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HomeMy WebLinkAbout042-1086-90-240 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) State Plan ID No: 589793 GENERAL INFORMATION Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2761997 Permit Holder's Name: City Village Township Parcel Tax No: Peter Gregg TOWN OF WARREN 042-1086-90-240 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 31.29.18.485A-24 TANK INFORMATION . ELEVATION DATA TYPE MANUFA(,N Q O PACITY STATION BS HI FS ELEV. Septic V /zz Benchmark f1 I O(, loo ` Lim Dosing -7 SV Alt. BM (I m6o ,V ~ - I i Bldg. Sewer Q- W. Flaldtn~ Inlet j jtr! _ 19Q,• U TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dos Head an Aeration ~J( Dist. Pipe Q H ding Bot. System r Final Grade J PUMP/SIPHON INFORMATION Manufacturer ~ I` e l~ DPn and St C r, , L~ U / 'V Model Number bpi k4 TDH LiftFrictio Loss System Head TDH Ft ~ , O y Forcemain Length 1 Dia. Dist. to Well ^ I / SOIL ABSORPTION SYSTEM i v \ BEDITRENCH Width 1 ILengW_ No. Of TrteNgLaes ~A PIT DIMENSIONS No. Of Pit Inside Dia Liquid De DIMENSIONS / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION T Of System- , CHAMBER OR YPg , b`l T D }2~ / UNIT Model Numb DISTRI TION SYSTEM 6u ' V ir Intake Heade M nifol Distribution M 1 x Hole Size x Hole Spacing lvptv o A Pi e s p Z Length Dia Len9th Dia Spacin9 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Ove Depth Over 7opsoil x Depth of xx Seeded/Sodded xx Mulched Bed/Tren C.Q d/Trench Edges :f/ of I .Z Yes No Yes 7~O _,o COMMENT (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 636 93RD ST (TboV vh V S (6 1.) Alt BM Description= &Jkp 2.) Bldg sewer length - amount of cover = 7 ~l1" b~ Covet on alp ~ -{~~1 o~ca~.~, Plan revision Required? Yes No 1 I r~ Use other side for additional information. IV) _ ` a56 ate Insepctor's Signature Cert. No. D SBD-6710 (R.3/97) yV Vic,%6 _ oa County 7 E' Safety and Buildings Division <1 w 201 W. Washington Ave., P.O. Box 71 Permit Number (to be filled in by Co.) Dig Madison, Wi 53 71 rar5 CquNY G78Y3N7YYY4JT i 3oMMUNITY ermlt Application ~Laie TratisaetionNumber i ~ In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 2 is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Proje Address (if different than mailing address) the Departtnent of Safety and Professional Servies. Personal information you provide may be used for secondary urposes in accordance with the Priv Law, s. 15. 1) m), Stats. 1. Application Information - Please Print All Information Property Owner's Name ) Pazcel # i Property Owner' Mai Ad ess Property Location 31-)1, Govt Lot O ,Y!4) City, State r Zip Cod Phone Number Section /a / / T-47 le " N, E ;2~pe of Building (check all that app)y) ( Lo - Family Dwelling - Number of Bcdroorik I Subdivision Name Ok ad Bloc v-~ ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Dycribe Use a! 1 CSM Number , Q Village of X 7J O Town of 1~~ 111. Type of Permit: (Check only one box on line A. Complete line B if plicable) A.. Mew System 11 Replacement System Q Treatment/Holding Tank Replacement Only Q Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type ofPOWTS System/Component/Device: Check all that a lv b ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) etrcatment Device (explain) r V. Dis ersal/Treat nt Area Informatio Design Flow (gpd) Design Soil Applicati (gp f) Dispersal Area Requir Dispersal Area Prop d ( System Elevation VL Tank Info Capacity in Total # of Manufactur& d Gallons Gallons Units i o 2 New Tanks Existing Tanta a m N/ ~t{/~►L U v va C Septic or Holding Tank _ - ~ I Dosing Chamber A VII. Responsibility Statement- the undersigned, a responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P] igtature MP/MPRS Number Business Phone Number Plumber's Address (Street, City; State,-Zip de) unty/De artment Use Only Approved ❑ Permit Fee Da Issued Issuine ent Signature X40 , Ob g ZZ ! w Reason for Denial 3\ (j DL Condt r Aepproval A ' ai cell must ell P kjjkf_S as per management plan provided by plumber. 04-t- 11,/ip. t LLLIII 2. .igpremartks must tai 1x~aiMFirfierJ as per applicable code / 04naltoea, 4 e A,~ear 6 h,w- 1r/( ~Aj_ Attach to complete plans for the system and submit w the C~oun~tyA lly ou paper n less than z 11 inches in size SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Peter Greaa ADDRESS P.O. Box 746 Hudson Wi 54016 NW 1/4 SW 1/4S 31 /T 29 N/R 18 W TOWN Warren COUNTY ST. CROIX SYSTEM ELEVATION 94.0' DATE 8/10/16 BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND M SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of wood corner post ASSUME ELEVATION 100° Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line 2 Acre Parcel Scale = 1/4" = 10' 93rd St. Well is to meet all WDNR setbacks Pro 4 Area 15' below Bedroom system is to remain House undisturbed -9 2' B - 1_• 'J 93' 4% Slope 94, B-2 AIC COP cuff Combo Tank Tank is to be properly bedded and provided with lockdown Grading is to be covers with approved warning done to divert labels B-3 run-off away from system B.M.* 309' Property Line 17 o~~?+F~~~ DIVISION OF INDUSTRY SERVICES o,\ 2331 SAN LUIS PL STE 150 c \wY~ GREEN BAY WI 54304-5211 -1 I D Contact Through Relay 1 j p ~~I http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor SSIONN Dave Ross, Secretary APPRO August 16, 2016 [DEPT OF SAS ^~~OFESSIONd~ CUST ID No. 226900 ATTN: POWTS Inspector fi SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA ~.I 1432 120TH ST 1101 CARMICHAEL, RD 'Z NEW .RICHMOND WI 54017-6409 HUDSON WI 54016-7708 SEE CORI.,' CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/16/2018 Identification Numbers Transaction ID No. 2761997 SITE: Site ID No. 827673 Peter Greg Please refer to both identification numbers, 93RD St above, in all correspondence with the agency. Town of Warren St Croix County NWLA, SW1/4, S37, T29N, RI 8W FOR: Description: Mound System (4 Bedrooms - New Construction) Object'Type: POWTS Component Manual Regulated Object ID No.: 1618625 Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10%12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component marnna](s) referenced above The owner, as defined in chapter 101.OI(10), Wisconsin Statutes, is responsible for coal + requirements. No person may engage in or work at plumbinu in rlIc stag Uri less hc'-nse-J to do so b\ stats. The following conditions shall be met during construction or installation and prior to oc.cuparicy 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. All loose organic material to be removed from mound area. • Divert surface water from POWTS 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 rollins a soil sample between the hands. If it rolls into a 1/4- inch wire. SHAUN P BIRD Page 2 8/16/2016 ~ r 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. • 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. • SPS 383.54(1)(e) The management plan for a PO WTS 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 horizontallv from where the servicing pad is located. • Verify property line(s) prior to installation. • 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 soi! available for proper treatment. if no other site is available, trees in the basal area of the mound must be cut oti 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 PO WTS 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 POWI'S. Sincerer 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 SHAUNV R BIRD Pale 2 8/16/2016 the site is too wet to prepare If it crumbles site preparation canproceed. If the site is too wet to prepare. do not proceed until it dries. • 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. • 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. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Anv changes may result in pump resizina to 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 round level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufcient 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. Ovmers 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 Cover Page 'ALLY Shaun Bird 'ED Bird Plumbing Inc. QTY AND SERVICES 1432 120th St. RY SERVICES New Richmond Wi 54017 715-246-4516 Date: 8/10/16 Owner:Peter Gregg Location: N W 1 /4 SW 1 /4 S31 T29 N, R 18 W Lot 15 93rd St. Warren Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cove 'r 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 and Contigency plan 9. Filter Specifications and r ss section Attachments: Soil Test Shaun Bird Signature License number 2269 u 1 jC; Page 1 of 9 System PLOT PLAN PROJECT Peter Greaa ADDRESS P.O. Box 746 Hudson Wi 54016 NW 1/4 SW 1/4S 31 /T 29 N/R 18 W TOWN Warren COUNTY ST. CROIX SYSTEM ELEVATION 94.0' 8/10/16 BEDROOM 4 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of wood corner post ASSUME ELEVATION loo' Filter Lifetime Filter ❑ BOREHOLE (DWELL *H.R.P. same as benchmark Property Line 2 Acre Parcel Scale = 1/4" = 10' 93rd St. Well is to meet all WDNR setbacks o Pro 4 C4.T' Area 15' below Bedroom QJ system is to remain House undisturbed 2B - 1 93' 4% Slope ~ 94 B-2 Huffcutt Combo Tank N Tank is to be properly bedded and ❑ provided with lockdown Grading is to be covers with approved warning done to divert labels B-3 run-off away B.M * from system 309' Property Line Mound System Cross Section and Plan View Dimension Feet J A B i l T f, D l7 ' .f i:i35*4J~t~igdii.J.r. 1r1•Ljti%1JLf1J1r111 1 L 1 1 lrl•Lr1j1~111rY1. LJgf1. JiJtiJ•l1 .f. 1~ti..•r. •r. 1•i.1.1.i.i.1.1.Y1 L 1.1r1J1r1rLrl.y:l.1: 1 A ' 1J• J•fyr1•yJ f r t Y r i.i'1.1.1.1ryrM1:i:1:111r r1:1r1r1111 ' t rii: r.i`-iLi4rJ•r:r•r•r. r r•r•rir•ririr-r-r•r1rvr L•-r- E. JtiJ1 r•J•r•r J•J•J•r•r•ririr•r•r•r•r'r r r r r r r r 1•:rY L 1•L Y1 1.1.1-1•YYS•L-L-1- r1• ti iw~lli~ ~ ~f4•Y41.1. -L J.J•J•rY•t•r-r•rY•f-r•r•r•r•r•r•r• 1.1.1.1• 1 1.1 ' f-J•J•r• 111?L'1.1•L•1M1.1.1.1.1.1.1.1 r.J•r.r-rY.r.J.r-r.r.r•r.!•r~!}i:~~~r.r.r.r.r•r J.J•f•r.J•r•r-J•r•f.r•r-f.J•f.J.r•!•i.!•f1.i•1.1. 1.1.1 j1 1.1.1.1.1.1.1.1.1.1.1 Y1.1.L•1.1• F r•r•r-r•r•r•r•r- r•r•r.r•r-r•r•r•r•r•r•r.r.r•r•r•r W 40 f G Z H I I l2 i J K 12- 7 - 7 - 7 7 L 3 c . r - - W 17 ~ K B -----1 Z ~ L Slo e - -1 = Topsoil = ASTM C-33 Clean aggregate = 4 in. sch. 40 pvc Ca Material p sand fill 1/2 to 2 '/z in. dia. observation pipe Geotextile G H Fabric_ 1; 1J 1r 7 `j r r~: J1: r1.1:1,1r1; rt E im j: j:: . cn' C~ 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 -3- of Pressure Lateral Layout Two Laterals - End Manifold .4 Threaded Cleanout Lateral Turn-up Plug Manifold M X L Long Force Main Sweep 90 Bend C> Distribution N twork Specifications Pressure System Construction Lateral Diameter In. Manifold Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter -5'1 nln. pipe. Orifices are drilled perpendicular to X Orifice S acin -2 In. the pipe with a sharp drill bit and face down. L (Lateral Length) 2 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 In. diameter lawn sprinkler valve box accessible Force Main Length Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box L Page of _ 03/05 lgj i Septic-Dose Tank Cross Section And Pump Performance Specifications Tauk Manufacturer Pump Manufacturer j Tank Model Number -U --1 x"27 Pump Model Number Total Tank Capacity Z '1 j Alarm Manufacturer -4- 9 Max. Bury Depth Alarm model Number G~ Switch Type 3-p A; ufacturer , ti s2 Total Dynamic Head (TDB - Feet Filter r umber j ' Elevation Head v Filter el N Distal Pressure Network Loss Minimum Pump Performance Required Force Main Loss J, CsPM Ft TDH Total l > 3 0, @1 lto)3 Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed WaterdjZht Securely Mounted Weather-proof Junction Box - - Fished Grade Vent Min, 12" Disconnect Above Grade Means With Vent Cap Outlet Filter Inlet Bale > h1let A 1/a» Switch Settings and Reserve • Weep f Tank Volume = GPI B Hole Volume Gal. Dimension Inches y~U (reserve) A 5 O B 2 < ev on C Ft Bottom (dose) C 7~2 (dead) D Dlevataon Total ~ j J •<•r < > , GENERAL INSTALLATIOI~i: The septic/dose tack is bedded and -back filled in accordance with the depth of h. as, speci&d by the manufacturer may not manufacturer's product approval specif ications. Maximum mY . device (padlock) be exceeded without prior approval. Manhole covers exposed to grade have an a ttve lacking ti ved material, connected to the tank with watertight fittings, and installed. Piping at the inlet and outlet is of appro 4» Sch. 44 PVC to bridge the tank orce laid on stable soil W went setting or sagging. ' € main is sleeved with 16.23- excavation Electncdl.Service mplw wl hNEC304 and Comm and thesleeveissealed watertight. Page of 02/05 IJ TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING MODES 152/153 Z c:: MODEL i 152 t5~ w w w L 50 Feet Meters Gal. i Liters i Got Liters 153 5 1.5 1 69 . 261 77 291 10 3. i I 61 231 1 70 265 12 4 152 i 5 4.6 53 201 I 61 231 ° 20 .1 6.1 44 167 I 52 197 LO i 30 I 25 i 7.E 34 129 42 I 159 • ~a 8 30 9 1 i 23 87 33 125 20 ` 42 40 12.2 o ~4-j j Lock Voive: 1380 FL (Ii.6m)144.n Ft. (13.4rn) 4 of+sos 10 1 0 20 0 60 80 100 GALLONS 6 1/4 LITERS 0 80 160 240 320 _ 3 27/32 1 1 4 5/8 FLOW PER MINUTE I 3 ?7/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. ! 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are availabe for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. T 'I • Seated Qwik-Sox available for outdoor installations. See FM1420. I I • Over 130°F. (54°C.) special quotation required. I I 1521153 Series' 12 1/8 I)--T 15211153 MODELS control Selection 1 Model Volts•Ptt Mode Am S Sim lex Du lex 1/8 N1 52 GGN152 115 1 Non .5 t 2 or 3 .5 InGuded 2 or 3 1 El 115 1 Ao 8 17 E152 730 1 Non 8n 4.3 1 2 or 3 sK20e4 BE152 230 Auto 4.3 Inclu;ed 2 or 3 Nt53 115 1 Non 10.5 1 1 2or3 SELECTION GUIDE BN153 115 1 Auto 10.5 Inclu:ed 2 or 3 bade variable level float E153 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggy BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. CAU-nON 2. See FM0712 for correct model of Electrical Aftemator E-Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. AD electrical and safety codes should be followed including the most Or (4) float system. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: P.O. BOX 16347 Louisville, KY 40256-0347 Manfiacturers. SNIP TO: 3649 Cane Run Road O ZD ® Louisville, KY 40211-1961 Q~/dt/TY~Uti1P5 ✓/HCE ~~✓~y 6. (502) 778-2731.1(600) 928-PUMP httpolwww.zoeBer.com L Q FAX (502) 774-3624 © Copyright 2000 Zoeller ~o. It rights reserved. (0 C') POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page -w FILEINFORMATtON SYSTEM SPECIFICATIONS Owner Septic Tank Capacity S S al 0 NA Petmit Septic Tank Manufacturer 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer ~j0 NA Number of Bedrooms ❑ NA Effluent Filter Model 0 NA Number of Commercial Units. NA Pump Tank Capacity `2 ,gal ❑ Estimated flow (average) al/da Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) ~6 c aVd . Pump Manufacturer 0 NA Soll Application Rate altda /ftz Pump Model ❑ NA Influent/Effluent Quality Monthly average` Pretreatment Unit -ANA Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/GMvel Filter 0 Peat Filter Biochemical Oxygen Demand (BODS) 5220 mg/- 0 Mechanical Aeration 17 Wetland Total Suspended Solids (TSS) 5150 m /L 0 Disinfection 0 Other. Manufacturer Pretreated Effluent Quality 0 NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (BODS) 530 mg/L 0 In-ground (gravity) ❑)n-ground (pressurized) Total Suspended Solids (TSS) 530 mg/L 0 At-grade ound Fecal Coliform (geometric mean) 510' cfu/100ml ❑ D ' ine 0 Other. Maximum Effluent Particle Size Y inch diameter Values typical for domestic (non-commerclal) 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 ear(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 0 mon ar(s) (Maximum 3 yrs.) ❑ months ear(s) Clean effluent filter At least once every Inspect pump, pump controls & alarm At least once every rl> 0 months r(s) DNA Flush latkrals and pressure test At least once every 0 months ear(s) 0 NA Ottier At least once every 0 months 0 year(s) NA At least once every 0 months ❑ year(s) ❑ A 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 Servicing 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 (Y,) 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, mnlcal or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at irltervals of 12 months or less shall be performed by a certified POWTS Maintainer. A serviW, report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high conceptrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicais thO may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of tho tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will bie discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenlt. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. compact, the area within Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or comps 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance drain entmfae fif faundatPO drab antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting producils; pesticides; sanitary napkins; tampons; and water softener urine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is prope y and safety abandoned in compliance with chapter Comm 133.33, Wisconsin Administrative Code:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property 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 sail, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compiiipnt replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption s em. The replacement area should be protected from disturbance and compaction and should not be infringed upon by qu setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rut" in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology/ a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. V--Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO mOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Ot A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS I POWTS INSTALLER POWTS MAINTAINER Name Name 'S/ 1 Phone f Phone s~ SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY E Name _ Name C- Phone Phone I) This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(~ and 383, 54(l), (2) & (3), Wisconsin Administrative Code. x = = tW 1I a f s7f r t13i i 11 t i I i i P ! i.) O ~ Ali Q O ~ - - O r 3 CO - ~ I I' rio i c i .C n ~ ~ N 0 U ~y z co 0 .O t- a LU v cn I I 1 1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE -AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 17 Marling Addres 0 s-' _c x Property Address Ote 93 g! _ 5kteJ- (Veracafion required from Planning & Zoning Department for new co on.) City/State Parcel Identification Number o ; LEGAL DESCRIPTION Properly Location~ti1/~ '/4 Sec T ` N RI/I W, Town of Subdivision , Lot # Certified Survey Map # 1 , Volume , Page # Warranty Deed # Volume , Page Spec house ye 3 Lot lines identifiable r 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, ii= 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 §Comm 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning & Zoning Department a certification form, signed by tsx; 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. Uwe, 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 Commerce and the Departinont 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 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 deed recorded in Register of Deeds Office. Numhervf b~dr00ins SiCNWTUME OF (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 reap if reference is made in the warranty deed. (REV. 08/05) o~ 2 w~ o y sus 5b S m F r m U O a § N iG~L g N ~O ¢`gwfr°s j ~ } If\ ~ `e F Z ¢~u y~aG~~~ ~ W ; 101 A 9q pC6 3 E B@ 44 i7g t 7 gc 9. i J ~W Q¢ da I ~ tl ~ ~ Z m o I~ I li r: II ~ ~ ~ II ~ ! ~f 4-1 i I I to II I R~ .I nr ' ~ I I L. I I I n i ~ I { EASY _ jig; w 22 Q t, 1111111 LLLL~~~ I I S I^T,..-1'~ Vie. 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