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HomeMy WebLinkAbout040-1185-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 578999 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: cQ tt 6~ Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].J ! ~.7V Permit Holder's Name: City Village X Township Parcel Tax No: McGee, William Troy, Town of 040-1185-20-000 CST BM Elev: Insp. BM Elev: IBM Description: f Q Section/rown/Range/Map No: Iou' ~5T ) M ' 36.28.19.758 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER S CAPACITY STATION BS HI FS ELEV. Septic Y' ST I N W~ ~ 1 b 6V „ Benchmark J~ I~- ~oi.8I o Dosing Alt. BM F-IL-m Aeferll6R' V Bldg. Sewer Ft_ %m'Tr-Lv t 2- Holding St/Ht Inlet TANK SETBACK INFORMATION S*WOutlet Lt-75 617. v TANK TO P/L WELL BLDG. to Air I ke ROAD Dt Inlet h 5. i 2 RQ'L. to l) S~tiq qj, 1q / Dt Bottom .15 • Do ' g l 'l 2y > 0 Heade Man. 1,S (00.2 Aeration Dist. Pipe 1.58 IOO. Z Holding Bot. System PUMP/SIPHON INFORMATION Final Grade b.56 bI. Z Manufacturer GPm~]and St Cover L1 . ~~'c7 2 Model Number Z Go Q I I~ 'J~ ~ 99 beviv-1- 2.69 Cl 9. t TDH Lift A Friction oss r System Head JT Z r J Ft Forcemain Length I Dia. ^ % Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length IN&-&rTre-nUre-r PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dept DIMENSIONS 1 b✓,C~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: 1 1 bo 1 / UNIT Model Number: W30 Mb DISTRIBUTION SYSTEM 41 E *at of hbost Header/Manifold r Distributilo~ x Hole Size x Hole spacing Vent to Air Intake Length Dia 11i~ Length l~. I Dia Spacing • 33 b 15 1 3 • 31 fS~ 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 BedAFrerM Center It Bed/Trench Edges / Topsoil 11 6.12 y 2 es ® No es j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 Inspection #2: Location: 57 E. Woodridge Drive River Falls, WI 54022 (SE 1/4 NW 1/4 36 T28N R1 9W) Oak rdgeep cues Lot5 ~ Parcel No: 36.28.19.758 1.) Alt BM Description = ~()L Q. CbV r S M a` Qt W1 Plow bo y Gka4'ns 2.) Bldg sewer length = b d f_ d tAtILv I&W - amount of cover = fl(IST1~~ -k b>f ~N60 yalydS dD M-tA.+ 3'1 SloptS by PIIVw~bz~ ~ V w.bt~ Plan revision Required? Fig] Yes No Use other side for additional informa on. (i SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Pe5 Of, I' Pl!o,t Plan Proper Qwne~r l~}~ 1-L.►.A.t L. Dl ~l~ G. 1Aek ~f = 1 4011 al LegdOn .1 thE (cccept where noted) LZ = Baclrhoe pit or- "firth 4 a ` ~b~ TZ$~t5# R~ 1lRyr1 i Tow/j 047 TZ8 Pew S"C-• L`RDLY. (;f)~1U14T ISG`T' StN • x7.17 A `t-5 Nort* owl 3 a~. xis 4~~~ 5 ~r $LAS Ct-AWW) ( s•,~~~ "iP 99 f r EAm p fin? to svj 1M- -mmr- WI ~ dt~J~ V6~~ Pr~T~ +v}=~m~ of T-PL fey J'S ' A19VF, GZAeA Z~ ,Site Location: 95'' f ySa ~ CT ~l. MAO' F-iVEU Industry Services Division County Y 0 400 W Won Ave e 1/` P - JINN 2 N IS IS B 162 Sanitary Permit Number (to be filled in by Co.) 707-7162 C_ ~ry C* S ITY OIDEVCOUNTY . OP ELOPMENT t At IN Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit ZS$ 15~ 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 Services. Personal information you provide may be used for secondary 'purposes in accordance with the Privacy Law, s. 15.04 1 m , Stats. Or) "v( 1. Application Information - Please Print All Information 1 L Property Owner's Name Parcel # WkLUAM L, ~ L, 11/lc~E ' 644-- I I VS- za-WO.", Property Owner's Mailing Address Property Location 57 ~L. V\300.tJ i~ t D Cc~E Govt. Lot Zi Code Phone Number , City, State P ~ /4, A) VJ Section 310 r - .Z (circle one (U ~ T~l~V lN-►S~Z T~N; R Eo W I~ II. Type of Building (check all that apply) Lot # $1 or 2 Family Dwelling - Number of Bedrooms -3 -5- Subdivision Name I ock # ~ . 1 Dry ~ s ❑ Public/Commercial - Describe Use N ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of j /t `IL~Uf~CJ L6_ XTown of III. Type of Permit: (Check on o e A. Complete line B if applicable) A. ❑ New System ~Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued / Before Expiration Owner r / IV. Type of POWTS System/Component/Device: Check all that a ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At rade Mound > 24 in. of suitable soil ❑ Mound < 24 in. of s itable soil ❑ Holding Tank ❑ Other Dispersal Component (explain), ❑ Pretreatment Device (explain) V. Dis rsalTreat nt Area Information: Design Flow (gpd) Design Soil Applicat Rate(gpdsf) Dispersal Area Requi (sf) Dispersal Area Propos System Elevation 11150 V 1. D7~057C 757 ~g z V1. Tank Info apacity in Total of Manufacturer Gallons Gallons Units _ o a o NewTanks Existing Tanks ~;Mkeh_ c 2 y a R w C7 fs. U va V Ln Septic or Holding Tank y Dosing Chamber / D ( ,j /U ~lLTO~ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) PI is Signatur ' M RS umber Business Phone Number 1P, Il~tc~~ ZZ 1073 715- 307-1 (,:,~no Plumber's Address (Street, City, State, Zip Code) - V 71 S~K f MTh 5? VII Coun epartment Use Only Approved 11 Drs ved P it Fee Date Issue Issuing Agent Signature/!- / f ur , ❑ Ow er Given Rea&owfor Denial $ IX. Conditions of ApprovaUReasons for Disapproval SYSTEM OWNER; a va (cr ( to 1. Septic tank, effluent filter and dispersal cell Mu It t f / S f e o14 1 14, as per management ply an~r did flintained , h11Slmtlib{~~A~ to the County only on pa r not lisi thank to a inch m Fast, j, as per applicable code/ordinances. y~ fli, i SBD-6398 (R. 08/14) I ~raxruF DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 o~ S eaP y GREEN BAY WI 54304 Contact Through Relay r+ P l~ http://dsps.wi.gov/programs/industry-services \ www.wisconsin.gov 1G Ado s N Scott Walker, Governor Dave Ross, Secretary June 18, 2015 CUST ID No. 224832 ATTN. POWTS Inspector MARY JO RUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 06/18/2017 Transaction ID No. 2559150 Site ID No. 813683 SITE: Please refer to both identification numbers, William L & Diane L Mcgee , above, in all correspondence with the agency. 57 E Woodridge Drive Town of Troy St Croix County SE1/4, NWl/4, S36, T28N, R19W Lot: 5, Subdivision: Oak Ridge Acres FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1540510 Maintenance required; Replacement system; 450 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, Pressure Distribution Component Manual Version 2.0 SBD-10706-P (N.01/01).SBD -10691-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 requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or us APP • The orientation of the mound system must be such that the mound's longest dimension is perpendi lar to the gp,FETY direction of the slope. • OF 0I IXVIS04 OF • The Infiltrator 540 tank shall be installed per manufacturer's instructions and state approval. Reminders • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the wner of gEE the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access enm used to service the filter shall terminate at or above finished grade with a watertight cover. • This POWTS dispersal component and septic system shall follow all setback requirements per s. SPS 383.43(8)(1), Wis. Adm. Code. • As per the Mound Component Manual, activities shall be limited in the mound area. Vehicular traffic, excavation, and soil compaction are prohibited in the basal area and 15 feet downslope of the basal area. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. MARY JO HUPPERT Page 2 6/18/2015 • The existing septic tank must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of ch. SPS 383, Wis. Adm. Code. If it does not conform, a state- approved tank must be installed. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 CA.U 4-u4 This Amount Will Be Invoiced. When You Receive That Invoice, Rachael E Huempfner Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-7726, M-f 7:45 am To 4:30 pm WiSMART code: 7633 rachael.huempfrier@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 and 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 o cc C i LU Project Name: WILLIAM L. & DIANE L. MCGEE Owner's Name: (same) 3 j Owner's Address: 57 E Woodridge Drive River Falls, WI 54022 Legal Description: SE1/4 of the NW1/4, Sec. 36, T28N, R19W Township: Troy County: St. Croix Subdivision Name: Oak Ridge Acres Lot Number: 5 Block Number. NA _ Parcel I.D. Number. 040 - 1185 - 20 - 000 Plan Transaction No.: ZOV GD Ot SERVICE pROFESSt s OlcEUr~r Page 1 Index and title y U RY SEZ V, 'n Page 2 Data entry ~~,~~•l,~~~~~ Page 3 Mound drawings • Page 4 Lateral and dose tank MARY d0 ; Page 5 System maintenance specifications HUPPERT RESPONDENCE Management and contingency pla Page 6 D 1859 Page 7 Pump curve and specifications =.ICIER FALL.~a' - g Page 8 Plot plan % W1 Page 9 Tank specifications Page 10 4'PFR01AL LrMR ~x~//~W ttts ttttt•~t~~~~` Designer. Mary Jo Huppert License Number: 1859 - 007 Date: 06/04/15 Phone Number. 715 - 426 -1775 Signature: D/V 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. 03/2012) Pagel of 10 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 soi! treatment for fecal coliform of 33 inches. 1.50 Peaking Factor (e.g. 1.5 =150%) 450.00 Design Flow (gpd) 3.00, Site Slope 99.12! Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ ) Distribution Cell Information 45.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width ;ft) 1.00 Dispersal Cell Design Loading Rate (gpd/f ) 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) e' Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the a evation (ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 11.54 fe/orifice 2.00' Forcemain Diameter (in) 93.00 Forcemain Length (ft) Does the forcemain drain back? Y 94.00 Pump Tank Elevation (ft) Enter Y or N q.9 System Head (ft) x 1.3 15.17 Forcemain Drainback (gal) Vertical Lift (ft) 41.63 5x Void Volume (gal) Friction Loss (ft) 56.80 Minimum Dose Volume (gal) 0.50 In-line Filter Loss (ft) 21.00 System Demand (gprn) 11.44 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 x 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/inch Calculator (options l) Treatment Tank Information Total Tank Capacity r,;gal) _ 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer galfin (enter result in cell B49) Dose Tank Information Effluent Filter Information 552.00 Dose Tank Capacity (gal) S~rmtech Filter Manufacturer 10.29 Dose Tank Volume (gal/in) A2 Filter Model Number Infiltrator Systems Manufacturer Project: WILLIAM L. & DIANE L. MCGEE Page 2 of 10 Mound Plan and Cross Section Views 1110 B : • - : Observation Pipe ' : ' . - :~oj"f'.^a ••°~'af:,a dOj•;'r;~Pm•+f Pe en v'~ra'~~~; d''•'~:J~a`ee°••.'... A ° hL a ~S~ . kare.v".~ i . . a e•° xS a L 5. S Ld°,°y;L.°:`°.'y:. :•''y~.en'L°,., ~•Li'6°.'LeL°•L:i^L+'ti..:.yw.+~n~ti _tin ~:0.r'.:e"n~S:'.'"°'4:•°~^9~: ea+".~:~°~ .•.•.•.•.I. W B •"f~TT"!~t•1•I• •!•1•!• I L Mound Component Dimensions A 10.00 ft E 9.60 in H [A4.87 ft K 7.2E ft B 45.00 ft F 9.25 in 1 ft L 59.52 ft D 6.00 in G 0.50 ft J ft W 21.7C ft 450.00 (fe) Dispersal Cell Area 757.21 (if) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 4.50 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.39 (ft) - ♦ H I F Dispersal Cell 100.1? (ft) Lateral 99.62 (ft)-► Invert Dispersal Cell r~( Elevation r 4 99.12 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key m Q. T Dispersal Cell See lateral details on Q =Topsoil Topsoil Cap c a 1.5 ft 7,7;7,7 ;r,,r„"r.r,•.".,~ Page 4 for number, size, O Subsoil Cap a CO and spacing of laterals. ~ W '•~'•°:°~-..~.:.••°'r Laterals are equally ASTM C33 Sand :5 t ; L L _ ti ed T it~1 Lateral °::s;~ Tilled Layer c m 0.5 ft spaced Vom the ? , , .4.L"L.L.L,~,s: , distribution cell's 'L L L b, o :+x~r~..',:.a o::.eF;•. centerline.,, in the © ?'~"f Aggregate - A distribution cell (AxB). Project: WILLIAM L. & DIANE L. MCGEE Page 3 of 10 End Connection Lateral Layout Diagram Comer aw laMrats over the A& Bdimension •a Tu rn•up Vdb®11 WSW&Cf *14snoutplu 11 All' laterals ace identical 14-X -J HalesdnUedonuneboatomof-theAateral S wed Later ft &ferceerain Sch 40 PVC per SPS Table 364.3" s Fame man connection via tee or toss to m.milold at any point. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.63 ft Lateral Length (P) 43.56 ft Orifices per Lateral 13 Lateral Spacing (S) 3.33 ft Orifice Density 11.54 fe/orifice Lateral Flow Rate 7.00 gpm Manifold Length 6.67 ft 1 gpm Manifold Diameter 1.25 in System Flow Rate 21.00 Total Dynamic Head 1.44 ft Forcemain Velocity 2.14` ft/sec Dose Tank Information Locking cover with warning label and lockinc device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC Disconnect 4 in. min. Tank component is properly vented : E-- Aitemaie outlet location Forcemain diameter Infiltrator Systems Manufacturer in. Ca acit 552.00 Gallons Volume 10.29 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon devic=e A 3gAy- y 00 C B 2.00 .00 P♦ ump off elevation (ft) C. QO 1(1/. CIO 1 94.67 D 8.00 qfj O Total 5Y.D C 552.00 tank elevation (ft) Bedding un er tank. 94.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number Tank Alert AB containing mercury may not be used in Pump Manufacturer Zoeller this system. Pump Model Number 98 Pump Must Deliver 21700 gpm at 11.44 ft TDH Project: WILLIAM L. & DIANE L. MCGEE Page 4 0•:' 10 Mound System Maintenance and Operation Specifications Service Provider's Name 6i i's Septic Service Phone 715425-1025 POWTS Regulator's Name St. Croix County Zoning _ Phone 715-386-4680_ System Flow and Load Parameters 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 fe 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 pressure tested every_ 1.5 ears Mound Inspect for ponding and seepage once every 3 years 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 sail erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade JI 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Sarne Diameter as Lateral Project: WILLIAM L. & DIANE L. MCGEE Page 5 ofi® 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 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 un,ound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by .fin 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 finer 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 113 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 edvise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tE nk. The addition of biological or chemical additives to enhance septic tank performance is generally not required. Hcwever, if such products are used they shall be approved for septic tank use by the Department of Commerce. Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be'rested 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 :he mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic i other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltratve 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 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 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 recommende J 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. Contingency 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) 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 atsorption 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. Project: 1,~ILrLIAAA Pi3ge 6 of to r/0 0 1/4 HEAD CAPACITY CURVE mom 'ger 4 5/b 30 a zs ( - 3 5/8 3 = e 20 cr -l- + 15 O ' 4 3/16 ~o rDo e z 5 1 1/2-11 1/2 NPT 0 US c~LLONS to 2 f 30 40 50 50 7o eo t tTF~S o ly Itow f taNU160 TE 240 mOOEL 4a 60 CYCLE Feet Cottons' Meters Liters 5 72 1.5 273 10 61 3.1 231 IS 45 4.6 110 12 20 75 61 so G i lacy lfd we 2S 009971 4 3/16 SK/162 CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical altemators, for duplex systerris, are avalable and • Variable level float swfthes are available for controlling single supplied with an alamn_ and three phase systems. • Mechanical affatnatm, for duplex sysberns, are available • Double p%MyWM variable level float twitches are available with or without alarm switches. for variable level rang cycle controls. SELECTION GU1t7 1. Integral float operated 2 Ode mechanical swll , no external control required. Standard all models -Weight 39 ibS_ -'l2 H_P- z skele piypyiuadc w:iabbe at float switch ordouble do variable level. 98 serles Gonrtrot selecdon floatswftc h. R9W to FmmT7. Model Votls-PA Mods An 811111"ASK Duplex & Medlanird alternator 10-0072 or 1000775. M98 115 1 Auto 9 A 1 or l d17 4. See FUUTIZ, fore ed rrmM of 68cfricai Mamator. ' NN 115 1 Non 9a 2 a 2 a 6 3 a4 & 5 5. Control swtc h 10-0225 used as a control adivaW. specify duplex (3) or (4) float system. D98 230 1 Arlo 4.7 1 or 1 & 7 - 6. Four (4) hole J-Pak, jurwiion box, for w t connection orwked4n en 23o 1 Non 4.7 2 or 2 a $ 3 or4 & 5 ssnpim or lupin opwadom lm4o02. 7. Two (2) hole J-Pak. for watertight connectim or splice. CAUTION For9dmraW on add aid Z.oeW t rirto 9 eo Plggybw* vedW l9l.wd Swft hes, All installation of controls, protection derices and wiring should be done by a qualified FMO477 rd1018k1AKlaWAM AReeAW F11MSucnpRSMMP;Issira l3ADl8T• rlcensed electrician. Ali electrical and safety codes sho ild be followed including the most PwwCtaatld, FMOtAb w FWM recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSKA). RESERVE POWERED DESIGN For unusual cond Ikons a reserve safety factor Is engineered into the design of every Zoeller pump. MAIL Tar P.Q BOX Ma Lunette "14317 . -htead9d 918rSOf.. Loubelk KY 410981form-/s.5%acE /~9r ow k1w jlYN7Y 20e~l.GOa! f,~X j501j71436M !a)Ict f11AV1 L. 31MS L Al CGe;9 P~'o,t Plan Paage~ ©f,V Property Owner ~J,L. ~ D~*N~ Legal D vi don (Cwq* where noted) o~ AM -SEC, -5b. rz R i~~►, TOWA) OF -n-04 ' = Buc'Ptoe pit 5t• CKoix. ulv JrY U,~ ~DA1stl~l W5 North ~orzTn P~ ~ g~ooM Off~C. Q 0/ ~O j N M S 44, 0~' Qt sue.., ./r ' ggdb ! 4401A O' - g sF5 D2 b ~M~ItJ NE,tt~ 1M- ~ 3~o (-DRM`N~e~T ~ Q m as p ~ ~~'eo~ 9$;zo BM,,MP of 7FeA9'ptt0A),F- 100.00 Site Location • w x CT N, MM'S' t Ss~' ',Slv Q,/rc."col Resources New/02-MS Products/fonks/Injection•Molded ron'rJIM-WGeredG Dr°vAngs/IM-540_00 TEE 05302013 ~mcno w !u O 0O>1c 50. AX N 7- z~SmxmAp -10 xro r m3x~MO x~ MwAg z* a D2ZDDO v+F "-m o - Z G r; N n O mCrxtn v 3i O =aZ A N 9 a m Z O'U- 10a m `n0 p w,3yx0Cn rn ~!'1 ~ 3 ~-z0m i >r O 3933Cyo - r3 0 oo .dam zcn 3u3 m 0E D o~ O in a N r rAOSm p= a, z z mzbO3 T 0 0 x l in 1 O1 n 5~ m i 11 MNG) 0 yz 'gym v 03 >p pm z Sp G, G) g z O $ a i r O c [pi omw v co mr z A rn m C) GI ~3m mao Cr N Z -;G T -6 w a na ~ on ~v z d~ a a G5 f) t fS z Np 0 C 17 O yS' O r o O m C ~ y v n ~ r ~ ~ 0 0n a o Q• u` '49 < g Q = t~ N.o N I ~ t a ~r o n m ° C 3 M v. lnfiitrator IW540 lank Volume as a Function of Liquid Level in 1-Inch Increments Liquid Level Above Bottom of Tank Volume -<:.c Centimeters Gallons LItEfS O 0 0 0 i 3 3 11 2 5 8 30 3 8 14 53 4 10 21 80 5 13 29 109 6 15 37 140 7 i8 46 173 8 20 55 207 9 23 64 243 10 25 74 279 11 28 84 317 12 30 94 356 13 33 105 396 14 36 116 437 15 38 127 480 16 41 238 523 17 43 150 566 18 46 161 611 19 48 173 656 20 51 185 702 21 53 198 749 22 56 210 796 23 58 223 843 24 61 235 891 25 64 248 939 26 66 261 988 27 69 274 1,038 28 71 287 11088 29 74 300 1,137 30 76 313 1,185 31 79 326 1,233 32 81 338 1 281 33 84 351 2,328 34 86 363 1,375 35 89 375 1,421 36 91 387 1,466 37 94 399 11511 38 97 41.1 1,555 39 99 422 1,598 40 102 433 1,640 41 104 444 1,681 42 107 455 1,722 43 109 465 1,761 44 112 475 1,799 45 114 485 1,835 46 117 494 1,871 47 119 503 1,905 48 122 512 11938 49 124 520 1,970 so 127 528 11999 51 130 535 2,026 52 132 542 21050 53 135 547 2,071 54 137 551 2,087 55 138, 552 2,090 e --r Soft M DIVISION OF INDUSTRY SERVICES 1, Plumbing Product Review P.O. Box 2658 Madison, Wisconsin 53701-2658 P S Trf: Contact Through Relay Scott Walker, Governor 'c'" P' ✓ Dave Ross, Secretary August 28, 2013 INFILTRATOR SYSTEMS INC. GOVERNMENT AFFAIRS DEPARTMENT 4 BUSINESS PARK RD PO BOX 768 OLD SAYBROOK CT 06475 Re: Description: SEWAGE TANKS, POLYETHYLENE Manufacturer: INFILTRATOR SYSTEMS INC. Product Name: SEPTIC, PUMP, OR HOLDING Model Number(s): IM-540 [INJECTION MOLDED POLYETHYLENE OR POLYPROPYENE RESIN, 2-SECTION TANK WITH MID-LEVEL SEAM; 44.0 IN. L.L.; 552 GAL. ACTUAL CAPACITY WHEN USED AS A HOLDING TANK; 475 GAL. ACTUAL CAPACITY WHEN USED AS A SEPTIC TANK; 227 GPD WHEN USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER; FOR TANK CAPACITY IN GALS. PER INCH SEE ATTACHMENT A; TANK DIMENSIONS (OD) = 61.7 IN. L X 61.7 IN. W X 54.6 IN. H] Product File No: 20130192 The specifications and/or plans for this plumbing product have been reviewed and determined' to be in compliance with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 130, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of August 2018. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. 0 The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • Installation and servicing of this product must be in accordance with the manufacturer's instructions. A copy of the manufacturer's installation and servicing instructions must be given to the owner of the system. • When this product receives wastewater from dwellings and is used as a septic tank, it will produce an effluent quality with a maximum monthly average value for BOD5 greater than 30 mg/L but less than or equal to 220 mg/L, TSS greater than 30 mg/L but less than or equal to 150 mg/L and F.O.G. less than or equal to 30 mg/L. Before this product is installed a warning label meeting the requirement of SPS s. 384.25 (8) (b), Wis. Admin. Code must be securely attached to the manhole cover. R w 'i INFILTRATOR SYSTEMS INC. Page 2 August 28, 2013 Product File No: 20130192 • This product is approved to use the following: - The tank provides one inlet and one outlet port. - Inlet and outlet pipe diameter is 4 inches for the inlet and outlet. The pipe can be Schedule 40 or SDR 35. - Inlet/outlet pipe water tightness is provided through the use of a rubber gasket, Serco Septic-Tite gasket. A detail of the tank wall penetration is provided in the installation instructions - Mechanisms for pump electrical connections from riser lid or other locations through the riser must be completed in conformance with the riser manufacturer's installation instructions. -Compatible risers include 24-inch-diameter riser products from Polylok@, Inc., Tuf-Tite® Corporation, EZ SET, and IPEX (Ultra Rib), in addition to 24-inch-diameter corrugated pipe. Maximum riser height is per the riser manufacturer's installation instructions. • Additional information is included as attachment(s) to this letter; see attachment A, B and C. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Glen A. Jones, M.S. POWTS Product Reviewer phone: (608) 267-5265 fax: (608) 267-9723 email: glen.jones@wi.gov ST CROIX COUNTY SEPTIC TANK MAMENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer fiy", 1 G rn I 1` 0,'Ct fin L AI c 6 ee maning Address S 7 r wood,-` A !fir Proptrty Adds 1 f` w odwf r~ v~ (Verification required from Pbmning Department for new construction) City/State R f' VW F 'q l fS W l Parcel Identification Number 0 t f o - 118SS- 20 ooo LEGAL EFA MO_N edy Lomfion _L LL p/4, /Y fit/ !4, Sec. 34 , T 2 f N -R L l W. Town of f 0 y "vision d of K l~ ►'d Ch°S . Lot # s Survey Map # Volume Page # W # L o volume . Page it Ll f~ Spec house 0 yes & no Lot lines identifiable A yeas ❑ no US's MAINTI?.NANCE trseand of your systemcWldr+ealtinitspremammhfi eto baudlowastes.Prnper consists of pumping out the septic tank every time years or soono; if needed by a licensed What you put into the system can affimt idw f on of the septic tank as a treatment m ge in fire waste disposal symm.' The proper ova= agrees to submat to SL Cmix Zonmg DDepartm= a ccatafiacatioa form, signed by dw owner and by a p jo ptamber, restrictedplundw or a licensed pwqm that (1) the on-site wastevatterdieVosal. sy e dudge. is in proper operating condition andfor (2) aft won and pumping (If *e optic tank is Iess titan Ili full of neccsrv, Uwe, the u igned have read the above requirements and agree to maintain sewage disposal system with rtes standards set fortis, herein, as set by the Department of Commence and the Department of ° a4 Resources, State of Wisconsin. Cartificaticm stating drat your septic system has been maintainecd nnrs~ be cmnpla4ed and recur _ ¢o the St. Croix C.ormilr Zormrg Ofl"rex within 34 days of the three year expirati- date MGNATURE OF APPLICANT ~J DWM , CL' AS90171'i I (we) certify that all statements on this form am true to the but of my (our) knovstt+edge. I (we) am (are) the owner(s) of dw property =LnA- ~ Y) - dcscn°bed above, by virtue of a warranty deed recorded in Register of Deeds Office. l /Lf SIGNATURE OF APPLICANT DATE Any infarnmatioa that is mn-re prescnwd may result in the sanitary permit being rvevo&cd by the Zouiug D nt $ndude with this application: a stamped warranty deed from fhe Register of Deeds office a copy of the certified snrM map if referanve is made in the warranty deed VE10 T(~ ~IC SYSTEMS Darrell Hubbell - Owner (0 2 z-- 1 S Thc? .5 ePr-,`C 7-ci k►K t' S7 c wood)-.° &Ole. Sv,`L Sc~r1/2Y.. -s 26r~s j 7- T7 -h e p-o(yet ye &-e u , h Le SS 7-h dy"O' 5-Cu'" Sea- yo t S > L-e Fo e ~p v,T. o Cl1e_an~o~e 1`0 h4 41-e- Rv "1 :9 ha G `t c( a [ir~~t /C~ h L a C k,%, de, ilyr Ce T-0 6 e ~Ccl c4eC r'12 S' [07~ Phone: T IS- -307-1630 Serving Pierce er St. Croix Counties R) _W co fU -9 H F- I--77----I/V W ~ r- 0 V I tj r/ 1 D V !_a V J F- ~]>M FI 3~z H -9 l J -U tJ by 3 -u ;7 M ;u D D On £ M ~ C ~ Z Hl :w ~J bd D t r p T) L h-" o 00 DD a-uR) ;u - N < m m FYI m 0 D E bad W w /-u m O D MEMO" M 0 m D D d < C) =mM, N O D -5 o O f 0~ 0 rIO m (-'-I m F- L RE Cn oly Wisconsin Departme o of Professional Services Division of Industry Services JUN 15 2016 SOIL EVALUATION REPORT Page l of 3 ST. CROIX COUNTY in accordance with SPS 383, Wis. Adm. Code rOMMUNITYp E pc County ST. CROIX Attach complete side plan~o9 piTt less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 040 - 1185 - 20 - 000 / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. !o Please print all information. Rev' Dpto / Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location «IJJI WILLIAM L. & DIANE L. MCGEE Govt. Lot SE 1/4 NW 1/4 S 36 T 28 N R 19 E() W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 57 E. Woodridge Drive 5 Oak Ridge Acres City State Zip Code Phone Number ity Ilage own Nearest Road River Falls, WI 54022 ( ) E.Woodridge Drive New Construction UseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD E] Replacement Q Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable ILIA tt. General comments Mound System 0.50 ft. sand fill 0.6 loading rate and recommendations: ❑ Boring # 11 Boring Q Pit Ground surface elev. 99.30 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 0-13 10YR2/2 - sl 2fabk mvfr gw 2vf-f 0.6 0.8 2 13-30 10YR3/2 - sl lf--mabk mvfr as lvf-f 0.7 3 30-38 10YR3/6 f2f IOYRS/6 sl Om mfr 0.2 0.6 F21 Boring # Boring 98.20 38 El Pit Ground surface elev. ft. Depth to limiting factor in. Soil A igtion 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 0-19 7.5YR2.5/2 sl 2fsbk mvfr as 2vf-f 0.6 -'0.8 2 19-38 7.5YR2.5/1 sl Ifabk mvfr as lvf-m 0• 0.7 3 38-42 7.5YR3/3 f2f7.5Y3/4 sl If--msbk mfr 0.4 0.7 * Effluent #1 = BOD > 30:E 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign CST Number Mary Jo Hu ertollistees Soil Testing & Design) ® 224832 Address Date Eval i n Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 05 - 26 - 2015 715-426-1775 SBD-8330 (1107/13) Property Owner MCGEE, William & Diane Parcel ID # 040 - 1185 - 20 - 000 page 2 of 3 3 Boring # 13 Boring Pit Ground surface elev. 98'6 ft. Depth to limiting factor 33 in. Soil 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 1 0-12 10YR2/2 sl 2fsbk mvfr 0.6 0.8 2 12-33 10YR3/2 Sl lf--msbk mvfr 0.4 0.7 3 33-40 10YR3/4 f2fl0YR4/6&10YR6/2 Sil lfabk mfr 0.4c 0.6 ❑ Boring # HBoring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # H 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L SBD-8330 (807/13) 4 Malt Plan Page-3 of A Propeny Owner bJt L-Li+AM L. b MN S G. ~1c I»=40ft Legal Description LaT 5 04k RIM ---CAC (vxqW Whem noted) o~ 'r►•t~ Nus`/~ fib. Tz~ Rlg►n1, Toh1~J a~-rR.oY. LII = $ackhoe pit HAAtb Pr sr. c~o~x G,ua►,~r 5/ w4sc~ ~t s~nl . , yR 5 North Ao2'C t► Pt ~~~,~ta- ,cReuE~~Y 3 ~ cor, "LAS Qai Ct.~uw) FeAk*z S S QR, OZ' 0 o ly 0 3 tV o -ST141- M7 M7 4 p cs+ Q 48~6bD' 191zo Q TE' .q,VE C,,eSLtAb> ~ ~o0.OQ Site Location: 8~ s I-xz cT N. Mht t a., k 'Ys a is t Yi a~