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HomeMy WebLinkAbout040-1296-00-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592134 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2776515 Permit Holder's Name: City Village Township Parcel Tax No: Kent & Julie Althoff 7 TOWN OF TROY 040-1296-00-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 1-b0 , L V~ 19.28.19.1702 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER /NbS CAPACITY STATION BS HI FS ELEV. Septic IN; n' W Benchmark I , I ~ ~ r ( r / b Z ' V~ U~4J .~G 0 Dosing plomP; ~~rj lJGoll Vl I Alt. BM V Bldg. Sewer q F49khng S t Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic i 2 j Dt Bottom _ Dosing o onn I Header/Man. C ""4on Dist. Pipe 17.1 0 H Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer DeP nan(d~ St Cover Model Number A TDH Lift 5, Friction Loll System Head TD O` Ft ! ~J Le th j Dia. /r Dist. to Well Forcemain I LID SOIL ABSORPTION SYSTEM BED/TRENCH Width Length j INo.Of+mAQbas Q~ (~v PIT DIMENSIONS No. Of Pit Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO VVV P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Typ Of rtem, j_ I ' f r UNIT Model Numbe L_ I DISTRIBUTION SYSTEM _ iR\YI e I Header/Manifold Distribution I t x Hole Size x Hole Spacing VPipe(s) is .5 / ~j Len Dia Length Dia Spacing V M I 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over TBedp/Trench Over Depth of xx Seeded/Sodded M e Bed/Trench Center Edges 7 to Topsoil f Yes No >eYes No 7T; ~wq- COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~0>o 2y•201 Ins ecti . fl ~j~ bow +0h': C-I I e v 6_i w A Lod" Location: 394 MITCHELL RD~ 1.) Alt BM Description I LT M cov f'112- 2.) Bldg sewer length - Cw\ I S~ Loy K-S ~I' °1~ b - amount of cover = 6- COVev Vn ail Plan revision Required? ❑ Yes 14 No h q IV A Us e other side for additional information. v _ Date 4Insepc or's Signature rt. No. SBD-6710 (R.3/97) z) Safety and Buildings Division t I1 201 W. Washington Ave., P.O. B x 7162 Sani etmit Number (to be filled in b Co. Madis '^1 53707-71 by ) xr. yV Lj ROIX COUNTY sk - J63 Sani N Lary Permit Application ✓RTNy ctionNumber In accordance with SPS 38321(2), Wis. Adm Code, submission of this form to the appropri ate goveturn e~tal unit is / required prior to obtaining a sanitary permit Note: Application forms for state-0wned POWTS are submitted to Prof Address (if differdTI than MaiIin. the Department of Safety and Professional Servies. Personal information you provide may be used for secon s) oses in accordance with the Law, s. 15. I) m , Stan. L A lication Information - PI All Information Property Owner's N me, 1 Parcel C~qo -lay b -Oe -a00 Property Ow'ner's M irtg dress Property Location o City; State 1 Govt Lot Zip Code Phone Number °1., Section C (circle M Ty of Bailding (check alI"that apply) • rot T- _ N, R or w r 2 Family Dwelling - Number of Bedrooms Subdivisi Name 41 Block h I q } / 4- El Public/Commercial - Describe Use J M0 ❑ City of f L ❑ State Owved - Describe Use CSM Number ❑ Village o own of III. Type of Permit. (Check only one box on line A. Complete line B if applicable) A_ System ❑ Replacement System ❑ TreatmentTlolding Tank RepIac„-went Only ❑ Other Modification to Existing S i ystem (explain) B ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration ~ Owner T of POR''fS S stem/Com onent/Device: Ch all that a 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground de ❑ Mound > 24 in- of suitable soil ❑ Mound &124 in. oable soil ❑ Holding Tank ❑ Dispersal Component (explain)_ ❑ Pretreatment Device (explain) V. Dis rsaUTreat nt Area Information: Design Pow (gird) Design Soil Application Rate(gp~ Disper-alArea Required (s Dispersal Area Pro s ~ rJ %,3 C POsed 3S em vation f VL Tank Info Capacity in I < 4~ Total # of Manufacturer Gallons Crellons Units New Tanks E. dsdng Tanks m v J Septic or Holding Tank ~s 1 ~ C Dosing Chamber I 7f VII. Responsibility Statement- - th undersigned, assume risibility for instRfl2fiion of the POAIS shown on the attached plans. Plumber's Name (Print) _ n Plumber's S' C _VP/IgRS,N bet Busittcss Phano Numb Phmmber'sess ( City_ state, ) / ~~~1. 12 VIl aty/De artment Use Onl proved Permit Fee Date ed Issuing t Si--nature, ZIA en Reason for Denial S 1~ V IX. Condi rason or.D' approval t 7 . nk, effltsrtt ~ an~ tllsspemsl cell must all *Wa l minta±g as per management plan provided by plumber. 2. AN alkb rdt requi0ements must be maintzined / as per app code / cfdinaom. Attach to complete piaw for the system and submit to the Comity only on paper not {ass than 81rz z ] i iaehes is Size SBD-6398 (R 11/11) System PLOT PLAN PROJECT Kent Althoff ADDRESS 915 Ferndale St. S. Maplewood Mn 55119 NE 1/4 SE 1/4S 19 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103.4' 9/13/16 3 DATE BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale = 1/4" = 10' Tank is to be properly bedded and provided with lockdown covers with Acre Parcel approved warning labels Property Line Property Line Pro 3 Bedroom House Huffcutt Combo Tan -1 Grading is to be done to 104' divert run-off away from 102' system B-2 101' 103.4' -3 12% Slope Area 15' below system is to remain Well is to meet undisturbed all WDNR setbacks B . M . * Mitchell Road ~C,Cd`` r"7 ~_v r RT E DIVISION OF INDUSTRY SERVICES s. 2331 SAN LUIS PL STE 150 r GREEN BAY WI 54304-5211 Q KI Contact Through Relay S http://dsps.wi.gov/programs/industry-services zn\ i www.wisconsin.gov \E~ SS ION N-- Scott Walker, Governor Dave Ross, Secretary September 269 2016 ~t<.`..)NDMO NAI APPROVE[ CUST ID No. 226900 ATTN. POWTSInspector D' P l OF SA►FEr r DFESSIONAL SE SHAUN R BIRD "ZONING OFFICE OF IN"l tUSTR' BIRD PIAJMBING I:NC ST CROIX COUNTY SPIA 1432 120TH ST 1 101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 7' , U rn CONDITIONAL APPROVAL RRESPOND PLAN APPROVAL EXPIRE Identification Numbers SFF S, 09/26/2018 Transaction ID No. 277651 Site ID No. 829147 SITE: Kent Althoff Please refer to both identification numbers, Mitchell Rd above, in all correspondence with the agencv. Town of Troy St Croix County NE 114, SEI/4, S19, T28N, RI 9W FOR: Description: At-Grade (3 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.. 1625249 Maintenance required; 450 GPD Flow rate: 38 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (NT.03/07, R. 1/12), 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(l 0), 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 hoimeovGner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over constriction 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. • Prior to construction of the dispersal area. check the moisture content of the soil to a depth of 8 inches. Smearing and compactina of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rollin-, 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. SHAUN R BIRD Page 2 9126/2016 • 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) • Tank Installation to follow all manufacture's recommendations. • Pum-!) Floa`s to be set and verified per aw)nroved plan. A.nv changes nnav result in ammo resizinQ to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 81.1 & 812. • 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 at-grade must be cut off at around level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • 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. Ownep° 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 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.vanderleestO!wisconsin.gov SHAUN R BIRD Page 2 9/26/2016 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) • Tank Installation to follow all manufacture's recommendations. • Pun no Floats to beset and verified Del' anDroved plan. A.?v chanties maV result in :'u ell resiZinQ to rneei TD1-I a3id GPM Soeciiications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 at-grade must be cut off at -round level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • 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 horizontallv from where the servicing pad is located. O-A,ner 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 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/install ation/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 10 1.12(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 1 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(a!wisconsin.2ov Cover Page ..m Shaun Bird AND ,VICES Bird Plumbing Inc. SERVICES 1432 120th St. New Richmond Wi 54017 zll~ 715-246-4516 _PvCE Date: 9/13/16 Owner:Kent Althoff Location:NE 1/4 SE 1/4 S19 T28 N,R19W 394 Mitchell Road Troy Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specificat' Attachments: Soil t Shaun Bird Signature License numb 22 900 Page 1 of 9 System PLOT PLAN PROJECT Kent Althoff ADDRESS 915 Ferndale St. S. MaDlewood Mn 55119 NE 1/4 SE 1/4S 19 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103.4' 9/13/16 3 DATE BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. 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Lsi Ft Lateral Invert r r r r•r•r•J• r•r~r r r r•r J•J• Topsoil Cap S L L•L•L•L•L• L•L•L•L L L•L•L L•L•L J J J r•r r r r•r r•J•r•J•J ;•J•J•r•r•;•r L •L L L L•L L L• •L•L•L•L•L•L•L•L•L•L•L•L L r r J J J•J J ~r J•J•J; J; r_r_J; Jar; r•r. r. r_r L L L•L L L•L•L L F L• L•• ~ _ _ ' ti•1!L L L L• L•• Ft Contour ti L 'L•L~~~ _ ~,F _ _ L•L•L•L•L L L L•L L•L•. t J•J~r J~J~;~; •;•r•r•1 r•r•J•r•r r•J L•L•L ,L ~L•L•L•L•L•L•L•L•L•L• ' D ----___y~ Plowed Surface r c- Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a I/4 inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After- the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/05 lgj Page of Pressure Lateral Layout One Lateral - End Manifold 4----- Threaded Cleanout Lateral Turn-up Plug Force Main L Long TT X Sweep 90 Bend Pressure System Construction Distribution Network S ecifications Lateral Diameter 2- In. Laterals are constructed of Schedule 40 PVC Orifice Diameter L. In. pipe. Orifices are drilled perpendicular to X (Orifice Spacing " In. the pipe with a sharp drill bit and face down. L Lateral Length) Ft. Lateral turn-ups terminate with a threaded Force Main Diameter -7 In. cleanout plug and are enclosed in a 6-8 inch Force Main Length f' Ft, diameter lawn sprinkler valve box accessible from finished grade. • • • • • Grade • • • • 6-8 Inch Lawn Sprinkler Valve BOX 03/051gj Page of Septic-Dose Wank Cross Section And Pump Performance Specifications Pump Manufacturer Tank Manufacturer - Tank. Model Number J Pump Model Number 4 Total Tank Capacity 3 Alarm Manufacturer Max. Bury Depth Alarm Model Number z/ Switch Type Filter Manufacturer"r Total Dynamic Head (TDH) - Feet Filter Model Number Elevation Head Distal Pressure S Network Loss 4 imn tm Pump Performance Required Force Main Loss GPM: @ j~1 % Ft-TDH 1y Total - - - - Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted Weather-proof l~ Junction Box Finished Grade Vent Min. 12" Disconnect Above Grade Means With Vent Cap • r<tY "t>t><>f> ,tl aYY1 I f Y IYY I)1 a>>t>I1Ya"Yaa' t"> ><1 Outlet Filter Inlet .li- Inlet Baffle ti ,h - - - - - - - A Switch Set*gs and Reserve Capacity %a" _ Tank Volume = Weep -5 GPI 40 Dimension. Inches Volume Gal. $ Hole 416 (reserve) A (alarm) $ 2 Off Elevation C (dose) C Bottom (dead) D' { + p Elevation Total j ::X[I i4444444 i, > >IY<a I1I;a , S a > S > > S > ♦altY>YtYa)i Ya,Ia><1 . ~i<> >aY<I1<" <t< t'J a a t>IalY t t<{ t a e 1 a a t I t t f{/ t i i tl tl><lYl'<>11/><1>Y>a>{>I>V>a>/>< taf>1 GENERAL INSTALLATION: The septicldose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service omplies with NEC 300 and Comm 16.28, 02/05 U Page of - i TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEwATERING to MODEL 152/153 i Cr MODEL i52 15 w r W w 77-77 I 50 ters I Gal. ,Liters i L j Feet .j Meters ~ Ga!- 5 1 I 69 I 261 77 291 } 0 3. i 61 231 i 70 255 153 i 12 40 15 15 4.6 i 53 i 201 61 231 o 2 6 1 44 167 52 197 i _ 129 42 ley 30 25 7.6 34 8 I 30 9.1 i 23 87 1 33 125 Q Z - - 22 85 o I 35 1 I 20 I 40 12.2 11 42 r ~ 0 4 . 1 1.b-n) X4 .0 Ft. ~.4 n) a , , j Lock Voive. 13~.0 F i W4508 i 0 20 40 60 80 100 GALLONS 6 160 240 5 e -1 LITERS 320 80 3 27/ 2 / FLOW PER MINUTE 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS e OO 3 2.7/32 • Timed dosing panels available. ; Electrical alternators, for duplex systems, are available and supplied with j an alarm. Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable - I;I level long and short cycle controls. FhT-- - • Sealed Qwik-Box available for outdoor installations. See FM1420.-, • Over 130°F. (54°C.) special quotation required. ,2 L h , _ 152153 Series j 1i Control Selection 1521153 MODELS 5 t /o Du lex Model Volts-Ph Mode Am s Sim !ex N152 115 1 Non 8.5 1 2 or 3 sK2oe4 BN152 115 1 Auto 8.5 Included 2 or 3 t -L E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2or3 SELECTION GUIDE 8N153 115 1 Auto 10.5 Included 2 or 3 back variable level float E153 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggy BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. F& CAUTION 2. See FM0712 for correct model of Electrical Altemator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) controls, protection devices and wiring should be done by a qualified All installation of licensed electrician. All electrical and safety codes should be followed including the most or (4) float system. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturersof. 611 SHIP T0: 3649 Cane Run Road Qvat~rY Pun~PS J/NCE 1917F Louisville, KY 40211-1961 ZO` ~ (502) T78-2731.1(600) 928-PUMP FAX (502) T74-3624 h ttpJ/www•zoe11 er. com p// © Copyright 2000 Zoell r Co. All rights reserved. t POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE INFORMATION SYSTEM SPECIFICATIONS Owner j Septic Tank Capacity Permit # ❑ NA Septic Tank Manufacturer " p NA ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms O NA Effluent Filter Model ❑ NA Number of Public Facility Units '7 67 NA 'Pump Tank Capacity al ❑ NA' Estimated flow (average) u j gal/day Pump Tank Manufacturer ❑ NA 1.(. 1 Design flow (peak), (Estimated x 1.5) Y \ 1 aUda Pump Manufacturer O NA Soil Application Rate A aUda /RZ Pump Model J .Z ❑ NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit f NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA D Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection D Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODs) 530 mg/L ❑ in-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg1L t-Grade ❑ Mound Fecal Colforrn (geometric mean)5104 cfW100ml ❑ Drip-Line ❑ Other er. ❑ NA iMaximum Effluent Particle Size 36 in dia. ❑NA NA Ot Other {Other. ❑ NA 'Values typical for domestic wastewater and septic tank effluent Other. ❑ NA NIAINTENANCE SCHEDULE " Service Event Service Frequency linspect condition of tank(s) At least once every. Q morrth(s) (IIAa~cirr um 3 years) ❑ NA !Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume ❑ NA Onspect dispersal cep(s) At least once every: P mont (s) (Maximum 3 years) ❑ NA ;7~ Clean effluent filter At least once every: ❑,rhonth(s) (s) 13 NA nspect pump, pump controls & alarm At least once every: 0 ~ ss) 11 NA ) M lwww ush laterals and pressure test At least once every' ❑.month(s) NA ' ear(s) At least once every: ❑ month(s) NA ❑ Year(s) r. ❑ A MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer; Septage Servicing Operator. Tank inspections must linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of czombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be hAsually inspected to check the effluent levels in the observation pipes and to check for any pondng of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a falling condition and requires the immediate notification of the local Iegulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (36) or more of the tank volume, the entire contents of the tank shay be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin 14dministrative Code. INN other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, 13nd any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. is service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 0 Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thEjt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thr' tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenlt. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the fife of the POWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dralin (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compli:pnt replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requitled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruI0 in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologV a holding tank may be installed as a last resort to replace the failed POWTS. ,The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evalualion must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative e. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OI A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER [Name Name Phone 6 Phone-n ~ J ~7 SEPTAGE SERVICING OPE OR PUMPER LOCAL REGULATORY AUTHORI Name Name I Al Phone Phone l _ ~y This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. 9 s+ N 1 I ,n M I, j S~q T=om. I ~ L4 v U i fen LR CO) O o v Q> l I I a N QS ~ H '7" O Q 1 GO y „ O U I L I C I i I .00L C4 z U. 00 El 4w '00, tcl -W N \ C~ 04.7 w r-1 u iy _Z [y Pon i ~ r ?n IID CL 0,00 ZI 60 \ co IN, Ap- ST. CROIX COUNTY SEPTIC TANK MAINTENANCE YLGREEIVIEN'T AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address / rn l Property Address P ill (Verification required from Planning & Zoning Department for ne onstruction.) City/State Parcel Identification Nuruber LEGAL DESCRIPTION Property Location tj_~E 1/a %a , Sec. T .Z N R W Town of E (09 Subdivision Lot # f C Certified Survey Map Volume , Page # Warranty Deed # Volume Page # Spec h es o Lot lines identifiabl yo SYSTEMMAITNANCE RCERTMCATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, ii= needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the wasir disposal system Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning & Zoning Department a certification form, signed by the 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. Vwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and retumed to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this f are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a deed recorded in Register of Deeds Office. n Nu of bedroo SI O PLI ANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) o OSa F"m 91 i~5 IM N nH a~ 'ON 113H';11W ib6 _ b = a .4~ti ~ a ~ I Ali' ~ ICI Z .I. ~ Q 0 I 1, ~ 1 ~ w A I a q O Q If Q ILL! ' O 4 LL : 000 w w V.11 F o ~ il, w ~I I I ~ ~ 1~L III . w ~ ~.o ~ A ~ a !I O: v 910yS IM 'NOGe3nH _ n p moo ~ 10 gP 8 a's's xA}jpy60(o ll I... .AG .HV .6.q ~ro ~ OY .OI~CL .OFII ~~F ~~~~~Zb ~y I II C §I i ~ rlxug~. nw §5 YS a Si R r' h - i f I !~,I I T i i= p Q~ I I J Q Q + Y ~iwi.c nn I I I I ~ 1GVYR I L_ X I i ~ 1 r- p I I ~ y I %Ip Jgtt ~ I ~ I I [ PI I Jt n 8 I: I ~ I IA 4 ~~3 I I p I I Q L-- ~iL 1--- Qg A 7 Q I p i i 1 I 1. I I i Q 1 • J 'moo FYI • I S l l a,. ®aqu tirvu.cc I r _ vio ~r 1 i t I I I I I Z 1 9 a oc I w I I 6 '~n i I y vovu ~ ~ ~ / I 1 J >f I I O ~ Oz I = ~ p ro<g A~ ~Y Sy ro0.9 ty A 1 Sd µ~µ~1pp s 1 <1 h fipt~i 1 1- i `Q Y3 i t I X~^ ~S3 i i ~ 4 I I h I I I I I ~ I I I I r I I I I I j I .ol .u I-,q I I I I I I I S I I ~ 1 1 f I - I I 0 I I aw.e I j E b I I I I I fit I I ~Y~ I I 11 y I I ' E ~J ~0. ~ I 910bs ~M'NOSanH ~oo 'aa TMH711W bbc w .au .rc o-.a .or,oc 4 M1.~ y 1` § I J L _ _ .17 Mg ° I i ~gRgg ~~8AI v s s" 'pF lr§b 1 F I I ow. o i8~a F h l X24 n p~ izg "NA F ~Y~ ~r5 : ~c5 9~ ~ ~ I gg r I'I .o-s .i b 4 ~ I ' I ~ uK g 3 s C ~ 4 C O fn5e ~ - ' >l .roc °II V3.~ F v ➢ > D 9 L-------- " 4 ee _ _ R W .uGPOGO,o-oy .u o,o~.u ao- I I 4 F Z o- I I Q - X .r.ol .ri of-.c I~ I h ao~ o,r. w o,o~ o,r-o" ~ Y h h ~ N Q yy " €C€ ~titiM1 ~i M w W 9105 IM 'xOSanH ~gg 'aa 113H~1IW X66 I 1 I I lJl L_._, I ava+ 41 I 111 a Q Q I R~ s Z I I i I .o,o _.oX I ~ I i r - 9 t i At I ; ~ I f -i I I I I I I I I i I ~ I I I I u a - e$ 2 € a a. a a t: a M1 b a A ~ ~ N 0 0 ~ a # ~ 3 l q 111 r ~ ~ N 3 I, A, a~a~ aM1 b A a a 4 ~ ~ ~ t RECEIVED SEP 2 ZOlo Wisconsin ST, CROIX COUNTY EN- SOIL EVALUATION R Page of Division of n uil mgs in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 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. v?^ Please print all information. Revie by Date -d' --6 -ALJ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / Property Owner Property Location Govt. Lot 1/4" 1/4 S T N R Ov E (o W Property Own er's Mailing Address Lott # Block # Subd. Name oitsW /a 4 06L- Ire City State Zip Code Phone Number City ❑ Village Town Neare oad w Construction Use:95esidential / Number of bedrooms. Code derived desi flow rate -Q GPD ❑ Replaoement(? ❑ Public or commercial - Describe: Parent material -~l~G~SIt Flood Plain elevation if applicable - n---- - - ft. General comments and recommendations: System Type System Elevation © Boring # rE~] Boring t03 Pit Ground surface elev. Ll_Z' , L ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 /Eff#2 AD, a -i Z E E I Boring # ❑ Boring • 61 Pit Ground surface elev 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 1 F (y 2 ! J, C, f u1 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 • Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) nature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conduct d Telephone Number 1432 120th St, New Richmond, WI 5404--l" / 715-246-4516 Property Owner Parcel ID # Page of Boring Boring # 1E 12 Pit Ground surface elev. 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 Ah~ ❑ 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 F] Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil ication Rate Horizon 'lepth 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 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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 (8.6/00) Property Owner _ Parcel ID # / Page of Boring # ❑ Boring ✓n. 1Z ~°pty-l. Pit Ground surface elev. 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 'Eff#2 3lL 5/ Ako E~~ Boring # ❑ Boring ❑ Pit Ground surface elev. 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 Bo ing # Boring Ground surface elev. _ ft. Depth to limiting factor in. ❑ Pit Soil icati rm Rate Horizon ')epth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/ff u in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg(L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 rrg/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. SOD-9330 (8.6/00) Soil Test Plot PI Project Name Kent Althoff S n Bird Address 915 Ferndale St. S. Maplewood Mn 55119 STM #22690(b Lot 10 Subdivision Trebus Valley Estates p e 9/13/16 NE 1/4 SE 1/4S 19 T 28 N/1319 W Township Troy ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation 103.4' *HRPSame as Benchmark Scale is F = 40' unless otherwise noted 2 Acre Parcel Property Line Property Line B-1 104' 103' B-2 102' 101' B-3 12% Slope B.M.* Mitchell Road Soil Test Plot PI Project Name Kent Althoff S n Bird Address 915 Ferndale St. S. Maplewood Mn 55119 STM #226900 Lot 10 Subdivision Trebus Valley Estates D I ~e 9/13/16 NE 1/4 SE 1/4S 19 T 28 N/1319 W Township Troy ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation 103.4' *HRPSame as Benchmark Scale is 1" = 40' unless otherwise noted 2 Acre Parcel Property Line Property Line B-1 104' 103' B 2 102' 101' B-3 12% Slope B.M.* Mitchell Road