HomeMy WebLinkAbout020-1123-00-040 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION (ATTACH TO PERMIT) 597360
State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]
Permit Holder's Name: City Village Township Parcel Tax No
MARK TOBIAS TOWN OF HUDSON 020-1123-00-040
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
1 A ,ft w At? 'A- ( ~ : C 07.29.19.547A-20
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
K 14)
Dosing r ; Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom r
Dosing Header/Man.
Aeration Dist. Pipe
io569`~
Holding Bot. System
PUMP/SIPHON INFORMATION Final Grade
Manufacturer i° Demand St Cover
° .rr i • GPM
Model Number
i
TDH Lift ( Friction Low System Head TDH Ft
c~~<
Forcemain Length Did. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS w„
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: t
INFORMATION CHAMBER OR rg ►
Type Of System:
~ ~ , ~ ~ t ~J ~ UNIT Model ~mber: / '
DISTRIBUTION SYSTEM r. 6'4-
Header/Mandold, ? Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia Length Dia Spacing M
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of 1xx Seeded/Sodded r Mulched
Bed/Trench Center . Bed/Trench Edges Topsoil Yes IJ No Yes J, No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
O'
Location: 407 KRATTLEY LN
1.) Alt BM Description =
2.) Bldg sewer length
J
-amount of cover
4
vision Required? ❑ Yes No
side for additional information.
3/97) Date Insepctor's Sigoature Ce tom. No,.
RECEIVED
In4o 5~ hI - ~o i7 ~ lb~ -4j' County
1400
'aom COUNTY EKT P.O. BOX Sanitary Permit Number (to be ffW in by Co.)
r)EVELOPM Madis~ W1 53707-716
rw'..Yt~"A1 V iJ / / (V ir)
Sanitary Permit Application State Transaction, Nurriber
!n acct Atanee with SPS 393-21(2), ibis. Aden. Code, Aibmissioo of this loan to the appropriate goverrunergal unk
is required pnor to atmft - - a permit. NOW Applitauion farms for stao-owW PC}WTS am subminW to N Ad&m (it'ditlffent than mailing addrem)
the of Safety and jnmd seevwc-, ptF=W tat, you povide- may be twd for
in accatance wit the Mvacv Law,, s !5. l tin) Std
Property Owner's Name
Parcel #
a
I%`/ 's '
Pmpcrty Owner's A,3aiiling Addre
Pt~ t=w'in' 0 7, aW
City, State t Zap Code Phow Number txs)vt Lot k Section ^7
~'ls J~R,,,}UVit I
(circle
IL Type of Budding (dbmk all that ply attx } Lot # T % N; R E
I or 2 Family Dwelling - Number of atrooma S Subdivision Name
EJ @~~~„r2.yyet~J
O PubliclCtotnrnerrial - Describe CTS Block
0 City of
State Owned- Describe Use Vim of
Towmof 'if
lIL Ty of Permit ( c & oaxly acme but seas lute A. is om ete line H iff aappliealnle)
Q New Sys
Rph..vt system D T mo - Tars Replacement c oly ❑ Other Modification t4o Existing System (eV lain)
B. 0 Permit Rr w vW Permit RevWori Chan of Plumber Permit Transfer to New List P:evuxm Permit Number awl Date Issue d
Before F.xpatrit xn owner
I V_ 3 of Tel $ all thAt a .nlvl
ao.
N
on in-ficawrnd Q h -Ground At-txz-dc 0 Mound ->24 iL of suimble &rn7 DMou nd <24 in of suitaNe sm] $
Holding Teak Cj . C-nP"m (Main) 0 Pret€eat mwtt D cv= (stn)
t3emgn Sod Amt (st) , DLversal Area
7TAnklefe (ufarraaaatro:
1 OPM (sf} System Ylevatian
Alf
67 11 V/'
Cs,wty in TOW 0 of go/
0
S ar Task
NI dr' . Sla t- Y, tim for " 7ta ' .a of the POWYS, shown en the attacked plans.
Pltmtber s s Si e
pp pp ) ' Ftme Nmba
umbts-`s Address (Street, City Sta1 ; Zstr Cntlc)
f'tlCrt? Vii' i f> t'rfri 4y
on
rtawat use fiat
> j Approved Q Permit Fee Date Issued Issuin#
Si
t 0-ner- liven Rcasca€a rx Aenial • ao ~~la 17
Blt Ct►redit Of ApPMvAYReMvs for Din
C:l~ c~, - (~5 a C~ P~ o
pip
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633E-2-6393 (it. G3114)
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uni-7^a1r,,5d pr,,,P8rtY hn8Z are -b--rcief than tC.3° fTc;m tz'ings
I Order: Mark Tobias Seim e ?n
foi?i'icti?1n: f
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-gn used-Gravity Management Plan PAGE 4 IMPORTANT:.
i'he owner of this in-ground dosod-gravllty system shall be responsible for its perpetual operation and maintenance
;pursuant to requiremen s of SPS 382-384, Wisc. Acirnin. Code, Pursuant to SPS 3$3.52 (2), Wisc. Admin. Code, This
system shall be considered a human health hazard if not maintained in accordance with this approved management
plan. Fun -rmore, all inspection and maintenance activities shall be performed by a registered ROVv rS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin, Code.
Maximum Dispersal Area Operating Limits.
s-.E
Design Flo glad; Cs < 2 d m L`", TSS < € aiigL"; FOG 30 m9L-1
ins ection Checklist INSPECT ;`VERY 3 YEAR
a type of use
age of system
* nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., purrips, valves, switches, floats, etc.)
material fatigue (i.e., leaks, breaks, corrosion, etc.)
c solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution l drop boxes)
v neglect or improper use (i.e., exceeding design capacities, prohibited acti'vi'ties, etc.)
extent of ponding in distribution cell prior to dosing
dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.)
electrical corponents - if applicable (i.e., wit n, , connections, switches, controls, Cimers, alarms. etc.)
3 distribution lateral or lateral orifice plugging (rr easure lateral distal pressure - compare to design specification)
surface discharge of effluent or sewage back-up into structure served
Q aims nance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the fankls? or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin, Code.
c~ Effluent 111ter? 'l shall be ;<'T`y?ccc('fI c"'v r`±yr 3 nears and ~`h,!! 1c c wcned when necessary to rermove a ,
accuz
1-2
`~~£i,sif i .Pvr,e ...t.,. .sE O i ..k. =i era "!teE.$ to ii F<.', rwa CP x l :-5 v. e'r in
rfa
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Narne of individual or company phone:
Local government unit. fft l t - V Phone:
Local government unit address: zip,
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Cone. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POW TI S may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Continaencv Plan
in the event that any tailed treatment component cf this POWTS cannot be repaired it shall be replaced pursuant to
a pfan subrnitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable sails.
..a"4,dsue Abarrcignrne t
If use of this PCtNTiS is discontinued, it shall be abandoned in acr ydance with SPS 383.33, Wisc, Admin. Code.
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The Quick4`~'Standard Chamber fits in a 36" wide trench r~
and is ideal for curved or straight systems. It features the
patent-pending Contour Swivel Connection which permits ~ turns up to 15°, right or left. The MultiPortr, endcap allows
multiple piping options and eliminates pipe fittings. The
chamber's four-foot length provides optimal installation
flexibility. ,
v .t
- ~ L
Advanced contouring connections swivel up to 15", right or left
• Latching mechanism alloys for quick installation
• Four-foot chambers are easy to handle and install
The Quick? Standard Chamber supports wheel loads of
16,000 lbs/axle with only 12" of cover
Q p"
•y
Certified by the International Association
of Plumbing and Mechanical Officials (JAPMO)
Tear-out seals on inlet pots provide a tight fit to the pipe - -
Eight molded-in inlets/outlets allow
for maximum piping flexibility
Eliminates pipe fittings
c ±s on either end of the Qu;ck4 Standard C hambcr