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040-1303-00-073
county: St. Croix r7SafetZyand Department of Commerce PRIVATE SEWAGE SYSTEM Building Division INSPECTION REPORT Sanitary Permit No: 597422 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)]. 1 143 U Permit Holder's Name: City Village Township Parcel Tax No: Nicholas & Sarah Canaday TOWN OF TROY 040-1303-00-073 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: cs t ti. _ . 22.28.19.1808 TANK INFORMATION :ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. . Septic JN Benchmark / w r Dosing jf(1 Alt. BM Reratim Bldg. Sewer St/ tt inlet r gGr' Hol4mg St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet - Dt Bottom,. 2q 7,, Septic " ~ ,.-j i , i0 ✓ t Dri Heade a b; Aeration r" 15st. Pipe J ✓ I e a Hol ing Bot. System Final Grade PUMP/SIPHON INFORMATION r Manufacturer Demand St Cover i GPM n j Model Number bI v TDJLfj Friction IS System Head 1 w TD f rF Forcemain L 1 Dia. ) Dist. to Well (O )b I SOIL ABSORPTION SYSTEM BED/TRENCH Width/A) LN61M PIT DIMENSIONS No. Of Pits Inside Dia. / Liquid Dep DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CHL ACHING AMBER OR Manufacturer: INFORMATION T f Syst m: tl UNIT Model Nu er: -7 oo IF 11- - DISTRIBUTION SYSTEM 1v Header/Manifold Distribution x Hole Size / x Hole Spacing 1 Vent to Air Intake Pipe(s) I S1~2 2 L _ Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ff De th Over Depth Over A )o( Dept of (t Im Seeded/Sodded Mulched p Bed[Trench Center Bed/Trench Edges Topsoil ii Yes L] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) I spection #1A f i - Inspection #2: Location: 261 WALNUT f1ILL WAY A Sub 1.) Alt BM Description = all + + vb ~'1 QLIr ~1j rJ 2.) Bldg sewer length = % 1 t` vny +0 1~1 - amount of cover = J Plan revision Required? ❑ Yes No I Use other side for additional informa Z n. Date *Insepctorr's lure Cert. No. SBD-6710 (R.3/97) 0H-,2o1~ -cW }ate . T - county 1 - rsl Y, Safety and Buildings Division > 1 _ l t 9 K 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number to be filled in by Co.) Mal! , 537 716t?, 57 7,z/ OF- ° At NT _ XG"9RSW06PM0Y Stale Transaction Number -7 g In accordance yttfii'SPS 38321(2), Wis. Adm Code, submission of this form to the appropriate governmental wit is requited prior to obtaining a sanitary permit Note: Application forms for state-owned POwTS are submitted to Project Address (if different than mailing' s) the Department of Safety and Professional Servies. Personal information you provice may be used for secondary A purposes in accordance; with the Privacy Law, s. 175. 1 m), Stats. f 1 r 7[ C C (.~lr~~ L Application Information - Please PLint All I formati Property Owner's N e ' Parcel # Property Owner's Mailing Address i Property Location 19 0 City, Stale Zip Code Phone Number ` < y. Section Z p~ ' le one; (lac 11. Type of Building (check all thtroo ply) I T L, 1~; R E Subdivision Name ( or 2 Family Dwelling Number of 73 Bloc ~ ,6-~--f-- Z ~ ^s^.~ ❑ A:iblic)Commercial - Describe Use c 4c 4M ❑ City of i CSM Number ❑ Village of State Owned - Describe Use own of/. ^ J al. Type of Permit: (Check only one box on line A. Complete line B if applicable)-_ :Z r.Ar OC" A' System 11 Replacement System ❑ Treatment/Holding Tank Replacement Only ~ Other Modification to Existing System (explain} B. ❑ Permit Renewal 0 Permit Revision El Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Tv ofPOWTS System/Component/Device: Che all that apply) ICJ OJ ❑ Non-Pressurized In-Ground ❑ Pressurized hi-Ground t-(suede ❑ Mound 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank 0 Other Dispersal Component (explain) ~ LJ Pretreatment Device (explain) V. Dis rsal/Treat nt Area Information: _ r Design Flow (gpd) I Design Soil Application Rate(gp f) Dispersal Area Required (sf) Dispersal Area Proposed f) Stem Elev I U G' 1rz) 1 , r~ < L _ VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a J pp po New Tanks Existing Tanks / o t I Septic or Holding Tank Dosing Chamber I KI-, ) VII. Responsibility Stateme - I, the undersigned, ass mV, r . Ponsibility for installation of the POwTS shown on the attached plans. It-PI bbe s Name (Print) Mum S' ante W/MPR S Number Business Phone Number 4/7 Plumber's Address (Street state, Pup CC ! VIII. uatyiDe artment Use Only _ pproved a Permits Fee Date sued issuing //-t Sign er raven Reason for Den p S ' ~`-i _ /7 IX CondrtT3 easo VSfe,-,r' D' approval .SP epU~ac e. u-sn:nigte• t~ni 1 " tis pe , n cell me all be pro by ~'W1 "1 r as per 7ar:ayernent plait pia rider) by plwnbe;. 1`-e_/LKI " Ao aft- Atl'setkvark rec tlrer^ten4s must.F~ep rrtrir E 2. w per apFilelble cam,: ! ;:rdinanrsl. Attacb to complete plaw. for the sy tem and submit to the County only on paper m.-z less than 8 in z 11 inches in size SBI3-6398 ~R. l i/11) System PLOT PLAN PROJECT Nick Canadav ADDRESS 1712 Windflower St. River Falls Wi 54022 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 93.8' DATE 6/27/17 BEDROOM 4 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line Grading is to be done B.M.* to divert run-off 95' away from system B-2 ❑ 94' Grading is to be done to divert 93.8 run-off away from system B-1 ~U ~zth1~►( (Do ~~r~, • t~C 93 B-3 (q•2. I~ff t{(i Itt~d -Z 6% Slope Area 15' below system is 1 Acre Lot to remain undisturbed 70' Huf~eutt Property Line Comoro Tank , 7, Pro 4 F k Bedroom House i t Tank is to be properly bedded and provided with lockdown covers with approved warning labels Property Line Well is to meet all WDNR setbacks Scale = 1/4" = 10' Walnut Hill Way n ART+?Fdr DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay 3i jam, ` P S http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary July 24, 2017 z a: t' e CUST ID No. 226900 ATTN POWTS Inspector ~73SIONAL , E SHAUN R BIRD ZONING OFFICE BIRD SELF STORAGE ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/24/2019 Identification Numbers Transaction ID No. 2974366 SITE: Site ID No. 840461 Nick Canaday Please refer to both identification numbers, Walnut Hill Way above, in all correspondence with the agency. Town of Troy St Croix County SE1/4, SETA, S22, T28N, R19W FOR: Description: At-Grade (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1716874 Maintenance required; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), 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. • 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, 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. SHAUN R BIRD Page 2 7/24/2017 • Divert surface water from POWTS Area. • 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) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizing to meet TDH and CPM Specifications. • 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. lfno other site is available, trees in the basal area of the at-grade 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. • 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. 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 a wisconsin.gov SHAUN R BIRD Page 2 7/24/2017 • Divert surface water from POWTS Area. • 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) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan Anv changes may result in pump resizinE to meet TDH and GPM Specifications. • 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 at-grade 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. • 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 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 healtl 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, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer ,Division of Industry Services Payment Submittal. WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov Cover Page Shaun Bird Bird Plumbing Inc. i1CES 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:6/28/17 Owner:Nick Canaday Location:SE 1/4 SE1/4 S22 T28 N,R19 W 261 Walnut Hill Way Troy Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specific ons Attachments: T Shaun Bir Sign Lice number 226900 -;t ` Page 1 of 9 System PLOT PLAN PROJECT Nick Canadav ADDRESS 1712 Windflower St. River Falls Wi 54022 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 93.8' DATE 6/27/17 BEDROOM 4 CONVENTIONAL AT-GRADE X)a CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line lb- Grading is to be done g.M * to divert run-off 95 away from system B-2 94' Grading is to be done to divert 93.8 run-off away from system B- 93/ B-3 6% Slope Area 15' below system is 1 Acre Lot to remain undisturbed Huffcutt Property Line Combo Tank Pro 4 Bedroom House Tank is to be properly bedded and provided with lockdown covers with approved warning labels Property Line Well is to meet all WDNR setbacks Scale = 1/4" = 10' Walnut Hill Way At-grade System Sloping Site Cross Section and Plan View i~------------------------------ E Dimension Feet •L•L...~L•L.L•L•L•L•L L•L•L•L L•L•L•L•L•L•L•L L L•L•L•L•L•L•L•L•L•L•L L L•L•L L L•L•L• ~ A ! 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J• - a E" Topsoil Cap LLL L•L L L•L•L• L•L•L•L L L•L•L L L•L J•r•r•. .'r•J.J•'r•r•: :•'r.J.r.':.l•J-r•J•t•J•r ~E' S LLL L•L L L :J !L•L•L•L L•L•L•L•L•L•L•L L ~ - r J r•r r r•J•l r l~r~J r•r; J; J•J~.•~J~?~J~l~ -stisl•L L L L•L L L F L•L•L LLL L ; Ft Contour L ti L•L•L L L•L• J J~r?r r J~r:r•J•r•J•r•J•r•J•J r r•J '4•L!L•L L•L•L•L L L•L•L•L•L• l -~.ti.!L L•L• T~ D Plowed Surface . C Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands.. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. r2 03/05 lgj Page of~ Pressure Lateral Layout - End Manifold One Lateral .4 Threaded Cleanout Plu g Lateral Turnj Force Main i X L Long Sweep 90 Bend Pressure System Construction Distribution N twork S ecifications Lateral Diameter -77 In. Laterals are constructed of Schedule 40 PVC Orifice Diameter s'j 3 Z- In. pipe. Orifices are drilled perpendicular to X (Orifice Spacing) In. the pipe with a sharp drill bit and face down. L Lateral Length) Ft. Lateral turn-ups terminate with a threaded Force Main Diameter In. cleanout plug and are enclosed in a 6-8 inch Force Main Len h ' Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade •••••••:;Q::;: • 6-8 Inch Lawn Sprinkler Valve Box Page _ of 03/05 lgj Septic-Dose Wank Cross Section And. Pump Performance Specifications Tank Manufacturer - Pump Manufacturer Tank Model N umber s-v Pump Model Number ' j►~-' _ Total Tank Capacity Alarm Manufacturer C " ~s Max. Bury Depth Alarm Model Number zo) t_ Switch Type Filter Manufacturer Total Dynamic Head (TDH) - Feet Filter Model Number ' Elevation Head J Distal Pressure 57- Network Loss Minimum Pump Performance Required Force Main Loss Q2 GPM Ft TDH Total Outlet Manhole Min, 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted r Weather-proof 1 Junction Box - - Finished Grade W - - - 7m Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter _ Inlet a~ inlet Baffle - - - - - - - --1-~ X ~5witch Settings and Reserve Capacity A %a" :Tank Volume = GPI Weep Dimension: Inches Volume Gal. B Hole (reserve) A 0 M6 i Off Elevation C (alarm) B 2 (dose) C i Ft (dead) D Bottom Elevation Total 7Y, 5 GENERAL INSTALLATION: The septicldose tank is bedded and back filled in accordance with the Manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without Prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and'outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical wrvic"omplies with NEC 300 and Comm 16.28. 02/05 Ll Page of I TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING MODEL 152/153 MoD EL i 152 153 or, ww ti j r cet Meters Gci. I Liters I Gal. Liters 50 V 5 1 5 j 69 261 77 291 153 10 1 3,1 1 61 231 70 265 12 40 152 15 4.6 ` 53 i 201 61 231 20 1 61 44 167 52 197 a 159 i 30 25 7.6 34 129 42 30 j 91 I 23 87 i 33 125 . 85 35 Q 20 40 12.2 ~tl, 11 ~t4 7 ock Voive 1330 6m)144A m) ssoa 4 ci I 10 ~ II 0 a0 60 80 100 2 6 1/4 GALLONS I LITERS 0 80 160 240 320 - 3 27/52-~---* 5/e -i j FLOW PER MINUTE i ; 27/32 I CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 • Timed dosing panels available. ed with 1 • Electrical alternators, for duplex systems, are available and supplit an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. II ( 1 • Sealed Qwik-Box available for outdoor installations. See FM 1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series 12 1/5 1521153 MODELS Control Selection 5 t/8 I Model Volts-Ph Made Am s Sim lex Du Iex 1 2or3 N152 115 1 Non B.5 f BN152 115 1 i sKZOSa Auro 8.5 Included 2 or 3 El5 E152 230 1 Non 4.3 1 2 or 3 Auto 4.3 Included 2 or 3 N153 230 1 1 2or3 SELECTIOf1GU1DE BN1 115 1 Non 10.5 5.3 .3 Included 2 2or or 3 3 1. Single piggyback variable level float switch or double piggyback variable level float E1553 115 1 t Non Auto 10.5 1 BE1 switch. Refer to FM0477. BEII 53 230 1 Auto 5.3 Included 2 or 3 2. See FM0712 for correct model of Electrical Alternator E-Pak. o cAUTlorr ol switch 10-0225 used as a control activator, specify duplex (3) Ali installation of controls, protection devices and wrong should be done by a qualified 3. Variable level control or (4) float system. licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16341 Manufactwersof.. Louisville, KY 40256.0347 SHIP T0: 3649 Cane Run Road ~ p r Q Y ~ Louisville, KY 40211.1961 QL(dUTY! LIMPS J/NCf 19,7 " Z (502) 778-2731.1(800) 928-PUMP FAX (502) 774.3624 frtipJ/www.zoel ler.com © Copyright 2000 Zoeller Co. AlllrigJits reserved. f ~ e, ~~?~1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner s 4 y ' t Septic Tank Capacity a S y al ❑ NA Permit # - Septic Tank Manufacturer _ El NA DESIGN PARAMETERS Effluent Filter Manufacturer ` O NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units 9_1NA Pump Tank Capacity al ❑ NA j Estimated flow (average) al/day Pump Tank Manufacturer ❑ NA tc Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer ❑ NA Soil Application Rate al/da /ftz Pump Model ❑ NA i Standard Influent/Effluent Quality Monthly average" Pretreatment Unit q Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 420 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other. !Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD5) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L / -Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other: Maximurn Effluent Particle Size in dia. ❑ NA Other. ❑ NA (Other: Nq Other: ❑ NA `Values typical for domestic wastewater and septic tank effluent. Other ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every' month(s) ears (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third ('fr) of tank volume ❑ NA ilnspect dispersal cell(s) At least once eve 13 month(s) ry' ;9 year(s) (Maximum 3 years) ❑ NA IClean effluent filter At least once every: month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) J :,year(s) ❑ NA i=lush laterals and pressure test At least once every: ❑ month(s) )4year(s) HNA ether. ❑ month(s) At least once every: ❑ year(s) ether: NA MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspect! ns must !include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of ic;ombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be. !visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local Iegulatory authority. INhen the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of j:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. n ~ Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals theyt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO. tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effiuenlt. cin remove pum of the the ation have To avoid is sit POWTS Ma ntainer~to ass stdin manualy operating the ppumpocontols o or store normal levels power effluent pummp orucontact a Plumber contorents within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POW 5: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins, tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propefly and safely abandoned in compliance with chapter Comm 83.33, 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 property 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 another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requhled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule;{ in effect at that time. ❑ 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. %A- Ida-site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation 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. 6Dnd 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. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name c' 41 Phone J - Phone SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY . n Name t '0 EN ame one This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. 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III la' .m,: L J b ~ ~ F-At ` !-Y r III g III d p III ~A L I I I I ~ III ti `mA v 8 ~ ~ I~ nl I ~ o rc 6 I b-.E b,C I ~ III n ~ ~ m III >1 n I ,~i ~o I ❑ I _ I III N LJ H9 9/Yx 2 dW31 HB 9/5x0/E !I~ M9 9/Yx92 OIxZ-L Olxx-Z tlX OIxZ-Z A-.E Z .C"Al .l l",l b-A b'.C .LL-.l ~ .ll~b .L'.il At-.Z .9-1 A".Z Al-.LL Q X.J.1 a a O ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owmer/Buyer 1-f r~ t` 4/) - i Mailing Address f (A1~ Q- 0 , Property Address t for w :on.) (Vesifiicationrequired from Planning &Zoning D ` < City/State Parcel Identification Ninnber LLGAL DESCRIPTION ~^4 r Property Location C.- 1A, , t V., Sec. T ~I-JN R_ZLW, TOwn of SubdividoII Lot M 1 Certified Survey Map # Volume , Page # Warranty Deed Volume , Page # Spec house yes ~no Lot line% identifiable yes SYSTEM MAINTENANCE AND OWNER CERTRICATION hVropa use and maimtenance of your septic system could result m its premature failure to handle wastes. Proper urlintenance consists of pumpumg out &e septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the fimetion 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 submit to St Croix County Planning & Zoning Department a certification faun, 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 foil of sludge. Vwe, the unda=gaed have read the above requirements and agree to maintain the private sewage disposal system with the standards set fortb, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating did 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 expiration date. Uwe certify that all statements on * form are true to the best of my/our kmwledge_ 1/we am/am the owner(s) of the property described above, by virtue of a deed recorded in Register of Deeds Office. C Number of bedroom, , SIGNATURE 0 PLICANT(S) DATE ***Any information that is saisrepresented may result in the sanitary permit being revoked by the Plannin g & Zoning Departracnt Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if referame is ma& in the Warmly deed (REV. 08" M Ln O LL ` / \ 80 a 1 1 C1j \ LO i n~11 - 11 ^ I h 111 M N ~b "~~o ti ' o 7 (V , * 1.00 N IF W _ ^ ^v ~Cl / 16 ev co `s U Eel N 1 Lh a 'O ! n 3 1 y to LLJ LQ ' h / I /i f to F' u w = 90 CV ,n {r z o l ,o N 40 cvr '6~Sp8 " v1r , 1 "~~R1tS 1 W E-4 w+~n 9£.Zt.ZO N L: a vi < L: ` M O ' N r 1 +r'1 Q v 1 "P off. / f V1 1~ f N V r ~ N ~ ` ms`s ps f 1 `'j vi Q 3l f tier < gag, reg, M r vi H S 00'42.59.0" E V)I V)I F cr) 220.19 p tY C\2 'n 4 4? a. f ` v \ U LL. U 1I to Ar CST S N 2g 201 i QJTB2WXV92MTC Wisconsin De _ ~ ~~r V K f Page of Division ~~p6 MV in accordance with Comm 85, Wis. Adm. Code County St C f Att'a complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ♦ i 1, include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. r a~ Please print all information. Revi by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z V , Property Owner Property Location l' c1 ✓ Govt. Lot K 1 /4 J l1 / T L N R E (opU Al Property Owners Mailing Address / Lot # Block # S(ubd. Na CSM# / City State Zip Code Phone Number ❑ City ❑ Village P~Iown Nearest Road 7 /D 41 New Construction Use$-Residential / Number of bedrooms Code derived design flow rate A 11/1 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable N ft. General comments and recommendations: System Type TI "e '!-9 r System Elevation Boring # 0 Boring F-1 I LA Pit Ground surface elev. ~ ft. Depth to limiting factor in. Soil Applicati on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 - #1 04 07 Z /G - U Boring # Boring ® Pit Ground surface elev. / 7 • ft. Depth to limiting factor k~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 •Eff#2 v -11 _ G Z. 4 3 L - 4 a Zer s Effluent #1 = BOD. > 30 < 220 nxyL and TSS >30 < 150 ` Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si ture CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 f.- 715-246-4516 Property Owner _ Parcel ID # Page of Boring # Boring F-1 ❑ Pit Ground surface elevi ft. Depth to limiting factor ~ in. Soil Application Rate 3 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#/1 'Eff#2 0_,q ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring El Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil lication Rate Horizon Iepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F__ I Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/_ and TSS < 30 nVL 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 608-264-8777. SBD-8330 (8.6/00) 'Property Owner _ Parcel ID # _ Page of a Boring # ❑ Boring Zc7, Pit Ground surface elevgl ' ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-1 ~3 114, /77Z/ S Y;-70 7~) 14 /1" 77 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring F-I Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon -)epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BODS > 30 < 220 nVL and TSS >30 < 150 mg/L ` Effluent #2 = BOD, < 30 nx3/L and TSS < 30 nVL 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 608-264-8777. SOD-8330 (RAM) I Soil Test Plot PI n Project Name Nick Canaday aun 'rd Address 1712 Windflower St. L River Falls Wi 54022 CSTM #226900 Lot 73 Subdivision Walnut Hill Farm D e SE 1 /4 SE 1/4S 22 T 28 N/R19 W Township Troy ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of steel fence post System Elevation 93.8' *HRPSame as Benchmark B M Property Line 95' p B-2 r 94' B-1 93' B-3 6% Slope 1 Acre Lot Property Line I Property Line Scale = 1/4" = 10' Walnut Hill Way isconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 W Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Goole county 5-r. CA PI x-- Attach complete C include, but not EROSION CONTROL PLAN must be Parcel I.O. L v7- percent slope, s completed before sanitary permit issuance d Date Reviewed by Personal information you provide may be used for secondary purposes (Privacy Low. S. 15.04 (1) (m)). Property Owner app j> Property Location 0r' o p'Pi Z3 ERS T'Csfl T` % 41b~ #M. Govt. Lot lot 1 *9 5' G 1/4 S ~Z' T 2-6 •r N R/? / # (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or 11 Z!-- S CA }~i LL Ave. 73 WAL Wvr tI f:,+ ❑ City ❑ Village R Town Nearest Road City State Zip Code Phone Number (rPDvE- _ H T3: MN 5so74- &51) Z~fB .lay -rRoy 50. GI00ER GPD . Y9- New Construction Use: (A Residential / Number of bedrooms 3 Code derived design flow rate ❑ Replacement ❑ Public or mercial -Describe: Parent material /d S L)V A1f10Aj 7~ Flood Plain elevation if applicable fl- General comments and recommendation: _d.0~ ~~-5 ~ ~(f~• ~ J~- /70~~V~ la- Stiff 7~i c~ N o Boring r a Boring # ® Pit Ground surface elev. ft. Depth to limiting factor in. Sort Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 S w • -S 0•i0 16 yR 31SiL zfs h K -5 00 Z a •Zg b S/ L iw, s W/ . S tA /o RS e zA lfofs 5, .3 /GL / 11117"-ir c ~ • 5 /D nM3 P M o fs G(- lm z-fi 0 o Boring# 0 Boring 1 I ® Pit Ground surface elev. b ft. Depth to limiting farms in. Soil Applicatim Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP' in. Munsell Qu. Sz Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 o• t2- /o ye 313 571 5 s6,t s 2, 0- z /10 Y 314 sic /f cs ! . z N ~G f-(S cS - .5 • 5 D y '-%3P m o r3 ©•w. - o a • Effluent #1 = BOD > 30:< 220 rrg& and TSS >30 < 150 mg& • Effluent #2 = BOD < 30 mg/L and TSS < 30 mgrL CST Name (Please Print) Signature CST Number "R•"uL-aRickT- x&3-15 Address Ulbrieht & Assgeiates Date Evaluation Conducted Telephone Number Private Sewage S - - ~ 715• 77A 3,Yq 2- 2812 10th Ave. Spring Valley, WI 54767 $ ' • rya • /o8s • • t~ . /d oao O yd . /(9 r yv • /~~'l~ - r~ oar o yo • /o~'l~ ~o ' 70 • 100 0 iY - /Onp ~o rr - a 7-ODl~ T.31 ~ ~ S T~D?- PropertyChNner Z 7 l'arcet l€3 3 Z 3 Page of, 7~d .::2j '?~d Ground surface elev. Depth to fimft factor in licatiora Rate SCA Eloriztn~ Depth €3ominant Color Redox Description Texture Structure Consistence Boundary Roots G€~I?t'~ in. fitunsell Ou. 5z. Cont. Color Gr. Sz. Sh. .E l T 'E #2 O • /k /o yn 3 s.L Z~~sh,~ s . s Z • L O J ~sh d L, G S L. 0 /D O •7 Boring L_.t Sorino i t El pit Ground surface elev. Depth to limiting factor in. Soil icaion €2ata i i torizon Depth f3ominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff 4iunsefl Qu. Sz. Coat. Color Gr. Sz. ita. `Ef## t f 'EfW - - f lfortng # ie Boring E] Fit Ground surface elev, ft. Ele/to miting factor in, Soil 'cation Pate t HCnzon t p9tt Dorratnant Color Redox Description- Texture Structure !Consistence t3mmdary Roots GF'CJM t in. Munsell Qu, Sz. Coral Color Gr. SZ Sh. "l_ff#4 'Eff##2 t Boring So-ring # Pi f pit Ground surface elev. ft. Dept to i"urnltirag factor in. ` Sr,~ Rate Horizon Depth Dominant Oo4orf Redox 'ption- TeXtvre SfrtChlre GonSistenCP Boarndary Roots GpO f , in. Munsell flu. Sz. Color fir. S z. Sh. 'Eff#l 'Eff#2 s e ~ ~ 9 a Effluent #1 = BOO', > 303 7<220 r and TSS >30 < 150 Crag! ° Effluent #2 = BOD, < 30 mgll_ and TSS < 30 mgfL. i i ~ co2rt€ncn* of cemrrmeree is an ct '.rat opportunity service provider and employer. Ifyou need assistance to access services or need material in an alternae format, please contact the department at 608-266-3151 or 609-264-87,77. 50D 83"to-41DO! r f PLOT PLAN WALNUT HILLS FARM. LOT # -7-3 Pg. 3 of 3 Contour elevation lines. • = Backhoe Soil pits. vtvoQ = Benchmarks set, maRKED WITH FLAGGED \ lathes. 1/2" steel conduit pipes. ua SCALE: 1" 3 1 P _ . N~ t C~aU 74 t ► ,~o -73 ox~ (LO 7- o qD s 0 13M b S S y 7.