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Home My WebLink About018-1096-19-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592248 GENERAL INFORMATION State Plan ID No: 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: Oevering Homes LLC T TOWN OF HAMMOND 018-1096-19-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 09.29.17.794 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number;' 'i TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHAMBER OR UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution Ix Hole Size 'r pacing Spacing Vent to Air Intake Pipe(s) y Length Dia Length Dia" Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil El Yes No ❑ Yes ❑ No ~ a COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: J''_1 tl~ inspection #2: Location: 1705 109TH AVE C } 1.) Alt BM Description = Y (J ~'~y 2.) Bldg sewer length= - amount of cover = Plan revision Required? ❑ Yes ❑ No J Use other side for additional information. LLLE Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) tlvru County s~ Safety and Buildings Division K q 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) `t 2017 Madison, W1 53707-7162 V COUNTY men= Permit State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate goveuuuc.,,_ ....it 3oc. is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary oses in accordance with the Pi Law, s. 15. 1 m), Scats. L A lication Information - Please Print All Info a Property Owner's Name / I Parcel # Property Owner's Mailing Ad Property Location y C.~i Govt t City; State ) Zip Code Phone Number Section 2- jr1pri yHA.Ype of Building (check all that apply _ Lot # T, N; R or W 2 Family Dwelling - Number of Bedr rns Subdivision Name BIo ❑ Public/Commercial -Describe Use Q V,O JSC~ ❑ City of ❑ State Owned - Desail Use J CSM Number ❑ Village of _ 5 0~ wn of Ill. heck only one box on line A. Complete line B if applicable) ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification :to Existing System (explain) ansfer to New List Previous Permit Number and Date issued Permit Revision Change of Plumber ❑ Permit Tr Owner I IV. Type ofPOWTS S stem/Com onent/Device: Check all that appj) 1 J ❑ Non-Pressurized In-Ground El Pressurized In-Ground El At-Grade ound > 24 in_ of suitable soil ❑ Mound < 24 in. of su T itahle soil El Holding Tank El er Dispersal Component ex lain ( P ) ❑ Pretreatment Device (explain] V. Dis rsaVrres ent Area Information: Design Flow (gpd) Design Soil Applicati e dsf) Dispersal Area Requ' (s Dispersal Area Propose S Elevation VI. Tank Info apacity in Total # of Manufacu= Gallons Gallons Units New Tanks F, e g Tanks ; ! U v 1~ o e U y U rn v rn c:. L Sepac or Holding Tank Dosing Clamber VII. Responsibility Statement- the undersigned, ass responsibility for installation of the POWTS shown on the attached plans. Plum s Name (Print), Plumb gnature MP/IvIPRS Number Busitress Phone Ntmm er cc~~ f Plumber's Address (Street, City; State, Zip Code _ (1 Z.. 1,--2, ~f. VMeounty/Department Use Only Approved ❑ Permit Fee Date ),sued Issuing. t Signature ❑ rven Reason for enial 31/2-7 17 DL Condi -ons for Disapproval - ✓1 ~ 1. Dept. , tank, etf ~"n fi t& WW X&e .6 t uispe►:t„i cell r lu$t aff titn nts roc: 1 , n . 1, YeA.A as per ; W3igement plan 1)0o sided by plumber. ~ i~^ I mo ` /l ~Vr ~ ` 2. =AN ppRolicra- n1 N col1ls rdi.n "KWAAW t 18il1tFlrE 1~`` ~10►~ r as per ~pF t bHl c r>rw rAi t1J1Ct]R. J ~ A- 7 F- Q~ Attach to complete plans for the system and submit to the County oul=otlesltba,18112z11iwhesinsize SBD-6348 (R. 11/11) System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 NW 1/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 99.5' 3/10/17 BEDROOM 3 DATE I~ CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of 1" pvc pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 109th st. Scalle = 1/4" = 10' 2 acre lot Tank is to be properly bedded and provided with lockdown covers with approved warning labels 170th St. 339' Property Line Well is to meet all Pro 3 WDNR setbacks Bedroom House Area 15' below system is to remain Huffcutt Combo Tank undisturbed Huffcutt Combo 3% Slope 98, Tank B-3 98.5' 99' B-2 B.M.* Il B-1 Property Line 2-- D 9 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 ( 0 ' GREEN BAY WI 54304-5211 13 s Ps' Contact Through Relay r http://dsps.wi.gov/programs/industry-services www.wisconsin.gov \~~OFES•sro:~ ati'~~; Scott Walker, Governor Laura Gutierrez, Secretary March 22, 2017 $O CUST ID No. 226900 ATTN.- PO WTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST l 101 CARMICHAEL RD / r NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/22/2019 Identification Numbers Transaction ID No. 2923025 SITE: Site ID No. 836411 Oevering Homes Please refer to both identification numbers, 1705 109TH Ave above, in all correspondence with the agency. Town of Hammond St Croix County NW1/4, NW1/4, S9, T29N, R17W FOR: Description: Mound System Q Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1697170 Maintenance required; 450 GPD Flow rate; 28 in Soil minimum depth to limiting factor from original grade- System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be construc'. and located in accordance with the enclosed approved plans and with any component manual(s) referenced above The owner, as defined in chapter 10 1.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • Divert surface water from POWTS Area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches Smearing and 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, SHAUN R BIRD Page 2 3/22/2017 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. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Anv changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragirments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cuI o at ground level. A larger fill area is necessar% when am of the above conditions are encountered, to pro% idL_ sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/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 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.vanderleestr(t"wisconsin.gov SHAUN R BIRD Page 2 3/22/2017 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. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Anv changes may result in pump resizing to meet TDH and GPM Specifications • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a heal t1h hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer ,Division of Industry Services Payment Submittal. WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vai-iderleest@wisconsin.gov Cover Page Shaun Bird "Y AND Bird Plumbing Inc..ICFS 1432 120th St. g New Richmond Wi 54017 715-246-4516 Date: 3/10/17 Owner:Oevering Homes Location: NW1/4 NW1/4 S9 T29 N,R17 W 1705 109th Ave Hammond Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specificati s and cross section AJ\ Attachments: So' st Shaun Bird Signature License n mb 226900 - L^' f(yp Page 1 of 9 System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 NW 1/4S 9 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 99.5' 3/10/17 3 DATE BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of 1" pvc pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 109th st. Scale = 1/4" = 10' 2 acre lot Tank is to be properly bedded and provided with lockdown covers with approved warning labels 170th St. 339' Property Line Well is to meet all Pro 3 WDNR setbacks Bedroom House Area 15' below system is to remain Huffcutt Combo Tank undisturbed Huffcutt Combo 3% Slope 98, Tank B-3 98.5' 99' B-2 B.M.* B-1 Property Line Mound System Cross Section and Plan View Dimension Feet J* T ~ A r_ J D 1.1.1.1.1. .lfM1jijM1:litifti: t: tif•1 f 1f1 .f1 E tij11tij1 f1f1f1.1f1.1.11111:\jti~Yti~tirti~ti:ti:tityr fyflj~jtij;f ' f A ~ .riry.1.1.1. 1:1:1rti.1.h~1.ti:ti?ti.i.1%ti.1~1:i:i~1~1~tir1r. y\y~t~[.f•f•T•f•t.J.f.f.f.f.f.f.f.f.r.fJ.J.f.f.f.1.f.f.f~r~l~.•'~r:l~r~~~f~l:f:l:l:t~•l:f:r1l:l'r'r'r~r:J~l'•f4f~f I •~Yi.~1~L 1 1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1. 1j1r1.1.1j1j1.1j1.1.1.1.1• F W ~ l G J H i , I t i I r. J . J K C i L P V ♦ ♦ W -s K -T B Z , L Slope % - = Topsoil = ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc f1f1r~ Cap Material sand fill "rr 1/2 to 2 1/2 in. dia. observation pipe Geotextile G H Fabric f.f...;•r•r.f,.. F 1 111f1r1.1.1. ~ ~ _ rt D E 7 7 7 Plowed Surface. c- - Ft Contour Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07lgj Page of i Pressure Lateral Layout Two Laterals - End Manifold 4 Threaded Cleanout Lateral Turn-up Plug Manifold M X L Long Force Main 1 Sweep 90 Bend Distribution etwork Specifications Pressure System Construction Lateral Diameter Z In. Manifold Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter If' In. pipe. Orifices are drilled perpendicular to X Orifice Spacing) In, the pipe with a sharp drill bit and face down. L (Lateral Length) Ft. Lateral turn-ups terminate with a threaded M (Manifold Len th} Ft. ceanout plug and are enclosed in a 6-8 inch Force Main Diameter In. diameter lawn sprinkler valve box accessible Force Main Len th Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box Page of 03/051gj Septic-Dose Wank Cross Section And Pump Performance Specifications Tank Pump Manufacturer - Manufacturer Model Number Pump Model Number 20 Total Tank Capacity Alarm Manufacturer Max. Bury Depth Alarm Model Number t/ Switch Type rr_r C,x Filter Manufacturer i . Total Dynamic Head ('TDH) -Feet Filter Model Number j Elevation Head Distal Pressure Network Loss i Minimum Pump f erformance Required Force Main Loss GPM Ft TDH Total outlet Manhole Min. 4" Above Grade With Manhole min. 4" Above Grade Locking Deg ice. Inlet Manhole securely mounted With Locking Device b" Below Grade Sealed Watertight Weather--proof l Junction Box Finished Grade sow ~ Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter inlet A-, Wet Baffle X. i~4» ' A Switch Setgngs and Reserve Capa~cit3' Weep Tank Volume = GPI Hole Volume Gal. B Dimension Inches .w (reserve) A O Elevation C (alarm) B 2. X Ft (dose) C o Bottom - D Elevation (dead) D Ft •.•r::: Total L a r, ~ 7 7. is bedded and back filled in accordance with the GENERAL INSTALLATION: The septic/dose tank roval specifications. Maximum depth of bury as. specified. by the manufacturer may not manufacturer s product app have effective locking device (padlock) be exceeded without prior approval- Manhole covers exposed to Wade watertight fittings, and and outlet is of approved material, connected to the tank with PVC to bridge the tank laid on stable soil w prevent settling or sagging. The force main is sleeved with 4 1. 1 excavation and the sle®ve is sealed watertigbt. Electrical $eevice complies with NEC 3,00 and Comm 16.2:x. Page -:2- of , 42105 L7 TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING Ln I ' MODEL 152/153 MODEL i t52 153 w I I, Uters 50 Feet i Meters Go!- Liters Gal. 5 1,5 fig 261 i 77 291 153 10 j 3.1 61 231 ' 70 265 12 40 152 15 4.6 53 l 201 61 231 0 20 _I 61t 44 167 52 197 i '27.6 34 129 42 159 30 l 23 87 33 1 125 9 8 30 , 42 20 40 I 12.2 -ter o L6m1 44.0 Ft. 3.4 ck Voive j 38.0 4 ,o D145W ;I I i ~ 0 20 60 80 100 GALLONS 6 t/4 80 160 240 320 3 27/2- LITERS 0 FLOW PER MINUTE -7/32 I i , ' it I CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 • Timed dosing panels available. a I Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable j - level long and short cycle controls. j Sealed Qwik-Box available for outdoor installations. See FM1420. - Over 130T. (54°C.) special quotation required. I - I 12 1/8 .1 r- 1521153 Series ~l ~l I j 1521153 MODELS Control Selection 5 t/8 Model Volts Mode Am S Sim lex Du lex Ph 4 2 N152 115 1 Non 8.5 1 or3 sK2asa BN152 115 1 Auto 8.5 Included 2or 3 [ E152 230 1 Non 4.3 1 2or 3 BE152 230 Auto 4.3 lnclu~ed 2or3 N153 115 t Non 10.5 1 1 2or 3 SELECTION GUIDE BN153 115 1 Auto 10.5 Inducted 2or 3 back variable level float 1 2or 3 I. Single piggyback variable level float switch or double piggy E153 230 1 Non 5.3 5.3 Included 2or 3 switch. Refer to FM0477. BE153 230 1 Auto 2. See FM0712 for correct model of Electrical Alternator E-Pak. A CAUTION 3. Variable level control switch 10-0225 used as a control activator, specify duplex All installation of controls, protection devices and wrong should be done by a qualified . float system licensed electrician. All electrical and safety codes should be followed including the most or Variable recent National Electric Code (NEC) andthe 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 70: P.O. BOX 16347 r / Louisville, KY 40256-0347 Manufactwersof.. SHIP T0: 3649 Cane Run Road ~NCf ~~c~c9 Z Louisville, KY 40211-1961 Ql[dUTY PUMPS ® (502) 778-2731.1(800) 928-PUMP ~C7VM/ `iO. FAX (502) 774-3624 httpJ/www•zoetl er.com Q Copyright 2000 Zoeller Co. All rights reserved. 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page--_of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity al ❑ NA 1 Permit Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms L> ❑ NA Effluent Filter Model ! ❑ NA Number of Commercial Units 16FNA Pump Tank capacity "a al 11 NA Estimated flow (average) -f C ~ gal/day Pump Tank Manufacturer ' ❑ NA Design flow (peak), (Estimated x 1.5) aVd Pump Manufacturer 2 ❑ NA / Sol! Application Rate 11 _7 al/da /ft2 Pump Model j ❑.NA Influent/Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Grgvel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD,,) 420 mg1L ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 m /L ❑ Disinfection ❑ Other. Manufacturer Pretreated Effluent Quality <NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (BODS) 530 mg/L ❑ In-ground (gravity) ❑ In-ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade 4pnd Fecal Coliform (geometric mean) 510' cfu/100ml ❑ Drip-line ❑ Other. Maximum Effluent Particle Size Y inch diameter • Values typical for domestic (non-commercial) wastewater and septic tank effluent " Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every e ❑ months (s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third of tank volume Inspect dispersal cell(s) At least once every a❑ months ar(s) (Maximum 3 yrs.) Clean effluent filter At least once every A] months year(s) Inspect pump, pump controls & alarm At least once every ; ❑ month ' ar(s) ❑ NA Flush laterals and pressure test At least once every ,;;41 months aqs) ❑ NA Other At least once every ❑ months ❑ year(s) ❑ NA Other At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections 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 include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined 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. The 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 (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechinical or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at irlervals of 12 months or less shall be performed by a certified POWTS Maintainer. A servrcg report shall be provided to the local regulatory authority within 10 days of completion of any service event. 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 that may impede the treatment process and/or damage the dispersal cell(s)- If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page of START UP AND OPERATION dispersaltreatmentcell(tank(s)s) for the presence of painting products 'or If high concen ations are detected have thercont nts lof thO For new construction, prior to use of the or damage check may, impede the treatment process a 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. wastewater During power outages pump tanks may l above normal highat overloading the levels. When poer is restored may result in the backup or surface ischarge of efflulebnit discharged to the dispersal cell(s) in one large dose, power thle To avoid this situation have lthe umber contents or POWTS Ma n ainer to as istdinymanually aoperating the Opumpocont olsotoe shore normal levels effluent pump or contact a P 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 within 15 feet down slope of any mound or at-grade soil absorption area. disinfectant and t life Reduction or ellminabon of the following from the wastewater stream may improve the performance foundation the oOn drab ers; antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diap intro rd rain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; pa g p 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 propefiy and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. • Ail 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 fined with sq)il, 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 comp on replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systeim. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requiijed setbacks from existing and proposed structure, tot lines and wells. Failure to protect the replacement area will result in the neled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules} in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology/ a holding tank may be installed as a last resort to replace the failed POWTS. he site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a son and site evaluation / must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as 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 O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name s~ - Phone SEPTAGE SERVICING OPERATOR P ER LOCAL REGULATORY AUTHOR Irv Name Name • nn y Phone 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. l? j .r~ 1 0. ~ 1-~jlf ~1~ i I _ fl I f i. lilt, j F I I a ~O I P ~ I ' _co a _ O O i 1 o 0 a o ~ d S ~ SJ j Q 1 c CC) 3 S ~ If uj i L i I I i I - ST. CROIX CO-(jNTY SEPTIC TANK MAINTENANCE AGREEMENT - AND OWNERSHIP CERTIFICATION FORM w3; Owner/Buyer Mailing Address ILI Property Addres (Verification required from Planning & Zoning ll epartment fo ne a truetion.) City/State _ _ Parcel Identification Number " ~Q r LEGAL DESCRIPTION - Property Location l Al 1~LL)%iSec. ~ ,TNR C 7 W, Town of Subdivision Certified Survey Map # ~ Lot # ~ ~ . R 0 t Volume Page # Warranty Deed # Volume ~ Page # Spec house yes no Lot lines identifrabl ye no SYSTEM MAINTENANCE AND OWNER CERTIFICATION hoproper use and maintenance of your septic system could result in its premature failure to ha maintenance consists of pumping out the the system can affect the function of the ceptic tank every three years or sooner, if needed, b ndle wastes. Proper a licensed responsibilities are specified in Co tank as a treatment stage in the waste disposal system. pwneu r ai What you put into § mm. 83.52(!) and in Chapter 12 - St. Croix County maintenance The property owner agrees to submit to St Crow County P Sanitary Ordinance, and by a master plumber, journe ty januiiig & Zoniri De umb owner catio form, signed by the wastewater disposal system is in proper p, er, plumber or a licensed patent a c ertifi less than 1!3 full of sludge. Operating condition restricted and/or plumber ar n the an-site after inspection and per verifying that Pumping (if necessary), the septic tank is I/we, the undersigned have read the above req. standards set torch, herein, as set by the t uements and agree to maintain the private sewage disposals stem Certification stating that your septic system ar beeen of Commerce and the De y with the Certification P at Natuxal Resources, State of Wisconsin. $ Department within 30 days of the three maintained must be completed d and returned to the St. Croi7r CounZonin ty year expiration date. ty Planning & Uwe certify that all statements on 'form are property described above, by virtue of a w true the best of my/our knowledge. I/we am/are the owner(s) of the ~Y deed recorded in Register of Deeds Office. Number of bedrooms Ml OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary PeTmitbeing revoked by the Planning & 7--owing Department. Cnelude with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey reap if reference is made in the warranty deed, ' (REV. 08/05) LEGEND PROPERTY ADDRESS: Septic and well location are subject to contractor X =PIN FLAG SET 1705 109TH STREET discretion based on site orientation and soil conditions, HAMMOND WI 54015 on site. ° ® =60d IRON NAIL SET AT 10' OFFSET OR ON BUILDING ELEVATIONS SHOWN ARE I, Ty R. Dodge, Wisconsin Professional Land F EXTENSION NAVD 1988 DATUM. Surveyor, hereby certify that this Stake-out Plan FOUND 1-1/4" IRON PIPE was prepared by me or under my direct T.O.N.- TOP OF IRON NAIL ELEVATION supervision and is correct to the best of my ° knowledge and belief. Y T.O.P.- TOP OF IRON PIPE ELEVATION 4 SETBACK LINE: t, N 50' FRONT, 100' 170TH AVE. Wu~ r 10' SIDE MIN- 25' TOTAL t co 25' REAR a~ , - - - - - UTILITY EASEMENT: Typ. 12' FRONT T.O.P.- 1068? 8 OWN - - DRAINAGE EASEMENT: o A SH N 82484 CLEARIUM * VA - Lkerxm~ \ 03/17/17 11,61 b 109TH AVENUE 1 I _ _ -7 T-~ 89° 38"~OU~OT~J N93°16'29"61.34' R 167.0 0' ~ a I j - - - L = 47.27 Jill, I / I it I r I 2b' ~a~ I g I I I I~ n =i I I 1 I 30'I §16 Fs~e OC~O F DRAINAGE 4Z I Co I E SEMENT cLil I 0 / I / 1 I i 1 H.W.E.- eo 1070.0 N T.O.N.-1071.27 c N I 13 -A I N I LOT 19 o z o I 1.60 ACRES GARAGE 45' of O z I r I I 69,800 SF ' m Q F O o f I 3 W I Z 018-1096-19-000 I ¢ 0 C LB.O.- 1072.0 HOUSE Z o w z I I I I I °o ~rOL¢~ 0 J Ln '0 zVD o T.o w.-1068.52 w x o D W 0 O o I I L0 (_DW S89°49'38"W 15.00' I O O Y I I I r / I.-_ LL V) -A 0 Z z W II //y I LfJ< (n I I V) N = I J "'s; I SEPTIC AREA, APPROX. I ~ I 1 Z N85°25 34'E 161.08' (Y W sri > z o W O I I ~QiL SCALE: O J z ✓,9y SHEET NO. 0 60 120 OF 11 I .1~ r ~ t :.,rr • ~ r : r1 i r J t E,4,MEMT ,1 '91J 3wdo .G - 9 r to *act 3.e0.of .ooN f Fp w r ~ r ~ t ib ~ ~ 2 ~ ~ D o e M _ r . i ~ all 40 ~t=====--- 1¢t------------ o-- DED t CA TED TO THE PUBLIC oo* ro' P!• w W, w 1330.62' soZ040. ON, ..STREET