HomeMy WebLinkAbout020-1395-02-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 5921 36
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
Pat & Traci Haugh TOWN OF HUDSON 020-1395-02-000
CST BM Elev: Insp. BM Elev. BM Descrip` Section/Town/Range/Map No: XUL .'Dl N
I st 51 1 00 ~nS ;A ~!o 25.29.19.2396
TANK INFORMATION LEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
GA IAA MM 100.31
Dosing -g>p~
. l0 K a 6
Aeration Bldg. Sewer
Holding St/Ht Inlet /Vu
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom
Dosing - Header/Man. -7 c13, /
Aeration Dist. Pipe J* / (O
Holding Bot. System
PUMP/SIPHON INFORMATION Final Grade 9. (oci (p•3 a2-
Manufacturer Demand St Cover
GPM
Model Number 6A , ~L ) V6, 1 Ve
TDH Lift n Loss Syste e TDH Ft t
u Ce Y~ sh 7.~~ q 3?
Forcemain Lengt Dia it ell to Z ' rav ' c~ b0+ - r~R 9y
SOIL ABSORPTION SYSTEM O r XWk V,
2 Z
BED/TRENCH Width Lengthpp~~ t No. Of Tre hes PIT DIMENSIONS No. Of Pits Inside Dia. _ Liquid Dept
DIMENSIONS -I 2- s
SETBACK SYSTEM TO tt P/L BLDG WELL LAKE/STREA LEACHING Manufacturer:
INFORMATION Type Of S~ys(tem: /~~~y~ , I CHAMBER OR (/0
UNIT Model N r
C,bNVt_;MQN 1A^- } ✓VI i-s L)
DI TRIBUTION SYSTEM N On S.SIC R 6
rLen r/Manifold Distribution x Hole Size ole Spa'ing Vent Air Intake
11 ipling
s
h D ia LPenegth)
( Dia Spacing O11h ~ /
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Z Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center I t t Bed/Trench Edges 12-' r Topsoil
21 Yes No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 806 PRAIRIE MEADOW DR' n ~V(h~ ~YW,~ C~cer c~a~d
1.) Alt BM Description AIMM In~ C~ (p A/1 JCIA A,~,
2.) Bldg sewer length = ,r'
.
-amount of cover =
Plan revision Required? D Yes No
Use other side for additional information._
SBD-6710 (R.3/97) Date Insepctor's Signa re Cert. No.
9t) j
County '
RECEIVED Safety and Buildings Division SL Croix
201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
~ Madison, WI 53707-7162
-A 517 z 43 Co
ST CROIx
COUNTY
q)APgM1t App11C~ QNOMH520YMFT8 ! State rransactiomNittmber
in accordance with SPS 383.21(2). Wis. Adm. Code. submission ofthis fort - _,11..1,,1.- b.,..,, -clitan unit Na
is required prior to obtaining a sanitary permit. '.Vote: Application forms for state-0\\ ned PO\b I S are submitted to project Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
Purposes in accordance with the Privacy Law, s. 15.04(1)(in). Slats. Same
1. Application Infor tion - Please Print All Information &L
W
Property Owner's Name Parcel #
ave-
Pat & Traci Haugh 020-1395-02-000 %
Property Owner's Mailing Address Property Location 2 39l.
806 Prairie Meadow Dr. Govt. Lot
City. State Zip Code Phone Number _NW _''a, NW '4. Section 25
(circle one)
Hudson. Wl 54016 (715) 531-1130 T 29 N: R 19 XV
11. Type of Building (check all that apply) Lot 4
vision Name
❑ I or 2 Family Dwelling - Number of Bedrooms 2~._ 2 Subdi
Block Scenic Hills
PubliciConunercial Describe Usc Na
❑ City of
❑ State Owned-Describe ['se CSM Number ❑ Village of
Na ❑ Town of _ Hudson -
111. Type of Permit: (Check 71y o box on line A. Complete line B if applicable)
A.
(I New System Replacement System F1 Treatment/Holding Tank Replacement Only ❑ Cnlter Modification to Existing System (explain)
B• I Permit Renewal ❑ Permit Revision Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
420330 issued August 19, 2002
TV Type ofPOWTS 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 Tatil Other Dispersal Compouuit ul) ❑ Pretreatment Device (explain)_
V. Dispersal/Treatment Area Informatio 50 In ltr or Quick 4 Standard Plus char bers & 4 end caps, new SymTech STF 100-A etlluent filter
Design Flow (gpd) Design Soil Application to - Dispersal Area Required (sf) Dispersal Area Proposed (s~ Sy. C .
600.0 Gpd 0.6 Gpd/Sq. Ft. 1,000.0 sq. ft. 1.010.40 sq. ft.. 91.25 & 92.25'
VL Tank Info Capacity in Total of Manutaeturer
Gallons Gallons t nits o
Nei' Tanks Existing Tanks
,t 1 U v~ w C7 0.~
Septic or I lolding lank Na 1.280 L280 1 Wieser Concrete X
Dosing Chamber Na 800 800 1 Combination ST/PC
VII. Responsibility Statement- I, the wide ►gned, as anne responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumbe s Sign ature MP'MPRS Number Business Phone Number
James K. Thompson MPRS 30021 (715) 248-7767
Plumber's Address (Street. Citv_. State. Zip Code
I
340 Paulson Lake Lane. Osceola. WI 54020
VIIL County/Department Use Only
I I"
Permit Fee 1)ate Issued Issuin ent Signah e
2cs Approved ie
$ Ljd5 06
co Reason for lnial TO •
IX. Condi0 l Rcxson for Disapproval / 1 A.
1: S Septic: tank, etflusntftter and n
dV4 isper al cell must all be sar_ic ! L inlq:r G
as per mar:agement plan prodded by plumber,
2. M-seftwik equiremenls must.k a malntslrted raC, A4L
as per appi=ble code / ordinances.
:Attach to complete plans I'or the scstem and suMnit to the Counts onl}' on paper not less that 8 l12 s l l inches in size
SBD-6398(k, it/11)
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Replacement Dose-Conventional POWTS Index & Tilte Sheet
Project Name: Haugh 4 Bedroom Replacement Dose-Conventional POWTS
Owners Name: Pat & Traci Haugh
O~~ner's actress: 806 Prairie Meadow Dr., Hudson, WI 54016
Site address: Same
Project Location:
Subdivision: Lot 2, Plat of Scenic Hills
Legal Description: NWca, NWi i, Sec. 25, T.29N.. R. 19W_ Tn of Hudson. St. Croix Co.. AV1.
Parcel ID 4: 020-1 395-02-000
Page 1 Index and Title Sheet
Page 2 Site Plan
Page 3 Dispersal Cell Suing & Infiltrator "Q-4"
Standard Plus Chamber Cross section
Page 4 System Cross Section
Page 5 Existing Septic/PumpTank Cross-section
Page 6 Pump Chamber Calculations and Cross Section
Page 7 Pump Curve
Page 8 Sym-Tech STF-100A Effleunt fitter Specifications
Page 9 Distribution Box Cross section
Page 10 Zoeller Zone Valve Specification Sheet
Page 11 Septic Tank Maintenance Agreement
Page 12 Certification for Utilization of Existing Septic Tank
Page 13 System Management Plan
Page 14 Parcel Map
Page 15 Warranty Deed
Attachments: Soil Evaluation Report
Stormwater Retention Pond HWL Elevations
Mater P tuber Re ricted Service: James K. Thompson. Dcp't. of SPS Credential 430021
Signature: Date: J~ • /6 2 Page I of I5
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Soil Absorption System Cross Section
ys.sa _
4 G.St~ ' ft
4" Schedule 40 Final Grade
PVC Vent Pipe
With Vent Cap S' z5' ft
Leaching ~j'/ Z3
Chamber ft
System Elevation
ft ft
Soil Absorption System Plan View
/03 ft
ft {
M
ft 7 Leaching Trench 1
Vent Or Observation Pipe Chambers
EIJ
4" Dia.
Trench 2 Header
Leaching Chamber Specifications
Manufacturer And Model Z-,,7~' f~~r- '✓~C -V
EISA Rating .2Z)-d sq ft per chamber Soil Application Rate d.6Jgpd/s.q ft
gpd Design Flow _ 6• Soil Application Rate .G EISA = -5C Chambers
2 rows of S chambers each.
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Haugh 4 bedroom Dose Conventional Pump Chamber Calculations
1. Force Main: 2. Total dynamic head (per inspection report)Diameter 2" Min. supply pressure 0.00'
Length 45' Vertical lift 9.30'
Flow rate 40.00 gal./min.± Friction loss 1.49'
Friction loss 1.49' (45')(3.30 ft./100ft.) = 1.485 ft. Total dynamic head = 10.79'
3. Pump selection:
Manufacturer: Exit Goulds
Model number: EP04
Pump will discharge approx. 40.0 gpm (d
, 10.79' TDH or 4.08 ft. sec. flow rate
4. Dose climuber: Existing Wieser 1,280/800 Comb. ST/PC - 36.00" P_ 22.24 gal./inch (800.64 gal. actual)
A) One day holding capacity: 18.00" = 400.36 gal.
B) Alann setting: 2.00" = 44.48 gal.
C) Dose volume: 4.00" = 88.92 gal.
(600gal.)(20% Design flow) + ( 164)(45') = 228.23 gal. Max. Dose
D) Reserve storage: 12.00" = 366.88 gal.
TOTAL 36.00" = 800.64 gal.
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and
SPS 316.300 WAC 4 in. min.
Disconnect
Tank component is properly vented Alternate outlet
location
MForcemain diameter
Wieser Concrete Manufacturer 2 in.
Capacity 800.64 Gallons T
Volume 22.24 gal/inch A
Weep hole or anti-
Dimension inches Gallons B siphon device
A 18.00 400.36
B 2.00 44.48 C Pump off elevation (ft)
C 4.00 88.92 88.00
D 12.00 266.88 D
Total 36.00 800.64, 1
Do tank elevation (ft)
Bedding And Backfill As Per Manufacturer 87.00
Alarm Manufacturer Existing SJ Rhombus _
Alarm Model Numbe SJE 1011421
Pump Manufacturer Existing Goulds
Pump Model Numbe EP04
Pg. 6 of 15
GOULDS PUMPS Submersible
Effluent Pump
i EP04
EP05
3871
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
grade turbine oil for tic enclosed design for heavy duty ball bearing
Specifically designed for the lubrication and efficient improved performance. construction.
following uses:
• Effluent systems heat transfer. ■ Casing and Base: Rugged
• Homes Available for automatic and thermoplastic design provides AGENCY LISTING
• Farms superior strength and corrosion
manual operation. Auto
Heavy duty sump matic models include resistance. SPCanadian standards Association
•
• Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron
• Dewatering assembled and preset at the for efficient heat transfer, Goulds Pumps is ISO 9001 Registered.
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover: Thermoplastic
FEATURES cover with integral handle and
• Solids handling capability: float switch attachment points.
i` maximum. ■ EP04 Impeller: Thermoplas- 0 Power Cable: Severe duty
• Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant.
• Total heads: up to 31 feet. pump out vanes for mechanical
• Discharge size: 1'/2" NPT. seal protection.
• Mechanical seal: carbon-
rota ry/ceramic-scat i o na ry,
BUNA-N elastomers.
• Temperature:
104~1` (40°C) continuous
140-F (60°C) Intermittent. METERS FEET
• Fasteners: 300 series 10
r
stainless steel. 9 30 .~.-5cPNI
• Capable of running
dry without damage to 8 2 5 Fr
components. 25
o
a
Motor: _
• EP04 Single phase: 0.4 HP, U 6 20
115 or 230 V, 60 Hz, 1550 a
RPM, built in overload with 5
0 15
automatic reset.
EP05
• EP05 Single phase: 0.5 HP, a 4
O
115 V or 230V, 60 Hz, 1550 ~ 3 10
RPM, built in overload with E 4
automatic reset. 2
• Power cord: 10 foot 5
standard length, 16/3 1
SJTOW with three prong
grounding plug. Optional 20 0 00 10 20 30 40 50 GPM
foot length, 16/3 SJTW with
three prong grounding plug 0 z 4 6 8 1 11
12 ni,,h
(standard on EP05). , f ti
CAPACITY J' y , 0'4" V•7 / ~e .
Ggulds Pum s
2002 Goulds Pumps Ck ITT Industries
Effective September, 2002
83871 Pg 7 a'j5
•
SIM/TECH
Sari FILTER
z FILTER
'f. x'.:. Sim/Tech Filter
The GAG Sim/Tech Filter is unique to the industry, engineered to pro.i::e
r maximum protection for your sanitary pressure system.
eV~i~~'' The Sim/Tech Filter has been designed as an effluent filtering device 'c
K assure small holes in the distribution piping remain unclogged Pressure
distribution systems are very effective in treating effluent, but only when
holes remain open. Many of these systems only partially fail, causing
contamination of ground water long before the system shows any vis b'~e
signs of distress.
" Placing a filter just before entering the forced main is a simple solution.
The filtering device installs by simply screwing onto the discharge port of
any effluent pump, thereby filtering out contaminants before they enter the
distribution system. Thus, maintaining even distribution of effluent
a. The GAG Sim/Tech Filter protects any pressurized system, includir~-j
Filters - Spray Irrigation Systems - Pressurized Chambered System'-
Recirculation Sand Filters Mound Systems
wr
~zalrt~(e(d - ~rrt~~7ovec ~~j~j(cu'ltt rac~tCCCt~ 6~ ~dSSU~iri~ evzri Misrzi6«t(o,i - '1,{~:;! .
S'~~Luertt ~u6Yrt~2si6Le ~~-cvitps - (~an 6e c<sed iyt 6ot6t ~esic~t'~~ti~t( ~t~td
~OY3-1311~?CL~~~ ~!"I"~lC:«C(oYlS
Order # Model Description List Price
STF-100A2 STF-100 GAG Sim/Tech Filter (field assembly)
~r~ll..~P~RIdJ
The STF-110 has well over 1/2 mile of filtration media with over 319 cubic inches >
of open area to eliminate clogging. The 2,215 square inches of filtering surface
allow a flow rate of over 1200 GPD, filtering to 1/16 inch diameter. This incredible
amount of filtering surface is achieved through the unique shape of each
triangular bristle, which more than doubles the filtering surface, with no uniform
holes or slots to plug..
Order # Model Description List Pric_z
STF-110 STF-110 Disposable Septic Tank Filter (yellow bristle)
6-5
P,. $aF/~
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SECTION: 3,20.170
/7 Jp
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E! u' ~nfn at S cer Fces
G~t1Pd harc- refevts ! rif 3" -
±ca( _r.. Consult factor,
MAIL TO: N_0_ BOX ',6347 • Louisville, KY 40256-0347 Vf5ltC3Uf WBbSlte:
SNIP 7'0: 3649 Canc, K;ir. Pz'ri • "as.iNa, KY 40211.1667 http://www.zoeller.com
i02 773-273' . 1 (800,0 928-PUMP FAX 156)21 74-3+i24
ZOEhh'QR ON"oSITC 'wuwAS-'rCWATCR PRODUCTS
JJ.tTY ry
Itr3~R"** 4~T
L LrLEN S'E'PTIC r YS rr ACCESSORIES
.t," CRi f
tN 'r'r. k
t-
~r
°
-
For zoning of larger
effluent distribution
networks. Zoning may 46,
reduce pump size.
VS 1"R
Never needs lubrication- q r
Highly reliable. i70-0150 j
Easier to install, easier to use.
Best materials & design. Made out of CPVC. NOW
Zone valve body is designed to allow maximum _
water flow while maintaining structural strength. 170-0149
18 qualttytestS on every valve. Valve Part Number Socket Connection
Easy to motorize, simple to automate, 170-0048 2' ID x 2"/ OD j
Can be operated manually,
1,, ID xZ OD
24 Month Limited Warranty. 170-~t=0,49 2" !D x 2~~~ OD
t l
t_.t 4j 1 f~. ID x 2 OD
Offers a convenient alternative to manually
turning valves.
Built in safety & simplicity,
i
Can stop or start diverters in any rotation posi-
tion, so the danger of deadheading the pump is
eliminated.
24 Volt. I
12 Month Limited Warranty. P,'N 170-0050 - waive Actuator
Distributed by Z2?
Co y ght 2C,02 !_of=ISer C b AH ,;tits =,sca
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer Pat & Traci Haugh
Mailing Address 806 Prairie Meadow Dr.
Property Address Same
V rification required from Planning &Z,oning Department for new' construction.)
City/State Hudson' Wl Parcel Identification Number 020-1395-02-000
LEGAL DESCRIPTION
Property Location NW r, . NW , Sec. 25 . T 29 N R 19 W. Town of Hudson
Subdivision Plat* Scenic Hills Lot # 2
Certified Survey Map # Na Volume Na Page # Na
Warranty Deed # (before 2007)Volume Page #
Spec house Elyes[11no Lot lines identifiable Oyes❑no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and mainntcnance of y our septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. O~kner maintenance
responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
o"I,ner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) tine on-site
mistev,,ater 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.
1/~yc, the undersigned have read the above requirements and agree to maintain the private seNvage disposal system with the
standards set lortlt, 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 Plamiing & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on thi/orm are true to the best ofmy/our knowledge. I/~+c ant arc the u~~~terrs) of the
propcrt\ described above, by virtue of a I my deed recorded in Register of Deeds Office.
Number of bedrooms 4
1 Li- `i 1241i~
SIGNATU OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Dcp,irtmcnt
Include with this application a recorded \wl-r ia" deed ti om the Register 01'Deeds Ot]icc Mid a copy of the certiticd sun cv map it'
reference is m tde in the VAarrant_ decd.
(REV. 04/12)
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) 806 Prairie Meadow Dr., Hudson, WI 54016 located
at. NW 1/4, NW 1/4, Section 25 Town 29 N, Range 19 W.
Town of Hudson , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25., and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service June 10, 2016
Did flow back occur from absorption system? Yes X No_
(if no, skip next line.)
Approximate volume or length of time: unknown gallons 15 minutes minutes
Tank Capacity: 1,280/800 gallon
Construction: Prefab Concrete X Steel Other
lufacturer (if known): Wieser Concrete
Age O Tank (if known): 14 years, installed 2002
Pelrnit uillber (if kno % 420330
James K. Thompson
Licensed Plumber Signature) (Print Name)
MPRS MPRS #30021
(Title) (License Number) MP/MI'RS
August 5, 2016
(Date) - -
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
1.2 aF/6-
Dose Conventional Septic System Management Plan
Pursuant to SPS 383.54. Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code. and shall be maintained
in accordance with component manual SBD-10705-P (N.01/01). All local and/or state riles pertaining to system
maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system
should be directed to the installing plumber. Jim Thompson at (715) 248-7767 or the St. Croix County Zoning Departnnent at
(715) 386--k,:,! i
Seutic Tank
Septic tank scrvicing nicclianies comply vw ith SPS 383.54(1)(e). Septic tank to be located within 1 So' of sen ice pad.
bottom of tank to be < 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance Nvith NR
113. Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48. Stats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter 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 lank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm the filter shall be
serviced if the alarm is activated. Septic tank manholes 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 entn, into the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce. Safety and Buildings
Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once even W o years. All switches. alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed at the pump discharge. it shall be inspected and serviced as necessary.
Soil Absorption Cell
Trees or shrubs should not be planted directly oil the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October-March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS. and 30 mg/L FOG. 111HUCnt (low nuy not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Pending leycls above 4 inches indicate an
impending hydraulic failure requiring additional, more frequent monitoring.
Effluent flow shall be alternated between dispersal cells on a two-year schedule by use of diversion calve. Effluent to
be diverted from new cell to old Drainfield at 4 year anniversary of new system installation. Old drainfreld to be utilized for
a 2 year period. Effluent dispersal to be alternated between systems on a tyro scar rotating basis thereafter or as needed to
prevent ponding of effluent within dispersal cell.
Continyencv 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. Excessive ponding yyithin the dispersal cell N\ ill be eliminated by installing a neu soil
absorption cell to bring the system into proper operating condition.
Pg. 13 of 15
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CREST Vaults For Electrical & Communication
Box Structures For Lift Stations & Storm Water
PRECAST CONCRETE, INC. Tanks For Waste Water & Fire Protection
1-800-658-9045 Grit Oil Separators
Speciality Items
EMAIL: info 9crestprecastconcrete.com
WEB: www.crestprecastconcrete.com 61151-16
Project
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Sy' 1-41 T. = 971 751
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Wisconsin Depart yi ~ffisional Services
~I I Page 1 of 3 7k
Division of Industr c LL VV
1620H SOIL EVALUATION REPOF QNOMH520YMFTg
In accordance with SPS 385, Wis. Adm. Code County
Attach complet 10han 8 1/2 x 11 inches in size. Plan must include, St. Croix
but not limited A. MhQRMENTpoint (BM), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road. 020-13 -02-000 Ref#2449
Please print all information. Revie d by Date /
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). a /
Property Owner Property Location ❑
Pat & Traci Haugh Govt. Lot NW '/4 NW '/4 S 25 T 29 N /19 E (or) W
Property Owner's Mailing Address Lot # Block # Subd. Na or CSM#
806 Prairie Meadow Dr. 2 na Plat of Scenic Hills
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
Hudson WI 54016 (715) 531-1130 Hudson Kinney Rd.
❑ New Construction Use: ❑ Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD
® Replacement ❑ Public or commercial - Describe:
Parent material Glacial Outwash Flood Plan elevation if applicable na ft.
General comments and recommendations: Site suitable for In-ground POWTS with 0.6 gpd/sq/ft. design loading rate. Suggested infiltrative surface elev. to be
= 91.25' & 92.25'.
1 Boring # ❑ Boring
Pit Ground surface elev. 94.40 ft. Depth to limiting factor >94" in.
®
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-23 10yr3/2 none sil 2fgr mvfr cw 2vf,fm 0.6 0.8
2 23-33 10yr4/4 none sil 2f&msbk dsh cw 1 vf,f 0.6 0.8
3 33-46 7.5yr4/6 none sl 2msbk mvfr cw 1 of 0.6 1.0
4 46-51 7.5yr4/6 none gr Is Osg dl cs - 0.7 1.6
5 51-71 10yr4/6 none s Osg dl cw 0.7 1.6
6 71-94 10yr5/4 none s Osg dl 0.7 1.6
F21 Boring # ❑ Boring ~
® Pit Ground surface elev. 96.21 ft. 440 iDepth to limiting factor >104" in.
` Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-11 10yr3/2 none sil 2fgr mvfr as 2vf,fm 0.6 0.8
2 11-19 10yr4/4 none sil 2fsbk mvfr cw 1vf,f 0.6 0.8
3 19-26 7.5yr4/6 none sl 2msbk mvfr cw 1vf 0.6 1.0
4 26-30 7.5yr4/6 none gr is Osg dl cw - 0.7 1.6
5 30-104 10yr5/6 a gr s Osg dl is 0.7 1.6
Effluent #1 = BOD, > 30!5 2 m /L nd TSS > 3q:5 150 m /L t #2 = BODjh_R 20 m /L and TSS > 30!5 150 m /L
CST Name (Please Print) /Signat e CST Number
James K. Thompson S►- 30021
Address Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020-5413 August 30, 2016 (715) 248-7767
SBD-8330 (R04115)
L3] Boring # ❑ Boring
® Pit Ground surface elev. 96.20 ft. Depth to limiting factor >102" in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-30 1Oyr2/1 none I 2fgr mvfr gw 2fmc 0.6 0.8
2 30-40 1Oyr4/4 none I 2fsbk dsh cw 3fm1c 0.4 0.7
3 40-48 1 Oyr4/4 none sl 2msbk dh cw 1 fm 0.6 1.0
4 48-56 7.5yr4/6 none Is Osg ml gs 1 vf,f 0.7 1.6
5 56-102 1 Ory4/6 none strat grs Osg dl gs - 0.7 1.6
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. + Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color r Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
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❑ Boring
El 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/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1
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Effluent #1 = BOD, > 30 220 mg. t_ and TSS > 30 150 mg/L Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 s 150 mg %L
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WisconsinjUpartmentof Commerce County:
Safety andbuilding Division PRIVATE SEWAGE SYSTEM St. Croix
' INSPECTION REPORT San" Permit No: 420330 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes (privacy Law, x.15.04 (1)(m)].
Permit Holder's Name: I, City Village Township Parcel Tax No:
Bonfe Builders, Inc. 4LW&w Hudson Township 020-1395-02-000
CST BM Elev: Insp. BM &w. BM Description:
2S",Z9.jq) a3gy
TANK INFORMATION ELEVATION DATA
i
I TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchma
rim /eb 51S cz.rs 9~•~0'
Dosing _ Alt. BM
Aeration Bldg. Sewer t
9. gz•yt~
Holding SVHt Inlet
Jo.60
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ' -3S r
2 S t Battota 14-10 8$• IS r
Dosing Header/Man. 4. go
Aeration Dist. Pipe
Holding Bot. System id S. °IL •3
6 o .v
PUMPISIPHON INFORMATION Final Grade z
19 •~{Sr
Manufacturer Demand St Cover
GPM m f (a . /S f
Model Number ,
EQp ~S
TDH Lift . l Friction Loss 1 Syste"7 DH Ft
Forcemain Length IDia.art Dis . to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Tre PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG LL LAKE/STREAM LEACHING Manufactu y '
INFORMATION CHAMBER T. d
Type Of System: q r t t ~ ~ U Model Number. k-2
I t n
DISTRIBUTION SYSTEM ~rsf r C.
ntfold x Hole S¢e x Hole Spacing -T ant to Air Intake
I Pi pals) i Length Dia Length Dia Spacing
SOIL COVER
x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over jxx Depth of jxx Saeded/Sodded xx Mulched
1Bedrrrench Center Bed/Tranch Edges Topsoil
® Yes Q No jYes p No
COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1:DZ- Vf~ inspection #2:
' 1J,q
Location: 806 Prairie Meadows Dr. Hudson, WI 54016 (NW 1/4 NW 114 25 T29N R19W) Scenic Hills Lot 2 P#rcel No: 2 .29A9.239~~P
4,0 I`ot`t,U•~p~/ a
1.)AItBMDescription = trSt ST. vup# edawr. SS.~ti ~t►~t~Kr~ c►.~~°rQ~A
2.) Bldg sewer length = ZS 1~ ! o,
j -amount of cover = ` nUUU fie-} ~Q~,,~ ~
j Plan revision Required? Ye Fj- No I I
I
Use other side for additional in a6on. _ _ --.TT
Insepctor s Signature Cart No.
SBD-6710 (R.3197) ~ P~ fytxµC.