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HomeMy WebLinkAbout030-2092-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CCOIX Safety and Building Division INSPECTION REPORT Sanitary Permit No: 592204 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ~\)_k City Village Township Parcel Tax No: Permit Holder's Name: -7 Wilfred & Christian Stout TOWN OF SAINT JOSEPH 030-2092-40-000 CST BM Elev: InsM Elev: BM Description: Section/Town/Range/Map No: 5 _ 3 26.30.19.774A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ?~tj CAPACITY STATION BS HI FS ELEV. T____ _4 , Septic fr 64-- -r., Benchmark ~ Z ~ tr y Alt. BM Bldg. Sewer k ~113 !a 5, 5 St/Ht Inlet 1-03. O TANK SETBACK INFORMATION t/Ht Outlet f03_,' /6Z TANK TO P/1Lt~~ WELL BLDG. Vent to Air Intake ROAD Dt Inlet ~J01) LU Dt Bottom Septic //57 y f Z7 t 7,50 Dosin J ) Header/Man. Q~ 1 7 H Bot. System I ` c 7 Final Grade PUMP/SIPHON INFORMATION Manufacturer and St Cover GPM Model Number O~.3 TD Lift Frictio~ss System' H`eadw TDH Ft ' Forcemain Length Dia. Dist. to Well ~k t ~.V6 ~ . SOIL ABSORPTION SYSTEM BED/TRENCH Width 1 Lengt~ / No. Of Trenches PIT DIMENS_ IONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS IT SETBACK SYSTEM TO P/L 5 BLDG WELL LAKE/STREAM LEACHING Manufacturer CHAMBER OR t I INFORMATION Ty e Of Systerrp / I UNIT Model Number: p ~ t LT7~ NJV DISTRIBUTION SYSTEM Vt:11,4 at.- Ix Hole. e x Hole Spacing Vent to Air Intak Header/Manifold p~~ Header/Manifold Distribution Lengthy Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only xx De th xx Seeded/Sodded xx Mulched Depth Over l I Depth Over - _ To soils----" No AP~' Bed/Trench Center ';"'7/ ,,..3 ~ Bed/Trench Ed es P I es ~n COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 l Inspection #2: Location: 1353A AWATUKEE TRL ~t~ I' 4 ' e, Ile- 6/ 1 I 1. Alt BM Description COIIuL- L 1~a J t G~Aw~ ~ ,O~ aY~ `'M 2.) Bldg sewer length = Zy 4- V3 z. 3`7 4-c4-,~-L [)OAS - amount of cover = vv~~ Oa 'tTcl10~ 7 qZ r 6w Plan revision Required? D Yes No Us e other side for additional Information. 4ull 'SAY Cert. No. Date *Insepcto' ignature SBD-6710 (R.3/97) _ _ _ I Y w 1 C31 °a°I (n v low 0 ~ u w i > C= _ " 0, 0 zzl I~0.'ma t 1i~` ~p I w= JJ aQ'U IwwwLL 0w°1 t I : 'n U, O z = Z w U to i t \ti IC's z;I I<wza~°0zzzI aJ °FI IUQQQ~UUFI Rgr ~,6~ b ° ~I I Q I L) 0 C) LLJ m wz O 00 wow M 4, ~ L___J Im JJZ oJUI Q z d Q , ' % N 15 /y t Zn o¢w t O N W W U 4~;., ~ ZwV ~Zw ~ ~LLa who ~ p-,,- ch~ owz °wz c.r in aid W3a JJ E1! N=~ 4y~ -..IJJJ-.JJ 3 w ° W JJJJJJJJJJ l a W o Z s 4 1 i f ~z" a¢> JJJ-JJ m w JJJJJJJ y 3 a ~JJ JJJJJ 4 It= J_IJJJ.JJ JJJJ IJJJJ v JJJJJJJJ ° ` ° w LL JJJJJJJJ Lu z JJJJ_IJJJ iJJ-1 !JJJJ O n JJJJJJJJJ JJJJJJJ a d JJ iJJJ I ' JJJJJJJ 2 m JJJJJ JJ JJJJ JJJJ l i !.JJ JJJJJJ i ~ »r JJJJJJJJ 1JJJJJ_,; o Y I J Q 0 r o CA v ti CA Uj > U) (n Q wm m Z Urn u Q'z F- V W O cn Q O a F- 0 W N cV W z N CN J 11 J ® *x W Z Z ~ LLJ J t7 * of= J W W J~ o v ® a w0°Qcn Cp0 N Q = W Q 11 ~ t!1 ~ ti d' N Z U . 000 M ~ (D W Z ti = 11 E it S Ln (1) N G ItfS N N RS ~ r 11 N Q. -)c U .L' x ti v ca cT V 9 w 113 C r Q. ti ch nn~1 W w w i Q= Q Q `,ZDe9~ w° z W R ¢ `p m wZK Q. ~0-00 -aL _ QUwo UJI :3 U) z w C:) U v z o C0 oLD i N REUSE OF DOCUMENTS GEO TECH, LLC LOT 3, CSM # JOBSITE INFORMATION; This document has been developed for a specific 1109130TH AVENUE WILL STOUT PART OF GOVT LOTS 88x7.26.30-19W PQwTs application and not for general use. Therefore it may ST. JOSEPH TOWNSHIP not be used without the written approval of CHIPPEWA FALLS, WI 54729 AWATUKEE TRAIL PLAN Geo Tech, LLC. Unapproved use is the sole PH; (715)577.6838 FAX: (888)466.8573 HUDSON, WI ST CROIX COUNTY, WI responsibility of the unauthorized user email: billy@wastewaterpros.Com PARCEL DESCRIBED AS 3_0 AC. T 7 f Installation and Maintenance Instructions Installation Step l Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it is centered directly under the access opening. (if outlet pipe is already in a fixed position, additional pipe may need to be added) Step 2 If utilizing the additional single side support and the two bottom supports: While the case is still dry fit to the outlet pipe, measure and cut 1"schedule 40 pvc pipe to the length needed to extend from the hubs that are pre-molded into the case to the side wall and the inside floor of tank. solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe. Insert the filter cartridge into the case pressing down on the cartridge until it locks into place at the bottom of case. Step 4 if utilizing a vertical read switch: Insert switch into the hole pre-molded into the top of the filter. Press straight down until it locks into place Maintenance 1) Remove the access lid of the tank. Note: To ensure undesirable solids do not exit the tank and into the drain field, the tank should be pumped out until the level of effluent is below the outlet level of the tank. 2) To remove the filter cartridge from the filter case, pull up firmly on the handle of the cartridge dislodging it from the case. (if utilizing a vertical read switch, removal of switch is optional) 3) Usirig an ordinary garden hose, rinse the filter cartridge ensuring all visible septage material is removed. 4) Place the filter cartridge back into the-filter case pressing down on the cartridge until it locks into place. 5) Place the access lid back onto the tank ensuring it is secure. Lifetime filter has a lifetime limited warranty: Lifetime filter LLC warrants the filter will be free of manufacturing and workmanship defects during normal use for the period of time the original purchaser owns the product. Lifetime filter will provide a replacement filter in the event that the original filter was not damaged during the installation or maintenance process. Damage to this product caused by accident, misuse or abuse will not be covered under this warranty. Improper care or malfunctions resulting from product not being installed, operated or maintained properly-will void this warranty. Lifetime filter assumes no responsibility for labor charges, removal charges, installation or other incidental or consequential costs. Contact: mike@lifetimefilterllc.com Phone: 502-7242231 _ SIN _ G County ai 5Ji"1:~ y ST C OIX Industry Services Division sp No JE~ , 1400 Elsh{r)on Sanitary Permit Number (to be filled in by Co.) 30 S Madis ST. CRO1X COUNTY ' S~ZZ -1 np /a[ nr-)MENIT anitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit ~A is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address) purposes in accordance with the Privac Law, s. 15.04(1)(m), Stats. AWATUKEE TRAIL, ~-40 Z j 1. Application Inform - Please Pri t All Information Property Owner's Name l Parcel # WILL STOUT 030-2092-40-000 Property Owner's Mailing Address Property Location 61, ' 648 OLD HWY 53, UNIT A Govt. Lot 6 & 7 City, State Zip Code Phone Number /a, '/4, Section 26 HUDSON, WI 54016 715.781.0108 (circle one) T 30 N19; R W E or W II. Type of Building (check all that apply) Lot # ® I or 2 Family Dwelling - Number of Bedrooms . 3 Subdivision Name L i ❑ Public/Commercial - Describe Use 6t~- dab Block # Jti VSO a El city of ❑ State Owned - Describe Use ❑ village of C/SM Number 7 9 d 2 8 1 W ZZ~-LZ- G JQ , ®Town of ST JOSEPH III. Type of Permit: Check onl on box on line A. Complete line B if applicable) A. ® New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) i B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System/Component/Device: (Check all that _apply) ® Non-Pressurized In-Ground El Pressurized [n-Ground ❑ At-Grade El Mound > 24 in, of suitable soil El Mound < 24 in. of suitable soil a/ , ❑ o mg n ter ispersal Component (explain) ❑ Pretreatment Device (explain) V. DispersallTreatme Area Information: tsf) System Elevation Design Flow (gpd) Design Soil ApplicatioV Dispersal Area Required (s Dispersal Area Prop 600 Rate(gpdsf) V 857.14 889.20 93.50' _ 0.7 VI. Tank Info Capacity in Gallons total # of Manufacturer m Gallons Units 00, o 2 2 n -5 New Tank, I Existing Tanks N y o C-) V ,2 p, Septic or Holding Tank 1250 0 1250 1 ESER ® ❑ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu be 's Signature MP/MPRS Number Business Phone Number KEITH HARINGS " . rI - - A ~ 224037 715-703-0337 Plumber's Address (Street, City, State, Zip Code) ADVANCED SEPTIC INSTALLATION - 105 E. CHIPPEWA STREET - CADOTT, WI 54727 VII punt /De epartment Use Only Approved Permit Fee Date I sued Issuin gent Signam r Given Reason for Den S -j d7 ' bd J Z' 7 A o ' IX. Condi o easn s for isa roval r ~.,a~ J~uf . zollo •6Z epf!c`tark; e ffiR m ti o- vn,~ pp 0 ( Uis(~et :cell must d I I be smi=te rs !r? intl.-, 4, Qe(1Nt 95 per mar:agement plan p!o tided by plumber. 2 lyq:tlefb~iGltreatiit~er:artcs must;te i lant.,ire 9 as per sK#wbW cods: I zrd'Jn11nraa. Attach to complete plans for the system and submit to the County only on paper not less than 81/2 a I I inches in size SBD-6398 (R03l14) Soil Testing, Septic Designs & Inspections gee Serving North Western Wisconsin since lgg4 ech t715 577-639 WastewaterPros.com VALUAT10i~ 3 Client: WILL STOUT n ~1 648 Old Hwy 53, unit A - Hudson, W1 ' r NON-PRESSURIZED CONVENTIONAL SOIL ABSORPTION COMPONENT USING GRAVELLESS LEACHING CHAMBERS Reference Component Manual In-ground Absorption Component Manual (VERSION 2.0) Location: AWATUKEE TRAIL LOT 3. CSM # PART OF GOVT LOTS 6&7, '/4, '/4 Sec. 26 T 30 N, R 19 W Town: ST JOSEPH County: ST CROIX Designer's information: William J. Bergh (License No. 1577-007) 1 the undersigned to that these plans were des~a0*dv111u,~~~ and ed under niv authority. ~sC0IV ~ Designer's signature: = WILLIAM J. t" 1 BERGH ~ V 1577-007 Contents CHIPP EWA FALLS, Page 1 cover sheet 1A11 `c Page 2 site plan AL Page 3 Distribution cells (leaching chamber x-section) Page 4 leaching chamber manufacturer specifications Page 5 treatment tank cross-section ~t1 Page 6 Effluent filter manufacturer specifications Page 7 Effluent filter maintenance Page 8 O&M 5 Page 9 O&M l' Page 1 of 9 1i091 30t" Avenue - Chippewa Falls, WI 5472a billy wastewaterp®os.com Fax (81?8) 466-5573 I Y I UZ oI Iav aN ° ~f- I Q ° d fi-1 1L) Ovasl Io~U01 0 mI I,Q °I I7It °LL~I M Igo zZI I°amEN LD cn i t'a M s° I ~oU) 0F, U W I~ to LL ZI w=, u- Z J L. 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JJJJ__I_i M m JJJJJ i.JJJJJ_a a JJJJ '._SJJJ_fJJ_ J ! ~JJJJJ_JJ Z I J < o a c) -a g a~ N p a> c► wa'o cnN ~vWi_CL Jw UM(L 0UU' Uari = o~ oil W U w z Q 0 a N owF-C: - (n a H9. * N ® N N J II W 41 w (0 C * n w Z Z M .Q a E (n co F W -j CD N a 0 to Q 101 ` tq 11 E Z = - W N to 4 tU N i U r V d' co M rl N v W Z * Ln if II E 11 M O 00 i N S O E C14 Cl% (n 11 N CL V N r- M sii (n c ~ wk ar l 1 0 O 0 -4f 0 @,L u I o n w O O . et C . , A~ u. z O to * 0 +r CL 49 T ~ W 0 4C L- I w O M LO -a ° ° Z ry CL 00 Z C/) L m 0 3WZ -k W 0 _=v -iO Q -T 4~ ?o tY1 * - z o z o c) „ REUSE OF DOCUMENTS GEO TECH, LLC JOBSITE INFORMATION: LOT 3, CSM This document has been developed for a specific 11091 30TH AVENUE application and not for general use, Therefore itmay WILL STOUT PART OF GOVT LOTS 6&7.26.30.19W PQ .S not be used wahoutthe written apooval of CHIPPEWA FALLS, WI 54729 AWA7UKEE TRAIL ST. JOSEPH TOWNSHIP GeresTeo, orm LLC. Unapproved usb is the sole PH: (715)577.6838 FAX: (888)466.8573 HUDSON, WI ST CROIX COUNTY, WI PLAN respons!b!Idy of the unautncrizad,sa, user email: billy@wastewaterpros.com PARCEL DESCRIBED AS 3.0 AC. INFILTRATOR QUICK 4 PLUS STANDARD LEACHING CHAMBER (typical) installations may require additional cells (not shown here) "DRAWING NOT TO SCALE" SOIL TO PROMOTE 4" SCH 40 pvc OBSERVATION PIPE (with removable PLANT GROWTH watertight cap or vent cap if >12" above finish grade) (must have an open bottom) must be anchored to leaching chamber to prevent removal (screws or collars are acceptable) k '12" 84 max bury I I_..... ; I I >4„ d ! if SYSTEM ELEVATION = 93.50' 22 NUMBER OF LEACHING CHAMBERS (per cell) 2 NUMBER OF CELLS 44 TOTAL NUMBER OF LEACHING CHAMBERS (all cells) 4" OBSERVATION PIPE (installed in end cap) ' t INFILTRATOR QUICK 4 PLUS STANDARD CHAMBER - OPEN BOTTOM AREA =16.1 SOFT INFILTRATIVE SURFACE PER CHAMBER BASED ON EISA RATING = 20.0 SOFT QUICK 4 PLUS STANDARD END CAPS PER PAIR EISA RATING = 4.6 SOFT ALL MATERIAL AND PIPING SPECIFICATIONS AS PER THE CONVENTIONAL SOIL ABSORPTION COMPONENT MANUAL PAGE 3 OF t I T ~QUICK4 PLUS STANDARD LP CHAMBER Quick4 Plus Standard LP Chamber Side and End Views 48" -►I (EFFECTIVE LENGTH) x i 4 ■ I !I T .l f .t 34 Quick4 Plus All-in-One End Cap Front, Side and End Views a 1 INVERT 9" 9" 10.4„ INVERT 3.3" -17.8" _ Quick4 Plus End Cap Front, Side and End Views Quick4 Plus All-in-One Periscope 4.5" INVERT 3.3" Ili ~ ~ srr 4.5" 8" I _ 17.8"-~ g11~ Quick4 Plus Standard Chamber Specifications Size (W x L x H) 34" x 53" x 8" 86 cm x122 cm x 20 cm Invert Height 0.6", 3.3", 7", 8" Effective Length 48" (122 cm) (1.52 cm, 8.4 cm, 18.5 cm, 22.6 cm) INFILTRATOR SYSTEMS INC STANDARD LIMITED WARRANTY (n) t s t v y - y nyl h 1 (U 7s) :tl full p- f I I u..s S ptu 'ys 1 II t s o s S a't Oe ory p Hs ( I Ib )age s; d l-I i 'rs a s v x a SI I, r y'a (or, r fal a e a r t'.S ss d o' the s p Sys!,,,, o y the . c v r d -b", . t s prop s !:u ' c y PPI I la .u war 1 y p -00 It b ea, uV Ih chru at t is allawn. La k •uplrc Sys e ccmr. c es. To exe c se s -Ord y qh s. 1 tolde 5 of :y I It aro wr'- y W its Corporate I Iundquar c s Old Saybrook. Cornoc.r i w'.;xn ten (15) days o - alk..tcd donct, 1 ..a,.r w11- s'.,pply ropler meat U^ :s nr U- h, dcterm, rd by Irf Itrelor in he -wed by t^u Lmited Wa• i-ity. Inflllra;nr's IlAnihly specifically excludes the Cesl Of emnval and/n. instaliande of the Uhl". ))THF l IMITFD WARRANT/ AND RFMFDIFS IN SUBPARAGRAPH (a) ARF Fx0! t1SIVF. T,HFRF ARF NO OTHER WARRANTFS WITH RFS?F" T TO THE UNI"S. 1NGI UDING NO IMPI IFO WARRANTIES OF MFRCHANTARJ ITY OR FITNESS FOR A PARTIOIii AR PURP(1SF (o) T-s In, ted War an y sh l be . a-v part o ne enaexber S" e^x s ma ed by anyone other tt L 1t`a:or. e L red War, ".y INFILTRATOR M cues t e e. d :o dente Cogs q' erl. I, spec a rci;rect ca ages Intl alor shall not oe I ab e b oe. I es o I q c .ed dnr„g„s r Clud r g h ss o ✓Od o' a c pro is lac and ate .i , overt' a _!ll ar h.' losses ur a S -s : Cu d by e Ho d o y!n r, pa•ly. S'ec,f Cally Cxcl-ea fart L. -Ted Warranty COVe are are dan age 'a t-e bli-ts cluE O Clans,y w a. and ;en', alteration. acc:den'. ald5 O' reglecr o the UnrS. F L i;5 bung Sub;elted IO VBh:Cle lra Or Giber CO d;l:on$ V,h,,dr'9 nc' pert Ifed uy t-e ;rvr i,ha, 'S:'.. 0 5 rl 're' to a s he g,0.. O ed' 5 Set t .:5:21 O S 'COI W S place t C .p'Or ate.'aIS into the sysl6 co a n ng tre U s J- c he ;s a' the seote Sys E due to mp c1 e s ,r !,L3 or n cpe so, ngexcessive water .m, doer 6 Business Park Road • P, O. Box 768 grease it sposal, or orope ..pera,o , o any athe true.: tux, caused by IrH..a T: :s L. xx .ed Nar.ar1y s al- be Vote: ! he HOICer aiStn emp;y w lh a 1 01 - e s SC fell' 0 th s Li,,tE W l y. F the , c eve, S. I I-,.h'e or be reSpons ble for a-y loss . Oahe- to t.-a Old Saybrook CT 06475 Ide t ,e U is o any i third party es IC c f c ns la on ors jament ~ro r p'oduci I. dl ty ..lams o` Holder c• a°.y I. rd Pa1y, For 'hs , ..ted Wa. a y tc ao ly. e U is s he rsad acc..,da.xce w:th .ill sate centlaxons 14,l by state are -I nodes all 860.577.7000 , FAX 860:577.7001 abet a.Ne la.vs . arb I-Q,wo -:ns,alla on s!r- u s. {o) tic renb,s.,:a ive o' In!,Knator baS :^e aaV)C1lty 'c c-arge or extend th;s Ul led Warranty. No warranty applies to any parry other !r.^„n :fie crglnal Holder, ha ado - p esbnrs he S ,.rd C ed Wa!rer,y ll-l by Intl!'ator. A fin led ^.,mher of states and Lour; es naee d'.9era~!! wa'rarty •oge.,E, 80 0. 221.4436 :its A y se U' I f - I--I a G.-"t S cu_- y p-'°s"pJ`'dSeC'"'""'' www.infiltratorsystems.com For technical assistance, • • or customer service, call Infiltrator Systems at 800.221-4436 J.S. Pa eats 4.759.661: 5,017 C4:' 5 156.488. 5.33(3.017: 5.431 116; 5.40'4--9. 5,541 .~u -,716 163, b. 588. 178- 5.839.844 Caradlan Patents: 1,329,959: 2 334,584 01-br pa!erlts c;urd'ny Infiltrator, Equalizer. Q::ick4 and Quick4 Plus are registered trademarks of Infiltrator Systams Inc. Infiltrator is a registered trademark it, France. I Ifilxrator Sy ~ r> u.c. Is a registered trademark in Mexico. Contour Swivel Connectioc is a trademark of Infiltrator Systems Inc. it) 2009 Infiltrator Systems tic. Printed in U.S.~+. r l „_U 10' U',Ati n i^ G WIESER 1250 X-SECTION (DRAWING NOT TO SCALE) MANHOLE RISER & COVER with warning label & locking device FINAL GRADE (per SIPS 384.25 (7) & (8)) (slope ground surface away from manhole(s) for proper drainage) 4" min. SCH 40 PVC tank vent. located 12" above grade or 24" above regional BUILDING SEWER flood eievation (per SPS 382.30 (11)) 1 4" min. MANHOLE 18" min. MANHOLE 23" min. a • a y 23" min. BOTTOM OF INLET (invert elevation) f-Y • (wastewater level) ii 4" ° I INLET 42.5" TEE OR BAFFLE EFFLUENT FILTER REQUIRED MAXIMUM DISCHARGE WASTEWATER PARTICLE SIZE (..1-d pvc handle to <1"from MH cover to prevent filter from floating) .4 A 4 . . MINIMUM OF 3" OF SUITABLE BEDDING BENEATH TANK TANK SPECIFICATIONS Max Length = 108" Max Width = 86" Liquid depth = 47" Gallons/inch = 26.81 gpi Max capacity = 1260.07 gallons i ANCHORING MAY BE REQUIRED PER SPS 383.43 (8) (9) MAXIMUM DEPTH OF BURY IS 96" i PAGE 50F9 U ° N N /C6 n O C N N O O 0 .2 _y O E 'C r ~"Q Y tr ry a 2 N N 2 s~- N C N Q "o N N i y 3 t d a~ln N z Y N N 3 _O O'c Of'~ ~Ga~dd H . N ~ D O LL ~p cQc N C "Op ,~g,'^y, O V LLU' ~ LLu a ~ Y O.N 3 L a d C E ' WwN f~ t } Fa jt: C O d N O U `y ~.J m a m CL c .N. Yj N L N 'O E T w N 01 y > > a > s c a mt- ~a v m2 r 3 m c,E c m d N C Q m > N N V O N d R C N F 3 ~ 6 cz ° c,° O C O - ° m o> c 0 m o c g y O c v 5 c7 w y o" S 8 igg ~~LL U.0Q.~ p NL-NN 4g " O '6 .V. 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NL.. v vOi C P so ZP Owner/Agent & Location: WILL STOUT - AWATUKEE TRAIL, LOT 43, CSM # POWTS Maintainer: Geo Tech Soil & Site Evaluation - Chippewa Falls, WI 715-577-6838 Local Regulatory Authority: ST CROIX County Zoning Department - Hudson, WI 715.386.4680 POWTS Installer: Advanced Septic Installation. - Cadott, WI 715.703.8337 DESIGN PARAMETERS Influent/Effluent quality (values typical for domestic (non-commercial wastewater and septic tank effluent) Fats, Oil and greases (FOG) <30 mg/L, Biochemical Oxygen Demand (BOD) <220 mg/L, Total Suspended Solids (TSS) <150 mg/L. Soil Loading Rate (SLR) = 0.7 gpd/ftz. SYSTEM SPECIFICATIONS The components of this septic system are intended to serve a four-bedroom (600-GPD) single-family residence. The components include a Wieser 1250 septic tank, (w/label effluent filter), (2) non-pressurized distribution cells using graveless leaching chambers. SAS component requires a minimum of 43 Infiltrator Quick 4LP leaching chambers are required when applying an EISA rating of 20.0 as specified by SPS. All parts of the components must comply with WI Adm. Code SIPS 384 and be installed per manufacturer specifications and approval letters. DESIGN CRITERIA ✓ In ground Soil Absorption com MAINTENANCE & MANAGEMEW Inspect the condition of the treatmt. y y~ A contents must be removed in accordance with Chapter NR 113, WI Adm. Code when the combined sludge and scum equals one-third (1/3) the tank volume. The effluent filter should be inspected annually to ensure maximum performance. At a minimum the filter must be cleaned every three years when the tank is pumped. Immediately following the tank pumping the effluent filter should be properly removed and thoroughly flushed with a hose or other suitable means so that any debris accumulated on the filter have been properly removed. Upon successful removal of all foreign matter replace the filter so that it is properly "seated" in the filter housing canister. Refer to individual filter manufacturer specifications for additional information about specific products. START UP For new construction prior to use of the POWTS check treatment tank(s) for 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. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of wastewater will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures and prompt repair of leaks reduces wastewater volume. Also, the brine from water softeners, iron removal units, and other water treatment devices should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc... The system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced be a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins, condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics (medications), solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Avoid vehicle traffic over all system components. Compaction of snow over the unit may cause it to freeze up. INSPECTIONS Shall be made by one of the following: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator Septic Tank Component: Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks of leaks, measure the volume of combined sludge and scum and to check for any backup or surface discharge of effluent. Access openings used for service of assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental of unauthorized entry in the tank. Page 8 of 9 The effluent filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications (see attached sheet). Provisions are to be made to retain solids in the tank during cleaning. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating properly. ✓ In-Ground Gravity Component dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. o Diverter Valve The divertor valve shall be switched to serve the opposing distribution component every three years (when the septic tank is due for it regular maintenance). However, if ponding is observed in the observation/vent pipe of any cell, the divertor valve shall be switch to the opposing component. Furthermore, ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with SPS 283.55 WAC. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPS 283.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe opening sealed. - The contents of all tanks and pits shall be removed and properly disposed of be 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 other 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 compliant replacement system. ✓ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure(s), lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. WARNING SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OF OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE. Major components The following is a list of the major components required to complete the installation of the POWTS. The list does not include an allowance for fittings, glue & cleaner and may not include all parts and materials: • Wieser model 1250 septic tank (with effluent filter) • Manhole risers, chain and weatherproof padlocks • -50' SCH 3034 Building/effluent sewer • -30' SCH 40 PVC Observation pipe and tank vent (ASTM 1785/2665) • 44 Infiltrator Quick4 Plus Leaching Chambers • 4 Infiltrator Quick4 Plus All-in-one end caps Page 9 of 9 ST. CROIX COUNTY 5i SEPTIC TANK MAINTENANCE AGREEMENT AND NOV 2 g L' `i,ti OWNERSHIP CERTIFICATION FORM ST. C;~C31X COUNTY Owner/Buyer ,OMMUPe1TY DEVELOPMENT Mailing Address tiz Qf (r Property Addre (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number Qom) - ~;~`d " Lt~'U LEGAL DESCRIPTION ii Property Location tr4 1/4 , Sec. T 3Q N R~W, Town of ~t ~~d5~J74~ Subdivision Plat: Lot Certified Survey nap # t'olulne . Page Warranty Deed # (before 2007)Volume , Page # Spec house Oyes4no Lot lines identifiableAyes[] no SYSTEM MAINTENANCE 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 §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 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 set 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 C ount\ Planning & Zoning Department within 30 days of the three year expiration date. I we certify that all statement/xarranty form are true to the best of my/our knowledge. Ihve am/are the owner(s) of the property described above, by virtue of deed recorded in Register of Deeds Office. Number of bedrooms .I i( 15!/6 (_b& IGNATU OF APPLICANT(S) DATE U ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded «arranty deed fi-om the Register of Deeds Office and a copy of the certified survey map it reference is made in the warranty deed. 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