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032-2067-50-050
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 582058 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2624988 Permit Holder's Name: City Village Township Parcel Tax No: Jeff & Kris Wroblewski TOWN OF SOMERSET 032-2067-50-050 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 5441E tx. 0a 5?g1~E Sf u&y *T- P v Ez 12.30.20.763A-20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Q i$ Septic nyf~ $ Benchmark w~ y. l.~ lvo,ao Dosing ~ eurf1P I AWOL N w sC oo ( r !oN • I y'. z 9 Aeration Bldg. Sewer 7 f, 6 4.51 Holding SUHt Inlet 79s i /Z /P 6.0 TANK SETBACK INFORMATION St/Ht Outlet ?y.s l~.ys (o 6.6-s TANK TO P/L WELL BLDG. Vent to Air Intake ROAD DtInlet DZ Septic $ I Dt Bottom Q / DC lOC7 SS^ Dosing Alff n 00 a Header/Man. ! 6~ loZ. YS Aeration Dist. Pipe Holding Bot. System ' I . ~ Z • ZS dol. gS S PUMP/SIPHON INFORMATION Final Grade 1U-1 0, 05~ Manufacturer n Demand Cover T5 oFGtD ZJ ~ It e 2 GPM P Tunk 79• So yYS 7-5. Model Number 19? t S haw !aY jig q. /D /00, v0 TDH Lift t Friction Loss System Head TDH Ft 3`t 6•S0' I T lsj offer .3.5- lol.3 .7 8.57 Forcemain Leng th + Dia. Dist. to Well (fL4f-f' 'r/bVJG 4,D)c N/A ru urti .vr 3.~s $I.82 to 77 7S-05- 4 2 SOIL ABSORPTION SYSTEM P oG auN ~9 s 3. oS BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO { P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: _ INFORMATION Type Of System: CHAMBER OR FGot.J t UNIT Model Number: 03, X/ DISTRIBUTION SYSTEM Header/Manifold w IDistriipebution u/ x Hole Size Li Ix Hole Spacing Vent to Air Intake Length 3,+3+Dia~_ Length§' Dia l Spacing c ,12$ / • j Z ' SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of Seeded/S dded 1xx Mulched Bed/Trench C nter > / Bed/Trench Edges Topsoil ( r (Q ~Y.(Z V, Yes No Yes TN] COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 17~.~ t` Inspection #2: -raav _PF Location: 290 165TH AVE ,,vaL 1.) Alt BM Description = MAD (Al Oa 7NE►41. ,4j 01-T ~l~(r 2.) Bldg sewer length = lS(~QuQC~ RAC si0r FE~cE Ia PGAE Ptow Qoois WC~E Qq.G~ a~ amount of cover 1406 -1;Ut. j'_-9r_ ruCnt ' E~ .((~f~(l S 57 Plan Use other side Required? for additional informatio No . J SBD-6710 (R.3/97) Date kpSnature Cert. No. StA i \ ~~p G 6°r6~ ter a V~ C_ Ir i S a l rr 2 p(Lf Agri -C yy ; G~-- r ~r -pF. fA L,2 t? $,A o F Count Safety and Bulldm ivis' n 201 W. Washington Ave , x 7 Sanitary Permit Number (to be filled in by Co.) pNov 17 Q 1 Madison, WI 707-71 ST. CROIX COUNTY OMM ani_ary eimlh Application Slate Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit ~~L is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privac , Law, s. 15.04(1)(m), Stats. lp_ 1. Application Information - Please Print All Information :i Property Owner's Name Parcel Property Owner's Mailing Address Property Location 3 O J QO . ?1#3 * 11 _ Q ►a . ~2j Govt. Lot City, State Zip Code Phone Number y, / Section (circle on Sly' ✓ ' h ~t T N; R ~f E o Il. Type of Building (c eck all that apply) Lot # A I or 2 Family Dwelling Number of Bedrooms ~ Subdivision Name Block # El Public/Commercial - Describe Use V'%- ❑ City of V%6 CSM Number ❑ Village of ❑ State Owned - Describ Use C' Town of SL` ~'~2 k CA X III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System KReplacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ List Previous Permit Number and Date Issued , B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner . - L 40- 't / i IV. Type of POWTS System/Component/Device. Check all that V ply) y~ V 91 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade .wand > 24 in. of suitable soil ®m Mound < 24 in. of suitable soil V ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) !944 1 V. Dis ersal/Trea ent Area Information: Design Flow (gpd) Design Soil Application Rat pdsf) Dispersal Area Require st) Dispersal Area Propos (st Sy vation 0 b 0,f 6..30 ;.i VI. Tank Info Capacity in Total # of Manufacture Gallons Gallons Units New Tanks Existing Tanks U in r ~ ii V a. Septic or Holding Tank •1 r' 2 C, I (/t a _A1 Dosing Chamber - l r ' 0 o , ' i VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumbers Name (Print) Plumber's natu MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) lei VIII. Coun epartment Use Only e Issuing gent Signature pp roved P Permit Fee DaAsu iven eason for ial IX. ConditfiU75EMOVdKi liteasons for Disapproval 3, CaJ~ /Opts f'~ haw.C ~ 1. Septic tank, effluent filter and f~ p dispen;~i cell must all Oe services / maintainec 2 its e !.J toe, as per management plan provided by plumber. aCC 2. AN:sottmck requirements must be maintained t r in per appNc" code / ordinllnlall, r") o's '^d' t fi►ti • • Attach to complete plans for the system and sub to the County only on paper n ss than 8 1/2 x ti inche~s~in s~iz~e o 3 1A e, SBD-6398 (R.ll/1l) 15) 6640a • r _ ~r~u7.irEti~ DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN HOLMEN WI 54636-9466 i D ~ti1 Contact Through Relay services http://dsps.wi.gov/programs/industry k ! www.wisconsin.gov Essras, Scott Walker, Governor Dave Ross, Secretary November 12, 2015 CUST ID No. 225410 ATTN: POWTS Inspector PAUL R KOEHLER ZONING OFFICE COUNTRYSIDE PLUMBING & HEATING INC ST CROIX COUNTY SPIA 321 WISCONSIN DR 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/12/2017 SITE: Kris & Jeff Wroblewski Identification Numbers 338 165TH Ave Transaction ID No. 2624988 Town of Somerset Site ID No. 818640 St Croix County Please refer to both identification numbers. NEl/4, NE1/4, S12, T30N, R19W above, in all correspondence with the agency. FOR: Description: Four Bedroom EZflow Mound System / Level site Object Type: POWTS Component Manual Regulated Object ID No.: 1572519 Maintenance required; 600 GPD Flow rate; 15 in Soil minimum depth to limiting factor from original grade System(s): EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD- 10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: !CN OF Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. L • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspections authorized representatives of the Department which may include local inspectors. PAUL R KOEHLER Pave 2 11/12/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sine ely, Fee Required $ 250.00 This Amount Will Be Invoiced. G rd M Swim When You Receive That Invoice, OWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm PAUL R KOEHLER Page 2 11/12/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. ZOMSwini ly, Fee Required S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, S Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm EZflow° MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: KRIS AND JEFF WROBLEWSKI Owner's Name: JEFF AND KRIS WROBLEWSKI Owner's Address: 338 165 TH AVE f SOMERSET WI 54025 Legal Description: NE 1/4 NE1/4S12T30R19W Township: SOMERSET County: ST CROIX _ Subdivision Name: CSM 20-5162 Lot Number: Block Number: Parcel I.D. Number: 032-2067-50-050 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page I , r -OT Pte" ATT- Paea-'t°0° SURVEY MAP Rege°-M TANK SPECS Designer: PAUL KOEHLER License Number: MP 225410 Date: 10/15/15 Phone Number: 7152462660 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSW MP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01 /81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) 0 EZflow Mound Version 3.0 (R. 3/1/12) Page 1 of q4- Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 0.00 Site Slope 99.50 Installation Contour Line Elevation (ft) 12000 Contour Length Available (ft) 15.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information r~91 Cell Width (ft) 3 4. 5 6. 7, 8. 9 or 10 Only 70.00 =Dispersal Cell Length (ft) Dispersal Cell Design Loading Rate (gpd/ft2) 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 or e) e Center or End Manifold 3 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 1.50 Estimated Orifice Spacing (ft) = 4.57 ft2/orifice 2.00 Forcemain Diameter (in) 220.00 Forcemain Length (ft) Does the forcemain drain back? :_Y = 69.50 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 6.50 System Head (ft) x 1.3 35.89 Forcemain Drainback (gal) 31.25 Vertical Lift (ft) 94.14 5x Void Volume (gal) 13.91 Friction Loss (ft) 130.02 Minimum Dose Volume (gal) 51.66 Total Dynamic Head (ft) 56.85 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice 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 Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser Concrete Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1000.00 Dose Tank Capacity (gal) !POLY LOCK Filter Manufacturer 27.83 Dose Tank Volume (gal/in) 525 Filter Model Number Weiser Concrete Manufacturer Project: KRIS AND JEFF WROBLEWSKI Page 2 of 8 Mound Plan View t C7. 75 1/T 10 * Observation Pipe . K - W B z 75 I~ L Mound Component Dimensions Down slope toe extension made. *A 9.00 ft E [Aft in H 1.00 ft K A28. ft B 70.00 ft F in z 9.75 ft L ft D 21.00 in G J 9.75 ft W ft 630.00 (ft2) Dispersal Cell Area 1995.00 (ft2) Basal Area Available 8.57 (gpd/ft) Linear Loading Rate 7.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 103.25 (ft) No 11 ♦ H G 1 F Dispersal Cell 101.75 (ft) Lateral Invert Elevation 101.25 (ft) 3 Dispersal Cell D. Elevation D A... L'1 A AA 99.50 (ft) Contour Elevation 0.0 % Site Slope ypical Dispersal Cell Shading Key ~ See Page 5 Q Topsoil Cap > d c. 2 ,:•:-„f.,. Subsoil Cap c' ° c 2.0 ft Approved Geotextile Fabric Cover ASTM C33 Sand d ®0 Tilled Layer Z F 5❑ EZflow Media t y a See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: KRIS AND JEFF WROBLEWSKI Page 3 of 8 End Connection Lateral Layout Diagram Turn-up v4ball valve or alaanoutplug P - 9Estorifice located EI-E- -I foil laterals ider€[icel, with or,fces eua1M1,~ ~p~c~ed. Force mr7in tion via. tee oanif€z ld of arty' point. Laterals & force main of P'dC Sch 40 S per 'S Table 384.3" orifices point up except e ery Stt, one points do.", for drainage, Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 1.52 ft Lateral Length (P) 69.20 ft Orifices per Lateral 46 Lateral End (Z) 0.80 ft Orifice Density 4.57 ftz/orifice Lateral Spacing (S) 3.00 ft Manifold Length 6.00 ft Lateral Flow Rate 18.95 gpm Manifold Diameter 1.50 in System Flow Rate 56.85 gpm Forcemain Velocity 5.81 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC fts in. min. Tank component is properly vented Alternate outlet l ocation main diameter Weiser Concrete Manufacturer 2 in. Capacity 1000.00 Gallons Volume 27.83 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 17.26 480.36 B 2.00 55.66 C Pump off elevation (ft) C 4.67 130.02 70.50 D 12.00 333.96 D Total 35.93 1000.00 Do♦ se tank elevation (ft) I Bedding And Backfill As Per Manufacturer 69.50 Alarm Manufacturer SJ RHOMBUS Alarm Model Number PS PATROL Pump Manufacturer ZOELLER Pump Model Number 189 Pump Must Deliver 56.85 gpm at 51.66 ft TDH Note: Switches containing mercury may not be used in this system. Project: KRIS AND JEFF WROBLEWSKI Page 4 of 8 Uflowe Distribution Cell Media Layout 9.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements 9 Fft WideA~ Component Legend ® SR1-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or Q~%s SR3-12H in 5 ft or 10 ft lengths o 4" Perforated Distribution Pipe With Pressure Lateral Inside • Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 9.00 Cell Width - A (ft) 70.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 9 ft Wide End Manifold Project: KRIS AND JEFF WROBLEWSKI Page 5 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name DARRELS SEPTIC Phone 7154251025 POWTS Regulator's Name PAUL KOEHLER Phone 7152462660 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 630 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 every 3 years Effluent Filter Inspect and clean as necessary at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years Other 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 EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 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 _ • • • . , 0 • • • • . . 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two Y 45 Degree Bends Same Diameter as Lateral EZflow Synthetic Media tel. - i?• 2.10 Feet Distribution Lateral Lateral Clean out Project: KRIS AND JEFF WROBLEWSKI Page 6 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 accordance with its' component manuals [EZflow Mound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. 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, Stats. 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 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 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 sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives 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 Wisconsin Department of Commerce. Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. *****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.**** 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 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. 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 for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency 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) shall 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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: KRIS AND JEFF WROBLEWSKI Page 7 of 8 TOTAL DYNAMIC HEAD FLOW PER MINUTE PUMP PERFORMANCE CURVE MODELS 18514185-186/4186-18814188-189/4189-191 a MODELS 185/4185 186/4186 188/4188 189/4189 191 Gal. Liters Gal. Liters Gal. Liters Gal. Liters ' Feet Meters Gal. F 5 1.5 58 220 145 549 145 549 45 170 5 170 32 - 10 3.0 - 58 220 140 530 140 530 4 20 61 58 220 128 484 1305 494 45 170 30 91 85 58 220 116 439 120 454 45 170 40 12 2 70 58 220 1035 392 109 413 45 70 50 152 51 58 220 90 341 97 67 45 170 60 183 32 58 220 71 269 85 322 45 170 70 21.3 9 34 52 197 51 193 69 261 45 170 80 24.4 45 170 28 106 51 193 45 170 90 27.4 30.5 115 2 8 34 129 45 170 ' 100 30.5 16 60 17 64 40 151 ' 110 32 4 15 30 Al 120 36.6 20 130 396 10 Shut-off Head 73It (22m) 114 R. (35m) 112n- NOTE: No UL listing for 200/208 single phase pumps, model 186 & 191, or double seal series. ih I 11 DCAUTION Model 185 should not be subjected to heads less than 30' (9 m) TDH. o -.cw to mwr[ 009903 MODEL COMPARISON CERTIFICATIONS Model Seal Mode Volts Ph Amps HP Hz Lbs Kg Simplex Duplex cCSAus UL D185 / * H185 Single Auto 230 / 200 1 9.8/ 11.5 1 60 85 / 86 38 / 39 1 Y Y E185 / E4185 Single / Dbl Non 230 1 9.8 1 60 85 / 92 38 / 41 2 or 3 4 Y Y * 1185 14185 Single / Dbl Non 200 1 11.5 1 60 85 / 92 38 / 41 2 or 3 4 Y N * F185 F4185 Single / Dbl Non 230 3 7.4 1 60 85 / 92 38 / 41 3 & 5 4&5 Y Y * J185 J4185 Single / Dbl Non 200 3 7.5 1 60 85 / 92 38 / 41 3 & 5 4 & 5 y y BE185 Single Auto 230 1 9.5 1 60 87 39 Y Y * G185 G4185 Single / Dbl Non 460 3 3.7 1 60 85 / 92 38 / 41 3 & 5 4 & 5 Y Y * BA185 Single Non 575 3 3.3 1 60 85 38 3 & 5 4&5 Y N D186 H186 Single Auto 230 / 200 1 13.7/17.2 1-1/2 60 91 41 1 Y Ni°' E186 / E4186 Single / Dbl Non 230 1 13.7 1-1/2 60 90 / 97 40 / 43 2 or 3 4 Y N * 1186 14186 Single / Dbl Non 200 1 17.2 1-1/2 60 90 / 97 40 / 43 2 or 3 4 Y N * F186 F4186 Single / Dbl Non 230 3 9.2 1-1/2 60 90 / 97 40 / 43 3 & 5 4 & 5 Y N * J186 J4186 Single / Dbl Non 200 3 10.3 1-1/2 60 90 / 97 40 / 43 3 & 5 4&5 Y N BE186 Single Auto 230 1 13.7 1 60 92 42 Y N * G186 G4186 Single / Dbl Non 460 3 4.6 1-1/2 60 90 / 97 40 / 43 3 & 5 4 & 5 Y N * BA186 / * BA4186 Single / Ohl Non 575 3 3.6 1-112 60 90 / 97 40 / 43 3 & 5 4 & 5 Y N *D188 / H188 Single Auto 230 / 200 1 14.0/16.8 1-112 60 91 41 1 Y'2' Y", 41 E188 / E4188 Single / Dbl Non 230 1 14.0 1-1/2 60 90 / 97 40 / 43 2 or 3 4 Y N11' * 1188 14188 Single / Dbl Non 200 1 16.8 1-112 60 90 / 97 40 / 43 2 or 3 4 Y N * F188 F4188 Single / Dbl Non 230 3 8.9 1-1/2 60 90 / 97 40 / 43 3 & 5 4&5 Y Y * J188 J4188 Single / Dbl Non 200 3 10.3 1-112 60 90 40 / 43 3 & 5 4&5 Y Y BE188 Single Auto 230 1 14.0 1-1/2 60 92 42 Y N * G188 G4188 Single / Dbl Non 460 3 4.6 1-1/2 60 95 / 97 43 / 43 3&5 4&5 Y Y * BA188 Single Non 575 3 3.5 1-112 60 90 40 3 & 5 4&5 Y N D189/* H189 Single Auto 230 / 200 1 17.1 /20.5 2 60 91 41 1 Y'2' Yn. E189 / E4189 Single / Dbl Non 230 1 17.1 2 60 90 / 97 40 / 43 2 or 3 4 Y'21 Yn' * 1189 14189 Single / Dbl Non 200 1 20.5 2 60 90 / 97 40 / 43 2 or 3 4 Y N * F189 F4189 Single / Dbl Non 230 3 11.2 2 60 90 / 97 40 / 43 3 & 5 4&5 Y Y * J189 J4189 Single / Dbl Non 200 3 13.2 2 60 90 / 97 40 / 43 3 & 5 4&5 Y Y *G189G4189 Single/Dbl Non 460 3 6.0 2 60 90/97 40/43 3&5 4&5 Y Y * BA189 Single Non 575 3 5.8 2 60 90 40 3&5 4&5 Y N * WD189 / WD4189 Single / Dbl Auto 230 1 17.1 2 60 93 / 100 42 / 45 1 4 N N E191 Single Non 230 1 14.5 2 60 87 39 2 or 3 4 Y N * no molded plug (1) UL listed unit available with 20 Amp plug. (2) CSA approval with 20 Amp plug. (3) 20 Amp outlet, P/N 10-0060 must be used. (4) H models are not UL listed. NOTE: WD models are controlled by an integral variable level pump switch. H, 1, J, F, G and BA models do not have a molded plug. Additional cord lengths are available in 25' (8 m) 35' (11 m) and 50' (15 m). SELECTION GUIDE 1. Integral float operated mechanical switch, no external control required. 2. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 3. See FM1228 for correct model of simplex control panel. 4. See FM0712 for correct model of duplex control panel. 5. Variable level control switch 10-0743 used as a control activator, specify simplex (3) float or duplex (4) float system. Refer to FM0526. 1A CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electrical Code (NEC) and the Occupational Safety and Health Act (OSHA). © Copyright 2015 Zoeller` Co. All rights reserved. 502-778-2731 800-928-7867 3649 Cane Run Road Louisville, KY 40211-1961 1 www.zoeller.com l - If SPAY VLtj n Sl rcS V p ~ ~ E E ~ 1 ~rd~'~Y f L~ ~ i i I 1 sG~ ~ BIZ 5 I NO 't.~Sr r La~~ ~ w n ~ 0 D ~ r S ~~ov°G 6fDO Ya - T~l 2 fiorC.~O~t1~ ~J p (.nc~Y 1J ~ V ~ lo~'a ~ o o~ SA. oFS I` F I I' j rv ICI ~ IIII v v I g U Izz J ~ V` PREPARED FOR: SURLtFYOR: KRISHJEI''WPCni.E`1YSM I' IGLAS l. 2AHLER 328 185 ZH, AVENUE S & N LAND SURVEYING S04AER.5ET, 4M 5$1125 292D ENL®E STREET SUITE 101 HUDSON, fNl W18 Legal AeSCription Part of Govefnment Lot S of Section 12,730N, R20W; °y q described as foilOWS: Lot 2 of Certified Survey Map ~ y Riy4~o Volume 20, Page 5162, Cj . 4 /'vk%1a 16 R C~ NORTH SCALE.• 3 SC' 6 S6 '2C ® QpoRWRY HIGH WATER MARK (ot WMI BLUFFLINE W *Q01-1 c z 2s' -25.r etu . J = . _ . ! f \ \ BLUFf(FIyF ~J 3657 AVE. PRIVATE ROB . \ \ \ I WRp tEWSKI ,x 290 165TH AVE. - TCiYhi Ca SOMERSET, ST. CRM CM* w, WS'C&t1$IAI S}TE PAN aath ora~lxg`aune2E?s S&fi(ar~3uNering .er a ` ra~a._ r~ : s R.20. W. -4-R. 19. W. frtOfH nvf . 1 r- State o Diamond D WI Farms Inc 52.7 W 3 3 :t f 1, 4~ a 23.3 ~mCN 10 Richard & S/1 i Melvin & °v Jeannine Kriese 0~ Karen Robert X { Jonk Johanna j f't f) AI f kr ►f N Arnold & Hildebroni 3i Dorothy Kustritz 40.1 Irene 2 iu 8 Hildebran Newman 3( p 3 w I t s Marsha K Jr 39.6 3 Anderson Q KHI I r - It frrye,s tr lit F- 39.7 r Miles & z c H5 ~nl M 10 difh A Audrey Wittig ER s Hartma So(I otI co ~R 137.3 3 0 3 Bs 18 I I I +7 / USA 46.1 Leucke CHABR 18 t nf„u t I Patterson 472ND AVE r' H Lang N ~4 20 N ord Davis 22.8 4 4 o D0 103 U Ask Aur11„ pe> UNPS 3 I,nun,i 17 !I<ru~a 19 9 W J6 0 4 Inc JH Y t i,rrrI / U A` y. 41.1Y -11 -1 Stark Jeffrey & hnilr,a A } .-4 Lowell a~ O 15 c o Lind 16 g'CLowell a K6 o ; Jan Un~f (.Ins fys If, urea.,, ! 8. $ ="il)h as 4 8 ° _Gabrick 661 MMrn Virginia Virginia u» Z U 15 3 ~P Rivard Rivard Z" J7 F7 3 18ri t If Avt ti & C Bursch 60.5 110.8 69.4 Chilakoot cuPeterson BowhunterZ DS 10 I"r"'"" trey,, i iY & I"ntrvll /oas Inc 47.4 LLi mhr"nun"Y ✓ cre~o~ o CC Z ; 2 John E I(1 3 ova ~o 13 -44 o o~ St. Croix Walsh ll~rl~r ~„Y Cie, co: N National 128 Lcnnu I H~ d VP 6 4 3 4 3 RRL 10 a v p~j 86.8 ✓ onhr,lrunt ti 1', `arread 5 ISC o o SC T MP NZ 160TH AVE 40 :t (oot C 16d95 40.2 L t2 - 2 co LH Doyle RD 2 John E f i Sc R 11 John E c? !r^lerr"y a hard a`) a) 1. Strese Deanna P TR L 5 Strese 39.9 38.9 Streng itt n x / 38.4 .v 2 4 3131"1. Jeffrey O cry r, iU Jeffrey A U.John Jr t` John Jr P a .,,i f. I It Ali Dale ,_o_ v 3 & ~J P5 Machace Machace a 2 & Evelyn & Evely } ' I w m A 12 Uj (q 3 40 399 Todd H SM h Z Strese Tr Z Strese Tr I I n,,,t N Gg 4 W Wulf 35 13 115.6 73.2 ur V 4 4 C W 1 4 Ronjit & M 6 3 113.5 a i P6 5~ J Paula B TCROF o~ " 15 nfa' •I D 5 MM Q o Bhagya J 9 co t m NAF O AL R v DL AVE 10 S5 LZl9 F- 11 U 39.2 9 ~M nLV SOUTHERN 4 y r 9 0 20.7 Henr & ur rr. Z N Bntz 61® .4 1) MR 4 ff 23RD ST o_ ~a V E_STS Spot 3 7 4 W j Kill 6 4 SoW Reed Lentz 61 64 Tr. °a0 - t~ Weld a: ~ Coarsen o 14 t o QUA/L r ~ - 0 w Urhommer Bryse 10 Tr 20.9 17 = °MO O RIDGEI o Z A r „ 'OD I K 8 N Gerald H Linrln I -0 Inc 79.6 Z 3 3 5 10 5 0 St ~e 4 3 o v m acroi Engeleiter Sirrt v.rat Sr 17 64.6 200 300 150TH AVE 400 R.20. W. + R.19. W. D Z X N D 521.. AS 84 m REQD D Z c 41 m z D r n m v 0 I T ~ I ~J D 1. I x 3„ I 444,E 5„ j D I. I O m m I m N N I 36" j m I _ I m ;j m C j I •I > M I: r- 0 mm N I p m m m z o c 41 39 ~ ' m n 1 D N --I I D I N m D r C o -I ro = r DO D D O p r r D om n z z ° mi --1 roogr=mow*w nm Xx -0 D v ACO D oNV tn~v p0~omm z 1Ti r z (nv IvTlo =1 co m >M> D m00 I~T1D0 ~O~-i0?p M r --I Z n ;o ZC ~(nv 'm IN) z z0 =tvi~ z O:c (n20 n I Fl ODr m3NNmNUI~ N r- il 0 OD Dm D(n~ (n I or-o0\~ ~N n U1 Z 0 D m L4 0) v w n l n (n o C En v m D r cn O : °v 0 o z m -i M r- Im m ca " o~ m D D z Cm c En (A0 r 0 > D0 o b m n o 'n rL D ~W ~(A Z D 0 m0 D O m O H 0 ~ A o ;u 0 (n Z m °v z -i D O y --A O -n 0jo --I M ;a U) o m< r F4 ~ v r ~rm n o D N m T, N v 0 o J0 0 (n X D n IT! V1 a Z O N mm r m r- x c: n 0 co Oz < 3 n r- ;u D H m m m \ N WLP1250-MR m DRAWN BY: WCP SCALE: 1 4"=1'-0" PRE-POUR: REV. CODCAETE DATE: 00 00 0o D ° ~ SEPTIC MANUAL MIESER ATE: POST-POUR: z W3716 US HWY 10 MAIDEN ROCK, WI 54750 800-325-8456 FILE: WP1250-MR z Z N D m 53j" AS REQUIRED 86„ D Z D 42° z F ;u m m v - 0 m I e \ x N o m 3" 36" II II i 11 D D LL 1~ o -n _ r ~I I m ;u r m m ~ ,O C_ -0 ;u 41 m o m > a z 39" D m N I D I N m D r C zo D r x r z Z v C O O O r r m° r~T1 z 2 2 z v mi -1 rWn co~N D ~N mz G) c0c:G) 0 O9z D-z 5c~pz5ZA O-0 z cp vx ~W m Dmz y MOO rnDp -7:o -xi=O~ ~r~ ~ C ~ N~ m m 0m v_1 r-iz n ~z~ ANC r- c r~ N C/) pD NN \ G7 nx.. NN rnmzrn J-1m N~ ~X ZZ om z >O DzM DD, 'Arms °~N mmt\a DN op Dm N N~ N I o.. o O n z 000 ZD O nm -j c~i~m°D I m r-0)"* On- C) ~ O 7C ..ice G1 (n ' c N -n D r Co ~s N p o p w -TI O o v n N NZ \ C 0 W mm~ (nom N p ' Y o D 0 CO C N pp r nDD Dp Nm D' Z 0 o O H 1 c'm D~ xrz r- --I wD :CJ D Ll rn -0 Z ~ p W O N 0 ;u ;u a v m< (Z D" D D vp~ 017 ~-i O o D N r m 'C7 Cn m ?1 N v e 00 00 V7 m m z D o 0 X C A X O NO N m r m O o z r cc: r~* D H ~ r r m m v 0 DRAWN BY: WCP SCALE: 1/4'=I'-O" PRE-POUR: n m Lf) wLP1000-MR MIESER CCt1CAETE REV. ~ SEPTIC MANUAL 3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: 00/00/00 DATE: POST-POUR: W3716 800-325-8456 FILE: NP1000-MR ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT • AND OWNERSHIP CERTIFICATION FORM Owner/Buyer >,~==j VA-z \,N(wtyjL`~nlSIG.- Mailing Address Property Address A-V 4 _ (Verification required from Planning & Zoning Department for new construction.) City/State 4>0'vVCf2, - Parcel Identification Number C> ZC k S~ C'>L~ LEGAL DESCRIPTION Property Location '/4 , /d , Sec. T R ILz W, Town of iv1 >c Subdivisiori -Z Lot Certified Survey Map # , Volume , Page # Warranty Deed # tE ' ~~,7== VJ/ , Volume , Page # Spec house yes no,) Lot lines identifiable y 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 haste disposal system. Owner maintenance responsibilities are specified in Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition andlor (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your 'septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this arm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warn ty deed 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. 08105) to POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of ? • FILE INFORMATION SYSTEM SPECIFICATIONS Owner n f Septic Tank Capacity qal ❑ N, Permit # t~=j kEffluent ic Tank Manufacturer Z,Ut, iS r O No DESIGN PARAMETERS 1 filter Manufacturer C ❑ Ni 4ai Number of Bedrooms NA ent Filter Model ❑ N ~ Number of Public Facility Units ANA Tank Capacity eV gal ❑ N, Estimated flow (average) gal/day Pump Tank Manufacturer ❑ N.t Design flow (peak), (Estimated x 1.5) Qa1/day Pump Manufacturer ,rt llt ❑ N.o Soil Application Rate al/day/ft2 Pump Model i ❑ NA Standard Influent/Effluent Quality Monthly average Pretreatment Unit La Wit Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOOS) s220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetiand Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection L3 Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) U NA Biochemical Oxygen Demand (SODS) x`30 mg/L C3 In-Ground (gravityl ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L Q NA ❑ At-Grade Mound Fecal Coliform (geometric mean) 510' ofu/100ml CI Drip-Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ Nix Other: ❑ NA Other: ❑ NA *values typical for domestic wastewater and septic tank effluent, Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency _ Inspect condition of tank(s) At least once eve: ❑ month(s) (Maximum 3 ears) 11 NA y ryi '91-v earls) Pump out contents of tank(s) When combined sludge and scum equals one-third (Ya1 of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ Nit -0 year(s) Cnt filter At least once every: ❑ month(s) ❑ Nit *0 year(s) p, pump controls & alarm At least once every: 3 .fC] a" month(s) 11 W, year(s) s and pressure test At least once every : ' ❑ month(s) ❑ NL .FJ year(s) At least once every: E7 month(s) N/4 C) yer(s) N MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any Cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surfa09, The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y31 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 11:3, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatmefit units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event, START UP AND OPERATION Page 71 of • For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other ehemic that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the conte of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge effluent. To avoid this situation have the contents of the pump tank removed by a septage Servicing Operator prior to restori power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls 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 or within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or.elimination of the following from the wastewater stream may improve the performance and prolong the life of t; POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; U foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; to painting products; 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 be taken to insure that the system properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings scaled. • The contents of all tanks and pits shall be removed and properly 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 filled will soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code eomplian replacement system: El A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorptkir system- The replacement area should be protected from disturbance and compaction and should not be infringed upon 1)> required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area 'Ail result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWYS ' technology a holding tank may be installed as a last resort to replace the failed POWTS. Th 40 hae nof been evaluated -site r! alua ' a o ►ng [attk e a~ be - ~RUNt~ r~ iF01~- N~'✓ CaDNS7X'C1G.?Z[~ ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the blomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NC T ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS r POW-117S INSTALLER POWTS MAINTAINER Name COUNTRYSIDE PLUMBING & HEATING ING Game PAUL KOEHLER Phone 715-246-2660 Phone 715-246-2660 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name DARRELL' S SEPTIC SERVICE Name S'r G(~p ( 2DrJ11V Phone 715-425-1025 Phone 7/-5-- 3WZei° (p 0 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&M and 83.54(11, i2) & (3), Wisconsin Administrative Code. lk~ ! 4 !B!" 1q J 2I Az--, AUSAl ELM '.L3S~11'OS ~9OAI,~QIS9?I IXSAi9780?IJN ozsz-sSyItrOH X jI2I?I yQ a M a z6a~n a YYE~EFv°reE;CE t~ a E14 U O M O ~ ~ ~1 O ~tix h O W - o ~~Nh ce l I i e q \ u y ~ y~~3 G ad ae c i~en r~rn o ; ___-Rbo~ `.^P R 9~ »O . . J L _ _ _ J I . 4 l Je o.~, I~ .ra g s: n g .o -----------.o- pg p. - g ' -an p 3ea~ ~y J ag qea vnn~s,.ms 1 U ~ ~i P~ ~ ;bs ,~±r a , `051 I Rn' ~\ti~,N --yb 3I apyO Yea ggi q.e , i , , ~ •aoa ~ o.s.z~ re ~amu ~s• wearw - F flea fry r~ d I SOIL EVALUATION REPORT Page 1 of 3 Wis., of Commerce Di Jffin of Safety and Build"Igs In accordance with Comm 85, Adm. Code J County St. Croix AtPafcttt completNmmensums, on paper not less than 8 '/Z x I 1 inches in sizmus ! incal and horizontal reference point (BM)di nand Parcel LD. 032- 067-50-050 Sp e~ N north arrow, and BM referenced to nearest roa . ✓oM~nv Please print all information Revie d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) li Property Owner Property Location Kris & Jeff Wroblewski Govt. Lot NE v4 NE v4 s 2 T 0 N R 19 w Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 338 165th Ave. 20-5162 City State Zip Code Phone ❑ City ❑ Village R1 Town Nearest Road Somerset WI 54025 Somerset 165th Ave 0 New Construction Use: R1 Residential / Number of Bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or Commercial - Describe: Parent Material Sandstone Flood Plain elevation if applicable N/A ft. General comments and recommendations: Property address is 290 165th Ave. 1 Boring # Boring 0 Pit Ground Surface Elevation 99.1 ft. Depth to Limiting factor 15 in. Soil Application 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 1 0-6 10YR3/2 - FSL 2-f-gr mvfr cw 3f-co 0.4 0.8 1 2 6-15 7.5YR3/4 - FS 0-m mvfr as 2f-co 0.5 1.0 3 15+ sandstone ❑ Boring - Boring # apit Ground Surface Elevation 99.6 ft. Depth to Limiting factor 20 in. Soil Application Rate_ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 1 0-8 10YR3/3 - FSL 2-f-gr mvfr cs 3f-m 0.4 0.8 2 8-20 7.5YR3/4 - FS 2-m-bk mvfr as 2f-co 0.5 1.0 3 20+ - sandstone bedrock cemented - - 0.0 0.0 i i " Effluent # 1 = BOD5> 30:s 220 mg/L and TSS > 30< 150 mg/L * Effluent #2 = BODS 30 mg/L and TSS 30 mg/L CST Name (Please Print) Signature CST Number Mark Iverson s - 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 9-28-15 715-796-5664 I