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HomeMy WebLinkAbout020-1017-90-020 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592270 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 TOWN OF HUDSON 020-1017-90-020 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 13.29.19.83A-12 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE~~Rii CAPACITY STATION BS HI FS ELEV. Septic Z nu3c 3 Benchmark it,-X (D, ~e ing r,~ / _ Alt. BM VA--l z-- (1 Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION i TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt l et Septic Dt Bottom Dosirl-9 Header/Man. Aeration Dist. Pipe '1 to v. 445 Holding Bot. System / PUMP/SIPHON INFORMATION Final Grade -Y / ' Manufacturer Demand St Cover . ref GPM Model Number 1 F~ VJ TDH Lift Friction Loss System Head TDH Ft r , T `l Forcemain Length Dia. i Dist. to Well / r / ` ?C SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ' j SETBACK SYSTEM TO J T P/L BLDG WELL LA E/ TR M LEACHING Manufacturer: INFORMATION CHAMBER OR Ty e Of System: UNIT Model Number: - DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake pipe(s) r ii n C, vt (<< Y Length Dia Length~~ Dia r Spacing_ j 4a A,v -z{ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth/of xx Seeded/Sodded Irh~~ Bed/Trench Center t' Bed/Trench Edges Topsoil L~ s No ~ Yes ❑ No r COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:' Inspection #2: Location: 914 CHIPPEWA PATH 0 Jam; 1.) Alt BM Description = -T 'LOUD YZ y t' / j 2.) Bldg sewer length= L~ ; 7/ 5 / s - amount of cover = ~y. Plan revision Required? ❑ Yes ❑ No~ 17 -J e Use other side for additional information. SBD-6710 (R.3/97) Date In or's Signature Cert. No. D County CC Safety and Buildings Division C; GIVE D K 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P Madison, WI 53707-7162 State Transaction Number 'pMMUNITY WWAQHI~Ermit In accordance with SPS 383.21(2), Wis. Adm- Code, submissic guvermnental unit iF ) to72- 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 w/ purposes in accordance with the Pdv ' Law, s. 15.64(1) m), Stats. ` w^ L Application Information - Please Print All l m 'on Property Owner's Name / Parcel # l Property Owner's Mailing Adfes Property Location 13 c~ . f ZJ T p r' i 1Govt_ Lot C' State ^ Zip Code Phone Number ~ y" Section circle ouo~ 11 Tye of Building (check all that apply) T N; R ~4- E X.,'2 Family Dwelling-Number of Bedroo Subdivision Name ❑ Public/Commercial - Describe Use V a ❑ City of ~ ❑ State Owned - Describe Use CSM Number 6 ❑ Village of x C Town of 5 0✓ V1 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A few System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber CJ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner rV. T ofPOVPTS System/Component/Device: (Check all that a I ' 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 rsal/Trea ent Area Informatio r gn Flow (gpd) Design Soi] Applic Rate(gpdsf) DispenalArea equired Dispersal Area Propo (S System Elevation VL Tank Info Capacity in Total # of Manufacturer U Gallons Gallons Units New Tanks Existing TanlS m v J v. E ~ o ~ ~ a m m Septic or Holding Tank Dosing Chamber 1 7k, VII. Responsibility Statement- L the undersigned, it e responsibility for installation of the PORTS shown on the attached plans. Pi s Name (Print) PI er' Signature MPYMPRS Number Business Phone Number J.- 71-; PI s Address (Street, City; State, Zip ouatv/)e artment Use Only pproved ❑ )uffp roved Permit Fee Date ued Issuing t Signature eri7Nen Keason for Denial DL Condiil ons ffor Dis pproval 1 tlotank, Etfltssn:IiRwtint f J11 pf0 i AEt•.J rt' Kper.::,, cell must all be seit^ieas hlt~`_e~ I ~1 per management purl p!o flfletl by plwnbei. /UA,J (AP6 2. X r+GC,t rret ze M n s mtrsl tn* r.,t>vrtt, u:E 2 t ~f ~i~l, fir? / ;:rill irlllr,8*. 1.~ tfie ~ i t`v~ : S '4t...Attach to complete plans for the system and submit to County only on paper not less than 8 re x 11 inches in size rr rr ff oaf ~ i t~ P +rt-~c~- t„✓l ~ ~P.l ktif~" SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 SW 114S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 103.8' 3/17/17 BEDROOM 3 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND 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 survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 117' Property Line Scale = 1/4" = 10' u' 2 acre lot Chippewa Path Tank is to be properly bedded and provided with lockdown covers with approved warning labels 103 Huffcutt Pro 3 101, Combo Tank Bedroom House B-1 5% Slope Grading is to be done to divert Well is to meet all WDNR B-3 run-off from setbacks ❑ ; system Area 15' below _ system is to remain undisturbed B - 102.5' 330' Property Line B.M.* u." . D~ ,.o rax7ay~ DIVISION OF INDUSTRY SERVICES o, 2331 SAN LUIS PL STE 150 w GREEN BAY WI 54304-5211 t Contact Through Relay P http://dsps.wi.gov/programs/industry-services 1 \ www.wisconsin.gov sIOT,N Scott Walker, Governor Laura Gutierrez, Secretary IJ .PPRO April 05, 2017 T OF SAI CUST ID No. 226900 ATTIC- POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1 101 CARMIC1 AEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/05/2019 Identification Numbers Transaction ID No. 2926721 SITE: Site ID No. 836747 Oevering Homes Please refer to both identification numbers, Chippewa Path Lot 2 above, in all correspondence with the agenc . Town of Hudson St Croix County SW1/4, SW1/4, S13, T29N, R19W FOR: Description: Mound System (3 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1699108 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • Divert surface water from POWTS Area. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing, and compactine of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by r~ olling a soil sample between the hands. If it rolls into a 1/4- inch wire SHAUN R BIRD Page 2 4/5/2017 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 • 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. • Tank Installation to follow all manufacture's recommendations. i • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any 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 health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 16eaf 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.vanderleest(clt,,wisconsin.gov SHAUN R BIRD Page 2 4/5/2017 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 • 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 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • _Pump Floats to be set and verified per approved plan. Any changes may result in pump resizin2 to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your WiSMART yment Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services Pa 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest cr wisconsin.gov Cover Page MAR 2® 2017 W[)jjSTRy SEnVl(, Shaun Bird Bird Plumbing Inc. 1432 120th St. if AND New Richmond Wi 54017 fVICES 715-246-4516 M. - Date: 3/17/17 Owner:Oevering Homes Location: SW1/4 SW1/4 S13 T29 N,R19 W Lot 2 Chippewa Path Hudson 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 Specifications and cross section Attachments: Soi est Shaun Bird Signature License number 226900 Page 1 of 9 System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 SW 1/4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 103.8' 3/17/17 BEDROOM 3 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND 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 survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 117' Property Line Scale = 1/4" = 10' 2 acre lot Chippewa Path Tank is to be properly bedded and provided with lockdown covers with approved warning labels 103 Huffcutt Pro 3 101, Combo Tank Bedroom House B-1 5% Slope Grading is to be done to divert Well is to meet all WDNR B-3 run-off from setbacks ❑ system Area 15' below _ system is to remain undisturbed B - 102.5' 330' Property Line B.M.* D~-f' Mound System Cross Section and Plan View Dimension Feet A i B T i=i.r.r.r.r.r•r.r•r.r.. 1:\.1.YY1.1:1:ti:ti:ti=ti:1: D 1•YL-L•1 •1+•r•r•r•r•r•r•fv-rvr-r• : 1.1.1.1•Y1.1.1.1•Y1.1n•1•v1.1• . ~1~,1.1?L:1:1~•1.1•YY1.1.1.1.1.M1.1.4? ?~?•?~?•r~l.r•r•Mf.f•r.f•r•f•l.f.r• I j1.1~ wJ1 r•r• Y11111~ v1.1.1.1•Y1-YL•1.1• r•r.rwr.rtirYir:-. A 1'r1 l1•~ f fyYLrlfl:t:t?ti,44ti?ti? 1?1f~f- f•r•r•r.r.r.r•f.rM•r•f111. 1 1 ' F 1,1.1.1,•• r.?.•. 1=11?ti-1.1~ L - ry 1?1r +1 L. 1 r•r•r. r.r.f.f.r-r.l.r- r.rti•1.1.1.1.1.Y1.1.1.1.1.1.1. ~:r ' L•Lr'-•f-1?1?1.1?11:YYti,ti 1 tiKrK%•Y~L?1.~.~ryr1r rt•1.1fY1?Y1.1fY1?1?11:1?1: •r~ 1:1?1?•rti111.1.1 W rY•f•f•f•rY•f•FFr. 1.1.1.1-1?1?• r•r•rY-r.rY.r.f.f.r.r1l~i.f.f.r~r.r+TYY1.1.1?1?1? -1 1•f•r•I.r.r•f•f•r.t.f.r-f.r•r.f.f~fr•f1r:•1.1•L•1.YYY1.1.1.1.1.1.1.Y1.1.1?1?ti r•r•r•r•r•r•r.r•r.r•r•r•r.r•r•r•f•fvr.}:r:i:r ~ F 3 =1 G i is H I i I t I 1 n J K I 7L K l B W ? - Z L Slo e % - = Topsoil = ASTM C-33 Clean aggregate r 1 O = 4 in. sch. 40 pvc Cap Material ~ YL 1 sand fill •1-Y1'•~1 to 2 1/2 ln. dia. observation pipe Geotextile H Fabric ri r1r1 y`1rti.1.1.YY1. F ~;;;?1.1?1c1.c? 1 j1. {1r1 f1r.; f. f e. r•t D ;.E Ft Contour Plowed Surface 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 s7ed in place with rebar or a closet flange. 10/071gj Page 9 of Pressure Lateral Layout Two Laterals - End Manifold 0 - Threaded Cleanout Lateral Turn-up plug Manifold M t X Force Main L Long Sweep 90 J f~ Bend zqo(-,~AA Y er Distribution Network S ecifications Pressure System Construction Lateral Diameter In. Manifold Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter In. pipe. Orifices are drilled perpendicular to X Orifice Spacing) In. the pipe with a sharp drill bit and face down. L ateral Length) Ft. Lateral turn-ups terminate with a threaded M (Manifold Length) Ft. cleanout plug and are enclosed in a 6-8 inch Force Main Diameter In. diameter lawn sprinkler valve box accessible Force Main Length c Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box Page of~ 03/05193 Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Zoe I'M Tank Model Number Pump Model Atumber Total Tank Capacity'] 6? ?-n Manufachuer Max. Burg DqAh Alarm Model Number Switch Type rC Filter Manufacturer Total Dynamic Head (TDH) - Feet Filter lvModel Number f _ Elevation Head ' Distal Pressure r Network Loss Minimum Pump ~erfomw= Required Force Main Loss GPNl~ Ft TDH Total Outlet Manhole Min. 4" Above Grade With Locking Device. Inlet Manhole Manhole min. 4" Above Grade < 6" Below Grade Sealed Watertight Securely Mounted With Looking Device Weathex proof Junction Box Finished Grade t Vent Min. 12" Disconnect Above Grade Means With Vent cap outlet Filter wet hnletBaffle A Switch Set# p and Reserve Capacity Tank Voh$ne = S GPI Weep Hole Dimension: Inches Volume Gal. B (reserve) A Elevation C (alarm) B : 2. (dose) C C", 5 7, > Ft t Bottom D Ele (dead) D 1'4"S Ft Total GENERAL INSTALLATION: 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 #pproval. _ Manhole covers exposed to grade have as effocnve looking device (padlock) installed. Piping at fire inlet and outlet is of approved material, connected to the tank with wit fittings, and The' f main is sleeved with laid on stable soil to prevent settling or 4" $ch. 4U PVC to bridge the tank and the.sleeve.is sealed watertight. Elec#ical service Iles v~ri#hAtEC30 and Comm 16.23 excavation . Page of 1,7 {#2105 I.J TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING Ln MODEL 152/153 p 152 ,53 W I l W W U.J 50 Feet ~ Meters Got. I Liters I Gal- Liters 153 5 1.5 1 69 261 77 291 10 3.1 61 231 1 70 265 12 40 152 15 4.6 53 201 61 231 20 -I 6.1 44 167 52 197 30 25 7.6 34 129 42 159 Z 8 30 9.1 1 23 87 ! 33 125 ° 35 1. - - 22 85 20 ^ ^ - ~0 40 12.2 I i - 11 I 42 1 i t 1.6~n 54.0 Ft. 4 j Loc ~.4m} _ Voive: 138.0 Ft t 0 D1i509 I 0 20 0 60 80 100 GALLONS 6 1/4 LITERS 0 80 160 240 320 3 27/2 i I' s 5/8 FLOW PER MINUTE I I 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. - = ®O 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with 1 an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable - i level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. ( ! • Over 130°F. (54°C.) special quotation required. i ! 152(153 Series 152!153 MODELS Control Selection ~Id ! I I a Model Volts-Ph Mode s Sim ex Du lex ! 5 1 /8 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or3 - sr20e4 E152 230 1 Non 4-3 1 2 or 3 BE152 230 Auto 4.3 Inclined 2 or 3 N113 115 1 Non 10.5 1 2or3 SELECTION GUIDE SN153 115 1 Auto 10.5 Inclu ed 2 or 3 E3 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BC153 230 1 Auto 5.3 Induded 2 or 3 switch. Refer to FM0477- n CAUTION 2. See FMO712 for correct model of Electrical Alternator E-Pak All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) 8censed electrician. Al 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 70: P.0- BOX 16347 Louisville, KY 402550347 Manufacturers of • . 7 SHIP 70: 3649 Cane Run Road C p Q Louisville, KY 40211-1961 QlLQL/TYPUn P5 ✓rHCf Ign ® (502) 778-2731.1(800) 928-PUMP i°VMP !O_ httpzlAvww.zoeper.com FAX (502) 774 3624 © Copyright 2000 Zoeller Co. All rights reserved. 61 0 9 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page FILEINFORMATION SYSTEM SPECIFICATIONS ' Owner 0e 2l f n~q Septic Tank Capacity al ❑ NA Permit 67 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer p NA Number of Bedrooms ❑ NA Effluent Filter Model p NA Number of Commercial Units j"A Pump Tank Capacity L-62 g al NA Estimated flow (average) al/d Pump Tank Manufacturer NA Design flow (peak). (Estimated x 1.5) -22 7- aVd . Pump Manufacturer e4 ❑ NA Soil Application Rate l< al/da /ft2 Pump Model O InfluentlEffluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) s30 mg/L ❑ Sand/Grgvel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODE 5220 mg/L ❑ Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5150 m /L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average" Manufacturer Cell(s) Cel Dispersal Biochemical Oxygen Demand (BOD,,) S30 mg/L ❑ In-ground (gravity) ❑ In-ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade Round Fecal Coliform (geometric mean) 510` cfu/100m1 ❑ Drip-line ❑ Other. Maximum Effluent Particle Size Y, inch diameter Values typical for domestic (non-cornmerdaq 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 ❑ months ar(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every ❑ month ear(s) (Maximum 3 yrs.) Clean effluent filter At least once every r, ❑ months' ear(s) Inspect pump, pump controls & alarm At least once every ❑ months ear(s) '0 NA Flush latrals and pressure test At least once every months ear(s) ❑ 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, m nical or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at idtervals of 12 months or less shall be performed by a certified POWTS Maintainer. A serves 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. ~ 0; i 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 the 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 ble discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenlt. 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 within 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 drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting producgs; 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 propety and safely 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 property 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 soil, 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 requirled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rulej in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soli limitations. Barring advances in POWTS teehnologN a holding tank may be Installed as a last resort to replace the failed POWTS. , 7'he site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil 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 a last resort to replace the failed POWTS. )1;'nd 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 Flame 60"'Z Ell Phone 7/ J--,2 G Phone - SEPTAGE SERVICING OPERATOR (PAPER) LOCAL REGULATORY AUTHORITY Names Name CX Phone J 6J Phone ~d This document was dratted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(fl and 383.54(1), (2) & (3), Wisconsin AdminiStra6Ye Code. 1 N O. h f M 1 { t ft }~~3r ,i t i f 1.t.~E. I. t O t' S !O 0o I ~ _ L~_3 i a\ I +v~ `1 lip.. Jt C / ~ ice} ' 11 Oo i m c c o Q N ~ N 13 0 m ; ~ Q co U S Q' Z 3 art ~ a U o N r- C\.# Parcel 020-1017-90-020 04/12/2017 09:58 AM PAGE 1 OF 1 Alt. Parcel 13.29.19.83A-12 020 - TOWN OF HUDSON Current k ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 10/13/2016 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner OEVERING HOMES LLC O - OEVERING HOMES LLC 1433 CERNOHOUS AVE STE A NEW RICHMOND WI 54017 Property Address(es): * = Primary Districts: SC = School SP = Special ' CHIPPEWA PATH Type Dist # Description SC 2611 SCH DIST OF HUDSON SP 1700 WITC Notes: NEW FOR 2017. CSM TOOK ALL OF 020-1017-90-001 & 020-1065-70-000 FOR 4 LOTS. Legal Description: Acres: 2.010 SEC 13 T29N R19W PT SW SW FKA PT LOT 2 CSM 9/2481 BEING CSM 27-6274 LOT 2 Parcel History: Date Doc # Vol/Page Type 02/17/2017 1043703 WD 01/24/2017 1042466 WD 10/13/2016 1037182 27/6274 CSM 10/06/2016 1036885 WD more... Plat: Primary Tract: (S-T-R401/4160i<GL) Block/Condo Bldg: 6274-CSM 27-6274 020-2016 13-29N-19W SW SW LOT 2 2017 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/28/2016 Description Class Acres Land Improve Total State Reason Totals for 2017: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 'Property Address (Verification required fro tanning & Zoning U . epartment for new construction.) - City/State Parcel Identification Number LEGAL DESCRIPTION Property Locations r' , S~_J %4 , sec. ~ T ~ C-N R % j ,w, Town of Subdivision - Certified Survey Map # ( ~j - Lot # - -Volume page 4'- -Page Warranty Deed # Volume , # Spec house 'yes no Lot lines identifiabl yes no -7`~ SYSTEM MAINTENANCE AND OWNER CERI'IFICATIQN Improper use and maintenance of Your s maintenance consists of purnping out the s septic; system could result in its premati he system can an affect the function of ep~ tank every three years or sooner, the mature failure to handle wastes. Proper the system s the septic tank as a treatment sta e ' by a licensed pumper- What you nsibil are specified in §Cornm. 83.52(1) and in 'Chap ter 12 _ St' m the if waste needed, disposal bsystem. Owner maintenance Put tutu P Croix County SauitaD' Ordinance. The property owner agrees to submit to St, Croix Coun p owner and by a master owner a ,,jounce plumber, restricted plumber & Zoning Department a certification fo wastewater disposal system is in proper operating condition and pl ber or a licensed signed by the less than 1 r ~ of sludge. pumper n verifying that (1) the on-site se t (2) after inspection and and pumping (if necessary), the septic tank is 1/we, the undersigned have read the standards set forth, here above requirements and agree to main Certifications t in, as set by the Department of Co tam the private sewage disposals stem g that your septic system has been rnmerce and the Department of Natural Resources, State of Wisconsin. the ~~g DeP~ment win 30 days of the three maintained must be completed and returned year expiration date, turned to the St. Croix County planning & 1/we certify that all statements ou Property described above b v form are true to the best Of MY/our of Deknowledge. I1we am/are the owner(s) of the Y trtue of a anty deed recorded in Register of Deeds Office, Number of bedrooms IGNA OF APPLICANT(S) 3/ ***An info DATE Y rmatton that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning D Include with this application a recorded Warranty deed from the Register of Deeds Office and a copy of the certified survey map if (REV. 08/05) ~l g l Q a ~ uWn SAM s+r r u . . iF, d a 9r I ==AM f f - - - - - - - - - - - - - f r a~ f Ale l I ~ i i 1 or-or RECEIVEL) OCT 'r ZU,16 Wisconsin Department af OIXCOU~-jiy SOIL EVALUATION REPO' 2KTXAAVZKV3pW -of- Division of Safety and BU ITY DE-~!E( O~ f` in accordan"" Comm 85, Wis. Adm. Code County + Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 'J include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. b 20 to 17 16-6M Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property location Govt. Lotj 1 /4 Sfl 14 S T Z ( N R E ( k W Property Owner's Mailing Address Lot # Block # Subd. Name M# 2- 0 City State Zip Code Phone Number ❑ City VI ge own Nearest Road New Construction Use: ['Residential / Number of bedrooms 34 Code derived design flow rate/_:' GPD ❑ Replacement Public or commercial - Describe: Parent material.( i Flood Plain elevation if applicable General comments and recommendations: System Type ril<, System Elevation l o--3 FT] Boring # a Boring Q Pit Ground surface elev. W 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 L14 yr 3 s n Boring # Boring L / 7 pit Ground surface elev. ft. Depth to limiting factor / tn. 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 co, - C. Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30:5 150 ' Effluent #2 = BOD. < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ture CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5404--l" 01 715-246-4516 I Property Owner _ Parcel ID # Page of F-S] Boring # ❑ Boring n pit Ground surface elev. ft. Depth to limiting factor J 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 2 S.) - 5j I q 31 U. C',1 m e ❑ 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. 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 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD3 < 30 rng/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 (8.6/00) e Property Owner Parcel ID # Page of Boring # ❑ Boring :Z a ~ Pit Ground surface elev. ft. Depth to limiting factor J ~ an. Sal ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in, Munseli Qu. Sz Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 U a Bodng# ❑ Boring . ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate kionzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff ' in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. •Eff#1 *01#2 Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to luniting factor in. Sod AAAcadon Rate Horizon -"th Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz Cont. Color Gr. Sz Sh. TMI `Eff#2 Effluent #1 = BOD5 > 30 < 220 rig/L and TSS >30 < 150 mg& ' Effluent #2 = BOD$ _ 30 nxA and TSS < 30 nVL 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 608-2648777. seo-craw pesroo~