HomeMy WebLinkAbout018-1066-85-050
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix
Safety and Building Division INSPECTION REPORT Sanitary Permit No:
592255
(ATTACH TO PERMIT) State Plan ID No: 24 22855
GENERAL INFORMATION G ~J,J
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: LORI KOOIMAN TOWN OF HAMMOND 018-1066-$5-050
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
AI{. M' 51A) COVW sf . 30.29.17.4558-20
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTUJM , 5' CAPACITY STATION BS HI FS ELEV.
. I
r~ ] I
Septic 12 ~ P" S t , ~1 Benchmark -1 2-
Dosing V J f W n Alt. BM
(^/t Bldg. Sewer -G1
TV/ J
H QIH6 g Ht Inlet 7,~ QA Z
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO Pa-1 WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom
Dosing t eader/ an. 2
Aeration Dist. Pipe 9S • 2
Holding Bot. System
' Final Grade
PUMP/SIPHON INFORMATION `r•~
Manufacturer Demand St Cover ,31 1.36'
PMI%
1~1 y
Model Number 6A)
TDH i` 05 Fricti .Los System J d* V~ TD , Ft
Forcemain Le 0 Dia. 7 Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH With ~ Length y No. Of Trenches PIT DIMEN/SIO~NS No. Of Pits/ Inside Di~ Liquid Dept
DIMENSIONS D i'-7~ 1
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type f yste / 1701 /,351 UNIT Model Numbe
M -7-
DISTRIBUTION SYSTEM
Header/Manifold Distribution x Hole Size Hole Spa iin""~` g_ J 1 Vent to Air Inta
Pipe(s)-7-Z.
`
Length is iLength__LWWia _ Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
IDepth Over / Depth Over xx Depth oxx Seeded/Sodd xx Mulched
Bed/Trench Center 7 Bed/Trench Edges Topsoil /G~ ►t /Yes E No es No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 I Z~ZO~ 1 'J'am Inspection #2:
f1Tk* : ark
r' LOW 0-i 1F
Location: 760 160TH ST
f~LTM p►EM- n[
1.) Alt BM Description =
2.) Bldg sewer length = ~J
- amounts of cover C>.,\\ Is
Plan revision Required? ❑ Yes o `L L- 11 Use other side for additional informatio Inse ctors gnature Cert. No.
Date
S6D-6710 (R.3/97)
1
County
Safety and Buildings Division ST. U-0 1X
APR 201 W. Washington Ave., P.O. BOX 7162 SanitaryPermit Number (to be filled in by Co.)
P Madison-WI W707- 16
S"1: CROIX COUNTY q Z ZJ ✓
,n= ,,QMMUNITY d~LOPM NT
State Transaction Number
Sanitary Permit Arrf.1,,a«.,11 ~l $ ✓
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
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 secondar -11~ 5T-
purposes in accordance with the Privacy Law, s. 15.04(1)(m), St ts.
1. Application Information - Please Print All Infortla-fibik
Property Owner's Name Parcel #
'L.-
~ Mk t,_~ ~ ( 1 al `~-Ia~'L $S cl>cl
perty Location_3 ;~h,
Property Owner's Mailing Address C J y~ j~ ' A1 P,0
ng V V l t V JT ~*Al ~bc V V 1 vt.
Lot
City, State Zip Code Phone Number_ Section -30
trcle one
T ~q N; R e o>
II. Type of Building (check all that apply) Lot #
Subdivision Name
3
0<1 or 2 Family Dwelling-Number of Bedroom
D~ Led Block #
El Public/Commercial -Describe Use
❑ City of
/ CSM Number a El Village of
[I State Owned -Describe Use
P 52-4 5LTOW11of tlt
Ill. Type of Permit: (Check only one box on line A. Complete line B if pplicable) ~i
A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner lift
IV. Type of POWTS System/Component/Device: Check all that apply) .eaiNI~Ljl 7-1
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/Trea ent Area Information:
1~ Design Soil Application Rate(gp f) Dispersal Area Required (sf) Dispersal Area Propos System Elevation
Design Flow (gpd)
45o (0o "N.L14i
VI. Tank Info Capacity in Total # of Mann acturer
Gallons Gallons Units n L U V-
New Tanks Existing Tanks ' c p i0 ro
~ R1I/Id'~'•.e - 0.U rig rn R, C7 0.
Septic or Holding Tank >C
WW ~~f
Dosing Chamber (eodl
VII. Responsibility Statement- 1, the undersigned, assu a res o sib ity r stallation of the POVVTS shown on the attached plans.
Plumber's Name (Print Plumber's g r MP/MPRS Number Business Phone Number
-T_(D OD SIN7- 139
Plumber's Address (Street, City, State, Zip Code)
f_%09 `ICK-11' kc e Ofdb~ liu w 5 i
VIII. County/Department Use Only
Approved Disapprove Permit Fe Date sue Issuing nt Signature
iven Reason for ~al $ to 6
IX. Conditr""_000$lllwasons for Disapproval \ rr
~ilip~'blt~t,.±ilfNt~t'N(irrx~rr! 3) ~a orb r 5
,**onto* Cie must do be lillvtft~li. #1 um
W pw qWA"MeW_ plats prvAd lrl by plumber.
2. AN au►br*`nl L,*W:'teM MUat>be rwkntrir.e.1
tillpK vakmW*
Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I l inches in size
SBD-6398 (R. 11/11)
Z lc
{fQ i0r1
J,,..~•""•'...-..~..'~""`^^-.~~~..•...,nrv...~.wr,1.. o,nf.1lla~~„il... ~~-~ry{~"%I f.>r7t:Pr'~f"1f.
,..•r"'~ .~,r<r':11 ~;Y;711„'f~'.,:~~„u~~~...~~~~J..J,~ l/ 'I~.
r cQ A
,......,.~.o """r'a'"n _ . `",r' 1~ • _ M~ .,-r•---°t ~:\e~ ~:~~~_''.K„''=~" 1~ 1 .
~'/.fK°~~'.5:, C.FIFl r! i"{''Gsc~rirZ r•5e. . ~'~'It'~~ „7~dV'~l!'~.E'~~.~};~~, ~G~f I}. ~I'
ri ,.-w'.......,~ ,ter, G''a(JC•''~ -t- . ~.n:-~rr~rr',`T.~~ Sc'C....~'--X91;,' ~15.,G~)•
~,>r ,.:I.!: ~s7-.rp~+.,~'~• ~e~' Y~"""~•~• t Lfki 1 l!'1 CJFr17s'.f""
¢•n'P,r,+,'•fy ~ ~,cl ~ trs-, f'~u~3`Um14:,~ d, i ~
IS ~ ~ J I
f/~ Tyr"-`s,"' ~ ..,...5~4,. ...._..:r~.,,._.,.-.....•..r~.,..ar_. .x,~.~..~...r. f,ti r ,_._,I. ..f,.+._+.,^.-.~'
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• pt~'~RT'~fENT DIVISION OF INDUSTRY SERVICES
3824 CREEKSIDE LN
HOLMEN WI 54636-9466
Contact Through Relay
P S http://dsps.wi.gov/programs/industry-services
www.wisconsin.gov
~0 ssioNN Scott Walker, Governor
Laura Guti6rrez, Secretary
March 27, 2017
CUST ID No. 139462 ATTN: POWTS Inspector
TODD L SINZ ZONING OFFICE
TL SINZ PLUMBING INC ST CROIX COUNTY SPIA
E5609 708TH AVE 1101 CARMICHAEL RD
MENOMONIE WI 54751-5520 HUDSON WI 54016-7708
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 03/27/2019
SITE: Identification Numbers
Lori Kooiman Transaction ID No. 2922855
160`h Street Site ID No. 836385
Town of Hammond Please refer to both identification numbers,
St Croix County above, in all correspondence with the agency.
SE1/4, NEIA, S30, T29N, R17W
FOR:
Description: Three Bedroom At-grade System \ Sloping site
Object Type: POWTS Component Manual Regulated Object ID No.: 1697024
Maintenance required; 450 GPD Flow rate; 39 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 Ot'
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, DEPT!
stats. PROF
DIVESt ES
The following conditions shall be met during construction or installation and prior to occupancy or use: Off! OF
Reminders
• 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.
C PR
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be ma ie
with 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.
• 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
TODD L SINZ Page 2 3/27/2017
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
This Amount Will Be Invoiced.
~OardVM Swum When You Receive That Invoice,
TS Plan Reviewer, Division of Industry Services Please Include a Copy With Your
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal.
jerry.swim@wisconsin.gov WiSMART code: 7633
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
MAR 2 0 2017
RESIDENTIAL AT-GRADE DESIGN
INDEX AND TITLE SHEET
Project Lori Kooiman new Home
Owner Lori Kooiman
Address 856 190th St
Hammond Wi 54015
Legal Description Se1/4 NE 1/4 S 30 T 29 N R 17 W
Township Hammond County St Croix
T OVALLY
Subdivision Name Lot No. ,ROVED
SAFETy.4NO
Parcel ID Number 018-1066-85-050
SAL SERVICE
Plan Transaction Number USTRY SEI4VJC
Index sheet Page 1
Calculations Page 2
At-grade drawings Page 3 DENCE~-""-
Laterals and dose tank Page 4
Specifications Page 5
Management & contingency plan Page 6
pump curve & specifications Page 7
Effluent Filter Page 8
PI Plan"-
lan Page 9
Designer Todd L Sinz License Number MP 139462
Signature Phone Number 715-235-2644
Date 03/14/17
Designed pursuant to:
At-grade Component Manual Ver. 2.0 for POWTS SBD-10854-P (N. 03/07, R. 01/12), and both
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)
Version 7.0 (11/12) Page 1 Of 9
PRESSURIZED AT-GRADE DESIGN
Flows and Site Data Entry.
r' Residential or commercial?
300.0 Estimated wastewater flow (gpd)
450.0 Design wastewater flow (gpd)
8.00' % Site slope
96.44 Contour elev. below lateral (ft)
39.00 Depth to limiting factor (in)
0.60 In-situ soil application rate (gpd/ft^2)
Distribution Cell Information
1 Influent wastewater quality
9.00 Linear loading rate gpd/ft
10.00 Effective absorption width (ft)
10.00 Max. effective width permitted (ft)
75.00 Aggregate length (ft)
Pressure Distribution Data Entry
e' Center or end lateral connection
L -J Number of laterals
0.188 Orifice diameter (in) e.g. 0.25
1.75 Estimated orifice spacing (ft)
2.00 Forcemain diameter (in)
2.89 Forcemain flow velocity (ft/sec)
X80.00 Forcemain length (ft) y Does forcemain drain back?
87.00 Pump tank elevation (ft) y Are laterals at highest point?
3.25 System head (ft) x 1.3 NA
8.94 Vertical lift (ft) 13.0 Forcemain drainback (gal)
1.39 Friction loss (ft) 59.0 5x Lateral void volume (gal)
0.00 In-line Filter Loss (ft) 72.0 Minimum dose volume (gal)
13.58 Total dynamic head (ft) 28.3 System demand (gpm)
Lateral Diameter Selection Gallons/Inch Calculator
Pipe diameter Design options Design choice Total Tank Capacity (gal)
1 in Total Working Liquid Depth (in)
1.25 in Gal/in (enter result in cell G46)
1.5 in
2 in x x Treatment Tank Information
3 in x 1000 Septic tank capacity (gal)
Huffcutt Concrete Manufacturer
Effluent Filter Information Dose Tank Information
Lifetime Filter manufacturer 640.0 Dose tank capacity (gal)
LT-1/8 Filter model number 15.2 Dose tank volume (gal/in)
Huffcutt Concrete Manufacturer
Project: Lori Kooiman new Home
Transaction Number: Page 2 of 9
AT-GRADE PLAN VIEW
1/6 B Observation pipes (2 typical) A 10.00 ft
T D 1 B 75.00 ft
~T 1/6 B 12.50 ft
W _TC 12.00 ft
C D 5.00 ft
E 2.00 ft
D L 85.00 ft
B W 22.00 ft
A x B 750.00 ft^2
L
E• Cap
pipe.
obs.
= Total aggregate cell A x B Typical
Slotted in n the lower 6", and
C~ = Plowed area L x W anchored securely.
6°
AT-GRADE CROSS SECTION
Svnthetic fabric cover
Fr< 98.27 ft Finished grade
Lateral F elevation
invert elev. 96.94 ft f/
Observation pipe
at aggregate toe
E i
Surface contour l 8 % Slope
and system 96.4 C A
elevation D
0 = 12 in. topsoil and subsoil
over aggregate and tapered to toes. Plowed layer
= 6 in. aggregate below below L x W
pipe(s), and 2 in. above pipe.
Project: Lori Kooiman new Home
Transaction Number: Page 3 of 9
PRESSURE DISTRIBUTION AND DOSE TANK
I P
Last hoI? drill?d n?sa to ?mi cap I~ X-?I Laterals rx force main of PVC Sch 40
Holes drilled on the bottom of the lateral per SPS Table 1114.110--f,
?qually_p~;eed « =Turn-upv.Yballvsfveoreleanoutplug
Lateral Specifications
0.188 Orifice diameter (in) End Lateral connection point
X 1.73 Orifice spacing (ft) 1 Number laterals
43 Orifices/lateral P 72.66 Lateral length (ft)
28.3 Lat. discharge rate (gpm) 2.00 Lateral diameter (in)
2.00 Forcemain diameter (in)
28.3 Sys. discharge rate (gpm) 80.00 Forcemain Length (ft)
13.58 TDH (ft)
Typical Pump Chamber Layout
Approved manhole cover with
Weather-proof warning label and locking device
junction box
Final grade y 4"
disconnect
Tank component is Alternate
properly vented outlet
location 18" min.
1
Electrical as per NEC 300 and A Approved
SPS 316.300 WAC outlet
Tank full joint
N Inches Gallons A Provide 1/4"
p A 23.4 355.2 Alarm on weep hole or
w B 2.0 30.4 l3 antisiphon
E C 4.7 72.0 Pump on device.
'p' D:i 12.01 182.4 88.00 ft C
Totals 42.1 640.0
Pump off
D
3" Bed di g under tank 87.00 ft
JZoeller Pump manufacturer j"(~ F~uivl~ Alarm manufacturer
BN151 Pump model number Alarm model number
Project: Lori Kooiman new Home
Transaction Number Page 4 of 9
At-grade System Maintenance and Operation Specifications
Service Provider's Name T L Sinz Plumbing Inc. Phone 715-235-2644
POWTS Regulator's Name St Croix Zoning Phone 715-386-4680
System Flow and Load Parameters
Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 750.0 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 eve 3 ears
Effluent Filter Inspect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test monthly
Pressure System Laterals should be flushed and pressure tested eve 1.5 ears
At-Grade Component Inspect for ponding and seepage once every 3 years
Alternate use between old system 1 yr and new system 2 yrs
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 at-grade component manual.
2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code.
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 at-grade structure and other disturbed areas will be seeded and mulched to prevent soil
erosion and help reduce frost penetration.
6. Areas within 15 feet of the downslope toe will be protected from compaction.
7. All other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07).
Lateral Turn-up Detail
Finished
Grade
6-8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Long Sweep or T
e 90 o wo
96.94 ft g p
45 Degree Bends Same
Diameter as Lateral
Project: Lori Kooiman new Home
Transaction Number: Page 5 of 9
At-grade System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SIPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its'
component manuals [SBD-10854-P (N. 03/07, R. 01/12), SSWMP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver.
2.0 SBD-10706 (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
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 of 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 Department of Commerce.
Pump Tank
The pump (dosing) 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.
At-grade and Pressure Distribution System
No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the at-grade
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 at-grade 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 at-grade be heavily mulched as protection from freezing.
Influent quality into the at-grade system may not exceed 220 mg/L BOD5 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 18 months. 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
system 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 at-grade 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 renovating the biologically clogged absorption and
dispersal media, installing new piping, and replacing other components as deemed necessary to bring
the system into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: Lori Kooiman new Home Transaction Number: Page 6 of 9
PUMP' PERFORMANCE.,CURVE
MODEL-1"5111521f53 TOTAL DYNAMIC HEAD/FLOW
PER MINUTE
u 4s 153 FFLUENT AND DEWATERING
12-
MODEL 151 152 153
36
10 1E2,,; Fee! Meters NGa L1ers Gal, filers Gal. Lltars
so - - 5 .1:5.. 189 69 261 77 291
10 3.0 170 61 231 70 265
15 4.6 144 53 201 61 231
20 0 44 61 S2 197
t045 1.6 .61 34 129 : 42 159
30 9,1 23 e7 : :JJ-... 125...
35 10.7 - - - 22 e5
11' 42
10
Shut off Head: 30 ft. (9.Lm) 38 M. (11.6m) 11 h, (13.4m)
2
S
ousoae
0
10 . 20 30 40 ..'s0 80 70 B0 90 100
GALLONS
LITERS 40 10 1 0 40 200 240 21110 3 0 3,60
FLOW PER MINUTE 014508. Model .151 - M o.dels.1..52..1._153
CON3ULTIACTORY FOR
SPECIAL APPLICATIONS e7132
i ys
' 3 ns 4 ba 3 21132
• Timed dosing panels available',
• Electrical alternators, for duplex systems, are available and , 718 supplied with'an alarm, e e e
• Variable level control switches are available for controlling ® e 37r11
sing to phasesystems.
• Double;plggy6ack variable level float switches are available
for variable level long and short cycle controls. _
• Sealed Qwik•Box available for outdoor Installations. See
FM1420.
• Over 130'F, M*C,) spatial quotation required.
151113/.153 eerie; a tvts a L
15111121113 IYoo Control Selectlon --T
Model velt;•Ph Mede': i'.-Am F Slrn lax Duplex s va
4 vs
N151 115 1 ..Non 8;0 1 2 or 3
1111,4151 115 1 . At at j; 6,0 Included 2 or 3
E151 230 '.t Non 3:1 2 or 3
BE151 230 1, Aulo' : 3.2 Included 2 or 3 SK24u sKZOa4
N152 115 1 Non 8.5. 1 2 or 3
1111 115 I : AU16 8.5 Included 2 or 3
E152 . J 1 oh . 4 3 2 or 3
B 1 .4.3....,.:Ineluded 2or3
N15 11 'on,. 10,5:; 2or3
BN153 115 . 1 Auto',. 10.5: Included 2o r3 SELECTION GUIDE
E153 230 1 Non 5.3 12or 3
BE153 30 1 Auto 5.3 Irlduded 2 or 3
I . Single piggyback Variable level float switch or double piggyback variable level float
e CAUTI N switch. Refer to FM0477.
All Installstlon of controls, protection devices and wlring should be done by a quallfled 2. See FM0712 for correct morel of Eleclrical Alternator E•Pak,
lleensed slectrlelan, All electrical and safety codas should be followed Ineludlnp t i most g Variable level control switch 10 0225 used as a control activator, specify duplex
(3)
recant National Electric Code (NEC) and the Occupational Safety and Health`Act (OSHA);
or (4) float system;
RESERV":POWERED DESIGN
For unusual conditions a reserYe safety factor is engineered into the design of every Zoeller pump,
MAX 76, ,PO. BOX 16347
LoulsGllle, KY 40256.0347 Manufacturers of..
SHIP TOr 9649 Cane Run Road
m Loulsvllle, KY 40711.1961 QVlC~TY FUA~P9 ~/INCE /9~9
X (52 1 3 9 4 PUMP
~ 50 ~ (502) 778-2731
htfp;/IWWW.IaNl9/4pm FAX (502) 77474..3624 Volt
l ~r nnn4 7-11., r`~ all InHtm rpAArvFid,
Ilk
The Best Just Got Better
_ - 0D
The most efficient, the lowest
maintenance, the most economical
effluent filter!
• Nearly Twice the Filtering Capacity
• Estimated to go 3 Times •
Longer Between Cleanings
• Cleaning Made Easy •
• Does Not Retain Solids Between Plates •
• Lowest Price •
O 0
- Eliminates the collection of solids inside the cartridge.
- Nearly twice the filtering capacity of any other filter. 5
- By eliminating solids between plates
drastically reduces the need to clean.
- Cleaning made simple and efficient.
01 LU
- LT 1/8: 3500 GPD/Residential Strength
Filtration 1/8"
- LT - 1/16: 3350 GPD/ Residential Strength
Filtration 1/16"
- LT - 1/32: 3000 GPD/Recommended for Commercial use with Residential
Strength - Filtration 1 /32"
- LT - 1/64: 2500 GPD/Recommended for Commercial usage with Residential
Strength - Filtration 1/641f g/q
- 2700 Inches of Linear Filtration (Nearly Twice the Comaetition)
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This alarm system monitors liquid Este sistema de alarma vigila Ce syst'me d'alarme detecte
levels in lift pump chambers, la altura del liquido en las le niveau de liquide clans les
sump pump basins, holding camarasde bombas aspirantes, "chambres" de pompe dq
tanks,sewage,agricultural, and I a s cu-betas de las bombas ' relevement,bassin~Icepomped'e
other water applications. de sumidero, los tanques de puisard, reservoirs de retention
The Tank Alert* AB indoor rated retencion,yen aplicacionescomo d'egout, de dechets agricole
alarm system can serve as a high aguas residuales, agriculture y liquide, et autres applications a
or low level alarm depending otros sistemas hidricos. base d'eau.
on the float switch model used, La alarma para use en interiores, L'alarme systeme d'alarme
The alarm horn sounds when a Tank Alert* AB, puede utilizarse «TankAlert®AB»estcongupour
potentially threatening liquid como alarms de nivel alto installation al'interieur,etpeut
level condition occurs. The o bajo segun el modelo del servird'alarmedeHaut oude Bas
horn can be turned off, but the interruptor del flotador. La niveau selon le type de flotteur
alarm light remains on until the bocina de la alarma se activa utilise. Calarme sonore retentit
condition is remedied. Once cuando el liquido Ilega a un lorsqu'une condition de liquide
the condition is cleared the nivel potencialmente peligroso. potentiellement dangereuse
alarm will automatically reset.A Es posible silenciarla, quedando survient. L'alarme sonore peut
green "Power On"lightindicates encendida la luz hasta que se titre desactivee, mais le voyant
120 VAC primary power to the resuelva la situacidn. La alarma d'alarme demeure allume
alarm. Low battery chirp feature retorna automaticamente a jusqu'a ce que la condition
indicates when battery should su condicidn inicial una vez soit remediee. Une fois la
be replaced. se resuelva la condicion que condition corrigee I'alarme se
la activo. Una luz verde de rearme automatiquement, Un
encendido ("Power On") indica voyant vert a Marche » indique
alimentacion de 120 VCA a la I'alimentation primaire 120VAC
alarma. El mecanismo indicador a I'alarme. Une fonction sonore
de bateria baja activa un sonido « criquetnindiquequela pile est
(tono corto y agudo) cuando sea faible et devrait titre remplacee.
necesario remplazar la bateria.
5
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ST. 'CRO COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer + C > C y
Mailing Address
r
Property Addres 4/n:
(Verification required from Planning & Zoning Department for new construction.)
City/State 4~ iE + Parcel Identification Number
LEGAL DESCRIPTION
4V, fown of -
Property Location'/4 , '/4, Sec... , T'P
Subdivision Lot #
r < • , L _
Certified Survey Map # Volume Page 14.
Warranty Deed Volume Cake
Spec house yes /ilo Lot lines identifiable yes no
SYSTEM MAINTEN CE AND CIWNER. C'FIZTIF CAT10N
improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. ov,,ner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying; that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the; private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are taste to the best of my/our knowledge. l/we arn%are the owner(s) of the
property described above, by virtue of a w anty deed recorded in Register of Deeds Office.
Number of bedrooms M
SIGNATURE OF AYPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(RFM 48/05)
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♦ RECEIVED
1959
-.1s
E tUAT10N REPORT
Wisconsin Department of Comm ce Page 1 of 3
Division of Safety and Buildings I v~~RFQI =size, mm, 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
County
Attach complete site plan on per not les Pla ust ~e; St. Croix
include, but not limited to: ve an orizontal reference point (BM), direction d -
percent slope, scale or dimensions, north arrow, and location and distance to near t road. Parcel I.D.
From 018-1066-85-000
Please print all information.
- Revie d By '/7/
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m))
Property Owner J' Property Location
Terry a I 4-L vi ✓L r Govt. Lot SE 1/4 NE /4 S 30 T 29 N R 17 W
perty Owner's Mailing Address Lot Block # Subd. Name or _
2122 5th Ave. --Pfpesed CSM
City State Zip Code Phone Number City Village ✓ Towf n -Nearest-Road-
Baldwin WI 54002 (715) 688-2944 Hammond 160Th Street
✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate _ 450 GPD
Replacement Public or commercial - Describe:
Parent material Glacial Till
Flood plain elevation, if applicable na
General comments
and recommendations: Site suitablle for At-Grade. Recommend installing mound system _wi_th 6"sand lift to increase dispersal of
effluent into native sol . onstruct system on 96.44' contour.
❑ Boring # Boring
✓ Pit Ground Surface elev. 96.40 ft. Depth to limiting factor 39" f in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-14 1Oyr3/3 none sl 2fsbk mfr cs 2fm,1c 0.6 1.0
2 14-22 1Oyr4/4 none sil 2fsbk mfr gw 1fmc 0.6 0.8
3 22-39 1Oyr5/4 none sil 2msbk mfr gw 1vf,f 0.6 0.8
4 39-54 1 Oyr5/4 f2d 7.5yr4/6 SO 1 msbk mfr - - 0.4 0.6
❑ Boring # Boring
✓ Pit Ground Surface elev. 96.49 ft. Depth to limiting factor >50' In. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-10 1Oyr3/3 none sl 2fsbk mfr cs 2vf,f 0.6 1.0
2 10-27 1Oyr4/4 none sl 2msbk mfr gw 1vf,f 0.6 1.0
3 27-50 1Oyr5/4 none Ifs Osg ml - 1vf 0.6 0.8
* Effluent #1 = BOD,> 30 < 220 mg/L and SS >30 < 1 m * Effl t #2 = BODS<30 mg/L and TSS <30 mg/L
CST Name (Please Print) Signature- CST Number
James K. Thompson 3602 - xc~~ - Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 12/912005 715-248-7767
Property Owner Terry Schnabi Parcel ID # FROM 018-1066-85-000 Page _ 2 of 3
3] Boring # Boring /
✓ Pit Ground Surface elev. 94.18 ft. Depth to limiting factor 42" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz _
in. Munsell Qu. Sz. Cont_ Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-11 1 Oyr3/3 none SI 2fsbk mfr cs 2fm,1 c 0.6 1.0
-
2 11-21 10yr4/4 none sl 2fsbk mfr gw 1fmc 0.6 0.8
I
3 21-33 1Oyr5/4 none Ifs Osg mfr 9w 1vf,f 0.6 0.8
4 33-42 1Oyr5/4 none sil 2msbk mfr cw - 0.4 0.6
5 42-57 1 Oyr5/4 f2f 7.5yr4/6 sil 1 csbk mfr -
❑ 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. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
i
❑ 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 ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * 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.
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