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HomeMy WebLinkAbout030-2161-10-000 Wisconsin n Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Guiding Division rParcel x INSPECTION REPORT Permit No St. Croi GENERAL INFORMATION (ATTACH TO PERMIT) 973 592171 Personal information you provide may be used for secondary No purposes (Privacy Law, S.15.04 (1)(m)]. 2781 159. Permit Holder's Name: r Hartman Properties i City Village Township x No: csT BM Elev: TOWN OF SAINT JOSEPH030-2161-10-000 sp. M Elev: BM Description: own/Range/Map No: TANK INFORMATION 24.30.20.3193 TYPE ELEVATION DATA MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 7 Benchmark z Dosing a ✓ ` 71 o Alt. BM Aeration PO 7 A Bldg. Sewer o ~C., S2 Holding St/Ht Inlet 7.45 TANK SETBACK INFORMATION st/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 3 Dt Bottom Dosing 3 Header/Man. Aeration Dist. Pipe Holding Bot. System PUMP/SIPHON INFORMATION !j ~c Final Grade Manufacturer Demand over Model Number GPM TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist to Well 501E ABSORPTION SYSTEM_ PCB, BEDlTRENCH Width Length No. Of Trenches DIMENSIONS PIT DIMENSIONS No. Of Pits Inside Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL INFORMATION LAKE/STREAM LEACHING Manufacturer: Type Of System: CHAMBER OR UNIT Model Number DISTRIBUTION SYSTEM Mrtbn - sx Hole Size x Hole Spacing Vent to Air =7:aP.'pe(bU Intake gth Dia Spacing SOIL CR x Pressur e Systems Onl Depth Over y xx Mound Or At-Grade Systems Only Depth O er Center Depth Over xx Depth of Bed/Trench Edges xx Seeded/Sodded xx Mulched Topsoil rj Yes [j No Yes [7 No COMMENTS: (Include code discrepencies, persons present, etc. 1 Zo /7 .e Inspection #1: spe ion Location: 1441 25TH ST i 0 ~ G .^eK d! L" $a / ~ic«a 1.) Alt BM Description = I 2.) Bldg sewer length = 3 ~~OS'r01/t_ ~`~~r0 i t rjb •S Tw dt~/ - amount of cover = / „ Plan revision Required? ] Yes 1,41 No Use other side for additional information. I SBD-6710 (R.3/97) Date Insepctofs Signature L - - Cert.No L County i ` I ~N Safety and Buildings Division 0 ? 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) =P Madison, WI 5311!' RG CEI 5? 733 "1 4 i State Transaction Number Sanitary Permit Application In accordance with SPS 383.21(2), Wis Adm. Code, submission of this form to the app I is required prior to obtaining a sanitary permit. Note: Application forms for state o et Address (i` different than mailing address) the Department of Safety and Professional Servies. Personal information you pro i purposes in accordance with the Privacy Law. s. 15.04(1)(m , Slats- 1. Application Information - Please Print All Information Property Owner's Name Parcel H Property Owner's Mailing Address Property Location Z Govt. Lot City, State Zip Code Phone Number ~f lflf y,, Section 1 ~7 (circle une T N; R E ore) 11. Type of Building (check all that apply) Lot # Subdivision Name / or 2 Family Dwelling- Number of Bedrooms t V ~~y r Block# R"IWO ~ l- ❑ Public/Commercial - Describe I-Ise ❑ City of CSM Number ❑ Village of ❑ State Owned - Describe Use Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' ;Ne;wSysstemm ❑ Replacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit N umber and Date Issued B. Renewal Permit Revision `Change of Plumber ❑ Permit Transfer to New A Owner piration IV. Tv a of POWTS S stem om onent/Device: Check all that a ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ound > 24 in of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsal/Treatment Area Information: Sy Elevation (c Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Pro sed (sf) stem C -~i L~ C~l • ` .cj 'O U ;S, ;p,,o, k Info Capacity in Total R of Manufacturer j Gallons Gallons Units V ro New Tanks Existing Tanks 'n / V ~n v c~ t% HoldingTank r ` V IC Dosing Chamber { 1 t y VII. Responsibility Statement- 1, the undersigned, assume responsibility for' stallation of the POWTS sh attached as. Plum s Name (Print) s Si tune M her Business Phone Number G X22 `/Z Z 1 y 5 Plumber's Address (Street, City, State, Zip Code) VIII. County/Department Use Only Permit Fee Date Issued Issuing Agent Signature ❑ Approved ❑ Disapproved S rvNi ❑ Owner Given Reason for Denial asons for Disapproval IX. Conditi W6111tuot 1111111, roll dbs}iejuui cell rlust till besgi rtttant gy as.per;lwagement plant plodded by pluimbee. 2. All'ttelb~cac;4i cnu+>t tre t teirt.• ire.i p per * co-itt I vd;nancsr. Attach to complete plans for the system and submit to the County only on papa not less than g Vz z 11 inches in size SBD-6398 (R. 11/11) t` r 1 L Li - ~ I Jf / 51, } ij S r -t a~ < ~L_,.~co O ~RISfE~ 4 DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 P ICI G L_~C~ Contact Through Relay t ://ds s wi. ov/ ro rams/indust services MA; r, l - p . 9 P 9 rywww.wisconsin. ov ST. CROIX COUNTY g 'OMMUNITY DEVELOPMFnrr Scott Walker, Governor Laura Gutierrez, Secretary May 01, 2017 CUST ID No. 223242 ATTN: POWTS Inspector JEFFERY V FOX ZONING OFFICE JEFF FOX CONTRACTING & SEPTIC INC ST CROIX COUNTY SPIA 2188 100TH AVE 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/01/2019 Identification Numbers Transaction 1D No. 2927943 SITE: Site ID No. 836875 Mitchell & Kari Lanz Please refer to both identification numbers, 1441 25TH St above, in all correspondence with the agent . Town of Saint Joseph St Croix County NW1/4, SE1/4, S24, T30N, R20W FOR: Description: Mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1699947 Maintenance required; 600 GPD Flow rate; 32 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 - ` C Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Co and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constpii to of and located in accordance with the enclosed approved plans and with any component manual(s) referencetOVS10% 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._ stats. 5C-[ COR F The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Care must be taken to preserve the bench mark during construction or reestablished prior to plowing. • Per scale, the slope appears to vary from 8% to 12% as indicated in the plan submittal. The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 6". The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. • The mound system must conform to the shape of the contour. The mound shall not be placed with greater than I% slope along the length of the mound. JEFFERY V FOX Page 2 5/1/2017 Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for Provide frost protection per SPS 383.43(8)(c). 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, Patricia L Shandorf Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (715) 634-7810, Fax: (715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat. shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 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 1S (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. JEFFERY V FOX Page 2 5/1/2017 Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for Provide frost protection per SPS 383.43(8)(c). 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, PatriciaL Shandorf Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 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. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Resident:al INDEX AND TITLE PAGE Project Name: Mitchell Wad Lanz Owner's Name: Owner's Address: 1441 25th St. Houlton WI 54082 Legal Description: NW1/4 SE1/4 S24 T30N/R20W Township: St. Joesph County: St. Croix Subdivision Name: Orchards of St.Croix Lot Number: 10 Block Number: Parcel I.D. Number: 030-2161 10 000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications J :NCE Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan 4-/ Page 9 Soil Test / Designer: Jeff Fox License Number: MPRS 223242 Date: 04104117 Phone Number: 715-491-3458 Signature` Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 S1313-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design e so3' "iosil 4 Site Information ~R or i ; R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50. Peaking Factor (e.g. 1.5 = 150°f°) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 10.00 Site Slope 100.00 Contour Line Elevation (ft) 32.00: Depth to Limiting Factor (in) 0.40` In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 70.00 Dispersal Cell Length Along Contour (ft) = 8.58 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N c° E-) e Center or End Manifold 2.86 Lateral Spacing (ft) If N above, enter the elevation (ft) 3' Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.00 T Orifice Spacing (ft) = 8.70 ft2lorifice 2.00 Forcemain Diameter (in) 4 e 420.00 Forcemain Length (ft) Does the forcemain drain back? Y 82.00 Pump Tank Elevation (ft) Enter Y or N ` System Head (ft) x 1.3 68.51 Forcemain Drainback (gal) 18.29 Vertical Lift (ft) 94.17 5x Void Volume (gal) 12.09 Friction Loss (ft) 162.68 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 37.16 System Demand (gpm) 34.94 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 x x 1.25 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator r l' i i Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gat/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) lifetime Filter Manufacturer 22.20 Dose Tank Volume (gal/in) 8 Filter Model Number Weiser Manufacturer Project: Mitchell &Kari Lanz Page 2 of 9 Mound Plan and Cross Section Views 1/1 0 B J Observation Pipe fl - K A O 0~ W -:•I:.:.:.:• .'.'.:.:.:.:.:.:.:•:.:.:•::::::::::::I:::: - g I 4 LL~- L C ~Mound Component Dimensions 2.~Cov,,n is 14. to L`s i. ext„^~„r.+-"F'?oYt A 8.58 ft E 16.30 in H 1.00 ft K 8.16 ft B 70.00 ft F 9.50 in i 12.85 ft L 86.32 ft D 6.00 in G 0.50 ft J 4.13 ft W 25.56 ft 600.60 (ft2) Dispersal Cell Area 1500.00 (ft2} Basal Area Available 8.57 (gpd/ft) Linear Loading Rate 7.00 (ft) 1/10 B Qbs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.29 (ft) - rr H rrF ,r rrr rrF G ...t r'rrf F - rr rrrr F Dispersal Cell 101.00 (ft) Lateral 100.50 (ft) - Invert Dispersal Cell y::::: D 3..:::::;: Elevation E Q : 100.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key $ _Q T Dispersal Cell See lateral details on Topsoil Cap Q 1.5 ft Page 4 for number, size, ® Subsoil Cap (0.0 and spacing of laterals. ASTM C33 Sand ~ ° Laterals are equally F spaced from the ®0 Tilled Layer 0.5 ft Typical Lateral distribution cell's © Aggregate d centerline in the } A distribution cell (AxB). Project: Mitchell &Kari Lanz Page 3 of 9 End Connection Lateral Layout Diagram the tatrrar_.,'ver the A Sdimenzton l=Turn-up•ni Ciall,vat,•a or ',l~art .~ut{:slu? P .x.11 tat~ral_p ere :.]enti=:at I~- --.1 H»I? drilled or, the t..-.rrorn : ~t r1- I ar:.r al Lat.'•rat~: forGen't_=,tn -ch 41-i Pper SP IS T:abte r 4.3_t_«, F ore e m air, ':'orene?CttCK'.'1.1 t~e or • rc,,,„ ro Rs ]Hire.,{d y. unr ('join= Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.11 ft Lateral Length (P) 68.42 ft Orifices per Lateral 23 Lateral Spacing (S) 2.86 ft Orifice Density 8.70 ft2/orifice Lateral Flow Rate 12.39 gpm Manifold Length 5.72 ft System Flow Rate 37.16 gpm Manifold Diameter 1.50 in Total Dynamic Head 34.94 ft Forcemain Velocity 3.79 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - e SPS 316.300 WAC I 4 in. min. Disconnect Tank component is properly vented E- Alternate outlet location _ Forcemain diameter Weiser Manufacturer 2 in. Ca acity 800.00 Gallons Volume 22.20 gal/inch A _ Weep hole or anti- Dimension Inches Gallons B siphon device A 18.21 404.22 B 2.00 44.40 C P♦ ump off elevation (ft) C 7.33 162.68 8271 D 8.50 188.70 D Total _ 36.04 800.00 Dom se tank elevation (ft) 3r' Bedding un er tank. 82.00 Alarm Manuafacturer Rhombus d > 5zwitchp Alarm Model Number MJ Plugger containing ,rig may not be tar r. x ;i, Pump Manufacturer Zoeller this syste Pump Model Number BNB Pump Must Deliver 37.16 gpm at 34.94 ft TDH Project: Mitchell &Kari Lanz Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Jeff Fox Phone 715-755-2461 POWTS Regulator's Name St. Croix Cty Zoning Phone 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 600.6 ft2 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 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once ever 3 ears Alarm Should test months Pressure System Laterals should be flushed and pressure tested ever 1.5 ears Mound Inspect for ponding and seepage once every 3 years 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 mound 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 mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum-up Detail Finished • • , • Grade 6-8" Diameter Lawn • Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral _``-y Lon Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Mitchell &Kari Lanz Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 11/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01, R. 10/12)] 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 shall 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 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic 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 accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter 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 1/3 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. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound 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 mound 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 mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 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 6 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 mound component fails 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 removing biologically clogged absorption and dispersal media, and related piping, and replacing said 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. HEAD CAPACITY CURVE MODELS '16114)61 163/4163 16514165 -}I~ MODEL 161/4161 Feet Meters Gal- Liters Gal, Liters Gal. Liters 4 8 3f 4 16314163 - 16514165 t-- 6 i z 5 1.5 100 379 61 231 61 231 10 3.1 93 352 60.5 229 "00.5 229 15 4.6 85 322 60 227 60.5 229 20 6.1 79 297 59 223 60 227 y _ 25 7.6 70 265 57 216 59 223 - 4 JJ 9.1 62 233 55 206 58 220 t;~ 41, 12.2 45 - 170 46 172 55 208 y 1 1 6 1 r 3, - 0 15.2 76 33 125 50 189 I 1t 60 183 - - 15 57 39 148 70 21.3 22.5 85 I I 1f2" I/j tval 80 24.4 10 38 i 2" 1: 1/2 NPT flirt; I " t Shut-of Head, 56 R 117m) 66 2 j2Jml 86.5 ft. (26m) I > 9tPT 0099208 Jill 1! I I t ~ I 5 y1iF I 11IL--11 P I~_~ OC9920A L- I l l I~ SK374 161 MODELS 4161 MODELS Control Selection Listings Single Seaoubie S aiVolts P Mode Amps ( Simplex Duplex CSA UL n '-V4 M161 i - 115 1 Auto 15.5 I 1 f r I r 6 '12 N161 N4161 115 1 Non 15.5 -_2 3o,5&6 j Y y I D161 , 230 1 Auto 7.5 1 y y _ - sX Et81 E4161 T 230 1 Non 7.5~ 2 _ 3or5&6 I Y Y~~r 4 H161 + 200-208 1 Auto 8.8 1 Y N 1161 14161 200-208 1 Nat 8.8 2 3 or 5& 6 I Y N * J161 `J4161 200-208 31 Non 6.4 4&6 3&4or5&E i Y i -T!, ~ - i F161 ` F4161 23D 3 Nat 5.2 4&6 3&4or5&6 I YY -1' tf~ .`JP7 6161 64161 460 3 Non 2.9 4&6 3&4or5&6 Y l y I!2 rIP1 (ns, N=T 183MOt3ELS 4163MODELS Control Selection Listings FF1~' l Single Seal Double SgatVolts - Ph Mode _ Amps Simplex Duplex CSA ' UL ' L M163 j 115 ~1 Auto 15.0 1 - -Y'11 Y N163 N4163 115 1I tones 15.0 2 3or5&6 Y Y' t NMI'' r _ oII'~ l j D163 X230 1 Auto 75 1 - I Y I I E163 E4163 ' 230 1 Non 7.5 2 3or5&6 Y Y 2n ills .'ti 'I' I H163__ - 20& 208 1 Auto i 8,5 1- Y N tm~ -F 1163 14163 200-208 1 i ion ? 8.5 2 I 3 or 5& 6 Y N ~Y J163 J4163 200-208 3Non i 3.0 4&6 3& 4 or 5& 6 Y Y ° F163 F4163 230 3 Non 4.6 I 4&6 3&4or5&6 Y Y (I 1j~ SK1413 G163 G4163 460 31 Non 2.9 1 4&6 13&4or5&6 Y Y 165MODKS 4165MODELS Control Selection _ Listin s 1. Integral float operated 2-pole mechanical switch, no external control Single Seal Double 5 aivoits - Ph Mode Amps ' Simplex Duplex 1 CSA UL required. ~D1G5~_- 230 1 Auto 10.2 1 Y Y i 2. Single piggyback variable level float switch or double piggyback AEI 965 E4165 230 1 Non 102 I 2 3or5&6 Y Y i variable level float switch. Refer to FM0477. H165 200-208 1 Auto 12.6 1 Y N i it65 14165 200-208 1 Nca1 12.6 2 3 or b Y N 3. Mechanical alternator M-Pak 10-0072 or 10-0075. Refer to FM0495 J165 J4165 20x208 3 Non 7.5 4&6 3&4or5&6 Y y 4. Simplex three phase control panel. Refer to FM1228. F165 F4165 230 3 Non_ 7.4 4&6 3& 4 or 5 & 6 Y Y 5. See FM0712 for correct model of Electrical Alternator. 6165 64165 1460 3 Non 37 L& 6 i 3 & 4 or 5 &6 Y i y fi. Variable level control switch 10 0225 used as central activator, BA165 BA4165 575 3 Non 3.0 4&6 I 3&4or5&6 N N I specify simplex (3) float or duplex (3) or (4) float system. No Molded Plug n UL fisted unit available with 20 Amp plug. For information on additional Zoeller products refer to catalog on Piggyback Variable Level Float Switches, FM0477; Electrical Alternator, FMO486; Mechanical Alternator, FM0495; Alarm Package, FM0732; and Sump/Sewage Basins. FM0487. For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. © Copyright 2002 Zoeller Co. All rights reserved. a _Y-- , i , , r t s ,t t a F 'e F .r a t. L r~ s REGEWEI) ST. CROIX COUNTY SI'PTIC TANK MAINTENANCE AGREEMENT NOV O AND ST CROIX COUNTY OWNERSHIP CERTIFICATION FORM -'OMMUNiTYDEVELOPMENT (Owner/L3uycr K_ia 6 t ~ GL{~Z Mailing Address l2~tp~~~,1( I~,~r~ Ue. , N J J~(g y Property Addresiv WT (Verification required front Phutning S Zoning Department for new construction.) City/State(, Parcel Identification Number LEGAL DESCRIPTION Property Location , , Sec. T N R W Town of Subdivision Plat: _ Lot # Certified Survey Map # Volume Paget Warranty Deed # (before 2007)Volume Page # Spec house t]yesno Lot lines identifiable ❑ves[lno SYSTEM AWNTENANICE 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 ASPS, 3113.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Departinent a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), file 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 sc.t 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. Uu+e certify that all Sbatemcnts On ris form are true to the best of m_v/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a w tranty deed recorded in Register of Deeds Office. Number of bedrooms 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 decd from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty decd. (R E V. 04/12) ka t4i~.4t: CST - ?~Of q-V O SOIL EVALUATION REPORT #1884 . p Department of Safety and Professional Services Page 1 of 3 Division of Safety and Buildings Geo Tech Soil & Site Evaluation, LLC in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. O D - l - /O ' O00 Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location HARTMAN HOMES Govt. Lot NW1/4, SE1/4, S24, T30N, R20W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 744 RYAN DRIVE #102 10 ORCHARDS OF ST. CROIX City State Zip Code Phone Number City ❑ Village ❑ Town Nearest Road HUDSON WI 54016 715-377-1555 St.Joseph 144 25TH STREET ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: NA Parent material GLACIAL TILL Flood plain elevation, if applicable NA ft. General comments Requires a 6" sand fill mound component. Upslope edge of distribution cell to be installed along the flagged 100.00' ground contour. and recommendations: Maximum basal SLR = 0.4 (eff #1). Maximum 12% design slope at the flagged contour. `E try t Su tL u l n~ (T " FG eG S/I at r m►?-Y ~s WL16: ❑ Boring S66' 40(2'N'A 3 ViS[D 7U 4&L>MrK00J1DEU tZ~✓• pk44 E C,R'4-`4/4ST F 1-1 Boring # ❑ Pit Ground surface elev. 100.00 ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0-9 10YR 3/3 LOAM 1 C SBK MVFR CS 2F 0.4 0.6 2 9-14 10YR 4/4 LOAM 1 C SBK MVFR-FR GS 1F 0.4 0.6 3 14-33 7.5YR 3/4 FSL 2 M ABK MFR GS 1F 0.4 0.8 4 33-50 7.5YR 3/4 C3D 10YR lOYR 5/6 4 -8 5/3 FSL 2 M ABK MFR-FI 0.4 0.8 ❑ Boring F2 ]Boring# ❑ Pit Ground surface elev. 98.00 ft. Depth to limiting factor 32 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-12 10YR 3/3 LOAM 1 M SBK MV FR CS P2F 0.4 0.6 2 12-24 7.5YR 4/4 SIL 1 C SBK MFR GS F 0.4 0.6 3 24-32 7.5YR 4/4 FSL 2 M ABK MFI GS 0.4 0.8 4 32-59 7.5YR 3/4 C21) 7.5YR 5/8 SL 0M MFI 0.2 0.6 7.5YR 5/4 ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 g/L • Effluent #2 = BODs< - 30 m and TSS < 30 mg/L - CST Name (Please Print) Signature: CST Number DANIEL L. STOIBER Address Geo Tech Soil & Site Evaluation, LLC Dat valuation Co ucted Telephone Number 11091 30th Avenue Chippewa Falls, WI 54729 'MI/2005 715-577-6838 SBD-8330 (R.11/11) PropCrty Owner HARTMAN HOMES - Parcel ID # Page 2 of 3 3 ❑ Boring f ZY Boring # Pit Ground surface elev. 100.00 ft. Depth to limiting factor 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 0-8 10YR 3/2 LOAM 1 M SBK MVFR CS 2M 0.4 0.6 2 8-14 10YR 4/3 SIL 1 C ABK MFR GS IF 0.4 0.6 3 14-36 10YR 4/6 SIL 0M ME GW 0.0 0.2 4 36-52 10YR 3/4 C2D 7.5YR 5/6 SIL 0M MEFI 0.0 0.0 OA) q ~8 Pik ~J GG %}a~ /h s ple~' U-1 26 F-1 Boring # ❑ Boring 6 T /qN /-b C~ GIM~r~'V ~Z- ❑ Pit Ground surface elev. ft. Depth to limiting factor 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 ❑ Boring # Boring Pit ❑ Ground surface elev. ft. Depth to limiting factor 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 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODs < 30 mg/L and TSS < 30 mg/L - - The Department of Safety and Professional Servicese is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330Test (R I I/11) Geo Tech Soil & Site Evaluation, LLC #1 (100 0) 4 a, \ r° f cl a 14 (1 030) (98.00) R N W E S SCALE 0 25 50 (UNLESS SHOWN OTHERWISE) WILLIAM J. BERGH WISCONSIN CERTIFIED SOIL TESTER DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227819 BUILDING SEWER MUST COMPLY WITH SIPS 382.30 WAC (11)(C) LOCATION OF WELL MUST COMPLY WITH WDNR CHS. NR 8118 812 THE INFORMATION CONTAINED WITHIN THE ATTACHED SOIL REPORT IS NOT TO BE USED BENCHMARK ELEVATION=100.0' TO DETERMINE THE SUITABIUTYAND/Oft - BASEOFEITHERFENCEPOST DEPTH OF ANY PROPOSED FOUNDATIONS. c LOCATION OF SOIL BORING(S) THIS POWTS COMPONENT IS NOT DESIGNED ® LOCATION OF SOIL PIT(S) TO RECEIVE THE ADDITIONAL WATER * NO APPARENT SPS 383.43 SETBACKS GENERATED FROM ANY WATER TREATMENT ® DESCRIBED LOCATION OF LOT LINE DEVICES. ® LOCATION OF RIGHT-OF-WAY ® CENTERLINE OF DESCRIBED ROAD REUSE OF DOCUMENTS GEO TECH, LLC ORCHARDS OF ST. CROIX This document has been developed for a specific JOBSITE INFORMATION: application and not for general use. Therefore it may 11091 30TH AVENUE HARTMAN HOMES NW-SE-24.30.20W LOT #10 not be used without the written approval of CHIPPEWA FALLS, WI 54729 25TH STREET ST. JOSEPH TOWNSHIP Geo Tech, LLC. Unapproved use is the sole PH: (715)723.5555 FAX: (888)466.8573 PLOT PLAN responsibility of the unauthorized user HOULTON, WI ST. CROIX COUNTY, WI email: billy@wastewaterpros.com PARCEL DESCRIBED AS 3.0 AC. S' nit: I.., f .Q 4 Safety and Buikii s Divi n cotmty 201 W. Washington Ave., P.O. Box 7162 Sanitary Peamit Number (to be filled in by Co) OCT 31 Zoo 6 Madison, WI 53707-7162 Zl71 Sr. cRaix cOurvrY At : `Lateon Number Sanitary ermi Application 7WA1Y3 In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the app. ~r-- WR3 HZ 27911 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are 5u..`_ ect AddrEss (if different than mailing addra ( I the Department of Safety and Professional Servies. Personal information you provide may be used for secondary Rgff*ses in accordance with the Privacy Law, s. 15.04 1 m), Stats. L Application Information - Please Print All Inf tion 5 P^ JITSA', Property Owner's Name 2 Parcel 4 ZI(O 30 H-3 Property Owner's AddreA _ Propetty Location 7, ~iv- Gout. Lot City, State Zip Code Phone Number Section Z~ d f! 7' ✓ `~7"' 1JJ7 crrck o T N; R Z~ E o(W II. Type of Buildin (check all that apply) u Lot # Pl. of 2 Family Dwelling - Number of Bedrooms ! ! v Subdivision Name S-T ❑ PubliclCommercial - Describe Use ~"w IV - r Q City of ❑ State Owned - Describe Use It Number ❑ Village of _ I Town of E' P 'T. aI X A5 &a- X ~ I K_ v M. Type of Permit: (Check only one box on line A. Complete line B if l ble) A New System Q Replacement System ❑ Tmamment&l lding T lacement Only ❑ Other Modification to Existing System (expli B. ❑ Permit Renewal ❑ Permit Revision ❑ hg. df p Q Permit Transfer to New List Previous Permit Number and Date Issued / Before-Expiration owner N. Type of POWTS Svstem/Com nent/Device: t o 1 Ct✓ r 11 Non-Pressurized In-Ground Q Pressurized In-Ground t-Grade Q Mound ? 24 in. of suitable soil ,Mound < 24 in. of suitable soil ❑ Holding Tani: ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsal/Trea ent Area Information: r+L / Design Flow (gpd) Design Soil Application Dispersal Area Require Dispersal Area Propos 10 System Elevation VL,Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks AJA. Septic or Holding Tank ' Z100 /Z& ' !'zJen Dosing Chamber f~ ~Y VII. Responsibility Statement- L the undersigned, assume responsibility fo installation of the POWTS shown a attached plans. Plumber's Name (Print) Plumber's Signature MP RS ber Business Phone Number Plumber's Address (Street, City, State, Zip Code) S:S 565 b W oue artment Use Only ~ Per~mi~t FJce~ Datcftnq Issuing t Sitrnature en ReasoQ for Denial IX. Condtl>~isons for Disapproval 1 NOW tahk, ttlMMl>riR lifer ~rxi 3, ~di ~ IA, ;jai C+~l ItN#I all bgsei~ leas n' nt f l~► G(~ _ l- G✓/ s ~'~,a1"~"I > kkpw maw plan proiided by mm eE 2 71 >~emGk ic" dents must be rtairt e as { per pK Cam? / i2rrtlfklnrA,3. " t i r't CWc-a IlA.+ LI rw• Attack to complete plans for the system and submit to the County only on pope less an 8 to 111 inches in sue PAA--* I.sJ r SBD-6398 (R 11/11) 5~ /~Jr y O ~'t/ G fr ~i~ ~ r. t v1 f :.1 _ s 4 [ d ( %fw5ek- (~~~/,~<~JA 1,1 l~ ,j lrCl f~ ! Jl~ l (Ito tip C 0 ~~~~rrnTF~~ DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD P\ \ HAYWARD WI 54843-6462 Contact Through Relay http://dsps.wi.gov/programs/industry-services \?7,,, www.wisconsin.gov ~Scott Walker, Governor Dave Ross, Secretary October 18, 2016 CUST ID No. 223242 ATTN: POWTS Inspector JEF'FERY V FOX ZONING OFFICE JEFF FOX CONTRACTING & SEPTIC INC ST CROIX COUNTY SPIA PO BOX 565 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/18/2018 _Identifi 27 Numbers _ Transaction ID No. . 2781159 SITE: Site ID No. 829406 Hartman Homes Please refer to both identification numbers, 25TH St above, in all correspondence with the agency. Town of Saint Joseph St Croix County NW1/4, SE1/4, S24, T30N, R20W FOR: Description: Mound, 4 br res Object Type: POWTS Component Manual Regulated Object ID No.: 1626335 Maintenance required; 600 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/0I, R. 10/12), Pressure Distribution Component Manual - P Ver. 2.0, SBD-10706-P (N,01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter 'I he submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes ~ FE; and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed ~ jslo~(, 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 c, ay engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Si_I= stats. The Collowing conditions shall be met during construction or installation and prior to occupancy or use: Key item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the r found component manual are complied with. A copy of this information must be given to the owner upon cot pletion of the project. • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 14". The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. JEFFERY V FOX Paee 2 10/18/2016 • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 lation/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, Please Include a Copy With Your Patricia L Shandorf Payment Submittal. POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat. shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 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. JEFFERY V FOX Page 2 10/18/2016 • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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, Please Include a Copy With Your Patricia L Shandorf Payment Submittal. POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 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. P29201r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Hartman Homes Owner's Name: Owner's Address: 744 Ryan Drive Hudson WI 54016 Legal Description: NW1/4 SE1/4 S24 T30N/R20W Township: St. Joesph County: St. Croix Subdivision Name: Orchard of St.Croix Lot Number: 10 Block Number: Parcel I.D. Number: 030-2161-10-000 O Plan Transaction No.: Y r ka 9's A i NAL SER V3 - Page 2 Data entry Page 1 Index and title q-f Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Designer: Jeff Fox License Number: MPRS 223242 Date: 09/27/16 Phone Number: 715-491-3458 Signature: _ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11112), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 7.70 Site Slope 96.70 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 65.00 Dispersal Cell Length Along Contour (ft) = 9.24 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2} 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y_J Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.08 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 2.50 Estimated Orifice Spacing (ft) = 7.70 ft2/orifice 2.00 Forcemain Diameter (in) 60.00 Forcemain Length (ft) Does the forcemain drain back? Y 89.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 919 Forcemain Drainback (gal) 8.45 Vertical Lift (ft) 87.39 5x Void Volume (gal) 2.17 Friction Loss (ft) 97.18 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 42.00 System Demand (gpm) 15.17 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options _ choice 0.75 1.25 1.00 1.50 x x 1.25 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) lifetime Filter Manufacturer 22.24 Dose Tank Volume (gal/in) 8 Filter Model Number Weiser Manufacturer Project: Hartman Homes Page 2 of 7 Mound Plan and Cross Section Views 1/10 B ............:.......~:J f Observation Pipe K A W B 3: I 40 L Mound Component Dimensions Down slope toe extension made. ft A 9.24 ft E 22.54 in H EAft ft K aft B 65.00 ft F 9.50 in 1 ft L ft D 14.00 in G 0.50 ft J W 600.60 (fta) Dispersal Cell Area 1500.00 (ft) Basal Area Available 9.23 (gpd/ft) Linear Loading Rate 6.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.66 (ft) y, rrrrrtr~rrri a, `';'k rirrrrrirrra ~+ririi rrir "p G ~ .rrirrirrrrrr.rrir4~Jriirrrrrrrrririr ,~:r F 98.37 (ft) Lateral Dispersal Cell 97.87 (ft) - Invert Dispersal Cell Elevation 96.70 (ft) Contour Elevation 7.7 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 1-11 E M Topsoil Cap c 1.5 ft „ Page 4 for number, size, 0 r rrrrrr Subsoil Cap vi c and spacing of laterals. © ASTM C33 Sand / Laterals are equally 2 F spaced from the ® Tilled Layer c 0.5 ft % Typical Lateral distribution cell's © Aggregate a centerline in the distribution cell (AxB). 16 71 An- Project: Hartman Homes Page 3 of 7