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HomeMy WebLinkAbout024-1009-10-025 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 592221 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] State Plan ID No: . Permit Holder's Name: City Village Township Parcel Tax No Andy & Holly Heinbuch TOWN OF PLEASANT VALLEY 024-1009-10-025 CST BM Elev: Insp. BM Elev: BM DescriptQn rpm Section/Town/Range/Map No: C 06.28.17.47A-25 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE a. CAPACITY STATION BS HI FS ELEV. Septic - Benchmark /04D Dosing O 0 ~ ~ Alt. BM ~a I a ~ZS Bldg. Sewer A q3. ~ Holding SUHt Inlet IZ•a7 9Z •4~ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. ent to Intake ROAD Dt Inlet Septic i Dt Bottom 93 137, - h,63 W. Dosing ! I 32,, 30 Header/Man. 7.3 Aeration Dist. Pipe 162.3 z. Holding Bot. System PUMP/SIPHON INFORMATION Final Grade r,L,~y 7 Manufacturer -r Demand St Cover d GPM t tt, J~, 3-> Model Number z7. 11 TDH Friction Loss ;j System Head TDH Ft x Forcemain Length Dia. 1( Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length NoTren a PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM'TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typ System: CHAMBER OR UNIT Model Number: DISTRIBUTION SYSTEM Header/Manrfol. r, Distribution a x Hole Size ix Hole Spacing Vent to Air Intake . / Pipe(s) Length Dia Len th 9 ..:Dia ~ Spacing ; _ T- SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only - a Depth Over Depth Over _7T Depth of Ixx Seeded/Sodded xx Mulched BedlTrench Center ::7 Dedlfrench Edges psoil Yes No S Yes ❑ No COMMENTS: (Include code discrepencies, ersons present, etc.) Inspection #1: Inspection #2: Location: 519 CTY RD J j , 1.) Alt BM Description = ~~.C~JL 00 2.) Bldg sewer length = yS 10/4D Li -amount of cover = .0 11 Plan revision Required? ❑ Yes J 0 NO Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. County R~~~~ Y G Safety and Buildings Division St Croix 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) ~QN ~ ~ Madison, WI 53707-7162 ~ I ZzZ ~ ~~MMIj!1iaY,~! ~el'~ Apph State 'I'rausaetionNnmber In accordance with SPS 383.21(2), ~ltis. adm. Code. submission ital unit 285266 is required prior to obtaining a samtar~ permit Notz: Apphcatioi ~ ~ ~ _ _ __.,..utted to pro ~t _ dress (iC different than mailing address) the Department of Safety and Professunral Szi~lces. Pei sonal infer, mason ~ ou provide may b~ used for secondary pu oses in accordance with thz Ynvac_v Law, s. I ~.04(1)(m), Slats. I. A lication Information ase Print All Information Co. Rd. J I'ropzrty Owner's Nana ~ Paree] _ _ p Andy & Hollti Heinbuch - - - ~ ~ Propzrtp Owner's Mailing Address Propert~~ Location G 62l 170' St. Govt. Lot SW SE City, State Lip Code Phone Number ''a. ' Section 06 ~ (circle one) Hammond. WI 54015 T 28 _ N; x _ _ 17 II. Type of Building (check all that apply) I,ot Subdivisiun Name I or 2 Family Duelling -Number of Bedrooms _ 4 _ 1 ~ Block I~ Public/Connnercial -Describe Use CSM VOl. 27. Pg. 6298 Na ❑ Cite of - State Ownzd - Describe lisz ~ - ❑ ~illa>cof ~ CSNI Number g' 1041096 ❑ Town oP Pleasant Valley ~W OJ IiI. Tti~pe o crmit: (Check onh• one bos on line A. Complete line B if applicable) New System ❑ Replacement System ❑ 'I7eatmzntrHolding "Cask Replacement Onl}' ❑ Other \4odi[ication to Existing System (zsplain) I;. ❑ Pem~it Renewal ❑ Permit Revision List Previous 'emit Number and Date Issued ❑ Change of Plumber ❑ Permit Transfer to h?zw Before F,xpiration Owner IV. Tv e of POWTS Svstem/Com onentlDevice: (Check all that a Iv) 1 ~ Non-Yressurircd In-Ground ❑ Pressurized In-Ground ❑ .lt-Grzde ❑ Mound 24 in. of suitable soi I Mound ~ 24 in. of suitable soil Holding Tank ~ ~ (hher Dispersal Component (explam)_- ❑ Pretreatment Dzvica (ztplain) ~ ~ ~ V. DispersaUTreatmentAree Information: PolyLok P1-~25 eftluent filter to be installed at ST outlet Design Plo~~~ (gpd) Design Soil application Rate(gpdsf) llispzrsal Area Kequired (sC) Dispersal Area Proposed (s _ ~levation 1.0 Gpd/sq. ft. ASTM-C33 sand 01.83 at 16" above 600 Gpd 0.6 Gpd/sq. ft. native soil 600.00 sq. ft 600.00 Sq. Ft VI. Tank In}o Capacity in Total ?I oC Manufacturer ^J Gallons Gallons [ Jnits v ^ V J ~j \zw Tanks t?xisting Tanks 'v ~ v ~ ~ a r J s ~7 Q. s~Ft~~ o~ xow~„~ rank Na 1200 1,200 1 Wieser Concrete X nosing chamber Na 800 800 1 Combination ST/PC X VII. Responsibility Statement I, the enders' ned, assume responsibiflt ~ ~ r installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber s Signature MP%MPRS Number Business Phone Number James K. Thompson ~ - NIl'RS 30021 (7I5) 248-7767 Plumber's Address (Sheet, City> State, 7' `odz} 340 Paulson Lake Lane. Osceola, Wi _5x020 VllI. ountv/De artment Use Only Approved ❑ Per~mji~t Pee Datc sued Issuing ~ ent Signahuz Q~I1lZL ~ ~ r eason for D~ ~al S r' ~ ~ ~ ~ IX. Condi _ "r' easons I2ir Disapproval 3 / ~d Ct,~° ~ lark e~f1ts61alllRr' ;°n i cyan. • ~'t tNSpar . ~ cell nuW(~II Ese s x _s! ~ t~;' . •i1~. ~ !~l ~ i ~ ~ gs per ;naray~Mn! pion p~c ~~a~+M UY plu~t~pe;. ~ 2. dents m~a;rt r~tz ~nRlr is € ss gr;wp~pblt! 1;~edinan4~ir, S13D-Ci3~1K(IZ. I1/11 i S ~Xi1~i~(~ ~radt ele% 5ca/e: vo' ra s ~~o/oXi E/ o~/Oro/4oSLC/~irt ~~pp S6.CM k(~., cJ/, Y ~1 i 3 -17 / ioP a1 % 'sue • s~o ~I,\~ / pvcPi/s2. Assu~ ~('p/(JO 3 e.d u.7 C¢So✓ ~n c / c~L CoM6;na"°r l.sus Prop•~" dry u< LJc.y ~--aje ; "At~MlJ-n~sss~ R✓Gj I I _ _ I I ' / oscd 1', ' Pro osc ~ I ; ,P s'dehca I ~ 4,~,// /oC4fi w+ I I I r .sa ~z P.9o~io Residential Mound POWTS Index & Title Sheet Project Name: Heinbuch 4 Bedroom Mound Owners Name: Andy & Holly Heinbuch Owner's address: 621 170th St., Hammond, WI 54015 Site address: XXX Co. Rd. J Project Location: Subdivision: Lot 1, CSM Vol. 27, Pg. 6298 Legal Description: SW%SE%, Sec. 06, T.28N., R. 17W., Town of Pleasant Valley, St. Croix Co., WI. Parcel ID 024-1009-10-100 Page 1 Index and Title Sheet Page 2 Treatment Tank Cross Section Page 3 Filter Specifications Page 4 Septic Tank Maintenance Agreement Page 5 Certified Survey Map Page 6 Warranty Deed Attachments: State Approved Mound Design Mater P er ricted Service: James K. Thompson, DSPS Credential 21 Signature: / Date. 2-0,17 Page 1 of 6 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01) ~pE4~RT^1F-~~ DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN ® HOLMEN WI 54636-9466 a Contact Through Relay Sp r K http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~~Po sS101SN See Scott Walker, Governor Dave Ross, Secretary January 03, 2017 CUST ID No. 30021 ATTN: POWTS Inspector JAMES K THOMPSON ZONING OFFICE ACE SOIL & SITE EVALUATIONS ST CROIX COUNTY SPIA 340 PAULSEN LAKE LN 1101 CARMICHAEL RD OSCEOLA WI 54020-5413 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/03/2019 SITE: Identification Numbers Andy and Holly Heinbuch Transaction ID No. 2885266 County Rd J Site ID No. 834553 Town of Pleasant Valley Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. SWIA, SETA, S6, T28N, R17W FOR: Description: Four Bedroom EZFlow Mound System / Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1685029 Maintenance required; 600 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade System(s): EZflow Mound Component Manual, (R. 7/12), 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. CONDITIONI No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, APPROVI stats. DEPT OF SAFE The following conditions shall be met during construction or installation and prior to occupancy or use: PROFESSIONAL Reminders ),VISION OF IND S1 • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be ma SEE RRES the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. l _ i JAMES K THOMPSON Page 2 1/3/2017 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Oa Fee Received $ 250.00 "MS Balance Due $ 0.00 d wim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm JAMES K THOMPSON Page 2 1/3/2017 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Fee Received $ 250.00 Balance Due $ 0.00 Ord M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swirn@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i ~I 0 ~ } t EZflow C, MOUND AND PRESSURE DISTRIBUTION COMPONENT it.S l?016 Residential Application INDEX AND TITLE PAGE Project Name: Heinbuch 4 bedroom replacement mound Owner's Name Andy & Holly Heinbuch Owner's Address: 621 170th St., Hammond, WI 54015 Property Address: xxx Co. Rd. J Legal Description: SW1/4 SE 1/41, Sec. 06, T.28N., R 17W. Township: Pleasant Valley County: St. Croix Subdivision Name: Proposed CSM ALLY Lot Number 1 Block Number: Na =D ,TY AND Parcel I.D. Number: From pcl #024-1009-10-000 SERVICES ; RY SERVK- Plan Transaction No. Page 1 Index and title ' Page 2 Data entry t ,trL: Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Site Plan Page 10 Attached Soil Evaluation Report Designer; James K. Thompson License Number: 30021 Date: 11/29/16 ; Phone Number: (715) 248-7767 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) EZflow Mound Version 3.0 (R. 3/1/12) Page 1 of 10 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 3.50 Site Slope 100.50 installation Contour Line Elevation (ft) F 130.00 Contour Length Available (ft) 20.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 6.00 Cell Width (ft) 3, 4, 5, 6 7 8 9 or 10 Only 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) El Center or End Manifold 3 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.09 ft2/orifice 2.00 Forcemain Diameter (in) 60.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 6.50 System Head (ft) x 1.3 9.79 Forcemain Drainback (gal) 11.38 Vertical Lift (ft) 90.43 5x Void Volume (gal) 0.9 Friction Loss (ft) 100.22 Minimum Dose Volume (gal) ' 18.84 Total Dynamic Head (ft) 27.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x _ 1.00 1.50 x x_ i 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 800.64 Total Tank Capacity,(gal) 1200.00 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 22.24 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.64 Dose Tank capacity (gal) PolLok ~ __~Filter Manufacturer 22.24 Dose Tank Volume (gal/in) PL525 Filter Model Number Wieser Concrete Manufacturer Project: Heinbuch 4 bedroom replacement mound Page 2 of 10 Mound Plan View T 1 /10 B J Observation Pipe K 5 A s 1. B U I r" L Mound Component Dimensions A 6.00 ft E 18.52 in H [Aft ft K 10.32 ft B 100.00 ft F 12.00 in 1 ft L 120.63 ft D 16.00 in G 0.50 ft J W 23.89 ft 600.00 (ft2) Dispersal Cell Area 1620.11 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZf/ow Dispersal Area Finished Grade 103.83 (ft) ► F y•. Dispersal Cell g 102.33 (ft) Lateral 101.83 (ft)--► - 6" " : Invert Elevation : Dispersal Cell s 3 Elevation:::.::.: I: e~ x 4 _J 61 1 A 100.50 (ft) Contour Elevation 3.5 % Site Slope Typical Dispersal Cell Shading Key ~ See Page 5 M Topsoil Cap > 0 2 Subsoil Cap C' 2 2.0 ft Approved Geotextile Fabric Cover 3B 0 ASTM C33 Sand 0 0 ® Tilled Layer 5 EZflow Media s .c::r::,::: F cn 0 0.5 ft See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4'' gravity distribution pipes as shown on page 5. Project: Heinbuch 4 bedroom replacement mound Page 3 of 10 L End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below P • =Turn -up -edbaII valve or cleanout plug L - '1 1 M rritice 3oCatr d at Z ( X Griti es p'7Irl "I exGef7t ever 51 h One Points do.,~i i lot, draln age- . Fore^ rri:wi oonr*<ti~oin vii :kP cq gr0y ro rri. rnhallj it .cnil point LaHvrajs 6 folcv main o! F d 3c11 40 .All tateral~ iderli vviti i entices equally ~~ca d per SPS T:,bl., 3k3.~U1 Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 99.28 ft Orifices per Lateral 33 Lateral End (Z) 0.72 ft Orifice Density 9.09 ft 2 /orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 13.59 gpm Manifold Diameter 1.50 in System Flow Rate 27.19 gpm Forcemain Velocity 2.78 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in min. Disconnect Tank component is properly vented E-- Alternate outlet location Forcemain diameter MidWestern Precast Manufacturer 2 in. Capacity 800.64 Gallons -T Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon eevice A 17.99 400.18 B 2.00 44.48 C 4__Purnp of, elevation (ft) C 4.51 100.22 90.96 D 11255.76 D Total 36.00 800.64 Dose tank elevation (ft) Bedding And Backfill As Per Manufacturer 90.00 Alarm Manufacturer SJ _Rho_m_bus _i t Alarm Model Number SJE 1011421 Pump Manufacturer (Zoeller Pump Model Numbe BN151 Pump Must Deliver 27.19 gpm at 18.84 ft TDH Note: Switches containing mercury may not be used in this system. Project: Heinbuch 4 bedroom replacement mound Page 4 of 10 EZf/owo Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements 1 Component Legend r;1 SR1-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths 1. SR3-12H or EZ 1201 P or tier. SR3-12H in 5 ft or 10 ft lengths 4" Perforated Distribution Pipe With Pressure Lateral Inside Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 6ftWide End Manifold EZ- ® Project: Heinbuch 4 bedroom replacement mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name 5T_6r_oi_xC76 maes K. Thompson Phonei(715)_248-7_767 POWTS Regulator's Name u nty zoning Dept _ l Phone (715)386--4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Inspect and clean as necessary at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years Outer L Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 4 A 45 Degree Bends Same ~aEZflowSynthetic Media 3Diameter as Lateral ,.r ~1 x,11 is~.~..~) 1.94 Feet Distribution Lateral = Lateral Cleanout Project: Heinbuch 4 bedroom replacement mound Page 6 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Ad m. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZflow Mound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation, The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank- If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Wisconsin Department of Commerce Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned --No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.-' Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg,L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 Cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the syster in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. PUMP PERFORMANCE CURVE MODEL 151/152/153 TOTAL DYNAMIC HEAD/FLOW 5° PER MINUTE 74 45 153 EFFLUENT AND DEWATERING 12- 40 Q MODEL 151 152 153 = 70 152 Feet Meters Gal. uters Gal. Utws Gal. Liters 30 5 1.5 50 189 69 261 77 291 10 3.0 45 170 b1 231 70 265 Q e 25 151 15 4.6 38 144 53 201 61 231 ~~j s 6 20 20 6.1 29 110 44 167 52 197 25 7.6 16 61 34 129 42 159 30 9.1 - 23 87 33 125 4 35 10.7 - 22 85 to- 1 40 12.2 - 11 42 2 Shut-off Head, 30 ft. (9, 1M) 38 ft. (11.6m) 441E (13.4m) 5 31BSCe6 D 10 20 30 40 50 60 TO 80 90 1 GAl1DNS [MFRS 0 40 60 120 160 200 240 260 329 FLOW PER MIMJTE 014508A Model 151 Models 1521153 CONSULT FACTORY FOR SPECIAL APPLICATIONS 67- B 9 776 45+6 3 27732 45a • Tuned dosing panels available. • Electrical aftem rtors, for duplex systems, are available and supplied with an alarm. 37/83 27,'12 t ( • Variable level control switches are available for controlling ® 378 3 n.12 single phase systems. - - - • Double piggyback variable level float sv itches are available r forvariable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FhA1420. • Over 130•F. (54'C.) special quotation required. 15111521153 Series 1117716 12 IA 1 5 111 5 211 5 3 YODELS Control Selection T - Yodel Volts-Ph Mods Am Sim lax Duplex I S ;16 B N151 115 1 Non 6.0 1 2 or 3 4I BN151 115 1 Auto 6.0 Included 2 c(3 L L I E151 230 1 Non 3.2 1 2 or 3 BEt51 230 1 Auto 3.2 Inducted 2 or 3 SK2444 s ob N152 115 1 Non 8.5 1 2o(3 BN152 115 1 to 8.5 Included 2 of 3 E152 230 1 Non 4.3 1 2 air 3 BE152 230 1 to 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 to 10.5 Included 2 of 3 E153 230 1 Nan 6.3 1 2m3 SELECTIOt4 GU,DE BE153 30 1 Auto 5.3 Induced 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level ,'float O CAUTION switch. Refer to FM0477. All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electncal and safety codes should be followed including the most 2. See FM0712 for coned model of Electrical A ferna(a E-Pak. recent National Electric Code (NEC) and the Occupabonal Safety and Health Act (OSHA), 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. AMUM 77 YA1L T0: P.O. BOX 1G347 74 ' Louavilfe, ICV 402560341 071 Manufacturers of.. u 4' SHIP T0: 3649 Cane Run Road Lou swllk, KV 40211-1961 7 httpJ/wwwzoellelcom PUMP !O. 1(5O2) 77&2731 ' 1 (600) 928-PU,UP cI~~YPUMP9 SN~E /9~9 FAX (502) 774-3624 © Copyright 2004 Zoeller Co. All rights reserved. ~o F/~ EXi1~,?,C({~9 Ara-c~! s.lE✓. • . LoCatc~J~Oro~. St~ Sca/e: / sz fa n buck Ta"n do C~ 6!e r`r'a s ~ /o~o/oU E/ Lob/ oF~ro~Oo51~~~►t Sc.JYs/SEY~Scc, uG rz8/t. O i gA~ry~ C9r r /O`~ / h p(opd.S e Y c.oi aSa-✓ 6'.'c "c{c We P 1 Zca~9~ C°M6 rnn Lo~Pz SzS~ eA~14cn~ /t"a~S Propl~~clr~ucu)wysPo'~~J -Iajr? i /~A~M/J irBSS~-swp.✓~ 1 i Pro~aoscd y5~y ° ~ DauC 1 Q s, dencc Pra10 0,5 e- 0( 1 ~ ~ 4.2 So I P.9o~/O 7 fo Z 1~ M-M/ooila :31IJ 95 8-5Z~-008 0 \ :BnOd-iSOd H!31 00/00/00 31V0 OSL4S IM 'NOOa N301dW Ol lMH Sfl 9lLfM ibnNdw OIld3S w o~ :?md-add ,0-,1=,4l ADM :.18 NM`da0 3138O110D 0-008/00ZId-M N W 0 N ~ J Of J U Z > ° coo w o D of w w cn d U Q ) cn N r Z W P: LL) a m ° O ° F- (L pW ^ N Q w U) U W F- J W = FF--CL 0 O_ ¢ mV5 ompliQ ZZ D Wm ¢ HO w o z ~ Li o °ow ¢QU as < U m~ Z 3 ° > C m LL > V) o U O p O NO m(i ww C~GD O wP C) Z Z< to a s o° ca C6 p N x 0i N 0 ~v Y a a CD LL = pOO~M0 w NH ¢mww vi C-4 ° QUA rn Q 00 O U `f OF-_I~~ F'QQ NQ MN W 0F\ Z~ Y~ O ~ M<°w`nrnz~Mo Ncn z nop 0- ¢o M~ 3p= ° :D UI) VY OOW ¢ W mFN p0 pV C.D OG✓ a_ Y °ao oQwW 0-JCY~' ZZ°R a °Z~0 < CL p zwo x No! z z3m Omm: ~m~ ¢tc~ 0 Z 0(no o0 LLI Q w w ° ~ Y 0Y N Or 0 F- w Z Z ¢ Q v U N I H N w ¢ p U Z Z) „6~ 0 I O d T d a Z II ~J~ II III I; W II If iI II I Li ~I If. I I n N II ~ I~ s .III ~ 5 En II `~J/ 11 I I ¢ I 92 0 j l L m 14' I f. w I If II Q II 9 r w~ o F N W ~I ~ `N ~1 it III ~ o U M L- H D W Z J ¢ m 0038 „96 ¢ St/ „fig N Y Z H ;7:~Gt'z$lc3f'.4 N)~rBCBti, hifd UlnF~k ~N` Zdtk,'l~ du .$i Effluent F_ifter si-asterrattt t~¢oc;s A bl16ion of Pri;kk Sir,. 11,525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It bas 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily sbut oft the system so the effluent won't leave the tank. Features. 1/16" Filtration Slots • Rated for 10,(1(}0 GPD (gallons per day). 1 Alarm 13w ch • -25 linear feet of 1/16" fi ltration. X10,000 GPD (optional) Accepts 4" and 6" SCHD 40 pipe. Accepts 1" YVC- ;t Extension Handle Built in gas deflector. • Automatic shut-off ball when filter is removed. r Alarm accessibility. Riled for ?ter M • Accepts PVC extension handle.' • o.uuti i'1'D s I Ir525 fn4tallatias2 A Ideal for residential and commercial waste flows ap to 525 linear Et. x 10,000 gallons per day (GPD). of 1 16" Filtration Slot, 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. t 4 611, 3. Glue the filter housing to the 4" or 6" outlet pipe. If Accepts SCHll 40 pipe e the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. R q 5. Replace and secure the septic tank cover. .4 Certified to NSPIANst standard 46 IT-525 Nlahitenanc e: The PL-525 Effluent Filters will operate efficiently forri uia several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three.? years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified Gas Defte( tor septic tank pumper or installer. Automatic. 1. Locate the outlet of the septic lank. shift-011 Ball 2. Remove tank cover and pump tank if necessary. 3. Do not use Plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. ;M^ 5. Hose off filter over the septic tank. Make sure all i solids fall back into septic tatnk. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted. & t_o r„ Polylok, Zabel & Besl fillers accept Easil y installs 7. Replace and secure septic tank cover. the Smartfilter(?~ switch acid alarm. into existing tail Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.coi n P5.3 6-r/' 6 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ox,ner/Buver Andy & Holly Heinbuch Mailing Address 621 170th St., Hammond, WI, 54015 Property. Address XXX Co. Rd. J (C( A (Vc ritication required from Planning & Zoning Department for new construction.) Cite/State Parcel Identification Number 024-1009-10-100 LEGAL DESCRIPTION Property Location SW '/4 , SE V4 Sec. 06 T 28 N R 17 W. Toyvn of Pleasant Valley Subdivision Plat: Na Lot # 1 Certified SU,-vey Map # 1041096 Volume 27 Page # 6298 Warranty Deed # (before 2007)Volume Page # Spec house 0yes0io Lot lines identifiable Dycs❑rno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Pion ,_r maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What ~r 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 Countv Planning & Zoning Department a certification form, signed by the o micr and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site v.N,asteNvater disposal system is in proper operating condition and/or (2) utter inspection and pumping (if necessary). the septic tank is less than 1 /3 full of sludge. lAve, the undersigned have read the above requirements and agree to maintain the private sevyage 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 y to septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department withi 30 days of the three year expiration date. l/we certifv that all statements on t s form are true to the best of my/our knoi ledge. Uhye ajn/are the omler(s) of the property described above, by virtue of a wa anty deed recorded in Register of Decds Ollice. mbe of bedrooms 4 GNATURE OF APP ICANT(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 col)v of the certified survey map if reference is made in the xNarranty decd. (REV. 04/12) P~ y f o w n F,j s d - ° b-E Bi IIII I ID > Q igo ~I c L I yl J f I, l s- 10 III I ~ li l ~I f} t -sAu 1 LL I O< I o] Q I ~ IIII Illllllllllll I I t - W U` lillinu I I I II Ilan\n°lil ill ~ = L£~~. \IIIII ~ ~ ~ ~ ~ w I I III'lil''1111 1 III "111111 VIII lan1~~~~i~ I I: - VIII; - 11111;;1 II i ~ IIIII 11,111 I 'i I IIII II ~I ~I 11;1 Illrll,~ i r ~ I r , I T III,IIII ~ ~ 6~a ~ 1~1 IL- III -J - ~~1111111 II III~,~II11111111 I +11~~11111 ~ A I ~ I III (i~ n l uul.nuunl!I i I ~II IIIIIIIIII ~ f ~ ~ ~ I . I Iullllll'i'i I I - - o I ~ a I I III IIIII III / I Ilnlli~ilwlunil - 1I I I I, l i n ~ ~ 0 w ~c J CID T=p I N oD -0 fir, ° w f, I I Z a 2 LL J °w U G mo `taw ~ I -j ~_J I i I - -o m 1. I I I a~ ; I I ~ I' I ~y I k I ; I I I 1 I I I J, ~ G I o T m< II _ of ~II I 0 r I I I I I 1 I 0 I 0 d I I o I I I - I ' I I ; I I I I na ° z T= W co ~t o > ` w Cl) o~ Q C = V1 Q .c Z~ 0 d > W J m e f-I m a m u , n J e - ~ m 6 - f 7 m b m I~ 1 . ~A o n 'ter T'l . + - e s, ~I - e o .Y ~ r I - m ff I In I I. I I I r o li I III - W;sconsin Depart f~} ional Services - t?e 1 of 3 Division of Industr e L` r alb ~b SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code county Attach complete site pIan o t t 'U°dTl~ St. Croix x 11 inches in size. Plan must include, but not limited to: vet. 1, f c3ri nta' tY~+erfence tt (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 024-10 10-000 Ref #2454 Please print all information. Revi d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Property Owner Property Location ❑ Steven & Renee Heinbuch Joint Revocable Trust - Andy Heinbuch Govt. Lot SW % SE S 06 T 28 R 17 E (or) W Property Owner's Mailing Address Lot # Block # Subpd, ame or CSM # 1648 Co. Rd. Z proposed na Ped CSM City State Zip Code Phone Number ❑ city ❑ Village ®Town Nearest Road Hammond WI 54015 ( ) Pleasant Valley Co. Rd. N 4- New Construction Use: ® Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD F-1 Replacemen ❑ Public or commercial - Describe: 2-0 At, Parent material Glacial Till Flood Plan elevation if applicable na ft. General comments and recommendations: Site suitable for mound POWTS. Recommended infiltrative surface elev. to be 101.84' at 16" above 100.50' contour. 1❑ Boring # ❑ Boring ® Pit Ground surface elev. 100.58 ft. Depth to limiting factor 20" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 A 1 0-12 10yr2/2 none sil 2fgr mvfr as 1 vf,f,m 0.6 0.8 k 2 12-20 10yr4/4 none sicl 1fsbk mfr gw 1vf,f 0.2 0.3 3 20-26 10yr4/4 f2f 7.5yr5/8 sicl 1 fbk mfr gw 1 of 0.2 0.3 4 26-36 7.5yr4/4 f2f 7.5yr5/8 sl 1 msbk mvfr as 1 of 0.4 0.7 5 36-58 10yr7/2 m1 p 7.5yr5/8 vfs - SS Os ml resid. 9 0.4 0.6 saturated flow at 53" 2❑ Boring # ❑ Boring ® Pit Ground surface elev. 100.36 ft. Depth to limiting factor 29" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr2/2 none sil 2fgr mvfr cs 1 vf,f,m 0.6 0.8 2 12-29 10yr4/4 none sicl 1 fsbk mvfr gw 1 vf,f 0.2 0.3 3 29-49 7.5yr4/4 f2f 7.5yr5/8 sicl 2fsbk mvfr aw 1 vf,f 0.4 0.6 4 49-60 10yr7/2 m1 p 7.5yr5/8 vfs -SS Os ml Resid. g 0.4 0.6 * Effluent #1 = BOD, > 30:5 220 mg/ and TSS > 0 150 mg/L * Effluent #2 = BOD, > 30s 220 mg/L and TSS > 30 150 mg/L CST Name (Please Print) Signa re CST Number James K. Thompson = 30021 Address ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 October 11, 2106 (715) 248-7767 SBD-8330 (R04/15) 3 Boring # ❑ Boring ® Pit Ground surface elev. 99.59 ft. Depth to limiting factor 22" in. Soil Ap lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-14 10yr2/2 none sil 2fgr mvfr cs 1vf,f,m 0.6 0.8 A2 14-22 10ry4/4 none sicl 1fsbk mvfr gw 1vf,f,m 0.2 0.3 1, 3 f33-56 10ry4/4 f2d 7.5yr5/8 sicl 1 msbk mfr as 1 vf,f 0.2 0.3 4 10yr7/2 m1 p 7.5yr5/8 vfs -SS 0s ml Resid. g 0.4 0.6 saturated flow at 49" Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Ra Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30:5 220 mg/L and TSS > 30:5 150 mg/L Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30:5 150 mg/L I EX.3~iny c, ra do a/Lo'` t ~ O ,34Jys~SEys; See. 6, T. zf3r! 17a), TA. of ~/tom 5o+ ~f ✓ i y, ~ . crv,-~ ~v c.J! />c./, X015/-/~9-ia -cam i i h Q eo. /~wy, e l Pro po sad p'~j Side U ~ hD all o Ci 2 d b✓ / /r 83 / ~c (l t°ro o se d &o ~C , a e e s SEA e'er. ~~Z PJ.C.~o;pt. Ass4.n e eta=/ 3 04.3