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026-1161-27-000
. Croix sin Department of Commerce PRIVATE SEWAGE SYSTEM County: St and Building Division INSPECTION REPORT Sanitary Permit No: 589702 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No. d / r Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. City Village Township Parcel Tax No: Permit Holder's Name: 026-1161-27-000 Oevering Homes LLC TOWN OF RICHMOND CST BM Elev: Insp. BM Elev: JBM Description: r. ` ( ~O.~Jen~ bio y Section/Town/Range/Map No: S A,'rJ Io r irat/ ~ C_ 15.30.18.1250 TANK INFORMATION ELEVATION DATA TYPE MAN T` ERA CAPACITY STATION BS HI FS ELEV. Benchmark Septic 100 ® Q Alt. BM Dosing bI Loyty a Aexa4ien IL Bldg. Sewer 10.q r~L 9 Ht Inlet 't T•Z St/Ht Outlet TANK SETBACK INFORMATION TANK TO PLL WELL BLDG. Vent to Air Intake ROAD Dt Inlet LAI et Septic t Dt Bottom 8 eader/ an. Z 'bl Z Do ng Aeration Dist. Pipe 2 -2 1L 2 Holding Bot. System f ~b • S Final Grade J I /1 IOZ. PUMP/SIPHON INFORMATION ` lJ Manufacturer Zo ema St Cover ~ GPM Model Number L~ ~1 a~ •S 115.9 It. I 9Z TDH L4, I • Friction oss~ System Head T TD b~ Ft o Forcemain Leggth b t Dia. ~t Dist. to WeuJ V SOIL ABSORPTION SYSTEM BED/TRENCH Width Length ) No. Of T t PIT DIMENSIO S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ITJy LEACHING SETBACK SYSTEM TO OL lik WELL LAKE/STREAM CHAMBER OR Manufacturer: INFORMATION Type f stem: r _~V, h UNIT Model Number: `N~ DIS TRIBUTION SYSTEM 5 x Hole Size x Hole Spacing Ve Air Intake ~h eader/ anifold j Distribution (M• 1~ Pipe(s) U~ Length Dia Length Dia Spacing__~E F/, I SOIL COVER X Pressure Systems Only xx Mound Or At-Grade Systems Only e"I J xx De th of xx Seeded/Sodded Mulched De th Over Depth Over ~ p I Bed /Trench Ceyer •D t Bed/Trench Edges ` Topsoil --7 'Z,( PI Ye1s E No X Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 1 W O b~ n ection #2: I G(~/'1 + wt~1 ~~t n Q I~~ r~tib~ , Todtl~src , Location: 1548 127TH ST hu U( IGS all ~iahioov Well y~Atl~ f~~12 Q~/b,~~5Mk~ 1.) Alt BM Description _ `p J 5{tbaC0JO 2.) Bldg sewer length = 3Zo - amount of cover = 1''~ L ` oE Ivavts~ ~in (n11 I, Plan revision Required? ❑ Yes No IJL" se other side for additional informatior r s Sinat re C Nop U SBD-6710 (R.3/97) I PUMP PERFORMANCE CURVE w PUMP PERFORMANCE CURVE PUMP PERFORMANCE CURVE SUMP! EFFLUENT MODELS LL 318 1/2"&314"SOLIDPASSING CAPACITY 318", 112" & 314" SOLIDS PASSING CAPACITY as I az MODEL 53155 48 57159 72 76 98 1371139 14014140 151 152 '53 i 3 s1 Feet Meters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. i Liters Gal. Liters Gal. Liters Gal. Liters Gal. Lite s Gal. ' Liters 4 13 5 1.5 29 110 43 163 38 144 50 189 72 273 93 352 86 326 50 189 69 261 77 1 291 1 10 3.1 22 ! 83 34 129 30 114 40 151 61 231 I 79 299 80 303 45 170 61 231 70 265 3 12 15 4.6 10 38 19 72 14 53 { 30 114 45 170 64 242 73 276 38 144 53 201 61 231 20 r 6.1 - 17 64 25 95 36 ! 136 66 250 29 110 44 167 52 197 12 25 7.6 - 8 30 59 . 223 16 67 34 129 42 1 159 '8fi 11 4186 30 9.1 - - - - - - - - - - 49 185 - - 23 87 33 125 40 12.2 - - - - 28 106 - 11 j 42 34 n 1 50 1,5.2 - - - - - - - - - - - - - - - - - - 1 - I 1 60 I 18,3 - - - - - - - - ! - 32 10 70 213 - - - - - - - - - - - - - - - 80 1 24 a 1 - - - - - - - - - - 100 90 3 100 30.5 - - - - - WN 110 33.5 2 120 36.6 -f - 130 , 39.6 - 2 s5 Shut-od Head1 18 ft. 5.5m) 19.25 ft. .9m1 18 25 ft. 7.6m 23 fl. 7.Om 9.1 m' 38 ft116m1 °a J 2 80 1fi5 65 i 75 a 22 70 161/4161 163/4163 16514165 185/4185 186/4186 I 188/4188 18914189 191 63 0 41 s3 Gal. Liters Gal- Liters Gal. Liters I Gal. Liters Gal. ~ Liters Gal. Liters Gal, Liters Gal. Liters 2 65 100 379 fit 231 fit 231 - - 58 220 145 549 145 549 45 170 93 352 61 231 61 231 - - 58 220 140 530 140 530 YS 170 1 60 161 189 85 322 60 227 61 231 - - 5B 220 134 507 135 511 45 170 41611 4189 79 1 299 59 223 60 227 - - 58 220 128 484 '.31 496 45 170 45 170 70 265 57 21fi 59 223 - - 58 220 =7 16- 1 140 62 235 S5 206 220 86 322 58 220 45 170 50 a14 0 - 2 45 170 5 170 46 4 4 172 55 206 10 285 0`8 20 418888 20 76 33 125 50 189 I 51 193 58 220 45 170 45 15 57 39 748 32 121 58 220 45 170 23 87 1 9 34 52 197 45 170 12 4 152 10 38 - - 45 170 28 106 51 193 45 179 153 j 31 117 2 l 8 34 129 45 170 35 16 00 _ 77 64 040 751 4 4 5 185 20 i6 4185 _ 10 38 25 56 1.(17.1 m1 688.12°.1 m( 898.(2fi_4ml 73 R(229m1 1148.(34.7m) 91 R.(27.7m) 110 R(335m1 1378.(41.8m1 0 98 15- 009922 A CAUTION Model 185/4185 should not be subjected to 2 less than 30 feet TDH. 48 72 53,55 76 :37 57.59 :ss NOTE: For Pump Performance on Model 112, Industrial column 9 m zo ao s0 so 7a as 9o mo 110 120 120 140 160 explosion proof pump, see FM0219. GALLONS LITERS 0 30 0 240 320 400 480 560 rLOW PER MINUTE SEWAGE AND MODEL 211 264 266 267 268 270/4270 28214282 28414284 29214292 29314293 29414294 29514295 MILL DEWATERING '7 "1 2" 1 'l I 224- a 2-2 1 22 ° - - - 70 - - 42 1, 1 1. 1 g 80 009904 w I v 16- I I I I z 293II 1 PUMP PERFORMANCE CURVE ° SEWAGE MODELS 20 I I ~ i 3- _F - 2" SOLIDS PASSING CAPACITY 266,1 270' I 10 - 1 CAUTION A e ;o ~i 295 Mod=299t3/4293 should not b 2544subjected to less than 1H. '0 ZO 30 10 50 00 70 80 90 100 10 120 '.-,0 140 150 160 17,0 180 190 200 310 220 2., GALLONS _ITERS 30 60 240 :;2 400 480 550 540 '20 800 FLOW PER MINUTE © Copyright 2003 Zoeller Co. All rights reserved. 6 System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SE 1/4S 15 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 100.4' 7/6/16 BEDROOM 3 DATE CONVENTIONAL CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark B.M.* Property Line Grading is to be done to divert 2 Acre run-off away Lot from system B-3 8% Slope 100.5' 99.5' M B-1 B-2 99.4' 98.5' 97.5' Area 15' below system Huffcutt Combo Tank is to remain undisturbed Well is to meet all WDNR setbacks Tank is to be properly Pro 3 Bedroom bedded and provided with House lockdown covers with Scale = 1 /4° = 10' approved warning labels All piping shall be ASTM SDR 30/34, within t - 10' of tank, piping shall be ASTM F891 127th st Property Line County' Safety and Buildings Division <10 w $ L~ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) JUL Madison, Wl 53707-716 ST. Gout ~courrP E482XBoIV DEVELOPME ggNBM ransactionNumber _A~L, Sanitary Permit Application In accordance 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 different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privac Law; s. 15.04(1) m), Stats. T 1. Application Information - Please Print All Information 1 Property Owner's Name Parcel 4 Property Owner's Mailing Address Property Location Govt Lot .0/A a /.,cJ Section City, State Zip Code Phone Number AAJ ircie on _1A J~ T N; R E n II. Type of Building (check a that app)y) . Lot W or or 2 Family Dwelling-Number of Bcdroomr~ Subdivision Name ••.i.N Block# ❑ Public/Commercial -Describe Use D - ❑ City o CSM Number El Mage of ❑ State Owned - Describe Use ,r own of L) ! 0 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. Oew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B ~ ff List Previous Permit Number and Date Issued ❑ Permit Renewal Permit Revision I El Change of Plumbeq~:T tTransfer to New L' Before Expiration I`Z. Type of POWTS S stem/Com onent[Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade 712-11--d > 24 in. of suitable soil D Mound < 24 in. of suitable soil ❑ Holding Tank El Other Dispersal Component (explain) 171 Pretreatment Device (explain) / V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Applicatiop Rate(gpdsf) Dispersal Area Recd ed7(sf) Dispersal Area Proposed (sf) System Elevat/io/ r , 9 su VL Tank Info Capacity in Total # of J Manufacturer P Gallons Gallons Units 2 New Tanks Extsting Tanks o B ' a T "c J 1 f / a U rn v v, C7 r Septic or Holding Tank 15..gCbamber VII. Responsibility Statement- I, the undersigned, ass responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' gnahue MP/MPRS Number Business Phone Number .J l lL Plumber's Address (Street, City: State, Zip Cod VIII. County/Department Use Only Permit Fee Date Issued Issuing Agent Signature ❑,-,kFProved ❑ Disapproved 13 Owner Given Reason for Denial DL Cone vaUReasons for Disapproval S~S~NER: 1. Septic tank, effluent filter and dispersal cell must be serviced /maintained nMlLbv~i~ as per management . All setback rrequ remenplan ts must be maintained plumber, 2 ~~11t as per app )Cr' b ~WoMe system and submit to the County only on paper not less than 8 1rz z 11 inches in size ~j IS U, 2 sBU5398(x 11/11) 000W. VCYMiv YeqoOcA i- >Ibbbo- ~yrarE~ DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay 's S. http://dsps.wi.gov/programs/industry-services www.wisconsin.gov \F`5$IOtiL%'~ Scott Walker, Governor Dave Ross, Secretary CONDITION July 14, 2016 APPROV PEPT OF SAFI GUST ID No. 226900 AT'IN: POWTS Inspector ` OFESSIONAL SHAUN R BIRD ZONING OFFICE BIRD SELF STORAGE ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 - ` APO CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/14/2018 Identification Numbers Transaction ID No. 2739707 SITE: Site ID No. 826514 Oevering Homes Please refer to both identification numbers, 1548 127TH St above, in all correspondence with the agency. Town of Richmond St Croix County NWI/4, SE1/4, S15, T30N, R18W FOR: Description: Mound System (3 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1612937 Maintenance required; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/O1, R. 10/12); Effluent Filter 'The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145,06, stats. 'The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short: and removed prior to tilling the surface for installation to prevent matting under the dispersal area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands If it rolls into a 1/4- 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. SHAUN R BIRD Page 2 7/14/2016 • 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) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufactures recommendations. • Verify property line(s) prior to installation. • SPS 383.54(1)(°) 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. • Pump Floats to be set and verified per approved plan Anv changes may result in pump res~meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1)° • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely Fee Required $ 250.00 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 tim.vanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm SHAUN R BIRD Page 2 7/14/2016 • 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) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • 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. • Pump Floats to be set and verified per approved plan Anv changes may result in pump_resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fi•agments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 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 tim.vanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm f Cover Page i '\LLY Shaun Bird D Bird Plumbing Inc. .TY AND SERVICES 1432 120th St. -ZY SERVICES New Richmond Wi 54017 715-246-4516 Le- t ADENCE Date: 7/6/16 Owner:Oevering Homes Location: NW1/4 SE1/4 S15 T30 N,R18 W 1548 127th St. Richmond Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10112) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance a' 0 Contigency plan 9. Filter Specificaons and cross section Attachments: Sol jTest i Shaun Bird ~A Signatur License nu er 226900 R;'_-- CEDVF Page 1 of 9 1NOL'ISTRY ISIERV1C-ES Mound System Cross Section and Plan View Dimensi on Feet 7777 7 7 J A B t ' - 1K•1KK•Y1K•Y1KKK.1.Y - r-r•r•r-r.rvr•r•r•r• ~ ?'1.1.1.1.1.1.1.1.1.1K•YY1.1•Y1.1.1• 1 D •...r r.1.~.~.ti. ti-1-Y1?1~1r{{;r1{1r-;+;r~r.ry r.r.r.r...J.r.r•fy.r.r.f.r:r:i}r7r2}:S:r':i:'i:}x$1'1 A t r r r Y1.1K 1.1.4 r•':i1'1'1'1'1'•1f1.111.1 jy~y~•r-r.f.t.f.r•!.r•f.r•r.r.J.fY.J.l~• 1.1.1.1.YY1.1•YYL•1.1•\.Y\.ti•' r•r•r•r•r M•f r:J1~1J1r f1J~'•f1.1.4.•n1.1.V1.1.1:~1{:LfL'-,i,1:15. r•f•J•!•f•r.f 1:1.1.fti~'yf 1-111.1~•~A.Y11 . r•J.f• fl:liyj Kf1.1.1. ti1~1KK~ E ~YrYti-YY1-TT1Y1 •r• •fyfYlf}JY•f,r: Z4: r:f~'V1:1:1i'r•J• ~:1`.yr• fyJy! firi:lf.l1f ' J r•1Jy1'1'1'1'1'1'1r1r1' YYY•rY• fM• 1'1f1,r~-1.1•Y1•Y1•Y1K•1.1%M1~1• r•J•r•f•f•fY•J•!•!•f•l.J~l1f ~•Y:J 1'1' F W r• hr•r• r.f•r•f.r.r•r•r•f.f•J.f.J J•!y'1'1KKKKKKKKKKKKKK•Y f•!Y . ' r•I•f•f•f•f•J•r•f•f•rM•!Y•f•f•rY1Ytir•!•f 'ti~1~ti•1.1• F r•r•r•r•r•r V G I H 1r v e I Z i . J l L fib, K - B 1 z b L Slope % - =Topsoil j E~j~]j~ = ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc Cap Material H r1rK 0 sand fill :,:err 1/2 to 2 %2 in. dia. observation pipe Geotextile G H Fabric ' \x111 Yti~' 111.1.1• ! rY• ~~rr f1.Y1. . F r•r•r'i•r•r.J....:.: 1.1• 1.1.1.1.1.1•Y1• t l ! 1f1r1r.f.J.r,f.r. f1r1.1•M• - J~1~d ~I1±•r1f1r1r f1I• I • _ t D E L l Ft Contour Plowed Surface Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a'/4 inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07 lgj Page j of r Pressure Lateral Layout Two Laterals - End Manifold 4 - Threaded Cleanout Lateral Turn-up o Plug Manifold M Is \4 L Long Force Main .:l Sweep 90 Bend Z $ Distribution Network S ecifications Pressure System Construction Lateral Diameter Z In. Manifold Diameter -Z-, In. Laterals are constructed of Schedule 40 PVC Orifice Diameter 31< In. pipe. Orifices are drilled perpendicular to X Orifice Spacing) In. the pipe with a sharp drill bit and face down. L (Lateral Lengffi) Ft. Lateral turn-ups terminate with a threaded M Manifold Length) Ft. ceanout plug and are enclosed in a 6-8 inch Force Main Diameter Z=- In. diameter lawn sprinkler valve box accessible Force Main Length 0-0 Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box Page of 03/0519) Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer oil Pump Manufacturer Tank Model Number Pump Model Nun:A r N Total Tank Capacity Maim MamfaCpaer Max. Bury Depth j Alarm Model Number ✓ Switch Type /?l ,->c C, c.1 Filter Manufacturer L ~ Total Dynamic Head (TDH) - Feet Filter Model Number j t Elevation Head Distal Pressure . U Network Loss Minimum P=P performance Required Force Main Loss 3 GPlvI 2-2. 2 Ft TDH Total L 2. Z Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Deice. Inlet Manhole With Locking Device < b" Below Grade Sealed Watertight Securely Mounted Weat~ proof Junction Box " - Fitxisbed Grade NMI ANN Vent Min. 12" Disconnect Above Grade Means • With Vey cap si Outlet Filter t-- Wet Baffle Inlet a,'----- ; ; Switch Settings and Reserve Capacity Weep GPI Tank Volume = Hole Volume Gal. Dimension Inches . (reserve) A Lt IS4 U Off Elevation C (alarm) B : 2 3 S, Ft • . 10 -4 (dose) C p S Bottom . , ` Elevation O D D Ft Total 1 Z V c~ ; , 'a; a • ` at, <<<.. <a a.<♦-. < <.< , as e...,: . : < • . <<;.::, i:,>,t a < - •a>,> •<•a>< :a<><>:aa: sa:i~aa<a: i <as>:>eaaasa< i :a::<a<•<>:<>a'::: ,'i i :i s'+',>:>sa~>, i i>:a: <>a>,a:: <`i ><as <>::as ~ a a~a;a<a:;i: <a<a:a'a in accordance with the GENERAL INSTALLATION: The septwJdose tank is bedded and back filled manufacturer's product. approval specifications. Maximum depth of bury as. specified by the manufacturer may not val. Manhole covers exposed to grade have an effoctive lociang device (padlock} be exceeded without pjcior appm t fittings> and installed, piping at ft inlet and outlet is of approved material, connected to the tank with watertigh laid on stable soil to Invent settling or sagging. force maul is sleeved with Ar Sch. 40 PVC to bridge the tank Electrical :seFrrice . mplies with NEC 3~ and Comm 16.2:1. excavation and the.sl"ve.is sealed watertight. page 5-.of . 02105 LI I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of i FILEINFORMATION SYSTEM SPECIFICATIONS Owner e f Septic Tank Capacity al ❑ NA Permit. Septic Tank Manufacturer NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model g❑ NA Number of Commercial Units NA Pump Tank Capacity at DNA Estimated flow (average) r / gal/day ' Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) 7. 1 v aVd Pump Manufacturer . ❑ NA Sol Application Rate ~.7 a /da ffe Pump Model / ZIT:3 ❑ NA Influent/Effluent Quality Monthly average' Pretreatment Unit ?NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODj 5220 mg/L ❑ Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 m /L ❑ Disinfection ❑ Other. Manufacturer Pretreated Effluent Quality Monthly average- ~ ~ Dispersal Cell(s) Biochemical Oxygen Demand (BODS) 530 mg/L ❑ In-ground (gravity) D In-ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade ound Fecal Coliform (geometric mean) 510' cfu/100m1 0 Orip-line ❑ Other. Maximum Effluent Particle Size Y inch diameter Values typical for domestic (non-commercial) wastewater and septic tank effluent. Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every Z ❑ monthear(s) (Maximum 3 yrs.) Clean effluent filter At least once every , ❑ months ear(s) Inspect pump, pump controls & alarm At least once every ❑ months : ear(s) ❑ NA Flush laterals and pressure test At least once every months ear (s) ❑ NA Other At least once every ❑ months ❑ year(s) ❑ NA other. At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage SerVk*Q Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on.the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mectWnlcal or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at irlervals of 12 months or less 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 STARTUP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. fl Page of START UP AND OPERATION painting products or chemicals th~It POWTS check treatment tank{s} for the presence of dtected have the contents of hO thO For'new construction, prior to use of the other may impede the treatment process and/or damage the dispersal cell(s). If high concentrations tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. and may result in the backup the excess wastewater will le During powe or surface discharge to will nl r outages pump tanks may fill above normal dj9~ecell(s}levels. discharged the dispersal cell(s) in one large dose, overloading the rator prior to restoring power to the To avoid this is situation have the contents of the pump tank removed by a Septage Servicing ~ ols to restore effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump contr normal levels within the pump tank. the area within Do not drive or park vehicles over tanks and dispersal s rptiis are not drive or park over, or otherwise disturb or compact, 15 feet down slope of any mound or at-grade sill Tr Reduction or elimination of the following from the wastewater stream may improve the performance and a i~ ~ ; the fat; Life foundation of u tfoundation d POWM antibiotics; baby wipes; curette butts; condoms; cotton swabs; degreasers; dental floss; diapers: outing products; (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; pa pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the f OWTS fails and/or is permanently taken out of service the following Administrative shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.3 3, • Ail 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 stop, gravel or another inert solid material. CONTINGENCY PLAN lipPnt If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code comp ' replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption s uel The replacement area should pr structure, f lines nand lls dFai ure to protect the replacement area will result In the neled setbacks from existing and proposed must comply with the rule:/ in for a new soil and site evaluation to establish a suitable replacement area. Replacement systems effect at that time. 0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologK a holding tank may be installed as a last resort to replace the failed POWTS. he site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluaoon be performed to {ovate 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. structed Mound and at-grade sots absorption must ayymply~nthe rules in in at ellace fo that time moval of the biomat at the infiltrative surface. Reconstruction Of Y «WARNI NG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO OT DEATH MAY RESULT. RESCUE O~ A ENTER A SEPTIC, PUMP OR OTHER TREATMENT BE DIFFICULT OR IMPOSSIBLE. PERSON FROM THE INTERIOR OF A TANK ADDITIONAL COMMENTS POWTS INSTALLER POWTS II~AIWAINER Name Name ~j e~ S Phone ~'/J Phone SEPTAGE SERVICING OPERAT PUMPER LOCAL REGULATORY HORfTY Name Name - Phone J- i Phone J J~ - This document was dratted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. 5 ~ ? r `W [Y A fl. I i E 1 f U l o O ~ ~ m P O 0. O - r t ~ i z a Qo 4 N Q ~ N co v , , 1 y Q o G U ( - V) r-- i i D T RECEIVEC C s r _av I l y P JUL U 8 201 KCKFHQX32K36J Wisconsin Department of Commerce SOIL EVALUATION REPORT of ' Division of Safety andSTpC WIX COUNTY COMMUNrrr DEVEI-9 nce with Comm 85, Wis. Adm. Code min=--Cf r 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. (i=-G - - 116 1a-~ - vi-C) Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). A- rl°_ Property Owner Property Location Govt. Lot 1/4 r 1/4 S ) T30 N R ' E ( ) W Property Owner's Mailing ess Lot # Bock # Surd. me or CySM# lit" r' City State Zip Code Phone Number ❑ City ❑ Villa Nearest Road ew Construction UseJ,Residential / Number of bedrooms Code derived design flow rate ~/~V -~aCf GPD ❑ Replacement r ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable General comments and recommendations: System Type'!. t; f r t System Elevation I © f ' Boring# F 7 A pn~ 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#l 'E'ff#2 0 - J(i C Y tits C ! C#2/ 2- c' J y Boring f Boring # e ® Pit Ground surface elev. i 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. f •Eff#1 'Eff#2 t j -7 17) 1 CIt 4.) ! MJ Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 mg/L ' Effluent #2 = BOD, < 30 mg& and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address ' Date Evaluation Conducted Telephone Number 71 1432 120th St, New Richmond, WI 54 5-246-4516 Parcel ID # Page of Property Owner a F1 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 2 r t.~ ❑ 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 # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. F-1 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 L Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 < 150 mgA- • Effluent #2 = BOD5 < 30 mg/- 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) Z Property Owner _ Parcel ID # Page of F-11 ❑ Boring Boring # ❑ Pit Ground surface elev.... y 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 Z r ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # E] pit Boring Ground surface elev. ft. Depth to limiting factor in. 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 I I I I Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 rng/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (8.600) Soil Test Plot Pi 3 ~3 Project Name Oevering Homes S un Bird } Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 -STM #226900 Lot 27 Subdivision cherry knolls Dat, 7/6/16 NW 1/4 SE 1/4S 15 T 30 N/R18 W Township Richmond F-I Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of power box System Elevation 100.4' *HRpSame as Benchmark B.M.* Property Line Scale is F = 40' unless otherwise noted 2 Acre Lot B-3 8% Slope 100.5' 99.5' B-1 B-2 99.4' 98.5' 97.5' 127th st Property Line ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer D2 veri ll „ Mailing Address - ILA Property Addres (Verification required from planning & Zoning ep nt for new construction.) City/State - Parcel Identification Numbero ~ - LEGAL DESCRIPTION CJ Property Location Y4 V4, T W, Town of Subdivision Certified Survey Map # - - Lot # Volume p Warranty Deed # page # Volume - - - Page # Spec house yes no Lot lines identifabl yes no SYSTEM M`'TENANCE AND OW~rER CER TWCATIQN Improper use and maintenance of year septic system could result in its maintenance consists of pumping out the septic tank ever the system can affect the function of the premature failure to handle wastes. Proper septic very three years or sooner, if needed, by a licensed l'eSlmnsibilities are specified in Cp talk as a treatment stage in the waste dis Pimper. a What on § mm. 83.52(l) panel system. Owner Y Put into and in Chapter 12 - St- Croix Co '~mtmtenance The sanitary Ordinance. Property owner agrees to submit to St. C owner and by a master plumber, journe roix County Planning &Lonin De wastewater disposal system is in u Yman Plumber, restricted lu g mper vet a certification form, signed by the less than 11-1 full of sludge. Proper operating P tuber or a licensed Pumper verifying that (1) the on-site condition and/or (2) after inspection and pumping (if necessary), the septic tank is I/we, the undersigned have read the standards set forth, here above requirements and a ree to Certification orth in, as set by the Department of Co t mament the Private sewage disposals isc stating that your septic system has be rmmerce and the Deparhnetit of Natural Resource 3 Y with the Loniug bion nt within Your days of the three been maintained must be completed and re ~ fate of Wisconsin. 30 Year expiration date. t<irned to the St_ Croix County planning & T/we certify that all statements on thi form are Property described above, by virtue of a warr true to the best tr of Deknowledge. T/we am/are the oer(s) of e deed recorded in Register of Deeds Office. wn th Number of bedrooms'z i ~IGIqAT OF APPLICANT(S) DAT, TF **"Any information that is misrepresented y rnaresult in the sanitary permit being revoked by the Planning 8t 'Coning Department. fnehide with this application a recorded warranty deed from the Register of Deeds Office and a co of the c reference is made in the warranty deed, PY ertifed survey map if (.REV. 08/05)