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HomeMy WebLinkAbout034-1004-80-000 econsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix afety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592274 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2744175 Permit Holder's Name: City Village Township Parcel Tax No: DONALD & JUNALEE HOGENSON TOWN OF SPRINGFIELD 034-1004-80-000 CST BM Elev: Insp. BM Elev: BM Description: Section[Town/Range/Map No: I 03.29.15.380 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER i S CAPACITY STATION BS HI FS ELEV. 1 Septic $ or1 Benchmark Dosing Alt. BM z-Z rN LA. 1b Bldg. Sewer 6• 0Z C~ cis Holding ~J St/Ht Inlet / TANK SETBACK INFORMATION St/Ht Outlet TANK TO ~P/l WELL BLDG. Vent Air Intake ROAD Dt Inlet Septic + Dt Bottom 756 1 / 07 7. G, Dosing Header/Man. 3.30 7_7 Aeration Dist. Pipe 3a 4:~T, O Holding Bot. System CIV q8 PUMP/SIPHON INFORMATION Final Grade Z . c/~• Manufacturer 1 Demand St Cover l GPM Lnl4 1- Z Model Number TDH Lift Friction Loss System Hea SS TD ` ~F v 9 Forcemain 1 Length / IDia. 11 Dist. to Well 40 Z SOIL ABSORPTION SYSTEM. ` BED/TRENCH Width Length No. Of Trenc PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS y r8 r~ ~ ~ SETBACK SYSTEM TO / P/L CJBLDG WELL LAKE/STREAM LEACHING Manufacturer: _a INFORMATION CHAMBER OR Type tem: j,) UNIT o J ~CJO 7~ / ~J Model Number: l~a ~ J 7 J"~ DISTRIBUTI N SYSTEM A4 1, Header/Manifold 011 Distributio x Hole Size x Hole Spacing Ve Air In ke Length Dia Length Dia 1,Z I Spacing 1qZ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded odded ulched Bed/french Center ( ~J Bed/Trench Edges Topsoil o ~ G l0 Q 1 es No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 2, 7 Inspection #2: Location: 3019 CTY RD DD 1.) Alt BM Description = 2.) Bldg sewer length = L Gk vC.1~'d~. [a,_ w~syN, G~ ~lJl - amount of cover Plan revision Required? ❑ Yes <No Use other side for additional information. SBD-6710 (R.3197) Date rinsepctorylignature Cert. No. `fl'ARTAtE~~ fount, rJ AN l>~l' 1 / Vl Safety and Buildings Division 5~ ~'rar k 201 W. Washington Ave., P.O. Box 7162 Sanitan Permit Number (to be filled in b} Co.) p p ® ~Q1 ! Madison, WI 53707-7162 p -7 -7 rrJ' t+V 's ei ~ORrvwh~~ tr State Transaction Number OWie r m i t 2? In accordance with SPS 383.21(2), Wis. Adm. Code, submission or Im> unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTs are suv„- ...:d to Project Address (if different than mailing udd)bb the Department of Safeth and Professional Servies. Personal information you provide may be used for secondary u oses in accordance with the Privac}Law. s. 15.04((in), 'tats. I. Application Information - Please Print All Info at n I~}'T7( (J Property Owners Name Parcel # J t Ot 4,(V t?-T6n ~y Property Owners Mailing Address Propertti Location 3 t e ew 6,6 Govt. Lot Cite. State Lip Code Phone Number !(f y,_ (/Uj Section 3 circle 011C) G /,e{n wood C, 7 / S- a&-5; - y7a I .f, N: R ~ L o(9 11. Type of Building (check all that apply) Lot # % Xor 2 Family Dwelling - Number of Bedroom Subdivision Name Block # ❑ Public/Commercial - Describe Use +`M ❑ CnN of CSM Number ~ El Village of L1 State Owned - Describe Use ~nI ZTovvn of / -jr Aj 5 1~oj 752% III. Type of Permit: (Check only one box on line A. Complete line B if applicabl ~,4, , CA ~I~ A. J. ~ El a New System Replacement System ❑ Treatment/Holding'fank Replacement Only ❑ Other ModtficaULO~to xistin_ vst texpfain) w ^.r4 rGtMOJ List Previous Permit Number and Date Issued 4N B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS System/Com onent/Device: Cheek all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade S -Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: r Design Floe (-pd) Design Soil Application Rate(gpds Dispersal Area Required Dispersal Area Prop d (,sq System Elevation 111' 1 Y5;6 . l° 4f 5o7- also `1 I V1. Tank Info Capacity in Total # of anufacturer Gallons Gallons Units 2 c Ners Tanks Existing Tanks ' U ✓ v v Septic or Holding Tank Dosine Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the PONN"I'S shown on the attached plans. Plumbers Name (Print) Plu bets Sisnature MP/MPRS Number Business Phone Number /1 IC.ftf-r- -er Z(e?~~S 7/ Plumbers Address (Street. City, State, Zip Code) VIII. County/De artment Use Only TT-TV ee Date Issue Issuin ent Signatu e pproved ❑ Disa rove Im yen Reason for Denial IX. Condtt~e $~qp Reasons for Disapproval 1. ept~:iar`k, Ei~fltsGtt: tilte nsi J~ (,ff'>Il Oc ~d1^+a fly tihsp2t ::+i cell nust all be gi its ' 'Mz 'r ec r a!s per i7tar3yement pl n n IaPh tw ~iu,nbe;. e, IWAA, 2. -'AN ►gGt;lftfnems mll:,t Le i. arnt..r.E as per arTxxlblip clod 1 : rd;nanr;-'.3. Attach to complete plans for the system and submit to the Count` oniv on paper not less than 8 1/2 x I I inches in size SBD-6398 (R. 11/11) P c Are9afS ~ ~ KT, ot` AAA aF-M ArrJCJ (txcpt wkeft A 7-7-4AJ R tst,►! TOW* F , , t sT' c►x A = 8~ Pit -SAN ,-its ~at~s, .5: `f71dR :Drq Non* 1)351 AAaq - V - 6W i A nom-"J; ivrr 'eEfAJ 014-,50 ~-LL-Oe~l - C ~ F1~LD~ za tK6 3u~ o ,t L~ploX• -TAI13EAr AJ o - PER 3 c. SsWe~~ 4 eu . KIDD ' S! 1 ~ / -to s3 Z(o 141 "A 5?~'{ 5~ r ~ ~ ion 9-y, t 8' ~ Ct4 ~ Ji?~5 SCE, e~~' Zy,zz tn)E~ - Sete lra~ap~o~c.• W N Nxl,'~ r N a r T F~f DIVISION OF INDUSTRY SERVICES W 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 NG' U Contact Through Relay h.tp://dsps.wi.gov/programs/industry-services ~2, www.wisconsin.gov Scott Walker, Governor Dave Ross, Secretary C0,N0.1 T1CI August 04, 2016 APPRO' DEPT OF SAF CUST ID No. 224832 ATTN: PO WTS Inspector PROFESSIONAI MARY JO HUPPERT ZONING OFFICE DIVISION OF INDUS HOLLISTERS SOIL, TESTING & DESIGN ST CROIX COUNTY SPIA DAN 28497 KING A830 ON WI 54 54001RD DANBURY WI 54 54830 HUDSON WI 16-7708 SEE CORRESP' CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08i04i2018 Transaction ID No. 2744175 SITE: Site ID No. 826981 Donald and Junalee Hoaenson Please refer to both identification numbers, Town of Springfield above, in all correspondence with the agency. St Croix County NEl/4, NWl/4, S3, T29N, R15W FOR: Description: Mound System (3 Bedrooms - Replacement) Object Type: POWTS Component Manual Regulated Object ID No.: 1615015 Maintenance required; Replacement system; 450 GPD Flow rate; 23 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, 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. • 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 Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil Proper soil moisture content can be determined by rolling a soil sample between the hands If it rolls into a 114- 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. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384,30-5 • Insulate building sewer beyord 30 feet per SPS 382.30 (11)(c) s Page 2 8/4/2016 • ' MARY JO HUPPERT Tank Installation to follow all manufacture's recommendations. Verify property line(s) prior to installation. soi Areas that are occupied with roc]: fragments, tree m thbbasalnrea of theh no ndumt~ t belcut off available, tre sumps available for proper treatment- if no other site i at Found level. A larger till area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities The current owner, and each subsequent system. owner, shall shall receive o tarcopy of the ppropriatections relating to proper use and maintenance of the 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. i inspectors. All permits copy of the approved plans, specifications be may include local n inspection by authorized representatives of the Department, required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. the right to require In granting this approval the Division of Indus, Services As per state stats 101 12( ),nothing inahis rev ew should aditins condition s arise making them necessary for co compliance. the designer of the responsibility for designing a safe building, structure, or component. shall relieve inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. I provide a copy of this letter and the POWTS management plan to the owner and any The above left addressee shal others who are responsible for the installation, operation or maintenance of the POWTS. Fee Required $ 250.00 Sincerely, Fee Received $ 250.00 -7 CAP y Balance Due $ 0.00 Tim Vander Leest Services WiSMART code: 76' 33 Private Sewage Plan Reviewer, Division of Industry (920)492-2214, Monday - Friday 6 am To 3;30 pm tine.vanderleest(c,wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm. Valerie Prueher, Chippewa County Housing Authority (Plans Mailed To) Hollisters Soil Testing & Design MART' JO HUPPERT Pale 2 8/4;'2016 Tank Installation to follow all manufacture's recommendations. o 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 mound must be cut off at ground level. A larder fill area is necessa v when any of the above conditions are encountered. to provide sufficient infiltrative area. i 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). _ -re malfimctions so as to create a In the event this soil absorption system or any of its coaiponc1l L P", - 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 ss orQ dditio review should ths conditions arise making them necessary for code compliance a pbuildinger state component. shall relieve the designer of the responsibility for designing 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, 250.00 7BalanceDue 250.00 0.00 Tim Vander Leest WiSMART code: 7653 Private Sewage Plan Reviewer, Division of Industry Services (920)492-2214, Monday - Friday 6 am To 3:30 pm tiin.vanderleest@wisconsin. gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Valerie Prueher, Chippewa County Housing Authority (Plans Mailed To) Hollisters Soil Testing & Design MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE ~r Project Name: DONALD & JUNALEE HOGENSON ED~ ETY AND Owner's Name: (same) SERVICES Owners Address: 3019 C.T.H_ DD TRY SERVICES Glenwood City, WI 54013 Cam/ ONDENCE Legal Description: NW 1/4 of the NW 1/4, Sec. 3, T29N, R1 5W Township: Springfield County: St. Croix Subdivision Name: NA Lot Number. 1 Block Number. NA Panel I.D. Number: 034 -1004 - 80 -000 Plan Transaction No.: ~1ttll!!r/y Pagel Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank 'MARY JO Page 5 System maintenance specifications 1IUPp'liT Page 6 Management and contingency plan D 1559 Page 7 Pump curve and specifications FAVER FALLSt: Page 8 Plot plan • i 1 ! 1 'ltHflt[t~{~i~`1 Designer: Mary Jo Huppert License Number. 1859 - 007 Date: 07/25/16 Phone Number: 715 -426 -1775 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N_ 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 0 0 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) - R.. Residential or Commercial Design Note_ Sara( fill (D) cakxdatiorts assume a 300 00' Estimated Wastewater Flow (gpd) Table 383-44-3 ir"itu sod treatment for fecal coliform of 36 itches. 1.50 Peaking Factor (e.g. 1.5 =150%) 450.00 Design Flow (gpd) 3.00; Site Slope 97.20. Contour Line Elevation (ft) 25 00' Depth to Limiting Factor (in) 0.60; In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 45 00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00* Dispersal Cell Design Loading Rate (gpd/f 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y orBN (C or E) _ e Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.50 Estimated Orifice Spacing (ft) = 11.54 ft'lorifice 2.00 Forcemain Diameter (in) 148.00 Forcemain Length (ft) Does the forcemain drain bade? Y 84.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 24.14 Forcemain Drainbadc (gal) ' 13.71 Vertical Lift (ft) 41.63 5x Void Volume (gal) q 1.48 Friction Loss (ft) 65.77 Minimum Dose Volume (gal) / L 6 0 00 In4ine Filter Loss (ft) 21.00 System Demand (gpm) `'t 19 74 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options _ choice in. dia. options choice 0.75 1.25 x x 1.00 x 1.50 x 1.25 x x 2.00 1.50 x A.._ 3.00 2.00 x - - _ 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000 00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) IWteser :Manufacturer gaUn (enter result in cell B49) Dose Tank Information Effluent Filter Information 650.00 Dose Tank Capacity (gal) Polyl-ok Filter Manufacturer _ m . 1700; Dose Tank Volume (gal/in) 122 Filter Model Number Weiser Manufacturer Project: DONALD & JUNALEE HOGENSON Page 2 of 8 Mound Plan and Cross Section Views _ 1/10 B J NIN"Iticm Pipe - .1:4: ,j[//fi~~r~~ .:4: :'r.• v:: d:"":"-""•"'d~•'•>"~i" _ `Le '~S'' .~^'.i 4:4i 4:L:4:%.~' :~4'•1:°:'4~Se 4?4`• W C . B :0 z • L Mound Component Dimensions A 10.00 ft E 14.60 in H Elft ft K 8.51 ft B 45.00 ft F 9.25 in 1 ft L 62.03 ft D 11.00 in G 0.50 ft J W 24.22 ft 450.00 (ft2) Dispersal Cell Area 819.02 (ft) Basal Area Available 10.00 (gpd/Pt) Linear Loading Rate 4.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.89 (ft) ll......,.. G j t f/I/I//IfIII//!/ 21!!!r!!f/rI!!llr.. 98.62 (ft) Lateral I F Dispersal Call 98.12 (ft) Invert Dispersal Cell t Elevation 3 97.20 (ft) Contour Elevation 3.0 % site slope Geotextile Fabric Cover Shading Key o ww. T Dispersal Cell See lateral details on 0 Topsoil Cap c 1-5 ft Page 4 for number, size, Subsoil Cap c 5 t and spacing of laterals_ © ASTM C33 Sand Laterals are equally Tilled Layer 0 0.5 ft °i Typicvj - Paced from the 4 4. = a ~ =:j :f; =~:'4~-=:~°' distribution cell's Aggregate o centerline in the A distribution cell (AxB). Project: DONALD & JUNALEE HOGENSON Page 3 of 8 End Connection Lateral Layout Diagram Centel the laterals over the A & 8 danension Turn-up wf ball vahre or clean outplug P AN laterals ate iOentical lE X-.1 Moles drMed on the bottorn of the lateral et"aft spaced S Laterals &forcemain Sch 40 PVC per S P S Table 384.30$ S Force main connection -Aa tee or cross to rnanifold at any point. Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.63 ft Lateral Length (P) 43.56 ft Orifices per Lateral 13 Lateral Spacing (S) 3.33 ft Orifice Density 11.54 fe/orifice Lateral Flow Rate 7.00 gpm Manifold Length 6.67 ft System Flow Rate 21.00 gpm Manifold Diameter 1.25 in Total Dynamic Head 19.74 ft Forcemain Velocity 2.14 ft/sec Dose Tank Information LockkV cover wM vrdrrwV label and kKftV device and seated watertight Electrical as per NEC 300 and - ► ii SPS 316.300 WAC Discorinect 4 in. mil. Tank component is property vented t~ Alternate outlet location Forceman diameter Weiser Manufacturer 2 in. Gapacityl 650.00 Gallons Volume 17.00 gaUnch A Weep hole or anti- Dimension Inches Gallons B siptlon device A 21.47 364.93 C B 2.00 34.00 Pump °f-ewiration Qq C 3.87 65.77 84.91 D 10.90 185.30 D Total 38.24 650.00 11 4 Dose ta* elevate (ft) 3' Bedding under tank. 84.00 Alarm Manuafacturer SJE Rhombus 7 Note: Switches Alarm Model Number 'Tank Alert AB f containing mercury may not be used in Pump Manufacturer Gould this system. Pump Model Number - PE 41 Pump Must Deliver 21.00 gpm at 19.74 ft TDH Project: DONALD & JUNALEE HOGENSON Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Berenes Sanitation Phone: 715-265-4623 a w-- POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 118 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1-5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum-up Detail Finished • • • . • • Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Lon Sweep 90 or Two 45 ~egree Bends Same Diameter as Lateral Project: DONALD & JUNALEE NOGENSON Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wm Adm. Code General This system shat be operated in accordance with SPS 382-84 Wis. Adm. Code, and shat maintained in accordance with its' component manuals (SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Damon Component Manual Ver. 2-0 SBD-10706-P (N. 01101)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tar* since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Ws- Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shag be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to faire must be replaced. Exposed access openings greater than 8-inches in diameter shat be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shag be disposed of in accordance with NR 113, Wis. Adm. Code- The operating condition of the septic tank and outlet titer stmt be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensue proper operation. The titer cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the titer when removed from its enure. If the titer is equipped with an alarm, the filter shag be serviced if the alarm is activated continuously. Interment filter alarms may indicate surge flows or an impending contieuous alarm_ The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a tr l assessment, maintenance personnel shy advise the owner of when the next service needs to be performed to mai tm less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is germemgy not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shat be inspected at least once every 3 years. At switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is instated within the tank it shat be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mounds perimeter, and the mound shat be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance on the mound is not recommended since son compaction may hinder aeration of the infiltrative surface witlmn the mound and snow compaction in the writer will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg& TSS, and 30 mg1L FOG for septic tank effluent or 30 mg1L BOOS, 30 mgt. TSS, 10 mg& FOG, and 104 cfut100 mL for highly treated effluent Influent flow may not exceed maxirnun design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was instated to determine if orifice dogging has occurred and if orifice clearing is required to maintain equal distribution within the dispersal cei- C bservatan Pipes within the dispersal cell stmt be checked for effluent pondng. Pondrg levels shall be reported to the owner, and any, levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent mooring Contingency Plan If the septic ft tankconordifimany. of its components become defective the tank or component shag be repaired or replaced to keep the system in pr operating If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mood component fads to accept wastewater or begins to discharge wastewater to the gourd surface, it will be repaired or replaced in its' Present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal mecca, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of ants plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatmert Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall managemerit plan for this system- mthds---,Wa ! Wastewater METERS FEET 40 i -MODELS. . PE31 PE41 PE51' W-5 17 z 3 : e 35 ~ ' - - 10 _ 2 - GPM - t 30 - T - i - 1 FT p - - - - - a -PE3'I _ --f - g - _ F x 25 - E , V - - - - 1 n TOW 15 O f.. _ • _ { 10 0 10 2 30 40 50 60 70 GPM 80 0°~- 5 10 15 m3/h CAPACITY RATINGS PE31 PE41 PE51 Total Head (feet of water) GPM Total Head (feet of wale? GPM Total Head 5 2 52 8 61 10 67 10 42 10 57 15 59 15 29 15 46 20 50 16 20 20 33 25 39 25 0 0 25 16 30 26 35 8 -NAJAM if JUNA LEE HWE4,S04 PAGES -leg 0 t am pdgtg of, Ow~ter .t~c~ua~..u ~ ~t,,l~tt~ }~o~;n1sDwt ' fir, o~ Aiw)4 ~c: (exacrt we TZQ R 1sU1 Tom r mijp- 5-r- c c~ 3 = Alt ~u w i s razes u 5. At;V Aicss ~Wlq WD Non* D3q 14pq - o- eW I ODO 1~.s0 ~ v (C.~1W N~ l ul i ~t~U EF+ELD aA/ rKE 3 xJ1/~1KS o ASTA4 a2 . APPROXL 7t/ ~3EA'IA1 o~ Fo~c~ivbg14 1KEE 3gD' 7b E,451- /L peR 5 t'S 3 ?3 ~R~ut~ f Z 80pROO+h ' 8~ 1 'Vol if 13'r ~e pit- E - - - 2~0 lift ST/~ ~o ion 9y rgi D 1??5 sc+", f s . Yp y W Gr Site Z.~oMC~rlir~r.• . GT;f4, V 00 FL00 PEAK ,V, FLOOD WAVE TRAVEL TIME = 0.1 HR, PEAK FLOOD ELEVATION = 1077.5 5 8 L A DEL 1 ~ ~ D--ELEVAA -I( -AO-7, 1. - - 01 I'll, A Q L E C ILLS FLOOD WAVE TRAVEL TIME = 0.0 HR PEAK FLOOD ELEVATION = 1099.2 1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer aa? ~[Ci/ 4 Vd•e~ t°-~~~~ Mailing Address To 67 ;V ~ b Property Address (Verification required from Planning Department for new construction) City/State C3 4 Parcel Identification Number LEGAL DESCRIPTION GU Property Location Sec. T_2 l N-~ ~S W, Town of Lot # Subdivision Volume ~ Page # Certified Survey Map # Volume Page # Warranty Deed # Lot lines identifiable Xyes ❑ no Spec house ❑ yes Ao SYSTEM MAINTENANCE Improper use and maintenance of.your septic system could result in its premature fail pumper. to handles wastes. P optenrto ai tens n e consists of pumping out the septic tank every three years or sooner, if needed by a licensed a you put can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Cemtf~ on 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office days of the three year expiration date. X A DATE .IRE OF APPLICAN C ONA,rNER CERTIFICATION I (wc) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) o,' the property descri ed above, by virtue of a warranty deed recorded in Register of Deeds Office. 411 /7 X DATE SIGNATURE OF LICANT • • • • Any information that is mis-represented mU result in the sanitary pcinut being revoked by the Zoning Department. Include with this application: a stamped warranty de6d from the Register of Deeds office a copy of the certified stirvey map if reference is :Wade in the `Warranty deed ID A L/ and Professional Services Wisconsin Der" V i 10-0 Divisi %.Wfv As 4VBVSYSFVOZ26 1 3 ~l..~ JQ Sol_-- POINT Page of in accordance with SPS 383, Wis. Adm. Code UWY County 3ST. CROIX Attach W5 ~ot less than 8 1/2 x 11 inches in size. Plan must includ .1 vertical and horizontal reference point (BM), direction and Parcel I.D. 034 - 10 4 - 80 - 000 p pe, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie d by 443 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Pro perty Owner Property Location - DONALD & JUNALEE HOGENSON Govt. Lot NW 1/4 NW 1/4 S 3 T 29 N R 15 E (or) Property Owner's Mailing Address Lot # Block # Subd. Name or M# 3019 C.T.H. DD 1 CSM 3/753 City State Zip Code Phone Number ity 17Village ■ Town Nearest Road Glenwood City, Wl 54013 ( 715 ) 265 - 4701 C.T.H. DD ® New ction Use Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 2Replacement ® Public or commercial - Describe: Pare ma ena loess over till Flood Plain elevation if applicable N.A ft. General comments Mound System 0.92 ft. sand fill 0.6 loading rate and recommendations: Z,5 ~S r7 ~l~" e' 0 Boring 11,44 tell ❑ Boring # Pit Ground surface elev. 97.83 ft. D pth to limiting factor 38 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 1 0-13 10YR3/2 sil 2fa&sbk ds cs 3vf-co 0.6 0.8 2 13-24 10YR3/3 sil 2f-mabk mfr cs 2vf-m 0.6 0.8 3 24-38 10YR3/4 sil 2f-mabk mfr cs lvf-m 0.6 0.8 4 38-44 10YR3/6 c2d 10YR5/6 fs Om mfr 0.5 1.0 Horizon 4 is weakly cemented ❑2 Boring # Boring 97.18 25 1-7 pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/if in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 -Eff#2 1 0-14 10YR3/2 sil 2fsbk ds cs 3vf-m 0.6 0.8 2 14-21 l0YR3/3 sil 1mP1 mfr cs 2vf-m 0.4c 0.6 3 21-25 10YR3/4 sil 2fabk mfr cs lvf-m 0.6 0.8 4 25-30 10YR3/6 12d 10YR5/6&1oYR6/2 sl lmsbk mfr as lvf-f 0.4 0.7 5 30-36 10YR4/6 c2d 10YR5/6 A Om mfr 0.5 1.0 some gr between horizons 3&4; horizon 5 is we. * Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) MkY_~.1a CST Number MARY JO HUPPERT Hollistees Soil Testin &Desi /~Wml 224832 Address Date Evaluation nducte Telephone Number 28497 King Arthur's Court, Danbury, WI 54830 07 - 20 - 2016 715-426-1775 SBD-8330 (807/13) f 2 of 3 Property Owner Hagenson, Donald & Junalee Parcel ID # 034 - 1004 - 80 - 000 Page ❑ Boring it Boring no Pit Ground surface elev. 97.18 ft. Depth to limiting factor 27 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 1 0-12 10YR3/2 2fsbk&gr ds cs 3vf-m 0.6 0.8 2 12-20 10YR3/3 sil 2fabk mfr cs 2vf-m 0.6 0.8 3 20-27 10YR3/4 A If--mabk mfr cs lvf--m 0.4c 0.6 4 27-33 10YR4/4 m2d10YR5/6&10YR6/2 cl lfabk mfi lvf-f 0.2 0.3 Boring ❑ Boring # IF r 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. ® Pit Soil Applicatio 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 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 6BD-83;t, (R07/11) Plot Plan page g of-3 Property OWNer J)OA LD " -JUAJALeC )+oGNsoAc 1"=4Qf~ Legal Descriptwn er r, ©p Auwyy c -ffe N1,jyzj s(except where noted) ' raq ul . K L5tn! -FOVON OF .ST M'SIX = Backhoe Pit CouUN is cogs 1A `f7a AMX5 30f9 ~,T D North p3y_ /09 - Sv - WO ~ (L-AW ~ ~ t=t EL.D r~ ptKe 3 rta+n~K`- P 9d' ApPgoy- ~gpvc 4X4 ' 3gv' 71) E-A ~~3=•~. fa6L ~+PPKoY. © ss r4J.JJ s~i10" fj CFiE~p~ O O 47e OaJ 80 1 [BROOM a31 b _ o -to to EST e ~ ~ 63 97.18' Site Location: N v Iv- ~ /0 -N1 U E. 4 f f 3 d ` .5 F t ~ r. g , r O' * ou le, s If IFW y a n ~ t e 5 "OP r , u lit t 5. oe. v i o a a ~ s . r sr rte'