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HomeMy WebLinkAbout042-1007-70-050 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 597326 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2931594 Permit Holder's Name: City Village Township Parcel Tax No TRAVIS MCGLOTHLEN TOWN OF WARREN 042-1007-70-050 CST BM Elev: Insp. BM Elev: BM Description. Section/Town/Range/Map No: 1 p 04.29.18.52C-20 TANK INFORMATION ELEVA ION DATA TYPE MANUFACTURER CAPACITY STATION .113 `(lHiI FS ELEV. Septic ~w~. / - Benchmark f Dosing Alt. M 1w 1.01 96~ 5 y~~.~.>xY Bldg. Sewer 3 3 P I 0 Ho din 9 St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inle Septic ` ♦ L, Dt Bottom Dosing / Header/Man. Aeration ist. Pipe Holding - Bot. System Final Grade • PUMP/SIPHON INFORMATION Demand St Cover Manufacturer '76 / GPM r Model Number TDH Li Friction Loss System Head TDH Ft Forcemain Length/ • , Dia. t, Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width ♦ Length No. Of Trenches PI7DONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ♦ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR TYpe Of s / Lii' UNIT Model Number: i DISTRIBUTION SYSTEM Header/Manifold Distribution Ix Hole Size ix Hole Spacing Nto Air Intake Pipe(s) ~ O N i1 Length , i Dia Lengthy ~%Dia 4Spacing ' SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ( Bed/Trench Edges Topsoil / es No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: g Inspection #2: Location: 1162 120TH ST 1 GU (L ~'~T~- ~~(~y 1.) Alt BM Description Q~ v "sjt^$ L 2.) Bldg sewer length= - amount of cover = s ~ Plan revision Required? ❑ Yes ❑ No C Ise other side for additional information. D-671 0 (R.3!97) Date Insepctor's Sign Cert. No. aO~Aat''T County ° Safety and Buildings Division f 201 W. Washington Ave., P.O. Box 7162 SanitanPermit Number (to be filled in by Co.) Z OW rgtj MN x'20 Madi ION. Sanitary Permit Applica nt _ 0117 State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form t ernmental unit 2- / 3 :55r is required prior to obtaining a sanitan permit. Note: Application forms JON Mumsed ~itted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal inform Al for secondan, purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1. Application Information -Please P int All mation V' ~f Property Owner's Namey 5~ I Parcel # LN - ' > Property Owner's Mailing Address Property Location ©q -119. S c c+~ Gt Govt. Lot City, State Zip Code Phone Number Section (circle one T~N. R~ Eoo 11 3'pe of Building (check all that apply) Lot # Subdivision Name I or 2 Family Dwelling - Number of Bedrooms k Block # ❑ Public/Commercial - Describe Use D J a ❑ City of El State Owned -Describe Ube j CSM NNuumber ❑ Village of _ -7, 5 RL, .10 / 0 ~ 1g I Town of 111. Type of Permit: (Check only one boa on line A. Complete line B if applicable) Zo ~2 A. A New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) i B• ❑ Permit Renewal ❑ Permit Revision ❑ Chancre of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration y Owner IV. Type of POU'TS System/Com stem/Component/Device: Check all that apply) e e J r' ❑ Non-Pressurized In-Ground ❑ Pressurized In-Grou At-Grade Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gp fl Dispersal Area Required (s Dispersal Area Propos (s System Elevation / (P LJ, V VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units J/ Z 5 p o New Tanks Existing Tanks J 2 o a. U v1 v va Z U Septic or Holding Tani: Dosing Chamber .,-F~d VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber' N e ( Plumber's ignature MPIMPRS Number Business one Number r, - ~2 ;7 Plumber's Ad ress (Street, CM. State, Z' C)de) VIII. County /De artment Use Only / Permit Fee Date sued Issuing ent Signature Z' / Approved ❑~Bisapprov S 7b a! $ /7 ❑ en Reason for De IX. Cand lifflPReasons for Disapproval 3l /il 6 s~ AMPI-1 ark as rs i cell st I n as per mar ayener' F alUftt M. I V,_ ~rl- ~C~ ~✓l T' G - ! 2 4t4eRkt * rec.< . rttc,a" i Attach to complete plans for the system and submit to the County only on paper not less than 8 trz 1 11 inches in size cDn «nc rv i i ii i 1 n r ~ f 11 I u! v - Mc-0 P ` ppRT,f DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 ~i SContact Through Relay 1 y\,' S i I http://dsps.wi.gov/programs/industry-services y,. www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary May 08, 2017 CUST ID No. 224263 ATTN: POWTS Inspector KIM A OCONNELL ZONING OFFICE KO CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE E 1101 CARMICHAEL RD OSCEOLA WI 54020-8173 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/08/2019 Identification Numbers Transaction ID No. 2931594 SITE: Site ID No. 837271 Travis Mcglothlen Please refer to both identification numbers, 1162 120TH St above, in all correspondence with the agency. Town of Warren St Croix County SE 1/4, NE1/4, S4, T27N, R18W FOR: Description: At grade, 5 bedroom residence with accessory building Object Type: POWTS Component Manual Regulated Object ID No.: 1702018 Maintenance required; 750 GPD Flow rate; 36 in Soil minimum depth 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), SSWMP Pub. 9.6; 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. AP owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code _ requirements. ' O~ No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.1406$,nFESSION stats. 1,T ,i.ZSION OFF I D The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system malfunctions so as to create a health hazard, the property wner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described the At Grade Component Manual are complied with. A copy of this information must be given to the owner upon completion of the project. Reminder • The orientation of the at grade system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2, • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of SPS 384. SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. KIM A OCONNELL Pale 2 5/8/2017 • Maintain well and waterline set backs per SPS 383.43(8)(i). • Insulate building sewer per SPS 382.30(l 1)(c). 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 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandorf WiSMART code: 763 )3 POWTS Plan Reviewer, Division of Industry Services (715) 634-7810, Fax: (715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. KIM A OCONNELL Page 2 5/8/2017 • Maintain well and waterline set backs per SPS 383.43(8)(i). • Insulate building sewer per SPS 382.30(11)(c). 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 Fee Received $ 250.00 --K►~ Balance Due $ 0.00 Patricia L Shandorf WiSMART code: 7633 POWTS Plan Reviewer, Division of Industry Services (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. '~I~~o201r, RESIDENTIAL AT-GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project Travis J McGlothlen Owner Travis J McGlothlen Address 1162 120th ST Roberts WI 54023 Legal Description SE--NE--sec4 T29N-R18W Township Warren County St Croix Subdivision Name CSM 225301 Lot No. 2 Parcel ID Number 042-1007-70-050 Plan Transaction Number VED FETY AND Index sheet Page 1 L SERVICES Calculations Page 2 At-grade drawings Page 3 ' TRY SE'' Laterals and dose tank Page 4 Specifications Page 5 Management & contingency plan Page 6 Pump curve & specifications Page 7 c~ Plot Plan Page 8 Soil Tests Page 9 r / ~ f Designer Kim A Oco e I License Number 224263/ Signature Phone Number 715-381-7917 Date 04/18/17 Designed pursuant to: At-grade Component Manual Ver. 2.0 for POWTS SBD-10854-P (N. 03/07, R. 01/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (11/12) Page 1 of 9 PRESSURIZED AT-GRADE DESIGN At_rirar¢n r-lesiOn Wo rknhi-_t C~rs :r~r. Cifrz. Flows and Site Data Entry. c) r Residential or commercial? 500.0 ~ Estimated wastewater flow (gpd) 750.0 Design wastewater flow (gpd) 11.00 % Site slope 103.00 Contour elev. below lateral (ft) 36.00 Depth to limiting factor (in) 0.60 In-situ soil application rate (gpd/ft^2) Distribution Cell Information r=? 1 Influent wastewater quality 4.50 Linear loading rate gpd/ft 7.50; Effective absorption width (ft) 7.50 Max. effective width permitted (ft) 167.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) E Center or end lateral connection 1 Number of laterals 0.125 Orifice diameter (in) e.g. 0.25 2.00 Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) 3.53 Forcemain flow velocity (ft/sec) 1. ;l} 45.00 Forcemain length (ft) y or n Does forcemain drain back? ~C 92.50 Pump tank elevation (ft) y or n y Are laterals at highest point? ! / 6.5 System head (ft) x 1.3 NA fC~ 10.33 Vertical lift (ft) 7.3 Forcemain drainback (gal) 1.14 Friction loss (ft) 134.5 5x Lateral void volume (gal) 0.00 In-line Filter Loss (ft) 141.8 Minimum dose volume (gal) 17.97 Total dynamic head (ft) 34.6 System demand (gpm) Lateral Diameter Selection Gallons/Inch Calculator Pipe diameter Design options Design choice.__1585; Total Tank Capacity (gal) Designer 1 in 1 38': Total Working Liquid Depth (in) n,,ust select 1.25 in ( 41.7 Gal/in (enter result in cell G46) one lateral 1.5 in i diameter 2 in x x Treatment Tank Information 3 in x 1585 Septic tank capacity (gal) Wieser Manufacturer Effluent Filter Information Dose Tank Information Ploylock Filter manufacturer 950.0 Dose tank capacity (gal) PL 525 Filter model number 25.0 Dose tank volume (gal/in) Wieser Manufacturer Project: Travis J McGlothlen Transaction Number: Page 2 of 9 AT-GRADE PLAN VIEW 1/6 B Observation pipes (2 typical) A 7.50 ft D B 167.00 ft 1 /6 B 27.83 ft W C 9.50 ft D 5.00 ft E 2.00 ft D L 177.00 ft B W 19.50 ft A x B 1250.00 ft^2 L T Cap obs. pipe. = Total aggregate cell A x B Typical Slotted in n the lower 6", and Plowed area L x W anchored securely. 6° AT-GRADE CROSS SECTION Svnthetic fabric cover r,, 104.83 ft Finished grade elevation Lateral invert elev. 103.50 ft Observation pipe at aggregate toe E Surface contour 103.00 ft C q % Slope and system elevation D = 12 in. topsoil and subsoil over aggregate and tapered to toes. Plowed layer = 6 in. aggregate below below L x W pipe(s), and 2 in. above pipe. Project: Travis J McGlothlen Transaction Number: Page 3 of 9 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - End Connection P La_rhole drdledne:rr.,endcap 1--X--'1 LareraL tom_emair. c-fF"dC'3c1. 41 H_.le= drilled on the br, atom of the hreral per' PS Table 3:14.311 r equalla-psoed • =Turn-uF.-Mballvalve Grclean._lutplug Lateral Specifications 0.125 Orifice diameter (in) End Lateral connection point X 1.99 Orifice spacing (ft) 1 Number laterals 84 Orifices/lateral P 165.17 Lateral length (ft) 34.6 Lat. discharge rate (gpm) 2.00 Lateral diameter (in) 2.00 Forcemain diameter (in) 34.6 Sys. discharge rate (gpm) 45.00 Forcemain Length (ft) 17.97 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather-proof warning label and locking device junction box Final grade 4" disconnect Tank component is Alternate properly vented < V--- outlet \ location 18" min. Electrical as per NEC 300 and I~ Approved SPS 316.300 WAC outlet Tank full joint c Inches Gallons JA Provide 1/4" .N A 22.3 558.2 Alarm on weep hole or c B 2.0 50.0 antisiphon C 5.7 141.8 Pump on B device. o D8.0 200.0 93.17 ft C Totals 38.0 950.0 Pump off D 3" Bedding under tank 92.50 ft Goulds ; Pump manufacturer R JS Rhombus _ Alarm manufacturer PE 51 Pump model number HW 101 Alarm model number Project: Travis J McGlothlen Transaction Number: Page 4 of 9 At-grade System Maintenance and Operation Specifications Service Provider's Name Kim A Oconnell Phone 71 5-381-7917 POWTS Regulator's Name St Croix CTY Zoning Phone1715-386-4680 System Flow and Load Parameters Design Flow - Peak 750 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 500 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1585 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1250.0 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the at-grade component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07). Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution` ~ Long Sweep 90 or Two 103.50 ft 45 De ree Bends Same Diameter as Lateral Project: Travis J McGlothlen Transaction Number: Page 5 of 9 At-grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10854-P (N. 03/07, R. 01/12), SSWMP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-grade and Pressure Distribution System No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the at-grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the at- grade be heavily mulched as protection from freezing. Influent quality into the at-grade system may not exceed 220 mg/L BOD5 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Travis J McGlothlen Transaction Number: Page 6 of 9 ""'GOULDS PUMPS Submersible Effluent Pump PE r i A ~iUEIdF PUMF SPECIFICATIONS MOTOR FEATURES General: ■ Corrosion resistant x Pump - General: • Discharge: 1112" NPT • Single phase construction. • Temperature: 104°F (40°C) • 60 Hertz ■ Cast iron body. * r maximum, continuous when • 115 volts ■ Thermoplastic impeller and F fully submerged. • Built-in thermal overload pro- cover. v ,17= n • Solids handling: Yz" tection with automatic reset. ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models include a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended service life. following uses: Pumping range: see PE31 Motor: • Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 12.0 Maximum amps operation. • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design ■ All ratings are within the working limits of the motor. • Basement Draining • Maximum head: 25' TDH PE41 Motor: • Heavy Duty Sump/ PE41 Pump • .40 HP, 3400 RPM ■ Quick disconnect power cord, 20 standard length, Dewatering • Maximum capacity: 60 GPM • 7.5 Maximum amps heavy duty 16J3 d SJTW length, with • Maximum head: 29` TDH •PSC design NEMA 5-15P, three prong, PE51 Pump: PE51 Motor: 115 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maximum amps portable and compact. • PSC design ■ Mechanical seal is carbon, METERS FEET ceramic, BUNA and stainless MODELS: PE31, PE41 PE51 steel. E51 HP:.33, .40, .50 ■ Stainless steel fasteners. 35 10- 2G PM AGENCY LISTINGS 30 PE41 - - _ 1 FT a 25 :PE31 U ~ C p 20 Tested to UL 778 and o CSA 22.2108 Standards _ By Canadian Standards Association 15 File #LR38549 O Goulds Pumps is ISO 9001 Registered. 0 0 0 .10 20 30 50 _ 60 - 70 GPM 80 0 5 10 15 m3/h Goulds Pumps CAPACITY R I ~ T r \o ~ j \ ff i ` tr 1- _ 'r , r~l ~r M. f 1 J s RECEIVED ST. CROIX COLfi'TY SEPTIC TANK MAD\7ENANCE AGREEMENT MAY 1,6 201 AND S OWNrER.SHIP CERTIFICATION FORM T. CROIX COUNTY 'OMMUN(TY 0 Owner/Buyer "'E!'WM s 1 14 c 61-4 k 1 I!-, Mailing Addresses 1 ~\vv , vywc. RkV2- ! l~ ~ y - i Property Address (Verification required from Planning & Zoning Department for new construe one) City/State Parcel Identification Number L U,-+- LS 1 LEGAL DESCRIPTION Property Location C F= 1/4 , INJI 1/4 , Sec. , T N RTown of \bl eur N -cA/' Subdivision Plat: , Lot # . Certified Survey Map # Volume , Page # I Warranty Deed # 1u3-}-b r (before 2007)Volume , Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE AND OWNTR CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 Safety And Professional Services 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. Uwe certify that all statements on this form are true to the best of my/our lmowledge. Uwe am/art the owner(s) of the property described above, by virtue of a warranty de recorded in Register of Deeds Office. Number of 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. 04/12) a lVisconsin SOIL EVALUATION REPORT #1960 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and O ~Q- . percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D - Please print all information. ing Review y Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 1 1) (m)). c~ Zd " Property Owner Property Locatio Larry Aebly l~ s- Govt. Lot na SE1/4, E1/4, S4, T29N, R18W A-) 9 Property Owner's Mailing Address Lot # Block # Subd. Name o SM# 1168 120th St P.O.Box 280 2 na CSM ` City State Zip Code Phone Number City Village Town Nearest Road ~l(o v Roberts WI 54023 715-246-4878 Warren 120Th St New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: na Parent material Ridges of grfaund moraines underlain by weathered sandstone Flood plain elevation, if applicable na ft. General comments At de or Mound Design, system elevation 100.50ft baed on contour linerelevation 100.00ft. Minimuum and recommendations 6 inches ASTM 33(}mound sand. 0 A)a eSc) c< 3 ?.t 17 LJ;9-,- . 6 . XTY r- A) ff Se; is 4b Boring # 10 ❑ Ground surface elev. _ 100.00 ft. Depth to limiting factor _36 ~ in. Soil Application Rate a~ r Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i -Eff#1 `Eff#2 1 0-4 10yr3/1 none I 2msbk mfr cs lc .6 .8 2 4-24 10yr4/4 none sicl 2msbk mfr cs if .4 .6 3 24-36 7.5yr4/4 none sicl 2msbk mfr j gw na .4 .6 4 36-60 7.5yr4/4 c2d 7.5yr5/6 sl/scl om na cs na .0 .0 5 60-72 10yr8/2 none ;andstonf residumm na na na .0 .0 ❑ Boring # Ground surface elev. _ 100.00 ft. Depth to limiting factor 45 ✓r in. Soil Application Rate 2 Horizon Depth Dominant Color Redox Description Texture Structure Consistence' Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0-4 10yr3/1 none I 2msbk mfr cs 1c .6 .8 2 4-45 10yr4/4 none sl/Is 2msbk mfr cs if 6 1.0 3 45-60 10yr8/2 none ;andston( residuum na na na .0 .0 Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD5 <-30 mg/L and TSS < 30 mg/L CST Name (Please Print) ~Signature, CST Number David J. Steel u 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 9/18/2006 715-760-0347 SBD-8330 (R.07/00) Property Owner Larry Aebly Parcel ID # Pending Page 2 __of 3 F3] Boring # Ground surface elev. _97.30 ft. Depth to limiting factor X7 ' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence' Boundary j Roots G_PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 `Eff#2 1 0-4 10yr3/1 none I 2msbk mfr cs 1c .6 .8 2 4-19 10yr4/4 none sic[ 2msbk mfr cs if .4 .6 3 19-37 7.5yr4/4 none sci om ' na aw if .6 37-50 4 7.5yr4/4 I none sl/scl om na cs na .0 .0 5 50-60 10yr8/2 none andston residumm na na na .0 .0 ❑ Boring # - Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color I Redox Description Texture Structure Consistence Boundary Roots _ GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 'Eff#2 I I ~ I I ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ,Consistence Boundary Roots G_PD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 'Eff#2 I Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 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 TTY 608-264-8777. SBD-8330 (R-07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Larry Aebly 994200 th St. CST-POWTSM SE1/4,NE1/4,S4,T29N,Rt8W Baldwin, WI 54002 Lic. #248956 Town of Warren, St. Croix Co. Direct 715- 760-0347 CSM Lot 2 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend N 1"=40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations BI = 100.00 ft B2 = 100.00 ft B3 = 97.30 ft B4 = 0.00 ft r n Yj vr~-'Gt v . ~G 56 , i Wis. Dept. of Safety and Professional Services SOIL EVALUATION REPORT Page Of Division of Safety and Buildings _ in accordance with SPS 385, Wis. Adm. Code County Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must r include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel 1.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ) S Revie by Date Please puarrf all inforntati®n. Personw information you provide may be used for secondary purposes (Prhmgr Law, s. 15.04 (1) (m)). Property Owner Property Location _ GovL Lot 114/ 114 S T N R E (or K Property Owner's Mailing Address Lot # Bkck Subd. Name or CSM# ZZ~112 I-,~2j City State Zip Code Phone Number 0 City O Village ® own Nearest Roa J0 New Construction use. ED Residential / Number of bedrooms ,S~ Code derived design flow rate 7p f~ GPD Q Repiacement El Public or commercial - Describe: Parent material 2L. 1,2 Flood Plain elevation if applicable _ General comments / and recommendations: ~ - 2 Boring # a pit Ground surface elev. R. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure nsistence oundary Roots GPDfft a in. Munsel Qu. Sz. Cont. Color Gr_ Sz- Sh. ff#1 2 F1 $orin # Boring S ~ Pit Ground surface elev. fL Depot to limiting factor in. soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure sistence Boundary Roots GPD/ft z f(#1 fr#2 in. Munseil Qu. Sz. Cont Color Gr. Sz. Sh. E t #1 = BOD 5> 30 < 220 mg1L and TSS >30 < 150 mg/- ' EtTiUerrt #2 = B4D < 30 mgt and TSS < 30 mg/L T Number CSTName t Sign~ture' Address Date Eval Lion Conducted Telephone Number I SBD-5330 (R11/11, Property Owner Parcel ID # Page of ~ Boring # ❑ Baring j [J pit Ground surface elev. ft Depth to limiting factor in. F1 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate 2 Horizon Depth Dominant Color Redox Description Texture Structure nsistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * tT#2 ❑ Boring F-1 # Pit Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure nsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sm Cont. Color Gr. Sz. Sh. ff#1 *111#2 Effluent #1 = SOD 5 > 30 < 220 mg1L and TSS >30 < 150 mg/L * Effluent #2 = BOD 5 < 30 mg/L and TSS 30 mg/L The Dept, of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-5330 (RI 1/1)) J ~ L-I I I p~ i ' ! 1 i ! Vr"z , I - LL-i a _ _ - F L_