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012-1057-10-000
ST. CROIX COUNTY WISCONSIN ZONING OFFICE O 0 q d R II p ■ r~ur ST. CROIX COUNTY GOVERNMENT CENTER I 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 Page of COUNTY ON-SITE VERIFICATION FORM Inspector: i"~n i-- G+ lei, I-,, Date: Jr Parcel ID Number Property C).-mer Property Location J 6L6V11- a Gad. bat ~ 14 AtelA 5 21 T 36 N R (-7 E o' " Preperty&wnersllailing Address Lrt» Bloek~ SLbd. Manz orCSh+fi; /3 *72- 24 City s'tatc- jig Coda Rhone Number ❑ Cite ❑ village Toren Nearest Road ~en ooeY w~ f'fFel t ~ r- ror.~r; 2ot~d-E,.. , Now Construction Us=: ❑ Residential 1 Number of bedrooms _ - Cade ded'Aed d€ ign flow rate GPD ❑Replacement ❑ Public orcommeruial - Describe: _ Parent material Rood Pl n General comments and rFCCimmendations: ~a ~aai w -K- laS Bering ❑ Bering j&/ a ❑ Pit Ground surface euv. Depth to limitim factrr in. Soil A li cri Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPIA, in. Munsell Ou..Sz. Cont. Color Gr. 5z. 5h. 'Eff? 1 `Eff#2 ! a-8 6: 00 G C" Jw 2- Jr- 14 Conditions: kill ('~L Soil Survey description: Notes: 44" d I FEE: County: St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT Sanitary Permit No: 597321 (ATTACH TO PERMIT) State Plan ID N GENERAL INFORMATION Personal information you provide may be used for secondary purposes [Privacy Law, S.15.04 (1)(m)] parcel Tax No: City Village Township 012-1057-10-000 Permit Holder's Name: JEFFREY R & JEANNE M JOHNSON TOWN OF ERIN PRAIRIE Section/Town/Range/Map No: CST BM Elev: Insp. BM Elev: BM Desc iption: . / ' 26.30.17.397-4A TANK INFORMATION V E E ATION DATA HI O 47- ANUFACTUR R ~ W CAPACITY STATION 3. BS S ELEV . Benchmark 7/~ •~B ~oa•~ ~~,o. e~ Bldg. Se erf3 L. 1,A Ht Inlet 8 St/Ht Outlet Q ~(l ~ J j ~(,c+ TANK SETBACK INFORMATION I L FJ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1 Septic Dt Bottom A 8~• 7. _ Dosing Hea Dist. Pipe Aeration Holding Bot. System 3 ,3 Final Grade PUMP/SIPHON INFORMATION 9~ I 0. Q Manufacturer Demand St Cover J GPM ~ R Model Number Q TDH Fricti9n oss System Hea A Ft i i. ' i Forcemain Lengt I Dia. It Dist. to Well., V r SOIL ABSORPTION SYSTEM PIT DIMENS NS No. O its Inside Dia. Liquid Depth BED/TRENCH Width ~I Length~O~ No. n&" / DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING Manufacturer: CHAMBER OR INFORMATION Ty e Of System. K• Y UNIT Model Numbe ~0 Head e D istrib ion STRI SYSTEM x Hole Spacing Ve to Air Intake x Hole Size P ut ~ /r_ . t ipe(s) . r ~f/ Length r•r Dia I4•1 _ Length_~~ Dia Spacing I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only De th O xx Depth a_f xx Seeded/Sodded v r Depth Over Bed/Trench Edges Topsoil es ❑ No es No Bed/Tre C t P Inspection #1: Inspection #2: COMM N S: nclude e ons pre~p~, etQt) 8l ~ ~/L.~~ ~ 1 Location: 1372 200TH " (t~ \,M a f IV p~ r elf 1.) Alt BM Description = lf L-W C 4 1 2.) Bldg sewer length = nA li "W4 - amount of cover = 1 l I I 4 Plan revise uired? L ;Yes / o itt Use other side for additional information. Insep s Signature SBD-6710 (R.3/97) ,crx~ttF ~ County Industry Services Division St. Croix 1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.) sS Sps P.O.Rox7162 e ' -Bison, W11,%707-7162 y A` f>Ef4 ROIX COUN 4 5 ST C 3Z T. AENT • State Transaction Number 10 a1y ermit AppliCCL,_ :2937874 In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the ap, --mental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned ri '-d to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be u~, try 372 'I 200"' St purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. ` Baldwin WI L Application Information ease Print All Information Property Owner's Name Parcel # Jeffrey R & Jeanne M Johnson 012-1057-10-000 _ Property Owner's Mailing Address Property Location 1386 290"' ST Govt. Lot City, State Zip Code Phone Number SE 1/4, NE /4, Section 26 Glenwood City, WI 54013 715-243-4277 (circle one) T30N R17EorW 11. Type of Building (check all that apply) Lot # ®1 or 2 Family Dwelling -Number of Bedrooms Subdivision Name ❑ Public/Commercial - Describe Use Block # ❑ City of ❑ State Owned - Describe Use 1 / Number ❑ Village of ' -6 (ob MM, M ® Town of Erin Prairie ll'D III. T e of Permit: (Check onl one box on line A. Complete line B if a licable OLL A. ® New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Otlicr Modification to Existing System (explain) B Permit Renewal Permit Revision ❑ Change of El Permit Transfer to New List Previous Permit Number and Date Issued ❑ ❑ Before Expiration Plumber Owner -7 -0 IV. Type of POWTS System/Com onent/Device: (Check all that apply) o._.) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil z. gel ❑ Holding Tank 4 Other Dispersal Component (explain) ❑ Pretreatment Device (explain) - K e V. Dis ersal/Trey ent Area Information: Design Flow (gpd) Design Soil Application Dispersal Area Required (so Dispersal Area Proposed (st) System Elevation 300 Rate(gpdsf) ` / / ,7 7 VI. Tank Info Capacity in o N Gallons Total # of Manufacturer Gallons Units ` U N w o New Tanks Existing Tanks W Septic or Holding Tank 840 1 W ESER ® ❑ ❑ ❑ ❑ Dosing Chamber 500 1 WIESER ® ❑ ❑ ❑ ❑ VII. Responsibility Statement- I, the undersigned, assume r sibility f stallation of the PONVTS shown on the attached plans. Plumber's Name (Print) Plumber's ' na re MP/MPRS Number Business Phone Number 139462 715-235-2644 Todd Sinz Plumber's Address (Street, City, State, Zip Code) E5609 7081h Ave Menomonie WI 54751 VII . Count /De artment Use Onl Approved ❑ Di Permit Fee Date Issued Issuing in Signature Z) s ICa 17 ❑ Own . tven Reason for Denial $ PfctJc~ G IX.Condi b A. a Disapproval A FAV I '3~ Slai .'IC3S t Ci1 c itl :qL F ~ETM • tiispeP su cell-ust all Ile atsPK."rmen! plan rna+iaeri^bV Plumber. ~j~~ v 1\ G~r^1~ 2. #ie `mcuwer- rrtus t:ew mrts ire i ~h I e. M mck / ,atlnoei. o n Ip IMURS Attach to complete plans for the system ands mit to the County only paper not s than/2 X i es in size -BD-6398 (R03/14) i A¢ 15 N ~Uo tlovj J,.j, Page 5 of,5 40t it Wkere BMW) %d,CkA / Hoe Pit 177) Pr-r Norlc LIZ' P, vl~ BIZ ` D i T N Page 5 of3 1 4D ft N whem noted) YEN - B4cMoepit -N 5 Non* Isr ,t r~ d- J f oQ oo- ~ t Iii w ~r far' II /AD MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Conditionally Project Name: Johnson Septic System AP MOVED DEPT. OF SAFETY AND PROFESSIONAL Owner's Name: Jeffrey Johnson SFRVICFS DIVISION OF INDUSTRY SERVICES Owner's Address: 1386 290th St Glenwood City Wi 54013 Z;W V,4" 0&edf 715-768-5299 - SEECORRESPONDENCE Legal Description: SE1/4 NE1/4 S26 T30N R17W Township: Erin Prai- e County: St Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 9 septic tank/ pump tank Page 10 effluent filter Designer: Todd L SinLicense Number: MP 139462 Date: 04/26/17 / Phone Number: 715-235-2644 Signature:~ ( Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 10/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 10 Mound and Pressure Distribution Component Design Site Information R Residential or Commercial Design Note: Sand fill (D) calculations assume a 200.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for fecal coliform of 36 inches. 1.50 Peaking Factor (e.g. 1.5 = 150%) 300.00 Design Flow (gpd) 6.00 Site Slope 98.00 Contour Line Elevation (ft) 8.00 Depth to Limiting Factor (in) 0.19 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft` 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? E' Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 4.50 Orifice Spacing (ft) = 10.71 ftz/orifice 1.50 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) E1 1 q.27 System Head (ft) x 1.3 3.67 Forcemain Drainback (gal) Vertical Lift (ft) 37.27 5x Void Volume (gal) ) Friction Loss (ft) 40.94 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 18.35 System Demand (gpm) 16.35 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 125 x x 1.00 1.50 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator Treatment Tank Information Total Tank Capacity (gal) 840.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 508.00 Dose Tank Capacity (gal) Lifetime Filter Manufacturer 11.82 Dose Tank Volume (gal/in) LT1/8 Filter Model Number Wieser Concrete Manufacturer Project: Johnson Septic System. Page 2 of 10 Mound Plan and Cross Section Views 1 J Observ ation Pipe /1 FK A W B L Mound Component Dimensions ft A 5.00 ft E 31.60 in H [Aft ft K aft B 60.00 ft F 9.25 in I ft L ft D 28.00 in G 0.50 ft J W 300.00 (ftz) Dispersal Cell Area 6!400 ) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate (ft) 1/10 B obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.10 (ft) --0-- ( H G 2 Dispersal Cell 100.83 (ft) Lateral F 100.33 (ft) Invert Dispersal Cell /1' Elevation D n ❑ 98.00 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 0 Topsoil cap c a 1.5 ft Page 4 for number, Z Subsoil cap N c Q., size, and spacing of 0 ASTM C33 Sand ea R laterals. Laterals are F equally spaced from the Tilled Layer H 0.5 ft Typical Lateral distribution cell's ©0 Aggregate v a centerline in the T A distribution cell (AxB). Project'. Johnson Septic System. Page 3 of 10 End Connection Lateral Layout Diagram Latprsl r,r:.red,=.errF•;..':Edimen-ir'n ♦=Turn-upva'ball•ralveoroleanouLplug P - - Adl lateral. ai a bjrnr.,r:al IE x-=r l Holes drilled on the br Ito rn of the lateral equallu spaced FOKO MT Ir, o ,r,narriOr, Via trw of oro55 b? rnartilold at anq pnlrlt. Lateral, _ fotc.eniiirt Sch 40 F`vC per SPS Table 304 30-5 I i Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.25 in Orifice Spacing (X) 4.50 ft Lateral Length (P) 58.50 ft Orifices per Lateral 14 Lateral Spacing (S) 2.50 ft Orifice Density 10.71 ftz/orifice Lateral Flow Rate 9.18 gpm Manifold Length 2.50 ft System Flow Rate 18.35 gpm Manifold Diameter 1.25 in Total Dynamic Head 16.35 ft Forcemain Velocity 3.33 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - SPS 316.300 WAC 4 in. min. TDis Tank component is properly vented ' Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 1.5 in. Capacit 508.00 Gallons T Volume 11.82 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A ~-25.51 301.58 B 2.00 23.64 C Pf ump off elevation (ft) C 3.46 40.94 89.00 D 12.00 141.84 D Total 42.98 508.00 Dose tank elevation (ft) 3" Bedding under tank. 88.00 Alarm ManuafacturerSJE Rhombus Alarm Model Number Tank Alert Pump Manufacturer Zoeller Pump Model Number BN151 Pump Must Deliver 18.35 gpm at 16.35 ft TDH Project: Johnson Septic System. Page 4 of 10 i End Connection Lateral Layout Diagram . +er3l-cenrered=.er tPi&.4 Edimension = Turn-up v:+'ba l I~,a I .._or cleanoutFdug L3 ♦ _ P I All lateral> aie identir..al IE X__, I Hole: drilled on the bottom or tire lateral equally spaced •1~ Fone main o~ ~nnar,rion via tee or erossto manifold at anil point Lateral-, force-main 'r_ch 40 PVC-: per SPS Table 38430-5 i 0.188 in Number of Laterals 2 Orifice Diameter Lateral Diameter 1.25 in Orifice Spacing (X) 4.50 ft Lateral Length (P) 58.50 ft Orifices per Lateral 14 Lateral Spacing (S) 2.50 ft Orifice Density 10.71 ftz/orifice Lateral Flow Rate 9.18 gpm Manifold Length 2.50 ft System Flow Rate 18.35 gpm Manifold Diameter 1.25 in Total Dynamic Head 1635 ft Forcemain Velocity 3.33 ft/sec Dose Tank Information Locking cover with warning label and locking device and / sealed watertight Electrical as per NEC 300 and - r i SPS 316.300 WAC 4 in. min. Disconnect - Tank component is properly vented E- - Alternate outlet \ location Forcemain diameter Wieser Concrete Manufacturer 1.5 in. Capacity 508.00 Gallons - T Volume 11.82 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 25.51 301.58 B 2.00 23.64 C P♦ ump off elevation (ft) C 3.46 40.94 89.00 D 12.00 141.84 D Total 42 98 508.00 Dose tank elevation (ft) 3 Bedding under tank. 88.00 Alarm Manuafacturer Sit Rhombus Alarm Model Number Tank Alert Pump Manufacturer Zoeller Pump Model Number BN151 Pump Must Deliver 18.35 gpm at 16.35 ft TDH Project: Johnson Septic System. Page 4 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name T L Sinz Plumbing Inc. Phone 715-235-2644 POWTS Regulator's Name St Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 200 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 840 gal Maximum TSS 150 mg/L Soil Absorption Component Size 300 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Ins ect and/or service once every 3 ears 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 eve 3 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. 1 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 seeaed and and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Johnson Septic System. Page 5 of 10 J Mound System Management Plan Pursuant to SIPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 10112), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01 /01, R. 10/12)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. It an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/I.. TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment 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 management plan for this system. Project: Johnson Septic System. Page 6 of 10 Mound System Management Pian Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 10112), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L SODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L SODS, 30 mg/L TSS, 10 mg/L FOG, and 101 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment 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 management plan for this system. Project: Johnson Septic System. Page 6 of 10 PUMP PERFORMANO_ CURVE TOTAL DYNAMIC HEAD/FLOW MODEL 115111,W,153.1 PER MINUTE s0 FFLUENT AND DEWATERING 12 !D MODEL 151 152 153 36 1b2 .feel Meters Gal. L'lera I Gal. Liters Oel. tiles 10 _ $ ":L5 50 189 69 261 77 291 30 t0 .3.0 45 170 61 231 .70 265 ! 76 171 15 4.5 38 144 SJ 201 61 201 20 6., 29., 0: t/ 167 s2 .19.7 is 3.4 i2q 4 139 25 23 30 iS r 36 10,7 - - /0 12.2 ° r 1' 42 0 ShuloHHled: 30 H.(9'T) JEh.{11,6m) Nq. 13./m) 2 y o,uoee 0 . 0. 20. "A k ..-50 - 60 7D 60. 90 100 OAILONa i o 46 f0 tie ISo 200 ' 210 2 0 3 0 360 p q c . - old'.(Sls 152 153 FLOW PER MINUTE OubO~a Model :151 IY CONSULT„FACTQ:RY: FOt " SPECIAL APPLICATIONS::.'. 1„22 I,u . 2U1~aNl J27i72 IYI • Timed dosing panels Available. I • Electrical alternators, for duplex systems, are-available and 371ST supplied with'an alarm, i ° ] 7.1~ 7 77132 Variable level control switches are available for controlling single phaseisystema. Doubie;plggyback variable level float switdhes it available for variable level long and short cycle controls. Sealed Qwik.Box available fordutdoor Installations. See FM1420. Over 130*F. (54'C,) special quotation required. it ii/ll Control election V11 Model velts•►h Ysde 't <Am t alln lu Ou lex Ni61 11s i om 8:.2or3 l E&- BN151 115 1,., "A lot: 0.0 Included 2or3 1 , E151 230 Nen . . 3. 1 2 or 3 SK2444 suoe. BE151 230 1 . Atito^`3.2 Included 2 or 3 N152 115 Non 8.5 1 2 .or 3 BN1S2 its 1':7'Ao)e'" 8.5 .included 2or3 152 3 1 on 8 1 2 t? o ;;Included 2 or Ni 11 20t3 BN153 115 . 1 Al 105` r =included 2or3 SELECTION GUIDE E153 230 .1 Non'.:': 5".3 1 ` 2or 3 8E153 30' .1 Aulo :"r . 5.3 Inci lded 2 or 3 1, Single piggyback variable level float swA tch or double piggyback variablelevel foal e GAl3TION switch, Refer lo M0477, All Installation of controls, protection"deyleas and wiring should be done by a l,titled 2. See FM0712 Icr correct mo, el of Electrical Alternator E Pak licensed Ilociril n, All electrical and safety codes should"be followed Including ihl'most 3. Variable level ccnlrcl switch 10.0225 used as a control activator, sr dupiex (1) recent National EUetric Geds (NEC) and the Occupational Safety and Health Act (OSHA) or (4) float Sysiem, 7 R~SERU ROW.ERED,QESIGN For unusual conditions i reservq safety (aclor is engineered into the design of even Zoeller pump. MAIL 7dr P,O. BOX 16317 Lcui la,'KY 10258.0317 Aanu!acfurers ol., SNIP TO: 3619 Gana Run Road ~~7 ytt Loulsv.114, KY Ml I •1961 ueurr f lm"'y SNcr /999 (502) 778.2731. 1(800) 9:8•PU.ip hKp;/na!ww.agtAeroam ~l.Ila'✓P' b L! FAY(S02) )71.31I .•_...._,..~r nnna ~..nne. Cn All..IMKIQ rgan,varj. ~dT {Aj ~ r /LSD Page -5 af3 E I" 40ft Aw"oepit `t = HAA) b Pn Nom* J rho Off 00 1rraFbt` ~ ~ 3 ~ 1~N w ,flj ,F €3 Y. iii ~ ~ [je,• ~f ' 9VIlD M-M/oooui 3,U 98tr8-SZ~-008 z \ :8nOd-ISOd :31x0 00 00 00 31x0 OSL*S IM 'N008 N301VVI of ,IMH Sr) 9t6:M ~ynNdW OI1d3S N : imd-38d ,0-,t=,4 t :31d0S dOM '-1.8 NMa80 31383lI03 13531M w_oo9/atie>~ W w ~ J Of w H Q a z m O < o D w w Ln a_ w w ~ ~ w d m z- c' a m w Vl Q p C! p a ? a E l7 J m H w Z F- w0 J0 ~a D U H O o a z v_ Q pm c»Q z? a wi2 ¢ 3 U- o a W 0 'o-Q QJU J J Q U li: Z Q C rn o a. p pW WWW C49 j WdW O~ U 0 a a a U 4. p x m to 0 En _ N f/1 p w © _ ~iv\ a-m Wei ¢wcn tO00• ° ¢ a oho z LO U ° cn H m vwi CIO ~ in < W `V = C-4 J~ w<< w Z 14- r w W U C) Z~ 0 0- ; `rte ;.y -1 0 1 c' _ cn z to 1= Q o d" (n DiNOtxp~~ 3~ oaY pqw ¢ w m P (n °o oD a>J Y a~~ 'Z:r M: ~Z O° 0 °zva Zoo U 0- x o a w o s Z Z3tmUgS-1~m-2j, z U O0 n z z ° o < o¢ J U r- U J wW I U J ° "v z ::D 91; Q a F- 0 z a. w M a cr N; I a I w w ~lS w _j m l~ I I I W 0 a W ~ U Z „g b l4i D oo3a `fi yes sa .,ass d N Y 2 Q H- The Best Just Got Better W OM I'll' r ~ a The most efficient, the lowest maintenance, the most economical y effluent filter! • Nearly Twice the Filtering Capacity • Estimated to go 3 Times Longer Between Cleanings • Cleaning Made Easy • Does Not Retain Solids Between Plates g • Lowest Price • l i 0 - Eliminates the collection of solids inside the cartridge. - Nearly twice the filtering capacity of any other filter. J- - By eliminating solids between plates drastically reduces the need to clean. - Cleaning made simple and efficient. - LT-1/8: 3500 G PD/Residential Strength W4,"""d Filtration 1/8" - LT - 1/16: 3350 PCB/ Residential Strength Filtration 1/1611 - LT -1 /32: 3000, GIB /Recommended for Commercial use with Residential Strength - Filtration 1/32'1,, - LT - 1/64: 2500 GPD/`Rec mmended for Commercial 'usage with Residential Strength - Filtration 1/6411: ID - 2700 Inches of Linear Filtr tion (Npariv Twirp the rn,mnptitinn) The Best Just Got Better The most efficient, the lowest maintenance, the most economical effluent filter! • Nearly Twice the Filtering Capacity • g Estimated to go 3 Times W*~'.: t • Longer Between Cleanings a Cleaning Made Easy • Does Not Retain Solids Between Plates • • Lowest `Price • 0 LM010JUM~ - Eliminates the collection of solids inside the cartridge. - Nearly twice the filtering capacity of any other filter. - By eliminating soli& between plates _ drastically reduces the need`-to clean. , - Cleaning made simple and efficient. - LT 1/8: 3500 GP D/Residential Strength Filtration 1/811 - LT - 1 /16; 3350PL~/ Residential .Strength Filtration 1/16°'... . - LT -1 /32: 3000 CP®/Recommended for Commercial' use with Residential Strength - Filtration 1 /3'~ ; - LT - 1/64: 2500 GPI[ ec+o►trr~+~nded for C+~mmercal usage with Residential Strength - Filtration - 2700 Inches of Linear Filfrafflj'n Nearly Twice thp_r:mmnptitinn) ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 'E'ffEYnf ~o ,~so.✓ _ Mailing Address & Zip 4C 4 ! sJm Property Addrel i z 242- oo (Verification required from Planning & Zoning Department for new construction.) ID-Oq0 City/State p.. a.-." ws Parcel Identification Number bl'2- - 11>5'-7- LEGAL DESCRIPTION r Sec. Z T N R W, Town of Property Location /a , A/►,J ~.v - Subdivision , Lot # Certified Survey Map Volume Page # ~I Warranty Deed # rr "15 Li 3 , Volume , Page # Spec house yes Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three ar expiration date. Uwe certify that all statements on form are true to the best of my/our knowledge. Uwe arn/are the owner(s) of the property described above, by virtue of a w ty deed recorded in Register of Deeds Office. Number of bedrooms SIGN OF APPLICANT(S) DATE P ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey reap if reference is made in the warranty deed. (REV. 08/05) i / i 1 _ o - - N N O - ~ O O O ~ CV i' 1 ~ . a r w+ e. w ti w` f p t a x, t ~ A { 7 I I ~ i ! S N I I ~ o R In r Wisconsin Department of Safety and Professional Services a o r 09 Division of Industry Services , SOIL EVALUATION REPORT Page 1 of 3 in accordance with SPS 383, Wis. Adm. Code ` s ? County ST. CROIX Attach complete site plan on paper not less than 8 1/2 x 11 i es i p include, but no Jimited to;:Yerti"l and horizontal referp^^° Parcel I.D. O 1 - 1057 - 10 - 000 percent . kale or dimensicP,sm" arrow, anc OOMMUN*, Please print all informarron. Revie by zz5//7 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location JEFFREY R. & JEANNE M. JOHNSON Govt. Lot SE 1/4 NE 1/4 2 T 30 N R 17 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Nam or CRIN 1386 290th Street City State Zip Code Phone Number ity Village ■ Town Nearest Road Glenwood City, WI 54013 ( 715) 76 - 5299 200th Street New Construction Llse[D Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD a Replacement Public or commercial - Describe: Parent material clay loam till Flood Plain elevation if applicable N 1a ft. General comments Mound System - 2.34 ft, sand fill 0.4c loading rate --soil on-site w/Ed Taylor, State of Wisconsin Wastewater and recommendations: Specialist and County personnel. SEE INTERPRETIVE DETERMINATION REPORT Property Address: 1372 200th Street ❑ Boring # Boring Q Pit Ground surface elev. 98.60 ft. Depth to limiting factor 1 I 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 0-11 10YR3/2 sit 2fsbk&gr mfr as 2vf-m 0.6 0.8 2 11-15 10YR4/3 cid I0YR4/6&I0YR6/2 sit 2f-msbk mfr lvf-f 0.6 0.8 a Boring # ®Boring 98.60 8 • 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 1 0-8 10YR2/2 sicl 2fabk mfr as 2vf-m 0.4 0.6 2 8-14 10YR4/3 c2f IOYR4/4&IOYR6/2 sicl 2f-msbk mfr lvf-f 0.4 0.6 " Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) V~LD,tev,Ion er MARY JO HUPPERT Hollister's Soil Testing&Design) 24832 Address CNumber 28497 King Arthur's Court, Danbury, WI 54830 11-16-2016 715-821-1440 SBD-8330 (R07/13) DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD „n HAYWARD WI 54843-6462 Contact Through Relay t r ~1 S P `i http://dsps.wi.gov/programs/industry-services =o. w ~~r I 1 CB f) L-`' y~\ S www.wisconsin.gov~ Scott Walker, Governor Eric Esser Acting Secretary ;CA January 18, 2017 CUST ID No. 224832 ATTN.• POWTS Building Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHURS 1101 CARMICHAEL RD DANBURY WI 54830 HUDSON WI 54016-7708 CONDITIONAL APPROVAL Identification Numbers SITE: Transaction ID No. 2895531 Jeffrey R & Jeanne M Johnson Site ID No. 834916 1372 200TH St Please refer to both identification numbers, Town of Erin Prairie above, in all correspondence with the agency. St Croix County SE1/4, NE1/4, S26, T30N, R17W FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1688552 The following conditions shall be met: • Approval is hereby granted to use a limiting depth to zone of saturation of 8 inches, as determined in the Interpretive Determination Report by Mary Jo Huppert, CST, dated 01-12-2017. The CST's report was submitted in accordance with section SPS 385.60(2), Wis. Adm. Code. All soil absorption components shall be in accordance with chapter SPS 383, Wis. Adm. Code. • Soil conditions at this site require a linear loading rate not to exceed 8.0 gal./lin.ft./day and a basal loading rate not to exceed 0.4 gal./sq.ft./day. Soil permeability could be impaired by compaction in the tested area; therefore, the proposed system area must be protected from compaction prior to system installation; it is very important that site preparation and plowing be performed when the soil is sufficiently dry. C)y • This approval is limited to the tested area described by Mary Jo Huppert, CST, as part of this referenced Interpretive Report. This report may not be applied to any other portion of the subject parcel or to other parcels. Reminders The decision on the Interpretive Determination Report does not have an expiration date. • The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(ft"m Wisconsin Statutes, is responsible for compliance with all code requirements. APPO • In granting this approval, the Division of Industry Services reserves the right to require changes or additions should cond' ' AND PR arise making them necessary for code compliance. QEP'T of~Sv` S),nA~*~ i{QV SEE CO MARY JO HUPPERT Page 2 1/18/2017 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Fee Required $ 240.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy Edwin A Taylor With Your Payment Submittal. Wastewater Specialist , Division of Industry Services (715)634-3484, Monday - Friday 8:00 am To 4:30 pm edwin.taylor@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i I APPR.doc INTERPRETIVE DETERMINATION REPORT Property Owner: JEFFREY R. JEANNE M. JOHNSON 1386 290th Street Glenwood City, WI 54013 Location: 1372 200TH Street SE 1 /4 of the NE 1/4, Sec. 26, T30N, R17W Town of Erin Prairie St. Croix County, Wisconsin Prepared by: Mary Jo Huppert, CST #224832, Des • ~ ALL . Date: S 12- - zp& ~o V~ YED 4;r IONAIL SF • p ,,g Hollister's Soil Testing Ft Design ;TRY SERVICES r •Rt, ° 28497 King Arthur's Court Danbury, WI 54830 K 715-821-1440 NCE I. INTRODUCTION This Certified Soil Tester was contacted after another soil tester had been on the site and decided that an Interpretive Determination Report was needed for this 20 acre site. The property owners are planning on constructing a two bedroom dwelling. There are no A+4 soil conditions that is required per the State of Wisconsin, Department of Safety and Professional Services (DSPS) regulations. This report is required to determine the suitability for installation of a private on-site wastewater treatment system (POWTS) in lieu of groundwater monitoring. 11. PREPARATION OF REPORT This report is being prepared according to the standards set forth by DSPS 385.60(2) of the Wisconsin Administrative Code and a guideline prepared by Leroy Jansky called "Preparing the Interpretive Determination Report. " Ill. REQUIRED INFORMATION A. A Soil Evaluation Report has been conducted according to DSPS 385.40 and is attached as part of this report. B. Local Hydrology 1. Surface Water: no ponding appears to take place on the site based on the slope of the land and vegetation. The tested area is at the shoulder of the slope with a ~Ax percent slope. The road also prevents water from entering the site. 2. Subsurface Water: some rainfall leaves the site and some is absorbed into the A horizon. The silt loam texture within the A horizon has good structure with root and worm action taking place. The subsoil has a higher clay content which tends to hold more water due to the evidence of redoximorphic features at 8 to 11 inches. 3. Soil Saturation - soil appears to become saturated under the A horizon due to evidence of redoximorphic features. The heavier B horizon holds moisture longer. PAGE 2 - JOHNSON, JEFFREY Ft JEANNE 4. Surface Water Elevations - this area is within the Rush River and Eau Cade River Basins, Where area few natural small ponds within a few miles of the proposed system. The map below shows water drainageways. The headwaters of Rush River is located 2 3/4 miles to the southeast and flows at a southerly direction. Pine and Casey Lakes are located approximately 1 mile south. 23 24 } i 5 F e Torn of ERn Prairie x, 26 1125 N 0 600 1000 15008 DISCLAIMER: TMs map Is not pwantW to be O tl, CafiCt CUMIk Or COMP14% and oonal :N drawn sm the responeWbIlhy of the user.