HomeMy WebLinkAbout042-1016-10-920
VViisconsin Cepartment of "cmmerce PRIVATE SEWAGE SYSTEM County St. Croix
Safety and Build ny I: visior
INSPECTION REPORT Sanitary Permit o:
;ATTACH TO PERMIT) 582063
GENERAL INFORMATION State Plan ID No:
Persurm irformation ycu orovide may he used for secordary pw-poses [Piiva.y Law, s.' 5.C4 A)(rri
Perm t Holder's Nat" C ly Village Towrsh o Parcel Tax No:
Robert & Tonya Underdahl TOWN OF WARREN 042-1016-10-920
CST RM Elev
I q- I f) Insp 861 Elev. Bid Des riptioi SecticnJown Hange. Map No
Z
r [~I 07.29.18.97L
TANK INFORMATION A ELEVATION DATA
TYPE MANUFACTLIJ~
~rA CITY SIA7ION BS HI FS ELEV.
v
Septic Rerchmarlc
l IoZ.B ~i7.
Dosing A Alt BM
lvi
Aerati M rr Bldg. Sewer
Holding
S Ht Inlet
~oz.a 8.2 qL1. 6~
TANK SETBACK INFORMATION St'Ht Outlet
TANK TO PILr_ VYFLL BLDG Vcnt to Air Intake ROAD Dt Irlet
Septic , I~ t / Dt Bottom ~OZ.IS '2, qv-11
Dosir>F}- Header, an. IQ l O
/Aeration 1
= Dist. Pipe of ,1{8 8 q0. S
R9, q r.
Holding - - Bo,,. System lay 89.S
Final Grad tt T7 PUMPISIPHON INFORMATION f
Manufacturer
e Demand CG P~
zol(e'ie- GI
Model Number
16N GN s 3 X ^ Zc)
TDH Lift _7 Friction L111 System HeW IDH/ Ft
O r
Forcemain eng t Did. 2- rr C st. to !
u Zl
SOIL ABSORPTION SYSTEM ZZ Zz C lV
BED;TRENCH 'Xiidth 7 Leng-,f Jc Of Trenches r IT DIMENSIONS No. Df Pits Inside D a, Ligwd D~plh
DIMENSIONS -7u i i
SETBACK SYSTEM TO WL FLOG vFLL LAKE;STREAh4 LEACHING Manufacturer rtfi ~~Yq
INFORMATION CHAMBER OR I1 N
Type Ci System: N er, , Ytk
N b V 1-16b 7b' 13(o f M k UNIT Mode ,
PI-STR)BUTION SYSTEM
Head .1a f ~d Cislnbes1ator x hole &7z x Hole Spacing Je t to A r'ntake
Pip!
Length Cia Leigh Dia Spacng
SOIL COVER x Pressure Systems only xx Mound Or At rade Systems Only
pth ver t Depth Cver xx Depth cf xx Seedr.d(Scdded xfVulcned
Bed/T ncY Uerle Bed%~renrn Edges Icosod>~ _
71 Yes [ No Yes No
COMMENTS: nC,uee voce discrepencies• persons present. [etc) Inspection #1: Inspection #2
Location: 968 107TH AVE 1 +54S'tm f uwLii un C~c odd C/~~ Im 6A
1.) Alt BM Description= +i I 1 t C6 v o- UQ -kb L``" 1 Q 6 AV\_. o q#k
2.) Bldg sewer length =foal Ces 1,~s S;~ vCC1'LeA~'b~ 'Z
amount of cover - Jll
Fi n i5h:~~ Q ~ac~•e ~ 6e di ssal utcl Pt r prV~6Z
Plan revision Required? Yes 07_No
Use other side for additional informat on. /j
860-e71C (R 3/97) Dare nsepct, s gravure Cer, h.'o
County
Safety and B fem. i
201 W. Wasnin9ton
~ Sanitaz} Permit Number (to be fii}ed ¢ by Co.)
)g_ q4 Madison, W1 53707-755
5 ~S d(o
jAN 21 201J
Sanitary Permit Applicationsr. cao~x COUNTY S'~eT
In accordance u•im SPS 38311(2), Wis Adm. Code, su`,trt. issi ni of this ibtm~' ~
is required prior to obtaining a sanitary prima. Note. Apphi atice fuum for Attu-owned POWTS are submitted w Pro ect Address (if diffiaem than mailing address)
the Dcpart = of Safe y and Professional Servics. Personal u'formation you provide may be used for secondary
ses m accordance with the Privacy Law, s. 15.C-441 :Km), S%rts. 9L /O~ 1 /
L A Gcation Informadbip - Please Print All Information
Property Otvrur's Nemc r b P=d #
f I
Pr°perty O-w- s Mailing Address ?ropert} Locazion
City, State / Zip Code Phone Number on
Type of Building (check all that app) Lot
or 2 Family Dwcllmg -Number of Bcdr ms / Subdivisirm Name
Block s: -
❑ PublidGoounercial - Dc mbe Use _ t_~ J City'of_.U State Owned - Describe Use y CSM Number 6~DV 11 Village of
vt►II z4 P ✓10 lownof
S 9057 6 L,
III. Type Permit- (Check onl one box online A. Complete line B if applicable)
A.
System Rcparcement system ❑ TreatmenUHolding Tank Replaccmeut Only. ❑ Other Modification to Existing Syst= (explain)
B- ❑ Permit Renewal ❑ Pamir Revision ~ Change of Plumber ❑ Permit I:masfer to New List Previous Pen" Number and Date Issued
Before Expiration Owner
IV. 'FIJLW of POW"TS System/Component/Device: (Check all that apply)
*lon-Pressurized In-Ground 0 Pressurized In-Ground A:-made ❑ Morad > 24 is of suitable soil r Mound <24.. itabic soil
Ho g Tank Ll Otber Dispersal Coanpooent (explaie) - ❑ Pret catrnent Uev~c a (expl
V. Dis rsalrl rest nt Area Information: r
Design Flow (gpd) I Dcsigu Soil ,pplidauon dsf) ,Dispersal Area Required W) Dispersal Area (sf) Eleti~ on
N'L Tank Info Capacity in oral q of ! Mrnufaaurcr
Crallons Gagons Unix ! " o
tiew• Tanks :Ming Tams
U y/► y c Yy o `o V
Septic or Holding Tank i r t t -
Ikl cng f bamber
v_ t~ I r J
VII. Responsibility statement the uedersigned assume r bility for installation of the POWTS shown on the attached Pians
Piu( 7 Nat°c (Print] I Plttmbcr's MP~MP VftS umbra Business Pbeme Numbq
Phnnber's Address (Street, City, State, Zip Code) J
~J ~'F_ L7 r t
I Z
VIII ety/De artmeut Use Only
Apr i IS^~ `ermn Fee L'su Issuing rnt Sigirature
o -ivcn Rcrxa Dccrial~_~ t~ r l
DL Coudi*%af#40v"* teasons for Disapproval
I 1. Septic tank, erfluent fitte• and
disperc.al cell rr-Wnt a,l -,e services I rvaintai " "
as per management plan provided by plumber. ^
2. All setback requirements must be maintziried r(v
as per aprilGabl~ tnrfp ! xr5 aY,rb: _ (g4~~~yp
413aeb to complete plan for the system and a%' w 1 4 ti l /1, Div
per that is
r ~
1' l J
P1,04' PLAN RECEIVED
PROJECT Boo Underdahl ADDRESS P.O. Box 6 Roberts Wi 5402,3 r.;
NW 1,4 NE 1!4s 27 /T 29 N' R 18 'row N yVarrer COL"N'TY ST. CROIX
SYSTEM ELEVATION 92.0/92.5 6' below grade l 4,'14TM MUN'T7' D=VE' OPMEN 1 4
DATE BEDROOM
CONS ENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK
SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44
BENCHMARK V.R.P. Top of 3i4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE AVELL * If. R. P. same as benchmark
220' Propcrty Line. ~
Scale = 1/4'1 = 10'
All piping shall be ASTI\1 SDR 30'34. within
B A4 10' of tank, piping shall be ASTM F'891
..M
99,100!
Vents
14'
Vent
B-1
>6" Quick4 Standard
61 ?-3' X 90' cells of Cover Leaching Chamber
with 3' spacing with 20.0 ft? of Area
.6ft^?ipair of end caps
67, B-3 r 4' Lono ]
Grade,
t Svctem 1Jevaticui
8co Slope
B-2 O1 '
45'
-)0'
B-4
14uffcutt Combo Tank
20'
Bedroom
House.
40(1' Property L.ir
10-th :eve
PLOT PIA RECEIVED
PRO,II•:C,r Bob Underdahl ADDRESS P.O. Box 6 Roberts Wi 54w
NW 1 /4 NE 1/4s 27 11• 29 1/R 18 ~
TOWN Warren COUNTY ST. CROIX
02~ E' &T, IX COUNTY
SYSTEM ELEVATION 92.0/92.5 6' below grade 4/141M&MUNITY DEVELOPMENT 4
)ATE BEDROOM
CONVENTIONAL IN-GROUND PRESSLRE CONVENTIONAL LIFT XXX HOLDING TANK
A
MOUND SEPTIC TANK SV,E. 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44
BENCHMARK V.R.P. Top of 3/4" pipe
ASSUME ELEVATION 1001 Filter Lifetime Filter
❑BOREHOI,F: O WELL *H.R.P. same as benchmark
220' Property Line
Scale = 1/4" = 101
All piping shall be AST-'\4 SDR 30,134, within
JO' of tank, piping shall be ASTNI 1-'801
B. N4.
99,100,
Vent
14'
5'
B-I fill Quick4 Standard
61 ' 2 3' X 90' cells Leaching Chamber
with spacing with 20.0 ft2 of Area
.6ft^2!pair of end caps
6 B-:~ 34
Grade at System Elevation
ik-
8% Slope
50'
50'
R-2 101'
45
R-4 20'
1 luffcutt Combo Tank
20'
Pro 4
Bedroom
House. 10' ~ j
400' Property Line
107th .Avc.
Septic-Dose Wank Cross Section And Pump Performance Specifications
I Tank M - - Pump Manufacturer P~M--
anu fac ture r
Pump Model Number 'i/' /J 3
Tank Model Number ; f _Sv 7 j-V
Total Tank Capacity Alarm Manufacturer CY~^ _
Max. Bury Depth c Alarm Model Number Lr/
- - - LSmitch Type - ; C'~ - -
Filter Manufacturer Total Dynamic Head (TDH) -Feel i
Filter'-Model:Number _ Elevation Head -
Distal Pressure _
Network Loss
Minimum Pump Performance Required - Force Main Loss
vu GPM a~ ~C7 Ft TDH Total l~.
- - -
Outlet Nianhole Min. 4" Above Gracie Wide Manhole Min. 4" Above Grade
Y ocking Device. Imes Manhole With Locking Device
6" Below Grade Sealed 'Watertight Securely Mounted
Weather-proof 1
Junction Box -
- Finished Grade - - - - - - -
I
Vent Min. 12" Disconnect
Above Grade Means
With Vent Cap
Outlet Filter w= _
Inlet Wet Baffle -
;witch settings and Reserve Capacity A
"Tank Volume - GPI Weep
Dimension Inches Volume Gal. ' N Hole
(reserve) A) -1 Ir 016
(alarm) B 2 Off Fle~otion C
(dose) C J Ft
(dam) D~ S~ D Bottom
Elevation
Total Ft
GENERAL INSTALLATION: The wptic/dose tank is bedded and back filled in accordance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not
be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock)
installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and
laid on stable soil to prevent settling or sagging. Tlie force main is sleeved with 4" 5ch. 40 PVC to bridge the tank
excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.23.
02/051-1 Page cif,
Moe 53/ ``57. 9
tia'. _trs.
5 1.:. 43 tiz
29
^ I 4 -72
-^r I e 1-.25 (.9rr
I htl\'JTE cosa4: a r
I
Variable level float switches available-
Variable level long cycle systems available. T
Available with special cord lengths of 15', 25'. 35' and 50'.
Alarm systems available.. -
Duplex systems available. 3 stew
Single Seal Cortrol Selection Listings
Model Volts Phase (Node Amps Simplex Duplex CSA UL 1 'ntegral floa: operated mechanlcaswrt& no external control %qL red.
IAS-355& M5?153 115 1 Auto 9.? 1 ^ Y Y 2 Single pig9i back•valaole leve' float switch or double d i99. °
vba(j variable level
NS3 55 h 1457/59 11-a 1 Non 9.7
2 3 or 4& 5 Y Y t
91455 10 t Auto ' 3.' y t1oa1 switch. Re'9r to FM047
31457 j 115 1 A;b 9.7 3 Mechanical ahemator 'M-Pak' 100072 or 10.005.
' BE53'57 21-0 1 t Aula 48 { Y - 4 See FPA0712 fe' correct model of Electrical Alternator.
D5S'55& J~2?Q V-D 48 1~L~.... Y 5. Vanaole level central swtlcn 10-0225 used as a cen:rjl act vato , v^itn = eclrical
E5355&ESN59 2?C o 43 5 Alt_rnator
- _ (3) or 4," iloa• s.-,rem
5arxile, p*~ back switch ircli.d~
L CAUTpN
=ountrrnaticr cn2dd~ondiZoell?rprciucsrefe•rcc:3lagonPiggyb2cx;urrabeLevHF7oatSw•:;i~r..Fhr'~34?' . _
E e [nc31 Itu re; r RA0485, Mechanical AR rwlcr. W0495; Sum aw+ r• fivsins, FMcv 7, and si-gie Pr,,ie:r. z;9, area wec. n^, ire..
Smtaex °urrp C Ar,6 Ahrtn S?sterrs, FhlQ7
For unusual conditions a reserve safety factor is engineered into the design of every Zoel er pump.
MAIL T0: PC 9C~ E
` s r. LrwrsvrNe,KY 4C25o
Ma wi~c;urer U
O SHIP TO: 364 aveR,r!ioao
3. LcusriNe, KY 4X11-r96 i
~7 j`
Xi 77?-2i3t • t (800, 928-PUMP rL(AU7rP&M W ;*,T
htfp.lAsvww.zoeller.com PU/1i1P l0. Fax (Y~2; 774-:?sa4
J Copyright 2N)L^^ 7oeller Co. All rignts reseved.
Wisconsin Department a` Commerce SOIL EVALUATION REPORT Page jt
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited tc vertical and horizontal reference point (BM), direction and Pal I.D I percent s
lope. scale or d mensions, north arrow, and location and distance to nearest road. Please print all information. 7 Re i w-ed by perso,is inforrnarion ya., vovioe may be
used for secondary purposes (Privacy Law, s 1 SOS (1) (m)) i i
Property Owner Property Location
Govt. Lot `/~k) 1;4 ~j r 1i4 S T N R E ( W
Property OWDm es MailinOddress Lot # Block # Subd. Name or CSM#
v ' ~Sf1k - City State Zip Code Phone Number ❑ city ❑ Village Town Nearest Roa
CU l ->,l ~ ( ) 6rJ r r zs~ / ~
Construction Use' Residential ! Number of bedrooms Code derived design flow rate 6 GPD
❑ Replacement ❑ Public_orlcommera - Describe:
Parerd material D; t~'✓~x~`l~rt - Flood Plain elevation if applicable _ - - f 15Z, Y- General comments ,
and reconmendabons. ~4 ~i+uJy
System Type [~f~. > -if U ~ !T System Elevation-?I;•
Boring # ❑ Boring
l~l Pit Ground surface elev. lU_ ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in, MunseA Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
I - ;jam 4J_
Boring # Boring
❑ Pit Ground surface elev\c 0- ft. Depth to limiting factor in.
Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtW
in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOO. > 30 < 220 mWL. and TSS >30 < 150 mgt- ' Effluent #2 = BOD, < 30
rixyL and TSS < 30 _ mglL
CST Name (Please Print) Sid CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address date Fvaluation ro dL,
Telephone Number
Fcd
I 1432 120th St, Ne,w Richmond, W1 54017 c 715-246-4516
Property Owner Parcel ID # Page of
❑ Boring
Boring 9 ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate
Horizon Depth TDominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh 'Eff#1 -Eff#2
j Boring # Boring
I___J ❑ pit Ground surface elev. ft. Depth to limiting factor in Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture SbWure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eft#2
Boring
Boring # Ground surface elev. ft. Depth to limiting factor n.
❑ Pit Soil lication Rate
Iff
Horizon 'lepth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPI)
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
Effluent #1 = BOD, > 30 < 220 mglL and TSS >30 1150 mgll- ' Effluent #2 = BODS 130 mg/L and TSS < 30 mg0..
The Department of Commerce is an equal opportunity service provider and emplover. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SUD-RIVI (R &W i
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 1/20/16
Owner:Bob Underdahl
Location: NW1/4 NE 1/4 S7 T29 N,R18W Lot 11 107th Ave Warren
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
ZC' 4-6. Mai ntanance angency Plan
7. Filter Cross SectiSignature ~
License numo #226900
v
PLOT PLAN
PROJECT Bob Underdahl ADDRESS P.O. Box 6 Roberts Wi 54023
NW I i4 NE 1/4s 27 /T 29 N/R 18 W TOWN Warren
COUNTY ST. CROIX
SYSTEM ELEVATION' 95.1/94.1 5.6' below grade 1/20/16
BEDROOM 4
DATE
C[)NVENTIONAI, XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFTTANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891
# of chambers 44
BENCHMARK V.R.P. Top of 3/4" pipe
ASSUME, ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE 0 1VF•LL * II.R.P, same as benchmark
220' Pro ertv Line
Scale = 1/4'11 = 10,
All piping shall be ASTM SDR 30/34, %vithin
g M ~ 10' of tank.. piping shall be AST M F891
14' Vents
5'
H-1 2-3' X 90' cells with 3' spacing Vent
>61' Quick4 Standarc
1 of Cover Leaching Chami ci
with 20.0 ft2 of Ares
5.6i't^,2/pair of end cal.
67' B-3 4' Long 12.
Grade at System Elevation
3 4'
8% Slope
50'
60' 30'
ST
50' Pro 4
B-2 101' Bedroom
98' House
99, 100,
400' Property Line
107th Ave
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Charnber
with 20.0 ft2 of Area per Chamber
5.6ft"2 pair of end plates To be >1 ' above grade
Finish grade elevation
Typical Installation 100.7'
Vent Vent
Grade
3'
3 X30/34 Septic Tank
5' Lono I " 5'
5' Long I
36" Grade at System Elevation Gracie at System Elevation
Spacing-- 5' -
2-3' X 90' Cells
Same on other end Observation tubeNent
At end of cell
A
22 chambers per cell B
System elevations:
A 95.1 '
B_94.1 '
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
.OWNERSHIP CERTIFICATION FORM
OwrwMuyer
Mailing AA&;;9
Property Address'
(VariflCCati m required from Planning & Zoning Department far new )
City/State Parcel Identification Number
GAL DESCRYPTION
Location 1
Ply /4 Sec. . T N R,/j W, Town of ~~dl/'
Subdivision . Lot #
Certified Survey Map # Volume
t,x page #
Warranty Deed #
:-J Volume Page #
Spec house yea Lot liner; identifiable no
SYSTEM-MAIlVTENANCE AND OWNER CERTaCATION
Rwropcr use and ainutaname of your septic system could result in its prenzww father; to handle wastes. Proper
mand mane consists of pumping out the septic tame every tbuee years or sooner, it needed, by a licensed pumper. What you put m1o
the system can affect the f nictiion of the septic tank as a treatment stage in the wasee disposal syst+ern. Owner maintenance
zespams* ities are specified in #Commn. 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, journeymen phu,•, yes 4111ed plumber or a licensed pumper verifying Chet (1) the on-site
wasteW t' disposal system is in proper operating condition and/or (2) alter inspeaticm and pumping (if necessary), the septic tank is
less dart 1/3 full of sludge.
Uwe, the undyed have road the above requacm mts and agree to main.tem the
mra sewage standards set forth, heroin, as act by the Department ofCommeree and the Depaftmilt of Nattr ul disposal system witNatural Resources, &itate of Wiacorrtrin,
Certification stating that your septic system has been maimed, must be compleW and returned to the St. Orom County Flemming ~
Zoning Depa ti naut within 30 days of the duce year expiration date.
Uwe certify that all statements on farm are true to the best of mytour knowledge. Uwe aware the owner(s) of the
property described above, by virtue of a deed recorded in Regieft of Deeds Office.
Number of b m$
SI A F PLIC (S)
DATE
***Any information that a misrepresented may result in the sanitary permit being revoked by the Plain & Zoning Depar t
lml ule with this application a recorded wMauty deed from the Register of Deeds Office and a copy of the cedifiW survey rap if
reference is made in the warranty cloud.
C~•g'~. OglOg)
POWTS OWNER'S MANUAL. & MANAGEMENT PLAN pop of
ILE INFORMATION SYSTEM SPECIFICATIONS
Owner
Septic Tank Capacity '
Permit f i E3 NA
Septic Tank Manufacturer NA
ION P8BaETERaS Effkent Filter Manufacturer
r ~ ❑ NA
Number of Bedrooms d NA Effluent Fitter Model
C] NA
Number of Public Fac ky,finite Pump Tank Cape*
gal
Estimatecl flow O u Pump Tank Manufacturer
NA
i Design flow (peak), (Estimated x 1.5) Pump Manufacturer ryA
Soil Application Rate - Pump Model
Standard Inlluent/Ef kient Quality monthly average" Pretreatment Unit
Fats; Oll & Grease (FOG) sap mg/L ❑ Send/Grr dial Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODE) 5220 mg/L ❑ NA O Mechanical Aeration 13 Wetland
Total Suspended Solids (TSS) 6150 mg/L Ca Disinfection 0 Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s)
Blochemicai Oxygen Demand (BODs) 530 mgAL n-Ground ❑ NA
{gravity} O In-Ground (presscrrfzed)
Total Suspended Solids MS) 530 mg/L >(NA ❑ At rade ❑ Mound
Fecal Cobform (geometric mean) 5104 cfW100ml ❑ Drip-Line ❑ Other
iMaxImum Effluent Particle Size 36 in dia. ❑ NA Othec
Other ❑ ]NA 3NA Other
❑ typical for dorn s k wastewater and septk: tank of luent. Other
❑ NIAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every:
s s 7(7um 3 years) 0 NA
(Pump out contents of tank(s) When combined sludge and scum equals one-third (lb) of tank volume ❑ NA
inspect dispersal cell(s) At least once every: morul8(s) Yore) ❑
(Max murn 3
Clean effluent filter At least once every: mo(s)
nth
nspect pump, pump controls $ alarm At least once every: Q month(s)
Mush laterals and pressure test At least once every: ❑ month(s)
NA
gar 8)
At least once every: ❑ month(s)
IYRF ❑ s NA
NA
MAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal cells shall be madeby an individual carrying one of the foikrwing licenses or certifications: Master
!Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Se a Servicing O
Include a'visual Inspection of the tank(s) to identify any missing or broken hardware i Aerator. Tank inspections must
combined sludge and scum and to check for any back u or n9 ' den g any cracks . ,measure the volume of
visually inspected to check the effluent levels in the obs6 adodiof effluent on the round surface. The dispersal cattle) uff be shag
pipes and to check for any pondtng of effluent on the ground surfac:s
`Ilse pondin9 of effluent on the ground surface .
regulatory authority .y indicate a failing condition and requires the immediate notiiiation of the local
IJllhen the combined accumulation of sludge and scum in any tank equals one-third
Ift tank shall be M by 9 ()5) or more of the tank volume, the entire convents of
Administrative Code. SOMICIng Operator and disposed of in accordance with chapter NR 113, Wisconsin
NI alter services, including but not limited to the servicing of afflcent filters, mechanical or pfessurized WW any servicing at intervals of 512 months, shall be rfonrred a
components, pretreatment units,
pe by certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page of
START UP AND OPERATION
For now. construction, prior to use of the POVVTS deck treatment tank(s) for the presence of painting products or other chemicals V*t
may Impede the treatment process and/or damage the Alsperssl cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when sod conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater lever. When power is restored the excess wastewater will t
discharged to the dispersal cell(s) In one large dose, overloading the Cell(s) and may result in the backup or surface disdcarge of effiuertt.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels
within the,pump tank,
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within
15 feet down slope of any mound or at grade soil absorption area.
Reduction or elimination of the following from the wastewater strum may improve the performance and prolong the We of the POW
antibiotics; baby wipes: dgereft butts; -condoms; cotton swabs; degreasers; dental flews; diapers; dish; fat; foundation drain
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produce;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or Is permanently taken out of service the following steps shall betaken to Insure that the system is property
and safety abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code:.
• All piping to tanks and pits shad be disconnected and the abandoned pipe openings seated.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filed with sail,,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWs S falls and cannot be repaired the following measures have been, or must be taken, to provide a axle compliant
replacement system:
-A I'lable reaacament area has been evaluated and may be utilized for the WOW of a replacement soil absorption syw".
The replacement area should to protected from disturbance and compaction,and should not be infringed upon by requh~ d
setbacks from exieft and proposed structure, lot litres and wells. Failure to protect the replacement area will result In the need
for a raw soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the Pates In
elfed at that time.
0 A suitable replacement wee is not available due to setback and/or sod limitations. Bening advances In POWTS technology a
holding tank may be hnstalled as a last resort to replace the failed POWTS.
17 The site has not beery evaluated to Identity a suitable replacement area. Upon failure of the POWTS a sod and site evaluation
must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
13 Mound and at-grade sod absorption systems may be reconstructed In place following removal of the biomat at the hnfiltr We
surface. Recorstnxxions of such systems must comply with the rules in effect at that time.
<<WARNING>>
SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASM ANDIOR INI3UFFICIENT'OXYGEN. DO MOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OP A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name, Name
Phone 7/,' = - Phone
SEPTAGE SERVICING OPERATO UMPER LOCAL REGULATORY AUTHORITY
Name 's Name 2ne-,
Phone Phone -
This doaxnent was drafted in o>> oance with chapter SM 383.22M0)(1)(d)&(f) and 383.54(1), (2) 8 (3). Wk=Wm Administrative Code.
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