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HomeMy WebLinkAbout020-1479-25-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 582087 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 263221 8 Permit Holder's Name: City e Township Parcel Tax No TOWN OF HUDSON 020-1479-25-000 CST BM Elev: P . E BM iptign:~ II]h~~[ s ~j (1 /6 Section/Town/Range/Map No 36.29.19.3046 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION S HI FS ELEV. Septic I 3'9 107. % / o Dosing kJ I er5 L A / Benchmark i / 1 10-7.1 103,0 g 5 l Alt. B 41 q Aeration J lJ 60,1 01 i~ C~ I - Bldg. Sewer Holding F i • I b "I' Ht Inlet 1 Ib .3 ~C~. 8 TANK SETBACK INFORMATION SI Outlet TANK TO P/ WELL BLDG. ent Air Intake ROAD Dt Inlet Septic Dt Bottom ,5.7 Dt Bottom 13. Dosing i 93- Header/Man. ~,j` •7 / Aeration A ~Q 3, b Dist. Pipe Holding Bot. System ~t4 /OZ.~T PUMP/SIPHON INFORMATION Final Grade Manufacturer It G 3' 3 4, 2.6't' ~ill Demand St f~over ~O J c PM v 7,41 c Model Number 5Z L TDH Lif~ Friction Los System Head TDH 1-7 1. a1 .3 Pouf Forcemain , Length r Dia. J Dist. to II " S7 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of renches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS G /00 _ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typ ystem: CHAMBER OR of l 5 X35 3'?. JV, ) UNIT Model Number to. A DISTRIBUTION SYSTEM Header/Manifold J Eh) ibution x Hole Size ~,,+C L~ J /I Ix Hole Spacing Ven Intake (s/ . Length Dia tDia Z 3S Spa cing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over lBed/Trenc epth Over w Bed/Trench Center ~ xx Depth of xx Seeded/Sodded jxx Mulched hEdges Topsoil ~ ~ Yes ~ No Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Inspection #2: / Location: 854 SETTLEMEpI,T~DR 1 t .mss / ~~s c ~ Vin, s' cy o 1.) Alt BM Description VNII 2.) Bldg sewer length - amount of cover = J* ~ 3 ° Plan revision Required? Yes No ' Use other side for additional information. _j SBD-6710 (R.3/97) Date rlnsepctors Si ture Cert. No. n~QrarM ~l~ira~~'~ County Safety and Buildings Division St. Croix $ 201 W. Washington Av O. Box 7162 P S R N IS Madison, WI 5 -7 Sanitary Permit Number (to be filled in by Co,) 08 / ° S.StUtiA ~ ST CROM COUNTY Zd$ 7 t Application 7 State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate govemm unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Persona! information you provide may be usIsecondary urposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1. Application Information - Please Print All Information 854 Settlement Dr. Property Owner's e 3 arcel # Kernon Ba st 020-1479-25-000 roperty Location 948 LaBar e Rd. ovt. Lot City, State Zip Code Phone Number S W_'/a, _SE _'/a, Section _36_ (circle one) Hudson, W1 54016 T 29 N; R 19 E or w II. Type of Building (check all that apply) Lot # 91 or 2 Family Dwelling - Number of Bedrooms 4 25 Block # Subdivisio Name El Public/Commercial - Describe Use 61C Na El City of ❑ State Owned - Describe Use MM CSM Number El Village of oa Na ❑ Town of Hudson (A )r- - - /s6c~x - 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. O New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) Addition ATU & filter canister B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number an d Date Issued Before Expiration Owner IV. T e of POWTS --stern/Component/Device: Check all that apply) i Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) ~ V. Dis ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Proposed (s System Elevation 600 Gpd IA Gpd ASTM-C33 sand 600.00 sq. ft. G 600.00 Sq. Ft. 102.32' at 17" above 0.4 G d native soil 100.90' contour VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o b .0 2 New Tanks Existing Tanks v U i o 2 2 2 -2 E ro a. U n i C7 n Septic or Holding Tank 1,250 Na 1,250 1 Wie r on rete X Dosing Chamber 750 Na 750 Combination ST/PC VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) PI is Si nature MP/MFRS Number Business Phone Number Jim Boumeester - MFRS 222904 (715) 386-9020 Plumber's Address (Street, city, State, Zip Code) 1070 H 35, Hudson, W1 54020 VIII. nt /Department Use Only Approved Ve Permit/Fee Date sgsue Issuin gent Signature eason for Denial $ f ' OD / IX. Condit a n; e ueen tjkerani~tsapproval 3 /_(M~ t 191spie►srai cell must all be rely a.~P `•vEil~'ti' W y Q ' in per management plan provided by plumber, . ik ifreraor+ts: must, ire r:lainta fined ✓►d[Q, J1 Attach to complete plans for the system and su mit to t County my on pape of less than 8 1/2 11 inches in size SBD-6398 (R. 11/11) tt/1.~ 1-~ AP i (n,ap {0. S ~Ebs;&Yl c _i • ads W ~ ~EXIS~;r~ clrade ¢ lu{ 6ca /e: sib .~..st s des tloYed. ~ eLe✓:o►is rep b d~6lr.rc,%ieo,^~~:n.P~r4de3, w~ls Plafo~Co top, ,oo.aZ, 5ou.~., sevyySFl'y, sec. ~y ~ $~•CIDiXCo.~ till, • ~ psi. ~ o ~D - iY7'9-.z s- s~ 9.9G $ P, d u-). u cl Can cry w /15D/ 750 -mW 5T1,13c w/ lOo/y 44 K \ 9Y, 72" PL-515eFf'/ue`~- 1,'/~craf AT. CAt -n Sy~ 8t v~ 41 "14sro-t-Ar7YSs~,y~~ ~.v.e. z„s~.s/o P.✓.C'. ire l o~,~oF~~''~ [3of~.n o P ~ ~rce..n4;n. L3en~ w f( W /TgOOj r,~pad9t. E~i d ~ /o ~ STD.' Z~ EX•sE;nq Sled i Dr; Bio Microbics Residential Mound POWTS Index & Title Sheet Project Name: Bast 4 Bedroom Residential Mound Owners Name: Kernon Bast Owner's address: 948 LaBarge Rd. Site address: 854 Settlement Dr. Project Location: Subdivision: Lot 25, Plat of Cottonwood South Legal Description: SW 1/4 SE1/4, Sec. 36, T.29N., R.I9W., Town of Hudson, St. Croix Co., WI. Parcel ID 020-1479-25-000 Page I Index and Title Sheet Page 2 State Approved Mound Design Page 3 Filter Specifications Page 4 Septic Tank Cross Section Page 5 Septic Tank Maintenance Agreement Page 6 Parcel map Page 7 Warranty Deed Mater Plumber Restricted Service: Jim Boumeester, DSPS Credential #222904 t Signature: Dater Page I of 7 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01) olr7l~,_,` V DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD /O r HAYWARD WI 54843-6462 ~I } ~1 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~ ~OF~ssiov ~ 7~e;; Scott Walker, Governor Dave Ross, Secretary February 18, 2016 CUST ID No. 222904 ATTN: POWTS Inspector JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER EXCAVATING ST CROIX COUNTY SPIA 1070 STATE ROAD 35 N 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/18/2018 Identification Numbers Transaction ID No. 2632218 SITE: Site ID No. 819081 Kerno,n Bast Please refer to both identification numbers, 854 Settlement Rd above, in all correspondence with the agency. Town of Hudson St Croix County SW1/4, SE1/4, S36, T29N, R19W Lot: 25, Subdivision: Plat of Cottonwood S FOR: Description: Mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1574602; Maintenance required; 450 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; System(s): Q. EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/O1, R. 10/12), SSWMP Pub. 9.6; Effluent Filter ~jEPT 0 F° OFESS The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cvdml S!a;. N OF 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. SEE C 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: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The mound area must be deep chisel plowed to help break up the massive soil structure that was reported at the site. The county may, at their discretion, request verification of the plowing prior to continuation of system construction. • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 17". The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. JAMES W BOUMEESTER Page 2 2/18/2016 • The gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval, and SPS 383 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandorf WiSMART code: 7633 POWTS Plan Reviewer, Division of Industry Services (715) 634-7810, Fax: (715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: James K Thompson, Ace Soil & Site Evaluations 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: Bast 4 bedroom residentail mound Owner's Name: Kernon Bast Owner's Address: 948 LaBarge Rd., Hudson, WI 54016 Property Address: NX5 Settlement Rd., Hudson, WI 54016 Legal Description: SE1/4SW1/4 & prt. SW1/4SE1/4, Sec. 01, T.29N., R.19W. Township: Hudson County: St. Croix Subdivision Name: Cottonwood South 1st Addition Lot Number: 25 Block Number: na Parcel I.D. Number: 020-1479-25-000 Plan Transaction No.: oNALLY OVED Page 1 Index and title ,,OVED AND Page 2 Data entry S Ry CES Page 3 EZflow mound drawings ~~Es 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 ;F'C j~J%Ei1CE Page 9 Site Plan Page 10 Attached Soil Evaluation Report Designer: Jim Boumeester License Number: 222904 Date: 10/28/15 Phone Number: (715) 386-9020 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSWMP 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) EZflow Mound Version 3.0 (R. 3/1/12) Page 1 of 10 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) 5.00 Site Slope 100.90 Installation Contour Line Elevation (ft) 130.00 Contour Length Available (ft) 19.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 6.00 Cell Width (ft) _34, 5 6. 7, 8, 9 or 10 Only 100.00 = Dispersal Cell Length (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 or ej e Center or End Manifold 312 Lateral Spacing (ft) If N above, enter the elevation (ft) Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.30 Estimated Orifice Spacing (ft) = 6.98 ft2/orifice 2.00 Forcemain Diameter (in) 75.00 Forcemain Length (ft) Does the forcemain drain back? Y 93.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 6.50 System Head (ft) x 1.3 12.23 Forcemain Drainback (gal) 8.82 Vertical Lift (ft) 90.56 5x Void Volume (gal) / 1.98 Friction Loss (ft) 102.79 Minimum Dose Volume (gal) 17.29 Total Dynamic Head (ft) 35.43 System Demand (gpm) c~ 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 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 773.76 Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) 48.00 Total Working Liquid Depth (in) Weiser Concrete Manufacturer 16.12 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 773.16 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 16.12 Dose Tank Volume (gal/in) PL-525 Filter Model Number Weiser Concrete Manufacturer Project: Bast 4 bedroom residentail mound Page 2 of 10 Mound Plan View T t 10 B 3 J Observation Pipe 1/FK 1 5 A W l - ~ l B 3; 2 Q. L Mound Component Dimensions ft A 6.00 ft E 20.60 in H 1.00 ft K aft B 100.00 ft F 12.00 in 11.35 ft L 1ft D 17.00 in G 0.50 ft J 7.61 ft W 600.00 (ft2) Dispersal Cell Area 1735.29 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 104.32 (ft) ♦ H F t Dispersal Cell 102.82 (ft) Lateral 102.32 (ft)--► - 6' Invert Elevation Dispersal Cell 4 i Elevation E D Q „ 100.90 (ft) Contour Elevation 5.0 % Site Slope Typical Dispersal Cell Shading Key 0-0 0 See Page 5 0 Topsoil cap > a) ,0- 1Subsoil Cap c 2 0 ft Approved Geotextile Fabric Cover [ ASTM C33 Sand ° 1 ® Tilled Layer a a I Al~- 50 EZflow Media F Z U) rn~ 0 0.5 ft ff --Iiv- - 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 Bast 4 bedroom residentail mound Page 3 of 10 End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below • = Turn-up vdbs l t «n M® or clean out plug =cofinn'ecNinionn , Orifces poirt up except every 5th ed ad T ~ X--~ one poa~ts down for drain"emain sma tee or cross to manifold at any Vint. L acr+als forcr m++n of PkC Soh 4d EFoTee P Ad laterals identical vv'h orrtices equally spaced. per SPS Table )8450-6 2 Orifice Diameter 0.125 in Number of Laterals Lateral Diameter 1.50 in Orifice Spacing (X) 2.35 ft Lateral Length (P) 99.35 ft Orifices per Lateral 43 0.65 ft Orifice Density 6.98 ft`/orifice Lateral End (Z) Lateral Spacing (S) 3.00 ft Manifold Length 1 3.00 ft .50 in Lateral Flow Rate 1_!3 7.71 gpm Manifold Diameter Forcemain Velocity 3.62 fUsec System Flow Rate 59em Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and 4 in. min. SPS 316.300 WAC Disconnect E-- Altercate outlet Tank component is properly vented location, Forcemain diameter 2 in. WN Manufacturer Gallons A gal/inch Weep hole or anti- siphon device Dimension Inches Gallons B A 2 7.59 4444.69 C Pump off elevation (ft) B 2.00 94.00 C 6.38 102.79 _t D 1200 .193.44 D Total 47.95 773.16 Dose tank elevation (ft) 93.00 Bedding And Badfill As Per Manufacturer Alarm Manufacturer SJ Rhombus Alarm Model Number SJE 1011421 Pump Manufacturer Zoeller Pump Model Number BN152 Pump Must Deliver 35.43 gpm at 17.29 ft TDH Note Switches containing mercury may not be used in this system. Page 4 of 10 Project: Bast 4 bedroom residentail mound EZfI o ow Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Component Legend 7 SR1-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths \KA~ SR3-12H or EZ 1201 P or O(to SR3-12H in 5 ft or 10 ft lengths 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 6.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 6ftWide End Manifold ProjectBast 4 bedroom residentail mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name Jim Boumeester Phone (715) 760-0117 POWTS Regulator's Name St. Croix County Zoning Dep't Phone (715) 386-4680 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 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 Inspect and clean as necessary at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test periodical) Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1 Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the 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 6-8" Diameter Lawn/ Threaded Cleanout Sprinkler Valve Box Plug or Ball VaNE Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same ;-~EZflowS nthetic Media Diameter as Lateral 1.80 Feet F- Distribution Lateral = Lateral Cleanout ► Project. Bast 4 bedroom residentail mound Page 6 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General l nis system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' compcnerr: ,rar uals [EZflow Mound Component Manual 8/20/07 Pressure Distribution Component Manual Ver 2 0 SBD-10706-P (N. 01/01) anc 3Sf✓MP 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 ised 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 uevice 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 proves ons ere 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 me tilter 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 ne dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms and pumps shall be tested to venf rope operation If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If he force main nas a weep nolr t mould be noted if it is functional during pump operation, and if not, it should be cleaned. "Nu one snould 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 seedee 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 r, ound 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 K mgiL BOD5, 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 tlusned of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test whet 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 ar evels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring Contingency Plan ~t the septic tank or any of its components become detective the tank or component shall be repaired or replaceo to keep the system ;n ,;roper operating condition if the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately iepa red 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 cs; . media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating conditioi See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider Pro]ect. Bast 4 bedroom residentail mound Page 7 of 10 PUMP PERFORMANCE CURVE MODEL 151/152/153 TOTAL DYNAMIC HEADiFLOV'J PER MINUTE EFFLUENT AND DEWATERING o MODEL 151 152 153 i - Feet '✓.ter5 3 Meters Gal. Liters Gal Liters Gal i 5 1.5 50 189 69 1 261 77 291 < 10 3.0 45 170 t 61 231 C ZbS 151 _ 15 4.6 38 144 53 201 211 d t A~ 20 6.1 29 110 44 1 167 52 19, 20 25 7.6 16 61 34 129 42 `59 17-29 30 9.1 23 87 33 125 35 10.7 - 22 85 t0 40 12.2 11 42 13 Orr, Shut-oftHead . 3011 (9.1m) 38h (11.6m) 4411 10 20 30 40 So 60 70 80 90 100 :A~.uNS ` 8 40 80 120 160 200 240 260 320 360 FLOW PER MIM,1E 0145UA Model 151 Models 1521 153 3s ~3~Pm ~rl,'niAtKrv1 sV~Ply r,Ee e9'd. r;~.. FACTORY FOR D YLCiAL APPLICATIONS 6152 _ e - 4y8 - - Timed dosing panels available. Elecmcai alternators, for duplex systems, are available and supplied with an alarm ~~V ne ~1 I 'aneele level control switches are available for controlling 31/8 single phase systems. - Double piggyback variable level float switches are available for variable level long and short cycle controls. Sealed Ovdk-Box available for outdoor installations. See FM 1420 Over 130°F (54°C) special quotation required_ r3 1 11 ;12)153 Juries v16 f~f 121;e Y I 151 1)5 15111511153 MODELS control Selection Mood VoltsPh Mode --.~Ab l plex i- Duplex - _ r.,l - - - - L oN151 +15 Auto 6.D ncluced 2 or 3 P7 i 23C Non 3.2 1 2 at 3 ~Et51 23J Auto - 3.2 Include0 2or3 Sv.2adn + 52 115 1 Non 8.5 1 2 or 3 BN152. 115 _ 1 Auto 8.5 ' Included 2 or 3- E152 290 1 T-Nm 4.3 1 2 or 3 BE.52 230 1 Cr. 43 Indutled 2 or 3 _ r 1 - t I Ntso 115 t Nm 10.5 1 2or3 yr' .,3 115 1 Auto _ 10.5 Included 2 or 3 53 23C 1 Non 5.3 1 2 or 9 , - - - ALIo 5 3 Included 2 or 3 Single piggyback variable level float swdch a double piggyo- -7 o CAUTION svntch Refer to FM0477 1a• 1 0, devices a id r-g sna.,d oa flora o; ; q .a~inod 2 See FM0712 for correct model of Electrical Alternator E-Pa, o c , a 1 aiet,, G(e s ) '.I1 Jig.. . _ _ : _ 3 Variable level control switch 10-0225 used as a control acliva a sr ~c , W (4) float system RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump MAILT0: P0. BOX 16347 Manufacturers or )P TO. KY 40256-0347 , Cane Run R 0 SHIP 70: 36449 9 Cane Run Road CJ G e LOUISVIIIB, KY 40211 J96 1 Q[Le41Tr PUMGS SNCE ' al i x5021 77&2131 1 (800) 928-PbM nripz/w w.zoeller.com Yu V/~ FAX (502) 774-3624 Copyright 2004 Zoeller Cc All rights reserved Loco-~co~p~vP. S ~'e fie; s ' .3.,,T,g d~st`foyed b So,-/P:-~ i Le ✓tt-~: ors s l'e Ev de •~c:.ie ~^~~:R.P~r~des, .4-v ils P/Q~o7,' ioo.acZ, Sccce., 5c~y~5Ely Sf c. sv' \ o~~~ \ \ a tonfou ~ ` . q;3~ pe- ~ \ 3 \ ~p~- -n \ f~ \ r,J."C.S cl ~a n uc.-Et w ~~SO/ 75a -r,rr,Q 9912 P~-SZSCF~'/uerrE 'l ~c~af A7. s /o/.s2~ 1 1 ~ 1 r7ySs~.~lo p.d E. Qf nG fY~ua 1~: 8o ~n c S~~;nS~Tgo of r~~p-QOl9t. EX~ SEi nq Sl. e.d ~G/7'~enL Ll Technical Specifications PL-525 EFFLUENT FILTER "MI `k; ?CU L) - dliZ"BP~L C4ECK E%CEPTS a'3HG{C '0 - } 1NLETz -t; cN➢GN 157 ~ 14.35 i XT ETKSHINGExCEPTS SCI, 40 & o` SCI, lC 68 I t m 31 rPL-52; FILER HOUSING f e 3e . _ PART NO -3;7142525 I MATERIA- HOUSING-POLYPROPYLENE _ - -T e OUTLET BUSHING - PVC 0 5 BAIL - HDPE so;xe=x~PrsF,oaTSwra~ _ ~ i ~ i 10'0 x;;_PTS I' SD, <j I r I, ArDLE EXTEN pON % b7.64 S39' JF 6' S- 2TS 711 _ SOGKT T E XCEI?S h01 95, B! LFUSh HOG OPENING 7` ' O a O Y ° 19,2 221: Ij POLYLOf<PL-525FILTER CARTRIDGE PART NO - 30141 . 525 VATERIPI POLYPROPYLENE vV-aI r T I ° P~ 3 ~-c7 D z x 66.' I' _ AS 86" A I I REQD 53" D z Z r c m r T1 N y D c rn 0 o UP 52" 0\~ N 1 4" CAS I I m 0 3„ 57° 6„ x I >m D m cn 48" _ A m p -i ri A m > f l I \ D V m 1 n c ~ i N I N m I I c UP 50° /I 4" CAS ' ~ z O IS 51„ I~ m > ~ D D I m O D C Z G Z O Z Z r p m D r m 0 C m ony z DCw~r= DK c~°m~z ~cNiz°VN' oo =Qa~ zo==O~o c° °x n co m N m° m n m N D moo r*1DO = ioAO N N oz c~' ~c\nc o AN~,~c-{ mzw' N Z N- < 7C Z O C7 m (n (n z \ -u m Z f l n y frTl A rT m U , D N co D -I 1 J r 7i (lt 'N N 11\ v z occoo 'o 0 D _rnv NmmOJ im O~UD -o{' - o n Nz O cn Nrn m~ D➢ roc oho O Z m m O 1 co CJ 0 s n O'~ N rD r'y r' mo a D i p O H nM 0 D \r nrD rDO m m > c~ c Z~ D Z i m 1--v z o m< -i D... Z ~OO 00 n N C> -0 V) m Lf) m m o c a "o c: x A Q (7 r n 0 CC n F O m < 3 OZ C m D H C D f- -i ~ r A m A m W1250/750-MR IESER COIICETE DRAWN BY: SME SCALE: 1 4"=1'-0" PRE-POUR: WNIN SEPTIC MANUAL REV. W3716 US HW'Y 10 MAIDEN ROCK, 14'1 54750 DATE: JANUARY 2012 DAFE:. POST-POUR: REVISED JAN. 2012 800-325-8456 FILE: W1250/750-MR P _ ~~~f 7 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Kernon Bast Mailing Address 948 LaBarge Rd., Hudson, WI 54016 Property Address 854 Settlement Drive (Verification required from Planning & Zoning Departm for new construction.) City/State Hudson, WI Parcel Identification Number 020-1479-25-000 LEGAL DESCRIPTION Property Location SE '/4 , SW y4 , Sec. 36 'T 29 N R 1 9 W, Town of Hudson Subdivision Plat: Cottonwood South Lot # 25 Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume Page # Spec house 121yes0no Lot lines identifiable ElyesE]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services 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. I/we certify that all statements on t 's form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a w rranty deed recorded in Register of Deeds Office. Number of bedrooms 4 G RE 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. 04/12) ~c 5W" nl.?f!/_Cfl~lg ,,I--" P, F O .v. ('a 1/2 E-11.5INFORMAT"IO-N SyST i I~ Iplfw tl'1 4J4NR1 Or A NA ~qptE s aWtlr Ar liC4/ 1 1 ~P-ermqit 4e 8aptlo Tank Manufadfiwror (JJ 11 J4A Q NA 05841Y 841Y PA =4 S 6flvtnt R nr M~enwfanturar ~ . M NA Number of Redrpom a JM NA FP.fTl'wn;it Miter Mode[ i":1 NA Number of Pvhlfc f~anility Unito 0 NIA p Tank C`tapaolty M NA II ~ j' gel Estlmate;f flow (avarage) 1 Y ~L~ alld Pump Tank MenwfBatwrar ()-.sign foam (peak), (Estimatnd x 1.5) (0y allda _ rump Menwfacturair - M NA, Soil At5(Sifna*lori Rate ailda a Pump Model 6 N 1 ~ p A4A Standsrd Inflvent/Effluent WOW iMcan"'hiv avarepr* Pretrestment Unit F-1 NA Fats, Oil Creasa (1*lJt) mp/L !0 i Viand/rurauAl Filter f i Peat Filter Biocherrlionl Dxgnn Demand (RODa) :W0 mg/f 0 NA, 0 Mechenlral Aeration 0 wotlsnd Total Suspended Solids (T SS) ;0 6o mg/l, a V,aln4,80tion 0 tither; Pwreato~ rient Quality Monthly average Dispersal Celf(s) C1 NA 6faaf7er ieaf Cxy an ~acarnend fiat )341 *20 mg/i- 0 in-Ground (gravity) 0 In-Ground fPreesWlWJ T'rraf fwapended 0*0116s (TSS) ~'*Q M911, 17 NA 0 At•tarade aawnd Penal CoWnron (gaomAtriw^ rnenn) Ala" ofulloomi 0 ~ripNilnc G7 Qthor__ ~atwaerE ~ ~ ~{,q~ Maxlmuln Effluent Particle ~fxa ~ in dl&o ~ ;UA t~tiaer; _ f hlA Gathers 0 IAA C3 NA *VattEt' TYPintal far domestle +Nastawrtar and saptla Ulk efflu4r k. MAINTENANCE SCHIBOUL ~+artitlca 5vsrat ~`ervio'ea ~ra>~wnrtitay ! rrEara•th(t (Illla imra►ra 4 yaws) 171 NA lnspsrt conGiftloro of tank(s) A inast cnn everi/~ yeas 9..,. - %Aihen combined stwdP aril Uum sq"le aYss~thlyd (ya} n Garnta uniram'e u ©NA PUMP Out Contents of tarrk(c) _ rr~rxrrth(nt Inspect disPiN'Ml Mll(s} At least once everyw c~ aa, (a fil xirdurwt yssrs) ~fA month Is) 0 NA Chan affiLirmt filter At, lass); Once naarys ~ I , f~i ..a r{af „ „ 10 mopffiW M NA Inspaat pwr,p, pump controls , all7m At least rnra every^ I a/serf-. A sS once revery; mwt je} ~fA Flush lstar>sfe and pressure rest C th-§ AT fanst once SVVY' f'} NA M NA Other, mapsations of tnnkn end dlsperg9l ::e!!s shall ~a made fay an individual carrying one of the fofiOuvinp lioanmt or cartiflo-atinrw Mastar Plumber; Master PlumUr Rastrictad Newer; POD NT inspsatnn POWTS Wntalnar; s-tago SVOIing Operator, Tank inspeatlona must include s visual inspection eat the tan? s} to idsntlfiy any rnissing or broken Wdwerc, Identify any nracks or (asks, mea wro the voilirne cf combin+r'd sludge and :aces arH to nhec(° fnr gnv hank up or pondTng of of(went on the grdwnd surfane, The dfspersaf (fall(s) sha11 be viauAliy inspected to check the affluent fevels in tha oMervation pipes And to nhack icsr any pondfng sfffuent on the grouEll surface, The yondIng of effluent on tho prpund eurfa" may indmote a fallCng condition and roqutres the Immediate notifin atinn Qf the local regulatow authority. Whan the corm insd srmirnulation of sludge and sGwm ill PPP tank equals cane-third (Y'4) or more of the tank vaa}uma, the entire can'tent;s of tha tank shelf ire; rarncaved by a SaMane Servicing Opermor and disposed of Pn MardarEOe With nhapter NR 113, Wisromin A,drnIniatrmtcPvs rnde. All other sarvlees, lrlc)Gldin,g but not 1117100 Ia the servicing of affluent: flitem, rnenflenicaal 0P preseurOd EaOMPOnartsr pretraatrrlant units, and any servtring st 1-ntsrvals of ,92 mcnths, shall be powftatrniad by a certified POWT" Msinta?nRr. A. shrvlra report shall M prma aided to the locasi rMMMIatQty eutb'orEty witk;in 'Era clays of CC$E't'Ipletion of ar-y sarvira avert. QMW t~/07)