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HomeMy WebLinkAbout026-1306-00-051 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) g Ev Ism 589707 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township Parcel Tax No: Fred & Amy Coulter TOWN OF RICHMOND 026-1306-00-051 CST BM Elev: Insp. BM Elew BM Description: Section/Town/Range/Map No: 18.30.18.1658 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~Cr Benchmark 0.3 106'3 Alt. BM Aeration rIT Bldg. Sewer 7 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet l D gq 3 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 66 Septic Dt Bottom Dosing a Header/Man. g~- 3 Aeration Dist. Pipe Holding Bot. System II.; , G Grade PUMP/SIPHON INFORMATION Final TW62a c6wS V, 7 Manufacturer Demand St Cover GPM Model er G `i 1 TDH Lift Fric Loss System Head TDH Force ifi Length Dia. ell SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS _ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Al F1L7-Type Of System: f . ' UNIT Model Number: ~t9.JI/VEiV~T~IGyU~~ ZO A/W /l-j/~ CSV4(-K- L/ iitra. DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of 1XX Seeded/Sodded r Mulched Bed/-rrench Center ± Z Bed/Trench Edges t' Topsoil I Yes No Yes / No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 zoInspection #2: Location: 1539 97TH ST pLckAt9E2- Pt-l- l m-(E2 Po ls;oAj ` 7dwa1 E-,4Ct Ve~7-/IT c k 1.) Alt BM Description = (~~r /AJ EN A11~ (eV T~L~ 2.) Bldg sewer length = -/Z - amount of cover = S (p (p ter? Plan revision Required? Yes No ? Use other side for additional information. Z Zv 1lv.~ ~u~ _ ~Z /'moo Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) $~~a~" County 1 g Safety and Buildings Division , 4, t K JUL U $ rt? 1' .J 201 W. Washington P. ox 162 Sanitary Permit umber (to be filled in by Co_) S Madison, V " 2 ST. CROIX COUNTY I U~ LOPM NT KCKFHQX32K36 Sanitary Permit Application J ;~TransactionNumber, A In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit ,W/J I/~'b•-- u required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than trailing address) the Department of Safety and Professional Servies. Person) information you provide may be used for secondary / L;~GI 97 u oses in accordance with the Privac law, s. 15. 1 m , Stars. / L A lication Information - Please Print All Information Property Owner's Name Parcel # CO~~ 6 Z 6 -130 (P - 00 - 051 P, rty mcr's Mailing Address % Property Location SV J Govt Lot City, State Zip Code Phone Number y. Section ~ I ~y ~ ~ lc TLN; 8E W II. Type of Building (check al! that apply) ~ Lot # 77~~~~~ r2FamilyDwelling-NumberofBedrooms Subdivision Name / 111!!! / t Block # ❑ Public/Commercial - Describe Use - ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Z 171STQIt'VnbN CELLS W ZZ u Gh~MbeKS wnof_~ III. Typ f Permit: (Check only one bo on line A. Complete line B if applicable) A. ew S stem y ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Exi g System (explain) ❑ Permit Ren ermit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Exp ti _ Owner 7 70 j / / - / lJ i IV. e ofPOWTS SYstem/Com onent/Device: Check all that a h' Jon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At Grade ❑ Mound > 24 th. of suitable soil ❑ Mound 4 . of tab sp' ~1~ L ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) r L/ y 7 T V. Dis ersai/TreatmentArea Information- L sign Flow (gpd) Design Soil Applicat Rate(.pdsf) Dispersal Area Required (s , D Proposed (sf) /Sy~steem Elle-vatr n VL Tank Info Capacity in Total # of Man a Gallons Gallons Units L o New Tanks Existing Tanl~ v- -~/~J' o ~ s m ro ' 1 U v~ v~ t- C7 Septic or Holding Tank rr Dosing Cbamber . , VII. Responsibility Staten t i the undersigned, assu ponsibility for installation of the PORTS shown on the attached plans. PI ber's Name (Print) Plumber' ignature MP/MPRS Number Business Phone N ber PI er's Address (Street, ity: State, Zip Code) / VIII. CountY/De artment Use Only ipr ~JDisapp7bved Permit Fee Date sued Issuing • i at ~pweer#tT"ven Reason for Denial - _ DL ConSYV&fAv% easons for Disapproval I~/ 1. Stiepticc tCCaJJnk, effluent filter and S~oPI isI~!✓bancel D,DOb-P-f•Z 0-1 SIOP6 12-1 dispersal cell must be s ryiced /maintained (Qp viM Qi. LU P . Pro,-e0-1- .4 %dWo~ as per management plan provided by plumber. 2. All setback requirements must be maintained t . al I e ze ft 4 CaAn04 b? dls r v'~ as per a p p or t3ie system and submit the Coun oa oa ry p per aof less tha s rrz z 1 inches ' size M us+- c Ma f JJ cI a- - o5pec -No SBA6398(8.11/11) '5• ~rtk) rC qe -~s~~-~- arcs ~ ~.Mb~- I~~ iS~V~ l~c~• M~~+- Ix Mc~r i~ ~ ~ Iced Spec , RECEIVED is, JUL 0 8 Z KCKFH Wisconsin Department of Co T. CROIX COUNT SOIL EVh,.. QX32K36J ZT Page of Division of Safely and Buildin;~~UNITY DEVELOP in accordance w kWrn 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ° include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. V(/ ' Please print all information. Review Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 l~ SCJ ell i't ) Property Owner ®s Property Location i/V Govt. Lot 1 /4 < 1 /4 S T R E( W Property Owner . M` linddress Lot # 8 ock # S .-Name or CSM# P City State Zip Code Phone Number ❑ City ❑ Vil ge Nearest ad J ( ) New Construction ;no esidential / Number of bedrooms ' Code derived design flow rate GPD ❑ Replacement ub a lic or commercial - Describe: Parent material 0 L / Flood Plain elevation if applicable Al General comments Z/ and recommendations: 1 C fJ<-61 System Type ~°✓`Q System Elevation El Boring Ground surface elev. ft. Depth to limiting factor- in. Boring # g[, pit t 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 Z- ,2 U B«irg # ~ BoriQ 7R 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 ' j/4- < 1 V '4F Effluent #1 = BOD. > 30 < 220 ndL and TSS >30 < 150 ' Effluent #2 = BOD, < 30 mg& and TSS < 30 mg/L CST Name (Please Print) rfatur CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401 / 715-246-4516 Property Owner _ Parcel ID # Page yof Boring # ❑ Boring ~ d P-Pit Ground surface elev. ! ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 r a`J 14 a 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 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon 7epth 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 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (8.6/00) Property Owner _ Parcel ID # Page yof ® Boring # 1:1 Boring spit Ground surface elev.l ft. Depth to limiting factor #0- 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 try -11 ,a 42 a hl Boring # ❑ Boring F-1 ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil 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 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ')epth 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 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/t- ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBo-8330 (R.6=) Soil Test and S M PLOT PLAN PROJECT Fred Coulter ADDRESS 80 34th Ave New Richmond Wi 54017 NE 1/4 SE 1/4S 18 /T 30 N/R 18 OWN Richmond COUNTY ST. CROIX t~ SYSTEM ELEVATION 89.0/87.5 4' below qrade ~/69116 4 DA' BEDROOM CONVENTIONAL XXX IN-GROUND PRESSURE A CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 , BENCHMARK V.R.P. Top of steel fence p` S ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark All piping shall be ASTM SDR 30/34, within Scale = 1/4" = 10' 10' of tank, piping shall be ASTM F891 Town Road Pro 4 Bedroom 97th st. House 15' S 18% Slope 10' Vent 80' B-3 50, B-1 >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area p' 95' 4' Long 12" S.6ft^2/pair of end caps Grade at System Elevation 3, 0 >25% Slope 34 AC & 91' B-2 X w 2- 90 ~ 3 X 90 cells with >3 spacing V VAS .M. Property Line N b ~ South n N jr- Q~tp,~ ssi I z~ 1 Who tt1 N N tD I 14=i O t~ ;p I ca 0 C6 'c `J Mw~o h tiQe2~~~r o for r3. LO ~5d,°; it (WSW i8'66z 1 T N F~NO I QH I 6`] ca M.9 .oz.zos ~ tl c ED o th w o / ry o Z t u`~g ; to I 047 SA ni 1 m° F M n / 3 (a ci e w~ b -tn F 33' 33 i 51875 / 2 q~v m QN r i n < N w s~•~6z .'ou ~ .~..r• _ 10 ~~b~ i i i W r• W Ng .1 q 4Z5 19 7 -1 CDR C-4 n ; w 51 E 147.92 N , - / E 4i h N Q ~ Pa h- ILO F-1 6z•94£ M Li, zozos Z / (Sp535'S1E \~ln~b~. F p r 0 h 1 N S' ~Si 106.03 w oO t C36 C1w~oh ZfC6 9[~~ C;5 -10 <v) m 0 (0 'A~ C4 453 C\i .5fl $13~0733~ ° / 0~ 9~`1f'~ to O p r i 13 16 57'39 E I ~ ~ ~ ~ t yt'! 1p^. So 6.5fl 1 AT 66 ~~c ~jl 791 J IQ Li i ST. CROIX COUNT 'le SEPTIC TANK MAINTENANCE.1kGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address r~ (Verification r _ equired from Planning & Zoning Departe t for new conshliction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location Sec., T N R W, Town of Subdivision Lot / e #;2~L Certified Survey Map , Volume , Page # Warranty Deed # Volume , Page # Spec house y no Lot lines identifiable yes~ } no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, it 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 wasLr disposal system Owner maintenance responsibilities are specified in §Comm 83.52(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. Vwe, the undersigned have road the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce 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. Uwe certify that all statements on form are true to the best of my/our knowledge. Uwe am/am the owner(s) of the property described above, by virtue of a deed recorded in Register of Deeds Office. Number oom~ Apr , , I6NA'I'C7RE 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. 08/05) lli m m m u z~f ~g Q LL v o a, 0 ,0,9L i a a t o~wow a.am~ u ~a pp V d~OS ~ T F` ¢ d °5 4ww 0 o ~ II Vd m I II ~i li - li l t & '6 k 7i _Q a ~y r ~ ~ 'P 0 O 6a Li Liu y € N B a a 000 ° N L_ ~1 i pl V w i I I I i P ,0 4 ° I e d 0 ! 0 V 0 - w U - N - y R 'g N d O • Ap ~ O ~ I Ka ~@ o e - •fl 9 o rc ms ~ o a ,o-s - „PAI ~p gp .q P ~p m u > 0 m 0 0 t O rA g Q LL m ~ Q m m P,91 ,P,YI .P,CI (i U N 8 - o ° o FI ~ ~-I Q v P m 'll - f c a in o c - J ~ m e o ~ m m - m g _ Nm - gy7~; S z C' d d .FS a Q 3 lp ~o g ~ ~ ~ JI{ !~~;ma QQ m m u m r > i Q L WI-,9 .FI-,6 ,FI-,8 .FI ,6 ~ .FI .B 1 a U 46. ~ _ 4 u 4 it IIII o~ o v 8 mmm d Q 0 o Q I Y'a6 rc s I III ii I I - t llh~ 0 I _ I 0 i i I ICI I I! W u u g d 0 - i N i ~ C N ~i s m m 0 ~m = s 8 0 d g n _ i m `a m . 5 a 2 - s gym,. rcm~ m n~FSrc>~ II'~ ~IIIfIIIII~I I I, ~ Y L 'd ~LL m. =~r~g LL ■~m M a 0 i 0 u i - oac - gu a - - g ~ m `o B x w° x 0 0 m W ~ LL - - J • - Q - - a g~ 2 A '0 e Y ~ e s ; m o~ m ~p J+ •s u a 0 C = o-d 6 D .R '4 5p v P 'gyp m 8 4 0 m O 0 ,LE/K 4,tfi co Ul ^ s 30 ^ t , t f- Tj s ~I i i ro crwa ~ ,o r ~ ~ f W o W oy~ V'M s W ;K N M n w A _ « CJt u a r w i y ~ • i J v.` F a 9 f U V v moo. CountyC (i = I Safe and Buildings s Division ! < n p SUN ~fi . , - i _ Q E 201 W. Washington Ave,.; P:O. B x 7162 -)L- Sanitary Permit Number (to be filled in by Co.) C Madison, WI 531 i S 4Permit Application State Transaction Number 1n accordauce with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit- Note: Application forms for state-owned POWTS are submitted to project Address (if di$erent than mailing address) the Department of safety and Professional Servies. Personal information you provide may be used for secondary ores in accordance with the Privacy Law, s. 15. 1) m , Stats. ,y ) 4M (JI L Application Information -Please Print All Information S Property Owner's Name Pa3 Parcel p fin a P ) l 3~ le uo - 0, t Property Owner's Matting Address Property Location City' State ^ Zip Code I Govt Lot Phone Number ft i Section (cleo II. Type of Building (check all that apply T `~N; R E W ~or 2 Family Dwelling-Number of Bedroo Subdivision Name ❑ PubticlCommercial -Describe Use rJ r' ❑ City of ❑ State Owned - Describe Use / CS er ❑ Village of Z N i'S~-S ~i►J own of III. Type of Permit: (Check onl one box on line A. Complete line applica le A. r ew System ❑ Replacement System ❑ we t/Hold' eplacement Only ❑ Other Modification to Existing System (explain) B• ❑ Permit Renewal ❑ Permit Revision Vhft, Permit Transfer to New List Previous Permit Num ber and Date Issued ❑ of Plumb ❑ Before Expiration Owner IV. ofPOWTS S stem/Com onent/Device: Chec all t t a I / " r4' Non-Pressurized In-Ground ❑ Pressurized in-Ground ❑ de ❑ Mound 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil A 't ❑ Holding Tank Otber Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaVTreat tit Area Information: Design Flow (gpd) Design Soil Ap Rate ~t r ; • r Dispersal Area Required { Dispersal Area a System tem Elevation VI. Tank Info Capac in h.., otal #t of C> l P~ Gallo Man acttirer New Tanks Gallons Units c 3 g Tanks m a U R o ~o - Septic or Holding Tank P C7 ) Dosing Chamber s - _ A VII. Responsibility State t- I the undersigned, a esponsibility for installation of the POR"'TS shown on the attached plans. Pltunber's Name (Privy) Plum gztature MP/IvfPRS Number Business Phone Number Pltnber's .Address (Street, City.,-State, Zip Cod J .t_.--- t . 1,. 7 ~ t - ~ ~+~4`~v.-•a...-cC.i/C.f A7 1`/ 1 ~ ~ / ` Y V? VIII. Co nty/De artment Use Only pproved a Permit Fee Date Issued Issuing t Signature rven Reaso r Denial $ O~ ~J DL Condi ons for Dispproval / 1 . tank, et'Ruent l Id 3 A tA. ~Igiemal Cell must all InAkYlVs I rr-,njLnec' ae.per management plan provided by plumber. 2. mattio maintfi6id 4) n per appti Wo code / adkt nm, Attach to com 0.J Piele planes for the system and submit to the Conary only oak pa of less rhea 8 t2 z l l ioc4es in sift SBD-6398 (R. 11/11) PLOT PLAN PROJECT Fred Coulter ADDRESS 806 134th Ave New Richmond Wi 54017 NE 1/4 SE 1/4S 18 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 94.8/94.7'4' below grade DATE 6/6/16 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark All piping shall be ASTM SDR 30/34, within Scale = 1/4" = 10' 10' of tank, piping shall be ASTM F891 Town Road 82' B-3 48 46' 20' E-71 '2 0' 10' ST B-2 Pro 4 Bedroom House 2-3' X 90' cells with .3' spacing B.M.* Vent >6" Quick4 Standard Vents of Cover Leaching Chamber with 20.0 ft2 of Area B-1 62' Property Line 5.6ft^2/pair of end caps 12 4' Long 4" Grade at System Elevation 3 Town Road Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/6/16 Owner:Fred Coulter Location: NE1/4 SE1/4 S18 T30 N,R18W 1539 97th St. Richmond Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and ontingency Plan 7.Filter Cross Sectio Signature License nunr r #226900 PLOT PLAN PROJECT Fred Coulter ADDRESS 806 134th Ave New Richmond Wi 54017 NE 1/4 SE 1/4S 18 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 94.8/94.7'4' below grade 6/6/16 BEDROOM 4 DATE CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark All piping shall be ASTM SDR 30/34, within Scale = 1/4" = 101 10' of tank, piping shall be ASTM F891 Town Road 82' B-3 48' 46' 0' 10' 20' ST B-2 Pro 4 Bedroom House 2-3' X 90' cells with .3' spacing B.M.* Vent >6" Quick4 Standard Vents of Cover Leaching Chamber 62' Property Line with 20.0 ft2 of Area B-1 5.6ft^2/pair of end caps 12" 4' Long Grade at System Elevation 34" Town Road Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.6ftA 2 pair of end plates Finish grade elevation Typical Installation 98.8' Vent A C/ Grade Vent 3' 4" 3' ,A/30/34 Septic Tank 5' Long 1 5' S' Long E::~-Grade at System Elevation 36" Grade at System Elevation Spacing- 5' 2-3' X 90' Cells Same on other end Observation tube/Vent At end of cell A B 22 chambers per cell System elevations: A-94.8' B947 POWTS OWNER'S MANUAL & MANAGEMENT PLAN P"e of 1LE INFORMATION SYSTEM SPECIFICATIONS Owner / - , 1~:~ Permit # t' Septic Tank Capacity ❑ NA Septic Tank Manufacturer - 0 NA IGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms D NA Effluent Filter Model 13 NA Number of Public Facility Units I-ZrNA 'Pump Tank Cape* I NA j Estimated flow Overage) ! y(1 ~i Pump Tank Manufac rer gaVday 1 Design flow (peak), (Estirroted X 1.5} aU Pump Manufacturer Soil Application Rate NA Pump Model ~ I. Standard Influent/Effluent Quality Monthly average' Pretreatment Unit Fats; Oct & Grilse (FOG) 530 NA Biochemical mgj- D Sand/Gravel Filter © Peat Filter Oxygen Demand (SODS) 420 rngiL D NA D Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mglL Q Disinfection 13 Other: i Preheated Effluent Quality Monthly average ty Dispersal Cell(s) NA Biochemical Oxygen Demand (BODs) S30 mgA. round (gravity) D in-Ground (pressurized) 13 Total Suspended Solids (TSS) <30 mg/L ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 Cfu/100ml J D Drip-Line D Other: iMaxtmum Effluent Particle Size 36 in dia. D NA Outer Ottser. ❑ NA ~d NA Other *Values typical for domestic wastwaler and 13 NA septic tank fluent Other D NA RLWNTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least once every: u . mortts(s) (Masxtinrxn 3 years) D NA (Pump out corrterrts of tank(s) When combined sludge and scum equals one-thircl (16) of tank volume ID NA inspect dispersal cep(s) At least once every: r . 0 month(s) (Magnum 3 dears effluent filter ,;year(s) Years) E] NA At feast once every , D y Oath s) 13 NA Inspect pump, pump controls & alarm At least once every: h(s) a D - f=lush laterals and pressure test At least once every: D month(s) ❑ year(s) 4A At least once every: D month(s) r. D year(s) D MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be madeby an individual carrying one of the following licenses or Certtkations: dumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer; SePi E1 33 include a visual inspection of the tank(s) to identify any missing or broken hardware, identify e any Servicing Operator. Tank re the io lu must '.combined sludge and scum and to check for arty back up or cracks or teaks, measure the volume of 'Visually inspected to check the P pondistg of effluent on the ground surface. The dispersal cell(s) shall be effluent levels in the observation pipes and to Check for any ponding of effluent on the ground surface. The poncIng of effluent on the ground surface may indicate a fading condition and requires the irmedialle notification of the local Iegulatory authority. 6%en the combined ac cumulation of sludge and scum in any tank equals one-third the tank shay be removed by a (36) or more of the tank volume, the entire contents of Administrative Code. ~ Servicing Operator and disposed of in accordance with chapter NR 113. Wisconsin All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, P rent units, Bird any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local 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 check treatment tank(s) for the presence of painting products or other chemicals the t may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infitttative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will bye discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to this effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park Vehicles 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 elimination of the following from the wastewater stream may improve the performance and prolong the life of the POW PI3, antibiotics; baby wipes; cigarette butts; -condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting product's; 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 propetly and safely 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 properly disposed of by a Septage Servicing 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 fails and cannot be repaired the following measures have been, or must be taken, to provide a code cornpCsnt replacement system: viable 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 requhled setbacks from wdsting and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the aged for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. 13 A suitable reel t area is not available due to setback and/or soil limitations. Barring advances in POWTS technologN a holding tank may be installed as a last resort to replace the failed POWf S. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sail 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 biornat at the infittralive surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Oi A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS iNST ER POWTS MAINTAINER Name t' , r Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name --Phone phone 7 This document was drafted in compliance with chapter M 383.22(2)(b)(1)(d)&(f) and 383.64(1), (2) & (3),1A/lscorrsin Administrative Code.