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HomeMy WebLinkAbout040-1134-40-000 - I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 579009 0 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 X Township Parcel Tax No: Cernohous, Scott & To a Troy, Town of 040-1134-40-000 CST BM Elev: Insp. BM Elev:q BM Description: Section/Town/Range/Map No: / Q 35.28.19.5561 TANK INFORMATION D. ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic •r~ Benchmark 2 lQ• L.. /000 Sam- aJ. 5, 6 3 • 99. 1 aosingr_ GO a 6 O~ Alt. F BM v G D 3 917, 3 Aeration r ` Bldg. Sewer / 9-7 Holding J St/Ht Inlet c~ , O TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Vent Air Intake ROAD Dt Inlet Septic Dt Bottom ~ , 7 y z y ~ Dosing c"J / / /6(.0 5 1 ) Header/Man. S 9'1.3s Aeration cJ Dist. Pipe 5. g 17~, Holding Bot. System 5.7 '77.77(., PUMP/SIPHON INFORMATION Final Grade 9 •s ak Manufacturer 1 Demand St Cover L' S GPM Model Number 32.3 TDH Lift, F -7 riction System HeaSL TD H~ I " 3• Forcemain Length Dina. Z Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of~ren s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS zi~J 711 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f ystem: ' 75 IZ45 UNIT Model Number. a,, wfJ~ DISTRIBUTION SYSTEM Header/Manifold Distribution T3 f x Hole Size x Hole Spacing V to Air take Pipe(s) 3L Length Dia Z5 Length 4. 7Z Dia Z5 Spacing I V SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded aw•eoci ulcned Bed/Trench Center \PZ Bed/Trench Edges Topsoil ' • Yes No No 0 1C~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection # -7 / 7b/ Jr Inspection #2: / / Location: 791 Pine Ridge Terrace River Falls, WI 54022 (NE 1/4 SE 1/4 35 T28N R19W) rn s & bounds Lot Parcel No: 35.28.19.5561 1.) Alt BM Description = I / CS `I I rr 2.) Bldg sewer length = 3-5 4-b e- J - amount of cover = 11 yZ_ ac 5 ~ " Plan revision Required? Yes No `I -7 Z k 15 01 Use other side for additional information. It V,,W SBD-6710 (R.3/97) Date Inse is Si ure Cert. No. ' I RECEIVE _ County JU Q Safety and Buildings Division CIO 4 0 y 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) k. ~ P S ' ST CROIX COUNi1' Madison, WI 53707-7162 Sanitary Permit Applicatio State Transaction NuQmb"erC/ In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 7 V / 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 , Stats. 1. Application Information - Please Print All Information 791 k, ~t r• Property Owner's Name Parcel # S C07 fJ 'Y A a. 2 0~4 0-< 0-1/0 - 113c~-~ yv -ao Property Owner's Mailing Address , ! 1 ,/y L { J dq i s / Property Location I J~ -7171 N t E kj r znq c 6 Govt. Lot , 55 City, State Zip Code Phone Number S /V __<e* Section (Z1 VE L.L's 5410 > -1 T~N; R t (circle 11. Type of Building (check all that apply) Lot # ~~~...JJJ /I or 2 Family Dwelling -Number of Bedroo Subdivision Name Block # Y ❑ Public/Commercial -Describe Use ❑ City of ❑ State Owned/_ Describe Use CSM Number ❑ Village of g X 5~.Z5 A Town of / p"o y III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) umber List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of PI Transfer to New ❑ Permit ~ Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) 6 V1111d J r 4.0 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil El Holding Tank El Other Dispersal Component (explain) Pretreatment Device (explain) C 1 V. Dis ersal/Treat ent Area Information: 4 Design Flow (gpd) Design Soil Application Rate dsf) Dispersal Area Required Dispersal Area Propose (sf) System Elevation y5© oa t/,~ lJb ZI S 445 . ~J VI. Tank Info Capacity in Total of Manufacturer Gallons Gallons Units ° c o New Tanks Existing Tanks U y U W SZ5 a 0 v w c7 a. Septic or Holding Tank O L ff) Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number &jILL ary, FA41-/ U) 1319,05 he-., 2 37Y7 Plumber's Address (Street, City, State, Zip Code) 000 P,aJ>t. s) pa,cS co L) I. sq0..) VIII. County/Department Use Only Approved ❑ v Permit F; Da sue Issuing nt Signature ❑ ne en Reason for D ial Z5' / IX. Condi qw%fte for Disapproval 4 t~ jdrZJ G 1 Septic tank, effluent filter and ✓ LOr~ .'~i`art.~ /t dispersal cell must all I;lj servrQga Finaintained q, f L G Gc)~ a rM f r as per management plan provided by plumlier. L - has perappl~icable code / ordinancesin&d ~ WL p~y~ Attach to complete plans for the system and submit to the County o y on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) Bat plan Page S of E Propeily Owner Scorn f~SA/J8-14 0 YS I = 40.A Leg/al Dscripiwn nl~'/u of -ter (except where nott s~ f/ 5 mss, { Rr'a ~,4I u}h d~ -7 R;7y I _ .Backhoei North r ^t ~f 4► s a C"f I%j D D W Site .,location: • - f F ;O a ~ ~ r+a, , R4 4 f 53 g RoeftgeTt V'1~ ~ 3 f 4 p~pP.RTAfk- r DIVISION OF INDUSTRY SERVICES eti` o~ 3824 N CREEKSIDE LA 02 1' ~ 1 HOLMEN WI 54636 oetvvry S Contact Through Relay -or P S http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~O sSION~ti Scott Walker, Governor Dave Ross, Secretary March 31, 2015 w4k CUST ID No. 224832 ATTN.- POWTS Inspector l tED MARY JO HUPPERT ZONING OFFICE APR 10 ? 15 HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA ST CROIX COUNTY W9875 690THAVE 1101 CARNHCHAELRD --OMMU` 1TYDE` ELOPmENr RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/31/2017 SITE: Identification Numbers Scott R & Tonya R Cemohous Transaction ID No. 2527892 791 Pine Rd Terrace Town of Troy Site ID No. 811244 St Croix County Please refer to both identification numbers, NE1/4, SE1/4, S35, T28N, R19W above, in all correspondence with the agency. FOR: Description: Three Bedroom Mound System / 7% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1529997 Maintenance required; Replacement system; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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 COND' requirements. APP No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, DEPT OF stats. PROFESS10 The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF IND Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE COR • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with ES the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The existing POWTS shall be properly abandoned per SPS 383.33, Wis. Adm. Code. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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 l MARY JO HUPPERT Page 2 3/31/2015 7 t , Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. eM Swim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm MARY JO HUPPERT Page 2 3/31/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. eM Swim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i L. r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: SCOTT R. & TONYA R. CERNOHOUS a MAR 2 7 2015 Owner's Name: (same) INDUS I RY SERVICE.' Owner's Address: 791 Pine Ridge Terrace River Falls, WI 54022 Legal Description: NE 1/4 of the SE 1/4, Sec. 35, T28N, R19W Township: Troy County: St. Croix Subdivision Name: NA Lot Number: NA Block Number: NAB NALLy Parcel I.D. Number: 040 -1134 - 40 - 000 4F'e Plan Transaction No.: `SFRVCF Page 1 Index and title rRY SERVO'S Page 2 Data entry ,~`gttttttttttrtttl~/p~/ Page 3 Mound drawings ~Ift - r'~ri~~~'~~.~✓ Page 5 System maintenance specifications 4 9. ~t Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot plan 9 t_ 10- 1;;, Mary Jo Huppert License Number. 1859 - 001 Date: 03/25/15 Phone Number 715 - 426 1775 Signature: 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 (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 r Mound and Pressure Distribution Component Design Design Worksheet Site Information (P or C) R Residential or Commercial Design Note: Sand fill (D) calcuk.tions assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ sail treatment for fecal coliform of 36 inches. 1.50. Peaking Factor (e.g. 1.5 = 150°l0) 450.00 Design Flow (gpd) 7.00 Site Slope 98.25; Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/fe) Distribution Cell Information 56.25 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 2.67 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 2.75 Estimated Orifice Spacing (ft) = 7.50 fe/orifice 2.00 Forcemain Diameter (in) 20.00 Forcemain Length (ft) Does the forcemain drain back? Y 93.00 Pump Tank Elevation (ft) Enter Y or 4.55 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) 5.34 Vertical Lift (ft) 52.30 5x Void Volume (gal) 0.44 Friction Loss (ft) 55.56 Minimum Dose Voiure (gal) 0.00 In-line Filter Loss (ft) 32.31 System Demand (gpin) 10.34 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 x 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optionFI) Treatment Tank Information Total Tank Capacity Igal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in,;ell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 16.76 Dose Tank Volume (gaUin) 525 Filter Model Number Weiser Manufacturer Project: SCOTT R. & TONYA R. CERNOHOUS Page 2 of 8 Mound Plan and Cross Section Views _-t 1 /10 FKg Observation Pipe . . fl A z L Mound Component Dimensions A 8.00 ft E 12.72 in H 1.00 ft K A21 ft B 56.25 ft F 9.25 in 1 8.85 ft L ft D 6.00 in G 0.50 ft J 4.39 ft W ft 450.0(3. (ft) Dispersal Cell Area 947.88 (ff) Basal Area Available 8.00 (gpdtft) Linear Loading Rate 5.63 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.52 (ft) H :fr>rr rrslrrrrr.+f~,r:;rrr. G riirc+.ii.. ri a\ a 99.25 (ft) Lateral F = ~ Cell = 98.75 (ft)-► Invert Dispersal Cell Elevation T `l:3- 0., 98.25 (ft) Cont Sur Elevation 7.0 % Site Slope Geotextiie Fabric Cover Shading Key m Q- Dispersal Ceti See later i details on Page 4 for number, size, Topsoil Cap r 1.5 ft 7 T Subsoil Cap and spacing of laterals. ASTM C33 Sand Laterals .:ire equally Tilled Layer a 0.5 ft Twical Lateral F spaced from the © distnbu ion cell's Aggregate v o centerline in the A - distribution cell (AxB). Project SCOTT R• & TONYA R. CERNOHOUS Page 3 of 8 End Connection Lateral Layout Diagram Center lb* lat~aia ovw thrA & $ cimo-nrion 4W x. Xurn-etp wf6 tll vsMer GaamauLPaEU i f Ad laterals are i+deadcat Ir X -°---).1 ricers d1~e.d CM "h - anatom es the lateral T egwallgspaced S =LLa*terra*ft&fbrcera&in Sash 44 PVC per SPS Table 384,30-6 s Frame main ccwmtection via tee or cxoss to mandold at any point- Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.88 ft Lateral Length (P) 54.72 ft Orifices per Lateral 20 Lateral Spacing (S) 2.67 ft Orifice Density 7.50 ft2/orifice Lateral Flow Rate 10.77 gpm Manifold Length 5.33 ft System Flow Rate 32.31 gpm Manifold Diameter 1.25 in Total Dynamic Head 10.34 ft Forcemain Verity 3.30 ft/sec Dose Tank Information Locking cover wih warning label and locking device and sealed waterfighl Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented E-- Aftemata outlet location Forcemain diameter Weiser Manufacturer 2 in Capac' 600.00 Gallons - Volume 16.76 gaUnch A Weep hole o' anti- Dimension Inches Gallons B siphon deviai A 19.58 328.23 B - 2.00 33.52 C Pump off elevation (ft) C 3.32 55.56 93.91 10.90 182.68 D Total 35.80 600.00 4 Dose tank a levation (ft) 3 Bedding under tank. 93.00 Alarm Manuafacturer SJE Rhombus Note: Seri; rhes Alarm Model Number Tank Alert AB containing mercury may not bo used in Pump Manufacturer Zoeller this syster). Pump Model Number 98 - Pump Must Deliver 32.31 19pm at TO-. 3-4 Project: SCOTT R. 8i TONYA R_ CERNOHOUS Page 4 of 8 Mound System Maintenance and Oueration Specifications, Service Provider's Name Darrell's Septic Service Phone 71542-1025 POWTS Regulator's Name St Croix County Zoning Phone 715-38E-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/3 in Estimated Flow - Average 300 and Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 151) mg/L Soil Absorption Component Size 450 fe Maximum FOG 3G mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10i~4 cfu/100 ml Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 year's Effluent Filter Should inspect and clean at least once eve 3 ears. Pump and Controls Test once eve 3 ears Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound Inspect for ponding and seepage once every 3 year: 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. palm. 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 •~~s~• Grade 6-8" Diameter Lawn Threaded Cleanaut Sprinkler Valve Box Plug or Ball Vah e Distribution Long Sweep 90 or Two 45 Degree Bends Sarne Diameter as Lateral Project: SCOTT R. & TONYA R. CERNOHOUS 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 Wis. 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 Var. 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 rerr oved 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 tl a 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 lank. 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 verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. 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 rng1L BOD5, 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 specked 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 compered 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 reportec' to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. C9ntinaenCy Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) slmall 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 w' II 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. The 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: C:"/u0 t Vs Page 6 of 8 W HEAD CAPACITY CURVE r/o c 1~ a 1 K)DEL "W 30 4 5/8 a 3 5/8 X s 20 m O t5 -I- /t) 3y 1 to 4 3/16 0 z s 0 1 1/2-11 1/2 NPT U.S. GALLONS 10 20 30 40 50 60 70 at1 UTMS I- 0 SO 160 240 FLOW I MINUTE MODEL 96 60 CYCLE Feet Gotiocs. Meters Liters 5 72 15 273 to 61 3.1 2,71 i5 45 4.6 170 zo 25 b a xi 12 Loch aaaa T. zr r eeBW1 P-4 11+6"r A7 a SK71e2 CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical alternators, for duplax systems, are available and - Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical ailemators, for di ipiex systems, are available o Double piggyback variable level boat switches are available with or wfthout alarm svAtchet>. for variable level long cycle controls. SELECTION GUIDE 1. Integral tbatopetated 2 pole medlamcal switch, no external control required. Standard all models -Weight 39 lbs. -'/2 H.P. 98 series cOntrot s 11 2 Skq* tpkigyback voluble level float swHch or d ruble p'lggyttack variable level. suet switch. Refer to Pik10477. aloder VOHS-Ph Mode Am ac Skopleat Du eK 3. tAechwdcolaRwnatorIG-0072orlO-0075. INBB 115 1 Auto 9.3 1 or 1 & 7 - 4. See FAW71Z for correct medal of ElecIrical Aikr-nu or. N98 115 1 Non g.4 2 or 2 & 6 3 or4 & 5 5. coriftal switch 1 used as a control acrPrAw, specify duplex (3) or (4) 088 290 1 A116u 4.7 1 or 1 & 7 6. Fcw (4) hole d-Pok, I n bwr, for hetatertght wnaection arwant" !98 230 1 tb1 4.7 2 or 2 & 6 3 or4 & 5 soegdex or duplexoperation. 1041001 7. TWO (2) hole .1 Pak, fa• watertight connection at splice. CAU71ON For kJor ration on addd'onal Zoeaer pmdwft mb to catalog on Plggybaa Variable Level Switches, All installation of controls, protection devices and :virinil should be done by a qualified FMD477•t3t U or,FWWMedmrm:*i or, :SmvSwmeBwnc,FM049P licensed electrician. Ali electrical and safety codes shout I be followed including the most gn*Ptas gn4 tPumce hhol, Fir158rxAfwnSy FMOM recent Nlational Electric Code (NEC) and the Occupation- Safety and Health Act (OSHA). sRESEEE POWERED F-SI- For unusual conditions a reserve safety facer is engineered into the design of every Zo 3ller pump. am- FD: P.O Box 16347 uwisv^ KY. 47 rt s5~.. Q. SWID. 3110CIoneRwRoof Pl1MP IIl_ Kr 40211-1961 rlwkvlrmeirer«N,. (S0~7TB-f-1{e"-- r~S j93~9y F"M774-MV ~ ~ Se.~rr-a~"or)Y.~ GereNo~vus R&I' Plan Page a of8 Properly Owner SGDxT -~1J r -EX N6-140YS I"=4oft Legal DayMption A r--r. 0-f--rt E nlp,4q oF -MF except where noted!). s~ s mss. T t } -c-4 WA 166 -TROY, = Backhoe pit North t h ~ G s t} ~ i- Gz~ o o p G1 0 t 4 Site Location: tosniuaoecr 4D B3 5 or kA Mound System Management Plan Pursuant to SPS 383.54, cos. Adm. Code General s. w This system shall be operated in accordance with SPS 382-84 Wis. 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. 01101)] 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 opw*Q deemed unsound, deflective, or subject to failure must be replaced. Exposed access openings greater than 84nches 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, Stats- 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 fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be ceaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions ate made to retain solids in the tank that may slough off the filterwhen removed from its enclosure. If the filter is equipped with an alarm, the filter shalt be serviced 9 the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous 3 alarm. ti 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 ac cumulatiorh 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 snap be, approved for septic tank use. by.tne.Oepartment of Commerce. r, Pump Tank The pump (dosing) tank shalt be inspected at least once every 3 years. Alt switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. 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 exoed 220 mg/L 13005,150 mg/L TSS, and 30 mg& FOG for septictank eftiuent or 30 mg/L BOD5, 30 mg/L TSS,10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flaw may not exceed maximum design flaw 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 montim 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 rT orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluentponding. Ponding levels shalt be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to. keep the system in proper operating condition. If the dosing tank, pwM, pump controls alarm or related wi*Q becomes rifle defective component(s) shall be immediately repaired or replaced with a component of to 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 dogged 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. Pretreatment Units The 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. ~'f as4~ C~~t~otb ~ Project: c Page 6 of 8 =OEM ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer SSc d jj CE P-.1) y r O U S Mailing Address , (JL 2{ o66 L Property Address 12 1 2 r-p t.,L-G Lj I (Verification required from Planning & Zoning Department for new construction.) City/State R I (,)2 l At ,LS ,j ) Parcel Identification Number e,~o ty LEGAL DESCRIPTION Property Location .LIE- '/4 , S,E '/4 , Sec. SS7 , T 9,E_N R_1_9__W, Town of %2 o Subdivision Plat: Lot # Certified Survey Map # z,, r J 0.5 , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house ';yes;.! no Lot lines identifiable yes 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 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. I/we, 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 this form 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 warranty deed recorded in Register of Deeds Office. Number of bedrooms IGNATURE OF APPLICANT(S) DA ***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) l PlOtplan Page S ofd Propei7y Owner ScoTr f j IIA r v -EX J6-140 ~s pA = 4D ft Legal D scriptwn _A ,t-r. a -T,r AjE'I of 7 (m,!ep►t where note sC-'/~. ~s, IAI, _Q0ViA aF -rt ~r r, _ $ackhoel o._ ueJ F t/ ~~115.~ ~JStlJ . North G`A rs. Gor o IZ°1 ~ d a t~ Y \ Site Locadon: caftaff I . caa ~3 40 J g. ~ Iaopla 3 5 14 1 i Wisconsin Department of Safe fo;ional Services ; et, PA-1 Division of Industry Se ' 6, ri A, SOIL EVAL PORT page 1 of 3 PQ 4 \34"ccor4nce with SPS 383, Wis. Adm. Code Attach com lete site Ian Inisions, ~Y CO EN County ST. CROIX P P ,i,t lAn 8 1/2 x 11 inches in size. Plan must include, but not limite4j ~ ' do horizontal reference point (BM), direction and percent slope, scalgnorth arrow, and location and distance to nearest road. Parcel t.D 040 - 1134 - 40 - 000 Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m) Property Owner Property Location 23 SCOTT R. & TONYA R. CERNOHOUS Govt. Lot NE 1/4 E 1/4 35 T 28 N R 19 E (or) W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# ( 791Pine Ridge Terrace City state Zip Code Phone Number []City avllage Town Nearest Road River Falls, WI 54022 ( 715) 760 - 0349 TW3Z Pine Ridge Terrace New Construction Uses Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable ly~ ft. General comments and recommendations: Mound System 0.50 ft. sand fill 0.6 loading rate E Boring # 0 Boring Q Pit Ground surface elev. 96.60 ft. Depth to limiting factor 37 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 10YR3/3 1 3f-mabk ds es 3vf-co 0.6 0.8 2 13-28 10YR3/4 sil 3fabk dsh cs 2vf-co 0.6 0.8 3 28-37 10YR5/6 s Osg dl as 2vf-m 0.7 1.6 4 37-38 10YR5/6 f2f7.5YR4/6 s Os dl cs 1vf-m 0.7 1.6 5 38-39 7.5YR3/4 f2f7.5YR4/6 sl Om dsh cs lvf-f 0.2 0. few cobs; 1 boulder. 2 Boring # Boring F El 98.10 40 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-14 7.5YR2.5/2 1 2f-ma&sbk mvfr as 3vf-co 0.6 0.8 2 14-18 7 5YR4/2 sil 2f-ma&sbk mfr cs 2vf-co 0.6 0.8 3 18-32 7.5YR4/3 - sil 3fabk mfr cs 2vf-m 0.6 0.8 4 32-40 7.5YR4/6 - s Osg ml as lvf-f 0.7 1.6 5 40-42 7.5YR4/6 Qf7.5YR5/6 s Osg ml as lof--f 0.7 1.6 6 42-44 7.5YR3/4 f2f 7.5YR5/6 sl Om mvfr 0.2 0.6 * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signa CST Number Mary Jo Hu ert Hollister's Soil Testing & Design) 224832 Address Date Evaluati onducted Telephone Number W9R75 690th Aveniie, River JFqllq W1 54072 1 05 14 SB -A__^30(9(77/131 SBD-9330 (807113) Property Owner CERNOHOUS, Scott & Tonya Parcel ID # 040 - 1134 - 40 - 000 page 2 of 3 3 Boring # Boring 98.90 36 ❑ E] 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/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-14 7.5YR3/3 1 3fabk ds cs 3vf-co 0.6 0.8 2 14-27 7.5YR4/4 sil 3fabk dsh cs 2vf-co 0.6 0.8 3 27-36 7.5YR4/6 sl if--msbk ds cs 2vf-m 0.4 0.7 4 36-40 7.5YR4/6 c2d 5YR4/6 sl Om mfr lvf-f 0.2 0.6 Horizon 3 has some gr/few cobs ❑ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-I H 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 = BOD5 < 30 mg/L and TSS < 30 mg/L @t31~9~~®~®9I1~~ 1 Rot Plan for Site and Soil Evaluation Page 3 of 3 Propet~y Owner Scour C,EX M64~0 us P = 40 ft Legal Description A :Fia, o-r -rgv Ajp-! ~ of Tte (except where noted). sit s , i T Gau t of -rRo'/. = Backhoe pit f sr. Cpofx ~t w i sf~_ . ~ s nJ . ~ `r`, : North d A] ~r i 45 o 7 a 0o81 5 Site Location: f® O` F f @" gg.eo e ~yv . SS @ coNm car VWW a @1t1t , Fine RdgeTa ♦ i g PAQRV* St $ D Nomad[ St C4„ W ~Y x ~1st W Division St r caRyu: " ydgti< °"wcwar it Izi W ".tip ~ ~ J2T t ra 1. 3 roq { i r~ R a « - 3 v - Y : i Y' op W x r - y n yXi, a 4,- [IGOULDS PUMPS Submersible Effluent Pump PE ftumT Pum" SPECIFICATIONS MOTOR FEATURES Pump - General: General: ■ Corrosion resistant • Discharge: 11h" NPT • Single phase construction. • Temperature:104OF (400Q • 60 Hertz ■ Cast iron body. ma)imum, continuous when • 115 volts ■ Thermoplastic impeller and fully submerged. • Butt-in mammal overload pro- cover. • Solids handling: tection with automatic reset ■ Upper sleeve and lower maximum sphere. • Class 8 insulation. heavy duty ball bearing • Automatic models include a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■ 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 a Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 12.0 Mardmum amps operation. • Low Pressure Pipe Systems Maximum capacity. 50 GPM • Shaded otor pole design ■ AB ratings are within the • Basement Draining • Maximum head: 25' TDH pE41 M n Quick d limits ~ power of the r • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM length , Dewatering • Maximum capacity: 60 GPM • 75 Maximum amps ~heavy . 20' standard • Maximum head: 29' TDH • PSC design NEM duty 16/3 tSJTW hree with EMA 5-15P, three prong, PE51 Pump. PE51 Motor: 115 volt grounding plug. • Maximum capacity. 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maximum amps portable and aompacL • PSC design ■ Mechanical seal is carbon, 40 METERS SET ceramic, BUNA and stainless MODM- PE31. PE41. PBi Steel. w - ---------,..ti..- • _ - - - - - r,_71 rim: _40. so ■ S 35 f ta'rnless steel fasteners. 2 GPM 0 - > - _ _ - r - - - - - i-~ r ° w 25 a 20 Ted tiD 1N.77$ and t /`Te /gy8 p S 78 ~ and } -1-"'~-- _l~ 7 -`-t-- 1 - -i- 1-~- 1 TT- - 1 ' I __]_~~-j' CSA 222 10Olandaid d 15 By CM3&= 5taadanls AS9Od liW Fie #Ueosa Goulds is 10 : E t~ X09001 Reg15~e1Ed. a 5 `~4- . _l. 0 0 0 10 20 30 r 40 50 60 70 GPM 80 . 0 5 10 15 rrr3/h Goulds Pumps CAPACITY 0 2002 C",-4 Ga,ws~ ~ ITT Industries