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HomeMy WebLinkAbout018-1098-10-100Wisconsin Department ofCommeme PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal inforn aton you provide may be used for secondary purposes [Privacy Law. s 15.04 (1)(m)] Permit HddeYs Name City Village Township PATRICK RANWEILER TOWN OF H/ TANK INFORMATION TYPE MANUFACTURER ••�s I CAPACITY Septic tJt't'G J Ali.,,_ s 1 I z a) DosingAeraftOrr- G `i L Holding r H TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. en to Air intake Z� / 1Z(o FROADSepticDosing Aeration Holding PUMP/SIPHON INFORMATION A Manufacturer Demand Zoel GPM Model Number 1SL ✓System f ` v TDH Lift Friction Loss Head TDH FI /• I , 3 (10 Forcemain Length / Dia If Dist to Well CIO Z1 2 SOIL ABSORPTION SYSTEM ELEVATION DATA St. Croix No 597310 2928364 018-1098-10-100 angNMap No: 30.29.17.817A STATION BS HI FS ELEV, Benchmark , 1 3 /0/• 3 ��� All. BM rm�. Bldg Sewer SVHt Inlet J SIMI Outlet a � Dt Inlet Dt Bottom Header/Man. 3 , 5 ry 7. 8 Dist. Pipe 3. s `t7• 'S Bo[. System �F.Z 97.1 Final Grade - Z.eA7 is , 78 St Cover Fr,14 J Z c/g. •3$ S. �6 l BEDITRENCH DIMENSIONS Width S Length r �7tJ / W (Y. T ches C PIT DIMENSIONS .�- No a Pits �— Inside Dia Liquid Depth SETBACK SYSTEM TO P/L BLDG [HELL LAKEJSTREAM LEACHING Manufacturer - INFORMATION Ty,p/,.p.•(�rJlf[� System: IX I/5 IZg I %-5IJX CHAMBER OR UNIT ber Motlal Num: nIRTRIRIITION RYRTFM Ala Ft I Header/Manadki I / Length_. Dia a Disbibubon�/ Lenglh / I- if Dia Spacing x Hde Slze 7/ x Hde Spaang / Ven Air Intake �""•P ROII COVER e—se,.,, nnb, .. M--r! nr At6raHa Rvdome Only ~•" Depth Over Sed/Trench Center/ ( d Depin Over Bedr7'. Edges \ . Depth of Topsoil V4- ra SeedeVSodtletl — we M Ic ad rY O ' i Ves C No Yes . No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 748 154TH ST 1.) Alt BM Description = / 2.) Bldg sewer length = IL-7 - amount of cover = / - /I Plan revision Required? iJl Yes >(No Use other side for additional information. J Date SBD-6710 (R.3197) Inspection #1: / _/�3 (� Inspection #2: Pi �"d-(.. � s J 1/P/ot1 a/c Cart No. D=d`CIIICn S" -a 0 1-7 -- ors Safety and Buildings Division s ..,t. rf APR 2 4 2Q i i 201 W. Washin9� n Ave., P.O. Box 7162 in'-2: Sanitary Pamfilled Pamir Number (m be by Co.) u' -lison, WI 53707-7162 CROIXCOUMY I ;; .. '5173/D NRYDEVELOPM /, T, Sanitary Permit Applica,- Sane Tn..6. Number m attada= with SPS 39311(1), Wa. Aden Code, mi masim of Bus f= m me aft- -w 2_ j .2— b - 6 _ u tequaed priv m oWmbtg a taoitary D®ie Note: Application forms for state-owned POW. s Protect Address (if d0weat 6& mailing addrms) the Department of Safety and Profmiooal Savior. Personal information ym provide may be used u, ry 11 in axwdaoce with the Pri Law, S. 15. 1 m Sums. 7 L L C L Applicatios Information- Please Mot All Lformatioa Property 0%ver s Perm f Property owner's MINIMS Aderxs Property Location 30 . a 7. 1 . 81 i fl V% ✓v t�: l�� con. Lot r f y �% vk 7 City, Sage Zip Code Phone Number ) T ` °r IL Type of Bolding (cbwk all that app Lu f 2 Fatuity Dwelling - Number ofBWr��osyy Z ,/ Subdvmm Name t/F-� ✓ O BI ❑ Publiu'Coemmercial-Desmbc Use � �— Ciry of ❑Stone Dwmed-Describe Um / f N'wage of CSM Number Town of j Oh IMPerutit (Check only one box line p ' on A. Complete line B if app ble), A Syxt® ❑ Raplacemus Sysmtu ❑ Treatmem/lIoldmB Teak Rcplx®ac Only ❑ Other Modifi a so Eaistiy Syaerao (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumbs ❑ Permit: Transfer to New List Previous Perml Ntanba and Date 1smed / Before Expiration Owner IV. T OfPOWTS SYst4WCDzwwuut1Dcvi= Cheek all that a —i ❑ In -Ground ❑ Prettm tad In -Ground ❑ At -Grade > 24 ue of .L.We soil ❑ Mood <24 vt of mil ❑ Holding iank ❑ Dmiend (a�meut (cV=) Devitx V. Dix ra eat Area Iaformadon: Design Fbw (gpd) D p Sod App in O ' Dispersal Asa Requbed ^ ^ Xit lJv Dispersal Asa Pr (sf) Synan T l•J.l�/, Elmanm/ VL Taaklofa to Toad of Gallons Gallons Unity Neo 7aab Fo•Taalo w t hge 1 y i N i C Sepoew A"MT k y �',' 1 5 I VIL Respoosibitity Ststgm t- 1, the as aunt posabibty for smuuatim of the POVM sbuwa no the suscheg Phmba's Naar: (Prim) i NOMtPRS Number B morns Pbme Nmoba Plumber's A"m (StmcL , State, Zip VUL Coua !De irtmeot Use Onl ❑DpWro PeMa Fee hsuioB. Sigomue _ &Y6 Acisca for Demai -9 ! DL Cord approval ;3) i ('aJ as per JIWylpnamd pan probderl by p vnW. G.re- 1 * � " 21"'�.�f+Kili+ata�tar(t(�1hat.W�:k'sf B. par OF- goes r xd tanoBg. Arad to easpbe ylusfur the eys®ad Walem tic C.sry.atf pperwIm m. a tc xil l iada is use SUD 6399 (R. 11111) 1 System PLOT PLAN PROJECT Patrick Ranweiler ADDRESS 1544 78th Ave Robert Wi 54023 NE 1/4 SW 1/4S 30 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 96.8' 3/31/17 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 steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL •H.R.P. same as benchmark 496' Property Line t teD Well is to meetAl WDNR \ setbacks a." tit W E' 1 75' B-1 0 154th St. Scale = 1 /4" = 10' 2.5 Acre Lot Pro 4 Bedroom House 3% Slope B - 3 / Tank is to be properly bedded and provided with lockdown covers with approved warning . r labels air Combo Tank 4.1 95.8' 95' Area 15' below system is to remain undisturbed Property Line Grading is to be done to divert run-off away from system r Z, z��.o""•'�?o� DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 $ 3 I e Contact Through Relay P'S� http:ltdsps.vA.gov/pmgmms/industry-services www.wisconsin.gov sslo"s �f Scott Walker, Governor Laura Gutlbrraz, Secretary April 17, 2017 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING INC 1432 120TH ST NEW RICHMOND WI A777V: POW73Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/17/2019 F NAL :;c Ci'/IciJ OF 1N0 jSTRY Identification Numbers Transaction ID No. 2928364 SITE: Site ID No. 937126 Patrick Ranweiler Please refer to both identification numbers, 748 154TH St above, in all correspondence with the agency. Town of Hammond St Croix County NE1A, SW 1/4, S30, T29N, R17W Lot: 38, Subdivision: Emerald Acres FOR: Description: Mound Svsrem (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1701193 Maintenance required; 600 GPI) Flow rate: 24 in Sell minimum depth to limiting factor from original ¢rode; 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 i 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 tell 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- SRAUN R BIRD Page 2 4/172017 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 394.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11 xc) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(I)(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 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 pans 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, dear 7/.�21u� oC�ttdr Tim Vander I.eest Private Sewage Plan Reviewer, Division of Industry Services (920)492-2214 , Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov Fee Required S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Payment Submittal. WiSMART code: 7633 SHAUN R BIRD Page 2 4/17/2017 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 wttil 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 (11Xc) • Well setbacks to meet chs. NR 81 I & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(lxe) 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 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 andlor owner's manual for the POWTS described in this approval SPS 393.54(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 constructionlinstal lationi operati on. 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 stars 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, Tim VanderI,eest Private Sewage Plan Reviewer, Division of Industry Services (920)492-2214 , Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov Fee This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Payment Submittal. W iSMART code: 7633 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/31 /17 Owner.Patrick Ranweiler r,r ^.r7D r n,rCJ �EitVICES Rl�ci6CE veo APR 0 3 1017 INDUSTRY SERVICES Location: NE1/4 SW1/4 S30 T29 N,R17 W 748 154th 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 Shaun Bird Signature License num r Page 1 of 9 System PLOT PLAN PkOJECT Patrick Ranweiler ADDRESS 1544 78th Ave Robert Wi 54023 NE 1/4 SW 1/4S 30 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 96.8' 3/31/17 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 steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL •H.R.P. same as benchmark Pro 4 Bedroom House 496' Property Line Well is to meet all WDNR setbacks 154th St. Scale = 1 /4" = 10' 2.5 Acre Lot Tank is to be properly bedded and provided with lockdown covers with approved warning labels Huffcutt Combo Tank B.M.' B-1 13 B- 2 1 3% Slope B- 3 En 95.8' 95' 1 75' Area 15' below system is to remain undisturbed Line Loy Mound System Cross Section and Plan View = Topsoil ._� Cap Material Geotextile Fabric = ASTM C-33 LLLJ sand fill LD Ft Contour = Clean aggregate Vito 2 Yz in. dia. Dimension Feet A g B 7S D E 3� F ASS G 5� H /. U I i2. K T 9:v L q3.p w z L Slope- •�. O = 4 in. sch. 40 pvc observation pipe 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 V) 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''/. 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 __� ofL_ Pressure Lateral Layout Two Laterals — End Manifold Manifold X —4 I Force Main 3 7 e f' A'cad Distribution Network Sp ecifications Lateral Diameter Z In. 7,_ In. S%�3/ Z In. r/ In. 2_ Ft. Ft. "L In. S l Ft. Manifold Diameter Orifice Diameter X Orifice S L(Lateral M Manifold Le Force Main Diameter Force Main Leneth 03/05 Igj f--- Threaded ` Cleanout Lateral Turn -up --q Plug M L Long Sweep 90 Bend Pressure System Construction Laterals arc constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral turn -ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. • • • • • Grade Q:::i::.::;:::;:: 6-8 Inch Lawn Sprinkler Valve Box Page l of-- Septic -Dose Tank Cross Section And Pump Performance Specifications Tank Manufecturar Tank Model Number LTank Capacity t A Sg ') 6� Bray Deptli Filter Manufacturer j ./ FilteraleMin, 11• �• .0 Outlet Manhole MiiL 4" Above Grade With Locking Device. Inlet Manhole < 6" Below Grade Sealed Watertight sea -� •� FuiiahM Grade Switch and Reserve Capacity Tank Volume = GPI Dimension: es Inch Voltmme Gal_ (reserve) A: .2` S �7J• (alarm H, 2. (deed) D � /S3 Total � ...... . ,�:L'S:�4f�' / Total Dynamic Head (MM - Feet Elevation Head Distal Pressure 3, j Network Loss Force Main Loss Total �3 %D Maobole Min. 4" Above Grade Securely Mounted With Lock®g Device Wagrilarhoof I function Boor —i t� Vest Min. 12" Disconnect Above Grade Means With Vent Cap A v." _ Weep B Hole Off Elevation C 7. 3 Ft Bottom D Elevation ..+�=fit GENERAL INSTALLATION: The septic/dose tank is bedded and Lack filled in acomdence with the manufacbads product approval specifications. Maximum depth of bury as specified by the [manufacturer may not be exceeded without prior approval. Manhole coves exposed to grade have an effoobve belong device (padlock) installed. Piping at the We and outlet is of approved material, connected to the taolr with w8ber*t fittings, and laid on stable soil to prevent settling or sagging The force mautis sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight Electrical lies with NEC 300 and Comm 163%. 02105U page I HEAD CAPACITY CURVE W MODEL 152/153 W yWj sW cl x u 30 z 6 0 20 0 20 40 60 TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERWG MODEL 152 153 Feel Meters Gal. Liters Gal. Liter] 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 4.6 53 201 61 231 20 6.1 t 44 167 52 197 25 7.6 34 129 42 159 30 9.1 23 87 33 1 125 35 10.7 -- -- 22 85 40 12.2 -- -- 11 42 I Lack Valve: 138.0 Ft. (11.6m) 44.0 FL (13.4m) 160 24C 320 3 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Tirtred dosing panels "able. • Ekbkal allemalars, for duplex systems, are available and supplied with an alann. • Variable Ieval corltrd swit hl are availabe for controlling single prase TOMI'ls. • DOibe piggyback variable level float switches are available for variable level long and short cycle contrds. • Sealed QwWA3ox available for outdoor inslallatons. See FM 1420. • Over 130'F. (54'CJ special gitota6on required. 19R53 Soda «tiara I aaY Dupkz N152 Its 1 alIS2 115 1 Au11 - as IrcyLd 2r3 23D 1 Nan 4.3 1 2or3 BEt4 233D AU10 43 bcaoAd 2w3 ma its 1 1" 1 2a3 1E152 an51 115 1 AM ICU ba" 2a3 Et0 23D I No 53 1 2a3 BEti1 5 1 Ako 53 brAkded 2a3 � CAVr1ON AN blaadfm of cnetrak. q 4e3tnn dnicet and edMa should be done by a WaHed aomd aYatrIdan. Ali demial and dolt/ codas should be ldbwed MWduy ale moo ream Naltnkul Elecrlc Coda (1EC) and ale Oceupationd Safety and Hush Ad (OSHA} 12 1/a SELECTION GUIDE NeMill 1. Single p9gybaek instable level boat 3wIxI ar pikgybs&"naNe level Boat switch. Refer b FM04T7. 2, See FW712 for ooaem nodal W EW&Ace[AlnWdrE7ak 3. Variable k+dcaladswich IGO 25uwdaamatlatlNwbr,apeily duplex(3) or (4) 6oet system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. © WIL M. py 9Carw e0x 163A Slap T0: 36rPon Road • ux mae, KY 40211-1961 ffMp�, �,ag �silJ PUMP !O. (W477-2731• I(M 32a-PUMP hCylMwwskaal/v.com M 774-3624 ® Copyright 2000 Zoeller Co. A0 rights reserved. (0a,t-q POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILONFORMATION owner i Permit # DESIGN PARAMETERS MAINTENANCE SCHEDULE Page.of • Values typial for domestz (nontnoonerdai) wastewater end septic tank eftluent. Values typl®I for pretreated wastewater. Service Event Service Frequency Inspect condition of tank(s) At least once every months ar(s i (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume Inspect dispersal ced(s) At least once every ❑months 4ear(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months r(s) Inspect PUMP. Pump controls & alarm At least once every ❑ months76-yea4s) ❑ NA Flush laterals and pressure test At least once every ❑ months s) ❑ NA oCKr. At least once every ❑ months ❑ year(s) ❑ NA other. At least once every ❑months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an Individual prying 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 fading 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 113, Wisconsin Administrative Code. The servicing of effluent fitters, m nical or pressurized POWTS components, pretreatfinent components, and any other maintenance or monitoring at of 12 months or less shall be performed by a certified POWTS Maintainer. A servic$ 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. 2 of 1 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 otter chamicels thEit may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will the discharged to the dispersal call(s) In one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenR. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to th(e diluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or Compact, the area within 15 feet dmn slope of any mound or at -grade soil absorption area. Reduction or elimination of the follow'srg from the wastewater stream may improve the performance and prolong the We of tie POWT3: antibiotics; baby w)pes; cigarette butts; condoms; cotton swabs: degreasers; dental foes; diapers; disinfectants: fat: foundation drape (gyp pump) water, fruit and vegetable peelings; gasoline; grease, herbicides; rant scraps; medications; oil; painting producW 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 propeliy and safety abandoned in compliance with chapter Comm 113.33, 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 property 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 swil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must he taken, o provide a code compliant replacement system: ❑ A suitable replacement area Ins been evaluated and may be utibzed or the location of a replacement soil absorption systeirn. The replacement area should be protected from disturbance and compaction and should not be irdr i ged upon by requirled setbacks from existing and proposed structure, tot lines and welts. Failure to protect the replacement area will result in the need for a new soft and ate evaluation to establish a suitable replacement area. Replacement systems must mrtpty with the rulert in effect at that time. ❑ A suitable replacement area is not available due to setback and/or sob limihat suns. Baring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. J"e site has not been evaluated to Identify a suitable replacement area. Upon failure of Me POWTS a sob and site evaluation must be performed to locate a suitable replacement area, if no replacement area is available a holding lent* may be installed as a last resort toreplace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in piece following removal of the bomat 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 OI A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER /t Name Phone S� POWTS MAINTAINER Name Phone !,j ✓ J SEPTAGE SERVICING OPERATOR LIMPER LOCAL REGULATORY AUTHORITY Nara o-, - Name S Plane ` II f - 1t12 —.S Phone This doc mere s dallied In aw"Once with chapter SPS 393.22(2)(b)i(1)(d)6(t) and 383.54(1), (2) s (3), Wisconsin Adm'ristr ilhWe Code. 20140048A 0/S2OO ,,erou ,en000 O,\ i ' I.1921 11/6/ 9.7779 rf� /A �, tt y [. ri - A4c oe+y ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ro- J Ct'L-- Mailing . City/State Parcel Identification Number t,91Y —IAY— n'� LEGAL DESCRIPTION ) Property LocatiOUVe r/. ,iLL V. , Sec. Subdivision Certified Snrvey Map # Warranty Deed # Spec house yes (t9' Town of l�y,u�o c ryrl� Lot # Volume , Page # Volume , Page # Lot lip ideuti a le /qes / no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its prematme hiltue to handle wastes. Proper n=Utenanx consista Of pumping out the septic tank every three years or sooner, it needed, by a licensed Pimps. 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 §Cow 93.52(1) and in Chapter 12 - St. (tort County Sanitary Ordinance. The property owner agree to submit to St. Croix County Planning & Zooimg Department a certification farm. signed by the owner and by a >mahs plumbs, journeyman Plumber, restricted phmmber or a licensed pnrt)cr verifying that (1) the on -site wastewater dispaeal system is in proper operating condition and/or (2) after inspection and pumping (if mecessary). the septic teak is less than 1/3 full of sludge. Uwe, the undersigned have read the above reauiremmts and agree to maintain the private sewage disposal system with the standards set forth, hweIn, as set by the Department of Commerce and the Department of Natural Resources, State of Wiacoosm_ Certification Stating that your septic system has been maintained must be coutpleted and returned to the St. Cmix County Planning & Zoning Department within 30 days of the three year upiiation daft. I/we certify that all its on than ramuc to the beat of myIota kmwkxlge. I/we arrv= the owners) of the property described above, by vittae of a warman r deed recorded in Register of Deeds Office. AX IGNATURE O LICANT(S) DATE ***Any information that is misrepresented may result in the samotry permit being revoked by the Plartring & Zoning Departm=L *** Include with this application a recorded warranty deed from the Register of Deeds C)T= and a copy of the certified survey map if reference is made in the warranty deed (REV. U105) c�3 m M £-Y F • C S7 RECEIVED Wisconsin Department of , CarmptWo jQj�ll SOIL �..-.�.+..r r.n. r�crvr�l Page of Division of Safety and Buildups Pr 1\ CR OIXraarax+ wan wmm- Si. ptv�ENS Attach complete site 1ase116Tf 8 i x 11 inches in size. Plan must include, but not NrNted and horizontal reference point (BM), direction and percent Mope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Por"" aaaanaoon you provide may be uaad for tacanoary Fwrw pa (Privaey Lan. a 15,04 (1) Imo cal+ay ` 5 Parcel I.D. Q 1 3 ^ } Re by Date p Property owner ?0-- l r l c- (` 1 1 Property Location Govt. Lot 1/4 1)4 S ()T 1 N R E (or W Property Owner's Mailing Address 1 21 4"4 - Lot # 18lo # - Subd. Name CSM# city State Zi Code Phone Number Si LU I --W o.124( 1 ❑ City ❑ Wlage Tovm Nearest Road aA m / l7 ,New Carobuction Use'.IX ResiderWal / Number of bedrooms Code derived design flow rate b _ GPD ❑ Replacwrent /,/Public or commercial - Describe: ----- Parent mate" iL/! Flood Plain elevation if applicable General cone nnerlfs and recorranendabona: System Type '177011 rK1 System Elevation [ tO Spring # ❑ Bong 9� , / Jr ®. Pit Ground avlace elev. � R. Depth to knitting factor in. Soil Application Rate Fldnfzon Depth In. Darrarlant Color Munsel Redox Description Ou. Sz. Cora. Color Textre G. F Conalatanca Boundary Roots GPQTf -Eff#1 -0102 oL0�, IL 1 Borft 99 eaiNiD # Pit Ground surface elev. L,0 ff. Depth to limiting factor rt' ir. FSellAwkvbW Mare Fio¢on Depth In. Dominant Color Mtnsea Rados DesaipGan Cu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIIP 'EII111 •E##2 1 E /7 Eldrerlt #1 - SOD. > 30 < 220 ndL and TSS >30 < 1 • Effluent #2 - SOD. < 30 OV& and TSS < 30 mglL CST Name (Please Print) rat CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Talephone Number 715-246-4516 1432 120th St, New Richmond, WI 54017 — j/-�' 7 Property Owner Parcel ID # Page -a_ MINE F-1 E) pit Ground sLwfaoe elev. ft. Depth to firnift factor _ in. Bork-g # El Boring El Pit GmndsLirfaceelev.—ft. Depth to WriffiN factor In. Bork-g # El Boring El Pit GmndsLirfaceelev.—ft. Depth to WriffiN factor In. ' EMA t #I = BODE > 30 c 220 nV& and TSS >30 < 150 nV& . EIIAaurt #2 = BODO 130 mgd. and TSS 130 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format. please contact the department at 608-266-3151 or TfY 608-264-8777. SGD41wtasmr I(�P'm^—pdvty Omer Parcel 10 x � 'vim' V 0 ❑ 0—V 9 Pit Ground surface olev. [ s' J tL Depinlo Wkb UChDr121-- in. Fg—A»a�� QW 6-... MMI�OQm ©I i11 11i MAPA"MM!MF-3MM®WN IN .'R. mmm IN : � V -� O MOM EfiMrk •t - BODE > 30 < 220 mglL and TSS >30 < 150 ng& - Eflkmt #2 = BOD. < 30 nxyt and TSS 130 ng& The Department of Commerce is an equal opportunity smite provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Soil Test Plot Project Name Patrick Ranweiler Address 1544 78th Ave Roberts Wi 54023 Lot 38 Subdivision Emerald Acres NE 1/4 S W 1/4S 30 T 29 N/R17 W ❑ Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft. IL System Elevation 96.8' 6,CSTM #226900 Date 3/31/17 Township Hammond County ST. CROIX Top of steel fence post 'HRPSame as Benchmark Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _Lof_� MOM= of Safety and Buildings m accordance mm l rem on, ww. Apr!. ewe Attach complete site plan on paper not less than B 1(2 x 1 f inches in sae. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest mad. Please print ad in/ormadon. Perwnal nbmla5on you provide may be used by sec oy purposes (Privacy Lew, s. 15.04 (1) (m)). County pamal I.D. �s ((� [/i �• 0 )I71- L' V 23 2002 Date `(,(iyN� 3 0 03 ROpaM Oanl�r - C RoOenY Location ONIN FFI Govt. La ,U L 1w w E (°M Owner's Mailing Address •Phone L7# Block N Subd. Name or CS 21 City Slate Zip Code Number w l ! (7! 1 3 ❑ coy ❑ Village U Town Nearest RoadC / Act $� ter • ® New Construction thre: ® Residential I Number of bedrooms _ 3 N Code derived design flow rate _ 0 d _ GPD ❑ Replacement ❑ Pudic a commercial -Describe: _— — — — _ —---_—_—_ Parent material_— t_� __------ Flood Plain o"Ition it applicable —1�� IL General comments5 S�cm e/c v. 9q 2 0 -- %z d f or M ayand recommendations: t a r !�— CoANvor C,kV- qf! ZO SZ 4 l33 AAe- �' ❑ Boring Booing R ® pitGround surface elev. _ L.-�— n. ��• �Oh. Depth lo Writing leclor _ Soil Icon Bale Holtzm Depth in. Dominant Color Munsed Redox Description Ou. Sz. Cant Color Texture4�1_ Boundary Roots GPDdf •EfF#1 •EfW 0- ( r3l3 S•' LG-3 /h!/`i .s- / ® mg # Q P g Ground wAace dev. _Q R Depth to infing factor _ _ in. Soe Application Rate Horizon Depth In. Dominant Color Monsell Redox Description Ou. Sz. CML Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDff 'EfWl •E11102 ( o—r2 laY 6313 Sr•/ m4 r G3 Arl • S • b" 2 1 / — S• b rOty • FJauertt at =BOO > 30 <220 mrg(L and TSS >30 1150 mglL - Eflluern a2 - BOO, < 30 mg(L and T55 < 3u mg•L - CST J Hone (Please Rint) II'• — �/$gnature CST Number ry PAO W\ 5(-J lA,VJI Address - Date Evaluation Conducted Telephone Number Property Owner _ �rr+�_! __ Parcal ID tl Boring e ❑ Boring ® Pit Ground surface elev.ft. Depth to lrn" factor_in. Page 7, of _a c.a eJ Horizon Depth in. Dominant Color Morsel Redox Description Du. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1R 'Eftat 'EIW2 0-!2 1,04r 3i 3 — S,/ nab , c-5 IZA IL-L sja L r C5 1- , 0 / Y 7 6 MEN NEM ENNE Bourg # ❑ lioring ❑ Ph Grouts surface alm. ____ 0. Depth to Willing factor---- in. c.r�Rnte� Effluera 81 - BODs> 30 S 220 rng7L and TSS >30 < 150 mglL ' Effluent N2 = SOD, < 30 ng1L and TSS < 30 ngit The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TIY 608-264-8777. SBPUJa1aA1N% PAGE.OF 3 SCALE: V BM 1 ELEVATION bC . U BM 1 DESCRIPTION BM 2 ELEVATION 9g pU BM 2 DESCRIPTION 4oPo1 / pvc O,D2 ¢ �. _StC. 30_ _. SYSTEM ELEVATION 99,20 k SYSTEM TYPE Mound + CONTOUR ELEVATION Z , La 0 Sa DATE 11-Z6-oL