HomeMy WebLinkAbout030-2133-07-000
Aisccns n -jeaa-t-nert of ::o,,,mercc PRIVATE SEWAGE SYSTEM County St. Croix
Safety and Bui ding civis or
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION • (ATTACH TO PERMIT) State Plan ID No 584764
Personal infor-rition you pi-code may oe used fc- Secunc:,,y pr.rpcses [P~vacy law s 15.04 (1;{m)I 2710693
Permit Hoder's Name City v age Township Pwcei Tax Ne
Stuart & Laurie Green TOWN OF SAINT JOSEPH 030-2133-07-000
CST RM Elev Ipso. 6M Elev Ink' De-.cription Section;TowniF-,ange Map No
/6a30.30.19.2007
TANK INFORMATION ELEVATION DATA
TYNE MANUFACTURER rn CAPACITY STATt=:N BS HI FS ELEV.
L.J tQ~
Septic ` Benchmark
Dosing Alt. BM
u J
Bldg- Se'.•rer
Holding SUHt Inlet 4/ j
TANK SETBACK INFORMATION SUFIt Cutlet 9
TANK TO N!` 1 NICLL BI DG. vent Air Intake ROAD Dt Inlet
Septic O 1
7 5o' ! 1 2 7 - Gt Bottum f 2-
Dosing -7 J`O/ ii / 07 Ileader;Man 7•/S
Aeration I 1 - _ D st. Pipe
J,15 99 9 S
Holding - - Bot. System
,
PUMP/SIPHON INFORMATION Final Grade lr
P,1anl.fachtrer
tLA Demand S1 Cover /a 5 b 9S^
d 3Nr,t ~ C..
Model Numoer Q Z ~l 5 G p J CA_
TDH Lfry! Friction Lo 4 W 1 srer, 1 `D F ,
~-orcernain Length D a it
Dist. to ^deu 1 z. 4 3. z
SOIL ABSORPTION SYSTEM
BEDfTRENCH Width / cthINo.OfTre hes PIT DIMENSIONS No Of Pits Ins de D a. Liquid Depth
DIMENSIONS /z T~'6
SETBACK SYSTEM 10 P'L BLDG WELL LAKESTREAM LEACHING Manufacturer
INFORMATION _ CHAMBER OR
yp f Sys: ,
fa Y6 UNIT Model rJ., ter
DISTRIBUTION SYSTEM 2A A
-Distnbuho i r I x Hole Size x cle Sodomy Je I Air Irate
s; ✓
Le,yth Dia PipeLength Ltia Spacing` ~ 3 z
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only wt.
Depth Over G Dept, :)oer xx Death of n xx SeededlSocded xx Mulched
Bed!Trench Center b J P.edrTrench Edges Topsol Nc Yes P.o
cc
COMMENTS: (lrr .ide code discrepencies, persons present, etc.) Inspection 1. V L Inspection #2:
Location: 1377 31ST ST ' J V Q JVa6rr41 '
11, Alt BM Description d 4A~ G ll
2) 11 sewer length
= G
XtI / I I _'I' ~/0try
- anotrlof:;over
Plan revision Required? ]Yes No
Use other side for additional information. lU p In IU
Date Insepclor, s S rat.ae ce't No-
SBO-6710 (R.3~97)
4. V r tl County t
Safety and Buildings Division (b
q 201 'd](. Washington P Go 6 Sanrtary Permit Number (to be fined it. by Co.)
MAY ~ 6 La Madison, %V1 `f e S7 CROIX CO
C Stab` 1 ransaction N7/11-
W, ber
~~'T Application D > acwrdan`ewith SPS iR3?1(_'j, is. Aden- Codc, subrnisstou of this form ro the appropriate governmental tmrf
is required prior w obtaining a sanitary pertnit Now ApplicaL-ou f:ums for state-owucc POWTS are submitted to Project Address (if different than mailing address)
the Jepartatc>~ of Safety and Professions Stzcieti. Pen mat in&xm:uion you provide may be usec for sewndary 41,377 ?m
poses in acccudance with the Privacy Iaw, sI5 04(1'Km Sacs. 1. Application information - Please Print AI Information -,C
Pro=Ty 0,Amei s Name a t Parcel N -
CD
Yom` -
Property(}wOer`sMailing.4ddrtss l Property location 20. 0.Iq.-00
_ Govt :rot 7
tae Zip Code T Phone Number
~~e] f✓~!; Section
- T~ t] N-, R L
LL Type of Building (check all that apply n Lot
r 2 Fam ly Dwelling - Number of Aedrax Subdivision Name
P,rbliciCommercial - Describe Use
❑ City of -
❑
State Owned - Describe Use CSM Nurribcr Vaage of
~V n of ~ ~C)1~ ~ 1
LX
III. Type of Permit: (Check only one boz on line A. Complete line B if applicable)
l ivew System epiaexment Sysrcm (J Treatruent lioldiag Tank Replacement Only L Other Modification in Existing System (explain)
E i Permit Renewal n Permit Rm isioc F1 Change of Plutinc LJ Per it Trancter to New List Previous Ppmi~ and I}ate ]slued ~ z` Q
Re''ore Expiration
DIV. Type of POWI'S System/CoutponenvIlevice: Check all that apply)
Ara
D Non-Pressiz^zcd In-Ground L Pressurize.: In-Ground XAt-Grade ❑ Mound > 24 in. of Suitable soil J Mound <2d in, of suitable soil
J Iioldina Tank C Other Dispersal Conrprmrw (expi 1 Nctrr ntent Device (acplaia
V. DispersaVIrea_t eat Area Information:
Des flow (gpd) Design Soil Application F d,f) Dispersal Area Requir (sfi Disp~er~sa-l+.Axea Propo (sf) Systgn ElElevation
7VI. TaakInfo Capacity in Total r of Manufac=- '
Cralloac Gallons Units V v i o
New cs Existing Tao)z
- m
r o
Septic or Holdwg Tank I - } I
:losing CLamba
VILL Responsibility Statement the ander•signett, a responsibility for installation of the POWTS sbowu oa the attached picas.
P rimbcr.S Hattie (Print) Pl er' ignaturc 161PINiPRSS Number I Business Phone NWnber
- .-2
Phraber's Address (Street, City, State. Zip ) ,
V-M. CountviDepartment Use Only
Approved Disapprove PC- itce IN I ss l ssutng . t Siprrattrre
_ r -riven Reason for Denial • m- 26 I
1k Coaditi ons for Disapproval 3 /8
1. ' .tank, eith.~nt fiMe* 2tnr'1 G C.G~t
disper.=ai cell must all be seric?s ' nli iota;" 2L
es per management plan pro, ce by ;lumber. 1 G ~ c f e (AJ /
2 All atllbiak rteWrements must W mairttE'fined 1"
' M pf q*lic tl ooo ! /:fdinavrNi3. 0 v JO ef^A, Attaeb to wmpkse plans for &e,-ymem and mbrnn m t (:ounp' ewly M praprr ow lM~ tttat A rn_ s 11 i8ebe5 in stn
J
6cr'P~ e 4b
SBD-63961,?L i 1 11 k,, ra-tk 6C
OA., AI tj N
I A01 Cf',
PLOT PLA
PROJECT Stuart Green ADDRESS 1377 31 st. St. Houlton Wi 54082
NW I ! 4 NVV 1/4s 30 'T 3 0 N / R 19 W TORN St. Joseph COUNTY ST. CROIX
SYSTEM ELEVATION 98.5' 5/9/16 3
DATE BEDROOM
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE: TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
BENCHMARK V.R.P. Top of well ASSUME ELEVATION 100' Filter SIM-TEC
❑ BOREHOLE O WELL, -H.R.P. sameasbenchmark
Vent
Scale _ 1/4" -10 1 3 Acre Lot Property Line
All piping shall be ASTM SDR 30/34, within
31 sit. St. lg' of tank, piping shall be ASTM F891
Fai led drai nfield
I
ST Tank is to be properly
bedded and provided with lockdown
covers with approved warning labels
Huffcutt Dose Tank
Existing
Bedroom
House 6% Slope
etl B. M. B-1
99
'
98.5'
98'
Grading is to be done B-2 B-3
to divert run-off 97.
away from system
Drainage Eaesement 200
Area 15' below system is to remain
undisturbed
1 388th Ave
DIVISION OF INDUSTRY SERVICES
_ 2331 SAN LUIS PL STE 150
0 GREEN BAY WI 54304-5211
Contact Througn Relay
P S http:;!dsps.wi-gcvfprograrrs~industry-services
www.wisconsin.gov
ts.erc`t Scott Walker, Governor
Dave Ross, Secretary
CONDiTIC
N1 ay 13. 201 APPRC
DEPT OF SA
COST ID No. 226900 A1-/A 1'0;1IN In cpecrar i'ROFESSIONA
P" 1SION OF INDU'
SiiAiJN R BIRD ZONING OFFICE
BIRD PLUMBING INC ST CROIX COUNTY SPIA
14-3321 120TH ST 1 101 CARMICHAEL RD I
NEW RICHMOND Wl _54017-6409 HUDSON WI 54016-7708
SSE CORRESI
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05%13/2018 identification Numbers
Transaction ID No. 2710693
SITE: Site ID No. 824210
Stuart Green Please refer to both identification numbers,
I 377 3 l ti l St above, in all corresnce with the agcney.
Town of Saint Joseph
St Croix Countv
NW 1/4, NWl/4, S30, T30N, R19W
Lot: 7, Subdivision: Deer Wood
FOR:
Description: At-Grade (Replacement 3 Bedrooms)
Objiect Type: POW' I S Component t9anual Regulated Object ID No.: 1602127
Maintenance required; Replacement system; 450 GPD Flow rate: 36 in Soil minimum depth to limiting. factor from
original `rade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.01'07, R. V12), Pressure
Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.0 L'01, R. 10112); Effluent Filter
the submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDI FIONALLY APPROVF,D. 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 f flowin, conditions shall be met during construction or installation and prior to occupancy or use:
• Pa,e 4 Orifices per Lateral = 41 Orifices
• Verifv Well Setback to POW'TS Components prior to Installation
• Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site.
• Any tall grasses. leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to
prevent matting under the dispersal area.
• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches.
Smearing and cornpactin_ of wct soil will result in reducing the infiltration capacity of the soil. Proper soil
moisture content can be determined by rolling a soil sample bet- een the hands. if it rolls into a 1 4- inch wire,
the site is too wet to prepare. If it crumbles, site preparation can proceed. if the site is too wet to prepare, do not
proceed until it dries.
• Abandon Existing System per SPS 383.3 3
• Pump Floats to he set and verified per approved plan.
SHA'.; N K BIRD Page 2 i; l 3x'015
• Divert surface water from POWTS Area.
• All piping shall conform to SPS Table 381_;0 and SPS Table 384.30-5
• insulate building sewer beyond 30 feet per SPS 382.30 0 1)(c)
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Areas that are occupied ~%Ah rock Ira<<m::nts. tree roots, st.u»ps and boulders reduce the amount of soil
available titr proper trcanrtent. it no other site is rvailahlc. trec,, in the basal area of the at-grade must be cut off
at _ Dung level. A laM-~er fill arLa is necessan when an-, of the above condition. are encountered. to provide
sufficient inliltrative area.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions
r~latin_ to proper use and maintenance of the system. Ovoiers shall receive a copy of the appropriate operation
and maintenance manual and.'or owner's manual for the POWTS described in this approval SIPS 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 prcpe,-t,. o,aner must follM% the c:mtmv.enc,, plan as de:>cribed in 'he approved plans.
A cops of the appro~ ed plar:s, speci tications and this letter shat l be on-,itc during cim;traction 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-instal Iation,'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 desi`ner 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.
T he above left addressee shall provide a copy of this letter and the POW'TS management plan to the owner and any
others who arc responsible for the installation, operation or maintenance of the POWTS.
Sincerelv, Fee Required S 250.00
~L This Amount Will Be Invoiced.
When You Receive That Invoice,
1 im Vander Leest Please Include a Copy With Your
Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal.
i 920)492-'214 , Monday - Friday 6 am To 3:30 pm WiSMART code: 7633
:vanderleestawisconsin.~~ov .
cc: Fdwir A Taylor. Wastewater Snec a:ist. t71 ~j 6,4-3484 . hior;day Friday 8 :o0 art To 4:30 pill
S i 1'_' N R B t
• Divert surface water frorr. POWTS Area.
• All piping shalt conform to SPS Table 35=30-3 and SPS Table 384.30
• Insulate building sewer beyond 30 feet per SPS 382.30 (:1)(c)
• Tank Installation to follo%N all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Areas that are occupied witL rock fragments. tree roots. stumps and bou;ders reduce the amount of soi;
available for proper treannem. If no other situ is available, trees in the basal a:-,-a of the at-grade must be cut off
at ground level. A larger Til. area is necessa v wren any o' the abo~ e cancitiori~ are enc:Iuntered. to prop ide
suf5cient i--ifilrrative area.
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 cop) of the appropriate operation
and maintenance manual and,or owner's manual for the PO)X TS described in this approval 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. tit,- prop:m- owner must foli-m t)e contin_encv plan as described in the approved plans.
:1 : op~ of the approved blar_s. specifications anc fai; letter shalt be on-sit,- du: ing construction and open .o
inspection by authorized representatives of the DeparLment, which may include local inspectors. A I permits
required by the state or the local municipality shall be obtained prior to commencement of
construction:'instaliation~ operation.
in granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise makin them necessary for code compliance. As per state stats 101.12(2), nothing in this revie"
shall relieve the designer of the resoonsibilit, for designing a safe building, structure, or component.
inquiries concerning this correspondence may be made to ttte 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
oiners who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fa: Required $ 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice.
Tirn Vander Lcest Please Include a Copy With Your
PrivaLL ScwaLc Plan Reviewer . Division of Industrv Services Pavtnent Submittal.
i 9_0)493-?? 4 , Monday - Friday 6 am To 3:30 pm WiSivLAR t code 7633
t`'a:~derleestrd wisconsin.sov
cc Fdwit A Taylo-. Was.cnwawr Specialist. ":3) 634-3484 . Monday - Friday 8:00 am To :30 pm
Cover Page
NIALLY
`1ED
Shaun Bird - ETY AND
SERVICES
Bird Plumbing Inc. TRY SERVICES
1432 120th St.
New Richmond Wi 54017 _te_-~
715-246-4516 ONDENCE
Date: 5/9116
Owner:Stuart Green
Location:NW 1/4 NW 1/4 S30 T30 N,R19W 1377 31st. St. St.Joseph
Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07)
Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01 /01 R. 10/12)
Page#
1. Cover Page
2. At-Grade Plot Plan
3. At-Grade Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and, ntigency plan
9. Filter Specificatioh
Attachments: Soil s
t
Shaun Bird
Signature
License nu r 226900
i V ED
9;
Page 1 of 9
PLOT PLAN
PROJECT Stuart Green ADDRESS 1377 31st. St. Houlton Wi 54082
NW 1/4 NW 1145 30 /T 30 NCR 19 W TOWN St. Joseph COUNTY ST. CROIX
SYSTEM ELEVATION 98.5'
DATE 5/9/16 BEDROOM 3
CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
BENCHMARK V.R.P. Top of well ASSUME ELEVATION wo, Filter SIM-TEC
❑ BOREHOLE O WELL :H.R.P. sameasbenchmark
Vent
Scale = 1/4" = 10, 3 Acre Lot Property Line
All piping shall be ASTM SDR 30134, within
31 St. St. 10' of tank, piping shall be ASTM F891
Failed drainfield
ST Tank is to be properly
bedded and provided with lockdown
covers with approved warning labels
Huffcutt Dose Tank
Existing
Bed roo m
House Wei 6% Slope
Wei I 0L B.M. B-1
99'
98.5'
9 8'
Grading is to be done B-2 B-3
to divert run-off 97.
away from system
Drainage Eaesement 200'
Area 15' below system is to remain
undisturbed x~
1 38th Ave Cal tJ~
At-grade System Sloping Site Cross Section and Plan View
E
t- Dimension Feet
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1- = Plowed Clean aggregate
C = 4 in. sch. 40 pvc
basal area to 2 ~/Z in. dia.
16 observation pipe
Lateral with 2" Topsoil Cap
aggregate over pipe
Geotextile Observation Pipe
- G'
With Cap
Fabric
-~q. f~ Ft Lateral lmcrt
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Ft Contour
_ _ r•r.~.~.r r•:•:•~
~1' r~rir~r~r•f J r•f•f ~
D Plowed Surface'-~-'
C
Slope Direction
GENERAL INSTALLA'T'ION: The at-grade area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a
moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to
forrrr a '/4 inch soil wire when a sample is rolled between the palms of the hands.. The A x B area is
covered by clean aggregate deposited overhead by a backhoe. Special care must be used when
placing the aggregate to minimize compaction of the plowed surface. After-the topsoil cap is placed,
the entire at-grade is seeded and mulched to promote vegetative gfow!th, limit erosion and protect
from freezing. The observation pipes are perforated in the lower 6 inches and secured in place.
03/05 lgj Page of
Pressure Lateral Layout
One Lateral - End Manifold
4- Threaded
Cleanout
Lateral Turn-up Plug
Force Main
X
L Long
Sweep
90
Bend
y~
0 r i t r G~ Pressure Svstem Construction
Distribution Network Specifications
Lateral Diameter Z In. Laterals are constructed of Schedule 40 PVC
Orifice Diameter 5j3 In. pipe. Orifices are drilled perpendicular to
'X Orifice Spacing) In. the pipe with a sharp drill bit and face down.
L Lateral Length) Ft. Lateral turn-ups terminate with a threaded
Force Main Diameter In. cleariout plug and are enclosed in a 6-8 inch
Force Main Length Ft. diameter lawn sprinkler valve box accessible
from finished grade.
Grade _:Q-
6-8 Inch Lawn
Sprinkler Valve
Box
03/05lgj Page of
Dose Tank Cross Section And Pump Performance Specifications
j Manufacturer Minimum Pump Performance Required
Tank Model Number 00 GPM S Ft TDH
Total Tank Capacity ( 3 t2
Max. Bury Depth 7-
Total Dynamic Head (TDI4) - Feet
Pump Manufacturer Elevation Head f
Pump Model Number J S Z Distal Pressure
Alarm Manufacturer - 3~
V Network Pressure Loss
Alarm Model Number Force Main Pressure Loss
Switch Type
I'n S Total $
Manhole Min. 4" Above Grade
With Locking Device
Vent Min. 12"
Above Grade Weather-proof
With Cap Junction Box 1
- - Finished Grade - -
Depth of Cover Ft Disconnect
~r/f1 T~ Means
r'r~Outlet
Inlet witch
Tank VSettings and Reserve Capacity-----
Volume
= - -
S GPI
t <
Dimension Inches Volume Gal. A >t
< - i
(reserve)A c2 _5 3 b s ' < ,/4„
r 2
` (alarm) B 2 3 i] g > < weep
(dose) C Hole
t ~s
(dead) D_ otal r - L7 Ft► '
<
T
't Bottom of Tank Elev. 8~ Z Ft D '
a ,
r > > a a > > > > a > > > > r > a > > > > > a a a a > > Y > r r > > > > > > > > > a a > > > e 2 2 2 t t t
{ < < i t < < t < i < i < < t < { t S S S S t < < t S < i < < < < C < < S S < < i < < < t < l < S S't'S t <><'t'<'<
GCNERAL INSTALLATION: The dose tank is bedded and back filled in accordance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the
manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have
an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved
material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or
sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the excavation and is sealed
watertight. Electrical service complies with NEC 300 and Comm 16.28 Wis. Adm. Code.
03/05Igj Page J of
T,-TA- ^,YNAM", r:cACJCA?ACiTY
PER 41NVTE
FHEAD CAPACITY CUR':'E -LUENT AND CEWATER NG
MODE' 152; 1 ~ MODEL I 1-2 153
I
W
~l ` I Fee: I deters Go!. Liters I Cc1I Leers
` i 5 09 251 7777 29-1
153 I I 70 1265 I
3..1_ 61 23'• ~
12-, 40 i52 i t5 a.5 I 53 I 201 61 231
I ~23 .1 E.1 1 44 157 52 197
a
z -t0-~- 25 7.6 34 t24 42 159
U
8 I 30 9; i 2! 87 33 125 1
r I I '4 I} - - "[2 85 r
40 12.2 i 2
1. 6m)'4 4-0 Fl. '';401)
4
01506
tU
2C• 4U EO 8C 100
_-LONS 6 1/4
LITERS 8'- 160 240 320 _ 3 27/32-4--- 4
LOW PER NINU E
27/32
CONSULT FACTORY FOR SPECIAL APPLICATIONS _
1 -1/32
• Timed dosing panes available. - '
Llectrical alternators, for duplex systems, are available and supplies with ^ _ L
an alarm.
• vanaae level control switches are available for controlling single phase I
systems.
• Double piggyback v&1able level float switches are available for variable -
level long and short Cycle controls. l li r
• Sealed Gtwik-Box available for outdoor installations- See FM1420.
• Over 130'F. 454°C.l, special quotation required. I i i l !
L I
1521153 Series
Control Selection
WAD MOD LS 5 1/6
I Mode V.65:Fh Node Am S lei I _Du !o-0
15 Non 2 sK2oe+
N152
BN152 etc jUp 8.5 2
t 2cr3 Non 4.3 S
~
L152 230 E 152 M t Auto 4.3 Inclu:eed 2o,3
N153 115 1 Non 10.5 2or3 SELECTION GUIDE
BN153 " 15 1 Auto 5 10.5 !ncw:ed 2 a 3 Piggyback variable level final
E1s3 236 1 Non 5.3 1 2or3 1. Singlepi93y~ck variable levetfloat switch ordouble Piggy
t3E1531 230 1 Auto ;_53 Inciudod 2 or 3 swath. Refer to FM04Ti .
A CAUTION 2. See FMD712 for correG model of Electrical Altentatflr E-Pak
All installation of controls, protection devices and wiring should be done by a qualified 3. variable level control switch 10-0225 used as a control amator, specify duplex {3)
licensed electrician, All FAecbkal and safdY codes should be followed includiay the most Of ;4) f~0at SySten .
recem Habonal Electric Code (NEC) and the occupational safety and Health Act IOSHA).
RESERVE POWERED DESIGN
For unusual ccnditicas a reserve safety factor is engineered into the design of every Zoeller purnp
HAIL TO: P.O. SOX 115347
Louisviie. KY 40256-0347 uam fzc; rersod .
SHIP T0: 3644 Cane Run Road AWRY /070r
O 1 t ..s' La6SvU1e. KY d~f 1-1961 QIIgL/rY JINCE /J✓J
923-PUMP
.p R. (502) T78-2731-1(8K, FAX (5021 774.3624
} PV~! fA
h nP :Iru v wn+rs o eu e.. coin
C Cooynght 2COO Zoeller Co. All nghts reserved.
~0~9
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
JLE INFORMATION
Owner YSTEM SPECIFICATIONS
Permit # Septic Tank Capacity
~i~ al D NA
Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter ManufacturerT
Number of Bedrooms ~ ❑ NA
DNA Effluent Filter Model v"~ ~ _ ❑ NA
Number of Public Facility Units E~ NA Pump Tank Capacity
Estimated flow (average) al C
Desi n flow 3`~d aUda Pump Tank Manufacturer ~ C3 NA
g n (Estimated x 1.5) al/day Pump Manufacturer 2 l~~ ❑ NA
'Soil Application Rate
i standard Influent/Effluent Qualify Month avers a/da m2 Pump Model SZ D NA
IY 9 ~ Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg/L
Biochemical 13 Sand/Gravel Filter O Peat Filter
Oxygen Demand (BODs) 420 mg/L ❑ NA ❑ Mechanical Aeration O Wetland
Total Suspended Solids (TSS) <150 mg/L ❑ Disinfection O Other.
!Pretreated Effluent Quality Morrthly average Di
Biochemical spefsal Cell(s) 0 NA
Oxygen Demand (BODs) 530 mgA_ ❑ In-Ground
Total Suspended Solids (TSS) a0 rngtL ❑ NA (gravity) D In-Ground (pressurized)
Fecal Coliform (geometric mean) 5104 cfu/100m1 >4.6t-Grade ❑ Mound
❑ Drip-Line ❑ Other:
'Maximum Effluent Particle Size in dia ❑ NA Other. ❑ NA
Other .
❑ NA Other:
'Values typical for domestic wastewater and septic tank effluent DNA
Other.
❑ NA
IAINTENANCE SCHEDULE
Service Event
Service Frequency
Inspect condition of tank( s) At least once every: O month(s)
Year(s) (Maximum 3 years) DNA
Pump out contents of tank(s) When combined sludge and scum equals one-third
of tank volume p N,o,
Inspect dispersal cell(s)
At least once every: 11 ~year(s month) s} (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: ~ ~ month(s) D
year(s) NA
i nspect pump, pump controls & alarm 4AAt least once every; 3 Cl r ear(s)
nt(s) ❑ NA
1=1ush laterals and pressure test least once every: 3 ❑ month(s)
ether. - > Lyear(s) ❑ NA
At least once every: 11 month(s)
ether. ❑ year(s)
11 NA
11 N~
MAINTENANCE INSTRUCTIONS
dnspections 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 inspection
iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure tolusmem o
ioombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal
'visually inspected to check he effluent levels in the observation pipes and to check for an g effluent he cell(s) shall surface.
The ponding of effluent on the ground surface may indicate a failing condition and requires nhreimmediate notificationn of the local
regulatory authority.
Nhen the combined accumulation of sludge and scum in an tank
i:he tank shaft be removed by a Se Y equals one-third (Jv,) or more of the tank volume, the entire contents of
Administrative Code. Ph9e Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
1411 other services, including but not limited to he servicing of effluent filters, mechanical or pressurized components, pretreatment units,
I3nd 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.
0
Page of
START UP ANp OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals theft
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of th¢
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 be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to thle
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels
within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area withln
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 the POW'M
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degnmwers; dental floss; diapers; disinfectants; fat: foundation drain
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produclis;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the P QWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code-
• Aill 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 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 with 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 complii*nt
replacement system;
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requirjed
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nged
for a new soil and site evaluation to establish a suitable replacement area, Replacement systems must comply with the rute$ in
effect at that time.
O A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
holding tank may be installed as a last resort to replace the failed POWTS.
Tate site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
t be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
u 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 ANDlOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSONiFROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Name ~w
Phone -7
"
7/ J , Phone
SEPTAGEISERVICING OPERATOR P PER LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone
This document was dratted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code.
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R A. S 00'13'56' W 1310.56'
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ST. CROIX COUN'YY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Maims Address ! 3 7
Property Address
(Verification required from Planning & Zoning Depmtnent for new construction.)
City/State Parcel Identification Number
LEGAL DESCRIPTION
Property Locati0U4/~ 1/4 //✓c,J '/4 , 3 y , T N R~? W, Town of J
5
Subdivision Lot #
Certified Survey Map # V(-,Iwne Page #
Warranty Deed # , 1 J , Volume , Page # ~
Spec house yea (no Lot line` identifiable (9p
SYS'T'EM MAUMNANCE AND OWNER CERTIFICATION
Imisoper use and mainte of your septic system could result in its premature &ihue to handle wastes. Proper
rnairttenance consists of pumping out the septic tank every three years or sooner, O '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 §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, signal 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 find of sludge.
Uwe, the undersigned have road the above requirements and awe to maintain the private sewage disposal system with the
standards set forth, herem, as set by the Department of Commerce and the Departzrlen t of Natural Resounxs, State of Wisconsin.
Certification stating that youi septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three ear expiration date.
Uwe certify that all statements on form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of a deed recorded in Register of Deeds Office.
7Number of
161
SI zo, APPL ANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department **'k
Include with this application a recorded warranty deed from the Register of Deeds C►ffice and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
_r
RECEIVED 5T _ G rb _ C;6% 1) A
MAY 10 2016
Wisconsin Department iffrecCROM COUNTY SOIL EVALUATION REPORT Page of
Division of Safety3"M01VrY pEVE4nO2ctSOh74R-.e with Comm 85, Wis. Adm. Code
County j ~ r?7
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
inciude, but not limited to vertical and horizontal reference point (BM), direction and Parcel 10
percent slope, scale or dimensions, north arrow. and location and distance to nearest road 01" - o2 1,13 - (72-
Please print all information. ZY Dat q~
Personal information you provide may be used for secondary purposes (Privacy Law, s 15 04 (1) (m)) vl;D
Property Owner Property Location
S / f- Govt Lot 114 M T N R E w
Property Owner's Mailing Address Lot # Block # iz~ii
NNamefor CSM#
3 Wit. t-.
City State . Zip Code Phone Number ❑ City ❑ Village Town Nearest Road
❑ New Construction Us esidential 1 Number of bedr Code derived design flow rate -Jy GPD
Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ZW= ft.
General corrrnents
and recornmendations:1 9
System Type/ System Elevation
❑ Boring # Boring -~1f 7 c f /
Pit Ground surface elev. , oft Depth to limiting factor I ~J in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD,"
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2
L/ -7
Boring # Boring
L in.
Il]~Pit Ground surface elev. ft. Depth to limiting factor
Soil Iicalxxl Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2
Z r 7. ~Y, S
~-c7 J
Mk-
I ~ ; ~ ~ ~ _ 5 s!~ rrI e4,7
Effluent #1 = BOD. > 30 < 220 mlyL and TSS >30 < 150 • Effluent #2 = BOD, < 30 "xA and TSS < 30 mglL
CST Name (Please Print) to CST Number
Bird Plumbing, Inc. Shaun Bird lle~A - 226900
Address Date Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 j - - i 715-246-4516
Property aomer Farrel 10 Page --of
Boxing # ❑ Bonng
FT EA-pit Ground surface elev,7, 5'-- ft. Depth to limiting factor - in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrff
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#'. 'Eff#2
o- (U r-,1L 11 C
1,12
,>7
Z 2- al
. 7r 5 sh 1 ~
❑ Boring # ❑ Boring
❑ Pit Ground surface elev ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cant Color Gr. Sz. Sh. 'Eff#1 'Eff#2
I
Boring
❑ Boring # Ground surfaceelev. ft. Depth to limiting factor in.
❑ Pit
Soil ication Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Eff lent #1 = BCD, > 30 < 220 nxYL and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
The DeparUrncn: of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need ma-.crial in ar alrrer-natc forma:. Please I:ontact the department at 608-266-3151 or TTY 608-264-8777.
SHD 1310 IR 60)1
i
Property owner Parcel ID # Page of
S,i,g,v El Boring
51 tgpit Ground surface elev99 tt Depth to lir v*V factor _-U- in.
Soil Rate
Horizon Depth Dominant Color Redox Description Texture Struch" Consistence Bounddary Roots GPDM
in. Mtnsell Qu. Sz- Cont Color Gr. Sz. Sh. 'Ef1#1 'E1192
a- I~ 31Z-
D # ° Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soul Rate
Horizon Depth OonunaM Color Redox Des~
Texh" Struch" Consistence Boundary Roots GPDRf
in. Munsell Cu. Sz. Cont Ccior Gr_ SZ Sh_ '01#1 'Eff#2
I
BM,g # ❑ Boring
❑ ❑ pit Ground surtace elev. ft. Depth to limiting factor in.
Sol Application Rate
Horizon "*)th Dort*nant COIM Redox Description. Texture Struetse Consistence Boundary Roofs GPDM
in. Munsell Qu. Sz. Cont. color Gr. Sz. Sh. 'E1f#1 'Ef N2
Effluent #1 = BODY > 30 < 220 nx L and TSS >30 1150 mg& ' Elfluert #2 = BODE 130 rrQ& and TSS 130 rnWL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the departrnent at 608-266-3151 or TTY 608-264-8777.
SOD4330 (R6U0)
S
i
Soil Test Plot Plan ,
Project Name Stuart Green Shaun
Address 1377 31st. St.
Houlton Wi 54082 (t5 1 #226900
Lot 7 Subdivision Deer Wood Date 5/9/16
NW 1/4 NW 1/4S 30 T 30 N/R19 W Township St. Joseph
Boring O Well PL Property Line County ST. CROIX
BNI or VRP Assume Elevation 100 ft. Top of well
System Elevation 98.5' *HRPSameasBenchmark
Vent
3 Acre Lot Property Line
Scale = 1/4. = 10'
31 st. St.
Failed drainfield
i
I
ST
Existing 3
Bedroom
House 6% Slope
Well ~ B M * B-1
99'
98,
B-2 B-3
97'
Drainage Eaesement 200'
138th Ave
ST. CROIX COUNTY ZONING O!~ U ICE
CERTI1`1CATION STATEI'IENT
FOR UTILIZATION OF EXISTING SEPTIC TA1'K(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the follo~\ ing residence:
(Street address) located
at: Section T&,vn N, Range
ToNvn of . St. Croix County Wisconsin.
Upon inspection, I certify- that I have found the tank(s), to the best of my
knoxvled,e, -vvill conform to the requirements of Conim. 84.25, and it (they)
appear(s) to be functioninL,, properlv.
-Most recent date of inspection or s0rvice
Did flow back occur from absorptian system'? Yes No
Of no, skip next line.
Approximate volume or length of time: gallons minutes
Tank CapacitN,:
Construction: Prefab Concrete Steel Other
Manufacturer if know-n):
A,e of Tank (if known):
Permit number o«-n)
(Liecnsod"- nber Siunature) (Print '.dame.)
(Title) (Liccnsc Number) MP,A4PRS
i Date)
Form to be completed by licensed plumber (Dept of C ommerce Chapter
rind s. 145.06.. Wisconsin Statutes) or licensed disposer (NR 11 1 ~?l-isconsin
Administrative Code)
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Wft t;
r, c ui
r ° ~ c
y cv O G obi
~ M
N r.
rI T T
o L: d
~y E V C ~ 3
L) n-