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HomeMy WebLinkAbout038-1082-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 592183 State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2796988 Permit Holder's Name: City Village Township Parcel Tax No: Tom & Rebecca Aluni TOWN OF STAR PRAIRIE 038-1082-40-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 111 20.31.18.342A TANK INFORMATION ELEVATION D TA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic . r^ s-/: Benchmark , lO~~~ IDV osing r~/~ ( Tl R11vt t4 l Alt. BM P.- . , r Acer3Tion Bldg. Sewer, ~ r ! Ht Inlet s TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. r Vent to Air Intake ROAD Dt Inlet Septic/b~ Dt Bottom t Dosing Header/Man. t 'd f i Aeration _ Dist. Pipe } Holding Bot. System l1e ~/f~ PUMP/SIPHON INFORMATION Final Grade 4Force Demand St Cover GPM 'I I 1 Loss System Head TD~I Dia., Dist, to Well tl ~ SOIL ABSORPTION SYSTEM BED/TRENCH ;Width Length No. Of Tfertehee DIMENSIONSIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK TEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: ` :J CHAMBER OR k 1V7 11\ ; \ Model Number: DISTRIIWTION SYSTEM [He.ad'er/NWifold rDistribution ; x Hole Size x Hole Spacing Vent)o Air Intake gh Dia / ;v Dia_ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Ovef Depth Over _TT Depth of Bed/Trench Cent t = xx Seeded/Sodded 1xx Mulched @G° • , i Bed/Trench Edges soil ` Jr p - Yes No E~ Yes ❑ No COMMENTS^ (Include code discrepencles persons present, etc.) spection #1: I) • ) Inspection #2: Location: 967 210TH AVE r~/j )JL(.C.' 1.) Alt BM Description = t`e ~ I t 4 COVO ~1 Pe ~~l/U , • ' u~ 2.) Bldg sewer length 43 e{, ~ t om/ 5 T1" x 1ST) N V. q -f L. ! amount of cover G Per pla ~.b ° fVAH T3 ~hb~t~dor~< 41 ~ Plan revision Required? El Yes VNo h , Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. D ro Safety and Buildings D i ~c c f S 201 W. Washington Ave., P.9 Il Madison, Wl 53707-7162 Samtar5. Peitnit her to be ed in by Co.} 4Jim nt ' `pelt -Application State Transaction Number In accordance with SPS 383 21(2), Wis. Adm Code, submission of this form to the appropriate governmental unit X / is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Servies. Personal information you provide may be used for secondary Project Address >f different than mailing address) ores in accordance with the Privacy Law, s. 15.04(1) m , Stats. L A lication Information - Please in All Information Property Owner's Name h'L" /4 C.t~ . GCS- Parcel Property Owner's Mag Address ~ ~ Property Location ~ J City, State i Zi Code Govt Lot p Phone Number t c~ . CA_- Section Z o L11 Typ of Building (check all that app T 3 irc on N~ R iJE W or 2 Family Dwelling - Number of Bcdr Subdivision Name d El Public/Commercial -Describe Use Block # Q City of Q State owned - Des;Ie Use CSM Number rQ,~Viltage of d ✓ ,,own of Al. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. n g _ + iYew system lacement system ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber Q Permit Transfer to New Issued Own er N. Type of POV1 TS S stem/Com onent/Device: Check all that a 1 ' ❑ Q Non-Pressurized 1n-Ground 11 Pressurized In-Ground ❑ AI -Grade w OV of ound > 24 in. suitable soil Q Mound < 24 in. of suitabl oil Q Holding Tank Q Other Dispersal Component (explain) - Q Pretreatment Device (explain V. Dis rsal/Treat ent Area Information: Design Flow (g Pd) Design Soil Appvc~ ~ (gpds~ Dispersal V Area Requir s Dispersal Area Propo s System 614's Elevation VL Tank Info Capacity in W, Gallons Tom # of Man ac ufnner New Tanks Gallons Units a Existing Taroks m u J _ v ~ Septic or Holding Tank ~j Dosing Chamber d' S 6 - V11. Responsibifity Statement- I, the undersigned, assu a esponsibility for installation of the POWTS shown on the attached plane Plumber's Name (Print) Plumber' ature ? C MP/MPRS Number Business Phonr N her Plumber's Address (Street, City; tare, Zip qDde 71~ f i VIII. ounty/De ailment Use Only Approved ❑ Di r Permit Fee Date ued S &y~ Issuing. t Signature Q er G eason for Denial DL Condi - asons for Disapproval 1. • S ' in tank, ettiu'cnt filter and 3) dispemw cell must all be ser; leas ! rie'ntsirg. A " as,per management plan provided by plumber. 2. All C*0er,Wo must be maim inEd n wr am ble w& I s'fdinanm 04 S~ J~b 6e,,, ~t.~O•►.,.~ I Attach to G/-0 plaus for the system and submit to the County only an a P Per not s thaIR irz zJZ iochcs m s{ze 66 SBB-5398 (R. 11/11) System PLOT PLAN PROJECT Tom Aluni ADDRESS 6902 Tavlor Road Virainia Mn 55792 NW 1/4 NE 1/4s 20 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 98.8' 10/23/16 4 DATE BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Bottom of garage siding ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 210th Ave Scale = 1/4" = 10' 30 acre parcel Well O Existing 4 Bedroom House Old system is to be pumped and buried Garage 400' ST pW B.M.* Vent Tank is to be properly bedded and provided with lockdown covers with approved warning labels ffcutt C mbo Tank Area 15' below system is to remain undisturbed 96' Grading is to be done to divert run-off away from 4% Slope B-3 system 97' 1320' Property Line 97.8' 98' B-2 B-1 ...?C 0 _ "~r~fti ~iF.tiT~ DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay IF http://dsps.wi.gov/programs/industry-services -r,. www.wiscons'in.gov Scott Walker, Governor Dave Ross, Secretary November 07, 2016 APF ; s OF r I C1_IST ID No. 226900 AT1'iV~ POkVTS Inspector 'DFESSIC~-3. SHAUN R BIRD i° ZONING OFFICE. BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST I101 CAR-MICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708_ CONDITIONAL APPROVAL, PLAN APPROVAL EXPIRES: 11/07/2018 Identification Numbers Transaction ID No. 2796988 SITE: Site ID No. 830985 Tom Aluni Please refer to both identification numbers, 967 210TH Ave above, in all correspondence with the agency. Town of Star Prairie St Croix County NWI/4,NE1/4, S20, T3 1N, RI 8W FOR: Description: Alottnd System (4 Bedrooms - Replacement) Object Type; POWTS Component Manual Regulated Object ID No_: 1637709 Maintenance required; Replacement system: 600 GPD Flow rate: 28 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. • 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 compactinv of wet soil will t_esult_in reducing the infiltration caoacitv-of the soil. Proper soil moisture content can be deterrriined 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 crumble site preparation canproceed . If the site is too wet to prepare do riot proceed until it dries. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per app-6 ed plan. AnN chan-its mas result in pump resi7ing to meet TDH and GPNI Specifications. • Divert surface water from POWTS Area. 0 All piping shall conform to SPS Table 384.30-3 and SPS Table 384..30-5 SHAUN R BIRD Pai,e 2 11/7/2016 . Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) Tani: Installation to follow all manufacture's recommendations. Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. Areas that are occupied with rock fragments. tree roots sumps 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 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 _15,0 feet horizontally from where the servicin° mad is located. 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/ instal tation/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. C/ C When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer , Division of Industry Services Payment Submittal. WiSMART code: 7633 (920)492-2214, Monday s Friday 6 am To 3:30 pm !11';banderleest4ib-~ 'lsconsrn.uov SHAUN R BIRD Page 2 11/7/2016 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) b • Tank Installation to follow all manufacture's recommendations. • 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 mound must be cut off at ground 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. 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.vanderleesti,c wisconsin.aov Cover Page Shaun Bird '.'ALLY Bird Plumbing Inc. s ED ET°( AND 1432 120th St. 3ERVIC" New Richmond Wi 54017 715-246-4516 Date: 10/23/16 Owner:Tom Aluni Location: NW 1/4 NE1/4 S20 T31 N,R18 W 967 210th Ave Star Prairie Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications and cross section r Attachments: Soil T Shaun Bird Signature License numbe 2 6 00 Page 1 of 9 5 ,V 0 System PLOT PLAN PROJECT Tom Aluni ADDRESS 6902 Tavlor Road Virainia Mn 55792 NW 1/4 NE 1/4S 20 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 98.8' 10/23/16 4 DATE BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Bottom of garage siding ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 210th Ave Scale = 1/4" = 10' 30 acre parcel Well O Existing 4 Bedroom House Old system is to be pumped and buried Garage 400' ST _DW B.M.* Vent Tank is to be properly bedded and provided with lockdown covers with approved warning labels Huffcutt Area 15' below system is to Combo Tank remain undisturbed 96' Grading is to be done to divert run-off away from 4% Slope B-3 system 97' 1320' Property Line _ 97.8' 98' B-2 B-1 r ~ Z, L_ Mound System Cross Section and Plan View Dimension Feet A r i g 7 D 1T ..1.1.1.1.1.1.1.1. . 1 ' 1.1.1.1.1. 11.1.1.1.1.1 1 - .t.f•J.J.J.r.J.J.ry:'r: J:fyf.JY•f•!•J•J•J•J•J•l•!Y•f•t r.t.J.J. t.J.t.:f:l~ A ®RI?L1 ' 1+'VJ1.111ti•1•ti•1~t~ti•1~1~ti1•ti•1.1%1.1%1?lftjtij.fl.liti.1.1f1 L t 1.4•ti• J ! f•!•!•J•t• •'t•fir,~t•t1J•J•J•f•J1J•t•t•t•r•t•r,•~J•r•t~J• J•/. Jti1~~L.1:4. 1J• •t1J1J•JtiJ•1tiJ•J ri!•:M1:•r:Y:l.r.Jit J 1J:t:t.r JYit:l:J:J J J J J t•r:r:J:1:1ij:j.t:r:t.t.J:J.J:t.t:t~J11:J:J1J~1 •f:r:J.lY~t:t:r•f:J.IN:JLf f:r:l:1~f~!~f~JyJ:f:i:l:f:l:f~f~J~f~f~i1j1f1f:j:J:r:r1r1f1j411>Lj1j1~tij1jti11.1•L.L. W F i t Z i G 5 r r H J l I I i J i i I i K Z . LE. . L ` - W 3 40 K B Z T L Slope % - = Topsoil = ASTM C-33 Clean aggregate = 4 in. sch. 40 pvc l1r1r1 Ca Material I 1 0 P sand fill 1:11 4 /2 to 2 /2 in. dia. observation pipe Geotextile G H Fabric F 9 C~ Ft D E: ^ Plowed Surface Ft Contour Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is 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. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07191 Page of Pressure Lateral Layout Two Laterals - End. Manifold 4 Threaded Cleanout Lateral Turn-up plug Manifold M t X ~ L Long Force Main Sweep 90 Bend Distribution Network S ecifications Pressure System Construction Lateral Diameter Z In. Manifold Diameter 7 In. FLat,-..ral s are constructed of Schedule 40 PVC Orifice Diameter S~ In. Orificesare 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 M (Manifold Length) Ft. cleanout plug and are enclosed in a 6-8 inch Force Main Diameter In diameter lawn sprinkler valve box accessible Force Main Length Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box i Page of 03/0519) Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer ee Tank Model Number Pump Model Number ~c /ESL Total Tank Capacity /aSS 6~ Alarm Manufacturer Max. Bury Depth ' Alarm Model Number f Switch Type c Filter Manufacturer < Total Dynamic Head (TDH) - Feet Filter Model Number / Elevation Head U Distal Pressure Network Loss I Minimum Pump Performance Required Force Maim. Loss .1-7 b GPM Ft TDH Total outlet Manhole MuL 4" Above Grade With Locking D". Ynlet Manhole Manhole Min. 4" Above Grade < b" Below Grade Sealed Watertight Securely Mounted With Lacking Device Weather-proof Junction Box . - Finished. Grade - - . Vent Min. 12" Disconnect Above Grade Means With Vent Cap XX: Outlet Filter lnlet Inlet Baffle - - a,a; A Switch Sett}trgs and Reserve Capacity X __0 Tank Volume = GPI " W`'' B Hole Dimension: Inches Volume Gal. (reserve) A (alarm) B : 2 Off levation C 3 Ft (dose) C 7,,5'- /X Bottom <>< . (dead) D 3 D Elevation 19 Total y~ 6 ,f' : r, __Ft > r a , > > > > a > • sa a a • a,7 > • a •a> • a•• a > > a'•i> >`>'ir',•> > r > a > , • r >,a >,a~+'r'•`s ail i a`i ail > ,><'i GENERAL INSTALLATION: The septic/dose tank's bedded and hack filled in accordance with the manufacturer's Product approval specifications. Maximum depth of buryas, specified. by the nmufacturer may not be exceeded without pjior 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 tQ went settling or sagging. The force man is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight Electri ice mpltes with IJEC.300 and Comm 16.21-1. Page 2 of 02/05 LJ TOTAL DYNAMIC DEAD/CAP.ACiTY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING 1n MODEL 152/153 ~W Li MODEL I i 52 153 50 Feet f9zters I Go.. Liters I Get. I Liters 153 5 1 5 j 69 251 77 291 12 40 152 10 3. i 61 231 I 70 265 0 15 4.6 53 201 61 231 i 20 6.1 44 167 , 52 197 v 30- 1 z 8 25 I 7.6 34 129 42 159 0 30 GO. 1 23 1 87 I 33 125 Q 20 35 1 22 I, Fill 40 I 12.2 ! 11 42 11-41 10 1 j Lcck Voivz. j 35.0 (1 Ern) I44A Ft. 4, ri) 01450a 1 0 20 60 80 100 GALLONS LITERS - 5 1/4 0 80 160 240 320 3 27/52-4 5j8--.1 i FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 2~/~2 • Timed dosing panels available. Electrical alternators, for duplex systems, are available and supplied with B 3 z~/3z an alarm. I T • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. ~j Sealed Qwik-Box available for outdoor installations. See FM1420. , rJ • Over 130°F. (54°C.) special quotation required. !I 1521153 series 2 1i e - L` 1521153 MODELS Control Selection Model Vohs-Ph Mode Amps Sim lex t' ex N152 115 1 Non 8.5 t 3 , BN152 115 1 Auto 8.5 Included 2 or 3 sK2os4 E152 230 1 Non 4.3 1 2 or 3 1 BE152 230 Auto 4.3 Inclined 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto 10.5 Included 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 or 3 1. Single variable level float switch or double back variable level float BE153 230 1 Auto 5.3 Included 2 or 3 piggyback p~J9Y switch. Refer to FM0477. o CAUT1oN 2. See FM0712 for correct model of Electrical Alternator E-Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. Au electrical and safety codes should be followed including the most recent National EtectricCode (NEC) andthe Occupational Safety and Health Act (OSHA). or (4) float system. 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 I-V Louisville, KY 40256-0347 Manl(aChversof.. 1Z SNIP TO: 3649 Cane Run Road oop M'' Louisville, KY 40211-1961 Q!!AL/Tr~UMPS iwCf ci~" (50Z) 778-2731 - 1 hiipJlwww.zoeller.com PUMP L"O. FAX (502) 0 PUMP 774-3624 © Copyright 2000 Zoeller Co. All rights reserved. • POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page of FILEINFORMATION SYSTEM SPECIFICATIONS Owner 7 AL D rvi Septic Tank Capacity o2~sr al ❑ NA Permit Septic Tank Manufacturer l NA DESIGN PARAMETERS Effluent Filter Manufacturer 0 NA Number of Bedrooms 0 NA Effluent Filter Model ~f 0 NA Number of Commercial Units ~dA Pump Tank Capacity a1 0 NA Estimated flow (average) 6 al/da Pump Tank Manufacturer ❑ NA Design flow (peak). (Estimated x 1.5) gal/day Pump Manufacturer 0 NA Soli Application Rate 0 al/da ffe Pump Model /OSZ- 0 NA Influent/Effluent Quality Monthly average* Pretreatment Unit Fats, Oil & Grease (FOG) s30 m /L 0 Sand/Grevel Filter 11 Peat Filter g ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) 5220 mg/L Total Suspended Solids (TSS) 5150 m /L 13 Disinfection ❑ Other. Manufacturer Pretreated Effluent Quality _I!rNA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (BODS) s30 mg/L 0 In-ground (gravity) ❑ -ground (pressurized) Total Suspended Solids (TSS) 530 mg/L 0 At-grade and Fecal Coliform (geometric mean) s1 W cfu/100m1 ❑ Dri ine ❑ Other. Maximum Effluent Particle Size Y inch diameter Values typical for domestic (non-cwnmerc ar) wastewater and septic tank effluent. " Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ monthsar(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every months Tm4qs) (Maximum 3 yrs.) Clean effluent filter At least once every , ❑ month year(s) Inspect pump, pump controls & alarm At least once every ❑ months ar(s) ❑ NA Flush laterals and pressure test At least once every ❑ months r(s) ❑ NA Other. At least once every ❑ months ❑ year(s) ❑ NA otlw. At least once every ❑ months ❑ year(s) ❑ NA 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 SerVidng Operator. Tank inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch- NR 113, Wisconsin Administrative Code. The servicing of effluent filters, m"nical or pressurized POWTS components, pretreattment components. and any other maintenance or monitoring at irltervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event 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 that may impede the treatment process and/or damage the dispersal cell(s)- If high conce=ntrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. 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 thElt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of tho 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 bo 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 parts 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 life of the POW 17J$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produc*, 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 propely and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. • Ail 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 compy;pnt replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requirjed setbacks from existing and proposed structure, lot lines and welis. Failure to protect the replacement area will! result In the noed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule/ in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology/ 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 F'OWTS a soil and site evaluation 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 surface. 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 Oj A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLED POWTS MAINTAINER Name U Name / Cw Phone / fJ"' c~ c~ ~J C Phone 7) J 'O J7 SEPTAGE SERVICING OPERATOR LIPUMPER) LOCAL REGULATORY AUTHORITY Name Name f 419 Phone , Phone , j 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. f ry t A A iT i p s c J it I P o a I p I 14, ~ _ . 1 i i.-LI U oll c ~ N Q ~ N ~ D C O co c Q a U I I ~ C\ 1 i o ST. CROIX COUN I-y SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer. " z zl Mailing Address ~1 0 1- lu-r Property Addres 011 , (Verification required from Planning & Zoning Dep t for new construction.) City/State Parcel Identification Nutaber 0 LEGAL DESCRIPTION Property Location J`J~J Y. %4 , Sec. 2 Q , T3 ~ NR W, Town of Subdivision -7- Lot # Certified Survey Map - Vc.,lume- Page # Warranty Deed # Volume Page # c° 0 Spec house yes no Lot line., identifiabl yes no SYSTEM MAIMNANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists ofpunVmg out the septic tank every three years or sooner, it 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 §Comm 83.52(l) 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 pun4mr 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 uud=sig=d 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 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 this orm 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, Nnmbe , f bedroo SI ATURE OF APPLICANT(S) ~ DAT l-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 Gffice and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) ED do? ,j Cj 'Z 4 Wisconsin Department ofComme~ COUNT`t` SOIL EVALUATIOP P6P4RYEPENXGE Page of Division of Safety and Builpg£Ri~'~` ~Pr~~~~ 4 ~MM,U 61TY arcs with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must x- include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. e percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Q$Z „ Property Owner _ Property Location Govt. Lot 1 /4 r 1A S T g N R E( ) W Props~v Owner's Mailing Address Lot # Block # Subd. Name or CSM# City State Code Phone Number ❑ City ❑ Village Town Nearest Road t n ❑ New Construction Use.;gResidential / Number of bedrooms Code derived design flow rate 4 GPD Replaoement ❑ Public or commercial - Describe: Parent material JcxCS~ Flood Plain elevation if applicable - - - ft. General comments and recommendations: D ~ System Type C vt System Elevation I ' Boring # El Boring F 7 E& pit Ground surface elev. 1 ft. Depth to limiting factor in. Soil FApplication 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 L171 /7 Boling # Boring gj pit Ground surface elev.' ft. Depth to limiting factor -ND in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh^ 'Eff#1 *EEEff#2 .3l ti t! s b 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) ature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date _valuation Conducted Telephone Number 1432 120th St, New Richmond, WI 54 715-246-4516 Property Owner _ Parcel ID # Page of ® Boring # Boring in. Pit Ground surface elev. ft. Depth to limiting factor 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 D °i Z 10 2- 3U-YS -i.S alb a 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 # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil ication 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 = BODS > 30:< 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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) w Property Owner Parcel ID # Page of 3 Boring # E] Boring 2 a Pit Ground surface elev. ff. Depth to limiting factor J in. Soil ;cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs GPD/IF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o -i Z I O 7 L S' C s- ' -3C) 30-107. s - - d-)j 10 F1 Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 `Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sod AUilication Rate Horizon ')epth Dominant Col Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. •Etf#1 •Eff$Q Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 < 150 nxA ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 nVL 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 608-2648777. saD-8330(R-6/W) Soil Test Plot Pla Projects Name Tom Aluni Sh ird Address 6902 Taylor Road Virginia Mn 55792 STM #226900 Lot Subdivision fete 10/23/16 NW 1/4 NE 1/4S 20 T 31 N/R18 W Township Star Prairie R Boring o Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of garage siding System Elevation 98.8' *HRpSame as Benchmark 210th Ave Alk 30 acre parcel Scale = 1/4" = 10' Well O Existing 4 Bedroom House Garage 400' 00-1 ST pW B.M.' Vent 96' 4% Slope B - 3 97' 1320' Property Line 98' B-2 B-1