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022-1024-30-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 579048 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: Village X Township Parcel Tax No: Kraft, Kenneth & Myrna City Kinnickinnic, Town of 022-1024-30-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: lob M I CS 09.28.18.132C -1 f6 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 17. ~7s CAPACITY STATION S HI FS ELEV. 5 v3•s ion Septic I Benchmark Dosing Alt. BM • 9G • !J cJ Bldg. Sewer ` .3t 9~, 1 ds f1diing 7 St/Ht Inlet A $ qz • .7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to r intake ROAD Dt Inlet Septic ~b Dt Bottom 14~ j dG , ~a Dosing t,/ -7,sa / 3p/ Header/Man. 7'T , $ 4)(* 4/ Aeration Dist. Pipe 7, a$ q` AZ Holding Bot. System ..7~ ~ ql t - 7 PUMP/SIPHON INFORMATION Final Grade p, d$ ON 7, Manufacturer Demand St Covert G 99 94. - O GPM Model Number V z4 z-!) i(" TDH Li~ 34 Friction Lboss_~ System H"/ j TDH Forcemain Length Dia.~ of Dist. to Well -71-66 SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Tren s PIT DIMENSIONS No. Of Pits Inside Dia, Liquid De_p DIMENSIONS !{S _,SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type f_System: / CHAMBER OR Q 'yam 13z ` /66' . fA- UNIT Model Number: rrlpJ ~IU 7 nJ DISTRIBUTION SYSTEM / Header/Manifold Distribution 3 Ix Hole Size ,r x Hole Spacing Ve✓ Air In L, Pipe(s) All 'L 5 I Length ~10 Length 7y' Dia 1126 Spacing Z' i SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil I es ®No s :ZN ] [ly • COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 478 Skyline Drive ; bq erts, WI 54023 (SE 1/4 NE 1/4 9 T2 IN R1*) metes & bounds Lot D o Parcel N,: A09.2,8.18.13JCS 1.) Alt BM Description 2.) Bldg sewer length = 3Z ~ re, - amount of cover 60- 00, ea V-_ rrrorv► ~,s a SP j 5 [ - - Plan revision Required? Yes No Use other side for additional information. 5 Date Insepc s Signatu Cert. No. SBD-6710 (R.3/97) I Plot Plan PageB of $ Property Owner Kf NVFrH j~ . /0 yiuJA K r<,- F-r I40ft Legal Description moi- of s~ A or- if,-- N, (except where noted) ,5 . q T ed, R/9 011; -rOVW or KIIANICAWAUQ.. ST d"tX _ IJ = Backhoe pit couN t 1, q0 ,~-G~~S North 3 8r-DRvoM (~AR~~ , pv~ ~cu r.~ ~r€ 7' # Z = 5 pT3 c! 7 I wh 4 Q~g-XIST:NG. TAd' ?o f3S /45RN ~D Jd~ i~a r N> 5+I DER sPS eatE ~ gF/A SCfi. Vd,~j , 9ygs~~ a `?6,56 ~ n ~Aj c N 9 Sy Sp r (Dal Site Loc 'on* R Y ~ z red ~x C E Safety and Buildings Division county C go ( X 201 W, Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 707 16 0 1 0 2015 V CROIX COUNTY ani to y ermit Application State Transaction Number In accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Z 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 urpoSes in accordance with the Privacy Law s. 15.04 1 m .Stets. S S i I 1 I c ✓ 11r' 1. Application Information - Please Print All Information Property Owner's Name Parcel # 6 /V 1"i ff K `-4 ZZ-/o=z-,54-30--oo Property Owner's Mailing Address Property Location Ow q -7 T 7c'J t Ll~ 1Z. (U L Govt. Lot City, State Zip Code Phone Number 57 6-- y, 1 r1/, Section Z -3 (circle one T 2 if N; R /g E ol0) II. Type of Building (check all that apply) Lot # Su;bdivision Name ~-t or 2 Family Dwelling - Number of Bedroom Block # ❑ Public/Comme rcial - Describe Use ❑ ❑ State Owned - Describe Use CSM Number ❑ Village of &Townof kIN/V(e(C1A1N/C u' x 5 r M ouNb LE LL III. Type of Permit: (Check on line A. Complete line B if applicable) 7-o NJL. A' ❑ New System Replacement Systetn ❑ Treatment(Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit, Renewal , ❑ Permit Revision ❑ Change of Plumber L6Per t Transfer to New 1 Before Expiration - I / W. Type o f POWTS S stem/Com onent/Device: Check all that a AM ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At a ound > 24 in. of suitable soil Mound < 24 in. of suitable soD ❑ Holding Tank ❑ Other Dispersal Component (explain) ce (explain) ) 7'V(J V. Dis ersal/Treat nt Area Information: Design Flow (g d) Design Soil pplication dsf) Dispersal Area (s ~ Dispersal Area PProp rsed (so System Elevation, or Tank Info Capacity in Total [ #4 of Manufacturer Gallons Gallons Units / L u New Taolo Existing Tanks I / f pli v r c iz % in w v a Septic or Holding Tank Sr-rC Dosing chamber 6.51.E 6 ~ e t VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name`(Print) Plumber' Signature MP/hfR•S Number Business Phone Number Plumb 's Address (Street, City, State, Zip Code) C- LL CJ a1/4(4 VIII. oun /D artment Use Only Approved ❑-ID roved Permit Fee Date sued Issuing Agent Sign ❑ Owner Giv Denial s to Z51 D: COQ iPEw ~al/Reasons for Disapproval ~~t1 da ()n S ~y,pa~O Vrn l C~ 1. Septic tank, effluent filter and - I` / dispersal cell must be serviced maintained uJ! f h +;11, S /~e 0- M r fi as per management plan provided by plumber. a3 ~ 2. All setback requirements must be maintained iC X / s, ll~ ~OW T5 as erapplicable code/ordinances. Attach to complete plans for the system an submit to the CO Inty Only on paper pOt less Jhan g in x it inches ~ ~ 0 l C(^^ S 0-e l"~ d a4- to sp,&W (I SBD-6398 (R. 11/11) hAR I DIVISION OF INDUSTRY SERVICES 0 1P 10541N RANCH ROAD HAYWARD WI 54843 Contact Through Relay 9 P S y G~ N7~s~ www.dsps.wi.gov/sb/ `cam www.wisconsin.gov A ~1 ~O ssfONAtis~ Scott Walker, Governor Dave Ross, Secretary February 06, 2014 CUST ID No. 224832 ATTN.• POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022-4011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/06/2016 Identification Numbers Transaction ID No. 2364113 SITE: Site ID No. 799473 Kenneth & Myrna Kraft Please refer to both identification numbers, 478 Skyline Dr above, in all correspondence with the agency, Town of Kinnickinnic St Croix County SETA, NE1/4, S9, T28N, R18W FOR: Description: Mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1469419 Maintenance required; Replacement system; 450 GPD Flow rate; 30 in Soil minimum depth to limiting factor from CQtat)' ' i `.1 original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Aplpk Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, R. 10/12), SSWMP Pub. 9.6; Effluent Filter T of S The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes $$10N and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be construc and located in accordance with the enclosed approved plans and with any component manual(s) referenced abo Ev/1S The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. a No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.14 . 6 ~pR 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. • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 6". The maximum finished slope of the mound surface shall not have a slope ratio steeper than 3:1 per the Mound Component Manual 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. MARY JO HUPPERT Page 2 2/6/2014 • 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 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. • Insulate building sewer per SPS 382.30(11)(c). 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. S' cere Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 -~P Patrice Sh &vier, POWTS Pl an tegrated Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered - dressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MARY JO HUPPERT Page 2 2/6/2014 • 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 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. • Insulate building sewer per SPS 382.30(11)(c). 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 res onsible for the installation, operation or maintenance of the POWTS. S~ ' Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patrici Sh orf POWTS Plan vie r , Integrated Services (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. Wi$MART code: 7633 pat.shandorf@wisconsin.gov y cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with Comm have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered . addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: KENNETH R. & MYRNA KRAFT Owner's Name: (same) Owner's Address: 478 Skyline Drive Roberts, WI 54023 Legal Description: Prt. Of SE 1/4 of the NE 1/4, Sec. 1, T28N, R18W Township: Kinnickinnic County: St. Croix Subdivision Name: NA Lot Number: NA Block Number. NA Parcel I.D. Number: 022 - 1024 - 30 - 000 Plan Transaction No.: Page 1 Index and title L S~Js Page2 Data entry Page 3 Mound drawings JSTRY SLR°;r3C,~.S Page 4 Lateral and dose tank r ` 1 e Page 5 System maintenance specifications lE Page 6 Management and contingency plan Page 7 Pump curve and specifications E Page 8 Plot plan ,ESRON N~ Designer: Mary Jo Huppert License Number: 1859 - 007 Date: 02/02/14 Phone Number: 715 - 426 - 1775 Signature: -)QV1'W4tL-1Z0 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 0312012) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 450.00 Design Flow (gpd) 7.00 Site Slope 95.00 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 45.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/W) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest !o!*,nt, in the distribution y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.166 Orifice Diameter (in) 3.00 Estimated Orifice Spacing (ft) = 10.00 ftz/orifice 2.00 Forcemain Diameter (in) 32.00 Forcemain Length (ft) Does the forcemain drain back? C Y-~ 88.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 5.22 Forcemain Drainback (gal) 7.09 Vertical Lift (ft) 41.61 5x Void Volume (gal) 0.42 Friction Loss (ft) 46.83 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 24.23 System Demand (gpm) 12.06 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options- choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Se tic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 650.00 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 17.00 Dose Tank Volume (gal/in) 525 Filter Model Number Weiser Manufacturer Project: KENNETH R. & MYRNA KRAFT Page 2 of 8 Mound Plan and Cross Section Views 1/10B Observation Pipe . J ...a K : tirgdtid,Td f.r:r ` T •.°'°°'"`4.L.L.•n.4.4.5.Lv5~. J.J'J.J'r°J..••J.J.J°J°d.f.:'.d J:' r•~•~•° " d•d.J: d.J•d •d•r"°r. r.J.t; .•;f :°•'°5'•1 L L L L L 4 L L L L L L S L'. °e.• y. LrLJ J L:L.L 4• 4•'a•4+4.4 L ti 4.4 G r`J•r.r°r. }.r..•'.: .r.r.1.:•.f.f.r.Y.r.' d.J dad ° J•J.J• d.d•J.d•J•r d•r•d; J s•L L L L L L L L L L L L L L L L A L~b•Ld4r44•Lv4.•m. L. 4.4.4.4• :LJ~L: LJ1J4: +J•r•J•d•d.J•l.d•J.J•J:J•d•l.r• JLJ••d i•r J°d' r•P•J•J•r.r•r•d•d.J d• '.'4.4°4.4.`.°4.4.4• ' W S•4.4•S•4.4.5•4.4.4.4••..4,1.4.5°L:4rtiJ4l'.:••dti:.'.14:.J. J1J4ryJ•41; d:d:r1l:l:r~~':J.d::•:d:J~d:1 . 4.4• 4'4.4.4.4.4.4.4.4.4.4.•..4. . I . . . . . . . . . . . . . . . . . . . : :I,':... B z LL~- L Mound Component Dimensions ft A 10.00 ft E 14.40 in H [Aft ft K [jift B 45.00 ft F 9.25 in 1 ft L ft D 6.00 in G 0.50 ft J W 450.00 (ftz) Dispersal Cell Area 872.23 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 4.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 97.27 (ft) •rii~irrrirrJ_ F rrrriiii riun~iir~irn,. G H F 95.50 (ft) - Dispersal Cell 96.00 (ft) Lateral Dispersal Cell Invert Elevation 4 4 a 95.00 (ft) Contour Elevation 7.0 % Site Slope Shading Key Geotextile Fabric Cover Dispersal Cell See lateral details on Q _ Q Topsoil Ca 1'•J•r•J•J•J•d f r•J r• o 1.5 ft Sf~ 4 4 4 4 4•ti•• 4••:~:.°m•°.ad Page 4 for number, size, /r/rfr/ 4i~2d•J .••1'+ J J J•JLJ4J4J° r•J Subsoil Cap Q r~ R ti•4•L•L•ti.4 L•L•L 4~ and spacing of laterals. ►®3J ASTM C33 Sand :6 F ?L~Lr4.4i•~+41•'. d r J Laterals are equally ® d J.r•r; r: J; r•._•~'d4.4r'.dLd5ir1•L 4. d, J• L.JS.q ~4r; J;d Tilled Layer m 0.5 ft Typical Lateral d dti::d p © y 1?{:L• . :d°J:J s aced from the 4rLr4:4' Aggregate fLd1•L•4.LJ ti• yry yf d distribution cell's Q 4:4~ti.4.ti.4:ti:4f1d1l. J.d.J.d:d .r•r.J•r•J•r•r.J•J.d•J.J•J1J1 centerline in the J•J.l A distribution cell (AxB). Project: KENNETH R. & MYRNA KRAFT Page 3 of 8 End Connection Lateral Layout Diagram Cr►ntarrlhelanaaalsowrthr. &0dimwnsian isTurn-upirbailvalveoaolesnoutpiup E P AlllmteralsaeelderKioat CE X-3l Holesalfibedan thebotiomoFthobdoral egwllg speoed $ takerols &foroemalin Sch 40 PVC per SPS Tobl4eo3e4.30~ $ Fvlme main ocnmeetion via tae or emoss to mantiold at any point. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.11 ft Lateral Length (P) 43.54 ft Orifices per Lateral 15 Lateral Spacing (S) 3.33 ft Orifice Density 10.00 ftz/orifice Lateral Flow Rate 8.08 gpm Manifold Length 6.67 ft System Flow Rate 24.23 gpm Manifold Diameter 1.25 in Total Dynamic Head 12.06 ft Forcemain Velocity 2.47 ft/sec Dose Tank Information Locking cover with warning label and locking device and Electrical as per NEC 300 and sealed watertight SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented E-- Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Ca aci 650.00 Gallons - T Volume 17.00 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 22.58 383.87 B 2.00 34.00 C Pump off elevation (ft) C 2.75 46.83 ~ 88.91 D 10.90 185.30 Total 38.24 650.00 D = Dose tank elevation (ft) 3" Bedding un er tank. 88.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number Tank Alert AB containing mercury Pump Manufacturer Gould may not be used in Pump Model Number PE31 this system. Pump Must Deliver 24.23 gpm at 12706 ftTDH Project: KENNETH R. S MYRNA KRAFT Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Ron's Sew_er_Service Inc. POWTS Regulator's Name St. Croix Count Zo Phone 7nin Phone System Flow and Load Parameter; Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and ressure tested eve 1.5 ears Mound inspect for ondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade " " 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution` ~ - - Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: KENNETH R. & MYRNA KRAFT Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code general This system shall be operated in accordance with SPS 382-84 W is. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to veri operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. fY Proper No trees or shrubs should be planted on the m Mound and ound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Conti If the septic tank or any of its components become defectiv proper operating condition. e he tank or component shall be repaired or replaced to keep the system in If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatmant information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: le-FiVNE*H R• AAY4A1A K8AFT Page 6 of 8 &9JUOULDS PUMPS Submersible Effluent Pump UNEMOM PE mom "ARM r Cwos n ` e: 1 NPT Temperatuve:104aF (40°C) • 60 ■ OnAVOWL nlaodmum, =Wuous whw • 115 and 230 5 Cast kon body. filly 1i ■ 1W"vwp~c impeller and • Solids handli%: tedan wit, mabc Pro- VOW »et ■ Upper sleeve and (oar maximum sphere, • ~ B;rrsula~on. APPMTM ' =odels irnhrde a • 0114W design, heavy duty ball bearing coramXtim SSp daily designed for the ' Manual Models aw&w. Veno carbon SW a Motor is by folkwAig uses: • Pumping range; see PE31 Motor: MWC*d for a OMW • Mound System Perf mwtce chart or calve. . smkp life. • Ef uenftsing Systems %*nU:GPadty: .33 HP, 3000 RPM r Powered for ~ • 115voh . • LOW Preswre Pipe systems 53 GPM • Shaded pole desiv ■ All W*W are within the • Ruenuft DvWnhV • Maxkm m head: 25' TDH • N" Duty pE41 Motor. Workblgg of the nlota► Dewatenng Sumps . 61 GPM 0 115 HP, 3400 RPM ■ Quids d~mrmectpower • Maximum head 29' TDH • PSC &qd 230 cord, 21Y awAv vo0s heavy duty 1 Q3ds)Tw wi Pg1 hmp; PB1 mom 115 or 230 volt 9 • Max;"" m capadty: 70 GPM • 50 HP, 3400 RpM P114 • Maxim= head: 37' TDH • 115 and 230 voks A COnPlete unit is heavy duty, METERS FEET • PSC design P04&e and catnpacL 40 _ ■ Medw*A seal is carhop, r •^T ` J L ! A IOO[iSc PQl. i~41 PE51 a r$mic, BUNA and sWnl.9S steel. 35 HP .so r St ainless steel bskvm 10 , 30 ' 2 GPM AGWYUSTOM I Fr y 25 ' - 17 20 » , u5 Tested to 1N. 7N NA is CMX2 108 qwWO& ftCmAftSftNft&AuodAw 'T H 10=-1 10 20 30 4 SO GPiN 80 AfZuSE. « r 0 60 70 1~ / t /\P Vol 0 "7e{8 10 15 m3/h Plot Plan Pagef of $ Property Owner l'ZA F M M yx,vA KKK. F- ' f 1"=40ft. Legal Description tx: of .sr /y of 2 ~j____ (except where noted) Ste, 9. TOAI; Rt_g t 7o,,W OF Kln/NIC+K 114 I,-. S.T. diwEx .Ll. = Backhoe pit ?0 7+eXF-5 L~ North 3 SG~EZOaM . GARa~~ , pw ~"cu~ yg ~ Z , lap nF co~sr~' ,~~C3 , lDI,Io7r , Lb t `a/ a0 ~~Xr57/n/~. T3t~1~to f3E f1g1lN4eMJ~D SHED Pop of 5 b P " ct~ ®-~z~srtnw t~kAWF'~~tA v~rt PER spS cro4E 32 2l' 1x6 A5~'M sicH.IV& ~ 73' 9t~45~ j-dlCcLM 11v g3 N gy sa ~ boy p3sa~ Site Loc SoccTft yip :i 15- ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer G- ..j_ K A r- + Mailing Address L/N s a Z Property Address $-In6 (Verification required from Planning & Zoning Department for new construction.) City/State 4t' /l Parcel Identification Number ® 72 - p z LEGAL DESCRIPTION Property Location 61/4 , Sec. _L_, T Z N R_LS W, Town of (C „cJ*Ick- /rV"IG Subdivision Lot # Certified Survey Map # Volume . Page # Warranty Deed # Volume Page # Spec house yes (fp Lot lines identifiable ® no 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 §Comm. 83.52(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 fo owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri l signed by the wastewater disposal system is in proper operating condition and/or (2) after inspection nmPinnecess r the on-site less than 1/3 full of sludge. pumping (if ary), the septic tank is P 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 Commerce 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 days of the three year expiration date. I/we certify that all statements on ' form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a wa anty deed-recorded in Register of Deeds Office. Number of bedrooms SIGNATURE F APPLICANT(S) Gg l AT DATE E ***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. 08/05) ~ J'~E.,.,_. - ~ ~ _ x ~ _ 1 1 K ~ U~ N"~z~F ro ` u Rs " 3 ~ Parcel 022-1024-20-000 02/18/2014 02:24 PM PAGE 1 OF 1 Alt. Parcel 09.28.18.132B 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - VORWALD, RAYMOND & GLORIA-FAM TR RAYMOND & GLORIA-FAM TR VORWALD 552 FAIRHOME RD ROBERTS WI 54023 Property Address(es): Primary Districts: SC = School SP = Special Type Dist # Description SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Notes: Legal Description: Acres: 27.080 SEC 9 T28N R18W SE NE EXC COM 135'S NE COR NE SE, W 20RDS, NWLY 65RDS TO PT Parcel History: 29RD W OF E LN NE 1/4, E TO E LN, S TO Date Doc # Vol/Page Type POB EXC P1 32C & EXC PT TO STATE IN 07/23/1997 877/32 421/431 & EXC THAT PART OF SE NE AS DESC 07/23/1997 757/437 IN 757/437 Plat: Primary Tract: (S-T-R 40%160%) Block/Condo Bldg: * N/A-NOT AVAILABLE 09-28N-18W 2013 SUMMARY Bill Fair Market Value: Assessed with: 261307 Use Value Assessment Valuations: Last Changed: 09/07/2010 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 11.080 1,800 0 1,800 NO MFL BEFORE'05 CLOSED W8 16.000 80,000 0 80,000 NO Totals for 2013: General Property 11.080 1,800 0 1,800 Woodland 16.000 80,000 80,000 Totals for 2012: General Property 11.080 1,800 0 1,800 Woodland 16.000 80,000 80,000 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Safety and Professiona i Division of Industry Services A u t~ S EVALUATION OT Page 1 of 3 .ST, OI OUNTY ' WPis. Adm. Code County ST. CROIX Attach com n o per not less than 8 1/2 x 11 inches in size. Plan must include, bu li `ed t • ertical and horizontal reference point (BM), direction and D. 022 - 1024 - 30 - 000 percent to cal dimensions, north arrow, and location and distance to nearest road. Please print all information. Revi Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 4 G(~liyV► / C Property Owner Pro KENNETH R. & MYRNA KRAFT Govt. Lot 1/4 S 9 T 28 N R 18 E( r)® Property Owner's Mailing Address Lot # Block # r CSM# 478 Skyline Drive pl(4 City State Zip Code Phone Number []City Village ■ Town Nearest Road Roberts, WI 54023 ( 715 ) 425 - 6638 Skyline Drive New Construction UseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD E] Replacement Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable NA ft. General comments Mound System 0.50 ft. sand fill 0.6 loading rate and recommendations: ,<-M, 4VI? ~ia~Co f/ /v I;~-)et rn 0-vt d MM e k A,~ -&0-4-t LeI~ -P/ IT] Boring # 0 Boring ED Pit Ground surface elev. 93.60 ft. Depth to limiting factor 32 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 0-12 7.5YR2.5/2 1 2fsbk mvfr as 3vf-co 0.6 0.8 2 12-18 10YR4/3 I 2fabk dsh cs 2vf-co 0.6 0.8 3 18_32 7.5YR3/4 sl 2fabk dh cw 2vf-m 0.6 1.0 4 32-40 7.5YR3/4 flf7.5YR4/6 sl Om deh 0.2 0.6 Horizons 2-4 have some gr; cobs F2 Boring # Boring 96.45 30 o 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/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-19 7.5YR2.5/2 1 2f-ma&sbk mvfr as 2vf-f 0.6 0.8 2 19-30 10YR4/4 sil 2fabk dsh as 2vf-f 0.6 0.8 3 30-45 7.5YR3/4 f1f7.5YR4/6 sl Om dh 0.2 0.6 Horizon 3 has some gr; few cobs * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:S 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sin CST Number MARY JO HUPPERT/Hollister's Soil Testin & Design 224832 Address Date Evalua lon Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 10 - 22 - 13 715-426-1775 SBD-8330 (R07/13) f" Property Owner KRAFT, Kenneth & Myrna Parcel ID # 022 - 1024 - 30 - 000 page 2 of 3 a Boring # © Boring 94.45 ■ pit Ground surface elev. ft. Depth to limiting factor 30 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 0-12 7.5YR2.5/2 1 2f-mabk mvfr as 3vf-co 0.6 0.8 2 12-15 7.5YR4/4 sl 2fabk dsh cs 2vf-co 0.6 1.0 3 15-30 7.5YR4/6 sl 1 f-ma&sbk dsh cw 2vf-m 0.4 0.7 4 30-36 7.5YR4/6 171f 7.5YR5/6 sl Om dh 0.2 0.6 Boring # Boring a Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. M Pit 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 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L SBD-8330 (R07113) Plot Plan for Site and Soil Evaluation Page 3 of 3 Property Owner 1eemvpm i NI yxNA I<KA Pr I"=44ft Legal Description Pxf of sp /y of -m_r Ng fg} (except where noted)- sEc TOO, Rig Wj, -row or K/n4Nt niN l a,~ sT tx IJ = Backh oe pit ® w*LL North 3 B&DRoo~ 9ARa6-6 _mp or S~rC'S 101.4.7 ` U~ "I STlA&;. ? w,9, 14 s MV . 9~„1! 5 fl 9ySS' S Q~_5'a ~c.1p~~,~„~ g y s© ~ (7t~1 9 ~ 61D 93,sd , Site Loc ion, WW `I-SOtt F(t PIS Pm 4, o i ' aai °o I °p v eyo N H o Q i o j' N rn ~ c (D w c E o N m ° m o t. c m E a a; a U m T z mEw c Li c T .2 E v, o a Y cu a o c a ¢ 3 0 ~ I o I _ v co W E v Z Z 11 c .r 0 ON co G) N 'D Z .0 C (D U) a o rn H a m c E 0 o ~ v' c E o Z E (D Z o Co N F- r N E CL ~ a N co w _ O N CL N N • NN a E 'o Maj O co N C Q Z Z Z 4i N a I', M m C N 16 O O R V CL M V/ d aNi 3 G a` a) o CL E r F H N c 0 0 0 0 p •~i ~aaa 0 0 0 v~ n 0 ~y U rn Z -j a) !n O N N C) 0 I, CO O O a O 7 a co c d W rn (p V1 ¢ N < z U) 75 N T p m N O `~rrr M, C N ,C C_ O Cl) LO O V _ 4 C N C a N N CZ4 co 4) .0 0 (D Y (D 'D C CD o o Y Y C) Z cn, Z Z m (A o y _ I V ~ a ` a ~#c a • Cc ad.~ m r`N y E ~ ~ ° °Y' ~ -1 A U as 0 U) U