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HomeMy WebLinkAbout018-2021-06-000 'Adsconsin Cepartmen: of ';crnorercc PRIVATE SEWAGE SYSTEM Courty: St. Croix Safety and Build nq D vision. INSPECTION REPORT Sarita y Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State = an ID No: 584724 Perscna information you arovide may be used `cr ser.:~ndary purposes [Privacy Law s 15.04 (1;(mj Per It Holder's Name City V rage Township Parcel Tax No'. Oevering Homes LLC TOWN OF HAMMOND 018-2021-06-000 CST RM Ele; Insp- BM Elev R," Description Secbor.rTcwn N.=ngerMap Nj 08.29.17.1287 TANK INFORMATION ELEVATION DATA TYPE MANUFAC I URER CAPACITY STATION BS HI rS ELEV. Septic 3 Benchmark C. Dosing r'J Alt. BM Aeration' Bldg. Sev.'cr Holding StIHt Inlet -6 Cl TANK SETBACK INFORMATION Sb'Ht Outlet TANK TO PIL 'AFLL BLDG. vent W. Tyr Intake ROAD Dt Inlet ; Septic _ Dt Bottom Dosing f Header; Man Aeration Dist Pipe S " i - Holding Bot. System (0 73 PUMP/SIPHON INFORMATION Final Grace 1 , S 7. Z_ Manufacturer Demand St Cover r U GPM (,li Ct 3. Model Number l TDHI it Fricln"L( S System I Ieak-1 Tri J ` - 1 Forcemaln : ength Dia, to'A"ell SOIL ABSORPTION SYSTEM BEDJTRENCH Nidth Length No )t Trenches PIT DIMENSIONS No. C` Piss Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P;L BLDG V:ELL LAKFrSTREAM LEACHING Manufacturer. INFORMATION r'ipr Of SVS:em: CHAMBER OR V. •r -f C-. Ll . UNIT Model Nurse[: DISTRIBUTION SYSTEM HeadedMandold jPipLUCn x -cle Sze Hole Spacing lVer)t to Air Intake e(s; Length Dia P pth Dia Spacing r z i I~n ter' SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth C've, Dcptn O~;er xx Depth of xx SeededlSodocd xx Mulched Bed,-rench ;,e rter Bed Trench Edges Topsoil 'yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: l `~Inspection #2 Location: 1(546 1 p1 ST AVE /to F: i~,,, Gay 1 Alt BP.1 Description = / 2.) Bldg sewer length = .32- - amount of cover = r r• Plan revision Required? 74 Yes No 0 - Use oth er side for additional`information. SBD 671C (R.3197) Date nsepCert. No -X=Signat FIVE -IRE D ' Safety and But! -dings Division T • v i x: $ , MAY 2 5 201;' ~ 201 W. Washington Ave., P.O. ox ' l S 5 Perulit ?Jumbo Re be filled Q b} Co.) F Madison, WI 5S?0?-71 C2 i I~ UNITY DEVELOPMENT Q Sanitary- Permit Application s I to accordance with SPS 18; 142'), Wis. Adn: C:o&, subrnissinn of this form to the appmTriffie govcrnmeo-al unit required prior to ohtain= a sanitary permit Note:'kppiicati:rr forms for state-owned PUWTS are submitrsd to Prolect.Addr= "if d0erent [hen mailin} adriress) l the Department of Safe and Prulessional Servies- Personal irfornalion you provide clay be used for secondary I purposes in accordance watt the Privaey Izw s I ~ l Stets. L Application Informafion Please Print All lnformati IN S~ ale PToperrv Owna's Name. l / Parccl 'ropes' Owners Mwling Address - L 1 I11 Property Location n~ `I ) C' State 4i f Z: C~-1 G vL i,ot t i 1 Zip Cede Phone Number /S Section L_ y( circle ouSt, IL ype of Building {chec Zl that apply ~ T~ y N. R E R' i ii~ arrilyDweliing NurnberofBulroo J • Subdi sion Name n ~ t Brock k' J Pu6iic.K;ottlmercia] - lles...rbe L;se _ /}7l L,{ti , , , City of ❑ State ved - Describe Use _ CSM Nun,lxr Vi11a- of LJ -3 ~30 LL~ 5-e- Cs III. Type of Permit: (Check only one os on line A. Complete B applicable) - lbtw System Replacmert System L T7eauncnol-loldir.8 Tanis R iaeement 0Wv - ❑ Other Modification to Ex stmo System (:xplain) B. Permit Renewal Perrai' - Revision __j Change o_ Plumber I ❑ P__ Transfer to yam, List Previoas Perms Number and 1>a4 Issued -7 Be`cre Expirati on rv. « ylli-1 ~~~lt Type of POR"IS SvstemJC_.omooneny'Device: {Check aL that apply) - Non-Pressurized In-G-mand C Pres s: i[ed In- 31"Ouni r] At-G: ade C Mound 24 in. cf suitable soil 0 M,x n: 224 io. of suitable so Holding T:ak L (xtia Dspersal Co:npunent (expiair;) ~~✓S - ❑ YrareaCttrnt Device (explain) ~ V~ Dis~tsai;Treat ent Area toforma6on: [kslgn flo~+ oFdi Dcsigr Soil,4lrplicauoar/ - t) A .-ca Rcqured (s . Dispersal. rea Propose sf) S.•stem Elevauo❑ v'L Tank Info Capacity m Total rt of Tvtrtntri Gallons G-41lons Units v New ranks g ranks m _ - Sepde a HoidinE Tank V' using i.~h-&tr - - ~e-- ~ ~ ) - I X I - =TI. Responstbilit Stateme Y - 4 the undersigned, assu r onsibilicy for installation of the POGVTS shown on the attached pleas Plumber's Name (F'rwi) Plumber' %iii re / hiP,IA.g'RS Number Susmess Pboree N ez Ylutnber's Address (Street, ity, Sta'te, Zip ~ ~ _?L_- VIII. ; otv/De artment Use On)v P pprried Tove - ermrt Fee Date suex lssL°f t Signature L- C Av R:asou ix Drnial Lk Coaditi ep r,k, a a.cn~lvi~~pprov a f disper-:4 ceh must all q~e -_e`.4c1rs!:-1ntalr.% Jt iM►CO as per management plan proviaed t,y plumtnr, `S t^ .44 l Z. ~l'SE1l,QC{G (tQ4fit'E}11B11tS Mllltitt:ire t~alMFir'ed ~ n W tirKkmble code I atdlnanosls. Atrams in cumpietc piarn for the state© and sabmi- to the C ~uutp ante oa pap- our less char R 1- 7. 1 i tucir- rn siu SBD-6398 iR 1 ] A 1 i PLOT PLAN PROJE(°r Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Ri chmond Wi 54017 SE 1/4 SW 1/4S 8 /T 28 N/R P9 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 93.3/92.9/92.5 4.5' below grade 5/23/16 BEDROOM 4 DATE CONVENTIONAL IN-GROUND PRESSURE CONV4XIIONAL LIFT )00X HOLDING TANK 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 MOUND SEPTIC TANK SITE HOLDING TANK SIZE LOAD RA'Z'E .5 ABSORPTION AREA 1 217 # of chambers 60 BENCHMARK V.N.Y. Top of survey iron ASSUME ELEVATION too' Filter Lifetime Filter ❑ BORI{IIOLE O WELL » H. R. P. same as benchmark All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTN1 F891 Scale = 1/4" = 10' 425' Property Line B. N14. Scale is 1" = 40' unless otherwise noted 300' Property Line to be >5' from propety line HuffCUtt Combo Tank Vents 40' 30' 30' Drainage easement is to be surveyed Ven and staked prior to installation 40' Pro 4 4% Lope Bedroom House 4 B-1 50' Vent 2-3' X 122' cells with >3' spacing >6" Quick4 Standard B of Cover Leaching Chamber 97, 30 with 20.0 ft2 of Area 4 Long 12" 5.6ftA2/pair of end caps 98' ' Grade at System Elevation 34" 101st. Ave Septic-Dose Wank Cross Section And Pump Performance Specifications n anl• Manuf=u_Zr Pump Manufactwer Tunis Model ber 2s~Z7 / P M Total Tank Capacity as - - ~ P Model Number S3 _ I Max Bury U t}i Alarm Manufacturer - _LZ - - Alarm Model Number Switch T YPe r Filter Manufacturer r Total Dynamic Head (TDFI) -Feet Filter N[~del Number FuElevation Head ~U Distal Pressure - Network Loss - Miniinum Pump Performance Required ~ - Force Main Loss GPM Ft' IT7H I. - - - oral D; Outlet Manhole Min. 4" Above Grade With D Locking Device. Inlet Manhole fi~ LO Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight Seciirlely Mounted With Locking Device Weather-proof Junction Box % 'Finished Grade Vent Min. 12" Above Grade Di Means , With Vent Cap C Outlet Filter Inlet - -Inlet Baffle - - - Switch ett}ngs and Reserve Capacity ' : A > Tank Volume - 1/4' GPI Weep Dimension. Inches Volume Gal. Hole r B (reserve) A 06 (alarm) B 2 Off Elevation (dose) C Ft _ C dead)- D Bottom L Total D , Elevation GENERAL INSTALLATION: The septic/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 tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 304 and Comm 16.28, 02/05 L1 Page of JIB '•L^1L ,.'E - - ~ -_.",Ll -~I - tvodB; i J/ 3, ' 39 _ rvte~e~s _ ' S 4. I g i f A-Z)ff Hn;;c 19.25 ft. ;5 9-" j2 -i GALL fV`, ~C 4:. r- t Variable level float switches available. Variable level long cycle systems available. f - - Available with special cord lengths of 1. 5, 25', 35' and 50'. I - { Alarm systems available. ` Duplex systems available. sE ~I I 1 1 3. Single Seal Control Selection - - _ Listings Model Vats Phase Mode Amps l Simplex Duplex :CSA I UL h153155& MP;59 115 !n1e5a float Operated mechar Cal switch, Auto r0 exerna contrO N53& N5j t 1 -31 y 2 Single piSgybaLn-variable level float swi- C~h or double piggybar.k variable lave' _ B~~ 115 t Acts.-c-.7_ I j float sw fch, Hafer to Fh40477. -131', 57, 15 1 1 Auto 9.7 3Mecha nics altematOr "M•Pak' 10-C072 or 10.0075. 230 - ~ y 4. See ROW12 for correc. mode: o! ElWne- Alternator C -T- :5. VM & D57,59 230 48 s ,s `59 2 ~n » s Vanable level control switch 10-0225 sec as a ocntral act'va,D, v, t E!ec,rcal S r gle pggpback switch irdl dad- -1 2 3o,4&5 Y Alterna'or i 3; e' i;4 i float syste Fo*ntorrnationonaodao,~alZoeikerp-aL.c:sreterlccatalegolDi59poackVaiebleLeve F ,atSwitcies F61IA7T o c.urioN Electical .Altenamr, FMO48E; M-Chanical Alternator, FM0495; ce.np,Sewage Basirs, rh1C497; and Sirg a Phase Simplex FuT,p C•er,,VAlarrSyslens, FMW32 se`ec•• .c _ . For unusual conditions a reserve safey factor is engineered into the design of every Zoel er pLmp. Z MAIL TO., sox •F111, - - - - - f 1 = Lup Sallie, KY Y15c - SNIP T07 3649 C3.,* Ron Pva: 11an~.rac ure s ui iii.•LL"Lr L r/} Lcv,svsk. KY 46111-1967 0 /wn w.zceller.com SUMP L L/ _ (5O2) 778-P731- i (80C; 92& :oUbSP Q TY PUtlP9 ~N £ ~,~j~ Fa_X f592i 74-2024 J Capyright 2002 Zoeller Co. All rights reserved. - - - l Catillty I Safety erne 3'.:ildirtcs Division 5IX, t. 201 W. '+^Jashington Ave., Box '162 Sm u, ennit NtnnbG (TO be filled in by Co t $ , QR 2 !z) n" Madison, VJI 5~?G? 2 ~T ps. 4 CROIX COUNN 7~ --I PVELOPMENT CON 11,411 - Sta e T:aasagon ~1tgn'xr Sarutary Permit Application A4_ In wxordanee with SPS ?B-j 21Wis. Adm. Codc, u: nnissinn of this form to the a?PnTmate gevarrrentai unit - is rcquirc3 prior to obLUning a sanitary permit Note Agplicarion forms for sate pµncd Pt~W , s are Submitted tc Projen Add,ess (if diCterar: titan trailing address', the Department of Safety and Prof~-Ssiarsl Se-vies Personal information you provide may be used for seconda.7v ?t..-Mcses in 8u xdance 7,ifa the ?riraiv -taw s. 15.041Ig61. Stan. r^ / / h p 1. Application Information- Please Print All infortn_ation- CJ l IJ UU P opetty l1Wn°r'S Name Parccl n or 0 Propery C,%=-s I."mGrtg Address i Property Location U (1, i , lay 1 Ce r i UOvt L.nt _ City, State Ztp CCde ?hone Nwnbcr s 5ectiotl O l _ ,LTE U. 'ype of Building (check all that app) Lot M - - j Sabdi Sion Nano 2 Fatnr7y llwcS:m~~ -Number of 13edroo (1 Public)C:ommeacial - DestnU 7_ise \ J City of es - CS_MN bcr Vi,lage of _ State Owned - L>cnbe isc _ Town n: 111. Type of Permit: (Check only out box on line A. Complete line B if applicable) 4 .w System C Rcplat=nt System r -IT I menb'Holdirg Tank Rept Clay, Other Madificafionto Existing Systeno fcxP:xitt~ List Previous I'crrun Number and Date Issued B. ] Permit Renewal ❑ Permit Revision C'hangc f Plum PenT,11 Tramfrr L-. Nm- ` Bcforc =xpiration i mer t ~ L7L IV. Type ofPOWTS Srstetn_/Com ouenv'Device: Ch all a Iv`I N00-Presstrraed In-cnnunt L Pressurizrd in-i}rmmi Mound >24 um- of suitable soil ❑ Mound < 24 in of suitable soil ❑ holding Taak Ohier is ,al on +r. (ex lam l✓ Pretreatnmem Device (explain) V. Dis rsaVrreat nt Area Information: i / flow (,rpd) Desiga Soil Apph at;.m. Rate(b, f,, Dispersal Area Required {sr! Dispersal Area T..>p d 'r, S.rtern. iev J 7o 102- a, ~a ~VI. Tank Info Ca -Jll m TOW ; of Manu`acnr r. v :sa loft Gallons Ilnits J ' /QJ C New'Iaaks ~iisringTan3~ / / f :n Y I r~ ~c Septic or ii,ldrng Tank Josmg Chamber ~ ~ i VII. Responsibility Statement- 1, the undersigned, assum ms nsibility for fnstAlatiun of the PORTS Shown on the attached plans N 7 Pltnri 's'ame (Port-) Pl urmt cr's , e hT/hiPRS Number i Busumess Phoric _lZ ` Phmlber's Addttss (Str ity, rate. Zip Camde) L fl~ t f VIII. L no,/De artment Use Only i PWmr, Fc Datc sucal jcsuing ?p t :gnmum r I PPmvcd G env j 1 Clwn m'en Z~rsun fei )eni I s 70 y 1 Ilk Condit- err ~tsons for Dii sapproval ('OV r 1. Septic tank, effluent fllle• t 3) QJI' disper::ai cell must all be sp,41&Os ! n'r ntt~?t e~ r Q ~ ~ ~ACt~~+ as per management plan provided by plumber. 2. Al ~4 4W*-WWft most be tttOOF [gad i as W apF&mbW code I crdharcm. ku.1b t0 wmptex plans for nc* sy,;mm and submit w Cou~t~y Y~lv 62 7.Der lesss tbac a Ir z 11 iocbr, in tin J t SBD-ti398 {R. ;1 1 !'1 1► dr.. PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cerrohous Ave Suite A New Ri chmond W 5401 SE 1!4 SW 1/4S 8 'r 28 NIR 29 R` TOWN Hammond COVNTY ST. CROIX SYSTEM ELEVATION 93.3;92.9!92.5 4.5' beow grade DATE 4!23/16 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSL'RF CONVENTIONAL LIFT HOLDING TANK 1255 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK stzE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 12-7 ~ of chambers 60 f, BENCHMARK N .RA,. Top of survey iron ASSUrVIL ELEVATION 100' Filter Lifetime Filter I i BOREHOLE O WELL. *H_R,P, same as benchmark All piping shalt he. ASTN4 SDR 30.-34, within ~C~~~ _ ~ ~~ii _ ~ ~i 10' of tank, piping shall be ASTNI F891 .?~1. 425' Propert-~~ Line 13 Scale is 1" = 4W unless otherwise noted 300' Properly Line Pro 4 10' Bedroom ST 40' to he from House propety line 50' -2 Drainage easement is to be surveyedr ~0' and staked prior to installation i 4 /o SLope Vents 40' 5' Rentention Pond B-1 1; 0' V ent j >6„ Qu1ck4 Standard B_3 of Cover Leaching Chamber q^ • 30' with ?0.0 ft? of Area 5.(ift^2ipair of end caps 98' 4' loner 1 2. Grade at System Elevation 3 4" y 101st. Ave r Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/23/16 Owner:Oevering Homes Location: SE1 /4 SW1 /4 S8 T29 N,R17W 1646 191st. Ave Hammond Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Co ti gency Plan 7. Filter Cross Section l Signature License nurr,> "226900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernchous Ave Suite A New Ri chmond Wi 54017 SE 1/4 SW 1145 8 !T 28 NIR 29 W TOWN Hammond COUNTY ST. CROIX SYSTENI ELEVATION 93.3/92.9/92.5 4.5' below grade 4123/16 4 DATE BEDROOM CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1255 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE, LOAD RATE .5 ABSORPTION AREA 1217 # of chambers U Ilk BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL. x 11.R.P. same as benchmark All piping shall he ASTM SDR 30%34, within 10' of tank, piping shall be ASTM F891 Scale = 1/4" _ 10' =1~ 425' Property Line R. Nq. Scale is 1" = 40' unless otherwise noted 300' Property Line Pro 4 10 Bedroom S'l, 40' to be >5' frorn House propety line 50' Drainage easement is to be surveyed 30' R 2 and staked prior to installation 4`%o SLope Vents 40' 5' B-1 Rentention Pond 50' Vent 15' >6" Qu1ck4 Standard B-3 of Cover Lcachin_ Chamber 30, with 20.0 ft2 of Area 9' 5.6fr',2ipair of end caps 98' 4' Long 12" Grade at System Elevation 34" 10 1st. Ave POWTS OWNER'S MANUAL & MANAGEMENT PLAN , of FILE 1NFOI111ATION SYSTEM SPECIFICATIONS Owner Permit ;k t' 0 1 _ ^i Septic Tank Capataty 115 i ❑ NA Septic Tank Manufacturer ❑ IGN PARAMETERS Effluent Fiter Manufaoturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model O NA Number of Public Facility Units ANA 'Pump Tank Capacity NA gal Estimated flow (average) Q gal/day Pump Tank Manufacturer NA i Design flow (Peak), x 1.5) U aUda Pump Manufacturer NA ! Soil Application Rats , ❑ 4 5, O Pump Model i Standard Influent/Effluent Quality Monthly average Pretreatment Unit 0 ~A Fats. Ofl & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Fker &oc hemical Oxygen Demand (BODS) 5220 mg& ❑ NA 0 Mechanical Aeration ❑ Welt" Total Suspended Solids (TSS) x150 rg/L 0 Disinfection ❑ Other: !Pretreated Effluent QueW Monthly average Dispersal Cell(s) B*dwncW Oxygen Demand (Bobs) 530 mg& In -Ground 13 NA Total suspended Sdids (TSS) <_:30 (gravity) 13 In-Ground (pressurized) m9~ ❑ A -Grade ❑ Mound Fecal Coiform (geomftx mean) 5104 di,/f 00MI ❑ Drip-Line ❑ Other. !Maximum EfBuerrt Particle $ize in dia. ❑ NA Other - Other ❑ NA Other. a NA 'Values typical for dom@Wc wasbawatsr and septic tank efMrent_ Other. ❑ NA NTENANCE SCHEDULE ` -Service Event Service Frequency knsped condition of ms(s) At Iasat once every. ~ 13 month(s) 3 Vem) Q NA (Pump out contents of tank(s) When combined sludge and scum equate one-thin! (3fi) of tank vbhane ❑ NA Inspect dispersal cep(s) At least once every: mom(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once everyonu(s) ❑ NA nsped pump, pump corrtvls & alarm At least once every: ❑ nwnth(s) NA ❑ year(s) ;lush laterals and pressure test At feast once every- ❑ month(s) O ear(s) NA At feast once every: ❑rth(s) r - ❑ year(s) NA NA MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: (Plumber, Master Plumber Restricted Sewer POWTS Inspector, POWTS Maintainer; Se a Semi Include a visual inspection of the tank(s) to id P~8 ~g Operator, Tank inspections must Combi cludned entity any missing or broken hardware, identify any cracks or leaks, measure the volume of In sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersed cell(s) shall be hrisuaUy inspected to check the effluent levels in the observation pipes and to check for any ponding of eft*M on the ground surface. 'The ponding of effluent on the ground surface may indicate a fading condition and requires the immediate notificadon of the local regulatory authority. 0Aw the combined accumulation of skidge and scum in any tank equals one-third (36) or more of the tank volume, the entire c onterrts of the tank shay be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized Components, pre nt units. I nd arty servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. lk service report shalt be provided to the local regulatory authority within 10 days of completion of any service event pa" of START UP AND OPERATION ~ of painting products or other chemicals thO For new construction, prior to use of the pOWTS check treatmeit~lt )s) If high conce wl'~tratiorta are detected have the contents of th3 may Impede the treatment process aridlor damage the disperse tank(s) removed by a septage servicing operator priorto use. System start up shall not occur when sod conditions are frozen at the infiltrative surface. will b~ During power outages pump tanks may fbl above normal highwater levels. When power Is restored the excess wastewater will discharged to the dispersal eel(s) in one large dose, overloading the cell(s) and may rwult in the backup or surface disc mrge To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to tt* 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. the area within Do not drive or park vehiclw over tanks and dispersal cobs. Do not drive or park over, or otherwise disturb or compact, 15 feet down slope of any mound or at-grade soil absorption area. and prolong the life of the POVVT$: Reduction or elimination of the following from the wastewater stream may improve the performance dislnfedants; fat; foundation drain aribbiotics; baby wipes; dgsrette butts; condoms; cotton swabs; degreasers; dental floss; diapers: fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps, medicstlons; ob; painting products-, (sump pump) water, pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT shall be taken to insure that the system is propeiiy When the POWTS fails and/or is permanently taken out of service the following steps and safety abandoned in compliance with chapter Comm 133.33, Wisconsin Administrative Code:. • All 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 or their covers removed and the void space filled with soil, gravel or anoftm inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compri;ont replacement system: ~sultabie replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelrn. The replacement area should be protected from disturbance and Compaction and should not be infringed upon by requirred Setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neO for a new soil and site evaluation to establish a suitable replacement area. RePlaoement systems must cornply with the nule:t in effect at that time. ❑ A suitable replacement area is not avaitable due to setback and/or soil limitations. Barring advances in POWTS technologW a holding tank may be installed as a last resort to replace the failed pow -IS. C3 The site has not been evaluated to identify a suftabte replacement area. Upon failure of the POWTS a sort and site evaluation must be performed to kxate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the faded POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with time rules in effect at thet time. <<WARNi NG>> ENNTE A SEPTIC, PUMP OR _OTHERRTTREEATMENT TANI£ UND R ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS - POWTS INSTALLER POWTS MAINTAINER Name Name . Phone '-7 - - Phone SEPTAGE SERVICING PERATOR UMPER LOCAL REGULATORY AUTHORITY Name Name Phone Phone 7)j = /6 This doaumermt was dm tnd in compliance with chapter SPS 383.22(2)(b)(1)(d)&dfl and 383.54('l), (2) & (3). Wisconsin AdminWistirve Code. I J i i _ c i I j • ~ ,~I I V i ~ Y IL_ i C ~ `J P d P Q ~ ~ ~ I 1 o ~ Z ts~~ y~r mot= t x ! A J1 ^ .fV.V x•f~y,. LL- i ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OV1~NERSF-Up CERTIFMATiON DORM Owri T/Buyer - 4 ~ rj~~ f Q Mailing Address Property Address 4- (Verification required from planning & Zoning DeFaz~nett - for ne c nsttuction.) - City/,State Parcel Identification Number LEGAL DESCR1rP`I'IO ' t _D>~ - N Property Location ;~4 St t) t r ` 4, See . T N R / . G / W, Town of Subdivision. ,t -A - Certified Survey Map # Lot # - , Volume , Page # - Warranty Deed z Volume Pagu ~ Spec house es no - 1_.or lines identifabl < SYSTEM MAINTENANCE AND UwvER CERTI>F'iC A fIQ~~ improper use and maintenance of your septic, system could result ill its iaiTi~ w ha,ielle wades. maintenance consists of Pumping out the septic tarsk ever propel the system eau affect the function of the every three years or sooner, if needed, by a licensed responsibilities are specified in §Cornm. 83.52 lin kd as a is Chaptez 1l - Si. Croix Co pumper. What you septic treatrrient stage in the waste disposal system. Owner Y pat into maintenance The ro County Sanitary Ordinance. P Periy owner agrees to submit to St t_'a oix County Pisutniiig & Zonili De owner and by a master plurnber,.joume Wastewater disposal systeru is ' Yrnan P111mber, zestricted plumber or a licensed upnt a certification form, signed by the less than 1 /3 full of shidge. Pro1~ operating condition and/or (2) after inspection and pipea uVnpenins (if f fyi that accessary), the the sep le sepe P tic tank is Uwe, the undersigned have read the above requirements and agree to u~aintain the Private sew standards set forth, herein, as set by the De Certification sla A rent of C'orrurrerce and the Department of Na age disposal sYste'ri with the. Zonis ~ hng that your septic, system has been maintained must he uual Resources, State tate of Wisconsin g eparttnetit within 30 days of Ibc three year expiration date completed and returned to the St Croix County Planning & I/we certify that all statements on this form a tn,e to the Lest Ofrny'ow knowledge I/we am/are Property described above, by virtue of a anfy ed recorded in Register of Ileecis Uffi r the owner(s) of the Number of bedrooms IGNATT OF APPLICAI~;T(S) DATb7AF **"An info Y rmation that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department Include with this application a recorded waiTanty deed from the Register of DCedS Office and a copy of the certified surve refizence is made in the warranty (k-ed. y map if (REV. 08/05) IC p z C~ s 4 1r CD 1> O m t-V,' =1027.39 _ i-~v O ah to - s~ • 1ti' { f_ frl J„ _ r~~, 45.55' - k I Ir 175.00' I w~ 175.00' 75.57' I O N 89'20'53' , E 425.57'--- 3 LID m f cr) x B M 1. L r ON U= .l/•'" TRCN PIN z FI FV--1025.08' I G LOT 6 so., g 00, 2.85 Ac. (31 ~9 C,LOT 7 r 6Q s A5 S. / J ri c T~ i J l L'/ 0 h;?~ \ S 8C'3 '18" E 2C6.4 ~N 101ST AVENUE - = / - ` - - F- - J 89'34' 18' 4`'J 206.48' 26 .6 % 79.8 MON LOT 5 ~D I yy ~k o fa ' E ~ I - - MI , I I (ilp r I • I • • • I I _ _ b l~/ I r, e/ ~ I~ G I -r-= II 41 l I I . I 11 1 T.__T t i I I I I I k A 1 i i 3 gEi R ' it ?E. i I _ a3ed i fF } I I , I I , 8 ~ ~3 w _ i J J { ' w J ' _ _ W 111 ~1Rpf( ~ i I I I I I I I u o Q i~ Cl t l 'z U - Q 'I s _ L Y s u, ~ I i ~I a i Wisconsin Department of Commerce SOIL EVALUATION REPORT Page-,_ / of Division of Safety and Buildings in accordance with Comm 85, Wis. Aim. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County indude, but not limited to: vertical and horizontal reference point (SM), direCion and Parmi I.D. ~t f/ Z/ / _ U~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ✓ . D f~ Please print all information. Revi ed by Date 61 Personal mtormatron you provide may be used for .15.04 1) (m)). I 7112)167 Property Owner / Prope Location (9e 0 "vl /D tQ rota. l 1/4~ 114 ~ T2? ! N R E (o W Pro rty Owners hta" Address Lot Block # I S Name or CSMar City fate p Coce Ph e ❑ City ❑ Village Town Nearest Road New Construction Usex Residential / Number of bedrooms 3_ Code derived design flow rate GPD o Replacement ❑ Pu is or commercial - D scribe: Parent material - G L' c Flood Plain elevation if applicable /tom /r R. General oonrnents is cc.+. -.0- / and recommendations: System Type Svsiem Elevation 13,11 ~ !t Beiririg 5 Boring - 1 # Pit Ground surface elev. f~ ft. Depth to limiting factor LU in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 i r r 911 ~ Boring Boring # ❑ 7 d R Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sn. 'Eft#1 •Eff#2 2- I-L-Sj Ile I I- 177 8 rr 11 /,4 Effluent #1 = BOD > 30.< 220 rmgll. and TSS >30 < 150 mKA • Effluent 3t2 = BOD, < 30 mg/L and TSS < 30 mg~L CST Name (Please PrinQ Siy a CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Cate Eva uaiion Conducted Telepnone Number 1008 192nd Ave, New Richmond, WI 5401r' 15-24E-4516 7 - o r Property Owner _ Parcel ID Page of a Ong # ❑ Boring Pit Ground surface elev. / YJ eft. Depth to limiting factor in, mil Application Rate Horizon. Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz Cont. Color Gr. Sz. Sh. 'Eff#1 'Eft#2 ry r 3~- 2tln ;7_1 2 OIL 2- 1 u),,,s1,4 I Z- to M _ 5 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Snit Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsek Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor it. Soil Application Rate Horizon 'leplh Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ff in. Munseu Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 i i Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = 0005 < 30 mglL and TSS < 30 mg/L 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 department at 608-266-3151 or TTY 608-264-8777. sena~w ~ dao~ } Soil Test Plot Plan Project Name Oevering Homes LLC Shaun ird Address P.O. Box 179 i~r~✓~ New Richmond Wi 54017 CM #226900 Lot 6 Subdivision Hammond Hills Estates Date 6/2/07 SE 1/4 S W 1/4S 8 T29 N/R17 W Township Hammond Boring O Well PL Property Line County ST. CROIX BM or VRp Assume Elevation 10o ft. Top of Survey Iron System Elevation 93.7/93.3 *HRpSameasBenchmark 425' Property Line B. N1. Scale is 1" = 40' 300' Property line unless otherwise noted Please note: survey was not complete at the time of testing, installer must check all setbacks 30' B-2 prior to installation. 4% SLope 40' 40' -13-1 Rentention Pond 50' 25' /B-3 q ; 30' 98' 101 st. Ave