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HomeMy WebLinkAbout040-1318-00-056 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: .St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 592214 : Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. State Plan ID No 2881 232 Permit Holder's Name: City Village Township Parcel Tax No: Creative Homes TOWN OF TROY 040-1318-00-056 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 11.28.19.2131 TANK INFORMATION :.v„ ; ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark -2 lo -5 .1 rjo Dosing ~ i Alt. BM i 7b,, 44donn Bldg. Sewer Holding St/ t Inlet u, St/Ht Outlet TANK SETBACK INFORMATION _ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet A c,..`I~, Septic Dt Bottom `~/D~o9. I1^ Dosing Header/Man. 2.1 l076.Z Aeration _ Dist. Pipe 7 r Holding Bot. System . Final Grade PUMP/SIPHON INFORMATION G. Manufacturer j t ,1 Demand St Cover t GPM ~_j -6 t (0 41 < Model Number / -3 Y TDH Lift Friction LossSystem Head.. TDH Ft 7 Forcemain Lengt - , Dia. Dist. to Well . ; Zoe SOIL ABSORPTION SYSTEM BED/TRENCH Width . Length___ No. Ofgrenches l PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / r' SETBACK SYSTEM TO P/ BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Typ Of System: 5,4 57 UNIT Model Number: DISTRI,WTiQN SYSTEM Head Manifold W: Distribution x Hole Size r + • Pipe(s) ttt✓~~~ z r s Ix Hole Spacing 1 Ve t t0 Air Intakyef Length Dia Length Dia Spacing 'l I~lC Z ~j 1/( SOIL COVER Q 4-x Pressure Systems Only xx Mound Or At-Grade Systems Only 1i k~r,~ Depth O r y' Depth Over ` xx Depth of xx Seeded/Sodded ulched e 11 Bed/Trh Centel , j . ! . Bed/Trench Edges Topsoil d j es ~ No es [ No .1 COI ' TS. (Include code discrepencies, persons present, etc.) Inspection #1: n 0-A T / - i Inspection #2: U' I I2 01 Location: ~rwv-, 472 PROMINENCE WAYtw* ~VE - by ~ 1.) Alt BM Description LO = ~"~-~OJ'~. rth~.~, > -t-- i • 2.) Bldg sewer length C()+ Pmv amount of cover r y i i' 7 g 7 C 64"t Plan revision Required. ❑ Yes `Wi'No , r 1 t( Use other side for additional information. i.• I ) • J SBD-671 0 (R.3/97) Date Insepctor's signature Cert. No. I e nntu r County C--,L t Safety and Buildings Division t 8„ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 7_ / Sanitary Permit Ap State Transaction Number i In accordance with SPS 383Jk(2), Wis. Adm. Code, submission of this form to the appropriate eoverltmcnuu-..v,, is required prior to obtaining a snn}tary permit Note: Application forms for state-owned POWT-S are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secon purposes in accordance with the Privacy Law, s. 15.64(1 m), Stats. I Application Information - Please Print All Informa ' " Property Owney%slName Parcel Property Owner's Mailing Address Property Location 't a S l r' j i -1 Ce, If Govt Lot City, State Zip Code Phone Number / . Section ~(rcleon R. Type of Building (thee that apply) Lot / *1y9r 2 Family Dwelling-Number of Bedroo ✓ Subdivision Name C l tRV` Blo ll t ~t 7 Q Public/Commercial -Describe Use Q City of Q State Owned - Describe Use CSM Number ❑'Village of 46 k 76 ~/2~TbwnofI/ - III. Type of Permit: (Cbeck only one box on line A. Complete line B if applicable) A. Aew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B- Q Permit Renewal Perrnit Revision Change of Plumber Permit Transfer to New List Previous Permit Number and Date Issued ❑ ❑ Q Before Expiration owner IV. Type of POVV TS System/Con onent/l3evice: Check all that a 1 ; OJT OJr Q Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade V Mound > 24 in. of suitable soil Q Mound < 24 in. of suitable soil ❑ Holding Tank ❑ er Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Informatio : Design Flow (gpd) Design Soil Apph Rate(gpdsf) Dispersal Area Req JX (sfL Dispersal Area Proposed (sf), System Elevation VL Tank Info Capacity in Total # of Manufacntrer Gallons Gallons Units / fl E o i/_ _ m `v m m New Tanks Existing Tan} 1 t U P y G - Septic or Holding Tank - ~ -1 Dosing Chamber X 7 undersigned, ass a esponsibility for installation of the POWTS shown on the attached plans. VII, Responsibility Statement- I ttLr Plum N e (Print Plumb S afore MP/MPRS Number Business Phonc Number Plumber's Address LS4reet, City, State, Code _ VIII unty/De artment Use Onl pproved ❑ Dis Permit Fee Da Issu lssuing . t Sipature - . C0 -7 1 i er Gin eason for Denial S0 1 ' ' L V_7 ~ DL Conditi tis ep P,pt`a" Alipproval 1 aLl dispel ' -ust so a s,- is?s !r it t( 3 ) gf as per ;-na: ernwft plan piwidetl by plumm. kp~~ 1~ W 1~IM0 2. All sefback re Jfm, -%Ir*r ff Mst b e rtaintJr,E d r r as par aKifcible oo& / vdinancaz. Attach to complete plans for the system and submit the County on on paper not less than R tr_ z 1 ruches in size r 6*~.Q,+ fo J~ 4 w SBD-6398 (R. 11/11) Gt/~ ` G System PLOT PLAN PROJECT Creative Homes ADDRESS 707 Commerce Drive Woodburv Mn 55125 NW 1/4 NW 1/4S 11 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 1075.0' DATE 12/16/16 BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of iron pipe ASSUME ELEVATION 1073.16'Filter Lifetime Filter ❑ BOREHOLE (DWELL *H.R.P. same as benchmark 1072 B.M.* 1076' Property Line Scale = 1 /4° = 10' B-97C 1 Acre Lot Huffcutt combo tank 6% Slope Prominence Way ❑ B-97B Pro 4 Bedroom Well is to meet Area 15' House all WDNR below setbacks system is to remain undisturbed ❑ P B-97A Grading is to be done Property Line to divert run-off away from system 1074' Tank is to be properly bedded and provided wiht lockdown covers with approved warning labels. IcicoP , ~atir\T DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 y:. GREEN BAY WI 54304-5211 3 f Q s Contact Through Relay p http://dsps.wi.gov/programs/industry-services 71 www.wisconsin.gov \~°S~S~or~LSw Scott Walker, Governor Dave Ross, Secretary T i0`4 December 27, 2016 A1°' ROVI 'T° CAF SAFE CUST ID No. 226900 ATTN.• POWTS Inspector ra t= ES S; O NAL 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 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/27/2018 Identification Numbers Transaction ID No. 2881232 SITE: Site ID No. 834404 Creative Homes Please refer to both identification numbers, 472 Prominence Way above, in all correspondence with the agency. Town of Troy, St Croix County FOR: Description: Creative Homes (600 GPD - Mound) Object Type: POWTS Component Manual Regulated Object ID No.: 1681530 Maintenance required; 600 GPD Flow rate: 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, 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. Smearing and com ap cting 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. SHAUN R BIRD Page 2 12/27/2016 A • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(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 servicinetipad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any chances may result in pump resizing to meet TDH and GPM Specifications. • 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 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 ~iK,L Lam/ 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 t;m.vanderleest@wisconsin.cov SHAUN R BIRD Page 2 12/27/2016 • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(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 i)ad is located 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Any changes may result in pump resizinQ to meet TDH and GPM Specifications. • 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 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 $ 250.00 I/i~-t 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 coder 7633 tim.vanderleestawwisconsin. gov Cover Page Shaun Bird AND Bird Plumbing Inc. _VICES 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 12/16/16 Owner:Creative Homes Location: NW1/4 NW1/4 S11 T28 N,R19W 472 Prominence Way Troy Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Secti n 4-6. Maintanance and C gency Plan 7.Filter Cross Section Signature License numb # 26900 -)EC 21 2i' s ; _~(,;TRY SFP0 4 System PLOT PLAN PROJECT Creative Homes ADDRESS 707 Commerce Drive Woodburv Mn 55125 r NW 1/4 NW 1/4S 11 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 1075.0' DATE 12/16/16 BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 600 # of chambers none Ilk BENCHMARK V.R.P. Top of iron pipe ASSUME ELEVATION 1073.16'Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 1072 B.M.* 1076' Property Line Scale = 1/4" = 10' B-97C 1 Acre Lot Huffcutt combo tank 6% Slope Prominence Way ❑ B-97B Pro 4 Bedroom Well is to meet Area 15' House all WDNR below setbacks system is to remain undisturbed B-97A Grading is to be done Property Line to divert run-off away from system 1074' Tank is to be properly bedded and provided wiht lockdown covers with approved warning labels. Mound System Cross Section and Plan View ~ ~ Dimension Feet c7 1.1.4.1.1.: 1. 4 .1.J. 1.L•L•L•1.1;4;L;1;M1;1f t J ril r4f J lLr1t r 1L 4f l r N 7 f r l / l 4•L• 4.1• L.M4.1. i iZi t.J.J.r.J.J. L L L 4 L i :i.J.r.r.r.r.f.r.JY.t•r~ {:.:r:;:;is::ti:~:•i•::;•;L• •:y.:,?c?.r;? ?L L t?l?i?i?I A ~ J~?~;:~~:~~1~ti~ti • ?~f f.f•l•J.f.f.f.J.J.f.r.f.J.J.J~J:f:J:f:f:f:J.J.?yf:J4J~?• 4.4.4.4.L.4.4.Y1. . J •L.Ltt ~1 f:1L11:4.4.4.4.4.1.Y1.LK•Y4.4.4•L•4•YL•4.1.1.1 L L L 4 L 4 L.L;:t.tYY•r.rYY.f.r : ••J\:L:1?Y4 1 1.4 J•J.t.t.f.J.J.f.l.t.J.r. f.l.J.l.f: t N W Z4 3, 7-7 :7 K B 1 Z - L Slope = Topsoil = ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc Cap Material sand fill '/2 to 2 1/z in. dia. observation pipe Geotextile G H Fabric `l?l? l'l?l`l?till?l?l?• t•!•J •tl?•t•t •t•J•t J• t~?:? 4J t r,?,~..: F 107 ,S. c. r J tJ L• r r rlJ r1 t D E Plowed Surface Ft Contour Slope Direction . ~i 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'/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 of Pressure Lateral Layout Two Laterals - End Manifold 4----'T'hreaded Cleanout Lateral Turn-up 0 Plug Manifold M X L Long Force Main Sweep 90 Bend ~fJ r Distribution Network S ecifications Pressure System Construction Lateral Diameter In. Manifold Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter Z. In. pipe. Orifices are drilled perpendicular to X On' In the pipe with a sharp drill bit and face down- L S ac in ` 7 L ateral Len h Ft. Lateral turn-ups terminate with a threaded M (Manifold Len th) Ft. cleanout plug and are enclosed in a 6-8 inch Force Main Diameter Z In. diameter lawn sprinkler valve box accessible from finished grade. Force Main Len th ~ (J Ft• • • • • • • • • • • • • Grade 6-8 Inch Lawn Sprinkler Valve Box Page of 03/0519) Cross Section And Pump Performance Specifications Septic-Dose Tank C Pump Manufacu= Tack Manufacturer pump model Number j Z Tank ltriodei Number i Alarm h~~udr 5 Total Tank Capacity d1 Alarm Model Number L- Max. Bury Depth Switch Type c Depth--c Head (TDH) -Feet Total Filter Manufacturer ~i~ Elevation Head Filter Model Number i Distal Pressure Network Loss Minimum pump ferformauce Required Force Main Loss GPM 3 Ft TDH Total t~ out manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade With Locking Device Locking Device. Inlet Manhole Securely Mounted < 6" Below Cede Sued Watertight Weath-proof Junction Box rs Fjnii ed Grade Vent Min. 12" Disconnect Above Grade Means With Vent Cap a~t~< putlet Filter _ - Inlet Inlet Baffle` A 1/e" Weep Switch and Hole Tank. Volume - : B al. Volume G Dimension: Inches (reserve) A g • C ff Elevatign C talazm) B 2 Ft, Bottom (dose} C. S 11 j D Ele on Ft Total . < < <; <'<,i a <; .>f>i1~ y;t<>a ;>;><1 >t>~i+Y: i i'l':i i a < < t • < < < . . • accordance with the < < dose tank is bedded and filled in 'back manufacturer may not GENERAL INSTAL. LTION: The um deed' of bury as. sped by the device (padlock) ifications. to gmde have an. effective locking ravel Spec manufacturer's product.app val Manhole covers exposed e0W to the tam with wght fittings, and be eked without prior aPPTO approved serial, ~ ~h, 4p PVC to bridge the tank installed- piping at the inlet and outlet is of appr is sleeved with 4" cut settling or The force main Ties wi~iNEC_300 and Comm 16.23. laid on stable soil to pnw Electrical servtCe comp excavation and the sleeve is sealed watertight Page of 02105 U r TOTAL DYNAMIC HEAD/CAPAOTY PER _INUTE EFFLUENT AND DEWATERING HEAD CAPACITY CURVE MODEL 152/153 i i 152 t53 ~ MODEL ~ I rr w . , Uters ti e-, 'I t1eters I Gal. .l liters i Gol 50 69 i 251 77 291 5 153 10 I 3.1 61 231 1 70 265 4.6 53 201 61 231 12 40 1 t5 167 52 i 197 ~ ?0 I 6.1 iI 44 _ 25 7.6 34 129 42 159 30 30 9 , 23 87 33 125 tt 42 20 40 12.2 - - CD ',1,44 c1s5c8 l 10 I I 0 20 60 80 100 GALLONS ! 5 8 -I LITERS 160 240 320 - 3 27/32 0 / 80 FLOW PER MINUTE I 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS Q 3 27/32 I i . Tinted dosing panels available. ed with Electrical alternators, for duplex systems, are available and supp I i an alarm. are available for controlling single phase level control switches • Variable systems. • Double piggyback variable level float switches are available for variable II level long and short cycle controls. Sealed Clwik-Box available for outdoor installations. See FM 1420, • Over 130°F. (54°C.) special quotation required. j 12 /8 1571153 Series yI 'I Ib. Control Selection 5 1~° 1521153 MODELS Du lex I ~ 1 Model Votts-Ph Mode Am s Sim lex I sKZOS+ Non 8.5 t 2 or 3 N152 115 1 Included 2 or3 BN152 115 1 Auto 8.5 E152 239 1 Non 4.3 1 2 or 3 4.3 Included 2 or 3 ~52 15 1 Auto 115 1 10.5 1 2 or 3 SELECTION GUIDE ONtN1 115 Non 53 230 1 Auto 10.5 Included 2 or 3 back variable level float switch or double pg9Y~~ variable level float 5.3 .3 1 2 or 3 1. Single Pi99Y aE153 ~ 230 1 1 uo 5.3 Included 2 or 3 switch. Refer to FM0477. E1 Au to 2. See FM0712 for correct model of Electrical Attemator E-Pa . du p 3 3. Variable level control switch 10-0225 used as a control activator, specify P p CAUTION qualified Alt installation of controls. protection safety des should be followed the most or (4) float system. licensed electrician. A9 electrical and saafety co recent National Electric Code (NEC) andthe Occupabonal 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 70: P.O. BOX l 34 Manufacrurersol. . Louisville, KY 402560347 SHIP 70: 3649 Cane Run Road TY f7Pg jjNCf 1c9.g9 4 Louisville. KY 40211-1961 QLIQU r 0 (502) 77&2731.10) 924 PUMP /SUMP 1,0: FAX (502) 774 hitpJ/yyYyN2Oe(ler.com © Copyright 2000 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILEINFORMATION SYSTEM SPECIFICATIONS E Septic Tank Capacity al 0 NA Owner Q, Septic Tank Manufacturer ❑ NA Pemut DESIGN Effluent Filter Manufacturer ❑ NA p NA Effluent Filter Model ❑ Number of Bedrooms PARAMETERS i~ . 11 NA Number of Commercial Units NA Pump Tank Capacity ~S a( x, Manufacturer Estimated flow (average) Pump lank aVda ❑ NA Design flaw (peak), (Estimated x 1.5) alld Pump Manufacturer Soil Application Rate L? allda /ftZ Pump Model /L J J~Z ❑ NA Pretreatment Unit NA influent/Effluent Quality Monthly average` ❑ Peat Fitter ❑ Sand/Gravel Filter Fats, Oil & Grease (FOG) S30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD5) 420 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer Pretreated Effluent Quality Monthly average" Dispersal Cell(s) ❑ In round (gravity) ❑ -ground (pressurized) Biochemical Oxygen Demand (BODS) s30 m9/L El At-grade Mound Total Suspended Solids (TSS,) 530 mg/L ❑ er_ Fecal Coliform (geometric mean) s1W cfu1100ml ❑ Drip-line Maximum Effluent Particle Size Y, inch diameter values typical for domestic (non-ca ercla9 wastewater and septic tank effluent. Values typical for pretreated wastewater- Service Event ; ;contents NCE SCHEDULE Service Frequency At least once every ❑ months year(s) (Maximum 3 yrs.) ndition of tank(s) of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every 10 monthsyear(s) (Maximum yrs.) Clean effluent filter At least once every /W o months r(s) At least once every ❑ month ear(s) ❑ NA Inspect pump, pump controls & alarm C3 NA At least once every months ar(s) Flush lat~rats and pressure test A ❑ months ❑ year(s) C1 NA Oei~ At least once every other. At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS of the following licenses or Inspections of tanks and dispersal cells shall be made by an individual carrying one Maintainer, Septage certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS inspector . POWTS Maimaser or broken Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing hardware, identify any cracks or leaks, measure the volume of combined sludge and scum an oto~ check ~fore~ back up or ponding of effluent on the ground surface- The dispersal cell(s) shall be visually inspected chin of effluent on the in the observation pipes and to check for any ponding of effluent on the ground surface. The Po g ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. ts, and any The servicing of effluent filters, m nlcal or pressurized POWTS components, Pretreatby a meet certified components, other maintenance or monitoring at irltervals of 12 months or less shall be performed POWTS A servicg report shall be provided to the local regulatory authority within 10 days of completion of any service event START UP AND OPERATION products or other painting . For new construction, prior to use of the POWTS check treatment tank(s) for the presence of P If high concentrations are chemicals that may impede the treatment process and/or damage the dispersal cell(s). detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page - of For new sence of painting products or other chemicals thElt treatment tanks} for the pre START UP AND OPERATION if high concenfiabons are detected have the contents of thO construction, prior to use of the PO check dispersal cell(s). may impede the treatment process and/ orator ma prior to tank(s) removed by a septage servicing op use. excess wastewater will b System start up shall not occur when soil conditions are frozen at the infiltrative surface- er is restored the may fill above normal highwater levels. Whent in the backup or surface discharge of effluenR. During power outages pump tanks operator prior to restoring pow discharged er to the to the dispersal cell(s) in one large dose, overloading removed the ce11(s) and may rP um controls to restore Pnorms] ow levels To avoid this situation have 1 mb~er ntonpOWTS Maine iner to assistt inymanually operating the p P effluent pump or contact a P the area within within the pump tank. drive or ark vehicles over tanks and dispersal cells. aDo not drive or park over, or otherwise disturb or COm~ pOWT~~: Do not p mound or at-grade soil absorption e ~g the life of the 15 feet down slope of any im rove the performance and prolong diapers; disinfectants; fat; foundation Reduction or elimination of the following from the wc antibiotics; baby wipes; ottonat sewra Sbsdeg easers; dental floss; cigarette butts; condoms; grease; herbicides; meat scraps; medications; oil; Painting P (sump pump) water; fruit and vegetable peelings; gasoline; pesticides; sanitary napkins; tampons; and water softener brine. tem is propeoy ABANDONMENT steps shall betaken to insure that the sys When the PO sn complian with chapter Comm 83.33,' Wisconsi following n Administrative Code: and safely abandoned • Ail piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. a Septage Servicing Operator' • The contents of all tanks and pits shall be removed and properly disposed of by all tanks and pits shall be excavated and removed or their covers removed and the void space filled with scull, • After pumping, gravel or another inert solid material. I nt CONTINGENCY PLAN or must be taken, to provide a code come i~, 'P If the POWTS fails and cannot be repaired the following measures have been, replacement system; replacement soil absorption system. uii ed [3 A suitable re ent area hould bebp protected from diand may be sturbance and utilized and should not be infringed upon by req area has The m r comply with the e:i in setbacks fro from existing and proposed structure, tot lines and wells. Fa'tl~ a toRp%tee~~ sPpstems~ am will result in the e nHe se for a new soil and site evaluation to establish a suitable replacement effect at that time. advances in POWTS technology a due to replace the setback faaed,P051Vi"Sm ❑ A suitable replacemeps~lledfas a not last resort available holding tank may be n failure of the POWTS a soil and site evaluation ❑ site has not been evaluated to identify a suitable replacement area. fta Upob~ans Barring re ,f / must be performed to locate a suitable Splacement area. . it if no rto replacement area is available a holding tank may be installed) as last resort to replace the failed POWT removal of the biomat at the infiltrative struct piece iVlound and at-grade stx~ abso c~krt systems musrt comply withnthe rule in effect atlthat time. Reconstructions s ace. SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GAES ANDOR INSUFFICIENT OXYGEN. DO NOT EN DEATH MAY RESULT RESCUE O A C RGUMSTANCES ` ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MAINTAINER INSTALLER Name ~ Phone 7Phone ) j - LOCAL REGULATORY AUTHORITY SEpTAGE SERVICING OPERAT PUMPER Name S/• ~ Name phone Phone Wisconsin Administratn+e Code. This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), a = ~w i+ 1 F-I t I i1t, , l1li~iil I f ~ j l 1 i ~ ~ P - O c a i m oz I O Q CI4 8 0 c m Z 3 o a LU t✓ N f 1 ST. CROIX COUNT'S SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address r Property Address I/ P L3 R P ,1 u' t~ ~t z (Verification required from Planning & Zo g Department for ne ' construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location/,/ V., 1/4 , Sec. , T Z1 N R_/ W, Town of ~ L Subdivision //s 4)2 , Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # Volume , Page # Spec h y no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper finance consists of pumping out the septic tank every tbree years or sooner, it 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 §Comm 83.52(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 1/3 full of sludge. I/we, the undersigned bave 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 Commerce and the Deparhnent 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. I/we certify that all statements on this orm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the deed recorded in Register of Deeds Office. property described abZve Number of bedr455-7 ATU RE 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 deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed (REV. 08105) l