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HomeMy WebLinkAbout040-1295-50-000 Wisconsin Department of Commerce County: Safety and Guildirg Div sicn PRIVATE SEWAGE SYSTEM St. CCOIX INSPECTION REPORT Saritary Permit No. (ATTACH TO PERMIT) 579088 GENERAL INFORMATION State Plan iD r,o 77 77 Personal infe•matien you provide may be used for secondary purposes ;Prvacy _aw, s-15 04 (1)(m)]. rte' fi' 7 1 Peen I HAde•'s Nai,e City Village Township PdrCe Tax No: Thomas Oeson TOWN OF TROY 040-1295-50-000 CST BM Elev Insp Bh" Elev: Bbl Description: SecticnJownrRangeiMap No. 50", _r(_A Ica. 19.28.19.1697 TANK INFORMATION ELEVATION DATA TYPE %AANUFACTLRER $ CAPACITY STATION 8S HI FS ELEV. Septic Z,ti +y Benchmark O /d,l Q /~v -e.5ef Fi ss /zoo U J Dosing -'r. !5 AL. BM o iw O A,ec }ttcln Bldq Sewer ~ Q R.L -7 :<2 pl z 3 F ;1 ~D I a Holding SO It In et ( TANK SETBACK INFORMATION SUHt Outlet TANK TO P;L Vv'ELL BLDG. Berl , a.u m!i3k- ROAD Dt Intel Septic Dt Bottom 14. S6. -',O Dosing r / 1 Headerman. /5 33 [eratr o n Uist. Pipe olding Bot. System 72- 6~2- PUMP/SIPHON INFORMATION Final Grade t 9 7 Y Manufacturer Demand St Cover ' ZoGPM 9~- Model Number TDH Lift 90+ Friction Less System Head TDH Ft Z . I Nr~~ /GZ•41 3.2-5- 6-Zs 4A1 ? 3 per/ Forcemain Length Dia. Z +r Cmt iWA(MI ! SOIL ABSORPTION SYSTEM BEDITRENCH 'A'idtn Length No Of Trenches PIT DIMENSIONS No. Of Pits inside Dia Liquid Depth DIMENSIONS CU i L SETBACK SYSTEM TO P!L ✓ HLDU WELL LAKFiSTRFAM LEACHING Manufacturer: rte) INFORMATION lope C`t System J~r CHAMBER OR^r/CL l L z t } t UNIT Model Number: 'htLIA/lj .1 4V' DISTRIBUTION SYSTEM HeadedManifold Distribution as x Hole Size x Hole Spacing `dent to A r ntake ' J1 1pe s) Length 7- r Y i"Dia S Length Dia soaring ;116 r 3 , S p r SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only O Cepth Over Deptn Over toe Deptn of xx Seeded)Sodded xx Mulched BcctTrer;l Cr, r'er / f BedrTrerich Ed es k Topsoil > 6 ` yes No Yes No COMMENTS: (Include code discrepencies. persons present. etc) Inspection #1: 1 Z ZZ S Inspection #2 S- 1,7 l6 Location: 370 MITCHELL RD -v- ~La~,/ [9 lJ~~ SAf&C_ W1&fj+ 1.) Alt BM Description tr~-!~ 2.) Bldg sewer length = 30 W-4 1a) S/Lit 6~ SEA amount of cover = (I CAD 416r sar Plan revision Required? - Yes No Use other side for additional informatioh. Date nsepctor's Signature Cert. No. SBD-6710 iR 3i97) / "'~'.`,`f• REGEI ED count Safety and Buildin JOvisi C (,,A I 201 W. Washington Ave., 7 VIR4 V PS 7 21115 MadISOn, WI 5 707-7 Sanitary Permit Number (to be filled in by Co ) rad C U NTY 5 Ir ml DD Cati0n State Transaction Number e with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate govemmental unit / rior to obtainin a rani ` ' g' tary permit. Note: Application forms for state-owmed POWTS are submitted to Project Address (if different than mailing address) ent of Safety and Professional Sen,ies. Personal information you provide may be used for second purposes in accordance with the Privac Law, s. 15.04 1 (m Stars. L Application Information - Please Print All Information Property Owner's Name r Parcel Property Owner's Mailing Address Property Location / ~ ,,L //i City, State Govt, Lot Zip Code Phone Vunmber Section L/ C/stm t~~ J circle one) II. Type of Building (check all that apply) Lo TN; R E or W ❑ I or 2 Family Dwelling - Number of Bedrooms T f Subdivision Name ❑ Publia'Commercial - Describe Use vim- ❑ Ciri of ❑ State Owned - Describe Use CSM Number ❑ Village of J W Town of _ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) .4. New System ❑ Replacement System ❑ "I'reatmenu'Holding Tat:k Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber U Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. T e of POWTS System!Com onent'Device: (Check all that a Iv' ❑ Non-Pressurized In-Ground ❑ Pressurized fn-Ground ❑ At-Grade Mound> 24 in. of suitable soil ❑ Mound : 24 in. of suita e soil I Iol ding Tank 0 Other Dispersal Component (explain) Pretreatment Device (explain) V. Dis ersal!Treah nt Area Information: Design Flow (gpd) Design Soil Application Rate(gpds , Dispersal Area Required (sfj f Dispersal Area Proposed System Elevation ~ I 6~<, c& e ~ / 5"00 /S_GC) I -110 f VL Tank Info Capacity in Total 4 of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks 111 L 7 V u u` P 1~Rr ~G u Septic orifetdiwg?9n x Dosing Chamber / 7 ~ X ~n r'f e X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum r Signature MPIMPRS Number Business Phone Number an r7f,14,- Plumber's Address (Street, City, Stale, Zip Code) VIII. ounty/Department Use Only Approved ❑ Permit Fee Date Issued Issuing t Signature eason for Den~ la $ ( . IX. Condigm6kReasons for Disapproval .3 (.b ~ rt r t . Septic tank, eftluent filter and 44" 1 cetl,must ad be servlc~gs! maintained e tI►JI iu~ es per rnensgenr*nt plan provided by plumber. 2. Al ssttitwck requWemwft must bemaintai4d 0 r as per appkcable code I ordinances. t~.r • Ai6 ttach to complete plans for the system and suffin it to the C my opi on paper not less than 8 17t x I1 inches in size I v `4 ~v~NvE-v r~ . Plot Plan Pdreg of8- PhWe"Y Ovser T/46,As D[ou ~s~ ~.+rt~. Legaf Dffc*dpjg _,u LA zy -pier 2u, R tiJ T = Baakoe s, v = NAA D f t'f Pit J.vV ASS NoPl* ID Sao ~ _ ~ 4~W ~u- o e h j a °0 re ~,p fir an( v ~y L" pie •n Pte` ~ x6°'~} yo• a `„~tC t Do NoT ~ ~ AlS7-~~ ~ , ~ `1U '4~tFJ9' t > O Site Locadon: GCE fq R p-.►~ f DIVISION OF INDUSTRY SERVICES ~l 1.541N RANCH ROAD D t HAY%VARD WI 54843 .S = Ccrtact Through Relay r P S http i(dsps.w .gov;programsJindustry-serrices t~ - www.wisconsin.gov Scott Walker, Govemor L Dave Ross, Secretary tieprernber 08, 2- COST [D No. 221832 .4 Mr. Poff'T,S lnspeclor MARY JO HUPPF.RT ZONING (_WFICC. HOLLiSTFRS SOIL TESTING & DLSIGN ST CROIX COUNTY SPIA W987~ 690111 AVL- 1 101 CARMICHAEL RD RIVLR l .ALLS W1 5-1022-4011 HUDSON Wi 54016 CONDITIONAL APPROVAL. PLAN APPROVAL EXPIRES: O9iO8/2017 Identification Numbers Transaction ID No. 2601313 SITE: Site ID No. 816786 Thomas Oleson & Terese Pachl Please refer to both identification numbers. 370 Mitchell Rd above, in all correspondence with the agency. Town of Troy St Croix Counts NL I ,4, SIL L4, S19, T28N. R19W FOR: Object Fype: PO'ti'tlTS Component Manual Regulated Object ID No.: 1553792 Maintenance required. 600 GPD Floti% rate; 38 in Soil minimum depth to limiting factor from original grade. System(s): \Mound Component Manual - Vcr. 2.0, SBD -10691-P (N.01 O1, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0. SBD-10',06-P (N.01101. R. 1& 12). SSWNiP Pub. 9.6: Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITiONALLh' APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manuali s) referenced above. The owner. as defined in chapter 101 0It 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. stars. The following conditions shall be met during construction or installation and prior to occupancy or use: 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 Ltranting this approval the Division of lndustn, Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101, t2(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 PMk I'S management plan to the owner and any others who are responsible for The installation, operation or maintenance of the POW I S. %1NRY:O 1 V1`)--R1 Pcgc' 20 1 i Sincerely. Fee Required S 250.00 k This Amount Will Be Invoiced. Wlien You Receive That Invoice. Carl J Lippert Please Include a Copy With Your Wastewater Specialist, Division of lndustrv Services Payment Submittal. (715)63-4-5031 . M-f 7AN1 - 13PNI WiSMaRT code: 7633 carl.lippert;"(r.µi"consin. ov cc: Edwin A l aylor, Wastewater Specialist. (7 15) 634-3484 . Monday - Friday 8:04 am To 4:30 prn N iK .C'hl_-➢P Sincerely, =~r Requited y iii A6, This Amount W'il' Be Invoiced. Z- f When You Recuive That Invoice, Carl J Lipper: P'e ~e Include a Corn With Your V\ astevvater Specialist. Division of Industrx Services Payment Submitta'. _ )6=4-5 it_ - nil -f ? Alvt - ?PM iSMART code rC=' asia. 0 cc: F-;~~ it A Tu~, lor. V,, a te,.cat_r Spr iaL;t- 1 ? ~1 s= . Vc:n :a~ El 5::!~` n; To _.;C r7 I J MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: THOMAS OLESON & TERESE PACHL Owner's Name: (same) Owner's Address: 1295 Woodcrest Avenu Shoreview, MN 55126 Legal Description: NE1/4 of the SE 1/4, Sec. 19, T28N, R19W Township: Troy County: St Croix Subdivision Name: Trebus Valley Estates Lot Number: 5 Block Number. NA Parcel I.D. Number: 040 - 1295 - 50 - 000 Plan Transaction No.: CONDITIONALLY APPROVED Page 1 index and title cEPT OF SAFETY AND `~,`~a~t►twr/~/~~~ Page 2 Data entry F KOFESSIONAL SERVICES ~a so() NS~~1 I~'~ Pages Mound drawings ♦ 'r y Page 4 Lateral and dose tank DIVISION OF INDU.,TRY S'cR1r`lC Page 5 System maintenance s MARY .!O * specifications / - i HUPPERT Page 6 Management and contingency plan 114% ~J D PE rc Page 7 Pump curve and specifications 1659 Page 8 Plot plan SL I- Lu4< ✓ %.RMR FALLS: - Designer: Mary Jo Huppert License Number: 1859 - 007 Date: 08/19/15 Phone Number. 715 - 426 -1775 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (0181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information f R or C) R Residential or Commercial Design mote: sand fill tot ceicuWdons assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soli heatrnem for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 1.00 Site Slope 94.90 Contour Line Elevation (ft) 38.00 Depth t0 Limiting Factor (in) 0.40 In-situ Soil Appl = ? ,3 i' . c t 4, ^ j Distribution Cell Information 60.00 Dispersal Cell Lengtn Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpde) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or i s C or F i a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 11.76 ftz/orifice 2.00 Forcemain Diameter (in) 38.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) Enter Y cr i 3.25 System Head (ft) x 1.3 6.20 Forcemain Drainback (gal) 4.99 Vertical Lift (ft) 80.60 5x Void Volume (gal) 0.90 Friction Loss (ft) 86.79 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 33.42 System Demand (gpm) 9.14 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice ::_d in. dia. options choice 0.75 1.25 1.00 1.50 x x 1.25 2.00 x 1.50 x x 3.00 2.00 x 3.00 x GallonsAnch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gain (enter result in cell B49) Dose Tank Information Effluent Fitter Information 800.00 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 22.24 Dose Tank Volume (gauin) 525 Filter Model Number Weiser Manufacturer Project: THOMAS OLESON & TERESE PACHL Page 2 of 8 Mound Plan and Cross Section Views T 1/14 B .1 . . . . - - - . . . . .a... Pipe J 41J _ 1 t ..tr :..,w •.:.•i .ti L:•..y-yy^•.•5.,..•.• rt..:.,-•.=•. -_.:1rS::.fti:'.:Sr,..: .`i:'ti: A T_ B W O-- L Mound Component Dimensions Down slope toe extension made. A 10.00 ft E 7.20 in H 1.00 ft K 7-03 ft B 60.00 ft F 9.50 in T ft L ft D 6.00 in G 0.50 ft J W 600.00 (ftz) Dispersal Cell Area 1500.00 (f?) 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 97.19 (ft) ► H G l 95.94 (ft) Lateral I F Di~iCel 95.40 (ft)--4, Invert Dispersal Cell Elevation E D 4 4 94.90 (ft) Contour Elevation 1.0 % Site Slope Geotextile Fabric Cover Shading Key a $ T Dispersal Cell See lateral details on 0 Topsoil Cap o 1.5 ft Page 4 for number, size, Subsoil Cap a o and spacing of laterals. 0 ASTM C33 Sand Laterals are equally F Tilled Layer = 0. ft Tvnjcal Lateral spaced from the distribution cell's © Aggregate v o.1: centerline in the A distribution cell (AxB). Project: THOMAS OLESON & TERESE PACHL Page 3 of 8 End Connection Lateral Layout Diagram Cvntet the later als owl th. A Z, B 4itr rt ,on •w Turn-up Mirbf 11 varWa. Or ol~asroutplup E P l AN lawetals at* fe.ntieat IE X->I Mow*s dtalod ata wM bottom a the l~&I equally spaeee S laRsrwis 8tiorcelnavt Sch 40 PVC per SPS Table 384.30-6 g Face norm corweotion via tee or cross to MwJc4d at any point Number of Laterals 3 Orifice Diameter 0.188 in Lateral Diameter 1.50 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 11.14 gpm Manifold Length 6.67 ft System Flow Rate 33.42 gpm Manifold Diameter 1.50 in Total Dynamic Head 914 ft Forcemain Velocity 3.41 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -r SPS 316.300 WAC Disconnect 4 in. min. Tank component is properly vented y is E-- Altemate outlet location Foaoemain diameter Weiser r Manufacturer 2 in. Capacityl 800.00 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.17 42631 B 2.00 44.48 C Pump off elevation (ft) C 3.90 86.79. 90.91 D 10.90 242.42 D Total 35.97 800.00 Dose tank elevation (ft) Bedding under tank. 90.00 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 33.42 gpm at 9.14 ftTDH Project: THOMAS OLESON & TERESE PACHL Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Darrell's Septic Service Phone 715-425-1025 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 118 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft? 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 every 3 ears Effluent Filter Should inspect and clean at least once eve 3 years Pump and Controls Test once every 3 ears Alarm Should test month Pressure System Laterals should be flushed and pressure tested eve 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 soil erosion and help reduce frost penetration. Lateral: Tum-up Detail Finished Grade - 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project THOMAS OLESON & TERESE PACHL Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in aco rdance with its' component manuals [SBD-10691-P (N.01/O1), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-1070&P (N. 01101)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet f fter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the fitter 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 sudge 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 advise the owner of when the nerd service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical adddives to enhance septic tank performance is generally not required- However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation [fan effluent filler is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mgA- TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD,, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked far 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. Contl[MMcy 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) shalt be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system Into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS requlator 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 time overall management plan for this system. Project -RMOLRS* ~ TGke L Page 6 of 8 Y Y HEAP CAPACITY CURVE .1 I~O O op7 S y ~,/~/~~y MOM 'SW 4 5/8 e 4 ® - s zu 3 5/6 is + C1 4 o s 4. I 4 3/16 yD*2 e s 0 1 1/2-11 1/2 WT u c Giit.orIs ro m .o so m6 m eo urCts v so tw z q FnILiMOW anaffE MOOD- w to CVCLE Fee Cetbas tdetus tams s n u ru r so I t an is 4 4L in s 25 c, a, 12 t.t, VA- u earn ~J r 4 3/16 atr,a CONSULT FACTORY FOR SPECIAL. APPLICATIONS 9ecktal abunalors, W duplex sysbmi% are available and - Variable imm sad sttta ri qs are amiable for aonIg oing skoe suppled with min eienlL and iftrtce p' 1 , svskw s. Medaicei alb enftS~ forduplex syskmw are available - Df>tbbb p%Wbm* varleble k%ld fast 3WWAS are available wilh tx wlllwtt alarm swftt l6. for variable level brig cyde oorflrals. SELECTION GUIDE opmahad 1• igrteat zD~e•• .~s.avr.noa~dasela0~111eea:ad Sbumiard a0 roodeis -Wei ht 39 lbs. -'e2 H.P. S 2 ladoe vidptrbadt t'eeitide brd tort sadtdt ardnrsla pr~hsrJt rarirMa tauet xsubs Cadteb 8aMc"m tomawML FAIm bFUN77_ Medlar vomm 'U wr 3 •fsdatiealabiwator1041Mar1G4Ws am 115 1 Amb 24 1 ar 16 7 - 4. See F#taM fora0nael wgdsl d t~ecbisf Abtiwetor. NN 11" 1 get zorzaG 3 or4 i 5 5. C o" swb* 1060M ad as a maid adreteL 9 3 dtlfat (M or (4) ON 230 1 Asb 47 1 or 1 i 7 - lust 6 Farr (4) hds J-Pak i tae for MINIMM ht oaarecroa or.ries4n em 230 1 Non 4.7 2 or Z i t 3 or4 i 5 eiagtat or dltlw 104X0U2 7- Two (M hoia .FPak for vraltr90 1 oora~eriut or s0ke- CAUTION foride.tr..a atdii~t mefrrt rear areYius4 P~ad<Y01/IrY taref ii#ieR AY Irmu too at cowafs, Womc mt d mxas and wiring shmN be d- by a *otaed Sn9a PMmaSTrghR PrgrQaiul FAr1 MrmSytfsr~ FbiPit. AN rece t NsdoaW Qee#k Coda MM and the Oerampatioeai Safeg aed Hoeft Ad faMU RESERVE POWERED DESIGN For moual Qon ftm a mama safely factor is engineered info the deSW of very Zloeher pump. rift 7~ PJZ ftOTr 1tiN ~ lalia~ xtt. _ _ • . _ e a>lror arrbt~f.atwltr L=wk"4 prf-err r,~rfi...$.or , " hod WAM P'?MMM : 7~ta~s OLD ~ T RAE ~c~t L ~~c~~,E:- ~ ~ ~ PIotphw PdVg -A g5c POOL D%ffdda Tk€ ~E'l~i - nF "ply QE Tica `r Ga,Jir nUArty Id115~~SiJ~ = HAIrD PIT AcJ10---s tl* Nort* T.Q IVA 6`- a ~ ~yJ WIES~R Old IZfl°~ 00 Cs~u PLO., Jf R$ i 9'V`~°'bARFJI1 ~ 4 9'4/.aer Site Location: CP mile U~ el ~.p rJ G r ST. CROIX COUNTY SEPTIC: TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Bu er 1 iL%y Mailing Address ;I P Ll A-,,i ~ nDeparrttm Property Address6-11, (Verification required from Planning & Zoning t for new construction.) City/State IAL6_ell 66'; Parcel Identification Number LEGAL DESCRIPTION Property Location '/4 , Sec, Z, T :4G N R li W, Town of /re Subdivision zzFy ~5 f4 P S , Lot# Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house yes no D 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 §Cormn. 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 , astewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than U3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are trre to the best of my/our knowledge. T; we am'are the owner(s) of the property described above, by virtue of a warrant decd recorded in Register of Deeds Office. - Number of bedrooms 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. 08/05) I I l I 1 i i 7~ •'Om S7w~ d.-,; -10; -N i~°d i I I I I 4 c r F 4j, V- I _I I T ' v 1 0.1,E 'A, 61 00 o z d . rco ;y Ala^r g CZ) lb. 22 _ _ - ~•""r'-H.ruv- - - tgrvc. ~ .C "M 3 •~i~fiC73 = 4 j - 3~1~13a1~3J NO^v~1D ~ I' is e d4 LL W r E'. tF t 4 III v L~ { € I; of lil X01 ly~ , ~I, 'I I II~ ' I ~ z Q ®C-=1 w ~ • , 1, ~1 4 ~ t } ~ 1~ i l z Ib~ t i' 41 0 WJ J L ZIONSCII i 1 I I t .~.~ra_s•.o~c.-h;.-~ 7. - - it i .c Q~ V 13i: 1 ~ ' f' J ' n 3 :I a ~ c ~ cL t z j!? f I p • ~ a It S i . ~ ~lj! $ i 1 7 'i. fl I ll~~.•~ Y' z ' S` ~I 4 i I Yp .P.fS I QS • [Gf I 3 7- z - .~r u 1. 7 7 a a-c+ SON90199N N09310 kit :i o L-j IL ' I 1 '.l I i • r - r,.e t'~d'~ t}11 iy z ok't ~c t ~I i~'rls 4 T ~E7 ,1 ~5 w S 9 77~ ~~~i ~1. 8 P .I A s o~ I °~~9~~ a s t P' ~ I t : e Z RECEIVED Wisconsin Department of Safety and Professional Services Division of Industry Services SEP 03 2015 SOIL EVALUATION REPORT Page I of 3 ST. CROIX.COUN y COMMUNITY DIV f SPS 383, Wis. Adm. Code County ST. CRO[X Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I 040 - 1 205 - 50 - 000 percent slope, scale ordimensions, nort h arrow, and location and distance to nearest road. 'I A Please print all information. Revie by Date n1 Personal information you provide may be used for secondary purposes (Privacy I aw s IS 04111 (m)) 71k j 400 r J Property Owner Property Location Qr THOMAS OI,F.SON & l+,RF.SG PACHL Govt. Lot \L 14 S 1,14 19 T 2X N R 19 E (or) W Property Owner's Mailing Address L Block # Subd Name /rCSW 1295 Wuudcresl Avenue 5 Tnbus Valley Estates City State Zip Code Phone Number tty ❑ Vllage ElTown Nearest Road Shoreview, NIN ; 55126 ( 651 } 247 - 6230 Mitchell Road TROY n New Construction Use[D Residential if Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material loess over till - Flood Plain elevation if applicable ft. General comments Mound System 0.50 f3. sand fill - 0.4 loading rate and recommendations: Additional test required because house site area is limited due to setbacks. Boring # ❑ Boring a Pit Ground surface elev. 94.90 ft. Depth to limiting factor 38 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 0-20 10YR2/2 1 3fabk&gr ds as 24-m 0.6 0.8 2 20-38 IOYR211 sil 2f-msbk dsh es Ivr-m 0.6 0.8 3 38-44 10YR3;2 fIfIOYR14&1OYR&2 sit Ifpl dsh _ Ivf-f 0.4c 0.6 t 2 Boring # a Boring 94.90 S0 W/1 ❑ 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 0-13 I0YR312 1 3fabk ds as 3vf-co 0.6 0.8 2 13-29 10Y'R4;3 1 1 fpl ds as 2vf-co 0.4 0.6 29-46 10 Y R2/2 sit 1 f-n bk dsh as I of-co OAc 0.6 4 46-50 10YR4/3 sil I fabk mfr _ 0.4c 0.6 Buried A horizon duc to natural erosion Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD, < 30 rngiL and TSS < 30 mg/L CST Name (Please Print) Sl a CST Number bla .lo Hu ert (I lolli aer's Soil fcsting & Desi 224X32 Address Date Eval n Conducted Telephone Number W98?5 690th Avenue, River Falls, WI 54022 08 - 1 1 & 18 - 2015 715 - 426 - 1775 SRI1`R310(Rffi/13) - t Property Owner OLLSON, 1'homa, Parcel ID # 040 - 129 - ti0 - 0(N1 Page of Boring # Boring ❑ Pit Ground surface elev. 94.60 44 ft. Depth to limiting factor in Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-12 1OYR12 1 3fabk ds cs 2vf-m 0.6 0.8 12-19 10YR413 1 if 1 ds Cw Ivf-m 0.4 0.6 19-30 10YR2i2 sil if=mabk dsh 0.4c 0.6 1 30-40 l OYR4,'3 - A 1 fpl dsh - 0.4c 0.6 5 40-44 7.5YR3l2 sil I fabk dsh - 0.4c 0.6 buried A hurizon due LO natural erosion ❑ Boring # HBoring Pit Ground surface elev. ---ft Depth to limiting factor in. Soil A ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 I 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 GPDJff in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh 'Eff#1 'Eff#2 i i I _ Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 mgfL ` Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L SBD-8330 W07' i 31 Plot Plan Page 3 of 3. Property owner 1"=40f~ Legal Description t o -t - T4 us V Y pRr OF (except where notewo ~ffE 6F-ME 5t-'!O Igo &WA) BacA*oe pit ~2F TCa~_ 3t: c~~x_~Un1rty ~1~,vnNSi /A = HAMD t'iT North y~ rA ~ S, y P►0 g co ~q4r U Site Location: t } K' Fi' x g$ @ p >i.. -ri•. # - . .r~., ` yr, . 3 ~ w. 4 Elf ~ ~ x het ~c'' p{ ~ ~ , r WIS: 9 r c, iL r n o ,n.Y 7 t ' NO ° ; x j i