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HomeMy WebLinkAbout022-1096-20-025 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No, (ATTACH TO PERMIT) 592117 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2767882 Permit Holder's Name: City Village Township Parcel Tax No: Alex & Kaitlin Williams TOWN OF KINNICKINNIC 022-1096-20-025 CST BM Elev: Insp. BM Eley: BM Description: Section/Town/Range/Map No: ) I 3 of Ric P 33.28.18.519A-25 TANK INFORMATION ELEVATION DATA TYPE MANUFACTUR CAPACITY STATION BS HI FS ELEV. NFrS ~7.-7 v7.7 b~! Septic L~ Benchmark / _ I/y oh 0A j Dosing / Alt. BM -7 SZ i IL~t ~uM~:S G ~7 p LTD) • b 6L5 S__ Bldg. Sewer / / • 8 O CJ,e; kleld+r~g- S Ht inlet (y O n ~ Ht Outlet TANK SETBACK INFORMATION 90, S TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet N 1-7.3 - 77 Septic + ;'1 1 _ Dt Bottom n Q (J~ Q~ J t J Gu V O l Dosing h~ a r J Hea p/F/lan.', l/ I v (P [J q, r Aer _ Dist. Pipe 7(~ - / (y l6-.q(o Holding Bot. System - 3.y I ~ay• zs- PUMP/SIPHON INFORMATION` V)e ]RSWW ~CN final Grade Manufacturer ( I Qwl 111 Ab Demand St Cover W VTDU `C~S Ma Ite i L GPM G~b ~IL 1 c~ I l ~i 1 lD . llJ Model Number 'f TUS -Z jL .2 101.7 TDH L ft~ r Friction Los System Head L1.55 TDHI Ft Forcemain Lengtl ' Dia. 2.1 Dist. to Well SOIL ABSORPTION SYSTEM pt L ~CD BED/TRENCH Width I Length No. Of Teich r N YqjS PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dept DIMENSIONS P) , / SETBACK SYSTEM TO J P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System t ' CHAMBER T OR Model Nu r: J Mc~7 IVA-- DISTRIB ION SYSTEM Header/ anif Distribution x Hole Size !A,/ Ix Hole Spacing Vent to Air Intake K_ of5l) Length Dia 2, ! Length] Pie sf Dia /J Spacing_L Z 6.0(0 t 9 M C haM SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only j (J xx Seeded/Sodded Mulched Depth Over Depth Over + °7 I xx Depth of I Bed/Trench C G Bed/Trench Edges r 1 Topsoil \ f 7 j [)heY ✓ es No Yes No (l COMMENTS: ncl de code discrepencies, persons present, etc.) Inspection #1: t 1. 1 • l.IJI Inspection #2: ja (]G(S+~"~' 1►o$ c~ N1 ~Lo W 0`, rIJ Location: ys.,ggp f o 1.) Alt BM Description = 2.) Bldg sewer length = I ~ - amount of cover T QX K)t -q concrnv~ ~~o~e quired? Yes No I 17--J :ditional information. peflb Date „ ®rdiisepctorr'sgnature Cert. No. t'F.= y ~~ar~ICr`o~~~ fCcount j Safety and Buildings Division f S } tl x 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) t 1~t y~ P~ SEP 12 2016 Madison, 370 -7162 ST. oftblx cC7lJN 92 and ary ermIt ApplicatiZB2BP1Y5EMPDC state Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit IQ 4!7 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 (m), Stats. 1 _ 1. Application Information - Please Print All Information Property Owner's Name - l Ya l l 1\ Pal14 ~Ie L 11 tons 1 ✓0a _/096-ark-6 as Property Owner's Mailing Address ` Property Location 3 _ a $ . 51 ~ t Govt. Lot City, State Zip Code Phone Number S (p' K.l I t1 A, Section 3_3 t CV CV t j' S Vii' 40 L Z circle one 11. Type of Building (check/all that apply) Lot # T N; R E or 1 or 2 Family Dwelling-Number of Bedrooms 4 Subdivision Name Q] U (A'~ Block ❑ Public/Commercial -Describe Use t^ ' " S ❑ City of r \6 'J S J S CSM NumbeTr_ %w ❑ Villa e of tote Own d - Describe Use g Y O N 1.2 Z ~ Town of i c e III. 'Eve of Permit: (Check only one box on line A. Complete line B if applica , A New System El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous a tt N b r and Date Issued Before Expiration Owner 5a/~ C~ l Bit .4 t / 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 Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain V. Dis ersal/Treatme rea Information: Design Flow (gpd) esign Soil Applicat on Rate(gpdsf) ispersal Area quir d (sf) Dispersal Area Pro sed (sf)- System Elevation. . 60 P11 I - ® ''di'p l~ Q ,S 11 ~l©'3.).5 VI. Tank Info Capacity in Tota of Manufacture Gallons Gallons Units o° v New Tanks Existin Tanks 21 U U N > g S2S- o aU C/) ti V) U. 3 P, Septic or Holding Tank r f , Dosing Chamber l)-co , 7 SG VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum t is Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) J , ~ rrN _ W C tai r f VIII. County/Department Use Oniv Approved Disapproved Permit Fee Date Issued Issuing Agent n caner Given Reason for Dem l ggol IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER:. ~O~d\~S -'1n s ~lCJ~ 1. Septic tank, effluent filter and ,S w y" y" dispersal cell must be_serviced / maintained W1 as per management plan provided by plumber, 2. All setback requirements must be maintained i--~, O 1S Q as per A s for the system ands mit to the Co ty only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) , a ti `;ytaR? 1Ft\ DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~r'~tssu>vn~=~` Scott Walker, Governor Dave Ross, Secretary CONDITION September 07, 2016 APPROV OUST" ID No. 224832 ATTN. POWTS Inspector DEPT OF SAFE ~:?FESSIONAL MARY JO HUPPERT ZONING OFFICE DIVISION Off'" I VDUS HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHURS 1101 CARMICHAEL RD DANBURY WI 54830 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/07/2018 Identification Numbers Transaction ID No. 2767882 SITE: Site ID No. 828383 Alex Williams Please refer to both identification numbers, Cth M above, in all correspondence with the agency. Town of Kinnickinnic St Croix County FOR: Description: Alound System (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1621838 Maintenance required; 600 GPD Flow rate; 18 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 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. 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 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. J MARY JO HUPPERI' Pa_e'- 9/7/2016 • 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 81 1 & 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 Any chanoes may result in pump resizin2 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 ofthe mound must be cut off at ground level. A larder rill 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 383054(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 PO WTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required S 250.00 JC, 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 tirn.vanderleest%r( lvisconsin.,ov MARY JO HUPPERT Page 2 9/7/2016 • 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 Any changes may result in pump resizin2 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 curt off at round level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice. Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214, Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vanderleest@wisconsin.gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: ALEX WILLIAMS . D Owner's Name: GERALD A. & CAROL WILLIAMS -1'Y AND )'ERVICES Owner's Address: 1056 C.T.H. M :zy ~CEIWICEJ River Falls, WI 54022 41DEIVCE Legal Description: SW 1/4 OF THE NW 1/4, Sec. 33, T28N, R18W Township: Kinnickinnic County: St. Croix Subdivision Name: na Lot Number: 1 Block Number: NA Parcel I.D. Number: 022 - 1096 - 20 - 025 Plan Transaction No.: Page 1 Index and title `yv,,~~elitillt!lPllPr;rl/~1,Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications MARIE J®~'' HUIaPERT Page 6 Management and contingency plan Page 7 Pump curve and specifications • D 1859 ' Page 8 Plot plan %RNER FALLS,. - r 0"s W1 •se w.• ~~tillll Designer. Mary Jo Huppert License Number: 1859 - 007 Date: 08/19/16 Phone Number: 715 - 426 - 1775 Signature: i r LL I 79 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. 01101) Version 7.0 (R. 03/2012) Page 1 of 8 ~~UG 29_ Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-443 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36, inches. 600.00 Design Flow (gpd) 10.00 Site Slope 101.75 Contour Line Elevation (ft) 18.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 8.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) e; Center or End Manifold 4.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.00 Estimated Orifice Spacing (ft) = 12.00 ft2/orifice 2.00 Forcemain Diameter (in) 16.00 Forcemain Length (ft) Does the forcemain drain back? Y 96.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 2.61 Forcemain Drainback (gal) 6.84 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.25 Friction Loss (ft) 69.99 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 26.93 System Demand (gpm) 11.65 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. -options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x _ x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell 1349) Dose Tank Information fluent Filter formation 750.00 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 20.24 Dose Tank Volume (gal/in S Filter Model Number Weiser Manufacturer Project: ALEX WILLIAMS Page 2 of 8 Mound Plan and Cross Section Views T 1/10 B n" J Observation Pipe . ! ••lb •L .eL ~'v.'. aL... ;L.•. V.... ev ;L.•. ' L.L j L L ~Lr L L : rL r rs L L Lr L L. `,'sj:. A g g W I L Mound Component Dimensions A 8.00 ft E A9.50 in H 1.00 It K 11.08 ft B 75.00 ft F n I 15.39 ft L 97.15 D 18.00 in G ft J 6.44 ft W 29.84 It 600.00 (ft) Dispersal Cell Area 1754.46 (ft) Basal Area Available 8.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 105.04 (ft) H . rliiru~i r r ! rill ! ! r riiirin , 103.75 (ft) Lateral F Dispel Call 103.25 (ft)-~ Invert Dispersal Cell Elevation : D 101.75 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Dispersal Cell Shading Key m s See lateral details on Topsoil Cap o C 1.5 ft n=, Page 4 for number, size, ❑2 , Subsoil Cap 0 0 5 and spacing of laterals. ASTM C33 Sand Laterals are equally Tilled Layer 0 0.5 ft Typical Lateral F spaced from the © 'i~:r•::i Aggregate v c r'`Frs';°:•rrr :ref;: distribution cell's centerline in the - A distribution cell (AxB). Project: ALEX WILLIAMS Page 3 of 8 End Connection Lateral Layout Diagram Laterals centered overt the nsion ♦=Turn-up id ball valve orcleanoutplug r P laterals are identical 1<-X--41 Holes drilled on the bottom of the lateral equally spaced S rce main connection via tee or cross to manifold at anu point. Laterals Morcemain Sch 40 PVC per SPS Table 384.30-6 Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.06 ft Lateral Length (P) 73.44 ft Orifices per Lateral 25 Lateral Spacing (S) 4.00 ft Orifice Density 12.00 ft2/orifice Lateral Flow Rate 13.46 gpm Manifold Length 4.00 ft System Flow Rate 26.93 gpm Manifold Diameter 1.50 in Total Dynamic Head 11.65 ft Forcemain Velocity 2.75 ft/sec 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 Forcemain diameter Weiser Manufacturer 2 in. Ca acit 750.00 Gallons- Volume 20.24 gattinch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.70 418.91 B 2.00 40.48 C Pump off elevation (ft) C 3.46 69.99 96 91 D 10.90 220.62 D Total 37.06 750.00 i I -,Z=~ 4 Dose tank eievatio6. 3" Bedding un er tank. 96.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number Tank Alert AB i containing mercury may not be used in Pump Manufacturer Gotgpm this system. Pump Model Number PE Pump Must Deliver at 11.65 ft TDH Project: ALEX WILLIAMS Page 4 of 8 Mound Svstem 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 ftz 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 eve 3 years Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 years Mound Inspect for ponding and seepage once every 3 years 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 Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: ALEX WILLIAMS Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code Generat 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 (01181), 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 84nches 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, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis_ Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. 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 tank that may slough off the fitter 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 1/3 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 fitter 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 sal compaction may hinder aeration of the infiltrative 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 BODS, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design t'o-r~ 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 bt, 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 dogging has occurred and if orifice cleaning is required to maintain equal distrihutior 1 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. Prebvatrnent 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. Project: AL-X W l t_L IAAkS Page 6 of 8 Wastewater METERS FEET fyE Jr 1_ PE31, PE41, PE51 -E - HP:.33, .40, -50 35: 10 2 GPM 30 PEA-1 1 FT _ i O - _ _ 1 - - = P 25 - - - - - z 20 - - . J 15 O - - - - i TAfi - r 10 5 T - p 0 0-- - 10 20 30 .40 50 60 70 GPM 80 0 S s 10 15 m3Jh v CAPACITY PERFORMANCE RATINGS PE31 PE41 PE51 Total Head GPM Total Head Tots! Head (feet of water) (feet of water) GPM (feet of water) GPM 5 52 8 61 10 67 10 42 10 57 15 59 15 29 15 46 20 50 20 A::~6 20 33 25 39 25 0 25 16 30 26 35 8 At_Ex W ( LUAM5 OAUZ: f$ . A169 4 Plot Plan Page '?'of g Property Owner W A- J eAKa W, iuAs -1 &KyEK.' ALEX V)k u, /ik5 4o ft. Legal Description ter. _ g__0r THE Nw/y. sue. (except where noted) 33,T-nm Rigw, -OW4 OF XIIV tt IAWIc, -Sr. CIfttx =Backhoepit ~~-ra9~ North flemposiqb CT S~Kl-z7z) 2 ,?e BEDRnonn ~ /~j - TD f 0 12-6c rANK 705 FXNA s~'rrC -tAN;< 6, f~ c ky w) FItTC14 > Sp ~~pM L7F~i~1Il~3~IFGU Itv~ tvf I~` IS4 LtM I ,j z''nsrwti e 8 N ]k6b5 FCIMIAVOO 7S cv I~~CO ° N , O ~ ~ p0 ti'! C°MPA~T oR 4 'Q i j tt 'S ~ / I bl T4t~r TH4~ AREA -roe of e J 1 D ~ k OAX Site Location: , `-3 eVUA)7y 'RUA,p A 4-T. ft- Ak Oct-19-2010 01 59 PM St. Crcix County Plan/Zon ng 715-386-4686 ST. CROM COUNTY SEPTIC TANK MAINTENANCE- AGREEMENT AND OWNERSHIP CERTIFICATION FORM Mailing Address _ --~Y~L_, Property Address 4 C-Ki d (Verifcation required from 41fflurl, & Zoning Department for new consmuetiun.) City/State r ~ S - Parcel Identification Number L L DE PTT0N Property LOCatiOll 5L,) . N w . Sec.:3~( , T 2LN R) W Town of t-(i K) Subdivision Plat: Aj Lot # Certifled Survey Map 4-ills , Volume l Z page # Warr2nty heed # (before 2007)Volume • ~ Abe # Spec house yes ro, Lot lines identi(iablo yes no SYSTEM MAINTENANCE AND OWNFP CERT MCATI N 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 it licensed pumper. What you put into the system can affect the fttnetion of the septic tank as a treatment stage in the waste disposal system, Owner maintenance responsibilities are specified in §Con,nt. 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 the owner and by a master plumber, journeyman plumber. restricted plumber or u licensed pumper verifying that (1) ttte on-site wastewater disposal system is in proper operating condition and/or (2) ttfler inspection and pumping (irnecessary). the septic tank is less than 1!3 nai orsh,dge. Vwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards sot forth, herein, as set by the Department of Commerce 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. I/we certify that all statements on t ' form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue or a rranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) -L - 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 mnp if reference is made in the warranty deed. (REV. 08/05) ~C b ~•b - 6 .0-.9 .0-.4 W X \ r`' b -fig `r N -5:~ N L R nC - O Y• v / w J M M ar N - tt cL a. U U W 2 0 N = 1IJ-- J C Qb Y= M r ~ Lll ~ Q Z J as o q To 0 9L .0-.0L O Q - - - - - - - - - - - - - - - EE I L) ID W C°p VX ° CL CL CQ.1 U ONV' 1Q A a. M - - UU Z X N N O O m M U - - - - - - - - - - - - v .E .4 V ae b I ® _ C ^ o-S .4/EE-.9 W C co I® I rU) - - - - - - - - - - - - w R Q N E-EZSZNMVI 1 Z-LVS CI J ~ 3L) .0 -,4 .0-3, .9-.9 .4/LZ-.9 .44 Z-.£ owa .4/L 9-.ZL Z/L 4-.9 .44 LL -3, m .0 ,8 .0-.4Z .0-34 .0 - ,ZE .0 - .94 .0 - .4 .0-.09 ~ m I I~ cn LL I -I------ I I m I I~ I -I------ I I I la I I I I I , I I m I i I I I o•0 z eL sassnal aoo~~ .9L I I i I I ' t;' ` I N I~ ~ ~ ~ I CI' I I I I ~ I I „8•,ZL „9•,Z „0-,4 „4/L4-,Z 4/ES-,4 ~ I I I I I I _ I I I I I = I I I a ~ ~ I I I I _f~ I I~ 0 I ~ I I I~ _ F N I Iv I I I I p~ I I ~I 6 1 I I W I I I I I m ~ _ ~`E I I I I I ~ ® N ~ I~ b I a I ----I IJ;o N N L T- I I N N I '.On m -,IF I N rl0 - - - - - - - - - - - - - - - - - p W~ J i m I I I 0'0. 6l sassna1 aoojd,Bt ~uj zp° J W Zp ~z~ ¢wp c5 LO =W w~0 pF 3 in N y!~ CQ' ~ m ~ X ,4Z „0•,4L .0 ,Z£ „0 - 1.0-49 -n aECEIVED ~ A Aff 'k CST- ZaIS-o~S NV2C.!w5 Wisconsin Department of Commerw SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Cldmm 85, Wis. Adm. Code , County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 07- 7- - (01& ZO Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). GQ P/ V '~*A.M10J Property Owner Property Location rrk- t/(X. Lv i /~Y /t ~ Govt. Lot; j 1/4 L,, M S 33 T /-'g N R E( W Property Qwnef's M ing Address Lot # Block # Subd. Name or CSM# l - _ b, z' P. 1015 ~ City State ZZjW a Phone Number ❑ City ❑ Villa e Towq Nearest Road I X, Y 2-,~ &&, I I h) " I -SZo;,)f, ( - , New Construction Use: sidential /Number of bedrooms ? Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable /I~i /Y ft. General an reconou~ne1endations: Alter System Type ~Z~ System Elevation Z 172)i, 0 "$g7 LyMnue. n 11 Boring # Boring Fr- Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E r l 7-7 7- 7 7 Boring # ❑ Boring 7 ✓ R Pit Ground surface elev. > ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. /M~unsell Qu. Sz. Cont. Color Gr. Sz. Sh. ^ 'Eff#1 'Eff#2 &ZW Effluent #1 = BOD- > 30 < 220 mg/L and TSS >30 < 150 mg/L/ ' Effluent #2 = BOD, < 30 mg& and TSS < 30 mg/L CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401 715-246-4516 Property Owner Parcel ID # Page of ❑ Boring Boring # Pit Gro und surface elev.l Z' ~ft. Depth to limiting factor / in. Soil Application Rate jj >-1111 - Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 7 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring El Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ' )epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ` Effluent #1 = BOD, > 30:S 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 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 (8.6/00) Property Owner _ Parcel ID # Page of n Boring # ❑ Boring / ~j I pit Ground surface elev. t D ~Ift. Depth to limiting factor in. M*Eff#l Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 .7 J ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. 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 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD5 > 30 < 220 nVL and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg& and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.W00) Soil Test Plot Plan Project Name Gerald Williams Shau rd 'P~T Address 1056 Cty Rd M River Falls Wi 54022 M #226900 Lot Subdivision Date 11/20/15 SW 1/4 NW 1/4S 33 T 28 N/R18 W Township Kinnickinnic Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 100.0' *HRpSameasBenchmark Scale is 1" = 40' Property Line unless otherwise noted B-3 102' - 100' 50' B-2 98' 20' 3 0' 3 0' 0-14~1 00 20' 50' B-1 10% Slope 35' 150' Area of poor soils County Road M