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HomeMy WebLinkAbout276-1153-00-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 592135 : Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: Winfield Solutions CITY OF RIVER FALLS 276-1153-00-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 34.28.19.1455 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ` j CAPACITY STATION BS HI FS ELEV. Septic f Te 2y s Benchmark Dosing l~ S D Alt. BM ; 4, o 0,./ tA- /6 l Bldg. Sewer Holding - St/Ht Inlet 94 y5.4 TANK SETBACK INFORMATION St/Ht Outlet /094. Zg TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet oJ)A^ Septic 4 Dt Bottom Dosing 0 ~v Header/Man. Aeration Dist. Pipe 7g el 7, (e Holding Bot. System p PUMP/SIPHON INFORMATION Final Grade 47, Manufacturer ZD ALA, Demand St Cover GPM _,ill- , i/l~~ • - ink Model Number 7 " TDH Li 35 Friction Loss System Hea TDH SFt 1 Forcemain Length i Dia. L /r Dis . to Well In_ \ SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenc es PIT DI%NSIONS No. Of Pit Inside Dia. LigyyLd Depth DIMENSIONS ~B t ^e~ cJ T SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR G Type f System- Model Number _ UNIT [MI ✓c~ • d D ISTRIBUTION SYSTEM f6.0 4' 4-23 'I Header/ManifojrJ ID istribution ` x Hole Size x Hole Spacing IVent jp Ajr Intalye~ 9 Pip s) ` ~s Asa (~j Len th D 9 ia Len th Dia pacing.5D'/M.. Cj SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only y 11 Depth Over Depth Over xx Depth of xx Seeded/ odded jxxMu c d ✓Y wT~ Bed/Trench Center ,53 Bed/Trench Edges Topsoil Yes No Yes ~No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 723 CTY RD MM ' FAG 60,1 t k, 6 1.) Alt BM Description = Q~ 2.) Bldg sewer length= Z / ^n - amount of cover = -73-5 4 _ (/x~! Plan revision Required? ❑ Yes Xo Lu 61 - Use other side for additional information. Date s pctor's Signature Cert. No. SBD-6710 (R.3/97) RECEIVED I n ndustrvScnn:rs o Counn p SEA U 1400 F Wshmgicn ~1vc _ Si. S P.O. Box 7162 Sanitan Permit Number (to he filled in by Co.) $ ST, CROIX COUNTY Madison. 3707-7162 COMMUNITY DEVELOPME14T 4W State fransicuon Number Sanitary Permit Appl'- GSGD7J1N1ED 7 In accordance vvitlt SPS 3,U 21(2), Wis_ Adm_ Code, submission o! thi9 !.inu tri the altpr~,~.•- snit is required prior to obtaining a sanitary permit_ Note: Application for ns for state-oxned POW] S are ratted to Project Address (if different than mailing address) the Department ofSalu~ and Professional Services. Personal information you provide may he used !or secondary purpose, in acc=ordance vaith the Privacy Laty, s. 15 04(1 }(m), Stats_ I1 rt „ 1. Application Information - Please rink. Inform ation A We /Y Property Owners Name t " Parcel ft A _ L- ~f n) d el Z.4 S Cfo ~C L ~o.t~5 3'Ru c r~A ~ l vim: /yiGL 5 Property O vner's Mailinc Address Property LOCall0o ~/oo/ ~~x1~t ro.~ ITU6 /V Gout tot ~t City, State -Ym Code Ph-w)e mbv'r IV41 1{jLel t'3- Section ST. Au[ /"//1/ ?-5-W d 37- ! ~'G (circle ono T & N: R 11. Type of Building (e eck all that apply) Lot 'l A ~ 1 or 2 Family Dwelling - Number of Hedmoms Subdivision Name F//Et© Block 9Plnhc'Connnlercial Describe Use 14G. !"~~Jt! TY - CSN1 Number 1tRe"t El State U4,roed - ihscrihc li se 10 333` - - to 3 LJ Z34-23 11 V&tP -P _ 111. Type of Permit: ((,beck oral one hox on line A. Complete line B it applicable) A (~^f NeIC Sastem ❑ Replaccment system 11 l rwtuentrl lolling funk Replacement tinily L] Other Nlodi tication to Im tine. System (explain) umber ,c,vv List Previous Pernut Number and [late Issued B. ❑ Pernut Reneivdl ❑ Permit Revision ❑ Change of Pl Permit l 'ransfer to >t ❑ ^ More Expiration Ovsmcr 1 t~ L.1 IV. Type of POWTS SystertiXomponent/Device: (('heck all that apple) 131 Non-Pressurized Iu-Ground ❑ Pressurized In-Ground AL-Grade ❑ Mound 24 in of suitable soil ❑ R9ound 24 in ofsuruble soil t ❑ Helding'(ank UthcrDispersal Component fesplaml ❑ Pretreatment Dcytcc fexplain)_- 1. llispersa!(1-reatn nt Area Information: - Desk n Fknv (gpd) Design Soii Application Ratc{gpds Drspetsa, Area Requited (s Dispersal Area Proposed l System Elevation 9a -1 S _ _ /380 1_ /393 e VI. Tank Info Capacity in Total #t of Manufacturer y Gallons Gallons Units \eu ra,,Ls f::xisnng Tattles Ai;6 1 /Gr=d_ lt/i~SErt - C csnlG~CrE- 1 - ; t - t)~smct_lranihar - 1 s~ i ~ N"I1. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. i Plumberr Name (Print) Number at MP,)b4r Number i3usinc, Phone Number - ` i EC/~E3l35~6 ( 7!5 L72-S.tLG Plungers Address (Sir et. City, State. Zip Code) - eu.~t,N Ill De artment t se 0nh Approred ❑ Permit Fee Date I tied Issuing> z t Signature I fS )tit cn Rc ton for Denial X. Contliti t asony for Disapproval n t 1. a tank e tin: nlt~ 1r 4101A e~/~~►~reD disper of cell must .III be as !rig s.per macagement plan pion Ued by pluniber. 2. AN VOWIt *i0oertents must be maintI j n per #ppNalbls ct& / ordinalrt S, D"/ 4..- L-- - - Attect to complete [Ilan . for tht ccsrem an i o the C ounty on pn pape not Iess tha i 8 lax It inche, in size a ;/►sc G[~`d7l SBD-6198 (R 01 14) `3z N t Iz v y Q~ e:Nc °ec ~ C ~ ~ It ell ~ c ah: 1% '4kj s° f ° Z `v a ~l : r Q tT~ ~i v ~u @ (4~ k 11 Cl 1. o ~ .s ~ a1c s:' v v 3t v +,.y o ~e~;l. DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 ~ S Contact Through Relay IF S http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Dave Ross, Secretary C0NDIT' August 31, 2016 APPP OUST ID No. 231346 ATTN.• POWTS Inspector DEPT OF," PROFESSIC JOHN HERBERT PELKE ZONING OFFICE DIVISION OF IN' PELKE PLUMBING STCROIX COUNTY SPIA N6298 ST HWY 25 1101 CARMICHAEL RD DURAND WI 54736 HUDSON WI 54016-7708 CONDITIONAL APPROVAL, PLAN APPROVAL EXPIRES: 08/31/2018 Identification Numbers Transaction ID No. 2766573 SITE: Site ID No. 828065 A2 Field Facilitv Please refer to both identification numbers, Co Rd Mm above, in all correspondence with the agency. Town of Troy St Croix County NW1/4, NW1/4, S35, T28N, R19W FOR: Description: In-ground - Dose (New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1620318 Maintenance required; 690 GPD Flow rate; 72 in Soil minimum depth to limiting factor from original grade; System(s): In-ground POWTS Component - Ver. 2.0, SBD-10705-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 onsit:e wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches below the svstem elevation. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling, a soil sample between the hands If it rolls into a 1/4- inch wire, 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 • Divert surface water from POWTS Area. • 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 (1 1)(c) JOHN''.-[ERB[ RT PGt.KE Page 2 3/31/2016 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. 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 333.54(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. 'T'he 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 Fee Received $ 250.00 Balance Due $ 0.00 'Tim Vander Leest Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214 Monday - Friday 6 am To 3:30 pm JOHN HERBERT PELKE Pa,-e 2 8/31/2016 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. 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/op eration. 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 J~ Fee Received $ 250.00 Balance Due $ 0.00 Tim Vander Leest Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214 , Monday - Friday 6 am To 3:30 pm tim.vanderleest a wisconsirn.gov RECEOE-6 AUG 2 5 2016 F=s'^ INDUSTRY SERVICED 2_Qj~ LG: /s, /f Lz~ tttGrt i +fnlG.~au ~0 ®dz~e.ll S td !'~rss'rlGf/r~~t~S 2L JCL G~aaTrzacT7d.d CI7=+~~ 1?ltts iow-no's h1 = t: Gw~ s Address: AND r Irw- ES .TRY SERVICES ~~e?DCSCiI~i!Cyt?: ff 4 11-v GAY Q TG':pa itf To s ~-a-u-'~'`'4i' -.5 . /cab/!ti ~tI~D~T~i5S0~ !`k~Tt}Pi. TPa^a 4Q _ -P 5F e ,rr ~EGTla r~rdti 1%r✓ ofi9c~S.aL rS'df~ , 'r?agge'~ rf G/r~lf n age fL1 7L Page ` Tlag ',fie p i J"IFGI~rY~ rr,'a ~at G ~ ~'~~ull1"ta d' ®.t,7' . !.~iCELi52 1~1)3L~ {7Ci: /'!r~' y~ erg' J SQL r~ a Q-LD e5I PCT: G3ft,Vl r 6E E i a-Lur iSopQnea~lavu? and ris,4 Desiguad scant Ea rne oLflwi~~ / r~~~f~trrltt ,,.:G7lG ts7r~~6t.llrF! ' ~~•.a~~c~f~ d z ~ v~ a f u v ~t '4- A M ` q fi ' f Y ty 1 Z a v Q {t ~ .t vs ~ LJ t9+, v v S h~ ~ i ~ ~ eve ` t3ti ~ w ~ w$ ~l 't Is a. ' ye y~ vj V I~z 3\ i Z e. L a sea 14 Oe m x _ d 1. tin ee Z e Ciz \ E1 ~k 'A ~)Qj 14, n /1'11 v z 'y ^i v :k 13 v 41 tf y ~ V s or PUMP CHAMBEI, CROSS SECTION AA}D SPECIFICA- IONS • - r Io `F.o,.t lJcoz; td+~J.G'od✓ oa F~ r~ ~ ii2 WEATHERPF,OOt: APPROVED LOCKI&IG .lUAICTIOAI SOX MAIJ14OLE: COVER GRAOE como liT i6'FltAd. \ ~ - PROVIDE. i I IAILE'!' AIRTIGHT SEAL i 1( * Jill ~ i ALARA *APPROVED i ! 0" ' JOIRTS WITH ~ I FT. APPROVED PIPE ELEV.V,d -Pump- 3 ONTO OFD SOLID SOIL COhjcRETE BLOCK RISER EXIT PERtAt-WED 01AL4 IF TxUV. MAUUFACTUR£& HAS SUGI4 APPROVAL. ®wfe 90 tdwlflao~ SEPTIC SPECs1F 1CAT12135 / DOSE—' OSE - ~L.JGrI~ =J.A]MSER OF. DOSES: PER VA-4 TAMKS _ MAa1uFACTURER: 3 Tmj seac l~atCGALLOk1S DOSE VOLUME ° IMCLUDIk9Gs DAC.KFLOW: - _GALLONS . ~,ALlOUS PkODEL k1U)kbER: ,V jx eAr CAPACITIES* A= U3CRE5 OF. SWITCH TSPIL.: Glf t~rsri G l G g IMC14ES OR 5-5-- 7 GALLOISS 7o I-r d 7, 83 G,ez$. S Iut 14E5 oR / r~ttous -PUMP MAMUFACTURER: X INCHES OR !:L.`? ~ GALLOUS M©DEL AIUMbER: SwITGFI TSPE° /°~ii'J/G oL MOTE: PLlHP ARID ALARM ARE TO bE ~ INSTALLED OU SEPARATE CIRCUITS t+11aIKUM DISCHARGE RATE Z10.0 GpA VERTICAL DIFFEREMCE bETWEEM PUMP OFF AWJD DISTRIbUTIOU PIPE.. FEET + MIL11MUM METWORK SUPPL!1 PP tS$UP.E . FEET " .i. FEET OF FORCE PMiI\i rZFRICTIOu FACTOR. FEET TOTAL -D!JUAMIC. HEAD = i FEET It - ItJTE.RUAL DIMEUSIDWS OF TAI, M LF-M&TH ;WIDTH TOTAL DYNAMIC HEADfFLOW ~ r~G 6F I PUMP PERFORMANCE CURVE PER MINUTE MODEL 15111521153 EFFLUENT AND DEVVATERING 1 .a ` 45 1 153 MODEL 151 5? ao ? l ~ ~ ' ~ ' ! Feet I ; ,ete y Gal I Li,ers Gal. Gat. Liter. i 77 X25:. - 261 1 5 5v 33 i 1.5 o da __•_T__ ..r _ SO t52 ' I iq` 3.0 D- 61 231 70 J-2-i5- &1 23! 11, J5 4.6 ~ 33 3 5"s 20 t h _f51 Zo~~ 1 S 44 16 52 S&i 42 - - 25 7.6 16 c T` ltd - 5s -125 3 87 22 65 40 12.2 - - 1_ 42 Strjt-mnHead _10 fl.tB.im) 38111 i'i.nm! i 41#± i13.4m} - I m,~eosa Model 1 51 Models 152 1153 c - , 21 r, e as so- E : z e^. o- :o 6 7172 - 6rl~lON? 67;82 eI 4~; w 120 1A C:, .40 ciU 32C 25n 37_ 014&0ed-.,` ark is _fk • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling ! " ~ single phase systems. { _ . • Double piggyback variable level float switches are available for variable level l Sealed owik-Boxavailable for outdoor installations. See FM1420. ! • Over 130°F (54°C) special quotation required. 15111521153 MODELS Control Selection Model Volts-Ph f0ode Amps Sia,plex Duplex N1m 115 Non 00 2or3_ BN 1151 ; 115 i Auto 6.0 Included 2 or 3 - Elor 230 , Non 32 2er3 BE151 231 , Auto 3,2 included 2 ut 3 "Easy aSSel7ltJlj!' -_2 a• 3 iptm & B,s&atae pipe -152 115 1 Non - 8.5 1 --2a-3 - t?N2 115 rKturuderi) ~ 1 auto 3 5 Included 2 c~3 E952 2,16 1 Mon 43 BE152 : 23D Auto - ".3 i Included 2 0, 3 N'53 115 1 Non 1C 5 2 or 3_ a BN 53 15 Aa o 10-5 lnc uded 2o(3 ~r s ~ 41 E-153 230 Ncn 5.3 2 u i BE153' ~~^l i 4,rm _ lnclnde~ 2or? l ~~`W 1. Single piggyback variable level float s:vitch or double piggybar-'~. vanable'evel Reduces potential clogging by debris. float sMtch. Refer to FM0477. Replaces rocks or bricks under the pump. 2. See FM0712 for correct model of Electrical .Alternator E-Pak. Made of durable. noncorrosive ABS. 3. Variable level control s4v',tch 10-0743 used as a control activator, specify duplex Raises pump 2" off bottom of basin. (3) or (4) float system. Provides the ability to raise intake by adding sections of 1W or Z' PVC piping. A CAUTION Attaches securely to pump. Accommodates sump.. dewatering and efluent applications. NOTE: Make sure float is free from obstruction. For unusual conditions a reserve safety factor is engineered into, the design of even Zoeller pump. 6 Copyright 200B Zoeller Co. All rights reserved. __s ra_.`~'i7 ~l':'.~~` min! ~a fa :i.i l._Ui~t rI-DiT I?._ ,`Tt:.= l~,a/!/ ~ t.Dl~ E S ~c~uC'•a~1' Lc~aC~", 1 ~+~.F.311 / ~ _3L •C1.~.~!`-; c~ ~_I~ s ~ 77 ' t ~`it?Csi_~'itiV~ !~l±c"~•.LicC_L~. 5 ~.~i L~.S ~ ]•.M1 I tics ic? C_ 4~'g?ciCia} ~i~ :c 1 ??i1c lank ' apaC i t?DO ozi i~ 1-T- - 1 i r ca ac~L ' t 1 ! - su ~ aa moEz:-.: i ~AEGL R - f :!/-;lrC'._.Dv1 •_7'rl: '..`()D _ S'_.-..a.C_.._ _..L''3'. 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