®1 or 2 Family Dwelling -Number of Bedrooms ~. ^Village 0 Public/Commercial - escribe Use - -' ~ist?unP.w>~ ? ~ (' ~ ~ HAMMOND Township ~, ,, ~ ~ ~ ^ State Owned "°'~ ' ~ ~ U k'~-S~ CtlLQ. `~D µ ~ 0•S ~(o ~ Nearest Road 160TH STREET III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A' 1 ®New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S sum Tank Onl Existin S stem B. ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that app!) n bering scheme is for internal use) ,~ eQ ~(t7tl , 44 ^ Non -Pressutized In-Ground 1^ Mo 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersal/Treatment Area Informat ion: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min.Mch) fleva6on 450 450 450 1 N/A 99.5 101.33 ,'l'ank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 - 100 1 HUFFCUTT CONCRETE X Dosing chamber 600 VII. Responsibility Statement- I, the undersigned, ae~~,,,. responsibility for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Pl 's Signature MP/IvIPRS Number Business Photte Number BENNIE HELGESON 220292 715/772-3278 Plumber's Address (Street, Ciry, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY WI 54767 VIII. Coun /De artment Use Onl pproved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is Agent Sigoa (No Stamps) ^ Owner Given Initial Adverse . Sure ge Fee) 3a ~ Determination ~ IX. Conditi ns of Approval/Reaso f r Disappr9val +- ~ ~ ~s [~- ~.s ~.~. U fit- ~ 3 C zP.a ~,) e,~ ~ ~ ~ . l,~- .~ 0~ ~nPn iS t~ `~S Part ) ~ / a+''~ ~~ 1 1ltik nNO~ ~p.~,~ C.~RO( ~~ ~ St~~• de_ ~ -#~ _ (1 ap ~ TI A '1'C'l~/ t5 nn nn G11~A~a~`Q~d~ ~S f 9+tiC ~ ~ ~ C - IJ~ "~-'"'-~ _ • Attach complete plans (to the C )tor the r~atem on paper not less than 81/1:11 lathe 1a size «~:: SBD~398 (R. 05!01) ,~. rec8uc , ~~ ~~ ... , . ' ~-- //~ ~o w~_~ ,1 l~P~s .~~o~~? aM. ~on.oo _ Yoko o~ QI~...~, ~,~ ~re~ose~Q r ~ ...~ I ~ ct~ien ~ FOun ~. y~. 3 ~r o~F S<-.Y /(>h0/60o (~../. // .c ~~ ~+ ~i 0 ~~ 1 07 c ~ - -- ~~ S~Uey Coth~r W1~r~PF- I P-P~ ~~"~~bou~G~ ~ „~ I~ q ~.3 ~5 . `1 lcx~ 3 q9, v . tE • ~ ~ ~~,. iscons~n ,,,,, ~ ~~_ Department of Commerce .F~'~;, Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD #: (608) 264-8777 vrww. commeroe.state.vvi. us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. BlanchaM, Secretary May 25, 2001 ~' t` ~ '~~`~ ` R ~~^ n CUST ID No.220292 ~'"' ~ ~ S~ ~~~ tiG~- " ~TfN: P W Ins ect r ~ ,, ~ O TS p/ c~` ;. d~ ,, r°~~ ^~` ~ ,,,r- ~`~; ~~ ZONING OFFICE BENNIE W HELGESON `~ ` E ~ ~ f~.l ST CROIX COUNTY SPIA W1229 770TH AVE ~~--'"`~! 1101 CARMICHAEL RD SPRINCr VALLEY WI 54767 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/25/2003 Identification Numbers Transaction ID No. 644091 SITE: Site ID No. 630317 HALLE BUILDERS INC LOT 5 Please refer to both identification numbers, ' ` ST CROIX COUNTY, TOWN OF HAMMOND above, in all correspondence with the agency. 160TH ST, HAMMOND 54002 FOR: OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 794102 DISCRIPTION: 450 GALLON PER DAY MOUND SYSTEM. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • 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 mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A 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. . r BENNIE W HELGESON Page 2 5/25/01 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Si ely, THOIv'L~ INS POWTS PLAN REVIEWER, INTEGRATED SERVICES (262) 521-5064, FAX: (262) 537-3623 , 7:30-4:00 TPERKINS@COMMERCE. STATE. WI.US FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMAR`f code. 7633 cc: BEN HELGESON HELGESON EXCAVATION 1NC isconsin Department of Commerce Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD #: (608) 264-8777 www. commerce. state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary May 25, 2001 CUST ID No.220292 BENNIE W HELGESON W 1229 770TH AVE SPRING VALLEY WI 54767 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 PLAN APPROVAL EXPIRES: 05/25/2003 Identification Numbers Transaction ID No. 644091 SITE: Site ID No. 630317 HALLE BUILDERS INC LOT 5 Please refer to both identification numbers, "'' ST CROIX COUNTY, TOWN OF HAMMOND above,.in all correspondence with the,agency.. 160TH ST, HAMMOND 54002 FOR: OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 794102 DISCRIPTION: 450 GALLON PER DAY MOUND SYSTEM. CONDITIONAL APPROVAL The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • 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 mound component manual aze complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval condi " ns. • A Sanitary Permit must be obtained from the county where this project is located in accordance kith th `~''L requirements of Sec. 145.135 and 145.19, Wis. Stats. ~.r,~ 3~~ji O • Inspection of the private sewage system installation is required. Arrangements for inspection ~Jd~ iA with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat r~~ 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/instal lation/operation. BENNIE W HELGESON Page 2 5/25/01 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Si ely, THOIV~ INS POWTS PLAN REVIEWER ,INTEGRATED SERVICES (262) 521-5064, FAX: (262) 537-3623 , 7:30-4:00 TPERKINS@COMMERCE. STATE. WLUS FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: BEN HELGESON HELGESON EXCAVATION INC ~- INDEX SHEET PROPERTY OWNER: HALLE BUILDERS INC 1767 115TH STREET NEW RICHMOND WI 54017 PROJECT NAME: HALLE BUII.,DERS INC PROJECT LOCATION: SE 114, SE1l4, S 3, T29 N, R, 17 W MUNICIPALITY: TOWNSHIl' OF HAMMOND COUNTY: ST CROIX DESIGN: PRESSURE DISTRIBUTION MANUAL: SBD-10573-P (R6/99) MOUND COMPONENT MANUAL: 5BD-10572-P (R6199} CONTENTS Pagel : Plot Plan ~~~~~~~~ MAY1G2001 Page 2: Cross Section & Plan View of Mound SR~~TY & BLDGS. DI'J. Page 3: Distribution Pipe Layout Page 4: Septic Tank & Pump Chamber Cross Section & Specs. Page S: Tank Specifications 870650 Pg. 1 Page 6: Tank Specifications 870650 Pg. 2 Page 7: Pump Specifications Page 8: POWTS Owner's Manual & Management Plan Page 9: POWTS Owner's Manual pg. 2 Name: Bennie Helgeson Signe ~ d~~~ ~~ Address: W 1229 770Th Avenue "r,~ O~ Spring Valley, WI 5476? ,~y~'~y~~ yo '~.~s rte. ~d, '1'0 Credential number: 220292 Date; May 14, 2001 ~ ~~ ®/~ ~'p`~~i,~, ~l0 • ~rU ~i/' o- v ~ ~l~ f ~ µ ` a~/L ~Gc /dPi~ T L~~- l,tlnn ~ ~ i o _ 7o w~s~ ~~ r ~, `~' 9,. ~o r~ ~~ ~" Sf« ~ ~~ , S~.rue7 Corner vw rkP,~ ate. -o~.oo ~ Top o~ Qlw~, I" S~«~ P~p-Q. I~"//~~6aueGr~e, ~eo~.~ L , ~`_ Pre ~ 05 F ~Q ~r ~wz- i ~1 pesC~Q a~d~ ~ ~ Fpctn ion ~. y7.3 Pto~e,s~...~ (ono~6ov 6..1. ,c ~~ i~ ~~ 0 ~~ c~ ~~ ` f Q.~'F Cry ' / ~J 1 ~' ' 9~.3 y5.`1 /cxa3 q9- v Synthetic .Covering. ASTM C 3:3 Medium Sand Topsoil 3,' _~ ~ % Slope ~ F Ll.O f ?~- 2 i Aggregate _ Cross Section Of A Mound Signed: License Number: Date: ~._--- - L 0 ~ S Ft. E . , 8ro Ft . F s$~ Ft. G .~ Ft. H / Ft. Observation Pipe J ~ ...-~--- K --_.-.__ _~_ ._- -_ ___ ~ .a..--.~.. -- - - ~ -- ' _ 1 KC ..__ A ~< ~ -G 8 t~ ~ r T___--_._.r_ -.------- ~ 6 N / Distribution ~`'t't" Of 2 - 2 2 Pipe Aggregate Observation Pipe Page ~. Of' -Distribution Pipe G F D Ek ~. 94. Plowed Loyer Force Main From Pump q ~ Ft. B 7S Ft. K7S,~Ft. L 9~.dC. Ft. ~ ~~ F t . I ~ Ft. W ~ Ft. Plan View Of Mound ~,~~~~~r~ ~~.~1~ ~~~ Id~rs~c. i~ a~.o...l" ~.L(C5~/ C.. ~fttvtCx.~~ Perloroterf rlp• Oetoll J End VI~>~ Perlorolyd ~ 1 l i~ 30~ ~ Holes Located on Bottom are Equally Spaced 'a r h -o i~ ~Q x~ -~n ~t~~; ~'ol~P (' ~f'c vip. Signed: Distribution Pipe Layout License Number: Js~e: R S 3~ X ~~ Y ~~/ ~~ 1 Inch Hole Diameter ,_~ Lateral /~ Inch (es) Manifold " ~ Inches force Main " ,,,~„_ Inches 3 8 Noles ~~~- ~o~+~ rd.' x ~ ~ ~~~ ~~. l s _____--~ ~ ~ .~oi~ ~~~/ Page_~} Of~ ~v~SP~ac ~~o~. 1 IBS y,•R,,,. COMBINATION SEPTIC TANK/PUMP CHAMBER (No Scale) ,Approved Locking Manhole Cover With Warning Label Attached Weatherproof Junction Box i rra~e, ., i 4" CI Vent Pipe wit Approved Cap, +25,' From Buildings Approved Yent Cap -~ 12" Minim -----~~ 4"Minimum Quick Disconnect 18" Minimum Approved Joint w/C.I. Pipe Extending 3' Onto Solid Soil Baffle: ZA R L F. l r~,~ ff 1O(~ ~.2 x / ~ ~_~ ; 1 /4" Weep ~ Hole i D ' i i A ~ ~ Alarm ~ B Approved Jo' On b"; ~ w/C.I. Pipe I C Extending 3' ;- ~ ~ Onto Solid Conc. Bloc 3" of Bedding Under Tank-~ 7oTa~ Gal. ~h L.ct~'era~S / ,Gti~~o~. .. ~ ~( Note: Pump and Alarm Are On Separate Circuits 11 Ga110ns I V Y r w ~ ~v «~ ~'e VO (U S ' D - ,. C . O M ~H . Volume of Backflow:...... •+ ° ~ M~~.Total Dose Yolume:....... Gallons .' Tank Manufacturer: c.~ Tank Size-Septic/Pump: a a ons Alarm Manufacturer: ~' T ~~~f• ~ ~~T- Capacities: A ~O, inches or~~Gallon: Gallon: Model Number: - Switch Type: ~ + B inches + Cinches or,~Q,.~,,, or;,,~,~',,~„~allon: Pump Manufacturer: _ inches S + D~ or Gallon: ~~ Model Number: ~ _, Total.....= inches' ~allon: or1 Minimum Discharge ate: ~ ~ ~~~ - vertical Difference Between Pump~Of f and Distribution Pipe:~y~Feet + i Feet Minimum Required Supply Pressurtr; :.. Fric ....................... tion Factor/100 Feet: +'~'~`~~~eet /~ Feet of Force Main x ~_Inch Diameter Force Main Total Dynamic Head:...=~y_yzFeet ''I ?nternal Tank Dimensions: Length_ ; Width Liquid Depth ~~,a ~,(. ~~-_ Z~, ~' J Date Signature~~. .,~ ~ ~ _License Number~~°~- i r ~~. H -1 D z t1 0 S c m D C) v D Z n O !, :(J N fU 2' W ' 7c,• A (J1 Ifl/I^ ,,, _ II I N to ~-J b D a d D _~-- _ fU -1 - _ .. _ - _ _ _ - - D r _ _ . _ _ _ ~ I ? ,•, I ~ i r r- I ~ D 1 O ~ I "~ rl m r r I vt o ~ I I G= I ; ~ ty I m ~ ri I d c t1 ~ ~ r ~ - i 2 ® I i ~ D ~ I I n.. C7 ^ I c n~ z. I S A p~ D I ~ ~ r~1 0 x I cC C I C~ ~ I -~ z ~ vt v I I I I is is r -~ N N a J Z T ~O . ~ o v d o D D = O D • D O x UI ~ N U a ~E G4M~b~11.p\ I Pry J H (7 rl t 0 f5 O rt A '~ ~~ n£ 0 < A n m z D A Z o~Z °m ~ N ~ r D c z "' r, ~ A O 1~'1 r relit o0 -Di 1 HC ~~ d Z -~ -+ of A~ A n ~ Z V! A A r1 I D ~ ~ N Z a -1 •Z o TANKS 870650 HUF~CUTT CONCRETE 737 HERBERT STREET VI 5729 CHIPPEVA t•ALLS MEMBERS OFD PRECAST CONCRETE ASSOCIATION T A A N = , NA ION L ]N T R ~ I000/600 GALLON (715) 723-7446 ^ FAX <715) 723-7111 (800) 924-1516 I VlSC01SIN PRECAST CONCRETE ASSOCIA ~~+ ~ 'i SEPTIC AND PUP TANK TNIS DRAVING SNAIL NOT 1E COPO:D OR SUiNITTED TO OTHERS VITHOUT CONSENT ~ TWS COMPANY 7 W ~• L L ~~ O C r m -~ 78' _.~ 3°' 39~ ---r I I r O A r D 2 D x m D H t1 r 0 c 0 n a D n 0 Rl ~D D r t- 0 Z fU v n D r r 0 z ~~ I I 20000781 RE~ElVED MaY 2 ~ 2000 SAFETY & BLDGS. DIY. ~^ ,~ w TANKS g7o65o ~ x Z n~ , m 1000/600 GALLON ~ ' v ~ SEPTIC AND PUMP TANK r D 2 L D Z x O H U~ F C U T T C O N C R E T E 737 HERBERT STREET MEMBERS OF, GRIPPE VA FALLS, vl 5729 NATIONAL PRECAST CONCRETE ASSOCIAT%="• C715) 723-7446 ^ FAX C715> 723-7111 C800) 924-1516 vISCONSIN PRECAST CONCRCTE ASSOCIAtiC~• THIS DRAVIN(i SHALL NOT BE COPIED OR SUBMITTED TO OTHERS vITlOUT CONSENT 0~ THIS COMPANr v 30' 12' 30' BAFFLE m W A W ~ A N R7 N J N a v to 6 7' I 72' I I I 1 7B• I 1 I ~~°~~: .. ~ll~~'1ef~s~~~ ~ue~'1t Performance Curves ~~ METERS FEET ' 25 ~ 70 20 60 O H 15 ~ 40 10 ~ 20 5 10 0 0 MODEL 3885 SIZE 3/a" Solids Illill~~iiii~ en on YM 110 120 GPM 0 10 20 30 40 bU ov . ~ .... __ . _ _ i ~ ' ~ 20 30 m'/h 0 10 CAPACITY ~GOULpS~.. PU~MlPS~IN~Ce METERS FEE' 12( 35 111 1a 30 s~ 25• ~ & g 7. = 20 6 O H 9 15 4 10 3 2 5 i l 1~ ~.. 0 ~`.t ~ ~ CAPACITY 01985 Goulds Pumps. Inc. m'/h Elfecliw July 1985 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of `~' cii•c InrFr7RMAT10N ~..... . Owner HALLS BUILDERS INC Permit # ncc~rwl DAReMFTFRS U1.6V~V~~ . n - -_ __ Number of Bedrooms 3 ~ ^ NA Number of Commercial Units I~ NA Estimated flow (average) ..300 aUda Design flow (peak), (Estimated x 1.5) 450 aUda Soil Application Rate , ~aUda /ftz Influent/Effluent Quality Monthly average' Fats, Oil 8 Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODa) x220 mg/L Total Suspended Solids (I'SS) 5150 m /L Pretreated Effluent Quality ^ NA Monthly average" Biochemical Oxygen Demand (BODS) 530 mg/L Total Suspended Solids (TSS) 530 mg/L Fecal Coliform (geometric mean) 510' cfu/100m1 Maximum Effluent Particle Size Y inch diameter SYSTEM SPECIFICATIONS Septic Tank Capacity 1000 al D N~ Septic Tank Manufacturer HUFFCUTT CONC. O N~ Effluent Filter Manufacturer ~A,BEL D N~ Effluent Filter Model A-100 12x 16 D NE Pump Tank Capacity 600 al D Nf Pump Tank Manufacturer HUFFCUTT CONC D N~ .Pump Manufacturer GOULD PUMPS INCD NF Pump Model 3885 WEO 5HH ^ N~ Pretreatment Unit DNA ^ Sand/CTravel Filter ^ Peat Filter D Mechanical Aeration ^ Wetland D Disinfection D Other. Manufacturer Dispersal Cell(s) O In-ground (gravity) O In~round (pressurized) ^ At-grade ®Mound ^ Dri -line ^ Other: • Values typical for domestic (non-commerclaQ wastewater and septic tank effluent. •• Values typical for pretreated wastewater. MAINTENANCt Scrttuu~t Service Event Service Frequency Inspect condition of tank(s) At least once every 2 ^ months ~(7 year(s) (Maximum 3 yrs.) Pump out contents of tank(s) ~ When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every 2 ^ months Q year(s) (Maximum 3 yrs.) Clean effluent filter At least once every 1 O months . ~ year(s) Inspect pump, pump controls & alarm At least once every 1 O months ~ year(s) DNA Flush laterals and pressure test At least once every 3 ^ months Q year(s) O NA Other. At least once every ^ months ^ year(s) ^ NA other. At least once every ^ months ^ year(s) O NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer; Septage Servldng 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 cell(s) 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 local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y,) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatgment components; and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A servir,~e report shall be provided to the local regulatory authority within 10 days of completion of any service event. STARTUP AND OPERATION. For new construction, prior to use of the POWTS check treatment tank(s) 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 tank(s) removed by a septage servicing operator prior to use. ~- . Page ~ of 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 Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS 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 soil absorption area. . . Reduction or elimination of the following from the wastewater stream may improve the pertormance and prolong the Ilfe of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss;'dlapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMIVIENT When the POWTS fails 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 ch. Comm 83.33, Wisconsin Administrative Code: • All 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 shall 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 be infringed upon by required setbacks from existing and proposed stivcture, lot lines and wells. Failure to protect the replacement area will result in the need 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. O A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. O The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evacuation must be performed to 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 POWTS. ® Mound and at-grade soil absorption systems may be reconstructed in place following removal 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 IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name HELGESON EXCAVATION INC Phone 715/772-3278 POWTS MAINTAINER < t~ Name JOHNSON SANITATION Phone 715/2y3-5811 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY ' ' Name JOHNSON SANITATION Phone ~X~Z~~~/~~~,( 715/273-5811 Agency ST. CROIX COUNTY ZONING OFFICE Phone 715/386-5680 ~ This document was draRed by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agenGgs. This document me0ta the minimum requirements or ch. Comm 83.22(2)(b)(1)(d)8(f) and 83.54(1), (2) & (3), wsconsln Adminlstratlve Code. Use of this document does pot guarantee the performance of the POWTS. Gt~AVN (2/ot) _w:,,:o,~~i~,Departmentoflndustry, SOIL AND SITE EVALUATION REPORT Labor ar.~ Human Relations f)ivisien of Safety 8~ 8uildinas . ~~ n_ ~_ Page ~ of 3 111 QyyV141 ~~Illl 14.1 ~~ ~ VV.VV, •~IJ. ..~~~~• vv~v COUNTY ~ ~ Plan must include but lete site lan on er not less than 8 1/2 x 11 inches in size Attach com a ~ `~ ' ~ ~ ~ , p p p . p not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION IEWED BY DATE l PROPERTY OWNER: ~~ • ~~ ~ ~y PROPERTY LOCATION GOVT. LOT SC 1!4 Sc 1/4,S .~ O T Zy ,N,R / 7 ~.(or) W PROPERTY OWNER':S MAILING AD~RESS LOT # BLOCK # SUBD. NAME OR CSM # .--- CITY, STAT ZIP CODE PHONE NUMBER ^CITY VILLAGE jic]fOWN NEAREST ROAD < o! Gr~~. 5 ~/ 7 (7/S) z ~F~6 -(08/3 d ~ - S> • [~ New Construction Use [ ~ Residential / Number of bedrooms 3 [ ]Addition to existing building j ]Replacement [ ] Public or commercial desaibe Code derived daily flow v~0 gpd Recommended design loading rate _~bed, gpd/ft2 • ~ trench, gpolft2 Absorption area required 3 7 5 bed, ft2 3 75 trench, ft2 Maximum design loading rate ~ `~ bed, gpd/ft2 ~ ~ trench, gpd/ft2 Recommended in filtration surface elevation(s) /DD ~ ft (as referred to site plan t~enchmark) ~ Additional design /site considerations l4- Parentmaterial (-~.e,, w. ~ L~i,• Flood plain elevation, if applicable IN ~" ft S =Suitable for system CONVENTIO AL ^ S U M UND S^ U IN-GROU D PRESSURE ^ S AT-GRADE ^ S SYSTEM IN ILL ^ S HOLDING T NK ^ S U=Unsuitable for s stem SOIL DESCRIP'i! ION REPORT ~L,,, ~~ • ,S~ 1 ~ Z,f10u ~j ~.~.n~ Boring # Ground elev. ~~~ Depth to limiting factor ~ ~~.c8, J Boring # tiO~4\}~}xv ~..•.~i:S:S:$ ti~ :.: :~ r:.,.:.>::: Ground elev. ~~ ft. Depth to limiting factor H i Depth Dominant Color Mottles Texture Structure Consistence Bourxia Roots GPD/ft or zon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ry Bed Trencft d-/z /a rL 3/z- ~ ~ d/m s ~ rv d , 5 - ,o ~ ~ • ~t3 0 `~ a` S; ~ ~ 3 ,~ /sJi yh ~'~- w ~~" ~ S S dS Remarks: t 3 ~ ©~ ~ Ots ~ ~. ~ ~ 7 S 3z_3? ~, sy~ ~i r~s~,-t. ~ s c.. ar,y, ~s®~~ m ~' ~ _ ~~ tJWt~ ~ Remarks: Name:-Please Print Signature: ~_ ~ ~ Phone: ~. 7~S ~ Z`f' "IOZUC~ ~ Date: T Number: ~C ` ~ // - ~..3 C`.S /9J ~z~j8 PROPERTY OWNER f~~ ~i[i~~F.,? S SOIL DESCRIPTION REPORT PARCEL I.D. # Boring # 3 Ground elev. ~ ~ ft. Depth to limiting fact3 7 ~ Boring # Ground elev. ft. ~- Depth to limiting factor Boring # :ti~p4+ i~:;S Ground elev. ft. Depth to limiting facbr Boring # ;:tire:;;.. Ground elev. ft. Depth to limiting facbr Page _~ct 3 H riz n Depth Dominant Color Mottles Texture Structure Consistence Bourxiary Roots GPD/ft o o in. Munsell Qu. Sz. Coat Color Gr. Sz. Sh. Bed Trerxh Z-- Z- z 0 ~ ~ ~- , .L .y,/S iG ~v ~ ~ S ~ ~ ~~~ 7.s~~r ~,C• ~/s ~~ ~ ~ .5 . ~ ~ .~~ ~ 3~ , Remarks: Remarks: Remarks: Remarks: SBD-8330(8.05/92) • ~. ~ STEEL'S SOIL SERVICE ,s.~-~ ~,,~. ,~~ Gary L. Steel . C.S.T. 2298 New Richmond, WI 54017 MPRSW-3254 ~~ ~~t ! ~~ c=oLS (715) 246-6200 SEr~ Scy~ S. ~a-~Zf'~--/2~7 ~J 7`~ cc~ r~ ~ ~,~~„'°~~ ~i0 ~ ~3 0 6 z ' z2' 23 ' ~'h ~ 75'` t~3` / / Y pQl O </ ~ ~ Zy 1 ~~~ ~-o ' Mr ~/~ ~~-~ /`fs.~EL Sw~ b~~ ~ ~,a ~~ ob g ~ ~-~ s 5 y l'~~,~.~~E~~ B•//- f3 ~"• ~• ~o ~ i~ Rt 05/31/01 17;02 FAX 17152467221 HALLE BIiILDERS ~-~-' HELGESON f7J02 ST CFtt7I7c; COUNTY SFPTtC ': "ANK MA1:N'I'I!NANCi; AGttE>MI'NT AND OWt,ERSHIP CER111~1CA^E•tpN FORM Owttar/I3u}~er ~_.~ l'~ ~ In ~t - - ----- -._.. Mailing Address __. ~_ ~ ~ ~. ~`~1 A ~u ~~ ~yt` l~ '~1 ~- ~trYlo~[1~~~`{~ (" j Prope~~ty Address - ~ ~ ~' ~G D ~~ (Vetificatiortrcq is red frw~i Nlaaruo~ Depttrtinent For new construcdon~,,~ CitylStkttc ,,,~'~~+(~(~ parcel Identification Ntunber 0/$ -~!o ~~-/~ -o So LEGAL bESCRIPTIOt~T Prape~ty Location 5~ ~1., S~~/,, sa t<. ~ -r a9..~-It._/`7 w, Town of sttbaivision 1M P ~ a.~. _!~ _ I.,~t ~ 5 Certified Survey Map # Jr" 70~~/ _ _ voikuae .~_..,., Page # i0 _ ~Yarraaiv Dced # _ ~~~-3 ~___, Volume ~~~ page ~ ^./~ _ _._._._ Spec u~~C ~ yes Q~I AQ Lot lines identi5al;te ~ yes D ua sx TES tv><an+rr;~r~~~cE imprapef 11sa wad mtaintenanseaf your sel pc aystetn eauad tewlt In its prc~ature C4iluue to bundle wastos. Propermaic+te:so.nee Consists of putnpinY out the septic tact` every thn a yetcs or aaotter, tf eardsdby a licensed puaoper, Whmt you put into tlie. symtern cea a~'cct the funedon of the septic task. u a txea ~aot atagt m the waste ~spasal ayatetn. The proptai,Ir oarne! aQrea to subkuit to St. t~oix Zoaistg Dcparttnent a cettiElcsttiua form. mimed by tha alwnrrr a1nd by a rnasterptutnbar, jottrneym~ pltutsber, reset ietedpl u<elu~ ar a ticc~utd pwmper vzu4`yiag !'oat (1, ~-e ot!-9it2 wastowatl7 at8p09 61 byCtba! is 111 prbpCr opetstllfg C~nditaon andlor {2} after ir: ~e+:ti0li pfd pumfllog (tf n~eramry}, the selsric ts»Sc is lass Hl~:, 113 tWl ~!' mluAge. i Uwe. the -andermiBoed bevt read tare about tequirc~ pants sad ago t., maintain the priva:c sewega dlipoaal myatetss vritb the ataadards set forth, herein, as eet b7- the t]epornneat aa: Cotfi~ nPrGe aaA th. Llepartnsont of Nanusl ReCCtlYeem, St,td of W isoonstn. Ctn~fcation st3tiaQ that your tioplie sy~atem Las been mawtalna I must be eoinpieccd vad tctnmd to tha St. C: rock CouAty 2ooing Of~ic ~ `r.itt~;a 30 days of the til.ree year a pirsition date. • ~l~~J~~ NA F ApAI,1CANC DATE OVA R' TION 1(a+e) eerti~(7- that all statamaats on this :1rm are truo to thn beet of my {our} lonowtedge. I (we) ani (are} the owner{s} of the property dasoribed oboe , by Virti+e of i, ws[TA qty deed lecorAe3 its Regiaket of heeds Office. ~- _ _ ~ ATLTJt$ U PL[CAtJ"1' ~ JaATC +. a. ~r AAy ip1'oemation (tilt is sais-rrpr4SGtiLClf rr sy io9utt is the sanitary permit heittg ravutttd by the ZoniuR Depms'1tYiettt.'"'t'"' "• tnciudt tHttt~ laic arypitemtt+sn: a ctatnped wur IatY QOed from 1110 l2G~iffer of Dtsed3 offs+:c a copy of the t~ flitted StllYOY lnlp it CClarenct is blade to the war*auty deed l Ob/10101 13:08 FAb 17152967227 HALLE BUILDERS 108 08!29x00 TSIr 19:13 FAI 71b Saa 9187 REG1sTEA OF D&~$, ®002 ~.,, ~ ., z ;nom ~.v a-~. "-` , { -., ~ ~ -h e :'F"i ~ .t.,: ~ '~ ' ~ T' ~ yx,.,. t ~~YMOY~ NO. ~ ~ ~ .' ~~~ ~O'".: .. ~ ~ rry waa ~~wr. r~. ~wrw^ M. ~. rr~rs spa ar wraaornrx snssr s-,r 1iE(~TEk'S Grr~~c . , :.:~t#t~lY,~.:~!tx7al,,~isdL.R,i~:.Ip~4~~..:scaoca~.~ _':. '~ ~1~~d tr ..............._~..._......»...._...----~_._..,......,.._......,......,.._. ....:. DES 3 4 !9~ u•r+s..wA saruW a -1IaLS~P,9p...~G...a.,llcaaendlt. ~. i~ ~ to:~ ~- w iuei-~ u~u~9ri w.l~wew 1s _•»••»_•_4~.L.~~3~~._...---•are.a~. s>W d l1rr~~ ~s 9ort !Ne _.. _.., do~Srd~t pw~'t~s ~t tlrr ~oKlrwG Qo~tse o[ f~ettoe 70~t1-17 QCirl doat3 -~!2 sods of CL~ iut l0 aeds ti~a+ol. ZOCi'8a QQ rrr WdarC! !Q soa~svatLor9~ niit•14tiaa~, ~a~sot~ aed el,~ta~t-wF oC ~te~td, !R imt. Tri....._«...~ .~l..» ~~ Mrs 9x9 iv .eu DY.I tW ----..__ ~SR.~...-_..-.-.-.-.. rY •t .................~Rwliwi..-...... _ . .._.~ i9....9~. .vrssx::owtrox .~.rr.w sr. ~.r. a~._._......_....y ti - . ~~ .`_ arw~ ~ w; nin n~w~rss ~~ t Ar w r ~ r•rwr aww w ao:xar-asaasesst: 9xaxs a~ atsooMSta _lia3~4~-~~ar• ~ ~ L.1' iww~6T r. moors s. 9ki..~.~.a. ~':..tas d r pW./~ ~ ~ r ' w 33' 33' i+ ~~~ ( i 60.28 ;,:: 297.00' ' 33. I ~ ~y ! D g ~. O T' ~ I o 0 v 5~ O I N m w ~I1.90 RE t. m ~ _O 82,547 S0.6T'. I ~ D ~ I- ~ I -~ Q I d~ m ,r~ .~ ° $ o .~ O T °' I -~ 6 ° ., o m '~ w ~_ A JO ACRES m m I 120 S0, FT N89°53'!8"E ~ I V) 29T.Qp' -! I -~ ~ ~~ ins Iri ~ + N ~ +-, N - ~ ~ ~ I I = W `, ~ LOT ~ i m «~ 293.89' v N w 1.90 ACRES m I 82 , 547 SO. FT. ~ ~ ~ A ~ iD ~ r 3 ' I w I ~RES n~ m 297.00' ~ ~ 33.00' so. FT. N m S89°5806"W 330.00 1 ( " 6 6' f w 0 a~ _ N ~ ~~ L I - -- - I I j I I Imo' I~ In I c~ Ir- I~ ~` (L7 ~"" ~~ ~ ~~ ~l ~e~ ~AA ~K o u~" ~' PLAT LOCAT104V SKETCH 0 ~ ~ ~ ~~ ~'~• SECTION 30 rn ~ o N N ~ ~ V17~. Q~ _ C.T.H. "TT'~ I _ _-__ _ `" U m i a? v ~v. 2084 tr - - - ~_ _ ~- NWI/4 ^ i/4 :a:~:.