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HomeMy WebLinkAbout020-1483-04-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 578910 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)j. Permit Holder's Name: City Village X Township Parcel Tax No: Waldschmidt Travis I Hudson, Town of 020-1483-04-000 CST BM Elev: Insp.BM Elev: BM Description: _ Section/Town/Range/Map No: � 1 CS J 16.29.19.3073 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER x+15 CAPACITY STATION BS HI FS ELEV. Benchmark Septic 14J FCC")J f �tL 4•5 1Z5b ?. z. f�2• Dosing s Alt. M 'L a 4• 756 9 Aetati3n t ` Bldg.Se er 15• ,g�•x Holding SUHt Inlet TANK SETBACK INFORMATION SVHt Outlet TANK TO P/L WELL BLDG. &nDto Air Intake ROAD Dt Inlet Septic 3 A'� �g/ Dt Bottom ZZ-•7 �• 5 Dosing i /V Header/Man. $►I z 9' Aeration Dist.Pipe g• 7 Holding Bot. System g• 3 Z q_ �� Fin I Gr de �y 9.� 7 PUMP/SIPHON INFORMATION �; � "S�ex4. ' Manufacturer / emand St Cover IZ� � 96 r 1 Z6 e—( GPM Model Number � i � '� � oe� TDH Lift Friction i�g/ System Heap TDH,�• t Forcemain Length I Dia. Dist.to Well Lo Z A-A_ SOIL ABSORPTION §YS TEM /Z-3 BEDITRENCH Width Length No.Of Tre�ch 5� G�� PIT DIMENSIONS No.Of Pits Inside Dia. liquid Depth DIMENSIONS C16 !►J\ ` SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactur r: n, r INFORMATION Type Of System, d 5 Z , ` CHAMBER OR Model�er. , fa y 4-cy 01 DISTRIBUTION SYSTEM Zz ^ q4) b � Header/Manifol) /( Distribution \ x Hole ize x Hole acing Venj�t0 Air Intake Pipe(s) - \ ///v,,.w� Length Dia � Length Dia 'Spacing I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/,Trench Center • .d Bed/Trench Edges \ Topsoil �\ p Yes 0 No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / �� Inspection#2: Location: 548 McCutcheo Road Hudson,WI 54016(NE 1/4 NW 1/4 16 T29N R1 9W) South Willow Acres Lot 4 Parcel No: 16.29.19.3073 1.)Alt BM Description 2.)Bldg sewer length -amount of cover Plan revision Required? rs] Yes 'Flo Use other side for additional information. Date Insepctors gnature Cert.No. SBD-6710(R.3/97) PLOT PLAN PROJECT Travis Waldschmidt ADDRESS 476 tv Rd A Hudson Wi 54016 16 29 N/R 19 W WN Hudson COUNTY ST.CROIX NE i/4 (du( 1/4S /T 91.2/90.5 3.5' below grade 6/4/158 BEDROOM 4 ELEVATION ~'���/ SYSTEM E DATE - CONVENTIONAL IN-GROUND PRESSURE ONYENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE ----" HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 19o' Filter BEAR Filter 0 BOREHOLE � WELL *H.R.P. Same as Benchmark 5' B-2 2-3' X 88' Cells with >3'spacing 35 B-1 3 ---..__...,,., ,_ 60 Vents 50' 260' Property Line 15' 96' 20' 120' 40' 7% Slope -4 ri B-3 Area of poor soils All piping shall be SDR 30/34,within 10' tank,piping shall be Schedule 40. 15' 60, Pro 4 Bedroom House Huffcutt Combo Tank Scab is 1" = 40' unless otherwise 235' Property Line noted Vent >6„ ck4 Standard of Cover hing Chamber 20.0 ft2 of Area 02/pair of end caps 4' Lon at System Elevation McCutcheon Road •- •� � PUMP PERFORMANCE CURVE PUMP PERFORMANCE CURVE : � .. • ■\■■■■■I°®°°®°°■gym°®®°®■gym°°°°©° °°eeaee°a°°eases°ee°�°°° NEON NOW . ■■\■1\■■�,��°°a°°°e©°ea°°o°e°°°°°e°°°°°e°°°e°°°tea°°°° BAISIIIMIRHIIIIMM�� a, howsw u■■■■■■■■■■ 70 IMP ■\■\I\\■■■■■■■■■ m■\■11w■\■■■■■■■ \ \ m®0®m®°a0m0m0mmm ■■■III■■■ ■■■■■ mm0®0m°°°emmm® o 0®©0mm0®0mmmm00m 0■■■\1111\■■M.\\■■■■ a°aaa®0oo®�® 0�0 IN ®■\■►I��'I■■■■■►■■■ °°°e°°°°°°a°°°a°°o®°°°°aeon ■■■II►�1\■■■■■■■■ °°°°°°°ea°°e°e°°°°°e°°°°°e°s0o ■■\\\1ol IIi\►\\■■■■\ .Model 185/4185 should not be subjected to xplosion proof pump,see ,' Jay mo©aoo���a®m®ovaoo®ooa�aoa o®m�om�o�v�0®o®m�0�oss�®® 0�©m000®a®a®room®0�ose�v�® A�osss0o0o0ao®©�0mm©�0®v®o ©masosssssaso�sa©mmvvv®®®v S .■■■�v�sssssssasassss0�o®©m®o®o ©�sososssssossssaso®o00v0© m®sassassssassssss0AV0vv®© o®ssssosssosssssasssssvvo© ■■',■■■■v�asssssssssasssssasssa0vo v®ssasssssassssosssssassov 1.1 ■■= ■■■■■N 551 IN OWN No .• ���■■■►�■►�■■■■■■■■■■■N �■\��■■\■■►\■■■■■�N ' =® ®N an�NN■■ in R . n.y!+t �!; `t',. E ( , .2' County �4� " g^ ` Safely and Buildings Division 5 (r© 0 i 1 r 'ex 7162 Sanitary Permit Number(to be filled in by Co.) •,u�Q�� t:�i) - --_.201 W.Washington Ave.,P �, Lary y i C Madison,WI 537 • " 51 �`1 1 U 1C,► •IT -�i°" `!„,„, . �hl��-StateTransactionNumber Sanitary Permit Applie C i”‘ N In accordance with SPS 383.21(2),Wis.Aden Code,submission of this fo '.o the tip�``.• ate go ti.,,• to” unit is required prior to obtaining a sanitary permit. Note:Application forms for state-o ;•i"a WTSS,ht't' • fitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide •ay l�QsF• .r secondary purposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. 0 '� 1. Application Information—Please Print All Information ��Z�� S/�� /�!�' � G d Property Owner's Name„---1.--) t �� / .-O���/ / ( P I /Cc�v 6</a- r c - ../ • Ol bZ�- 1 83- 0`�� 66C5 Property Owner's Mailing Address / ro - Location / �� 72 4 r f/ ft (4/ City,S / _ip Code i 1 Phone Number �'&, /4, Section ,, / le o l II.Type of Building(check all that apply) ( Lot# T ��N; R E Family Dwelling—Number of Bedrooms ` I rp �� Subdivision Name / I V` Block# t...52-1� �/�,/1 Public/Commercial—Describe Use P o avo,h A/�l -\) CSM Number ❑Village of❑State Owned-Describe Use 1/�rY JrJ '-- / Town of a/fy✓ III.Type,o •rmit: (Check only one box on line A. Complete line B if applicable) 2 Q N0 A.4 ❑Re Replacement System p y ❑Treatment/Holding Tank Replacement Only Other Modification to Exi ung System(explain) 2 D iStribUion CMS ivl ZZ chumnlorfu e B- ❑Permit Renewal 0 Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV m/Component/Device: (Check all that apply) 1•i111tI, .- t?-kressurized In-Ground �i Pressurized 1n-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil v i Ur_ p < ❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) K_.-''///�� J V.Dis•ersaUTreatment Area Information: �,_ Design Flow(tg7 Design Soil Appcaton ate(gpdst) Dispersal�a Renui sf) Dispgssal A Proposed(sI) System Elevati•_ al� 6 60 VI.Tank Info Capacity in I Total #of Manufacturer Gallons Gallons Units /�I �y/ p�/"��. , o 'g New Tanks Existing Tanks Y t//4ea i,'fJ`� �' ^ , e 1E t. Septic or Holding Tank 1/.2.s r� J rn v. ,n .,.. �.Dosing Chamber l� 41EC,L,a-t J VII.Responsibility Statement- I,the undersigned,ass esponsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) � Plum Mature I�/MPKS Number I Business Phone N�r/�/ Plumber's Address(Street,City,State,Zip _*de) t- L / J / 2 .24 dt,,,z' A _.c 0/_7 VIII.County/Department Use Only Permit Fee Dat Issued ' Issuing A ;,tfa�ur ( I :^•er Given Reason for semi y75. �1 //t6/5 1 IX.Co i rjpkgy ,/Reasons for Disapproval ® Oeve Ib ty' -lb sup p Iu Iwo 1.Septic tank, effluent filter and 1,01‘111 MU,i tl+t i l Ct..t'lt.L p l' x/1-5 t dispersal cell must bgAtryiced/maintained ,!; as per management plan provided by plumber. ���I ��812 Q Pyv1✓C.ik 4 2.All setback requirements must be maintained 6 as per app llcal.h�c®o...ett yttt>ias> ,the system and submit to the County only on paper not less than R IC x 11 inches in size SBD-6398(R. 11/11) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/12/15 Owner:Travis Waldschmidt he,,9,re✓y' /4 L.L C Location: NE1/4 NW1/4 S16 T29 N,R1gW 548 McCutcheon Rd Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve 10.-12. Soil Test I Signature Al License nu b= #226900 PLOT PLAN PROJECT Travis Waldschmidt je(7e/ific�� ADDRESS 476 Ctv Rd A Hudson Wi 54016 NE 1/4 NW 1/4S 1 /T 29 /�9 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 91.2/90.5 5' below grade 4/10/15 4 BEDROOM DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 591.1 # of chambers 44 IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark B.M.* 1ZU' 260' Property Line Scale = 1 4" = 1 0' 2-3' X 88' B-2 • Vents Cells with >3'spacing 35' 7% Slope 50' '■B-1 35' ►' 15' 96' %,)t.\\ • 40' B-3 94' A 40' , 25' Huffcutt Combo Tank Area of poor soils Pro 4 Property Line Bedroom House Scale is 1" = 40' unless otherwise 235' Property Line noted Vent >6" Quick4 Standard All piping shall be SDR 30/34,within 10' Leaching Chamber of tank,piping shall be Schedule 40. of Cover with 20.0 ft2 of Area 5.6ft^2/pair of end caps 4' Long Grade at System Elevation McCutcheon Road 34" • Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above rade 5.6ft^2 pair of end plates g Finish grade elevation Typical Installation 96.0' Vent Grade ► Vent 3' 4„ 3, x • /30/34 Septic Tank 1" 5' 1„ 5' Long 5 Long. Grade at System Elevation 3 6" Grade at System Elevation Spacing 5' 2-3' X 88' ' Cells Same on other end Observation tubeNent At end of cell A B 22 chambers per cell System elevations: A_91 .2' B 90.5' ST. CROIX COUNTY SEPTIC TANK K4AINTENANCE /LGgEEMLN]` AND OWNERSHIP CFRTl.](`&'r| -N FO M Owner/Buyer / � ,5 �t ~ //� L , � / � -_—' � � ^~~`-~^^/^~" �� +.\~- Mailing Address_ _6 __ �� . ../t.3--1ropor(y��&droua 7�_�-) y}o (Verification 6- Planning P � -~ -----=�~-'-++==`�'�� �-�-��-- - - - uouz:9uorvunm &Zoning 0upuu.oe.ot/bc new coust/uc'ioo) 02-0 ~~~��� City/State _-_ _'____ _________ Parcel Tdoo1if�ca�uu ��u'lhrr v LEGAL DESCRIPTION . . } � - � Property Location NCI- �� 4V�i �� , Soc. � �� ], '7 }� l{ / �V' Town ^� -� ��� -_/'_ _-/_ __-_ , __ Subdivision ~J � �1 ___________ L , u[4 -_- ~~--_ Certified Survey Map # _ ___ __ _ ____` V�'buxe �_____ Pagu # Warranty Deed #--_-- \/o|ouuc , Page�_______ Spmhou, ho 0 ]o/)iu ^ i6muihuhk no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its pr.znav're faihue to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, il 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 wasie disposal system. Owner maintenance responsibilities are specified in§('onun. 8].52(l) and i'Chapter 12 St. Cwix County Sanitary Ordinance The property owner agrees to submit to St. Croix County Nanning Sc Zoe m8Dvpa/uuwo`ucu,ibcadooholm, signed by hut owner and by a master plumber,,journeyman plumber,restricted plumber or a licer.sed pumper verifying that (1)the on-site wastewater disposal system is condition and/or(2) rifler inspecion and pumping(if necessary), (he septic tank is less than 1/3 full of sludge. 1/we,the underssgraed/u/,e^u*du*m`ov"moui/onv`u;a`duu/n" monaiotaio0h:zni,uu` sowuu°d6qrup)xrom,v*'id' 0'u stuiuctasds set foitli,herein,as set by the Department of Uouimeiee and the Department vf Natural /6:voozxnu State of Wiscousro Certification stating that yoar septic system has been maintained roust be complete.l and returned to the St. Croix County Zoning Department within 30 days of the three year expiration date. -' ""e ]hwecertify that all stat ents on irs form arc one to the best of inviout k nowleJge I/we ariilare the owner(s) of the property described above, by v no 'f a wa ranty deed recorded in Register of Deer Is Office. Number SIGNATURE 'x--/��/��^�' '�^ `.o"v/(uy~ � DATE �**Aoyiofxzom/ix��uti»u^iu�p,o~�C~ d may result iu the sanitary permit being c yoked by the Planning&Zoning l)epal-tmeut. Include with this application a recorded warranty deed from the Register of Deeds E,flice and a copy of the certified survey map i I reference is nna(le in the warranty deed. (REV.08/05) • POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION • SYSTEM SPECIFICATIONS j // C/ A Tank Manufacturer 4( ❑ NA Permit# fi.apptic ❑ Dose ❑ Holding Volume:/(9,5-S (gal) DESIGN PARAMETERS Tank Manufacturer: ❑ NA • . Number of Bedrooms: 4- ❑ NA ❑ Septic Dose ❑ Holding Volume:7 1,,3"--- (gal) Number of Public Facility Units: 1?;1,-.NA Vertical Distance Tank Bottom(s)to Service Pad:/0 (ft) Estimated(average)Flow: •4'o-(J (gal/day) Horizontal Distance Tank(s)to Service Pad:w (ft) Specific servicing mechanics must be provided if vertical is>15 feet or Design (peak)Flow=(estimated x 1.5): 4:(6 (gal/day) If horizontal is>150 feet. Specific instructions to be provided on back. . In Situ Soil Application Rate: , `7 (gal/day/ft2) Effluent Filter Manufacturer: �� � �- ❑ NA Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model: Fats,Oil&Grease (FOG) s30.mg/t Pump Manufacturer: ZZ, /�� ❑ NA Biochemical Oxygen Demand (BOD5) s220 mg/L ❑ NA • Model: .5-3 Total Suspended Solids(TSS) 5 Pum p 150 mg/L /5 J High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L �) Manufacturer (BOD5) >220 mg/L NA ❑MMechanical (TSS) >150 mg/L ❑Disinfection 0 Wetland Pretreated Effluent Monthly average ❑Sand/Gravel Filter ❑Other: (BODO) s30 mg/L 744 Soil lion System 5530 mg/L a,-t Fecal Coliform(geometric mean) 5104 Abso Ground(gravity) ❑In-Ground(pressure) ❑ NA ❑At- ade ❑Mound Maximum Effluent Particle Size 38 in dia. ❑ NA ❑Drip-Line ❑Other: Other: NA Other: MAINTENANCE SCHEDULE Service Event Service Frequency • Pump out contents of tank(s) hen combined sludge and scum equals one-third(h)of tank volume ❑Wh the high water alarm is activated C4 m Inspect condition of tank(s) At least once every: � earonth(ls)s) (Maximum 3 years) ❑ NA !, ■ ,onth(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: •• .,,r(s) every: At least once eve �t / onth(s) l l y ❑ NA Clean effluent filter ear(s) [�month(s) ❑ NA Inspect pump,pump controls&alarm At least once every: ear(s) — ❑month(s) Flush laterals and pressure test At least once every: ❑yBBr(s) Other: At least once every: ❑month(s) NA ❑year(s) Other: NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). Tank inspections must include p ude a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, i measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil effluent for any ponding of e in the observation pipes and to check y p 9 absorption system shall be visually inspected to check the effluent levels p P 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. n treatment tank equals one-third (')or more of the tank volume,the entire When the combined accumulation of sludge and scum in any trea eq and disposed of in accordance with chapter NR 113, of the tank shall be removed by p contents o Y a Septage Servicing Operator (pumper) Wisconsin Administrative Code: All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 5512 months,shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005(02/05) • • 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, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are •detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior to use. , Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will bedischarged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. 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 treatment tanks and soil absorption system: acids, antibiotics, baby wipes,-cigarette"butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps,medications,oils,painting products, pesticides,sanitary napkins,solvents,tampons,'and water softener brine discharge. 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 properly and safely abandoned in compliance with s. Comm 83.33,Wisconsin Administrative Code: • All piping to tanks,pits and other soil absorption systems 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(pumper). • 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 repl cement system: table 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 and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. , ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology,a holding tank may be installed as a last resort. ❑ 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 surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK d� SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER -� POWTS MAINTAINER. • Name �X _ 1-- Name4_5-1 /` c Phone 7 i i G % /� Phone 7/J ,� i ,�7, , J SEPTAGE SERVICING OPERATO PUMPER) LOCAL REGULATORY AUTHORITY �7,..� Name () 1//��" � Name ( 9✓�/x ,C7�!/ - ��' / Phone 7'J (7 /� 1 Phone 2),"�3 )7o Lf' fj This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code. ,-, ,--it Oititis i.,4;, ;„ w FILTER CARTRIDGE I STRUCTIONS' - .�.,' - ' i a,,,,,r.,,,,...:. p p T _ Installation end of the outlet pipe to ensure it is ., rcas case onto the 4 STEP 1 Dry fit the filter 4:,;;.::-.... centered under the access opening. If not, then either insert more pipe into the " tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. K, STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the w optional supplemental side support. If side support method is not utilized, proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: solvent weld the 3/4-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter t, :d cartridge into the case, pressing down until the filter locks into the bottom of y: , the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning zv. a, r „ clockwise 90°. Maintenance 1. The effluent filter should be cleaned every time the septic tank is - M serviced. � �, � t ,� ” �.. �°,�. 2. Open the outlet access opening to inspect the tank and filter. , t '1 `: .�- 3. Pump the septic tank completely, making sure to remove the sludge _ ;A layer on the bottom of the tank and not just the scum and effluent. .�` , 4. Once the effluent level has been lowered below the invert of the firmly pull up on the filter handle to dislodge the te' outlet pipe, y P 5 cartridge from the case. ` 5. Slide the cartridge up and out of the case for cleaning. «,re 4 * wY^ � ^'1 6. If a VRS switch connected to an alarm is present, the switch 1 r ' should be removed by turning counterclockwise 90° and cleaned '. Fix ,i with water only. ; 7. While holding the cartridge on its side (large flat surface facing ; down) over the access opening, rinse off the cartridge with water ', ; only, making sure all septage material is rinsed back into the tank. 8. If VRS switch is utilized, replace by inserting into filter and >k.• _ turning clockwise 90°. . y ; 9. Insert the filter cartridge back into the case, pressing down until F ; `" r, the filter locks into the bottom of the case. ^ 4 " 10.Replace and secure the access opening on the tank. BEAR ONSITET'FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY {_� , BEAR ONSITE''Filter Case-Lifetime Limited Wa an:y :' ',r• r rdi �a r- .3 1 JI C I t.. a sales I .2 Y I: t I"' --; 1 ur. a a M i , r:5 'I'_Ir..Li lo..: .: i 5 ", a .-a.. ,.3ia1 ':a .. G h l f S( '.. P 1 , ,,-,-...r.,A-,;WM-;:a*Y-„Eltu.404400,,,t,.$0....1:1,;,,,,10-,,mv,4,,,,f,,,, ua T lu.k+ dab„„ 7 . t .1� a 4 E4 . fir= a ”` + 5 ., `hi"";✓'°b+i 4 t n wZ $6> et ray. ,' '�"' x• vt0m-; , . � k� Septic-Dose Tank Cross Section And Pump Performance Specifications —____ pCcijt– Pump Manufacturer 72-,i7.7_&,--/ I Tank Manufacturer Pump Model Number ki- 'Tank Model Number /�.s�/7�ID _ p Total Tank Capacity !j2.s-5-/7 4; Alarm Manufacturer G2?C,Xi f 5 ,_ ._--_ Max.Bury Depth 9 Alarm Model Number 01_c, Switch Type ',`Y ' r Filter Manufacturer B Z4LA.-- Total Dynamic Head (TDH) Feet Filter Model Number Elevation Head /`L>__ __ ~_Distal Pressure -----__—_. Network Loss �_- lMinimum Pump Performance Required Force Main Loss , 7 I ,2 v GPM'I @ 0, ? Ft TDH I Total /0'7 Outlet Manhole 1VXin.4"Above Grade With Manhole Min. 4"Above Grade Locking Deice• Inlet Manhole Ell Securely Mounted With Locking Device < 6"Below Grade Sealed Watertight Weather-proof p , —""—'-► p Junction Box �i' ,; .. "11 Figished Grade '" II t ...i 1.6MBEIMEESJ Mil Vent Min. 12" Disconnect Above Grade low Means With Vent Cap .:177.7:777:77":77, ...< tiff��a' ' NVYYl Filter �. Outlet Ft1 ---...._„a„� �1r .. ._ _T"::::::1 ' -- i Inlet Baffle >; •r. ,:,: ' a: �,.J 1I4" Switch Setti4ngs and Reserve Capacity ; ,, ': Weep Volume= Tank 'l GPI ::: "i _" Hole :; Dimension. Inches_ Volume Gal. ::::: —11r— (reserve)A Q2(� ' ,1_>-t). j ::::; ;: B �� Off Elevation C ` i:':• (alarm) Ft . :: (dose) C 7 j A2 7 i': �Z' r •–•-- :,:, Bottom '' (dead) D /S.3 : D Elevation 6s" �l � Total ��" � : : :� Ft • 4 i,a a>a>a,a f>>>a>>l a>a i>���� a•• • ,,il,••1,,1•,,•,a,+,•�a 'a'i a i«:��r,l�i�i• a s.<a a a.s.a a r s a .�•�a�.a��ii•i+aa>ei,.S'i i:i'r i:i:>:i,a ii io .y �a,a+••t, ;+:a�+::+, a.. + •�a r >�> i a.•>.,ai„ a'>'...> a.:a...`'. c.1„.!. 'is:.. 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 and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 Ll Page of ?'� A.L Dvi\4`,;'':C =UL/,4P:"CI S s — 91EA0 CAFACi? L 3E ER ' t UCOILS 53/55/57/59 =FLJ Nib AN5 <'NC �I Voce. 53/55/57/59 6 _` (� e- Cal. trs . 2-2 2 47, Cz 5 — 3/ "2 z G I r , 10 0 30 40 50 > — T U S. GALLONS ,�, I / 615 1 -} :LOW EP P1NUL= 00ee97 ,� �, -. T T I - Variable level float switches available. Variable level long cycle systems available. - y . A - Available with special cord lengths of 15', 25', 35' and 50'. ' - Alarm systems available. Duplex systems available. I —! ;I It, C�v- �I . 3/32 SK858 — Single Seal � Control Selection Listings Model 4 Volts I Phase Mode Amps I Simplex_' Duplex CSA UL I 1. Integral float operated mechanical switch,no external control r:quired. M53/55&M57/59 I 115 1 1 I Auto 9.7 1 Y Y 2. Single piggyback variable level float switch or double piggyback variable level N53/55&N57/59 j 115 i 1 l Non 1 9.7 2 3 or 4&5 Y Y__' float switch.Refer to FM0477. BN53 _115 I 1 I Auto I 9.7_ Y Y 3. Mechanical alternator"M Pak"10-0072 or 10-0075, BN57 115 1 Auto 9.7 j N Y 4. See FM0712 for correct model of Electrical Alternator.• 'BE53/57 230 1 Auto ' 4.8 Y YY -- D53/55 8,1357'59 230 1 Auto 1 4.8 1 Y_Y 5. Variable level control switch 10-0225 used as a control activator',with Electrical E53/55&E57/59 230 1 I Non _ 4.8 I 2 3 or 4&5 Y- Y Alternator(3)or(4)float system. 1 — 'Single piggyback switch included. i l l.CAUTION I For information on additional Zoeller products refer to catalog on Piggyback Variable Level Float Switches,FM0477 Electrical Alternator,FM0486;Mechanical Alternator,FM0495;Sump/Sewage Basins,FM0487:and Single Phase -- _- - -- ._Simplex Pump Control/Alarm Systems,FM0732. For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O.BOX 'F 19 .1g/ft:,'wk.-. Louisville,KY 4025o.:.;:-.;.. Manufacturers of.. O ® SHIP TO:3649 Cane Run Road Z 4, ® Louisville,44 40211.1961 QVdL/TY!Amos SNCE mg ' u (502)778-2731•1(800)928-PUMP http://www.zoeller.com PUMP !O FAX(502)774-3624 ©Copyright 2002 Zoeller Co.All rights reserved. I - E It ° i 2tY,T , ..t-1 liV lii`l--;'-1 uij g iEttli5; Ii i!, Iti! 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Vq4 Nig Filli Viiii ,, › cs, f I > r- m w, o.) m ,ggtwi 1g2.- 8 '"g 0 r t In mX,' 1 (#) \ 43/,, Ri ' I k • I /'w Q b a (4 Q 'NI Id■ jV .6114 li 43N Q its 1 i N. , .4, w S44'3h17'�Y— 43,x.98' ! ap, '37• _ _ ,, • i 4 + IN � 4k Is II W A Ni,s sib`i ; I N i •IN1 t\ti rte.` ,,, $ , (, w I 'A %tit N ti . ! -4 (.4 / 25. , / i 4 1 , . s 1 i 1 cst „ ti 1 4■ i ?111 t1 I I tl; 1 I. F:11 k it I / : i. CSt ., IIPO, / t,;44j . ` erg a 33' VA I N j'zs Ikkg -, 00W7F31"E /1/a2.©7i / - SO677797 3979#3' n+ ` ,. 1 / •� 1 W I ,,4 W N r--^' ', ' Er. sconsin Department of •.. I elm 0 n 1.,, SOIL EVALUATION K PI T� Page L of 3 Division of Safety and Buil. a v* kJ l I l in accordance with Comm 85,Wis. Adm. Code I tri County Attach complete site pl±jltT11tf1ry rap 4it y73is'than 8 1/2 x 11 inches in size.Plan must ��" `'��t include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimensions north arrow,and location and distance to nearest road. I' MG, Please print all information. #U1_r _ Da Personal information ou provide may,e used for secondary purposes(Privacy Law,s.15.04(1)(m)). `� 1 3 13 Y � l / Property Owner Property Location ..--1--- ) ,(.:i./C,t_/.CSC,"rn I< Govt.Lot A/ 1144.0/4 S/G_, TL/ N R! E(o Property Owner's Mailing Address of d` �'Block# Subd.Name ofr CSM# // ` '' 4, ' ,?.- f -- Svv-n--f knit <-L-ou) AC e,SS City State Zip Code Phone Number lty ❑Village I$-Town Nearest oad Z- . A , ) `fl' /44,V)/36-1?,21 , 2 —' UV'a eoAi NMI ew Construction Use:%Res,dential/Number of bedrooms_-4,/ _ Code derived design flow rate_yJ1.--/6 QQ__ �—GPO ❑Replacement�I , �2 ❑ Publiicc,/car commercial-Describe: _.-_-----_---.---.-_-_-.- 1 1 Parent material LJ'�- - .-e/ yt./ Flood Plain elevation if applicable A/1/9 ft. General comments and recommendations: System Type�7� ✓!>f ---- System Elevation_- _. '.0 5.. 0 Boring Boring# / 1 ®,pit Grou id surface elev. b ` a•ft. Depth to limiting factor I/ in. Soil Application Rate Horizon' Depth Dominant Colon Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2 I o-/ fpy 5/L1 ------ -g � � r cj'" •- - 6 • g L 12-95/ s// /-72 ,,,�<,v I-� -y i ‘ „3 rg-iify0-0 ----g---- S Osas, m/ it/J4 1-ild - - /, ‘, a ea• \ - - # ❑ Boring .� Z. Pit Grot�nd surface elev._ 6` ft. Depth to limiting factor /�� in. Soil •..lication 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 1 0-i3 Lou 3/z / •�Mill • G ys � 13 �y Ivy lY „�._ !�WZNIFZEIRESZNIEri ,. 4.3 5 '-/IS►o7tt Ott NM . Mill iffilM _ II�Aw��/�. Effluent#1=BOD >3F)<220 mg/L and TSS>30<At.#4 ;1•�'A/// (fluent#2=BOD <30 mg/l.and TSS<30 mg/L CST Name(Please Print) 141 ."44111111111111r CST Number Bird Plumbing, Inc. Shaun Bird / 226900 Address Mate:luation Conducted Telephone Number 1008 192nd Ave, New Richmond, 54017 D --//L. 715-246-4516 1 Ai Property Owner Parcel ID# � Page _of Boring# ❑ Boring q �' c 3 pit Ground surface elev. 13 1 _ft. Depth to limiting factor !i 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 •Eff#2 1 0_9 Ill►P�E / 2 „ . °I(- Gs Z" 'C • S' - Z 6-3 ► r9A, c 1 el�s6k- em,i �' _ / f • y 4 F 1 kt/A- , el- ,_ ' 7 --,4 I, =II 0\■ , -/04\ . , - _ ‘IZ\,-A‘)\* . 1;30' - . 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 Cu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 ❑ Boring Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ 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=BOD6>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD8<30 mg/L and TSS<30 mg/t. 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. I SBr18330(11600) �, Soil Test Plot Plan 1 7) Project Name Travis Waldschmidt Shaun W)1, Address 476 Cty Road A ..di Hudson Wi 54016 Cf #226900 Lot 4 Subdivision Date n/31/12 NE 1/4 N W 1/4S 16 T 29 N/Ri 9 W Township Hudson ❑ Boring 0 Well PL Property Line County ST. CROIX 1 op BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBD *HRpSame as Benchmark j M. 260' Property Line 1 $ I 5' / 2, e •' 34 27 B-2 • 35' 7% Slope t) B-1 35' t ' 50 '� 15' 96' 7 ,_,.//2., �s- B-3 N 94' A j 40' i , \ 1 Scale is 1" = 40' Area of poor oils unless otherwise property lille noted t 235' Property Line // .'L! 7 ! /o /';, ,2 Jam _. C 'C r ` _,D- (, 14( 7 V McCutcheon Road - — o_ r - - II w `� 1 1 1II1 ! I I Q 1 ' i I .. r i 5 I t .. . , I I , , 1 a r , I II( N / ' l S 11111 ` 1 �T_1 t f; t t t t � ‘ i ' \ k k ",itT_, QV a4 I�N��I N u 1 1 1 1 �' � I ti Q "i N1i i` .y k " I I —� m Q l I r (�I �o `I \\\� It I N Nt I 11 ` \\ I ik 1 ) ' 1...`', , , - L 1 v I I I • _ I _ LD PPZ• _ ®..., rQ7 T.. .���+�T'• I 1 , I l 1 ;, I 0 . Q l‘ 4 C'� 1 `". 2 i I t I ' ., 0 I im 5,- _Ali op " ` / I in oSEO ill / /_ r , /i* , , —096_..., 4 '� rrr //,1ly.. I i I I I 'Ia ' „, , ,.. ...... ..„. ._ . ik \ 4 44 I r t °� �l % ,1 tip, ,1 0 9 0 . . 0p l i (r) 1. ,..4, ,,,,-r---,'..;;; \ or 04:1 — '-, Z ' . 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