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HomeMy WebLinkAbout018-2021-23-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 592280 State Plan ID N Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Cl G*2 19 ` Permit Holder's Name: City Village Township Parcel Tax No Oevering Homes Investments, LLC TOWN OF HAMMOND 018-2021-23-000 CST BM Elev: 1 10 (&&1 :11 Insp. BM Elev: IBM Descri ion: Section/Town/Range/Map No: 08.29.17.1304 TANK INFORMATION ELEVATION DATA TYPE MANUFACTUR CAPACITY STATION BS HI FS ELEV. T lg\_t Septic 1 Benchmark :w : - r I~, ~ tau Dosing F1c- j + Alt. BM j Bldg. Sewer ~iJ ! f0', _ /Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom ~y IZ• l Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer ~ Demand St Cover -~-y t 4~( GPM C .0a, Model Number f~ y I Coil 1( • I 'O~ , TDH Lift FrictiotL System HeadTD Ft Forcemain I Length Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width + Length R No. Of-T+aAehes----- r IT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I 'J SETBACK SYSTEM TO P/L BLDG WELL LAKE TREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: _ r : } - ° x' UNIT Model Numl?er: DISTRIBUTION SYSTEM N~f Header/Manifold Distribution r Ix Hole Size ) IX Hole Spacing c Vent to Air Intake LengtF w Dia Length Dia Lr Spacing v 1« Z -Pylu 2 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over o Depth Over xx Depth of red/Sodded 1xx Mulched Bed/Trench Center t ti Bed/Trench Edges ` p Topsoil ) y dyes El No vx,Yes D No COMMENTS: (Include code discrepe cies, persons pr sent, etc.) Inspection #1: 5/30// '7 \w Inspection #2: ChA;AS1jth(_tj &i I 1 Location: 1027 166TH ST n DISpeful ovs& beeA h'lk l ow '/eo'''n' coll)U A64 1.) Alt BM Description -1'bo 2.) Bldg sewer = Vi COVrii- ins'la►►t~d Fz IKAle 8Mf or 8en?js. WA1hd o-W ~a 81 bi0~t'~l - amount of cover ='?">1p t Gt/b @ $9' U' j(►~ P~ }-ja(~ do esr shod' Ca oJr Lt. ~j'•~v+C!~ i i-¢a~r' Padi~tl~o~ PLOW Plan revision Required? Yes 4SC~.,No Use other side for additional information. dl~7 1 I SBD-6710 (R.3/97) ate Insepcto W 'Signature Cert. No. System PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 SE 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 104.9' 3/21/17 BEDROOM 3 DATE 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 Ilk BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE (DWELL *H,R,P. same as benchmark Scale = 1/4" = 10' 2 Acre Lot 0 437' Pro~rty Line 166th st. ro 3 droom Hou ,Ws to meet all DNR setbacks Area 15 b w -.Wy \ system is to B . M . r~ remain -1 undisturbed Huffcutt Corn T nk . NO J/ N 1 -2 V 444' Property Line 105.5 B-3 104.9' 7% Slope 103.5' Grading is to be done to divert run-off away from system P10+ ~ ~ Property Line ECE,IVED► County 1 Safety and Buildings Division ' in K 201 W. Washington Ave., P.O. Box 7162 gan;mr ermit Number (to be filled in by Co.) P ' Madison, Wl 53707-7162 ApR 14 N11 1,41 ST. C 'ULofty e T ction Number „ ~N ~1~`fnlt ApDI 1 cati n-n In accordanet 383.21(2), Wis. Adm. Code, submission c is required prior to obtaining a sanitary permit Note: Application :ct Address (if different than mailing address) the Department of Safety and Professional Servies. personal info s_ _ ay uc usea rot secondary Purposes in accordance with the Priv - Law, s. 15. I m), Stats. .t L Application Information - Please Print All Information b / Property Owners Name Parcel # Property Owner's Mailing Address Property Location a , e(, ( , j o y Govt Lot i, 7 City, State Zip Code Phone Number /a Section T Z-'/ N; RE W Ii. ype of Building (check all that apply) _ Lot # or 2 Family Dwelling-Number of Bedrooms Sub~i -siou Name ,s ! r Blook # t~ n d~ Q Public/Commercial - Describe Use U rI D City of ~~ust State Owned - Describe Use ~,5. CSM Number ❑ Village of Q ~ Town of t>7ti;1CZ"\ III. (Cbeck only one box on line A. Complete line B if applicable) ,y.. ew stem ❑ Replacement System Q TreatmenvHolding Tank Replacement Only ❑ Other Modification to Existing System (explain) p m ouT B. ❑ Permit Renewal Q Permit Revision El Change of Plumber 11 Permit Transfer to New List Previous Permit Before Expiration Owner Nrm er Daze ue~iOV/1'1/ 1~ 1 / IV. Type ofPOW TS System/Component/Device: (Che a 1 ❑ Non-Pressurized 1n-Ground Q Pressurized In-Gro t Grade Mound > 24 in. of suitable soil ❑ Mound < 24' of suitable soil El Holding Tank El Other Dispersal Component (explain ❑ Pretreatment Device (explain) V. Dis rsalPTreat ent Area Information: Des" Flo;w~ (gpd Desigt Soil~pplication dsf) Dispersal Area Requ" sf) Disgeersal Area Propose Of) System El vation VL Tank Info Capacity in 'Total # of Manufacturer Gallons Gallons Units) .~j ,~/ff New Tanks Fa fisting Tanlz r/1/ C~ I / t 1 1' w- v a m n o m ~ ~ U vy v cn C~ Septic or Holding Tank f- Dosing chamber VII. Responsibility Statement- the undersigned, assu ponsibility for installation of the POWTS shown on the attached pleas Plumber's Name (Print) Plumber' i ature MP/MPRS N bet Business Phone Nyrnber Plumber's Address (Street, City. State, Zip Co _ Court epartment Use Only Approved oved hermit F(V Date u~// -7 Issuing Agent Si e ~IA Owner eason or ial Z DL Conditions of A val/Reasons for Disapproval " SYSTEM OWI~ C~ni~a~-br Ut`(llxc S~~P~I-~ ~1~ 1. Septlp tank, 9ff{L)ent tiler and 01 M4Att k(1Cefi Q~°1'A~1 61 diSpQf5al Deli rl "t Opp $Q1 Prwl I_rdnair. Ptalu ,ber. RQr as per mar)S~erner;t Platl provide a ? Ali s~,±ba 1< r*~li.t reMen1s must be maintained ~YG0a c Easepvt - 10V54 1Y MqP* as per appiic@biAt1iWta p for the s?•stem and submit to the County only oe pa not less 8 11+z 11 F~-Fofl @ ~6q 1n s SBD-6398(811/11)5 5'tctFC 6LPPDVk rpnc~r'}~~D~$ A►"C !n ~ CC-f IN~fh ~"h~S peow 5o1*15 m t)54- no+ wear donor P )6W _ u CD 4, 1 t TV _ Lj' Ott Ad Lo"I N Oki I r.- CN a b k CN k k`~, Yrtxt 3 a J v. ~•Y~ ~ ,v ~ ~ ~ " rs'~ ~~~'~t r4 yam' ~ J Pm, kk a ~ IDm~ a . ~ ks,. j 5 ~ o :Ll 1 k~l t,~ !n NL ,ass„ ~ F .I m ` m ~ E u m 0 ..6 LL~ F ` Vn N o w ,mss O E , o~ra.~RTa1wr DIVISION OF INDUSTRY SERVICES q, 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 3i'P Contact Through Relay s http://dsps.wi.gov/programs/industry-services www.wisconsin.gov 55IOti,Scott Walker, Governor Laura Gutierrez, Secretary /I r" P F, April 10, 2017 O F S,' CUST ID No. 226900 ATTN: POWTS Inspector F E S S IO N w ION OF INDD SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CAR-MICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 C: : " CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/10/2019 Identification Numbers Transaction ID No. 2928186 SITE: Site ID No. 836907 Oevering Homes Please refer to both identification numbers, 1027 166TH St above, in all correspondence with the agency. Town of Hammond St Croix County SW1/4, SE1/4, S8, T29N, R17W FOR: Description: At-Grade (3 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1700087 Maintenance required; 450 GPD Flow rate; 37 in Soil minimum death 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 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 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. e SHAUN R BIRD Page 2 4/10/2017 • 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 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(t)(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 c onstruction/instal lation/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, 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.vanderleestAwisconsin.gov SHALTN.R BIRD Page 2 4/10/2017 • 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 chanties may result in pump resizin2 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 cirt off at ground level: A largerfi_ll area iS necessary when any of the above conditions are encn>>ntPred, 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 servicinipad 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 $ 250.00 7e This Amount Will Be Invoiced. When You Receive That Invoice, Tim Please Include a Copy With Your Vander Leest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services Pa WiSMART yment code: 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm thn.vanderleest@wisconsin.gov Cover Page Shaun Bird AND ~:r~allrF'S Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:3/21 /17 Owner:Oevering Homes Location:SW 1/4 SE1/4 S8 T29 N,R17W 1027 166th St. 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 r' Attachments: Soil Test ! Shaun Bird Signature .:i License number 226900 R 2 zo r Page 1 of 9 System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 SE 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 104.9' 3/21/17 3 DATE BEDROOM _ CONVENTIONAL AT-GRADE XX)< 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 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale = 1/4" = 10' 2 Acre Lot 437' Property Line 166th st. Pro 3 Bedroom House W9 -is to meet all Area 15' below ,-WDNR setbacks B M system is to remain B-1 undisturbed Huffcutt Combo Tank iij IINN B-2 444' Property Line 105.5' B-3 104.9' 7% Slope 103.5' Grading is to be done to divert run-off away from system /0jf/~ e m~~ptd Pff + Property Line ~ 7 At-grade System Sloping Site Cross Section and Plan View E Dimension Feet 1.1.1 L 1.1.1 L 1•L•1 1 1.1.1 1 1•L•L 1 1.1•~ L 1•L•1 L 1.1.1 ~ 1 1.1•L 1.1.1•L•1.1 .,I A r r•r•r J•r•r•r r•J•J•J r•r•r•J J•J•J•J J•r•r•r r•r•J•J J•J•J•J J r•r•J r J•J•r r•r• A I 1 L•L•L•1.1•Y1•L•L•L•1•YL•L•L•1.1.1•YL•ti,•'4,••,•1•L•~•~•L•L•L•L•L•L•L•L•L•L•L•~ ~•1 ..J l•r•r••1r••L••r• ••r•r•r•Ar•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•J•r•r•r•r•J•J•r•J r r• 1 rM%.%* •L•1.1•L•1•L•L•~•1•L•1.1•L•L•1•~•~•~•L•1-L•L•L•L•L•L•L•L•L L•1 ,:.:I D L r r•r•J•r•r•r•J•J•r•rr•r•r•J•r•r•J•r•r•r.r•r•r•r•J•J•J•r•r•r•r•r•r•r•r•r•r•r•J r r• B 20 I 1 1.1.1.1.1•L•1.1.1•L•4•L•1.1•L•L•L•1•L•1.1•L•1.1•L•L•L•1.1.1.1.1-L•1.1.1.1.1.1 1.1 r r•J•J•r•r•r•r•r•r•r•J•r•r•r•r•r•Ar•J•r•J•J•r•r•r•r•J•r•rM-r•J•r•r•r•r•r•r•r J•J• L 1.1.1•YY1.1.1•~•1.1.1.1.1.1.1.1.1.1•~•1.1.1.1•L•L•L•1•L•L•L•1.1.1.1.1.1.1.1.1.1 :I F r r•r•r•r•r•r•r•r•J•r•J-r•r•r•J-r•r•r•r•r•J•J•J•J•J•J•J•r•r•J•J•r•J•J•J•J•J•J•J r-r• k 1 L•1.1•L•YL•1•L•L•YL•1•YSr- 1/6 B Y1•L•1•L•1•YL•L•~•1•L•~•1.1.1•L•1.1•L•~•1•~•~•~ r r•JM•r•r•r•r•J•r•r•r•r•r•r•r•r•r•r•J•r•r•r•r•J•J•J•J•r•J•J•J•J•J•J•J•J•J•J•J J•r• 1 ~•L•L•1.1•L•L•L•L•L•1.1•L•L•L•1•L•L•L•L•~•L•L•1.1•L•L•1•L•1.1.1•~•1.1•~•~•1•L L•L W A I jlrtirti:'rfti 1rtirLrti?1:ti:!Ljti ti? ti ti •J•r•J•r•J•r•J•J•r•r•r.J.r•r•r•J•r.r•r•r•r•J•r J•1• i 1.1•Y1.1.1•L•L•L•1•L•1•L•~•1•~•~•~•L•~•1.1•~•~ 1.1• _J•r•r•r•r•r•r•r•r•r•r•J-r•r•r•JY•r•r•r•r•r•J•J•J•J•J•J•J•J•J•J•r•J•r•J•J•J•J•J J•J• :.I D 2.0 .1•L•1.1.1.1.1.1.•y.•,.•,.~.1.1.1,•1.~.1.1.1.5,•5,•1.L•~5,•1,•L••L•1•~•1.1,.~.~.1.1.1,•1•L•~•~•1 I r r•r•J•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•J•J•J•r•r•J•J•J•J•J•r•J•r•J•J•J r r• ~•1•L•1.1.1.1.1.1•L•1•Y1•L.1.•1.1.1•L•L•1•L•1.1•LK•1.1.1.1.1•L•1.1.1.1.1.1 1.1 1K I. r r•J.r•r•J•r•r•r•r•r•r-J•r•r•r•r•J•r•r•r•r•r•r•r•r•r•J•r•J•J•l•J•J•J•J•J•J•J•J J•r• I E 5.0 1•L•1.1•~•1.1•L•1.~•L•1.1•L•L•1•~•~•~•1•L•L•L•L•1•YL•1•L•L•1.1.1•L•1.1•L•1•L•1 J r•r•r•r•J.....t •r•J•J~J•t.J•r•r•r.r•r•J•J•J•J•J•J•r•r•r•r•J•J•J•r•J•J•J•J-J•J J J• 1.1•L.1•L•LLL•L•1-1•~•bL•1•L•~•1•L•~•L•L•L•1•L•L•~•~.~•L•L•L•L•L•L•L•~•L•L•L L•1 "I J r•r•r•r•rrr•r•r•r•r-r•r•r•r•r•r•r•r•r•r.r•r•r•r•r•J•r•r•r•r•r•J•r•r•r•r•r•r r•J• ,I F 0.5 1•L•L•1•L•1•L•L•L•1.1.1•L•1.1.1.1.1.1.1.1 L•L•L•L•1.1•L•L•L•1•L•1•L•1•L•1.1.1.1 1.1 i r•r•r•r•AJ•r•r•r•r•r•r•r•r•r•r•r•r•r•J•r•r•r•r•r•r•J•r•r•r•J•r•r•r•r•~•J•J•AJ r r• .r r r~r~r~r 1 1 r tti1'~rLf j~: •~•1.1.1.1 1.1•1•L•L•~•L-1.1•1•1.L. ~.~•1.1 1 1•~ I 1.1•L•1..... ~•1.1•L•~•~•L~ti?ti?ti~'Ljt~'.~t~'Ljti ~-~::ti:ti ti ff ?tirti:tirti:~:tirti I G 1.0 I ~ L /00 E 1/6B l W - - - - - - - - - - - E L s B L T, T, L % Slo i Plowed Clean aggregate 0 = 4 in. sch. 40 pvc 1.1 basal area r1:'L '/2 to 2 '/2 in. dia. observation pipe Lateral with 2" Topsoil Cap aggregate over pipe GeotextileObservation Pipe Fabric G With Cap l J•r•• r rLr~f•r 6 ,5. Ft Lateral Invert 1 ti•ti•1•ti•1• rte, r•r•r•J-r•r•r• J•r•r'r'r'J•J•r`r' Topsoil. Cap 1.1.1•L•~•L•1.1•L• 'L•1.1.1.1.1.1.1.1.1.1 1'•r•r•J•J•J•r•r•r r r•r J•J•r•J•r•J•r•J•J•J• ~ ~t r ~s ~~1 r~~~~~}~ ~•1.1••N1•L•1.1 1.5,•1.1•L 1•ti•ti•"L•~•1.1.1 ~h! ~Sy, ~1s r•r r•r•~•J•r•r•r-, r r•r•r•r.r, i•r, r,t r, r, r, r_ ia~j^`p i 1R r,P I ~ ~ •1.1-5,•1 1.1.1.1.1 F N L•• _ _ - : •y~ I,,!. .-.~,,,py.r,•~r•J.r.r,r,• ,r j•,r, J, J, '^•'~+t!... •ti•~~L•1• •L•• a Ft Contour '••1.1.1.1.1.1.1• +,1• ~ J• r•r•r•rM•J•r•J• :r:r:r:r•r•,f•r•r•r•J•J•,~',r.J•J ---.v.~.~1•1~•ti 3a~1{~rtirtir Jtir r~J • 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 I/< 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 gto~vth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6-in6hes. and secured in place. 03/05 lgj Page 3 of Pressure Lateral Layout One Lateral - End Manifold Threaded Cl eanout Force Main Lateral Turn-up -0 '.Plug X L Long Sweep 90 Bend ~Q of l Pressure System Construction Distribution Network Specifications Lateral Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter 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 Z In. cleanout plug and are enclosed in a 6-8 inch Force Main Length Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade •••••••'::Q _ 6-8 Inch Lawn Sprinkler Valve Box L 03/05lgj Page of Septic-Dose Wank Cross Section And Pump performance Specifications Tank Manufacturer Pump Manufactuner Tank Model Number Pump Model Number Total Tank Capacity Ot~a jJ Alarm Manufacturer G Max. Butt' Depth Alarm Model Number Switch Type Filter Manufacturer Total Dynamic Head (TDM - ]Feet Filter Modell Number Elevation Head _ Distal Pressure 3 Network Loss _ Minimum Pump performance Required Force Main Loss ~ -7 GPM: @ Ft TDH Total Outlet Nlanhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted • _,_-_•_-._._-_._.a• weather-proof Junction Box - - Finished Grade - -a - Vent Min. 12" Disc oiinect Above Grade Means With Vent Cap i,. 'i > >'>',`>'i . > •`i r i •ha, 'c'i i t; ,a :'a's::' .'i ' ~i <'i li i i > Outlet Filter Inlet Baffle Inlet - ' A Switch Sings and Reserve Capacity ` %a„ Tank. Volume = j GPI •'t Weep Dimension: Inches Volume Gal. B Hole (reserve) A; e j 6 7. (alp) B 2 t7 Off Elev 'on C (dose) C , j `S < . Bottom (dam) D' 3 D Elevation Total *;;"3 F1 0 a'a•t <'t a•t. ( f a'1'a'<'<: a a . . . i • a . a t . a a < . s t a i ! < a>a < a t i•<•t iii < (>ta .j{::>.><>a "•ta GENEPLAL 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 manufactures may not be exceeded without prior approval. Manhole covers exposed to grade have an effective looking device (padlock) installed. Piping at the inlet and'outlet is of approved material, connected to the tank with watertight fm.,ings, 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 add the sleeve is sealed watertight. Electrical . rviee mplies with NEC 300 and Comm 16.28. 02/05 L,7 Page of • TOTAL DYNAMIC HEADICA?.ACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING MODEL 152/153 1 MODEL i 152 153 50 Feet Meters Go'- Liters I Gal. ;Liters 5 1.5 i 69 251 77 291 153 10 I 3.1 61 231 ' 70 265 12 40 15 15 4.6 53 1 201 61 231 °a 20 .I 6.1 1 44 167 52 197 w i 30 25 7.6 34 129 42 159 . Z 8 30 9.1 I 23 87 33 125 ro 35 1 - 22 8b -e 20 40 122 I 11 I 42 ~ j Lock Voive: j38.0 FL (11.6rn)144-0 Ft- '1 3.4rn) 4 o,awe I 0 20 240 60 80 100 GALLONS • f ~f- 6 ,/a LITERS O 80 160 240 320 _ 3 27/;2-11 -~1 '-s FLOW PER MINUTE 1 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. - ® 3 27/32 • Electrical altemators, for duplex systems, are available and supplied with e I i 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. 1 • Sealed Qwik-Box available for outdoor ins nations. See FM1420. • Over 130°F. (54°C.) special quotation required. i i 1521153 Series' 2 1/8 152I753 MODELS Control Selection I Model Volts-Ph Mode Am s Sim lex Du iex i 5 1 /6 N152 115 1 Non 8.5 1 2 or 3 BN:152 115 1 Aulo 8.5 Induced 2 or 3 t -1 SK2064 E152 230 1 Non 4.3 1 2 r3 SE152 230 Auto 4.3 Induced 2 or 3 N153 115 1 Non 10.5 1 2or3 SELECTION GUIDE BN153 115 1 Auto 10.5 Inclu:.ed 2 or 3 E153 230 . 1 Non 5.3 t 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE753 230 7 Auto 5.3 Induced 2 or 3 switch. Refer to FM04T7. o cAtmoN 2. See FM0712 for correct model of Electrical Alternator E-Pak. Ali 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. AR electrical and safety codes should be followed including the most Or (4) Boat system. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: P.O. 80X 16347 Louisville, KY 40256-0347 Manu(acurersof. . Z SNIP 70: 3649 Cane Run Road p Louisville, KY 40211-1961 QpyP//,LfPS SvcF %9.~~9` 2) 778-2731 - 1 FAX (502J 03624 PUMP y P)aIff/wiff 'C,0. (50 httpJ/www.zoeller.wm © Copyright 2000 Zoeller Co. All rights reserved- e -t POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner e - Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer ❑ NA 3ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model f~ ❑ NA Number of Public Facility Units NA Pump Tank Capacity b al ❑ NA j Estimated flow (average) 13~ aVda Pump Tank Manufacturer ❑ Nq Design flaw (peak), (Estimated x 1.5) gal/day Pump Manufacturer -20 ❑ NA Soil Application Rate aUda tftz Pump Model /J -Z NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit _)4A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5950 mg/L ❑ Disinfection ❑ Other. !Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODs) 530 mg/L ln-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other. 'Maximum Effluent Particle Size S6 in dia. ❑ ]NA Other. ❑ NA Other: ❑ Other: ❑ NA "'Values typical for domestic wastewater and septic tank effluent Other: ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency (inspect 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 cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA .year(s) (:.lean effluent filter At least once every: l Y ear(sjs} ❑ NA Inspect pump, pump controls & alarm At least once every: 3 0 month(s) ❑ NA years} '=lush laterals and pressure test At least once every: ❑ month(s) 14 NA _14-year(s) Dther. ❑ month(s) At least once every: ❑ year(s) NA ether: 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 ic;ombined 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 deck the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the endre contents of j:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, And 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. ~~7 Page r_, 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 theft may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thr 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 bye discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenit. 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 Wthln 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT:G: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants, fat; foundation dralin (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 propetly 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 compy*nt 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 required 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 technology/ a holding tank may be installed as a last resort to replace the failed POWTS. ` P"e site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. -Adound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone 7i- ?L"z f G SEPTAGE SERVICING OPERATOR UMPER LOCAL REGULATORY AUTHORITY Name rte,.- Name C n74 Phone ~J f~a 6 Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. .i-~ 4- J^ glj L/ N P i a I ins . Fs i 7 I Siam j~uh e ~ I 3 Q m ~1 ..1 . 5.:1:.1 if LL5 OF e//" o° a m ~ ~ N 8 ~ U Q y Z 0 4 F- LU C\j I i - ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Bu er (52eoer),11 Mailing Address ~9-C~GO G~~✓~~~ ~LI. Property Addres _ r . ? [:x (Verification required from Planning & Zoning apartment for new construction.) City/State _ 1,1QM/1W Parcel Identification Number LEGAL bESCR ~ ip`1'ION Property Location--%j `l, , % , SeC T % N R/ i /w Town of C y~ ~rC Subdivision - - _ f - Lot # 1 Certified Survey Map # 'Volume PT Warranty Deed # Page # Volume Page # Spec house,-;-Y-es no l,ot lines identifabl yeS no SYS~`E1K MA'ENANCE AND OWNER CERTib'tCATION -Improper use and maintenance of your s maintenance consists of purnpin,9 out the epttc system could result in its premature failure to handle Wastes. Proper the systerrt can affect the function of the septic t~ every three years or sooner, if needed, by a the Syste ii can are specified in Co eptic tank as a treatment stage in the waste disposal system. 0 pumper What you § . 83.52(1) and in Chapter 12 - St. Croix county Y Put into caner maintenance Sanitary The property owner agrees to submit to St Ordinance. o der and The a master plumber, es to Croix County Plannirt wastewater disposal system is in pJO"Me roper ova lumber, restricted g 'Coning Department a certification form, signed by the less than l r plumber a licensed pumper verifying that ar the on -site fall of sludge, ing condition and/or (2) after a r inspection and pumping (if necessary), the septic tank is l/we, the undersigned have read the above re set forth, here quirements and agree to maintain tl~e private sewage disposalsystem Certification standards seDeP nt within Y stating o in, as set by the Department of Commerce Septic and the Department of Natural Reso with the 30 our days of the three been maintained must be completed and re urc- State of Wisconsin. year expiration date, ttunad to the St. Croi7t County Planning & unty Planning & T/we certify that all statements ou this form are property described above, by virtue statements a Warr true to the best of my/our knowledge. I/we am/are the owner ant}' deed recorded in Register of Deeds Office. (s) of the Number of bedrooms ~INAT OF APPLICANT(S~) ***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 co of the c reference is made in the warranty deed, PY erhfied survey reap if (REV. 08/05) oooo~,,, UD LO °97034 S. F. ~ 2,23 c, Lur 23 /0" UD 7-7051-9 S wF .6 a LOT o'::-::`4, 65712 19 AA' L 0"' T -22.f 5 s N w O g Aso w ~ rg ~ ~ ~ Q ~I A 4 & R R o,, ;I `a lid ion; 21 n~ ~ 3 21~ ~rv ~ ~ y O!. 8' w~a J W ~ L j. El F i- I t oil Q w IP Q I rys t: z,~ s t z O s Q~ J~,o LU w~ ~ J ~ ~ z ~ O o' W : Q pfi ~sa= Rfi ~~:gl `j Z, ~ N z k'a 5~~~u Z~ t O ~ 3 Ell 3 It }se y, I fl sam.o,~o`e j ~2.i: ` 9? 22.6 - o OII - - i M1 , a vv I _ r- c ry s 5 § __r - $ 0 I t - i ICI A e - i ' ' I ~ ooze w,*a~rmua~ I ~ i'.. I I "I y - - - - 1q - - - - -