HomeMy WebLinkAbout032-1003-60-050
Wisconsin Ocpor:nuela of Gvnnxuc" PRIVATE SEWAGE SYSTEM c.ru~l'5AA)-&1/F,-030 St. Croix
Safety and Build,,., Drvecam.
INSPECTION REPORT Sellmuy Perini! no
(,v 1 ncr To hERwrl 589744
GENERAL INFORMATION Sen+PwnID N.
Perrmnal nlormata Y. Provide may he uso!z fur :uoo.. daq porposea P,vmY Lew. z S o4 I1)(ni11
Purmd Hold ei s Name Oly Val:ge Township P"., (it lax N,
Ronald Selinski TOWN OF SOMERSET 032-1003-60-050
CSI BM Flnr InsD BM Elev BM Cesr. pl,on sochonrrcwnAanga'M;,p No
b~ M 1 615-1 02.31.19.20A-10
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER tiffs CAPACITY STATION RS H( FS ELEV.
Septic Tim r Benchn,alk /e 3. T
C32.l~ 1 T
o T+- P zs Alt. BM tJCX oz. s~
Aeration Rld9. %hre
3.51 49.95
Holdinq SVHt Inlet 5 LS CI 7,'% 1
C 9>'~y
TANK SETBACK INFORMATION SFF outlet
TANK TO WE[ 1 13L DG, Vert Ip Au Intake ROAD DI Intel `
Septic 7 SA ! 75 Zif Ut Bottom
Dovrg Header/Man. 92 q(, I
Aeration DISL Pipe - / •0 41'a . ` 4,
q L 9a-18
Holding But. system !Z'Ist, 9Y•V
/Z Utr 40 S
PUMPISIPHON INFORMATION Final Grade
S,S g •9
ManulacAwer Dv~and StC,wer
Model Numner -
TDH I ifl =dclkm I ass System Head 1 DH H
FcTcemalo Lengrh a. Ili•:I to Wull
SOIL ABSORPTION SYSTEM
BED/TRENCH W.,!In L.Mih Na Of Tmurbr-; PIT DIMENSIONS No. OI Pas Ineidc Dia. Lqmd Dopth
DIMENSIONS ll// /-5 . -
SETBACK SYSTEM TO P1 ]BLDG WELL UIKCISTREAM LCACInNG Kmuruutmnl /
INFORMATION r CIIAMDFR OR 6~ 7- r a
-ype Ol System l UNIT Model Number
r+J ~yt•'r0 >SO sk
DISTRIBUTION SYSTEM
NeaaerlManibld II D,stributicr 1.Hole size xllole Spacing Venjjo,/Lir lnWe
I c Myth _ Lha Leny:n Dla spat,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only O`O
Dry,lh ever Depth Over xx DvT,lh d -_'xx Seedea'so]aml u Idn0ee~1
[kvVl wnun Ctnler 2 G j BelrTrench Edges ` Topsoil
l'' J { ~_Yeg No Yes No
~ S
COMMENTS: (Include code discrepancies, persons present, etc) Inspection N1: / Inspection 02:
Location: 7 VC• aa`
1. ) Alt BM UeSCrlption
I
2) Bldy sower Innqlh -
. amount c' cover
Plan revision Required? 7 Yes) )<N-
other side for additional InlormaUoon,lP l/ T~
Use
SBU-671e (R.3/37) Date Insepclo1 Ignature Cert. No.
G/~ gip} ll
Oun,
y.~ I~rnaar4~•n L~,V IOdustry ~I Vicl I~IJAIon Cam Wn
K 3„J II
1400 F Washin for Ave nn 1 III h 1 1 he Idled In I" t t
S' - F U. BOX i -
S At 201 ti Madlsol 7 5S 9 7,~ -
j~1 ~SF
-rr.cROlxcf ' O/USr titutc Iran action Nut"..,
f oMMUMIrv DEVeI,MMMY I el hilt Application
GI A -
In rsoldume ell \I \ 18'I, 0. \d ,l ,,b I t I fbl I rn l t ",props I „ 36 A
r required pool to ,,I Nrl a. u nrn pules \,I, 11 ill t I roil I I ,1.1 t ud IVl 1 I ti -r ul I• ic. 1\ I r>, d'.hltocin Intel I'll addrn+l
1h UcparlnlCnl. I wl I 1 and Fr 1 naI \os1 :mat I h Isn't pr»IJC ua) I+ uxd 1 v _,a t 1 u ],r \rcntw
~nlrp.,>,_in a.avt m c e1Y.I Ih, l f- a. tae 1 oi.l I,ml \t.nz-
1 Application Information Please Print All Information nJa
r, I n) I Iene1 I: u'?-II(H (yl oho nn Q l I~~
0) sl Ir 1)O L_-
- u-- - - - Plopol, 1. rae nn
I.open l iencr > Al Ih hut. 9,.d¢ee
,till (''"I Lane
(Vas 1. . t
~ It /iP Cia Plaaw ]umber Lam"' :mrck onai
\I ruuo I la_hls.. \i\ e51 IN
It .v I m l\
_ I
ype of Ruddmg Irheck all Thal apphl 1,1 1.
~n"'l Vuaw
I m.' I lmlih D cIuu- \.url of lr.dnw+rl~`-L
IOlhh: llmml ual (lexnhC l x
\INC (hv'c 1 IR>.1 hi 1 _ _ _ _ _ 11 ❑ \ illa~r nt
1\\ 1.11I1,1µ1 `
I
III. irpe of Permit: (('heek oult. un hu♦ on hoe it. Comyletc line N it applies M1lel 1
T u l el , do, 11. I l_ I rI>111IY, Av'>Iem (C,plat I
\ i j] NC„ti atilt I I~ H:danlron \»Irln 11❑ Inaun.-ml .+Jrn. .ln+Ktpl wC~.nall Unh - F -
It ❑ I em 1 K t , -1 I ❑ Vertnil Ralnste 1 n l'Larl oe Tj I rrnm I cn'xtcr :o',a\, i li>t • Permit \omF" and U:nC ksucd
OClrc ' rm n
pe of PON rS ti - V-f~
IV.ly `Iem Congwn ntT e,)cc. (Check all th.tapp\I
❑ Nlomul .'J ill. W ahl> ,oil ❑ •I: w.f - 11 1 ;I I nn:de >n9
Vnl-1`C»lurCL'III (ipnlnd Pr. ula i Iln ronW ❑ VYI naAC
(]Illdinyl mA lalter i'},n:dr ill I :>I•I:In1 -CPralreannau
IAspersaliLl m 1 Ors I Inter mnnnn: _
1* L1%~ainl-talool
IA 1„n 14.n, iPpJ' I >.1 r. \r.ll \I pl :uua /I,-Dl peni \ra 'cycueJ bO $p r>prrvnl :\retl' pl~Cd i>I'I t4,Cut
J+ . HdUt:~;d1 _
L Callon,
VI. Tank lard 1 - l Ip.1ut, m ~ I I _
h ,t Ian\~ h>ulinl I nA> _IF/.ILI - ~ - r J
Vsp11 r Ilnlc na IanA )ll _I III NI- I - Olc.or rcle 1❑~ r❑-~ 1 I''I r~-
\ 11. Responslbililr Statement- 1• the umlrrsrgneJ, asrnme rralanlrlMllh fm inshlllatiml of III POM I h amen no lhr .llacheJ plans. - I
I'LlmhCe p'talu RI'HS\unltcr Hump, Phone NLmhu
1,611 Mr e al- IPnnI' If L LI' % M_'M_ N.1-pJPh
hn is lu lul_ - 1
f nlhcr's Vddr > I>acc1. t.1,. >tolCJip ('oJcl ~
61(. I AIIIIds c. Som rrxl. 1A I ~ pl! 5
II1. ountrlDrpartment 1 se Only
( F- I r st I\m~m1Q: cc ~I I-TdfL: ,aedeJ T»eu• e_on tih:nat idd t S LfQs / D
I 1 n, h'a n La Ol ZU I
CIV Condi,~y~ ea runs fur Dlsapproial 3/ 1
'1°-lipdc e1 uem rift.' and -Jl((yNaLe. Akerw~
Znn!g~s ~Ijx~,'ss - 17
tlNpel li cell rust If
p eer mlrKernent plar prc, ii,it 9y DW laL
2- Ah aaft)ick mcl( rerwnts mutt tas maird K d ,
w pu sp*t la cob! 1 :rdina(gtl. - -
Anacbe., mnlett Ulan.forthe,.uen1 aad>aun.,to In, 'I mMp as Ir>a iinua I': cII inrh.•>In>Ire
NHI)-o3981H11; 1 1
PLOT PLAN N
Project Name. F Seliski 3 Bedroom Septic System
Legal Description NEL_4, S2 731N, R19W P LD 032-1-1003-60-050
Sabdlvis on Name `NA Lot NA
Township. Somerset Parcel Size 51.960 Acres SCALE- +"=4e'
Countyi St. Croix__ ! -
System ElecaLo~i. T1= 91.40' Proposed 65.00' EZ Flow Trench
Slope. T7o T2= 90.60' Pro osed 65.00' EZ Flow Trench
BY., Elevah" 100.00' Top of 2" PVC Pipe -
of 2" PVC Pipe -
BPd2 Eievati:n 94.16' To
■ Barxhne P. ,s Tank Wieser Concrete_WLP1000-MR
Bonngs filter Pol lok 526 _
See CSM or Plat for complete View of parcel
4 mch bch 40 ASTM 0%65
. inch 3034 AS 1M 0303.
III
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CONVENTIONAL COMPONENT DESIGN
INDEX AND TITLE PAGE
Pro ect Narte' Selisk 3 Bedro0r-1 ecPUI_ ~ySteri
o•xnvrs Name-. Ronald SeLski -
Dwner's AddmSS 907 Carmen Lane -
Mendota Heights, MN SS 118 -
Legal Description. NF 1/4. S2, T3' N, RLW -
Township Somerset-
Co.lnty: St. Croix -
yubd,v,sion Name: NA -
lot Number: NA Block Number
Parce, I.D. Number 032-1003-60 050
Pld. Transacticn No. _
Page 1 index dnc utly
Page 2 plot Plan
rage 3 Se:1llc Tank Spec ficatlo^S
Page 4 Ettluert filter Information
?age S System Sizing & Cross Sectlon
I'dgc 6 EZ Flow Information
it,ge 7 & 8 Management anc contingency pla7'
Page 9 Sep-. c Tank Maintenance Agrer•Irent
Wage 10 Warranty Deed
Page 11 CSPJ~ or Plat
Atlachmert 1 Soil Evaluation Report
Attm hmemt 2 House Plan
_ L.cnese Nurnher MPRS 223760
UeSigncr JohnSchmitt
Date (;/T,'2016 J Phone Numher. Ili-760-(k186
Si,ynature: Z 2/ t/
In -G no So I Abso,pRcn Co-nponvnt Man,& Version 2,~l SBD 10705-P (N 01%01)
rou
Page 1
PLOT PLAN N
P,ucctName F- SeIISki 3 -Bedroom Septic System
Legal Descrip,i01 ' L~S", NE114,- 92. T31N, R19W P I C 1032-1003601_060
Su J' iwv.n'r Nance A Lol ' N NA -
T wnsFq me rset Parxl Size 51960 Acres acme t'=4o
County St. Croix -
_ Syslem Elevation T1= 91A 0' Proposed 65.00 EZ Flow Trench
Sleoe. 7°/, T2= 90.80' Proposed 55.00' EZ Flow Trench
♦ 8M1 Eeoanun 1100.00' To of l" PVC Pi
BM2 E'.evat:un 94.16' Top of 2" PVC Pipe
Backhoe Pits Tank Wieser Concrete WLP1000-MR
■
• Rw rus -.1!r Polylok 525
See CSM or Plat for cuniplete view of parcel
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PaLy/.q]E l INSTALLATION INSTRUCTIONS
PL-525/PL-625 FILTER
INSTALLATION INSTRUCTIONS
:'ewe-r n:er
j
o ~ z I ~ 'I
WN
J7
LL= i
I
l ~ ® II
Step 1: Step 2: Step 3:
(A) Locate the outlet of the septic tank l;A.l Before installation :Mach the !A1 Glue the filter housing on the
(B) Rerrovc lank cover and pump tank f Itei housing on to the outle: pipe. outlet pipe.
if necessary (U) Make sure that the housing (B) Insert the filter cartridge in the
is positioned so the filter can be housing, vial sure the filler
removed from the tank for cartridge is properly aligned and
maintenance and service. completely inserted in the housing.
MAINTFNANCF INSTRUC (IONS
1
1
1
Step 1: Step 2: Step 3:
Loca:(! the cutlet of the septic tank jA) Remove lank cover and pump iA) Insert the filter cartridge back
if necessary into the the housing making sure
• a
)Bj Pull the filter out of the housing. the filter is properly aligned
" and completely inserted.
(C) Hose oft the filter over the septic tank. (B) Replace septic tank cover
USE RUBBER GLOVES Make sure all solids fall back into the
WHEN CLEANING FILTER septic tank Page 4
SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT
Project Name. Ronald tie skl
Gravelless Leaching Unit Specifications
Manufacturer Model Laying Length EISA Rating
In LNrae:l L2'20F-511 50 _
EZ1207H. " led' sr p
System Sizing
EISA Rawig pe• Foot of EZ Flow 5 ft' Son Axhcatlon Rate 0.7 gpdW'
1-74750 qpd Design Fcw 0.7 Sol ApphcaUOn Rate + C1SA = 128.6 Feet of F7 F1.,,,
trenches 65 feet Iong each
No. of Cells 6 5 _ Per Cell
3 1 Cell Width 13 Total No of 1203H
65 a Cell Length 325 sq ft EISA Per Cell
3 Cell Spacing 650 sit it Total EISA
Typical Cross Section
Finished Grade H P'• Observation Pipe with
"approved..... nl vent
1'~1fI Soil aackfi l
. GeoteYtile Fabric
12 inch O
Slotted and A,chorvd YcnUDAserva6on eyle
--91.40ft O
N,/\1_1 with Cap
~I
90.80 h Inhltlatrve Solid,
Plumber/Designer Signature:
License p: 10PR5?73760 Date: .u1% 1'JiF
Page 5
Installation Instructions for 4%EIZ ow-
EZ~rm,Systems in Wisconsin flwlFILTRATOR
i_ a^sin U.cJartn ert ,f t^,)n'n9r 'e- `=nIc7V 41 :3j hCI I : 5. roe An~c piton:_ e s!S ie:- .;s.Af ro' a (ver r;to oil
Cn• S1Jn, ha; c-evitrr:ed it n,•.:riu,:b, r, anc n! I .r; h : hC s?rC based en na. hum C ~„3a, fh t;4'Jj and
prod:.cl and defermired it t0 be n romplance with chapters the Permeabisty to, the site. If c,ta;n cute w is met, the
Canin 82 hncugh 84, Wisccirl Acmm. Ccde, and Chaptu's FISH 5171ng car, be used in'Nsconsin, resulting in a 40°I
145 and too, Wisconsin Statute. At s~.tes mull rneC: the Ste : smaller dr infield.
Soil Condiliurc: & .L9ca0ons & coat<:r d stances as rri:4rc it ;
In:.ai regulaUcni o. 'lace FZf cw hordle(s) jr, the FZf cw config,uation ap
p•ovec by system design permit specified for the pa•tou-
The approved products are 1903f- (3-' 2" ov c es w:- pipe n ar c tc. The top or center most bundes containing p.pe
center trundle m 5' or 10' lengths', anc ;2_'13f--(3- 12' b,.ndes ate joined end to end with an intema p pe coupler. Any
with pipe in each bundle it 5' or 10 leiltf's. add tonal aggregate enli bundles that may be re,ured,
should be butted against the other aggregate-only bun-
A single pipe bundle contains a four inch perfcratec pine su• de, and do ,ot require any type of conned on.
rc:inded by FPS aggregate a-d is held to^eettr• w•th poly-
ehb,~ene netting. /A singe aggreyate horn, s wafv. hrrgrcq iTc_ fhe tnn of each GEO c; free, contains a filter faonc dre-
n-1, and ;s held loget°Cr vft° pslyeth;lrnc rctt rig- nan.Jactured r between the netting and aggregate. The
fa--ric is irseitec to pievert sol irthusioh. The instaler
Materials and Equipment Needed r.-.I make sure the the GEO is posdiioned upward and is
• FZf ow Runcle^ : I -awact with the fabric contained in the adjacent uyrn-
• EZflow Geatc:..:dc r aBn:- der ocrore backbling.
• LZftOw Internal ape C_~.-pb=r.
• Pine To• Header and The EZ`.7w Dranfield Systems should be installed in a
• Backhce.%Fxcavator level bend in at d'reclionn (loth across and along to
'rent h bottom) and!:horad follow thecontour of the grniiri
Installation Instructions : surface elevator (uniform depth), with all cbnfinucu
'ee nsbuchons for nstallatiu•-. c' EZflow products are givr n adjoining 1()-font cylindrical bundles placed e•hd to end.
t>elcw. This prCduct must bo ~nS:alled in accc•eance with state : '"th central bundle uistibu'.iun pipe intercunnected,
rules defined in chapte,s Cnmm F51 through 84 W scohsin Ad- without any dams. Strpdnwns of ri water ;tops.
mr-iseaLve Code, and Chanters '45 and l bQ. Wsc.onsin Stag
utes, as well as the loca health dcoani)cr •s current design 9. The trench lop s~all h= graded s!,cF that water wd not
manual. Dona. Bac<`III sh Jd be seeded u• Budded immediale r
a"te' cnmpleticn ro n:ru::e ems;r.^
1. After the local health depaitmc rt has Cetenined sizing,
configwat or, and layout for tnC EZflow• systems, stake 10. EZflow FPS bundles are flex:ble anc car fit in cui., I
er mark walk pan' thn location of trenches and lines. `re trenches as may be necessary to avoid trees, boulders.
arefa to set collect tank, invert pipe, header like or of s- ; other obstacles.
tibution bdx and trench botto^r elevations before instal-
:atior of pipe bunccles. ' 1 FPS aggregate is lighter than water, therefore. d nhig• t
• or cxjleclcd that natural Woyancy forces would tend t,
Remove plastic EZflow sripprhg bags prior to plarirg : cause EZflow assemblies to `load cit of ground when
trundles in the trench(es). Rehhove airy plastic bags in !ne pt:nd,ng occurs. F e,J CxIxf, once has shown, hcrwt,vl.
trench beto,e system is ccvered. tnat this is not a proclem. ,-when systems have a nrin^;urn
u. Ci •.ht ::nl. .:over z rc,:,am,.rron!ied bq mannfa:-a,.irpi.
'his product must have geotexiile fabric that meets 'e-
uuirenlerts of s. Cor rte 84.30 {6) (g) vVis..Adm. Code-,
installed directly on top of the product and extending 1203111-GEO
down along the sides of the product to a point at least :r• :
i-ches from the bottom ci product
L+ar :r t:tar u.,~
When installed in a -rrrrh, the trench should be dug to
a width of 36 inches. This hol only +rvus !abcr in excava- : - -
lion but also prrn°des be?ter bad Dearing capsoty after,
bacx9lling is comp etc. ;
..............................................................................Page 6......
POWTS OWNER'S MANUAL & MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
i~A'nC`. I?nnaln Se ,skl
Tank Id anu!a C,wer VJ,CSrr :.O ~C `e(u [ y:.
Penmta
Septic GIDOSC '~JHPlnrnp voturrc 1QDD qal
DESIGN PARAMETERS Tank ManuGduret Wieser Con:rety NA
"mDer Of NOdr.)pms. 1 NA - Sepuc [~DOae _ to din
Nn¢ce: of'eohr Fncn lrty l.yis --T~ 1 g VPL::ne gal
NA ierli al Distance Tan< Doaomell to Stnvlce ?ac, x'
Esnmatec 0vd ioll, Puy, 300 gamily I/ontcntal Olslan Ce IalkfeRo Senvice Pad. R
1lesign Rely = esentaled x 1 5. 450 ,alioay ,
9 - Lt Our t-I[-"•n+na
n c1u Jml Apphcalipr RSIe g.' gahd9y!'12 ,n:, mo
,r r.. rr,.: ,rya maeccyn,r r...
Standard Domoetic nourrntlEHluont Monthly average Fff''u m Ftltef Malufacturer Polyiok J I NA
Feb Oiiabii :11?r3:i Fdir cur's F,der lAOd01 525
B <Ure nual Jargrn'a^rac~;p_.I?~~ NA
f Olal Suaonrdnd Solds",. .,IgO.lpr umpiv anl--(Tc;Urei
,y Punt) 1: noel
High Strength InNuent/Effluent Monthly averago Pwwatment Und
'ass. ;ire R;i'ease d9lj zn •ngn Manufacturer
O'csrmrncal irgppn'3Nnand iBOCa s21o..ra.C .
NA L2.
odl $uSxnd00 plus ',IBS; SIS:)rp~
b
Petroated Effluent
Monthly average
ae>(- lral F:ne,
O chum Calf Ypcr br ld H' _.r z30n}
irE: Sl x(endBC 5 itl i 5JOn1 rl ` nl 50l1'[Ih00 yS 2m
I S5,
Fe tit :,.r,drm 4 VA I' r .r..a era. rn r r.
',ceco -ca rr,nm r00nl _ 1e,,:,.:
Maximum LfBLect Pad r.le Si[e r: ,n it a r'A
Omer ro,
011-" U Na
MAINTENANCE SCHEDULE
n ron,hrngo vng+S'.roqu arc Scum equals onC4hnd i,'h1 of •ank •:m uni -
Vp.~P rTA Service Frequency
tcn the high wetcron I toast once every3 sl
RJaximun 3 years) Nq
ance every 15 (Maximin 3 Years) ❑ NA
latI 10951 once eVrJ NA
rmI IEa51 once every rcylh',.;
H NP.
4
mn?ci _
-rya
_ canmr;:_ -
WINTFNANCE INSTRUCTIONS
mwcTMSpf Links arrd UUPC'3a4111+1nal Lt) ,R r ar:
Uyan J r q 1 (:,I. 'a x- t ur: 61,1c rr
Plummq Maslar Plumber 4csl-JaU )W'1`[^se,n lW .'eeT$', -
' ra rc' ;;eple AC a turn Opc! t Vymppn n.
I tipo.01, muss "Lon it v Sud h'p"'o^ M Ina Iankno 71 da, "rcy m ssm9 U¢ler harowarB wel-fy eny rmcts Y leans.
1108ye l' toll wueV b oarh led sludge aid smm aid a epee,, roc any Wc, or por:C.ng or Watley, or groprq xur/aw TPO
Jis;xnwr Col'rsj boat [e .¢ualy rspa-.led to check the effloe'C Ic:eo; Ir :te nnx in.,,c ,n prpab anal b ehe(k?0` any willing 6f ef•..c
on row groald sudace -in :ending of eH,~em On c^a yrplrld sr. race may -1 Ceted v failing cond,oon aM requ ray the mnredle:n
'toOficsaar of YM local /egubtorv a.rfr+a'ry
'.\'ner the cemonad acWm.:a14G0 q' sludgy arM u'um ,P any VBBlmmt W 0a CquoJ OOblhnd j'b1 Cf rlpre cA'rc rank r04mr ihr pal 'e
mn:er,a of Ine lack mall oe rencvrvf by a srtpvya SenrCmg OPOrelor aid d yyusd ul m aoaxdanr»'w.ln cge!er VN ' 13
Admni^Slydtrva Code.
AI ulner soryCey nc A.riq nut not "mltad M the aery4rng nl OCI{.pnt (herb (nf!Chan al Or pre55rr92ed gYnF;'InntS Velrep'nerr .n.15
arc any .nrvrcrp a, mrBNBG Of 512 Tc+'ha. ypel Lin per lurrad eY a ne4mM CON^. $ MH:nbina
„ cr•.. - .eoort Yrai m n•mncx m Pr ual my 8w'y.-umron•.y worm 301311,+ lt ~,nVC4r el a,rr ceurv::z co- :
Page 7
START UP AND OPERATION
For nevv construction pier 10 use of the POWTS r.heck IreaMent tank(s) for the presence of painting products. solvents or other
cr.w rlCBls or sedimeol that may impede the treatment process andref damage Me soil dispersal cell ISI If agn cOncerbat cns are
detected nave the contents of the tank(s) removed by a seplage servicing operator proof to use.
,rirwm start up shal not occur when soil oor ldions are frozen at the adlltrative. surface
I
During extended power outages pump tanks Tay toll above normal highwate- levels When power is rastorerl the ex(PSS wastewater will
ne alscharged to the dispersa calks, m one large dose and may Overload them resulting n the backup or surface discharge of effluent
To avoid this situation have the emilents of the pump lana removed by a Septage Servicing Operator prior to fester rig pow* to the
effluent pump Or i.nnlael a Plumber or POWTS Mainn roe' to ive l m manually ep<Inlr'ly the pump IXrnbols to restore normal levels
with r the pump tank
DO not dive or park vehicles over talks and dispersal ce Is Do not drive or pan over. O' otherwise disturb or compact, the area wel-in
16 feet down slope o` any mound or al-grade soil absorption area
Reduction of elimination of the forow'ing from the wastewater stream may improve the performance and prolorg the lfe of the POWTS
a Itbioh0s. baby wipes, cigarette Oulls. condoms, cotton swabs. degreasers, dental Boas diapers. dis nfectanls fat, fduonafion draw
;sump pump) discharge, fruit and vegetaG'e ceeungs, yascline. grease herbicides. meat scraps. Oredleahcns', oil pa nung products,
pest codes. sanitary napkins. to nr :ns: and water softener brine.
ABANDONMENT
When the POWlTS fails androf is permanently taken out of servnce the following steps shall be taken to insure that the s'✓stem is pfopeoy and safety
abanceYed in tomphance w.th chapter Comm 83 33. Wisconsin Alkormstraliva Ccde
• All piping to tanks, pits and ether soil absorption systems shall be disconnected and the abanduned pupa opemnge sealed.
• The contents of all tanks and pits shall be emrtved and properly Cisposed D' by a Septage Se'vicing Opi
• After pump:ng• all tanks and pits shall be excavated and renlovrc o' their rOVe'n rein u'vec B'C the vuid tiara h led w th soil
gravel of anothe' inert solid material
CONTINGENCY PLAN
If 1ne POWTS falls and ea^.rOt be repaired the el nwlnq iT'(!4sbie5 navu ricer. must Ce -a-:en in rnJYOe Igo cpvodun it, to Obtai, r saritary pe"mit for
a ride compliant •eplacement system
C A s6itable replacement area has been evaluated and may be utilized for the localwr of a replacement soil absorption system
The replacement area should be pfolec:ed from dts:urbaance and compaction and sel not be nornged upon by required
sa:bacKs from existing and proposed stricture, let lines er'C wells Fadue to pr.^.tect~!he replacement area wilt result or the 'teed for a re'.v so 'I
and site evaluation to establish a suitable replacement area Rep,acement systems must comply with the rules in effect at the to, tncir
ll 111.1 lsslaoce
A suitable replace'nenl area is not available One to selto irel l soil tlmnatem, Ii the soi absorption system oannot be
,ehaNhtated and barring acvances n1 POVITS technology. a holding tank may be installed as a last resort
.
The site has no, peen evaluated reidentify a suitable fee.acement area. LPCn failure of the POWTS a soil arc site eveluahor
mist W performed to locate a salable replacement area f ro replacenlerit wea is available a hold rig tank may be installed ar. a iasl'esc•t to
replace the fai ed POVITS.
i-J Mound and at grade so I absorphdr systems may be reconstructed in place following •en,ta'' of the blomal at the wf lira:ive
surface Reconshurlions of such systems mus: comply with the rules in effect at that Ome
WARNING: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT
OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY
CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT.
s
ADDITIONAL INFORMATION:
POINTS INSTALLER POWTS MAINTAINER
Name. Jahn Scmrnt ff
inc Join
Pnotno 715 75)L.144<;
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
N roc Oahe s ,nor" Na St C
L Cc _'t' Air re ,
This dn: umem ~s Intended to meet mm mum requirements o` Ch Comm 83 2Z2)tbilt hid:8(fi and 83 b4i 1), (2) d (3) Wisconsin Al strabve Code.
Use of this document does not guarantee the performance of the POWTS.
Pa" 8o5t
5I.'lRksix t oz.'s i}
V! Pl]CT.4K~~i:'~T1'lL.'~A'r'C1=AisRr~f~S~EV'i
AND
pVVN RiiTfPCLRIlFICATiONFORM
Om,li r, R.Y. Ronald Seliski
MailingAd&cs, 907 I144o6 1 I-N /NE,uc~orA /{Ei6/1~f M,,J SVX?
YropcnyAddlre,a 66_7 .a36M AdENUS - - -
-
V'CTm Canr t' .cti a Po:._ i'u ZC:n r .r:.-i '0r1 C ornCN RS[]IIC:IJnJ
t I:s'stau Somerset, WI 032-1003-MO50
_.4 Patcci Licwfica tat ,\uo>~r
14 GAL j],LC('DIPTI(lN -
1'r;_rperty Location NE SCC 02- T 31 \ 19 u.. Town of
-Somerset
.hdivision Plar. -
- - Lot
r ti(•!ed Survey tap
Volume-. page
manly Deed # (hcfore 2'00?)Volume
- Spec house m c%ca'
Lut urn`f i,.
s~"$TEM hU~I~TEi\A\CE ~\D Oq'~ER CENCIFICATIO~
huPmpcr i aad mainrcycatkc Ji yuur septic syacm could yeah r, n.:.:
ntalnl,nanCe consists ts 11 of pumping out Lx Septic lank eery One, veers
the system can art,,, the funcuon of the septic tank as a trea[nrrnt sage m the scant drspOSal`sgstcm u';ter ntamtenancc +
rcanmzibilifies are specified in ¢ O
SPS. 3S3 5211 t and m Chapter i2 - St. Croix County tiannan' Ordinance.
The proprnv owner agrees to r❑ym❑ w St Croix County
rr Plannutg & Zoning Department a certification form. signed b•.
net and by a master pl in n; in in ponnseyme,t pllunbet. restricted plumber or z licensed plumper +trd''%Ing that t 11 The omit,
asuwamr disposal l *
.v'slatt is proper opcraung cprdiuon at:dttn2l after specoon mid pumpmg itlbrecssap 1. she sepr
c ss than I!3 full of sludge. cn
I: tic. the undcrsigncd 1,,, reaa the, boy, rcqulmnem, and agree to tnamtatn the pr,,,:c seuxge disposal ssstcnl
ru:dard e fo~h, herein, as >ct hs the Depantcen; of Safety :Nne Proicsstona: Sees.ces and the Dcpaninrru of Yatural Rcsc u:.
"A ~.::?nsin. Certification stating ;hat four septic system has ixcn maintained mist be completed and returned :h_ y.
„_,g & Zoning Depanmcm wnl:in 30 dais of-hc three veal aspiration dam.
'rnih 'hat all slatcme;.ta On "n "mm rte in c tr (h, :v ,1 , r I:rr 1
.P:. -ci ihcd abO',c. be s .n.err
c. ..i
ittuc
Number u droauls 3
SIG\r1i[iRFOFAPPIIC:\^,li':i 7.7 00.6
DA 7F
•-ti,,; mfumwuun drat li lwsrcPre.aued ma} resin: it, rl[c sanitary permit being rccoked by the Plmuung b' Zoning Uepanmc:- • • .
F-iude ss'nth this application a rccordeA aermm v decd from 1:1C Reeiata cr Deeds riff cc and a cnnr of -hc cerr,ne,' 'w' a r;a;.
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"ar``'"'I0I SOIL EVALUATION REPORT
. 1 S P Safety aril in accwuN .ap vn L i Nis Ad,-1 L.d, Pays 1 of 6
s Professional Sefvices - Scnmat Soil Testing. Inc
„loch complete site plan on paper not less than 8'/, x 1 ties m county
t St. Croix
TIdude but not hooted to vertical and horizontal reference pom direction and parrnl I D
percent slope, scale o, dimensions, ronr arrow. and location and distarce In nearest road G32.1003-60-050
Please print a~ll, iin~nf//o~.Tttµr`m`a''ttr~i,onn.p. Reviewed. Da
Per~nnel Nurrrabpi yco pinvWemay beuik mib EWF2& (Privacy Law 15 04 (1) ;rmi 1
epeny Owner Property Location
Selrskx. Ronald _jLi_ ~ 3 [Q 13 Govt. Lot 1/4, NE 1/4, S2. T31 N. R19W
Property Owner's Ma ling Adcress Lot # Block a Su'h10 Name SM#rb p(~ (/'7 L~1F
1013 Sibley Memorial Hwy No. 219 sT l1RO~x CUUNI y 0j, 1 V • 27 / . a ! 7 / "
C:t, State Zip Code Phone Number City Village Town Nearest Road
Mendota Heights MN 55118 612-986-9142 Somerset 236Th Ave.
New Construction Use Residential I Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement public or commercal - DesGibe.
Parent material OutwaSh (PmD Plainfield loamy sand) Flood plain elevation. I applicable NA R
General comments Anfa is_suilai lur a wwenliuu I syshPm wits a J sq8 rate Possibie system elevation lox Area 1 is ;high french) 9140, flow
and teconumendabone YCnt3ti 90.8' „ ; ! ~ j r j - 1- , r1. _ t -i • ~['ti / r r. vt./
Boring rr^!-r(1-i ;{YCa» t-C -C -
Boring #
Pd Ground surface clev 9637 h. Depth to IimduxJ factor 108+ in SoA ADOhcauon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence] Boundary Roots GPD%W
in Munsell Ou. Sz Cam Color Gr Sz St. •cn, •Etla2
1 0-10 10yr3/3 none sl lfsbk mfr cs 2vf 0.4 0.7
2 10-22 I0yr5/6 node grcos Osg ml cs IVf 0.7 1.6
3 22-108 10yr6/4 - none s 05g ml 0.7 1.6
,
,t
j1 qb
lob
a Bonng # Boring r- _
pd Gmuud surface elev 94.47 it Depth to limdirg facto, 107+ in So I Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consxslenco Boundary Roots GPD,ri'
n. Munsell Ou Sz Cont. Color Gr Sz Sh •ERa1 •EIra2
1 0.18 10yr3/3 none sl lfsbk mfr gvv 2vf 0.4 0.7
1
2 18-36 10yr4/6 none sl 1ni mfr 9w _ lvf 0.4 0.7
3 36-55 7.5yr5/6 none s Osg ml cs 1 1.6
4 55-107 11 none s 11s9 ml 0.7 1.6
' Effluent 01 = ROD-.- 30 < 220 mi and TSS --V < t mryl ' Effluent #2 = BOD <30 mgil and TSS < 30 mgA
CST Name (Please Print Signature -7 CST Number
Thomas J. Schmitt 227429
Address Schmitt Sod Testing. Inc Dale Evaluation Conducted 1 eleptlone Number
1595 72nd Sheet New Richmond, WI 54017 6712013 715-760-1978
Propenyowner Scliski, Ronald farce. ID is 032-100360-050 Page 2 of 6
Ewnng fi Bonng
Pn Ground surtace elev 94.47 h. Depth to hmNnq factor 104+ in. '.Son Application Rate
Homan Depth Dominant Cob: Redox Description lexture Structure Consistence Boundary Roots GPDjff'
in. Munsel, Du. Sz Canl. Color Gt. Sz Sh. 'Etas •EIfw2
1 0-12 10Vr3/3 none 51 _ 1fsbk mfr gw 2vf 0.4 0.7
12-27 7.5yr5/6 none sl Imsbk mfr gw 1vf 0.4 0.7
3 77-39 10yr5/6 none grcos CA ml cs 0.7 1.6
q 39-I04'. 10yr6/4 none s Osg ml i 0.7 1.6
Bang
BonngA
4 Pit i
Ground surface olev ...96.37 11. Depth to Ilmning tatlor 72+ In ;Soil Applicat-i Rata
Honzon Depth Dominant Color Refdox Description rexlure Structure Consistence Boundary Roots GPDgt'
m. Munsell Ou Sz Cont. Cnlnr qr Sz Sn. •ETn •EtFS:_
1. 0-13 10yr3/3 none sl Itsbk mfr gw 21 0.4 0 7
2 13.29 _ 7.SyrS/6 - nurse sl lmsbk mfr gw 1vf ! 0.4 OJ
3 29-37 1nyr 5/6 note grcos Osq ml gw 0.7 1.6
4 37-72 10yr6!4 none s Osg ml - OJ 1.6
D Bor no 4 Boring
Pd Ground surface elev. 97.17 n Depth to binning factor 72+ m. Son Application Hate
Horizon Depth Dominmt Color Redox Description Texture Structure Consistence Boundary Roots GPD411
in Munson Du. Sz Cont. Color Gr Sz Sh._ •Etat •Eraz
1 033 1Oyr3i3 fill sl LS 2vf I.
- ' l
2 3343 10yr5/4 none d Ini mfr gw lvf 0.4 0.7
43-72 10yr5/6 none 1 01 ml - - 0.7 1.6
1kii L-
- - I -41- .
'Effluent pl70-??;rIC~L anti TSP, X30-'SG murL 'Fffnlent 8l-BOD 30 mn4 and-SS-30 mg,_
The Department of Commeree is ail equal opporwi sin ice pruv Iii 'roil emploaer. If 1ou need m.i,lancc r. Ai .cn i.c1
o:
nocd malcaal r. ¢ul dhrmntc loi pleas conla,t rht dql mtnrnl if NIS-ebb T, sl nr 1 I ) nlld-761-5-7"
1 .1 s-f mre m,
> ..nyr. I-...
Frul:erty Owner Seliski, Renard
ParceHQa 037-1003-60-050 Paue rr 5
6 Boring
Sonng t ed
Gro,rq sudace elev 97.77 M Depth to Umrong facto, 51 m. - -
rSud Applicaton Rate
Horizon Dapth Dommanl Color Redux OescnpUOn texture Structure Consistence Boundary Roots GPDMI
in. Munsell Qu Sz Cont. Cti Gr Sz Sh
'Effat -F.MN2
t 08 10yr3/2 none sl 2mgr mvfr es
Zvf 0.6 1.0
2 8-17 IOyr4/3 r
nrme sl 2msbk mfr gw lvf 0.6 1.0
3 17-31 10yr5/6 none Is Osq mfr gw Ivf 0./ 1.6
4 31-51 10yrs/4 none grls Osq ml cs 0.7 1.6
5 51-65 I IOyr5!6 _ Od 6
/.iyr5,3 Ivfs lcsbk mfr Cs 0.4 0.6
6 65-78 Syr4/4 m2d 7.SyrNs -
7.5rtS!3 sl 2mpl mfr CS 0.0 0.2
7 78-100 10yr6i4 none grcos Osg nil r U.7 1.6
I-
Boring
Boring M nil _
Ground surface elev 97.77 1' Depth to UmNng factor 67 in sod Applcalton Rate.
Hnnion Oepth Oommanl Color Redox Dascrlpuon Textum Structure Consistence Bounary Roots GPOM,
in Murn ell Ou Sz. Cant Color Gr. Sz Sh
'EMat •FnN~
1 0 46 1Or 3/3 FILI. sl
- CS lvf
2 46-54 10yr3/4 none sl 2fsbk mfr
4w 0.6 Lil
3 51-6 0yrS16 none fs lcsbk mvfr gw 0.5 1.0
c2d S^/8
4 67-93 7.5yr5/6 Srr5l3 I(s labk mvfr CS 0.5 l'O
5 93 100 10yr6!4 none r
r - fs Osg ml 0.5 1,0
Boring X Boring
PR Groan surface elev. 96.27 E Depth to frmnmg factor 49 in. -
Sod Appicaua l Rate
Horton Depln Domnnanl Color P.edox Oescnp6un Texture Structure Consistence Boundary Roots GpCM"
in I Munvlt Qu. Sz Com. Coto, 31 St Sh . 111"I
'FfIN^
1 0-23 10yr3/3 fill sl Imsbk rnfr qw 2vf 0.4 C.7
2 - 23-49 i f 1Oyr311 none sit lmsbk mfr qw lvf 0.4 0.6
3 49-79 10yr5/4 c2d 10yrb,% -
IOyr6!1 sl Om mfr 0.2 0.6
I
Effuent 61 - RnU_ yo 220 mgi. a,d TSF] -30 150 MmI,L ' Effluent 42 = EOD_ 30 myiL and TOS < 30 mQ'
L
I tee I)CPanmcnl of Commerce i. ar. equal o' ortunih
" P +cntte provider mid rnrplo}:r. If nu n.rd us i. I m.c to :w~c.~ un nr. ur
nerd nnlcria in en u:rcm:oe tirmtel plra.c cnulaci Ihu ;I: panm of 'u !q8 I a m fl fir 4-' • -
Property Ovaier SdiSki, Rmakl Par::el lD# 032 1003-60-050 Page 4 of 6
Bonng # Boring -
Pit Ground suifarn elev. 93.97 R Depth to limnirg factor 72 f in Sod Application Ralej
Homon Depth Dominant Color Redox OesnipUOn Texture Structure Consistence Boundary Roots GPDIB'
m_ Munsell Qu Sz. Cent Color Gr Sz Sh. •E Wi 'FW
1 0-15 I0yr4/3 none sl imsbk mfr gw Ivf 0.4 0.7
2 15-37 _ _10yr4/4 none Is lcsbk mvfr 4N Ivf 0.7 1.6
3 1 37.45 I0Yr4l6 na.e sl 2msbk mfr gw b✓f 0.6 LO
4 : 45-59 .I 7.5yr5/4 none cos Osq ml CS 0.7 1.6
S 59-I2 IOYr6l4 none s Osq ml 0.7 1.6
- - t
Bonng
Boring Y Pit
Ground surface elev I Depth to IimNrg factor m. Soil Apdiw0en P.ale~
Horton Depth Dominant color Redox Description Texture Structure Conirslence Boundary Roots GPDrn'
m Nunsetl , Ou Sz. Ccnf Color Gr S<. Sit
•E'rot Tna.
El Bonng
Boring # Pd Ground su'face elev 0 Depth to limning factor in
Soil Appl¢aeon Rate
Horizon Depth Ownlnanl Color Hedox Descnpoon Texture _ Structure 'Consistence Boundary Roots GPDW
in. Munsell Ou. Sr Cont Color Gr. Sz Sh. •E##t •Etro_
I 1
I
t
'Etfluent#i-BPO,,~?w^,~7?o ¢g;~and l5S 39--ISOmq+L 'ETu,-nt#:=PoF -3OreglLand TS$,
Ilnc Dalxrrtmenl of (~onvnerce i4 au espial OPPOrmm'. vr% ire provider arnl cmplocer. It anu nred axiuana' to actt.... i,r. nr
neeJ malc-lul n: un alhrit0ie timnat. plca.c cnnl;ICt &..e dcp;irTncn' at MIX21,6 3151 or I I Y t,IIS-164-S-1
'IIL t: .i rti
(bnducted by: (onducleA "r: Page ~ of 6
~
Schm-tt Soil Testing, Inc Name. Ronald seliski
T
1595 homas J. Schmitt, CST 227429 Address: 1013 Sibley NemoriUl Ilan No. 214
New Ricchndmoon nd WI 5401 1 City, State, Zip. %lendotn Ileights. NJN 55118
New .
Phone 715/60 1918 PID 032-1003-60-(ho
.r.<a.: ~(L Lot NO. - ♦A (51,96)
Legal Description NLIA s2 13IN R19N
Backhoe Pit Tnnwnship, County Somcrwi. %st ( rois ('uunh
Bench Mark 1 Et 100.00' Top of 2" PVC pipe
Bench Mark 2 El 94 16' Top of 2" PVC pipe
Tape= r %
i
1' 40'
J
IZ5
l
13~
_ \7
-6
r.y_ , 117
0 i