HomeMy WebLinkAbout036-2003-80-000
. Croix
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St
Safety and Building Division Sanitary Permit No:
INSPECTION REPORT 592141
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
2774752
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]
Permit Holder's Name: L City Village Township Parcel Tax No:
Wilbur & Helen Falkenthal TOWN OF STANTON 036-2003-80-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
r VI~-•1~ S;l//V 31.31.17.637
TANK INFORMATION ELEVATIONDA 101)QI D
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
016 / Benchmark ( 'O'• 1~
Septic N 9:"/j 7iv
Dosing 7t (,(/[J Alt. BM V
Prmi~; y u~ ~ Q ! q
~SL3t+tuZ Bldg.ew r C ~~J 7c2 J 7 /
~~Lr 1 k 45 ho
Ht Inlet s4
Ht Outlet
TANK SETBACK INFORMATION 01 17
TANK TO P WELL BLDG. Vent to Air Intake Dt Inlet
D2S
Septic t Dt Bottom
-1 101111- 5 2L]
.
Dosing t Heade an. el i TLi~
tymk) IDS_
Dist. Pipe ~,~rr Q• G'[J C?C
Holding Bot. System 9+ 2
1 r7 U
PUMP/SIPHON INFORMATION Final Grade
Manufacturer GePrlr ~ St Cover
i
Model Number ~1~~ h ~Y„( C}~ q~l• (p2
TDH Li I Friction Los System Head TD Ft , \ W e
I.55 Aker IQVrxhan t8y 99b.~z lo.°I 972.22
Forcemaln Leng IDia. Z *1 Dist. to Well
jb~ , O Qd 1 A rr ft/1,
SOIL ABSORPTION SYSTEM A\ ~°Ib.b7y-gBD= 10.102`1 f r
BED/TRENCH Width ) Lengj) I No. Of~pcues A PIT DIMENS No. Of Pits _ Inside Dia. Liquid Depth
DIMENSIONS /t `
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION T f S ste I CHAMBER OR
y y ~ UNIT Model Nurp er:
DISTRIBUTION SYSTEM L 1n1~~rS ell mu\cwre 1• -ft ed "e.,
Header/Manifold Distribution Ix Hole S' & x Hole Spacing Ve to Air Intake
Pipe(s)
I.5 3z- i • ~s"u
Length Dia Length_~UV Dia ~J Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of jxx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ No n Yes Noon
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: P L.UW t' I
Location: 1824 OAK RIDGE DR'FLbbD'PLRN
1.) Alt BM Description = IUgL co'll ~Q~ ~ • C hG~ ins LockSl' v' bed
2.) Bldg sewer length -ex~c}h X18 h" ~Rb
- amount of cover = 04 1\(J'r?gL XtSriNl e01475
tVAS bA0dW_jJ SASS ~5-
of
Plan revision Required? ❑ Yes No 1b 1' (A j 47-ve Use other side for additional informatio Cert. No.
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SAN 3V& - J9Q
County
Safety and Buildings Division St. Croix
_ 0 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
SpS Madison, WI 517162 G
S~J
-0NIM i Y ary Permit Application QRR3gp P State Transaction Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate govo_ Q~ 2774752
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are sub 6~ Project Address (if different than mailing address)
the Department of Safety and Professional Sen-ies. Personal information you provide may be used for seconuary Purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats.
1. Application Information - Please P ll Information 1824 Oak Ridge Dr.
Property Owner's Name ' Parcel #
Wilbur and Helen Falkenthal 036-2003-80-000
Property Owner's Mailing Address Property Location I ` 3 1 1-7,
1824 Oak Ridge Dr. Govt. Lot
City, State Zip Code Phone Number 1/4, Section 31
(
New Richmond Wi. 54017 T 31 N, R_17 cirelF ones or)P
II. Type of Building (check all that apply) Lot #
t_1'1 or 2 Family Dwelling -Number of Bedroom Subdivision Name
Block # Oak Ridge Estates
❑ Public/Commercial - Describe Use
❑ City of _
El State Owned -Describe Use CSM Number ❑ Village of
r Town of _Stanton__
r 1
AD ey 1310 )uk-
III. Type of Permit: (Check only one box on Ifni A. Complete line B if applicable) 77
A.
❑ New System ~ Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision List Previous Permit Number and Date Issued
Pemit Transfer to New
❑ Change of Plumber FEIwn:
Before Expiration r
V. Type of POWTS System/Component/Device: (Check all that apply) L.'s VVI do
I
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade (Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
Pretreatment Device (ex lain) _
❑ Holding Tank ❑ Other Dispersal Component (explain) P _
V. Dispersal/Treat nt Area Information:
Design Flow (gpd) Design Soil Appl tion Rate(gpdsf) Dispersal Area imd Dispersal Area Propf ed (sf) System Elevation
600 .67 7? 896 ~j 900 ! 93.95
VI. Tank Info Capacity in Total # of Manufacturer y
Gallons Gallons Units n U
New Tanks Existing Tanks c u a
` n n aU C7 G
Septic or Holding'fank 1200 1200 Wieser X
Dosing Chamber 800 $QQ Combo X
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
Keith Knudtson 648443 6511170-1737
Plumber's Address (Street, City, State, Zip Code)
927 150th St. Roberts W. 54023
VIII. oun /De artment Use Only
Approved _ Permit Fee Date X11 Issuing t Signature
wt en I: anon to enial $ wo zb /1
IX. Condi M a wlW- lsapproval
v ` ttL•J~. 5 F
~lep ti tolt,i*mt an be W_yicas r mutni_re~
pet aagement plan pronded by plumber.
2 19i~'> kCk''+tlulyemenls rnmt be maint2.ined
s~ pst s licslble codrt / ordinances. I $ l • 42-4 1y`~~ Jer
Attach to complete plans for the system and submit to the County only on paper not less t n 8 t/2 x 11 inches in size
Obi AaJ 0
SI3D-6399 (R. 11/11) all e, ~ 6-,
Ab "k., .
~Qti2AxTa1FVT DIVISION OF INDUSTRY SERVICES
3824 CREEKSIDE LN
off' o~P HOLMEN WI 54636-9466
f D a Contact Through Relay
S P http://dsps.wi.gov/programs/industry-services
v S w www.wisconsin.gov
20~ 1
~O~ssrorTtis~ Scott Walker, Governor
Dave Ross, Secretary
September 22, 2016
CUST ID No. 224059 ATTN: POWTS Inspector
KEITH E STONER ZONING OFFICE
KEITH STONER SOIL TESTING SANITARY DESIGN ST CROIX COUNTY SPIA
23220 WOODCREEK RD 1101 CARMICHAEL RD
SIREN WI 54872-8728 HUDSON WI 54016-7708
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 09/22/2018
SITE: Identification Numbers
Wilbur Falkenthal Transaction ID No. 2774752
1824 Oak Ridge Dr Site ID No. 828657
Town of Stanton Please refer to both identification numbers,
St Croix County above, in all correspondence with the a enc .
P.O. S31, T3 IN, R17W
Subdivision: Oak Ridge Estates; lot 18
FOR:
Description: Four Bedroom At-grade System / Sloping site
Object Type: POWTS Component Manual Regulated Object ID No.: 1623055
Maintenance required; Replacement system; 600 GPD Flow rate; 45 in Soil minimum depth to limiting factor from
original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.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(10), Wisconsin Statutes, is responsible for compliance with all code
requirements. CONDIT
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, APPI
stats. DEPT OF
The following conditions shall be met during construction or installation and prior to occupancy or use: PROFESSIOI
DIVISION OF INC
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made SEE CO
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per
SPS 384 product approval conditions.
• The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or
soil compaction is prohibited in this area.
• 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.
KEITH E STONER Page 2 9/22/2016
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.
• The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS
occurs in accordance with this chapter and the approved management plan under s. 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.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
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.
Oerca ely, Fee Required $ 250.00
This Amount Will Be Invoiced.
M Swim When You Receive That Invoice,
POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal.
jerry.swim@wisconsin.gov WiSMART code: 7633
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
Keith E Knudtson (Plans Mailed To)
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
"SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
KEITH E STONER Page 2 9/22/2016
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.
• The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS
occurs in accordance with this chapter and the approved management plan under s. 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.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
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.
erard M Swim When You Receive That Invoice,
0
POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal.
jerry.swim@wisconsin.gov WiSMART code: 7633
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
Keith E Knudtson (Plans Mailed To)
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
"SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
SEP 8 2616
RESIDENTIAL AT-GRADE DESIGN
Pressurized - Sloping Site
INDEX AND TITLE SHEET
Project Wilbur and Helen Falkenthal Replacement System
Owner Wilbur and Helen Falkenthal
Address 1824 Oakridge Drive
New Richmond WI 54017
ZONALLY
`OVED
Legal Description Sec. 31 T31N-R17W AFETY Air:
L SERVICE:
Township Stanton County St. Croix JSTRY SERViC, ;
Subdivision Name Oak Ridge Estates Lot No_ 18
Parcel ID Number 035-2003-80-000 .._ji_
Plan Transaction Number
Index sheet Page 1
Calculations Page 2
At-grade drawings Page 3
Laterals and dose tank Page 4
Specifications Page 5
Management & contingency plan Page 6
Pump curve & specifications Page 7
Plot Plan Page 8
Te5
Designer Keith E. Ston ~~ulllllun/ _ _ License Number Designer# 1575-007
Signature Phone Number
# STON 5
Date TO05-/, D-157
Siren,
off[ igned pursuant to:
At-grade Corr( I ►I~ . 2.0 for POWTS SBD-10854-P (N. 03107), and both
SSWMP Publication 6!#WW of Pressure Distribution Networks for ST - SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) r" wla)
Version 7.0 (03/12) Page 1 of 8
PRESSURIZED AT-GRADE DESIGN
At-grade Design Worksheet - Sloping Site
Flows and Site Data Entry.
(r or c) r Residential or commercial?
400.0 Estimated wastewater flow (gpd)
600.0 Design wastewater flow (gpd)
19.00 % Site slope
93.95 Contour elev. below lateral (ft)
45.00 Depth to limiting factor (in)
0.67 In-situ soil application rate (gpd/ft^2)
Distribution Cell Information
(1 or 2) 1 Influent wastewater quality
10.00 Linear loading rate gpd/ft
10.00 Effective absorption width (ft)
10.00 Max. effective width permitted (ft)
90.00 Aggregate length (ft)
Pressure Distribution Data Entry
(c or e) c Center or end lateral connection
2 Number of laterals
0.156 Orifice diameter (in) e.g. 0.25
Not a final
calculation 2.00 Estimated orifice spacing (ft)
2.00 Forcemain diameter (in)
2.51 Forcemain flow velocity (fttsec)
20.00 Forcemain length (ft) y or n Does forcemain drain back?
87.00 Pump tank elevation (ft) y or n Are laterals at highest point?
4.55 System head (ft) x 1.3 NA
6.78 Vertical lift (ft) 3.3 Forcemain drainback (gal)
0.27 Friction loss (ft) 40.5 5x Lateral void volume (gal)
0.00 In-line Filter Loss (ft) 43.8 Minimum dose volume (gal)
11.60 Total dynamic head (ft) 24.6 System demand (gpm)
Lateral Diameter Selection Gallonsllnch Calculator (optional)
Pipe diameter Design options Design choice Total Tank Capacity (gal)
Designer 1 in Total Working Liquid Depth (in)
must select 1.25 in x Gal/in (enter result in cell G46)
one lateral 1.5 in x x
diameter 2 in x Treatment Tank information
3 in x 1200 Septic tank capacity (gal)
Wieser Concrete Manufacturer
Effluent Filter Information Dose Tank Information
Pol -LLok _ Filter manufacturer 800.6 Dose tank capacity (gal)
PL-525 Filter model number F22.2 Dose tank volume (gaUin)
Wieser Concrete Manufacturer
Project: Wilbur and Helen Falkenthaf Replacement System
Transaction Number: Page 2 of 8
AT-GRADE PLAN VIEW
1/6 B Observation pipes (2 typical) A 10.00 ft
T D B 90.00 ft
I t--# 1 /6 B 15.00 ft
W --i- C 12.00 ft
D 5.00 ft
E 2.00 ft
D L 100.00 ft
B W 22.00 ft
A x B 895.52 ft^2
L
Cap
obs.
= Total aggregate cell A x B Typical pipe.
Slotted in n the lower 6", and
= Plowed area L x W anchored securely.
s°
AT-GRADE CROSS SECTION
Svnthetic fabric cover
95.74 ft Finished grade
Lateral elevation
invert elev. 94.45 ft f- Observation pipe
at aggregate toe
E
19 % Slope
Surface contour g3 95 ft C A
and system
elevation D
= 12 in. topsoil and subsoil plowed layer
over aggregate and tapered to toes. below L x W
= 6 in. aggregate below
pipe(s), and 2 in. above pipe.
Project: Wilbur and Helen Falkenthal Replacement System
Transaction Number: Page 3 of 8
PRESSURE DISTRIBUTION AND DOSE TANK
Lateral Diagram - Center Connection
I P I
IE- X---->IEx12 x1241 Laterals & forcer main of PVC Soh 40
Last hole drilled next to end cap per SPS Table 384.30.6
Holes drilled on the bottom of the lateral,
equally spaced ♦ =Turn•upvri'bsllvslvoorcl*anoutplug
Lateral Specifications
0.156 Orifice diameter (in) Center Lateral connection point
X 1.95 Orifice spacing (ft) 2 Number laterals
23 Orifices/lateral P 43.88 Lateral length (ft)
12.3 Lat. discharge rate (gpm) 1.50 Lateral diameter (in)
2.00 Forcemain diameter (in)
24.6 Sys. discharge rate (gpm) 20.00 Forcemain Length (ft)
11.6 TDH (ft)
Typical Pump Chamber Layout
Approved manhole cover with
Weather-proof waming label and locking device . . junction box
Final grade 4"
disconnect
Tank component is Alternate
properly vented outlet
location 18" min.
Electrical as per NEC 300 and 0 Ir^ Approved
SPS 316.300 WAC outlet
Tank full joint
Inches Gallons JA A Provide 1/4"
A 24.1 534.8 Alarm on weep hole or
B 2.0 44.4 antisiphon
_ C 2.0 43.8 Pump on device.
G D 8.0 177.6 87.67 ft C
Totals 36.1 800.6 -i
Pump off
D
3" Bedding der tank 87.00 ft
Goulds Pump manufacturer SJE Rhombus Alarm manufacturer
EP04 Pump model number Tank Alert 1 Alarm model number
Project: Wilbur and Helen Falkenthal Replacement System
Transaction Number: Page 4 of 8
At-grade System Maintengnce and Operati on Specifications
Service Provider's Name Powers Sanitation Phone 715-246-5738
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 895.5 f:2 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 ears
Effluent Filter Inspect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested eve 1.5 ears
Mound lns ct for ndin and seepage once eve 3 ears
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap,
and are secured in as shown in the at-grade 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 at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
6. Areas within 15 feet of the downslope toe will be protected from compaction.
7. All other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07).
Lateral Turn-up Detail
Finished
Grade
6-8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Long Sweep 90 or T me,
94.45 ft 45 Degree Bends Same
Diameter as Lateral
Project: Wilbur and Helen Falkenthal Replacement System
Transaction Number: Page 5 of 8
At-grade System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD-10854-P (N. 03107), SSWMP Pub. 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (N. 01/01)]
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 shalt 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 lacking
device to prevent accidental or unauthorized entry into a tank or component.
Sgotiic ,Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic
tank shall be disposed of in accordancewith NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet finer shall be
assessed at least once every 3 years by inspection.
The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter Is equipped with an alarm, the
filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products
are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary.
All-prate and Pn3ssurePitlitribution System
No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the at-grade 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 at-grade is not recommended since soil 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 at-
grade be heavily mulched as protection from freezing.
Influent quality into the at-grade system may not exceed 220 mg/L BODE 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD5 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system Is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test
when the system was Installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any
levels above 4 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 at-grade component falls 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 renovating the biologically clogged absorption and
dispersal media, installing new piping, and replacing other 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.
Project: Wilbur and Helen Falkenthal Rep Transaction Number: Page 6 of 8
Page 7 of. S
A GOULDS PUMPS Submersible
Effluent Pump
tEP04
EPOS
3871
~www~ ~ w•• ■ r~ww
APPLICATIONS • Fully submerged in high ■ EP051mpeger: Thermoplas- ■ Bearings: Upper and lower
grade turbine oil for tic enclosed design for heavy duty ball bearing
Specifically designed for the lubrication and efficient improved performance, construction.
following uses:
• Effluent systems heat transfer. ■ Casing and Base: Rugged
• Homes Available for automatic and thermoplastic design provides AGENCY LISTING
superior strength and corrosion
• Farms manual operation. Auto- resistance. Cad m SUwxbrds AssodeUon
• Heavy duty sump matic mallets include
• Water transfer Mechanical Float Switch n Motor Housing: Cast iron (CSA listed model numbers end
• Dewatering assembled and preset at the for efficient heat transfer, in "C" or 7".)
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover Thermoplastic sails Punps is iso mm naosixeti.
FEATURES cover with integral handle and
• Solids handling capability: fiat switch attachment points.
!d' maximum. ■ EP04 ImpeNer: Themtoplas- ■ Power Cable: Severe duty
• Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant.
• Total heads: up to 31 feet, pump out vanes for mechanical
• Discharge size: I Ih" NPT. seal protection.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104`F (40`C) continuous
140OF (60cQ intermittent METERS FEET
10-
• fasteners: 300 series
stainless steel. 9 30
• Capable of running 2s Fr5
dry without damage to a
components. 25
a 7
Motor:
x
;
• EP04 Single phase: 0.4 HP, 6 20
115 or 230 V. 60 Hz, 1550
RPM, built in overload with s
automatic reset.
• EP05 Single pphase: 0.5 HP, 0 4 ? EPOS
115 V or 230V, 60 H7, 1550 RPM, built in overload with D
t'
automatic reset. 2 EP04
,
• Power cord: 10 foot s
standard length, 1613 1
SJTpW with three prong
grounding plug. Optional 20
° °0 10 20 ' 30' 40 _
so sPM
foot length, 1613 SJTW with
three prong grounding plug
(standard on EP05). ° 2 4 6 a 10 12 rn'Ih
CAPACITY
Goulds Pumps
40 2001 Goulds Pumps
E ITT Industries
Effective May, 2001
83871
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer Wilbur Falkenthal
Mailing Address
Property Address 1824 Oak Ridge Dr.
(Verification required from Planning Zoning Department for new construction.)
City/State New Richmond Wi. Parcel Identification Number 036-2003-80-000
0
LEGAL DESCRIPTION
Property Location '/4 '/4 Sec. 31 T31 N R17 W,TownofStanton
,
Subdivision Plat: Oak Ridge Dr. Lot #141
Certified Survey Map # , Volume , Page #
Warranty Deed # (before 2007)Volume , Page #
Spec house OyesOno Lot lines identifiable Elyes[]no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
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.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County Planning & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements this form are true to the best of my/our knowledge. 1/we am/are the owner(s) of the
property described above, by virtue of warranty deed recorded in Register of Deeds Office.
Number of bedrooms 4
- -(t/,&&/c,/
SIGNATURE OF APPLICANT(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. 04/12)
r ST
Wisconsin Department of Safety and Ussional Services
pivision of Indu i
SOIL EVALUA~ HA C #3134
Page 1 of 3
QQQ38gKHDj
r~ 246 in accordance with SPS 385, Wis. Adm. Code Keith Stoner CST
Attach corte site pin, County
M per not less than 8% x 11 inches in size. Plan must St. Croix
include, but yl}4 ~ kkp[1~ horizontal reference point (BM), direction and
percents v~i $ons, north arrow, and location and distance to nearest road. Parcel I.D.
036-2003-80-000
;,OMM Please print all information.
Reviewed BY Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 _ - 2/3 -'Fh -000 A6 I 1 63 Property Owner Property
Location l~
Wilbur & Helen Falkenthal Govt. Lot 1/4, 1/4, S31, T31 N, R17W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1824 Oakridge Drive 18 Oak Ridge Estates
City State Zip Code Phone Number 1 City Village Town Nearest Road
L
New Richmond WI 54017 Stanton Same
L j New Construction Use: P1 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement F-1 Public or commercial - Describe:
Parent material Sandy drift on outwash plains _ Flood plain elevation, if applicable NA
General comments Propose a 10 x 90' at-grade mound with apntour grade and system elevation = 93.95'. Contour staked onsite.
and recommendations:
F -1 Boring
i, Boring #
F/i Pit Ground surface elev. 94.92 ft. Depth to limiting factor 65 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-11 10YR3/3 - Is lfgr mvfr Cs 3f-m 0.7 1.6
2 11-38 10YR4/4 - Is Osg ml gs 2f-m 0.7 1.6
3 38-42 10YR4/4 - sr s Osg ml gs if-m 0.7 1.6
4 42-65 7.5YR3/4 - sl m mfr gs - 0.2 0.6
5 65-80 7.5YR5/4 f2d5YR5/8 sr s Osg ml - - 0.7 1.6
#4 - with bands of sand #5 - with bands of sl 7.5YR3/4
❑ Boring # i Boring
r'j Pit Ground surface elev. 95.22 ft. Depth to limiting factor >80 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfW
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-7 10YR3/3 - Is lfsbk mvfr Cs 3f-m 0.7 1.6
2 7-24 10YR4/4 - Is lfsbk mvfr gs 2f-m 0.7 1.6
3 24-40 10YR4/4 - Is Osg ml gs 2f-m 0.7 1.6
4 40-58 10YR4/4 - srs Osg ml gs if 0.7 1.6
5 58-67 7.5YR3/4 - fsl m mfr gs - 0.2 0.5
6 67-80 7.5YR5/4 - sr fs Osg ml - - 0.5 1.0
#6 - with frequentl - 2" bands of 7.5YR3/4 sl
Effluent #1 = BODS> 30 < 220 mg/- and TSS >30 < 150 Mg/l uent #2 = BOD5 g30 mg/L and TSS <30 mg/L
CST Name (Please Print) Signature: CST Number
Keith Stoner 224059
Address Keith Stoner CST Date Evaluation Conducted Telephone Number
23220 Wood Creek Rd Siren, WI 54872 8/18/2016 715-566-0900
SBD-8330 (RA7/13)
Property owner Wilbur & Helen Falkenthal Parcel ID # 036-2003-80-000 ~ Page 2 of 3
[ ] Boring
3 Boring # Pit Ground surface elev. 91.84 ft. Depth to limiting factor >64 in.
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-6 10YR3/2 - Is lfsbk mvfr cs 3f-m 0.7 1.6
2 6-15 10YR3/4 - Is Osg ml gs 2f-m 0.7 1.6
3 15-34 10YR4/4 - Is Osg ml gs if-m 0.7 1.6
4 34-45 7.5YR4/4 - sr s Osg ml gs if 0.7 1.6
5 45-64 7.5YR5/4 - sr s Osg ml - - 0.7 1.6
#5 - with 6" wide bands of massive sl 7.5YR3/4
F Z Boring
4 Boring # Pit Ground surface elev. 92.00 ft. Depth to limiting factor 45 in.
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-7 10YR3/2 - Is imsbk mvfr cs 3f-m 0.7 1.6
2 7-33 10YR3/4 - Is Osg ml gs 2f-m 0.7 1.6
3 33-40 10YR4/4 - sl 2msbk mvfr gs A 0.6 1.0
4 40-45 10YR5/4 - sl m mfr gs if 0.2 0.6
5 45-64 10YR5/4 c2d5YR5/8 sl m mfr - - 0.2 0.6
Boring
F - 1 rJ Boring # pit Ground surface elev. 95.62 ft. Depth to limiting factor 0 in.
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2
1 0-6 10YR3/4 Fill sl 2msbk mvfr cs 3f 0.6 1.0
2 6-21 10YR4/4 Fill Is imp[ mvfr gs 2f 0.7 1.6
3 21-31 10YR3/3+4/4 c2d5YR5/8 Is Osg ml gs 2f 0.7 1.6
4 31-34 10YR3/2 Buried A Is lmsbk mvfr gs if 0.7 1.6
c2d5YR5/8
5 34-49 7.5YR5/4 - Is Osg ml - - 0.7 1.6
*Fill placed in low spot
I - ell Effluent #1 BOD5> 30 <220 mg/t_ and TSS >30 <150 mg/t. " Effluent #2 = BOD,~ < 30 mg/t_ and TSS <30 mgA.
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