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HomeMy WebLinkAbout030-2007-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592188 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2790371 Permit Holder's Name: City Village Township Parcel Tax No: Oevering Homes, LLC TOWN OF SAINT JOSEPH 030-2007-80-000 CST BM Elev: Insp. BM Elev: BM Description. Section/Town/Range/Map No: / nO -0- 1 6,57- 34.30.19.376D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE JN~_,S CAPACITY STATION BS HI FS ELEV. SepticV /N; 2 1 Benchmark r ~ Dosir}@~, u n , 5~ Alt. BM ~ JA_ F-7 ! AZ Aertien~ r Bldg. Sewer dq . H t Inlet / yfe f , TANK SETBACK INFORMATION St/Ht Outlet TANK TO Pt/~ WELL BLDG. Vent to it intake ROAD Dt Inlet Septic ~d Dt Bottom -7.3 /0 Dosing y Header/Man. Aeration Dist. Pipe Holding Bot. System !f PUMP/SIPHON INFORMATION Final Grade 161,7 Manufacturer D emand St Cover -7 GPM FiL Model Number A ~ c C, 613 1 ! / TDH Lift Friction Loss6 Z System H TDH Ft ead Forcemain Lenath Dia. Dist. to Well 7 ± SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. 49rench s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ^ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION T e pppfffgg~stem: CHAMBER OR yP /y rd j ef~~ C~G 546 UNIT Model Number ` DISTRIBUTION SYSTEM / Header/Manifol~r Distribution y~ x Hole Size 11 ix Hole Spacing Vent o Air Int Pipe(s) y~ / V Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 4•~• Depth Over Depth Over xx Depth of xx Seeded odded xx Mulched Bed/Trench Center °j Bed/Trench Edges Topsoil Yes No s F] No COMMENTS: (Include code discrepenci s, persons present, etc.) Inspection #1: / W~ tY Inspectio #2: / 7 Location: N A res Ava a 7)a„~,•. (~~"cx 1.) Alt BM Description= r atv_ CaU - 6 r II11 _ a 2.) Bldg sewer length = 1 C, amount of cover = vhv o In Plan revision Required? [ ,1 Yes VN o /f 4 ) Use other side for additional information. 4-In-sepctor's Date Sign re Cert. No. SBD-6710 (R.3/97) IL va'~ny - County Safety and Buildings Division 1 201 W. Washington hi P.C Box 62 Sanitary Permit Number (to be filled in by Co.) 1a P ~p17CCUl.'t~-~ Madisor Prl. Nt.Y uEV 6P4RYEPENXGE 12 I g Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit ~ V ~ :21 is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if differ t than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary oses in accordance with the Privacy Law, s. 15.04(1) m), Stars. r I. Application Information - Please Print All Information Property Owner's Name Parcel 4 G .J f; ll.G ' 35 030- - --in Property Owner's M 'ling Address Property Location e J I ^5 `7 J Govt Lot City. State Zip Code Phone Number L&Z ys Section Lj L J cle on (Z N; R E / - / II. Type of Building (check all that apply) Lot # T~ ~--C- 2 Family Dwelling -Number of Bedrooms 1 Subdivision Name Block # ❑ PubticlCotnmercial -Describe Use Y r . ❑ City of ❑ State Owned - Describe Use ~0 1 ~/~W~ ❑~Village of I V W Town of S ,8 Rf. Type of Permit. (Check only one box on line A. Complete line B if applicable ew system Replacement S ystem ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner. IV. T e ofPOWTS S stem/Com onent/Device: (Check all that a ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ound > 24 in. of suitabl ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V V. Dispersal/Treatment Area Information: Design Flow (gpd) Des Soil plicW o W -7 n $ate(gpdsf) Dispersal Ar~eaRequu (sf)~ Dis 41 Area opo (sf) em Elevation VL Tank Info ' Capacity in Total 4 of Manufacturer Gallons Gallons Unite New Tanks 'Gx.=g Taal s t r J,.~7, AA O I m ~.U i:n" ) Septic or Hording Tank Dosing Clamber ~ r53 V11. Responsibility Statement- 1, 2undersigned, • responsibility for installation of the POWTS shown on the attached plans. Plyur 's Name (Print) ignature MP/MPRS Number Business Phone Number Plumber's Ad ss (S~ City; STate, 7D 71 j VIII. Countv/De artment Use Only proved Permit Fee Date Ls~suef d 7n` Issuing 4gent rgnahue r 'ven ReasoHDemalj Approvai/Reas IX Conditions SYSTEM OWNER ons for Disapproval tVt ~O~G~ On ~CfiDr ~yx V ` ~t.. ) 1. Septic tank, effluent filter and dispersal deli most be, Serviced / maintained ~IDNI{OWE nee MU 11ee as per management plan provided by plumber, ~1 ~ S ~ r~u~at ~ V 2. Al! sett rk o ;reM2ltb Must be maintained " 1• Cond(t~onS (XpU V~ / as per aNi4~f 'i~ 1 f g }stem and submit to the County only au per not less than 8 I1 m es in size are ~n ~-~-ec~ W~+~1 ~~S pQr m SBD-6348(R. I1111) 111 J ` mm pl ~ b~~u a~fis . e ~Vp- ZDI ~ - 05 . E,rus i Cnn~u ~ q~ i ~ ~ c) ! I S DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 -1 Contact Through Relay http://dsps.wi.gov/programs/industry-services www wisconsin.gov ~...sloN - - Scott Walker, Governor Dave Ross, Secretary October 19, 2016 s OUST ID No. 226900 ATTN: POWTS Inspector 1 i. FE S S I La SIGN OF 1§N . SHAUN R BIRD ZONING OFFICE BIRD PLUMBING fNC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 .w t CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/19/2018 Identification Numbers Transaction ID No. 2790371 SITE: Site ID No. 830129 1 Oevering Homes Please refer to both identification numbers, 645 Perch Lake Rd 3h~we in all l 'ri rc~ Town of Saint Joseph St Croix County NE 1/4, NWl/4, S34, Lot: 3, FOR: Description: Mound Si,stem (3 rooms - Merv Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1630068 Maintenance required; 450 GPD Flow rate: 24 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, stars. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • Divert surface water from POWTS Area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. if it rolls into a 1!4- inch wire. SHAD R. BI12I Paz- 2 10%19/20 t6 the site is too wet to pr-~oa1 e. If-it crumbles, site reparation cars proceed. If the site is too wet tyre are, do not proceed until it dries. • All piping shall conform. to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building server beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • 'l'ank Installation to follow all manufacture's recornmendatiorls. • SPS 383.54(l)(e) The management plan for a POWTS shall specifically address the .servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2 The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan 4nv changes may result in pump resizina to meet TDH and GPM Specifications. Arius "h2f are occ?:""Ied with rock fragments, wee 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 aTOUnd level, h larger eiwo rater°d. to provide sufficient infiltrative al'e£t Owner Responsibilities • The current owner, a.[tj eat,! ,lIJS(C~iif;7li.ov,J.,_ shaati ['°ce7cc a col? 'F:illS .V~er mc!l-IJML' a 5.1"IaC„t10R:': 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(3). • 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 orI-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 designina a safe building, structure, or component, Inquiries concerning this correspondence may be made to me at the 'telephone number listed below; or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the PO WTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POW'TS. Sincerely, Fee Required S 250.00 This Amount Will Be Invoiced. Tim Vander Leest When You Receive That Invoice, Private Sewage Plan Reviewer, Division of Industry Services Please Include a Copy With Your (920)492-2214, Monday n Friday 6 am To 3.30 pm Payment Submittal. im ~;a it,rI Vest: Iseonsirl ro; WISMART code: 76333 s w SHAUN R BIRD Paae 2 10/19/2016 the site is too wet to prepare If it crumbles sit-, preparation can proceed. If the site is too wet to prepare. do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(I)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Puma Floats to be set and veri_ied Der imnroved Alan. Any chanties may result in pump resizing to meet TDH aDd GPM Specifications. Areas that are occupied with rock fragments, tree roots, st>>mps 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 su-mcient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In antmg this approval the Division of Industry Services reserves the right to require .,han,g ~es 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 S 250.00 This Amount Will Be Invoiced. Tim Vander Leest When You Receive That Invoice, Private Sewage Plan Reviewer, Division of Industry Services Please Include a Copy With Your (920)492-2214 , Monday - Friday 6 am To 3:30 pm Payment Submittal. tim,vanderleest(z wisconsin.aov WiSMART code: 7633 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St.t'41 S New Richmond Wi 54017 715-246-4516 Date: 10/12/16 Owner:Oevering Homes Location: NE1/4 NW1/4 S34 T30 N,R19 W 645 Perch Lake Road St. Joseph 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 Attachments: Soil Tes Shaun Bird Signature License nu 226900 .17 21 Page 1 of 9 System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 NW 1/4s 34 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 10/12/16 3 DATE BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. top of 1.5" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE (DWELL *H.R.P. same as benchmark Perch Lake Road V:ed o 3 Scale = 1/4" = 10' r oom 5 acre lot lJ~ e i a~ Tank is to be properly bedded and provided with lockdown covers with approved warning labels 647' b~ II is t meet all WDNR setbacks Huffcutt Combo Tank B-2 B.M.* 2' 10 B-1 100, 150' B-3 98' 13% Slope Grading is to be done to divert Area 15' Below grade to run off away from system remain undisturbed. 335' Property Line 85 Mound System Cross Section and Plan View Dimension Feet i j........... B S 1 i T i r D E R i rrrrr~r~r~i~r: r, rr l fyJyJM1f~JLJ~f~f~f~t~J~l~J~fM1fM1f~J1J~JyJ~J~JM1J1f1f4fyr1l1fyfLlLf~l ~J F W . Z H i i r_ I I J i ~r _t K i 0, 2 ` L 7 W -3&-j- K -T B Z L Slope -3% - 1 = Topsoil ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc _ Cap Material sand fill '/2 to 2 1/2 in. dia. observation pipe Geotextile G H Fabric Ft D E /0(9,4? Ft Contour Plowed Surface 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 1/4 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. 10/07 lgj Page --l> of- Pressure Lateral Layout Two Laterals - End Manifold 4 - Threaded Cleanout Lateral Turn-up Plug Manifold M X --T L Long Force Main Sweep 90 Bend Distribution Network Specifications Pressure System Construction Lateral Diameter In. Manifold Diameter - In. Laterals are constructed of Schedule 40 PVC Orifice Diameter 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 M (Manifold Length) Ft. ceanout 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 • • • • .:d 6-8 Inch Lawn Sprinkler Valve Box Page of - 03/05 lg; Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer r v Tank Model Number r. Pump Model Number Total Tank Capacity Alarm Manufacturer g' t Mau. Bury Depth ° Alarm Model Number t_ Switch Type C G s~ Dy He - Filter Manufacturer Total namic ad (TDH) Feet ~ Filter model Nber j r' Elevation Head Distal Pressure Network Loss Minimum Pump Performance Required Force Main Loss 1 r GPM, _ Ft TDH Total s outlet Manhole Min. 4" Above Grade With ~ole Min. 4" Above Grade Locking Device. Inlet Manhole ✓ With Locking Device < 6" Below Cr de Sealed Watertight Securely Mounted Weather-proof Junction Box Fuushed Grade Vent Min. 12" Disconnect Above Grade Means With vent cap . YY >,Y,> Y . Y >,,.i>i •'i i a> Y+~: i t~ ai i ,~>a,a~ i i Y Y >aY > s >;Y Outlet Filter i - - Wet Baffle Inlet A 1/e» Switch Settings and Reserve Capacity Weep .,'r Tank Volume = /S r GPI Hole B Dimension: Inches Volume Gal. (reserve) A vation C Off E e (alarm) B : 2 C7 Ft Bottom (dose) C `D Elevation (dam) D 13 Ft > > > i lY > Y I a i < l a>{ < I i t>4>ay > ,;Y > ••i+~ tY`~ > >~•a>a>~ t a < . a a a <>a,<1 .;>;Y,>a,a,,>: ,a. >aY,,' J {>a < . a < `'`yi>< a>a~ +><>`Yi>i, ~I;Y+ <>a,;Y~>~Ya, y,,Y;)j>,Yi>C a~{>i>i> .><>i a a a 1 < i < < t . < ~pN• The .septic/dose .tank is bedded .and :back filled in acc ufacture may not GENERAL IN5TALLA d th of bury as specified by the man manufacturer's product approval specifications. Maximum to have an effective locking device (padlock) be exceeded without prior approval. Manhole covers gmde with watertight fittings, and installed- Piping at the inlet and outlet is of approved material, connected to the tank force main is sleeved with 4" Sch. 40 pVC to bridge the tank The laid on stable soil to pmvent settling or sagng- ties with NEC 30.0 and Comm 16.2 excavation and the sleeve is sealed watertight. Electrical service comp Page of 02105 U TOTAL DYNAMIC I-, EAD/ CAPACITY PER MINUTE I CURVE EFFLUENT , AND DEWATERING CAPACITY HEAD U) MODEL 152/153 i 152 715 3 Or- r MODEL LLJ LL1 50 r eet I, Meters I Go!. ! Liters Gal. , Liters 153 5 1.5 69 261 77 291 10 I 3.1 61 1 231 1 70 265 12 40 15 '15 4.6 53 1 201 61 231 1 a 20 .I 6.1 44 107 I 2 191, w ~ S ; 30 25 I 7.6 34 129 I 42 i 159 U 23 87 I 33 125 a 8 30 9.1 11 S - - 22 85 20 I 40 1 12.2 I 1 11 42 CD ccK Voive. 136-0 (1 L6m1 44.0 Ft (1 .4 Gt+5G8 10 e 20 40 60 80 100 GALLONS i--- 6 1/4 -#I LITERS 0 80 160 240 320 _ 3 27/32_x._ FLOW PER MINUTE I ! 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. 27/32 Electrical alternators, for duplex systems, are available and supplied with e t an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable- ii level long and short cycle controls. i Sealed Qwik-Box available for outdoor installations. See FM142 . • Over 130°F. (54°C.) special quotation required. 12 1/3' r 1521153 Series.-- ' '1i~ 1521153 MODELS Control Selection 5 7/0 Model Volts•Ph Mode Am s Sim lex I Du lex N152 115 1 Non BS 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 SK206+ -I_-.-- E152 230 1 Non 4.3 1 2 or 3 I BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2or3 SELECTION GUIDE E153 115 230 1 1 Non Auto 10 5. .5 tncto ed 2 2oror 33 1 Single piggyback variable level float switch or double piggyback variable level float E153 3 1 . BE153 230 1 Auto 53 Included 2 or 3 switch. Refer to FM0477. FA CAU 110N 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 14-0225 used as a control activator, specify duplex (3) licensed electrician. Ali electrical and safety codes should be followed including the most Of (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 T0: P.O. BOX 16347 Z"\ Louisville, KY 40256-0347 Manufacturerso . - SHIP 70: 3649 Cane Run Road yCE /999 (Qiie /TY~UMPS ` Louisville KY 40211-1961 Zo 502) 778-2731.1(800) 928-PUMP e ~VM~ L LJ. FAX (502) 774-3624 http://Www.zoeller.com © Copyright 2000 Zoeller Co. All rights reserved. y✓~ V 61 (7 I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page__,, FILE INFORMATION SYSTEM SPECIFICATIONS Owner , Septic Tank Capacity al ❑ NA Permit Septic Tank Manufacturer ❑ NA ❑ NA Effluent Filter Manufacturer ge-1 PARAMETERS DESIGN Effluent Filter ❑ NA umber of Bed r Model rooms [3 NA N Number of Commercial Units NA Pump Tank Capacity al ❑ NA Estimated flow (average) ? gal/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) Cf ; aVd Pump Manufacturer ❑ NA ❑ NA Sol? Application Rate aVda /ftz Pump Model / Influent/Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Fitter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD,) 420 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids (1 SS) 5150 m /L Manufacturer Pretreated Effluent Quality NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (BOD,) S30 mg/L ❑ In-ground (gravity) ❑ n-ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade )OWqund Fecal Coliform (geometric mean) 510` cfu/100m1 ❑ Drip-line ❑ Other. Maximum Effluent Particle Size Y inch diameter Values typical for domestic (non-commercial) wastewater and septic tank effluenL " Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every month year(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 ❑ monttw--<Uxear(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months ear(s) Inspect pump, pump controls & alarm At least once every ❑ months- ~-near(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ear(s) ❑ NA Other At least once every ❑ months ❑ year(s) NA Other. 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, POV TS Inspector, POWTS Maintainer, Septage Servicing 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, meclinlcal or pressurized POWTS components, pretreatgment components, and any other maintenance or monitoring at iritervals of 12 months or less shall be performed by a certified POVVT'S 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 concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page of START UP AND OPERATION painting products or other chemicals th It For new construction, prior to use of the POWTS check p treatment tank(s) If for high the presence of concentrations are detected have the contents of thO may impede the treatment process and/or damage agthe dispersal cell(s). tank(s) removed by a septage servicing op prior System start up shall not occur when soil conditions are frozen at the infiltrative surface. . When r is surfaces is astege terew ll b of . restored During power outages pump tanks may fill above normal high water lev cell(s) may resu pow ften the backup the discharged to the dispersal cell(s) in one large dose, overloading the um controls to restore normal levels To avoid this situation have the contents of the pump iato removed operatinlg the per Por prior to restoring power tot the effluent pump or contact a Plumber or POWTS Maintainer 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. fife of the POWT 13: Reduction or elimination of the following from the wastewater stream may improve the performance tl ; ,siprolo g the t fat; foundation dralin fectants; antibiotics; baby wipes; cigarette butts; condoms; cotton b grease; herbicides; mfleascraps; medications; oil; painting products; (sump pump) water; fruit and vegetable peelings; gasoline; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT 83 33 i e the following steps hall be taken to insure that the system is properly When the POWTS fails and/or is permanently taken out and safety abandoned in compliance with chapter Co Wisconsin Adminisative 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;lrn,, replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption seysueied upon The replacement area should be structure, lot ne ts and wells. dFai u ecompaction protect the r placement area wilill result in the need setbacks cks from existing and proposed with the rule=i in for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologiV a holding tank may be installed as a last resort to replace the failed POWTS. as The site has not been evaluated $ table rep cemennttlar a, if no replacement area is avail ble a hold n9 t nk m y be siteinstalleevaluailion must be performed to locate 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 infiitrati.-=' 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 NO ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR P PER LOCAL REGULATORY AUTHORITY Name Name _ (.`~Jl Phone Phone l J r This document was drafted in compliance with chapter SPS 38322(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. N is ! 1 M i 3 IS' 7 P - 11#i~ii1 f i- b i v U 4 ~ w / l ~ VJ tl 6~ 1 3 0 ! c o U S i 1 i PROPERTY ADDRESS: 645 PERCH LAKE ROAD HUDSON WI 54016 Note- This map is not a boundary survey. Bearings and N90°00'00"E 335.89') distances shown reflect record data from the Certified Survey Map. Distances shown to property lines are a IMPERVIOUS AREA CALCULATION PERCH LAKE ROAD IMPPERVIOUS AREA TOTAL AREA WITHIN 300' OF OH W M- 2.77 ACRES I ME MPERVIOUS AREA WITHIN 300' OF OW HM- AND 0.13 ACRES 4.7% IMPERVIOUS COVERAGE WITHIN 300'OF OHWM 1 I 990 I LEGEND Sa, RECORDED DISTANCE ONLY. (500.00') EXACT PROPERTY BOUNDARIES \O+ 'o NOT VERIFIED. \ ~O - X =WOOD LATH OR PIN FLAG SET O O / ® =WOOD HUB SET AT 10' OFFSET WE ND EDGE \ p OR ON BUILDING EXTENSION S7 KED AS FOUND 1-1/4" IRON PIPE APPROXIMATED BY QXl SURNEYOR I T.O.H.- TOP OF WOOD HUB ELEVATION I J SETBACK LINE. ❑x 75' FRONT I 20' SIDE 25'REAR WETLAND EDGE AS 50' FROM WETLANDS / APPROXIMATED BY 75'FROM NAVIGABLE WATER ( SURVEYOR w o « ~~5coa~ p LO T~3 sD' YR * mz ACRES o T S.O Lr U G 0. OOOGE 9~ 030-2007-8 000 I zQ r= S-24M a E a •CLEARL" I 3 m wK v NORTH .•'••OQ' EXISTING WELL +n ELEVATIONS SHOWN ARE 9 ~ y a NAVD 1988 DATUM. ~'~FreunnxaN`~~ 3 l \ w 11o14/16 GAR E °o I, Ty R. Dodge, Wisconsin Professional Land Surveyor, FLOG +9 5.0 hereby certify that this Stakeout Plan was prepared T.O 984.58 o Q+ ° by me or under my direct supervision and is correct to o \ \ \ \ the best of my knowledge and belief. o a n Z SCALE: © mGARAG@, a N ROPOSED I 0 60 120 noILT FENCE ) a PROPOSED o GENERAL EROSION CONTROL M HOUSE PROPOSED' / NOTES "~~I, 5---- CONTOURS 1. THE CONTRACTOR SHALL INSTALL AND MAINTAIN EROSION AND SEDIMENT CONTROL DEVICES TO LIMIT EROSION AND //(Z T.O.H. 981.77 \ SEDIMENT FROM LEAVING THE SITE. EROSION AND SEDIMENT CONTROL MEASURES SHALL BE INSTALLED AND MAINTAINED IN ACCORDANCE WITH THE "WISCONSIN DEPARTMENT OF 15 O\ / \ QQ NATURAL RESOURCES TECHNICAL STANDARDS". \ Q PREN 2. INSTALL SILT FENCE AS SHOWN ON PLAN. ! WNAV ETILAND EDGE SE 3 HALL STUBED AREAS TO BE SEEDED & YDROSEE DED OR SODDED IMMEDIATELVUAFTER FINAL "`CCC STAKED AS Oy' C ec Q~NO SdSAE //©'/O GRADES ARE ESTABLISHED ON THE SITE APPROXIMATED BY \ l //QQ 4. TEMPORARY SEED SHOULD BE APPLIED, IF CONSTRUCTION SURVEYOR ~O EXTENDS PAST SEPTEMBER 1ST, OF ANNUAL RYEGRASS AND QQ OATS AT THE RATE OF 5 POUNDS PER 1000 S.F. OF AREA AND L/ UTLET SWALE LEFT OVER WINTER. PERMANENT SEEDING SHALL BE \ FROM WETLAND a+ COMPLETED THE FOLLOWING SPRING. IF TEMPORARY SEEDING CANNOT BE COMPLETED BEFORE WINTER FREEZE \ UP THEN ALL DISTURBED AREAS SHALL BE MULCHED ATA WETLAND RATE OF 120 POUNDS PER 100 SQUARE FT AND PERMANENT . I SEEDING SHALL BE COMPLETED THE FOLLOW NG SPRING 5. ALL EROSION CONTROL MEASURES SHALL BE LEFT IN PLACE ` AND MAINTAINED UNTIL RESTORATION ON SITE HAS BEEN ESTABLISHED (A MINIMUM OF 70%VEGETATION) . J 6. ANY SOIL STOCKPILES WHICH ARE LEFT MORE THAN 7 DAYS < MUST BE PROTECTED BY SEEDING AND MULCHING, EROSION MAT, SILT FENCING, COVERING OR OTHER METHODS. THIS DOES NOT INCLUDE FILL OR TOPSOIL PILES THAT ARE IN ACTIVE USE. / (S89°4 '\W 335.6S 1 7. SITE MONITORING OF EROSION AND SEDIMENT CONTROL f ) PRACTICES FOR MAINTENANCE NEEDS SHALL BE COMPLETED AT THE INTERVALS SPECIFIED UNTIL THE SITE IS STABILIZED. SITE MONITORING SHALL OCCUR AT LEAST WEEKLY OR WITHIN 24 HOURS AFTER A RAINFALL EVENT OF 0.5 INCHES OR GENERAL GRADING NOTES GREATER. A RAINFALL EVENT SHALL BE CONSIDERED TO BE THE TOTAL AMOUNT OF RAINFALL RECORDED IN ANY 1. CONTRACTOR SHALL NOTIFY UTILITIES AND HAVE ALL UTILITIES LOCATED PRIOR TO ANY CONSTRUCTION, CONTINUOUS 24 HOUR PERIOD. MONITORING RECORDS SHALL BE KEPT O CONTAIN AT A MINIMUM THE CONDITION OF EXCAVATION OR DEMOLITION ACTIVITIES COMMENCING. THE EROSION AND SEDIMENT CONTROL PRACTICES AT THE 2. EROSION CONTROL DEVICES SHALL BE IN PLACE BEFORE BEGINNING ANY DEMOLITION, EXCAVATION OR INTERVALS SPECIFIED AND A DESCRIPTION OF THE CONSTRUCTION ACTIVITIES AND CONTINUOUSLY MAINTAINED. MAINTENANCE CONDUCTED TO REPAIR OR REPLACE EROSION AND SEDIMENT CONTROL PRACTICES. 3. CONTRACTOR TO COORDINATE WITH SMALL UTILITIES ALL REQUIRED UTILITY RELOCATION TO AVOID CONFLICTS WITH PROPOSED GRADING. 8. OFF-SITE SEDIMENT DEPOSITION RESULTING FROM THE 4 ALL TOPSOIL, ORGANIC, & UNSUITABLE MATERIAL TO BE REMOVED BEFORE FILL MATERIAL IS PLACED. NO SHALL FAILURE BE CLEANED OF AN EROSION OR SEDIMENT CONTROL PRACTICE ORGANIC, UNSUITABLE, OR FROZEN MATERIALS TO BE PLACED IN FILL AREAS. WITHIN 24 HOURS . OFF - SITE SEDIMENT DEPOSITION RESULTING FROM CONSTRUCTION ACTIVITY, 5. ALL GRADES AND ELEVATIONS SHOWN ARE TO FINISHED GRADE, UNLESS NOTED OTHERWISE. THAT CREATESA NUISANCE, SHALL BE CLEANED UP BY THE END OF THE WORK DAY. IF THE FAILURE OF EROSION OR 6. CONTRACTOR SHALL SALVAGE AND REPLACE TOPSOIL IN ALL DISTURBED AREAS (4"-6" TYP.). SEDIMENT CONTROL PRACTICES RESULT IN AN IMMEDIATE 7, TEMPORARY STOCKPILES SHALL BE PLACED WITHIN THE AREAS SURROUNDED BY SILT FENCE AS SHOWN. THREAT OF SEDIMENT ENTERING PUBLIC SEWERS OR THE WATERS OF THE STATE, PROCEDURES SHALL BE 8. PRIOR TO ANY SITE GRADING ACTIVITIES, CONTRACTOR SHALL LOCATE AND FLAG SEPTIC LOCATION. SEPTIC IMPLEMENTED IMMEDIATELY TO REPAIR OR REPLACE THE LOCATIONS SHALL BE PROTECTED FROM VEHICLE TRAFFIC AND LAND DISTURBANCE. PRACTICES. SCRAPING OF THE STREET SHALL BE COMPLETED WITHIN 4 HOURS AND STREET SWEEPING WITHIN 24 HOURS. p rx~cr !>~dIQ.~ YI~'l~l OE6ING HOMES 16-55 Halverson v m w cou~us mo n/+.ne LOT 3, C.S.M. VOL 3 PG. 602 se'n Oo w.m ~.'u. ma.m wsrucm re is/u/+s la. +°"/1e Auth•Consultin assceiates SO Land Surve HOUSE STAKEOUT PLAN g~ ~i°~ - ST. CROIX CO"TY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer aeuerjC? Mailing Address / ILI /L9Tif~ Property Addre C - L c'S_Lr___~~ , - • --I/,, (Verification required from pjannin & g Zoning Dep or new construction.) City/State I % aim) arcel Identification Number-03 , LEGAL DESCRIPTION nom, Property Location y `l~ ,rJUJ Sec. 3() T ON R T TW'Townof , Subdivision , Lot i~ta Certified Survey Map # -3 r _ , ~oltune ~ - Page # 6 Warranty Deed # ~ Volume 4 , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND 01ME.R CERT IICATION Improper use and maintenance of maintenance consists of your septic system could result in its re the system can Pttmping out the septic tank ever P mature failure to handle wastes. Proper affect the function of y three years or sooner, if needed, by a licensed t"esponsibilities are the septic tank as a treatment stage in the waste disposal system. o her ma. What You specified in §Comm° 83.52(j) Y put into and in Chapter 12 - St. Croix Coup weer tnamknance The property owner agrees to ~ sanitary ' Ordinance. owner and b a submit to St. Croix County Pla Y master plumber, journeyttlan Plumber, restricted lumbber or a licensed umper Department a verifying certification ite that (1) cation fo the wastewater disposal system is in proper operating condition and/or (2) after inspection and on-site less than 1/3 ~ of sludge, by the pumping (if necessary), the septic tank is Ilwe, the undersigned have read the above requirements standards set torte, here and agree to maintain the private sewage disposalsystem Certification se stating as set by the Department septic of Commerce and the Dep with the Zoning system has be aet a Resources, State of Wisconsin. g Department within 30 days of the three year expiration date, be completed ed and returned re turned to the St_ Croix County planning & Uwe certify that all statements o property described above, by virtue of s f onn are hue to the best of my/our knowledge. I/we am/are the owner(s) of the arranty deed recorded in Register of Deeds Office NUMber of bedrooms TGNAT OF APPLICANT(S~ _~L ***Any information that is misrepresented may result in the sanita DATE rS' permit being revoked by the Planning & Zoning Department. Include with this applet y g g Pat-4ment. cation a recorded warranty deed from. the Register of Deeds Office and a copy of the certified serve reference is made in the warranty deed, y map if (REV. 08/05) J J £ 9y~ <W ~ aJ 3 o s a ~ a, a a, a o ~ I I ~ I I ~ I I ~ I I j _ ~ I W I s I , I ~~I I _ E0 RW ~x = q s - O ae -N - - a ,I X 1 .43 ® i in o I p1 s _ z tE9 ~ _ ~'I ~ I 1 ``-~I z8 iu 32 I ~ 1 w 4 ! vr,nnaauvrvn I oxnn~e3amvn ~ 1 ~ in i4o y4~~ g y5e tl Litre < 6d 6 ~8 r ?D e~ t~ I I as n j„ I ~g3 ~ I I ~ ~ ~$Q i 1 - I\ I I I S° 1 i _-_-_.1® 3 ~¢'n¢ F~F \ it I 'o~ I I I sRF~ onG I I j I 1 alA? I I i~ I I ~ og ~I II 1 I 1 I 31 1 I 11 11 v e s I I I Ili fll rll I I I i I I I I I 1 I it ~j I 1-._1 I 1 I v ~ . 4 " s j i~ I I I - % I I I ~ i ~ E I I I I ~H Bz ~ v I 8~ i r I I 1 i R ii - - I I 1 j i 6,E I I v II ___-J{-o~ a4L~__~__ I 1- ~ ~ 1 I C I I ~ II I I I I I II ~I I I I S I I ~ I II ~1 I 5 I 1 II X` 1 I a ' I y I II I I ° I I I I O ~ ~ I I I a ~ ~ < I I I II I I v ns a I I I II I 1 I ni.we II I I xx wrou[a w.o..we I I 1 I ' I v I a - 88 #1593 Wisconsin I VALUATION REPORT c, Department of Commerce o nc h Comm 85, Wis. Adm. Code Page 1 of 5 Division of Safety and Buildings Schmitt Soil Testing, Inc. Attach complete site plan on paper not less than 8'/ x 11 in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point ( M), direction and - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 30-2007-80-000_ Please print all information. Reviewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 ^ 1~ Property Owner RECEIVED Property Location G i Cran, Ruby L. Govt. Lot NE1/4, NW1/4, S34, T30N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1411 Pinetree Drive APR 18 2008 3 CSM# 3/602 City State Zip Code Phone Number 'City Village Town Nearest Road St. Paul MN 551 % CROIX COUNTY St.Joseph Perch Lake Road New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Glacial till (Amery Series) Flood plain elevation, if applicable NA ft. General comments and recommendations: Area is suitable for a mound system. System elevation is 101.22' based off contour line established at 100.22'. Slope of area is 13%. Depth to limiting factor is 24". Boring # Boring Pit Ground surface elev. 100.47 -ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr- Sz. Sh. `Eff#1 'Eff#2 1 0-11 10yr3/2 none sl 2fsbk mfr cs 2m,2f .6 1.0 2 11-26 10yr4/4 none grsl 2fsbk mfr gw lvf .6 1.0 3 26-33 7.5yr4/6 none sl 2msbk mfr cs .6 1.0 4 33-72 7.5yr4/4 map 10yr6/2 sil lmsbk mfr 4c 6 _ 7.5yr6/6 F2 ]Boring # Boring Pit Ground surface elev. 100.87 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 I 0-7 10yr3/3 none sl 2fsbk mfr cs 2m,2vf .6 1.0 2 7-16 7.5yr4/6 none grsl 2fsbk mfr gw 1vf .6 1.0 3 16-25 7.5yr4/4 none sl lmsbk mfr gw .4 .7 4 25-43 7.5yr4/4 c2d 7.5yr6/1 sl Om mfi w 2 6 7.5yr6/6 9 5 43-51 7.5 r4 6 m2d 10yr6/2 Y / 7.5yr6/8 sicl imsbk mfr gw .2 .3 6 51-72 7.5r5/4 m2d 7.5yr6/1 Y sl Om mfr 2 6 Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD5 <30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt -~m 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 3/14/2008 715-247-2941 SBD-8330 (R-07/00)