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HomeMy WebLinkAbout016-1037-80-000 (VL,0V4S-t0-1(,@ 11:00 F1^1AL. 8/s"g //•°4 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 589711 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 22431 19 Permit Holder's Name: City Village Township Parcel Tax No: Dan Cormican TOWN OF GLENWOOD 016-1037-80-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: SAM. 0D STAB .00` A) 11tUSr.91L cva7'0tLP- 17.30.15.2738 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z k w. w C~ 7~ -71)6) Benchmark r.-741 1D3 !01 60 Dosing U'` rr,, / Alt. BM J;• YS ~d~. Q ~l~- N Aeration w Bldg. Sewer ~0/ICHIta I~lo?uB5 g- ld3. s q6' Holding St/ let Y-7 ,3 10 jtwyy St/Ht Outlet TANK SETBACK INFORMATION pG ZAm-rm) Q Y IS 79 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 776e 70 Y,-J' 7? Septic 7 s„O, '~i Dt Bottom ol,~ ~ • Dosing , H a w v. Header/Man. ! f r ± ys (py R~ 2 V lc~z.S3 Aeration Dist. Pipe Holding Bot. System PUMP/SIPHON INFORMATION Final Grade 9y ~li•/ a3 Manufacturer Demand St Cover drGliG~ GPM Model Number /~rL :fgs; (1)r ~ o„.L• ~ (03.~ z•Z7 ld . Yg TDH Lift Friction Loss System Head TDH Ft ud5asr -it S••r Q H O- "U,5_ Forcemain Length , Dia. Dist. to Well 3S Z`• > SD SOIL ABSORPTION SYSTEM BED/TRENCH Width I Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 6 75 SETBACK SYSTEM TO P/ BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION T e Of S ste CHAMBER OR Yp . UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold ID istributionn X Hole Size ix Hole Spacing Vent to Air Intake g C r`` Pipe9s) [ DiaL~ ( Spacing d • 19~Q t Z th _ Dia Len th /N Len SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of Ixx Seeded/Sodd d xx Mulched Bed/Trench Ce ter / Bed rch Ed es / 14 Topsoil / K Yes [ No Yes No o E r 1 (-5 • COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: (=1A1&) _ GS~7 ~K- CJ's Location: 2807 160TH AVE 1.) Alt BM Description = lG / ,.,r/-~(y~~ ///tj lu/V rE~ 2.) Bldg sewer length =3s •j'^*,,S Cp4WC`,C ✓ g• o T( amount of cover = (0 S r D;~ C,1 QNJ lVD.T. q 1 Co 5ePr<< -rANKS ~ N t F ulsl~l Ar ,~vs PECno~. IGLGtm,~~' Ta 1"+~~.sy ~1~,~~~u 7a RA~tn; Plan revision Required? El Yes V1 No g Use other side for additional informatidn. _ [117- 6 d Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) County Z;E1VF.1) Safety and Buildings Division jf - St. Croix c, p $ 201 W. Washington Ave., P. OX 7162 Sanitary Permit Number (to be filled in by Co.) 1 j JUN 0 9 2016 Madison, wl 53707 2 ST. CROIX cOU 1 y ertnit Application 'Abate Transaction Nwnber ,OmMuNIT ~almf In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 2-7-A4 3 / 1!1 is required prior to obtaining a sanitary permit. Note: application forms for state-owned POWTS are submitted to Project the Department of Safetv and Professional Services. Personal information you provide may be used for secondary Address tf different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(iXm), Stats. -7 J6 1- L Application Information - Please Print All Information Property Owner's Name Ul/ Parcel # l~~aeler b , X J, rA'^ ` A 016103780000 Property Owner's Mailing Address Property Location (3, ~;tt, 15. )'1'313 2807 160th Ave. Govt. Lot City, State Zip Code Phone Number . NW, i, NW_ s. Section 17- Glenwood City 54013 715-808-9203 - - - (circle one) - 11. Type of Building (check all that apple) Lot # T _30 N-, R 15___ Nest X I or 2 Family Dwelling Number of Bedrooms 3 This proposed system will serve one 3 bedroom residential Home. 11C64446Block 4 Na F1 Crty of CSM Number ❑ Village of x 75 x T.of Glenwood III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System Replacement System Treatment Holding Tank Replacement Only ❑ Other Modification to Existing-Systery (explain) X B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber r to New Li7Prs Pennit Number and Date Issued ❑ Perntit Traztsfe Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) t> Non-Pressurized In-Ground ❑ Pressurized Iii-Ground ❑ At-Grade X Mound > 24 in- of suitable soil Mound < 24 in. of suitable soil / Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsal/Tre ment Area Information: Design Flow (gpd) Design Soil Application Rate( gp ) Dispersal Area Required (s Dispersal Area Proposed System Elevation V .6 450 sq ft A~p 450 sq ft 101.83 450 VI. Tank Info Capacity in Total 4 of Manufacturer Gallons Gallons Units o New Tanks Existing Tanks rf: U in CIO u, C7 P. W ~i Septic Tank X 700 gal 1400 2 L is Bjork X Lift Tank X 700 al 700 1 Lewis Bork x VII. Responsibility Statement- I, the 'gued, assipme responsibility for inst ation of the POWTS shown on the attached plans. Plumber's Name (Print) P u s Sigrfature, MPiMPRS Number Business Phone Number Lewis Bjork 253976 715-231-7375 Plumber's Address (Street, City, State, Zip Code) E7818 County Road E Menomonie W1 54751 VIIL County artment Use Only proved ❑ Permit Fee co r-ate sued Issuing nt Signattu ❑ cn Reason for De al $ v IX. Conditions of Approval/Reasons for Disapproval t ~G liew_ a.IOL, SYSTEM. v- ER:. 3) e~w~ / 1 {itvs tank, effluent i,Rer ark! t l:iert` ttJ~ W` ~P'~Lbt i eYlsper:si cell must all be seix~kcas7 ntaint~,.Jc , as per management plan provided by pplumber. 2. ` i°esl k t abl co& s must. i;?aintsiriEd 4 6a S- L/yam~ 4A/WA-. as per applic~+ble ct~ 1 odtnan lite;a. J I _ n C~Od~ l Vt ~ t~ o p o ; 3 44 2 ~ J v M~ ~ llz~t T o o x?:tTG DIVISION OF INDUSTRY SERVICES 10541 N RANCH ROAD HAYWARD WI 54843 l r' j 0 S Contact Through Relay K P S www.dsps.wi.gov//sb/ www.wisconsin.gov ssro-,~~swr Scott Walker, Governor Dave Ross, Secretary May 03, 2013 CUST ID No. 253976 ATTN: POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/03/2015 Identification Numbers Transaction ID No. 2243119 SITE: Site ID No. 790476 Eric Keeler Please refer to both identification numbers, 2807 160TH Ave above, in all correspondence with the agency. Town of Glenwood CONDITI St Croix County NW1/4, NW1/4, S17, T30N, R15W APPR FOR: DEPT OF S Description: Mound, 3 bedroom residence PROFESSION Object Type: POWTS Component Manual Regulated Object ID No.: 1426455 OF IND Maintenance required; Replacement system; 450 GPD Flow rate; 14 in Soil minimum depth to limitinP&m*Q original grade; System(s): EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - 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 SEE CORRE and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The 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. Reminder • The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • 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. LEWIS C BJORK Page 2 5/3/2013 ' • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. 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 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandorf~ 1 POWTS Plan Reviewer `integrated Services WiSMART code: 7633 (715) 634-7810, F~-(715) 634-5150 , M - F 8:00 a.m. -.4:45 p.m. pat. shandorf@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer 11, (608) 789-7893 , 7:45 am - 4:30 pm Monday - Friday Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly 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 Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. LEWIS C BJORK Page 2 5/3/2013 • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, State, • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. 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 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandor~ POWTS Plan Reviewer Zteggated Services WiSMART code: 7633 (715) 634-7810, F~ -(715) 634-5150 , M - F 8:00 a.m. -.4:45 p.m. pat. shandorf@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer II, (608) 789-7893 , 7:45 am - 4:30 pm Monday - Friday Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly 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 Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. T ~ EZf/ow® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Eric Keeler- Replacement Mound Owner's Name: Eric Keeler - Owner's Address: 2807 160th Avenue Glenwood City WI 547 715-808-9203 Legal Description: NW NW 17 30 15 West Township: Glenwood County: St. Croix JN,ALLY Subdivision Name: NA JVED FETY AND Lot Number: Block Number: NL SERVIC Parcel I.D. Number: 75T RV ICE Plan Transaction No.: Page 1 Index and title _~,PGND CE Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Plot pan , Plot plan Legend Page 10 Attchments , Soil test , effluent filter,Man hole , Septic and dose Designer: Lewis jork License Number: 253976 Date: 04/29/1 Phone Number: 715-231-7375 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, 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) Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 4.00 Site Slope 100.00 Installation Contour Line Elevation (ft) 120.00 Contour Length Available (ft) 14.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 6.00 Cell Width (ft) 3,_A_ 8, 9 or 10 0n1v 75.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3 Lateral Spacing (ft) If N above, enter the elevation ft) 2 Number of Laterals of the highest point. C 0.188 Orifice Diameter (in) (e.g. 0.25) 4.00 Estimated Orifice Spacing (ft) = 11.84 ft2/orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 94.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) F3.25 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 7.33 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.69 Friction Loss (ft) 75.54 Minimum Dose Volume (gal) 11.27 Total Dynamic Head (ft) 24.90 System Demand (gpm) 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 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1400.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Lewis Bjork LLC Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.00 Dose Tank Capacity (gal) Bear Filter Manufacturer 18.85 Dose Tank Volume (gal/in) MPL3-619 Filter Model Number Lewis Bjork LLC Manufacturer Project: Eric Keeler- Replacement Mound Page 2 of 10 Mound Plan View T J FK.. Observation Pipe ❑ t: 5 A 771 W I . :I B I L Mound Component Dimensions in H 1.00 ft K 11.86 ft A 6.00 ft E [Aft B 75.00 ft F in I 12.18 ft L 98.72 ft D 22.00 in G ft J 8.93 ft W 27.11 450.00 (ft2) Dispersal Cell Area 1363.64 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7750 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 103.83 (ft) > H F Dispersal Ceu 102.33 (ft) Lateral 101.83 (ft)--*l 6" Invert Elevation Dispersal Cell Q_; D Elevation 100.00 (ft) Contour Elevation 4.0 % Site Slope Typical Dispersal Cell Shading Key See Page 5 Q Topsoil cap ~ Approved Geotextille Fabric Cover Subsoil Cap 0- ° a 2 0 ft 3 ASTM C33 Sand a, ® Tilled Layer F Q EZflow Media ran 0 0.5 ft U-4 0- - A See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. 1 l~ End Connection Lateral Layout Diagram • = Turn-up veball valves or cleanoutplug Z 4, 1st orifice located at Z 64,° XOrifices point up except every 5th S one points down for drainage. F arcQ main connaetion via tPp or cross to manifold at any paint Lae+eali rx P~eco main of FVC S ch AtI All laterals idertical with orifices equally spaced par SPS T:jH# 3 4.30.6 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.08 ft Lateral Length (P) 74.22 ft Orifices per Lateral 19 Lateral End (Z) 0.78 ft Orifice Density 11.84 ft 2/orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 12.45 gpm Manifold Diameter 1.50 in Syst3m Flow Rate 24.90 gpm Forcemain Velocity 2.54 ft/sec Dose Tank Information Locking cover with warning _ label and locking device and / sealed watertight Electrical as per NEC 300 and l~ SPS 316.300 WAG 4 in. min. Disconnect Tank component is properly vented F- Alternate outlet location Forcemain diameter Lewis Bjork LLC Manufacturer 2 in. Capacity 700.00 Gallons - T Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.13 360.56 B 2.00 37.70 C P~ ump off elevation (ft) -t d C 4.01 75.54 95.00 D 12.00 226.20 D Total 37.14 700.00 Dose tank elevation (ft) Bedding And Backfll As Per Manufacturer 94.00 Alarm Manufacturer SJE-Rombus Alarm Model Number TAAB-01 Pump Manufacturer Zohler Pump Model Number 152 Pump Must Deliver 24.90 gpm at 11.27 ft TDH Nate: Switches coniai ning may not he used in this system. Project: Eric Keeler- Replacement Mound Page 4 of 10 Uflow® Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements 6 ft Wide 1 ® N Component Legend SR1-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or &me SR3-12H in 5 ft or 10 ft lengths O 4" Perforated Distribution Pipe With Pressure Lateral Inside • Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 75.00 Cell Length - B (ft) Center Laferz Force Main rya?---- . 6 ft Wide End Manifold Project: Eric Keeler- Replacement Mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name Lewis Bjork LLC Phone 715-231-7375 POWTS Regulator's Name St. Croix County J Phone 715-386-4650 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1400 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft 2 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 Inspect and clean as necessary at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years Other Lewis Bjork Pumping 715-231-7375 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 EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 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 00"0000600000. 6-8" Diameter Lawn - Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where . Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same . EZflow Synthetic Media Diameter as Lateral 2.06 Feet f-Distribution Lateral --P'If Lateral Cleanout Project: Eric Keeler- Replacement Mound Page 6 of 10 EFFLUENT KEY CODES FOR ZOELLER PUMPS k),7t BN = w/ Float In Box PUMPS M -Auto Float Attached (vertical) N = Non-Auto (manual) !O_ E = 230V Non-Auto (manual) :gW17Y aZ11 W SacE /~3.9" "FLOW MATE" 98 O r- Mo " ( HP Y_ otyPh T02 p _ on Lisa-Price ZBN98 BN98 1/2 HP 115/1 Automatic Cast Iron 1/2" Solids, 1-1/2" Disc. Tethered Float (15') 358.95 ZN98 N98 1/2 HP 115/1 Manual Cast Iron 1/2" Solids, 1-1/2" Disc. 319.45 FEATURES: The "Flow-Mate" is constructed HEAD CAPACmr CURVE BN98 MODEL "98° 1/2 HP of durable cast iron, carbon 30 ceramic seals and a non- clogging vortex impeller. zs 15' Cord 20 APPLICATIONS: ,s The "Flow-Mate" is ideal for septic tanks, dosing, low 10 pressure pipes, large mounds and step systems s 0 0 10 M 30 40 50 60 70 80 "DOSE-MATE" 151, 152, 153 Order # aAR HE NoWPh 7we Description _ st A r1 ZBN151 BN151 1/3 HP 115/1 Automatic Cast Iron 1/2" Solids, 1-1/2" Disc. Tethered Float (20) 322.08 ZN151 N151 1/3 HP 115/1 Manual Cast Iron 1/2" Solids, 1-1/2" Disc. 281,16 ZBN152 BN152 4/10 HP 115/1 Automatic Cast Iron 3/4" Solids, 1-1/2" Disc. Tethered Float (20') 355.08 ZN152 N152 4110 HP 115/1 Manual Cast Iron 3/4" Solids, 1-1/2" Disc. 314.16 ZBN153 BN153 1/2 HP 115/1 Automatic Cast Iron 314" Solids, 1-1/2" Disc. Tethered Float (20') 498.95 ZN153 N153 1/2 HP 115/1 Manual Cast Iron 314" Solids, 1-1/2" Disc. 462.00 ZE153 E153 112 HP 230/1 Manual Cast Iron 3/4" Solids, 1-1/2" Disc. 462.00 FEATURES: PUMP curtvE The "Dose-Mate" is constructed of MODEL 151/16W53 BN152 durable cast iron, carbon ceramic U t9 seals and a non-clogging vortex impeller. 4D20' Cord >s 70 APPLICATIONS: a 2 The "Dose-Mate" is ideal for septic s , 20 tanks, dosing, tow pressure pipes, is M N mounds and step systems m s a m Zo » a so co ro m ao wo GKtA"5 Lis a 4 eo lie 150 Zoo ZZw m X0 FLOWP@ WWTE maTae t a ~ a 4 3 I-N s aJ ~1 0 ~v d ..1 Plot Plan Legend 4" PVC ASTM D 3034. 42"Min. Cover where snow is not removed. 24" inside diameter concrete manhole brought min.4" above surrounding grade. Concrete covers chained and padlocked . Precast concrete septic tank. O Effluent filter location. 5 4" PVC ASTM D3034. 18" Min. cover. Effluent piping or building sewer where tank is within 30'. 0 Precast concrete dose/pump/filter tank. 0 12-2 OF-B Power conductor. 14-2 OF-B alarm circuit conductor. Both wires are UL listed A-2057 8 2" PVC ASTM D-2665 -09 Schedule 40 Pipe Force main. 4" PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. 10 Carlon All weather pvc junction box. UL listed # A-241 11 Ez- Flow Cell treatment/dispersal cell 12 Inspection wells Project Page Wisconsin Department of commence SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Coderny St. Croix Attach complete site plan on paper not less than 812 x 11 inches in size. Plan must include, but not lirnited 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. Please print all information. Reviewed by Date Personal inform ion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ❑ El Eric Keeler Govt. Lot NW 114 NW 1/4 S 17 T 30 N R 15 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2807 160th Avenue - - - City State Tap Code Phone Number []City ❑ Vdiage ■ Town Nearest Road Glenwood City WI 547 ( 715-808-9203 160th and 280th street Glenwood © New Construction Use[D Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial - Describe: - Parent material loess cap over tilt Flood Plain elevation if applicable -JT n ft. Install replacement mound on 100' contour. and General comments me ns: an 9% ML ir PI Boring # © Boring Q Pit Ground surface elev. 100 ft. Depth to limiting factor 14 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. •Etf#1 `Eff#2 Al 0-5 7.5YR3/3 - SIL 2FSBK MVFR GS 2F .6 .8 A2 5-10 7 5YR3/3 - SIL 2MSBK MVFR AS 2F .6 .8 B3 10-14 5YR3/4 - SCL 2MSBK MVFR GS 2F .4 .6 BT 1420 5YR3/4 F3P5YR5/8j0YR6/2 SCL 2MSBK MVFR - - - - Boring P2 Boring # © 100 14 pit Ground surface elev. ft Depth to limiting factor in. 308 lication 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 "Efr#2 Al 0-4 7.5YR3/3 - SIL 2FGR MVFR GS 2F .6 .8 A2 410 7.5YR3/3 SIL 2MSBK MVFR AS 2F .6 .8 10-14 5YR3/4 SCL 2MSBK MVFR CS 2F .4 .6 B3 l F3P5YR5/8,10YR6/2 SG' - - Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 'Effluent = BOD < 30 mgl1- and TSS < 30 mg/L CST Name (Please Print) _ 5 to CST Number LEWIS WORK t - 253976 Address Date Evaluation Co ucted Telephone Number E7818 COUNTY E MENOMONIE WI 54751 7-21-2012 715-231-7375 Property Owner Parcel 1D # Page 2 3 Boring [7j,j Boring # O Ij 99 pd Ground surface elev_ R Depth to Igniting factor 15 in. Sod ApAication 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 Al 0-4 7.5YR 3/3 - SIL 2FSBK MVFR CS 2F .6 .8 A2 4-8 7.5YR3/3 - SIL 2MSBK MVFR CS 2F .6 .8 133 8-15 5YR5/3 - SCL 2MSBK Nf FR CS 2F .4 .6 BT4 15-24 5YR5/3 F3P5YR5/8,10YR6/2 SCL 2MSBK MVFR - - - - L Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 'Eff#2 ❑ Boring # S Boring Pit Ground surface elev. ft Depth to limiting factor in. Sod -n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Etf#2 Effluent #1 = BOD, > 30 < 220 mg/- and TSS >30:< 150 rng/L ' Effluent #2 = BOD, < 30 rng/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. SM-8330Tat (It07/00) 3 p , a jr O ~ ~ a3 L ro ~ J J v co s ! ih Z ~ . J 3 Y J N J Bear Onsite Filters - w - MO True Effluent Filters It has been fifty years since Bob Zabel was issued a United States Patent for an effluent filter for use in septic systems. Since that time, and especially in the last twelve years, other products have been introduced that are variations of the initial Zabel filter.. All of these had something in common: each incorporated a simple screen to keep solids larger than a certain nominal' diameter, typically either 1/16-inch or 1/8-inch, from passing out $ of the septic tank and out to the drain field. - Some specialty filters followed, designed to retain even smaller- sized solids, from 1/32-inch down to 1/64-inch. However, most of these filters were maintenance intensive due to their single- screen design. 4 i With the introduction of the new MD filter series, Bear Onsite, " LLC. brines the first tree filter io the mdusiry,_ The ML3 filter provides multiple levels of filtration within the cartridge to allow for progressive removal of smaller and smaller solids from septic tank effluent. By spreading the removal of solids over several levels, ML3 filters feature a longer service life, while stilt ensuring that the drain field is protected from excessive solids. In addition, ML3 improvements aren't restricted to the cartridge itself, but extend to the filter case, with a design that includes a built-in baffling system to keep solids out of the case, and a settling chamber to slow the velocity of effluent entering the filter cartridge. This patent- applied-for design allows solids to drop out of the effluent before ever coming into contact with the filter cartridge-therefore, increasing the service life of the filter" Finally: today's new, true filter design, competitively priced with the screens of the past! gee the System in Action Find a local distribUtoY Learn more: Filter Function Brochure Filter r2 iNcat ons _Brochure Product warran inforl~ l~r€x'yg>F~t r? tallatiox: & Maintenance Instructions State Approvals: No MN SD wl MI HE lA , Tuf-Tite Riser System w~-_ - Tuf-Tite makes a full line 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. I Al _k- Arm- Safe Lid - May be used in lace of concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan - Safety Pan TM available for 16", 20" and 24" Risers. Green Only. 6" Tall Riser - For septic tanks. Stackable in 6" increments. Available in 1299, 16", kx k 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. LIZ r 00 v 0 C D V a ~ _ x D a 0 3 Ln o a x 1 fD H N d O a O -Ph C) i o 3 N (D T 70 O V O o m 3 x. n PL£r L UM LEVEL. Lbte,ET 4 own" e - SEAM. - - - - - - - - - A FILTO R n o 0 ~ ~ F$me L 72A I 64,0 72.8 SECTION A--A END VIEW iBb 3" Iso LB 700 came TANK SPECIFICATIONS f 41 RCDW VM COW- WALLS 4• REMMRM COC. CUM A A 4• RED7FUMD COIL "Ill MNolom 2r PRECAST RISER ~LMIST OmEr~ LENGTO r54* ILL e a& VIM 7r oa { DO.Er VMERT- 4r OUTLET HrVOM 3w (LNM LEVU> MUM IESgiM fr_.v uNSATLJmm SOD_ 18.85 GALI M PER VERTICAL D1CN DIM TANG. FOR USE AS RJIP/SEPTB:IFO.DDKi TANG. MHE WMlATIM AVAILABLE CONTACT, L.EVIS WORK 64.0 72.8 PLAN VIEW TOP SLAB L E W I S B J O R K, L L C NOT M SCALE AUGLOST 20. GM2 WM304IE, WI DRAWN BY3 JCP 1 V co 'tH a. J ti~ u~ V - i c g ' c c > .//rt11 o°i-3 I ~J ~ ymm - li b i I _ ~ m m c 5 p -0 a v m v n d o o w (p ~ 3~z = m c° °1 m m m 3 n F 01 z- N° m 3 (D n o n 3 ~ m x o, om, m - m ° z ~ m 3 7 0 0°, y x N n n o m m o o o m c m F z Q ° 3 3 x mmm~ - m F a n p 8 °o ~ m y < ✓3 a m 3 m ` 0.6 0 m Q O q s 7 r . tv y s w u 3 t a k ~ y ~ n t t f ' t k d£ 3rw'kdg 'j• y ~ "~+j,~ d ns a ~t x ~ ' rt n k{ y i a ti~ "*,~rY4yFr~s 14 + 44'#.~I.. p ~(1n O V/ c Q D ~ a~A ~ ~ a ~ ~ ~ a p ~ g o m tb ~ _m3 p o - z ° p 3 d_ z 3 3 tD O o °o p o ~ m x m m o _ z m 8 m 3 ~ z 3 )C m i n c__r_ m y = m E m n o'. c o m O O m 0 m m A " 3 00 tQ 5a ~ p m em.. _ m o m w C m o 5 00 - ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND SHIP CERTIFICATION FORM OWNER Owner/Buyer ~a ~ ' c• - Lv-_ Mailing Address Z496.7 166 otk Awe Property Address Z$0-1 /664-L. I40c, (Verification required from Planning & Zoning Department for new construction.) City/State hlGN.W004 Parcel Identification Number 01 1637. ~f0 ^ c ob LEGAL DESCRIPTION Property Location Nw 1/4 , N~ 1/4 Sec. 1-7 , T 30 N R~W, Town of "1oa Subdivision Plat: , Lot # Certified Survey Map # - Volume Page # - Warranty Deed # 55703h (before 2007)Volume t ZZ9 , Page # 011 Spec house D yes D no Lot lines identifiable D yes D 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 (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, 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 th' 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 wa my deed recorded in Register of Deeds Office. Number of bedrooms _ k11A!44/ R (P /zb/ i 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. 04/12) Wisconsin Department of C ope( SOIL EVALUATION REPORT Page i of 3 Division of Safety and Buitd~ ' - ' % / - _ - in accordance with Comm 85. Wis. Adm. Cate r '~ytliltG County St. Croix Attach complete site I~~0f~ noft less than 8112 x 11 inches in rt#st ~ include, but not limited to: vertical and horizontal reference paint (Bf~reaon and Parcel I.D. 7 percent slope, scale or dimensions, north arrow, and location and dis nce to nearest road. Please 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 ■ Ene Keeler r~~~~ ,~J~w4 _ Govt. Lot NW 1/4 NW 1/4 S 17 T 30 N R IS E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2807 160th Avenue - - - City State Zip Code Phone Number []City ~ Village Town Nearest Road Glenwood City WI 547 ( 7) 5-808-9203 160th and 280th street New Construction User Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD El Replacement Public or commercial - Describe: - Parent material loess cap over till Flood Plain elevation if applicable N ft. General comments and recommendations: t Install replacement mound on 100, contour. ~O (4/LI/n f D s 't. ~C rc✓ ;iln ' c( r ry~,j A- ORIGINAL Fl Boring # Boring 0 pit Ground surface elev. 1.00 ft. Depth to limiting factor 14 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 At 0-5 7.5YR3/3 /A SIL 2FSBK MVFR GS 2F .6 .8 A2 5-10 7.5YIt3/3 SIL 2MSBK MVFR AS 2F .6 .8 ~t B3 10-14 5YR3/4 SCL 2MSBK MVFR GS 2F .4 .6 BT 14-20 5YR3/4 F3P5YR5/8,10YR6/2 SCL 2MSBK MVFR - - - F P2 Boring # Boring Q 100 14 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/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 -Eff#2 Al 0-4 7.5YR3/3 - SIL 2FGR MVFR GS 2F .6 .8 f ` A2 4-10 7.5YR3/3 SIL 2MSBK MVFR AS 2F •6 •8 B3 10-14 5YR3/4 SCI, 2MSBK MVFR CS 2F 4 .6 F3P5YR5%8,10YR6/2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30:< 150 L * Effluent # = BOD < 30 rn1 X and TSS < 30 mg/L CST Name (Please Print) Si to CST Number LEWIS WORK 253976 Address Date Evaluation Co w4ed Telephone Number E7818 COUNTY E MENOMONIE WI 54751 7-21-2012 715-231-7375 I ? Property Owner _ Parcel ID # Page of 3 B3 Boring # i Boring 99 15 • 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 F in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Al 0-4 7.5YR 3/3 - SIL 2FSBK MVFR CS 2F .6 .8 A2 4-8 7.5YR3/3 - SIL 2MSBK MVFR CS 2F .6 .8 133 8-15 5YR5/3 - SCL 2MSBK MVFR CS 2F .4 .6 BT4 I5-24 5YR5/3 F3P5YR5/8,10YR6/2 SCL 2MSBK MVFR - - - - ❑ Boring # Boring a Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication 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 r a Boring # H Boring - Pit Creur?;: s.arfaca ele v `t Depth to !in,,t:ng factor 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 mg1L and TSS < 30 mg/- 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-8330Te,tt (207100) y I t~ Jr) V k 41 J B N ~ ~ r o Parcel 016-1037-80-000 01/08/2013 08.09 AM PAGE 1 OF 1 Alt. Parcel 17.30.15.273B 016 - TOWN OF GLENWOOD Current XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner. C = Current Co-Owner 0 - CORMICAN, DANIEL L DANIEL L CORMICAN 2807 160TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ` 2807 160TH AVE SC 2198 SCH DIST GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 17 T30N R1 5W 2 ACRES IN NW NW COM Block/Condo Bldg: 1.56 CHAINS E OF NW COR TH E 4.56 - CHAINS, S 3,83 CHAINS W 4.56 CHAINS TH Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) N 3.83 CHAINS TO POB 17-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1229/011 V VD 07/23/1997 1162/255 TI 07/23/1997 477/110 2012 SUMMARY Bill Fair Market Value: Assessed with: 218814 79,000 Valuations: Last Changed: 06/07/2011 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 20,000 80,700 100,700 NO Totals for 2012: General Property 2.000 20,000 80,700 100,700 Woodland 0.000 0 0 Totals for 2011: General Property 2.000 20,000 80,700 100,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00