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HomeMy WebLinkAbout004-1066-10-000 Wisconsin Department o` Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT San ta-y Permit w (ATTACH TO PERMIT] 582030 GENERAL INFORMATION State Plan ID No 2621618 Personal informatior• gnu provide -nay he used for seccidary purposes [Privacy Law, s.15 04 (1)(ri Village Township Parcel Tax No: Perms Holders Nane: City Ann G Jacobs Trust TOWN OF CADY 004-1066-10-000 CST 9M Elev Irsp BM Elev BM Descrip.icn: Serh ti"ownlRange.Map No OG• S CST ~jN~ 28.28.15,434A TANK INFORMATION ELEVATION ATA TYPE -1 r 111, (A ( M.ANUFACTURE~ CAPACITY SIAII~) N BS HI FS ELFV. Septic ~p ~W1~ bl~ G, Benchmark Dasin 1 bf- Alt. BM O ~I 1 J q'S lo. y. `Ll 1 Y p LI b v Bldg. Sewell e 1\ I I a r q- "7 Holding Ht Inlet 'Ht Outlet 'Ht Outlet TANK SETBACK INFORMATION Z~r I ANK TO P: l^,'FLL R1 Dr. vent to Air Intake RCAD DI InIct Septic ) 1 jZ Dl Bottom ~G~ 01 Dosing f , W)I Cade .4an S G 'y Aeration Dist. Pipe (J G , rJ Holding - - Bot. System n q r J ~7 "I I -T I PUMP/SIPHON INFORMATION Final Gram= Marufacturer ge ntl~ St C-Gver- - - GPM U Z Z Mocel Number TDH Lift Friction Loss System Hea TDH t o. L4 1~ Forcemain Lengt 1 Dia. -y f Dist. to;.'ell I L! SOIL ABSORPTION SYSTEM Inside D a Liquid Depth BED/TRENCH Niidth r- Length No. Of IrCRChff$ LA I PIT DIMENSIONS No Of Pits DIMENSIONS SETBACK SYSTEM TO P,T BLDG WELL LAKEIS EAh4 LEACHING Manufacturer: INFORMATION CHAMBER OR T pe Of S ste : PL I r ) ! f I j;' UNIT Model Nu r: DI ~ IBUTION SYSTEM 5 loo V1 ea~rir'Manifolc r Dist•ibuJon I x Hole Size x Ho a spacing r bent to Air Ind I u ' ipe(s) ' 11 f f Length~ Dia_'? _ength ! a Spacing 1.. SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Ceptt• Over Deph Over xx Depth of 1xx Seeded:Scdded x blulched BcdiTreri;h (1en:er Bed,'-rencn Ld es I 1 r To sod I r - g p 1 I / Yes P.o LYes No COMMENTS: (Inclu a code discrepancies. persons present, etc.) Inspection #1• 5 1~ ~p1Z.61+ Irspection #2: ~_5J-au~a~c(; VC Location: 182 H:'JY 128-~'~l 1.1 Alt BM Description = I V d ° ' ~1 l~ P 1}1 1~1~{ lS- ) 4~I I J 2.? Bldg sewer length amount of cover 1."J I 6 1(~S {C"'11rOn, b~C~ 5 SM w~ r" Cove on czbow4uuA a Plan revision Required? Yes No I r Use other side for additional information I _l Dale is Sre Cart No S6D-671)tR 3197; 1?j \,,li b~ ov oMb\*,4 [W4, Q - E£Ef 1 l_ „t nt, Safety and Buildinqs Division 201 W Washington Ave.. P. Box 7162 V1 11 S OCT 262015 Pen,til \latlhcr Ile 1 iieJ ill .11 S ST. CROIX COUNTY Madison, VU' -53707 !N:~k sOMMUNITY DEVELOPMENT 6? - Sanitary Permit Application 5 I;u. Tran, elit,r \tanhe; ccnntance with SPS ;5 ;.-11 I. 11 iS :Vlltlt ,,l Th" tnrrtt In the g:nci:urtetit:,l l:n I Z -2 1 U taut kl prior to obtain ng a sandal.` (,rnnit \,ae :1ppl:i:a.rn 1,111, !.n' ,tatc-out%d P(111 I S :trc submi'.tec to ProIvk:t r Lkpartntettt of S:tf;h' and P utee.inr al ,Cr, le, I'er,l•,G,I 1-1 .+tniatimi vot. pro: lie ate', ht f0: scern&r.' lddt'~,s I r d AM-.11C t an lll.liliu addic"! inaccordancL: « 11) t';te , ~ ill . urhse, I':na. • . 1. Application Infoi- on - Please Print All ! I o g II Information :operr (hrner \;.rr rcc Dick Jacobs V,\ q,c:t t i t . \L1111:1 Akidre;> I'ropero Location 3 $ t 5 182 Hwy 28 t l.d. ,htr_ - 11 it I'It `n; \n rJ';t NL'.. \I: . Seaton Springy `'alley. ti~'1 57th -1 ,1 I .ti N K ,•1 cs'. 1. Type of Building, (check all that appl.i) I X I ,u _ an,il. I),,cil:rv %"1111N.. of Hedrr Kt 1c~ t Block = ~ T v This proposed system will serve (ne 4 nevi room residential Home. villa : ,r C ,\1 Nilloor I otin of C;tdg 5 x z~ Mo j J Cell 11. TN pe of I'erntit: (Check onh one box on line :1. Complete lint B it applicable) Zoe- 1. I:0I,L•L.rjn,m S,,IVIll l1*..,t1r~C1'1 :1u11&11C l a1 .,1aietnent Galt t.)tt n `.loditictlion 14, 1 xisling Sistan (c\plaint Id. Pernii'. Kenr~:ill - -Permit Re•.isior 1_ h:nir. , 1'lanlher Prmit fran;'cr to Ne,c List P:e, iou, Ptrtr.il \nmhei and ':)ale Issued Befort I.y,irati,tt 1 rrr 11. Tspe of 1'011 FS ~~stenvComponenUDerice: (Check all (hat apph ) -I re"uri!eJ In-(xa t .I i' t ri t 61oln'i! (na.fe \!runtl _ `-l ❑t- , i sui zlf lc oil \1c and in. of st:uahlc ,•,,:I/ ~1 f I I ,!Llin ie ti. I )Ihcr rt,.tl , omI , r,, I.rtl L,in'_- I't U':a!nuttl Ua. iu letplait ~ \ . DisptrsaUTreat nt Area Information: _a I I, c. tcpJl Il..i• t I1:.; tci e(xl.I Dispels tl 1r:a RV)lkxv.11,11 Uis-%I',a. Arc; I':oP1- 1I l>Il "dent I !e,:,ti,,n 600 ~ d .6 ; ocw Sc ft s tt b 92.7 ft Carl,~o-I 1 1. l ank Info ('aar;iC. u' local . i,f \lanufeiumrr - _ _ _ liana is C_iailon, I -ills = - ti Ptic Tank X ?00 f Lewis Bjoi-k X lift lank \ 7()j) 1 - Le\vis Bjork 1 11. Responsihilitt Statement- I, the undcni„ t . ac,umc ,o 'biliAf, tallation of the P(M IS sho„❑ on the attached pl tn,. I'Itrrha , \:nne,l'rnni Plun _ \IP \i! 'RS \.tnthr: ,s,,i Ic,; Phan: \unhc•r 71 5 31 I.c\vis Bjork I ')S39?6E -1 15-X31-? utrJ I ; IJcit:,,,,t r.t llt•,.,t lc. /i•., ( odei 1:781 C'ouut~ Road L klcnoulonie, 111 - 547 - 1 ' 1111. Countv'Depar•tment Ise f)nls - %PPtn'.i t,! .rnu' fee I 1)a1 1 11011 I,,IIIItL' '_enl Sit-, will 1V ('ondi Wtpt#;Reasnns for DisapproNal 1. SSephc tank, eMuent lifter and 3 C", dispersal cell must all be services f malrltalned r Ntd as per management plan provided by plumber. l 1, k&, ~J ~ aA 2. AA aNbdck icabl etude / must be meiMiirt~d , 6l fl 5 64 6 ~ as per applicable code / vdinalces. T oc LbdLL I t J p f J t ' r J t~ rt o- ~ r ~ V I \ \ DIV'SION OF INDUSTRY SERVICES 1054' N RANCH RD HAYWARD WI 54243-,452 0 $ Contact Through Relay s tpaidsps vvi.gov:prograrrs!industry-sevices P n www wisconsin gov Scott Walker, Governor Dave Ross, Secretary October 15. '_O 15 Ct,ST ID No. 25J07fj .-1 ~ P0,11 IS LL\k IS C L3JORK ZONING OFFICE LEWIS WORK LLC S1 CROIX COUNTY SPIA E7818 COUNTY ROAD L 1 101 CARMICHAEL RD MENOMONIE W1 5475t-6637 HCDSON 11'1 54016-7708 CONDITIONAL. APPROVAL PLAN APPROVAL EXPIRES: 10115;'2017 Identification Numbers Transaction ID No. 2621614 SITE: Site ID No. 313256 Dick Jacobs Please refer to both identification numbers. 82 l I\%-\, l28 above, in all correspondence with the a~encv. I'owm of Cady St Croix Countri NE1'4,NEI'4, S-2 3, 128N. RI5 V FOR: Object Type: P01'Y'TS Component Manua] Regulated Object lD No.: 1560759 Maintenance required; Replacement system; 600 GPD Hun rate: System(s): Mound Component Manual, - Ver. ?.0, SBD -10691-P (N.01 'O1, R. 10 1=), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01-"01, R. 111, 12): Fffluent Filter [lie submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes- The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and kvith any component rnanual(s) referenced above. P.O.Woi The owner, as defined in chapter 101 011 10), Wisconsin Statutes.. is responsible for compliance with all code tZt'ItIJ requirements. C l•O No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06. APPM stats. DEPARTMENT 0 I lie followin;l conditions shall be met durin, construction or installation and prior to occupancy or use: 1gf ~UF ,AFET~ -I • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy, on file with the Department. Chan;.-es to the approved plan must he submitted for revie%ti and approval. Failure to SLR C~, properly attach the approval and index page to plans that match the cope on file with the Department may result in enforcement action under 141.10. S,=11. • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite 1-Va,,te\yater S}stems Version 2.0" SBD-10691-P (N.01 01- R. 10,12). • This system is to be constructed and located in accordant-, w ith the approved plans and with the "Pressure Distribution Curr.ponent Manual for Private Onsite Wastewatcr Treatment Systems Version 2.0" SBD-10706-P (N-0I.'0l • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches- Sntearing and compacting of wet soil will result in reducing the in`iltration capacity of the soil. Proper soil moisture Content can be determined by rolling a soil sample bet~sccn the hands. If it rolls into a 1,4- inch wire, the site is too wet to p-epare. If it crumbles, site preparation can proceed. If the site is too Nvet to prepare. do not proceed until it dries. 0 Abandon the existing system components per SPS 383 .33 L__°kl~l 1~R1 Pa it 1= I'lli • The system was designed to meet the influent quality defined in SPS 383.44(2Na) The qualith o influent discharged :nto a POW FS treatment or di persal component consisting in part of in situ soil shall be equal to or Tess -h,-in all of the following: 1. A month] average of 30 mat fats, oil and grease. 2. A monthly average of 220 rn~_- L BOD5_ 3. A month]- average of 150 mg L YSS. • SPti ',S,.i i; _3)tbl (b) The servicinL frequency of an anaerobic treatment tank for ;I I ti ;h-III occur at least kkhen the combined sludL~e and SCUM volume equals 1 3 ofthe tank volume • The inspection, maintenance and servicing reports shall be submitted to :he Lovernmcntal unit within ;U calendar da,, s nom the date of inspection, maintenance and servicing. • The owner is responsible for the operation and maintenance of the private onsite wastewater treatment svslcm (PO TS) in accordance with SPS S' and the approved management plan • The owner of a PONNTS shall be responsible for ensuring that access opening covers remain locked or secured except for inspection, ~:Naluation. maintenarce or senici:is paiposes. • Owners shall receive a copy of the appropriate operation and maintenance manual and or owner's manual I"m the POWTS described in this approval. • Provide a cope of the approved POWTS plans and this letter to the owner. • Prohibit vehicle traffic and soil distur)ancc within 15 feet of the downslope edge of the mound p irsuant to "Mound Component Manual Version 2.0" SBD-10691-P (\.0Ii0I, R. 10, 12). • insulate -4° O conveyance pipe as necessar} pursuant to SPS 383.30 (1 1)(c). 11'.A C. • Install clearout(s) as required in 4" O covee-ante pipe pursuant to SPS 382.3 %k A_C. • M iinmin a minimum I S" per Ii1o1 pinch on "IT'-" 4" (1 conyc~',:nce Pipe pLrsuart to SPS 812.30 ('~)(O-' _ 1l a _C r~ Cop_, of the appro%eu plan,, ti ~Ci'IC;I'lon and this letter ikzill be oli-AIL: :LIrII? I COntitrtletli)n and Orell 10 inspection by authorized rcpre entarives of the Department. which may include local inspectors All permits required by the state or the local municipalit, 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 addi,wri> .Houle conditions arise makinLz them necessary for code compliance. As per state scats 101, l2i2), nothing iii tli > ic,, shall relieve the.designer of the responsibility for designing a sate building. structure, or coinponcnl Inquiries concet on this letterhead The above left a,:.: others who are responsible for the installat r., operation or maintenance of the PO\ IS. Sincere] Fee Required S 250.00 Fee Received S 350.00 Balance Due S 0.00 Edwin A Taylor Waste%-ater Specialist , Division of Industn Services 1V4'iSMART code: '633 15)634-3454 Monday - Frida- 8:00 am To 1:30 pin ed~~ in.tay[or a \N isconsin.,ev MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Dick Jacobs -Replacment Mound Owner's Name: Dick Jacobs Owner's Address: 182 Hwy 128 Spring Valley Spring Valley WI 54729 715- 772-3135 Legal Description: NE NE 28 T28 15W Township: Cady County: St. Croix Subdivision Name: Part >100acres Lot Number: Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title T-S Page 2 Data entry 11 0r 1117 Page 3 Mound drawings Page 4 Lateral and dose tank. ;I Page 5 System maintenance specifications cE GS Page 6 Management and contingency plan `"x t Page 7 Pump curve and specifications Page 8 Plot plan Page 9 plot plan legend Page 10 Attchments : Effluent filter / septic & dose tanks /manhole Page 11 Soil report Designer: Lewis Bjork License Number: 253976 Date: 1 5 Phone Number: 715-231-7375 Signature: 1 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01!01), and both SSW MP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01!81) and Pressure Distribution C:nmprnnent Manual Ver, 2 0 SBD-10706-P (N 01!01) Version 7.0 (R. 03/2012) Page 1 of 11 Mound and Pressure Distribution Component Design Site Information r Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal colitorm of 36 inches. 600.00 Design Flow (gpd) 14.00 Site Slope 92.70 Contour Line Elevation (ft) 12.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft) Distribution Cell Information 120.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 4.50 E=stimated Orifice Spacing (ft) = 11.54 ft2lorifice 2.00 Forcemain Diameter (in) 20.00 Forcemain Length (ft) Does the forcemain drain back? Y 86.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) 8.62 Vertical Lift (ft) 108.73 5x Void Volume (gal) 0.49 Friction Loss (ft) 111.99 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 34.08 System Demand (gpm) 12.36 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallonsllnch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1400.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Lewis Bork LLC Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.00 Dose Tank Capacity (gal) orenco Filter Manufacturer 18.85 Dose Tank Volume (gal/in) Bio-tube Filter Model Number Lewis Bork LLC Manufacturer Project- Dick Jacobs -Replacment Mound Page 2 of 11 Mound Plan and Cross Section Views T -11-0t Observation Pipe . . . . . . . FKK © - •J I O A W - - 1 B z = L Mound Component Dimensions ft A 5.00 ft E 32.40 in H 1.00 ft K [Mft R 120.00 ft F 9.50 in 1 20.65 ft L fl D 24.00 in G 0.50 ft J 6.95 ft W 600.00 (ftDispersal Cell Area 3077.59 (ft2) Basal Area Available 5.00 (gpolft) Linear Loading Rate 12.00 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.49 (ft) ♦ H (2 G 1 F Dispersal Cell 95.20 (ft) Lateral 94.10 (ft) Invert Dispersal Cell [ t Elevation E D []3 . 92.70 (ft) Contour Elevation 14.0 % Site Slope Geotextile Fabric Cover Shading Key a T Dispersal Cell See lateral details on Topsoil Cap o C 1.5 ft Page 4 for number, size, Subsoil Cap a O Ll and spacing of laterals. ❑ D . j c; f 1 ASTM C33 Sand _ f4 `9 T r Laterals are equally i Tvo c.~ Lateral F spaced from the Tilled Layer c y 0.5 It distribution cell's © Aggregate 'Rr o centerline in the A distribution cel' (AxB Project: Dick Jacobs -Replacrrnent Mound Page 3 of 11 Center Connection Lateral Layout Diagram Fort t mii n conr*.KWn via tee of cross to manaoW at "podnt Latet:ls itt ident.c A IL ri P S Turn-up vWbsllvslv*or IEX--- 3-IEx02 x1241 Lateral$ aforceffg ► Sch40 PVC alesnoutplug ptr SPS Tab1E 384,30-6 Holts d1dlt4 On tht bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.74 Ft Lateral Length (P) 59.25 ft Orifices per Lateral 13 Lateral Spacing (S) 2.50 ft Orifice Density 11.54 ft2lorifice Lateral Flow Rate 8.52 gpm Manifold Length 2.50 ft System Flow Rate 34.08 gpm Manifold Diameter 1.50 in Total Dynamic Head 12.36 ft Forcemain Velocity 3.48 ft/sec Dose Tank Information Locking coverwtth warniru / label and locking dov ce and / sealed walertiyllt Eleulr teal as per NEC 300 and - SPS 316 300 WAC 4 in. mir. Disconnect i;i,•.., iri:_>ne°•i? ~f dented E- Alters.,.- r- loca' Forcema ji evyli; 6wK: Manufacturer Ca acit 700.00 Gallons Volume 18.85 gal/inch A IDimension, Inches Gallons g 22 ' 9 418.36 I B _ 2.00 37.70 i G, I D 131.95 D Total 37.14 700.00 7- 3" Bedding under tank. ~ 8C Alarm Manuafacturer SJE-RomBus hole Switches Alarm Model Number 520-002A containing mercury may not be used in Pump Manufacturer Zohler this system. Pump Model Number 152 Pump Must Deliver 34.08 gpm at 12.36 ft TDH Project Dick Jacobs -Replacment Mound Page 4 of 11 Mound Svstem Maintenance and Operation Specifications Service Provider's Name Lewis Bork LLC Phone 715-231-7375 POWTS Regulator's Name st. Croix County 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 1400 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years 2I11P. r Lewis Bjork for Pumping Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SIPS 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 Turn-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: Dick Jacobs -Replacmr:nl Mound Page 5 of 11 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. Coce, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01101), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present :hat 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 ano 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 contems of the septic lank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure If the filter is equipped with an alarm, the filter shall be serviced it the alarm is activated continuously. Intermittent filler alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceecs 1;3 the liquid volume of the !ark. 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 addition of biological ur chemical acditives to enharre septic tank pgrfnrmance is generally not required However, it such orcducts am usad tlsy =.hafl'uf: approved for septic tank .isr: h, 'he Capartment of ,;~rnmr~rce. Pump Tank The pr.mp (dosinyl tank shad to irspected at least once Ivory 3 years. A,I swrches. alarms. and pumps sna'l be :ester to verify proper operatnn. If an ettlue it filter is installer: within the tank it sha.1 be inspected and serviced as neressan Mound and Pressure Distribution System No trees or shrubs should he planted on the mound. Plantings may be mane around the mound's perimeter. and the mound shall be waged and mulched as necessary to prevent erosion and to provide sume prutec:ion 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 ni BOD;, 150 mq'L TSS. and 30 mglL FOG for septic tank effluent or 30 rng; L BODE. 30 ni TSS, 10 mg1L FOG, and 10° efu/100 mL for highly treated effluent Influent flow may not exceed maximum design 'low specified in the permit for this installation The pressure distribution system is provideo with a flushing point at the end of each lateral, and it is recommended that each lateral he lushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial tcs: when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribute;n within the dispersal cell. Observa:iun pipes within the dispersal cell shall be checked for effluent pond ng r'ond no c•vnls shal hr-~ repnrte;: to 'hp nv.rer. nnr, levels above n-^s cnnsideru,` aii irrpend!ng hydraulic failure requ,rmg a ~ Contingency Plan 1' :he septic tan; nr any nt its components become defect.vr: the tank or cnri. : .I r. J. : a :r i proper operating curid tier. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shalt be immecir. 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 replaced in its-' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and media. and related piping, and replauing said components as deemed necessc,r"'_u ` iwii r;l: i r to fv nr !r er iti^^ cn^ci: Scc Papc 5 of ;his Elan for the name an•7 tPlephonc number of your local F'. Pretreatment Unite. Thn information and schedule of mananagement and maintenance for pretri: units are attached as separate documents and are considered part of the overal n ,n~ l nv! 1" i r , Project: Page 6 of 11 OC ; LU w PUMP PERFORMANCE CURVE MODEL 15111521153 50 14 _ 45 153 i 12 -I 40 35 10_ 152 ° 30 z 8 25 151 r- j 20 15 ~ I ti i 2 o 10 20 30 40 50 60 -0 8G 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 F± OW PER MINUTE 0 14;08 M w J $ tin n v CIO o ~j Q 1 _ I r~ I ~ f M \ r _ _ M vlo o ~ --sue ~ ~ ~ ~ ~ 3 i~q I i Plot Plan Legend 1) Building sewer > 30' of building drain (home) has > 42" cover where snow is not removed . 2) Schedule 40 PVC entering and exiting concrete tanks. 3) Precast concrete septic tanks. 4) Effluent filter location 5) 24" Tuff Tight riser system brought min 4" above surrounding grade. 6) 2" sch 40 pvc force main pipe 7) 24" plastic Tuff Tight dome covLE rs' vvit1h fe covi::er ~Cre'+fiCw down as securement devi~~-, 8) Vent - inspection 9)Treatment -dispersal cell/ce 10) Building sewer clean out with frost sleeve per code 11) The old un-used POWTS will be pumped and properly abandon 12) No issue with toe protection below the mound 13) All wiring and electrical wiring materials per code Products Catalog - • Wastewate" Effluent Filters Biotubeo' FT Series Base Inlet Effluent Filters (FT) r T , a',r'.e. ~fftuerir~'ters rr _~.2 •a;u.::? ~:"~i) ~c anCn'> aiptC.be $~•'I S t3aS T )t suspenr:e~ Solids fror'~ a ftuar,t hetping -xt~ Ic drartfie,c li:e. r de the loud area of a iuu-srZe triter In a Sr"alp Gu~k.a!~e `L" short Sep'IC arcs base Inlet L,,Iuent Filters ,re rstall?J on he j a redule 4G or Txe 3034 outwit pipe of a rle'n" ~r exshrg ,w k. Tr~i m Tx e ,,itr a tlitar artrldae PVC housing, and an e~erdable anote. Hr JotlCrJat 0".ertlc'jv plate is availattie for rn=~ (~C' ` mm} wodeis p PVer t Jert from bvpass'rg'he titter f " Chas. . z-Ir(;h ;200-nun-; ')Om!'tal filer "'a' e"' . '.4-inCr !3^Grl'' titter heiyrt. s 9~riar:f . 2~-Irch 55u-mr ; housinc helaht, Stzrdard a"le r .5 mn ? filter mesh railab • i3-mrn; or 1,16 nc . :~Cdros;on pf~Oi ConS'r,v:tor _ "moo . Extendable hanO,. • -:-Sy to ocean • i'~ptional overM" p!~te a_N ah&;Cle d,oru~e' r lI Serves Base Ne • for hlyh 'lave! alarm as 2 reS opt,cnal float elbow available * Elf;uenr Fitters -Ie1iel alarm assenibly' ordefe-l seDa'af 'i'i iSee 'El~at 'Iteh ! ' ~er.•n'iee' r 'h~ 'Pr'')ril:"t'Jr:lerlna .~t'Jf'lat''on" Se~tlC~t Ci ihlS C2ta10i11 Sample Product Codes` SA. - B J't;~e' ~ Elite . s~-Ir•,-h ,200-; {m! ~icnteti'f 4 incr. ~o m fi!te' rei'aht. base r _ - 31ctut:e T filter 5-Inch i200-m-1-0 d'ame*.er, ?^F.-..i~, fIC~' I'"~f'.L lie5e .I~r riS~?rto7r J!?t° 1[l$ta!ieG ■ Tuf-Tite Riser Svstem r '1 - - Tuf-Tite makes a full line of Risers and accessories for Pre-Cast applications. Riser Lid - with Molded-in gasket. Available in 12", 16", 20 and 24 diameters. Green Only. j Concrete Lid - with handle. Use the Safety Pan to cast your own concrete lids. W s Safety Lid - May be used in place of i concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan - Safety PanTM available for 16", 20 and 24" Risers. Green Only. 6" Tall Riser - For septic tanks. Stackable in 6" increments. Available in 12",16", 211" and 24" diameters. 12" Tall Riser - For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring - For mounting riser or lid to tank when casting-in is not an option. +AY. 9 2 . ► ~n FPA N;. tiAl 459 28A9 z ~ ar~ , zzg a. N r~ i V R D P trFa Noce 711 0" vso~~ Feem f, El 2) LB700 Design Sequence Septic 1400 gallon s.. If Baffle Filter i Page 6 I [ . s.fr o t1 K= LEVCL OUTLET ° oun Er e i FILTE ! 0 ear 4 n a o FMLI= f SAM - - - - - -gem- - - - - - 64D 7" SECTION A--A ARYL Sca-ma END VIEW I8C 9" tao i LB 700 mrm TANK SPECIFICATIONS 4' REbFi1%'H CONr_ WALLS A A 4' ~ COCONC~ COVER W-DaTTTON 11M09F,r 24' PRECAST RISER LL' W~LET_.._I LHIE(D(T- 54' OA LNGlT- 72' aB WDT►* 72' Ma { INLET D(VM- 4r XTLET DiRU 3B' d-I&Jn LEVEL) Lam" nEsjg& 8'-0' LN"7tVA70 SOR.. J n ISAS GALLONS PER VERTr.AL BCH DGM TANG. FOR USE AS PUIP/WTICAlGL=1G TANG NOW DFTItMTT' V AVAILABLE CONTACT, LEWIS LORK 64D 72.0 PLAN VIEW TOP SLAB L E W I S B J O R K, L L C NOT TO SCALE ALKAMT 20, a12 MEbOMONIE, Wl DRAWN BY! MCP ST. CROIX COUNTY Sl-,P'1'1( TANK ~'1,-~1\TL\ \tiCl; r1GRI:L~tC\T AND (AN 1LRSI HP (I.KI IFWA I ION FORM c)wner Htl,~t DICK JACOBS .MailingAddreSS 182 HWY 128, SPRING VALLEY, WI Property ,address 182 HWY 128 (Verification rcyuircc from Plannine& /oning !):parttnent for ne%+ construction.) Spring Valley' WI City:iState _ Parcel Identification Number LEGAL DESCRIPTION Property Location NE r:a N E sec. 28 . ~I' 28 N R1 5 tip'. To,yn of CADY Subdivision Plat: Lot # Certified Survey Map # Vt)lume Page # Warranty Deed # (before 2(_1(_)7)Volu111c . Page 4 Spec house ❑yesE:jto Lot lines identifiable ❑yes0no SYSTEM'[ MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic. system COUI,c result in Its picntat.ire failure to handle wastes. Proper ntairttenanec consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. \k hat you put into the system can affect (tic function of the septic tank as a treatment stage in the \tiaste disposal system. 0tivner maintenance rc;pon~ibilines are specified in `SPS. 383.52(1) and in Chapter 12 - St. ('roix County Sanitary (_lydmance. The property owner agrees to submit to tit. Croix County planning & Zoning Department a certification form. signed b) (tic owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) the on-site wastewater disposal system is in proper operating Condition ardor I? ) after in,pccliou and pumping i if ncces~ur~ the septic tank is less than 1,3 full of slud_e. Fy,%e. the undcrsiuncd have rea;i ncL' above reyuiremcnts and a-1" to maintain the prirat :sewage disposal ,y,tcm ,%ith tltc standards set 1`6rth. herein, as set by the Department of Safety And Professional Services and the Department of natural Resources, State of Wisconsin. ( edification stating that your septic s)'stem has been maintained must he completed and returned to the tit. Croix Count) Planning & Zoning Department wrthin :0 days ofthe three year expiration date. I,xvc certify that all statements on 1is IOrrn are true to the best of m\ c)ur knowledt!e. 1. xr,e amiare the o~rner(sl of the property described above, by virtue of a arranty deed recorded in Register of Deeds Office. Number of bedrooms 4 0, SI ATCJRE OF APPLICANT(S) DATE ***.Any intbrn•ation that is ntisrepre,ented nrty result in the sanitary permit tieing revoked b) the Planning k Zoning Department. Include with this application a recorded warrawN deed from the Register of Deeds Office and it copy of the certified survey reap if reference is made in the warranty deed. (REV. 04i 12) RECEWtu RA .1, OCT 2 6 201n Wisconsin Department of Commerce SOIL EVALUATION REPORT '7 1 S of 3 ye Division of Safety aod~Vp.AOMIX COUNTY COMMUNITY DEVELice with Comm a85. Wis. Adm. Code County St.Croix Attach complete site plan on paper not less than 8 tit x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I_D- Perrent slope, scale or dimensions, north arrow, and location and distance to nearest road 06 /64. lQ _ QGO - Please print all information. Re d by Date Personal information you provide may be used fur secondary purposes (Privacy Law s. 15.04 (1)(m i) Property Owner Property Location Dick Jacobs Govt Lot Nh 114 NE 1i s 29 T 2X N R I- ©r) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 182 Highwav 128 - Part of > 100 acres City State Zip Code Plwne Number ity Village Town Nearest Road --O M Spring Valley WI 54729 ( 7) 5-772-3135 Cady Highway 128 © New Construction Usci] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD El Replacement ® Public or commercial - Describe: Nr'A Parent material locss over till Flood Plain elevation if applicable Iwi114 ft. General comments Install S'x 120" rock cell mound on the 92.T surface contour with up slope edge of mound sand 24" and recommendations. S.E 94.7' ~[Iwbi6~"'tl~ P 1 Boring # 11 Boring a Pit Ground surface elev. 94.45 ft. Depth to limiting factor 12 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu Sz Cont. Color Gr. Sz. Sh. 'Etf#1 `Eff#2 1 0-4 7.5vi-3/3 sil 2fgr mvfr cs 2f .6 .8 2 4-12 7.5vr414 sit 2fshk mvfr cs 2f .6 .8 3 12-24 7.5yr ,'4 tvttP.yT, 10yr6 ' scl I fshk mf - - - - P2 Boring # ❑ Boring 89 , 12 Pit Ground surface elev ft. Depth to limiting factor in. Soil Appfication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gk. Sz. Sh. 'Eff#1 'Eff#2 1 0-5 7.5yr3/3 sit 2tgr mvfr cs 2f .6 K 2 5-12 7,5vr4/4 sit 2fsbk mvfr cs If 16 x 3 12.20 7.5yr4l4 kllp-iyployrh,Z sel Imsbk mf Effluent #1 = 80D > 30 < 220 rrxllL and TSS >30 < 150 mg ,(L ' E t #1 - B U 30 xyL and TSS 30 rnglL CST Name (Please Print) Signat CST Number Lewis 13 ork 253976 Address Date Evaluation Conducted Telephone Number E7819 County E Menomonie W1 54751 9-23-2015 715-231-7375 ? 3 Property Owner Jacobs Parcel ID # Page of P3 Boring. Boring 92.7 pit Ground surface elev. ft. Depth to limiting factor 12 in. Soil lication Rate Horizon Depth Dominant Coke Redox Description texture Structure Consistence Boundary Roots GPDlff in. Munsell Qu S7 Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff42 1 0-6 7Syrir2 sit 2fgr mvfr cs 2f .6 .8 2 6-12 7.5 vr4A sil 2fsbk m% r cs 2f .6 .h 3 12-20 7.5vr4r4 M3115yr!IOyr62 scl Ifsbk mf - - - ❑ Boring # LJ Boring Pit Ground surface elev it. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfP in. Munsell Qu. Sz. Cont_ Caor Gr. S7 Sh 'Eff#1 'Eff#2 II BonN Boring ❑ # Pit Ground surface elev. fl. Depth to limiting factor in. Soil Appliaition Rate Horizon Depth Dominant Color Redox Description I exture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. S7. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent 91 f3OD, > i0 < 220 mg1L and -5;; >3CI : 1.N nrlrL Effluent 42 - BUD,, all 1ISYL ar~J I&S 30 ni,T'L I h.: I)cparuncnt of Comriierce is an equal oppoutunit% sen ire Prop idea and enipiu~.r. If \ cur nred assistarue to access sen ices it need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. 0 Z M 1 •j V' M. a f L J ~ co 2 O Q M ~ ~ v ! J 1 41 o ~ ~ g D a~ 4 S v 1 1N n c JA N