HomeMy WebLinkAbout038-1078-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
578927 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)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Baillar eon, James W. & LaVonne Trust I Star Prairie, Town of 038-1078-70-000
CST BM Elev: Insp.BM Elev: BM Description: / cy— Sectionlrown/Range/Map No:
I bo �pl . N l.J I �j� 18.31.18.323B
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER Y' CAPACITY STATION BS HI FS ELEV.
Septic I �� Un boi^m I d nf1 Benchmark I , l I' MID ,1
Dosing I y u (� n_Ut Y N+ S Alt. BM lJ
AeraflorT- n �'�( U
Bldg.Sewer R
Hofdtn� _/ Ir r St7Mttr7tet
TANK SETBACK INFORMATIONt
TANK TO / WELL BLDG. Ve qr l9take ROAD Dt Inlet �J. Cf
Septic 1 �I 1 � � �, � Dt Bottom l I, g GpJ. b
Dosing \ r 0 1 ( 0I G t HeaderfMan. O / C/l�
I ,J "I Z. C
S g 7 7
-' Dist.Pipe
Bot.System 22G 7
PUMP/SIPHON INFORMATION Final Grade 2 d
2 • 9Q -3
Manufacturer U GPM errand St Cover . I
,/�^ I �•� �1•� ,3 9�.
-(�
Model Number 15 2- )�v 1
TDH Lift I Friction Loss System Head TDH� Ft
I , 3
Forcemain Length �� Dia. 2)I Dist.to Well r
SOIL ABSORPTION SYSTEM
BED/TRENCH Width �1/ ] IL ength t No.Of Trenches 0 PIT DIMENSIONS No.Of Pits Inside Dial Liquid Depth
DIMENSIONS �U(
SETBACK SYSTEM TO P/ LDG IWELL LAKE/STREAM LEACHING Manufacturer: _
INFORMATION CHAMBER OR
Type Of S stem: � � � �] I�f � UNIT
Model Number:
DISTRIBUTION SYSTEM
Header/Manifold � Distribution �r �r ' x Hole Size � Ix Hole Spacing I Vent to Air Intake
Length Dia Length Dia _ Spacing
SOIL COVER gMC4qop�sitems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of ] xx Seeded/Sodded
Bed/Trench Center 1 Bed/Trench Edges Topsoil
1 Yes E No s F7 No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1:�/ Z / Inspection#2: / /
Location: 872 210th Ave.SOMERSET,WI 54025(SW 1/4 SE 1/4 18 T31N R18W) metes&bounds Parcel No: 18.31.18.3236
1.)Alt BM Description=
�,�
2.)Bldg sewer length=litS� ���
-amount of cover
Plan revision Required? Yes No I
Use other side for additional informal n.
SBD-6710(R.3/97) Date n epctor's Sign re Cart.No.
Il E CE County
d Buildings Division 7� 2 0 1 W.Washington n P.O. 0) 7162 S,
I— �'Safe'ty and Buildings Division
n Ave.,P Box 7162
V 201 W.Washingto Ave.,67_ 6 Sanitary Permit Number(to be num in by Co.)
Vo
V -7162
, 4 37
it F Madison,Wi 53707
COUNTY
EVELOPMENT, State Transaction Number
�A-nT'di�cntio�
Sanitary Permit Application
In accordance cc with SPS 38321(2),Wis.Adm governmental unit Code,submission of this form to the appropriate govern
is required prior to obtaining a sanitary POrnat- Note:Application forms for State-owned POWTS are submitted W Project Address(11 amerent man mailing address)
the DepaymiI of Safety and Professional Servies. personal information you provide may be used for secondary V2_
_r
sea in accordance with the PrivW
L A. lication Information-rjcxbc Print Ail Information Parcel
Property ms's Name C., k ,''I - '2
.............. () 7S— 1.0,
Yf0 --
prope Location
� III, rty
property Owner's Mailing Address Govt.Lot -3 Z 3
Zip
1/4, Section Iq
Zip 1 phone Number 5�p; —
City,state j(circle o9s)-N
3 N; RLD E�jw
Type of Building(check 211 that apply) Lot#
Subdivision Name
2 Family Dwelling-Number of
Block#
❑Public/Commercial-Describe Use 11 City of
El State Owned-Describe Use CSM Number 0 Village of
&1,.of
III.Type of Permit. (Check 05)y one box on line A. omplete line B ifapplicable)
A. New System ew System Q Treatment/Holding Tank Rcplaceanent Only ❑other Modification to Existing SYS—(-Plain)
Permit Number and Date Issued
B. ❑permit Renewal
❑Permit Revision ❑El Change of Plumber ❑Permit Transfer to New List Previous
Owner
Before Expiration
of pOVM System/Component/Device.- (Check all that a
❑IV.T Mound<24 in.of Suitable soil
Non-Pres,==d In-GrO-d ❑pressurized in-Ground ❑At-Grade )&Vound�:24 tn.of suitable soil
❑Pre
❑Holding Tank El er Dispersal COmP—t(explain)in) treatment Device(explain)
V.Dis rsaVrrea eat Area Inforailtio . Die al Area Pr
d(sf) S Elevation
Design Flow(gpd) Design Soil lic - RjueWdsf) ElisPelsal)"':;' I !!�jj ir (Sf) pers
11 9
#of Manufacturer
VL Tank Info Capacity in Total
Gallons Gallons Units
New Tanks E=tmg Tauk5 I It 6 -A
Septic or Holding Tank k-111/
/WD i. ily %,dW
Dosing Chamber r.installation of the POWTS shown On Number Pli"Lv-
VEL Responsibifity Statement-1,the undersigned,as ScrCbPu....j., MP/WRS umber Business Phone N_),
ignature
Plimbjr's NMI P1
City,State,Zip Code
Plumber's Address( P
Y
uutv/Depsrtment Use Only Permit Fee ing t Signature
proved rov
for D..W 2!2
IDYL_Cowd* as r Disapproval 3) 66 At�
J., k; efflu6nt fifter and !maintained 1, e_re:,t- L.-J,JLL
dispersal cell must all be ON es
ss per management plan provided by plumber,
k*9rnwft]must 00 mgirAtirfed
2. All SII,k noft. 6LA 1,�4,,� 4-Z (0�c
n Per. oWina" 8 1/2 X I I inches in simme
Attmach compktepi&w
fur the sysmmand submhto ecounty only on paper not kss than
SBD-6398(R. 11/11)
PLOT PLAN
PROJECT James and Lavonne Bailaraeon ADDRESS 872 210th Ave Somerset Wi 54025
SW 1/4 SE 1/4S 18 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST.CROIX
SYSTEM ELEVATION 98.4' 4/14/15 3
DATE BEDROOM
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none
IL BENCHMARK V.R.P. Top of wood corner post ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
AC Property Line (not to scale) 300' 96.5' B.M.*
7. 97.4' 97.5'
Area 15' below B-2
system is to ❑ Scale = 1 /4" = 10'
remain 6 acre site
undisturbed
Grading is to be
2 Slope done to divert
run-off
All piping shall be SDR 30/34,within 10' B- 1 away from
of tank,piping shall be Schedule 40. system
B 3
Failed H uffc utt Dose Tank
drai nfield
Tank is to be properly
bedded and provided
with lockdown cover
with approved warning
ST label
Property Line (not to scale)
O Well
Existing 3
Bed roo m
Ho use
ICOPY
21 0th ST.
}
T.
1 a
SHAUN R BIRD Page 2 4/24/2015 '
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19,Wis.Stats.
• Inspection of the POWTS installation is required.Arrangements for inspection shall be made with the designated
county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stat
• SPS 383.22(7)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.
Owner Responsibilities:
• SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the a pp roved management plan under s.
SPS 383.54(1).
• SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. SPS 383.54(4)shall be considered a human health hazard.
• SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
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$ 250.00
This Amount Will Be Invoiced.
d` YLJ� When You Receive That Invoice,
Charles L Bratz Please Include a Copy With Your
POWTS Reviewer 2 ,Division of Industry Services Payment Submittal.
(608)789-7893 ,7:45 am-4:30 pm Monday-Friday WiSMART code:7633',
charles.bratz@wisconsin.gov
cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm
t 3
�EY�RTUN DIVISION OF INDUSTRY SERVICES
T
3824 N CREEKSIDE LA
o HOLMEN WI 54636
3 R c Contact Through Relay
http://dsps.wi.gov/programs/industry-services
�'y w www.wisconsin.gov
�OsSION�15� Scott Walker,Governor
Dave Ross,Secretary
April 24,2015
CUST ID No. 226900 ATTN:POWTS Inspector
SHAUN R BIRD ZONING OFFICE
BIRD PLUMBING INC ST CROIX COUNTY SPIA
1432 120TH ST 1101 CARMICHAEL RD
NEW RICHMOND WI 54017 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 04/24/2017 Identification Numbers `
Transaction ID No.2533575
SITE: Site ID No. 811946
James&Laverne Bailargeon Trust Please refer to both identification numbers,
872 210TH Ave above,in all correspondence with the agency.
Town of Star Prairie
St Croix County
SWIA, SE1/4, S18,T31N,R18W
FOR:
Description:Mound/Three Bedroom/Sloping Site
Object Type: POWTS Component Manual Regulated Object ID No.: 1532988
Maintenance required; Replacement system; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from
original grade;
System: Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12),
Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01 101,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. 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:
Reminders
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
component manuals listed above.
• The existing septic tank must be inspected for structural soundness,size and baffles and must be brought into CONS
conformance with the requirements of ch. SPS 383,Wis.Adm.Code.If it does not conform,a state approved AP
tank must be installed. DEPT OF
• The existing POWTS must be properly abandoned per SPS 383.33 Wisc.Adm.Code. PROFESS"
piVlS10N OF It
• Per manual cited above,limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction,excavation,vehicular traffic and other similar activities that impact the treatment and
dispersal are prohibited.
• The well must be a minimum of 25 feet from any POWTS tank,and a minimum of 50 feet from the absorption SEE CO
area. chs.NR 811 &812c
SHAUN R BIRD Page 2 4/24/2015
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19,Wis. Stats.
• Inspection of the POWTS installation is required.Arrangements for inspection shall be made with the designated
county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stat
• SPS 383.22(7)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.
Owner Responsibilities:
• SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
SPS 383.54(1).
• SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. SPS 383.54(4)shall be considered a human health hazard.
• SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
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$ 250.00
This Amount Will Be Invoiced.
YYYLUUJ� When You Receive That Invoice,
Charles L Bratz Please Include a Copy With Your
POWTS Reviewer 2 ,Division of Industry Services Payment Submittal.
(608)789-7893 ,7:45 am-4:30 pm Monday-Friday WiSMART code:7633
charles.bratz @wisconsin.gov
cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484 ,Monday-Friday 8:00 am To 4:30 pm
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 4/ 14/15
Owner:James and Lavonne Bailargeon Trust
Location: SW1/4 SE1/4 S18 T31 N,R18W 872 210th Ave Star Prairie
Manuals Used: Mound Component Manual Version 2.0 (01/31)
Pressure Distribution Manual Version 2.0 (01/31)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9-11. Soil test
12. Filter Specifications an oss section
Shaun Bird `
Signature 'TIONALLY
ROVED
License number 2gig SAFETY AND
)NAL SERVICES
JDUSTRY SERVICES
' t14
�RESPONDEN
PLOT PLAN
PROJECT James and Lavonne Bailaraeon ADDRESS 872 210th Ave Somerset Wi 54025
SW -1/4 SE 1/4S 18 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST.CROIX
SYSTEM ELEVATION 98.4' DATE 4/14/15 BEDROOM 3
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none
BENCHMARK V.R.P. Top of wood corner post ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
AC Property Line (not to scale) 300' 96.5' B.M.
97' 97.4' 9?.5'
Area 15' below B-2
system is to ❑ Scale = 1 /4" = 10'
remain
6 acre site
undisturbed
2 Slope Grading is to be
done to divert
All piping shall be SDR 30/34,within 10' B- 1 run-off
away from
of tank,piping shall be Schedule 40. system
B-3
Failed Huffcutt Dose Tank AL
drainfield
Tank is to be properly
bedded and provided
with lockdown cover
with approved warning
ST label
Property Line (not to scale)
O Well
Existing 3
Bed roo m
House
I
210th ST.
Mound System Cross Section and Plan View
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
� � Dimension Feet
i A
J B j
l
T 1 I
. . . . . . ...... . . . . . . . . . . . .
. . . . . ... ...
D /�?
' ♦ 1 1M1 1 hh 1 1 11 11fh1 h1 T
1 M1 ��•+�111 L M1J1 1.Lf1:M1•M1.h•1 .fM1?M1. M1 ..1 •, �+ I r+ )7
A ' 1 1 1 1 { �•1 1 1r1+1 r1•L:\?hf1t1 tijhj jLJ1J1,1.1r'?1?1J1?`Jl???tifti of M1f1 r L / y�
'r4l4f4?4?:'.\_�1 f r.1• f•}:f.:.iM1::r•:.:1r•i•r•f•r!•r:hf J (a �j-;,rti:r
•l•!•!•J•!• J. r1.1�?1.h?1?1?\?•.?:..1.1:4.•.•.•?ti?ti:1. 1.h.1.1.1.1.L.:..1.1....M1.ti.1.1.•.1.1�"R}'J1r f1. f1f1. ' 9
M1 1r;M1r;4{•;•l.J4r;r4?4?•J,1.?1?•r`•?i?4?1?{?4?4?•J.f.f.f.f.f4?4?4?':X4:;4?4.4?•.?4?4?L:4:1•{.4.',
' l%f�f~l•f�J�f•:J 1:f••t J J•J!�•!:f•J•:�!•!•f•r�•f1ly::f~.•�•1•:•f•f.,.. f :•f•f! f l•.y J1 F
W ' l G
Z �T
II
K
r v
r L
r
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -' w ,
K B Z ---'
L Slope
i – = Topsoil = ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc
L - J
Cap Material sand fill '/2 to 2 '/2 in. dia. 0 observation pipe
Geotextile G H
Fabric ----�—
D
E
1
Plowed Surface
Ft Contour
Slope Direction
GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or
chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a '/4 inch soil wire
when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately
after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot
thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound
is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The
observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange.
10/071gj Page of
Pressure Lateral Layout
Two Laterals — End Manifold
-- Threaded
Cleanout
Lateral Turn-up --► Plug,
Manifold
M
A
X —�
Long
Force Main Sweep
90
�f d' Bend
InNetwork S eciticati— ons -� 47 Pressure system Construction
er ,�_,,. In.
eter In. Laterals are constructed of Schedule 40 PVC
ter 3/f In. pipe. Orifices are drilled perpendicular to
cin } In. the pipe with a sharp drill bit and face down.
L (Lateral Length)
e Ft. Lateral turn-ups terminate with a threaded
M (Manifold Length) Ft, cleanout plug and are enclosed in a 68 inch
Force Main Diameter _In_ diameter lawn sprinkler valve box access]
Main Length Ft. from finished grade.
Force
• • • • • Grade • • • • • • • .: j,. . . ::::.
i
6-8 Inch Lawn
Sprinkler Valve
Box
Page -------of --
03/05 Igi
Dose Tank Cross Section And Pump Performance Specifications
Tank Manufacturer Minimum Pump Performance R'.equired
Tank Model Number � GPM @ , Ft TDH
V
Tank Capacity t;7
Tan �a �
'Total P h' �
Bur De th TDH - Feet
Max y p OTotal al Dynamic Head( ) __
pump Manufacturer � ,� Head
P
Pressure
Pump Model Number f -
Alarm Manufacturer v C.- �'_ c ressure Loss _
Alarm Model Number ���.... n Pressure Loss
Switch Type
Manhole Min.4"Above Gr ade
With Locking Device
Vent Min. 12" Weather-proof
Above Grade Junction Box
O
With Cap 4-)
— -
t -
Finished Grade
Depth of Cover Ft Disconnect
Means
f�� Outlet
Switch Settings and Reserve Capacity ------
ITank Volume= GPI Dimension Inches Volume Gal. A L'i 1/41(reserve)AWeep
(alarm) B 2 j a B Hole
i Y
>` (dose) C 7! _ Off Elev. C 1.{
Y
t
(dead) D -- /3.S` j' Ft> s
t Total �n i
}>G L L}>
>G S { L t < S S S S S G S G < C SY< L D
Ft Bottom of Tank Elev. > J >
GENERAL INSTALLATION: The 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 excavation and is sealed
watertight. Electrical service complies with NEC 300 and Comm 16.28 Wis. Adm. Code.
03/051gj Page of
Y,f Y T� n N;; r.V'� t r��_r111Vv
HE-AD
UPS r`
--DE L 15-Lj r
50 i ----- �, z9
i 7
-— --
2� 40 Y— _ J
5 ----
s
jI 30
4
—t
i
i
I j
i
0 n, 4 6' 60 1 GO
2„ _
GALLONS — --.
i+— , 6 a C
tRS ,� 0 7 6G � - -
FLCw PE R VNU7E �
CONSULT FACTORY FOR SPECIAL APPLICATIONS _ tl
!; 3 -1/ .
Timed dosing panels available.
•Electrical alternators,for duplex systems,are available and supplied with
an alarm.
variable level control switches are availab e for controiling single phase
systems. - —
•Double piggyback variable level float switches are available for variab',e `
long and short cycle controls. -
Sealed Qwik-Box available for outdoor installations.See Ff,S1420.
Over 130'F.(54°C.)special quotation required. --
152j153 Series
�ontrol Selection _
152153 MODELS ----
Model Volts Ph _.Mode _AMPS t S+m�lex Duplex_ e
src2064
N152 115 T115 1 I Non
4 115 1 Auto 85 _Tlnclu7edT—i2 or? � --� ---
aN152j
--- r— 1_ 2or3
E152 230 1 I Non 4�Incl � 2 or 3
BE1521 230 Autc _ 1
_ — I -Non- - lC 5 2.or 3 SELECTION GUIDE
N153 —
10.5 ncloaed 2 or 3 r piggyback variable level float
i 8N1531 1� Auto —— --
2 or 3 1 Single piggyback variable level float switch or rouble p gg,
I E15-3—230 1 Non + 5.3 I? _
!BBiE153 Du
Amo } 53 i tncluaed 2 or 33 Switoh_ Refer t0 FV4C477-
2- See Fr,40 71 12 for correct model of Electrcal Altemator E-Pak
A CAUTION
3. Variable level control switch 10-0225 used as a control activator,specify duplex(3;
All installation of controls,protection devices and wiring should be done by a qualified Or 14)float system
licensed electrician. All electrical and safety codes should be foilowe
recent National Electric Code(NEC)and the Occupational Safety and Health Act(OSHA).
RESERVE POWERED DESIGN
r is engineered into the design of every Zoelier pump
For unusual ccnditlons a reserve safety facto .
MAIL T0: F.O BOX,5347
_�. 14a iacrurersor..
I Lc isv+le r 4025- 3 '
:� SNIP 70 364 cane Run rear' n �? o
� � L ouisvii e,KY 402'7 56• �Ll4UTY PUMPS,J1h'C: ���d
Z \ ®
718-2131 ,jar-3024
323 P aa? --
' �A.y(517 21 77 4-
http://www.zoelier.com - ---
O Copyright 2000 Zoeller Co.All rights reserved-
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner-' w GL�4� y r /? c Tank Capacity c al ❑ NA
a
Permit# Septic Tank Manufacturer /1 ❑ NA
Effluent Filter Manufacturer ,j ❑NA
DESIGN PARAMETERS !. T�
Number of Bedrooms ❑NA Effluent Filter Model O ❑ NA
Number of Commercial Units NA Pump Tank Capacity al ❑NA
Estimated flow(average) 2T& al/da Pump Tank Manufacturer ❑NA
Design flow(peak),(Estimated x 1.5) / al/da .Pump Manufacturer ❑NA
Soil Application Rate
/� e? galtdayfif Pump Model ❑NA
Pretreatment Unit ❑ NA
InfluentlEffluent Quality Monthly average* ❑ Sand/GMvel Filter ❑ Peat Filter
Fats, Oil &Grease (FOG) 530 mg/L ❑ Mechanical Aeration ❑Wetland
Biochemical Oxygen Demand (BODS) 420 mg/L ❑ Disinfection ❑ Other.
Total Suspended Solids (TSS) 5150 mg/_ Manufacturer
Pretreated Effluent Quality �_. Monthly average" Dispersal Cell(s)
Biochemical Oxygen Demand (HODS) 530 mg/L
❑ In-ground(gravity) ❑ In-ground(pressurized)
❑At-grade ❑ Mound
Total Suspended Solids (TSS) 530 mg/L ❑ Other.
Fecal Coliform (geometric mean) 510`cfu/100ml ❑ Drip-line
Maximum Effluent Particle Size Y inch diameter Values typical for domestic(non-commerclan wastewater and
septic tank effluent.
•+ Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every j ❑ months)9..year(s) (Maximum 3 yrs.)
Pump out contents of tank(s) When combined sludge and scum equals one-third(Y,)of tank volume
At least once every c_`7 ❑ months' year(s) (Maximum 3 yrs.)
Inspect dispersal cell(s)
Clean effluent filter At least once every [I months earls)
Inspect pump, pump controls &alarm At least once every ❑ months ears) ❑ NA
Flush laterals and pressure test At least once every ❑ months ar(s) ❑ NA
Other. At least once every ❑ months ❑ year(s) NA
Other. At least once every ❑ months ❑year(s) NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or
certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage
Servicing Operator. Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken
hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up
or ponding of effluent on the ground surface. The dispersal cell(s)shall be visually inspected to check ffluent on the
in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding o e
ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third(Y,)or more of the tank volume, the
entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR
113, Wisconsin Administrative Code.
The servicing of effluent filters, mechanical or pressurized POWTS components, pretreattment components, and any
other maintenance or monitoring at ir*ervals of 12 months or less 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.
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 that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a septage servicing operator prior to use.
Page of
START UP AND OPERATION
P products or other chemicals th�',t
For new construction, p p If high concentrations are detected have the contents of thi:
Prior to use of the damage the treatme t tankjs)for the presence of painting p
may impede the treatment process and/or stator prior to use,
tank(s)removed by a septage servicing P p
System start up shall not occur when soil conditions are frozen at the infiltrative surface.power is restored the excess wastewater will t7,a
During power outages pump result in the backup or surface discharge power to effluent
tanks may fill above normal hlghwater levels. When P stator prior
to restoring
discharged to the dispersal cell(s) in one large doss,overloading lank the cell(s)and may the urn controls to restore normal IevE^s
To avoid this situation have the contents POWTS pump to assist d in manually operating Servicing OP P P
effluent pump or contact a Plumber
within the pump tank.
vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area wit ale
Do not drive or park the hfe of the POWT �'.
15 fleet down slope of any mound or at-grade soil absorption area
dental floss; diapers; disinfectants; fat; foundation dralin
Reduction or elimination of the following condomswco tonaswabs; degreasers;prove the performance; and
edications; oil; painting produci!s;
antibiotics; baby wipes; cigarette butts,
(sump pump) water; fruit sa dveget and water softener bite; grease; herbicides; meat scraps,
pesticides;sanitary napkintampons;
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the Administrative to insure that the system is propea Y
and safely abandoned in compliance with chapter Comm 83.33,Wrs
• Ail piping to tanks and pits shall be disconnected and the abandoned pied of b 1 a SeP age Servicing Operator.
• The contents of all tanks and pits shall be removed and properly disposed Y
• After um ing, all tanks and pits shall be excavated and removed or their covers ;moved and the void space filled with :;c„il.
P P
gravel or another inert solid material.
If the POWTS fails and cannot be repai measures have been, or mu
red the following meast be taken, to provide a code campl',�;rn}
CONTINGENCY PLAN
replacement system: nd may be
❑ A suitable replacement area has been evaluated disturbance and ecomopaction location
should enot be infringed upon tby requite(
The replacement area should be protected with the rule<! it
setbacks from existing and proposed structure,lot suitable lines and ells.replacement Failure rea.t Rep acement systems must comply suit t the el nee(
for a new soil and site evaluation to establish
effect at that time.
❑ A suitable replacement area is no'available esort du;liars the faialedlPOSWTSmitatians. Barring advances in POWTS techno ogN
holding tank may be Installed as a P evalualiO
The site has not been evaluated to identify ace stable repl ifce et a area.
emenpareaa'suavaiab a aOho d ng tank may be installed
�be performed
ace locate
the faileduPOWTSp
a last resort to rep
Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infi!tratit
ace, Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNI NG>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY UNDER ANY CIRCUMSTANCES.GAS1aEATH MAY RESULT. RESCUE(�C
ENTER A SEPTIC, PUMP OR OTHER TREATMENT
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS MAINTAINER�_�_. —�
POWTS INSTALLER
"
Name
Na me ce
'J,)—
Phone
Phone
LOCAL REGULATORY AUTHORITY
SEpTAGE SER ViCIN G OPERATOR PU PER ..
Name
Name 's
-- C'" C Phone
Phone
383.22(2)(b)(")(d)&(f)and 383.54(1), (2)&(3),Wisconsin Administrative Code.
This document was drafted in compliance with chapter SPS
.....................
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It
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jj
S TF-100
SCJ!7 Cl 3E)Vd 03 dHnj tl3a83A3�ld 89S.LVL8STL Lb Cl T T T 0 7'.113 Ci Cj
?11
SETTICTA-NK 'v(%11N'('P_`;!` rA,N.(_'1? :�(_it�i�,I
�)WNIRSI-1IP 0 PJAI"lG:'y I'I N' I OR,N1
4—____
- U
l'roperty Address
----_ -
{1-erifcationc(lnired Ciotti E_lannu)g b. /,imil" )c.)at I"nt
lttl uew cruisiructit)u j
P'll.c.ed kit„titiftcallon Nia 1-tel ���_
�'itv;State _ _
11FGNAL DESCRIPTIONNI
E'rclEaert_y Location �l,r� `:. ,� _ i ., S�;t,.� � �.� , I owl)
<---
Subdivisi()II Loi 1,;
Certified Site-,ev Map
Warranty I:'1'eed # � � � � � V:,ltuiie Z.7
,Sp house y;s uu 1 iit 1ir��r idc.iitiii�+hle� vc''� nt;
SY5'I'1;1y1 -M.A.INT'la N ANCE AND O NFU CER11FK A ION
It use and inaintcitancc of Vour Sepiic Sv stean could resin[ in uS pr•matatc faiItttc it)liandlc vaster (hopes
inaintenauce consists ofpunrpim� our[Ile sej1H tank(,\rr�,ihre+ Yt aur,�,r soouCr. �! n+��.ded.bti t hcens<ui punrt)eI ��/tat Vml put i�uc;
the systern ran affect fhc funct.iorr, Onlie septic cant,as a ttcatruC.ni stag/_')n the' tN as;c disposal ;,1 sMu t)""Iel tikuntenauci
responsibilities are specified in 4Cornw. S I :i4l au<l in C'haptet G' - `�i. O OIy C'crnn\�,-�'iniituv )nlinanc;e-
The property ownei agw.:to submit to St. ('im (�otuity flaunu; ,S i't�u 11„L'�{tanincnt a �cilil e;ativn tout, .ip,tt�al i��.� tl�c
owner and by a master plumber, I"iu-ncy�nIan p[uriihrr.Icst:�icicd pltrrithur 01 a lt�.,'r.SCd I)turrpt�t �crii}iut� that l I)the on ��itt�
wastewater disposal system is in h,ropci operaiiug condition and/or(2) ai1V_r mspo: iotr and Inurt}�urp,(ti�tt�ceSSaryj, tht �,rp[ic taiil- 1,1
Jess than l/.1 Full ol'sludge.
llwe,the undersigned read the ahovv) ;yutrvn.wolt� aixi aer,Ici, ;o rnniFtaiii tln� pnv<iic sc� at�,�: dispos:+l with, [lir
standards set 1,6011,tiereiu, as set by the. Dupartnwot of( omilicic( and dw 1)cpnrtincnt Iii Aaturai ltc.tiouw(!,, State on"ur
C ettification,stating that yotu Septic system tras heat train mi d trust he (ompIclo't tmd vcmlm d to ilia- st_ ( im.” ( llkmiunn a`
olling Deparlii;C:nt within 30 Cj�JM;;of tJ�r tlirt�C ��t�ar e t1�ruion datt.
l;we certify that all statements on dii, ot�rn ate 11 LW u> dw ht�si of myrotn 1;1ww1ctir_(. li',se mil aic the tw,`net(s) �)l tlu
property described above, by viritr;of it dceti Iccoldk�d iHi kfi p.istcr W,Dcct!S (ifiwc.
Nin ber of bedrooms
*Arty iii fofiawiori that is tnisielzreseuted miry result in ilre srtnitatV pcalttit 1wI]Ig vol)t:-d 1) the l'l,tuninw cti %onin}r Ueparttrurtt_
Include with this application a rocoi(led warranty deed Irozn thy= Rcgistet of i),.(.rd fticc a tit i a',If)I of tht. cci,I t-d suIvcy neap
iefercnce is made: in the warranty 1-red_
(REV, 08/05)
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
is to certify that I have inspected the e tic tank
'Orving the P
residence located
Section -31
l f f x-1iL� D T N, R- _W, Town r�f
the tank Upon inspection, I certify that
and baffles to be in good condition, I have found
functioning properly. and it appears to be
i.,ast time serviced: L
flow back occur from absorption system?
— -- Yes _ No
(If . no, skip next line)
APProximate volume or length of tame: —
!-aPa city:/D7-+v --- -- gallons _ minute
Construction: Prefab Concrete Al
Steel Other
t,7ranufactu er: (If known ---------_- --
• LL/d c ail c9t.c,/,✓
Age of T k (l f known) ,:
{Si ture} air✓(Name) Pease print
/-01i t Te�) ------- 2- 6��
(License Number) —��- --- -
Date
I`orm to be completed by
Statutes} or Licensed Disposer s(NR Plumber 13 Wisconsin5 AdminWSSCOnsi_n
Code)
trative
Plumber (applying for sanitary permit) Certification:
111 accepting the above statement regarding
condition, I certify that the tank to he eteof my knowseptic ledge will
conform to the re irements of ILHR 83
inspection openi n" over outlet baffle s• Adm. Code (except for
Name
Signatu
MP/MPRS_W�o
VOL 1496 PAGE 22'7 6��-P, s
KATHLEEN H. WALSH
REGISTER OF DEEDS
STATE BAR OF WISCONSIN FORM l-199S ST. CROIX ca., WI
Document Number WARRANTY DEED RECEIVED FOR RECORD
03-17-2000 10:00 AM
This Deed,made between James W.Bailla eon and LaVonne A 1Ra;Ilar,2con WARRANTY DEED
husband and wife_as ioint tenants, Grantor,and James W. Bailla EXEMPT # 16 eon and CERT COPY FEE:
LaVonne A. Baillareeon. Trustees or their successors in trust under the COPY FEE:
James W. and LaVonne A. Bailla 9e0n lAviny Trust dated April 27 19984 TRANSFER FEE:
and any amendments theretq Grantee. RREECORDING FEE: 10 .00
Grantor,for a valuable consideration conveys to Grantee the following described
real estate in St.Croix County, State of Wisconsin:
Recordin Area
Name and Return Address
James and LaVonne Bailin Leon
872 210'x'Avenue
Somerset,WI 54025
/f038-1078-70-000
Parcel Identification Number(PIN)
This is
homestead Property.
A part of the Southwest Quarter(SW 114)of the Southeast Quarter(SE 1/4)of Section Eighteen (18),Township Thirty-
one (31) North, Range Eighteen (18) West, described as follows: Commencing at a point on the East line of said
Southwest Quarter (SW 1/4) of Southeast Quarter(SE 114) which is 33 feet North of the Southeast corner of said
Southwest Quarter (SE 1/4) of the Southeast Quarter (SE 114); thence North along the East line of said Southwest
Quarter(SW 1/4) of the Southeast Quarter(SE 114) a distance of 512 feet; thence West a distance of 512 feet; thence
South parallel with the East line of said Southwest quarter(SW 1/4)of the Southeast quarter(SE 1/4)a distance of 512
feet, thence East parallel with the South line of said Southwest Quarter (SW 1/4) of Southeast Quarter (SE 1/4) a
distance of 512 feet to the point of beginning.
Together with all appurtenant rights,title and interests.
Grantor warrants that the tide to the Property is good, indefeasible in fee simple and free and clear of encumbrances
except subject to existing highways and subject to easements and restrictions of record,if any.
Dated this 8th day of September.1998.
! 'Jam s W.Baillargeon
V i
'LaVonne A.Baillargeon
AUTHENTICATION ACKNOWLEDGMENT
Signature(s)James WBaillargeon and LaVonne A.Baillargeon STATE OF WISCONSIN )
a thenticated this 8th day of September,1998. ST. CROIJCCOUNTY )
Personalty came before me this day of
1998, the above named James W. Baillargeon and LaVonne A.
Baillargeon to me known to be the person(s) who executed the
o h P.Earley foregoing instrument and acknowledge the same.
MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by§706.06, is tats.) .
THIS INSTRUMENT WAS DRAFTED BY Notary Public,State of Wisconsin
Joseph P.Earley,Attorney My Commission is permanent. (If not, state expiration date:
New Richmond,WI 54017 )
(Signatures may be authenticated or acknowledged.Both are not necessary.)
*Names of persons signing in any capacity should be typed or printed below their signatures
I
Property Owner_ Parcel ID# / Page of
❑ Boring# Boring J
91pit Ground surface elev., 26. 7 ft. Depth to limiting factor in.
R*Eff#1 cation Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots Dlft?
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#2
F-1 Boring# ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor )n 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
F-1 ❑ 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.Collor Gr.Sz.Sh. 'Eff#1 I 'Eff#2
Effluent#1 =BOD,>30<220 mg1L and TSS>30<150 mgll. 'Effluent#2=BOD5 130 mg/L and TSS<30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330(8.6/00)
WiisconsinDepartment ofCnc rcA SOIL EVALUATION REPORT Page of
Division of Safety and Bulldi t
m atxprdatit'.ie`wkh Comm 85,Wis. Adm. Code
Attach complete site plan pnp8per riot less than 81/2 x 11 inches in size.Plan must
County<4
include,but not limit `toi,vertical and horizontal reference point(BM),direction and Parcel I.D. 3
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Q 3Y— 70—X0
Please print all information. Revie by D7)21 Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). /,/5
Property Owner Property location
{l Govt.Lot 1(-J 1/4 JL 1/4 S 3 T 3� N R/ E( W
Property Owner's Mailing Address Lot# I Block# Subd. Nance or CSM#
City State Zip Code Phone Number ❑City ❑Village Town Nearest Road
❑ New Construction Use: 'dential/Number of bedrooms�� Code derived design flow rate SV GPD
Replacement , Public or commercial-Describe:
Parent material Flood Plain elevation if applicable /v /¢ ft.
General comments
and recommendations:
e
System Type System Elevation r ��
M Ong# ❑ Boring �j rte,
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
G' 5
M. B.Ning
pit
T # ring
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
•Effluent#1 =BOD.>30<220 mg/L and TSS>30 5 150 •Effluent#2=BOD,<30 mg/L and TSS<30 mg/L
CST Name(Please Print) 4rature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 �-- j 715-246-4516
Page _._of
Parcel ID# .__�.. ---- �--
Property Owner—____ ----—
❑ Boring 1
Bonng# Ground surface eiev. I , ft. Depth to limiting factor - �, in soil lication Rate
Q Plt Roots GPD/fF
Horizon Depth Dominant Color4 Redox Description I Texture Structure Consistence Boundary •Eff#1 'Eff#2
i in. I Munseii Qu.Sz, Cont.Color ! Gr.Sz.Sh.
i .
I
i
i
1 )
i
—1 ❑
Boring
j Bo rin g# ❑ __
ft Dap ro limiting
In.
o
licat i on Rate
pit Ground surface eiev
t GPDIff
r Roots onsistence Boundary
I Horizon Depth Dominant Cdol Redox Description ! T extura f Structure •Eff#1 'Eff#2
in. Munseil Qu,Sz. Cont.Color Gr.Sz.Sh.
t
Y
t
I f
i
i I
e
i t
Boring in.
Boring v, f. Depth to limiting factor ication Rate
n9 surf-ace ele Soil
❑ Pit
Ground _-
Boundary Roots GPD/ff
Texture Structure Cons
isience rY
Horizon 'lepth Dominant Color Redox Descriptor, { `Eff#1 'Eff#2
in. Munseil Qu.Sz. Cont.Color Gr.Sz.Sh.
e
1 j
t
i
1 j
� I
r
> < fL and TSS>30 150 mglt `Effluent#2=BODS<30 mgli..and TSS<30 mg/-
•Effluent#1 =BODS 30_220 rrxy _
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.
S1313-8330(R 6M)
Soil Test Plot Plan ,
Project Name James Bailargeon Trust Shan, d
Address 872 210th Ave
Somerset Wi 54025 M #226900
Lot ------ Subdivision --------- Date 4/14/15
S W 1/4 SE 1/4S 18 T 31 N/R 18 W Township StarPrairie
❑ Boring 0 Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of wood corner post
System Elevation 98.4' *H R PSame as Benchmark
AL—Property Line (not to scale) 300' 96.5' B.M.*
97' 97.5'
B-2
❑ Scale = 1 /4" = 10'
6 acre site
2% Slope
❑ B- 1
B-3
Failed
drainfield
ST
Property Line (not to scale)
o Well
_f
Existing 3
Bedroom
House
21 0th ST.