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HomeMy WebLinkAbout018-2013-11-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 597301 : Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j 2932376 Permit Holder's Name: City Village Township Parcel Tax No WILLIAM FLETCH TOWN OF HAMMOND 018-2013-11-000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town/Range/Map No: 08.29.17.1112 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Tot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over jxx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~I Yes No Yes n No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1013 167TH ST 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? E] Yes ❑ No Use other side for additional information. L Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) County' j'2 l' Safety and Buildings Division , k 1 Y- = _ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) f Madison, W! 53707-7162 Mary Permit Application Transaction Number In acco; S 383.21(2), Wis. Adm. Code, submission. of this form to the appropri ental unit is requYte r io obtaining a sanitary permit Note: Application forms for state-owned PO~~s Ttift project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secon purposes in accordance with the Priv Law, s. 15.94 1)(m), Stats. - 6-T MIX cou L Application Information - Please Print All Information 11 itl. ~i Property Owner's Name a arce Property Owner's Mailing Address Property Location Q G I 7 1 t f f~ Govt j of C State Zip Code Phone Number ,e~J, Section y y , J .w' t t'~ ~ r ~ one 1 T N; R (Eie -e) 11. Type of Building (check all that apply) Lot # r2 Family Dwelling-Number of Bedrooms Subdivision Name lock Ok L eh e-, x y II ❑ Public/Commercial - Describe Use D City of ❑ State Owned -Describe Use / CSM Number ❑ Village of A6 1~~ - J X-Town of tt III- Type of Permit: (Check only one box on line A. Complete line B if applicable) A. System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B- ❑ Permit Renewal ❑ Permit Revision El Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that %pund i 67 N X -0 ❑Non-Pressurized ]n-Ground ❑ Pressurized In-Ground ❑ At-Grade > 24 in. of suitable soil 11 Mound < 24 in. of suitable soil ❑ Holding Tank ❑ er Dispersal Component (explain) ❑ Pretreatment Device (explain) z / V. Dis rsal/Trea ent Area Information Design Flow (gpd) Desi Soil Applic t) Dispersal Area Requ s Dispersal Area P-P819 s S ystem Elevation I VL Tank Info Capacity in Total # of Manufacn= Gallons Gallons Units y o New Tanks F~';e;ng TanlS m U o Septic or Holding Tank ~ n 6 Dosing Chamber, E s„ VII. Responsibility Statement- a undersigned, assume r p nsibility for installation of the POWTS shown on the attached plans. PlmnWss Name (Print) ! Plumber's e MP/NTRS Number Business Phone Number rr Plumber's Address (Street, City. Stew, Zip Coo} 6 f / VIII ountv/De artment Use Onl Approved oved Permit Fee Date sued Issnins t Signature ❑ ive R for Denial V l DL Condi p~~• pproval 77 , - n ti Ai. oen rlust an F finen'• inn Pi'aaivaet try NWmber• ~ .ell ` 1A F%f i'~ G~f `r ~ Z At so PM ApFM VA6 00tw 1 Y44AM", 1 10 11A. Attacb to compiete plans for the system and submit to the C ry only on paper not less than 8 it z 11 inches in size SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Bill Fletch ADDRESS 1025 170th Ave Hammond Wi 54015 SE 1/4 SE 1/45 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 98.3' 4/11/17 4 DATE BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of fence post ASSUME ELEVATION 100' Fflter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line 1.8 Acre Lot Scale = 1 /4 = 10' Tank is to be properly bedded and provided with lockdown covers with approved warning labels 230' Propery Line 514' Property Line Area 15' below system is to remain undisturbed Well is to meet all WDNR setbacks B-1 97.5' ❑ 96.5 4% Slope _ Pro 4 B•M•* Bedroom Huffcutt its, Combo Tank B-3 House B-2 Grading is to be done 97.3' 167th St. to divert run-off away from system 292' Property Line DIVISION OF INDUSTRY SERVICES N 99 2331 SAN LUIS PL STE 150 ail p GREEN BAY WI 54304-5211 3i } aSr ' I< Contact Through Relay R r http://dsps.wi.gov/programs/industry-services www.wisconsin.gov \0~;~.5~yl~igb/ Scott Walker, Governor Laura Gutierrez, Secretary April 24, 2017 AP CUST ID No. 226900 OF ATTN: POWTS Inspector ~ ~ ~ !?F:._.S - l~ a: SHAUN R BIRD ZONING OFFICE; BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/24/2019 Identification Numbers Transaction ID No. 2932376 SITE: Site ID No. 837352 Bill Fleteh Please refer to both identification numbers, 1013 167TH St above, in all correspondence with the agent . Town of Hammond St Croix County SE 1/4, SE 1/4, S8, T29N, R17W FOR: Description: Mound Svstem (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1702536 Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to Iimitin2 factor from original trade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Code 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, stars. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area • Divert surface water from POWTS Area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches Smearing and 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, SHAUN R BIRD Page 2 4/24/2017 the site is too wet to prepare If it crumbles site preparation can proceed If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative arci 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 '6etl 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.vanderleestra~wisconsin.gov SHAUN R BIRD Page 2 4/24/2017 the site is too wet to prepare. If it crumbles. site preparation can proceed. If the site is too wet to prepare. do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your code:ubmittal. Private Sewage Plan Reviewer, Division of Industry Services Payment ment Submittal. 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim. vanderl ee st@wisc ons in. gov Cover Page RECEIVED APR, 1 3 2017 Shaun Bird INDUSTRY SERVICI`S Bird Plumbing Inc. 3 -y A.Np 1432 120th St. EIVICS New Richmond Wi 54017 ; 715-246-4516 Date: 4/11/17 Owner:Bill Retch Location: SE1/4 SE1/4 S8 T29 N,R17W 1013 167th St. Hammond Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications and cross section Attachments: Soil Test C j 1 Shaun Bird Signature ` License number 4900 Page 1 of 9 System PLOT PLAN PROJECT Bill Fletch ADDRESS 1025 170th Ave Hammond Wi 54015 SE 1/4 SE 1/4S 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 98.3' 4/11/17 4 DATE BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line 1.8 Acre Lot Scale = 1 /4 = 1 Q' Tank is to be properly bedded and provided with lockdown covers with approved warning labels 230' Propery Line 514' Property Line Area 15' below system is to remain undisturbed Well is to meet all WDNR setbacks B-1 97.5' ❑ 96.5 4% Slope _ Pro 4 B•M•* Bedroom Huffcutt lbs. Combo Tank B-3 House B-2 Grading is to be done 97.3' 167th St. to divert run-off away from system 292' Property Line Z LL o ~ Mound System Cross Section and Plan View 7,,7 77 Dimension Feet J A i" B l 5- T ' 1.1••• ' 11.444441•E•4L•M1• hfY•rY•f•r•hf• L 44E•L•41.1•L•1•L•44 . •rWf•hf•f•r• • 4\•M1•444L•1•M1•M1•M1•M1•M1•M1• D •1.41.1.1. 1•\K~1K•4E• . rYYY•f•fYY~}.!•f•hfY•hfY• • 1•L•1•M1•1.41.41.4E hhf• 1 1.1.1.1,1•M1.1.1.1•L.1.L. • 441.E-41•M1• f.f•l.rYl-r.r.J.f.J•f•r•f.J U; A ~ •1.1 1 1 1 •f`fiJ f•JYWfY•r•J J hf f lYYi%.f• 44L•44E•1%Y1K L• YY•hf• r.f:fM1JyJ,l:rt•ti.1.1.L•Y1111.1.441•'.111::ti~Y1?t1ti1t1•J-:-:-:-:J-J 1•L~\11~M1`Y _ •M1•1•L•M1.1• •t•M1•1•M1•1.L•L• f f f•r•f•rY•fYY•r•J•fY•f•f•r•J•J•r•J• 4\ 1 1 L L•1• 441.1.1.4 M•f•h .f 1 1 4 1 1 441.1.1.1-\•\•E•4 J hJ f•J•f.J•hJ .,.1.1.1.1.1.1 r•f• . 1 1 E J•rYYYY.JYYY•h fLf\\.-•}f~f~%%~i11:1M1J1J:r1,1j1 W JY•f•f•rY•f•r•f•fY•f f rti• F Z + G. H (7 z ~ I i J : K L K T B 1 3 Z L Slo e % Topsoil = ASTM C-33 =Clean aggregate O = 4 in. sch. 40 pvc r• 1-~ Cap Material sand fill 4til r. % to 2 1/z in. dia. observation pipe Geotextile „ G H Fabric J f1j 1f~:':~rti:' M1• Ytirti:til4ri 1 E - . D E Ft Contour Plowed Surface Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07 lgj Page ~ of~-- Pressure Lateral Layout Two Laterals - End Manifold 4 Threaded Cleanout Lateral Turn-up -0 Plug Manifold - M Force Main L Long " d Sweep 90 Bend 3 To r il-c')?4 )oe,- ("C41-LS1 Distribution Network S ecifications Pressure System Construction Lateral Diameter 2 In. Manifold Diameter In. Laterals are constructed of Schedule 40 PVC Orifice Diameter 5 / 5 -L In. pipe. Orifices are drilled perpendicular to X Orifice Spacing) , 2 4/ In. the pipe with a sharp drill bit and face down. L (Lateral Length) - Ft. Lateral turn-ups terminate with a threaded M Manifold Length) Ft. cleanout plug and are enclosed in a 6-8 inch Force Main Diameter In. diameter lawn sprinkler valve box accessible Force MainLength Ft. from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box Page Lj of~_ 03/05 lgj Septic-Dose Wank Cross Section And Pump Performance Specifications Tack Manufacturer Pump Manufacturer Z v e,111, l Tanis Model Number 13-50 -7 Pump Model Number Total Tank Capacity j s Alum Mazwfacttuer Max. Bury Depth Alarm Model Number Switch Type C ~4i,~1 G~ Filter Manufacturer i Total Dynamic Head C IDH) - Feet Filter Model Number Elevation Head DisW Pressure Network Loss Minimum Pump f awe Required Force Main Loss , U GPly 13 Ft TDH Total outlet manhole Min. 4" Above Grade With Locking Device. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight Securely Mounted With Locking Device Weather-proof Finished Junction Box as . shed Grade r s . t>Ya r. air s Fuu Vent Min. 12" Disconnect Above Grade Means With Vent Cap . . < Outlet Filter inlet Inlet Baffle - A . Switch Settings and Reserve Capacity i/ GPI Weep Tank Volutme Hole B Volume Gal. Dimension; Inches (reserve) A' S 5 v ; Sr ' Off Elevation C (alarm) B : 2. , (dose) C -7, Bottom (dead) D 3 D Elevation g~. Ft Total - r. :>,a,, , a,>a>, > aa>~ aaO >a7<,<~ i~,<: Y: a<j: a<s::l;<<• < < <:<aa a < a f< .•a s< a a< a t a a t< a f a a s<< t a f< t s•t•i ~ <•::<:>: <•<•: f•::: a><l GENERAL iNSFMXAnON: Tote septicldow.tank is bedded and back filled in accordance with the manufacbmes product *mal specificatiions. Maximum depth of bury as, specified by the manufach"r may not be exceeded without lam 4PI"V81. Manhole covers exposed to grade have an. eft w&t locking device (padlock) at t inlet and outlet . of approved material, connected to the tank with wdmfi& fittings, and installed. Piping laid on sable soil to a vent settling or swing. The forme main is sleeved with 4°' Sell. 4o PVC to bridge the tank Ejooujcd-.sgvice complies withNEC304 and Comm 162 . excavation and the .slemve. is sealed *ate7tight. p$ge of 02/05 IJ TOTAL DYNAMIC HEED/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING MODEL 152/153 MODEL I 152 153 w 50 'eedeters Go!- Liters I Gal. Liters 5 , 1.5 1 69 251 77 291 153 I 61 231 , 70 265 12 40 15 10 3 • ; 15 4.6 53 201 61 231 0 20 .1 6.1 1 44 167 52 197 _ 25 7.6 34 129 42 159 a 8 30 30 9.1 I 23 87 I 33 125 r 35 I; - - 2G 65 42 20 40 12.2 11 t 4 1 Lock 'Joiv .6m) 144.0 Ft. (13-4 ~38.0 ; t . ( 1 Gti506 10 I 0 100 20 40 60 80 GALLONS 6 1/4 LITERS 0 80 160 240 320 _ 3 27/32-I~ I 5/8--1 FLOW PER MINUTE ; 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS ® 3 27/32 • Timed dosing panels available. hed with _---T-~- Electrical alternators, for duplex systems, are available and supp an alarm. • Variable level control switches are available for controlling single phase I systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. j i 12 1/8 . 1~ 1 T 152/153 Series I I J~ 1. 1521153 MODELS Control Selection 5 t/a Model Volts-Ph Mode s Sim lex Du lex i I N152 115 1 Non 8.5 t 2or3 f _1- BN152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 t 2 or 3 SE152 230 1 Auto 4.3 Inclined 20r3 N153 115 1 Non 10.5 1 2o r3 SELECTION GUIDE RNiS3 115 1 Aura 10.5 tnct ed 2 or 3 back variable level float 3 230 1 Non 5.3 .3 1 1 2 or 3 1. Single piggyback variable level float switch or double piggy BE153 230 1 Auk 5.3 included 2 or 3 switch. Refer to FM0477. A CAUTION 2. See FM0712 for correct model of Electrical Alternator E-Pak. PAN duplex Alt 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, s (3) licensed electrician. AN electrical and safety codes should be followed including the most or (4) float system. recent National Electric Code (NEC) and the Occupationat Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Manukcturersof Louisville, KY 40256.0347 SHIP T0: 3649 Cane Run Road ~[I~[ Puwv$ HCE Louisville, KY 40211-1961 (502) 778-2731.1(800) 928-PUMP FAX (502) 774-3624 hitpJ/www.zoell er. corn © Copyright 2000 Zoeller Co. All rights reserved. 6b~ ~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page.,, FILE INFORMATION SYSTEM SPECIFICATIONS FP wnerSeptic Tank Capacity at NA e nit Septic Tank Manufacturer S> NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ --h NA Number of Bedrooms [3 NA Effluent Filter Model ❑ UNA Number of Commercial Units It jJNA Pump Tank Capacity jl~- al NA Estimated flow (average) L~ alld Pump Tank Manufacturer ENA Design flaw (peak), (Estimated x 1.5) TJ -galtday- Pump Manufacturer -51-70 to 13 Soil Application Rate 40 Ud fle Pump Model l J'~ ❑ NA Influent/Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg/- ❑ Sand/Gravel Fitter ❑ Peat Filter Biochemical Oxygen Demand (BOD.) 420 mg/L ❑ Mechanical Aeration Q Wetland Total Suspended Solids (TSS) 5150 m g& ❑ Disinfection O Other. Manufacturer Pretreated Effluent Quality Monthly average- IY 9 Dispersal Cell(s) Biochemical Oxygen Demand (BODS) 530 mg/L ❑ In-ground (gravity) ❑ In-ground (pressurized) Total Suspended Solids (TSS) 530 mg/- ❑ At-grade Fecal Coliform (geometric mean) s1W cfu/100m1 ❑ Drip-line ❑ Other. Maximum Effluent Particle Size Y inch diameter Values typical for domestic (ri commerclal) wastewater and septic talk effluent Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every f-P months ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (S) of tank volume Inspect dispersal cell(s) At least once every ❑ months year(s) (Maximum 3 yrs.) Clean effluent filter At least once every C ❑ months-7F'[year(s) Inspect pump, pump controls & alarm At least once every ❑ month ear(s) ❑ NA Flush laterals and pressure test At least once every months ear(s) ❑ NA Offer At least once every ❑ months ❑ year(s) NA I Other At least once every ❑ months ❑ year(s) NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage Servicing Operator- Tank inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface- The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (4) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 11'3, Wisconsin Administrative Code. The servicing of effluent filters, m"rncal or pressurized POWTS components, pretreattment components, and any other maintenance or monitoring at irlEervals of 12 months or less shall be performed by a certfied POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thElt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO 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 by discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenli. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 fleet 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 fife of the POWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produc*; 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 properly 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 nail, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compli.pnt replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requirled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the neled for a new soii and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruled in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologN a holding tank may be Installed as a last resort to replace the failed POWTS. X 'he site has not been evaluated .to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluatlion 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. ~lound and at-grade soil absorption systems may be reconstructed in place following removal of the blomat 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 13E DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name tCc~ Phone j - Phone l~ J G SEPTAGE SERVICING OPERATOR JFAMPERJ LOCAL REGULATORY AUTHORITY Name J Name Phone f ' - Phone / 1J Al- This document was drafted in ownpliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. l7 9 N A P tsi.. l 1 1 a c Mli X J I it ~o v a? a ' y,i ~ ,r ~tl ..t < ~ ` Cry L! . 0 m o Q N Iq h l7 U ~S Q c 11 Z Q ~ a U c~ ul Ic* 1 ~ I ~ ~ I ST. CROIX COUNYY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address C' ':j- S I ? 4n=ingg Pr operty Address erification required from Planning & tinent for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location r u/4 , t/4 , Sec.' T 1 1 NR/ .-W , Town of Subdivision J. r 4,L/ Lot Certified Survey Map # , Volume , Page # Warranty Deed # Volume Page # Spec house yes no Lot line., identifiable/ yy 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, ii= 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 was he 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 ism 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 year expiration date. I/we certify that all statements on form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a deed recorded in Register of Deeds Office. Number bedrooms SIGNATURE OF APPLICANT(S) DATE ***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 map if reference is made in the warranty deed. (REV. 08/05) W)/- W7 ooizi z).r. 3 1.98 Ac. 'D 8 S. F. 4 Ac. F f -1025.OO 643'49.,, a~~a 513.60. 80567 S- 1.85 Ac. fir, 6>. v ~IK 90 29 i 9s' LOT 12 N 80.35'14" E 230.17` 70672 S. F. 1.62 Ac. z LOT 14 a r i /r 70135 S.F. 89'04'20" E 471.73' 1.61 Ac. n r,+ o O vsn - NISNOOSIM g HaN z I O ZLD bN s s a s _ b3-18W" JN121dS L OZ 0 LL o m NOIlOf12llSNOO HOl3l3 Pi~wp~ ~ _ ~ I $95 i z 9 9 ~ t I p 6°s gggg ys „ ~ LL 9 Ir i z O ' I ~ D°o W I Q3 Hsorc Q § / Y co f w w0 U Q' ~ r o z ~ FE- - Ell i i III , I I 1 1 ` I 'I~ I~ f 11 II I ' III I it I ,III j~ III z I~I~ii 'I I ®o > J LUII. ~ C - 1 LL I I ~I VIII Eliot 11 Z III I ~I~I I Ills W o` III a~ LII~ I - - Z I, III II D11 D I ~DEll E J Llyl E-E- ' I I I I .K«-s I I ' I I I ! I w 3'x - ~~~~@~ w a r ow $m VSn - NISNOOSIM o q a Q OV aN s bas =o~ U3'18W`dZl JNIbdS 1OZ g ° L° a € NotionN1SNOO HOI3IJ oI LU ~ N lip i I- 9 I A9~~i 1. OZ LL°~8 610 K a •y i Hsme alai o- z K'•ia i o ~~5~~ mb I LL ~ ~ gnu F~ok ~i ~ ~ m Smb a'~g~ ~ 3 I I I I Fll I I ~ ~ p I I I I I I I `T ! 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II' w SW ~..aYW w G+ vSfl _ NISNOOSIM a y Z k s a s s 213"18W`o21 JN1UdS LM ° ROM NOuomJ1SNOO H0131=1 o co u, I lot E`sa s I ~ tr-o LL LL W LU goo yw v9 K ° x &x a az I Q I .o-.Le ono I I I e.9 0a ~gygyqy?,,,N _ N y t7 : O ~i I 3'J IYa b F Z~Z' O ll Z § U y r O ~3m ` rcjW I ~ a o~mK O - _ ~ c~ $ .o-,e p ~w . w ~ mw 300 I 0- x ; I n ~ z eve alava > ~ o a ~ w .az ~x x 3 .tr,c ) a .o-.Yz Z.P.Y .0 L'.fi I _0311l1VA_ ~ _ d LVI~.tr.9~ Q§ O jo Oi a3A3ll a~V~YBllal rc m I; ~m K w ' ® a= EB W .rz 01 I § N fm Q'I~ ~g ~ .az AL e a 4 i m ~ 0 .Drat - -01 «4 oU 3" ~ H N p Y r 7 - 0 m - I d .01 z I C ~ I .L-.ez -.t t-z m N I i I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis- Adm., Code County~: Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy taw, s. 15i1 (tn))- I Z V b~ Property Owner L / Property lkication , f~ ` / lY?hJ ! J L9` A t S~ h a Govt. Lot S, 1J v 1/4 S T N R E ( r) Property Owner's Mailing Address Lot # Block # Suubd. Name or GbNW -s- / 7 0 4~ - ~ r n 10? city State Zip Code Phone Number ❑ City ❑ Village own Nearest Road ~ New Construction Use Residential I Number of bedrooms Code derived design flow rate - " 'e,~ / C GPD 4' ❑ Replacement~^~ ❑ Public or commerd It- Desstribe: Parent material. / r! ~'t ✓ d' L ~T > F~ Flood Plain elevation if applicable oo< 1 111_1_1 ft- General comments `7t 0241 and recommendations: t 1 Jv, 14~e X? Boring Boring -f i~ # Aflpit Ground surface elev. j l fL Depth to limiting factor in. t 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 V r~ Ali' V I Boring F1 } ring / < FEI rpit Ground surface elev. ft. Depth to limiting factor 1 in. Soil lication 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 5&S A. L r y/~ L~ 5~ - n h < ` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ` Effluent #2 = BOD 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird d.= 226900 Address Date Evaluation Conducted Telephone Number 5-246-4516 "`!r 1008 192nd Ave, New Richmond, WI 54017 0 ~r- 71