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Home My WebLink About018-2011-85-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Mousel, Dave Hammond, Town of CST BM Elev: BM Ele Insp v : BM Description: ~ / /~.~ (~ !~ . L9 V' ~i e lJ" I ~..vJ~ TANK INFORMATION p ° ~ ~.[, TYPE MANUFACTURER CAPACITY Septic r ~ J`~ ~ Dosing ~ ~ S o p g(~ ~7 (r ((~~ te- 12,vti.W 1~4, hit-` t'~ Holding TANK SETBACK INFORMATION TANK TO ~ P/ WELL BLDG. Vent to Air Intake ROAD Septic jg~ ~b$/ ~ai ~/ i----_ Dosing / ~s~+ ~ /gig ~ y~ ~ ~® .--_ Aeration ___. _____ Holding PUMP/SIPHON INFORMATION i ~~ Manufacturer ~ Demand ~d ~Cc~ ~ ~- GPM Model Number / ~ ~~ 3 / ~~ TDFi Lif~ Zl Frictio~ ohs 7 System H~d ~ TDH F't ' tb Forcemain Lengths ~ // Dia . - / Dist. to Well ~$, ' ~ z SClll ~RSnRPTII~N SYSTEM County: St. Croix Sanitary Permit No: 499139 0 State Plan ID No: Parcel Tax No: 018-2011-85-000 Section/Town/Range/Map No: 30.29.17.1100 ELEVATION DATA S ATION New ~ r~ PJ~- BS ~ , ~ ~ HI 0 ~ ~ ~ FS ELEV. 95' Benchmark n y' 7 3~ ~ ,D~ ~ 9 g, $ AItAIt. BM q~ ~~ / ~ (~~ ~ Z,~ Bldg. Sewer Z ,.7~( /~+ jI~ '7 St/Ht Inlet .7• b~ 5 f 5 St/Ht Outlet Dt Inlet \ ~ Dt Bottom ~~~ p.Z 9Z' ~ g Header/Man. ` v O /~I' 3c ! Dist. Pipe / Q U / 6 (. 3 Bot. System ~ , / ~ ~ L Final Grade r ~ /Q~ ~7~j St Cover ' ~ ~-$ ~~~ ~ Z( ~~'~,..~r' ~. Z 74 BEDITRENCH Width ~ Length ~ No. Of T nch PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~7 / ~X C~ ~ ~ ~~' SETBACK TO SYSTEM P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ` CHAMBER OR INFORMATION Type O System: 't 7 I) ,7 ~ / O ~ / ! ^ UNIT Model Number ~ r11STRIRIITI()N SYSTEM r_.e1r- Header/Manifold '/ ~ /~ ~ Distribution ~ ~} // Pi e s G ~ ' ~ J ~~~ ~ x Hole Size ~ f ~ ~~ x Hole Spacing ~ 3. Z'S Ve Air I ke v Length_y~Dia Spacing Dia Length S(lli (_f1VFR ., ore~~~~~e c.,~•em~ n.,r.~ YY Mnnnrl nr At_Grade Systems Only 111 _\~ J. Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center / $ Bed/Trench Edges ~ Topsoil ~ ~ ~~Yes ~ No ~i'es No J COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ ~ 7 / O / Inspection #2: / / Location: 1507 78th Avenue Unknown (NW 1/4 NW 1/4 30 T29N R17W) Emerald Acres Lot 85 ~~~ ~,..J /~I~- ParcelNo1~30.29 7.1100 ` "^ ~OveJ ~-~J 1.) Alt BM Description = ~ ~,~'y~„ 2.) Bldg sewer length = ~[~} Vi J~~ ~a~~ ~5 Oc3 ~' 6 ~" ~p ~<y~ CI ~ ~ f,e~, ~'- ~bG~~S 0"~ - amount of cover = r / nn J lJ~- ~P O ~ 4~L~ S ~ Z rS \ o..~ .. i _ _ _ "'''~. 6~ 9 __ _ ~-- . 'Ian revision Re uired? Yes ~ 'G `'~ ~ ~~~ 'se other side for additional rnformation. No ` ~ _ __ ___ _ -- ' - Date Insepc pr Signatu Cert. No. D-6710 (R.3/97) { Safety and Buildings Division County ` ~ 201 W. Washington Ave., P.O. Box 7162 1!" o, ~ ~ S On~~~ Madison. WI 53707 - 7162 Sanitary Permit Number(to be filled in by Co.) Department of Commerce (608) 266-3151 ~~g J ~t~ Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~Z ~ 9 3 $ s may be used for secondary purposes Privacy Law, s15.04(I xm) Project Address (if di8erent than mailing address) I. Application Information -Please Print All nfor ~ -7 ~~~ / ~~ - 78 ~vE Property Owner's Name AU G ~ 2006 Parcel # Lot Block # ~ E our t - e .l t~ 8.s ~ Property Owner's Mailing Address ST. CROIX COUNTY operty Location 8730 ~'~/ S / ~ ~ !/ Ci S ~ ., ~ ~., section 30 ty, tate Zip Code Phone Number ~/l sw! .S",S~f~.?d 9.5.7 g8 y .~.,~ p circle oar •e) / ~~~~ N T ~ R ~ ~ ( , II. Type of Building (check all that apply) ~ a~ Sud ; L M~ // 1 or 2 Family Dwelling -Number of Bedrooms 7 /~p,~,~ p~ e,.wS Subdivision Name CSM Number ~r ^ Public/Commercial -Describe Use F „~~ oo('S ova 6~F"i t.+2 r sr G' iC / ~t ^ State Owned -Describe Use a' ~/b ~(~ Q f4~~_ ~Eity_~Village ovvnshi of` III. Type of Permit: (Check only one box on line A. Complete line B if applicable) ~ Zd (1 A' New S stem y ~--~. ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V, T e of POWTS S stem: Check all that a I p p~ , ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Dri Line ' p ^ Gravel-less Pipe ^ Other (explain) •~- ~~ 5 V. Dis ersal/Treatment Area Information: ~g~ Design Flow (gpd) Design Soil Applicatio~°te(gpdsf) `~ Dispersal Area Requtr~d sf) a Dispersal Area Propo~(sf) System Elevation ~ ~ . a / ~ G6o /, ~` L.~d / S~ a..~ p9. o ~.~r , ,ia~ s VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Tanks Existing Tanks L ~ o W 5, v`+• ~ 5 Septic or F{eidewg-pmt}; Aerobic Treatment Unit Dosing Chamber T.'r0 "' 7.Sa ~ ~~ « ice' VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbe ' Sig P/~~LF1l~ Number Business Phone Number ~ s y.~./ .?.~.? 8/G ~iS g ~~ ssio 9 Plumber's Address (Street, City, State, Zip Code) VIII. Coun /De artment Use Onl Approved ^ tsapprov Sanitary Permit Fee (includes Groundwater Surchar e Fee) Date Issued Issuin gent Sign e o S ^ ~ en Reason Denial g ~ ~~ f1 DO lJ / g 25 b l0 IX. Conditions of ApprovaUReasons for Disapproval 1 ~ ~ t sYS~ awl~a: 3, NJ ~.~- s~ ~ Q~ t r~.~ 1. Sepik: tank, eftltteM tiller snd ~,5 ~~ ' dispersal cell must all be services / maitttained as per management plan provided by plurttber. /~ 2. All setback requirements must be maintained ~ IYU ~b~ i -'~^ ~' v~~~~ t~ er a as ~cabk tide /ordi n ~n 1- "~`-" / p pp na ces. ~ ~ . w.uy.cac p.aus tw rce ~uunry omy~ ror me system on paper not toss Wan nllL x 11 inches in size ,.c SBD-6398 (R. 01/03) ~8 l',y~aF. Lar~6 ~a,/Orv~srvii~ i O da r 8s" QRa~°~r~ ~.~ o/ns~o F/ E` pXid/w~Y /~<oPas~a ~ 6A~A~F y-,6,~. ~/sE i Pagc,~? of j La ~- ~ y ~ ~ .~ ®a~ ya'.sE~.~ ~~..~~ /J~a/7~ ~ o,Y.ao t 4Y• T t~j Z ~ y ~ e-3 ~ P i~ i i ~ 7 X 90 ~ac~ ~ //f!".ti.0arria/ Lt. C.I,IJJ ~%J. ~ /oo ~ F'e/ •f E. / "//c ~i/! ~ 8 x//y ~~s~a~/ Poairs fir~o ~ Srs, c"~, - /oo. S x 99, a Go,ir .t d !3' ~ ~ 8?o Ce.~cAvr O. ,6.~1 ; 99.8 - r~P 9G. o /a.o ~ ®~.Ii./.osr ~"ASF,~~.~r C as ' yo ~ ' ~L l lo.v.-. gd, ys' .srrso~aJ .,-~ r lrv7'it1' Lo r /J ~A.f JJ Tilt/ AdPRaX. d Rc.cd .ca f' v •.Q.ItK.~ei~ P»'.s ~8 r`Y,~~o'. Lar~6 ~c~.~Itv~u/a~ O ~ i o sz/.~/ e~-,9// -~ ~a r 8S 0 Da ~°~~~ /~<oPas~o Pagc~7 ,of~ Lar 8y ~,t o/osio ,ptialw~ y ~ 6,Qtl i i T y~ 2 y ,y ~~ Arc , /.lea ~ ~o qq.~~ c o~bo r,~ ~ b' 3 ~ P` I i ~ 7 X 90 ita cK .off jc i.6u rir t4 ~ ~. ~ /oo ~ t'e/ .f L.I~fJ E, .. ~ 6i/E 'Z 8 x//y ~ i'fiu.ro Po~rrS f/e'to ~ / // Srs. E~. • /oo. S x 99o io,+r `~e ~ ,~./~ 99.8 - r~P ~ 8lo ~a~~A~r .OFF,(` rra/ of / "Poc P~/~ I ~. 96. o ~ , . ~a o ~ ,~.~ T! /a.o ~ ®~~i.~.o~~ dr'ASFi~~rr . Lo r /~i~~ / ~= f'd ~ .?// ~ i o .~a yo ' ALL love. F.l. ys' .ft'rso gal n-t t S.~rie~ ao r /J ~itAJS' Firms/ APPRax. a Ac,c ~ ,car L7 v QAtKNo s t ~»'J commerce.wi.gov ^ ^ isconsin Department of commerce Safety and Buildings 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 TDD #: (608) 264-8777 www.com m erce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary June 20, 2006 CUST ID No. 232816 RUSSELL E RYAN CERTIFIED INC 350 SUNDAY DR ALTOONA WI 54720 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/20/2008 Identification Numbers Transaction ID No. 1279385 SITE: Site ID No. 714411 Dave Mousel Please refer to both identification numbers, 78TH Ave above, in all corres ondence with the a enc . Town of Hammond St Croix County ' NW1/4, NW1/4, 530, T29N, R17W FOR: Description: Mound System for Dave Mousel Object Type: POWTS Component Manual Regulated Object ID No.: 1081402 Maintenance required; 600 GPD Flow rate; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O 1 /O 1) 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 the component manuals} referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 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: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P (N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706- P (N.O1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". 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 RUSSELL E RYAN Page 2 6/20/2006 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 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 maybe 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~ ~~ • ~. Keith A ilkinson POWTS Plan Reviewer ,Integrated Services (715) 524-3630, Fax: (608) 283-7444 , M-f 7:45 am - 4:30 pm keith. Wilkinson@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist (715) 726-2544 ~~.~,' "1.~.~. ~ ~6. / ~. .~ 9 ~~ t ;~: ~ ~ , ~ :;~ a p;rAP,T~~!~ra G~ ccrst,~~RCE p~`11510N aF SAf ETY At~D ',LDINGS -~ . ~E~E GORRESPONQENCE Private On-Site Wastewater Treatment System (POWYS) Indez and Title Sheet RECENED JUN 1 9 2006 SAFETY ~ BLpGSL pfY, Owner: ~AvE /~oasEt Project Name and System Type: _ ~~ ~QUSEt - S/-.~,~. ~re~..~o ~o,vrs Location: >~ r''~ ~o~ Street Address ~.r/~~l~J .~Or .~ 9.r1~ l7!/ Lo r ~S~ e~.+,-~.ris.~ Qic~f_ /~•Oe,~ Legal Description g-~ Township/County Contents: Page 1: ~„i,oe~X ,o.ra ~ ~irtE S~.~rr Page 2: ~ o r G•'i s~ Page 3: ~/lo.rs - .~~c r~~.~ ,o.ro ~%/ ~~./ of /f ,..oo Page 4: ~.ve~ L A rs~r..L L,a!'rr f Page 5: S EPTiG ' l~ A,rx /Q~.,~~ ldoy.or.~ C~ofs • .~~~ r., r . Page 6: ~~.yo ~s~~Fo~,ti,..~~~ CuAd~ Page 7: /tea ~/ rs O.r./r.c s ~,i./aia ~,o.~.ys.rir~,~r ~~.,~ ,~ " ~~ ~ „ Page 8: .Page 9: " ~ „ Plumber/Der: ~~r ss /ls~,~.~/ Credential Number: ~,o- ~~.~B~G Date: G- y-oa G~SEO SBA ' /06 9/•P~~ ~u.vo G O~yPO.~lNr /7./av~ ~ l~dilsii./ .lO G1 soo ~ s.CO - /0 70~ -.o ''~~rss~v.~ ~ ~i1 r.,.au r..r LO.raarl~r r9,~..~NAL " dE,~ r...r ~.o ' } ,' q\ .~ ~1 z 0 n Z ~ 1 a ~ C h ~ t ~ ~ ~ n . M ~• ~~ r ~` V x ~ ~ k S .ch o~ * L O•~ -n _ n Z 4 i .: ~ v ~^ ~1 ~\ a a aC yt•ti H.~ ~ ~ . M R • R fMf R .'R • .. w V 4iD ~k ~k A ~ ` , ( • rN,' . .y . N. ' p ,~ ` t, h ~ h • ~ ~~ . . ~ l ~ O .z ; ~ ~ ~ . o . °' oaf. t ^ MO ti ~ og ~~ ^ 'rd~ .t a n: a ~~ ` Os K 1 .. o N. N A ~ N ' ` p r I . -~ ~D A~ O M V ~~ N~ u= ~ n~ Q ~~ . b .~ • d• . ~~ .y~ .; ;~. d. :. ....~ N. ~. ~0 • .eF H ..y ~r\ . y.. .. ~ ..:~... N ~ N• ,~ ~'.. 0 ~ , .Y A O f5 N V1 . ~ ~ ~ COS ... ~~ x c .• .. d ': ~.~.•A~~ ~. ~ 1 '~ ~.•`~~ ,~~' ~~ a ~. ... ~o .. ~. ~, z ~ . ~ ~ ~~ Q. e I~ O '7 ISO. j~ j~ ~i '1 ~ ~ o W ~- c~i ~ cH*. M• ~ ,~ to ~ ~h~.~~ ~~ . R R R C- F'} . ,• ~= ~ ~ ~ ii i7 i7 ~ • • • ~ ~:. ~~ ~ ~ pro ~. ...•. '~ ~,. • ~ •~ ~ ~ ...~ ti .~~ ~ ~ . • ~ ~ a ~ ~ ~ ti I ~ ~ ^` ` ~ ~ M ' w y a -~ ~ •. ~ • • . \ M w ~ ` f.. ~ n • ~ k ~ ~ a ~ • Y• a ^ ~ ~ ~ y ~ , • ~i ~. ,~ +- ~'~ ~ ~ 4 ~, • ~ ~ ~ ~ ~~ ~ Q' •^ Z M ~ ~ w ~ O ~ •~ • o ti. o ~ ~ C r (~ ~ R ~ ~ ~ ~~ r :., ~ • • • o ... ., ~. i '. ro m~ ~~ 0 ..~ .~ Page ~" Of 9 • SEPTIC TANK E' PU1~IP CHAMBER CROSS SECTION' AND SPECIFICATIONS . .~ •sL,~. yo. 4" CI.YENT PIPE 12" MYN. ABOVE GRADE E y /O~FROM DOOR, WINDOW OR FRESH AIR INTAKE /~/.~J/-i'N d0 •,~.~Aor . ~~, ~. 18" MIN. INLET I (- .~ Y ,QfL vnl L,t II! WATER TIGHT SEALS r APPROVED PIPE 3` OttTO SOLID SOIL' PUMP OFF ELEV . 9/.4 FT. WEATHERPROOF JUIJCTION $OX WITH CONDUIT ~~l ~- , i~ I` GAS- i 1' ,~ TIGHT: `~ A SEAL ~.~ B S~~/r~~i' r -~-- f/cr~~t. ' Y C s rf X00.0 z ~ y D y `~ 3" APPROVED BEDDING UNDER TANlC APPROVED MANHOLE COVER S W/ PADLOCK E WARNING LABEL 4" MIN. r~ ~ /APPROVED JOINTS WITH • ALM APPROVED PIPE ON 3' ONTO SOLID SOIL OFF ~'4i~ RISER EXIT PERMITTED ONLY IF TANK • MANUFACTURER HAS APPROVAL' CONCRETE .PAD SPECIFICATIONS SEPTYC./ DOSE TANK MANUFACTURER: _ ~/f~e-.sE,< <a,,ic,~~r~ TANK SIZES: .SEPTIC _ ~.TSLS GAL. DOSE 7So GAL.. ALARM MANUFACTURER: --,- -- S. ,T. E, ~,da.+a~Iis ` - MODEL NUMBER: ~.e./,rA'i~.~r t SWITCH TYPE: , _ /''E.Ccci.iY PUMP MANUFACTURER: ~yp.~aw,.rir MODEL NUMBER: sv sa.. SWITCH TYPE: _ M~.~«y D . = - /o 'INCHES = ~_GAL . REQUIRED DISCHARGE RATE ~L,: 9G GPM PUMP E ALARM WIRING AS PER ILHR 16:23 WAC YERTICAL'DIFFERENCE $ETWEEN PUMP OFF AND + MINYMUM NETWORK SU P ~0 `~~ ~IST~IBUTION IPE ~ ~ ~~ ~ /o,/ FEET P LY PRESSURE : .3,~% :- . ~3 FEET + . /.3S FEET FORCEMAYN `X _ ,l 8 FT/100 FT. FRICTION FACTOR „~'8 ~ FEET ,~ ~ TATAL DYNAMIC HEAD ~ ~_ FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH SS ; WTDTH_ 80 ; D~A~METER LIQvrD s~Tx" .~..,~,,, NUMBER DOSES PER DAY : S. ~ (/7. P?,~ • • /GL.7 t .?.T / _ DOSE VOLUME .INCLUDING FLOWBACK: ,?R8 .GAL. 27 Y3s, z~ CAPACITIES: A = .~. INCHES ~ GAL. ~`,~ a~LS . B = 2 INCHES .= .~,~ z GAL. ~.va,v C = $._ INCHES = /,18~ GAL. ~~. oaf 9 _. -- u SD33 V~33 ' Typical Application' ~ Sump/Effluent pump ~ Capacities SW/SDNS33 - to 48 GPM (3.0 I/s) Heads SW/SDNS33 - to 26 h. p.9 m) Electrical SW/SDNS33. 115V, le, 10.0 FIA, 60 Hz Motor SW/SDNS33 - 1/3 HP shaded pole w/thermal overload 1 SSO RPM Minimum Recommended SDNS33 = 12" 1304.8 mm) Sump Diameter SW33 = 18"1457 mm) Automatic Operation SW =Wide-angle float switch (manual available) SD =Diaphragm pressure switch VS = Vertiml float switch ~' !d~ie~iai<, of Construction Cast iron and engineered Thermoplastic Impeller Thermoplastic vortex Discharge Size 1-1/2" NPT {38.1 mm) Solids Handling 3/8" (12.8 mm) Power ford 10' , S1TW,120' optional) Superior Features • Carbon/Ceramic mechanical seal • Oildilled motor w/automatic reset thermal overload • Uses single row ball bearing construction • Piggyback plug available for easy maintenance and replacemeN 9 30 6 2 z C f ° 3 °I 0 C ' SD33, SW33, VS33 ,.__ __ _ F -. _-___. -- j iI i' I i (opaciry~U.S. G.P.M.O liters/Second Q 10 2U 30 40 1 y 50 3 Typical Application' Sump/Effluent pump __ Capacities SW/SDN550 - to 44 GPM 12.8 I/s) Heads SW/SDNS50 - to 24 h. 11.3 m- Electrical SW/SDNS50 - 115V, le, 8.0 FIA, 60 Hz Motor SW/SDNS50 - I/2 HP shaded pole w/thermal overload 1550 RPM Minimum Recommended SDNS50 = 12" (304.8 mm) Sump Diameter SW50 = 18" (451_ mm) Automatic Operation SW =Wide-angle float Imonuol available) SD =Diaphragm pressure switches VS =Vertical float switch hdmarials of Consnudion fast iron and engineered thermoplastic Impeller Thermoplastic two vane semiopen Discharge Size 1 1 J2" NPT138.1 mm) Solids Handling 3/4" (12.6 mm) Power Cord 10' , SJTW,120' oplionalJ Superior Featwes • Carbon/Ceramic mechanical seal • Oil-filled motor w/automatic reset thermal overload • Uses single row boll bearing construction • Piggyback plug available for easy maintenance and replocentenl C- LL 10 20 30 40 50 60 10 GPM •. _.. ., Prr~ss~irE~ ~FiltErs ~ ~ c o rFtEr~i~i ~filt~rs , .~~ ~ . Sy~tEr,~~ componEnts ~AccESSOriES ~ ~ ~'~ ~ ~ c ~' ~ r __~ STF-102 'Ij+pe 347 stainless steel screen, filters .062 inches in diameter (installed in all filters) ~ ]detail d a ings arnd/ r~~AU'tiles in DXF and f-' ~~ ~ DWG fQQ~~ix}ats are av~ila~l~ to helf• . ~ ~ w~our blltepruit and draftuig needs. f ~ ~ ~ CAD file cata•be sent to you on di~ CD~O1 ~.. downloaded fro ~ ur w~ ~tte ~ ~ ~ ~ )W.gag-simt~c--h.~fn~ _ ~ ,., c Wsmtc~c"~iC?frEEV+tsy.t STF-105 Wire cage Mounts in filter screen. Prevents debris from re-entering the pomp. STF-lUU Job ready Sim/Tech Filter - prefitted with 2" Sch. 80 union & 2' inlet pipe.w/fitting (2" NPT) STF-104 Optional filtration socks Polyester knit 600 micron (.023) 150-190 micron (.006) Thermal nylon 100 micron (.0039) STF-101 Adjustable pressure alarm switch adjusts from 3 to 241bs. standard ~ STF-100A2 Sitn/Tech Filter - field assetnbled unit STF-107 2" inlet / 2" outlet Tank alert w/ tt ~: latching light ,,:;< `~ STF-100A3 Sim/Tech Filter 3" inlet / 3" . outlet (socket weld) ..~ 'x - STF-103 ' ~ 4 `' "''~ Filter lid/screen removal ~ ly~i } ~~,3,~, ~ . wrench ~"~ ~- 40" long - holds lid after removal r- r ~ ' I `~ ~~~- i ~ , `\! ``;.: ~' Wisconsin Departmer-t of Commerce Division of Safety and BuAd'ntas SOIL EVALUATION REPORT Payo _ I _ of in aoconlar-ce rvru- ~onnn uo, curs. nwn. ~,uue County ~ V~O l X Plan must ss Uran 0 1/2 x 11 brclres bt size t l le l l l _ . an cn- paper Tro e Attad- wnrp e te p s Inducts, hart not Iimlted to: ve-lical and horizontal reference point (0 ion and percent bps, scale or dimensions, nor0- arrow, and loplion and I lf- l crest road. Parcel LU. ~ / ~" ~Q) j - ~ ~ ~~~ Please prfnf aft lnfornlat~le.~. "; ~' ~ rt e ~ Dale ~ /S~ 0 Personal In/om~n0on you provide may be used roc eocorrtl~y tNirpoaos (P~ivacy Law, e 41 t ~y` PropertyOvnter ~ ~` ~~ _ `~.. ~. J `ylr-~.., ~ ~ pit ~ Pr part urr G Lut ~ 111 /~Jrt,Jll~t S3C~ f~ Z~ N R ~~ E (or 11 _ N -- --- ----------- Property Owner's Melling Address iX~' ~ I3J3 ~v~ -~. u~oF~~~ L Bkx:k # lSulxl. Name or CSM# ~~~r~e~.1~T~U~ City State Lip Curie Rune N ^ Cily ^ Viliaye ~4own tJearesl Ruad l-~u~n i w~ 5Lt0~ c '~f~'1-(0~3 ~~~ m~c~rr~ ~ _ 7 ('New Construction Use: (~Residenliai I Number of bedrooms Crx1e dorived desiyn Ilow rate ___ ~5~ ~e OLJ___ GPD ^ Replacement ^ Public orcommercial - Describo: ______-___________ _ _-_--__ Parent material ~~___ _________- Fluod Plain elevation if apI>ficable ____._/v~%f- -_ _ _______ R. Gerteralcrnnmertts SYS~e~ ~~~` %v(J• ~ " and racommendaliats: C'U,~ .(~ ~ r ..~f-sir, ~f ~l ~ G U Boring # ^ Brriny ~ ~ s~ ~'Plt Ground surface elev. _ It. Depth Iu Ilndliny lector __'J_~ _ _ ___-.- in. __ _ _ __ +- - Soil Appiir:aiion Rate Florizon UepOt Dominant Color Redox Description Texture _ SUudure _ Consistence Boundary Rr«tis- GPUlf(' _ in. Munsell Qu. Sz. Coral. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 L 0-2c~ lp yr3IZ --- 5i I 2n-~~bk _~ -~~ ~_ v--~ . 5 • ~ -~~ ~ ~ Zm 5~ Yom' c S •-- ~_ 4 -gl ~ f Z ~ I P 7. _ (_ rn~i _ - ~_ - Boring # ~~;7 Bonny ^ ^ ~ _ Y'1-pit Ground surface elev. 1~•~ L fl. Depth to limiting factor I~ ' irt• Sod A IicaGon Rate Florizon DepU- Uurninar-t Color Redox Description Texture SUudure Consistence Boundary Roots GPDflF in. Munsell Clu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'ER#2 I ~9--2 (~ 312 ~-' s; I Zr~,~_ _~Y~r _ C ~ ~ v~ ~ • ~ 3 ~ C y Si~1 ~ ~ ~ ERluenl tM1 = BOD > 30 <_ 220 n-y/L arnJ TSS >30 < 1,riU n-y/L 'Effluent N2 = BOD < 30 mylL and TSS < 30 mg/L CS7 Narne (Please PrinQ Siynature CST Number ~ ~~ rrnker ~~~~~ -- __ _ Z53 3D_~° Address Date Evaluation Conducted Telephone Number ~tt.'3 ~o~ ~, _ crfu~, UJ I `~Ir~Z.s `~ - Zi~-_-"~ ___-----C 1/5~7(~ D -OZ~~. ~~ I ID # ~~ v ~ Page __ ~ of Properly Owner ~_-_ Parce -_- ------ ^ Boring f ~ Bornrg # q8 ~) ~ --~I 'Pit Ground surtac;e elov. tt. DepUr to Gn-iGng (actor ~i~_ in. Sol ~ feat l e Slrudure Consistence Boundary Roots GPD lI Horizon DepUr in. Dominant Color Mansell Redox Desc.~tplion Qu. Sz. Corr(. Cobr ur 7@x '°~.~~ _ Gr. Sz. Sh. - 'EINt1 - 1 6-1~ 3 ~ gi ~ 2~sb~ r~r c `~ I v-~ 5 _ 3 21-~I) r t~ -,t r5 ~ C~ -7 ~ L`~~t° 5 ~ c l =~,~ ~i~ . - ~-- = - .~ 4 Rate 'E(f#2 LJ Boring Boring # - ^ pit :Ground surface elev. ` fl. Ueplh to limiliny factor __ ir'• Sofl A licatlon Rate r d B Routs GPDItF liorizar Depth in. Drntrinanl Color Mansell Redox Uescriptan Qu. Sz. Cont. Cobr Texture Sbudme Gr. Sz. Sh. Consistence y oun a 'E'It# _ EffN7 U Boring Boring # Ground surface elev. _____ ft. Depth to limiliny tailor _____..__.____ in• ^ pit __ SoB !1 rlicaGon Rale xture T SUudure Consistence Boundary Roots GP OItF Horizon Deptlr in. Dominant Color Mansell Redox Despiptbn Qu. Sz. Cont. Cobr e Gr_ Sz. Sh. 'Ett#t 'Etf#2 'Effluent #1 = BODS> 30 < 220 mglL and TSS >3U < 150 mylL ' Et(luenl tt2 = BODS < 30 mylL and TSS < 30 rnyfL 'Ihe lleparttnent of Comntcree is an equal opportunity service provider and employer. If you aced assistance to access services or need tnatcrial in atr alternate fomtat, please contact the dcparUncut at G08-2GG-3151 or '1"I'Y GUS-2(v1-8777. sao-aw rrt.vnovr Property Owner _~~~ Parcel ID # ~~ V ~ _______ Page __ ~ of Boring # ^ Boring C ]-pit Ground surface elev. It. Depllt to Gnritirrg factur ~_ in. Sod n ~ ica6rnr Rate Horizon DepUt Dominant Color Redox Desc.-riptbn '~@xtur~ ' Strudure Consistence Bvundary Roots GPDifF in. Mtntsell Qu. Sz. CottL Cobr ~~ + Gr. Sz. Sh. 'Eflll l 'Eff#2 I 2 t~- i~" I •-21 ~~ C~ tr 5~ 1 ~<<I 2~r-~sbL ~r'YlS ~ rY~r' ~~~ c 5 ~__ I v-~' - ~ ~ ~~ _ ~8 ~- 3 2 -fit) 5 CAP 7.5 r ~"/c~ 5~ ~( 2~ ~. ~'t~ - L-I___. _ ~ l~ ~J Boring # ~ Boring - ^ Pit Ground Surface elev. tt. Ueplh to lirniliny taclor __ in. Sod A licatbn Rate I lorizar DepUr Dominant Cvkx Redox [?escripl'ron Textwe SUudwe Cvnsistence Boundary Rvols GPDIff in. Munsell Qu. Sz_ Cont Cobr Gr. Sz. Sh. 'EII#1 'EItH2 Boring Boring it ^ Pit Ground surface elev. _______ tt. Depth to limiliny factor _.______ ___ in_ __ _ _ Sod A IicaGon Rale Norizat DepUr Dominant Color Redox Despiption Texture Slrudwe Cvnsislent,~e _ Boundary Rrwts GP D/fF in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Str. 'Efftlt 'EQll2 'Effluent #1 = BODS> 30 < 220 rng/Land TSS >3U < 150 nry1L ' Eilluent il'L =BUDS < 3U my/L and TSS < 30 nrylL 7 he llepartment of Cvmrnerce is an equal opportunity service provider and erap[vyer. If yvu recd assistance to access services or need materia} in arr alternate fomtat, please contact the deparUucnt at 608-2GG-3151 or '1-1'Y G(IS-2W-8777. sno urora.onont rr ~ . . ` 1'~1Gli ~l)I~ _~ NAM[:: ~?D~T --- ___LC)I'Jl ~r„~' I.I?c;~1L I)I;`;l_'IZII''11~1t1;,U(.t11/~t~(J~allr'~1,.`;~O IZ`~.T`I,IZ,(~'I:(ur)1~ f -- -- - SCALL': I' -- - __ __ -- _- _ - - -- DNi l DL•SCRII'flOhl:~_tl-~_ ~-_,_Ru~--~~'~e--- fi _..__ . - -- -- DM 2 DLSCRII'I']~)t~l: ~~ c1~--~_;-~i!C-_-~~~~~--- SYS'I'Ltil LL1Vi~'I'1~ ~tl: /O nO • S ~ SYS'I•GM"1'l'I'1~,:_~(YIC~J__!1_C~___ _ ~,~ l ~ ~^ Z SIGNA~•URG: ~ l)A"fl:: ~"-~--o NOTE - 60 ft. ~'~d ente Does not appear for drainage easem have dammed PDWTS sites COUN1 PREPARED FOR: SURVEYOR EMERALD AC R ~ KERNON BAST EDWINCfLANUM 948 LaBARGE ROAD HUDSON. W154016 NORTHLAND 6DRVEVINO. INC. P.O. BO%14 LOCATED IN THE NW1/4 OF THE ROBERTS, WI 54023 RICHARD STOUL PART OF THE NWi/4 OF THE NW' 1353 AWATUKEE TRAIL HUDSON, WI54016 TOWN OF HAMMOND, ST. lil ICI i III I I I NW CORNER SECTION 30 N)G7pdQ5~i CAD dL.1GJDD~S ' /(COMPUTED FROM WITNESS ------------~- - i y MONUMENTS OF RECORD) - /(//L _- S89°49'lz'W 858.00 a COUNTY TRUNK HIGH' --------------------------------- - - -~ - - T - - ,-~- - - - ~ TO BE DEDICATED TO _ ~ ~ - - ~ I ~ I I c _.__.__.__.__._ ..__.__.__._ O FII $I ( I I tnv ~-- e Wi rv d04 9 I d04 z3 I ~'/OO do 94 PC~o ~3L3139 ~ $ ~ ~ - - ~i I g C~o~oG',t/lo N/00[So1949 PC~e 3J69 I -------9--------- ~ ~ ~ so. , I I m.DRIVE -_'--------r----------- I r ~ ~ (~ ~ I I I I C ~ / LOT 43 I ~/O~/~~ I 3. S89 4912 VY 2]5.01' 180.62 O/i I ~~ U i 435.63 1 ' ° LOT 38 / ~ I o / ~ 2.00 ACRES / / '~, ~ I tar 87,125 SG. FT. / ~PI ~I I w < / / ~ / / I~I I ~I I al ~ / / 1 / / / Pl .~ ~ ~ j ( W O / I 435.67 / di~i - .zaala I ~ - - / z4o.3a I _ r ; I ~ ~ : I t. ( m ~ ; ~ I I o ~ I ° I I - - - ~ I ~ LOT 37 w LOT 38 N L99 ACRES ~. -86,578 SG. FT. ^_ 200 ACRES ~ 87,123 SQ. FT. I ~ I::. o L8.Q~1019.40 a.. .. ~ p n ~t:.~. ................. ....................... o j j I N f: ~ f _ ~' " a o~ I , ~ I 1 n X1 I I ° I~ ----------'----- C> I I ° ~ I I ~I y ~' O ` r _... {.: ~ ~i I qq O .I::.C ............... '.L'.- A. I ...... I w m o ~ . .-iJ ~ LOT 88 s ~ 99 ACRES I N 99 SQ. FT. ~ I ^ M z I IOlA40 .i. __ o r. I' Z I I ( 33 I I 33 . I 1 I _ _ _ _ i ~ ~'~ ~ ~ -- - --- ~ ~~ ---~-- -~_~~ __ . RAI LOT 85 87~ . / ~ 31s.9r DRAINA / / / LOT 39 200 ACRES 87,133 S0. FT. AREA ""~~ ---------__ ~-1 LOT 42 200 ACRES 87,173 SQ. FT. ~ ~' ~. % LOT 40 2.00 ACRES LOT 41 $ 87,126 S0. FT. ~ e ..... ....... .............................. ...................................: 1$ N89°45'02'E 1061.]3' --------- --TOWN ROAD-------' LOT 84 2.00 ACRES 87,125 S0. FT. --AREA-C--- z„nr--- --- --.~_ _-~---- -t -r -- -- _- -- I I i I I I I ........................ i. i....................... I I LOT 83 I I LOT 82 200 ACRES I~ I 87.125 SQ FT. Ig' i 87,123 ~ FT. I~ I I~ I I I h-,5 ,SJ I I 211.4T I I of ~i~i °8 NIOL~,o lJ9 pC~o ~J~`t7 I L~04 96 ~ Q' \ ~I~1 IN W~/4 CORNER I ~i SECTION 30 I i \ SOUR1 L1NE OF THE NORTR 12 OR THE n dOO4 9a SHEET 1 POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION Owner v ~ Permit # n~err~rr vei2AMF.TF.RS Number of Bedrooms 100 Broom ^ NA Number of Commercial Units -- NA Estimated flow (average)* oo aUda Design flow (peak), estimated x 1.5* Goo aUda Soil Application Rate g,„.~ ~; !1 /. o al/da ft Influent/Effluent Quality tNA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mg/L Biochemical Oxygen Demand (HODS) S 220 mg/L Total Suspended Solids (TSS) 5 250 m Pretreated Effluent Quality ^ Montlily Average*** Biochemical Oxygen Demand (HODS) < 30 mg/L Tots! Suspended Solids (TSS) ~ 30 mg/L~ Fecal Coliform (geometric mean) <10 cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter * Wastewater Flow Verification and Calculations: (Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank effluent. * * * Values ical for retreated wastewater. D1~:51(ilV (;tc11 ~tuti ^ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) ^ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ^ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 ^ "Design of Conventional Soil Absorption Trendies and Beds". R.J. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD - 10570-P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ^SBD - 10567-P (8.6/99) "In Ground Absorption Component Manual" ^SBD - 10705-P (N.O1/O1) "In Ground Soil Absorption Component Manual" Version 2.0 ^ SBD - 10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD - 10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ^ SBr _ 10572-P (R.fi/99) "Mound Component Manual" j~'SBD - 10691-P (N.O1/O1) "Mound Component Manual" Version 2.0 ^ SBD -10595-P (8.6/99) "Single Pass Sand Filter Component Manual" ^ SBD - 10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" ^ SBD - 10573-P (R 6/99) "Pressure Distribution Component Manual" ~' SBD - 10706-P (N.O 1/01) "Pressure Distribution Component Manual" Version 2.0 ^ Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units ^ Sri... a ~rr~ wR w AT A rL`MTi NT c~vc~mZ+la.T c~L`rTTTr ATi(1NC J 1JiLara u• -.. •~ ---- - Se tic Tank Ca ci Sd 1 ^ NA Se tic Tank Manufacturer ~/i ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model _ico, z ^ NA Pum Tank Ca ci 7So 1 ^ NA Pum Tank Manufacturer .!~/~Jd.C ^ NA Pum Manufacturer i4/ ,O,kw,.r~~ ^ NA Pum Model Sv .s'o ^ NA Pretreatment Unit ~A ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) ^ In-ground (gravity) ^ In-ground (pressurized) ^ At-grade ~f Mound ^ Dri -line ^ Other: ^ Leaching Chamber Manufacturer Model Laying Length/Chambe Soil Application Rate_gpd/ftZ Area Req. ft z Infiltrative Surface/Chamber-ESIA Rating ft Minimum Number of Chambers ^ A e ate Desi Flow/Loadin Rate= ft min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and a royal letters. irir~u~ ir,a.s~a.a..:~ ~. .... ........._ MAINTENANCE MONITORING SCHEDULE Service Event inspect condition of tank(s) _ At least once every out contents of r dispersal cell( Clean Inspect pump, pump controls & alann Flush laterals and pressure test Valves At least once At least once At least once At least once At least once At least once scu Service F, ^ months m-equals on ^ months months p months ^ months ^ months n months tank volume (Maximum 3 ® year(s) ^ NA G~ Year(s) ^ NA ^ ear(s) NA ^ year(s) NA of START UP 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. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc: This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. p Valves Valves shall be operated in the following manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). (Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (I/3) 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 NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. O In-Ground Gravity Component Dispersal Cells '. The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page~of~ START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals iltat ' 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. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron femoval units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc: This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fi uit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ^ Valves Valves shall be operated in the following manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1/3) 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. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump ChamberlTreatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. p In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page~of~ ~~ Mound, At-Grade, In-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure 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 taidcs and pits steal; be ree:xoved nd properly disposed of by a Septi~ge Se:vicirg Gp..rator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other 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 structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement azea 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 dme. ^ 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. 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 to locate a suitable replacement azea. 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 CONTIAN LETIiAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Or A PERSON FROit+i TIIE L'~TERIO1n OF A TA NK 1V:AY BE DIFFICIJLT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name uss Y,~./ - ~P-•Z3~t 8/G Phone 7/S 8.~f~ Ss~a 9 SEPTAGE SERVICING OPERATOR (Pum er - ,v.~,v,...r Name Phone I~:\WPDATA\E}I\POWTS OWNER'S MANUAL.dce POWTS MAINTAINER Name y ~ Phone / 8.i' -S a LOCAL REGULATORY AUTHORITY A enc .ff ~ ei a.vi,. D ~ Phone i ~ 38~ ' S/G d Page 9 of~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND CERTIFICATION FORM ,--~, Owner/Buyer ,~rfl V 1 ~ ~~ L Mailing Address ~ ~ 3~~ Property Address ~ ~1,~Mln-~io~ . IvIN (Verification required from Planning & Zoning Department for nefv construction.) jn _ /~ City/State '~~tS ~,(~~ ~~OZ3 Parcel Identification Number ~(g- ZDl(- gS-000 ~CJ~ LEGAL DESCRIPTION Property Location `/a , '/4 ,Sec. , T N R W, Town of Subdivision ~t/i~'1~1/!~{ ~ -'~- S ~ s~ ~~j~ ,Lot # g~ . Certified Survey Map # Volume ,Page # Warranty Deed # ~7OB ~ ,Volume -- ,Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 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 of be ~--~ SIGNATI~ bF /~_/~ DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05)