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r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592273 GENERAL INFORMATION State Plan ID Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] o:'1 3( f y~ Permit Holder's Name: F City Village Township Parcel Tax No: Daniel & Nicole Wells TOWN OF RICHMOND 026-1158-00-068 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: f~~p~y o~ P~~ 25.30.18.1203 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURET) Z s CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing _ Alt. BM. C J A ` i loo Aeration n Idg. Sewer too. y o~ H Iding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION ' TANK TO P/ L'1 WELL BLDG. Vent to Air ntake ROAD Dt Inlet Septic _ Dt Bottom L 4 N Header/Man. >s .y /o y. Aeration Dist. Pipe -t !6 y Irv ~l l l Holding Bot. System P-5 PUMP/SIPHON INFORMATION Final Grade j•~5 f~5~q,~ Manufacturer Demand St Cove ld `O~ fj'1~ 1 GPM tC I 3 Model Number / 16 ~5+ TDH Lift Friction ; Loss Sm Head l TFt 4L lp ~L,~ of fw / V ~ 'l' lY Forcemain Length O t Dia. µ Dist. to Well - SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Tre hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS o SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING MairfWacturer: INFORMATION CHAMBER OR Type~Of Sgsiem: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution ix Hole Size x Hole Spacing VE`ntto Air Ijtake rl Pipe(s) ~ s~~~ Length Dia Length Dia Spacing _ SOIL COVE x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of 77odded xx Mulched Bed/Trench Center / ] l~ Bed/Trench Edges Topsoil `Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) (Inspection p#1:Tj _ i(t) - )j-)j _ Inspection #2: Location: 1441 136TH AVE_ IT,4t `O¢ 1.) Alt BM Description = Ct 2.) Bldg sewer length - amount of cover = t~ t Plan revision Renuited: - Yes-- No Use other side for additional information. [~C4 Date Insepc tur Cert. No. SBD-6710 (R.3/97) System PLOT PLAN PROJECT Dan Wells ADDRESS 1510 Ctv Rd GG New Richmond Wi 54017 SE 1/4 NW 1/4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 105.2' 4/11/17 3 DATE BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none r, BENCHMARK V.R.P. Top of telephone pedistal ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 144th ST. B.M. B-1 104' 105' 105.2' 6% Slope 106* Scale = 1/4" = 10' Area 1 5' below system is 2 acre lot r B-2 to remain undisturbed B-3 Grading is to be done to divert run-off away from system Huffcutt Combo Tank Tank is to be properly beddedand provided with lockdown covers with approved warning labels Pro E3 ~ Well is to meet al I WDNR setbacks Bedroom 136th Ave House rsI~~ Safety and Buildings Division County it-*--- 9 K 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.} p Madison, WI 53707-7162 MAY03 Nfm ~Z 5 22~ State Transaction Number rpMMUN it Application , In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit (_,Lye is required prior to obtaining a sanitary permit Note: Application fors 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 urposes in accordance with the Privacy Law, s. 15. 1 m , Stats. ~ jqq A-Ve L Application Information - Please Print All Information Property Owner's Name Do-A 1r, e' Parcel Cab- Is 6- DD-DCOB Property Owner's Mailing Address Property Location a 1,G1 4.~ Govt Lot City, State Zip Code Phone Number '1. j i ~Y Section, ~ 11 ~~l 't 1 T y N; D~ (circle on ,~.i 'Y- E o(,/ II. Type of Building (check all that apply) Lot # or 2 Family Dwelling-Number of Bedrooms Subdivision Name , r ❑ Public)Commercial - Describe Use L _ mel ❑ City of f ❑ State Owned - Describe Use I CSM Number ❑ Village of - Town of n /2 x 1 era _ III. ermit: (Check only one box on line A. Complete fine B if applicable) A 1 A4 SYs m El Replacement System ❑ TreatmentJHolding Tank Replacement Only ❑ Other Modification to Existing System (explain) B- Permit Ren ❑ Permit Transfer to New List Previous Permit Number and Date Issued ❑ ai Kt Revision ❑ Change of Plumber BeforeExp- Owner i IV. Type ofPOWTS S ste o roe: 1 -1 l ❑ Non-Pressurized In-Ground ❑ Pressurized In-Gr d At-Grade Mound .124 in. of suitable soil ❑ Mound < 24 in- of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) I V. Dis rsal/Treatment Area Information: • Design Flow (bpd) Design Soil AppIi Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed (s System Elevation ~ I VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 2 2 7E New Tanks T-Eusang TanlS W1 ~'~J~•/-~M A F14a t u i;, w C7 Septic or Holding Tank A..4 Dosing Chamber VII. Responsibility Stat ent- 1, the undersigned, e responsibility for installation of the POWTS shown on the attached plans Plumber's Name (Print) { Pl a Sienature MPlIvIPRS Number Business Phone Niirnber I Z " " / ; - /44/ G 7 Plumber' Address (Street, City, StaW, Zip Cade) VI]L County/De artment Use Only ❑ Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signatue S V l ❑ Owner Given Reason for Denial { IX Co SYSTEMAO WNIE al/Reasons for Disapproval 1, 8600 tank, ®Kont filter and ~n e Ptct wl *Ais pel-Aii -If• dispersal call must b~ dip@dl l in in d as pQr rn y.. r i > l~ln p. ~virlec by plumber. S I ~C IUG~G+ ' jl~ 2. All setback rcyul~a~,ririetarL~~u b6 inairitained as per appliCc ctftepnVNt " the system and submit to the County only ou paper not le~Qt~pp~ es / ~ yr Tor IV.V r' f SBD-6398 (R. 11/11) DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 r GREEN BAY WI 54304-5211 Contact Through Relay P S. http://dsps.wi.gov/programs/industry-services www.wisconsin.gov n R Scott Walker, Governor Laura Gutierrez, Secretary > April 25, 2017ar OF Sk CUST ID No. 226900 .ATTN.- POWTS Inspector ~.~g. SHAUN R BIRD ZONING OFFICE BIRD PLUMBING 1NC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708; CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/25/2019 Identification Numbers Transaction ID No. 2936188 SITE: Site ID No. 836835 Dan Wells Please refer to both identification numbers, 136TH Ave above, in all corres ondence with the agency. Town of Richmond St Croix County SE 1/4, NW 1/4, S25, T30N, R18W FOR: Description: At-Grade (4 Bedrooms - New Construction)- Revised from 3 Bedrooms Object Type: POWTS Component Manual Regulated Object ID No.: 1699686 Revision; Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R.. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. 'The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducin; the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands If it rolls into a 1/4- inch wire the site is too wet to pure. If it crumbles, site preparation can proceed. If the site is too wet to prepare do not proceed until it dries. 1 j SHAUN R BIRD Page 2 4/25/2017 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the at-grade must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • 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 $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleestna wisconsin.gov SHAUN R BIRD Page 2 4/25/2017 • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizina to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the at-grade must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. SPS 383.54(1)(e) The management plan for a PO1..'TS shall. Specifically address the servicug mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Payment Submittal. Private Sewage Plan Reviewer ,Division of Industry Services WISMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tiin.vanderleest@wisconsin. gov Cover Page RECEVED APR 13 2,917 INDUSTRY SERVICES Shaun Bird 3 Bird Plumbing Inc. 1432 120th St New Richmond Wi 54017 715-246-4516 Date:4/11/17 Owner:Dan Wells Location:SE 1/4 NW1/4 S25 T30 N,R18W Lot 68 136th ave Richmond Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications Attachments: Soil Test Shaun Bird Signature License number 226900 Page 1 of 9 System PLOT PLAN PROJECT Dan Wells ADDRESS 1510 Ctv Rd GG New Richmond Wi 54017 SE 1/4 NW 1/4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 105.2' 4/11/17 3 DATE BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none y, BENCHMARK V.R.P. Top of telephone pedistal ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 144th ST. B.M. 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Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a '/4 inch soil wire when a sample is rolled between the palms of the hands.. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After-the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative grovv.th, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches. and secured in place. 03/05 lgj _ 0 Page of Pressure Lateral Layout One Lateral - End Manifold 4 Threaded Cleanout Force Main Lateral Turn-up Plug X L Long Sweep 90 Bend E Ar Pressure System Construction Distribution Network S ecifications Lateral Diameter Z- 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 Lateral Length) Ft. Lateral turn-ups terminate with a threaded Force Main Diameter In. cleariout plug and are enclosed in a 6-8 inch Force Main Length Jr Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade •••••••:;Q_••••••• 6-8 Inch Lawn Sprinkler Valve Box 03105 lgj Page of Septic-Dose Wank Cross Section And Pump Performance Specifications Tank manufacturer ^ Pump Manufacturer f o 2 Tank Model Number Pump Model Number j L Total Tank Capacity i s > Alarm Manufacturer Max. Bury Depth Alarm Model Number Switch Type Total Dynamic Head (TDH) -Feet Filter Manufacturer ~I kL+ Filter Model Number " Elevation Head Distal Pressure Network Loss I Minimum Pump Performance Required Force Main Loss GPM: @ j . Ft TDH Total - Outlet 1%lanhole MV n. 4" Above Grade With Looking Device. Inlet Manhole Manhole Min. 4" Above Grade 6" Below Grade Sealed Watertight Securely Mounted With Locking Device Weather-proof i Junction Box r► - - Finished Grade - Vent Min. 12" Disconnect Above Grade Means With Vent cap • s • > . > > > > s > > > . > . > . . >i J., Qutlet Filter - - In.t. inlet Baffle ` • Jlet ~iwitch Settings and Reserve Capacity A Tank Volume = GPI Weep Dimension ; Inches Volume Gal. B Hole (reserve) A; S-06 (alarm) B 2 Off Elevation C (dose) C ; 7, _~r Ft " Bottom (dead) X S D Elevation Total Ft ::<`< .'i ..'<>< ~ r>> ><><> > ~.;r;>,.~>~>~>~•~>•Y'>>;)~I~><>s>~>a>.•1>.: <><>.r!=<>:<><>: < <•:t><'t ~•1<><•1'.•a•i'1 is : 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 p"or approval. Manhole covers exposed to grade have an effective Iocking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fritmgs, and laid on stable soil to prevent seWiug or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 LJ Page 5 of TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153-~- - w MODEL 1 i52 153 ~ uj cow I 50 Feet Meters Col. I Liters I Col. Liters 153 5 1.5 69 251 77 291 12 40 10 3. i 61 231 I 70 265 0 15 15 4.6 ` 53 1 201 61 231 = 20 -I 6.1 44 167 52 197 L, 30 25 7.6 34 129 42 159 z 8 30 9.1 I 23 87 i 33 1 125 0 20 35 ; 22 85 o 40 ( 12.2 I I - 11 42 j Lock Voive: 136.0 (11.6m)~44.0 Ft. (13.4m) 10 0145W 0 1 20 40 60 80 100 GALLONS ' LITERS 0 80 160 240 320 3 -4 51/4 X7/32 i 6/8•--~~ 1 FLOW PER MINUTE it l 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ I • Timed dosing panels available. OO 3 27/32 Electrical alternators, for duplex systems, are available and supplied with an alarm. Variable level control switches are available for controlling single phase systems. I • Double piggyback variable level float switches are available for variable I level long and short cycle controls. j I • Sealed Qwik-Box available for outdoor instatlations. See FM1420. l • Over 130°F. (54°C.) special quotation required. i I 1 1' I I 1521153 Series 12 1/8 r I 10153 MODELS Control Selection i T/7 I I Model Vora-Ph Mode Am s Simplex Duplex ; I 5 1/8 N152 115 1 Non 8.5 1 2 or 3 i BN152 115 1 Aura 8.5 Included 2or3 1 SK2064 E152 230 1 Non 4.3 1 2 or 3 BE152 230 Auto 4.3 Inclu• ed 2 or 3 N153 115 1 Non 10.5 1 2 oc 3 BN153 11s t AuN 10.5 included 2 or 3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. O CAUTION 2. See FM0712 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) licensed electrician. An electrical and safety codes should be followed including the most Of (4) float system. 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 Louisville. KY 4025&0347 Manufacbwsof.. Z SHIP 70: 3649 Cane Run Road L~: 0 - Mfy® Louisville, KY 4021 f-1967 QlLdL/TY PL/MP✓$ 5111CF 91pO 7 (502) 778-2731.1(600) 926-PUMP FAX (502) 774-3624 httpJ/www.zoeller.com 169, 0 Copyright 2000 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner , Septic Tank Capacity , al 13 NA Permit # Septic Tank Manufacturer I-] NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA i Number of Public Facility Units NA Pump Tank Capacity al ❑ NA ~ j Estimated flow (average) J avda Pump Tank Manufacturer ❑ NA i i Design flow (peak), (Estimated x 1.5) cf> Pump Manufacturer IVAI i ~ gal/day p ❑ NA Soil Application Rate aUda le Pump Model O NA i. Standard Influent/Effluent Quality Monthly average` Pretreatment Unit A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) <220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) _<150 mg/L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) D NA Biochemical Oxygen Demand (BODs) 530 mg/L 0 In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L 7"1 At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 ckdl0oml ❑ Drip-Line ❑ Other: iMaximum Effluent Particle Size X in dia. ❑ NA Other. 11 NA (Other. Other: D NA "Values typical for domestic wastewater and septic tank effluent. Other C3 NA IAINTENANCE SCHEDULE Service Event Service Frequency Ilnspect condition of tank(s) At least once every: ❑ month(s) ears (Maximum 3 Years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA (Inspect dispersal cells} At feast once eve 11 month(s) ry: -ayear(s) (Maximum 3 years) ❑ NA (Clean effluent filter At least once every: Yearmont(s) hs) ❑ NA Inspect pump, pump controls & alarm At least once every: 3 month(s) O NA jLLyear(s) s=lush laterals and pressure test At least once every: ❑ month(s) 11 NA year(s) ether. At least once every: [I mar(s) ❑ NA ether. ❑ 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 linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of ixmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local I-egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (36) or more of the tank volume, the entire contents of !:he tank shad be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. fall other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals th.1t 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 be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of 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 POW 'T$: 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 products; 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 propeily and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with 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 requitjed setbacks from existing and proposed structure, lot 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 rule,{ in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologN a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluatpon 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. Mound and at-grade soli absorption systems may be reconstructed in place following removal of the biomat at the infiltrative %ce. 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 OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name S Phone Phone /J L SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone ' - Phone ~16 This document was dratted in compliance with chapter SPS 383.22(2)(b)(%d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. U 7 n r) .F 1 i v v o f/) C3 a C> r P p A O I. a ~ ~ r I tY~ _ .J ~_L l 6 oe o N Q 1 h ~ t v1 0 6 ~ G Q N 3 N O LLU i t i I- i i 7 I RECEIVED MAR 3 0 2017 - Wisconsin Departme ® OUNjy SOIL EVALUATION Ktf'vrld` Page of Division of Safety% DEVELpce with Comm 85, Wis. Adm. Code County C Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. C~-~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). io~~ 4/~ U / Property Owner Property Location "D J-L Govt. Lot 1/4 tW/4 S T N R E( r) W Property Owner's Mailing Address Lot # Block # Subd. Nayrip or M# City State Z C e Phone Number ❑ City ❑ Village Nearest Road Flew Construction Use: O Residential / Number of bedrooms ~ Code derived design flow rate 11-f Z? GPD ❑ Replacement ,L Public or commercial - Describe: _ Parent material %'6C ~Cl Flood Plain elevation if applicable ~✓I f' ft. General comments ~ and recommendations: System Type System Elevation / MBoring # ❑ 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"- VVV I c~ / 'Y YY' Boring # Kul Boring Pit Ground surface elev. L r 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. /art 'Eff#1 'Eff#2 7 _ r t~ t ' Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 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 ell Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 j 715-246-4516 Property Owner _ Parcel ID # Page of FN Boring Boring # 24it Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 _LL Z 3Z 0 6 2Z 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 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD5 < 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 (8.6100) Property Owner _ Boring Parcel ID # Page of ❑ FN Boring # Rpit Ground surface elev. , t?5,3 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 -7 Z- L el"J ❑ 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 i it i ❑ Boring Boring # ❑ pit 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 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-6330 (8.( M) Soil Test Plot Pla Project Name Dan Wells S n Bird Address 1510 Cty Rd GG New Richmond Wi 54017 STM #226900 Lot 68 Subdivision Red Pine Corner 2nd Date 3/21/17 SE 1/4 NW 1/4S 25 T 30 N/R18 W Township Richmond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of telephone pedistal System Elevation 105.2' *HRpSame as Benchmark 144th ST. B.M.* B-1 104' 1 05' 6% Slope 106' Scale = 1/4" = 10' 2 acre lot B-2 B-3 136th Ave -av)-7 0G ON 1% 11M County e.. <1 Safety and Buildings Division 'S 'A" F 1 1 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) 1 Madison, WI 53707-7162 oPM~' S9 Z z7 : oo Sanitary Permit State Transaction Number In accordance with SPS 383 .2l(2), Wis. Adm. Code, submissio Z 9 Z 7 el c7 - I is required prior to obtaining a sanitary permit Note: Applicati Project Address if different than mailing address) the Department of Safety and Professional Servies. Personal information you proviae may uses in accordance with the Priv Law, s. 15.04{1) m , Stats. /L I Application Inform 'on - Please Print All In f rmation r J A, A Lope-, Property Owner's Name AWA1 Q~ t G.a Parcel # Property Owners Matlmg Address F Property Location 45. j C? - f i aC 4(check Govt Lot City, State Zip Code Phone Ntmiber Section (circle oqe II Type of Buildithat appl T L N; If~ E W i or 2 Family Dwer of Bedroo c-~ F Subdivision Name ❑ Public/Commercial -Describe Use 6X 4Jb X" I ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of r pwn of sr-". ; p_ f ~r<'t L,t-~; rof er only one box on line A. o able) ❑ Repl acement System Treatm t/Ho Replacement Only Other Modifcaton to Existing System (explain) Permit Revision Ch e urn e ❑ Permit Transfer to New List Previous Permit Nrunber and Date Issued 01 Owner W. Type ofPOW TS Sys tem/Com onen vice Chec all that a I ' a ❑ Non-Pressurized In-Ground essu ound Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ er Dis a on (explain) ter. ❑ Pretreatment Device (explain V. Dis rsal/Trea eut Area I rm on: Design Flow (gpd) Design Soil li on Rate(gp Dispersal Area Required ( Dispersal Area Propose (sf) System Elevation VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks ° Existing Tanks m u U ° L Septic or Flnlding Tank ! i' U P cn ;z, C: ' Dosing Chamber r VII. Responsibility S e ent- the undersigned, ass a esponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) f /f Plumb s imature MPlMPRS Number Business Phone N ber s r Plumber's Address (Street, City, State, Zip Corlej• n VIII ounty/De artment Use Only S Approved Permit (/~Fee(j Date sued Issuing. t Signature ob 4 / 3 /~7 ❑ eason for Denial IX Conditt r L Faso tIS ,)I ~ ypproval 00, ep ark, E t•: n: ` A t uispel cell must dll be . ic S ' nt' 2L A- ss;per larigement plan pio naeri by plumber. _ _ ~o ~ ~✓i 2 :rail: ,k to gk0e is must t m ma ntr ire -z a^e~:. ~ " 1 as PW WOPM619 COW I -.fdiwmaj. Attach to complete plans for the system and submit to the County only on paper not less than 8 12 z l l inches in size SBD-6398 (R. 11/11) I System PLOT PLAN PROJECT Dan Wells ADDRESS 1510 Ctv Rd GG New Richmond Wi 54017 SE 114 NW 1/4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 105.2' 3/21/17 DATE BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of telephone pedistal ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 144th ST. B.M.* B-1 104' ~ 105' 105.2' 6% Slope 106' Scale - 1/4 - 10 Area 15' below system is to remain undisturbed 2 acre lot B-2 B-3 Grading is to be done to divert run-off away from system Huffcutt Combo Tank Tank is to be properly bedded and provided with lockdown covers with approved warning labels Pro 3 Well is to meet all WDNR setbacks Bedroom 136th Ave House z-, D DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 x7.~ GREEN BAY WI 54304-5211 f a! Contact Through Relay P ;J http://dsps.wi.gov/programs/industry-services www.wisconsin.gov \k0FE~SIOr ~Scott Walker, Governor Laura Gutierrez, Secretary April 06, 2017 ,J P R tia V E 'F SFE CUST ID No. 226900 ATTN: POWTS Inspector'` SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON Wl 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/06/2019 Identification Numbers Transaction ID No. 2927469 SITE: Site ID No. 836835 Dan Wells Please refer to both identification numbers, 136TH Ave above, in all correspondence with the agency. Town of Richmond St Croix County SE1/4, NW 1/4, S25, T30N, RI 8W FOR: Description: At-Grade Q Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1699686 Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • 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. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smeariniz and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined b-- rig, a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare. do not proceed until it dries. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizin2 to meet TDH and GPM Specifications. • Divert surface water from POWTS Area. • Well setbacks to meet chs. NR 811 & 812. 1 SHAUN R BIRD Page 2 4/6/2017 " • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. 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. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the at-grade must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. 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. • 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. 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 PO WTS. Sincerely, Fee Required $ 250.00 117eleal This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest a wisconsin.gov SHAUN R BIRD Pan 2 4/6/2017 • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. 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. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the at-grade must be cut off at round 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. • 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 horizontaliv from where the servicing pad is located 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.vanderleest@wisconsin.gov Cover Page Shaun Bird Bird Plumbing Inc. 4w,~ 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:3/21 /17 - Owner:Dan Wells Location:SE 1/4 NW1/4 S25 T30 N,R18W Lot 68 136th Ave Richmond Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications Attachments: Soil Test Shaun Bird ' Signature License number 226900 Page 1 of 9 System PLOT PLAN PROJECT Dan Wells ADDRESS 1510 Ctv Rd GG New Richmond Wi 54017 SE 1/4 NW 1/4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 105.2' 3/21/17 BEDROOM 3 DATE CONVENTIONAL AT-GRADE XXXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of telephone pedistal ASSUME ELEVATION 100' Filter Lifetime Filter O BOREHOLE O WELL *H.R.P. same as benchmark 144th ST. B.M.* B-1 104' X-11 105' 105.2' 6% Slope 106' Scale = 1/4" = 10' Area 15' below system is to remain undisturbed 2 acre lot B-2 B-3 Grading is to be done to divert run-off away from system Huffcutt Combo Tank Tank is to be properly bedded and provided with lockdown covers with approved warning labels Pro 3 Well is to meet all WDNR setbacks Bedroom 136th Ave House At-grade System Sloping Site Cross Section and Plan View E A P__ t •L•L•L 4 L•L•1 L L•L•1 L L 4 L L 1 L L L L L L L L•L•L•L L L•L•L L•L•L•L L•4•L•L•L•L ~ Dimension Feet ~~•r•r•r r•r•r•r r r•r•r r r ~•r r r r•r r r r•r r r•r•r r ~•r r r r•r•r r r•r•r r r• J ' L•L•4•L•L•L•L•L•L•L•L•L•L•L L•'L•L•L•'L•L•L•L•L•L•L•L•L•L•L L•ti•L•L•4•L•1•L•L•LK L•L ,r ~,•j,j,j,j,j,j.j.j.j.j.r•r•r•r.r•r•r•r•r•j.,r.j.j.r.r.j.j.j.r.j.r.r•r•r•r.r.r•r r•r• L,L•L•,L,L,L,L„L,L,L,L,L•L,L••y~,L•L,L•L•L•L••yvL••L••.•L•L•4•L•L•4•L•L•L•L•L•L•L•4•L L L B r r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•j•r•j•r•r•j•r•r•r•r•r•r•r•r•r r r• IJ I 1 L•bL•L•L•L.L.L•L•1•L•4.1•L•L•L•L•L•L•L•S,••L•ti,•L•L•L•L•ti,•L•L•4•L•4•4•L•L.L.1•L L•L r r•r•r•r•r•r•Ar•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•j•r•r•r•j•r•r•r•r•r•r•r•r•r•r r•r• f r~r r~r~r~r~r s~r:r~r~r r:r r r:r~r~r~r rtirtir~rtir r~r~r~r~rtir=r~J~l~rtir~r~r~r~r~l~r~ 1/6 B L•L•L•L•4.,t,L•L•,L•1,1,,ti„ti•,t„L,L,4,•L,4,L,4•,.•5,••t••L•L•4•L••.•1.L•ti,•1•L•S,•5,•1•L.L.L•L.L r•r•r•r•r•r•r•r•r•Ar•r•r•r•r•r•r•r•AAr•r•r•r•r•Ar•j•j•r•j•j•r•r•r•j•r•r•r•r•r•t• 4.4.4.4.4.4.4•L•S•1•L•L•1•L•4•L•4•Y1.4.4.4.4.4.4•L•L•L•L•4.4•L•L•L•L•L•1.1•L•1•L•L•' I r•r•r•r•r•r•r•Ar•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•r•j•r•j•j•j•r•r•r•r•r•r•r• W C 1•L•L•L•1•'L•1•L•4.L•L•4.1.4•L.L.L•4.4•L•4.1•L•1.4.4.4•L•L•L•ti•L•1.4_•4•L•4.4.1•'L•1•L• .r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•j•j•j•r•j•r•r•r•r•r•r•r•r•r•r r•r•r•l•r•r•r•r• D 2.0 L•L•L•1••L••.•L.L•1•L•L•4•L•L•L•L•1•L•4•L•L•L•L.L•4.1.1.'L•L•L•L•4•1•L•L•L•L•L•L•L•L•L•. .r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•j•r•j•j•r•r•r•r•r•r•r•r•r•r•r• 4,r:j:j:r•r=r:rtir~r~r r r~r r 1 r~r r:}:r~r~r~r~r~r~rtir r~rLrtir=rtirtirtir~r~r~rtirtirti L•L•L•L•L•L•L•L•L•L•L•Y1•L•L•L•Y4•L•YL•YbL•4•L•1.1i•1•L•1•L•'LA•L•L•L•L•4.1.1.1• E 5.0 ' - :.r•r•r•r•Ar•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r.r•r•j•j•r•r•r•r•j•r•r•r•r•r•r•r•r•r r•r• L•L•1•'L•1.4.4•L•L•L•L•L•1•L•L•L•L•4•L•L•L•L•L•1.4•L•4.4.1.1.L•1•L.1•L•L•L•4.1 L•L.L rL:ti 4~L?ti 1~L:ti ti 1:L~L?L~1jLjL 1~L~4iti ti 1~L~4j4:L~L?Lj1j1iL~L~LiL:1~'L%~tirti tijti 'Lrti :t~ F 0.5 ' -:•j,j,j,j,j.j.j.j.~.j.j•j.j.j.j.j.j.j.j.j.~.j.j.r.r.j•j•r•r•r•r•r•r•r•~•r.r•r•r r•r• 1•L•1.4•L•L•4• 1K•4•L•4•L•L•L•L•L•L•L L•LK•4•L•L•L•L•L•L•L•L• 4•L•L•1 L L•L G 1.0 !j, j, j. j. j,j.j. r.j.j.j.j.j.j.j.j.r•r•r•~.j.r.r.j.r•r•r.r•r•r•r• ~•r•r•r•r r•r• I 4.4K•1•L•L•L• L•L•4•L•L•L•L•L•L•L•L•L •.•L•L•L•L•L•4.1•L•4•L•L L•LK•L•L•L•L 11 j L E T-- 1/6 B -T i W 2 Z E B L L % Slope - "1 = Plowed j~fti = Clean aggregate O = 4 in. sch. 40 pvc ` _ basal area ?1r1 1/2 to 2 1/2 in. dia. observation pipe Lateral with 2" Topsoil Cap aggregate over pipe / Observation Pipe GeotextileWith Cap n s~ G Fabric r ftirr•r .5 Ft Lateral Invert . 4 4 L•L•4•L• j.r.j.j.j.j.j. r:j:j. j•r•r•r•r r 'ti> Topsoil Cap L•L L•L•L•1•L•L•1• ti•4•L•L•4•L•L•L L 1 L r•r r•r•r•J•r•r•r•r ~•r•r•~•~•~•r•r•r r r A Y ~ ~ 'L•L•1i•1•L•L•L•L 4•L•ti ~ ti ti•M1•4 L L 4 ~ 4 . i r• ~ •r•r.r•r•r•r.r•, r ~ •r•r r r .r r__ r_ r r r r• r r, _ 1 L•L•L•1•L•1•L•L F L• L ' -1 ~4l~4~~ ...,a r,r.r•r•r•r.r•. +r r r~ .j. j. . +L+~,w ~3 • • `-t•ti• L•L•L•L• 4 dS'Z.+ Ft Contour L•L•L•4.4 L L L • •.,.r r~ •r•r•r-r•r r r r•r• ~ c j~r~r:r r j:j.j.j.j.j.j.j.r•r•r•r•r ~ °-~"-~.S,r1 ~L,~} L L• ~ •L•4.4.4•L L•L- ~ y ~_.r_r~r r•j.r•r r r . D Plowed Surface C Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe.. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After, the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches. and secured in place. 03/0519) Page of Pressure Lateral Layout One Lateral - End Manifold 4 - Threaded Cleanout Force Main Lateral Turn-up ► Plug i X L Long Sweep 90 Bend yJ O / 4-ea~ op, n Pressure System Construction Distribution Ne ork S ecifications Lateral Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter In. pipe. Orifices are drilled perpendicular to 2 -3 7- X (Orifice S acin In, the pipe with a sharp drill bit and face down. L Lateral Length) 9 23 Ft. Lateral turn-ups terminate with a threaded Force Main Diameter -z- In. cleanout plug and are enclosed in a 6-8 inch Force Main Length _5 Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box 03/051gj Page of Septic-Dose Wank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tank Model Number p Pump Model Number 0`~ ~J L Total Tank Capacity ~t077 l D Alarm Manufacturer 1/e Max. Bury Depth 17 Alarm Model Number , Switch Type (C~~ c Filter Manufacturer Total Dynamic fIead (TDH) - Feet Filter Model'Number Elevation Head Distal Pressure s Network Loss l~ Minimum Pump Performance R aired Force Main Loss GPM: @ Ft TDH Total l Outlet Manhole Min. 4" Above Grade With Locking Device. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight Securely Mounted With Locking Device Weather-proof l Junction Box - - Finished Grade - - Vent Min. 12" Disconnect . Above Grade Means With Vent Cap t'> Outlet Filter Inlet inlet Baffle - - :r X tt A Switch Settings and Reserve Capacity " %a Tank Volume = GPI Weep Dimension. Inches Volume Gal. B Hole (reserve) A (alarm) B 2 Off Elevation C (dose) C ; , S 1-7 Bottom To D' l S D >:;Elevation tal y.Z Ft <t~. ..::`::":';tit.. a `:'~'~:;•1~•};'`r a < :'i :'.a:'e :r~r:.•: . > a s >t> ~s'+ . > is`>`.'>`s`> i<;<.': ta<; < . < . •t':t t a t. l a t a. t.< t a a t< <at•t•<'t•t•t't•t't t•1 t•t•i•. GENERAL INSTALLATION: The septicldose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an e€factive locking device (padlock) installed. Piping at the inlet and'oudet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch_ 40 PVC to bridge the tank excavation aud the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 U Page 5 of J TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153 w r MODEL I 152 153 W I W 50 Feet I Meters Go!. Liters I Col. I Liters 153 5 1.5 I 69 261 77 291 12 40 10 1 3.1 61 231 70 265 15 15 4.6 53 1 201 I 61 231 O w 20 -1 6.1 1 44 167 52 197 30 25 7.6 34 129 42 159 z 8 30 9.1 1 23 87 i 33 125 - - 85 10. 7 20 35 o I 40 12.2 11 42 ~ i 41 i Lcck Voive 133.0 Ft (I1.6m)!44.0 Ft (13.4rn) 10 0145M 0 i 20 40 60 80 100 GALLONS LITERS 6 1/4 0 80 160 240 320 - 3 27/32-~- FLOW PER MINUTE I 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Tinted dosing panels available. I 3 2i/3z • Electrical alternators, for duplex systems, are available and supplied with e t an alarm. • variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. I !I ~ • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. ! I ~ 2 1/8 L 1521153 Series 1521153 MODELS Control Selection I j I I ! Model Vohs-Ph Mode Am s Sim iex Du lex 5 1 /o N152 115 1 Non 8.5 1 2 or 3 6N152 115 1 Am 8.5 Included 2 or3 sK2064 E152 230 1 Non 4.3 1 2 or 3 BE152 230 Auto 4.3 Inclu,ed 2 or 3 3 N153 115 1 Non 10.5 1 2 of BN153 115 1 Aura 10.5 inclu:ed 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 or 3 1.. Single piggyback variable level float switch or double piggyback variable level float BE153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. O CAUTION 2_ See FM0712 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) licensed electrician. AD electrical and safety codes should be followed including the most or (4) float system recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 .7 R jW(.502) Louisville, KY 40256 D347 SHIP T0: 3649 Cane Run Road Louisville, KY 40211-1961 QaauTr Pu rPS SNCf /~99~9778-2731.1(600) 928-PUMP httpJ/wwwzoeUer.com PUMP !O. FAX (502) 774-3624 © Copyright 2000 Zoeller Co. All rights reserved. le C9 0 ~