HomeMy WebLinkAbout040-1267-90-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No
(ATTACH TO PERMIT) 589714
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)) 2723899
Permit Holder's Name: City Village Township Parcel Tax No: -7 Kyle & Maggie Holmlund TOWN OF TROY 040-1267-90-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
tv 16.28.19.1461
TANK INFORMATION A• ELEVATION DATA
TYPE MAN t*i2 • CAPACITY STATION BS HI FS ELEV.
Septic Benchmark ry
Alt. BM V
Dosing
4L
lJ Bldg. Sewer
Holding St/ t Inlet 11, 13.4
St~b~-eattet'
TANK SETBACK INFORMATION
TANK TO WELL BLDG. Vent to Air Intake ROAD
Septic Dt Bottom q
Dofog~ ~J eader/ an. 2+ 'O ~f
Aeration Dist. Pipe 3 •'4 10 (1, 7
Holdin Bot. System l00 .
•
Final Grade
PUMP/SIPHON INFORMATION
Manufacturer GP2n, ' 1 D 1 • S
Model Number ~E ~ITDH Lift Friction Loss System HeadJTDJ lI1T'', 0
Forcemain LJengt q) Dia. 2 f ► Dist. to well
SOIL ABSORPTION SYSTEM N1F}'
BED/TRENCH Width TT ngtU j IN., Of es _ PIT DIMENSIONS No. Of Pits , Inside Dia. Liquid Depth
DIMENSIONS U 3 ,
SETBACK SYSTEM TO ED( P Si- BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Typg Of Systgrr UNIT Model Numb
D IBUTION SYSTEM j I) eader/n~iffolld Distribution Ix Hole Size x Hole Spacing Ven Air I t
~
t (M
9 A~0D Pipe(s) t JJJ~ P 9 ' If q j/
Len th la Length W Dia S acin J J ur
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Lie V 12 1 AA
Depth Over Depth over ` xx Depth of T Seeded/Sodded xx Mulched-
Bed/Trench Edges 7 \7 Topsoil '7 Yes No Yes No
Bed/Trench Center
I 1 IT
1 /
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #11: WOO :51D Inspection #2:
TL O
W X -i
Location: 563 CHATTANOOGA DR \ 0 r
VDIV
1.) Alt BM Description = fi mv W V ia" Oy11 is t~' d
2.) Bldg sewer length tI ~T r~r~ttR
- amount of cover = _t
I
`7 LAS'' A ow o4 all
Plan revision Required? ❑ Yes 1~1(1 No
Use other side for additional informa{on.
Date Insepc or's Signature Cert. o.
SBD-6710 (R.3/97)
County
RECEIVED Safety and Buildings Division
p 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
I,
" K
Madison, WI 53 -7162
JUN z o Z0 1b ~°~u,ox~~~ CROIX COU TY
State Transaction Number
Wlication `1 'T
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unt
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address)
the Departmeht of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. 6 ✓ CJ #A AMY,
L Application Information - Please Print All Information
Property Owner's Name Parcel #
0~0 - 2 _ -
Property Owner's Mailing A dress ' / Property Location' I
41 VIt-1:
+J C ~r~ 7rLJ Govt. Lot 1~
Ci State L Zip Code Phone Number 1, 1/4, Section
ty, S i~I %
circle one
"V I . °~6. r T 7_ N; R E o>w
H. Type of Building (check all that apply) Lot
El 1 or 2 Family Dwelling -Number of Bedrooms Subdivision Name
gam, 3`
46 Y- 10
Bock , I~.~ (~C~ / ~'lJ ~.1~
6k ~
El Public/Commercial -Describe Use ❑ City of
CSM Number El Village of
❑ State Owned -Describe Use
Town of ~l
A
III. Type of Permit: (Check only one bog on line A. Complete line B if applicable)
,141iNNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
A" '
B. ❑ Permit Renewal Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued /
Before Expiration Owner
IV. Type of POWTS System/Component/Device: Check all that applyi_
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/Treat ent Area Information:
Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required Dispersal Area Propos (sf)1 System Elevation
. 6 VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units o 2
-0 U U U ~ cC
New Tanks Existing Tanks p
U in ti v~ i~. C7 0.
Septic or Holding Tank
Dosing Chamber " a
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature j MP/bgaFt Number Business Phone Number
e~-q 73
- /0 - Plumber's Address (Street, City, State, Zip Code)
b:1 t 1 l v l
VIII. oun epartment Use Only
Approved ❑ Permit Fee Dat Issued Issuin gent Sign e
$ LD , oc~ (o~Z3, l to
ban
ial
Ov,5rven Reason for
IX. Conditi MTdVAPY AERReasons for Disapproval ~ S roil/~G. FG
1. "Septic, tank, ettluerr !r.-* and
3) r, dtsper:4w cell rnu t 3 ; ran sPAVk#S ( aint~re~ j s I e~ fit/ 1,
as per maragemer r. provi ed by plumber.
_0p ,naint€ it ed
Z. l aWitbeck require its FFW
as per applicable code / ordinances.
Attach to complete plans for the system and submit to the County only on paper not less than 8 ll2 1 11 inches in size
SBD-6398 (R 11/11)
Plot Plan page of s
Property Owner4Le- /t~~c~,~ b~4-0
I" =-5011
Legal Description (except where noted)
Er- Tff& s7 SF--~ i to . 12 S AJ ~ PJ'q UJ j, -MwrJ o~ • = BacA*oe pit
-TeDV/ sF C prvx C -n u AN-V, W r.Seb k 5; Z. 5G3 Ack5
Nor&
Pin
Wet- -*?5
F KO PAD
4
~a fi
Dz _ ,,,,~~11
uM~ pp.00 ~ o~ a~.~ c~p~-r o 9'S 5p ~ Pvc PIPS vj/
A55 1 D~ pis-N-'~ 3.7''ttiuf
J-f-rD~ Pt~C P►~ G
3.9 I ftlaH Pic pipe
fC. ant ,Ply '
4~AR" DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL STE 150
9! GREEN BAY WI 54304-5211
S~ Contact Through Relay
http://dsps.wi.gov/programs/industry-services
S www.wisconsin.gov
ssroNNScott Walker, Governor
Dave Ross, Secretary
June 13, 2016- ESS10
~N OF
CUST ID No. 224832 ATTN.• POGI'T.S Inspector -
MARY JO HUPPERT ZONING OFFICE J l
HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA v
28497 KING ARTHURS 1101 CARMICHAEL RD SEE CORRESPU
DANBURY WI 54830 HUDSON WI 54016-7708
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/13/2018 Identification Numbers
Transaction ID No. 2723899
SITE: Site ED No. 825226
Kyle and Maggie Holmlund Please refer to both identification numbers,
563 Chattanooga Dr above, in all correspondence with the agency.
Town of Troy
St Croix County
SWIA, SE1/4, S16, T28N, R19W
FOR:
Description: Mound System (4 Bedrooms - New Constructio .
Object Type: POWTS Component Manual Regulated Obj
Maintenance required; 600 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; Systen;t
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 10 L01(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 Pa.-e 2 6/13/2016
• 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)
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area.
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Pump Floats to be set and verified per approved plan. Any changes may result in pump resizina to meet
TDH and GPM Specifications.
• 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 PO WTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required S 250.00
This Amount Will Be Invoiced.
~'~•f 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
tvanderleest@wisconsin.gov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
Roger D Nelson, Nelson Plumbing (Plans Mailed To)
MARY JO HUPPFRT Pale 2 6/13i2016
• 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)
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area.
• Tani: Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Pump Floats to be set and verified per approved plan Anv chances may result in pump resizina to meet
TDH and GPM Specifications.
• SPS 383.54(l)(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 r)ad is located.
The bottom of rthe tank t is l t~,..,ocated ,t more th +t, an 1 t - 50 n feet ho ra=, 11S , frpm where the Servi-mQ>7ad i 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 zround 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 383054(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/install ati on/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required S 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice,
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
I
tvanderlecst@wisconsin.gov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm
Roger D Nelson , Nelson Plumbing (Plans Mailed To)
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: KYLE P. & MAGGIE D. HOLMLUND + AND
oERVICES
Owners Name: (same) 1Y SERVICES
Owner's Address: 801 Glen Meadow Street
River Falls, WI 54022
iDENCE
Legal Description: SW 1/4 of the SE 1/4, Sec. 16, T28N, R19W
Township: Troy
County: St. Croix
Subdivision Name: Glover Station 5th Addn.
Lot Number: 100 Block Number. NA
Parcel I.D. Number. 040 -1267 - 90 - 000
Plan Transaction No.:
Nttitlll~u~44ii Page 1 Index and title
~i•~NS'~A;'4Page 2 Data entry
• 4 Page 3 Mound drawings
G
MARY JO * Page 4 Lateral and dose tank
HUPPERT Page 5 System maintenance specifications
D 1859 Page 6 Management and contingency plan
Page 7 Pump curve and specifications
~R FALLSJ
VA Page 8 Plot plan
Designer Mary Jo Huppert License Number: 1859 - 007
Date: C15/28J16 Phone Number 715 - 426 -1775
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both
SSWMP Publhcation 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)
Version 7.0 (R. 0312012) RECEIVED Page 1 of 8
,JUN ® 3 zol6
INDUSTRY SERVICES
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(R or C) Rl Residential or Commercial Design Note: sand fill (D) calculatim asswne a
1 400.00 Estimated Wastewater Flow (gpd) Table 38344-3 in-situ soil treatment for
1.50 Peaking Factor (e.g. 1.5 =150%) fecal conform of - 36 inches.
600.00 Design Flow (gpd)
4.00 Site Slope
100.50 Contour Line Elevation (ft)
X30.00_ Depth to Limiting Factor (in)
0.60 In-situ Soil Application Rate (gpdtfe)
Distribution Cell Information
O Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/fe)
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
L 3.~ Lateral Spacing (ft) If N above, enter the elevation
3 Number of Laterals of the highest point.
0.156 Orifice Diameter (in)
#.u 3.50, Estimated Orifice Spacing (ft) = 11.76 felorfice
2.00 Forcemain Diameter (in)
20.00, Forcemain Length (ft) Does the forcemain drain back? Y -
82.001A Pump Tank Elevation (ft) Enter Y or N
4.55 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal)
8.59 Vertical Lift (ft) 55.97 5x Void Volume (gal)
0.33 Friction Loss (ft) 59.23 Minimum Dose Volume (gal)
W 0.00 In4ine Filter Loss (ft) 27.46 System Demand (gpm)
v.. 13.47' Total Dynamic Head (ft)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 s 1.25 x zµy
1.00 1.50 x
1.25 x x 2.00 !
1.50 x 3.00
2.00 x
Gailonslinch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gat)
1_..A 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
!Wieser _ Manufacturer gaVn (enter result in cell 1349)
Dose Tank Information Effluent Filter Information
800.0(? Dose Tank Capacity (gal) P ok aFit6er Manufacturer
r 22.241 Dose Tank Volume (gain) 525 Filter Model Number
;Weiser _ Manufacturer
Project KYLE P. & MAGGIE D. HOLMLUND Page 2 of 8
Mound Plan and Cross Section Views
T
1/10 B J
observation . .
K L~Lda.,,.S4.S.4.S,L.L.S.L:4.4,L+L.S.•.,S•S.b•S•i.1,•,•,.•S.4•'4.4. }.S,L. L.S. .l,a,' • }
J•d•r; d; d; t; t•r•r•r•r•°•F•r r r t r r r t t r r't•d•l•r•t+l•d•d•t •r ,r:l:r.l
r4~S , S•S•S.L. • • . . ,L. .
S~S•'• 4•L S 4•ti•S 4 1 1 4 S L L+S S 4 L••.•S• .
•L~Se•6.L LjL:ti i%•t•`'„ •l,r~~.885~If{F 1,l•l,•„'r•t•l•l•`.r•l•d:l,l,r•l•,•. l ~•:•'r,l
L•'.••,•L•4•LxS•4 S*•.,L,L+L•L•L•'.•L•S•4•L+L•L•S•L S,LK•S• A
pL 4dL 1.r1 S•^r; r r r r; .•;r r •.yTiy_ r•:;1 l r r;r r r 1 r t~ t r • t., y. l l; l;
•l,r'; d; Y, 'L Sl `StL • L 4+1. ; L•4 tiv +.4 4 L 4 S %S S S:S S•L L
l.r,r.l• r:1.t.F,rel•l~l:r:re,';lel•1,t,f,l„e,ti.'.,'.r"l,l:l,{•,•„F„+.. :r
40
W ~ -
B
[j]• I
16
L
Mound Component Dimensions
A 10.00 ft E 10.80 in H 1.00 ft K 7.41 ft
B 60.00 ft F 9.25 in I 7.40 ft L 74.83 ft
D 6.00 in G 0.50 ft J 4.74 ft W 22.14 ft
600.00 (fe) Dispersal Cell Area 1044.03 (fe) 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 102.77 (ft)
F _ Dispersal Cell 101.50 (ft) Lateral
101.00 (ft)-► - Invert
Dispersal Cell '
Elevation ' D
4
100.50 (ft) Contour Elevation
4.0 % Site Slope
Geotextile Fabric Cover
Shading Key D*persai Ceti See lateral
Q ® details on
Topsoil Cap a 1.5 ft Page 4 for number, size,
Subsoil L•L•b•S'S•~:L• 4•'4:L: and spacing of laterals.
Cap ~ Q •r•l 4y11••~e
ASTM C33 Sand d't '''L ;ar-r•. r• r Laterals are equally
Tilled Layer r : Typical t aeeral s, a` spaced from the
l•r•r:r:i:i:r:i-i:r:l:i:i. distribution cell's
r•J•r• 4•L•L•S•S•S•S•L•4•L•4•S•S••.
S•S.S• mowV~ l•l+l•d•r•.'•l •d; r; d; lti ••~^L
1*
Q L L~L•S. L. L, L.L•. centedine in the
A distribution cell (Ax8).
Project: KYLE P. & MAGGIE D. HOLMLUND Page 3 of 8
End Connection Lateral Layout Diagram
Center the laterals over the A & B drnerrsion 40 - Turn-up rdball valor or olaanoutplua
E P
Ali laterals are identical IE X-~I Holes driked on the bottom of the Lateral
eq-a ft spaced S
laterara 8.forcemain Sch 40 PVC per SPS Table 384.30{ 8
For** main concoction via t►► or cross to manifold at any point.
-JI
Number of Laterals 3 Orifice Diameter 0.156 in
Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 It
Lateral Length (P) 58.56 It Orifices per Lateral 17
Lateral Spacing (S) 3.33 It Orifice Density 11.76 If/orifice
Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft
System Flow Rate L27.46 pm Manifold Diameter 1.25 in
Total Dynamic Head 13.47 ft Forcemain Velocity 2.80 ft(sec
Dote Tank Information LoclcifV cover with warning
label and locking device and
Electrical as - per NEC 300 and 0. sealed watertight
SPS 316.300 WAC Disconnect 4 in. min.
Tank component is properly vented 17LFForccemain Altemate outlet
location
diameter
Weiser Manufacturer 2 in.
Ca 800.0Gallons -fi
Volume gaUnch A
Weep We or anti-
Dimension Inches Gallons B siphon device
A 20.41 453.87
B 2.00 44.48 C
Pum off elevation (ft)
C 2.66 59.23 92.91
D 10.90 242.42
Total 35.97 800 00 D
Dose tank
3" Bedding under tank. 92.00
Alarm Manuafacturer SJE Rhombus
Note: Switches
Alarm Model Number ;Tank Alert ABµ containing mercury
may not be used in
Pump Manufacturer Goukd
this system.
Pump Model Number PE 31
Pump Must Deliver 27.46 gpm at 13.47 ft TDH
Project: KYLE P. & MAGGIE D. HOLMLUND Page 4 of 8
Mound System Maintenance and Operation Specifications
Servioe Provider's Name I Darrell's Sebc" Service Phone 715-425-1025
POWTS Regulator's Name St. Croix County Zonirr~ Phone 715-386-4680
Srstom 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 fe Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
Service Fm- 11 rcy
Septic and Pump Tank Inspect and/or service once eve 3 ears
Effluent Filter Should inspect and clean at least once every 3 years
Pump and Controls Test once eve 3 years
Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 ears
Mound Inspect for ponding and seepage once every:
ears
Other
Miscellaneous Construction and Materials Standard
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 Tum-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 KYLE P. & MAGGIE D. HOLMLUND Page 5 of 8
Mound System Management Plan
Pursuant to SPS 383.94, Wis. Ackn. Code
General
This system shall be operated in accordance with SPS W244 Wis. Adm. Code, and shag maintained in accordarm with its' component
manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01181). and Pressure Distribution Component Menial Ver. 2.0 SBD-1070&P (N.
01/01)) and local or state rules pertaining i o system maintenance and maintenarxe reporting.
No one should ewer enter a septic or pump tank since dangerous gases may be present that could cause deafh.
Septic Old PUMP t w* abandorrruert shag be in accordance with SPS 383.33. Wis. Adm. Code when the tams are no longer used as
POWTS components.
Septic or pump tank manhole risers, access veers and covers should be isped ed for water tightruess and soundness. Access openings
used for service and assessment shah be sealed watertight loon the completion of service. Any opening deemed unsound, defective, or
subject lo Muni must be replaced. Exposed access openings greater than 8-inches in diameter shall be seamed by an effective locking
device to prevent accidental or unauft ized entry into a tank or component.
8/olic Tank
The septic tank shag be maintained by an individual Certified to service septic talcs under s. 281.48, State. The conten of the septic
tank shag be disposed of in accordance with NR 113, Ws. Adm. Code. The operating condition of the septic tank and outlet filter shag be
assessed at least once every 3 years by inspection.
The outlet fitter shag be cleaned as necessary to ensure proper operation.. The triter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the firer when removed from its enclosure. N the filar a equipped with an alarm, the
flier shag be serviced if the alarm is activated oortinuoursly. Intermittent filter alarms may indicate surge flows or an inpamling continuous
alarm.
The septic tank shall have are conter. removed not remo at the eke of sludge volume of a triennial assessment, and
scum into tank exceeds maintenance personnel 1/3
advSquid volume ise the awrier of
tack If the cWtOlft Of the tarnk
when the next service needs to be performed to maintain less than max r um scum and sludge accumulation in the tank.
The addition of biological or chemical additives to atharim septic tank perlbrmance a generapy not m"red. However, if such products
are used they small be approved for septic talk use by the Deparbrient of Commerce.
Pump Tank
The pump (dosing) tarok shall be inspected at least once every 3 years. AN switches, alarms. and pumps shag be tested to verily proper
operation. N an effluent filter is installed within the tank it shag be inspected and serviced as necessary.
Mound and Pressure t WOMufion Sys tern
No trees or shnibs should be planted on the mound. Plantings may be made around the mou ors perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traft (other than for
vegststi- ) the Mound is not recommended since sod compaction may hinder aeration of the infiltrative mood and snow compaction in the winter will promote frost penehationh
Cold weather installations October masurface within the
mound be heavily mulched as protection from treezing. ( y) dctate that the
lr^x nit quality ito the mound system may not exceed 220 rnglL 800y 150 mg/L. TSS, and 30 mA FOG for septic talc efluert or 30
mg/L BOD5. 30 rgfL TSS,10 mglL FOG, and 104 Cfu/100 ML for highly treated effluent Influent now may not exceed maximum design flow
specified in the permit for this installation.
The pressure ution system IS prarided with a fiushirg 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 data mns if orifice dogging has occurred and if orifice cleaning a required to maintain equal dWb*Aon
within the dispersal cell.
Obsavstion pipes within the dispersal call shag be checked for effluent pondig. Ponding levels shag be reported to the owner, aid any
levels above 6 inches considered as an impending (hydraulic faigme mquring additional, more frequent monitoring.
ConflnOsney Plant
If the septic tank a any of its components become defective the tank or component shag be repaired or replaced to keep the system in
proper operating condtion.
If the dosing tank, pump. pump controls. Mom or related wring becomes defective the defective component(s) shag be immediately
repaired or replaced with a component of the same or equal pedkwnence.
If the round component falls to accept wastewater or begin to merge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal tea d toe leakage occurs or by removing biologically dogged absorption and dispenSal
media, and related piping, and replacing said components as deemed necessary to brig the system HAD proper operating cahktition.
See Page 5 of this plan for the name and telephorne number of your local POWTS regulator and service provider
-
P.Ob sabmatt Units
The information and schedule of mananagement and mainltBnarm for pretreatment devices such as aerobic frPPfmRnf tmifc nr Ac;nf-Ff
units are attached as separate documents and are considered part of the overall maragernent plan for this sa
Project: ~~yt,~ NLA°tE ' l,M LiMSd Page 6 of 8
cwu~DS PUMPS
mllerdbie
Effluent Pump
PE
par
wMMM Noun
0 PUMP-CAMN& Nff . Cattos+on
~fon.
T iOMF (40°(~ ` 60 NetQ 4 cast MOnslwbon body.
4 condttuo~us when • 115 aM 230v~aits ■ The~etnop~ itnpdaand
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tnadmoton sphere. ' Ow B Madan. beating
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P
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M1Srtgs ate wihitt dte
pear-
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trtoeot:
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• Mafturt bead: 29' TM ' PSC design 1 he"dwy I SaW wilt
PE51 pow MI Now! gmwdg
MaodtrM capttrW. 70 GPM ' S0 HP. 3100 OM P4
• 1Mlaadenwo heart 3r 7DH • 115 and 2" molls • w* is hN" dadiy,
METM
PSt design ■ MKkmkd and is nobaL
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Plot Plan page t of f 8
Property Owner J(urE NI~►~ -{~~,uu~
Legal Desc *don L py, 61- U Me JAATZPAJ ~t A.D DAJ, (fit where noted)
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N 88010'36" W 390.00' l DRAINAGE ° _
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b N 88° 10' 36" W 390.00' W I ° o ° o
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UNPLATTED LANDS
SOUTH LINE OF THE SW 1/4 OF Tf
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
r
Property Addres
(Verification required from Planning & Zoning Department for new construction.)
City/State Parcel Identification Number
LEGAL DESCRIPTION
Property Location n/4 , 1/4 , Sec. , T N R W, Town of
Subdivision Plat: , Lot f
Certified Survey Map # , Volume , Page #
Warranty Deed # (before 2007)Volume , Page 4
Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (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 this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
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)
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