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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 592246 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: Tyler & Trisha Sellen TOWN OF SAINT JOSEPH 030-2089-50-000 CST BM Elev: Insp. BM Elev: Description: Section/Town/Range/Map No: -1.6 ` i BM k7 " 2- 65T 34.30.19.754 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic v ~ 7F4-iLA-11 it I Z,56 Benchmark • /AD Dosing 1 7S6 Alt. BM ~a. ~v cn, Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL. BLDG. Vent/to it Intake ROAD Dt Inlet lrT) Septic Dt Bottom Sd /A 216 Z. v Y t Dosing Header/Man. If ~ -7546 71; Aeration Dist. Pipe _ Holding Bot. System ?7 PUMP/SIPHON INFORMATION Final Grade Manufacturer r I - Demand St Cover Zd b~ GPM e l go Model Number AAJ 1-5-3 T a~ /o•-e TDH Lift. • Frictio Lots System Fie d TDH F • ~ . ~1 C. It I Forcemain Length Dia. i Dist. to Well e ' Zi SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. renc a PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 12- 1 /Z,,., ~ SETBACK SYSTEM TO _t P BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION ' Type CHAMBER OR re /Z- Z y UNIT Model Number: 1 DISTRIBUTION SYSTEM _ J Header/Manifold Distribution d y IX Hole Size Ix Hole Spacing JVAir In Pipe(s) * y•~ Length - ~ Dia Length Dia ~ Spacing 131> SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 4 Depth Over Depth Over \ xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 1 -Yes L] No p Yes No COMMENTS: (Include code discrepenciies, persons present, etc.) Inspection #1: -1 Inspection #2: Location: 1228 CTY RD I . ~ J "k, fd 4.N, ` i~- 1.) Alt BM Description 2.) Bldg sewer length = 2 ~ ~ ~W - amount of cover = n ' `PPS` Plan revision Required? ❑ Yes No Use other side for additional information. ~ /n ~ I ~ -1 ) SBD-6710 (R.3l97) Date Insepctor's Signature Cert. No. ~Qesr County c aE I - Safety and Buildings Division / . rn~ fl t 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co) P Madison, W) 53707-7162 2-2- Sanitary Permit Application ransactionNumbeerr In accordance with SPS 383.21O2 , Wis. Adm. Code, submission of this form to the appropriate go ev P is required prior to obtaining a sanitary permit_ Note: Application forms for state-owned POWT ub oject dress (if different than mailing ess) the Department of Safety and Professional Servies. Personal information you provide may be us or secondary 00 Purposes in accordance with the Privacy Law, s. 15. 1) m), Stats. ST GR L Application Information -Please Pri t AI Information N Property Owner's Name Parcel ii t9 -70 Property Owner's Mailing Ads Property Location C). 19 -Isq ✓ t t %,c ~.t Govt Lot X ,(City, She Zi Code Phone Numb A/ Section 1 1 JZrZti i` JAL - ir(~ I ~'1 ie o T -/_2 N; R E W IL Type of Building eck all that apply) or 2 Family Dwelling - Number of Bedrooms Subdivision Name / 6k a~r~wi1/ ❑ Public/Commercial -Describe Use per- I ❑ City of ❑ State Owned - Describe U e CSMNumber El Village of ~ ~ ~ Z Ion _ r~ -Town of _,2-[- III. Type of Permit: (Cbeck only one box on line A. Complete line B if applicable) Za e- A. 1 ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) / R. El Permit Transfer to New List Pre us ermit Number and Date Issued ❑ Permit Renewal Permit Revision ❑ Change of Plumber Before Expiration Owner IV. Typ~ ofPOWTS System./Component/Device: Che all that apply) Non-Pressurized In-Ground ❑ Pressurirsd In-Ground de ❑ Mound 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil ❑ Holding Tank ❑ ~ffierl)ispersal Component (expiai ❑ etreatment Device (explain) V. Dis ersal/T'rea eut Area Information: Design Flow (gpd) Des' Soil Application dsf) Dispersal Area Required (sf) Dispersal Area Proposed l S Elevation / VL Tank Info Capacity in Total #i of Manufacturer Gallons Gallons Units ~ 0 3 New Tanks Existing I'anl5 I m o , U rn ' I rn C7 Septic or Holding Tank i - Dosing Chamber l VII. Responsibility State nt- 1, the undersigned,, ' responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plui Signature MP/MPRS Number Business Phone N er Plumber's Address (Street State, Zip Co 6 VIII ounty a artment Use Only proved ❑ Di approv Permit Fee Date sued Issuing , t Signature $ ! OD 9 ❑ rven Reason for Denial DL Condt VfRqUeasons for Disapproval 1. Upl.~tark,E~'flt~tlrllltil°i"ni 3J Cdv1 {-;cry G ►~tPproJe.Q_ Glsper::o cell must all 1}e s tL.1c rs !rit mt0. -sec 1/ I/' • as par TtAr apemen! plan pro ndetl by Nlumbe: • ~L A a,('e- 1r~ tom/ ~-~a 0 /~G~rL; 2..AO Y~G1iir+s tentsmust,tepaint,ir11J / as pt #fpkW9 wd? 1 wfdinawm. Attach to complete plate for the system and submit to the County only on paper not less than 8 ir_ x Il ioches in size SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Tvler Sellen ADDRESS 2002 Pink Doawood Wav Green Bav Wi 54313 NW 1/4 SE 1/4S 34 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 95.5' DATE 4/27/17 BEDROOM 4 CONVENTIONAL AT-GRADE XX)< CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL -H.R.P. same as benchmark property Line fb ~l~a, B-2 B.M. Scale = 1/4" = 10' Grading is to be done to divert 3 acre parcel run-off away from system B-1 Well is to meet all WDNR setbacks 96' 4% Slope B -3 95.5' 95' Huffcutt Combo Tank O Area 15' below • system is to remain 94' undisturbed nd provided Alabel to be properly Pro 4 down covers bedroom roved warning House J 3 d _Poo P roperty Line xt Not to scale Cty Rd I v Risw~ DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 7\ GREEN BAY WI 54304-5211 j Q $ Contact Through Relay P http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary May 09, 2017 CUST ID No. 226900 ATTN.- POWTS Inspector SHAUN R BIRD ZONING OFFICE SPIA BIRD PLUMBING INC I 10 CROIX COUNTY 1432 120TH ST ST 1 1 CARMICHAEL RD D NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/09/2019 Identification Numbers Transaction ID No. 2944148 SITE: Site ID No. 836130 Tyler Sellen Please refer to both identification numbers, County Rd I above, in all correspondence with the agency. Town of Saint Joseph St Croix County NWI/4, SE1/4, S34, T30N, R19W Lot: 14, Subdivision: Deer Field FOR: Description: At-Grade (4 Bedrooms - New Construction) Revised Location Object Type: POWTS Component Manual Regulated Object ID No.: 1695648 Revision; Maintenance required; 600 GPD Flow rate, 36 in Soil minimum depth to limiting factor from original grade.- System(s): At-grade Component Manual, Version 2.0, SBD-I0854-P (N.03/07, R. 1/12), 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. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compactinaof 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, 1 SHAUN R BIRD Page 2 5/9/2017 the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 at-grade 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. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. 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). • A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest;ctwiscorlsin.gov SHAUN R BIRD Pa°e 2 5/9/2017 the site is too wet to prepare. If it crumbles site preparation can proceed If the site is too wet to prepare do not proceed until it dries. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizina to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 at-grade 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. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located 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). • 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 permi required by the state or the local municipality shall be obtained prior to commencement of c onstructi on/installation/op erati on. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services Payment S code: 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm ti.in.vanderleest@wisconsin.gov Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. r New Richmond Wi 54017 715-246-4516 Date:4/27/17 Owner:Tyler Sellen Location:NW 1/4 SE1/4 S34 T30 N,R19W Lot 11 Cty Rd I St. Joseph Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications Attachments: Soil Test Shaun Bird Signature- License number 226~O 'y ECSV=_! MAY Q 1 2017 1,NDUSTRY SFF?VIC Page 1 of 9 System PLOT PLAN PROJECT Tvler Sellen ADDRESS 2002 Pink Doawood Wav Green Bav Wi 54313 NW 1/4 SE 1/4S 34 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 95.5' 4/27/17 4 DATE BEDROOM CONVENTIONAL AT-GRADE XX)< CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H,R.P. same as benchmark / property Line L B-2 B.M. Scale = 1/4 " = 10 ~ Grading is to be done to divert 3 acre parcel run-off away from system B-1 Well is to meet all WDNR setbacks 96' 4% Slope B-3 95.5' 95' Huffcutt Combo Tank Area 15' below system is to remain 94' undisturbed Tank is to be properly bedded and provided Pro 4 with lockdown covers bedroom with approved warning House labels Property Line Not to scale Cty Rd I At-grade System Sloping Site Cross Section and Plan View 40, Dimension Feet 1.1••.•1.1.1.1.1.1.1.1 1•L•L•L•1.1•L•L•L•L•L•L•L•L•1•L•L•L•L•1.1.1.1•L•L•L•1•L•L•1.1• 'I A / ~•r•r•r•J•r•r r•r•r•r r J•r•r•r•r•r•r•r•J•r•r•J•r•r•r•r•r•r•r•J•r•r•r•r•r•r•r•r•r•r• 11.1.1.1.1.1.1+1.1.1.1 L•L•L•L•1.1.1.1•L•1.1+L•L•L•1.1.1•L•L•L•L•L•1.1•L•L•L•1.1•L•L• r•r•r•r•r•r•r•r•r•r•r•r'•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•J•r•r•r•r•j•r•j•r•r•r•r• 1.1•L•L•L•L•L•L•1•L•L•L•L•L•L•L•1•L•'L•'L•L•'L•°°•L•L•L••~•L,L'L,L'L'L'L'L'L•L'L'L'L'L'L':-.. r•r•r•r•r•r•r•r•r.r•r•r'•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•J•J•r•r•r•r•r•r•r•r•r• I B I' 1•L•L•1.1.1•L••L•L•,L,L,L•°,,L•L,L,L,L,•°,L,~y,+.,L,L,L•L•L•L•L.L•L•L•1.1_•L•L•'L•L••.•L•L•L• G ~•r•r•r•r•J•r•r•r•r•r•r•r+J•r•r•r•r•r•. •r•r•r•r•r•r•r•r•r•r•r•r•r•r r•r•r•r•r•J•J•r• 1/6 B rtir~1~J~1 ~r~11f~1 ~r~J~J1rtiJtiJ~rtiJ~r~JtiJ1JLJtiJtiJ~J~JLj~J~r~r,%j~J~J~J~r1r~r~r~J~JtiJtir~• I ,L+,L.L.,L,L.++•L,L••°,L,L•1,1,5„L,L°L,L+L,L•'L•5~•1.1.1•'.•'L•L•L•'L•L•L•L•L•L•L•L•L•'L•L•L•'L• '•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•r•r•r•r•r•r•r• I L A ,L•L•L•L,L,L+L+••,,L,•,••°,L,L•,L••,,1.5~,1,1,5.•'.•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•L•'L•L•'L• VV r.r'r•r•r•r•r•r•r•r•r.r•r•r•r•r•r•r•r•r+r•r•r•r•r•r•r•r•r•r'r•J•r•r+r•r•r'r•r'r•r• L•L•L•L•L•L•L•1•L•L•1•L•L•1.1•L•'L•L•L•L•L•L•L•L•L•L•'L•L•L•L•L•L•5.•L•L•L'L•L•L'L•'L•L' :Lj'Lj1?LfLj1:1?L?L~LfL:LjLJLjLf1?LrLj1?L?Lr1?Lr1?L?Lr1~1?tijLjLj1~1?L?L?L?L~L?L~L?L~L• I I ~,r,.7"r•r,r,r+r',.'°r',r,r•1'+j,j•j•j•r.r•r•r•r•r•r•r•J•r•r•J•J•r•J•.r•j•j•j•j•j•j•j•j•j• D 2.0 L•L•L•L••.•1.1•L•L•1•L••+•L•L•L•L•1•L•1.1.1.1.1.1•L•1.1.1.1.1.1•L•L•L•1•L•L•1.1•L•L••.• r•r•r•r•r•r•r•J•r•r•J'•r•r•r•r•r•r•J+r•r•r•l•r•r•r•r•j•r•J•j+j•j•j•r•r•r•j•r•r•r•r• I E 5.0 L~~tijti~~j~j~~~~~~~j~f•~jLjLfLjLfLf~f~~L ti• %j%~ r•1~. I r1•~1•~l+J ;I t•L•L•,L,L,L,,L,L,,L,S.,'.,L,'L,L,L,L,'L•'L,L,L•L,L,L,L°L•L•L•L•'.•L•L•L•S.•L•L•L•L•L.L•L•L•L• r.r.r•r•r•r•r•r•r+r•r•1'r•r•r•r•r•r•r•r•r+r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r• I L•L•L•L•L•L•1•L•1•L•L•••1.1.1.1.1.1•L•1•L•L•1.1•L•L•L•L•1•L•L•1.1•L•L•..1•L•L•1• L L 1 1 F 0.5 l•r•r•r•r•r•r•r•r•r•r•1'•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r+j•r•r•r•r•r•r•r•r•r• 1 r•J• 1 r• 1.1.1.1.1.1.1• L•L•L•1•L•L•1.1•L•L•L•L•1.1.1.1•L•L•L•1•L•L•1.1• 1.1.1.1.1°1•L• ~•r•r•r•r•r•r• ~•r•1'•r•r r•r•r•r•r•r•r•r•r•r•r•r•r•:•r•r•r•r•r• :•J•r•J•r'r•r• I G 1.0 I 1.1.1.1.1.1.1• L•1!1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1 1.1.1.1.1.1 l 1.1..1.1..1• I E t- 1 /6 B i~ W E - B L , L 411 % Slope r - = Plowed rtirti• = Clean aggregate 0 = 4 in. sch. 40 pvc I basal area rtirti, ' 1 /2 to 2 /2 in. dia. observation pipe Lateral with 2" Topsoil Cap aggregate over pipe Geotextile Observation Pipe G Fabric With Cap •r•rtirtir•r Ft Lateral Invert r. r.: +r.j.j.j+ `r.r:r.r.r.r+r•r r 1••.•1••. ••1.. . . 'L•L•1.1.1•L•L•L L L L Topsoil Cap rr•rrrr•rrrrrJrr•rrr•r•rrrr• " L 1.1 5 1 L1 L 1 1 rr•rrrr; 1.1 1 1 1.1 1 L L•L 1 rrrr•rrr•r•J F.rrrJrr;r;rr, " 1 1 1.11 L 1.11 L• L 1 r_.r _r~J J J•r•r •J r r ( •J J~ ' 11.1 1",tip 1j r , Ft Contour 1 1 1 L•1 1 •r r r r• r Jar . _ 1.1.1• •1• , L.1• = . ._,r:s j"j:j:j j:j: j. j. j. j. j. j.j.r. j. j.r•r ,4,1,1,1 1.1.1.1•L•1•L•L•1.1• D Plowed Surface Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After-the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative grow-th, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/051gj Page - of Pressure Lateral Layout Manifold One Lateral End .4 - Threaded Cleanout Lateral Turn-up -0 Plug Force Main i ll L Long Sweep 90 Bend r Pressure System Construction Distribution N' twork S ecifications Lateral Diameter In. Laterals are constructed of Schedule 40 PVC Orifice In. pipe. Orifices are drilled perpendicular to Diameter the with a sharp drill bit and face down. X Orifice S acin In. thpipe L Lateral Len th Ft. Lateral turn-ups terminate with a threaded • Force Main Di enclosed in a 6-8 inch ameter c_ In. ceanout plug and are diameter lawn sprinkler valve box accessible Force Main Length Ft' from finished grade. Grade •••••••::Q_:::: • 6-8 Inch Lawn Sprinkler Valve Box 03/05 lgj Page of _ Septic-Dose Wank Cross Section And Pump Performance Specifications Tank Manufacturer y-11 Pump Manufacturer Zo.j~ 1 Pump Model Number t 4. 'Tank Model Number , - Alarm Manufacturer • '7- Tow Tank Capacity Max. Bury Depth Alarm Model Number Switch Type Total Dynamic Head (TDH) - Feet Filter Manufacturer r;;,, Filter Model Number % Elevation Head Distal Pressure J Network Loss f Minimum Pump Performance Required Force Main Loss ~ • ~ ~ _ @ Ft TDH Total M. Outlet N[anhole Min. 4" .Above Grade With Manhole Min. 4" Above Grad; Locking Deg ice. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted Weather-proof l Junction Box Finished Grade --t I Vent Min. 12" Disconnect Above Grade Means With Vent Cap X, A Outlet Filter - Inlet wet Baffle - - - - - - - - - ttrigs and Reserve Capacity d S witch Se A Weep Tank Volume GPI ,1. Hole Gal. Dimension: Inches Volume B (reserve) A y> B. Off Elevation C (dose) C Ft Bottom (dead) D Elevation Ft > t Total ll_ -~-n; fT",1~rT ;:TF; TTT,-T~TT-S-~-F-nT-T :~~-[-F; -.z; .:a~ . . . . . ` + a ~ t.•a 1 2 t d t•< < t t << i<<<< > • ,,•;;Y a > > > s 1•>•/<Yt;Ia>a,a><,.`a>a aj.;<>'~ t1>< f 1l•ta < a>l lea>1~<><>f l<>1>1>t>t . a i . t 1 < < 1.1 < 1 l t><><><>lY<><><•/•1><•1>1.1 <>t•; a>1•<•V>a•t•a•a•i t•1 GENERAL INSTALLACION• The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and'outlet is of approved material, connected to the tank with watertight fritings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch_ 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28, r t' 02/05 U Page of TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING MODEL 1521153 ~I 152 157 MO SEL i w 50 iI Feet N.jeters Gol. 1 Lifers I cal. I, Uiers 261 i 5 t 5 j 69 77 291 153 10 3. i 61 I 231 70 265 12 40 152 11 5 4.6 53 I 201 61 231 ° 20 6.1 44 167 52 197 i ~ 30 25 7.6 34 129 I 42 i 159 z g _ 30 9.t 1 23 87 1 33 125 o I 35 - - ; 2 ~_8? r 20 40 t 1 42 12-2 o 1 1-ock Valve: 38.0 (11.6m 44IJ ft. ",Arn) 10 casoe I 1 0- 20 40 60 80 100 GALLONS r e t/° LITERS 0 80 160 240 320 _ 3 27/37 II I FLOW PER MINUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with a I i an alarm. • Variable level control switches are available for controlling single phase systems. I • Double piggyback variable level float switches are available for variable level long and short cycle controls. i • Sealed Qwik-Box available for outdoor installations. See FM1420.-, • Over 130°F. (54°C.) special quotation required. I I 2 1/8 r % t°, I 1521153 Series ! q -T 1521153 MODELS Contr ol Selection 1 5 Model Votts•Ph Mode Amps Sim lex Du lex t /8 N152 115 1 No 8.5 t 2 or sK2O6a BN152 115 1 Auto 8.5 Included I 2 or 3 r 1 2or3 I E152 230 1 Non 4.3 3 0 E1 52 230 Auto 4.3 Indu- 2or N153 115 1 Non 10.5 1- 2or3 SELECTION GUIDE BN153 115 1 Auto 10.5 Inclueci 2 or 3 E153 230 1 Non 5.3 t 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE153 230 1 Auto 5-3 Inciuderi 2 or 3 switch. Refer to FM0477. & caunON j 2. See FM0712 for correct model of Electrical ARemator E-Pak. All installation of controls, protection devices and w+nng should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most or (4) float system. recent National Electric Code (NEC) and the occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.0. BOX 16347 Louisville, KY 40256-0347 Manufacturersof. . SHIP T0: 3649 Cane Run Road ® Louisville, KY 40211-1961 Q /TYPUMPS s sw Z (502) 778-2731.1(800) 928-PUMP httpJ/www.zoell er. com ICY FAX (502) 774-3624 © Copyright 2000 Zoeller C Affrights reserved. n , rI POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner -f f al ❑ NA Septic Tank Capacity Permit # ~r Septic Tank Manufacturer NA )ESIGN PARAMETERS Effluent Filter Manufacturer O NA Number of Bedrooms ❑ NA Effluent Filter Model El NA Number of Public Facility Units NA Pump Tank Capacity j of ❑ NA I Estimated flow (average) al/day Pump Tank Manufacturer NA I Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer ❑ NA Soil Application Rate aUda !ft2 Pump Model J ❑ NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (6005) 120 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5950 mg/L ❑ Disinfection O Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) _<30 mg/L ?4A t-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 efu/100ml ❑ Drip-Line ❑ Other: iMaximum Effluent Particle Size Ye in dia, ❑ NA Other: ❑ NA Other. )rA', A Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other. ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency linspect condition of tank(s) At least once every: ❑ ;Kyear~ (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA ❑ month(s) Maximum 3 ) ❑ NA ilnspect dispersal cell(s) At least once every: year(s) ( Years 1--lean effluent filter At least once every: f; month(s) ❑ NA x ( ) Inspect pump, pump controls & alarm At least once every: p month(s) ❑ NA year(s) 1 lush laterals and pressure test At least once every: ❑ month(s) ❑ NA ear(s) ether. At least once eve ❑ month(s) ❑ NA every: ❑ year(s) ether: ❑ NA MAINTENANCE INSTRUCTIONS llnspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of ixmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. T'he ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local Regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of 1.he tank. shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 592 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thelt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO, tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area withln 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dram (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produclo; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with stilil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requhled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the noed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruleft in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologN a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation st be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed! as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OI A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER !Name Name Phone Phone SEPTAGE SERVICING OPERATOR UMPER LOCAL REGULATORY AUTHORITY Name y r rr.~. l.ka.~ z Name Phone Phone _.'1 This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. ;E cv Y a .Y .r> <+i 41 3 t t \ - 11 IIf~}h~ i O I , j' o F ~ c D f a~M'q. U z 11 ~~tt,,~~ 3 Q I LLU 1 i I i i rS - OLOS RECEIVES Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings APR of APR ,~rt. LAInce with Comm 85, Wis. Adm. Code County 'S/- Attach complete site plan ;aToft COM" x 11 inches in size. Plan must \ include, but not limit t int BM, direction and . l ) Parcel LD1 percent slope, scale o w, and location and distance to nearest road. Please print all information. Revie ed by Date i Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner .T-- s Property Location Govt. Lot 1/4 1/4 S N R / E or) ~N Property Owner's piling Address Lot # Block # Subd. Name of M City State Zip Code; Phone Number ❑ City ❑ Village Town Nearest Road ~j t,i d'i ~~~Jf ^ w) C ! c, c_ J L~= - a ^'c 4' r 1 F Cclnstru 'on Use: Residential / Number of bedrooms Code derived design flow rate GPD eplacement ❑ Public or commercial - Describe: Parent material '-f , X Z° Flood Plain elevation if applicable General comments and recommendations Z _ h ) i System Type/` System Elevation F T1 Boring # Boring. / pit Ground surface elev. t ft. Depth to limiting factor ! in. Soil APplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 r 0 / IY % G•~ It: 1 Boring # Boling r, Iht Pit Ground surface elev. C` ft. Depth to limiting factor f in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 0 (Z. 1 1 ad h 2,2 L Effluent #1 = BOD_ > 30 < 220 mg1L and TSS >30 < 150 ' Effluent #2 = BOD, < 30 mg& and TSS < 30 mg(L CST Name (Please Print) ature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401 ' 715-246-4516 Property Owner Parcel ID # Page of Bori# ❑ Boring ~--D J Pit Ground surface elev.9 I- Z- ft. Depth to limiting factor > in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 C } 1,4 Li.Zza4 . J ✓ I r- r' 3 7-Y F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Effluent #1 = BODS > 30:S 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BODS < 30 mg/- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SOD-8330 (8.6/00) Property Owner Parcel ID # Page of 3 Boring # ❑ Boring Pit Ground surface elev. Depth to limiting factor ( in. Soil icatim Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2,3'7 e G / r --S 3M t Y 7j El Boring # [3 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 GPDtfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I i ❑ i Boring # Boring Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon ')epth Dominant Col Redox Description. Texture structure consistence Boundary Roots GPDRF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sBD-8330 (8.600) Tyler Sellen Soil Test Plot Pla Project Name Sh Bird Address 2002 Pink Dogwood Way Green Bay M 54313 M #226900 Lot 14 Subdivision Deerfield Date 4/27/17 NW 1/4 SE 1/4S 34 T 30 N/R19 W Township St. Joseph F] Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation 95.5' *HRpSame as Benchmark Property Line B_ B.M.* Scale = 1/4" = 10' 3 acre parcel B-1 4% Slope 96' B-3 95' 94' Property Line Not to scale Cty Rd I I 6`}°°~T+rt''~o County J JYL / o Ertl Safety and Buildings Division ; 201 W. Washington Ave., P.O. Box 7162 s anirary Permit Number (to be filled in by Co.) Obi 7lx etU1 ~1n Madison, W1 a507 X162 yC/ -~a t t tY` d~i ~ Sanitary Permit AppiwatIUI1 iie Transaction Number In accordance with SPS 383.21(2), Wis. Adm Code, submission of this form to the appropriate governmental unit 9 Z 6 36 (40 is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing adir s) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary 111 purposes in accordance with the Privacy Lavas. 15.04(1) m), Stats. L Application Information -Please *AlInformation Property Owner's Name y. Y Parcel # O Property Owners ling Address Property Location of CC/carp Govt Lot City, State Zip Code Phone Number '~y Section l (2A, a.. S le e) H. Type of Build' (check all that apply) Lot # R E W or 2 Family Dwelling - Number of Bedroo Subdivision Name n ~ lock # ~ Q G~ L9 r~ . ❑ PublidCommercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM N ❑ Village of ~A~) own of III. Type of Permit: (Check only one box on line A. Complete line B if applica A. ew System ❑ Replacement System ❑ Treatment/Holding T R ent Only ❑ Other Modification to Existing System (explain) B- ❑ Permit Renewal El Permit Rev lion Change of Pllm Permit Transfer to New List Previous Permit Number and Date ]slued Before Expiration er /101, IV. Type ofPOWTS S stem/Com onent/Device C c- t I' Non-Pressurized In-Ground ❑ Pressurized In-Groun ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ er Dispersal Component (explain) Pretreatment Device (explain) ` V. Dis rsal/Tren ent Area Informaton: Design Flow (gpd) Design Soil Application Rat f) D ersal Area R e4uired (s D.~'persai Area Propo (sf) System Elevation ~ ~ /L~~C7 f l~ . l VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a 2 ° T New Tanks Existing Tanks \-J ~ C ) m d N m inn Septic a Holding Tank Dosing Chamber/ let VII. Responsibility Statement- a undersigned, assu res risibility for installation of the POWTS shown on the attached plans. Plumb' Name ~int1 n Plumber' e MP RS Number Business Phone N er f 4 2Z 7 Plumber's Address (Street, City, State, Zip- Code 17> /4 VIIL C untv/De artment Use Only proved. Permit Fee Date ysued Issuing. t Signature er Giv Reason fo %DenW S 1-7 IX Conditt1 494 e t:!1i on r I?ispproval 3 e~~onS G i = :sn 'ti ;per c., X 99 Y ost all t e tic s ~nt~'-e L J as per nar3gemeM pl«n p!v nae t by PhTn_be Z. AN xvtlaack recU". gents must W: 17«nnt tr,e-i as pw **AWAW cant I 414MAM Attacb to wmpkte plans for the system and sobmrt w the County oalp oa paper sot less thaa 8 rrz z 11 rashes in sin SBD-6398 (R 11/11) System PLOT PLAN PROTECT Tvler Sellen ADDRESS 2002 Pink Doawood Wav Green Bav Wi 54313 NW 1/4 SE 1/4S 34 /T 30 N/R 19 W TOWN Saint Joseph COUNTY ST. CROIX SYSTEM ELEVATION 100.5' 3/1/17 DATE BEDROOM 4 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION loo' Filter Lifetime Filter ❑ BOREHOLE O WELL *1-1,R.P. same as benchmark Property Line 100.5 101, Grading is to be done to divert 3 acre parcel 100' run-off away from system 99' , B-10 ae = 1/4" = 10' r B-3 7% Slope i o meet all R setbacks Area 15' below system is to remain undisturbed 0 Huffcutt Combo Tank B-2 Tank is to be properly bedded and Pro 4 provided with lockdown covers with Bedroom approved warning labels House Cty Rd I p. I ~o~r*R?~~ Fyn DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 IqGREEN BAY WI 54304-5211 S I Contact Through Relay 5 P S http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~Essro* A% Scott Walker, Governor Laura Gutierrez, Secretary March 14, 2017WE CUSTIDNo. 226900 ATTN: PO WTS Inspector E ,I~E~ SHAUN R BIRD ZONING OFFICE a 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: 03/14/2019 Identification Numbers Transaction ID No. 2920356 SITE: Site ID No. 836130 Tyler Sellen Please refer to both identification numbers, County Rd I above, in all correspondence with the agency. Town of Saint Joseph St Croix County NWI/4, SE1/4, S34, T30N, R19W Lot: 14, Subdivision: Deer Field FOR: Description: At-Grade (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1695648 Maintenance required; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), 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. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling, a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Divert surface water from POWTS Area. L ~ SHAUN R BIRD Pa,-e 2 3/14/2017 • 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) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 at-grade 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. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. 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/instal l ati on/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 cltim This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov I SHAUN R BIRD Page 2 3/14/2017 • 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) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan Anv chances may result in pump resizin2 to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 at-grade 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. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. 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 erat ion. 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 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer ,Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:3/1 /17 Owner:Tyler Sellen Location:NW 1/4 SE 1/4 S34 T30 N,R19W Lot 14 Cty Rd I St. Joseph Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross SPCtion 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications `1 Attachments: Soil Te Shaun Bird Signature License num (7~ 6900 ECENE LIAR 0 12 017 MDUSTRY SERVICES Page 1 of 9 System PLOT PLAN PROJECT Tvler Sellen ADDRESS 2002 Pink Doawood Wav Green Bav Wi 54313 NW 1/4 SE 1/4S 34 /T 30 N/R 19 W TOWN Saint Joseph COUNTY ST. CROIX SYSTEM ELEVATION 100.5' DATE 3/11/17 BEDROOM 4 CONVENTIONAL AT-GRADE )00( CONVENTIONAL LIFT HOLDING TANK _ MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE •6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line 10. 100.5' 101, Grading is to be done to divert 3 acre parcel 100' run-off away from system 99' B-1 Scale = 1/4" = 10' B.MA B-3 7% Slope Well is to meet all WDNR setbacks Area 15' below system is to remain undisturbed ❑ Huffcutt Combo Tank B-2 Tank is to be properly bedded and Pro 4 provided with lockdown covers with Bedroom approved warning labels House Cty Rd I