HomeMy WebLinkAbout042-1016-10-900
~~•tk~G (e) wl z - 30 _
Viisconsin Dv.I:arloie'lt of Corrmr'-re PRIVATE SEWAGE SYSTEM County: St. Croix
Safely and Bu Icing Division
INSPECTION REPORT Sanitary Permit No
!ATTACH TO PERMIT) 584713
GENERAL INFORMATION k State Plan ID No
Personal irformation you oro•: de may tie used •cr s.econdary purpm f!s IPnvacy Law s 15 04 (1:;rn j 2687030
Perm t Holder's Name. !;ity 'village Township Parcel Tax No
Oevering Homes LLC TOWN OF WARREN 042-1016-10-900
CST BM Elev. InSO- SM Elev BM ❑eu;criptior SectiontroxrlRangewaD Ne
/00. -7 l 6&^~ 07.29.18.97J
TANK INFORMATION ELEVATION DATA
T YNE MANUFACTURER i CAPACITY S I A fIUN BS 1 HI FS ELEV.
Septic Bcnchmark Z / 6z.4g
Dosing AII. BM
Ilv~ 4l 73 '75.,5
Aemtt0lT Bldg. Sewer
Ic ` g. 7 9
Holding Sl'Ht Inlet
,VAUM
TANK SETBACK INFORMATION suH 1>
TANK TO P,jL WELL BLDG. ve )t Air Intake ROAD t Inlet
r
Septic 4 3-167 Dt Bottom
Dosing ,7 J r 5 J -leaderiMan. xx 1 3.6 Aeration Dist Pine
Z•o /d0 .g
Holding Bot System
Z•7 466. 1
r
PUMP/SIPHON INFORMATION Final Grade /16 16 It •7
Manufacturer Demand 5l Cover 2 Q5 .7
C
Model Number 5 GPM ^k-n V r -3rJ ~ ~
TDH l l Friction Loss System Head' TDH t J
Forcemain Length Dia. sl t.r A'r J
SOIL ABSORPTION YSTEM
BEDlTRENCH Width Length No. L` 1 rent s PIT DIMENSIONS No. Df Pits ns do C a ll Depth
DIMENSIONS S7
SETBACK SYSTEM TO P/L BLDG SWELL LAKEtS T RFAM LEACHING Manufacturer _
INFORMATION CHAMBER OR
Type ystem UNIT Model Number:
41, .J 34 72 /6S
DISTRIBUTION SYSTEM
lil it Intake
lleader,'Manifol9l ( Dist-ibution ) Z / z Hole Size T,ie spat ig Ven
1ape(s) 3
Ll ` _ength $4 Dia Spacing _ 1G v
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only r.,..
Depth Cve, Del Dver xx Depth of xx Seeded/Scdded xx Mulched
BediTrench Center 6ed'Trench Edges Tcosol No No
~ I `11) ` `Yss ~ J Yes ~-f
COMMENTS: {Include code discrepencies, persons present etc) Inspection #1 Inspection #2:
Location: 976 107TH AVE R h CND _,+t, 10(0,-) U--.il
1.; Alt BM Description = Pao ~
2., Bldg sewer length = V ^
amount of cover = ~ ~ z-
Plan revision Required? F_ Yes >Il o Llb 4C~art. Use other side for add tional information. (v ")a-e nsepctor's S re N
SBD-E710 (R.2i97)
r
tr~~ - tmty ~
2~~ \ Safe4r and Buil n
s 8 $ t ► L 201 W. Vdashington Ave., P. St.n- r Pe mTNtibc (to be filled in by Co)
P Madison, VVI 5370,77J771652
RUo
K GpuNT( _ 5~ 7l 3
D LOPMENT
EVE
Sanitary- Permit Application StvcTransaca5on?vm'rcr
IL accordan::c with SPS 383 It;2j, this. Awn i:odc. submission of this form to the apprcvriate. etn•etwneoal unit ~ CJ (J ~ L/ L~
is reonirrd prier w ob•.aising a sanitary permit Vutr.:. pplicanar, fotm5 for state-owned PO W'7J re;ubmirxed to Project Address (if different than mailing aidr s)
dte jepartrnrnt of Safety and Professional Smvic, Parrral mfbrnatios you provide may be uses far secondary A~~ I E.Tcses in ac:cvrdance with the Pnvacy Law, s. 15.04(] l(m
, Smis. Ki 167A-
1 1. 'A`pplication Information - Please Print 431 Infor
Pr.+pcrt Owner's name (
1 Property Owner's Mlaiailing.addriess `
I r:)pettpl.ocatrcttr ~j"~. I~, r.17 J
~P Govt. L°,.
City; State Lip lode Phoie Number 17) _2
i ir . in .1 _ 1 ~ tote on
Il 'type of Baildinu (,chtxk all that Luc ; T T` R E W
p I
°r 2 Farr.ily L>we;im; -Number °fl3cdrk-tr:s~~ Subdivision Name _
U PublicCornmemial - Describe i;se_ 4 ~ ""'~C• B a / -
_J City of
I _
EState ()Naed -Des be Use Ntarrber Vitlane of
_ k 57 ~✓rt owncf 64"-W Pc/
U1. Type f Permit: (Check only one box on line A. Complete line B if appli bl
A- System-1 J Rcpiaemew System L Tr_almentEolding Tank Replacat:ent C)ih Ottrcr .l4odi5 anon to Existing Symm c~tp:airt
B. ❑ Permit Renewal L Permit R-c-.-ision ❑ Clan of Pi ttmber ❑ Permit Trtnsttt to Ne~ L.ut Previous Permit Nrunbc and Date Iss
f $c w•
1kfor. Expi etroy I. i Owner
QC)
IV. Tv e ofPOWTS Svstem/ComponenLIDevice_(Check all that a ) I Ur-
Nou-Pressrav,,cd In-Ground ❑ Pressurized In-Gror:nd ~ at-Grade d 24 at. of suaable soil ❑ Mound < 24 in. of suitable soil
l Bolding Tank ❑ Cxt+er 1itspers:d Comporicat (explain - Preunrvnem Device (explain]
V. Dis ersat'Tre went Area Information: t
Design Fw (;pa' Dates S It .APplicati(m e( f) Dspet-' e, al Vra K uir sf Dispersal Area F3opojpf to 5ystcm Elevation
Z7 J
Zvi L7
NIL Tank Ltfo - - Capaetry in Total of~ Mnnuiacarre -
Crallons _ (-rAons Uans
i .:ew Tankc -:xsung Tattls I .m ~ _
~ a o ^
I ~cpnc or 1tio13iag Tank - 1 ` ~ r: I
L-.-. -
Dcsiag Cbsnber
VM. Responsibility Statement- the undersigned. to responsibility for installation of thr POW n shown on the attacbcd plans.
Plomttr..'s \atne 1,?=', P: gmature WilvtPRS Number Business ?bone tvranb -
P'hunber's Address 1, m City. iP C' e - f
oun /De arunent Use Unly
Approv d J Disapproved Pem ita'Fr~e_ey Date sued Issuing . Sigma urc
1 er casca or .layer] S • cc)
/
/ ~v
IX. Contliti~d6~t!?pSpyutns for Disapproval ,
1. 5epti~ tark• e'flccnt iille an:1 3
&s:>a veil must all be s-, . ic>S ! n+aint , --ec
as per management plan pro Tided by plumber.
2. AA setback rea,uimrnwts must be maintzined ' r r .I /
as per applicable code / : rd;naxf}. _ r1 A._ %kf..f Apn~'X ke'4 .
A"c± to complete places fvr the s:,smm and submit to the County only oe not less &ao 8 12 es to W"
IA
OD-6398 rR, 1 1:'11,
1
PLOT PLAN
PRO JI'Cl rwerina Hc~rnes :ADDRESS 1435 Cernohous Ave Suite A New Richmond Wi 5401
NE 1!4 NE 1/4S 7 %T 24 N,R 18 w TORT Warren COUNTY ST. CROIX
SYSTEM ELEVATION 100.0' 3/15/ 1, 6 3
DATE BEDROOM CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND xxx SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none
BENCHMARK A .R.P. Top of 3/4" pipe ASSUME ELEVATION loo, Filter Lifetime Filter
BOREHOLE (D 40'ELL - II. R. P . same as benchrrnar k
312' Prope rt y Li ne B_h1_
Grading is to be done 13- i
to divert run-off
ale = 1./4 = 10'
- away from system
..1 acr& lilt E
Tank is to be properly 100'
bedded and provided
with lockdown covers ❑
-with approved -warning
labels B-3
Huffclift Combo Tank Q$, 4% Slope
11i piping ;hall be _%STM SUR ?W',4. within
10' of tank. piping shall be. AS'l'_\,l W) Area 15' below system is to remai n
undisturbed
Pro Well is to meet all WDNR setbacks
Bedroom
~:Ho use
3
1
3
I
297' Property Line
10 7th Ave
DIVISION OF INDUSTRY SERVICES
f 10541 N RANCH RD
HAYWARD WI 54843-6462
!\D S I Contact Through Relay
P S http:!i :sps wi govi,rogramslindustry-services
wmv wisconsin gov
Fels" -c\` Scott Walker, Governor
Dave Ross. Secretary
\pril 06. 2016
CL ST ID No. 22A900 ATTV: P0117, his ector
SHAI'N R BIRD ZONING OI DICE
BIRD PLUMBING INC ST CROIX COLNTY SPIA
1432 120TH ST 1 101 CARMICHAEL RD
NEW RICHMOND WI 540 1 7-6409 HUDSON W't 54016-7708
CONDITIONAL APPROVAL.
PLAN APPROVAL LXPIRES: 04!0612018 Identification Numbers
Transaction ID No. 2687030
til7'L: Site ID No. 822433
Oeverinu Homes Please refer to both identification numbers,
976 107TH Ave above, in all correspondence with the agency.
I own of Warren
St Croix County
NF1,4,NE.14. S7, T29N, R18W
FOR:
Description: Mound, 3 bedroom residence
Object Type: POWTS Component Mamtal Regulated Object ID No.: 1593433
Maintenance required; 450 CWD Flow rate: 30 in Soil minimum depth to limiting factor from original grade: System(s):
)found Component Manual - Ver. 2.0, SBD -10691-P (N.0 1,'O1. R. 10,12), Pressure Distribution Component Manual -
Vet. 2.0, SBD-10706-P (N.01'0 1, R. 10,'12); Effluent Filter
'The Submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and''isconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed CQNDI
and located in accordance with the enclosed approved plans and with am component manual(s) referenced above. ApF
The owner, as defined in chapter 101,0 1(10). Wisconsin Statutes, is responsible for compliance with all cede OF
requirements. _ N
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,~ { , N F ~SxID
Mats.
The followimu 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 am or its component parts malfunctions so as to create a heap
hazard, the property owner must follo%i 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 VI II of the
mound component manual are complied v+ith. A copy of this information must be given to the owner upon
completion of the project.
• The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension hall
be a minimum of 12" per design. The maximum finished slope of the mound surface shall be equal to or less
than I per the Mound Component Manua].
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along, the surface
contour per SPS 3V44(6)0)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 anka% from the system area per Mound Component Manual.
III V R 111Rp
• Materials shall conform to the requirements of SPS 384.
• Maintain well and waterline set backs per SPS 38-3.13(8)( i I. Consult the Departmcnt of Natural Resources for
well setbacks and other regulations and exceptions.
• Insulate building sewer per SPS 382.30(1 1)(c').
A copy of the approved plans, specifications and this letter shall be on-site durinIg 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
c(nstntction-'installationloperation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise makine them necessary for code compliance. As per state stats 101.12(` nothin~z in this revi.\k
shall relieve the desiner of the responsibility for designing a safe building. structure, or component.
Inquiries concernin this corresporder,ce ma-, be made to m.e at the tcl:phonc -iumhcr i ~tcd haloes, or at the address
on this letterhead.
The above left addressee shall pro%idc a copy ofthis letter and the PONN TS rnanallement plan to the owner and any
others who are responsible for the installation, operation or maintenance or the POW I S.
Sincerely, Fee Required S 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice.
Patricia I. Shandorf Please Include a Copy %Vith Your
PO\k I S Plan Reviewer . Division of Industry Services Payment Submittal.
(715) 634-7810. Fax: (715) 6:4-51 >0 , %t - F 8.00 a.m. - 4:45 p.m. WiS%tART code: 763
pat.shandort'liv, isconsin._o%
cc: Ldwin A Taylor, Wastewater Specialist. (715) 6', 4-,Av, 4 , 'Monday - Fridai 8:00 am To 4:30 pm
Note: Effective January 1, 2012, all codes under thejurisdiction of the Division of Industry Services (formerly
Safety & Buildinss) will he modified. Code references with prefixes starting with "Comm" have been replaced with
"SPS" to reco_nize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally. all IS itormerly S~~B) codes have been renumbered
aril addressed in a "300 series. For htture reference. the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
L! 11 _ fir; ;1(,i(
• Maierials snalI conform to the -equirements of SPS -,S4.
• Nfaintain weal and waterline set backs Der SPS 383.43(8)(i Consult the Department of'Natural Resources for
%+elI setbacks and other regulations and exceptions.
• Ltsuiate buildings sewer per SPS 382.30i l I )(c).
A copy orthe approved plans, specifications and this letter shall be on-site during construction and open to
i-ispection by authorized representatives of the Department. which may include local inspectors. All permits
required by the state or the local municipality shall be obtained _Drior tc, commencement of
construction 'installation- operatior..
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise maUia them necessarn for code compliance. As per state stats 10I.12(21. nothing in this review
shall relieve the designer of the respon ibility for designing a safe building. structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number lists:: below, or at the address
on this letterhead.
The above left addressee shat: provide a copy of this letter and the POW FS' management plan to the owner and zui
:-)thers xvho are responsible for the installation. operation or maintenance of the PORTS.
Sinccrcls. lee Required S 25C;.00
This Amount 'Will Be Invoiced.
Mien You Receive That Invoice.
Patricia L Shandorf Pleas,. include a Copy 'With Four
POw'TS Plan Reviewer. Division of Industry Services Pav-rent Submittal.
(715) 634-7810. Far: (_715) 634-5130 . 's1 - F 8:00 a.m. - 4:4~ p.m. WiSMI4R7 code %6.3
pasha: dorf ~iisconsin._"v
cc Cry:n _ Ta.lor. F-aste~~ ater Specialist. ( 1 i 63 l-_ <15,{ , Nlondav - F-idav 8:00 am To 4:30 pin
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly
Safety & Buddinss i «ill be modified. Code references with prefixes starting \,%ith "Comm' have been replaces with
"SPS" to recoarize the relocation of the Division of Industry Services f-om the former Department of Commerce to
.h. Department of Safety R Professional Services. Additionalh, all IS (formerly S&B i codes have been renumbered
and addressed in a "300" series. For future reference. the Wisconsir. Commercial Buildinn Code will be addressed
I•y SPS Chapters ?&'i-366.
PLOT PLAN
PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NE 114 NE 1/4s 7 rT 29 N/R 18 w' TOWN Warren COUNTY ST. CROIX
SYSTEM ELEVATION 100.0' DA'I'S 3/15/16 BEDROOM 3
CONVENTIONAL IN-GROUND PRESSURY CONVENTIONAL LIFT HOLDING TANK
MOUND MIX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none
BENCHMARK V.R.P. Top of 314° pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL - H.R.P. same as benchmark
B.M.*
312' Property Line
Grading is to be done B_ 1
Scale = 1/4 " = 1 01 to divert run-off
away from system
2.1 acre lot B-2
Tank is to be properly 100'
bedded and provided
with lockdown covers ❑
with approved warning
labels 99' B-3
Huffcutt Combo Tank 98' Ogg Slope
X11 piping shall be ASTl~1 SDR 30x3, within
10' of Tank, pipin- shall be ASTNI F891 Area 15' below system is to remai n
undisturbed
Pro 3 Well is to meet all WDNR setbacks
Bedroom
House
297' Property Line
107th Ave
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 3/16/15
Owner:0evering Homes
Location: NE1/4 NE1/4 S7 T29 N,R18 W 976 107th Ave Warren
Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01 /01 R. 10/12)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross Section/Pipe Layout
• 1 ~Ll.,`l
5. Pump Chamber Cross Section ;FD
6. Pump Curve LTY ~t _
L SERV I
7-8. Maintance and Contigency plan
,S
9. Filter Specifications and cross section
Attachments: Soil T
1 tONDENLE
Shaun Bird 11
Signature r /
License number 6900
Page 1 of 9
Mound System Cross Section and Plan View
~--T-, -
Dimension Feet j
T ,
i B s ~
, L .
i E r
l j
F z-
- G
.Z
i
3 ;
- - - - L r~Jj7.
r B
Z
-
L - ~j Slope
- 1 -Topsoil
= AST1\vI C- 3
F' Clean aggregate = 4 in. sch. 40 pvc
Cap Nlaterial sand fill
to 2 t;. Z in. dia. observation pipe
(icotextile - - - - -t-
~r
Fabric
F
hrl
D
E
P
Ft Contour lowed Surface
Slope Ducction
GF"NER9I, INSTALLATION: The mound area is shed out along the design
vegetation is mowed and raked off the site. The mound basal area (L x is plowed with a moldboard Existing
chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a inch o l wire
when a sample is rolled between the palms of the hands. ASTINI C-33 quality sand is placed inunediately
after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot
thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound
is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The
observation pipes are slotted ui the lower 6 inches acid secured in place with rebar or a closet flange.
10/07 1a1
Page of
Pressure Lateral Layout
Two Laterals - End Manifold
f-- Threaded
Cleanout
Lateral l urn-up - Plug
\ldntlold
M
r. ~ X
-T 1
Force - - -
Main Long:
Sweep
90
Bend
Distribution Network S ecifcations
~ r Pressure System Construction
Lat-ral Diameter In.
Manifold Diameter
In. Laterals are constructed of Schedule 40 PVC
Orifice Diameter _ ~_Y16 In. pipe. Orifices are drilled perpendicular to
X (Orifice Spacing) Tn. the pipe with a sharp drill bit and face down-
_L (Lateral Length) Ft. Lateral turn-ups terminate with a threaded
N,1 (Manifold Length) cleanout plug and are enclosed in a 6-8 inch
Force Main Diameter In. diameter lawn sprinkler valve box accessible
Force Main Length Ft_ from finished grade.
[Trade •
/
6-8 Inch Lawn 7~
Sprinkler Valve
Box /
J ~
Page - of
03/b 1g;
Septic-Dose Tank Cross Section And Pump Performance Specifications
Tank Manufacturer rPump Manufacturer
Tank Model Number Pump Model Number
! Total Tank Capacity J C7 Alarm_ Manuftwtu er
:1~Iax. Bury Depth f Alarm Model Number c/
Switch Type C
Filter Manufacturer Total Dynamic Heed (TDH) - Feet
Filter >viod -1 Number Elevation Head I /X)
Distal Pressure
Network Loss
Minimum Pump Performance Required Force Main Loss
GPM' .~Z Ft TDH Total
Outlet Manhole Min. 4" Above Grade With
Locking Device. Inlet ?vfanhole Manhole Min. 4" Above Grade
< 6" Below Grade Sealed Watertight Securely Mounted With Locking Device
Weathw-proof j
L~~ Junction Box i
Finished Grade . r 1 was
.
Vent Min. 12" Disconnect
Above Grade Means
With Vest cap
Outlet Filter
ln1eE Wet Baffle - -
Switch Settings and Reserve Capacity A 1/4"
Tank Volume GPI we"P
Dimension: Inches Volume Gal. B Hole
(reserve) A- • r; l
(alarm) g 2 Off Elevation C
(dose) C
' a Bottom
(dead) D D Elevation
Total
a < . a a•.a>ai >~I{>ai rai >{.ai >si > • 1>`>..•{ . t l aa'.; ! 1 :i•{ 1 .
GENERAL INSTALLATION' The septlcldose 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 m went seUling or sagging. The farce main is sleeved with 4" Sch. 44 PVC to bridge the tank
excavation and the sleeve is sealed watertight Electrical service complies with NEC 300 and Comm 16.2:1.
02105 U Page of
= r , i,-APACITY
UP`i L E~F'~UEN. A,,() 'ES'rATER IVv
I ~ I I~_~I r,teter~~at_ I Ltars I G~_i'' - ~ L- t°rs ~
- r-r-
I S , E j 20' 7; I 29-
l 70
l 167 52 97 i
a i I
30 - - ( 2 ~ 434 4~ `
42
- i
t:
z 3G i ? 27
2
i 2 2 I 1 t
44
4 --1
i
i
?rl n0 r"". UC
CAL_CNS -
LITERS p ~ R "1 4,0 1 I
L
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• !:me(i dosing panels availac:e. 3
E'a;tnca: alternators, for duplex Sys.E,ns, are availab e and st,Fpej w'th H
,
c'1 313ft11
variable level control s'witchee are PvaiIab,e for c.,.<,trolI;rg single prase
sysfe,ns
Double piggyback ~zriable level float switches are available fof vanabie i s
ievel lord and short cycle controls. ;
• Sealed &A-Box available for outdoe. ins?allauons. See L:M1420 i -1 -f
• Over 130°F 154'C.) special quotatcn reeuirec. i
1521153 Senes i
i
1521153 MODELS_ Cortrol Selecxion
Modd' Vogl ph fdo(!e _ ws Slm ? Duplex ,4152 115 , Nu! 1~ 3 E '
8N152 1!5 1 Aide 6.5 nclu.iee or3 L_ s'a°ea
E152 i ZA t Non 4-3 _ 2 cr 3
L'30 30 Auto } 43 Irxkr:ed E 2cr3
15 f_Non '.0-5 ---t _ 2or3
Ill ALto 1C.S Inclu ed or 1 SELECTION GUIDE
1 Na; E3 1 i 2 or 32 or 3 t Si }yie D+c vhace, varat!e level ftrat s7micn or double pg9ybeck variable level foat
8£1531 230_ 1 A.uk3 3- lr- hided i 2:)e 3
- ,.witch. Refer to F^A04T?.
.1, CAUTION 2. See FMC i 12 `or wmect model of Elearical .Altematcr E-Pak.
All installation. of controls, protection devices and wiring should be done oy a quaAed 3. 'tia'iabte iev-aicortrol svit1& 1C-0225 used as a conni acty:ator, specify duplex (3)
licensed electrician. All elerrical and safety cedes should he tobowed ircludir.g the most or ;41 iJat n5[e r
recent National Elect kCode (NEC) and ttls occupational Safety and Heatth Act i.OSHA;.
RESERVE POWERED DESIGN
For unusua! concitons a reserve safety f3Ktar iS ergineered into L.?e oeSig ? 01 -Very 7;,ii pump. -
MAIL TO. P.C. 90k' 1b3,
L:;csoit?o,. KY 402°e-034 ' Mam`aCiVrfsG
Sh1P TO 76s9 t ~~e Run oal Z-7 ~JlJ
kL [/Tl rJY~S JJNCf ~~JJ
Zo LOUIS KY 40 1 . .131
/~,/~~iiirr 1509; 7i32731 • 1;80!1 326-PVafP
http-i1www.zoeller.com !J L O. SAX %2,, "4-3624
4 Copyright 2003 Zoeller Co. All rights resew°-1
I
POWTS OWNER'S MANUAL & MANAGEMENT PLAN F~3e
of
FILE (NFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity
Permit # Septic Tank Manufacturer
❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer r 7` ~ ? ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA~
Number of Commercial Units _LYNA Pump Tank Capacity J ❑ NA
Estimated flow (average) j aVda Pump Tank Manufacturer NA
i
Design flow (peak), (Estimated x 1.5) aVd . Pump Manufacturer ❑ NA
Soil Application Rate aitda lft2 Pump Model ❑
Influent/Effluent Quality Monthly average- Pretreatment Unit
Fats, Oil & Grease (FOG) S30 mg/L ❑ Sand/Grgvel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODS) 5220 mg1L ❑ Mechanical Aeration U Wetland
Total Suspended Solids (JSS) s150 m /L ❑ Disinfection ❑ Other.
Manufacturer
Pretreated Effluent Quality NA Monthly average" Dispersal Cell(s)
Biochemical Oxygen Deman (BODS) 530 mg/L ❑ In-ground (gravity) ❑ In ground (pressurized)
Total Suspended Solids (TSS) 530 mg1L ❑ At-grade -A134~und
Fecal Coliform (geometric mean) 510` cfu1100mi ❑ D ' ine ❑ Other.
Maximum Effluent Particle Size Y inch diameter Values typical fa domestic (non-carnierciaQ wastewater and
septic tank effluent.
" Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every ❑ months ar(s) (Maximum 3 yrs.)
Pump out contents of tank(s) When combined sludge and scorn equals one-third (Y) of tank volume
Inspect dispersal cell(s) At least once every ❑ month wear(s) -(Maximum 3 yrs.)
Clean effluent filter At least once every ❑ months ar(s)
Inspect pump, pump controls & alarm At least once every ❑ months r(s) ❑ NA
Flush laterals and pressure test At least once every ❑ months 4s) ❑ NA
I Other At least once every ❑ months ❑ year(s) ❑ NA
later. At least once every U months ❑ year(s) ❑ NA
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 identity 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 surface. 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 tailing 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 (Y,) 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 ch. NR
113, Wisconsin Administrative Code.
The servicing of effluent fitters. m"ncal or pressured POWTS components, pretreattment components, and any
other maintenance or monitoring at irftervals of 12 months or less shall be performed by a certified POWTS Maintainer.
A servik'p report shall be provided to the local regulatory authority within 10 days of completion of any service event
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other
chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a septage servicing operator prior to use
Page of
START-UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals th::it
may impede the treatment process and/or damage the dispersal cell(s). It 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 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 b~
discharged to the dispersal cell(s) In one large dose, ovedcading the cell(s) and may result in the backup or surface discharge of eftluen.,
To avoid this situation have the contents of the puma tank removed by a Seplage Servicing Operator prior to restoring power to thie
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal leve s
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 dawn 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 kfe of the POVJ_l
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain
;sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting prod";
pesticides; sanitary napkins; tampons; and water softener brine
ABANDONMENT
When the POWTS fads and/or is permanently taken out of service the following steps shall be taken to insure tnat the system is prope-1y
and safely abandoned in compliance with chapter Comm 133.33, Wisconsin Administrative Code:
+ A.l piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed
• 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 of their covers removed and the void space filled with suit.
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 compliant
replacement system.
O A suitable replacement area has been eualuateo and may be utilized for the location of a replacement soil absorption systeim.
he replacement area should be protected from disturbance and compaction and should not be infringed upon by requiried
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neled
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rulef, in
effect at that time.
0 A suitable replacement area is not available due tc setback and/or soil limitations. Sawing advances in POVVTS technology a
/holding tank may be Installed as a last resort to replace the failed POWTS.
77-11 has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a sultaNe replacement area. if no replacement area :s available a holding tank may be installed) as
resort to replace the failed POWTS.
X~11asI
_
und and at-grade soil absorption systems may be reconstructed in place following removal of the biomet at the inf!trative
rfiace. 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 NOT
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
POWTS INSTALLER POWTS MAINTAINER
Name Name
"hone _c Phone - j~
SEPTAGE SERVICING OPERATOR PUMPS LOCAL. REGULATORY AUTHORITY
Name
n~~ fume r ~~~lla_~~»
Phone 7 Phone //J
This docaunent wes drafted in complianw with chapter SPS 383.22(2);b)(')(d)aM and 383.54(1), (2) & ;3), Wiswrrsm Administrative Code.
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATfON FORM
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Owner/Buyer_(je L71~
:Mailing Addre
Property Addr
(Vetift cation from Planning ~ & Z oning 1} ~ -
-
r~tured nt for new construction.)
eP
City/State
Parcel Identification Number
LEGAL DESCRIPTION
.Property I,ocatioll 14~ y~ , Scc. ~
~ T 'w, Down al
Subdivision
Certified Survey Map # Lot # _
Volume aa
Warranty Deed
- Volume
Page #
Spec house es no lot lines tdentifiabl ye. no
SYSTEM MA VTENAN
CE A.ND O'R'NFR CERTLFICATZOtY
Improper use and maintenance of your septic
ruaintenance consists of ptur system could result in its prematu- failure to handle w
tg ont the
the System can alier;t the function of the s~dc tartk every three years or sooner, if needed., } licensvc! antes. Proper
What you put ante
the System can are specified t Co eP~ tattle as a treatment stage in the waste disposal system. Ownerr~maintenance
responsibilities in § ntnt. 83.52(1) and in Cha ter 12 - St. Croix Count Satri p tars Ordinance.
The property owner agrees to submit #o St. C`.rotx Counh/ Plattttut
owner and by a master plumber, 'o to g $ Z.ctnin De
~ Yn'►au plumber, restricted plurtther or a licensed P~~nt a ceriifcation form, signed by the
wastewater disposal system is in proper operating condition andior m after inspection and
less than 1/3 full of sludge. Pamper veritj~ittg that (1) the on-site
pumping (if'aecessary), the septic tank is
I/'we, the undersigned have read the above re
standards
, hcrcirt, as se( by the De qurrements and agree to maintain the private sewage disposal systein with the
Certification cation set stating forthpartment of Contruerce and the Department Of -Natural Resources, state of wiscousin.
Zoning I)epU1ent lduu 30 da, s of the tb ee yea expiration date st be completed and returned to the St. Croix Count
. y planning
I/we certify that all statements on -s form ate tare to the hest ofmy/our kaowiedge_ Uwe arrt/are the owner
property described above, by virtue of a w
anfy deed recorded to Register of Deeds Office. (s) of the
Number of bedrooms S
'IGNAT[ OF APPLICANT(S) yn DATE
,***A
ny information that is misrepresented may result in the sanitary permit being revoked by the Planning At Zoning Department. **'t
Include with this application a recorded warranty deed front the kcgister of Deeds Office and a ropy of the certified surve
reference is made in the warranty deed.
Y map if
(REV. 08/05)
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? `viscons n r SOIL EVALUATION REPORT #2111
Depa-tiof Comm 'oo y in accordance faith Comm 95 vVis Adm ^e Page 1 of 3
Division of Safety and
d Steel's Soil Serv cc
IN YIA
Co:mh
Attach complete site p an on pa er rot less than 8'./_ x 11 rches in size. Flan must St. Croix
mcluce, but not I mited to: vert cal and horizontal 'e`erenco po rt (i c rection and
percent slope scale or dimensions. no th arrow, and locat or and distance to nea,est road. Parcel I D
Please print all information. Re sued Date
Personal information yo.r nrr.,ic may be uxc `or seC Law. s_ 15 04 (1) (m);
-'roperiy Owner Prope ty Locator
Francis Lands. LLC tjAy r~ mQ Govt Lot na NFV4. NFIM, S7 T29N, R18W
Property Ow.rer's Mailing Address 1 Lot # Block # SUM Nam or
P. 1404 First National Bank Building Sl C>~~u.~~vh~y" g na CSM l~/P
City State Zip C(ft%HNIMG41 ' P City Village To,.vn Nearest oad
Saint Paul MN 55101 651-222-5555 Warren 67-)6G 107Th Ave.
Xrqe,,v Constructicr Use xRes cent al ! Number of bedrooms 4 Code .".erived design flow 'ate 600 =Pn
Replacement Public or commercial - Cescribe na
Parent materia Pitted outwash plains Flood pla r elevation, f applicab c na ft
General comments Vound Design system ePVat -,n 100.20ft 0ased on contourline e1e18lion~~ ,'~'(t M n nu nl l3 ri hes of ASTV 33 M,:uuid sand
and recom•nendatrons.
F1 Bo'ing It 3oring
Pit Ground surface elev. 149.70 tt. Cepth to limiting factor 50 n. I Soil Appl cation Rai=
Horizcr Depth Dominant Color Redox Description Texture Structure Cunsistence Ebuundary Roots GPD!ft°
in. Munsell Yu Sz Con,. Color Gr Sz Sh =_fftsi .Eflx`
1 0-16 10yr3,2 none SI 2msbk mfr cs lvf 0.6 1.0
2 16 34 1 none SO 2msbk mfr Cs na 0.4 0.6
3 34-50 7.5yr4J4 none sl 2msbk mfr cs na 0.6 1.0
4 50-62 5yr4; 6 c2d7.5yrb16 scI om na na na .0 .0
BCr nc
Fi boring # Gro.rnd surfa:;e elev. 99.70 t Depth to imitin factor 30 m.
t 9 oil Apchcat on Rate
Horizon Depth Dorninant Color Redox Description -extuw Structure Consistence Eoundarv Roots GPDM2
in Munsell Qu. Sz. Coat Color Gr Sz SI- 'Ef`#' •Eff#2
1 G 10 10yr3; 2 none sil 2msbk mfr cs lvf 0.6 0.8
2 10-21 10yi none SO 2msbk mfr cs na 0.4 0.6
3 21-30 7.5yr4; 4 none cos 2msbk o5g cS na 0.7 1.6
1 30-18 10yr6; 4 c20.5yr5; 6 c1 0M na na na .0 .0
- - - -
Etfluert #1 = BOD~ 30 22- rrcrL and TSS ---30 1 rry. _ Effluent #2 = BOD < 30 mg;L and TSS <30 mg/L
CST Vance (Please Print) Si natrr7: CST Number
David J Steel fem. ~iJ 248956
Address Steel's Soi Serv ce / Date Evaluation Con^Ucted T eleci 'Vumber
1_~9 ' SCth 5t ~~de,N Richmcrc. WWI 54~ I' S?19!2~C9 ; 15-r'60-7347