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HomeMy WebLinkAbout018-2001-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 597411 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2965553 Permit Holder's Name: City Village Township Parcel Tax No JILL FOSTER & KIRK LYKETT TOWN OF HAMMOND 018-2001-30-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 14.29.17.894 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. I Septic ,Afl -Alf BeRehmaTK I~I Dosing ~inx'.f Li ,f!! BM t} _ c. 6erf..(4L( qg 5 Aeration Bldg. Sewe Holding St/Ht Inlet TANK SETBACK INFORMATION SUHt tle TANK TO P/L jW EL L BLDG. Vent to Air Intake ROAD Dt Inlet V Septic ~ Dt Bottom Dosing log, Header/Man. Aeration Dist. Pipe Holding Bot. System (cly rc~i. I PUMP/SIPHON INFORMATION Final Grade fJ Manufacturer Demand St Cover GPM Model Number ~7-12 TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. ) y Dist. to Well f SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches qf;; No. Of Inside Dia. A Liquid Depth DIMENSIONS I SETBACK SYSTEM TO P/L BLDG WELL LEACHING Manu ctur INFORMATION Type Of Sy em: CHAMBER OR "~I ' o~ UNIT Model mb ~ 6 LA b" ~~~~~YUUU DISTRIBUTION SYSTEM ✓ Tv r,,-,/ Header/Manifold JDistribution 14~ 'rT V Ix Hole Size a Hole Spacing Vent to Air Intake ipe(s) _ Length Di Length Dia Spacing 4-~2 L5_ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Center ~.9 Depth Over xx Depth of xx Seeded/Sodded Bed Trench xx Mulched Bed/Trench Edges To iA Topsoil Yes No Yes No COMMENTS: (Inclu code.-discrepencies, persons present, etc.) Inspection #1: Inspection Location: 1949 CTY D E ~"'T~ USX. PIbtJ Cj~G 7C 4 1.) Alt BM Descr ion Fr~•Kptnidi"gj ~1(, /(~pd (~nt3tlwY. t~a~►~ 2.) Bldg sewer length = -g J any _ Q J~ - amount of cover = 7~^~ t n ~~i r 1. 3 (I 'e' ✓ Plan revision Required L7 Yes F_~ No Use Use other side for additional information. l~ SBD-6710 (R.3/97) Date Inse or's Signature Cert. No. 1 ~ ~ I I ' _ _ F r ~ i ~ ~ f f i ~ V i ~ i C'6 ~ ~ ~ ~ ~ ` r ~ j I 1 1 `l i County Ell Sa ety and Buiin lsion P:`$1 201 W. WatorfVe~Box 7962 - Madi5370710"2 Sanitary Permit Number to be flledin by Co ) -BGpYC~(8 c~ow, CM1l'~►~~ Sanita o~ ry Permit App ieation State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate govemmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PO the Department of Safety and Professional Servies. personal information you provide may be used for seco secondary oses in accordance with the Privac Law, s. 15.04 1) m , Stats. Project Address (if different than mailing addres I. A lication Information - Please Print All Info ~ 6 9 Z/ Property Owner's Name on Parcel # Property Owner's Mailing Addr s --3?9- t~Cr Property Location L City' S Zi Code Govt. Lot P Phone Number ~ V~ _ ~-I_ Section (circle one),- - Type of Building (check all that apply) Lot # T. N; R EorY1 or 2 Family Dwelling - Number of Bedrooms -~rJ Subdivision Name ❑ Public/Commercial -Describe Use 46 Block # -moo Jyt i 4v`, ❑ City of ✓ ❑ State Owned - Describe Use CSM Number ❑ Village of ` Town of / III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. rL X New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing em exp ain) B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El List Previous Permit Number and Date Issued Before Expiration Permit Transfer to New Owner / IV. T e of POWTS S stem/Com onent/Device: Check all that a i ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil , El Holding Tank El Other Dispersal Component (explain) Mound < 24 in. of suitable soil V. Dis ersai/Treat nt Area Information: Pretreatment Devtce (explain) Design Flow ~ (gPd) Design Soil Application Rate Q ( Dispersal Area Required ~O Dispersal Area pro P° ~ sf) System Elevation VI. Tank Info Capacity in Total # of Gallons Gallons Units Manufacturer New Tanks Existing Tanks /6k Z5 p Y w C U U vs Septic or Holding Tank tW" Dosing Chamber VII. Respo ibility Statement- 1, the undersigned, assume respousi ity for installation of the POWTS shown on the attached Plumber's Name (P 'nt)~ Plumber' ignawre j? MP/MPRS Number plans. r Business Phone Number Plumber's A dress / treet, City, p-te, Zip Code) _ 70 y. _ VIII. un /De artment Use Oul Approved ❑ Disapproved Permit Fee Date Issuing Ag Signature ~ wen Reason for Denial 41;b. * 7 IX. Condieasons for Disapproval 1. b>tadc, evRtxnt I;Rw t4nd 3 6.QKOr •'~t`sr~ 1 A per i r saiceHrustallbe t ac:e ~ n lam es b ~ ~ Wl us per artaragemenR plan p c ~icle~l by Nlwnbe:. r eor- 1 & I • _ 2. All it ok rectjaPrten;s must i4--mt- ntrire•~ G as per tpl3cnbl4i co / , rdina:ncr?. Attach to complete plans for the system and submit to the County only on paper not less than 8 12 2 11 inches in size SBD-6398 (R. 11/11) _ - _ _ _ / _ _ _ _ _ - - _ _ ~ - ~n- _ --_I- _ . _ _ - _ _ _ _ _ ~ _ I h - ~ _ _ ~ 1- ~ i __I_. _ _ _ i ~ _ - - _ _ _ _ _ t _ _ _ - _ I _ _ _ I f - - _ ~ _ i _ y _ _ ~~e t-~ y ~G S~_ i, _ _ _ _ _ - . _ . ~G - - _ - - _ _ _ ~ .S , i ~~S f;, ~ _ _ _ _ _ ~ _ _ - _ _ \on DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 3 S' i GREEN BAY WI 54304-5211 P ; Contact Through Relay http://dspsmi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Laura Guti6rrez, Secretary June 29, 2017 CUST ID No. 224263 CIF SA ATTN.• POWTS Inspector KIM A OCONNELL KO CONSTRUCTION ZONING OFFICE 504 3RD AVE E ST CROIX COUNTY SPIA OSCEOLA WI 54020-8173 1101 CARMICHAEL RD HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/29/2019 Identification Numbers Transaction ID No. 2965553 SITE: Site ID No. 839643 Jill Foster Please refer to both identification numbers, 1949 Cth E above, in all corres ondence with the aaenc . Town of Hammond St Croix County NE 1/4, NE 1/4, S14, T2 9N, R17W FOR: Description: Mound System (2 Bedrooms New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1714119 Maintenance required; 300 GPD Flow rate 16 in Soil minimum de th to limitin factor from on final rade; 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. • 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. • 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 reducin- the infiltration ca aci of the soil. Proper soil moisture content can be determined b rol]ina a soil sample between the hands. If it rolls into a 1/4- inch wire 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 • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan. Any changes ma result in ----1!113 resizin- to meet TDH and CPM Snecifications • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS `Table 384.30-5 0 Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) Page 2 6/29/2017 KIM A OCONNELL Tank Installation to follow all manufacture's recommendations. Verify property line(s) prior to installation. Well setbacks to meet chs. NR 811 & 812. 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 around 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. FBalanc e Required $ 250.00 Sincerely, e Received $ 250.00 e Due$ 0.00 Fim Vander Leest WISMART code: 7633 Private Sewage Plan Reviewer, Division of Industry Services (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest,cr,wisconsin.gov KIM A OCONNELL Pate 2 6/29/2017 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 conceming 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 Tim Vander Leest Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tiTn.vandei-leest@wisconsin.gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Foster/ L ksett "I 11S!! , I ; Owner's Name: Jill Foster--Kirk Lykett Owner's Address: 1949 CTH RD E Hammond WI 54015 Legal Description: NE-NE sec14-T29N-R17W Township: Hammond County: St Croix Subdivision Name: Forest Ridgd Estates Lot Number: 30 Block Number: Parcel I.D. Number: 018-2001-30-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 10 Soil Evaluation Designer: Kim Oconnell License Number: 224263 Date: 06/19/17 Phone Number: 715-381-7917 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) Residential or Commercial Design Note: Sand fill (D) calculations assume a 200 00I Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for fecal coliform of 36 inches. 1.50; Peaking Factor (e.g. 1.5 = 150%) 300.00 Design Flow (gpd) 4.00 Site Slope 98.50 Contour Line Elevation (ft) 16.00; Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00' Dispersal Cell Design Loading Rate (gpd/ft2) 1 i Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution t' Pressure Disribution Information network? Enter Y or h (C or E) E' Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) _2; Number of Laterals of the highest point. _ 0.125 Orifice Diameter (in) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft2/orifce 2.00 Forcemain Diameter (in) r 0.0 Forcemain Length (ft) Does the forcemain drain back? Y 91 A0 Pump Tank Elevation (ft) Enter Y or N act? ] it U 6.50 System Head (ft) x 1.3 17.94 Forcemain Drainback (gal) 3T 9.00 Vertical Lift (ft) 53.60 5x Void Volume (gal) 9 riction Loss (ft) 71.55 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 19.77 System Demand (gpm) 16.49 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 i 1.50 j 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 1000.00 Total Tank Capacity (gal) 1000.00': Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) Wieser_..-- - 4 Yanufacturer 27.78 gal/in (enter result in cell 649) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) 'Ploy lock Filter Manufacturer 16.76 Dose Tank Volume (gal/in) iPL 525 _::::_]Filter Model Number Weiser Manufacturer Project: Foster/ Lyksett Page 2 of 9 Mound Plan and Cross Section Views 1/10.6 J Observation Pipe . K O Q A W B : I 41 • L Mound Gomponent Dimensions ft A 5.00 ft E 22.40 in H 1.00 ft K gift B 60.00 ft F 9.50 in z 10.77 ft L ft D 20.00 in G 050 ft J 7.92 ft W 300.00 (ft) Dispersal Cell Area 946.02 (ft) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.96 (ft) 0 ♦ H G 1 F Dispersal Cell 100.67 (ft) Lateral 100.17 (ft)~ - Invert Dispersal Cell ( t Elevation ::,E D . . . . . . . . 98.50 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key 0 T Dispersal Cell See lateral details on Q Topsoil Cap c 1.5 ft Page 4 for number, size, 2❑ Subsoil Cap H o © O ~Q T and spacing of laterals. ©0 ASTM C33 Sand R / -*0 are equally Tilled Layer y 0.5 ft Tvpical Lateral F spaced from the distribution cell's ©0 Aggregate It o © centerline in the A distribution cell (AxB). Project: Foster/ Lyksett Page 3 of 9 End Connection Lateral Layout Diagram Cent- rh. later al_- over rha A;, Bdrmen~ton • - Turn-up -Y ba II va 1-or of as n out plug i P All lateral: are i.ienti al Ir X I Holey drilled on the bottom of the lateral "".ally Spa. ed 1. atar.al:e ,3 Yro'C:ernain Sch 40 PV ner '?,P`. TM-4p, 84 30-5 - Fon>e mare c =.nn:-r.tr _.n wa 1- or ..ros r- -roc Ad ar ynq Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.54 ft Lateral Length (P) 58.42 ft Orifices per Lateral 24 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft2/orifice Lateral Flow Rate 9.89 gpm Manifold Length 2.50 ft System Flow Rate 19.77 gpm Manifold Diameter 1.25 in Total Dynamic Head 16.49 ft Forcemain Velocity 2.02 ft/sec Dose Tank Information Locking cover with warning label and locking device and 0/1_ 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 Manufacturer 2 in. Capacityl 600.00 Gallons -r Volume 16.76 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 21.53 360.85 B 2.00 33.52 C Pump off elevation (ft) C 4.27 71.55 _t 91.67 D - 8.00 134.08 D Total 35.80 600.00 Dose tank elevation (ft~ 3" Bedding un er tank. ~ 91.00 Alarm Manuafacturer FR-JS-Rh-0 mbus Note: Switches Alarm Model Number tank alertcontaining mercury may not be used in Pump Manufacturer Goulds this system. Pump Model Number ,PE 51~ Pump Must Deliver 19.77 gpm at 16.49 ft T D H Project: Foster/ Lyksett Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Kim Oconnell Phone 715 381-7917 1 POWTS Regulator's Name St CTY Zoning Phoney 715-386-4680 s System Flow and Load Parameters Design Flow - Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 200 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 300 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequencv Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound ------Inspect for ponding and seepage once every 3 years Gather 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 • . 000000000000000 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: Foster/ Lyksett 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 SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 11/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01, R. 10112)] 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 113 the liquid volume o 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 BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, an 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. i, 4- a GOULDS PUMPS Submersible Effluent Pump PE h T 1h y' ~z EFFI.OEW PUMP = SPECIFICATIONS MOTOR FEATURES Pump - General: General: ■ Corrosion resistant • Discharge: 1'/a" NPT • Single phase construction. k AN, * Temperature: 1040F (400C) • 60 Hertz ■ Cast iron body. Z N8 maximum, continuous when • 115 volts ■ Thermoplastic impeller and A w.F s " fully submerged. • Built-in thermal overload pro- cover. • Solids handling: Y2" tection with automatic reset ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models include a • Oil-filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor: service life. • Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 12.0 Maximum amps operation. • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design ■ All ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor: working limits of the motor. ■ Quick disconnect power • Heavy Duty Sump/ PE41 Pump: .40 HP, 3400 RPM Dewatering • Maximum capacity: 60 GPM • 7.5 Maximum amps hcord, eavy duty 16/35 TW with • Maximum head: 29' TDH • PSC design NEMA 5-151, three prong, PE51 Pump; PE51 Motor. 115 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maximum amps portable and compact. • METERS FEET PSC design ■ Mechanical seal is carbon, 40 ceramic, BUNA and stainless PE51 ( ;MODELS: PE31, PE41, PE51 steel. i HP .33-40_50 s Stainless steel fasteners. 35 - 10 -►-2GPM e AGENCY LISTINGS 30 PE41 v_ 1 FT PE 31 v 25 i } 20: - _ - Tested to UL 778 and CSA 22.2108 Standards By Canadian Standards Association 75 a . File #LR38549 Goulds Pumps is ISO 9001 Registered. 10 5 O 0 0 10 20 30 46-1- 60 70 GPM 80 a , , 0 5 10 15 m3/h Goulds Pumps CAPACITY F c , • i I ST. CROIX CBOT SEPTIC TA1\- 'KAD\ -_kWCE AGREEMENT AN 0" V ERSHIP CERTIFICATION FORM 3vr•3 Address I 1 (V erif icaiion required froV-- ng Departtamt fw new coassu-u dou) City" State Parcel Identification Number C06 . D SCRIPTIO'N' O eF' pgg sec. _A~ T R /7W, Town of it VIA V" 0- P: S sbcfiidsion Plat: Fd f e b4- I- 0 , Lot Certified Survey Nfap , Volume Page Wan-anty beet 4 / (o cl z (before 2007)Volume ; page Spec house yes ED no Lot saes identifiable oyes L-3 no S` STEM MA LNUENANCE AhTJ OWIWER CERTIFICATION improper use and maintenance of your septic system could result in its premaiire failure to handie 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 'tee system can affect -die function of-the septic tank as a treatment stage in the waste disposal system. Ovimer maintenance responsibilities are spec?ixed in WS. 83.52(l) and in Chapter 12 - St Croix County Sanitary Ordinance, lbe property owner agrees to submit to St. Cron County Planning & Zonm-a Depart;=t a certification form signed by the owner and by a master plumber; journeyman piwnber, restricted plumber or a licensed pumper veri6,ina that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) afmr inspection and pumping (if necessary), the septic tank: is less than I13 fish of sludge. Uwe, the undersigned have read the above requirements and mgr to masn7air, dthe private sewage disposal system with the stanciards set for aL hrrmn. as set by i e Daparw = of Safety And Prrsiessaauzl Services and the DepartaxUofN;&tural Resources, State of W usffi CZVECMDU 90=Q the youu' .sepias system has beM maimed must be completed and returned to the St. Croix Coua-y Planning & Zom ng Deft within 34 datis o the,three year cq)kation date. Ywe ceerti that all statements on form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above; by vktue of a w r deed recorded in Register of Deeds Once. Number of bedrooms _A, CRE OF DATE "Az y information that is misrepresented may resin m she sanitary permit being revoked by the Planning & Zoning Department include utj this application a recorded walrranf dead fi om the Reamer of Deeds Once and a copy of the certified sunrey map if reference is made in the warranty deed. V. I i1 ^~v I AL I ~ / 3 -z -LOT 1 SAM VOL,45,~- G~ Ord ZONED AG-!-fESID AC ► I I I ~cn 1 , ~ _~II 1 w, 3 -zW J I + I 1 U~ o ff--, Lo ( f/ = = - = I I f 4AN 0071-103"- adl- ~--e 30.00' , /Cr z o - z ~n LL- C) I 33.00qq L) I re fi /0 a / I I ( 1I I- / / rn Q M n / 11 I I Io°~ ( Nip i 00 I I 0,-- m " I i ; i o I/ / - - S 002103 570+59_ \ a / WIo~ I ! I/ //`r o \ of I III + 111 X x4 U p \\\JII I i\ I// Q / N 1C7 0 ~ Lo / ~ ao n u; 1 I I / N I'~ C-4 x i I I / o~ ~ 00 m N NN z z \ I I ~ Im / / ~ z I I ! I / L_ 00'21'03" E~ 7 .5i \dlll I m / FT - \ml- Q Q~ ' N 100' I / ~""i rn 00 "?mac LJ or,~ `nom Cl III 11 I m cN Z o ` 0o I aC~lq, sr X 1 I i LL: V L.J APR 2 7 20lin ST. CROIX COUNEVALUATION REPORT P e o<- vV4Wor,Wn papartrnent of Division of Setety and 8 uild Ms.- in scwrde 65. Vft- Iufm. Code car S7. CR~i X Af1eC► aomplsts .tie p + on paper not ten then 8*tn, pion must s Parcel 1.0 G/~ / -o--z~z grdude, txut not tlrrited to: verdrai end }writorttal ratarance P~ percent slope, scale or dtmerrelons. north arrow, end Location end distance to nearest road. evved ~ Date Please print atJ Jnformatlvn. ~ i a~ D Personr Intonrrrion you w~ m.y ee uud ror skonday Ourt~ n,~,~, PropertYlacetim' ( p O wner 1!4 Al W 114 S y T F N R 17 Q~ W P+opefN ` ' ' 1aorA..l et LQ Lof SIO& # Sub& Name or csM# pfepe sMatiirrgAddres: - ►2ES tO6~ E~TaT~S v, y , p v S 1 b/J ST Yawn Nearest Road State rip Phone Nu ❑ city 0 C.'T ~ v >e oyz 15 ZLo-~{$aZ a _ GPD Corte derived deign ticw Me + - FAus w-1 y 11 P New Construction Uee: aC RP"dsntiat ! Number of bedrooms Public or oornmsrdat - pyoibe: A1.A • rt' It appticeoie Q Replacement ~11t S F't F",Plain 1116"' Parent matadat } ry_ i s C r n t~ ; I .f sndeaons: MO "'D SA &TeAk 5AAD F ~L~ ~ , ~ ; t and 0.yC{-•C~kO~tJC~ ~t'~ 2dZj0~ (,l~L"►'?{'~ f'~'r;u~ owing n~c~t n!~n~ JT9 In. fob # Pit owing G►oundCQ elev. y alas- R Depth to Yrnl~ Fedor Z- Roots ~ ~ P Rate g7~ Cowsterme Boundary l pondnant Color Redox Desalption Texture Stye ~ •Eryp~ •Et7p2 Wrizon Dept Color Gr. SL Stu. In. Munsati t]u. Sz Coot Qb p,j O.g i 5t Q-3 a - ) 3f sl l aX aloi r a b f- 0.5 0.8 Z - 0 :54 m yv y r 0.W V eo s✓ O 3 -iB 0 r?,3 b sh a.t,J -nn O.y or(o 75`1 a~ - s~ p z9- Y 0 Boring Gads e 5 'tj ft. Depth toNmiting,feator M sou tbn Rate I L1 Pit GPD/t - Texture Structure Consistence tioundenr Roots 82 tior ¢on DeP1h Dominant Color Redox Description Gr. •0, . . . Sz Sh Du. SL Cont_ Color 0. in. Tt+lunseC S 0, ~ ~ • g Z- 5 0 r aS 3 -zo . S o. 3 - 7 SO y - -vtlabi O.la s1 d ~ -2 7 EMuent #1 = BOD • Eftgnt #2 BOD = 30 IV& and TSS: 30 mgrt. • > < 220 n V& and TSS >30,c 150 mglL Number 30 nature cT Nwm M.". P"A Y ne Number 0 FIO LL\ST~ Dew Evahratlon Conducted A4ddresa t~ WI 54022- 0$-a(-Oz- -?t N2te-~~75 W44T5 ~~o A~E~ R~dE 'FAt.~s KT- QDT *%5 Page o' _ - - Property Owner L``.1- Parosl ID # RL Boring # Boring ) K. Horizon th Dominant Color Redox Description Depth to limiting factor Soil icatlon Rate ZS' Pit Ground surface elev. Texture Structure Consistence Boundary Roots GPD/ff •EA#t 'EfNf2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. QT 't R %Z0 Boring odng # Ground surface elev. _ l Depth to 1irtWNng --7Z oN Pit in. y3 --A) Luff Horizon Depth Dominant Col Redox n Texture Structure Consis Boundary Roots GPOM •Ef1#1 'EII#2 In. Munsell Qu. Sz. Color Gr. Sz. Sh. t_ v r 3v~ 4S D•S 1 D-$ 6 & 0.5 0.fit Z- i _ l ~R3h L _ it 3 i5.z Rwl sit -m s tm~ uJ tv4- S6'1 4 ,ty-31 to b 5 -4D R fs tf ms W4-m L 0 - Z54A 3 ~ S 7 _ C{ yr (JapPRarC. ZO 0 p Boring it. Depth to limili tg factor _ l.(¢-_ in. 0 Pit Ground surface elev. _ Soil Icafion Rate Texture Structure Consistence Boundary Roots GPf)It! Horizon Depict Dominant Col Redox Descrlpilon .E01 -F~ in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. L Z r•»biC mJ~r of -m ,S 0.8 t D-$ tovrtz/2 Z f9- 3 l0 tt`~l3 t_ ~~co 0,4 34f fb 0 40 aF SbK c5 Z 1i-co `43 0-5 zico 0.4 iONIk 5 0 7'5'4K 'S /q 1 W, I Effluent #j = SOD, > 30 220 mgrL and TSS >30 150 mg& ' Effluent #2 = BOD, 30 mg/L and TSS 30 ^g(L < • _ The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8711. sroo•r3tota.eao~ MOr PLAN pp= rre Pt Pt= . i #4 24 a pF Sor N ~KDa[ - t St vmmw wam 98, 7D G BS'Si.°aAQ.l1 m 3,2-7 AC-E4 WEST L1 1L/ o l~3A,,_~. ~d. EL -30 LDT ~s0 Ur F&4 E~ 4Si.33` n y 1 J A1:3 L4 x - - 14 Apr 17 05 12:29p owner 7154264827 p-4 li of WH N o wya. IbM , Pic. P l0~ 5e•.14 I.io~~tdav& 6~CpLLNP Tz'W Knv IN C-T-VL Pow pEW ~ _ ~al4D PK^1k ~ - -I Ed4SED ; Off-i$-DZ v -~SS~'^E 10 -C7" , N C.~ ,a.,_s-os ~l 2, FED O 00 ~b- C) c j1 we,~~'o 3UB 0. 0 'IL,-6 Z - /1M -__`~7-Gc LZ000 N',,* OQ' o Xv1~L~ F71 ~7 -3, o I I ~ V r t / ~'l 1 ~ ,n 1 C"i 1I~`I ~I l \ / I I ITT 11 CSM VOL j5,- G 4081 ZONED AG-!-,'ESID~KIA II/wCr- I I I I _ w it 1 1 ~x ) o / \273. _ J I II U `n goo f C5 x -=7 T I N 00713 aN- 00 - - I / X30.00' LO o Z 29-00' - - b x OD\ I ~,133 oA' F / III I I I ct~ V) c /0 / Q / 0 N co I r", X S 00'2103_"/C570.59' oI on I I I / / z C) 0 1 0~ I i III / I xLLL5 jam/ I ►IV~ / I / UT- - LL: -IS- '2 10 Lc) r" 00 I I I I `n / N NO N w 00 04 x "II I\ I ~N m I N m z\ it la / L _L I '2103 E~ 7 .59 00 i A I I I m t- T m x IIII I i / (L v ~ (3 Us 6 100' 0) N 00 n = iII I11 I i ~ / 0 r,, Ln N m LL- r- O I W I -311 LL: \ Z,j I I I vi to Parcel 018-2001-30-000 12/03/2004 11:59 AM PAGE 1 OF 1 Alt. Parcel 14.29.17.894 018 - TOWN OF HAMMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner E W HOMES INC E W HOMES INC 1114 W DIVISION RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1949 CTY RD E SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acr s: 3.160 Plat: 1961-FOREST RIDGE EST 1/30 018/03 SEC 14 T29N R17W PT NE NW FOREST R DGE Block/Condo Bldg: LOT 30 ESTATES LOT 30 (3.160AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-29N-17W NE NW Notes - Parcel History: Date Doc # Vol/Page Type 01/14/2003 705829 9/46 PLAT 2004 SUMMARY Bill Fair Market Value: Assessed with: 271,200 Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.160 42,500 0 42,500 NO Totals for 2004: General Property 3.160 42,500 0 42,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r • i SOIL EVALUATION REPORT Pane _A of s2j WlacotsIn Department of Commerce DMsion of Safety and Buildings In accordance with Comm 85. Wia. Adm. Code CW* S`T. Cl2AI X Attach complete eke plan on paper not less than 8 1/2 x t i Intdres in size. Plan must include, but not limited lo: vertical and)iorizonUnl reference paknt (BM), dlredlon and Percat I.D. PE001N r percent slope, scale or dimensions. north snow. and tocatfon and distance to nearest road. R Oete Please print all Inforrnatlon. at Penonar rnron-uan y-j preride may be veed for secondey Purvass (Prbet:y L-. a.15.04 (1) (rn))- n Property Location Property s 17 t~W en LL E Vv, RUWQ,.; o~"C roa..A- A] C; va N vS ua s J 4 T ?-j NiR q P, 'y owner, Msi(utg A as Lot ff Blodt R subd. Name or CSMX 1 TC T-Y 6 1 V 151 b/J 5T O 12E5 12 104° ,f T SUMS ~P Q City ❑ \ALVe Town Nearest Road 11.1 • Phone Number e,T ~ K f`ALt5 WS yozz t 15 2to-ggbZ- HAm D ___1___ Code darhred design flow rate GPD New Construction Uae: aResidentiel l Number of bedrooms ❑ Replemnont ❑ Public or commercial - Describe: Al . A • rt Flood Plain elevation it >ap/pllce nb~ie - , ~ ~ ~ ~ < Generm / / ~,u loo,.4~/ ~t Wr+ Pe General l Corrxn m mad r~ frJ and recotrurnendtietiona: MOIlAi7 S,1SlMJtk 1_1,71' SflI:,D F\L-jL- dot Boring factor? 39 In. \ Boring f)' ,1-~ f pit surface elev. j, 1 ll R. Depth to tlmltlnD Sol lion Rate ICJ Texture structure Consistence Boundery Roots GPD 11 Horizon Depth Dominant Color Redox Desafptlon h ~ •Effp1 _ -E02 In. fvtunsen Du. sz Cont Color Gr. Sz. S ab f~ 0, J 0A g z std 3f w~v~1' i p -3 ~ a.b 0-- o. 8 s+ 1 z~abb ► r 04Q3 St ~-m yy\.Vy aW 7-LE-do a t,J wl;-M 0.4 0.6 14 I Z' 1 754 aJ - s~ bK 0%Z I.Z 5 to IVES Boring p Boring C~ Ground surfece elev. R. Depth to timlitng factor In. sou Lion Rate Pit GPDRt Horizon Depth Dominant Cola Redox Description Texture structure consistence Boundary Roots •EfNf1 'Eff#2 in. MunseB Du. SL Cont. Cola Gr. Sz. Sh p~ D t 0-5 0 441 0.5 0.!:) -1 z_ sbl< r Q5 -to o. 3 -17 t o y - ►1 -vttabl r aS 3 -tD • S _ o. 0.(P ti -z5 7 ~1 d , • Effluent #2 n BOO _ 30 rng1L and 1 30 mgfL • Effluent fit = BOD > 30 < 220 rnplL and TSS ~ 150 mgr- Akrrr>tter helUre ZZ 2 7 CST NASrre (Ptesae Print) Jcr HD LL1S'rE- Date Evaluation Conducted T no Number Address Z t N 2b -1175 W98~5 t,go'~~'AdE, R1tJE 'FADS WI 5y02Z L0 K~1 L 09 - It- G2- ~~v 1S~TJ : 11-L4-oy y ~9 T Page of - L~~+•R~ Sy LLB Parcel ID 0 Property Owner m. Boring N Boring ~ ft. Dsplh to limiting factor , Soli icatpon Rate Zg~ Pit Ground surface elev. _ GPDAP Texture Structure Cpnslstertce Boundary Roots Horizon th Dominant Color Redox Descripilat Gr. SL Sh. 'Effli t 'EfW In. Munsel Qu. Sz. Cont. Color s OT SS- 0 -t4 R1Zp oitng 0 ~ Boring r Doh to limiting - In. Boll Uat Rate U-Lff so) 1.>L Pit Ground surface elev. GPDf y3 n Texture Structure Consl Boundary Roots Horizon Depth Dominant Col Redox •Etflfl 'Eft82 In. Munsell Qu. Sz. Color Gr. Sz. 5h. t_ v r 3vf [~S D.S 0-$ 6 R~2 0.5 o.~t %Lna Z i ~Iic~1Z L _ fr ab IV\ lv4- 0.5 0.8 3 IS-2 Ryl - stl -m s s{ zf sbK rnV~r G~ tv o. ~ Z - i s if-m s 14-m 0.1 5 -4a Rs S Q M - 0 1r 0 - 7.548 3 -7 _ CI 147-3'-f -1.C/+PP~K. zo 0 IL ~ Rate Boring p Boring Ground surface elev. g~0~ ft. Depth to timiUng factor I~¢ - in soil r Lt-o1 3d Pk GPUM Texture Structure Consistence Boundary Roots Horizon Depth I DominajC::odlc-)r Redox Desalptbn 'Eff#t '002 g Gr. Sz. Sh. in. MunQu. Sz. Cont Color 1, Z rn~bK v+~J~r of - co ,S o •8 t 0- roy>z- t_ f r+tv r 5 YF-CO .4 3 P W3 t_ { m~r Qs 3d4 co 0.4 0 o •H y lKy~j 5t15 3d~-CO ,,IO L 4o,11 3 sbK 5 ~-c5 494 0 G4 4 - .V z2 O.' { ''113 4! t,44t,/! &s Z-A - t5 0 ~ S , L rr.'S 5 ~ mi l4~-tt'1 U 2S-tf0 YK 3 Effluent 91 = BOD, > 30 < 220 mgfL and TSS >30 < 150 m91L ' Effluent #2 = BOD, - 30 ngiL and TSS 5 30 nV(L is an equal opportunity The Department department at 608-266-3151 or a"I']Yt608-264-877CSS 7 services or col material ninran alternate format, pica. service suu•uro rrc.wo~ r-cwRES~ Roc LzES . LO-T 50 , C.l', ti1. E Pte. of L ~ N =Oe-v *11 c~cr. ~v ~TZ9~1, R1'IW T "-'E J i Bhl- sP1 tN C }-C e4,- Poe-NEW _ goftV PK. -A 5W No .00 S v P-844) m#~ Assusn~D 100-D O D C) U~ Q c p , f f T f C c 0 OL,6 Z z ---nn cc 4 co _ X O - 0 O rn v v Lcsf50 a- Of o naG. P i O~ SFC. iv td l^6DVE ~'oRpt1j1 TZ'U1~ 9, 1-1W Bnl- SPu tN Cr H.'E / 0 AT e4,- pow ~u~W F'dAV '00 s =,:Z! WAMV4 llJ~1E`-~ / 41*% -lSSuA1-z'D y00.D N cyl ~ n 00' C~ =rl 0 0' G r~ _ , , X ' O ` O 1 ~ r /