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HomeMy WebLinkAbout024-1003-50-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 579075 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2590629 Permit Holder's Name: City Village Township Parcel Tax No: Michael & Amy Weber TOWN OF PLEASANT VALLEY 024-1003-50-100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /6`1~!) i G-5r 05.28.17.18C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE S CAPACITY STATION BS HI FS ELEV. Septic 4. /Z 6SGT' -:C-, l Benchmark IL~j _ Dosing ~ 7 ~ ZDiS t~~ , le r , 5 $ Alt. BM 1O O Bldg. Sewer Holding p St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO R I WELL BLDG. o Air Intake ROAD Dt Inlet Septic ~I /J 4 t~ L Dt Bottom T - iZ.95 91 tJ Dosing ~ t /tY '7 `Z / Header/Man. 5 q C Aeration F ~ ~ ~ J~ Dist. Pipe C Holding Bot. System s. ~5 98.9J PUMP/SIPHON INFORMATION Final Grade Manufacturer 166,:5 / o 1 L GPlm~and St Cover 6I 6a I Model Number f6 41 z -7.,4 TDH Lift Friction Loss System Head TDH Ft 8.45 8.4L q. s5 /3. Z. Forcemain Length 5 Dia. I Dist. to Well 2 i. rl SOIL ABSORPTION SYSTEM BEDITRENCH Width 11-ength No. Qf Tr ches PIT DIMENSIONS No. Of Pits Inside Dia. IL!quid Depth DIMENSIONS ~D d K/7~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type O stem: ~ ed ^ G ~1 A A UNIT Model Number: DISTRIBUTION SYSTEM 0A- - Header/Manifold Distribution , ~1 x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) L G 1 (P, / Length Dia Z5 Length ~'S` Dia t5 Spacing 3. 3 a ` ce SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of~ xx Seeded/ odded xx M ched Bed/Trench Center Bed/Trench Edges Topsoil tY Yes Fo~ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1667 60TH AVE 1.) Alt BM Description = ~l' G✓~~G~C~,~JS 2.) Bldg sewer length - amount of cover = i 00, Plan revision Required? 0 Yes No d Use other side for additional information' SBD-6710 (R.3/97) Date klinseepct Cert. No. ECEIVED County Safety and Buildings Division 5' c 2d / x 201 W. Washington Av O. ox 7162 Sanitary Permit Number (to be filled in by Co.) EMadison, WI 5 -7 * A,- ~ COUNTY 57907-5 CROIX PCA =1 f LJ State Transaction Number anitary ermit Application 75`7 b (.,Z`? In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fort to the appropriate 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 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. Lff 1. Application Information - Please Print All Information A V6 Property Owner's Name Parcel # /;4 Lc- 2-- /0 0 3 - o Property Owner's Mailing Address Property Location D G vt. t J 0"P* J3 City, State Zip Code Phone Number y., 1/., Section circle one) T -Z-,V N; R E or W II. Type of Building (check all that apply) Lot # Subdivision Name 1 or 2 Family Dwelling - Number of Bedrooms Block # VA IZ ~ #21-3 12 El Public/Commercial - Describe Use C 61A r-WA_ ❑ City of 4L 1,- 57~t~r Number a, ❑ Village of ❑ State Owned -Describe Use CSM i/%t Mown of Ar (aO III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. jd-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 IV. Type of POWTS System/Component/Device: Check all that apply) 671 6 or 0 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dis ersaVrrea ent Area Information: DeLeo ign Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Proposed System Elevation Q p b O 1 g, VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units u New Tanks Existing Tanks n c y Septic or Holding Tank (Z ®O f' Z ( W S1 Dosing Chamber o 8a~ / r VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Pl' ature MP/h~SNumber Business Phone Number D~ X)Ez-~, ✓ :K 7 Plum er' ddress (Street, City, State, Zip Code) E-: C C 5; u-.9 d GtJ VI oun /De artment Use Only Permit Fee Date sued Issuing ent Signature Approved rrw $ • w ~ n ' en Reason for Denial DL Conditi"fi> NOffieasons for Disapproval \ 1. Septictank, efili entMar 6'M 31 1444h / A.. Dispersal cell must all be ser0ces / maintained I ; LtJ / ,(J _ a as per management plan provided by plumber, (r"W PeAAAe rpl7St ~e.►rnlint~irrid as per sppNa" code / ordi ww". Attach to complete plans for the system and submit to the County only on paper not less than 8 1/I z 11 inches in size SBD-6398 (R. 11/11) tiY~x7.~Tg DIVISION OF INDUSTRY SERVICES 3824 N CREEKSIDE LA /s~HOLMEN WI 54636 Contact Through Relay http://dsps.wi.gov/progratns/industry-services s PS', \ S c4 www.wisconsin.gov ~O~ssrorNtisw Scott Walker, Governor Dave Ross, Secretary t August 21, 2015 CUST ID No. 224832 AT7N: POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08/21/2017 Transaction ID No. 2590629 Site ID No. 816344 SITE: Michael & Amy Weber Please refer to both identification numbers, 1667 60 Ave above, in all correspondence with the agency. Town of Pleasant Valley St Croix County NW1/4, NE1/4, S5, T28N, R17W Lot: 2, FOR: Description: Mound / Four Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1552106 Maintenance required; 600 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, 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. The owner, as defined in D,,~` chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. GIN R No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s145.06, p►P~ cJ stats. O ~pS The following conditions shall be met during construction or installation and prior to occupancy or use: pRO~~ 0 Reminders pw%a • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. SEE • 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. 145.20(2)(d), Wis. Stat MARY JO HUPPER.T Page 2 8/21/2015 ' • SPS 383.22(7) A copy of the ap roved 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 c onstruction/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 This Amount Will Be Invoiced. When You Receive That Invoice, Charles L Bratz Please Include a Copy With Your POWTS Reviewer 2, Division of Industry Services Payment Submittal. (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday WiSMART code: 7633 charles.bratz@wisconsin.gov "a x cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm ,'p2 MARY JO HUPPERT Page 2 8/2112015 • SPS 383.22(7) A copy of the approved plans, specifications and this letter shall be on-site durin)z 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 $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Charles L Bratz Please Include a Copy With Your POWTS Reviewer 2, Division of Industry Services Payment Submittal. (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday WiSMART code: 7633 charles.bratz@wisconsia.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: MICHAEL & AMY WEBER Owner's Name: (same) Owner's Address: 815106th Street Roberts, WI 54023 Legal Description: NW 1/4 of the NE 114, Sec. 5, T28N, R17W Township: Pleasant Valley County: St. Croix Subdivision Name: NA Lot Number: 2 Block Number. NA Parcel I.D. Number. 024 -1003 - 50 -100 Plan Transaction No.: t ~t~~~t>NNUI Page 1 Index and title Page 2 Data entry Page 3 Mound drawings ~ Page 4 Lateral and dose tank NALLY MARY JO WED Page 5 System maintenance specifications D 1858 a Page 6 Management and contingency plan kFETY AND Page 7 Pump curve and specifications 4AL SERVICES Page 8 Plot plan jUSTRY SERVICES y~~~~~~f~ntttrir111Nit►~~~~ , )RRESPONDENCE Designer. Mary Jo Huppert License Number. 1859 - 007 Date: 08111/15 Phone Number. 715 - 426 -1775 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01101), 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. 0312012) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Mote: sand fill (o) calculations assume a 400.a Estimated Wastewater Flow (gpd) Table 38344-3 M-slt, sW teatnent fcr 1.50; Peaking Factor (e.g. 1.5 =150%) fecal coftrm of 36 inches. 600.00 Design Flow (gpd) 6.00 Site Slope ~98.40 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) r 0,40 In-situ Soil Application Rate (9pd/lf) Distribution Cell information 60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/fe) I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Dis ibution Information network? Enter Y or N (C or E) a Center orEnd Manifold 3.33 lateral Spacing (ft) If N above, enter the elevation (ft) m . 3i Number of Laterals of the highest point. ~ 01561 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 11.76 felorific:e 2.00; Forcemain Diameter (in) 26.x' Forcemain Length (ft) Does the forcemain drain flack? ~ Y.m u. 90.001 Pump Tank Elevation (ft) Enter Y or "N 4.55 System Head (ft) x 1.3 4.24 Forcemain Drainback (gal) 8.49 Vertical Lift (ft) 55.97 5x Void Volume (gal) 0.43 Friction Loss (ft) 60.21 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 27.46 System Demand (9Pm) - 13.47 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options I 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 (optional) Treabnent Tank Information _ Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) _ Total Working Liquid Depth (in) Wieser Manufacturer gain (enter nesuft in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Ca u pacify (gal) PolyLok f Filter Manufacturer 22.24 Dose Tank Volume (gain) 525 !Fitter Model Number l Weiser Manufacturer Project: MICHAEL & AMY WEBER Page 2 of 8 Mound Plan and Cross Section Views t B 1/10 J Observa Wn Pipe K.-•• 1K~Y'M1r'!1ti 1:ea•.1vhP.r.r`l•r.r.r••-•.P.rM.hP-F.r.P•P'r.r•r.1.J•r•l.P1P••S.S+.••-SAP•1•f • - S 1•S•S•S•SK•S•S•S• SK•YSKKKKK S•S•YSaYSK• - ;:}+r•r rxhd P hP=•`. ;.4~4:~h> •r•PxfnP•r r rx 1x r~l}f S•S•:' 'L••.•i..S.e.S-S•i.. S•S•S S~a.S•Sx r x.P•re. .dw°+hr+ f=r=r•. r+r:P=P.P=.°.P•r•r 1. P•P-' 1.S•S+q.1•S.q•i•S.S•i•S• S.SKK A S+S•S-S•t S.•-•;xq.q+S..•+;.5.4.;. g• hr.hP•P=r•r.r.r.P.r•r.P+1'xr .°xXhr•r •'.r•r•P•r+hr•P•h1•P•P+1•rY•/•r•r+r•?•li S*S•YYSq•S+SK•S•P•r S:Yg•S•S•S•S• Y°eK`S••x• S:YYS-S•SK•S•S•S+°••S••.•S•S•SK+ i•hr•r+hr•r+1•r•P••r•r•r•rsr•r•r+r•r•r•rY W S•1+1•S•S S+S•S•S•S•Y1•S•YS•S•S•S•S•S+S•YYS•i++xK•Y I .I._....... e. .r • B _ I L Mound Component Dimensions Down slope toe extension made. ft A 10.00 ft E 13.20 in H Aft ft K [Aft B 60.00 ft F 9.25 in 1 ft L ft D 6.00 in G 0.50 ft J W 600.00 (fe) Dispersal Cell Area 1500.00 (fe) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.67 (ft) /f' ♦ H f/f/IIII// Iflfl/N/ G l I F E)ispef" 99.40 (ft) Lateral 98.90 (ft)-► Invert Dispersal Cell] Q; . Elevation D 4 4 40 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on Q Topsoil Cap a• 1.5 ft •r•r-r hr•hhr•d r+r'r.r r.r Page 4 for number, ssize, f!/!!!! O C S-YL•Y1•S S+Y1~K•S•YYS• Q Subsoil Cap i O r•rgrai~r,hr.hr•r; sr•r and spacing of laterals. °SA+ar f s' 1 T ASTM C33 Sand 1° •?;:s rrq r 1:.`. ';:y:.f F .r • ® S.S.S•S S S S.Y~•e4~K.1'Y Laterals are equally ••4+5?•rpf•r+r r F•r•r.~ K~~rtiP Tilled Layer 0. ft Tvaicat Lateral ~'P'P•r spaced from the C S^•YS"+K•S•S•SK•S•S-SKIS •r dWbtK Uon cell's Aggregate iiiiii M•hh~.r.r+r•r•hr.P•P•P.r © r•rv S•S•SK• lG ~ SK•S S••.+S•S•S•4+'xv4•S•YS O . r•r+•`+hhr+r> wP•P=r•hh + l +`~}t-. •Sr`~fSx~°+~'.~S•;L;':• oenteriine in the • A distribution cell (AxB). Project: MICHAEL & AMY WEBER Page 3 of 8 End Connection Lateral Layout Diagram G'onut dae tat+wals OY 0( ^&0.5nw4wicp¢n 40 m Tu rn-up vwmsif vatve d®f 0*0tbutpfua F P AN tawrads xe ideMieal lE X-- >I Hones dared owne i~oaaora of die tafatyal equally Sp--d 8 Laterals &VWCeW4w'n Sch 40 PVC per SPS Tolle 384.302 Fome main fcwviafeeorROSS4ornanAbldatanypoWK. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ft2/orifice Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft System Flow Rate 27.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 13.47 ft Forcemain Velocity 2.80 ftlsec Dose Tank Information t.ocluM cover with warning label and locking device and sealed watertight ElecUical as per NEC 30,0 and SPS 316.300 wAC Disconnect 4 in. min. Tank component is property vented Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Capacityl 800.00 Gallons T Volume 22.24 gal/inch A Weep tole or anti- Dimension Inches Gallons B siphon device A 20.36 452.89 B 2.00 44.48 C e~yapcn (ft) -d np off C 2.71 60.21 90.91 D 10.90 242.42 D Total 35,97 800.00 11 Dose tank 3 Bedding under tank. 90.00 Alarm Manuafactuurer SJE Rhombus Note: Switches Alarm Model Number Tank Alert AB containing mercury may not be used in Pump Manufacturer Gouk1 this system. Pump Model Number PE31 Pump Must Deliver 27,46 gpm at 13.47 f t T D H Project: MICHAEL & AMY WEBER Page 4 of 8 Mound Sw em Maintenance and Oaemdon Specifications Service Provider's Name Ron's Septic Service Phone 71 9 5-749-0153 POWTS Regulator's Name St. Croix County Zoning Phone' g 715386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.75 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Sw v, ice, Frauencv Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and dean at least once eve 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound p Inspect for pondinand a 3!s _ . Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tung-up Detail Grade Finished 4/FN 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution g Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: MICHAEL & AMY WEBER Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code t This system shall be operated in accordance with SPS 382-84 Wis. Adm. Cock, and shall maintained in accordance with lts' component manuals [SBD-10691-P (N.01 101), SS~ Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBDA 0706-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 cowers should be inspected for water tightness and soundness. Access openings used for service-and assessment shag be seated watertight upon the completion of service. Any opening deemed unsound, defer or subject to failure must be replaced. Exposed access openings greater than 84nches in diameter shall be secured by an effective kicking device to prevent accidental or unauthorized entry into a tank or component. 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 tiller 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 removes( unless provisions are made to retain solids in the tank that may slough off the fiftw when removed from its enclosure. H the filler 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 shag have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The are addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products used they approved for septic tank use by the Department of Commerce. Purnp Tank The pump (dosing) tank shall be inspected at least once every 3 years. AN switches, alarms, and pumps shag 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 Svstenn No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shag be seeded and mulched as necessary to prevent erosion and to provide some protection from front penetration. Traffic (other than fur vegetative maintenance) on the mound is not recommended since sod compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L SODS, 150 mg& TSS, and 30 mg& FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice dogging 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 shag be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. If the septic tank or any of its components become defective q2WNW the tankkoor component shall be proper operating condition. repaired replaced to keep the system in if the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shag be immediately repaired or replaced with a component of the same or equal performance. If the mound component faits to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POINTS regulator and service provider. Pmtmatmem 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 M e-5eR, NA I CW-t- r ~N`Y Pie 6 of 8 c"CULDS PUMPS Efflimmt Pump PE m. 0 Ow". err l.VW OHM lioa wftm4 mama rda~ • 115 aw 23it* ■Cattiron badY ~ _ • 6riEin>i~p~~, ~~~pddraxd ' tegiaa~a~t ■~~aodbw~er ASK modals #ude a • 0 ye~d esi.WL d ► 6aN bead~j SP designed forte tnodeb aaaiobk, c rbop sled • Mew . ' see` pE31 Malrr: ~d~'e4ended ft W. Motnd PE31 dart arcerMe. • , Hp.3009 Nplli • ftwmd fw • ~qip • 1i5tRtllc s 9 JM ■ , m" ftw • CIO UP 3m rpm ~ Qaidc ~ t PWAW tpr. a 61 GM • 1i5add23l W420' /Anal be& 2W IN • PKde* ~lyd* 1W3 wwa Pict Pmw pESt Moeor QPaW. 78 UM 115 or2 rg bft 3r 7W • 15 ~ NU MWftm A QwPWW*is 40 EMB&I"adis"fNk 35 .l~ Sled. . Jaw to sa Slams seeel , 30 zs I Fr 25 - - 20 ' C m TMWUULIXmd 4CMW%w mft*Awsdwn to ~+NI~a6e -F , to 20 30 ~ o~s1rltkls0leei 11, 50 60 70 6PM 803E ~'T ° N n 10 I,tJOW e ` Plt Pmt Ptqgez:~ of S M t~ 8~g 1------- h' Owner Legal l iou .h-;.mm ik w- (fit When no , MtY ;f`I, Vic- s,,?~sAi 1, R I I -OWAI OF Pi, Vr = ~IOiC~lit N P~s~ a r o yQ s~2'ua~'~ 1 r VF \ s sP'K+P+~U, c s ` 1•~ROILL } tt L4~ydAS114 , X1743' S~fM Ib# Sxitt` _ ~ b - 4k "jo- X' SATE - Dins scfii. yn ~o~~Mdlt~l .SSG • . SEPTIC TANK. MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM i Owner/Buyer Mailing Address + Property Addrest 14:21JAA V" L-WA A-) (Verification required from Planning Zoning Department for new cons ction.) City/State 1 "A 011 Parcel Identification Number ©Z ~ - z o 0 -3 ',5-h zo CD LEGAL DESCRIPTION Property Location %a , 1/a ,Sec., T rN R 1-7W. Town of P(L~Gc~~-~ p Subdivision Lot Certified Survey Map # Volume , Page # Warranty Deed # 31,E , Volume , Page # Spec house yes `no Lot lines identifiable es 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning.& Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this fo are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warran deed recorded in Register of Deeds Office. mber of bedrooms IF /2 Y/ S I ATURE 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. 08/05) ri r, " J rr rr 0) r r J E3 ,r 0 ,r J r r QQ CID r, n ~ W mU Z " W N D 0- 4-- 0 LU t w ' am ❑ ow ~ ~ T- a-+ 4., C C C cn .21 E w 0 aj In (n u D U 0 U D ® 13 u w z W4 a a J U J J C O N o2S CF) _C 'a mV Z a~ oUj Qm ow I s-.L .Z U ~ RATI3e21V.3 Se' ~C.V9/9s2W b' I RD . 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LL N mear~w 3NW°RLH11M an~na3adazsz~ c•- ppp CO F 6` x £4 W z a (O lItlF1IXJ°M N3d° ? .4/£ 9-,94 2 ,L Cc O ~~~m b U ~ ~ d r a Q a° W d 88 ~a Z x ; L £.Ol is LU T d €S is a) gNU w NRO v ! S N ar~wrtMw t W tpg xoNSma,s ao C O cr- U"3 - - fir l- xJ Y o ~ g LU .9 1 ` ~ 3MAtlb'k3,tlnS6YA ct'~ 1- `_~a~ ~ G+~~~6 \ X60 C M1316Y°4Bddn.it Y - ? N U) CO J =co aa' U a \ oa gab-„at/4 :s a \ w;F Q X oC QO N v \ 7 ~e v l s~ rQ'o 2g f w. xw,o . w Jw.» -F a t~ '.V. Wisconsin DepartmeA6tip4po i4 ftfessional Services D f - S Division of Industry Services d ?,S- - ST. CROIX COUNTY SOIL EVALUATION REPORT Page I of 3 OMMUNITY DEVELOPMENT in accordance with SPS 383, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not 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. 024 1003 - 50 - 100 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Rev' by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). l Property Owner Property Location • MICHAEL & AMY WEBER Govt. Lot NW 1/4 NE 1/4 S 5 T 28 N R 17 E (or® Property Owner's Mailing Address Lot # Block # Subd. Name or M# 815 106th Street 2 I CSM 12/3420 City State Zip Code Phone Number ity []tillage Town Nearest Road Roberts, WI 54023 ( ) 60th Avenue New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Q Replacement 0 Public or commercial - Describe: Parent material sandstone Flood Plain elevation if applicable ft. General comments Mound System 0.50 ft. sand fill 0.4 loading rate and recommendations: ❑ Boring # 11 Boring o pit Ground surface elev. 98.10 ft. Depth to limiting factor 42 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 0-9 10YR2/2 1 2fsbk ds cs 3vf-co 0.6 0.8 2 9-17 10YR3/2 I Ifsbk ds cs 2vf-co 0.4 0.6 3 17_26 7.5YR3/4 sl Ifabk dsh cs 2vf-m 0.4 0.7 4 26-30 7.5YR3/4 sl Om dh cs lvf-m 0.2 0.6 5 30-42 7.5YR4/4 is Osg ml as I of--f 0.7 1.6 6 42-45 7.5YR4/4 c2f 5YR4/6 scl Om dh 0.0 0.0 few cobs & stones. 2 Boring # 11 Boring 97.20 30 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10YR3/2 $l Ifsbk ds cs 3vf-co 0.4 0.7 2 11-26 7.5YR4/4 sl Ifabk ds cs 2vf-co 0.4 0.7 3 26-30 7.5YR4/4 - 1s Osg ml cs 2vf-m 0.7 1.6 4 30-37 10YR6/3 c2d 1oYR5/6 fs Osg MI lvf-m 0.5 1.0 few cobs & stones. " Effluent #1 = BOD, > 30:< 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig CST Number Ma Jo Hu ert Hollistees Soil Testing & Design) ® 224832 Address Date Evalua Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 08 - 10 - 2015 715 - 426 - 1775 SBD-8330(R07/13) Property Owner WEBER, Michael & Amy Parcel ID # 024 - 1003 - 50 - 100 Page 2 of 3 11 F Boring 99.80 42 3 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 1 0-8 10YR3/2 1 Ifgr ds cs 3vf-co 0.4 0.6 2 8-16 IOYR4/4 1 Ifsbk ds cs 2vf-co 0.4 0.6 3 16-32 7.5YR3/4 SO Ifabk dsh cs 2vf-co 0.2 0.3 4 32-42 7.5YR3/4 Is Osg ml as lvf m 0.7 1.6 5 42-46 7.5YR4/4 c If 7.5YR4/6 scl Om deh 0.0 0.0 few cobs & stones. ❑ Boring # Boring Pi{ 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 I ❑ 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 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L SBD-8330.(R07/13) Plot Plan Page 3 of 3 Property Owner M MAEL7 h HMV I------4 1"=40ft Legal Desc* on t -r ~ c , ~,~3~r~ r/~ o~ (exept wk m not4 ->yw- u/m- & SUe- s~-r2q.p R r 7rJ. -TORW of Pc. OF = Backhoe pit s7: Ge® Co cchtrX W t s cousrn~ . 5; ao , .5 V&u- 'Y' North ~w G~ N l~ lAROX• /00 8Z yP~K~~~3 pKuPt)5ED vxsr Tt1P 0~ S SpiKs ► Q~~ t• 10 6~0wM~D ~~oo.oo A Site Location: 041k o x„VI-sTA -r#. Z 1