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HomeMy WebLinkAbout022-1030-75-026 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 589783 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2738022 Permit Holder's Name: City Village Township Parcel Tax No: Matthew & Keli Rudd TOWN OF KINNICKINNIC 022-1030-75-025 CST BM Elev: Insp. BM Elev: BM Description: v ( pCf Section/Town/Range/Map No: t'I - 94 W 8 z-,A La on ' 11.28.18.1650-10 TANK INFORMATION ELEVATIO DATA TYPE MA ER ` 0 CAPACITY STATION BS HI FS ELEV. Septic VV ' L~l wO p' Benchmark - 1 ~o Dosin 00' Alt. BM v lJ Aerdtt0T1' Bldg. Sewer ~ / ~ • ~ 1,~~' 2 7 Ht Inlet , 7.. ✓ O TANK SETBACK INFORMATION St/Ht Outlet TANK O P ' _l WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosin h* 161) j Hea r an. L* 6 2 Aeration Dist. Pipe Holding Bot. System ; Final Grade PUMP/SIPHON INFORMATION OIL- Manufacturer GPlm~and St Cover Model Number I xv, J / 1VVVV// V TDH Lift t Friction Loss System Head TD t 1 y l~a~ Forcemain Leng 5 % Dia. ' Dist. to Well SOIL ABSORPTION SYSTEM C BEDITRENCH Width 1 Length,~ t No. Of T~eMes Ig-I 1, 1 C4 PIT DIMENSIONS No. Of Pits Inside Di~ Liquid Dept DIMENSIONS 10 6 _5 / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of tin:, 1 ~I n ( !1\•'w h- ` UNIT Model Number: L DISTRIB TION SYSTEM N 2,11A&LTIN Head /Manifold it Distribution Ix Hole Size/ C o le/ SS cing V to Air InFiPs) , il " I n th Dia' r I Spacing Length SOIL COVER ressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over ` xx Depth o dd ed xx Mulchd Bed/Trenc % Bed/Trench Edges tl Topsoil 1 r7~ / Yes ~ No es i No COMME TS: (Include code discrepencies, persons present, etc.) Inspection #1: V . ~y . I W Inspection #2: 41?y7 LOUD : O~ w it c c 0-4- J6QA',lo Location: OLD ~EMETERYV? kVYeii 'ST tD C L 1.) Alt BM Description =T-1-' `t C6V 2.) Bldg sewer length = 4ZL I H St~~~ amount of cover = 1 4r, ~ m v V\ all Plan revision Required? Yes No ~_j f 3 . Use other side for additional information. 1~YQ SBD-6710 (R.3/97) Date epctor's Signature Cert. No. r County Safety and Buildings Division e O x w 201 W. Washington Ave., P.O. Box 7162 Sanitary permit Number (to be filled in by Co.) O 53 Madison, WI 5 Q ,Tyt ffCEIVED <3 g713 ?J Os~oN~t • State Transaction Number Sanitary Permit Application Z -73g6 Z z In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appiS7rii *6&*M sect Address (if different than mailing add ress) is required prior to obtaining a sanitary permit. Note: Application forms for state~(,~t the Departmdht of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law s. 15.04(1 m , Stats. 1. Application Information - Please Print All Information Parcel # Property Owner's Name (JCL i (.k P d 7- z - /0-.;0 - 7s _ o zs / ~ ♦ + Property Owner's Mailing Address Property Location l/ cr c , N 1~ Govt. Lot City, State J Zip Code Phone Number /V P!~y,, 14 J'/<, Section (circle one) ; R EorW 3.3 T~N II. Type of Building (check all thaLot # KIOXtrlt ~pply) Subdivision Name IH-or 2 Family Dwelling - Number of Bedrooms Block # 6~ ❑ City of El Public/Commercial -Describe Use Ab VOJSC_, CSM Number ❑ Village of ❑ State Owned -Describe Use ,)K Town of IC I Ajl ~'l2 /lir/V ( C a/O N III. Type of Permit: (Check only one box on line A. Complete line B if applicable) Zp A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Dale Issued B. El Permit Renewal Permit Revision El Change of Plumber 11 Permit Transfer to New Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) ❑ 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) ❑ Pretreatment Device (explain) V. Dis ersal/Treat ent Area Information: t Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requ d sf) Dispersal Area Propos s System Elevation c% v ;vim VI. Tank Info Capacity in Total # of Manufacturer y Gallons Gallons Units New Tanks Existing Tanks Y w U h w w l5is Septic or Holding Tank ~C Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MPNumber Business Phone Number Plumber' Address (Street, City, State, Zip Code) C. S ca%c - u-) VIII. Court epartment Use Only Permit Fee Date sue Issuin ent Signatu Approved ❑ $ ~ 0 tven Reason for Denial o V G Cat.) IX. ConAI'16£Nld'f1~"E3ilReasons for Disapproval 3 1. Septic tank, effluent filter and ~ 1 disper-ss, cell must all be seivtces / nji in gj=. II Gr1rc~ GaJ' i►4rtA l as per inanagement plan provided by plumber. / 2. AJI aekiadk iegW er.wts must:be mw tttAti Q a Y fa; r+ `471 ae per applicable code / ;:rdinancea. CD U 1, Y Attach to complete plans for the system and submit to the County only on er not less than 8 tR x 1 in es in size , SBD-6398 (R 11/11) MAI+ ~f Plot Plan e% Pro ~~ot~2rsd 2uob) Legal Desca°; tion FR1 =DF 7r (except ere note o ~EC~ f f, iz81.1. ~tSUI lcWn~ K WJ3i ~ if~n1 ~ { S C7'.f1Y. C t t ~iS ~ S Tl _ Backhoe pit Z-Z North PROPOSED HOME y 1 9p ^ i~ n . bC r'~ ice- .~1 ° PROPOSED DRIVE C r y J '~'A ZO' D b bS/,' S 'F7. z ,Tr ~ i Jar Location: f a 5r G~ ! it 9ti~7SSe-1- DIVISION OF INDUSTRY SERVICES r c ~ 2331 SAN LUIS PL STE 150 y-Pv GREEN BAY WI 54304-5211 S~ Contact Through Relay S http:/ldsps.wi.gov/programs/industry-services www.wisconsin.gov \ Ffs'sroN~tiSC Scott Walker, Governor Dave Ross, Secretary ~ C oil, APPRM July 08, 2016 OF SAFI CUST ID No. 224832 ATTN: POWTSInspector PROFESSION;,-,L DIVISION OF INDUS1 MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHURS 1101 CARMICHAEL RD wL DANBURY WI 54830 HUDSON WI 54016-7708 SEE CURRESP CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/08/2018 Identification Numbers Transaction ID No. 2738022 SITE: Site ID No. 826338 Matthew and Keli Rudd Please refer to both identification numbers, Old Cemetary Rd above, in all correspondence with the agency. Town of Kinnickinnic. St Croix County SE 1/4, NW1/4, S11, T28N R18\ FOR: Description: Mound System (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1612084 Maintenance required; 600 GPD Flow rate; 38 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-I0706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 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. MARY .10 HUPPERT Pale 2 7/8/2016 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizing to meet TDH and GPM Specifications. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of c onstruction/installation/op eration. 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 conce on this letterhesi The above left others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. Tim Vander Leest When You Receive That Invoice, Private Sewage Plan Reviewer, Division of Industry Services Please Include a Copy With Your (920)492-2214, Monday - Friday 6 am To 3:30 pm Payment Submittal. tim.vanderleest@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm Roger Nelson, Nelson Plumbing (Plans Mailed To) MARY JO HUPPERT Page 2 7/8/2016 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Anv chances may result in pump resizing to meet TDH and GPM Specifications. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees Ill 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, Zl_~ Fee Required S 250.00 This Amount Will Be Invoiced. Tim Vander Leest When You Receive That Invoice, Private Sewage Plan Reviewer, Division of Industry Services Please Include a Copy With Your (920)492-2214, Monday - Friday 6 am To 3:30 pm Payment Submittal. tlm.vanderleest@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Roger Nelson, Nelson Plumbing (Plans Mailed To) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Resides ntial Application, INDEX AND TITLE PAGE Project Name: MATTHEW L. & KELI D. RUDD Owner's Name: (same) - I Y P.- SERVIC Owner's Address: 301 W. Warren Street HY SERVICL3 Roberts, WI 54023 G:e~dl =dDEPv~E Legal Description: SE 1/4 of the NW 1/4, Sec. 11128N, R1 8W Township: Kinnickinnic County: St. Croix Subdivision Name: NA Lot Number: NA Block Number: NA Parcel I.D. Number: 022 - 1030 - 75 - 025 Plan Transaction No.: exc.. Page 1 Index and title U q. Page 2 Data entry • Page 3 Mound drawings LIAMil JO ~ ~ Page 4 Lateral and dose tank HIJ-RY ry Page 5 System maintenance specifications Page 6 Management and contingency plan D 185-0 RIVER FP,.LLS Page 7 Pump curve and specifications % I Page 8 Plot plan 4~i`6r9~ "t J em w~~ti i ~~y\ Designer: Mary Jo Huppert License Number: 1859 - 007 Date: 07/01/16 Phone Number: 715 - 426 - 1775 Si 'ure: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) j_ R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00; Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for I 1.501 Peaking Factor (e.g, 1.5 = 150%) fecal cofiform of 36 inches. 600.00 Design Flow (gpd) 6.001 Site Slope I 102.001 Contour Line Elevation (ft) 0 Depth to Limiting Factor (in) 0,40 In-situ Soil Application Rate (gpd/ftz} Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution j Y Pressure Disribution Information network? Enter Y or N (C or E) [_e r Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) I 31 Number of Laterals of the highest point, 0.1561 Orifice Diameter (in) ~i. 3,501 Estimated Orifice Spacing (ft) = 11.76 ft 2/orifice 2.00( Forcemain Diameter (in) 20.001 Forcemain Length (ft) Does the forcemain drain back? I Y 90,001' Pump Tank Elevation (ft) Enter Y or N i 4.55 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) 12.09 Vertical Lift (ft) 55.97 5x Void Volume (gal) 0.33 Friction Loss (ft) 59.23 Minimum Dose Volume (gal) i 0.00 In-line Filter Loss (ft) 27.46 System Demand (gpm) 16.97 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in, dia. options choice 0.75 I 125 x f x 1.00 { 1.50 x 1.25 x j x 2.00 1,50 x E 3.00 1 2.00 x I I 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information I I Total Tank Capacity (gal) 1 0 Septic Tank Capacity (gal) ) (Total Working Liquid Depth (in) 1'Wieser ;Manufacturer gallin (enter result in cell B49) Dose Tank Information Effluent Filter Information 0 Dose Tank Capacity (gal) PolyLok Filter Manufacturer j 22.24€ Dose Tank Volume (gallin) 525 Filter Model Number Weiser Manufacturer Project: MATTHEW L. & KELI D. RUDD Page 2 of 8 Mound Plan and Cross Section Views .:.:.:.:.......:...n..,.,: J Observation Pipe fl.. . K" - I 0 A W J.: - ,.:.3 I L - - - Mound Component Dimensions Down slope toe extension mad.. A 10.00 ft E 13.20 in H 1.00 ft K 7.71 ft B 60.00 ft F 9.25 in 1 15.00 ft L 75.43 ft D 6.00 in G 0.50 ft J 4.50 ft W 29.50 ft 600.00 (ft2) Dispersal Cell Area 1500.00 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 104.27 (ft) to 2 . 1Q'Z 0 (ft) Dispersal Cell 100 (ft) Lateral Invert Dispersal Cell i is ii j Elevation E D a 1 0 (ft) Contour Elevation 6.0 % Site Slope ' Geotextile Fabric Cover Shading Key Q - Dispersal Cell See lateral details on 0 = Topsoil Cap c a 1.5 ft Page 4 for number, size, 2 Subsoil Cap 0 50 O ~'~Q and spacing of laterals. © ASTM C33 Sand ~ ~ / Laterals are equally Tilled Layer c N 0.5 ft Typical Lateral F spaced from the Aggregate ~r c I distribution cell's --i-- centerline in the _ A } distribution cell (AxB). Project: MATTHEW L. & KELI D. RUDD Page 3 of 8 , End Connection Lateral Layout Diagram Center the lat+xaic 0,-, the A& E dimensior, i=Turn_up -Iba l l valve, or ,~Ie,anoutplug I:- ~ ~ I Holes drilled on the boctorr, W the lateral equally spaced fotoemsin Sch 40 P61C per SPS Table 354.30-5 cross to maniiedd .ar any point, P=035E Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1 .25 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ft`'/orifice Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft System Flow Rate 27.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 16.97 ft Forcemain Velocity 2.80 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and B SPS 316.300 UUAC ILL: 4 in. min. Disconnect -1- i Tank component is properly vented E- Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Capacity 800.00 Gallons -Volume 22.24 gal/inch A Weep hole or anti- Dimension inches Gallons_ B siphon device A 20.41 453.87 B 2.00 44.48 Pump oft elevation (ft) C 2.66 59.23 90.91 D I 10.90! 242.42 D Total 35.97 800.00 Dom se tank elevation (ft) 3" Bedding un er tank. 90.00 Alarm Manuafacturer SJE Rhombus Note_ Switches Alarm Model Number !Tank Alert AB containing mercury may not be used in Pump Manufacturer Gould this system. Pump Model Number `PE41 i Pump Must Deliver 27.46 gpm at 16.97 ftTDH Project: MATTHEW L. & KELI D. RUDD Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Darrell s Septic Service Phone"' 715-425-1025 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once eve 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested ever 1.5 years Mound _ Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • • • Grade \ 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: MATTHEW L. & KELI D. RUDD Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01101), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. .Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 1113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure, If the fitter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiftrative surface within the mound and snow compaction in the winter will promote frost penetration, Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 101 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. "PRG.31-. 4:!- rc Wastewater METERS FEET 40 -'MODELS: PE31, PE41, PE51 PE51 - HP:.33, .40, .50 35 10 2 GPM _ 30 PE41 1FT = 25 PE31 s - Q 20 10 5 € _ 0 0 0 10 20 30 40 50 60 70 GPM 80 N 0 5 10 15 m3/h CAPACITY PERFORMANCE RATINGS PE31 PE41 PES1 Total Head Total Head Total Head (feet of water) GPM (feet of water) GPM (feet of water) GPM 5 52 8 61 10 67 10 42 10 S7 15 59 15 29 15 46 20 50 20 16 20 33 25 39 25 0 25 16 30 26 35 8 %J plot peen a f - f i Proper Ownser im4T7~tEN L. ,f- )Kg L b, R u no F'0 3z2r.sa A L~ 99 LegalDescription ~-t=DF TtrG s6 /H tr SHE rj(except kere no ems) '5E C. 11, i Z81~7_ ~f5v) TGWI~1 t K WJ3lC'R~ ~Nr1 t 'St GR{~tZC _ n ` Backh e i _ North PROPOSED HOME 7 PROPOSED DRIVE ,0 cs rt 5~~ "_1 3 7 , - ire Location t kl X ''<xe Dip" f FROM : MAURY BRAUN OZ X NO. : 651 450 0097 Nov, 29 2012 02: 48PM P3 p 7 ! ~y NW CORNER MAP OF SVR IE SEC501UN I I LOCATED IN PART OF THE NEt/4 OF THE NWt/4 AND IN PART OF THE SE1 /4 OF THE NW 114 OF SECTION 11, T28N, R48W, TOWN OF KINNICKINNIC. ST. CROIX COUNTY. WISCONSIN. ' Moan tj>z e~_ ~~.wv ~ 1 1 y. I se9.36-08-E 487.07' 1 ......_.453.39'._...... ' ~ ; ~ (n] CSI W O ~ Ct1 ~ • IA ~y~~i ~ j D~ 1 : ~ VV' 1 t , ~dL••0 25 ~ ~i71 a' $ f, PARCEL AREA c-IIt~, fI az ! 4(- ` If 3 f b UO ACRES INC. RNl (O)' w / "sa:c ~ ~ 13Rd3G50.F1. .'4•;,nc ` ` 4~2 ®i 4.56 ACRES EXC. AAN l ` f ; IUURy BRAUN ER - ° -m 188,824 SO FT t000ALL£N WAT U) n W of 1 INNER GROVE hDGHTS. MN 95077 P NET 80LOARI F AREA 1,4 ACR;$ 0.64 ACRES EXC SETBACK 8 20% SLOPES '/p SURVEYOR r U / ORBOHtx IIJ•D SURVEYING. INC. Rol 8ERT9. WI oaa I i R0 •-$OtJTNGRN FRL+E OF 20 ~ SLOPES y1 SOUTFI LINE OF THEW/41cf THE 114 tQ~~/~C 132 ro /LINEOf•TliegE1/4OFTH , W110/ L qi IV CD NOTE C l - • / /1 THC HOUSE AND CYtMGii SHUWN ON TH3 m / / AVV / MAVANk :iNtNM FOR REFERENP.E f:N{Y 00 pj1 ,6 - ~~,,uu r I Z _ o .0 W r' NOTC: 7KS MAP HAS BEEN RPVISEO TO 1N01CATC THCW BUILOINA SE1T 14X FROM THE BIGNT.OF•WAY ~J WHICH ISALLOWED UNOERTHE $T. CitO1X 1 / COUNTY ZONWO OROwA,NCE. IN WtkCI III Ili I , TOWN OF KINNICKINN C M'5UGdECT 10 . S7. Z • / Cr ~1K COUNTY ALSO ALLL7IVS SLOPES OF 2(M TO 2e,_A'iCI UE 0157URBED IF AN APPROVAI. KM; tlEEN GR#NT'ED UNDER A LAND USE PCtIMIT LEGEND SUBMITTED TO IT. CROIX t;OUNTY ZONING. P ALUYJNUM C(XJNIY SECTION 1 / Cry / 0OPNERMONUMC14TfO:rvD PARCEL DESCRIPTION ut t' O.D. IRON PIPF, FOUNCI 'NAT PROPERTY DESCfaBCD IN VOLUMtl ZiG'_. iq/ / peamTERFCOHDEDATTHEBTCROIXf.'OI ffJ14'O,U. IRON PIPE FCHiNU p .v m 4 ~ REWBIER O OF DF•EO$l,1FFlCF_EXCCPT CERTIACD f7C•D L] 8 O N/ / ■ ;L'e'IHON RE6t3+FCUxO SUPV[Y MN' N VOLUME 16, G/LL;F 1MI. y W J / V4' X IN IRgN RERAn:,ET vvC G- NG 1, tUWIN C. FLANUM, REGIRTERED WIRrON,CIN C "O lCii. "Eh LINCArI f001 %AND SURVEYOR. HEREBY rEPTIFY THAT TW z ` ABOVE DMAIBEO AND MAPPED PROPLRTY WAS Q IG~. -X--X L•'XI$TING fENCELINE 'I!RVEI'ED @Y ME OR UNUCH MY DIRECT SUP[1NISION AND T}tAt THIS l.1F,P IS A OURREI'T 1- f 8000GLNG SETSA[7K LINE (Agil4( VN) HWHESENTAU N TO SCALE OF THE R(IONDARIFS TOME BEST OF MY KNOWLEDGE v I C) r NET BUUDABLE AREA AND BELIEF. jp ,nucrrrry.r ~ ' / • 011. TCST LOCATION - - T - r EDWIN C e wtaf ~R R ;y1; A~wR M secfinfiE I 2p 4a `.yy J'aJV_c3"__U+__~S:faKl,, ` ,WERr rr t MCw" ('K -`?C~Se 417/ t~ `est r'~ L SCALE IN FEET 1" = 80' / p 60 0 SO NUMBER C1 c: r3... • U U5 C6 RADIUS MAY 747.00_ 645 ON 112(;.'13' 780.00' 6~~.OD' CENTRAL ANGLE 31.21'49' 21"40'00' !07.24'31• 3/•2t•a4- ZY4DtlU' 05'4209' _ - i......_ CHORD BEARING 325-54.52.5'W S3PP45'47W- ;Tn•73'21,5w 825°Sa'S[.;w 5384547W _ 318M4'o2iW -i pHUH_ULENGI>i 356.31' 280.80' 70.47' 338.48' 293_1' 37.34. -r ARC LENGTH 380.81' 282.48' 7032' ZeA 'X YP4.96' 37.35' 7ANGErNi7N 10``13'58" 1341-$54l-vv SILY5u47W ct01J'S8'W Sat'35'cTW _ .it!i'a54TVJ 1ANGLNI'UUT 341"3T47'VV ..IS18"SVII7w rS123656W S4t'35'4TW G19'55147W S10'13'3tiw -._.-50-90-15 REMSE011•t 1 YH:S mSTRUMCNi ORAf7CO8Y KEVI•V GEED JOB NO 05^96 SCE _ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CER'T'IFICATION FORM owner/Buyer Matthew and Keli Rudd Mailing Address 534 Skyline Road, Roberts, Wi 54023 Property Address Ot rCemetery Ise si ~c (Verification required from Planning & Zoning Department for new construction.) City/State Roberts, WI 54023 Parcel Identification Number 0 ZZ /0 30 - 75 - D ~J LEGAL DESCRIPTION Property Location N E '/4 , NW '/4 , Sec. 11 , T 28 N R 1 8 W, Town of Ki n n icki n n is Subdivision Plat: , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # _ 72 (before 2007)Volume Page # Spec house ❑yesdto Lot lines identifiable (]yes[]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What im i)ni into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenanc,. responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed b,~ owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 1/we certify that all statements this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property- described above, by virtue of warranty deed recd n Register of Deeds Office. Number of bedrooms 4 / /2 / SIGNATURE O APP CA S) DATE ***Any information that is misrepresrted may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recor ed warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty d ed. 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CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road • ' =y Hudson WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 Page of COUNTY ON-SITE VERIFICATION FORM Inspector: Xo a,F - ya.M n art Date: v/16 f l (0 Parcel ID Nu Aber OZZ-• 630 - 7 bzS Pn3perYyCrrner 120-0-u Gon~LotLaaiion ~ J ~ 1A/Ujt 4 5 T ?,'g N R E to 'vryr Property owners ailingfirJdre s Lot; 61eck 54bd. Name orCSW 5 kA f, Ci41e[4--s ate dip ode Phone Number ❑City ❑Villag€ earn Nearest d w o(T M ever Construction Usu: ❑ f'wsidential l Number of bedrooms Code derived design flo,.v rata._.' _ _ . ❑ Replacement ❑ Public or commercial - Describe. Parent mater al _ _ _ vrv~_ w Flood Plain alevuton if applicabic ccmments '6 General onJ f uJ f Ses 11v~ . and recommendations: d-t~f~e cu'to . , a Gon r`n~a+~ or, ~vO r, ~t • S Escring # ❑ Boring Pit Ground surface elev. ~ J-oft. Depth to limibrra factorin. Sal Application Pate Horizon Depth Dominant Color Redox Description Texxture Structure Consistence Eoundary Roots GPD1. in. Munsell Qu. Sz. Cont. Cobs Gr. Sz. Sh. `F=ff4l "Ef e2 I -5 / z 4- , F Y~4 / ^ L 3 z~l- . 5 Conditions: Soil Survey description: Notes: 0 1o4-i4 FEE: RECEIVED ~Wisconsin Department of Commer e JVIL VALU i N REPORT e of Division of Safety and Buildings - tr omm 5, Wis. Adm. County NING OFFICE ~ / Attach complete site plan on paper not less than x Inc size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 5_ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. _ e222-1030-7 R 'ewed by Date Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Locatio le- Govt. Lots 1/S / T N R / E (o W Property Owner's Mailing Address Lot # Block # e or CSM# ( A_ tl/ C-iy State - Zip Code Phone Number ❑ Villagjgg Town earest Road 15- ( 'A 1 1 -6 Ali- New Construction Us esidential / Number of bedrooms Code derive ow rate GPD ❑ eplacement 0 Public or commercial - s _ Parent material Flo(A Plain elevation if applicable ft General comments and recommendations: C I(' f e~ Boring f Boling # Q. Pit Ground surface elev. Depth to limiting factor0 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 i 6 Boring # Boring ( G~ ft. Depth to limiting factor In Soil Application Rate \ EI-Pit Ground surface elevf n Horizon Depth Dominant Color Redox Description Texture Structure Con 'stence Boundary Roots GPD/fF \ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 rng/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 rng/L CST Name (please print) Signatur ST Numb Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715-246-4516 Property Owner _ Parcel ID # Page of 1:51 Boring # ❑ Boring pit Ground surface elev. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 2 2- nvc' rr u tt{I a Boring # l~Boring v~1wi b~ BOO D' Pit Ground surface elev. ft. Depth to limiting factor h O ' lication 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 i Boring Boring # Ground surface elev. ~j, l ~ It. Depth to limiting factor ~ in. Pit S2- *Eff#1 lication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 ?5 3 V/ J J 1 Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 Rr.6/00>