HomeMy WebLinkAbout026-1098-30-200
t'J:scor,3a [r Dalrnen! of C.omme-ce PRIVATE SEWAGE SYSTEM ' St. Croix
-afea and Buiidme Drvlstor
INSPECTION REPORT .,anitan Permit N:; ,
~g-/7 ~h D ,
GENERAL INFORMATION ~'=RP~1 T' State Plar IC Nc
Le-sona tnformat or voc provioE~ may i, csec i,• s-~',nrar DurocsE fin _ 'C.Oa ;1;;mj 7- 70
yoioe- RNre .r. V!;30- _ X 7;nvnMn Paroe. Tas Nc
aten a n 0 ZCo /67 -9 - 36 &6
-'s- BM Z'Iev
TANK INFORMATION ELEVATION DATA
TY::)= 4NUFA: Ti.IR F. ~APACi-l' STf.TI:7N BS HI FS V
i~ uttc IBe, an. 55 I ia~,s 1
t✓~~ /eac> SO /CSZS
I',0sing
'~3 C"--~ J T ~
Aeration Br^ Sewer
Lj ~ n %X1 1~ ZN
tioidinc _~I--• St;H inlet I,
TANK SETBACK INFORMATION
-AyNk: TC P/L 1q=LL A- mare ?:-;AD Jt Inge: 16 1 ! a~ ~y
V
'7(o Z -1 U: cotton
jS•~
~
3(c I
a~ Heaaen4Jiar. p G2 • X
IJI tn~ ~ I / J ! $ ~ D / J V ~ :
eraticr ` IG st. Pioe $ 5 1 3 0
- q C/,
Iholdin_ 60. System Z / 2 ?
7r 9, ~1 •
PUMPISIPHON INFORMATION Fina Grade Zc
7
Iaanufacturer -b G ! Demanc a Cov.r _ 3.9f
Mode Number
J
-DH Ft _ _
D7 1L = iatior _oss System H,-a^,
a •~7 3 z 5
"oroemain _en? DIEZ Gist tc UJeI dO~~ - - j
i
SOIL ABSORPTION SYSTEM
BED,TRENCH D/ _--m#l No C3`nch~ ~PrT DIMENSIONS Nc O` °its rnsloe c a lLlJLllCl De: tr
DIMENSIONS !l / 7 ` n `
SETBACK !SYSTEM -U C P!L BLDG WELL LAKE"STREAM L=EACHING Man.itacture--
INFORMATION CHAMBER OF,
Tf O ors` m. /Z / d~ 1 / r1 i UNIT tlooe. Nu Hoer
DISTRIBUTION SYSTEM /I )
IHeacar44pte- _c_trj1al-'r / 1 z Hoe Size ~I H01? Srac.nc vfn,, t. Ar intake
I eDptr Dc2 _ rptr G 1 3 ;na Srz ,rc V
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systerns Only
IJeot;^ "ever If)-ntr over jxi. D_cdn o: Seeaed'Scooec xr h,1ucned
i •ad i ien n ; inter 1 I Dec Trerrr -aces I soi = ye _ Nc N-
COMMENTS: inciude code dlscreoencr s oerson_ pr sent etc' inspection #L 5 13 ~-f+~/gyp ins0ecior ; L
Location: / ~ G k a t "-b n ' • O LAJ Parcel No:
AL BU Descnptlon = Cam a @ ~1 P to d Fe
- amount of cover =
='lar revision Reauire:: Yes l0 5 JQ ~3
Lse other side to, additiona information f V
Date Icseocto. Swrta _ Cer; No.
3Q-•-6'IC IF3`5'
RECEIVED CoumN
Safety and Buildings Division St. Croix
® MAY 10 2016 201 W Washington Ave. P.O. Box 7162
l
$ P Madison, WI 53707-7162 Saritan ?omit Number Ito be lill.d in h. (o
ST. CROIX COUNTY
rG 75 0
✓J
'NAT n
COMMUNfTY DEVELOPMENT
Sanitary Permit Application S z 1-'6-3`tat` IransactionNunber
In accordance w:t:'t MIS ,1 i. 21(-'l. 11 ;\dni. e~,dc. ,ubntis,4n Cl tit:, limn to the. appropriate ox.rrmental unit z t0 J !
required prior to obtaining a sanitan permit. Vote: App:ica:ion lornis for crate-owied 11011 IS arc sr+brnittcd to Proleet
t`+c Ckp uun.nt r t Sates ar.d Profe„innal S~ xices Pcnonal inf,i malinn you prneide ma} he used ti~r,ccondan Udres, (itdittc%nt than mailing, uddiessl 11tt
pur}tosC in accordance with the Pnvac, 15.04(1 i(m1. Slat,. sr tnf-7 ~ w I 1
1. Application InfornItliqp - Please Print ,111 Information
Properl Owncr's \arc Parcel
Karen Hanson v2&, ' /09 2049
Properiv 0v ner's %1ailitt_ Address Proaeils I ocation
1208 County E 0,1\1 53 1
,,ct Lot 0
Cry, State lip Coco Phone Nwnccr SW SNV Section 34
(cucle one}
New Richmond. WI 54017 715-781-1615
T ;u R-19 West
11. Type of Building (check all that apple) tot
X I or 2 I-ainik Dv%ellirL Nurihc[ d RL-dn,oct
This proposed system will sen e o 4e room
residential home. Block,;
Na I_ I Ci'} of
CSM Number ❑ V114mc of
x loon of 1ZIC11n1onC1
Ill. Type of Permit: (Check only one box un line A. Complete line B if applicable)
\c,c Sc,teni Replacement SWa nii Treahncn;iHoldin_ I tuck R,placcnicnt Only
E oihcr Ntodttiralion to Exislmg S%slent (expl, n i
z
1;• Pennil Renewal ❑ Permit Revision Lisi Precious Permit Nmtther and Date Issued
❑ change otPlunt'tier I Permit I ran,fer to Ness e l 4S 7
Before Gspiration (Miner
IV. Type of Pok I S SVStem!C'omponent!Dc%ice: (Check all that apply) O/fr I Z
\on-Pressurized In-Ground Pre,surized In-t:ircnnd S At-Grade Mound- 24 ut.01 :tntablc,oil Mound `a in ol'saitable soil
Halcin_- -rank Other I )i,pe,,:J ( nntponent (exphlin) ❑ Pretrcauttert[ Dc~1ce ;explains
V. Dis rersal,Treat cnt Area Information:
I);,.,m hloti, i~pd; Ue ign Aod `,;,pliration Ratc-(r_t d Dkper,al Area Required ctDtspcr.al :1rea :'ropu,ed. 1) Sxstent Flevatioc
750 (pd .6 1250 1250 92.30 ft
V1. Tank Info Cap:a:it} :n total ul \tnnul;tcuirer
Gallons Gallons I_.nns s _ -
to reV
New 1:111:. F%i,lim~ I:,r6,
Septic Tank l 0 1 1600 1 \V esrer X
Lift Tank 1 0 1150 1 Le« is Rjork ITC X
V l1. Responsibility Statement- 1, the undersigned assume res'peasihilih for installation of the PONNTS shoes n on the attached plans.
Plawhcr', Name (Print) Plum - m ) _ - dP+'N1PRS Numb._r Basincss Phone Number
LevVis Rjork 253976 71 ~-231-7375
Plus-her', Adcress (Street. Cilt. State. /ip ('.,del
1
1:7818 Countv Road L Menomonie. W"I 5475
VI11 nunW a artment t se Only
~ 'N~ sappnsscd Prnna ! ee Date k,ued Isuine A t Signature -
4ppr;ised
en Rea,on fix Denial S G 46,
IX. Condifi'46T'UAR rReasons for Disapproval t ~G
t. Septic; Lark, e'RX- tt blte, end 44 ,NA r A.
clisper..:, cell mus! all be s?+ acas ! rn ntarg5;
as per maragetnent plan provided by plumber. erM v
2. AN soft;* mgww ferns must be mainttririt d
n Pw,,PFali's c*de / ardinarim. v a(d~ ,met/ r 1
I I I I I
1 F `ELF ~lr1 f Poo 8
,.rrJ D'~' ft-!~%r, vvs.alvu-f ,5j" ~.~-•fi°- r~
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DIVISION OF INDUSTRY SERVICES
10541 N RANCH RD
HAYWARD WI 54843-6462
? S. Contact Through Relay
` P S http:;idsps.wi.goviprogramslindustry-services
www.wisconsin gar
t
Scott Walker, Governor
Dave Ross, Secretary
Mav 04, 2016
CUSTIDNo. 253976 ,477A. POWTSInspector
I EWiS C RJORK ZONI\G OFFICL
LLWIS WORK LLC ST CROiX COUNTY SPIA
E7818 COUNTY ROAD L l 101 CARMICH.AEL RD
MENOMONIE W( 54751-6637 HUDSON W] 54016-7708
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 0-5!04!2018 Identification Numbers
Transaction 1 D No. 2696239
SITE: Site ID No. 823029
Karen I lanson Please refer to both identification numbers,
I20S CfH 1_ above, in all correspondence with the agency.
i own of Richmond
St Croix County
S%V LA. S%V 14, S34, T30N, R I BS O~O`Tlr~
FOR: C pPRO\
Description: At ,grade, ` bedruom residence p` SAN
Object Tvpc: POWTS Component Manual Regulated Object ID \o.: 159625 t rpOf Maintenance required; Replacement system; 750 GPD Flow rate; 39 in Soil minimum depth to
limiting factor >~'otfi_ SSA
original grade: System(s): At-grade Component Manual, Version _2.0, SBD-10854-P (N.03'07, R. 1112), Prc-.Ta901- 0
Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01 01, R. 10.'12), SSWNIP Pub. 9.h; F,ffluent~F,ik-(ut4
Viva
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDI I IONALLY APPROVFD. This system is to be constructe
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. LL~'riP
The m iwr. as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code
requirements.
No person may en-age in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
Che following conditions shall be met during construction or installation and prior to occupancy or use:
Kev item(s)
• in the event this soil absorption system malfunctions so as to create a health hazard, the property owner MUST
follow the contingency plan as described in the approved plans. In addition, the owner must insure that the
operation, maintenance arid monitoring duties as described the At Grade Component Manual are complied
with. A copy of this inlurmatiun must be given to the owner upon completion of the project.
• l he proposed pump is ex.remely near its (Unit with the proposed total dynamic head. It upon installation, the
total dynamic head increases, the proposed pump must be reevaluated and may he inadequate.
Reminder
• The orientation of the at grade system must be such that the longest dimension is oriented along the surface
contour per SPS 383.44(6)(a)2.
• Limit activities in the area 15` beyond the down slope edge of the at grade per At grade Component Manual.
• Surface water drainage shal I be diverted awav from the system area.
• Materials shall conform to The requirements of SPS 384. SPS 384.10. No fixture, appliance, appurtenance.
material, device or product may be sold for use in a plumhing, system or niay be installed in a plumbing system,
unless it is of a type conforming to the standards or specification,, ofchs. SPS 382 and 383 and this chapter and
ch. 145, Stats
• The existing POW' I S must be properly abandoned per s. SPS 383.33 Wis. Adm. Code.
• lnsalate building sewer per SPS 382.30(1 1 )ic)-
A copy of tae approved plans, specifications and this letter hull be on-site during construction and open to
inspection by authorized representatives of the Department. which ma}` include local inspectors. All permits
required by the state or the local mull icipality shall be obtained prior to commencement of
construction installationioperation.
In grantina this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concernirt`l this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shal l provide a copy of this letter and the POW'TS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POW, I'S.
Sincere!%, Fec Required $ 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice.
Patricia L Shandorf Please Include a Copy With Your
POWTS Plan Reviewer , Division of industrv Services Payment Submittal.
(715) 634-78 10, I-ax: (715) 634-5150 . M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633
pat.shandorfi wisconsin._ov
cc: Edwin A Taylor. W'astcwalvr Specialist. (71 5) 634-3-18-1 . tilondar - Fricay 8:00 am To 4:30 prn
Note: Effective January 1, 2012, all codes under the jurisdiction ofthe Division of Industry Services (fort-net-IN
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
"SPS" to recognize the relocation of the Division of Industry Service,, from the former Department of Commerce to
Lie Department of Safety Professional Services. Additionally, all IS (formerly S&O) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Buildim= Code will be addressed
'L~% SPS Cha:!lcrs 360-306.
r
4 11s1
unless it is of a type conionning to the standards or specifications of chs. SI'S 82 and ,S_ and this chapter and
cr. 14~, Stag..
• The existing POW TS must be properly abandoned pe- s. SPS 38=.=: Nis. Adrr.. Cod-
• Insulate buildin_ sewer per SPS 38230 11
A aop~ oC the app-o~ ed plans. specifications and this letter shall ne on-site dt:rinc construction and open to
inspection bl, authorized representatives of the Department, which may include local inspectors. All permits
required by the state Or the loca: municipalitc shall be obtained prior to commencement of
construction"installation, operation.
In grantiq this approval the Division of Indusm Services reserves the 7i`h-. to require changes or additions should
conditions arise making them necessary for code compliance. As per state state 101.:2(?), nothing in this review
shall relieve the designer of the responsibilit\ for desi_:ung a safe building, structure, or component-
IncuL'leS concerning this correspondence maybe mad:: to me at -,he telephone number listed nelowx, or at the address
on this iettertead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner an-- any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Rcyuired S 250.00
I his Amount Will Be Invoiced.
ItiVhen You Receive That Invoice,
Patricia L Shando-f Please Include a Copy With Your
PC)A'TS Plan Reviewer, Division of Industry Services Daymen. Submittal.
X15) 6=4-7810. Fax: (7i5) 614-SISO , M - F 8:00 a.m. - ,:4; p.m. 'WiSWxRT code: 76:
pat. shandorl a-wiscorsin.gov
c;:. E1wht A Taylor, Wastewater Specialist, (715) 634-3484 ,Monday - Friday 4:00 am To 4:33C pin
Note: Effective January 1, 2012, all codes under the jurisdiction of the Divisior of Indusm Services (formerh-
Saferv & BuiAings) will be modified. Code references with prefixes stanhng with "Comm" have been replaced with
"SPS" to recognize the relocation of the Division of Industry Services froth the former Department of Commerce to
the Department of Safety R Professional Sen•ices. Additionally. all IS (formerly S&B;) codes have been renumbered
and addressed in a "300 series. For future refe-enc.e. the Wisconsin Commercial Building Code will be addressed
b~ SPS C;iantcr, X60 ?56,
}
RESIDENTIAL AT-GRADE DESIGN
-essurized - Sloping Site
INDEX AND TITLE SHEET
Project Ka-en Hanson Replacement At-grade design
Owner Karen Hanson
Address 1208 County L
New Richmond WI
715-781-1615
Legal Description SW SW 34 30 18W
Township Richmond County St. Croix
Suodrvisior Name na Lot No na
Pa•cel ID Nurrber Y
Plan Transaction Number SERV~~ iGr
Index sheet Page 1
Calculations Page
At-grade drawings Page 3
Laterals and ccse tank Page 4
Specifications Page 5
Management & contingency plan Page 6
Pump Curve Page 7
Plot Plan Page 8
Plot Legenc Pane
Att . Manho:e . filter tanks . soil report Pac
Designer Lewis Bork L cense Number
Signature Phone Number 715-231-7375
Date 04i 10116
Designed pursuant to
At-grade Component Manual 'pier 2 0 for P01,617S SBD-10854-P (N. 03107). and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01,81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)
Version 7.0 (03112) Page 1 of 10
PRESSURIZED AT-GRADE DESIGN
At-grade Design Worksheet - Sloping Site
Flows and Site Data Entry.
rl Residential or commercial")
0 Estimated wastewater flow igpol
750.0 Design wastewater flow (gpd)
8.00; Site slope
92.30] Contour elev. below lateral (ft.)
36.00 Depth to I miting factor (in)
___0.60; In-situ soil application rate (gpd1ft^2)
Distribution Cell Information
cr 1) Influent wastewater quality
10.001 Linear loading rate gpolft
10.001 Effective absorption width (ft)
10.00 Max effective width permitted (ft)
125.00 Aggregate length (ft)
Pressure Distribution Data Entry
c r;r e c Center or end lateral connection
2 Number of laterals
0.188 Orifice diameter (in) e ,q. 0.25
i 1.90 Estimated orifice spacing (ftl
2.00 Forcemain diameter (in)
4.43 Forcemain flow velocity ,ft/sec)
40.00 Forcemain length (ft) y or n y Does forcemain drain back?
Pump tank elevation (ft) y o, r Are laterals at highest point?
3.25 System head (ft) x 1.3 NA
ertical lift (ft) 6.5 Forcemain drainback (gal)
1.54_ ~riction loss (ft) 100.0 5x Lateral void volume (gal)
.00 Ir-line Filter Loss (ft) 106.5 Minimum dose volume (gal)
8.59 Total dynamic head ift) 43.4 System aemand (gpm)
Lateral Diameter Selection Gallons/inch Calculator
Pipe diameter cis.- 00x011, 1_:w~!; a, cno:.P Total Tank Capacity (gal)
s yn~ 1 n Total Working Liquid Depth (in)
seieci 1.25 in _ J ~Gal/in (enter result in cell G46)
ate a 1 5 r
2 r, x x Treatment Tank Information
x 16001 Septic tank capacity (gal)
;Wieser Manufacturer
Effluent Filter Information Dose Tank Information
Orenco _ Filter manufacturer 1150.0 Dose tank capacity (gal)
FT0822-14B-FSO Fi ter model n-amber 18.9 Dose tank volume (gal/in)
,Lewis Bjork Manufacturer
Pro ec*. Karen Hanson - Replacemeri. At-grade design
- rarsaction Number Page 2 of 1C
AT-GRADE PLAN VIEW
1- B Observat cr p pes (2 typical) A 10 OG ft
~D
D B 125.00 ft
1 116 B 20 83 ft
C 12.00 ft
1 v l c D 5 00 ft
E 2.00
ft
L 135.00 ft
B W 22.00 ft
A x B 1250.00 ft"2
b
I ~ac
Typical obs. pipe.
= Total aggregate celi A x B siotted m the lower 6° and
= Plowed area I x W archored securely
AT-GRADE CROSS SECTION
Svnthetic fabric cover
_ 94. 3 ft Finished -grade
Lateral elevation
i,ivert elev. 92.80 ft
Observation pipe
at aggregate toe
E
_ _ 8 % Slope
Surface cortour g2 30 ft ` C - F' and system D
elevaticn
= 12 in tapsai and subsoil \ Plowed layer
over aggregate and taperea to toes. below L x e
= 6 in. aggregate below
i
pipe(s), and 2 in above pipe.
Project. Karen Hanson - Replacement At-grade design
Trc nsactlon Number Page 3 of 10
PRESSURE DISTRIBUTION AND DOSE TANK
Lateral Diagram - Center Connection
P I
~?C=I I1-;13~I Liti-ral_ 6 f ifce main of P'dC Sch 40
per `;PS~ Table' "+8430.6
Last hr -le ~~rdl?~~ r,:.;.r r. ?rc :.p i
F'i,IF= dflll?d ]ri t hr t}i irfOR~ -rf 1f1 ate4al, ,
equallq-par_:e,J • =Turn-up -.-'gallvahrgor clesnoutplug
Lateral Specifications
0.188 Orifice diameter ;ir) Center Lateral connection point
x 1 89 Orifice spacing {ft) 2 Number late,als
33 Orifices lateral P 6' 43 Latera length (ft)
21.7 Lat discharge rate (gpmj 2.00 Lateral diameter (in')
2.00 Forcemain diameter i(in)
43.4 Sys. dlscl'arce rate {gpm j 410.00 Forcemain Length {ft;
8.59 TDH if-)
Typical Pump Chamber Layout
Approved manacle cover tvAh
]cti--r- 'atl•er- oo warning label and locking device
box
Final grade - 4
:isccrrect
Tack con ponent is 'A Alternate
properly vented outlet
ccation 18" min
E lectr cal as per NEC 1100 and Aooraved
SPS 318.300 WAC outlet
Tark full --Al f joint
Inches Gallons A P•ovide 1W
N
A 41.2 r 78 9 Alarm on 1 veep dole o,
B 2 0 37 8 B 0 art siphon
_ C 5.5 106 5 Pump on crevice
o D - 12.0 226 8 89 00 ft
Totals 610.8 11500
Pump off
D
3 dd r 88.00 ft
g mcertenk
Zohler Pump manufacturer jje-Rohmbus Alarm manufacturer
151 I Pump model nun-her TAAB Alarm model -Iumber
Project Karen Hanson - Replacement At-crade desicn
Transa,-tion Number Page 4 of 10
I
At-grade System Maintenance and Operation Specifications
Service Provider's Name Lewis Bjork LLC _ Phone! 7,15-231-73,,5
POWTS Regulator's Name St Cr-) x County Phone !715-386-4680
System Flow and Load Parameters
Design Flow - Peak 750 gpd Maximum Influent Particle Size 118 in
l=stimated Flow - Average 500 gpd Maximum BOD5 220 mg!L
Septic Tank Capacity 1600 gal Maximum TSS ' 50 mg1L
Soil Atsorption Component Size 1250.0 ft` Maximum FOG 30 mgiL
Type of Wastewater Domestic Maximum Fecal Col form -10E4 cfu/100 mL
Service Frequency
Septic and Pump Tank' Inspect ancror service once every 3 years
Effluent Filter Inspect and clean at least once ever 3 years
Pump and Controls Test cnce every 3 years
Alarm Should test monthly
Pressure System Laterals should be flushed and pressure tested eve 1 5 ears
Mound Inspect for ponding and seepage once every 3 years
OtherjCall Lewis Bork fo' Pumping 715-231-7375
Miscellaneous Construction and Materials Standards
1 Observation pipes are slotted and ma~erals conform to Table SIPS 384 30-1, have a watertight cap,
and are secured in as shown in the at-grade component manual.
2 Dispersal cell aggregate conforms to SPS 38430 Wis. Adm. Coce.
3 All gravity and pressure piping materials conform to the requirements in SPS 384, Wis Adm. Code.
4 T Ilage of the basal area a accomplished with a mold board or chisel plow.
5. The at-grade structure and other cisturbed areas wT be seeded and mulched to prevent soil erosion
znd help reduce frost penetration.
6.' Areas within 15 feet of the downslope toe will be protected from compaction
7 1,11 other construction details are as per the at-grade component manual SBD-' 0854-P (N. 03107)
Lateral Turn-up Detail
Finishec
Grade r
E;-8" Diameter Lawn - Threaded Cleanout
>prinkler Valve Box Plug or Bal. Valve
Distribution
Lateral
- Long Sweep 90 or Two
92.80 ft - 45 Degree Bends Same
Diameter as Lateral
Project: Karen Hanson - Replacement At-grade design
Transaction Number Page 5 of 10
At-grade System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
fns system shall de operated r accordance ~,itni SPS 1182-354'0:is. Adrr Code, and shall maintained in accordance with its'
component manuals [,,;Rn-1 nR54-P {N o3;r1% ssvvmp P_ui 9 6 tn1iu11 a t t'. Pressire nislribriliun ("":rnponpnt Manual Ver 2 0 S8D-
10706 (N. 01;01;) and local or state rules pertaining to system maintenance and mainterance reporting.
No ore should ever enter a septic or pump tank s rice dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with SIPS 383.33. VV s. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or Dump tank manhole risers. access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective. or
subject to faiure must be replaced Exposed nn-p- -perings greater than 8-inches in diameter shall be secured by an effective locking
device to prevent incidental n- unautl-nrizec into e tank coriccrent
Septic Tank
The sectic tank shall be ma rtairec by ar rd,vidual cert,fied 1 sen;ice septic tanks uncer s 28' 48. Slats. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis Adm -ode -he operating condition of the septic tank and outlet filter shall be
assessed at least once every 3 years by inspection
The outlet filter shall be cleaned as necessary to ensure proper operation The filter cartridge siculd not be emoved unless provisions
are made to retain solids r the tank that may slough off 'he filter when •emoved from its enclosure If the filters equipped with an a':arm.
the filter shall be serviced if the alarm s activated cont ruously. Intermittent flter alarms may rdicate surge flows or an impending
continuous alarm
The septic tank shall have its contents removed when the volume o` sludge and scum in the tank exceeds V3 the liquid voaume of the
tank. If the contents of the tank a•e not removec at the t me of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and s udge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance s general,y not required However, if such
products are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump {dosing) tank shall be inspected at least orce every 3 years All switches. alarms, and pumps shal be tested to verify proper
operation If an efflaert filter is installed v thin the'ank it shall be inspected and serviced as necessary
At-grade and Pressure Distribution System
Nc trees or shrubs shuuid be ulanted on tie at-grade Plantings may be made around the at-grade's perimeter, and the at-grade shall be
seeded and mulched as necessary to prevent e-osion and to provide some protection f,om frost penetration. Traffic (other than for
vegetative maintenances or ,he at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in -he winter will promote frost cenetration Cold weather installations (October-Februarys dictate that the at-
grade be heavily mulched as protection from freezing.
Influent quality into the at-grade system may not exceed 220 mgIT BODE 150 mgr[ TSS. and 30 mgtL FOG for septic tank effluent or 30
mg1L BOD5 30 mgeL TSS, 10 mg!L FOG. and 10` cfur1;;~ mL for highly treated effluent. Influent flow may not exceed maximum design
flow specified n the permit for this installation
The p,essure distribution system is provided with a flushing po rt at the end of ea-h lateral, and it s recommended that each lateral be
flushed of accumulated solids at least once every 18 worths Wien a press ire test is performed it shoo c be compared to the initial test
when the system was installed tic determine f orifice clogging ias occurred and if orifice cleaning is regwrea to maintain equa distribution
within the dispersal cell.
Observation pipes within the dispersal ce I shall oe checked for effluent ponding. Pending levels shalt be reported to the owner, and any
levels above 4 inches considered as an impending hycraulic failure requiring additional, more frequent monitoring
Contingency Plan
If the septic tank or any of is components oecome defective the tank or component siall be repaired or replaced to keep the
system :r proper operating cond:tion
If the dosing tank pump, pump controls, alarm or related wiring becorres defectve the defective component(si shall be mmediately
repaired or replaced with a component of the same or equal performance.
If the at-grade component fails to accent wastewater or begins to discharge wastewate, to the gmuid surface t will be repaired or
replaced in its' present location by increasing basal area f toe leakage occurs or oy renovating the bio ogically clogged absorption and
dispersal media, installing new piping, and ep.acing other components as deemed necessary to bring
the system rto proper operating condition
See Page 5 of this plan for tie name and telepnone number of your local POVVTS regulator and sevice provider
Project: Karen Hanson - Replacement At- Transaction Number Page 6 of 10
Ct?
PUMP PERFORMANCE CURVE
MODEL 15111521153
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GALLONS
UTERS 4'0 8'0 12 1 60 200 240 280 320 360
014508
FLOW PER MINUTE
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Plot Plan Legend
1) Building sewer > 30' of building drain (home) has > 42" cover
where snow is not removed .
2) Schedule 40 PVC entering and exiting concrete tanks.
3) Precast concrete septic tanks.
4) Effluent filter location
5) 24" Tuff Tight riser system brought min 4" above surrounding
grade.
6) 2" sch 40 pvc force main pipe
7) 24" plastic Tuff Tight dome covers with safety cover screwed
down as securement devise.
8) Vent - Inspections
9)Treatment -dispersal cell/cells
10) No issue with toe protection below the At-Grade
11) All wiring and electrical wiring materials per code
8-10
Effluent Filters
BiotubeO FT Series Base Inlet
Effluent Filters (FT) '
r ~ r. Sur s NBS„ I iii =~~,iaci' r Iters rento'~c alin~t b.~!r
encC 3 ni;be
thirds C' suspe;lded snlids ,ruin efflue~'.t helpinG extend dra;rfield',te.i're~f
have tha slow area of a `u',I-s' c flter i i a small packr,~e for,hort Sept r.
r,
Biotuhe~O = `=cries Base Inlet Effluent Filte's are instance ""Me
,c'nedUie 410 Or T'Xe jCjJa outlat pipe 1f a (le 'N 0~ ?:+.IStl~la Inn 4(. ~~iP,'y ~0 .
rritr P. f lter cartndge. PVC housing. and ar ?.xierdable P`1C !-andle..;n
;purnal a'ierf'o'h' Jlate is 2.,ra;lzcie `or 8 ~nCr(2C~~'-mml models. tC pr?vent
=ol+P ont from bypassrig to filter if 7t clr~gs.
• 3-inch &,-mm} noMnai filter diameter
. 1 a-inch (356-mv, filter height. stanaarc!
• ?^-inch c559-rvn: hojsinc ne ahl, standarn
• 1 5 'nCf, (3 m "i ::r 1: E• )rich 3-rnm; ,diet ❑-esh avitliable
. (;;xros,Cn-proof construction
. =xterdable handle
• _asv to clean
• -Ctional ovemlow plate availanie
diotuoe` Fr Series 89se ,pier Effluent Firers
. ijpt;enal float elbow availab~e k)[* high-level alarm asse^'tbI'
• digh-level alarm assembly; ordered separateiy IS09'F'eat S~°;itrn Ns
r~f~s° r rie udcct Carr rg Inforn atioe" section ;:i tnis catalog)
Sample Product Codes`
. y? 1 aR - c otr-,e f iter 8 -incr (N Mn: diameter.
^4-incr i356-'T rj titer I eicrt, base inlet
. '-X082'? t :B-P~0 - P";~tuoe',,' tdtcr 8-incf-(,2~"-mm;diameter,
e...va'Ir c~::~~ Installer
ago
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FlumbwN Product Hewew
P.O. Box 2658
( x+' ' ®s Madison, W kconsin 53701-2658
TTY: Contact Through Relay
Scan Walker, Governor
~"o+ Drve Ross, Secretary
June 28, 2012
LEWIS BJORK, LLC
LEWIS BJORK U
E7818 COUNTY RD E
MENOMONIE WI 54751 J
Re: Description: SEWAGE TANKS, CONCRETE
Manufacturer: LEW IS BJORK, LLC
Product Name: SEPTIC, PUMP OR HOLDING (TANK AND ADAPTOR)
Model Number(s): LB700, LB1150 (700 AND 1150 gals.)
[LB700 BASE TANK; LB1150 CONSISTING OF 3 SECTIONS WITH THE 450-GAL.
ADAPTOR AS THE MID-SECTION)
[38 IN. L.L., 18.85 GAUIN.; 96 IN. MAX. DEPTH OF BURY, 335 OR 551 GPD WHEN
USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL
WASTEWATER; TANK DIMENSIONS = 66 IN. L X 36 IN. W X 54 IN. H; ADAPTOR
DIMENSIONS = 66 IN. L X 36 IN. W X 24 IN. H]
Product File No: 20120193
The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance
with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin
Statutes.
The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative
Code. This approval is valid until the end of June 2017.
This approval is contingent upon compliance with the following stipulation(s):
• This tank must be designed to withstand the pressures to which it will be subjected.
• The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the
department's stamp of approval. The plans and specifications must be open to inspection by an authorized
representative of the department.
• All manhole covers terminating above grade must have effective locking devices.
• When this product receives wastewater from dwellings, it will produce an effluent quality with a maximum
monthly average value for BOD5 of less than or equal to 30 mg/L, TSS of less than or equal to 30 mg/L TSS and
F.O.G. of less than 30 mg/L.
• Bedding: Tanks must be placed on soils capable of bearing the weight of tank and its contents, when full. Soft
soils or bedrock must have 3 inches of tamped material, sand or gravel, 100% of which passes Y2 -inch screen.
• LABELING: This tank must have a permanent warning label as per s. SPS 384.25.
88D-10564-E (N.10197) File Ref: 12019303.DOC
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SEPTIC MANUAL -
GA-c 'DO/CO/CG IDATE POST-POUR:
Tuf-rite Riser S sY t
makes a full line of Risers and
Tuf- Cite accessories for Pre-Cast applications
as ~ ~.{r
~~x;,a Riser I .id - with Molded-in gasket-
20" and 24
p Available in 12, 16
diameters. Green Only.
Safety
Concrete Lid - with handle. Use the
pan to cast your own concrete lids-
Safety Lid - May be used in place of
Black
concrete lid. Fits 24" Riser Pan only.
Only.
ty pan - Safety Panim available for 16",
Safe
20" and 24" Risers. Green Only*
6" Tall Riser - For septic tanks. Stackable
z` in 6" increments. Available in 12", 16,
20" and 24" diameters.
a l~" Tall Riser - For septic tanks. Stackable
in 12" increments. Available in 20" and
24" diameters. Slack Only.
- mounting riser or lid to tank when casting-in is not an
Tank Adapter Rini,T For
option.
S'1. C12OI1 COUNTN ZO ENG OFFICE
CERTIFICATION STATE\1E\'T
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and,,or dose tank
presently servinc, the following residence:
(Street address) I Zo z, L- t Ft E located
at: I, SectionTo«-n jc~ N, Range NN'
Town of ~In St. Croix County ~NVisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge. will conform to the requirernrents of Conlin. 84.25, and it (they)
appean s) to be functioning properly
Most recent date of inspection o_- service
Did floNv ~acl: occur from absorption systern'' Yes \o
(if no, skip next line.)
Approximate volume or length of time: ~j gallons minutes
Tank- Capacity: l CX~>O ~L ~3ov
Construction: Prefab Concrete Steel Other
Manufacturer (if known): RU,
A,,e of Tank (ifkno«rn): ( 49)
fP 7'tjmber (if 1, o~vn) s-~6 S -o
(Licensed Plumber Si`nature) (Print Name)
t 'P
(Title) i;l.icense' umber) MP/-%1PRS
1 ~ zv t
(Date)
Form to be completed by licensed plumber (Dept of Commerce Chapter 5
and s. 145.06, A,'isconsin Statutes) or licensed disposer (\R 113 NNTIsconsin
Administrative Code)
Rcv. 9/2005
ST. CROIX COt NTY.
SFI'TIC 1'.\ K MAINT[ NA1\CI; AGRI IA'l[:NT
NND
OWNERSHIP CF.RTIFIC.-A ION FORM
()~Vtl~l' I31? lt' ~I.`>'~c' ~fVr S
Mailing Address /~C a~t. t z ti
Property Address
I Veriticatioa required from Planning. & Zoning. Department for new coniu action.)
Cit% StaLc Parcel Identification Number
LEGAL DESCRIPTION
Property Location Scc. 1 N R l W Town of -j
Subdivision Plat: Lot i!
Certified Survey Map # Volumc . Page
Warranty Deed # i helorc ?007)1V'AnTik: Page
Spcc itOttw ~es01o I cn line; identifiable Elyes❑no
SYSTEM[ NIAIITFNANCF. AND ONNAER CERTIFICA FION
lmpraper use and maintenance Of'%Our septic system cou.d r.;.Ilt in its premature Failure to handle wastes. Proper
maintenance consists of pumping out the ;optic tank every three rears or sooner. if needed, by a licensed pumper. W'hat you put into
the system can affect the function of the septic tank as a treatment stave in the waste disposal system. Ok%ner maintenance
re;ponsihilities are specified in sSPS S I ) and in Chapter I? - St. Croix Count}' Sanitary Ordinance.
The property owner agrees to uhmit to tit. Croix COMM Planning, & Zoning Department a certification form. signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying, that i I ) tile on->ite
wastewater disposal ys:em i; in proper operating condition and or i-1) after inspection and puntpin" ( If necessary the septic lank is
css than 1 3 full of slud!,e.
I we. the undersigned hake read the ahove requirements and agree to maintain the private ;e auc disposal system %%Ith tile
standards set forth. herein, as set by the Department of Safety and Proles ional 1,ervices and the Department of Natural RcsourCCS.
Statc of Wisconsin. Ccrtilication statin<~ that vnur septic system na: been maintained must he completed and returned to the St. Croix
C ounk Planning & Zoninu Deparuncnt within ?0 davs of the three year expiration date.
I we certity that all statements on this Corm are true to the hest oCim our ktim ledge. I w e am are the owner(s) of the
propel described above. b\ virtue of a warranty ud recorded in Roister of Deeds office.
Number of bedrooms
5 _j
i
SIGMA? T"'I IRF OT APPI IC AN I (S) DAT F-:
1 IAnv information that is mi;repre;rnt:°d may result in the sanitary permit being= revoked by the Planning A Zoning Department.
Include w-ith this application a recorded warranty deed from the Register of I )eed Office and a copy of the ccrtilicd surrey mar. if
I%terencc k made in the wan an:~ weed.
(REV. 04,' 12 )
RECEIVED
Wisconsin Department OfCommercMAY 10 2016 SOIL EVALUATION REPORT Page I of '
Division of safety and Buildings
ST. CRC~Y~dfMwith Cornm 85, VVis Adm Code
sQ0a? County st.croix
Attach complete site planes l ches in s ze. Plan must
include, but not limited to vertical and horizontal reference point ('BN1), direction and Parcel I. p Zov
pe,cent slope, scale or dimensions north ar^o~w~, and location and cistance to nearest road. oe (G ~Aastp
Please print all information. Revi d by Da/te P-1nal mfonnatic•i yc,, prr.iri~ nay he used for Sr; ordary ourroses ;P-ivacy _2 vv. 5- 15-04 I) f,m;'(-
~ ~ 1 t,
Property Owner Property Location M.
Karen l lanson Govt Lot "k' V4 1;4 ~1-1 T 30 N R 18 E (or) W
Property Owner's Mailing Address Lcd # Block # Subd. Name r CS-M#
I 208 ~ F 1== - 6d
City Stare Zip Code Phone Number 4ity ~ Village To.vn Nearest Road
New Richmond 1 54017 i 7.)';-781-1615
county L
F1 New Construction Use] Residential i Number of bedrooms , Code derived design flew rate 750 GPD
Replacement 0 Public or cernmercial - Describe: NA
Parent material Loess over out ash ti I I Flocd Plain elevation if applicab e ~:,4 ft
General comments Install neva Al - Grade on [lie 9-13' contour. use .6 loadin,, . 10' x 125' rock cell
and •ecommenda-ions:
zo~ ~
{
Will
Boring
P I Boring #
0 pit Ground surface elev 92.3 ft. Depth to limiting factor 39 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff
in. Munsell Ou. Sz- Cant Color Gr. Sz Sh -Eff#- 'Eff#2
1 0 IOyr,:; sl ?I'_rr mvfr cs ?f .6 LO
3 4-13 IO~r3 ? 51 1fsbk mvfr _s if .6 1.0
3 12_39 6 6 cost ?mshk mull a if G 1.0
fs Os,5 44-60 ,5vr5 6 rtrcosl l tsbk - - -
F P' Boring # Boring 9 I }0
Pi- Ground surface elev ft. Depth to limiting factor n
Soil Application Rate
Horizon Depth Dominant Co or Redox Descrpticr Texture structure Ccr•s stence Boundary Roots GPD;ff
in Munsell QU ST Cont Color Gr Sz Sh `Eff#1 'Eff#2
1 0-4 10-1-_ - I ~I 't I. mvfr cs ?f 6 1.0
4-12 1Ov 1-3'2 sl _'ishk mvfr US ?f 'I 111 .6 1.0
7.5-vil cosl 2msbc mvfr 1 t .6 LO
4 511 10\ r4,6 YS13R;'rcs. to hn:t; blade - - - -
Effluent #1 = BOD, > 30 < 220 mgiL and TSS >30 = 150 rtrg/L _ effluent #2 = BOD, < 30 mg!L and TSS < 30 ngJL
CST Name (Please Print) S.gnature CST Number
L LVis Bjork 25 3976
Address Date Evaluation Conducted Telephone Number
F7818 County F. Menomonie %V1 547151 4.8-2016 715-231-7,7,;
Property Owner I Janson Parcel ID # Page , of
Borirg
p-~ Bona # 92? 40 ® pit Ground surface elev I Depth to limiting factor ir.
Soil Ap Iica:ion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consisterce Boundary Roots GPDirt
in. Munsell Qu. Sz Cont. Color Gr. Sz Sh 'Eff#1 `Eff#2
1 0-3 10`r3 sl f<_=r mvti- cs 'f .6 1.0
2 3-13 1Ovr3i2 sl 2fsbk mvfr es 2f 6 1.0
13-40 7.5N r;,6 _ Cos] ?msbk mvfr "s I f 6 1.0
4 40-48 1Oy1-6,-2 FIF5yr5:3 f` - -
Boring # ❑ Boringi
o Pit Grounc surface elev. ft Uepth to lirniling factor in.
Soil Application Rase
Horizon Depth Dominant Color Redox Description -exture Structure Consistence Boundary Roots GPDiff
in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 -Eff#2
Boring
Boring #
Pit Ground surace e ev. ft Ueptt• :o limit rg factor in.
H Soil Application Rate
Horizon Depth Dcminart Colo, Redox Description Texture Structure Consistence Beurdarv Roots Gf'U;ft
in Munsell Qu. Sz. Cont. Color Gr. Sz. SI•. "Eff#1 -Eff#2
" Effluent #1 = BOD, > 30 < 22C mgIL and TSS 30 < 150 mg! L Effluent #2 = BOD, < 30 mg;L and TSS < 30 ntgiL
The Department of Commerce is an equal oppor;,utit% service pro% ider and cmplo,, cr. 11'.1, cv IIC::d assistance to access ser% ices or
need material in an alternate format. please contact the department at 608-166- )1 I or I Tl 008-'64-8777.
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