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HomeMy WebLinkAbout002-1024-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 584746 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2695578 Permit Holder's Name: City Village Township Parcel Tax No: Glenn Malcein TOWN OF BALDWIN 002-1024-10-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 12.29.16.168 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER •,a, CAPACITY STATION BS HI FS ELEV. -7 (e Septic 1 Benchmark C, I { " Dosing 7 AIL BM w L.WOO, r / it -f- . Aeration Bldg. Sewer Holding St/Ht Inlet Is, TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/t WELL BLDG. -O Air Air Intake ROAD Dt Inlet °r Septic `7 /aD f 27 Dt Bottom 2d.z ~ y Dosing / , ~ Header/Man. 7 / ~ ~dl G /06 It. - Oft. Aeration Dist. Pipe Holding Bot. System 1~ ~ ~ /~Z Z • o 16Z PUMP/SIPHON INFORMATION Final Grade 3, (p J Manufacturer Demand St Cover M UT GPM Model Number ~ b TDH Lift 7 77 t Friction L System Head TDH CJ 3. ZS Z(0 Forcemain Len Dla. Dist. to Well SOIL ABSORPTION SYSTEM -5, a". BED/TRENCH Width Length No. Ogren c e PIT DIMENSIONS No. Of Pits Inside Dia. T iquid Depth DIMENSIONS 'w 166 A 11_ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Ty~faJem: 16L A~/L UNIT Model Number: DISTRIBUTION SYSTEM C Header/Manifold 1AJDi / x Hole Size Ix Hole Spacing Vent to Air Intake l Pipe(s) Length -3Dia Length *16 Dia /1 5- Spacing 1 - t SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth 1XX Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 1 11L_ es No es No 7 r COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ! ~b Inspection AM- . tau! / r Location: 2681110THAVE 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = 4 Plan revision Required? ❑ Yes SeNo t ( 1 is ' _ 7] Use other side for additional information. 1 1 QO SBD-6710 (R.3/97) Date +.e ctor's S/ure Cert. No. V" r% County Industry Services Division st. Croix 0S 1400 E Washington Ave ~ MAY Q ~ Sanitary Permit Number (to be tilled in by Co,) 5 1 tl P.O. Box 7162 Madison, WI 53707-716 PMENT er)o Al All INIV anitary Permit Application '6 e1i,>„ Nnrnber In accordance with SPS 383 21(2), Wis. Adm. Code. submission of this norm to the appropriate gorernnrental unit 9 5575 is required prior to obtaining a sanrt u'y permit Note: Application torn., for state-o~N ned POW 1 S are submitted to the Department of Safety and Professional Services. Personal il-Iformation you provide na\ be u:.ed lin' secondary Project Address (if dittzrent than mailin_ address) ur poses in accordance with the Privacy s. 15.04(I)(m). Stals. 0 1. Application Infor tion - Please Print All Information Property Owner', Nan Parcel Glenn Malcein Do a OA CM0 Property Owners Mailing Address Property Location 1058 C ounty~ Road D Goct. Lot City. State Zip Code Phone Number N1 AV , "NSA' ' Section 12 Woodville. WI 54028 715-505-1446 (circle one) 129N1W : RW'f_:oryy' If. Type of Building (check all that apply) Lot =z 0 I or 2 Family Dtaellino -Number of Bedrooms Suhdicision Name . k 1A 1 - Block-- ~IVA-ae-S ❑ Public/Commercial -Describe Use ❑ City of ZtC ❑ State Owned - Describe Use ❑ vil la-e of CSM Nunbei k ~M / / IOVION ❑x Town of Balchvin 111. Type of Permit: (Check only one boa on line A. Complete line B if applicable) 201%G >5~ A. Z New System ❑ Replacement System ❑ TreatmenNholdin L lank Replacement Oilk ❑ Other Modification to Fyj.,ting Sy:titem tevplain) B. ❑ Pernit Renewal ❑ Permit Recision ❑ Change of ❑ Per nut I rursfer to Nee List Prec ious Permit Number and Date IYed Before Expiration Plusher O\+ner IV. Type of POWTS SvstenvCom onendDevice: (Check all that apply) U6AAb-Ljf- &V ❑ Non-Pressurized In-Ground ❑ Pressurized ht-Ground ❑ At-Grade ❑ Mound - 24 in. of suitable soil Mound 24 in. of suitable soil ❑ holding Tank ❑ Other Dispersal ( onponent (explain) ❑ Prctrcannent Deice (explain) s V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (sf1 Dispersal Area Purposed (sfl System Elevation 600 Rate(gpdst) .6_ /G~c~ W C~ _ ✓ V1. Tank Info Capacity in Gallons f Total oI = - - Gallons I nit; Manufacturer - v - \UNe Tauke t-.sixrin~ lanl.~ r_ f _ f^~ 1 Septic or Bolding 1 ank N 1400 Lewis Rjork LLC ❑ ❑ ❑ ❑ Dosing Chamber X 700 I Lewis Rjork LLc ❑X I ❑ ❑ ❑ ❑ VII. Responsibility Statement- 1. the undersigned.,assume esponsihilitr for installation of the PONVTS shoN%n on the attached plans. Plumbers Name (Print) Plumber's-srenatne - l?'~11PRS Nrunber Business Phone N!unher Al Lewis Rjork 253976 715-231-I75 3 Plumber's Address (street, City. State, Zip Code) F731S County Road F. Menomonie. WI 54751 VI l ounty/De artment Use Only Approved approo e( Permit Pee Date ssuc Issuing ; rot Signature T~i,1~w+ %en Reason till Dcni;rl 5640 ~Y A3 V-7 IX. Condig Reas ns for Disa > iroyal ► _ -A 10 ept rNN e!flcen; I i~t©* anri I I 31 lQ • T"1 ~K1 + ti c5 thspec:: cell must all be ~n tc.?s ! rn nta rec , a- Li/ as per management plan pro tided by plumber. (,vlY,i • l/ 2 IM. 4 must~amalntzir;Ed as pw appillicble code / ord'snaness. Attach to complete plans for the system am s mit to the County only on paper not less than 8 1/2 x I I inches in size SBD-6398 (R03/14) l L. - t - - I` IS. it of, 40 per x7.tirF~T DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD ~9~ HAYWARD WI 54843-6462 S Contact Through Relay P http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Dave Ross, Secretary April 27, 2016 CUST ID No. 253976 ATTN: POWTS Inspector LEWIS C WORK ZONING OFFICE LEWIS WORK LLC ST CROIX COUNTY SPIA E7818 COUNTY ROAD E 1 101 CARMICHAEL RD MENOMONIE WI 54751-6637 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/27/2018 Identification Numbers Transaction ID No. 2695578 SITE: Site ID No. 822952 Glenn Malcein Please refer to both identification numbers, 110TH Ave above, in all correspondence with the agency. Town of Baldwin St Croix County NW1/4, NW1/4, S12, T29N, R16W CC" FOR: P'PP Description: Mound, 4 bedroom residence t)F~)'T OF Object Type: POWT'S Component Manual Regulated Object ID No.: 1595969 S S 10 Maintenance required; 600 GPD Flow rate; 12 in Soil minimum depth to limiting factor from original grade; S~vtp#fj:~ Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Of Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructe i..--,7 and located in accordance with the enclosed approved plans and with any component manual(s) referenced above, 5F- CO 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 following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 24". The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. 0 Surface water drainage shall be diverted away from the system area per Mound Component Manual. LEWIS C WORK Page 2 4/27/2011,1 • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a. Copy With Your Patricia L Shandorf Payment Submittal. POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (715) 634-7810, Fax: (7 15) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. pat. shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm LEWIS C BJORK Paee 2 4/27/201:; • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Patricia L Shandorf Payment Submittal. POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday -Friday 8:00 am To 4:30 pm MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Res,c~Lnt c n i i, ct 01~ INDEX AND TITLE PAGE Project Name: Glenn Malcein- New Mound Design Owner's Name: Glenn Malcein Owner's Address: 1064 County D Baldwin WI 54022 715-505-1446 Legal Description: NW NW 12 29 16W I Township: Baldwin County: St. Croix Subdivision Name: Part of 98 acres Lot Number: Block Number: f jGES Parcel I.D. Number: Plan Transaction No.: l Page 1 Index and title , NDEN +i .ice ~St O Page 2 Data entry iPage 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot plan Page 9 plot plan legend Page 10 Attchments : Effluent filter / septic & dose tanks /manhole Page 11 Soil report Designer: Lewis Bjork License Number: 253976 Date: 04/04M6 Phone Number: 715-231-7375 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), 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 (R. 03/2012) Page 1 of 11 Mound and Pressure Distrgibution Component Design Site Information (R or C) r Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 600.00 Design Flow (gpd) 4.00 Site Slope 100.00 Contour Line Elevation (ft) 12.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highe_s_t_point in the distribution Y Pressure Disribution Information network? `rater Y or N J ° (C or E) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) - - 3.75 Estimated Orifice Spacing (ft) = 11.54 ft2/orifice 2.00 Forcemain Diameter (in) 20.00 Forcemain Length (ft) Does the forcemain drain back? Y~ ' f-; t 95.00 Pump Tank Elevation (ft) Enter Y or N 1 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) D~ 6.92 Vertical Lift (ft) 0.38 5x Void Volume (gal) Friction Loss (ft) 93.64 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) ~j 34.08 System Demand (gpm) ` 10.66 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in, dia. options choice 0.75 1.25 x 1.00 1.50 x x ~Q 1.25 x _ 2.00 _ 1.50 x x 3.00 2.00 x U' 3.00 x Gallons/Inch Calculator Treatment Tank Information Total Tank Capacity (gal) i f 1400.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Lewis Bjork LLC __j Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.00 Dose Tank Capacity (gal) Eorenco Filter Manufacturer 18.85 Dose Tank Volume (gal/in) I Bio-tube Filter Model Number Lewis Bjork LLC Manufacturer Project: Glenn Malcein- New Mound Design Page 2 of 11 Mound Plan and Cross Section Views T 10 B 1/ } - - J Observation Pipe - K A W L Mound Component Dimensions A 6.00 ft E 26.88 in H 1.00 ft K 11.74 ft B 100.00 ft F 9.50 in 12.04 ft L 123.47 ft D 24.00 in G 0.50 ft J 8.82 ft W 26.86 ft 600.00 (ft2) Dispersal Cell Area 1803.98 1t2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.79 (ft) H MEMO t G I 102.00 (ft)- F Dispersal Cell y 102.50 (ft) Lateral I invert Dispersal Cell. Q Elevation F D 1 1 100.00 (ft) Contour Elevation 0 4.0 /o Site Slope Geotextile Fabric Cover Shading Key Q T Dispersal Cell See lateral details on 0 ® Topsoil Cap o 1.5 ft - Page 4 for number, size, - Subsoil Cap w o and spacing of laterals. Q 0 ASTM C33 Sand 15 G F Laterals are equally Tilled Layer N t7 5 ft Tvoical Lateral spaced from the Aggregate It o © distribution cell's centerline in the - A distribution cell (AxB). Project: Glenn Mall New Mound Design Page 3 of 11 1 Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifold at ang point. Lateral= are identir.,l (I' f. P J der- A- 0= Turn-up YdbaII valve or y-. I ;,12 I xi2 41 ~rcernain ==cP 4i i F''' _ Lateral= fr cl ea nout pl u g : per F Table :3 .4.:70; , Holes drilled or, the bottom - ,F the lateral. Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.94 ft Lateral Length (P) 49.25 ft Orifices per Lateral 13 Lateral Spacing (S) 3.00 ft Orifice Density 11.54 ft2/orifice Lateral Flow Rate 8.52 gpm Manifold Length 3.00 ft System Flow Rate 34.08 gpm Manifold Diameter 1.50 in Total Dynamic Head 10.66 ft Forcemain Velocity 3.48 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC Disconnect 4 in. min. Tank component is properly vented F- Alternate outlet location Forcemain diameter Lewis Bork LLC Manufacturer 2 in. Capacity 700.00 Gallons - T Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons R siphon device A 23.17 436.71 B 2.00 37.70 C P♦ ump off elevation (ft) C 4.97 93.64 95.58 D 7.00 131.95 D Total 37.14 700.00 Dose tank elevation .(ft) 3" Bedding un er tank. 95.00 Alarm Manuafacturer SJE-RomBus _ ;vote. Switcnes Alarm Model Number 520-002A i containing met:;,.;rv _ may not be -sea n Pump Manufacturer IZohler his s el-, Pump Model Number 152 Pump Must Deliver 34.08 g p m at 10.66 ft TDH Project: Glenn Malcein- New Mound Design Page 4 of 11 Mound System Maintenance and Operation Specifications Service Provider's Name - - Lewis Bjork LLC Phone 715-231 7375 POWTS Regulator's Name - ---5 g__._ St. Croix Phone 715-386 4680- System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1400 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Others Lewis Bjork for Pumping Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Glenn Malcein- New Mound Design Page 5 of 11 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and 'pump tank abandonment shall be in accordance with SPS 383.33. Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owrier, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 11 PUMP MANGE CURVE MODEL 151/1521153 14 . 7 i ? Q 12 a y t g 9 25 a E l ~ s b 3 4 N 0 20 3 E. p 40 50 60 70 i 40 80 120 160 Zoo 240 280 320 360 SLOW PER MINUTE . I! v lfl r.r L, _ - 41 \ ~ '-fem. . ~ ~ f ~ 3 i 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) All wiring and electrical wiring materials per code 9-10---------Glen M a l ce i n • 1 Effluent Filters Biotube® FT Series Base Inlet Effluent Filters (FT) Orenco,'~ Biotubeo FT Series Base Inlet Effluent Filters remove about two- thirds of suspended solids from effluent, helping extend drainfield life. They have the flow area of a full-size filter in a small package for short septic tanks. Biotube` FT Series Base Inlet Effluent Filters are installed on the Schedule 40 or Type 3034 outlet pipe of a new or existing tank. They come with a filter cartridge, PVC housing, and an extendable PVC handle. An optional overflow plate is available for 8-inch (200-mm) models, to prevent effluent from bypassing the filter if it clogs. ' • 8-inch (200-mm) nominal filter diameter • 14-inch (356-mm) filter height, standard • 22-inch (559-mm) housing height, standard • 1/8-inch (3-mm) or 1/16-inch (1.5-mm) filter mesh available • Corrosion-proof construction "WOO • Extendable handle ' • Easy to clean • Optional overflow plate available • Optional float elbow available for high-level alarm assembly Biotube' FT Series Base Inlet Effluent Filters • High-level alarm assembly ordered separately (see "Float Switch As- semblies" in the "Product Ordering Information" section of this catalog) Sample Product Codes* • FT0822-14B - Biotube`^ FT filter, 8-inch (200-mm) diameter, 14-inch (356-mm) filter height, base inlet • FT0822-14B-FSO - Biotube"~ FT filter, 8-inch (200-mm) diameter, 4-inch (356-mm) filter height, base inlet, overflow plate installed For the full range of standard options, see the "Product Ordering Information "section in this catalog. F9x N0. S41 459 2884 O Q N .C N N 9 1 m N~ _J 0 Y } r1o IL to ! lope" LXv" LEVEL aunFr ^ o OWLET In n Qt q i3tER O _ 720 as f ~'6 64,D 720 SECTION A--A 1°" L 244--T END VIEW ieo ~.o leo F LB 700 a F2TER TANK SPECIFICATI13NS A I 4' REMIND cuc WIA I.S NANHMZ S4 -p,~CAST RLSfR itaET ourL~T LElsft 72" an VISTK 7E' pa m/1.ET n'IVER't+ 4i' OIlT! ET F~IVERRT' a.T4lBD LEVW 0 Lam" DESAm B•-0• UNSATUi011TE8 SD$_ 18.85 CiALLOiS PE'!t yQtT=,ti BCjl B4IDE TANG FER USE AS PUM'/SEPTr/FoLji TANG +[RE fWBONTHN AVAILABLE COWAM LE W= I OW a b4.Q 72.0 PLAN VIEW TQP SLAB FLLEWIS B J D R K l L. L C NIT TO SCALE Al~GUST 20, 2012 041E, VI DRAWN By. ,JCp 7-lo Tuf-Tite Riser System Tuf-Tite makes a full tine of Risers and accessories for Pre-Cast applications. Riser Lid - with Molded-in gasket. Available in 12",16", 20" and 24" diameters. Green Only. Concrete Lid - with handle. Use the Safety Pan to cast your own concrete lids. Safety Lid - May be used in place of concrete lid. Fits 24" Riser Pan only. Black Only. Y Safety Pan - Safety PanTM available for 16", 20 and 24" Risers. Green Only. 6" Tall Riser - For septic tanks. Stackable in 12»1 6» > Available in 6" increments. 20" and 24" diameters. 12" Tall Riser - For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring - For mounting riser or lid to tank when casting-in is not an option. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code County St.Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. P/ease print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s 15 04 (1) (m)). Property Owner Property Location Glenn Malcein Govt. Lot NW 1/4 NW 1/4 S 12 T 29 N R 16 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1064 County D - - Part of 98.1 City State Zip Code Phone Number City Village ■ Town Nearest Road Baldwin WI 547022 ( 7~5-505-1446 110th ave El New Construction Useo Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ® Replacement ri Public or commercial - Describe: NA Parent material Loess over scl / till Flood Plain elevation if applicable N 4 ft. General comments Install new mound system on the 100' contour , use 2' sand lift 6' x 100' rock cell and recommendations: P I Boring # ~ Boring Q pit Ground surface elev. 100 ft Depth to limiting factor 12 in. Soil Ap lication Rate Horizon Depth . Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~Eff#1 `Eff#2 1 0-4 1Oyr3/3 sit 2fgr mvfr cs 2f. .6 .8 2 4-6 10 r3/2 sit 2fsbk mvfi• gs If .6 .8 3 6-12 7.5yr4/5 - sit 2msbk mvfr gs if .6 .8 4 12-24 7.5yr4/6 C2P5yr5/8, 1Oyr6/z scl Imsbk - - - - P2 Boring # ® Boring 99 12 0 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/t in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-4 1Oyr3/3 sit 2fgr mvfr cs 2f .6 .8 2 4-6 10 r3/2 sit 2fsbk mvfr gs 2f/lm .6 .8 3 6-12 IOyr4/4 sit 2msbc mvfr gs If .6 .8 12-24_ 1 Oyr4/6 C2P5yr 5/8. 1 Ovr6/2 scl 1 msbk _ - - Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Lewis Bork 253976 Address Dat6 Evaluation Conducted Telephone Number E7818 County E Menomonie WI 547~>i I 1' i ~h~'15 715-231-7375 Property Owner Malcein Parcel ID # Page 2 of 3 F p3 Boring # ®Boring 100 ft 12 ■ pit Ground surface elev. . Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 1Oyr3/3 - sil 2fgr mvfr cs 2f .6 .8 2 3-6 10 r3/2 - sil 2fsbk mvfr as 2f .6 .8 3 6-12 1Oyr4/4 - sil 2msbk mvfr 5s if .6 .8 12-24 1Oyr6/4 C2P5yr5/8, 1Oyr6/2 scl lmsbk - - ❑ Boring # F~ Boring m. Pit Ground surface elev. ft. Depth to limiting factor in. Soi! Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fig in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # Boring r7m 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/fig in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L 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 608-266-3 15 1 or TTY 608-264-8777. SBD-8330Test (R.OT00) _ 1 t'J J 4 r 1-0 j C r ,t AN Q- 0 _C; Nil ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer AA l G 6 C, e- I Mailing Address Property Address <6 I I A,,, (Verification required from Planning & Zoning Departmen for i1 construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location NIA) '/4 '/4 , Sec. J Z , T n N R I ~ W, Town of Subdivision Plat: Lot # Certified Survey Map # Volume Page # Warranty Deed # (before 2007)Volume Page # Spec house ❑yes❑no Lot lines identifiable ❑yes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Oft-ice. Number of bedrooms /-6 SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 64/12) r: r clst-d,j6 Vtrq Wisconsin Department of Commerce , +~w o '~AY OIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings S7.. © J Zola COMM OR cordanY'e with Comm 85, Wis. Adm. Code utgy O(~ County St.Croix Attach complete site plan on paper not IA'' x 11 inches in size. Plan must include, but not limited to: vertical and horizontal a¢Ipoint (BM), direction and Parcel I.D. D - Please slope, scale or dimensions, north arrow, and location and distance to nearest road. D V ((J0 (J Please print all information. Revi d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Glenn Malcein Govt. Lot NW 1/4 NW 1/4 S 12 T 29 N R 16 E (or)OW Property Owner's Mailing Address Lot # Block # Subd. Na or CSM# 1064 County D - - Part of 98.1 City State Zip Code Phone Number City Village Town Nearest Road Baldwin WI 547022 ( 7)5-505-1446 110th ave New Construction User Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: NA Parent material Loess over scl / till Flood Plain elevation if applicable ft. General comments Install new mound system on the 100' contour , use 2' sand lift , 6' x 100' rock cell and recommendations: 11 Boring P 1 Boring # n Pit Ground surface elev. 100 ft_ Depth to limiting factor 12 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f ` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr3/3 sil 2fgr mvfr cs 2f- .6 .8 2 4-6 10 r3/2 A 2fsbk mvfr as if .6 .8 6-12 7.5yr4/5 - sil 2msbk mvfr gs if .6 .8 4 12-24 7.5yr4/6 C2P5yr518, 1Oyr6/2 scl Imsbk - - - - - F 1-7 p2 Boring # Boring 99 12 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. Sh. *Eff#1 *Eff#2 1 0-4 1Oyr3/3 A 2fgr mvfr cs 2f .6 .8 2 4-6 10 r3/2 sil 2fsbk mvfr as 2f/Im •6 .8 3 6-12 IOyr4/4 sil 2msbc mvfr as if .6 .8 12-24 l Oyr4/6 C2PSyr 5/8. 1 Oyr6/2 scl I msbk - * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Lewis Bork 253976 Address Dat6 Evaluation Conducted Telephone Number E7818 County E Menomonie WI 54751, s~2~15 715-231-7375 Property Owner Malcein Parcel ID # Page 2 of F 3 Boring # ® Boring 100 12 p 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/fig in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-3 10yr3/3 - sil 2fgr mvfr cs 2f .6 .8 2 3-6 10 r3/2 - sil 2fsbk mvfr gs 2f .6 .8 3 6-12 10yr4/4 - sil 2msbk mvfr bs if .6 .8 12-24 1 Oyr6/4 C2P5yr 5/8, 10yr6/2 scl 1 msbk - - - - - Boring Boring # 11 p C~ c F-1 ; Pit Ground surface elev. ft. Depth to limiting factor in. Soi. Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 Eff#2 a Boring # Boring ® Ground surface elev. ft. Depth to limiting factor in. Pit 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 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L 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. SBD-8330Test (R 07/00) _ t, J J Z VI)l { 11Q, ti. ~ t p f, s ct - i W 1 r i J i _ I i 1 9 N eke P - p i S i 'Al c ~0 I S