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HomeMy WebLinkAbout022-1098-80-300 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 584798 GENERAL INFORMATION State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2715435 Permit Holder's Name: City Village Township Parcel Tax No: Brandon & Christy Anderson TOWN OF KINNICKINNIC 022-1098-80-300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: X00 f r'V l I -r- 34.28.18.532C TANK INFORMATION ELEVATION DATA /(_)z J TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Z .'S /OZ Septic ; ear Benchmark COJ •t LA A z 7,66 Z. 5 i Z5U Dosing Z Alt. BM Al (0 O b 1 I, ~ CC)J Aeration Bldg. Sewer 95• F 16 -7, Holding St/Ht Inlet C j - -7 c-l ~t T Z TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. ent t Air Intake ROAD Dt Inlet / Septic Ll Dt Bottom ~1 ~l ~1 • Z. Dosing > / Header/Man. Aeration Dist. Pipe Holding Bot. System q PUMP/SIPHON INFORMATION 411 Final Grade Z .6 3 lJ ZC Manufacturer l Demand St Cover L71 GPM Model Number Z 7, C/ 6 L01 td TDH Lift Friction Loss System He d l / TDH , t Forcemain Length Dial., I Dist. to Well `47 - SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length / No. Of Tre ches PIT DIMENSIONS No. Of Is Inside Dia. Liquid Depth DIMENSIONS 0 / h L SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Typef~f Syst m: J UNIT Model Number: 777, 6J~ DISTRIBUTION SYSTEM Header/Manifold Distribution y x Hole Size/ / I rHole Spacing Vent/f~ Air Int Pipe(s) /T~~ Length V Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only C' AC Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil- Yes L] No Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1288 CTY RD M ► ~``N'~• ' ` S` k /1~0`^1~ ' F % ( CiJJ c,` lDe~ G s~L l a,J 1.) Alt BM Description L 2.) Bldg sewer length - amount of cover = Z Z / Gt F L v1\ ~I d sew. , ~ Plan revision Required? ❑ Yes y No C' J Use other side for additional information. II I S Date Insepctor's nature Cert. No. SBD-6710 (R.3/97) County ei'~gfART Safety and Buildings Division C K 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) 'ECEIVED d Madison, WI 53707-71 JUN 07 201' C1 iloi p VSIV% State Transaction Number coMMVNirr U"eflrmit Application In accordance with SPS 383.21(2), Wis. Aden Code, submission of this form to the appropriate governmental unit L. 7 is required prior to obtaining a Sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if Brent than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary M zr ~ 2 tats. 5-f} L /0613 C purposes in accordance with the Privacy Law, s. 15.04(1 m ,S 1. Application Information - Please Print All Information Parcel # Property Owner's Name ~01 4 Property Location Property Owner's Mailing Address 3 ' 2 C 6peD to Govt. Lot City, State Zip Code Phone Number 5 /4, Section g 61-Z Z0 - 71 one) (/.'-'✓T t t 5 fill / (circle o T 79 N; R E one) A Lot # II. Type of Building (check all that apply) I or 2 Family Dwelling - Number of Bedrooms - Subdivision Name 3 ~ Block # ❑ Public/Commercial - Describe Use 11 City of CSM Number 0 11 Village of ❑ State Owned -Describe Use U/ C}~►n/tli P4 AM 01 Town of lC 14) III. Type of Permit: (Check only one box on line A. Complete line if applicable) A. tNew System ❑ Replacement System El Treatmeut/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued 01 B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber 11 Permit Transfer to New Before Expiration - Owner IV. T e of POWTS System/Component/Device: Check all that apply ' f 11 Non-Pressurized In-Ground El Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil X Mound < 24 in. of suitable soil El Holding Tank ❑ Other Dispersal Component (explain) El Pretreatment Device(explain) 16 on: V. DEFlow rea ent Area Itn Design Soil Desigd) n Rate(gp D ispersal a Required Dis ersal Area osed (sf) System Elevation f g VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units h New Tanks Existing Tanks G a. cg ~ ~ u, c7 a Septic or Holding Tank ty et, Dosing Chamber f ( VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name`(Print) Plumber' Signature MP/N Number Business Phone Number LAC A z b -7 Z~s" 2 r~ Plumber's Address (Street, City, State, Zip Code) C-L L µ eel l i~ 1,7 VI oun /De artment Use Only Permit Fee Date Issue Issuing t Signatur Approved ❑ pprove e on for Den ial $ IX. Condit Weasons for Disapproval t c 1:''~"tank, eiflt:~tcnt rt►tef argrl ~ f ~ tli5c *mbi call must All bj~M.' Nlr~ _ritairec aa,pw.ryllr:aPment plan pl41I9ggt ~y plwrbee. 2` I iral ndi fflust w ftii w [rif d as per OPPA"Ne COME / * d mmm, Attach to complete plans for the system and submit to the County only on paper not less than 8 La x it inches in size SBD-6398 (R 11/11) OT of S L 7' 7j cs ,SrA7 Sco-1, 1 " -So SEf~f OF °-P+C ,JZ Y'4 'R! 3Lj) B~czL s ,i l~ apt ~ N ~ 0 00 8044 2 4J m TOP Ott hc~- c~sOVC ri 1 Q EL. I DO. V d rn 70 L w r#-/- r/. 9 S. 70 Ct(RfsT r Rra o~pale•~. ``mot ~~'t eaae }o T, DIVISION N OF INDUSTRY SERVICES -~fo APPROVED 2331 SAN LUIS PL STE 150 -9? GREEN BAY WI 54304-5211 / 0 ~ \ a DEPT OF SAFETY AND Contact Through Relay ~;I $ PROFESSIONAL SERVICES \ S, http://dsps.wi.gov/programs/industryservices www.wisconsin.gov b~ ~oF~s5 Scott Walker, Governor Dave Ross, Secretary CONDITII APPRI May 27, 2016 DEPT OF W CUST ID No. 224832 ATTN: PO WTS Inspector PROFESSIONI DIVISION OF INDC MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHURS 1101 CARMICHAEL RD DANBURY WI 54830 HUDSON WI 54016-7708 SEE CORRE~ CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/27/2018 Identification Numbers Transaction ID No. 2715435 SITE: Site ID No. 824616 Brandon and Christy Anderson Please refer to both identification numbers, 12889 Cth M above, in all correspondence with the agency. Town of Kinnickinnic St Croix County SE1/4, NEI/4, S34, T28N, R18W FOR: Description: Mound System (New Construction - 4 Bedrooms) Object Type: POWTS Component Manual Regulated Object ID No.: 1604397 Maintenance required; 600 GPD Flow rate; 17 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); 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 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: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 114- inch wire, the site is too wet to prepare. If it crumbles. site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. MARY JO HUPPERT Pase 2 5/27/2016 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation, • Final elevations of pump off and invert of distribution pipe; need to be verified for proper pump sizing. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • 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. 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 L,/1 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)4922214 , Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tvanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Roger Nelson, Nelson Plumbing (Plans Mailed To) W4RY JO HUPPERT Pace 2 5/27/2016 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture`s recommendations. • Verify property line(s) prior to installation. • Final elevations of pump off and invert of distribution pipe: need to be verified for proper pump sizing. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing nad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located • Areas that are occupied )A ith rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper L, ea-Linent. if no other site is available, trees in the basal area of the mound must be cut of at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. I Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • 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. 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 G 1-1Z n~ This Amount Will Be Invoiced. When You Receive That Invoice. Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214, Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tvan derleest@wis cons in. gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm Roger Nelson, Nelson Plumbing (Plans Mailed To) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: BRANDON P. & CHRISTY N. ANDERSON ~101'0 Owner's Name: (same) - r Owner's Address: 1288 C.T.H. M RY SERIViCES River Falls, WI 54022 zlz~ ~tGEf~CE Legal Description: SE 1/4 of the NE 1/4, Sec. 34, T28N, R18W Township: Kinnickinnic County: St. Croix D ``ALLY Subdivision Name: NA WED , ETYAN,0 Lot Number: 3 Block Number: NA ,L SERVICES Parcel I.D. Number: 022 - 1098 - 80 - 300 STRY SERVICES Plan Transaction No.: F~"cGla D o+, Page 1 Index and title Pot` MkEgr- xa~ Page 2 Data entry r T. WED Page 3 Mound drawings &< 4 •iY YETY AND °feFe® ! Page 4 Lateral and dose tankL SERVICES e~rars,e ~~C Page 5 System maintenance specifications Page 6 Management and contingency plan tiTRY SERVICES Page 7 Pump curve and specifications Page 8 Plot plan QT'S s W PONDENCE (fE IOf , _ f.\~i Designer: Mary Jo Huppert License Number:. 1859 - 007 Date: 05/18/16 Phone Number: 715 - 426 - 1775 Signature: 0 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 (01181) and Pressure Distribution Component Manual Ver, 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 MyTopo f Start a custom topo map or satellite image Page 'l of 2 rya ~~F ' Search by Place or Address 1288 County Rd K River Falls, WI, United States • Step is Find the center of your map Slide the map, zoom in or out, and change the map type to identify the area you would like on the - center of your map. _ Proceed to Step 2 to finish designing your map, which will involve selecting the base map type (toPo, aerial satellite) and map scale. Continue to Step 2 dL it r - _ f ttp://www.mytopo.com/search.cfm 5/17/2016 Mound and Pressure Distribution Component Design Site Information or 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 r- 36 inches. 600.00 Design Flow (gpd) 10.00' Site Slope 95.60 Contour Line Elevation (ft) 17.00 Depth to Limiting Factor (in) 0.60: In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 10.OQ Cell Width (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 or E) e Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3' Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.50; Estimated Orifice Spacing (ft) = 11.76 ftz/orifice 2.00Forcemain Diameter (in) 94.00 Forcemain Length (ft) Does the forcemain drain back? y 88.00"I Pump Tank Elevation (ft) ` aer Y or EE] .55 System Head (ft) x 1,3 15.33 Forcemain Drainback (gal) .77 Vertical Lift (ft) 55.97 5x Void Volume (gal) X 1.55 Friction Loss (ft) 71.30 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 27.46System Demand (gpm) 14.87 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x j 1.00 1.50 x j 1.25 x x 2.00 1.50 x 3.00 i 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00; Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser ! Manufacturer I~ gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00', Dose Tank Capacity (gal) PolyLok Filter Manufacturer 22.24; Dose Tank Volume (gal/in) 525 Filter Model Number Weiser Manufacturer Project: BRANDON P. & CHRISTY N, ANDERSON Page 2 of 8 MyTopo Start a custom topo map or satellite image Page 1 of 2 1-1 AN, f Search by Place or Address 1288 County Rd M, River Falls, WI, United States • Step 1: Find the center of your map - Slide the map, zoom in or out, and change the map type to identify the area you would like on the center of your map. - Proceed to Step 2 to finish designing your map, I which will involve selecting the base map type (topo, aerial, satellite) and map scale. - Continue to Step 2 3 II ttp://www.mytopo.com/search.cfin 5/17/2016 Mound Plan and Cross Section Views t J 1/10 B Observation Pipe - K Q Q A W "t:..... l: - B • L Mound Component Dimensions ft K 11.56 ft A 10.00 ft E 31.00 in H [Aft B 60.00 ft F 9.25 in s ft L 83.13 ft D 19.00 in G 0.50 ft J ft W 33.10 600.00 (ftz) Dispersal Cell Area 1591.07 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 98.95 (ft) G H rrrr rrirriiir,~L }rrr.'riirr rrr\ F Dispersal Ceu 97.68 (ft) Lateral 97.18 (ft) Invert Dispersal Cell ® t E Q3 Elevation D e . A 95.60 (ft) Contour Elevation 10.0 Site Slope Geotextile Fabric Cover Shading Key a - T Dispersal Cell See lateral details on 10 0 Topsoil Cap c 1.5 ft Page 4 for number, size, Subsoil Cap 0.0 and spacing of laterals. ®0 ASTM C33 Sand Laterals are equally Typical Lateral spaced from the ® Tilled Layer w 0.5 ft F distribution cell's Aggregate o centerline in the --A distribution cell (AxB). Project: BRANDON P. & CHRISTY N. ANDERSON Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals o,er the A & E dimension Turn-up vn ball valve or cleanoutplug P All laterals are identical If- K ° I Hof es drilled on the bottom of the lateral 4 equallq spaced Laterals &.forcernain Sch 40 PVC per SPS Table 30-67 s Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ftz/orifice Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft System Flow Rate 27.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 14.87 ft Forcemain Velocity 2.80 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 4 in. min. Disconnect Tank component is properly vented Altemate outlet location Forcemain diameter Weiser Manufacturer _ 2 in. Capacityl 800.00 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.87 441.80 B 2.00 44.48 C Pump off elevation (ft) C 3.21 71.30 88.91 D 10.90 242.42 D Total 35.97 800.00 Dose tank elevation (ft) Bedding under tank. 88.00 Alarm Manuafacturer SJE Rhombus Note: Sv~,itches Alarm Model Number Tank Alert AB containing mercury may not be used in Pump Manufacturer Gould this system. Pump Model Number PE 41 Pump Must Deliver 27.46 gpm at 14.87 ft T D H Project: BRANDON P. & CHRISTY N, ANDERSON Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Darrell's Septic Service Phone 715-425-1025 POWTS Regulator's Name St. Croix County Zoning 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 1200 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 ears Effluent Filter Should inspect and clean at least once every 3 ears Pump and Controls Test once eve 3 ears Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested eve 1.5 years Mound Inspect for ponding and seepage once every 3 years 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 Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: BRANDON & CHRISTY ANDERSON Page 5 of 8 i 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, Slats. 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 BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfUf100 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 owner, 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. 0 t ~ry Project:' Page 6 of 8 L%QOULDS PUMPS Submersible Effluent Pump PE Orr Pura' SPECIFICATIONS MOTOR FEATURES Pump - General. General: X Corrosion mart • Disetxarge: l h` NPT • Single phase construcfiom. • Terrxperatlrre:104°F (40oo ' 60 Hertz a Cast hon body. maximum, continuous when • 115 and 230 volts ■ Thermoplastic impeller and fully submerged. • BA4n thermal overload pro- cover. • Solids handling: tecticm with automatic reset ■ upper sleeve and lower maximurn sphere. • Class 8 insulation. heavy duly ball bearing AiPPtICATI0AIS • Automatic models include a • Oil-filled design. construction. float switch. • High strength carbon steel i Motor is pemrramerxdy Specially designed for the • Manual rnode!5 available. shak lubricated for extended fallowing uses: - Pumping range: see PE31 Motor service life. • mound Systems performance chart or curve. • 33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pumm • 115 volts operation. • Low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design m All ratings are within the • Basement Draining • Maximum head. 25' TDH PE41 Motor wonting limits of the motor. • Heavy Duty Sump/ PF41 Pump: • .40 HP, 3440 RPIA ■ Quick disconnect power Dewatering • Maximum apaeity 61 GPM • 115 and 230 volts corm, 20' standard length, • Maximum head: 29` TDH • PSC design heavy ~O 16 volt g SJTW with PE51 Pump: PE51 Motor. plug. • Maximum capaw 70 GPM • .50 HP, 3400 RPM A Complete unit is heavy duty, • Maximum head- 37' TDH • 115 and 230 volts portable and compact METERS FEET • PSC design ■ Mechanical seal is carbon, 401 - ceramic, BONA and stainless Moon PF31. K41, MI; Steel. ►IP 33..40..so lu Stainless 9M fasteners. 35 10 T, 2 GPM 0 I - AGENCY tISTiNGS --+1 F 25. cc 5 < 20 ; Tested to 778 and 322.2 108 Uindain& Q f 6y Gam4m St Assodmtion 10 GouxdsPumpskr509L01 rim 5 t-.L..!_ Q Q iQ 20 30 40 50 60 70 P3E ~'T a ~''r~~ fj GPM 80 t~~~' 0 S y 10 is m~/h L®t FLAW Q gof8 L o 7- -3, csrh , g A ScQ11- Sv 1z Sg e•7--j4- M, -0) T~ L-ts ~11- sE/I OF - AJ~ /4 sc3y.TZ~~►. ~z~ s uJ s~ - r 'Al g3 B Z. c _ N cy N i )JO0 N L 0 00 a~ Pv~EL` Qm J TOP 5 4tr~Er cl~ov~ q rs~4 FZ, DO, a d 2 'T AkbeKsa,V, 13RA"Al ~-C""' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Rre.- ►1 n '4-- C: r S y .A vt J e i S n p) Mailing Address ] i-A$ ~ QcL -R) 'v e r F« II z Property Address %n I Fl i'r L-} P,&k k i v e r '44 , F I/s k. ~ (Verification requir d from Planning & Zoning Department for new construction.) City/State Parcel Identification Number ('9 z Z _ le j _ - y _ 3 yd LEGS-.L DESCRIPTION Prope -ty Location Sec. T Z3 N R W, Town of Subdivision Plat: Lot Certified Survey Map # :z ~26 Volume J age # Warranty Deed # (before 2007)Volume , Page # Spec house ❑ yes Kno Lot lines identifiableKyes ❑ 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 wastew.iter 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 t 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 w anty deed recorded in Register of Deeds Office. Number of bedro 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. )4/12) Wisconsin Department of Commerce A SOIL EVALUATION REPORT Page of Division of Safety and Buildi493;-; c " G 66cordarice with Comm 85, Wis. Adm. Code i Attach complete 19te plan on paper not less than 8 1/2 x 11 inches in'size. Plan must ! _ Include, but not Iftted to: vertiealan¢ hod=tal refbrence point (BM), direction and Parcel I.D. ~C /'J'- .1 3v',. percent slope, sca"i0ardtmertsbRSY ~_enti location and distance to nearest road. Please print all Information. viewed Date 6 ? Personal Intomistion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location d q g Y~, I F Govt. Lot 1/4 1/4 S T- N R- E( W~ Property Own Ws Mailing Address Lot # Block # Subd Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road GPO ® New Construction Use: ~ Residential / Number of bedrooms Code derived design flow rate ❑ Replacement ❑ Public or commercial - Describe: Paront material Flood Plain elevation If applicable R. General comments f U- and recommendations: 1 h 5 7 u l 1) L 5y57crh L. 70 be ~8. -i ~ I zlr7-t? --r- tip) Z ~'i i~~l5 f~ F`~ 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 >t Y Boring # Boring . ❑ Q Pit Ground surface elev. Depth to limiting factor In. 7*Eff#l ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Address Date Evaluatir Conducted Telephone Number it Property Owner Parcel ID # Page of ❑ Boring Boring # El I pit Ground surface elev: Depth to limiting fadoc in _ SoU Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIN In. - Munsell . Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 • 'Eff#2 Z. ,f5b~ r J Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. SoA ication Rate F-1 ❑ 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 ❑ D 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 = BOD, > 30 < 220 mg/L and TSS >30:5 150 mgA- ' Effluent #2 = BOD, < 30 mg/- and TSS _5 30 nVL 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. SBD4330 (RGAO) ' 'OPY ' Wisconsin Department of Commerce SOIL EVALUATION REPOI Page of 3 Division of Safety and Buildings in accordance 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 1. Y o 1 indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. n percent slope, scale or dimensions, north arrow, and location and distance to nearest road. r Please print all information. Reviewed by Date Personal Information you provide may be used for sooondary purposes (Privacy Law, a. 15.04 (1) (m)). Property Owner Property Location R d e Y C k r 5 7-1 a n S c K Govt. Lot 5 F 1/4 fv~1/4 S Tae N RE( W Property OwnW3 Mailing Address Lot # Block # Subd. Name or CSM# 2 q -r fl -5 r.- en~ I.r City State p Code Phone Number ❑ City ❑ Village ® own Nearest Road Ii// p J~ 4Q Z2 71 4a5 'SSQ3 fir` C. C New Construction Use: CS Residential / Number of bedrooms Code derived design flow rate a 5 C GPD ❑ Replacement ❑ Public or commercial - Describe: Paront material lA 1 ° 4 [ v 1 i, o n Flood Plain elevation If applicable L y9 ft. General con'vnents II _ and recommendations: h 5 ~Cl I r y1 0 k k, d S y 'M W rn i_ !1 _ 4_ 1~~ r v e~f $ 4 r I I Sys7,f Fz. 7o 6 C Bo4ing # Boring / Ill 1 __JJI © Pit Ground surface elev. 9. CO ft. Depth to limiting factor in. ~ Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM! In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~Eff#1 'Ei"i#2 CS IQ lUY 2 ,i! a75bk ~Y- Z z~ ~o 3 r 1vYr af5lK 0 1L ~J Boring # Boring L J © pit Ground surface elev. J-1L n• Depth to limiting factor' in. Son ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. •Eff#1 'Eff#2 D 'J 1 11 irI loY(( - S i 1 ~f5 l m r C 5 I v~J r 4 r c iL Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L CST Name (Please Print) / Signature CST Nun-ber " C'r Address Date Evaluafind Conducted Telephone Number / S % 5 i Y ~ k( ~ .J 1 5 Qa L i S q 3 ( Parcel ID Page ot # property Owner_ ❑ Boring a .boring # q 2 o ft. Depth to Urrj ng.factor 2 Soo tlon Rate pit Ground surface elev: _ Texture Structure Consistence Boundary Roots GPDM t-todran Depth .Dominant Color Redox Description •Eff#1 'Et(#2 Gr. Sz Sh. in. MunseA . Qu. Sz Cont. Color Ia 3 aT5k f r c s l ,s o. s) I r ~ S t,, 0,5 I af5bk 3 ~?d-3 loYR 3 Cad l u 5 ..;1 f sh/ f r _ - s Y RG q ~ -ql 5 YR El Boring # ft. Depth to limiting factor ~ icatidn Rate ❑ Boring Ground surface elev. in, pit ptlon GpD/ft Texture Structure Consistence Boundary Roots Horizon Depth Dominant Color Redox Desai Gr. Sz Sh. 'Eff#t 'Eff#2 in. Munsell Qu. Sz Cont. Color Boring a Boring # ❑ Ground surface elev. ft• Depth to Ilmiting factor in. Sol icab0n Rate ❑ Pit Horizon Redox Description Texture Structure Consistence Boundary Roots *EfW2 onizon Depth Dominant Color Gr. Sz Sh. in. Munsell Qu. Sz Cont. Color ' Effluent #1 = BODE > 30 < 220 mglt and TSS >30 150 mg/L • Effluent #2 = BODr 30 mi;& and TSS _5 30 mWL ssistanc The Department of Commerce is an equal opportunservice tprthe ovider andenemployer 608-266you need aTIY 608 to acc 7 services or need material in an alternate format, please S8D43 0 (1L") • Q Qj ~ Y C. r ~ S T~ Q, n 5 e' n 1 ~ ~ ~ A r v ~ 3 ~ / ~ t CJ 6- 'l PAS tt.