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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 0 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Oeverin Homes LLC, aka Oeverin Pro ertie Tro , Town of 040-1303-00-016 CST BM Elev: Ins lev~ BM Description: r1 ^ k / t Y V Section/Town/Range/Map No: 22.28.19.1751 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER JN CAPACITY STATION BS HI FS ELEV. Septic /A/ , D ` 0 U F-) 11 TR f- U Benchmark O 5, 100,0 Dosing , 0 104 P' N r Alt. BM v` Bldg. Sewer &,35 H2-111~ St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ~4- Septic 54 r n `fj Dt Bottom /vJ Dosing Header/Man. M Aeration Dist. Pipe Holdin Bot. System PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cover ) GPM 1 O Model Number 04 TDH Lift Friction Los 7 System Head / TDH. Ft / Forcemain Length. 1 Dia. - Dist. to Well i / l SOIL ABSORPTION SYSTEIV~d n-e b Ws weii p y-7 ,I it d k Y101/ aS 1fU f2bc k_ BED/TRENCH Width Length e , N f Trenches t } e., } PIT DIM SIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typ Of System [ I CHAMBER OR C ] 1 UNIT Model Num fv DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size role~ing Vent to Air Intake - an t s i Length Dia Length `y Dia Spacing / L ''.~.1 ( tlll SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only i ` Depth Over . / Depth Over xx De th of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges .71 Topsoil C Yes No ;:Yes No i rr COMMENTS: (Include code discrepencies, persons present, etc.) P Inspection #1:~/r / Inspe'cflon 2µ Location: 280 Walnut Hill Way River Falls, WI 54022 (SE 1/4 SE 1/4 22 ?RR19W) Wa nut HillFarm a a The Tribute P rcel No: 22.28.19.1751 1.) Alt SM Description 2.) Bldg sewer length = Q 1 f ~h yl'~ (t; - amount of cover b I [ wev, 0 Ili Plan revision Required? Yes -No f4 Use other side for additional information. / i ~ f SBD-6710 (R.3/97) Date Irctor's Signature Cert. No. oe '~<I eft Safety and Buildings Division County , D K 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) ' h Madison, Wl 5 -7162 ~a ROIX COUNTY LAITY DEVELOPMENT 514::1797 Sanitary Permit Application State Transaction Number in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate Qov F i n is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitte Project Address (if doerent than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary oses in accordance with the Privacy Law, s. 15.04(1) m), Stats. I. Application Information - Please Print All Into a Property Owner's Name ' Parcel # O~ /3lJ ~ Property Owner's Mailm Addr ` J T i Property Location Govt Lot COY ity, State zip e Phone Numb i, LL-1 Section Q~~~(((jjj~~~~~~,,,,~~~,~~~~~~///////// / c - " q~ude o H. ype of Building (check all that apply) Lo T N; R E r W Family Dwelling-Number of Bedrooms >7 Subdivision Name ❑ Public/Commercial - Describe Use ❑ City of ❑ State OwvY - Describe ~se CSM Number 11 Village of i ~Z 7~ i r Vn of C' III. Type of Permit: (Chec t only one box on line A. Complete line B if applicable) A. !'Vew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) B. ❑ Permit Renewal Permit Revision ❑ List Previous Permit Number and Date Issued Change of Plumber ❑ Permit Transfer to New / Before Expiration Owner I e< 1 !!7 IV.'T e ofPOWTS System./Component/Device: Che k all that a I ( id Al 60 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsaVTreatment Area Information- Des i Flow (gpd) Design Soil Application dsf) Dispersal Area Required f) D' ersal Proposed ~ - ~ ~,P , f) Syst Elevatio i VI Ta k Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanta Yr t U n> v c Septic ur Holding Tank " Dosing Chamber VII. Responsibility Stateme I, the undersigned, u e responsibility for installation of the POWTS shown on the attached plans Pl s Name (Print) ~ Plum ignature MP/MPRS Number Business Phone Number Plumber's Address (Street, City; State, Zip Code) VIII. C utv/De artment Use Onlv PProved ❑ Permit F Date Iss ed Issuing Ag Signature ❑ en Reason fo Denial DL Condi asons for Disapproval 1. Septic tank, effluent litter 0(d 3 3 disper::ai cell must all a seivicrrs ! EEOnt~m~ , ^ as per management plan provided by plumber. w / /~/4• 2. AN setback requirements must to mainteined as per appNtxlblrl rode / t rdinanc w. S r ize ~f- Attach to complete plans for the system and submit tvAthe County only on paper not s than 8 irz z l l ioch~ jn s SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SE 1/45 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 101.7' DATE 9/27/16 BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100,'_ Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 1 Area 15' below > system is to remain undisturbed 5 ~-,,~i Scale = 1/4" - 10' } 4% Slope B-2 B.M. B- Property Line -rJ Acre Lot 101.7' 102' B-3 Grading is to be done to divert run-off away from system Pro 3 Bedroom Huffcutt Combo Tank House Well is to meet all WDNR setbacks Tank is to be properly bedded and provided with lockdown covers with approved warning labels Walnut Hill Way Property Line Area 15' below system is to remain undisturbed Property Line L - 9 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 r Contact Through Relay http://dsps.wi.gov/prograr-is/industry-services www.wisconsin,gov ~o~~ssro ~i Scott Walker, Governor, \Dave Ross, Secretary C INDiT{O APPRO October 06, 2016 DEPT OF SA CUST ID No. 226900 ATTN: POWTS Inspector PROFESSIONA MVI&ON OF NNDU SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL, Identification Numbers PLAN APPROVAL EXPIRES: 10/06/2018 Transaction ID No. 2782134 Site ID Noe 829585 1 SITE: Please refer to both identification numbers, Hillesway above, in all correspondence with the agency. 280 Walnut Hon 280 W _ Town of Troy St Croix County NW1/4, SE1/4, S22, T28N, R19W Lot: 16, Subdivision: Walnut Hill Farm FOR: Description: At-Garde (3 Bedrooms - Replacenien!2 Object Type: POWTS Component Manual Regulated Object ID No.: 1627261 Maintenance required, 450 GPD Flow rate: 37 in Soil minimum depth to limiting factor from original Grade, System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code T-equirements. 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: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is reconunended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal, area. All loose organic material to be removed from mound area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capaci of the soil. Proffer soil moisture content can be determined b_v rollinE a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to RreDare, If it crumbles, site preparation can proceed. If the site is too wet to prepare. do not proceed until it dries. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384,30-5 • Insulate building sewer-beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set aiej'ver if?e;_' Tel annroved -)!,mi. Ai?v chant s nmv i uli ELL e-ef TDI1 and GPM Soecifica+ions. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fi-agrnents; tree roots. stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the at-grade must be cut off at Around level, A larger fil area is necessary v, lien any of the above conditions are encountered, to provide sufficient infiltrative area. • SPS 383a54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of are aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontallvroom where the servicingpad is located. Owner .Responsibilities • The current. owner, and each subsequent owner, shall receive a copy ofthis letter including instructions relating to proper use and maintenance of the system. O,,vners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383,54(1)= • In the event this soil absorption system or any of its component parks malfunctions so as to create a health hazard; the property owner must follow the contingency plan as described in the approved plans. 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 Deparhnent, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/install a ion/operati_on. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the PO WTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely [Fler) ee Required S 250.00 his Asxiount Will Be Invoiced. You Receive That Invoice, Tim Vander Leest ease Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214 , Monday a Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vander]eest c--~visconsn.2ov SHAUN R BIRD Paoe 2 10/6/2016 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and v°r if ed :Der a poroved phin. Any changes may result in nu-mr' resizinE io meet TDH and GPM Soeciricatiors. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the at-grade must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. SPS 383.54(l)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. Owner Responsibilities • The current-owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • 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. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required S 250.00 This Amount Will Be Invoiced. When. You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214 , Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vander] eest t*sconsin.gov Cover Page "ALLY -D Shaun Bird " TY ANY"D ERVIC'. . Bird Plumbing Inc. 4:,. . 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 9/27/16 Owner:Oevering Homes Location:NW 1/4 SE 1/4 S22 T28 N,R19W 280 Walnut Hill Way Troy Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and G niigency plan 9. Filter Specification, Attachments: Soil Tt Shaun Bird / Signature L ~ License numb 226900 WYJ TR`/ SERVIORR Page 1 of 9 System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 101.7' 9/27/16 BEDROOM 3 DATE CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Area 15' below system is to remain Scale = 1/4" = 10' undisturbed B.M.* B-1 4% Slope B-2 Property Line 101' 1 Acre Lot 10 1.7' 102' B-3 Grading is to be done to divert run-off away from system Pro 3 Bedroom Huffcutt Combo Tank House Well is to meet all WDNR setbacks Tank is to be properly bedded and provided with lockdown covers with approved warning labels Walnut Hill Way Property Line Area 15' below system is to remain undisturbed Property Line At-grade System Sloping Site Cross Section and Plan View , E i Dimension Feet I •L•L•L•L•L•L L•L•L•L L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•LL L•L•L•L•L•L•L•L•L•L•L•L•L•L•L ~•r•J•J•r•r r r•,r•r r•r•r•J•r•J•J•J•J•J•J•r•J•J•r•r 1'.J•J•J•r•r•r•J•J•J•J•r•r•J•r• L•L•L•L•L•L•L•L•LK•L•L•L•L•L•L•L•L•bL•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L• I -~'•JtiJ•J•J•r•J•J•r•J•r•r•r•r•r•r•r•J•J•r•r•r•r•r`r•r•r•J•r•r•r•r•r•r•J•r•r•r•J•r•r•r• -.I bL•L•L•L•YYL•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L I B 20 .r•r•J•J.J•J•r•r•r•r•r•r•r•J•r•J•r•r•J•r•r•r•r•r•r•r•r•J•r•r•r•J•J•J•J•r•r•J•J•r•J• I L•L•L•L•L•L•L•L•L•L•L•L•L•L•YL•L•L•YYL•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L• r•J•J•J•J•J•r•r•r•r•r•r•r•r•J•r•r•r•r•r•r•r•r•r•r•J•J•r•r•J•r•r•J•r•J•J•J•J•r•r•r•J• '.•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•S~.L•L•L•L•L•L•L•L•L•L•'L•L I 1/6 B f J•r•r•J•J•J•r•J•J•r•J•J•J•r.r•J•r•d.r•,••r.J•r•J•r•J•J•J•r•J.J.J•r.J. r.J•r•J.J•J•J• bL•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•bL•L•L•L+L•L•L.S,.'S,•L.L•L•L•S,•L•L•L•. 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'~•L .'~r,•,-J Jar J~J r J r J•J•r•r•J•l•r•r . L!L,!,L L S ti•~•ti•L•L•L•L•ti• l .r . S,.t ti.•ti~ T~ D Plowed Surface C Slope Direction GENERAL. INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a I/4 inch soil wire when a sample is rolled between the palms of the han ds. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches. and secured in place. 03/05 lgj Page 3 of Pressure Lateral Layout One Lateral - End Manifold - Threaded Cleanout Force Main Lateral Turn-up Plug X L Long Sweep 90 Bend r' Pressure System Construction Distribution Network S ecifications Lateral Diameter Z, In. Laterals are constructed of Schedule 40 PVC Orifice Diameter In. pipe. Orifices are drilled perpendicular to X (Orifice S acin) In. the pipe with a sharp drill bit and face down. L Lateral Len h a Ft. Lateral turn-ups terminate with a threaded Force Main Diameter '2,_, In cleanout plug and are enclosed in a 6-8 inch Force Main T.PncTtb Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box 03/05lgj Page of Septic-Dose Wank Cross Section And Pump Performance Specifications Pump Manufacturer - Tank Manufacturer au -Wr J~ -z Tank Model Number 6 d Pump Model Number ~Z Total Tank Capacity 3 D Alarm Manufacturer V s Max. Bury Depth 01 Alarm Model Number i _ ✓ Switch Type Filter Manufacturer Total Dynamic Head (TDH) - Feet Filter Model Number Q rr Elevation Head Distal Pressure Network Loss , Minimiun Pump Performance Required Force Main Loss :3 GPM: @ S Ft TDH Total /-S 3 Outlet lt+Ianhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Looking Device. Inlet Manhole With Locking Device < ti" Below ('W'ade Sealed Watertight Securely Mounted weather-proof Junction Box. MW LFwishedG Now aft tVent Min. 12" Disconnect r ir Y Above Grade Means With Vent Cap Y;Y Qutlet Filter ~y r Inlet inlet Baffle Switch Settings and Reserve Capacity A %a" Tank Volume = GPI Weep Dimension : Inches Volume Gal. B BOIe (reserve) A; 06 (alarm) B 2 Off Elevation C X- Ft (dose) C j - d < • Yi (dam) D Bottom l .X 315- D Elv on Total r .7, •1<f > Y<>`Y<Y`YY~Y .7 77 7. 7. i>{•.•I•<•<>< GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without Prior Approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation aad the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 U Page 5 of~_ TOTAL DYNAMIC HEP.D/CAP.ACiTY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153 w W j MODEL i 152 153 w u1i 50 Feet Meters Go!. I Liters 1 Col. Liters 153 # 5 I 1.5 j 69 261 77 291 12 40 10 3.i j 61 I 231 70 265 15 0 15 4.6 I 53 201 61 231 20 ! 6.1 44 167 52 197 30 25 7.6 34 129 42 I 159 r 8 30 j 9.1 23 87 i 33 125 20 3-i - - j 22 85 Q I 40 12.2 j 11 42 4 1.,ck voiVe. ~ 38.0 (1 1.6rn) j 44.0 Ft. ~.4T) v F , JOI4508 I Y I 0- 20 40 60 80 100 GALLONS LITERS 0 80 760 240 320 E 1/4 3 27/32 I 5/83 FLOW PER MINUTE* 3 27,732 CONSULT FACTORY FOR SPECIAL APPLICATIONS ; - -I- • Timed dosing panels available. OO zi/3z • Electrical alternators, for duplex systems, are available and supplied with T an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. I j • Over 130°F. (54°C.) special quotation required. j 1521153 Series 12 1is ~I I` i 1521153 MODELS Control Selection Model Votts•Ph Mode Amps Simplex Du lex 5 1 /8 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 SK2064 E152 230 1 Non 4.3 1 2 or 3 BE152 230 Auto 4.3 Inclined 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto 10.5 Included 2or3 SELECTION GUIDE E153 230 t Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FMO477. n cAu nON 2. See FM0712 for correct model of Electrical Alternator E-Pak Ali installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. AD electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: P.O. BOX 16347 Louisville, KY 402560347 Manalactureriof. . L7 RA SNIP TO: 3649 Cane Run Road ~LlL~7 ® Louisville, KY 40211-1961 Q/TY PUtfPS ~NCf ~~~i9 u a O / (502) 778-2731.1(600) 928-PUMP httpJ/www2oeUer.com h L 0- FAX (502) 774-3624 C Copyright 2000 Zoeller Co. All rights reserved. b D~ 9 .POW TS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner ( SYSTEM SPECIFICATIONS l~eoer, Permit # Septic Tank Capacity al JNA LOZR Septic Tank Manufacturer 3ESIGN PARAMETERS Effluerrt Filter Manufacturer Number of Bedrooms ❑ NA Effluent Filter Model Number of Public Facility Units )PZNA Pump Tank Capacity j Estimated flow (average) 3 ZU al ❑ NA rD aVda Pump Tank Manufacturer ❑ NA 1 Design flow (peak), (Estimated x 1.5) ~jf J aUda Pump Manufacturer ❑ NA Soil Application Rate / Standard Influent/Effluent Quality Monthly average" Pretreatment Unit Fats, Oil & Grease (FOG) s30 m A g/L ❑ Sand/Gravel Fitter ❑ Peat Filter Biochemical Oxygen Demand (BODr,) <220 m /L 9 ❑ NA O Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L 11 Disinfection !Pretreated Effluent Quality ❑ Other Monthly average Dispersal Cell(s) Biochemical Oxygen Demand (BODs) 530 m 13 NA g/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) <30 mglt 1KNA Fecal Coliform (geometric mean) 5104 cfu/1 OOmI 0DiGrade ❑ Mound iMaximum Effluent Particle Size ❑ Dr-Line ❑ Other: in dia. p NA Other. Other: 13 NA NA Other: Values typical far domestic wastewater and septic tank effluent. Other. CI © NA NA IAINTENANCE SCHEDULE ~ Service Event Service Frequency Inspect condition of tank(s) At least once every: ~ ❑ month(s) ears (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA (inspect dispersal cell(s) At least once every: O mont (s (Maximum 3 years) ❑ NA -lean effluent filter At least once every: oath(s) ❑ NA i nspect pump, pump controls & alarm At least once every: > ❑ month(s) 1=lush laterals and pressure test ~ ~lyear(s) El NA At least once every: ❑ month(s) ether. ear(s) ❑ NA At least once every: ❑ month(s) ether: ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS NA !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 Servicing Operator. Tank inspections must linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of ixmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be ivisually inspected to check the effluent levels in the observation pipes and to check for an g of on the gun surface. The ponding of effluent on the ground surface may indicate a failing condition and requires h'eimmed atet notification o fthe local Iegulatory authority. INhen the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of I:he 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 filters, mechanical or pressurized components, pretreatment units, 13nd 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 10 days of completion of any service event. _1 o-F 9 Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thalt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO 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. 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 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; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propefly and safely abandoned in compliance with chapter 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 property 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 POWi'S fails and cannot be repaired the following measures have been, or must be taken, to provide a code comphiont 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 requiijed setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the ri {e for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule: in effect at that time. ❑ 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. -A~_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 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 ce. 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 POWTS MAINTAINER lei Name , Name Phone 7/ j Phone , , Z-7 1 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone 2j,)-1W This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. "go ~ b W~ N _ i P .rPj St151 n P M I Ili f 3 Z 1 h S i ti.. #41.ii f. r ~ i ~ r a O w 1 m N p- C D CID v n.,p. y Z V 3 0 Q , 'C LU o N r C~ 1 I I Q S'~ i~ Lrai RECEIVED q AEKI5GRR7F3CA Wisconsin Depaetroti{amr SOIL EVALUATION REPC Page of Division of Safety and uildings ST, CROIX COUNTY in accordance with Comm 85, Wis. Adm. Code ' ~nCounty l~ AttaG~l~l>owapf~ e~Mttess than 8 1/2 x 11 inches in size. Plan must include, ut not limited to: vertical and horizontal reference point (BM), direction and Parcel I. A ` Y Co ercent slope, scale or dimensions, north arrow, and location and distance to nearest road. -rU /(J " w " L (40 Please print all information. Revi by Date / Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). t4j~Lll' ;D// / Property Owner Property Location w Ol V P Govt. Lot 'PAO 1 /4 1 /4 S Z. T Z 3 N R E (o W Property Owner's Mailing Ad Lot Block # Subd. Na or M# mot. City , late Zip Code Phone Number El City El Village Town Nearest R ad 41 New Construction Use;Residential / Number of bedrooms a Code derive design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material a Flood Plain elevation if applicable General comments and recommendations: System Type r? System Elevation M Boring # I~ Bonng t pit Ground surface elev. 1 l ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 01 - YY1 - - 0 r~ Boring # El Boring ` • LI? ft. Depth to limiting factor - in. pit Ground surface elev. o j Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ r 1q-30 Id" C Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 1 ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ture CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5'- 715-246-4516 Property Owner _ Parcel ID # Page of F~;] Boring # ~ Boring W pit Ground surface elev. . ~ft. Depth to limiting factor in. Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rood!*EZff#l PDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 / 7. I - 3 V-4 L F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BOD5 < 30 rngA- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-9330 (8.6/00) Property Owner _ Parcel ID # Page of F-.sl Boring # ❑ Boring ~ Pit Ground surface elev./ . ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 -iL r-~i1 L S c ^ ax~_, Ar) z-Z~ - C s < r fn Q),-7 3?- U - ' 1 wi,4 2 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Appl Rate Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPDM in. MunseA Qu. SL Cont Color Gr. Sz. Sh. 'Ef1#1 'Eff#2 Effluent #1 = BODS > 30 < 220 ng/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 rng/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SOD4330 (ROOD) i Soil Test Plot Pl Project Name Oevering Homes n Bird Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 (~L'STM #226900 Lot 16 Subdivision Walnut Hill Farm a 9/27/16 NW 1/4 SE 1/4S 22 T 28 N/R19 W Township Troy Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation 101.7' *HRpSame as Benchmark B M B-1 4% Slope B-2 Xt- Property Line Scale = 1/4" = 10' 101' 1 Acre Lot 102' B-3 Walnut Hill Way Property Line Property Line ar County J Tq Safety and Buildings Division 2 D 2 `ZO 0 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) S` K AUG Madison, Wl 5 -7 i COUNTY 5~9 d / T'CRO oEVELOPME V1PTQ56G7VPW0 rransactionN b Sanitary Permit Application ]n accordance with SPS 383.21(2), Wis. Adm Code, submission of this form to the appropriate governmubinn al unit pro ect Address if different than mailing address) state-owned POWTS are s j is required prior to obtaining a sanitary permit Note: Applicarion forms for the Department of Safety and Professional Servies. Personal information you provide may be used for secon urpoSeS in accordance with the Privacy Law, s. 15.04(1) m), Stats. 1. Application Information - Please Print All Inform 'on pazCe Property Owner's Name ope Ownerslittg Ad Prope Location Pr - N ~ A"A • /3(Jr~ ~ 1r 7 1✓' x-~ J Govt Lot 27 -7 City State Zip Code Phone Number Y., Section ~7 (circle one) f- 1 T7- N; R~EorW H. ype of Building (check all that apply) ~ LotC ! Subdivision e 2m 1 or 2 Family Dwelling -Number of Bedroo r~,.s d~ M Public/Commercial - Describe Use ❑ City of CSM Ntunber ❑ Village of ❑ State Owned - Describe Use wn of d,, lit. Type of Permit: (Check only o e box on line A. Complete line B i pph A. ew System ❑ Replacement System ❑ Treatment/Holding T ep t ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Permit ❑ Permit Revision hange of PI be t New Issued Be re Expiration 1V. oIPOVVTS System/Com onent/Device: he all th 1~ - essurized Tn-Ground Pressurized In-Ground e Mound of suitable soil ❑ Mound < ?A7 . of suitable soil v~ US ❑ Pretreatment Device (explain) ❑ Holding Tank ❑ Other Dispersal Component (explain) V. Dis rsaUTreatment Area Information: easi v on n Design Flow (gpd) Design Soil Application f) Dispersal Area Required (sf) Dispersal Area opose s Syst v on VI. Tank Info Capacity in Total # of Manufacturer p Gallons Gallons Units J -g 2 New Tanks Existing Tanta Septic or Holding Tank I I Dosing Chamber VII. Responsibility Statement- a undersigned, assume ponsibility for installation of the PORTS shown on the attached plans. P) Name (Print) Plum r' ature MP/MPRS Number Business Phone Num r 7 /74 Plumber's Ad ess treet, City; rate; Zip Code unty/De artment Use Only Permit ee Date sued Issuing. Signature Approved app $ I er Given Reason for Denrat new, IX. ConditiStY6b~asons for pisapproval ✓rl 1. Septir tank, effluent filty ahd 3 dispersal cell must all a ps 1 m iota as per management plan provided by plumber. 2 `AU seleeck roquUerMWts must be maintained "per apFNcanbirs code I ordinances. Attach to complete plans for the system and submit to the County only on paper not less than 8 la z 11 inches in sae SBD-6398 (R. I V11)