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HomeMy WebLinkAbout002-1049-95-000 (3) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 579057 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Hailing, Karl Baldwin, Town of 002-1049-95-000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town/Range/Map No: 21.29.16.309B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head T DH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes 0 No 51 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 891 230th Street Baldwin, WI 54002 (NW 1/4 NW 1/4 21 T28N R16W) metes & bounds Lot Parcel No: 21.29.16.309B 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 0 Yes ❑ No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. County REC tr~ ,~,nd Buildings Division J ilS ZO'11~11.a1hlklhin9ton Ave., P.O. Box 7162 - ` Sanitary Pennrt Number (to be filled m by Co.) PS ; Madison, WI 53707-7162 A 0 2 0 2015 S State Transaction Number anit n ~ I n accordance with SPS 383.21(2), Wis. Adm. Code, submission of tRs§*th e ap propriate governmental unit _ is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than m ling address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary ~ J 7 ~Q Y-k S purposes in accordance with the Privacy Law_ s. 15.04(1)(m), Stats. 1 ~+7 1. Application Information - Please Prin 1 Information - Property Owner's Name d 1 Parcel # r Property Owner's Mailing Address - -i--- - Property Location / Z 310 -S Govt. Lot [ • 6~ City. State Zip Code Phone Number 4 _JV(4 y, Section Z Li o,) e a o Z circle one v T N; REorw ll. Type of Building (check all that apply) #C&iAf h" Lot# t~ Kor 2 Family Dwelling Number of Bedrooms _ Subdivision Name - - Block # 'L Public/Commercial -Describe Use CA , /~GJ ❑ City of_ State Owned - Describe Use COO.~n. F r »ber ❑ village of Mown of 111. 'Fype of Pei mit: (C he k only one box on Ime A. Complete line B if applicable) ~ ;A New System ❑ Replacement System Treatment/Holding'rank Replacement Only El Other Modification to Existing System (explain) Go { lre Nit _uD_ H. List Previous Permit Number and Date slued ~ Permit Renewal ❑ Permit Revision ❑ Change of Plumber Permit Transfer to ew Before Expiration Owner `7 7 I N' I'ype of POWI'S Svstem/(ompont nt/Device: (Check all that a Non-Pressurized In Ground 1:1 Pressurized In-Ground ❑ At-Grade ~XMound_>, 2 f 4 ill. - - ' ' e soil ❑ Mound < 21 in. of suitable soil Holding rank ❑ Other Dispersal Component (explain)- _ ❑ Pretreatment Device (explain) V. Dispersal/Treat nt Area Information _ . _ - - Design laow t d Dcsie Sit Apihon R te(pds is e ~~rsal Area ea Re Yst) _Dispersal Area_ Pro osed (sf) System Elevation f7/ (p )L_ fp// u _ l~3Sy Nil. I ank Into Capacity in total # of Manufacturer Gallons Gallons Units v °o o a he" Tanks Existing Tanks CJ o 1J p y u r, U a U cn r`n iz J Septic of Holding lank Dosmp Chamhei 1 11 V/11. Responsibility Statement 1 the undersigned assume responsibility for installation of the POWTS shown on the attached plans. Plumbers Namc (Print) Plumber' gnature MP/MPRS Number Business Phone Number Plumbers Address (Street City, State, "/_,ip Code) S Cd t __SS_ - --e.~e VIII. 'ounty/Department Use Only - Permit Pee Date Is ied Issuing A t Signature \ppioted ~ „d en Reas *tpr Denial IX. Condit (c to.s for isapproval . 1. Septi 'ank, effluent H~ter 3) Gp,,t d+, o t n.. dispe I ton ^tt t P e irp¢ / maintained s as per fflandige rein liidn rti Ur tier. /A. «'r 2' A o , Tontained oU - - - _ - - h~ - 5 " is be -Attach to complete plans for the system and submit to the County out f-& aper not less than S 1/2 x H inches in size SBD-6398 (R. 11/11) X?a~7~ 07 SM f Joe, j ~ 7--oajd oc cA aw d ~r„~-s~ td►~ ~ ~ l'$2 Sps 3$3.33 0 10 1161 r~• ~r 1 Ike All t Iol.7S l6a A, be, te 4 i se ~iN~ ~a~ d~ eaJ ~Asf- 895 laq,~ Pre~ae L,Nt, nn~ ~ 5.srr` ~Aaf ' i Iy Sep / J X 0" 7 y,~,tJt' °r''5 ` ( I ve ~ ~ u CS%y~' Fed \•t A)( PXta~o~~ I ~ i to f~Po~~C- i OPY ,o~Y'~7arFA. DIVISION OF INDUSTRY SERVICES • T°~ 3824 N CREEKSIDE LA HOLMEN WI 54636 3 Q K Contact Through Relay P j http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~O -SION~~Sw Scott Walker, Governor Dave Ross, Secretary August 07, 2015 CUST ID No. 931384 ATTN: POWTS Inspector ZONING OFFICE MIKE RODEWALD ST CROIX COUNTY SPIA 285 COUNTY RD SS - 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/07/2017 Identification Numbers Transaction ID No. 2583686 SITE: Site ID No. 815745 Karl Halling Please refer to both identification numbers, 891 230TH St above, in all correspondence with the agency. Town of Baldwin St Croix County NW1/4, NWI/4, S21, T29N, R16W FOR: Description: Mound / 450 g1 / Per Capita Sizing / Combo Tank Replacement Object Type: POWTS Component Manual Regulated Object ID No.: 1549786 Maintenance required; Replacement system; 450 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade;. System: 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.01101, R. 10/12), Effluent Filter, Combo Tank Review The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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 use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • NOTE: This approval is only for the replacement of the combo tank and force main. The assessment of the absorption field for the compliance of Department of Safety and Professional Services SPS 383.25(2)(b)2.dN~ Wis. Adm. Code rules as they pertain to treatment capabilities is the responsibility of St. Croix County. p►p IDelp-T OF • The sizing for this mound system is based on per capita of not more than 6 person residence. Evidence of a f$SV deed recording that indicates that the system is designed and operated at occupancy is required prior to p1t0F OF ` issuance of the sanitary permit. • The existing POWTS tanks must be properly abandoned per SPS 383.33 Wisc.Adm. Code. • All of the conditions of approval for this system as noted in the transaction I.D. number 1431692 shall remain in SEE force including the management plan. MIKE RODEWALD Page 2 8/7/2015 • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20O2(d), Wis. Stat • SPS 383 22(7) 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. Owner Responsibilities: • SPS 383.52 Responsibilities. 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). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 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. 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 $ 80.00 This Amount Will Be Invoiced. When You Receive That Invoice, $.y Charles L Bratz Please Include a Copy With Your POWTS Reviewer 2, Division of Industry Services Payment Submittal. s, (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday WiSMART code: 7633 Jkarles.bratz@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm REUSE / RECONNECT OF A MOUND SYSTEM (tank replacement) c"EIVED 3 2015 FOR Y SERVICES A RESIDENCE WITH A DESIGN FLOW OF 450 gpd (Maximum occupancy of 6 persons) LOCATED IN THE NW 1/4 OF THE NW 1/4 OF SECTION 21, T29N, R16W. TOWNSHIP OF BALDWIN, SAINT CROIX COUNTY WI. INDEX PAGE 1 TITLE SHEET PAGE 2 PROJECT SUMMERY PAGE 3 DATA PAGE 4 DOSE CHAMBER CROSS SECTION PAGE 5 PUMP PERFORMANCE CURVE PAGE 6 PLOT PLAN PAGE 7 MANAGEMENT PLAN PAGE 8 INSPECTION REPORT 11/16/2007 PAGE 9-$ ORIGINAL 2007 MOUND DESIGN/approval PREPARED FOR KARL HALLING 891 230" ST Baldwin WI, 54002 PREPARED BY MICHAEL RODEWALD MPRS 931384 715-425-6200 FAX 715-425-8466 Bettendorf@dishup.us TONALLY This plan has been prepared in accordance with the ROVED Pressure Distribution Manual V2.0 SBD-10706-P (N 01/01 R10/12) SAFETY AND PAGE1 MAIL SERVICES 4DUSTRY SERVICES ORRESPONDENCE PROJECT SUMMERY A mound was constructed in 2007 for a 3 bedroom home -Design Flow of 450gpd. The existing 3 bedroom home and all out-buildings have been razed. Construction is planned on a new home on the site in a different location than the original, existing septic/pump tanks are to be abandoned as per SPS 383.33 and a new septic/pump tank installed in a new location & elevation. Homeowner is filling a occupancy statement with St Croix County showing a maximum occupancy of 6 people -(Design Flow 450gpd) as the new home will be in excess of 3 bedrooms. KARL HALLING PAGE 2 of Reuse/Reconnect of mound Original Conditional approval letter 8/15/2007 Transaction Id # 1431692 Site ID # 729151 Customer 226524 - Roger Timm As-built data from St Croix County inspection report 11/16/2007 Alt BM -top of filter cover 101.75 ft Manifold 102.33 ft Design data from Mound design 8/15/2007 Lateral volume 9.936 gallons Manifold dia 1.5 inch Manifold length 4 ft System demand 25.08 gallons/min Distal Pressure 2.5 ft Network pressure com loss 0.75 ft New force main dia 2 inch Force main length 240 ft Force main volume 39.12 gallons Mainifold volume 0.37 gallons Drain Back 39.49 gallons Manifold elevation 102.33 ft Pump pad elevation 93.45 ft Vertical lift 8.88 ft Distal Pressure 2.5 ft Network pressure com loss 0.75 ft Vertical lift 8.88 ft Friction loss 3.34 ft @25gmp --1.39ft/100ft x 240ft Total head 15.47 ft Minimum pump preformance 25.08 gallons/min at 15.47 ft 5X void volume 49.68 gallons Drain back 39.49 gallons min dose volume 89.17 gallons 20% of DWF 90 gallons Design Dose volume 90 gallons Septic / pump tank Wieser WLP 1200/800-MR Combo 800 gal pump chamber 22.24 gallons per inch Effluent Filter Best GF-10 Project Karl Halling Page Septic-Dose Tank Cross Section And Pump Performance Specifications 'l'ank Manufacturer Wieser Pump Manufacturer Gould Tank Model Number WLP 1200/800 -MR Pump Model Number p Total Tank Capacity Alarm Manufacturer SJE Rhombus Max. Bury Depth 8.00 _ Alarm Model Number Tank Alert AB Switch Type Float - non mercury -filter _Manufacturer_ Best Total Dynamic Head (TDH) - Feet Filter Model Number GF-10 Elevation Head 8.88 Distal Pressure 2.50 _ Network Loss 0.75 Minimum Pump Performance Required Force Main Loss 3.34 25.08 GPM CM, 15.47 Ft TDH Total 15.47 T Outlet Manhole Min. 4" Above Grade With Locking Device. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight Securely Mounted With Locking Device Weather-proof Junction Box - Finished Grade 'IF ~ l Depth of Cover Vent Min. 12" Disconnect Ft Above Grade Lean- With Vent Cap t'<'<'< t>t>< s aS let Outlet Filter Inlet Inlet Baffle_____ _ ySy <'< }t < >ta Switch Settings and Reserve Capacity ,/4)5 pop 5 > Tank Volume = a GPI t;< 's Weep Dimension Inches Volume Gal. B hole (reserve) A / 7, q Z. 398.64 < > a~> (alarm) B 2.00 44.48 Off Elevation C (dose) c 41<05. 9000 a, `lam' FFL* y; Bottom 't' (dead) D 12, ob 266.88 x <'< - - D Elevation Total _ ,3,5, 800.00 <'< > c < < tt 93, '-/at ' ' - - > S t < sl> > > s > : > > > > > > > a > > > > > > > a > > > > <at < 1 < / t < i < < < { < t < 4 < t 1 < a t a < t a < < < < t < < < < < ! < < t t < { < < ! S t t ! { < t i t S < {'t GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28 WAC. 02/05 U Page _ of Wastewater xr CETERS FEET 10 9 30 5GP 8 2.5 FT 25.__.._. n , 7 i V 70: (1 TD,. EP05 t 0 30 46' GPM APA( I I Y ~)C)" AJ o2dd 7 -ssl CIO r° : ' so d, oz g ~N , R A~W frr~ ~e,2 Sps 38s.3s t ~Nt' -Fr d C2> ot~ r6 to c~ >c ie 'yyf lae. A /QS~rr .D ~ [A/C F ~ ' Std` ~"a¢ ~ i I C iere r2. f Sep -30 s u) f~~ O 1ilDrivea~ a~ ~t I z Weg System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, jWe.,j".p I. or the St. Croix County Zoning Department, 715-386-4680, should be contacted for assistance. 7/S"►!~/¢~ ~rdZ00 General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which bows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water-saving appliances whenever and wherever possible, 3 Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7 No chemicals should go into the system. 8 Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. The upslope toe of the mound system must be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run-off; final settled slope shokiId be 2-3% over the system or 2-3% diverting surface run-off around the ends of the system. Maintenance I The septic tank must be inspected every three years by a properly licensed person. 2 If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3 When the septic tank is pumped, any solids in the bottom of the dose tank must be. pumped, and the filter must be back-washed into the septic tank to remove accumulated material, System use may require more frequent filter cleaning; initial inspections of the ±llter should be made every 6 months until a minimum time sequence is determined. I Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption :eII. If this system contains specific treatment components other than those mentioned here,.maintenance requirements will accompany their specifications. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allo~\ s reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. S Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. C) Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10 Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the s\ stem ;u e a I I Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring. may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83 54 (2) Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designin and/or installation of additional treatment components or conversion to a holding tank may be necessary. #10 11;A A 7 1 W isconsm Department of Commerce County: PRIVATE SEWAGE SYSTEM St. Croix Safety and Bulfding Dlvisiw INSPECTION REPORT Sanitary Permit No. 506397 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No. Personal information you provide may be used for secondary purposes [Privacy Law, s.1 5.04 (1)(m)l. r'ermit Holder's Name. City Village X Township Parcel Tax No: Simmelink_, Earl Baldwin, Town of 002-1049-95-000 CST BM Elev: _ Insp. BM Elev SM Descrit Section/Town/Range/Map No: - p /0-0 ~ 21.29.16.3098 TANK INFORMATION ELEVATION DATA TYPF MANUFACTURER CAPACITY STATION BS HI FS ELEV. 7. O~/ p /dy. /od Septic F ~ / DOd Benchmark Wee l a , y /0 •~3 /f0. /AA jj Dosing P~ Alt. B 411 ! v/ liecaEi~ f B dg. Sewer Holding St/Ht Inlet /6.29 q~ 9 TANK SETBACK INFORMATION 5UHt Outlet 14. ~2 • 4(. TANK TO K 11 Pt ~ WELL BLDG. Vent to Air Intake ROAD Dt Inlet ,O 5 5S o 1- Septic Dt Bottom lg 3 79 q3,2-7-3 Dosing '/q l /g Header/Man. 7"S /b . 3 H;_at;on Dist. Pipe 5•b3 iQZ. a5 Holding Bot. System PUMP/SIP ON INFORMATION Final Grade 03 /6.3.0 5 Manufacturer 1 5 Demand St Cov 5,33 O ! cJ,~ Cp Model Number P 31 Jos r ,r3 <D60 TDH I Friction Loss System H ad TDH Ft of 0. (07'. /Z.91 Forcemain Length If Dia. I / Dist, to Well `S Z_ M/ SOIL ABSORPTION SYSTEM BE011RENCH Width ~T Length No. Of Trent s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 5 7 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type O ystem / UNIT Model Number a _3 _36 32 N DISTRIBUTION SYSTEM C4L.4t. (L c(.t,J Header/Manifold Distribution x Hole Size x Hole Spacing IVepto Air take /,~j Pipe(s) 1. 5 3 / l..engtli___ Dia Length Dia Spacing. G SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 1 ur.+... Depth Ovc:~r Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed!Trenc h Cewer Bed/Trench Edges Topsoil `,~(es No Yes No - . I ] COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:_ j-/ / Inspection #2: Location: 891 230th Street Baldwin, WI 54002 (NW 1/4 NW 1/4 21 T28N R16 metes & bounds Lot Par I No: 21.29.16.309B 1 .)Alt BM Description 4-C) Q "'iv = r (3ldg sewer length = ZSS 1,As iAc,. pJ~rN,~o ; nc, nee,~~5 ~Jor k,. 4 & I✓c amount of cover = t / .1 Ja 3 a ~a~u cam. 5 7 ~ :Z~, b,~ O W4_0 POwTS JI Jb D7 - - PROJECT KARL HALLIN(i Date ~ Insepcto Signat / J3 JD ,p, Cert. No. PAGE OF / / Safety and Buildings 4003 N KINNEY COULEE RD Commerce.Wl.gov LA CROSSE WI 54601-1831 TDD (608) 264-8777 h www,commerce.wi.gov/sb/ C V www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary August 15, 2007 CUST ID No. 226524 A7TN: POWTS Inspector ROGER L Timm ZONING OFFICE TIMM EXCAVATING ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/15/2009 Identification Numbers Transaction ID No. 1431692 SITE: Site ID No. 729151 Earl Simmelink Please refer to both identification numbers, 892 230TH St above; in all correspondence with the agency. Village of Baldwin St Croix County NW1/4, NW1/4, S21, T29N, R16W FOR: Description: Three Bedroom Mound System / Replacement construction Object Type: POWTS Component Manual Regulated Object ID No.: 1147470 Maintenance required; 450 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01101) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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 use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • The existing POWTS shall be properly abandoned per Comm 83.33, Wis. Adm. Code. Comm 83.22(7) - A copy of the approved plans specifications and this letter shall be on-site during PROJECT KARL HALLINCi authorized representatives of the Department, which may include local a P.O.W.T.S. PAGE OF Conditionally ,APPROVED I)EPARTMGNT no; rnaAkAcnne ROGER L TIMM Page 2 8/t5/2007 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. Comm 83.54(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 Safety & Buildings 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMA_RT code: 7633 jerry-swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. Henry F Grote, Certified Soil Testing II PROJECT KARL HALLINU PAGE OF Earl Simmelink - Mound v`~' ~Y g ZOp~ Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Pressure Distribution, SBD-10706-P (01/01) Mound, SBD-10691-P (01 /01) Location: NW '/4, NW V4, Sec. 21, T 29 N, R 16W Town: Baldwin County: St. Croix Date: August 15, 2007 Owner: Earl Simmelink Address: 886 230`h St. Baldwin, WI 54002 Plumber: Roger Timm Signature: / ✓ License: 2265 4 Attachments: SBD-10577 - Plan Approval Application SBD-8330 Page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management DSAfE7Y AND BUILDINGS ~ pW_T of 8 ~"_RES ONDENGE PROJECT KARL, HALLING PAGE OF -4 I I Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD5 < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 df7_b gallons/day hydraulic load Design Calculations In situ designed loading rate gallons/sq. ft. per day Depth to estimated high ground water ? Z ° in. Depth to bedrock in. Cross slope at system S' % wY Force main length S S ft. of Z in. q,q 6 Manifold/header length 4'o ft. of I L in. Drain-back 9'3 gallons Lateral length Z @ ft. of 1 in, Lateral elevation ° q ft. @ bottom of lateral Lateral hole size in. @ 3b in, ( 1,0 ft.) Spacing 1~ holes/lateral 3 holes total Lateral volume gallons Total lateral discharge rate Z5' ° g gallons/minute @ z.S ft. head i Network pressure compensation losses Lo'~'s Elevation difference i Friction loss ft. @ ~S gallons/minute l~ S Total dynamic head ft. Pump/si`~hon 1b gpm @ 1 S ft. of head Manufacturer Cs- Model Dose volume `66.C b gallons I,ift/sipVbn tank "C' gallons Septic tank gallons Effluent filter Ca m o (L Jvov°0 Measurement pump on and off in. a Height alarm from tank bottom ' o in. Reserve capacity gallons specs .caics.res PROJECT KARL HALLING Page Z- of g PAGE 1* OF a~~ S'.,..,...~,,a~~,~ P~a~ ~ 1,.~. 1.0 4, Nw. 1~1w•2\-Z~-Ib~ i c~r>'Z- 1 o~t-aS•c~va cam. ~II k S (v~ o~ { owV J co~it- t` JCS ASK ~ 0'1 i'l'l 2 L Z i : . \ < q 4~ -ate w SS ~V~VC~ 4o c11, 1, ..l•s Ctos !s L _ i r ~ I-------- S w. s e C 4 I, too JUa4.~ lcrlj~ ZoC', .CA p~ 1-\.ti3~ S 5 o <l \o s,S~ e-~ G-V ~a c o ~i V Q • ~fuJVno~ PROJECT KARL HALLING 3 DS $ PAGE OF 112 y oe. l,, to ~ 0. ¢X trv , \ ~ , i t 01.4 / I Ate ~o ~ o,p t a',, - 1 1, ' ~ lam' ~.5; ` 1 \ M w.a b i c o II w., o.v 4,a,,, ly o~a, oc\ le, I i PROJECT KARL- HALLING PAGE A OF . 0.h ~ \Q y~ • 1 _ z o C, Y X3,0' b. lc l o', 4\ ?~C ~.l!//((()~ 1 o~ts.rv.'K.r. ...IL L`► O ~a.; , vet-v~.`~ +a.V...1..s.~ l,5' ~~aw n...~{ • 1. ~ac.1~ bs~ p 1 ~ ,4}ar..\1 4,0 S 4 , o' We(- Ole Q V L t t_~ (T a IL A'. r. } 4L-l~ 4, U ~ Q0, ~o PROJECT KARL HALLING PAGE OF It f,'? • a 1~ O VEIJT CAP VENT FIFO WEATHER PROOF APPROVED LOCKIKIC, > JUUCTION BOX MAIJHOLE COVER 25' ~:ROM DOOR, wgRN~N V 4WDOW OR FRESH AIR INTAKE LAQ~t^ GRADE PROVIDE AIRTIGHT SEAL ~ III ~ t I I p it f~~ S. E~~SI?2V lT ~LO`I I I i I APPROVED JSfQITS W ` I I ( W/ PIPE 0 w~ Q- .\IV I ALARM ETE►JOtuC. 3' I II OIJTO SOLID SOIL O `I• OFF PUMJK CLI ~ ~S I , i PROJECT KARL HALLIN(i O jlli * 06 PAGE OF ITT GOULDS PUMPS Wastewater PERFORMANCE RATINGS COMPONENTS Total Head Gallons Per Item Descri tion (ft. of water) Minute No. p _ EP04 EPOS i impeller 5 53 - 2 Base O`~~ \ 10 46 62 3 Pump Casing 15 36 55 4 Mechanical Seal 20 21 46 7 5 Ball Bearings 25 0 33 6 O-Rings y - 30 - 11 7 Power Cord 5 ty 8 Oil Filled Motor 4 Motor Housing/ 9 Stator Assembly r 10 Motor Cover Z'w METERS FEET 10 ~ ~ ; 9 30 ► 5 GPM g I 2.5 FT 7 777t~ i 6 2 D z 5 q 151 e 4 EP05 O ~ 3 101.. , EP04 z i s E-- - - I - - - - 1 i. D 11 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m'/h CAPACITY PROJECT KARL HALLING 3 o g p PAGE OF _4 System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Roger Timm, 715-772-3214. or the St. Croix County Zoning Department, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. The upslope toe of the mound system must be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run-off; final settled slope should be 2-3% over the system or 2-3% diverting surface run-off around the ends of the system. Maintenance I The septic tank must be inspected every three years by a properly licensed person. 2 If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accontpan. their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allo~%s reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7 Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. S. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9 Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10 Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 1 1. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 33.5-4 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing. and/or installation of additional treatment components or conversion to a holding tank may be necessary. PROJECT KARL HALLING Page 8 of 8 PAGE OF ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Kq'L ~a l t tiny Mailing Address 5- &ok w, 1 r C~ ~-a-•e! , WT 5"*f0t 5- Property Address $ q l P30' t` & W W,"' L>L- 6460a (Verification required from Planning & Zoning Department for new construction.) City/State (act IJ W ,V-\ Parcel Identification Number ©OoZ to Ll44 Soot) LEGAL DESCRIPTION Property Location 11 (1 1/, , A)U , Sec. _gl, T _eq N R I (p W, Town of /3a talw%L% Subdivision Plat: Lot # Certified Survey Map # Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house 13yesMno 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 §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. 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 Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe 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 ?1 to r 57 SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12)