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030-2121-40-000
County: St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Sanitary Permit No: 59214$ Safety and Building Division INSPECTION REPORT (ATTACH TO PERMIT) State Plan ID No: ~ 2780316 GENERAL INFORMATION Personal information you provide may be used for secondary purposes [Privacy La Village 04 (1)(m)]. Parcel Tax No: Township )(m) 030-2121-40-000 Permit Holder's Name: ad & Jodell Carson TOWN OF SAINT JOSEPH Ch ection/Town/Range/Ma 30No: .30.19.986 11 CST BM Elev: Insp. BM Elev: BM Description: ~ 1 I? EL NATION DATA TANK INFORMATION STATION BS HI TYPE CAPACITY FS ELEV. MANUFACTURER e Benchmark b0. Septic J G ✓ 11w ?.S 06 0 J = Dosing Alt. BM G op 6 0 N^'~n Bldg. Sewer ~ . 5 Aeration St/Ht Inlet ~ ~ • b Holding St/Ht Outlet TANK SETBACK INFORMATION ent Air Intake ROAD Dt Inlet TANK TO P/L WELL BLDG. Dt Bottom p 'lj • , Septic Header/Man. 'C4•' Dosing Dist. Pipe X 13 Aeration Bot. System Iu$ 9 Holding Final Grade PUMPISIPHON INFORMATION Demand St Cover ,0 Manufacturer GPM Model Number coq.) N,s v`f• TDH Lift Friction Loss System Head TDH Ft Dist. to Well Forcemain Length Dia. SOIL ABSORPTION SYSTEM Inside Dia. Liquid Depth No. Of Trenches PIT DIMENSIONS No. Of Pits BED TRENCH Width Length DIMENSIONS LEACHING Manufacturer: P/L BLDG WELL LAKE/STREAM CHAMBER OR SETBACK SYSTEM TO UNIT Model Number. INFORMATION Type Of System: DISTRIBUTION SYSTEM x Hole Spacing verto Air I ke Header/Manifold Distribution x Hole Size Pipe(s) g Al Dia Length Dia gPacin Length ,a Mulched SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems only Depth of xx Seeded/Sodded Depth Over ~oTopsoil C Yes [ No Yes No Depth Over ged/Trench Edges BedlTrench Center ~I I ^ p I ~l g A, ns ec I tion #2: nspection #1: I 1 ` COMMENTS: (Include code discrepencies, persons present, etc.) ~c,,ti5 f^CCi~S d►~ ' Location: 361132ND E PLOW ~ I~ 1.) Alt BM Description OV K f`I ~'S un 2.) Bldg sewer length = Zoo ' / ^ fn u~~ - amount of cover eN~ 10 ~p(A l., gwefA !l ~ - eCCSS C f 1-0 4-0 0 Plan revision Required? Yes No Use other side for additional information. Date Insepctor s Signature Cert. No. SBD-6710 (R.3/97) 0^'6WA County Safety and Buildings Division 1 b 201 W. Washington Ave.; P.O. Box 7162 Sanitary Permit Number (to be filled in by o. _ K Madison, Wl 53707-7162 with SPS ~8 itaic Tratrsa on Number , anitary Permit Apph In accordance 3.21(2), Wis. Adm. Code, submission of this form to the appropriate eovemmental unR is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are subLed to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary „1 purposes in accordance with the Pnvac ' Law, s. 15.64(1) m), Stars. 3 L Application Information - Please Print I 1 rma Parcel # ~j Property' Owner's Name ~ C 44, cC Y Sin- / ~o ,v 7 p i Property Owners Mailing Address Property Location, Z 19 , 9 0 L Govt Lot Q State Zip Code Phone Number 1/, Section ircle T~ N> R_~J - or W II, ype of Building (check all that apply) Tot Subdivision Name 2 Family Dwelling-Number of Bcdrooms ~L mb Block C ❑ Public!Commercial-Describe Use 1~ ❑ City of CSM Number 11 Village of ❑ State O- ved-Describe Used Town of I , $ k o~ 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. System i ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date ued 7 1 B. ❑ Permit Renewal Permit Revision El Change of Plumber El Permit Transfer to New Before Expiration Owner IV. T of POWTS System/Component/Device: (Check all that apply) ❑ Non-Pressurized hi-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound <24 sui le soil ❑ Holding Tank ❑ Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsal/Treat ent Area Information Devi Flow (gpd) Design Soil Applicati te(grdsf) Dis 'rsal Area R (s, Dispersal Area Propo d (s~ S em levauon b ,.w 1 r2 0, L VL Tank Info Capacity in Total # of Manufacturer V Gallons Gallons units 2 .w o J Z New Tanks EuSUng Tan15 a~ o :3 a~ a m 1/✓ 1 AA4 1~ • v n _ L Septic or Holding Tank I ;Dosing Chamber y •'1j ~ VII. Responsibility Statemen I, the undersigned, ass e r ponsibility for installation of the POWTS shown on the attached plans. Plumber' Name (Print) Plumb ature MP/NTRS Number Business Phone Number i Plumbers A¢ css {str eet tty: state, zip Co l 71 VII7 unty/De artment Use Only Permit Fee Date Is ed Issuing. Signature $ Approved 90 eason for Denial 7 DL Conditign5:; _ gt 4,Wpproval 31 6a, pisper. sti cell must all to aw Ic s ! me, nta;rg~ t#s'per merarcement plan pro4ided by plumber. 2. ' AN isibiCk ► W*V.Wt must to . ntt d ~0✓ as per twiiCtlbla cot* / Ydinam 4 Attach to complete plans for the system and submit tot County only on paper not less irz z inches~s 1 ♦ , A \ 0A. re. ilk ems ~~iJ1MaA~ SBD-6398 (RR I1/11) PROJECT Chad Carson System PLOT PLAN ADDRESS 361 132nd Ave Houtlon Wi 54015 SW 1/4 SE 1/4S 30 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 107.0' 11/5/16 3 CONVENTIONAL DATE BEDROOM 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. Grade at Drainage Easement Stake ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H-R.P. same as benchmark 204' Property Line 132nd St. 106' 102.5' 106.5' 104. B-2 Scale =1/4" = 10' B-3 ~.M.* 13% Slope 3.2 Acre Lot Area 15' below system is to remain B-1 undisturbed 567' Grading is to be done Property to divert run-off Line away from syste ° Huffcutt ~o bo Tank Drainage Easement b -a Well is to meet all WDNR setbacks p Pro 3 Bedroom /4 House Tank is to be properly bedded and provided with lockdown covers with approved warning labels DIVISION OF INDUSTRY SERVICES spa rE, 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~Ayro~ 5~~ Scott Walker, Governor Dave Ross, Secretary s' November 28, 2016 "'T OF c; CUST ID No. 226900 ATTN: PO WTS Inspector t W FESS101 SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 l/ CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/28/2018 Identification Numbers Transaction ID No. 2817429 SITE: Site ID No. 829393 Chad Carson Please refer to both identification numbers, 132ND Ave above, in all correspondence with the agency. Town of Saint Joseph St Croix County SWIA, SETA, S30, T30N, R19W FOR: Description: Mound System (3 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1626312 Revision; Maintenance required; 450 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/O1, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • 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 (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • 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. Smearin Z and compacting of wet soil will result in reducing the infiltration capacity of the soil Proper soil moisture content can be determined b rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, SHAUN R BIRD Page 2 11/28/2016 the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare do not proceed until it dries. • 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. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizin2 to meet TDH and GPM Specifications. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicinipad is located 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at around level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient 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 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 $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214, Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vanderleest@wisconsin.gov SHAUN R BIRD Page 2 11/28/2016 the site is too wet to prepare If it crumbles site preparation can proceed If the site is too wet to prepare, do not proceed until it dries. • 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. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Anv changes may result in pump resizing to meet TDH and GPM Specifications. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relatin, to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214, Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vanderleest@wisconsin.gov 2W Cover Page iNOUSTRY Shaun Bird Bird Plumbing Inc. AND 1432 120th St. W RVI C E. New Richmond Wi 54017 Y S E R V I C = 715-246-4516 Date: 11/5/16 Owner:Chad Carson Location: SW1/4 SE1/4 S30 T30 N,R19 W 361 132nd Ave 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 cro `s sectio►i Attachments: Soil Test r~ f Shaun Bird Signature License number 26900 Page 1 of 9 System PLOT PLAN PROJECT Chad Carson ADDRESS 361 132nd Ave Houtlon Wi 54015 SW 1/4 SE 1/4S 30 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 107.0' 11/5/16 BEDROOM 3 DATE 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. Grade at Drainage Easement Stake ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE SWELL *H.R.P. same as benchmark 204' Property Line 132nd St. 106' 102.5' 106.5' 104. B-2 Scale =1/4" = 10' B-3 B.M. 13% Slope 3.2 Acre Lot Area 15' below system is to remain 567' B-1 undisturbed Property Grading is to be done Line to divert run-off away from system Huffcutt Combo Tank Drainage Easement Well is to meet all WDNR setbacks Pro 3 Bedroom House Tank is to be properly bedded and provided with lockdown covers with approved warning labels Q Mound System Cross Section and Plan View - Dimension Feet J 1 a A I I N- 1 a B 11 t D 1. J:r. L Ll •4.4.4.1 L 41YL-L.L.L. i•r4 Lr r r J r r r 4 r.f•r1r- r r-r-r r f r r f4-r r r r•f•f•r•r 4 114. L.LY4rti14r1.t•L.L•l:ti:1j\>4.L. 4rL11fL.LjL.4rLr4.LfL1LrL.4. L.YL. f r~.r~.t.t-L•Y ;.t r~r~r.i. r. 4rM1r r r.r.r.r 4 r.f.r.r : E •:1.1.1.1.1 ti:LiL.LiL:S•1.S•ti.ti:4:ti:L:Yti:ti•1.1:4.1:'•4.ti.t. L.:.•ti:ti•ti.L. L. ~1ti•t•L-L•4•L•L• •11.1.1-L• A t r•r.r. r r r J-f.f-f-r.r M1 ;r.r.r.f.r •:1~1.YL.1. 1:1:4iy1:~:ti:1:1:1:V:4:ti.~.:tiK:ti:ti~ti~ tiltit'.~tirti.ti•'.1ti1ti111M1.L.YL.YL. jyy~y~~y~L.YL-L. .J.J.r•f•f•l:r.r.J.J.r.f.f.r.r.r•rV.r.r.r.r.J.J.f.r1 f.J.r.r.r.f-f.f.r.r.J.f.J.J.r.r•r'r•/yr.J.r-f•f.r L.YYYL•L•YL•Y4.4.L•L•L•L•L.L•L•1•L.L•L•YYYL•L.L~\~ti•4•L.M1•L•L•1.4.4•L•1.1•M1•4.1.1•L•Y1.4.1•L•1•YL• t isi.J.r.r.r.Jw.r.r.r.J.r.r.J.J.r.r.r.r.r.r.r.r.r.J.f.J.J.r•f.r.r.r.r.r.r.r-r.r.r•r•r-r.r-r.r-r.r.r.r.r.r.r.r.r ' F ~Q v~ W i G . 15 H ~J 1 1 t c7 I I 1 1 J ar 1 1 J K t Z 1 W ,3a_4 K- i B Z 7 7 L Slope 1 = Topsoil = ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc Cap Material sand fill 1/2 to 2 1/2 in. dia. 0 observation pipe 411:1 Geotextile G H Fabric 4 4 ~1~rti~1r1f414:1r• j1 1 ti~4:1?1r~ryltil~f•; F ~Ft D E / 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. 10/07191 Page 3 o~____ Pressure Lateral Layout Two Laterals - End Manifold 4 Threaded Cleanout Lateral Turn-up Plug Manifold M X L Long Force Main ,J// Sweep ~t 90 /tJ Bend 0,4 0! Distribution Netwo k 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 Ft. cleanout plug and are enclosed in a 6-8 inch M (Manifold Length) Force Main Diameter In. diameter lawn sprinkler valve box accessible Force Main Length G Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box I I Page -of 03/05 l9 i Septic-Dose Wank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tank Model Number 0 Pump Model Number 1 Z Total Tank Capacity 6 3 Alarm Manufacturer Max. Bury Depth Alarm Model Number Switch Type a C-.14 XU, c Filter Manufacturer Total Dynamic Head (TDH) - Feet Filter Model Number Elevation Head C~ Distal Pressure Network Loss Minimum Pump ~ erformance Required Force Main Loss GPNL Ft TDH Total Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Devsce < b" Below Grrode Sealed Watertight Securely Mounted Weather-proof ~FiuishedGQTmaddee Junction Box a fta ~ - - i ♦ 10 f Vent Min. 12" Disconnect Above Grade Means With Vent cap Outlet Filter _ _ Inlet Inlet Baffle i A Switch Setqugs and Reserve Capacity Weep Tank Volume = GPI : B Hole Dimension Inches Volume (reserve) A. , S d ~>c Off Elevation C B : 2 Bottom (dose) C ~ =j 71:~ (dead) D Elevation Ft Total t a • •:Yt1 s Y >~Y~la: >I •><y<~ty<`<' .t : t: ><Y : >i~i~ ♦>t>: t>f.:1 Y.> - ~f~{>1 t < <•<>tYt>f>`><> ><>+>S7, ` `>f>?><s~Y~>~s.1 >~>~>:>~>:>~i ~Y~s .Y~ti > f t s . { a l < t • accordance with the GENERAL INSTALLA'T'ION: The septic/dose tank is bedded and back filled to a ' manufacturer's product approval specifications. Maximum depth of bury as specified.- by .the nmuffa ~ (padlock) ockt locking be exceeded without prior iipproval. Manhole covers exposed to grade have an effective installed. Piping at the inlet and outlet is of approved material, connected to the tank vAth watertight fittings, and The force main is sleeved with V Sch. 40 PVC to bridge the tank laid on stable soil to prevent settling or sagging.: excavation and the.slmve.is sealed watertight. Elecuicall service complies withNEC344 and Comm Ib.28. Page-,) of y 02105 U TOTAL DYNAMIC HEED/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING Z V) MODEL 152/153 MODEL ! 152 t5 Ww ~U-i 50 Feet 'I Meters j Gal. I Liters I Got. I Liters 153 5 t.5 i 69 261 77 291 10 ' 3,1 61 231 1 70 I 265 12 40 15 i5 4.6 ~ 53 i 201 61 231 20 '1 61 44 167 52 197 30 257.6 34 129 1 42 159 Z 8 3' 0 ! 9.t I 23 87 1 33 125 I I 35 ~ - - ; 22 55 20 11 f 42 o 40 1 12.2 F- 4 ~ Lock vcive 136.0 ill 6m1 44.0 Ft. ' 3.4 o,asoa 10 I I I 0 20 0 60 80 100 GALLONS 6 t/4 LITERS 0 80 160 240 320 _ 3 27/32 FLOW PER MINUTE I 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. O® 3 Electrical alternators, for duplex systems, are available and supplied with e an alarm. Variable level control switches are available for controlling single phase systems. ; • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Wk-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C,) special quotation required. i ~ I ! 1 ~ 1521153 Series ~ I 152!153 MODELS Control Selection ' f. mow VottsPh Mode Am s Sim lex Du lex 5 t/8 i N152 115 1 Non 8.5 1 2 or 3 8N152 115 1 Aura 8.5 Included 2or3 s~064 E152 230 1 Non 4.3 1 2 or 3 BE152 230 Auto 4.3 Inclined 2 or 3 N153 115 1 Non 10.5 1 2or3 SELECTION GUIDE BN153 115 1 Auto 10.5 Inclu ed 2 or 3 back variable level float Et53 230 t Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggy BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. A CAU50N 2. See FM0712 for correct model of Electrical Aftemator E-Pak. Ali installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most or (4) float system. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturers - . Z SHIP T0: 3649 Cane Run Road ~~77 pp Q Louisville, KY 40211-1961 Quq(lTY/YIMOS JlhCf ~~Jc/ F / (502) 776-2731. 1 (800) 928-PUMP PV~P L Y FAX (502) 774.3624 httpJ/www.zoeJ/er.com © Copyright 2000 Zoeller Co. All rights reserved. 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE WFORMATION SYSTEM SPECIFICATIONS Septic Tank Capacity at ❑ NA Owner, C. 114-1 dL Permit Septic Tank Manufacturer DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Commercial Units ti-NA Pump Tank Capacity at ❑ NA Estimated flow (average) 3Mgavday Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) j-0 aVd . Pump Manufacturer ❑ NA Soil Application Rate A L,? aVda /ft2 Pump Model --7 NA Influeni/Effluent Quality Monthly average' Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Fitter ❑ Peat Filter Biochemical Oxygen Demand (BODS) 5220 mg/L ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS). 5150 m /L [I Disinfection ❑ Other Manufacturer Pretreated Effluent Quality ❑ NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (SODS) 530 mg/L ❑ In-ground (gravity) ❑ ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade Aund Fecal Coliform (geometric mean) 510` cfu/100m1 ❑ Drip-line ❑ O er. Maximum Effluent Particle Size Y. inch diameter Values typical for domestic (nog-commerciari wastewater and septic tank effluent values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Fre uency Inspect condition of tank(s) At least once every ❑ month ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume Inspect dispersal cell(s) At least once every ❑ months ear(s) (Maximum yrs.) Clean effluent filter At least once every ❑ months ar(s) Inspect pump, pump controls & alarm At least once every ❑ mon year(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, POWTS Inspector, POWTS Maintainer, Septage Serticing 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 shalt be removed by a Septage Servicing operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mnical 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 POWTS Maintainer. A servicg 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 prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thr4t For new construction, may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will bia discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of of fl tnt To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT•G. antibiotics; baby wipes; cigarette butts; condoms;; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundations dr kin (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produc; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propeoy and safety abandoned in compliance with chapter Comm 53.33, Wisconsin Administrative Code: • Ail piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compl4ont replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. u ed The replacement area should be protected from disturbance and compaction and should not be infringed upon by q setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in nit ei in for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology/ a holding tank may be installed as a last resort to replace the failed POWTS. site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative rtace. 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 NIOT 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 1, Name Phone 7~J a 7 Phone SEPTAGE SERVICING OPERATOR P PER LOCAL REGULATORY AUTHORITY Name Name Phone Phone r This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)8,(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. c I a4~ r r f~ -g~ - 1? W t N a t a t r\ c'Y S ='t t I, i 1 t 'f tll. L. a I _ II -o r ~ I c7 m -l m o, a V ~ 8 ~ i Q U/ ~ Q c I N Z 3 9 F-- 0 c lit o (DI D- Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings ti% t • o! X : r'' i .`'Y u(1tkP?! Q5?!I~..,,-Adm. Code county Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ' include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. ~q percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ® V CY-A Please print all information. Revie by 4t, Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location C cep Govt. Lots 1/v 1/4 5 ( f? N R - E (or W Property Owner's Mailing Address Lot* Block # !~Or'CSM# ~ C r City State_ Zip Code Phone Number ❑ City ❑ Village o Nearest Ro A- J01+ 1-4 2:6 ,P51-New construction Use:yClsesidential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: Parent material 1~ c_X1~4.D Flood Plain elevation if applicable ft. General comments and recommendations zort-'r1<00 System Type System Elevation /C'n ` Boring # Boring © R'Pit Ground surface elev./ 0;&P'!5ft. Depth to limiting factor . in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 f _ r '414 Boring # ❑ Boring { / tPit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? 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 ffluent #2 = BOD, < 30 nxA and TSS < 30 mg/L CST Name (Please Print) SigZ~X~ CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 715-246-4516 Property Owner Parcel ID # Page of Boring # ❑ Boring . Pit Ground surface elev. ' ft. < Depth to limiting factor in. fl Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2 ' T- F-i 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 El Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SHD-9330 (8..6100) Property Owner _ Parcel ID # / Page of Boring # ❑ Boring fui Pit Ground surface elev. Depth to limiitiing factor ~ji in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 11 J a 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/ff° in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Sod Application Rate Horizon ')epth Dominant Color Redox Description. Texture Stricture Consistence Boundary Roots GPD/ft; in. Munsed Qu. Sz. Cont Color Gr. Sz. Sh. `Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg1L and TSS >30 < 150 mgA- ' Effluent #2 = BODS 30 rngA- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD4330 (R.6W) Soil Test Plot Plan Project Name Chad Carson Shaund Address 361 132nd Ave Houlton Wi 54015 CS , j #226900 Lot 4 Subdivision The Sanctuary Date 11/4/16 S W 1/4 SE 1/4S 30 T 30 N/R19 W Township St. Joseph Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Grade at Drainage Easement Stake System Elevation 107.0' *HRpSame as Benchmark Scale is F = 40' 204' Property Line unless otherwise noted 132nd St. B-2 B. M. B-3 13% Slope 3.2 Acre Lot 567' B - 1 Property 102.5' Drainage Easement Line 106.5' 104.5' Pro 3 Bedroom House ? 7 . . , Safety and Buildings Division 8 K 201 W. Washington Ave., P.O. Box 7962 Sanitary Permit Number to ed in by Co.) t y Madison, WI 53707-7152 70 VQMMUN(TY 01 rmit ApT AEKI5GRR7F3CA Stare Transaction um In accordance with SPS 38321(2), Wis. Adm Co , submission of this form to me aPP..,r.- is required prior to obtaining a sanitary p=uL N m: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) ioyou ovide may be used for secondary the Department of Safety and Professional Servi . Pe4f-~t-'-n", purposes in accordance with the Pri Law, s. 1 Srs. 361 L L Application Informatio - Please rint l ! Property Owner's Name Parcel 4 Property Owner's Mailing Address ~ Property Location ~3f7, 3()• 1 9, 6 Z. Govt Lot /a, Section iy~pe_of r Zip Code Phone Number circle n" ding (check all that apply) '7 Lo T3L or 2 Family Dwelling - Number of Bedrooms Subd' on Names, 10 6k Bl ~k,~~ r ❑ PubticlCommercial-Describe use t l~ ❑ City of ❑ State Owwned~ Describe Use) ber ❑ village of v ✓ O~/ /l Town of~ III. Type of Permit- (Check only one box n line A. Complete line B if app e) A. ew System ❑ Replacement Sy, t cm ❑ Treatiment/Holding T, cement Only ❑ Other Modification to Existing System (explain) B- ❑ Permit Renewal ❑ Permit Revision ge of Plum Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner el, 0 V. T ofPOWTS S stem/Com omen vice: ec l ❑ Non-Pressurized In-Ground ❑ Pressurized -Ground ❑ Mound 24 in of suitable soil ound <24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Componen (explain) ❑ Pretreatment Device (explain) V. Die rsanrea ent Area Information: J, Design -P pt Flow (gpd) Design Soil Applicati c(gpdsf) Dispersal 'Area Requ- Dispersal Area opose s ystem Elevation VL Tank Info Capacity Total of Manufacnucr Gallo Gallons Units New Tanks g Tanks m v J a. U vz > cn .r C7 Septic or Holding Tank Losing Chamber VII. Responsibility Statement- a and ed assum r sibility for installation of the POwTS shown on the attached plans. PI ber's Name (Print) umber's e MP/1viPRS Number Business Phone Number Plumber' Address ( eel, City. State, Zip Code) k~ VIII. ountv/De artment Use fl-proved Permits F/eee~ Date Is `ed Issuing, t Si ven Reason for $ Geld • /D i IX_ Condit r ~asoa or approval p ar w:lt h a m 31 C P"JI S i ciisper. _ -ell must all ll be ~s ! nl~ mtdlrS; J / as per management plan ie i by plumber. A / 2. kwa k regWpomm mu t tie ir, nt-ined dC ~a A- 9t m per 1PpMo09 006 / 44 fi. 1 WOW 1,4V Attach to eompiete p for the system and submit to tbI County only oa paper not kss than 8 112 z I l iaches in sine GlG - I 'A_ G~ 0al SBD-6398 (R. 11/11) o Ird1. Vo.x.~. 10C4,,~", o i-\ t System PLOT PLAN PROJECT Chad Carson ADDRESS 361 132nd Ave Houlton Wi 54015 SW 1/4 SE 1/4S 30 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 100.5' 1.4' sand lift 9/21/16 DATE BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING 'L'ANK 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 3/4" steel pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL * H. R. P. same as benchmark 335' Property Line 3 Acre Lot P roperty Line Scale 1/4" 10' ~t%J Well is to meet all WDNR setbacks Tank is to be properly bedded and provided with lockdown covers with approved warning labels TaHuffcutt nk Combo Tank Grading is to be done to B - 2 divert run-off away El from system 50 pe Area 15' below _ system is to remain undisturbed Pro 3 Bedroom B-3 House B-1 98, F0.9. 1 to 132nd Ave 100' 389' P.L. B.M.*