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HomeMy WebLinkAbout004-1012-60-400 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 597366 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2926684 Permit Holder's Name: City Village Township Parcel Tax No: JEFF BREWER TOWN OF CADY 004-1012-60-400 CST BM Elev: Insp. BM Elev. BM Description: Section/Town/Range/Map No: 06.28.15.84A-40 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER , CAPACITY STATION BS HI FS ELEV. „erg S Septic Benchmark I / ZOp J 3 3 ~l g Dosin 6 J 9 '760 Alt. BM LL C, C> _j ` O Bldg. Sewer 1 r d Holding u 1 ; J St/Ht Inlet 1121 CK , 8 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. ent t it Intake ROAD Dt Inlet , Dt Bottom Septic /~L I A4 '9 Dosing Header/Man. 161. 7 Aeration Dist. Pipe /-'Re A61-7f Holding Bot. System PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cover l.; GPM 3 ll-~ Z.~ /aa Model Number ► a- 7 a , 3. /ltd TDH Lift o ( Friction Loss System Head,, TDH lI ✓ Z Forcemain 1 Lengths Dia.Z Dist. to well SOIL ABSORPTION YSTEM 07 /Z BED/TRENCH Width Length No. Ofnchg PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type stem: /,0 Izo I /il UNIT Model Number: Qj ~ 1 DISTRIBUTION SYSTEM ae- Header/Manifold Distribution x Hole Size Ix Hole Spacing V o Air Int Pipe(s) I,,~, u~ Length Dia l ~s Length Dia /'6 Spacing fl- SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~l Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed Trench Center Bed Trench Edges Topsoil Yes, No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 2780 55TH AVE~, 1.) Alt BM Description P pu 2.) Bldg sewer length a G ~a - amount of cover Plan revision R aired? 4 ❑ Yes o -7 Use other side for additional information. I SBD-6710 (R.3/97) Date Insepctor's Sign re Cert. No. flip Indusirv Sen-ices Di.isio i Coun1• 1400 E Washinvon Ave p P.O. Box 7!63 r ° /X MAY 2 r1 2017 Viadison. Wl 53707 S(-'nttan• Permit Number (to be filled in ov Co--) 163 1 rOMMUN &Dfi O i j! gp] State i Vnsaction Number In accordance ktiidt SPS 32?1(211'is- Adm. Code, submission oftt s 2quired prior to abtainine a l w~a sanita^! pemtt Note: Application fomts for,-_ r Dlnartment o; Safeg and Professional Services. Personal information You proct¢t f P11-1 111-11,11 W I'll -rem than mailing address) ~urposs in :iccoldance with the Pm•acv Law, s. i5.0a(1 }(m stays- ppflcation ;niorm2tion - n it III [case print _i ll i1i"'I ration Property Ouncr's ivame i ire! = I TE~F /i £C.1E/L G/ ~IE.ciZ/GK °rope n Ovzters itIailin, Address /+1 STo GK ©o y - / (3 r a _ ~Q, it ~t/ it e? Pronem Locztion . I N - l 1 Cin, State 441'0 ~"d GlI 5-y60.2 Go,u. Lot /T Zio Code (Phone isumher i ! I SE E 4✓/L Sa.✓ 4f r I LV Section -57f'6-77 ( 705 SSG -OC 77 icircle one S vpc or 3 iidinc; (Check all that aPPiv) f . Lot T i or 2ramiivDtvellin,-Number ol'Bedrooms y - L 4 ~ Sttbdirision Name i t--, dot .r~~ Slock- j U PubliciCommereial - Describe Use . ~-tC" I f SrzteQane~-Describc~ll;e CSit'l 1 umber 164(( 9/13 To= of /tom 1` a~ Z ¢f Roy } pc or pct mit•: Check only k3 ( one oos on line Co ;tpiete line ? is applicable) i _ X. ! tier= Svsiem LI Renlacement system I Treatment/Holding lank Re iacemem Oni t P ~ ❑ Other Ivlodincation to Rsisti»g system (e;nlainj ' 1 t t S El Permit Renewal j ❑ Permit Revision Q Chanac of Plumber List Previous Permit Number and Date Issued Bcforc Lspiratio» ❑ Permit 1 ansler to Net: 4 Oiinlr 1 Tvoe of PDjS-S SystenvCorrtponent/Device. (Check ali that apply) U Non-Pressurized In-Ground ❑ Pressurized in-Ground ❑ - t-Grade 19 Mound >-24 in. of suitable soil l- j f -3 -~'Iound - 2.: in. ei suitable soil ioidin_ Tani: ❑ Officr Dispersal Component frxphtir. j Pretrcatmcnt Dwit:e (explain) Dlspcisal/Treata nt At'ea 3niOrritatiOn_ Flov.- Pd1~/ i D iqr Soil Application Ra a Lion Pds } Dispersal Area Required Dispersal Area Propose • sl] SX:st j ?i. ianltinro Canaciti in Gallons Total ; -ot' ;vlanuiacmrer i i Gallons Units _ j \nrTanis ` Eiistin^Tanta I 3 v j_ ! 1 _ 5'.ptic a113wlt3ing-~m~te I I 14e.& co • ' ~~'~F :r r CT - r. 1 - Dosing U amucr `SQ L✓ E S Gr2 ~owlfaSrE i I ? I 7So ' - ~ I 7So , ~ ~ it l'i. Rcsponsibilitr Statement- 1, the undersigned. assume responsibility installation of PONITS Shown on the attached olans_ Plumbers Name t not) 1 Plumbers si- afore i I IPiS Number Business Phone Number f~ E,v r o.c E i aka? 5~~ p 9 ! Ptumbzr's jd-11,1,1 (Strict. City- S ate Zip Code) 15- 9G.7 _ `//S$ I t I ~o, x,X a ~otFAx ~z J30 I 1:'1a'• tlant'/Dep2rtment Use Only ! ADProted Permit Fee I Date i ed ( Issuing - - iSignature 5 / ! I Ot V Reason for Denial 1 10 . ~i • Condit p~,~~~•~ 11Rf*i+fFf53ppr OV 11 I Cam, i~0 i A- rte ~s l~1St}~1'Jdti oeM must anma- rd2m, ' ft1E!nti~r in y :w pK,q'~ plan oAded by plumbei. J ~~"t-C'C.~ t,•~ #-r r .~n ~--1 2 '~'i~albllMtril~,irsc7s~rts.er~ust.be tnairst~ iced ' a~ per mppkrA t co to i aelitmneat. .'attach m rnmpiete mans fur (he scstem anti suhmit to rite COUnCY onlr On payee not 1e than S IC 11 incites in size t L a V V ~ o q~ y\ o ~ QQ~\ V O Q!1 M t ` X x ~ C "tz o ku p ti C~ ~ o h~ f6` o ? J Q ~ h W o ~ C o e 3 \ o ~ Q ~ a 0 v x r ~ C ~ V N 1 / PART f ! DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD w HAYWARD WI 54843-6462 Contact Through Relay I S P I / http://dsps.wi.gov/programs/industry-services VI" 4, www.wisconsin.gov ~nF2e N s~~ Scott Walker, Governor Laura Gutierrez, Secretary April 05, 2017 CUST ID No. 224199 ATTN: POWTS Inspector KENT HOKE ZONING OFFICE H&H PLUMBING LLC ST CROIX COUNTY SPIA PO BOX 10 1101 CARMICHAEL RD COLFAX WI 54730 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/05/2019 Identification Numbers Transaction ID No. 2926684 SITE: Site ID No. 836727 Jeff Brewer Please refer to both identification numbers, 55TH Ave above, in all correspondence with the agency. . RS Town of Cady St Croix County AppR(}V SE1/4, NE 1/4, S6, T2 8N, R15W SAFE ~T FOR: ,~FESS 5 Description: Mound, 4 bedroom residence F~-R Object Type: POWTS Component Manual Regulated Object ID No.: 1699076 DOVIS10 Maintenance required; 600 GPD Flow rate; 25 in Soil minimum depth to limiting factor from original grade; s): EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-1 (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Adminis ve 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: 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 gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval, and SPS 383 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • Care must be taken to preserve the bench mark during construction or reestablished prior to plowing. 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. KENT HOKE Pa,-e 2 4/5/2017 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • 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 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 i KENT HOKE Page 2 4/5/2017 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • 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 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@wiscons in. gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm A;. aF Private 4-usite Wastewater Treatment stem lu&x aad Tide Page I\leb Pxojeet Name: J _ _ 01? EFF ~it EGJE~t 5/ ,~a / %6 va0 ~a cal 1'15 Ownees Name: vR Q Z 0-j-- 's . ' s9~ss r ~/S SSG - OG J a Despt om S E il/ E', a?8 i'vsrmicipalitg: Town, Verge, C!ky of L,o a ~:it€3~Y= ~r ~ao~X ~Y A ,CEO R~1 Subd+sion.Name: :~tC LotNumber: Block Number. Pazue=LZ_Num.aVer; J~ Pagz~ Page 2 y~ ro 3- 6'L•~l Wage 3 C/losj c r/o,J 4 f fy (Jj~w a F c%✓4 Page 4 _ G /PE - ZA r-zWO,t Z414, r ?age 5 SE,oric V ,Gn/,~ zzr y o Lf/.QrJBEit ~idoss- ~Ec t'~oa ¢ ; f~-es Page 6 Page 7 ,~o~ r S 4~✓~1Eiz s olA.eluvG t ~.o~Gr~E.+~s' ~lA.✓ Page g /t ie r~ Page 9 j'lL 1-ElZ IAIAO LA1AT/o,✓ hiame of Designer. License Number: /W d .7 y/ 99 Signature: Date: 3 - 3e-,,,7 7 Designed. Pursuant to the Following POWT'S Component Mmual and 9 s P s 8I-85: >`~iiESSuaE isr-~c~e~_r~D.=,r ~aRSO6.vE.il~-./f q.ruAL tJ~~rr~cv a1o- ",64 7QC-~° ~irl o1/6r) FZ fL©~/ /~ou,,/p Co~,oa.✓E.~r/lcrr/uAC IJE~CSio.~! _ r r~ c / 8~~6~.7007 AoD4c r "g` W04590211-1' Ns ~E"rv %S ~ •j d/L ~l1R7 LI,//7 T/ o/J ~Et~da i J V o~ ~J O v W V ~ C ~ Va ~e oh 0 o e a: ~ 3 ° ° w z~ a 0 H a~ MO ' ` V t i h 5 "Cv v3 -'4 C~ o o h Wo ~ ~o b o `h 3 V C 3 \ 0 m 0 Vi ~ O U k C M ~ ~o IV) V , y w o Z ~ a s Q V ' J h .-C`d er Pe O @ x a~ h V Z~z &a dQ { r r w 0 14 { w t t Nq t 'Q C a f 3-4 es . Q _ INn NP, L fi ev pM~~ ` ~•°ro s+y V Q' ~i jam{ ? d DOI tD w ~ w rt e t• c O Q qi..i y y Ak le r 1110 J _o °I~n 41 U-1 O~ •rS 6, 7 ~ _ FFV - - cy~ V • V t' it 4 `lr~ 1-l d.! L7 41 Li e ~ S~+ 3:.a Is+ ts+ ~ tsi lf? ~ ~ h E-i cO ~ c3 i i t i CON11BINIA"T ►O NI SE-TIC T ;NK,"'UMP C r,'.I~tiS-F~ X -CTiON (DFv'-MI NG NO 10 SCALE} FNI AL GRADCE {per_s;°S 3 8~:?5 it} c ` - (slope ground surface away from / 4"e vent =;Q_ [vi, o D R i Ai" / lilanhole(s) forLrOp°rdrainage) f ( nLOloing ikilCt?O: ill(s) as IcCw£_ S PS 3B-.'": r r ' r:,._i~?1 Y f 1 r+]rCti2^ c..7 ~ 3UlLDiNG SE4VE j- - ( / =LC t`~,.IC;;L ~•wa3 _aWno i;:anheta 1 t vUfvC I tOi? DOr ~ i i 4i+enirc `6el ~i_ci:d 1 ~ + /N,ai~ly 1 - - - - ~ is-m_ ar _ ,t ~c•= t j t ( MANHOLE f I t. -1 , , r- i8" mfr ! 4_I MA,ttiiiot = - 1 30i OIM OFUMLct (m-.e,--l--'-!talon) - - ( ntaosiys_d (-_1 v C.^~StEP:2hCl3t'L•I N=, L ! tief,,rLIor.7 ON, -I S" (NL EF alp` - 1-'L7ER- . u _UEtTS I EI- Q= vt i'_ i { 0 3f } APPROVEDEFFWEILr: F1 MEP R=QUiRED OM OU r;_E t a eta t = ?Ul- 8nke ivianuiauiufer 5.S e--,t CO 1GRETe4 DWI (dail,kf wasit-Wi ilovf) 4i DO '12:1 J 5epiic(Pump tank: model _ 1.75-017S6 Number of daily doses I actual dose voiumal_ i i =tai II m2nuiaciurer S J. E Q//O ` IJ41 s la!~ model number T/fiVK 44&I cr I rorcemai% vOlumG 3.3 d o x , /Z3 uc aI iieai SIFfCG( GR L Actual dose 1+CID[rlc (52tlCRv) 1174 ioial dose volume - :tolume of forcemain} /.76.9 - 3.3 = =ffluani pump manuiaCiurer Li rrtE 1-,/Aj f" V ~ Eluen- pump model number 9E/v G/M PUMP i, i' lK CAPACITIES °ese-,ve above ai$rm 30.5' inches = 9/ 7+galloris ' Allinirrlunl pump discharge rate (GPivt} ,3 y, 3.? r% farm i4aai dhoti+e on IaaL .7 inCIi = -7.2.-2 gallons (C) OnIGfi Boat measuimerif 75 i n C ; es = /.?0.9 zjallons ,6} !eriicai lift (pump oi'i io disiributiOn lateral) q..5- Ott Roai abode iank bottoin ego Inches = _Z2j gallons (A) S ysi;vm head (distal pressure" -i feet) 3, 3 ANI(DIMENStOttS - PUI-AP CHAMBER SP-GIFICA1-IOf 45 7riciion loss in the iorCemain ae x - 0.?S = .-5- a } Dqt:rnain[c head r~tI f /,3.3 Lengtit 15S ~,Mdih 8-/ ial _ i - cuid 1 y8 "Gallons per itch r i ~ I I L~ I 7 Per iamance GRAt @ 1-iead I Dimensions j { Solids Size Running Am sr item 6lodel a ( tr F- a' it;r 1~ 20' 25' ShuiOii Cord Weigh! H.LX,W (in) Listing (S) H. Volts dia- In-) daus i I ~ (ft) PSI I Length fibs) 509209 9EN-CIA-RF cCSAus 4110 115 i 3!4` 9.0/920 ` 80 70 60 I 45 2 32 11 : } 20' 27-5 9.15 ` 9.6 6.8 549214 9tLCIA-RF EC-'A- 4110 115 3/4= 9.01920 80 f 70 60 45 I 25 32 1e. I 30' 28.5 #55 9-6 6.8 509 207 9EN-Cltvi cCSAus i 4110 i 15 3!4' ! 9.0/920 80 70 60 45 25 32 14 20' 26.5 96 6.8 09268 9tTi-Cfi'~f CCSAOS 4110 115 3/4` 9-01920 80 25 32 14 30' 9.6 6.8 Cover Epory--c-o-?ted cast iron Ala - ! to ./Minute ~tr5otorFtousing ~Eouxy-ceatedcastiron D so i0o "so 200 250 300 {Impeller&4aterial IThermoplasticElastomer 1 35 a 1 11.0 ilmpeiler type Non-clog 10_0 30 ilOluie Epexy-caafed cast iron 9.0 Power CO Mechanical Shaft Seat I Nitdle Zvi h carbon and ceramic laces 7-e !Fasteners I5tiintessSteel r` I 6.0 CD Shari ~SteEl ' 1 i } 5.0 )Bearings ?tlppersintered sleeve and (Diver pall bearing a i 1D i I ! T 3.0 5 1 yT 2.0 7 1-0 0 I I 0.0 T- 0 20 40 60 80 Flow - Ciailons/Minute ~'t+:; ^ ~rJ"c`1tTdL^°r+~'~L'7 L It~~G° - P.O. Box 12010 Wahama Oty, OK 73157-2010 Phone: 1-800301.7894 Fax: 1.800-6783867 ca011 Fenklin oect7ic co., inc. www-LittleGiantPump-com little Giant' is a rcgistered trademark of Frdnkl'm Electric co., Inc. Form 986193 - 07111 f TS Oo@NIER'S tyfr`3iNU2~L AN'D N1A1l: G`!,[t•' EN-s- PLAN "IL IN ORNI.3& `Ol i SJ sail T ul}V! SF vCI f7i C?-aT10 NS Ovvtner ~EF~ ltEAlE!( i Septic Tank Capacity /,75gal ❑ Perntit i Septic Tank iManufacturer I W E a 4 oIJt.t. ❑ NA DESfG?t -P-4-R IVI TERS Effluent Filter Manuracturer OQE.✓GO i] NA f \umber of Bedrooms (100apd/bedroom) ; I Eff uent Filter Model I j FTd8.?l ❑ w.", Number ofCommerciai Units j 1 Pump Tank Capacity 2.S-o gal ❑ NA Estimated flow (average) 1 y60 gal/da, Pump Tank Manufacturer jlfjESEt r!oNC. NA Design flow (DlNtr), estimated x 1.5 0 j Goo gjalida~ I I Pump Manufacturer (li rrct Giv,1 r ❑ iv?y Soil Application Rate Pump iviodel 1 5? ~~.y ❑ i`IA I gal/day Influent/Effluent Quality t -treatment unit ( RrNA) (E] N A) iviontlilyAveraae 1 aTS. OiI t? Grease FOG I ED Sand/Gravel Filter 0 Peat Filter Biochemical Otyae t Demand (BOD)) I 10 n`/f ❑ iviechanic J Aeration 72 Wetland Total Suspended Solids (TSS) 220 mg/L i C] Disinfection [I Other: I < ISO mg/L Ian ifaciurer: Model: Pretreated Effluent Quality (tgNA) j Monthly Average i I Soil Absorption Component NA) Biochemical Oxygen Demand (BOD;) ❑ tn-around (trravity) 1-1 1n-around (pressurized) Total Suspended Solids (TSS) '0 m?rl ❑ At-grade 0 Mound Fecal Coliform (geometric mean) 30 mg/L , ❑ Drip-line [I Other: 1 <10 cfu/100ml Vertical Distance Tank Bottom to Service Pad: N-lax"Imum Effluent Particle Size 1 1/8 inch diameter Horizontal Distance Tank(s) to Service Pad: Apo Dispersal Unit- t,, fg./Mode' Number: EZ 4400 1•703W 8u1&)&4Zr5 ❑ ~A -8'+_Cul?ttons: Soil Dispersal End Can (Dispersal Unit EISA) or D _ Application rate = Area Required - EISA - (Trench Vdidth) - Units or Total Length of Trench(s) /60 /0 /60 ❑ "Design of Pressure Distribution! Networks for Septic Tank-Soil Absorption Systems" Publication 9.6 (SS~AFMP :Manual) ❑ "ICC Fiov4ech Nlound Component Manual' Version 1-2 0"EzFlow Mound Component lvianual" Version 81'20/3007 j ❑ SBD - 1085'-l-P (R-1/12) "At-Grade Component Manual Using Pressure Distribution" Version 2:0 ❑ SBD - 10705-P CN.01101) "In Ground Sail .-Absorption Component Manual" Version 2.0 ❑ SBD - I0691-.p (N.0I/01) "N4ound Component Manual" Version 2.0 ❑ SBD - 10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" i 9 SBD - 10706-P (N.01/01) "Pressure Distribution Component ivianual" Version 2.0 ❑ Other - -i l': _ PV1Sr'_i C i1.y~1 Rt :N - P,17E CE ' 1_i Service Froqnorc,, Pumpiinspect tank(s), inspect dispersal cell(s), clean Filter I At least once ever;: 5ff 13 months i9 3 years ❑ Other - l aspect pump pump controls. alarm, pretreatment unit At least once even: ❑ _ months 12 3 years ❑ NA i hush and pressure test laterals I ' nt least once every: ❑ months 3 years p NA i ART UP AND, OPEf_. _ ' "OTlL- For ne,v construction, prior to use ofthe PONAITS check treatment tank(s) `or the presence ol painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations re detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System sta ft up shall not occur Hen soil conditiotts are frozen at tie iF?2 1t-ra"title sr_r ace. -lie property owner is responsible for the operation and maintenance of the POXVTS and submission of required reports. The quantity nd quality of the wastewater stream will affect the performance and longevity of vour P OViTS. The installation of water-saving a,pliances and fixtures along with prompt repair of leaks reduces the wastewater volume- Also the brine or waste from water soiiencrs, iron removal units; other clear water treatment devices and foundation drains should be discharged to the ground surface henever possible. Note: this does not include laundry haste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, ho.vever the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons; sanitary napkins -Iondoms, cijarette butts. dental floss, and cotton s ,:Hbs shoule net Cole-, the svstLm. ch micals such as ~,ctroleum products, paint. Pace 7 of 9 disinfectants, Pesticides. antibiotics. solvents, etc_. Should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. 'Viaintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. :SI'ECTI®Pv~ SIN ENANCE: Inspection shall be made by an individual carrying one of the following licenses or ertifications: Master Plumber,'Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached \-laintenance Schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, dentiA, any cracks or leaks, measure the volume of combined sludge and scum and check for any backup or ponding of effluent to the :-:-ound surface and test all electrical equipment such as pumps and alarms. Any defects shall be promptly corrected. Exposed openings -neater than S inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry the tanks. 1Vhen the combination of sludge and scum in any tank exceeds one-third (1/3) 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 Chapter NR113, Wisconsin Administrative Code- The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Solids %vashed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. farms should be tested on a regular basis by the home owner- If an alarm sounds, contact an individual licensed to service POWTS. There is normally a I day reserve under regular operating conditions, however water should be conserved until any problems with the s,,•stem are corrected to prevent back-up of sewage into the dwelling or surfacing. '_BANDONMENT: When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the svstem is properly and safely abandoned in compliance with Ch. SPS 353.33. Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CC'N T xis'GENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be inh•inged upon by required setbacks from existing and proposed structure, lot lines and wells- Failure to protect the replacement area render it unusable. Replacement systems must comp., ly with the rules in effect at the time of replacement. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation I must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. -!YARNING- SEPTIC, PUMP AND OTHER TREATMENT TANKS it-€AV CON'T•I N LETHAL GASSES AND/OR i!NSUF ICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREA'T'MENT TANK UNDER ANY CIRCUMSTANCES. DEA T I4 MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS !NSTAL,LEI? PO-VVTS MAINTAINER Name /<,"A) r name 1<16W r o.l'6 ~u yis a - - jPhone Phone 71S 9Ga7- y'/SS SEPTAGE SERVICING OPERATOR (Pumper) - LOCAL REGULATORY AUTHORITY Name Agency Sr < /If I C 26,ol,04 OFFicE Phone t- Phone 7/_' 38.1- yG 8o Page 0 of 7 U Pro ~ r3 rte; Iters a 310tua. e Errluev-,-,~, ippl cations Standard Wlode9s Orencov 8-inch to 15-inch Biotube`- Effluent Filters are designer FI0854-36, F1 1254-36. FT1554-35. FT0822-14B, FT1254-36AP e:noye solids from eihJGllt 100-I i10 Gorn,nercial Septic tanks. TiiE; car, oe used in ne,,v and existing tanks. roduct Code Diagram eE3 eral FT `i ❑ - 36 i I ( i Jrenco~ 8-inch to 15-inch BiotuW Effluent Filters- are used to improve i l l E qualit}i of effluent exiting a commercial septic tank. The Bloiuhe I t = a, indge fits snugly in the vault and is removable for maintenance. The l riche assembly snaps into the notches in the top of the yaul, and the handle can he ex-tended for easy removal of the cartridge ; "base I I l h e" model (see p. 2) is available for lotw-profile tanks. An optional slide . l sl'Stem, a«clfahle an 18ru°r I bo - 60(15?.! models. S1 iiililaj Iiisia118iIC!1 =?!l. I E5-.,,.i616TIi , i i = B7 f=f_~I 1 .5 f315: _ lilarrn float assembly a .t . r- .i n I . nt .,b ~ (o I ~I (t i0rdered Seoarately) ' m r L u: -E3 , 11 ' c r :..7(r. 7.1[. -Cal `I o l 5 2 Ft. ^22-AB ao~o o -Pepe coupling ats r ~i~ti o0 oQ p' ! i I t t~~ l l i na ~ Biotubes Vault inlet holes r r; i `uppori coupling ~It1 `r vault Pipe coupling F:fG - - Yc _ auopor bracket u:rtarYa4' tliet;l G . Handle component, P11G Slci,. I„ - Support coupling and bracket P`d B Ctube canrdce Polynr"ylene and polyeth I n r:'die: Satzon coming, and ~ on' nrac,V art:'L 90 it 71..'? and 15 (fiCll Afters on":, UPT r~ Drenen 5ystems'D Inc. 114 Ainr,ay Ave_, Suthertin, OR 97479 USA 8DD-348-9843 541-459-4449 nivi d.orenCa.cam i -Fl-FT-2 acv. 1.1. 0 09114 "arm; 1 rl~ l ST. CROIX COU-N7Y SEPTIC T.LNK IvLA-R\TENAIN' CE AGREENZ-N 1 RECEIVED AND OVNIERSIEP CLRTIIKICATION FORM MAY 31 20 1 0-v~aevTuyer Jeff & Kelsey Brewer ST, CROIX_('011 UNITY DEVELOPIyENr a`l~az Address 570 County Road NN, Wilson, WI 54027 Adze' '2780 55th Avenue Prope Ti (Verification recrsimd from Planning & Z ag Department for new construction-) Wilson, WI City/ State Parcel Idend5catian Number G6 `f LEG-AL DESCRIFTIO-N Praper SE , NE 1i,4 5.,C6 T 28 T R 15 W. Toa~ of Cady t~' Loca~on 4 Subdivision Plat: ~ Lot'' 4 Certified Survey 112ap 9 4163 s Volume 28 ; Page # 6339 NVarranfv Deed n (before 2007)Volurae , Page # Spec house El yeszno Lot lines identinablezyeso no SYSTEM -NLAr`TE?` .A-NCE A\'D ONVNE.R CERTIFICATION Improper use and maintenance of your septic system could result in its premature failize to handle wastes. Proper 2ainte-ance consists of p7=ping out the septic tank every three years or sooner, if needed, by a licensed pumper. 'Vhat 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 1.2 -S- Croix Count; Sanitary Ordinance. Tb-. property owner agrees to submit to St. Croix County Planning & Zonin g Department a certification form, signed by ~ ovaer and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verfying that (1) the on-site wastewater disposal system is in propar operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. lhxe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system rAith the s andards set forth, herein, as set by the Department of Safety And Professional Services and the Department ofNatuzal Resources, State of W, isconsin. Certification stating that your septic system has been maintained must be completed and retumed to the St. Croix County Planning & Zoning Department within 30 days ofthe three vear expiration date. Ilwe cer fv that all statements on this form are true to the best of my/our lmowledge. I`we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register o Deeds Office. '_\umber of bedrooms 3 ✓ a4 30! /7 SI NATURE OF APPLIC_A? D aTE ***Any Lformation that is misrepresented may result in the sanity r' permit being revoked by the Planning & Zoning Deparrnnent. In lude with this application a recorded warranty deed from the Rezister of Deeds 01-9ce and a copy of the certified survey map if reference is made in the warranty deed- (REV. 04/12) 1