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HomeMy WebLinkAbout040-1260-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 578992 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: Village X Township Parcel Tax No: Wilber, Brent & Jennifer City Troy, Town of 040-1260-20-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 18.28.19.1391 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head T DH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 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 Bed/Trench Edges Topsoil Yes R No 0 Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 394 Deer Valley Drive Hudson, WI 54016 (NE 1/4 NE 1/4 18 T28N R1 9W) Deer Valley Lot 12 Parcel No: 18.28.19.1391 1.) Alt BM Description = Bldg sewer length = - amount of cover = _ I 1 revision Required? Yes No - other side for additional information- Date Insepctor's Signature Cert. No. 710 (R.3/97) RECEIVED '00W444 Safety and Buildings Division County (Z /X ,i JUN 12 ZQ 15 201 W. Washington P. Q. Bo 161lk Sanitary Permit Number (to be filled in by Co.) P' Madison, WI 7 62 $ XJS'Te CROIX COUNTY ;74E 47 MUNITY DWVI-LOPMENT 0 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit r---- is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 1 m , Slats. 1. Application Information - Plea a Print All Information 00, Property Owner's Name Parcel # t & 09 Le:~4 Gtl& 0q0--1266 -zo Property Owner's Mailing Address Property Location i / 3 f r +67 Govt. Lot f/( City, State Zip Code Phone Number AV 15 y, C 4Section / (circle one that apply) Lot # T N; R E o II. Type of Building (check all 0~ or 2 Family Dwelling - Number of Bedrooms / Subdivision Name aGGv cti..~. Block # ` t-- A L L C El Public/Commercial - Describe Use ❑ City of tw~ ❑ State Owned - Describe Use ~ec e► CSM Number El Village of Own of Z zz r III. Type of Permit: (Check only one box on li A. Co plete line B if applicable) A. KNew System El Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Trahsfer to New List Previous Permit Number and Date Issued Before Expiration Owner 04, IV. Type of POWTS System/Component/Device: Check all that apply) ,(Non-Pressurized In-Ground El Pressurized In-Ground El At-Grade L1 Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil A tt❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: Desi n Flow (gpd) Design Soil Application Rate(gpd Dispersal Are Required (sf) Dispersal Area Proposed ( System Elevation a0 8 S VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks c y Septic or Holding Tank Z ~1 J z r ~s Dosing Chamber D o Da 1 ` VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/N4P19-Number Business Phone Number /UeLtyAJ Z 9 7S" Z7 Plumb is dress (Street, City, State, Zip Code) V1II unt /De artment Use Only Approved appro Permit Fee Date Issued Issuing ent Signat e er' ~.,enRe.son Q IX. Condlt(MRdReasons for Disapproval Z i. "Septic tank, efHt~?ant I~tst aiitl + ttrs*sal cell must all be Sibl s I malbtained es per management plan provided by plumber. +R. tl reglJli m. ellts must be maintained as Per VOW" 66* / ordklances. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/I1) . i Z ~ fa8 V w~ \ o ~o m ~ " U ~ W w Ol U '4%-_i \ ` ~o , ~ CIA- t1 0' ~ AID a t M~ D ~ 6 \ a U ~ I. O O co cc ~'s, ~ a ~ ~ csJ II -4 04 0.199 x Y-0,9 ~cYj N OEI - ado c \ `F` - M CV, C6 00 z oci 10) CID Ar e sa m s, N i j 1 v~ m to ~88 aN , d c~r1 m Oo m S~ I bjdb m a at O III j J1 \ 0 CL 'M 010 1 .m , W w I 1~1~,,`\ ;p 4L8 a X rvoo LL m ~~pG - -OL9_ 0 Q ~ U Z 6 _ X G 5 ti 860 " ~ Wb HWLs85q.0 L.L W cC bsg ~C l c o ' u LL CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: C-AJ Owner's Address: ~A (B t U c N `O SK0/ Legal Description: Ai r- me f Township: Tf`aV~ County: j f C X-0 / Subdivision Name: ~LL Lot Number: Parcel ID Number: Z!) --Dao Page 1 Index and title Page 2 Plot Plan ! c~t6'EyR Page 3 System Sizing & Cross-Section Page 4 Filter Specs lA fC arc r1P C Itiz U6 Page 5 Maintenance information Page 6 Management Plan 12 C ZOf f Page 7 St. Croix Cty Septic Tank Maintenance Form f~G,fien/ Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: 96f Ce& License Number: Z 2( Date: Z Phone Number 7/,s 773 fC~~ Signature Designed pursuant to the in-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 I \ figg o w Q p ~ p w} ~ \ u CC Lei c6 W w \ p z ~ X \ lqr DC Ch O ~`'b mac' \ t.. I Qk- fp \ It; CD C ? O Q -k- N m o o cc Co ah ~9 a M eta r ~ ~1 • ' 04 m W o"c 882. Y 1 J \ co ~ ,£"0~1 , i 00'~~ v. I Sa m Sri r, A~ I j 1 ~Q . to a 8 l~ ai m 00 6N m .fig ~r~ `3 0.V) 1 ~ r \0 m ut bjdb m V7 i ai O u I j0 tyh \ s~ °ild~s 0.S -yy• r n • \ di Vim, s ids ~ _ \ X i m ~~G~ oce. W w 20 5 ~q,`~ 3 5~ UZ _ X Q .v 860....... G ~ 858 LU ~ bsg U U- / f 1 Quick4 Plus Standard Chamber Side and End Views 0 48" (EFFECTIVE LENGTH) 12" i FAA 34" a t aui&4 Plus All-in-One 12 Encap Front, Side and End Views 1 13" 8" INVERT 8" INVERT ~ ~ 5.3" INVERT I T ---182" 33" 1 r Quick4 Plus All-in-One Periscope i OUICK4 PLUS ALL•IN-ONE ERISCOPEr- z (360'SWI VEL ) \l\ S 12.7" INVERT lin-GUICK4PLUS ALL-IN-ONE 12 15" ENDCAP -►j j Quick4 Plus Standard Chamber Specifications Size (W x L x H) 34" x 53" x 12" (86 cm x 135 cm x 31 cm) invert Height` 0.6", 5.3", 8.0", 12.7" Effective Length 48" (122 cm) (1.5 em, 8,4 cm, 18.5 cm, 22,6 cm) INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ( "Units"), when installed and it operated in a leachfield of an onsite septic system in accordance with Infiltrator's Instructions, is warranted to the original purchaser ("Holder") against defective materials and workmanship for one year from the date that the septic permit is issued for the septic system containing the Units; provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that Installation of the septic system commences. To exercise its warranty rights, Holder must notify Infiltrator in writing at its Corporate Headquarters in Old Saybrook, x Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units. (b)THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS; INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE (c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty INFILTRATOR does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. systems inc. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units: the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure to maintain the minimum ground covers set forth in the installation instructions; the placement of improper materials into the system containing 6 Business Park Road • P.O. Box 768 yi the Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, improper grease disposal, or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply with all of the Old Saybrook, CT 06475 terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any 860.577.7000 • FAX 860.577.7001 third party resulting from installation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Units must be iti'sfailed in accordance with all site conditions required by stale and local codes: all other applicable laws; and Infiltrator's installation instructions. 800.221.4436 (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.com original Holder. The above represents the Standard Limited Warranty offered by Infiltrator.' A limited number of states and counties have different warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook, Connecticut, prior to such purchase, to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units. .Ya'V C. ¢'ri kt,4 vw' tl~-~f~~ lad.~f~ferm.,'46cP'N iET U.S. Patents: 4,759,661; 5,017,041; 5,156,488: 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer, Quick4 and Quick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. is a registered trademark in Mexico. Contour Swivel Connection is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed in U.S.A. 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POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner r1~ Septic Tank Capacity 1 Zo v al ❑ NA Permit # Septic Tank Manufacturer fESLG12 ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units J$f NA Pump Tank Capacity 000 al ❑ NA Estimated flow (average) V40 gal/day Pump Tank Manufacturer L(} lES~R ❑ NA Design flow (peak), (Estimated x 1.5) f,,0al/da Pump Manufacturer 6 (A LO ❑ NA Soil Application Rate al/da /ft2 Pump Model P~ ttl~ ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODE) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD6) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ys in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ! ❑ NA i MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At !east once every: 3 ❑ month(s) (Maximum 3 years) ❑ NA 9 ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third W3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ® year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA ® year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA 10 year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA IM year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ ear(s) Other: ❑ 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 c,011(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding 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 of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. 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 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or r chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents I of the tank(s) removed by a sePto9a servicing operator prior to use. System: start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent: To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve.the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; :',foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products,. pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed., e The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN ' If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and shoul6l "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 that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name O IZ CL SO/V Name Phone '7 1 S- z 7 3 7 T Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Xo (-{,,Jja%~! 5a4nri fit• ev.1/ Name S~ CQd/X Zovl y Phone 7l5 Z 73" If~ P 1 hone E7rj~38b~1/b90 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Brent Wilber Mailing Address 75 Tribute Ave, Hudson WI 54016 Property Addres394 Deer Valley, Hudson, 54016 (Verification required from Planning & Zoning Department for new cons on.) City/State Hudson Parcel Identification Number 040-12 20-000 LEGAL DESCRIPTION Property Location N E V4 NE 14 , Sec. 18 , T 28 N R 19 W, Town of Hudson Subdivision Plat: Deer Valley Lot # 12 Certified Survey Map # , Volume , Page # Warranty Deed # _ T 7 V t (before 2007)Volume , Page # Spec house Dyes~]~ Ono Lot lines identifiable Elyesono SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 da s of the three year expiration date. b Uwe certify that all statements on this fo are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warran deed recorded in Register of Deeds Office. Numbe of bedrooms 4 ° kw-16 5 / 3i l ~5` SIGNATURE OF APPLICANT(S), DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) DEER VALLEY LOCATED IN THE AIE114 OF THE NE1//4, PART OF THE SE1/4 OF THE NEi14, PART OF THE Slit 4 OF THE NE114, AND PART OF THE NW114 OF THE NE114, OF SECTION 18, T28N, R19W, TOWN OI~TROY, 1V ST. CROIX COUNTY, WISCONSIN. F-1 FbT,Cl, ~ ~ Lot 4 c .3.0 .F IJ N 12 13 f4 9 IS \ a _ _ _ 9 802 w I332.1a' 21 21 of w,s J 24 J a H~1f \ . MATCH LINE _ Y/4v, SNECT I OT J SHEETS Ii ~►oil Absolratfon System 5111088Seotion k4' 5F9. ft Schedule 40 Final Grade VC Vent Pipe ith Vent Cap g 77 ft ~1- Leaching Chamber . t System Elevation :Soil Absoratfon System plan View ~S ft V. ft Vent Or Observation Pipe Leaching Chambers Trench 1 Trench 2 " Dia. 4 Header i..eachin Chamber Specif cation Manufacturer And Model EISA Rating ZD sq It per chamber Soil Application Rate d ~Z gpd/sq ft A gpd Design Flow + ~ 7 So' ll Application Rate T -o--_IZ EISA = Chambers 2 rows of- chambers each. ~~-t•~F J 7-7 S (page of APR-12-2005 16:28 FERGUSON ENT HUDSON 715 386 6144 P.01 NGOULDS PUMPS Submersible Effluent pump PE "'WW Pump SPECIFICATIONS MOTOR FEATURES Pump - General; General: ■ Corrosion resistant • Discharge: 1'/t" N P T • Single phase construction. • Temperature: 104OF (400C) • 60 Hertz ■ Cast iron body, maximum, continuous when • 115 and 230 volts X Thermoplastic impeller and fully submerged. • Built-in thermal overload pro- cover, • Solids handling: lh• tection with automatic reset ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing APPLICATIONS ' Automatic models include a • Oil-filled design. construction, float switch. • High strength carbon steel R ,Motor is permanently Specially designed for the ' Manual models available, shaft, lubricated for extended following uses: • Pumping range: see PE31 Motor service life. • Mound Systems Performance chart or curve, • .33 HP, 3000 RPM ■ Powered for continuous • Effluen0osing Systems PE31 Pump: • 115 volts operation. • low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor. working limits of the motor. • Heavy Duty Sump/ PE4.1 Pump: • ,40 HP, 3400 RPM ■ Quick disconnect power Dewaterfng • Maximum capacity: 61 GPM • 115 and 230 volts cord, 20' standard length, • Maximum head: 29' TDH • PSC design heavy duty 16/3 S1Tw with PE51 Pump: PE51 Motor. 115 or 230 volt grounding • Maximum capacity: 70 GPM • .50 HP, 3400 RPM plug. • Maximum head: 37T DH • 115 and 230 volts ■ Complete unit is heavy duty, METER5 FEET • PSC design . portable and compact. 4077 ■ Mechanical seal is carbon, ceramic, BUNA and stainless fE51r I I I I I I I MODELS: pF31, PE41, 7E51 Steel. 35 , l i l l 1 i irw .as, .ao, .so ■ Stainless steel fasteners. 10 30 BI I ~ ~ I~ ~ ~ o I „r r I 1 2 GPM i _ 1 I I ..1 ! 'i ' AGENCY LISTINGS I'II' r X 25 20 I I I' I t, i I C u i i ~ I 1 I Tested to U1778 and 0 15 r ; „ I I ' ) I I_~ I- ' , r ; J I I CSA 22.2108 Standards ~-~--~--r BY Canwim Standards Anq6DOn ~ , .1 ' ~ I i I• ~ ! I ~ I F1k #LR385 10 ^„--1 I ' I ~I I i ' I I ' I I x I i I ~I , Goulds I~+ntps 15 ISO 9001 Registered, 5 I I I I I ' I 1 I I I! I i{ I i' I l i I I I t l` ! l l' I ~l' I, I~ I I 0 00 10~ 20 3 40 50 60 70 GPM 8o 0 5 10 a 2004 ITT water Technology, in, CAPACITY 15 m3/h Goulds Pumps Effective June, 2004 ~E3 T/4T ITT Industries - Combination Sepac~Tank and 1 SPECIFICATI0~15 Pb-MP CHAMBER CRO55 SECTIO A yE1JT CAP. WEATHER PR0 Ju1JCTI0u BOX . ti'C.I, VENT PIPC APPROVEp LOCKING '-I0, fROM DOORr, . t'tA1JHOLE COVER wlv I wAR1Ji>JG LA.6EL. »SP10>J IPE .i1J00W OR FRESH S A~IIJTAKE: c couDulr w/ PrtRr s tm- are p> i I 151 AIIJ. t-+ 'PROVIDE IJLET AIRTIGHT SEAL I I I ' '"I III APPROVED JOIIJT 2P~~L Ptl WIC.I. PIPE DR APPRDYEO J0111T Tank construction I III I w/C.T. PIPE~W shall comply with I II ALARM _I II ILHR ()'3.15 and 33.20 a I . I I o~J C I I I PUMP "J 1%. OFF 0 COAICRETE RISER E:XIT PERMITTED OIJLV IF TAWK MAIJUFACTURZR HAS SUCH APPROVAL 81rp0 I NG sEPr1c F SPECIFICATIOUS DOSE TA 1.1K MAWUFACTURCR.: ~"4 TL C-MJCV-P_} 1JUMbER OF DOSES: PER DAy TA.1K ,IZE: GA.LLO-WS D05E VOLUME ALARM /'~AWUFACTURGR: SS~Z Z-~ s ~ 1'I~ IWCLUDIIJG 6ACKFLO~Wq: / GALLONS MODEL IJUMBER: 10L Hw CA CITIES: Ac Z30 d IIJCHE5 OR ~(I/CALLOUS SWITCH TyPC: - B = Z IUCHES"OR r 0~LLOIJ5 HUMP MAIJUFACTURCR:~~,/o "L c> Cr~-IUCHESOR ~ MOpEL 1JUMBER: ~ALLOUS D=~LHES OR 23 6GALLOJJS SWITCH TYPE: z 0•`~ IN' 1JOTC: PUMP AMI) ALARM ARE TO 6L l'1IMIMWl -DISCHARGE RATE ---v-- =-CpM INSTALLED OIJ 5EPARATE CIRCUITS VERTICAL DIFFEREmCE OETWCEI,! PUMP OFF AU0•.015TRINTIOIJ PIPE.. rEET fi Mlu MIJM NETWORK SUPPLY PRESSURE / L( ~i FEET OF FORCE MIN X Tj AL L.F/oo FLFRICT FEET IOU FACTOR.. FEET TOTAL. OtiWAMIL HEAD = 22,3 FEET As per.manUfacturer gal/in. Wisconsin Department of Safety IDfessional Services Division of Industry Servi SOIL EVALUATION REPORT Page 1 of 2 gIp arcs dance with SPS 383, Wis. Adm. Code Qy s1~` ~uMY ST. CROIX Attach complete site~an on I*A'Man 8 112 x 11 inches in size. Plan must include, but not limited tea orizontal reference point (BM), direction and Parcel I.D. 040 - 1260 - 20 - 000 percent slope, scaler} i ns, north arrow, and location and distance to nearest road. yON~~~ Please print all information, viewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I ?~D Property Owner Property Location BRENT E. & JENNIFER A. WILBER Govt. Lot NE 1/4 NE 1/4 S 18 T 28 N R 19 EE((or)W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 12 Deer Valley City State Zip Code Phone Number O-City' ■ Town Nearest Road ( ) NK Deer Valley Drive Q New Construction UseEj Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial - Describe: Parent material sandy outwash Flood Plain elevation if applicable NA ft. General comments Conventional In-ground Trenches loading rate and system elevation to be determined by licensed plumber. and recommendations: Additional borings required to move system out of construction area. Verified with Ryan Yarrington, Zoning )jja~ Specialist. Previous report dated 6-4-99 is attached as part of this report. J-o /3 13 -7 L9& a'f-V b,,- Boring # ❑ Boring 0 pit Ground surface elev. 880.20 ft. Depth to limiting factor 130 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 1 0-13 7.5YR2.5/2 - l 3fsbk&gr mvfr cs 3vf-co 0.6 0.8 2 13-45 10YR2/2 1 2fsbk mvfr cs 2vf-co 0.6 0.8 3 45-70 7.5YR4/4 1 lfabk dh cs 2vf-m 0.4 0.6 4 70-130 7.5YR4/4 s Os dl 0.7 1.6 Horizon 4 has some gr. I% tl i~ 7 Boring # ❑ Boring 880.40 6c) 136 El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicat 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 0-13 7.5YR2.5/2 1 3f-ma&sbk mvfr cs 2vf-co 0.6 0.8 2 13-25 7,5YR3/3 1 2fpr mvfr cs 2vf-m 0.6 0.8 3 25-33 7.5YR3/4 sl 2fabk ds cs lvf-m 0.6 1.0 4 33-39 7.5YR3/4 is lmsbk ds cs lvf-m 0.7 1.6 5 39-.136 7.5YR4/4 - cos Osg ml 0.7 1.6 Horizon 5 has some pockets of gr. * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si CST Number Mary Jo Hu ert Hollister's Soil Testing & Design) 224832 Address Date Ev I ation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 11-13-14 715-426-1775 SBD-8330 (1107/13) z W (v O ce ~ IT, Q G. $r *14 IA cJ o o -3 0 Cie ac 0 R Q z m a M ~ bey S, 0 4 VIA ~09 a I 1{ - 10 It- N "Odp + x - --'r ♦ ~ ~ 4 4 W ` C yu 1, ~ ~ 6L9 . LL. k~ * $ LLLJ Sgt E,,~ _ _ _ s GC V f 4' s,a Wisconsin Depirtment of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of d3 Labor agnd Human Relations • Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM),-dir-ectiamancl % of slope, scale or PARCEL I.D. # 040 dimensioned, north arrow, and location and distance to nearest road!/ APPLICANT INFORMATION-PLEASE PRINT ALL INF-MATION' REVIEWEDBY~~ DATE i PROPERTY OWNER: ._U .~.PR PERTY LOCATION Derrick Construction, Inc. o© .LOT NE 1/4 NE 1i4,S18 T 28 AR 19 Nor) W PROPERTY OWNER':S MAILING ADDRESS 7999 -L0 # BLOCK # SUBD. NAME OR CSM # 1505 H 5 GROX Valle CITY, STATE ZIP CODE PHO ITY []VILLAGE [x]TOWN NEAREST ROAD New Richmond, WI. 54017 (115) 2 - r, Troy E. Cove Rd. [ 31 New Construction Use [X] Residential / Num f'4 o_ n '4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2 . 8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 •8 trench, gpd/ft2 Recommended infiltration surface elevation(s) A=97.6-B=96.3/95.20 It (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft L S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ®S ❑U ®S ❑U 13S ❑U XIS ❑U 13S ❑U ❑S UU SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ' 1 1 0-12 10yr 3/3 none 1 2msbk mfr cs 2f .5 l 66 2 12-38 10 r 4 4 none sl lcsbk mfr if .4 .5 Ground 3 38-96 7.5 r 4/6 none cos os ml na na .71 .8 elev. 101.6ft. Depth to limiting factor q~,(oo +9Fi ~ 8y Remarks: Boring # 1 0-10 10 r 3 3 none 1 2msbk mfr cs 2f .5 .6 2 2 10-26 10 r 4/4 none sil 2csbk mfr w if .5 .6 .S A0 Ground 3 26-36 10 r 4/4 none 1 2 bk mvfr if .4- -rS- elev. 4 36-90 7.5 r 4/6 none cos os ml na na .7i .8 101.6 ft. Depth to limiting factor +90"' 8q Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200 v New Richm d WI 54017 Signature: Date: 6-4_99 CST Number: m02298 PROPERTYOWNER Derrick Construction SOIL DESCRIPTION REPORT Page2 of 3 PARCEL I.D. # 040-1070-10 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BourW Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-8 10 r 3/3 none 1 2msbk mfr cs 2f .5 .6 2 8-21 10 sl lcsbk mfr if .4 .5 Ground 3 21-90 7.5 r 4/6 none cos os ml na na .7 .8 elev. 100.8ft. Depth to limiting 1; - TO IT- factor--"'"- 0 511 a +90 Remarks: Boring # 1 0-10 10 r 3/3 none 1 2msbk mfr w 2f .5 .6 2 10-32 10 r 4/4 none sl lcsbk mvfr qw if .4 `.5 Ground 32- na. na .7 ' .8 elev. 98.2 ft. - Depth to limiting factor q4 9 S. Z-0 +84" 3W? 2 Remarks: Boring # 1 0-8 10 r 3/3 none 1 2msbk mfr gw 2f .5 .6 2 8-20 10 r 4/4 none is os ml w if .7 .8 Ground - s ml na na .7 .8 elev. 98.2 ft. Depth to 2 limiting factor +84" Remarks: Boring # Ground elev. i ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Ins- 1554 200th Ave. CSTM2298 NE4EN4 S18-T28N-R19w New Richmond, WI 54017 MPRSW-3254 town of Troy (715) 246-6200 lot #12-Deer Valley This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shoran as permanent lot lines were not established at the time the test was conducted. ;-1 =40' top of 1" pvc pipe C el. 100.00' Alt. BM.= top of 1" pvc pipe C el. 97.95' r~ I-Ik '.,5o 1 b 31 ` bit a~ Gary L. Steel 6-4-99 Olisbemsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor end Human Relations - Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Cro ix not limited to vertical and horizontal reference point (BM), direction•aryd % of slope, scale or PARCEL I.D. # ld& o- ' dimensioned, north arrow, and location and distance to nearest road. 040_}g~g.~-- APPLICANT INFORMATION-PLEASE PRINT ALL INF"MATION'\, REVIEWED BY DATE PROPERTY OWNER: ":-;J PROPERTY LOCATION Derrick Construction, Inc. GOVT. LOT NE 1/4 NE 1/4,S18 T 28 'N'R 19 5(or) W PROPERTY OWNER':S MAILING ADDRESS ,z?~ 9 LOT # BLOCK # SUBD. NAME OR CSM # 1505 Hwy 5 ` r x na Deer Valle CITY, STATE ZIP CODE PHO _ - CITY VILLAGE MTOWN NEAREST ROAD New Richmond, WI. 54017 (715)24 Troy E. Cove Rd. 11 j New Construction Use [X] Residential / Numf 66t.5.1 4 [ ]Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd/ft2 .8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate .7 bed, gpd/ft2 •8 trench, gpd/ft2 Recommended infiltration surface elevation(s) A=97.6-B=96.3/95.20 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft 7uniss able fo r system CONVENTIONAL MOUND 7IN-GSIOUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK uitableforsstem CAS ❑U ®S ❑U ❑U 1JS ❑U 13S ❑U ❑S ~U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-12 10yr 3/3 mone 1 2msbk mfr cs 2f .5I .6 2 12-38 10 r 4/4 none sl lcsbk mfr CIW if .4 .5 Ground 3 38-96 7.5 r 4/6 none cos os ml na na .7 .8 elev. 101.6ft. Depth to limiting factor q? ~o +c)6,, ~ gy Remarks: Boring # 1 0-10 10 r 3/3 none 1 2msbk mfr cs 2f .5 .6 2 10-26 10 r 4/4 none sil 2csbk mfr if .5 .6 Ground 3 26-36 10 r 4/4 none 1 2 bk mvfr if "1 -,-5- elev. 4 36-90 7.5 r 4/6 none cos os ml na na .7: .8 01.6 ft. Depth to limiting factor -17 +90" ~8 gY Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200 v New Richmond. WI 54017 Signature: Date: 6-4-99 CST Number: m02298 j Wisconsin Deparwientoflndusuy, SOIL AND SITE EVALUATION REPORT Page 1 of 3 l ebot and Human Rellations Division of safety & Widings in accord with ILHR 83.05, Ws. Adm. Code . COUNTY Attach complete site plan on p--9w not less than a 1/2 x i 1 inches in size. Plan must indude, but not limited to vertical and hotinntal reference point (BM); dt ptraI4 % of slope, scale or PARCEL I.D. # I dimensioned, north arrow, and location and distance to nearest road1. APPLICANT INFORMATION-PLEASE PRINT ALL INF"MAT10N` R IEWEDB.~ DATE -1 2dt PROPERTY OWNER + . p 4PERTY LOCATION Derrick ConstructiFm, Inc. 1 . LOT NE 114 NE 114,S18 T 28 N,R 19 Oaor) W PROPERTY OWNERS MAILING 10DRESS 17999 _ # BLOCK # SUBD. NAME OR CSM # 1505 Hwv #65 ~T CFOX nowar Vail CITY, STATE ZIP CODE PHOW ft& []VILLAGE DOWN INEAREST ROAD WI. 54017 (715) Troy _ E. Cove Rd. [:j New Construction Use [A Residential ! Nu beo1~ [ J Addition to existing buiking I I Re*cement [ ) Public or amnemial describe Code derived daffy flow 600 _ gpd ReDtkltmended design loading rate _,L7 bed, 9pdAt2 .8 trench, gpolft2 Absorption area reWired 853 bed, ft2 750 trench, 112 Maximum desip baling rate .7 bed, glxW . 8 trench, gpd1ft2 Remmmended inli tration surface elevation(s) A=97.6->=96.3/95.20 it (as referred to site plan benchmark) AdditioriN design / site consider Am na Parent material ou twash Flood plan elevation, t applicable na g S - Suitable for ~EMRS DNVENTIONAL MOUND IN-GROUND PRESSURE ATGRADE SYSTEM 0V FILL FI XDM TANK u=Unsuitable ❑u CBS ❑u ®s Du ~ls ❑U [~s Ou ❑S Iml I SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consislence Bo nld3y Roots GPD/ftin. Munseli Qu. Sz. Cant. Cola Gr. Sz. Sh. Bed tench 1 .5 .6 mfr if .4 .5 GfQ 3 38-96 ml na na .7 .8 11 .6 to 9-7011,3'P-14z t1 [ 3 ~S S X iu -n Deo limiting I factor E ~ 8y Remarks: Boring # 1 0-10 10 r 3/3 none 1 2msbk r cs 2f .5 .6 2 10-26 l r 4 4 nave 13 sit 2csbk mfr Q-w if .5 .6 26-36 10 4/4 none 1 bk mvfr if to ft 4 6-90 7.5 r 4/6 none Cos MCI mi na ro .7: .8 Dep limiting ID G~T N~ ~~t~ r V 17 +90 Remark:.: CST Name. Please Print Clary L. Steal Phone: 715-246-6200 Address: 1554 2 v New Richmabii W154017 Signature: Date: 6-4-99 CST Number. mO2298 PROPERTYOWNER Derrick Construction SOIL DESCRIPTION REPORT Paget 0 3 PAMELLD.# 04Q-10 70-1C Boring# Horizon Depth Cominant Color Mottles Texture Struftre C oe Bouifty Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed lwr c 1 0-8 10 3 1 mfr cs .5 .6 3 2 8-21 1Q= 41A Mfr Crw if A .5 Ground 3 21-90 7.5 r 4/6 ncme cos ova ml na na .7 .8 100.811. Depth to inuring factor Remarks: Boring # 1 0--10 ! r 3/3 none 1 2msbk mfr 2f qi. 10-32 -10v-r 4A ncm 81 lcsbk --if Grand .7 .8 -na elev. f . 98.2 it Depth to uniting tf factor 9S.ZO 3t:/3 2 Remarks: Boring # 1 0-8 1 3/3 none 1 2msfk mfr 2f .5 1.6 2 8-20 10yr 4/4 none is 08 ml if a- gw El .7 .8 8 3 2Q.-A4 na .7 .8 w GGmund 98.2 ft Depth to urruting +84„ Remarks: Boring # Ground elev. ft. 1 1390 to factor Remarks: ~-833o(R•o5~zi STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Ixtec1554 200th Ave. CSTM2298 MkM4 S18-T28N-x19w New Richmond, WI 54017 MPRSW-3254 town of Troy (715) 246-6200 lot #12-Deer Valley This soil evaluatim was caiduated to satisfy -a zoning requirement, it may or may not be suitable for your use. The locatican of the test may or may not be as shown as permanent lot l-.aes were not established at the time the test'was vonducted. t .-~T r1 EMS ' top of 1" pvc pipe @ el. 100.00' ,Alt. BM.= top of 1pvc pipe 0 el. 97.95' a~ 41 'Olt r . Gary L. Steel 6-4-99 1 14 d fT a n / m 854 g58 ~ ~ 0-b58c'tM~ 098..... 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