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020-1318-50-000
Jisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 597339 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2929773 Permit Holder's Name: City Village Township Parcel Tax No: BEN & NICOLE TOWN OF HUDSON 020-1318-50-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 66T 12.29.20.1623 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 2~. JO Z, iaa Septic Benchmark /Z4n6 • (o,3 /Lob Dosing Alt. BM L"J -75 d fu 1-0 6, u.. IS . z yd . 9S Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO / WELL BLDG. ent Air Intake ROAD Dt Inlet ~3 d?~ Septic a Dt Bottom 17-61 TY, 17 Dosing Q / D0 I 1 ZLA Header/Man. .0. Y6 $ 7 Aeration Dist. Pipe Holding Bot. System PUMP/SIPHON INFORMATION Final Grade ZA 4M 77 Manufacturer Demand St Cover Model Number P, . V V JY~~ /ps.Z lW 1 J / IT(a pal~j TDH Lif Friction Loss System Heads T /0 f-61t QJ d T2 . 3 r q, 0 $ Forcemain Length Dia. / Dist. to well a Z 2Aj SOIL ABSORPTION SY TEM x.31 BED/TRENCH Width Length No. Of nches NSIONS No. Of is Inside Dia. Liquid Depth DIMENSIONS / 96 e_ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR TM System: a j 110P.- T~ UNIT Model Number: NA- DISTRIBUTION SYSTEM (~,)g Header/Manifold Distribution S x Hole Size' 4 / x Hole Spacing Ven Air Int Length Dia ~r Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only a'M a Depth Over Depth Over xx Depth of 1 xx Seeded/Sodded J Mulched Bed/Trench Center G-7 Bed/Trench Edges Topsoil Yes E, No Yes ❑ No a COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Z~--7 Inspection #2: Location: 276 BRANDON 1.) Alt BM Description LA1~~_ ~U 2.) Bldg sewer length = 1 0IbLj - amount of cover = Plan revision Required? Yes 75~<o Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Sig ture Cert. No • County IV Safety and Buildings Division St. Croix 201 W. Washington A P.O. Box 7162 Sanitary Permit Number (to be tilled in by Co.) MAY 1 20 7 Madisr WI 7-7162 -T. CROIX COU "CIM State Transaction Number NNYWary 'pplication a3 In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropn, ,ntal unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POW7~ to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used j, purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. Same -t I 1. Application Informatio$ Please Print All Information i gat ff_y Property Owners Name Parcel # i' i Ben & Nicole Hanke 020-1318-50-000 Property Owner's Mailing Address Property Location)), 276 Brandon Dr. Govt. Lot City, State Zip Code Phone Number NE SE _'A, Section _12 (circle one) Hudson, WI 54016 T 29 N, R 20 E or W I1. Type of Building (check all that apply) _ Lot # ❑ I or 2 Family Dwelling - Number of Bedrooms 4 y OS ) Subdivision Name Block # Plat of Heartland ❑ Public/Co"mmercial - Describe Use Na ❑ City of CSM Number ❑ Village of ❑ State Owned - Describe Use ❑ Town of Hudson _ y Na III. Type of Permit: (Check only one box on line A. Complete line B if applicable) ❑ New System B.Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) - Addition ATU & filter canister R. List Previous Permit Number and Date Issued ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ 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/Treatment Area Information: SymTech STF 100-A effluent filter at ST outlet Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Arca Required (sf) Dispersal Area Proposed (sf) SYt Elevation 600 Gpd 1.0 Gpd ASTM-C33 sand 1,500.00 sq. ft. 2,356.63 Sq. Ft. y 87.00' at 6" above 0.4 Gpd native soil 86.50' contour V1. Tank Info Capacity in "Dotal # of Manufacturer Gallons Gallons Units , o v New Tanks Existing Tanks Septic or Bolding Tank Na 1,200 1,200 1 MidWestern Precast X Dosing Chamber 750 Na 750 1 Wieser Concrete VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) PIqc' naMP/MPRS Number Business Phone Number Jim Boumeester MPRS 222904 (715) 386-9020 Plumber's Address (Street, City, State, Zip Code) 1070 Hwy. 35, Hudson, WI 5401 VIII. County/ eartment Use Only p Approved 11 Disapproved ~F~ecDate Issued Issuing Agent Signature 0 V11 'i en Reason for Denial IX. Condl o f Disapproval '1ii14~781::`~i Cell nusf'811 Qg_sw:tSl~S lit l~ ~n~ es. ~ s~-a.+~•td. QA ~ G.C. f.-G~C- C.1 -:7. Ian o iicleri by lumber. k >4` r z - 1, C llC~M9~LS R"IUb't L!f! p'k8ttlti 11"E'~ 2. as per ill Wki bla cwitt / CMii1ance1. JJ to Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I I inches in size S13D-6398 (R. 11/11) ~ . 5 0, ~ e (/Q ~LC a U'an P/ ~ EXis fins ~ 0.d[ e /e 5 C'R~2 : ~ 7"' ¢l Z S/G 9 s c~iZtt pct /(iCo% / /o~o~. A-01-0 .s'-d /Yloa ic) 44-2, 6B C 7.2 6..6,7'x90.00'd3jouSa/Ce//. 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B Ll Replacement Residential Mound POWTS Index & Title Sheet Project Name: Hanke Bedroom Residential Mound Owners Name: Ben & Nicloe Hanke Owner's address: 276 Brandon Dr., Hudson WI 54016 Site address: Same Project Location: Subdivision: Lot 05, Plat of Heartland Legal Description: NEI/4 SEI/4, Sec. 12, T.29N., R.20W., Town of Hudson, St. Croix Co., WI. Parcel ID 020-1318-50-000 Page 1 Index and Title Sheet Page 2 State Approved Mound Design Page 3 Filter Specifications Page 4 Pump Tank Cross Section Page 5 Septic Tank Maintenance Agreement Page 6 Existing Septic Tank Certification Page 7 Parcel map Page 8 Warranty Deed Mater Plumber Restricted Service: Jim Boumeester, DSPS Credential 9222904 Signature: Date: W 4 I Page 1 of 8 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01) DIVISION OF INDUSTRY SERVICES ;T ro, 10541 N RANCH RD HAYWARD WI 54843-6462 Contact Through Relay http://dsps,wi.gov/programs/industry-services www.wisconsin.gov ssION, Scott Walker, Governor Laura Gutierrez, Secretary April 25, 2017 CUST ID No. 222904 ATTN: POWTS Inspector JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 STATE ROAD 35 N 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/25/2019 Identification Numbers Transaction ID No. 2929773 SITE: Site ID No. 837079 Hanke Please refer to both identification numbers, 276 Brandon Dr. above, in all correspondence with the agency. Town of Hudson St Croix County NE1/4, SE1%4, S12, T29N, R20W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1701008 Maintenance required; Replacement system; 600 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0,, , SBD -10691-P (N.01/01, R. 10/12); Effluent Filter PR.OF~ The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Code 'VJS10t40f and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be construct) 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. /"SQL= CC No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145-.~66, stats. 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 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The bench mark, defined as the bottom of the siding will serve as vertical reference point only as there is no specific point to measure horizontally from. The alternate bench mark will serve as a horizontal reference point and vertical reference point. • The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total dynamic head increases, the proposed pump must be reevaluated and may be inadequate. Reminder • The orientation of the mound 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 mound per Mound Component Manual. JAMES W BOUMEESTER Page 2 4/25/2017 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. 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 WiSMART code: 7633 Patricia L Shandorf 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 I JAMES W BOUMEESTER Pan 2 4/25/2017 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. 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 WiSMART code: 7633 Patricia L Shandorf 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 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE ~Y~~ c a,D Project Name: Hanke 4 bedroom residential mound Owner's Name: Ben & Nicloe Hanke c5'~.'p Owner's Address: 276 Brandon Dr., Hudson, WI 54016 Site Address: Same Legal Description: NE1/4 SE1/4, Sec.12, T.29N., R.20W. Township: Hudson County: St. Croix Subdivision Name: Plat of Heartland Lot Number: 5 Block Number: Na~ Parcel I.D. Number: 020-1318-50-000 Plan Transaction No.: ST Page 1 Index and title. Y,- Page 2 Data entry Page 3 Mound drawings 1`'f LSy'ON ENC 4 Page 4 Lateral and dose tank t% Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Attached Soil Evaluation Report Designer: Jim Boumeester License Number: 222904 Date: 0404/17 Phone Number: (715) 386-9020 Signature. Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 18.00 Site Slope 86.50 Contour Line Elevation (ft) 42.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 6.67 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) e Center or End Manifold 3.34 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. E_ 0.125 Orifice Diameter (in) 2.00 Estimated Orifice Spacing (ft) = 6.67 ft2/orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? 81.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) IK 5.60 Vertical Lift (ft) 81.15 5x Void Volume (gal) 1.15 Friction Loss (ft) 87.67 Minimum Dose Volume (gal) 0.50 In-line Filter Loss (ft) 37.07 System Demand (gpm) / 13.75 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 750.36 Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 20.28 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.36 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 20.28 Dose Tank Volume (gal/in) PL-525 Filter Model Number Weiser Concrete Manufacturer Project: Hanke 4 bedroom residential mound Page 2 of 9 Mound Plan and Cross Section Views T 1/10 B : 7~I J Observation Pipe 71 K _•ror r rr r;•y°; r; s.t.r•r.r~✓.r.r=r.r•r~ y•r;r r r r r r r r r r r r r r r r r r r t~1 - r r r s r ~r r rrr r r~r~ra r~r~.~rod r r r` ''r A 'rrrr rr rrr _r rrr rr rrrrrr`rr r rr r r r r r r rrrr r r rVVe~r_"` r_ r r h r r r 4 r r r -r r ,r r W 5 . . . B a: L Mound Component Dimensions ft A 6.67 ft E 20.41 in H [Aft ft K [Aft B 90.00 ft F 9.50 in z ft L ft D 6.00 in G 0.50 ft J W 600.30 (ft2) Dispersal Cell Area 2356.63 (ft2) Basal Area Available 6.67 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 88.79 (ft) ► • H 87.50 (ft) Lateral I F Dispersal Cell 87.00 (ft)-* - Invert Dispersal Cell Elevation D ti 14 1 c 86.50 (ft) Contour Elevation 18.0 % Site Slope Geotextile Fabric Cover Shading Key a Dispersal Cell See lateral details on Q or 0 Topsoil Cap ° 1.5 ft f r•;•r.r•r.r.r.P: ; ;;_r.r.r.r Page 4 for number, size, ° ,.w.... • w.•..•..•. , rrrr.r ~,s.'.•,.,ir r Subsoil Cap W.0 and spacing of laterals. © ASTM C33 Sand ' s,sr r.r r• Laterals are equally F spaced from the Tilled Layer 0.5 ft =;?.,Typical Lateral ;r:r: © N ~ :r .rrp.`r~tr~.•?rxr~Vr`r:r distribution cell's Aggregate v o r"••r• r r=r r•s-r•r•r.r..•.r t centerline in the A + distribution cell (AxB). Project: Hanke 4 bedroom residential mound Page 3 of 9 End Connection Lateral Layout Diagram 3 Lvoralsoontaartdov the A& d~n*Asion i - Turn-up*dballvelva orolwanouiprug I P ~y i All as tarrals ue W+r4Jo: W J{- X I HoW& drilled 00 the bottom of tier taetrat S equally sp,~t" F`orco mgr et3rrnootion 4 too or eross to M40 old aW 4r" rrow Laterals &forcerrt+ Sch 40 PVC per SPS Ted"e 384.31 Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 88.44 ft Orifices per Lateral 45 Lateral Spacing (S) 3.34 ft Orifice Density 6.67 ft2/orifice Lateral Flow Rate 18.54 gpm Manifold Length 3.34 ft System Flow Rate 37.07 gpm Manifold Diameter 1.50 in Total Dynamic Head 13.75 ft Forcemain Velocity 3.79 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ► SPS 316.300 WAC 4 in. min. Disconnect _ Tank component is properly vented E- Alternate outlet location Forcemain diameter Weiser Concrete Manufacturer 2 in. Capacity 750.36 Gallons T Volume 20.28 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.93 404.12 B 2.00 40.56 C Pu mp off elevation (ft) C 4.32 87.67 81.90 D 10.75 218.01 D Total 37.00 750.36 Dose tank elevation (ft) 3" Bedding un er tank. 81.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number SJE 1011421 containing mercury may not be used in Pump Manufacturer Zoeller K this system. Pump Model Number BN 151 Pump Must Deliver 37.07 gpm at 13.75 ft T D H Project: Hanke 4 bedroom residential mound Page 4 of 9 l Mound System Maintenance and Operation Specifications Service Provider's Name-- Jim Boumeester Phone (715) 386-9020 POWTS Regulator's Name L St. Croix County Zoning Dep't. Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.3 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 every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for pondin and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 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 mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution - Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Hanke 4 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SIPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 11112), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, 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. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 101 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project. Page 6 of 9 PUMP PERFORMANCE CURVE MODEL 151/152/153 TOTAL DYNAMIC HEAD/FLOW PER MINUTE 1445 11 EFFLUENT AND DEWATERING 12 MODEL 151 152 153 152 Feel Meters Gal. Wars Gal. Liters Gal. Uers 1"6 30 5 1.5 50 189 69 261 77 291 10 3.0 45 170 61 231 70 265 o e 25 151 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 s 6 20 25 7.6 16 61 34 129 42 159 7s- 15 30 9.1 - - 23 87 33 125 35 10.7 - 22 85 /7 1 40 12.2 - - - 11 42 Shut-off Head' 30 ft. (9.1m) 38 R (11.6m) 44 ft. (13.4m) 2 5 014508B 0 10 20 50 60 0 80 90 100 G.YiDN3 (HERS 40. 80 1 160 240 280 3 360 Model 151 Models 1521153 O7 510M 0- S'plol , e ' CONSULS FACTORY FOR SPECIAL APPLICATIONS 671a2 8114 8774 45/B 371132 4 S8 • Tuned dosing panels available. • Electrical alternators, for duplex systems, are available and 27a2 supplied with an alarm. ~ 33 • Variable level control switches are available for controlling ® i 4716 327a2 single phase systems. • Double piggyback variable level float switches are available far variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM 1420. • Over 130'17. (54'CJ special quotation required. 15111521153 Series +1+v1e 12ve 1511"1521153 MODELS Control Selection' -f Yodel VoltPMode Am slim lax Duplex 4 i~ 5 N151 115 1 Nan 6.0 1 2 or 3 BN151 115 1 &to 6.0 Included 2 or 3 E151 230 1 Non 3.2 1 2o,3 BE151 230 1 Auto 3.2 Included 2 or 3 SK2444 SK2064 _152 115 1 Nan 8.5 1 2 or 3 6N1 52 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2v3 -153 115 1 Non 10.5 1 2c(3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Nan 5.3 1 2or3 SELECTION GUIDE BE153 30 1 Auto 5.3 3 Included 2 of 3 1. Single piggyback variable level float switch or double piggyback variable level float O CAUTION swltph. Refer toFM0477. All installation or controls, protection devices and wiring should be done by a qualified 2. See FM0712 for correct model of ElecUicalAlternator E-Palc licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA), 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. 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 , KY 40258-0341 ,Manufacturers c1.. 649 Cane Run Road pp 6 4 ' o Louls2733 ICY 4 02 11-1 95 1 ~nlLlL/TY PUMP9 SMCE ~jlJ af' p~~~ ~O 1(5SO2H)L77 1P T 082731 1 (800) 828 PUMP y bttpJAnvw.zoetlercom FAX(502)774.~624 © Copyright 2004 Zoeller Co. All rights reserved. 7 6) r ♦ Er%Sfi ~r-de 64-1 6 CAA , W ~ z ~G 9 -0P05cd IYlouod a E 19. ~B r /07. 3S ~a; ~c~ v!i'Co% ~/oro4. ~.G7'x 90.E J/ousa/ce •z~-,~/~~c ~'~e 271e Bra.,d~ Su~~ce 6e 8~0¢C 4- "abar~86.4~uoCSon cJ/. 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QshU Q~v z3mU~=om~ z_QO Z_ U o0 LLJ ~ J O S O Y w~wY H Z Z O O p Z >Z N ° J 2 J 00 FF- U J W N I Q N H F- W z ~ U F A+~ ° w D d x 0- o w on C14 / ¢ ° L \t w 3 LLJ Of I~ 5 I s Q l~\ \ m o s I L~ I ~ o w F- V) 0 I LLJ `Fg~ I I I Il o f- w w N W O J ° Z W U Q 03Nino3a sd „-Vs z w Q Y Z FQ-- I W t~W~ Cu 0 W o Q(~o N Q o ZWW= CD Q> W z Q L> W I- ~ Q ~ ~ o W F-I Q V ~ W ~ W W rQ WW/ WJ {W(vj O W Q- of F- Z zo o w CD a Li ~ _ O J F W `0 z Q - w 3 u0 Q~ F- ¢ (/0 w Q wQ~ W O W W3 V) cl/- W W Q Q:~ W Q_ Q -I 0 Q L D m W W W CLJ co m CLJ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSI IIP CERTIFICATION FORM Owner/Buver Ben & Nicloe Hanke Mailing Address 276 Brandon Dr., Hudson, WI 54016 Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Hudson, WI Parcel Identification Number 020-1318-50-000 LEGAL DESCRIPTION Property Location NE ,4SE ;4 , sec. 12 T 29 N R20 W, Town of Hudson Subdivision Plat. Plat of Heartland Lot # 05 Certified Survey Map # na Volume na Page # na Warranty Deed # (before 2007)Volume Page # Spec house ElyesOno Lot lines identifiable Byes[:] no SYSTEM MAINTENANCE AND OWNER CERTIFI('ATION 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. 'I he property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of 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 ofthe three year expiration date. 1/we certifv that all statements on this form are true to the best of my/our knowledge. I /we am 'are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 4 r Number of be roo s 5'~~ , ~Yl SIG Wl R OI, APPLICANT(S) DA"I'I- ***Anv 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) rev ; o~~ / i X01 ~ ~~R74 00, S. M. I R~~yr hti VOA. 67 PG. 1596 OA, /ou- Nes°007"E N89°04'17"E 1354.81' 402.86' 311.98' CENTER SEC. 12 z / i00, 0 LOT 4 f LOT 3 a • I %o.`~~~/ V s~ 1.43 AC. 2.01 AC. / 62,290 SQ. FT. ro 87,700 SQ. FT. P A LOT 5 3'es. W 1.67 AC. a U. 72,619 SQ. FT. / _ z w _O w \ ww S89-04-17-W 353.26 O. 1 S~.Z Q6 1 5p. Nmw LOT 6 9 m i- Z to Z z 1> O 1.39 AC, I I A N v 60,464 SQ FT. \ oo~ 01 ~ N co a~6~6 o m x to N sa x rn i x m LOT 7 Dym IT' co e~90g N LOT 8 ~.5 ;a mz 1C7 ? y1 1.55 AC. - ,,:z m I -I S ; 1.08 AC. °A 0 67,570 SQ. FT. o m 0 8C„ 47,250 SQ. FT. °w^1 ° Nmo M r; n = O y Zm ° 350.00' 279.44' 4A4°nf,'nl°W R7Q AA, SOUTH LINE OF THE NI12 O ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 276 Brandon Dr., Hudson, WI 54016 located at: NE '/4, SE 'l4, Section 12 , Town 29 N, Range 20 W, Town of Hudson , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.225, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service February 2, 2017 Did flow back occur from absorption system? Yes No x (if no, skip next line.) Approximate volume or length of time: Na gallons Na minutes Tank Capacity: 1,200 gallon Construction: Prefab Concrete x Steel Other Manufacturer (if known): Midwestern Precast concrete Age of Tank (if known): 16 years, installed 8/20/99 Permit number (if known) 344537 (Lice lumber Signature) (Print Name) MPRS MPRS #S9 (Title) (License Number) MP/MPRS April 4, 2017 (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 (~0~d~ k C 8 G VELA sT-de i~ -cs3 IRE Wisconsin partment o Safety and Professional Servicesy Page 1 of 3 Division of Industry Seyibe MAR '01.1 SOIL EVALUATIOi-i L„1 ST.~wCROInX COUNTY In accordance with SIPS 385, Wis. Adm. Code County 6A 3 Attach cor>QW01T W%,rr o'f'less~han 8 1/2 x 11 inches in size. Plan must include, St. Croix but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. 200 scale or dimensions, north arrow, and location and distance to nearest road. - Ref #2469 Please print all information. Revie by Dat tt / Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Property Owner Property Location ❑ Ben & Nicloe Hanke Govt. Lot NE '/a SE '/d S 1 T 29 N 20 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 276 Brandon Dr. 05 na Plat of Heartland City State Zip Code Phone Number ❑ City ❑ village ® Town Nearest Road Hudson WI 54016 (651) 894-2440 Hudson Adam Dr. New Construction Use: ❑ ®Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD ® Replacement ❑ Public or commercial - Describe: Parent material Glacial Till Flood Plan elevation if applicable na*W. 40.L1 X11 General comments and recommendations: Site suitable for nrytpy d POWTS. Site has complex, irregular topography. Additional ASTM-C33 sand fill will be required to provide uniform system elevation. Recommended infiltrative surface elev. to be 87.0' at 6" above 86.5' contour. 1❑ Boring # ❑ Boring ® Pit Ground surface elev. 85.93 ft. Depth to limiting factor >68" in. _ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 1Oyr3/3 none sil 2fgr mfr cw 2fm1c 0.6 0.8 2 9-28 10yr4/4 none fsl 2fsbk mvfr cw 2fm1c 0.4 0.8 3 28-42 7.5yr4/4 none vfsl 1 msbk mvfr gw 1 fmc 0.2 0.6 4 42-68 10yr4/4 none vfsl Om mvfr 1 fm 0.2 0.5 2❑ Boring # ❑ Boring ® Pit Ground surface elev. 81.33 ft. Depth to limiting factor >76" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr3/3 none sil 2fgr mvfr cs 2fm1c 0.6 0.8 2 7-21 10yr4/4 none sil 2fsbk mvfr gw 2fmc 0.6 0.8 3 21-36 7.5yr4/6 none sicl 1 fsbk mfr cw 1 fmc 0.2 0.3 4 36-42 7.5yr4/4 none Is Osg ml cw 1 of 0.7 1.6 5 42-56 7.5yr4/6 none s Osg ml aw 0.7 1.6 6 56-76 5yr4/4 none fsl 1 csbk mfr - 0.2 0.6 * Effluent #1 = BOD, > 30s 220 m and TSS > 30:5 150 m /L (fluent #2 = BOD, > 30 s 220 m /L and TSS > 30:5 150 m /L CST Name (Please Print) Signature CST Number a4WAN James K. Thompson 30021 Address -AEYaie Evaluation Conduct Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 February 2, 2107 (715 248-7767 SBD-8330 (R04115) E3 Boring # ❑ Boring L~~~...JJJ ® Pit Ground surface elev. 86.85 ft. Depth to limiting factor >74" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/3 none sil 2fgr mvfr cs 2fm1c 0.6 0.8 2 8-26 10ry4/4 none fsl 2fgr mvfr gw 2fmc 0.4 0.8 3 26-54 7.5yr4/6 none vfsl 1 msbk mvfr cw 1 vf,fm 0.2 0.6 4 54-74 7.5yr4/4 none fsl 1 csbk mfr 0.2 0.6 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 El Boring # ❑ Boring ❑ Pit Ground surface elev ft. Depth to limiting factor Soif Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = BOD, > 30 220 mg/L and TSS > 30 150 mg/L Effluent #2 = BOD, > 30 220 mg, 1L and TSS > 30:5 150 mg1L i So.%edalua~~~Pl~ Eris Grao/! e/e►~ 6 Cale 27l 8~a. a m a n e //udSon cJ/. SSIO/~ z~~s P/6~a~//folt ~o. /IE yfy Sec./1, rz9~ (',20~., 7n.o~ briny /.61ac~~S e7.5~ d SS. SIJ' B6. sa \ ~ ` E e : f~~ea a do< /n &.1. ,o sr ~ \ ` ~ cP be t'•/1.S~i ~rac%a/'t`o dr/eC~Scc~ tc Ja~ci &3. SO \ l {L cro/;1 dawn wa/ to I 1 I + ~ ~ ~ I AlE. I ~a i h 3 G.E at.SPuts ct!/ I rl rs f/an~~4,j0 ~ N ~T e-Q.i/~•~ CXi1~.~i u~a3dLd o (3ti,~ ►ti'loiK~ C~o~m o s,d,~, A55a tec/ e%% /60.14. r 3 sS.zv