Loading...
HomeMy WebLinkAbout032-2126-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CCOIX Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 578966 GENERAL INFORMATION 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 Township Parcel Tax No: Jesse Schmig TOWN OF SOMERSET 032-2126-30-000 CST BM Elev: Insp. BM Elev: BM Description: Secti n/Town/Range/Map No: 05.30.19.1131 TANK INFORMATION ELEVATION DATA 4XtL-AVaAbf- TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. N Septic (N 2 ZS_ ODV Benchmark D l/ I-c) ~I\ IDll Dosing A/M Z Alt. BM V t l ~4er~tttln Bldg. Sewer ` 9,t Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t r 1 Dt Bottom i D Din t Header an S' Aeration Dist. Pipe 3. Holding Bot. System Final Grade L l PUMP/SIPHON INFORMATION Manufacturer GPMand St Cover Model Number iss t V / TDH L^ Friction Los System Head TD w (-loFt ift Forcemaln Leng h,, Dia. Dist. to Well t SOIL ABSORPTION SYSTEM k BED/TRENCH Width Length IN o. Of Tromeft~t ^ 01A PIT DIMENSI NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z 1t SETBACK SYSTEM TO P/ BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION t HA~ MBE OR Type f ystem: 2-b ( '5Q ` ` b' Model Number: DIST N SYSTEM ill J Hea ~ r Pipe(s) Distribution Zx / x Hole Size 3 x Hole Spacing nt ugl) to Air Intake ~j~ /y t V! t L / l.I ~I/~ 1Length Dia Length~_ Dia_r Spacing i to I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Q Depth O er IDepth Over 1 xx Depth of jxx Seeded/Sodded Mulched Bed/Tr r r' 1, I Bed/Trench Edges J T'?) Topsoil ` es Ej No Yes ~ No CO MEN (Include code discrepencies, perso s present, e Inspection #1: I l(J Inspection #2 Cho ~ /t/ is Y I~ Noy ° Ex«va-hnq CbM an cbMP ~l~ 2 l" : 9,#a- Location: 17 41ST S tk~t&hA co-p 1.) Alt BM Description = L'~t Cw ~1t-- ~x i' ~ilJ1G, JUC.. 2.) Bldg sewer length = r~ ► Mai I~ an e6sll uve1\ mu`~ n t amount of cover = I \ 06 '*A, ow D tb~ boy n a` { kvill" Cate 6~ F~~v~ ~vlw v~, e WGS r~'~ ,t\s'so~~b b-S Plan revision Required? ❑ Yes KNo ' r Use other side for additional informa on. I Insepc or "Date igna ure Cert. No. SBD-6710 (R.3/97) ,~,1 Nl /nsl~~d Main ~enc~ County a~ Safety and Buildings Division ti 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled to by Co ) P~' - Ni 15 Madison, Wl 53707-7162 9 cRolx aauN~^r k state Trannsac ion Number .OMMU ry ermit Application aS accordance with Wis. Adm. Code, submission of this form to the apPtnpr1aft governmental unit t bra 3R321(an ' ~ required prior to obtaining a sanitary permit Note: Application forms for stare-owned POWT5 arc submitted to Project Address C different than mailing aadress) the Department of Safety and Professional Savies. Personal information you provide may be used for secondary / tl seer in accordance with the Privacy Law, s. 15. 1 m , Stats. L A, lication Information - Please Print All Information Perccl p Property Owner's Name e ~ -a! a J Et S 1 JL/ ~ Property 1,ocatron / Property Owner s Mailing dress J I ! 3 a r ~nz / SO I Govt Lot City S Zip Code Phone Number TN; Rl / E°nW J IL /Type of Building (check all that apply) Lot # Subdivts Name ~ i 2 Family Dwelling -Number of Bedrooms z ,3 r ~C -ems lock W ❑ Public/Commercial - Describe Use f'~J L~ ❑ City of hb CSM Number ❑ Village of ❑ State Owtxd -Describe Use Town of O/Y 1 S 'X MaL)fUf3 CELL III. Type of Permit. (Check only one box on line A. Complete line B if applicably A. System ❑ Replacement System ❑ Treatment(Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Numbs and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New cI i, Ae / Before Expiration Owner TV. Type of POWTS S stem/Com onwtJDevice: Check all that a 1 ❑ Non-Presstnized In-Ground ❑ Presstuized In-Ground ❑ At-Grade =24 of sole le soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretmit ment Device (explain) V. Dis rsal/Treatment Area Information: Design Flow (gp Design Soil App cation Rate(gpdst) Dis Area R ircd (sf) Dispersal Area Pro (sf) Systun levauon I D ~ j\ l ~J 112.5 /128 VL Tank Info Capacity in Total # of Manufa.rrer „ c Gallons Gallons Units )gyp y _ / New Tanks ~Fv isbop Tama I Aaf W Q aU rn" cn :i 'v` Sepac a Holding Task 7 44, t Dosing Chamber' /t i7 VII. Responsibility Stateme t- I, the undersigned, assume r biGry for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si MP/ vtPRS Numbs Business Phone Nurn Address (Street, City, Staic, Zip C_W Plumber's n / J Y!5 2, IaF~qlet , CountvlDe artment Use Onl Permit Fee Dattiss ed Lssuimg. Sign at* Approved rov ~j S ❑ cGiven Denial D~ Con`fYDI bt i nS-hAIl2 , p e uenn fRrfl~h isa rover] n MC° pP ~voSi ~n 1. Setic to dispersal cell must be 5ery~ced 1 maintained ~j as per management plan provided by plumber, 2. Atl setback] cable code/ordinances. aintained requirements must be as per app Attacb to complete plans for the system and submit to the County only os paper not trss than g ra x l l inches in size SBD-6398 (R. 11111) SHAUN R BIRD Page 2 4/28/2015 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L Shandorf Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART'code: 7633 pat. shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm I ~I i ~ )t ARTNFyT DIVISION OF INDUSTRY SERVICES 11%, 10541 N RANCH ROAD P HAYWARD WI 54843 t;Q Contact Through Relay rt S o- http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~o~FssrorScott Walker, Governor Dave Ross, Secretary April 28, 2015 I 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: 04/28/2017 Identification Numbers Transaction ID No. 2531100 SITE: Site ID No. 811701 Jessie Schmig Please refer to both identification numbers, 1708 41 ST St above, in all correspondence with the agency. Town of Somerset St Croix County SW I/4, SW 1/4, S5, T30N, R19W FOR: CQN Description: Mound, 3 bedroom residence A Object Type: POWTS Component Manual Regulated Object ID No.: 1531763 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s Mound Component Manual - er. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - R01FV-S Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter pw S,Q14 Q 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 5E 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: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it i SHAUN R BIRD Page 2 4/28/2015 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L Shandorf Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm I PLOT PLAN PROJECT Jesse Schmia ADDRESS 219 Indian Trail South Afton MN 55001 SW 1/4, SW 114S 5 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 100.0' DATE 4/6/15 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 Ilk BENCHMARK V.R.P. bottom of shed siding ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Property Line Wel l is to meet all WDNR setbacks Shed Grading is to be done to divert run-off away B.M.* 99, from system 98' B-3 B-2 97' O r, Bed roo Ho 7% Slope i B-1 Area 15' below 41st. St system is to remain Huffcutt Combo Ta~ k undisturbed OHM Tank is to be pra rly bedded and provided Rand with Iockdown covers with approved warning lebei§ Scale = 1/411 = 10' I Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/ 6/15 Owner:Jesse Schmig Location: SW1A SW1A S5 T30 N,R19W 1708 41st. Somerset Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# ,~`ON~~LY 1. Cover Page pR OVE~ p,ND 2. Mound Plot Plan ~~NPL SERV~~v,CES R~ 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section o~ E 6. Pump Curve CORRES~o 7-8. Maintance and ntigency plan 9-11. Soil test 12. Filter Specificati ns d cross secti Shaun Bird Signature License nu er 226900 Mound System Cross Section and Plan View Dimension Feet i i g l i D U T i ~ ♦ ~ y ti ~ r r J Jryxr~~r.J J r ' J J J r J lL rl! ! r J+ J l 1 ti?y 4 J J J l.',, y. { + `!}r~i:iii`•}:r,`•`r`r`i{i.i.i:r•r:J"r: r.r.?•r• ~J~J~ J.?y?L "'1tAA•• /~7 .r.I ~J 1 J J J Jyr J~JV?4rRJti?iJtiJ \ J S f .i.J. r G 1 1 , J ~ , r1 K i i L - Z U K B Slo e L i - -1 = Topsoil = ASTM C-33 = Clean aggregate = 4 it do p pvc Cap Material ~ sand fill '/2 to 2 I/2 in. dia. observation pipe L Geotextile G 11 Fabric F OVA D E Plowed Surface 167L), OFt Contour Slope Direction _ basal area out along the design conur. GENERAL INSTALLATION: The mound area is p owed with a moldboardlor III vegetation is mowed and raked off the site. The mound chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to sand or a 1/44 inch soil to wire when a sample is rolled between the palms of the hands. ASTM C-33 quality is placed imme after plowing. Sand is placed with a tracked machine keeping 12 or more inches S of sand undser th oneks or is placed overhead by a backhoe. Special care must be used when placing thickness to minimize compaction of the plowed surface. After the tops andap rotec lt from hfreezi~ bmoThe protect is seeded and mulched to promote vegetative growth, limit erosion observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/071gj Page of I Pressure Lateral Layout Two Laterals End Manifold ' f--- '1-breaded Cleanout Lateral Turn-up Plug Manifold - R M X - I - / J Long; Force Main Sweep r 90 r Bend V Distribution Network S ecitications Pressure System Construction Lateral Diameter In. Manifold Diameter 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. r~ Ft Lateral turn-ups terminate with it threaded L Lateral Len th M (Manifold Len th) cleanout plug and are enclosed in a 6-8 inch n. Force Main Diameter er 2- In. diameter lawn sprinkler valve box accessible r Ft from finished grade. _ Force Main Len th 0 • • • 0 • • Grade 6-9 Inch Lawn Sprinkler Valve Box Page of 03/05 193 I i And Pump performance Specifications Septic-Dose Wank Cross Section p ~=v Pump Manufacturer Manufacturer pump .a Tank Model Number ,<?j / Tank, Model Number Alarm Manufacturer L3 Total Tank Capacity !~zr Alarm Model Number Z -Max. Bury Depth Switch Type Total Dynanuc Head (TDH) - Feet Filter Manufacturer T' l Elevation Head Filter Model Number C) Distal Pressure Network Loss erforrnanee Required Force Main Loss Minimum Pump GPM Ft TDH Total ' 4" Above Grade Outlet Manhole Min. 4" Above Grade With Manhole Min. With Locking Device Locking Device, Inlet Manhole sacurely Mouated < 6" Below Car de Sealed Waterh~cht Weather-proof Junction Box r Finished G31'r-ade i Vent Min. 12" Disconnect Above Grade Means With Vent cap putlet Filter y - - Inlet Wet Baffle A 1/4,s and Reserve Capacity Weep Switch Scttugs GPI Hole Tank Volume = B Volume Gal. Dimension : Inches (reserve) A"`/ off Elation C (alarm) B 2 Bottom (dose) c D Elevation Z F1 (dead) D Total 4~L i ; . . with the ION bedded and back filled in accordance c/dose tank is as specified by the manufacturer may not GENERAL YNgT,i,AT: The Maximum depth of brad device (padlock) manufacturer's product approval specifications. a have an effective locking be exceeded without prior approval. Manhole covers exposed to tank with watertight fittings, and inlet and outlet is of approved material, con leeted to il1e VC to ridge installed. piping at the , The force main is sleeved with C 04and Commb 6 23.~e tank laid on stable soil to prevent settlmg or sagng complies with excavation and the sleeve is sealed watertight. Electrical service page of 02/05 U I Pi'R ti,N'J C -N7 AND DcY;AiERiN3 ~uRV` IT IY HEAD CAPAC~' 15~ MODE I , 5C , oa 2~` I 44 I I II c - - 3A J., i 1 - i a 8 - _ -1 _ z --r-- Z" 1 - } 4-1 I, to ,I 1 ,1 I fiO ,OC 0 60 4 GALLONS ERS ' QO ; - - LT C FLOW PER bIINU?L" CONSULT FACTORY FOR SPECIAL APPLICATIONS - a b: ~7 i 72 Timed dosing panels available. ed with , are available and suppied with Electrical alternators, for duplex systems an alarm. I switches are availab e for controlling single phase variable level contro systems • variable level float switches are available for variable Double piggyback T--y level long and short cycle Controls. Sealed Qwik-Box available for outdoor insiallaUCns. See Fh'1420 Over 130"F. (54°C.) special quotation required. I I ^ M 1521153 Series Y, Control se 1521153 MODELS Sim lax Du lax o MlodelTtys ts•Ph N .4 tL2 I I odo B'~ rt Je-' _f-- s~ w 1 'L" E 1552- r No t 2 or 3 E152 230 o 3_ - Auto i i3Et52! 230 _G5 Inclu.ed 2 or3 SELECTION GUIDE Non i Nt53 115 2013 - back variable level float r- T 115 Auto I Itl r -=r 2 0 3 1 single piggyback variable level float switch or double Piggy I BNt531 ------I--T Nom 5.3 Et53 230 53 ~ncudd 2 or swatch. Refer to FM0471- ~E3E153 1 230 Auta See=h'r9; 12'or correct motlel of Elect cal Altemator E-Pak nCAUTION 2. uallfied 3. variable level control snitch 10-0225 used as a control activator, specify duplex (s; All installation of controls, protection devices and wiring should be done by a g or (4) f1031 System. Health ncl Act uding the (OSHA)most . licensed electrician . All ele arical and safety codes should Safety and followed including recent National Electric Code (NEC) and the Occupational RESERVE POWERED DESIGN F For unusual ccnditions a reserve safety factor is engineered into the design of every Z_ Della( Gu MAIL TO, 60X,6347 40256-J3+? Aanv;aclurersot. tcursvi~ e 5H1P 70: 3645 Care Rc cad p oWSvii,e KY 440211 961 Q1LeC1rr P(/iL/F$ ,jlh'Cf • t 18C0' 9[3 Y~'44° x Z~ v ® (502,77!1-2731 z" =;a t1p FAX (502,, 774-3024 hnP;7/.zoeller.com / ` L Copyright 2000 Zoeiler Co A!I rights reserved. ST, aCROIX COUNT i( SEPTIC TANK IMAIN`I`l.?NANCT 2tURFF,1\ LNT AND OWNERSIIIT' CI~,1ZT7t~7CA1'It ~N PORM t / r Owner/Buyer - e SC u_rr! 1 5 S a Marlin Address .---L~ _ _~~--1~-_ _ _ - _ _ - _ _ __~r~ -~r1►~ -S--off Property Address -03 {Vertjtcatron required f )III Plammal; b. Zontnt, Oepatt-neat for new conslrut,liun-1 City/State - Parcel ldcntitication utabea- 0312' LEGAL DESCWH ION Properly Location ~(c~ , 5cc. I. ~U 'iV K W' Town 01 tP Subdivisi Lo on 1-~-~- Certified Survey Map # -r Warranty Deed # V:tlurrte 1 age P Spec house yes nu 1 ut tines identifiable ve., no SYSTEM MAINTENANCE AND OWNER CERTIFICATION lm}-)roper use and maintenance of your septic system Could result in its pr.rmature failure to handle wastes. Proper tnaintenauce consists ofpumping out the septic tank every three veals or sooner, it needect, by a licensed puurpez. What you put into the system can affect the function oftJte septic tank as a treatment stage in the wasre disposal system. Owner maintenance responsibilities are specified in §Conim. 83.52(1) and in Chaptm 12 Croix County Sanitary Otdinancc_ The property owner agrees to submit io St. Croix County f'itwnutg d'c l on,ng 13epar11ncrn a ecriii'icalion fixnt, siKned by the owner and by a master plumber, joorne.ynnan plumber, rest icled hh.imOm or a licensed pumper verif),1119 that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspcl;:ion and pumping (it ne(essary), the septic tank is less than 1 /3 full of sludge. l/wc, the undersigned halve read the ahovc recfuucn.icuis quid al;lec to maictain 11,10 private sr;wage disposal system with the standards set forth, ficioirt, as set bly the Departruclit oi'Counnercc anct the Dcparnncnt of Natural Rcsoun:cs, State of Wisconsin. Certification stetting that yotu septic. system has been inaintairted tmtst he complete, I and returr ed to the tit. Croix County Plauutnl., & Zornrg Departartent within ;30 ciavs of tine three, year eNpir<nio.n date- ]/'we certify that all staternernts ore this foc:rn atv: nuc to the bast of illy/our k uowlcdge. 1hve am/are the owlicl(s) Of the property described above, by vii-tuee o7wa y deed recorded iii Register of l)cet Is Office. Numb of bedrooms - - - SIGNATURE. OF APPI_ICAN 1(S) DA'1 Y :'**Any infonnation that is misrepresented nuty result iu the sanitary permit tieing n yoked by the Planning & Zoning Departanent. include with ties application a recorded warranty deed tioin the Register of Deeds 'office and it copy of the certified survey map If' reference is rtlade iii the warranty deed. (REV. 08/05) 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of SYSTEM SPECIFICATIONS PILE INFORMATION < Septic Tank Capacity owner al ❑ NA Septic Tank Manufacturer ❑ NA Permit # Effluent Filter Manufacturer f/ ❑ NA DESIGN PARAMETERS Effluent Filter Model ❑ NA Number of Bedrooms❑ NA Number of Commercial Units Pump Tank Capacity al ❑ NA PF-NA Estimated flow Pump Tank Manufacturer (average) c aUda / ❑ NA ~L 7 M . Pump Manufacturer s>~f ~7 ❑ NA I Design fkrnf (peak), (Estimated x 1.5) aVda V Pump Model 2- Z~ ❑ NA Soil Application Rate Monthly average' Pretreatment Unit Influent/Effluent Quality p Sand/Grdvel Filter ❑ Peat Filter Fats, Oil & Grease (FOG) 530 mg/L p Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODE) 420 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids , SS) 5150 m /L Manufacturer Pretreated Effluent Quality A Monthly average" pispersal Cell(s) s30 mg/L ❑ 1n-ground (gravity) ❑ In-ground (pressurized) Biochemical Oxygen Demand (BOOS) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade Mound ❑ Other. Fecal Coliform (geometric mean) S10` cfu/100m1 ❑ Ori ine Y, Inch diameter Values typical for domestic (non-commerclaq wastewater and Maximum Effluent Particle Size septic tank effluent Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event At least once every ❑ month ear(s) (Maximum 3 yrs.) Inspect condition of tank(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume At least once every ? ❑ monthsZyear(s) (Maximum 3 yrs.) Inspect dispersal cell(s) ❑ months ear(s) Clean effluent filter At least once every Inspect pump, pump controls 8 alarm At least once every ❑ montht3 Year(s) ❑ NA At least once every ❑ months ear(s) ❑ NA Flush laterals and pressure test ❑ months C1 year(s) ❑ NA Other At least once every 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 um and o check back u or hardware, effluent levels vi ually inscpected otcheck thfor The dispersal cell(s) shall sludge identify any effluent on the ground surface measure in or the observation he obg of of efflservation pipes and to check for any pondin9 of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation shall be of by a Septage Servicing Operators and disposed of inoacco dance with ch.., NR entire contents of the tank 113, Wisconsin Administrative Code. components at mechanical or pressurized a als of 12 months POTS components, pretreatt and The servicing of effluent filters shall be performed by a certifi d POWTS Ma stainer. other maintenance ce or or monitoring 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 f high chemicals e the contents of thtank(s) t reprocess moved and/or damage servtec ng spersal operatorllpn'orito use~ncentrations are detected hav _ Page of _ Presence of Painting products or other chemicals 11"'t For new UP AND constructi d have the contents of t START on, prior to use of the POWTS check treatment tank(sy for the OPERATION dispersal cell(s). if high concentrations are detecte treatment process andlor damage the may impede the a servicing operator prior to use. infiltrative surface. tank(s) removed by a septag the in tewater will b" System start up shah not occur when soil conditions are frozen at ater levels. When power is restored the xc surface di rge of 2ffiuena. ~,e pump tanks may f►11 above normal high ne cell(s) and may result in the backup nor to restoring power to tl During power outages p e dose, overloading a Septage Servicing Operator p ' tank removed by erarvici the pump controls to restore normal teve:s discharged to the dispersal cell(s) in one larg To avoid this situation hoe P' the contents ntor p~N(fS Ma npainer to assist in manually op the area within within effluent the pump pump or tank. contact ark over, or otherwise disturb or comps ct, Do not drive or park vehicles over tanks and dispersal cells. Do not drive or p life- of the POW- 1- mound or at-grade soil absorption area. im ve the performance and prolong the 15 feet down slope of any dis ere; d'+sinfectents; fat; a 9atiiondu 115 antibiotics; baby w~p cotton swabs; degreasers; dental floss; p medications; oil; P tre eas aherbi~cides; meat scraps Reduction or elimination WiPBBn cigarettellbutts; condoms' cotton 9 . (sump pump) water; fruit and vegetable peelings; gasoline; e pesticides; sanitary napkins; tampons; and water softener brine. Codeetaken to insure that the system is prop ~ilY ABANDONMENT out of service the following steps tshall ABAN Wisconsin Administra When the POWTS fails and/or is permanently taken ter Comm 83.33, and safely abandoned in compliance with chap e openings Sealed- • Ail piping to tanks and pits shall be disconnected and the abandoned pip operator. ace filled with s(uil, rl disposed of by a Septage Servicing • The contents of all tanks and pits shall be removed and grope y n g, tanks and pits shall be excavated and removed or their covers removed and the void sp • After pumps g, gravel or another Inert solid material. CONTINGENCY PLAN the following measures have been, or must be taken, to provide a code compi''Nnt If the POWTS falls and cannot be repaired a rep lacement soil absorption system. replacement system: be utilized for the location of n by requii!ed p A suitable replacement area has been evaluated and may with the ruled it tam m ust comply suit in the need setbacks from existing area and proposed replacement structure, lot lines and wells. Failure to protect mo the ment feplsys on to establish a suitable replacement area. Re advances in POWTS technology;f/ for a now soil and site evaluation effect at that time back ❑ A suitable replacement are is vai du piace the fai ed/POVVTSmitations. Barring holding tank may be Installed a la eso lrt e on failure of the POWTS a soil and iteinstalle evalualiV area. Up MU identify a suitable replacement available a The site has not been evaluated to a holding tank m{ at the infdtraliv ~ be performe to d e locate a suitable replacement area. if no replacement area is / a last resort to replace the failed POWTS. removal of the biome Mound and at-grade soil absorption systems may be reconstructed in place following surface. Reconstructions of such systems must comply with the rules in effect at that time. INSUFFICIENT OXYGEN. DO NIO SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND <<WARNING>> TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O` ENTER A SEPTIC, PUMP OR OTHER THE PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. - ADDiTIONAL COMMENTS T POWTS MAINTAINER POWTS INSTALLER blame ~ -~"-`•l Name ~ f r Phone .J Phone ~Aj _ r~ " 7 7 j LOCAL REGULATORY AUTHORt P MPER Name l?i SEPTAGE SERVICING OPERAT011 j - Name I--,' J ( Phone / J Phone 2 3 Wisconsin Administrative code. This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)8(f) and 383.54(1), O & O. w Q;8 ^Ul~rs, FILTER CARTRIDGE INSTRUCTIONS yt V j~n~~~~Z~~a~ TM Installation .r' STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the a tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. 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 optional supplemental side support. If side support method is not utilized, proceed to step four. I, STEP For installations utilizing tlcase. supplemental If de suppside support; ort method is not e solvent t weld the /<-inch pipe ono the filter utilized, proceed to step four. s y, STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning clockwise 90°. Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. . 2. Open the outlet access opening to inspect the tank and filter. j 3 layer Pump the bottom of the tank and anot just rtheoscum remove and effluent. the septic tank completely, 4. Once the effluent level has been lowered below the invert of the k outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm is present, the switch should be removed by turning counterclockwise 900 and cleaned I with water only. e 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 turning clockwise 900. 9. Insert the filter cartridge back into the case, pressing down until; the filter locks into the bottom of the case. 10. Replace and secure the access opening on the tank. BEAR ONSITE" FILTER CARTRIDGE - FIVE-YEAR LIMITED WARRANTY _ BEAR ON5ITE'" Filter Case -Lifetime L m ted Wa rn'Y Z;~ nu of J- w._,. is I.. is i. a ~ k A~, yxw ~~(yys~ 0534583 • rr~wo w Isaww MAW* House . \ \ \ IMN 23 \ ~snsr ~o a ~ ~ ti f H.W.L. l0~.00 ' POND / ~•~q +~w . sr.K k• N / z~. / ~v? k 9r A p 4l;ba f, ~ N J ~ f 4 s E w N s z Y ~e~~~ [ > e h N i o aae JJ ~(fr. ` y t s to , y l r, e' S e 3O 0 E W Q ozz t U2 ~ 33 I Y,~ Y Qa W ~~~Y ~ ~Y S Q a N a b 6' „ I I I ~ - I I n~-- ~ I r 1 tm w s S e % s. x IN,e ^ . a~ A i I 2e t+J . b 5 - i li i a t G it C\j U~~ ~ei~k a C m Q [ 6 w ~yyy °a JJ I 4 wZwZ s yy4 Q I j8~ m a I ~ 5 I I c deft I - i. I I I I i II I I___------ - P © , ♦ ~ o I I II I ~ II I ~ II I O ~B 1 °.e I a 11 I , I - y 1 1 I ~ t ~ I I I 1 i vie 1 .e < r s r. 1 1 L ~ C E I I ~ .o. ei saes,u•uoov Y, I I I 1 I I I I I I Q 86 ~b i ~I Prrperty _ Parml ID p Pogo Boma N ❑ Brnrp -Pit Ground suface ebv. n. Depth to kri4rq taROr n. Sol Rate Horizon Depth Dorninanl Cda Redo. Description T.- s- Consistence Boundery Root GPDrIP In. MurtseH Ou. Sz. cool. col. G. Sz. Sh. 'EtNt1 'E#2 z s-2 ~ -6(c aY-- / S -.n- rn / / a ❑ Balni, N n' Pil Gourd surface elev. n. Depth to HmiMp lads Or. Sotl ication Rale H- Depth Dom nanl Redo= Descripaat Texts Strvdura Conalsmnce Boratlary Roots GPDIIP MureeH Uu. Sz. Cart. Cdr G. Sz. Sh. •EMl1 'EIIk2 P-] F-I Box, N ❑ Bonrg ❑ pit GroutssurfacesHan R. Depth so ".V laWr N. Sol Application Rate Horzon •lepth DonvneM Color Redox DesaipHon- T.- structure, c -w- Bondary Roots GPDff Munasl W. Sir cont. Cdar G. Sz. Sh. 'EfWi •ERN22 'EIINremN1•BOD,>30 < 220 mgI and TSS X30 f 150 nV& ' Efluset N2 - BOD,<30 a iand TSS<70 myL The Department of Commerce is an equal oppotrunity 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 608-261-8777. seoona~i