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HomeMy WebLinkAbout040-1296-20-000 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 597370 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2948676 Permit Holder's Name: City Village Township Parcel Tax No: MATTHEW & ALLISON THOMFORD TOWN OF TROY 040-1296-20-000 CST BM Elev: Insp. BM Elev: BM Des iption: Section/Town/Range/Map No: (a 19.28.19.1704 TANK INFORMATION ELEVATION DATA TYPE MANUFACTUR R CAPACITY STATION BS HI FS ELEV. 1 Septic Benchmark ` ~UV ~n~~D al Dosing jpv A& A, Alt. 13 WP~Z ~V V LZ Cl t~l~ Aeration Bldg. Sewer Ho ng St/ t Inlet Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent t Air Intake ROAD Dt Inlet Septic Dt Bottom 'A 6 74 Dosing h K q 14 dt %k A a/ o Header/Man. •6 Aeration Dist. Pipe /j .0 3 3.4 Holding Bot. System 22 W. g c~ PUMP/SIPHON INFORMATION Final Grade CJ Manufacturer ~ Demand St Cover ~ p O n0. GPM ~(JI~tG 1. Q `7 oC Model Number Qc~ 7 _ ^d ~ . TDH L'ft ri 'ion ss ysteryl. FJae1, ZJ~~,• 't)`t Forcemain Length Di V Dist. to `/^,~j~y+' SOIL ABSORPTION SYSTEM BED/TRENCH Width, Length~1 No. Of Tr nche PIT DIMENSIONS No. Of Pits Inside Dia. Depth DIMENSIONS ((//ffi~/fJ SETBACK SYSTEM TO P/L BLDG WELL LAKE/ REAM' LEACHING Ma actur INFORMATION CHAMBER OR Type Of S tem: 16' ~J46 J UNIT Model DISTRIBUTION SYSTEM 3' tool .-~eAbaa Header/ anifold h ID istributio f Hole Size Tx Hole Spacing Vent to Air Intake Pipe(s) l Lengt 'LJ• ?ia~ ` Length Di Spacing x C/.~►)/ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over k 1 1 Depth Over \ xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges \ Topsoil / Yes ❑ No Yes No ~S, COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 400 MITCHELL RD w.~I A~~ 1.) Alt BM Description = vc G, / v P, szt g 0V\ ~ - `r"' l..UV445 2.) Bldg sewer length - amount of cover? LI* L► Plan revision Required? E. Yes No Use other side for additional information. 1 SBD-6710 (R.3/97) Date fnsep Cert. No. County o~ f2-~ r 7L Safety and Buildings Division itary Permit Number (to be 5lled in by Co.) r • , 201 W. Washington Ave., P.O. Box 7162 San a TpS~''` K UN 0 9 20 1 i Madison, WI 53707-7162 S► CiZ®IX COUNTY 55 UNITY DEVELQPMEN? State Transaction Number ,Sanitary permit Application Z ?o 7 in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) nQ the Deparment of Safety and Professional Servies. Personal information you provide may be u r secondary n / C(~" z n D u oses in accordance with the Privacy Law, s. 15.04 1 m „Stats. / K. A lication Information.- Please Print. All Information Parcel # Property Owner's Name a C~ _ Z D U t a Property Location ! ~i • a jf ill 7 1 MA- Property Owner's Mailing Address n Govt. Lot It C- Zip Code Phone Number Section City, State P (circle one) T E or~? l C Lot # ype of Building (check all that apply) Subdivision Name or 2 Family Dwelling -Number of Bedrooms L C 67 t Block# ❑ Public/Commercial - Describe Use ❑ City of CSM Number ❑ Village of > ❑ State Owned - Describe Use -Town of T CIZ d y /O / [Old 57 III. Type of Permit: (Check only one box online A. Complete line B if applicable) A. r El Treatment/Holding Tank Replacement Only ❑ Other ModiScatiou to Existing System (explain) 11 Replacement ;.New system System List Previous Permit Number and Date Issued / B. ❑ Permit Renewal Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. T e of POWTS S stem/Com onent/Device: Check all that a 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade 4 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable so 1-1 ❑ Pretreatment Device (explain) ❑ Holding Tank ❑ Other Dispersal Component (explain) V. Dis ersaVTreat nt Area Information: Desigp Flow d) Design Soil Application Rate dsf) Dispersal Area Require (sf) Dispers Area Proposed System Elevation b /J VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units JPJ New Tanks Existing Tanks la ~ 2 2 - G aU h V, w(, Septic or Holding Tank t1.." L` -n x Dosing Chamber ~;j"L9 f t VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/I4 Number Business Phone Number I'd Plumber's dress (Street, City, State, Zip Code) VIII oun epartment Use Only Permit Fee Date Issued -f Issuin gent Sign e Approved 0 . $ 1„', fo • ~ 4 ~3 ~ [ ❑ liven Reason foADenial IX. Conditin easons for Disapproval rQ Q ~e, r, Lt, 61 tl~ft 3) 6eJ• ',W dW D I A, 1.' '1fan~c; ef~ft of i(Il ters9i t~eM tttust ~lU ~w~Mc~s~~ mts _ ec l- f7n _ ~ ~ / ~L/`M~~{~': p gWogemeM plan proAded by plumbei. Z lf,* *L*W.i M must tx> m4ntc. ir.E p P*t *PP#CW41 cx)& I :rdina;v-,Fa Attach to complete plans for the system and submit to the County only on paper not less than 8 in z 11 inches in size SBD-6398 (R 11/11) Zo-OOO Efu/ct~.bn MfTC-Hi ZL go AD ~s ~tZaM i'R~v r t,~s ~ ~Ar~ ~aRf/`,►~s ZSY86' - ~'tlCE. /IV+1Y16r°!~~ to 8c/'L ;C elcJ: _ CIMff. s Bled: IAAJp 9S;S~i;o r- fmW ~CrD f f z/f Fm~c NfdN pI~ i NuT j>ISRLRH I vs, ! v 3? it ~j~"J l+Jf a o 6 66 a~'~1vRSrv~ ~ ~a I Z0.7r gOv ~ r?BS acs!. `~0 - ~14-Cl~ a ,yatLO.V TUVI, P + dam' s Q \ ' . - ~OD yam. ~y ' l~ZoPbss~p w7au. -to 8~ : 1 N tsuNe. S,s7=..X" 3~' APP 1 ©p~-i"rc td l W cock. p ,N v 5~a y~Ei 1.~{i4i~ QS ~ P ~V Y! tYY pose! a~Y Cc~-cue- Sac PC _8 0~'8 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay 3 $ P http://dsps.wi.gov/programs/industry-services www.wisconsin.gov oNNScott Walker, Governor Laura Guti6rrez, Secretary May22,2017 PT OF CUST ID No. 224832 ATTN.• POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHURS 1101 CARMICHAEL RD DANBURY WI 54830 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/22/2019 Identification Numbers Transaction ID No. 2948676 SITE: Site ID No. 838231 Matthew & Alison Thomford Please refer to both identification numbers, 400 Mitchell Rd above, in all correspondence with the agency. Town of Troy St Croix County NE1/4, SE1/4, S19, T28N, R19W FOR: Description: Mound System (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1707021 Maintenance required; 600 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from mound area. • Divert surface water from POWTS Area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, MARY JO HUPPERT Page 2 5/22/2017 the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • SPS 383.54(I)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizin2 to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of 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 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest~wisconsin.gov I MARY JO HUPPERT Page 2 5/22/2017 the site is too wet to prepare If it crumbles site preparation can proceed If the site is too wet to prepare. do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 I • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. I • SPS 383.54(1)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist: 1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Any changes may result in pump resizina to meet TDH and GPM Specifications. • Areas that are occupied with rock fi-agments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of 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 This Amount Will Be Invoiced. r/ orrr Z/~zyra~t oleof When You Receive That Invoice, Please Include a Copy With Your Tim Vander Leest Payment Submittal. Private Sewage Plan Reviewer ,Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim. vanderleest@,wiscolisin.gov Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) RI Residential or commercial Design Note_ Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 0-sin, soil WeabY dfor 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal cohfonn of 36 kids. 600.00 Design Flow (gpd) 7.00; Site Slope 92.501 Contour Line Elevation (ft) i 30.00 Depth to Limiting Factor (in) 0.60; In-situ Soil Application Rate (gpd/f?) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 10.QQ Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd/fe) 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) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation_~ 3 Number of Laterals of the highest point. I ! 0.156 Orifice Diameter (in) 3.50j Estimated Orifice Spacing (ft) = 11.76 fe/orfice 2.00; Forcemain Diameter (in) 45.00' Forc amain Length (ft) Does the forcemain drain back? 1_iY 1 84.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 7.34 Forcemain Drainback (gal) 8.59 Vertical Lift (ft) 55.97 5x Void Volume (gal) 0.74 Loss (ft) 63.31 Minimum Dose Volume (gal) ?P\ f 0.00 In-line Filter Loss (ft) 27.46 System Demand (gpm) Nil ~L.J 13.88 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection 1- 1 in. dia. lions choice in. dia. options choice 0.75 1.25 x x 1.00 i 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallonslinch Calculator (optional) Treatment Tank Information' Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weser !Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800 00 Dose Tank Capacity (gal) s Pol ok Filter Manufacturer 22.241 Dose Tank Volume (gal/in) 22 -Filter Model Number Weiser Manufacturer ~ Project: MATTHEW & ALISON THOMFORD _~J Page 2 of 8 GSF WI MOUND DESIGN PROGRAM DATA ENTRY Site Information R Residential or Commercial Design ONumber of Bedrooms (optional) 450 Design Flow (gpd) 1.0% Site Slope 96.30 Installation Contour Line Elevation (ft) 120.00 Contour Length Available (ft) 36 Depth to Limiting Factor (in) 1.0 In-Situ Soil Application Rate (gpd/ft2) EFF #2 Distribution Cell Information B43 Unit Used 6 Cell Width (ft) 3, 4, 5, 6, 8, 9 or 10 61 = Dispersal Cell Length (ft) 2.0 Dispersal Cell Design Loading Rate (gpd/ft2) 2 Influent Wastewater Quality Are the laterals the highest point in the distribution y Pressure Distribution Information network? Enter Y or N e Center, End or No Manifold (Pump to Gravity) 0 Lateral Spacing If N above, enter the elevation (ft) 1 Number of Laterals of the highest point. u 0.125 Orifice Diameter (in) (e.g. 0.25) 1.9 Estimated Orifice Spacing (ft) = 11.81 ft2/orifice 2 Forcemain Diameter (in) 250 Forcemain Length (ft) Does the forcemain drain back? 0 88.3 Inside Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 40.78 Forcemain Drainback (gal) r ' 8.58 Vertical Lift (ft) 47.71 5x Void Volume (gal) 1.00 Friction Loss (ft) 88.49 Minimum Dose Volume (gal) 16.08 Total Dynamic Head (ft) 12.77 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. diam. options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 x 2.00 1.50 x 3.00 2.00 x x 3.00 x Gallons/Inch Calculator Septic Tank Information Total Tank Capacity (gal) 1000 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in Dose Tank Information Effluent Filter Information 600 Dose Tank Capacity (gal) Pol lock Filter Manufacturer 11.82 Dose Tank Volume (gal/in) 525 Filter Model Number Wieser Manufacturer Project: ROBERT DYBUIG Page 2 of 10 GSF WI MOUND DESIGN PROGRAM GSF MOUND DRAWINGS Mound Plan View ■ I/II/II/IItI~IIIIIIII~I~~~i~•ll~tl~ 11 Dispersal - Area (ft Basal 1 • Area Available Mound System Maintenance and Operation Specifications Service Providees Name i Darrell's Septic Service Phone 715-425~-1025 POWTS Regulator's Name SL Croix County Zoning Phone 715-3864680 ? 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 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftz 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 month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Finer! l 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 Ban Valve Distribution - Lce Sweep 90 or Two 45 ~egree Bends Same Diameter as Lateral Project: MATTHEW & ALISON THOMFORD Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.547 Dis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N- 01101)] and local or state nil" 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 shaft 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 shag 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 84nches 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 shag 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 fitter stag be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shell 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. AD switches, arms, and pumps shag be tested to verify proper operation. If an effluent fitter 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 shag be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration- Traffic (otter than for vegetative maintenance) on the mound is not recommended since sal compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather instigations (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 BODS, 30 mg/L TSS,10 mg/L FOG, and 104 cfiu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit fo' 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 dogging has occurred and if orifice deaning is required to maintain equal distribution within the dispersal cell- Observation pipes within the dispersal cell shall be checked for effluent pxding. Ponding levels shag be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency 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) shag 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 growl surface, it will be repaired or replaced in iW present location by inning basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to brfrg 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 8 Wastewater METERS FEET 40 PE51 MODELS: PE31. PE41, PE51 + - E j - 351, 10 2 GPM 30 PE41 1 Fr = 25 -PE31 - - v _ i z 20 - H - _ - - - - _j _ r t 10 _-.E - - _ I - - - 5 p 0 0 10 20 30 40 50 60 70 GPM 80 0 5 10 15 m3/h CAPACITY PERFORMANCE RATINGS PE31 PE41 _ PE51 Total Head Total Head (feet of water) GPM (feet of water) GPM (feeTotal Head t of water) GPM 5 52 8 61 10 67 10 42 10 57 15 59 15 29 15 46 20 50 20 16 20 33 25 39 25 0 25 16 30 26 35 g /'AA-tm :w A u sce -7t 0,'V1 Ft ~?7o- 8 J oy0- zqb - zO - 000 AD EJu/arE.on -T- LLt, FROM PR~vtOCAS NthC~i AIHAA Sty RI N6 Scale: 44. Mark. e elect = .ao' CtK•+sp. elt,+/:- ?S;S7!' ~ 1 Bi $z ILA OF- - -A Jc K D ~~``S~rB,4d Air' _~a~~• 9Z.SO' G' BFCfLGQrtz _ _ ~ 9 ya. 63 y5 of VIA Y Fo N rC!G NoT DisruRS I~ ~.e AP AV 0(3 6 ofd If All V L Q SAL D ?C Ste. YO •~t ri rt ~ s c~ ~ c..., L 'Pui e& y7S.y3 ~ ~ p~ t1ZoPoSD WT=LL to ZE:: 1 L5' 70 7ANK r "Mb D J~vt.~': c!d t woo" ti Sac Qg _8 ors ST. CROIX COUN`ry SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1 r v1 uyv1 Y m& &e k- DI LI Mailing Address CtA-Y'yr C Property Address 1 ~Ct' C ri (alt (Verification required from Planning & Zoning Department for new construction.) City/State'LZ.L- , VV ~L. U inert 1~1 Parcel Identification Number t'~ f~U / Z Z © 6 ®t} LEGAL DESCRIPTION Property Location Sec., T 2-;jN RI W, Town of -T-v- oil Subdivision "G 1rn t Lot # 2 Certified Survey Map # , Volume , Page # G Warranty Deed # ~j Volume r ~ Spec house yes Lot lines identifiable (15) no SYSTEM MAINTENANCE AND OWNER 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 §Comm" 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to subrrut 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 Commerce 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 o this form are true to the best of mylour knowledge. Uwe am/are the ownerts) of the property described above, by virtue of a •arranty deed recorded in Register of Deeds Office. Number of bedrooms L.l -4- SIGNAT'URE OF APPLIC (S) BATE 'Any information that is misrepresented rmy result in the sanitary permit being revolted by the Planning & Zoning Department. 1whide with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is mock in the warranty deed. (REV. OU5) a ,1r9'LC9Z t s ~ .t9 flQM \ ~ cc , LL: N ~ .00L 00 'D W) ca L~ /4ff n E-4 9 % .ool ^ ^ ly ra '~sy~ ~-{s '049 t;aj3~6P! , ttg~~ QNO=1WOH1 t ; N0911V' > I-LV'W lliN lia iil - O I Z II 1 N iT~ ~iTI { i•ai ai•av i~I~i I~ iil I i i•~i i lilt .rl'A ,A~s OI ~ III ;I I ~ a~.V!{ i 7i. ai + ~ III i I ~ i il! L i i•'i i i i~r ~ ~ ~II~ ~ I~ ~III~'~~I ~ Ilia ~ . 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