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042-1052-50-000
PRIVATE SEWAGE SYSTEM sxrv."ee.um DI1 . INSPECTION REPORT GENERALINFORMATION IATTACX TO PERMIT) No S PIT u[xai au. .oi.. o.M IS 3, �Tm2. sremro c uxFrsTRewmORION xw<..wx Op RE COUP 111 Swbu UNIT x.ellIt— �.�—uavP DISTRIBUTION SYSTEM Ml .+ [er+✓ m.",ae n ° .x3�. UnRT LI SOIL COVER xPrcxeure"I Dory .. Pau.e or Avana. Sy,,,,, Only wM e m ON' .0 ) n COMMENTS: a �e.e�.�aoexWa,re .ere.m. UE) INREPO1n�'n�-. IlLq� /4 �(a,�'"Ra m1^n hrvll� q/I'wwV n dmox,m 5� t, Ael CaA-sett) S `:,'� �yS��y. 2)NOa U,qar111I 2a(I 3) 516fin+ r })xu fa.x/ ual Ral IS y" mre�wxm�meme".i �mm�m�%N" 9x /b P� a.P.T�elxma» SEP 282Uto 201 w. Washington Ave. P.D. ew l+ez smmY rams"'' w �. Maalwn, WI 0 1-7 1621, 55'Z 1ZS C CROIXCO pIA ME 7 `� Cm DE`� f/B�'V Su¢i,wuuvvmNomb no..,hit Ann inn ion 6�GTs..__ sC �1kL ._Iva��/ �� T7yO_tN'. RJ69!— ZD ){Llnrltmuyuweuwe—nomvn... .. BIN _ o— ❑Wbtitlf eaW—nembe Orz ^ ❑Cpst ow ❑v �a CSM Wmbv ❑saomm-tea. m.--�--- ., _ __ ,_ 62rmrnm l aTtREN 1 ❑ r me.otrhm� Ope.,,,hsv mma ❑n.mm. ❑Hama>:. �. otwimi.:au ❑ w 3 am Moru-,uoo w sae sr+ma �w�w) Plot Plan Property Owner J�qi� � LA0.R 4uti K Legal Description m i, can vs IN5. , w 2E THE Nw%4 - F - 14 T q4, IC W lb �N of Wd 5r.Ca K CouuTYi WIS D1\ LN. 9)W usNw/ iz 6AZ-l0ma-COJ STIKF IH 1K':`�uD\ 3.z�,ea�c /OG.YO�4�J SJ Site Location: sn£ Y Page 2 I"=40Jk (except where notet9 7 = Backhoe pit 3b5 Ad,<c North 1//�/f-gu�<K W � 1k .tot b �p' i p0 lire 1� WELL t COPY CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: 7/ cj r.( s (y'&/ /7 Owners Name: aCEE r L,4t/d/l+-� Owner's Address: _f2ffR ] Gn ryw`/7/Z wtL T9 6A Legal Description: N W Af O./ < /9 179 2 /R / Township WARREN County'. S+ elk a/X Subdivision Name: 1/15 pg /3y$ Lot Number'. j Parcel ID Number'. Q[(-Z_ltg5) _sp _ooD Page t Index and title Paget Plot Plan A( Page 3 System Sizing & Gross -Sec on Page G Filter Specs Page Maintenance Information Page Management Plan Pager St Croix CN Septic Tank Maintenance For Page Warrenty Dead Page GSM or Plat Attachments : Soil Teat & House Plans Designer/Plumber r� RL5/� nlccLicense Number:./!Ve zz6J197 Date: 9 'z (2-/(, Phone Number 7l 2 73 nvwy Signal Deagn¢4 Pursuant tt000tthe In Gmund sell Apsorpllon O mnonent Mmual for POWr$ Vanier 20 SB610IDSP IN then) Pape 1 Plot Plan Property Owner :S�EEy LA k6 tl by e- Legal Description ram* i, esn v s vv ins_ �, w/4 GP rH6 Nwlk SEC. I4 tza ,.(� Klkp/� Tfwb CF W+��C¢EO SY cgbm OWTY WISCONI (4, Opz-104.c91•400 sPu£ INm` n� 9zs'uwrc cv�'"' VSJ Site Location: 1 SGii •�i 6a z qdv l �� 5N 1"=40,ft (except where noted) 7=Backhoe pit ik5 �� s North (VIVO) urYrvr+�r. 4y e w vieu �43C' �3 4 o Va t2A J� F � bon pc I- or 2—Family Dwelling In -ground Soil Absorption System 2-cell /Connventional Dalrywastewater Flow(DWF) , _4— �{ ,eofbedrooms x 13ogal/Lay/bedroom = �(L gal/day Dalgn Loadlna Nate filcar sell Appllwtiim Pate= ' gpd/h'(per SPS Table 383.44,1, z, m3) 8eiulred Myrbu6onaell area=OWf�ea gal/day tole iZgpd/h'=.I R' 0 Chambers= Required 01shmulan cell area 55-j5. He+ zQ! h'/unitEll=%CM1ambers Chamber Manufacturer and Model x�rricocanicaga Q�pp pp T ©per Actual Diddi lon sell area= Required cell area "a h' c lee Z Lot l End Cap Pair= R9o1h Cross -Section in -ground Soil Absorption System 12-cell): 4^ Schedule 40 PVC vent pipe win vent cap 13 inches minimum 12 Inches mlmm in o �03 36 inches Soil Cover Trench 1 Sys tern Elevation inch Chamber Height L✓1�R �h Trench 2 system r —e� uewdon h h 1 Trench Separation Leaching Chamber WitlPo y Yfo limlEngfaROr Plan View In -ground Soil Absorption System (2-cell): Trench 1 Modify it header/ deslgiras Rjl Leaching CM1ambersr I7 needed, Trench R 4Inch hj'jHeader SCM1.I1Z�v` ' �RwlfM1 end amps Draw Q for a Ventand 0 for Observation Plm above. Theywlll be located It from the end of the cell. Vent pipes shall be Schedule 40 PVC and attend at least lE Inches above finished gratle. Observahon pipes that extend above finished Wade must also be 4Inch Schedule 40 PVC. A GreM Oeeign RESTWRLMR POWTS OWNER'S MANUAL & MANAGEMENT PLAN MILE INIF 0 door owner u�.F E—� Septic Tank Capacity 1200 el 0 NA �I meantF Y� I optia Tank shanufacturor w NesFi2 DNA Effluent Flttw Manufacturer r G NA OE610N P MMETEPB Effluent Filter Model Jp F /a Cur NA O NA Number of Bedrooms Pump Tank Capacity Qo al NA Numbeiof Public Feollby Units RNA Estimated flow leverage) _ /(00 time Pump Tank Manufacturer LU fESER GNA Design flow )peak, Btlmrted x l.M k,00 slide Pump Marmha er s0U LP ONA Soil AppllaGrn Rate W/de this Pump Model PE a// O NA $moose lnfiuent/E(nuem Due[ Manmly average' pretreatment Unit O NA Fate, On & Grease (FOG) SEC mgh O Small Miter O peat After BiochemiceJ Oxygen Demand (Ol AGES mg/L O NA O Mecnamcal Aeration ❑ Welland Total Suspended Slide (TSSI A160 mg/L ❑ OlaNfection ❑ Other: Pommevd Effluent Quality Monmly average Disported Collis) ONA Biochemical Oxygen Demand IBODLI AGO mglL O ln-0mund foravityl 0 wGround 1prenurimdl Total Suspended Solids (TSS) A3C ml DNA O At Grade O Mound Fecal perform loommetrw meant I Ato'cfu/100m1 O Drlp-line O Other; Matlmum Effluent Particle Ske $In rile. ONA ONor: DNA Other ❑ NA Other: - 0 NA. Other; ❑NA vmvmxTwCal Mrdemmm wastewater and aepM tank efnwnc MAINTENANCE ECIll Sorml Event Sarvlea Frequency Inspect condition of tanks) At least once every: 3 g ear lal (Msslmum 3 yeast) d NA When combined sludge and scum equals oneSNrd (al of think volume D NA Pump out Comor v of ankle) Inspect dispersal¢artist At least once rvery: 3 0 ond10 IMetlmcm 3 "are)❑ NA O monthlal O NA Clean effluent filter At least event: ent: N earls) • Pj O moray s) O NA Inspect pump, pump controls & alarm At least once every: E earl ) Flush laterals and pressure test At least once everyr 3 drlous) ® year ONA 00ec At least ones every: onto del o mule ONA Omar: - o NA MAINTENANCE INSTRUCTIONS Impectlomi of tan" and dlepenel calls shall be made by an mull Carolnp one of rho following licenses or callllce[Icna: Master Plumber; Master Plumber Restricted Sewer; POINTS Imports; POINTS Mantalmer; Septepe Servicing Operator. Tank Inspectlens must Include a visual inspection of the tends) to comply my missing or broken hardware, identify any Cracks of looks, measure the volume of combined sludge and scum and to check for any back up or panting of effluent on the Around surface. The dispsmol collie) shift be visually Inspected to check to effluent levels in the observation pipes and to check for my ponding of effluent on me ground surface. The flooding of effluent on me ground surface may Intlaete a felling condition and requires rho Immediate modification of the local regulatory aumcrin. When the cwnbmed eaumulaton of sludge and scum In any tank equals one-third (,) or more of me tank volume, the entlre contents of the tank shell be removed by a Septage ServlcNg Operator and disposed of In accordance with Chapter NR 113, Wlaccnsin Admslsvativo Code. All other servdcam Including but not heated to the scrolling of effluent filters, mechanloal or pressurized components,.prememmenr units, and any servitors at Intervals of Al2 months, shol be performed by a certified POINTS ofthmmer. A service report shell be crowded to the local regulatory scroll wMN 10 days of completion of any eervlm event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(sl for the presence of painting products pro arc emieal: that may Mpatle me Veewent process and/or damage the tlhpenal celllel. If high concentrations are detected have the content* of the tarsals) removed by a moorage serviclnp open ar Prier to use. Systemwart up shell not occur who men conditions are frozen at the Infiltrative •una During power outages pump tank• may fill above normal hill levels. when power Is reached me exec.s wastewater will be chancel to the response! eiHel In one large dose, Meloaa Inv the eenl.l and may result In me beckon or surface eleehmae OI efflupower M avoid this pump or contact a Pln have the umber or POWTS Maintainer [o assist ents of me pump tank removed by a nomanually operating rtherproor pump to to power o ma effluelevels heroic normal levels vehMn rho Pomp tank. Do not drive or parkown veMcba avm manna and dispersal cello. DO not drive or park over, or o[M1erwlae disturb or impact, the area within Ion or down trope of mound or at -from rhea sell absorOwnegrlion area. ROWTS: t tlMinatlop of the following Vora tM1a condoms; r coven s may Mpmve 1M1e pm talflo s; and prolong f0 life of tole PORTS: .drain lNo; baby wince cigarette and vegetable; conbpeelings; ration webs;; reaeh tle0cles; me; t scrap; dylnoctente; fro; r paint pl products, peetpldEve;p) water. fruit eanitary mykenena mpone'andweteoXenler mnx.greaser M1erb lCltlea; meat scraps; medications; OIF ACANDONMENT When the POINTS fells and0r Is persweramly taken our Of service the following steps shell tie taken to Insure that the system Is properly and safely abandoned In compliance with chapter Comm 83,33, Wisconsin Administrative Code: • All piping to ranks and pits dell be disconnect" and me abandoned pipe openings sealed, • The contents of all tanks and pits steal be removed and properly disposed of by a Septago ServicingOperator, • After pumping, all tanks and pits shall be "covered and removed or Weir covers removed and the void spaco filled with roll, gravel or another loan solid materiel CONTINGENCY PLAN If the POWTS fslh moos cannot be mpalr" the following manures have been, or must be ekmb to Povitle a ode compliant replacement system: evaluated and may lized for the location of a acement sall kon ❑ P'tultable replacement m.The repleementraea aM1uldea has nbe selected (rem disturrbanice and contraction and should! not be Infringed inged upon by reyu4atl setbacks from existing and proposed armature, lot lines and walls. Follow to protect One re0leemen[ area will result In me need for new roll and site evaluation to establish a suitable replacement area. Replacement systems must comply wlm me rules In effect at the Limo. ❑ A suitable replacement area Is not avallebe due to setback motor soll limitation. Marine "venrae In POINTS technology a holEing tank may be Installed are a last reason to replace One failed POWTS. ❑ The s14 bay not bean evaluated to Identify a suplao replacement tree. Upon failure of the POWTS a soil and site evaluation must be performed to locate a mutable replacement area. U no replacement area is available a ha Ming tank may be Install" are a last human to replace the felled POINTS. ❑ Mound and argeme soil absorption systems may he recbnStrvcted In place following removal of the Inomat at the nfil surface. ReconetrueNens of much systems must comply with me solar In rtlact at!than time. «WARNING» SE1rND PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSER ANDIOR INSUFFICIENT OXYGEN, DO NOT EWER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON MOM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. POWTB INSTALLER POINTS MAINTAINER Noe K0 E2 M EL Solt Name Phone S - Z 73 - /fTf Phone SEPTAOE SERVICING OPERATOR(PUMPER) LOCALREGULATOflY AUTHORITY Name C S�C/>ls 704 i Phan. - 7/s•3db•Ybdo INS reeamrm was rnNer in eempllmo, with chapter Comm 8122RAuNlm4ln and M3.5gn,(n S CO, Wlaaommn"M®ra tlM Cade: Name $O N^rfoN PM1ona 7/S-z73-Sg�f StP2tID1B BB:9B Feum inA) e 32PIIC TANG NAINIffilAN(P AGRE@A+NT No OWN@81@ CFRTMGTION FORM o,mre� .af-iMu. P novel l�i� kr _ M�RAsa -1.43� S_ Pip 212 Rmemr CayRmm gobu4s Wr amw�w n42-iM2-Sn-qp Aaa.nw+aw '�v.,�v.,s:. j�.r�QxR�w,rw+w N�nri+ C lmts.Fnym.Rr 38�7 zo val 55 �v # Bx . w.,,..ya.ax /0 J321s vi,s mg will,bbibil by, re �,mmmww.. o:nmwv....®m.n�ummr�.w.ee.sm®. rmem �rvevua9evK�s+sago®mn0)..n..aWiz�rtOmuFuy'OWs� inaa�u nm..'�mmem�m��� vm��F•Farw•�•oeem..�� bk edewBm®�m �zvoemotim,.waowv�..tisnpgm..�M f�l wwei, a.wa.. °memmlp�mFW�mrAm4.mmi. F �.�wia�9ss•rmmem�urw•�^mow ovr vn®Wa >®WMmmmi vne/m. w.�ye. mp.e®u w Nevwneme®me/mmuewmwm�ww/�ddwx uwo'mvwnA.ttlu�a pyy YUY.Mn M m e!. swot CMisma s eTm eFLV � CY xWaY ARPIICAxliRl 1DA'IH/J.b "'wr � mu o idugr�l ma �4 a m. mvmr wa W ...r1 N w Mhn4 s» 4^m�9..• m.+Y�=..�fwm4rarwWktwammr.onarmuaaenrmea nmm�.wu .urM'e�F rysv.wvx Combination Septic an add ( O Pump CHAMBER CR055 SECTION AMD 5PECI FICAT10L3' V[IJT CAP 11 WEATHER PRaoF JVuCTIOu BOY 'L VLNT PIPE APPAOVCD LOCKING a To, FROM OooR.. _. wAnRNCIUC V�wBEL 'dupOMOA PRCSX f 1usvrcnou PIPE \ ALIUTM1RF � ..�/m Haut ertv } I c ""fla BO: �L * IB'AIU. I APPROVLO JOIVI APraavm JowlFlak mEL x�ttc -' I III V/C.x.PIPE>nw v/c.x.Pv[eR acctonmplay vt[h15 nd 83. 20 ° ou PURA ft6CK CYIT PERMMED OWL IF TALK MAUUPACTURCR HAS SUCH APPR0VAL jL 5[P*ICt SPCCIFICATIOIJS OOss WIESfln.C C TAUKS MAUYFA[TU0.CR: �"•TPe 4WIbCR OF OOSC4:PCM1 PAi TANK LZC: IZO oo OALOUS DOSE VOLUME ALARM MUFAC7WKDR:—Y.5 Fi0'IAf:1uf I UCLUPIUG OAFXPPLOW. NY ZQp�GALLONS W L MODEL LU M BCR: �4 CAPACTTXV A= n 6"Es OR 11'LGALLOW 5MrCX T]PC: r-L Ai f / 0= `�I IINCx[i/p( OR �'DBLLONS PUMP MANUFACTURER: nCk I OF 7 NnES OR 'V 1 �o L2LALLOUS MODEL NUMbCA: pan V/ D=$INCXfS OR)231L UAlLON6 SNITCX TVPE GL&A} YOTC PUMP AMD ALARM ARC TO bL MIUIMUM'DISCHARGC RATE CPI,, INSTALLED DU 5CPARATC CIRCUIT5 V[RTICAL DIFFELENCE ECTA1UU PUMP OFF AUO,OI5TRI5UTIOL PIPE—LL PELT t MIu�gXUM LCTN0 KK SUPPLY PRESSU&CC..... — FECT f .J o_ RET OF FOKCC MIL X YLff/IPonFKICTIOL FA[TOR„—Z� FEET TOTAL OGLAMIC HEAD - FEET As perManufacturer ._�,� gel/in. qFp-12-2005 16:28 FERGI9B—' ENr MIOOW [gGOULDS PUMPS NPIICAnONS Speaally designed for the following uam: • Mound System • FfllventlDxnp Systems • mw Pressure Plppe Syalemt. •BMemem Dmininy • Hory Dury Sump' weaterny SPECIPICAilON5 Pump —"mars,: 0"Cle ego: I N'Nn • Temperature: lbafla0°d ma rviconuume en iunysubmemed. • Seldd, nana0ng: d' mAvlmurrol. • Apmmadt traded (non&a noarswum. • Memel models village, • Pull ln9 cull see per kmenud1ad01mrve. Pal Pump: • Madmum eapa4:53GPM • iup,hwd:25'iDN Putspm P Pump Maximum HeadConsul61 GPM • Pmm head g' iox PESI 51 Pump: • Maximum mp371 T GPM W • Mmum head: 31'iDN ?iS 3&5 as" P.01 Submersible EffluentPum PE MONA General: • Single phase • NORM • 115and230volts • NrR-IngemMlouvrlp5dpo Coos wlgatoeuc • Oasseimulane, e0ry • Oil fared deign. • af strength mgen speei shaft. Pal Motor, • 33 HP, 3000 RPM 115 Was • Shaped pale Goal Pal Motor: • AO HP, 34DO RPM • 115 and 230 whs • PSCessign PE51 MObn. •.0 HP, 3400 RPM • llSwd230wIM • PSCmdon FEANRF3 �C0lmslon rabpnt mn5rrvetion. • tAmnppUmt Impeller and mwr. upper Seem and mo bearyduty ntoft ball moved swNort • MDiDrdepemanenty lubricated(oredendeded seNlo servera tile. aFederal brmndnuom opm on. • NIratings are owithinf o wr erldng Innis the m omr. •Oun%tlbmmae pwre N, 20' Needs kngq, heavy duty 1&S VM with I IS or Paid will gmureing plug. • Qmplm ON is heavy dury, podxbleand mmpa2 Merharked sal N urhan, wfa RBONA wd maindeO ruHL IF SalNeee speed fMeners. A6ENLYu91110 ISkes TuNdin Ol116ana CSA 2221us Btudstbu t IyOra3mtoruWmauw'ym , fikBWmne oublOOultDemr RNl o s to 15 nam Goulds Pumps cvncrtr •..,,,., "` =w. w.% ITT lndustCies i .. lv'pa3`r HUM R 919USHWY1 �a m � 3> YLLS ��- ✓iER�c��CJ nsr Rat b Ir7cJs�� Ffuldcil Ti .Fvd AnJrP n'i' {hJ L2 _SEGG µuH/ex Aa �SwS I J lino i "o_ tol_... 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