HomeMy WebLinkAbout026-1020-40-000
AT.'°F,':"t`r ;-W Of r.on--r- PRIVATE SEWAGE SYSTEM `ot ntV St. Croix
Sa`c~y and °_,rildinq Division INSPECTION REPORT °ani7ary hermit h0.
584782
GENERAL INFORMATION (ATTACH, TO PERMIT) ' tate Plar ID No
Pe-sOral ~nrormaton you provide nay he u;ec for secrndary purposes (('rivacp Law. s.15.04 l iimj) Permit Holcers Name Cit; village 'ovnsrip Parcel -ax No,
Paul Sisson TOWN OF RICHMOND 026-1020-40-000
DL Hrd Elev rs:: RM Elev RM script n Sector,Tcwn,Range;Map No:
1 Q , t 06.30.18.72C
TANK INFORMATION ELEVATION DA1h
TYPE IvIANUFA':;_URER CAPACITY iTATION Dn hl LS ELEV.
Se^1ic Ad .5'93115S 1°X~S~ I AI benchmark ~D
Dosrg Hu Alt 3tv1
In
Adc26CR Elde Seaver
~ L I ~ J 1 M 1 Z stet It Inlet
TANK SETBACK INFORMATION Ht ..~et ./0.19
TANK TC F.1L WITI I R 17G vent to Air Intake ROAD ~DNnlt.
11 l 9
Sec:ic Dt Bo:tom 1 y.9 . d
Dcsinq ) t He rlMan O
[Hc tion Dist Pipe Z
' 45fe I Jn Ce
ng
Pr 5'. '77 Be t. system
7
PUMP/SIPHON INFORMATION Fria! Grade
Z.
Manufacture, Demand St Cover
Model NLmber y 1 1
TDh Lift 0' n Fr Ilion 12Fss System Head i _)H Ft 6 6 j n5 c
Forcemain _ength .n ia C St. to well ! `7 I
SOIL ABSORPTION SYSTEM K( S-f S- f S- i r 3
BEDITRENCH '.^iieth , Le^ctr t No. Of Trenches PIT DIMENSIONS No t)t Pits Ins de C a. Liquid Depth
DIMENSIONS ] i i
SETBACK SYSTEV TC ✓ P!I BLDG s:ELL LAKE/STREAM LEACHING Manufacturer Q ~r
INFORMATION
T .;I'-. ')f Systc CHAMBER OR MVI GEC /U~
• ~Jbi&L ~ tr2_I ' ~Z' N~ UNIT Model mber
DI IBUTION SYSTEM D
eaden anifo d D stnhuLnn le ; ze IN Hole SFac ^a v'e^t to Air Intake
I Pipe(sl
fen~tn_M I Len h D~
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 44
Ceptr vier ~~~111 7 I Dept-1 tive' Dcet r` .:x .ulrhe
Eedllrench i:enter Rcd;T•ench Edges / T-pso~l - -
r?s NO X_ 1eS No
COMMENTS: (Include code d:screpercies, persons present, ex.) InspFC•inn 01 Inspection #2: V
Location: 1 ir,3 95TH ST F X s fi1}npU~l►~ ~ &J' -
1) Alt BM Description = J 1 ' V~ { u 4'" J
Bldg sev:e, length = aha~clb
- amount of rover
Plan revision Required? Yes~lo
Use other side for addit oral informatpfr
SBD-6710 (R.3A7) Dare I got s Sigratu Cert. No.
PLOT PLAN
PROTECT Paul Sissor ADDRESS 16074 2rd St. N Lake:and %1n 55043
MV Ii-1 NE I!-I5 6 r 3Q NiR 18 w TON,N' Richmond COUNTY ST.CROIX
SYSTEM ELEVATION 95.8r'c5.'r'9 '.E/95.5' 30" below 5,122%' 6 3
DATE BEDROOM
CONVENTIONAL IN-GROUND PRESSI-RE CONVENTIONAL LIFT XXX HOLDING TANK
14 O L'N D SEPTIC TANK SIZH: 1000 gallcns LIFT TANK SIZE DOSE TANK SIZE 6
HOLDING TANK SIZE LOAD RATE •4 ABSORPTION AREA 1142 # of chambers 56
BENCHYIARK Y,R.P. Rcttcm of siding ASSUME ELEVATION imr Filter Lifetime Filter
❑ BOREHOLE ~ WELL . H. R. P. same as benchmark
Scale is 1" _ 40'
i
unless otherwise. Seale = 1`4" = 1'
noted
EtistinQ 3 Tested area is higher than
edroorn 5' grade at drywell, area around drywell
House is all fill.
All piping shall be ASTM SDR 30134, within
B. M.;' 10 of tank, piping shall be :ks'r'M F891
120' 2>~
T
5
B- t 40' Ll Old drywell to
be pumped and
50• buried
10% Slope
l0'
B-3
4-3' X 58' cells with
>3' spacing g-' 1-')7,c Slope
Ridge Top
b
Vents
10'
B - 27
40'
V alt 9
Property Line Quick4 Standard
";(h St >6'
of Cover i Leaching Chamb C
4
ith 20.0 ft2 of Are
w
-5.6ft^2ipair of end caps OA
1-0 a 4' Long, 1 ~
Grade at Svstem Flevation
4'
~CEIVED .~ouny _ ;I
frro~9 Safety and Buildings Division S , 1, jQ
sr; 1 201 W. VVashingtvn Ave., P.O. 60 1 2 Saner} Permit Number (to be 511ed in by Co.)
Mad !son, YJl 33707-7131
Ps MAY 3
~,E~1 !~1 2 2Q1~ ~
y C'
~cT rROtx COUNTY
i ~OMMUNITYS1W~"gII]it Application n ~t~ber
La acoxjaucs wilt SPS 3832:(2), Wi5 Ada Code, subrusswn of this forty; to the a~propn= gc-mjeytati tmit
is required prior to obtaining asanimn permit Note: Apphcauon forms for sale-owned POWTS are s,Uomilted m Project Address (if differrnttbac mailing address;
tie ilepar•tmmt er Safety and Professional Scvies. Persona tnfamatmon you provide may be used for secondary
vurr:,oscs is accordance w,th the Privacy :raw, s. 15.04 IYmai• Stats.
1. Application Information - Please Print All Information _ _ II ! J`f t~ lT
Praperr0%n-r'sName Pace:B
s l1 /0 20
Prop-rty Owners Mailin Address Protxtty ;.,ocaaouu 7V,' Q, G
v ~n ~Q IJ GM Lot-- U
Cry, Stare Zip Code Phone Number
Section p
? lc m
A SS O I1 l 1`; N, E . W
ii. P?e 4,
uildiug (check all that apply)
family DwelL:u, Number of 13cdroom_s _ Subdivision Name
Block N T
G Publia'Cbmmerc:al - Lkscnbe Use
U state owned - Describe Use CSM Number J Village of - '
t/ Town of
L/ -17
1.Type of Permit: (Cbec inc A. omplete line B if applicable)
a
ew System eplaecaxnt Sy V Treaaoenuriulriiug Tack Replacement Only ❑ Other Mndi )cation to Lt.. System iatplara;
l - - List Previous Permit Number and Date Wace
g• Permit Renewal ❑ Permit Revision ❑ Change of Plu:nber Permit Transfer to New r Ilk
Before Expiration j Owner
IV. JA-pe of POWTS System./component`Device: (Check all that apply) _ _
❑ Pressurized in-Ground ❑ At~rade E, 24 d < 24 in of triable soil ~r
o - vraun i 9astci = L-1- of suirable sot ❑ h1o /
Holding Taak C C ether Dispersal Component (explait) l' etreanuent Devitt (cxplam)-
V. Dis ersal?reatment Area Information:
Dpi Fluw r Design Soil Applic on Ra.e(gpds Dispersal Area Racuu ed fs Dispersal Area Propose is SvRuu Elevation s
VL Tank Info c4acity in Total' ii of anufac-huer
Gallons Gallons Units I E
3 s' H
tic. Tanks =x~cag Tanks L , u.. 9 I i
I1/ ym~lc~i Fl/t/ 2 U . r
Sepnc or Hold= Tank'
Boring Chambc i -
VII. Responsibility Stat a t- I, the undersigned, a c,responsibility for installation of the PORTS shown on the attached plans.
Plumber's Name (P)ent; - - PI x tgnanrrc ?tlPi:~RS Number [i/usJiruss Phone
Plumber's Address (Street; c, Zip Co
'III. County"D artment Use Only
Pc met rc• Date issued Issuing Agent Si
proved Di; *oved
7v, = Rear _
_ t5. U-' -IDJ
UL Cunditiom
SYSTEM OgrovffReasons for Disapproval 3 5w~ 1 qk'(A \ M
1. Septic tank, effluent filter and Q~ b~ {b r bW~R~ V CN,
dispersal cellmust ire - __iced i mainta~UeCer
as per managen ent plan provided
be moyainp.ained
All Setback requirements must be ' , Iyf 'j '0u ~r 1 Of
as per apple r the stem and submit to the County only on paper t less ocher aze ,
~ ins ~ an vet ly"*
b~
5Br6398 11r:7, ~j~i~fil► d ~s~?L+'Sq lei
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 5/22/16
Owner: Paul Sisson
Location: NW 1/4 NE 1/4 S 6 T30 N,R18W 1783 95th St. Richmond
System type: In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Pressure Distribution Manual (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
8. Dose Tank Cross SeV#222
ti9. Pump C10.-12. Soil SignatureLicense nu
PLOT PLAN
PROJECT Paul Sisson ADDRESS 16074 2nd St. N Lakeland Mn 55043
NW 1'/ 4 NE 1/4S 6 /,1, 30 N/R 18 W TOWN Richmond
COL NTY ST. CROIX
SYSTEM ELEVATION 95.8/95.7/95.6/95.5' 30" below 5/22116
BEDROOM 3
DATE
CONVENTIONAL IN-GROUND PRESSURE
CONVENTIONAL LIFT XXX HOLDING TANK
VIOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1142
# of chambers 56
BENCHMARK V.R.P. Bottom of siding
nssuMr: ELEVATION 100 Filter Lifetime Filter
❑ BOREHOLE O WELL ~ H, R. P. same as benchmark
Scale is 1 " = 40'
unless otherwise
noted 8' Scale = 14" = 10'
Fxisting 3 Tested area is 7' higher than
Bedroom 5' grade at drywell, area around drywell
l louse is all fill.
25, All piping shall be ASTM SDR 3034, Ni,ithin
B.M.* 10' of tank, piping shall be ASTM F891
120' 25'
T
25'
5'
B-1 40' L Old drywell to /
be purnped andzf
50' buried
10% Slope.
10'
4-3' X 59' cells with _ 3
>3' spaein~ 97' 13% Slope
Ridge Top
Vents
10'
B-2
40'
Vent 97'
roperty ure
5th St >6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
4' Long 12" 5.6ft^2/pair of end caps
Grade at System Elevation
3 4"
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 4 cells
Quick 4 Standard
Leaching Chamber with
20.0 ft2 of Area per
Chamber 5.1ft^2 pair of end plates To be >1' above grade
/ Finish grade elevation
Typical Installation ~ X98,5
Vent Grade Aent
4' 4°~~30/34 Septic Tank
Grade at System Elevation
4' Lon, 5' 34" Grade at System Elevation 34"
Spacing- 5'
3-3' X),O' ' Cells
Obser+ration tubeNnnt
Same on other end To be loo: itc d on end ;t Cell,-
A
B
System elevations: C
A95.8'
B 95.7' D
C-95.6'
D___95.5' 14 chambers per cell
ST. CROIX COUNI-y
SEPTIC TANK MAIN'T'ENANCE -,'►GREEMENT
AND
OWNERSHIP CERTIEzICATIC:N FORM
OwnerBuyer
Mailing Address/f(
Property Address 3 G ~ ✓ t _
Verification required from Plaaniug & Zoning Department for new construction.)
City/State
Parcel Identification Nurnber n - v
LEGAL DESCRIPTION
Property Location NA ,,sec. T3 N R ~
L 'yy, Town of C Z
Subdivision
Lot #
Certified Survey Map #
Volume , Page #
Warranty Deed #
Voiume Page #
Spec boast yes no Lot line- identifiable (Y no
SYSTEM MAINT'ENAI•j AND PER CERTIFICATION
ImProper use and uniatenance of your septic system could result in its premature fails= to handle wastes.
m= consists of Fling out the septic tank every three ~OFC1
the years or sooner, it needed, by a licensed pumpx• What you put into
system can affect the function of the septic tank as a treatment stage in the wash disposal system Owner maitrtnee
responsibilities are specified in §Conmi- 83.52(1) and a Chapter 12 - St. Croix County Sanitary nfy fart' Ordinance.
The property owner agrees to submit to St. Croix Co
owner and by a master plumber, journeyman plumber., unty Planning & Zoning Department a certification form, signed by the
wastewater restricted plumber or a licensed puffer
disposal system is in proper operating condition and/or (2) after inspection and vm1fying that (1) the on-site
less than 113 full of sludge. Fling (if necessary the septic tank is
V-e, the unde"igaed have read the above requirements and agree to maintain the private sewage
standards set forth, herein, as set by the Department of Commerce and the Departtricnt of Natural Reso ose system with the
Certification signing that your septic system has been maintained crust be completed of Wisconsin and
Zoning Department within 30 days of the three year expiration date. returned to tbe St. Croix County Planning &
Uwe certify that all statements on this form are true to the best of my/our k.aowledge. Pwe amlam the owner(s) of the
property described above, by virtue of a deed recorded m Register of Deeds Office.
Number bedrooms
SIGNAT[ B OF APPLICANT(S) l DATE
E
***Any information that is misrepresented
may result in the sanitary permit being revoked by the Plamung & Zoning Dqm-troent.
Include with this application a recorded warranty deed from the Register of Deeds 0f5ce and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN P" s of
ILE IWORMATION SYSTEM SPECIFICATIONS
owner G _
Pennit wner;il QAA J 1 ~ Septic Tank Capacty I 11 NA
O
Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufachr+er ❑ NA
Number of Bedrooms 13 NA Effluent Filter Model
❑ NA
Number of Public Facility Units ~LVA 'Pump Tank Capacity `
Estimated flow I 0" NA
3 iT'c 7 gal/day Pump Tank Manufacturer
•~~c 0 NA -
Design flow (peak), (Estimalad x 1.5) Pump Manufacturer r 7`
gali/day c ❑ NA
Soil Appkahm Rate
m/ ile Pump Model ❑ NA
1 Standard Irrfluerat/Efflr,err{ Quality Monthly average Pretreatment Unit
Fats, Oil & Grease (FOG) 530 mglL ❑ Sand/Gravel Filter 0 Peat Filter
Bloc heroical Oxygen Demand (SOD$) 5220 mg1L 0 NA I] Mechanical Aeration ❑ Wetland
TOW Suspended Solids (TSS) s150 mg/L ❑ Dislrtfection D Other:
lPretreated Effluent guaflty Monthly average Biocftemicat Oxygen Demand ~ Dispersal Cell(s) ❑ NA
(BOCQ 530 mgA. and (gravity) ❑ In-Ground (press<r )
Total Suspended Solids (rSS) 530 mg/L NA O At-Grade
Fecal Coiform ❑ Mound
(geometric mean) 5104 CfUM 00ml ❑ Drip-L jne ❑ Other:
(Maximum Effluent Particle Site
>is in dia. G NA Ntaer.
Other. NA
NA Otfaer.
NA
"Values typical for domestic wastewater and septic tank effluent Other -
NA
NTENMCE SCHEDULE
Service Event
Service Frequency
inspect condition of tank(s) At feast once every: month(s) (Abxkmn 3 yum) E) NA
Pump out contents of tank(s)
When combined sludge and scum equals one-third of tank Volume ❑ NA
inspect dispersal oeN(s) At least once every: D MOWS)
_ r(S) (Maxinurn 3 years) ❑ NA
Clean effluent filter At least once every: onth(s) 0 NA
G nsPecil pump, pump mr~rols & alarm At least Fnce every: f.month(s) ❑ NA
Mush laterals and pressure test At least avery. ❑ month(s)
+7tfaer: D year(s)
11 NA 11 At least every: mor gays) NA
r.
NA
MAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal cells shall be made by an individual carving one of the following ficer u% or certifications: k,~.
Plumber; Master Plumber Restricted Sewer; POWT8 Inspector, POWTS Maintainer, Septage Servicing Operator. Tank
hxlude a visual inspection of the tank(s) to identify any missing or broken hardware, i PSthe volume must
tDombined sludge and scum and to check for any back u or dig of ~ ` any cracks .leaks, measure the of
'As~y ins Wed to heck the of kmm levels in the observation effluent on the ground surface. The dispersal cell(s) shall pipes and to check surface.
The pond+ng of effluent on the ground surface may indicate a fatlingcond afor eqany uires nthe immediate notificatllon of the local
regulatory authority.
WIM the combined acccuauiMon of sludge and scum in any tank equals one-third (J§) or more of the tank volume the
the tank strap be removed by a Septage Servicing Operator and dis , entire contents of
Administrative Code. posed of in accordance with chapter NR 113, wsoor>sfn
!ill other services, including but not limited to the servicing of effluent filters, mechanical or pressurized oomponents, pretreatment units,
and any servicing at intervals of 512 months, shall be performed by a certified POWS Maintainer.
A service report shall be provided to the loCW regulatory authority within 10 days of completion of any service event
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS dieck treatment tank(s) for the presence of painting products or other chemicals that
may impede the treatment process and/or damage the dispersal cell(s). If high concentraklons are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will bis
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface dls wge of effluent.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to fibs
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restom normal levels
within the pump tank.
Do not drive or park vehicle$ over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within
15 feet down slope of any mound or at-grade soil absorption area.
Reduction or efimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT$:
antibiotics; baby wipes; cigarette butte; condoms; cotton swabs; degreasers; dental floss; diapers; dis"irrfedants; fat; foundation drafin
(sump pump) water; fruil and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting producgs;
pesticides; sanitary napkins; tampons: and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:.
• 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 SLlyieiny Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compC*nt
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requioed
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nged
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must campy with the rule:1 in
at that time.
replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be Performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed; as
a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must campy with the rules in effect at that time.
, WIARNiNG»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK' UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE 0 A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
7~ 7-
r
ame
/
Name ~i - EP
Phone o
ne ,
F . el-A-
r
SEPTAGE SERVICING OPERATO LIMPER LOCAL REGULATORY AUTHORITY
Name ti r' t (n Namme
u
Phone Phone 7)1'- /
This document was drafted in compliance with chapter SPS 383.22(2xb)(f)(d)&(fl and 383.54(1), (2) & (3), Wls+corrsin Administrative Coda.
IF
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BAY NEPTH PD
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i ! DIE LiTY, MI 4971
8q-1, , -Igcl Fox
STF-100
9_'Lt'LUSZ: b:AT 1IP7/cM 171
Dose Tank Cross Section And Pump Performance Specifications
Tank Manufacturer
ank Modei Number Minimum Pump Performance Required
o
tal 'tank Capacity Z D - GPM
3 y ~1 /LZ Ft TDH
T
Max. Bury Depth EA -
Pump Manufacturer r, Total Dynamic Head (MH) Feet
-
' Elevation Head
Pimp Model Number
Alarm Manufacturer Distal Pressure
(/G rS" ` i--~ Network Pressure Loss
Alarm Model Number L
Switch 7'yp c Force Main kressure Loss
Total _
L'A Manhole Min. 4" Above Grade
2" With Locki ng Device
e Weather-proof Junction Box Firushed Grade Depth of Cover Ft
)t>{ tY >r}~><> >Ti S--> Y )
< r
>
Outlet
Inlet Switch Settings and Reserve Capacity {
Tank Volume = UPI
y{ - -
Dimension inches Volume Gal. `
A
< (reserve) A
(alarm) B 2 3 J _ < <
Weep
(dose) C 7 3' J - Hole
(dead) D Jam- /nffE~:env. C ~s
y' Total= ~1` =LJ J t {
>t Bottom of Tank Rev. eL , -5-Ft
D
f t { t>t><><}S>t><'C'S-->-l-->-<~>S><.~>t><><Y G ) t >t ) C > t ! C) < t > i< { < i< << t < < G a{t >
J
GENERA' INSTALLATION: The dose tank is bedded and back filled in accordance with the
manufacturer's product approval specifications.
manufacturer may not be exceeded without prior appr~ova]711Manhple coofverus exposed to grade the,
an effective locking device (padlock) installed. Piping have
material, connected to the tank with watertight fitticigand laid onistable and
tolprevent settling or
sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the excavation and is ses.led
watertight. Electrical service complies with
NEC 300 and Comm 16.28 Wis. Adm. Code.
03/OS Igj
Page of
AL "D/CAFACITY
\ 'L'r YIN I-7 Model 1-7/59
-
t M, et e.
4.6 72
r
Variable level float switches available.
Variable level long cycle systems available.
Available with special cord lengths of 15', 25, 35' and 50'.
Alarm systems available. _
Duplex systems available. 1
S M,GSE
single sa Control Selection Listings?
Model
Volts Phase Mode Arnps Simplex Duplex CSA UL -
1. Integral float cpe2,.ed mechanical switch; no ex-.crnal control n:guireo.
M83'S5 & Mni/59 11S 1 ~ Au:'a 9 7 ~ 1 Y
n5a5gN57.59 tt3 I non g.7 pT---- 2. Single piggyback variable le.'el final snitch or dou5le piggyback varah'e te;e;
3 or a a ; Y Y
8 v53 15 t
Aulc g float switch Refer tc R+141' i.
eNS7 1!5 hut0 s? - N V 3. +dechani:d alternator "M Pak 100072 or 10-W75.
9E5+.57 230 1 Auto 4.8 4. See Ff~^O. , 7~
Y Y 2 for corner: mode of c
_lect~cal Alteriacr
mu D57i59 230 t Aulo 4.8 y 5. Variable levc conlrc svm~h 10-0225 used as a con.ro! activate, with Elc~ trcal
E51- 3 =Sil59 2 A I t + Non 4.9
2 3 or d & 5 v I A!terneror 13; c•41 'Inat system. Sin_qlr. !,"?3'> aCk sw8cl• oc:u.lasi- -1
Foriofor n3tianonadoilionalZoele•produVisr0ertoratakrgonPi9gybackVanatnleLeielFloatSwitctr.3,--MC47: LA-cm- N
EACtriral AltemaW, FMW6 blechanail Alternator FMC495, Sump Sewage Bas ns, FMO487; an7 Sirgie Ruse
Simplex Pump Contrcl;Alarm Systerns. FPA0732
v _ = f-•• _
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL T0: PO 5CA
KY 4G250,
SHlP TO. 3 F4s w e Run Rcad Manufscrurers of . .
a LJ Lovsv.-6e KY 4u211-1961
http://wwwzoeller.com PUMP 732'3?•YfbuYl)O78-PUUP ~I~TyPU~PS SALE /c9.~9
FAX 15C; J 774.W4
g ht _00c 7oel.er Lc. AI ri:,hts reerved
S I • LlZQI~{ COUNT'
1~pR UTZ CURTTFIrATION STATE NT ,To]
L ZAZ ION of U CXISTING STATEMENT
,
f t: Z ANlC
cent
.,crvin fY that I h
the ave inspected the
septicr_ar7k
Section
_ TIP_S1CtPrCE? 1Ucatc~ct st.
the U
tank and R_baffles tobennspectiotr, !~~N, t~-+nrtlohinT certify that •
9 good condition I Have r f
i
pCOPer1Y• and it JU
3Apears ra
time serviced; -
bock oCCUr - -
troth
Yep absorption System?
^p))roxitnaf no, skip next 1is
-E volume ~c
or length of t
'3paci ty:/ b17--o
ime: gallons
Cbt
I.C;truction:
PrefaT, Concrety
Manufacturer: Steel
(If known) ; iptL / other -
ank
(If known)
S~ (Name
d--7 ) Please
('t'itle) Print - -
(L1Cense Number-
Vurm t,0 be
COMPleted
Code ~tes) or Licensed DiGpas~r sed plumber
(NR 113 W3.sca •U~, WiSr::,rl~;~r~
nsin Admiiti.str,,t-_.jv,
Plumber (applying for sanitar
Y permit) certification:
c=vndif:ion the above stat
I certif ement regardi
cunform tot Y that the tank to the eX-sting septic tanx
1.r1S he requirements o t of m
pect.io open.in of rLHK 83 Y knowledge w ; i.
ver outlet baftle)~ AdT Code
(except
~~irllf' ~ ~ For.
147
Signature ?
MY/MPRc
Wisconsin DepartrneAd4ttrle4a, { 70
Division of Safetsy~~~~~~ouNTY SOIL EVALUATION REPORT Page of
.
,,OMMUNITY DEVELOPC ordance with Comm 85, Wis. Adm. Code _
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County z
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D _
Please print all Information.
Re by ' Date
Personal iMonnabon you provide may be used toe secondary purposes (Privacy Law, s. 15 ilk (1) (rn)) 1 ~G
Property Owner
Property Location
Govt. Lot 1!4 ; 4~1 14 T' N R E (o w
Properly Owners Mailing Address 1 Lot # Block # Subd. Name CSM#
-7 Z 9,1" '14
State Zip Code Phone Number - W,
I] City ❑ Village ATi7wn Nearest Ro
New Construction Use Residential / Number of bedrooms _
Code derived design flow rate GPD
Replacement 0 Pyblic or commercial - Describe _
material C?~!~-~i~~-=~i~ - -
C*neral _ Flood Plain eievation if applicable ✓ ft
cormlents ~.Z,
an r
recommendations: f -
System Type 111- - ! `JDi~~ It c.y$;✓e SL ~!1
System EIe0111
T__~
]Boring # Bonn9 /
~ Pit Ground surface elev, ft. Depth to bmking factor in.
Soil Application Rate
►iorizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD#f
in. Munsen Qu. Sz. Cont. Color Gr. Sz. Sh
'Efi#1 •Elf#2
f ~
Boeing N Boeing
K,Pit Ground surface elev,/_fi ft, Depth to limiting factor in,
Soil Application Rate
Honzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
In. Munsell Qu. Sz. Cont. Odor Gr. Sz. Sh.
Effluent #1 = BOD. > 30 < 220 mg/L and TSS X30 < 150 • Effluent #2 = BOD, < 30 mg1L and TSS < 30 nxVL
CST Name (Please Print) nature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address
Date Evaluation Conducted I-elephone Number
1432 120th St, New Richmond, WI 54017 - ' 715-246-4516
Farce' ID Page L of
#
Property Owner Boring in. soil licatron Rate
# Ground surface elev7__'L- ft Depth to timil5ng factor
Pit
7 ~
Texture Structure Consistence Boundary Roots GPDIff
Horizon Depth Dominant Color Redox DPSrnpbon •Eff#1 'Eff#2
Gr. Sz. Sh.
in. Mansell Qu. Sz Cont. Color
~ rr11 ' to /7 r ( i
i
-
❑ Boring
Boring # tc liriting factor ui,
Pit Ground surface e.ev boil lication Rate
Horizon De Texture Structure Consistence Boundary Roots GPDIff
Depth Dominant Color Redox Description
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
❑ Boring # Boring Ground surface elev. Depth to limiting factor in soil ication Rate
❑ Pit
Horizon "lepth Dominant Odor Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
. Qu. Sz. Cunt Color Gr. Sz. Sh. •Eff#1 'Eff#2
.n Munsell
Effluent #1 = BOD, > 30 < 22o rrgl- and TSS >30 1150 rng/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 ml
The Department of Commerce is an equal opportunity service provider and employer, If you need assistance to access services or
need material in an altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
.,BD 6170,R -Cl
Property Owner Parcel ID # Page
IT boring # 4 Boring r C -
pit Ground surface elev ft. Depth to 4miting factor. / Y-) in.
Soil ficatior. Rate
Horizon Depth Dominan! Of Redox Description Texture Structure Consistence Boundary Roots GPD1ff
in. Munseli Qu Sz Cont. Color Gr. 5z. Sh. •E"! •EU2
U Boring # ❑ Boring -
❑ pit urouna su~u;;e elev ft Deptrt to limiting fa i~ ;r
°~oil Annii;,ahor Rats
Horizon Depth Dominant Color Redox Description Texture Structure Consistence BoundaryRoots GPD/ff
in Munsell Qu Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
i
I
i
F-1 Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil AnnliaUon Rate
in
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
Munsel Qu Sz Cont. Color Gr. Sz. Sh.
'Eff#1 •Eff#2
I
Effluent #1 = BODS > 30 < 220 mWL and ?SS >3C < 150 mglL ' Effluent #2 = BOD, < 30 mgrL and TSS < 30 mg/L
The Department of Cornmerec 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-gbh-315 1 or T-F608-264-8??'.
seo-9330 (R 41U)
43-
Soil Test Plot Plan
Project Name Paul Sisson Sh ird
Address 16074 2nd St. N
Lakeland Mn 55043
~STM #226900
ri
Lot Subdivision Date 12/23/15
N W 1/4 NE 1/4S 6 T 30 N/R18 W
Township Richmond
Boring O Well PL Property Line County ST. CROIX
BM or VRp Assume Elevation 100 ft. Bottom of siding
System Elevation TBD *HRpSame as Benchmark
Scale is 1 40' ~~'ell
unless otherwise
noted
Existing 3 Tested area is higher than
Bedroom 5 grade at drywell, area around drywell
House is all fill.
25'
B.M.*
120' 25'
T
25' ~ ~ ✓1. C~
1w,
c, D a
B-1
50'
10% Slope 99
9~ 10'
B-3
65' 13% Slope
'
Ridge Top
10'
B-2
40'
['roperty Line
95th St