Loading...
HomeMy WebLinkAbout040-1303-00-037 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 597446 GENERAL INFORMATION State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2951 1 04 Permit Holder's Name: City Village Township Parcel Tax No: PATRICK & KRISTIN MALLEY TOWN OF TROY 040-1303-00-037 CST BM Elev: FInsp. M Elev: BM Description: Section/Town/Range/Map No: 22.28.19.1772 TANK INFORMATION ELEVATION DATA P_ 4A4+- TYPE TYPE MANUFACTURER CAPACITY STATION HI S ELEV. 2 Septic t7 Benchmark Z~ Alt. BM Aeration v f Bldg. Sewer qa.4~ I I Holding"- St/Ht Inlet 367 TANK SETBACK INFORMATION SUHt Outlet- TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inle TANK GJ ~ Septic b U~ Dt Bottom IZ ey" Dosing Header. / Aeration Dist. Pipe i~ 9au y lot J tZ> Holding Bot. System j o Final Grade PUMP/SIPHON INFORMATION Manufacturer G ~ /J GPMand St Cover y~ Model Number ' J ' TDH Li Friction Loss System eacL TDH r~ Ft Forcemain Lengtt1 t Dia. It Dist. to Well SOIL ABSORPTION SYSTEM ~ •Q lU;L,lYj /Do a~ BED/TRENCH Widtp 1 LengJ~,~~ I lNe.,-If~;F@- PIT DIIM NSIONS No. Of Pits Inside Did/ quiept DIMENSIONN/ ~ / I'll a V/~/ W~ / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING Manufacture i°o % INFORMATION CHAMBER OR Tye f Sys;terr~ , (l) UNIT Model14.ri b r 3 DIN ''`YI JV~) i R v U z! ION SYSTEM DVS 10 Ifack- Head ~B ifold Distribution ix Hole Size ix Hole Spacing Vent to Air Intake Pipe(s) Lengthol'1~ Dia 21 Length-,-tip Dia Spacing . It,J r SOIL COVER t x Pressure Systems Only xx Mound Or At-Grade Systems Only T8A l ver 11 a Depth Over jxx Depth of ` xx Seeded/Sodded Mulched °-a~ O r Bedrfrench Edges t ( Topsoil I L C No es 7-N. I X71 C MENTS: (Include code discrepencies, persons present, etc.) Inspection #1: - rlspection #2: I01 11I1,?O/7 _ Location: 232 WALNUT HILL WAY 1.) Alt BM Description = V ~~~~J 2.) Bldg sewer length - amount of cover =Z Y 2 ti Lo Plan revision Required? Yes No ' p Use other side for additional information. 7 Date Insepctor's Signat ` e Cert. No. SBD-6710 (R.3/97) r- County Safety and Buildings Division ton 4i 201 W. WasbiN Aye., R.. 0 . Sox 7162 Sanitary Permit Number (to be filled in by Co.) ,0 Q Madiprt, 370-7162 ' Sanitary Permit Application State Transaction Number 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 Proje/t Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary U es in accordance with the Privacy Law, s. 15.04 1 m Stats. ~/T'jl" - z lj~^ ~h4 1. Application Information - Please Print All Information Prop Owner's Name Parcel # t ' n ' f ,7 Property Owner's Mailing Address Property Location "1G Govt. Lot City, State Zip Code Phone Number Section x r~ ,~/J (cir Z W U T, _N; cle Otte W, ,7 II. Type of Building (check all that apply) Lot# 1 Subdivision Name 9 1 or 2 Family Dwelling - Number of Bedrooms - , 1 ok Block Gf r ❑ City of ❑ Public/Commercial - Describe Use tnl~ - C ber ❑ Village of ❑ State Owned - Describe Use %75 X 40 O Town of ` III. Type of Permit: (Check only one box on line A. Complete fine B i applicable) b New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) A. List Previous Permit Number and Date Issued B. El Permit Renewal ❑ Permit Revision C3 Change of Plumber ❑ Permit Transfer to New / Before Expiration Owner IV. Type of POWTS S stem/Corn onent/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in- of suitable soil Mound < 24 in. of suitable so' V JCc' b /fix ❑ Holding Tank ❑ Other Dispersal Component (explain)_C-t' ❑ Pretreatment Device (explain) V. Dispersal/Treat t Area Informations Design Flow (gpd) Design Soil AppI' ation Rate(g DisFGallons equi (sf) Dispersal Area Proposed ( System Elevation / 1 s~ nt o VI. Tank Info Capacity in # of Manufacturer c Gallons Units U New Tanks Existing Tanks ' V y S or Holding Tank ! tx_" Dosing Chamber VII. Res onsibili Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P s Signature f MP/MPRS Number lusiness Phone Number ' 1 , Plumber's Address (StIvet, City, St4eZipCodeA kAppro 'euntv/Devartment Use Only / d Issuing tSignature Permit FFee Deane sue ved $ l f~ • a l 7 Given lesson for nial IX. Condi ajt/ftn Disapproval t r LG i1YY(3iiRtS~i pFN'(T►nSt all be,,., pi , ~ 1 t)y to mu "t y t'ialrtt7ff+M J 2#l itllt aRt'"'" aper rtxi: t :rrfi ;a,~oet. Attach to complete plans for the system and submit to the County only on paper not less than 8 In x 11 inches in size SBD-6398 (R. 11/11) PkW Plan Page Oaf /0 Property Ownez!57 _ ]"=4Dft Legal Descrption ld- 4~1, TR15urE ~ 5E!Yg of Tw. (c wAtere Ito SCA4 SQe. 2Z, T2_`d. Qqj, , 'T~bW k) DF 1-RtlY-,S11,_ BacM0@pft _)303-00 037 North Z3Z W R LxIuT 4++" kmy w ,J t'~Kol~osED 3 ~ BEDRUPAA (;TAKEU) ~y v e ~ t zoo goo G~ atar~ 1~,Izopos;Ep "d 3 t ki e Kl - atPr Ft~rEK *WELL- 70 Br-- - b? s 0. ~ 6'CM f~nur} A_ ~Dsr _ a S4 n u~R ~~'yjz' yfl P~ 4 lc> /G. i 4• Re A i tau 1 pZ~ tC Seurn Pit_ 3Z4 ' ~//FZ 5our,t ~(L ~Fccr uric Flo-A L` Site IA)cQon: CHI L A DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 a Contact Through Relay PS ~N`i http://dsps.wi.gov/programs/industry-services www.wisconsin.gov PoF~ssio N Scott Walker, Governor Laura Guti6rrez, Secretary June 01, 2017 CUST ID No. 224832 ATTN: POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHLJRS 1101 CARMICHAEL RD DANBURY WI 54830 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/01/2019 Identification Numbers Transaction ID No. 2951104 SITE: Site ID No. 838762 Patrick T. & Kristin K. O'Malley Please refer to both identification numbers, 232 Walnut Hill Way above, in all correspondence with the agency. 'Town of Troy St Croix County SEIA, SEI/4, S22, T28N, R19W FOR: Description: GeoMat Mound (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1709765 Maintenance required; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): Pressure Distribution Component Manual - Ver. 2.0, SBD-1070(')-P (N.01/01, R. 10/12), Synergy Systems LLC, GeoMat Mound Component Manual - Edition 1, 2017; 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 6/1/2017 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(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 serviciniz 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 resizing 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/instal lation/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 S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services Wyment S code: 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov MARY JO HUPPERT Page 2 6/1/2017 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(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. Anv chances may result in pump resizinc 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 GOOMat MOUND AND PRESSURE TRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Owner Info Project Name: PATRICK.T. $ KRISTIN K. O'MALLEY Owner's Name: (SAME) Owner's Address: N8460 805TH STREET RIVER FALLS, Wi 54022 Property Info Property Address: 232 WALNUT HILL WAY HUDSON, WI 54016 Legal Description: SE SE S 22 T 28 N R 19 W Township Troy County: St. Croix Subdivision Name: TRIBUTE Lot Number: 37 Block Number: NA CSM#: NA Parcel I.D. Number: 040 - 1303 - 00 - 037 Plan Transaction No.: Index Pages Page 1 Index and title Page 9 Tank cross sections Page 2 Data entry Page 10 Plot plan Page 3 GeoMat mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications MARY JO HUPPERT License Number: 1859-007 Date: 05/16/17 Phone Number: 715-426-1775 t tf4 err np, re: si Stamp: State of Wisconsin Approval Stamp: ge,r r: aw 3 -N Designed Pursuant to the •ygy Systems L.L.C., GeoMat Mound Component Manual (Edition 1, 2017), (N. 4/17), a WMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and f " = Ads` Pressure Distribution Component Manual Ver. 2.0 Sl3R-10706-P (N. 01/01, R. 10/12) GeoMat Mound Edition 1, 2017 Page 1 of 10 R t' RV i MomW and Pre"ure Distributoon Cm"nent Site In rmation R Residential or Commercial Design l N ISD_ Required? 400.00 Estimated Wastewater Flow (gpd) Component manual not yet approved. See 1.50; Peaking Factor (e.g. 1.5 = 150%) ISD page for explanation. 60100 Design Flow (gpd) 4.00= Site Slope 100.00 Installation Contour Line Elevation (ft) i00 00 Depth to Limiting Factor (in) Reason For ISD 40 In-situ Soil Application Rate (gpd/ft2) Contour Length Available (ft) Distribution Cell Information 9 S~ Cell Width (ft) 9_75 Only 60.00 Designer Input Cell Length (ft) 200Dispersal Cell Design Loading Rate (gpd/ft2) 60.00 Dispersal Cell Length Required (ft) 2, Influent Wastewater Quality (1 or 2) Pressure Distribution Information E Center or End Manifold Are the laterals the highest point 3 Number of Laterals in the distribution r Y ~ 3.25 Lateral Spacing (ft) network? 12.23 Forcemain Drainback (gal) If N above, enter the elevation (ft) i• 4 x k 0.00 Forcemain Filter Loss (ft) of the highest point. _75 2.00 Forcemain Diameter (in) Forcemain Length (ft) Does the forcemain drain back?[- Y 90.00 Inside Pump Tank Elevation (ft) 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimt.ed Orifice Spacing (ft) = 9.75 ft2/orifice 4.55 System Head (ft) x 1.3 10.08 Vertical Lift (ft) 1.67 Friction Loss (ft) 16.30 Total Dynamic Head (ft) 81.06 5x Void Volume (gal) 93.30 Minimum Dose Volume (gal) 32.31 System Demand (gpm) Diameter Selection Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Manufacturer Information Treatment Tank Information Effluent Filter Information 1 1200.001 Septic Tank Capacity (gal) Polylok Inc./Zabel Filter Manufacturer Wieser Concrete Products, Inc. Manufacturer 122 Fitter Model Number Dose Tank Information Gallons/Inch Calculator ioptional) 800.00 Dose Tank Capacity (gal) Total Tank Capacity (gal) 22.24 Dose Tank Volume al/in) Total Working Liquid Depth (in) Wieser Concrete Products, Inc. Manufacturer gal/in (enter result in cell DoseTankVolume) Project: PATRICK.T. & KRISTIN K. O'MALLEY Page 2 of 10 Mound Plan View T 1/106 :...3 J Observation Pipe ❑ - - pp~ s A B pp " ::{,=J Mound Component Dimensions Dova ion: e,Iei isio i ;aiav. ft ft E 68 in H 1.00 ft K Eaft B ft F 14. i 1 15.25 ft L ft A AO 4 gi D in G F -UM. ft J 4.58 ft W LL o rQ; . 585.00 (ft2) Dispersal Cell Area 7a' 1500.00 (ft 2) Bashi Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View GeoMat Dispersal Area Observation Pipe 12" ASTM C 33 sand as GeoMat required for Geo Mat Distribution Cell component - GeoMat + 12" ASTM C-33 sand H. ,G 102.21 Finish Grade Cover Material O 101.08 lateral Invert Elevation f 100.00 Dispersal C Slope 4.0 Elevation I Contour Elevation 100.00 Tilled Area Forcemain In situ soil In situ soil Shading Key 1 © Topsoil Cap 2 Q Subsoil Cap z ~ ASTM C 33 sand (F) 4 Q ASTM C 33 sand (D) 5 Q Tilled Layer 6 Q Geo Mat See details on page 4 for number, size, and spacing of laterals. Project: PATRICK.T. & KRISTIN K. OWALLEY Page 3 of 10 End Con+ne~ Laftma Loymd L 1st orifice located at Z Turn-up w/ball valve or clean plug /-Laterals 8, force main of PVC Sch per SPS Table 384.30-51 All orifices point down P Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 110 It Lateral Length (P) 59.45 ft Orifices per Lateral 20 Lateral End (Z) 0.55 ft Orifice Density 9.75 W/orifice Lateral Spacing (S) 3.25 ft Manifold Length 6.50 ft Lateral Flow Rate 10.77 gpm Manifold Diameter 1.50 in System Flow Rate 32.31 gpm Forcemain Velocity 3.30 ft/sec Dose Tank Information I.c6m r„~rw11h„arnin:-Iuh~I- 1,.',':c. Jr, c cold ,,,dc] 1"ehl x';11 I Iraricul M~ ,1•• Vented Cu,u _ ,I "Pti 16 'R N.1( t Yru, out I',pc t lptional tall , nl, r irc, I rant 1 Ic.h is suUfCC ' I Lcontrol'1"ed Ml-w h6ne d.11111 (11'1'1"'al "°tt`I Forcemain diameter r td~1 rat 1 d1c1 2 in. 1st,,,„,p NO. I r ,,I~1a~,ir~,: nlih( ta,6r1 Polylok Inc./label i 3014-PF 1/16 111 h „a;cr:darm~• I'11tnp un 1 L,m Pump ( )11 I laat• f-•--- Pump off elevation (ft) Punq, 90.83 Dose tank elevation (ft) - s} s § lx' - ;rI" Re(ktint, under lailh 90.00 Dimension Inches Gallons Wieser Concrete Products, Inc. A 19.78 439.82 Capacity 800.00 B 2.00 44.48 Volume 22.24 gal/inch C 4.20 93.30 D 10.00 222.40 Total 35.97 800.00 Filter Manufacturer Polylok InDZabel Filter Model Number 3014-PF 1/16 Alarm Manufacturer SJE RHOMBUS Alarm Model Number TANK ALERT Pump Manufacturer GOULD Pump Model Number PE 41 Pump Must Deliver 32.31 gpm at 16.46 ft TDH -401c Ssltcl~t . c(~,ts+, s IFS, 1 :~t t~,; d ir, Project: PATRICK.T. & KRISTIN K. O'MALLEY Page 4 of 10 . GeoMa Distribution Coil Media Layout 9.75 Cell Width (ft) 1.63 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements ornpanent Legend 0 Distribution Pipe With Pressure Lateral L-6-11 Orifice Shield • Tumup Enclosure - - - - - Pressure Lateral GeoMat is covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 9.75 Cell Width - A (ft) 60.00 Cell Length - B (ft) .ni+. w,~.1 +4~+~'T.'r' ~ .wf!'}r! 1LI~F) ~!7~'~ .w/!~'`}~rrk~ 4~P ~1~+!n ..4~hv ':n'w'r PP'rlr Typical Mpersal Cell Sand Cover recommended Distribution Lateral A _ Orifice Shield Pipe Dia. Approved infiltrative fabric L-~Z ~w GeoMat Component "'A. N33W A t i6,T ' AMA ! •3 weal . . . ° - - infiltr2ow Surta /plow laver atinF =znor Observation Pipes Shading Key 1 6 ° 1 0 Topsoil Cap Toilet Flange i , © Subsoil Cap Reber Z ASTM C 33 sand (F) 4 Q ASTM C 33 sand (D) 1 Id 3-""'" , u I Min 5 Q Tilled Layer 1 6 Q Geo Mat See details on page 4 for number, size, and spacing of laterals. Project: PATRICK-T. & KRISTIN K. OWALLEY Page 5 of 10 Mound System Maintenance and Opwation fixations Service Provider's Name' DARRELL'S SEPTIC SERVICE Phone' 715-425-1025 POWTS Regulator's Name St Croix County SPIA - Zoning Office Phone 715 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 30 mg/L Septic Tank Capacity 1200 gal Maximum TSS 30 mg/L Soil Absorption Component Size 585 ftz Maximum FOG 10 mg/L Type of Wastewater Domestic Maximum Fecal Coliform 10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 years Effluent Filter Inspect and clean as necessary at least once eve 3 ears Pump and Controls Test once every 3 ears Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound Ins ct for ndin and seepa once every 3 ears Other 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 Synergy Systems GeoMat Mound Component Manual Version 1, 2017. 2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component Manual Version 1, 2017. Media is covered With an approved geotextile fabric. 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 6-8" Diameter Threaded Cleanout Finished Lawn Sprinkler Grade Plug or Ball Valve Box Lateral Ends at Last Orifice Where Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral + s r t , PRO Distribution Lateral Lateral Cleanout 1.6 Feet Project: PATRICK.T. & KRISTIN K. O'MALLEY Page 6 of 10 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 [Synergy Systems L.L.C., Geomat Mound Component Manual version 1, 2017, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. 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 fkwvs 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 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 as to 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 Wisconsin Department of Commerce. Pumo Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verity proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. *****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.'" 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 3 years. 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, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contincfency 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 ifs` 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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: PATRICK.T. & KRISTIN K. O`MALLEY Page 7 of 10 r Wastewater - " METERS FEET 40 PE51 MODELS: PE31, PE41, PE51 a . HP:.33,.40, _50 35 10 2 GPM 30 PE41 1 FT PE31 = 25 - u z 20 a N roN Q 15 10 5 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 GPM Total Head (feet of water) (feet 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 8 ~ 7 lCK- 1577AI Q /Ulf~ L&. y wmftwn -mu 99*9-5z2-008 OIOZ •NVr 33SIA38 0 09Lb9 tM I)MN w3arow of AMH Sn 9LL£M z =anod tso ova oloa xavnMm 3tva wnNVW OLLd3S i- L~ :sr «o-.L=,4 L -3wos 3FI.S 1k8 rwivva 3131a181 aw-oos/oozldlN► x Z VI o W Q O O k-' o oc U Q - IX W 0. U) 1.- O OTC Fa U W U W i- j W a' s z a MOP S. am D: ~ ° Z ui CK U) to $ LL Q O m $Q p-r J Q O ° ° Ckt °o Nn° mt~i W W 0 j a O< U O~ S Z o> O Q a O. c c ~ic~o a<Q°tn `gN o 0 Sai Z n t- a a 00 _ o o o.r M m<N~ m w N A, c~i W aria a g 1= <I 0 a R- 63 13 in M _ J N 1- ZZ \p. W Ul H N N V7. cc ..3°= OvW3UW a w J=~ MF:W x° W~ Y `rQOOa~aIZ°WQO QdU' Q~`Ov V O YJZ zblg ms N~ Z3m c~2 x~ ~m~3 ° Z zp iLL W W W Q 25 Ha x O Z U) U) i Q 1 in t~i! Q ° U Z D «6£ a t O d sr d 0 Z Plo, W Svo -t «e£ do I Cl I U p n~+ W J WW LL- LL- N F- m x Q ti F Q ` N Svo It U 1 x rob do o: U s Q M {L N ~ J (1038 w «96 Sv «£S N x .Q s Plot PIM page 1d4 of i( 9 Pr"pterly owners 4TV ICKT L KRi~-:n k, UA14uji Y I » = 40.t Legal Del on Ixf ter, TRt 61AT-6 I 5EZ9 VE Tkik- (C"Wt WIMM ""9 '%V- S'tV, zz, TzS_ ~ Rt9v~lr Tbw oft nY- ~r. _ ~'aC tOe jHt 51 j~. 610-1303-OD-037 Nord 030 W A«mus 41LJ- wmy i w 3 4 a G 8 AD p) :'r, L ~ RoP i3R.~• w~- ° ~~Ev~ W~~r` t P~ FSo ° o TAAK wf "~UN ri 2 `yZa` flMT~tN 'sp J JbOA ~ ` a FRonn nnou i v n T~srUR y9 t I Ml 43 ~eQ , > ` A R~ A j ow pi,tl' t a C- /o/ ao O 160M, E7 P Ssurti pit_ 3241. F post' TDfz -so am Ocn uRE F PWIT ,Site Location: TRH.=TE "4" , ►~Py 54TH - N Ira, ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 14, Owner/Buyer Mailing Address t>`1 Property Address (Veri&cation required from Planning & Zoning artment for nc Ltru,don,) City/State j 6 ~1/ i . t~ 7'arcel Identification Number -A'43 LEGAL DIESCIOPTION ti Property Location, '>q ,3f- ~i4 , Sec. , T -9(~N R,/L~Tovmof Subdivision CLot. 9. , Cerditied Survey Map # , Volume , Page # Warran Deed # Volume _ Page # _ Spec hotise yes no Lot lines identifiable yes no SYSTEM MAI NT)ENANCE Al 6VNER CER'lrMCATIM 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 §Comrn. $3.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Pluming & 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 113 full of sludge. I/we. the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards scf forth, herein, as set by the Deparhnent ofComimerce and the Department of Natural'Risources, 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. I/we certify that all statements on thi orm are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a ty deed recorded in Register of Deeds Office- Number of bedrooms IGNA APPLICANT(S) ppTE ***Any information that is miss' y i represented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. W05) 19 `og, 1 r- co N W45" E 237.2 co co C3 t - W CIO e # co - OD ILA to C.0 A 7n p Ul) o / L tott ~ I Sr POP Itt"Ar£ 3 .60,00 S ~ ~a...r .y .rte r +NOMMO. . W.-P" _ .r..___ _ . y AP dh.- 7 z I F F ~ 711 Ln G7I Cn } C3 I t~ nCA Co C IL4 o t c ,0919L I / t 3S 3HL .40 3Nn 15V3 ,Q8'Lt9 Cs'"=aO17_ 09 9 Wrsconsul Department of Safety and Professional Services Division of I~C;~ it ~M C SOIL EV TION REPORT Page 1 of 3 JUN 08 2017 in accordance with S ` Attach rrrr~~to site ~Mnoat less than 812 CO1~ ST. CROIX induce built ' onfal refers i~mee aon and Parcel IA_ 040 1303 arrow, and locate to nearest road. -00 - 037 Please print all info- Re ' by Date Q~ Personal information you provide may be used for secork oases (Privacy law. s_ 15.04 (1) (m)). Property Owner Property Location (J ANDREW C.&DANA M. SWANSON (Buyer: O'Malley,Patrick) Govt Lot SE 1/4 SE 114 S T 28 N R 19 Property Owner's Mailing Address Lot # Block # Subd_ Name Mi E E W 230 Walnut Hill Way 37 Tribute City state zip Code Phone Number River Falls, ®v`~~ °'"n Nearest Road WI 54022 715) 760 - 0677 Walnut HUI Way 11 New Construction Use[D Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ® Replacement Public or commercial - Describe: Parent material loess over till Flood Plan elevation if a General comments applicable and recommendations: Mound system - 0.50 ft, sand fill - 0.4 loading rate system contour 100.00 ft. Zee_ Boring # 0 Boring Pit Ground surface elev. 100.97 ft. Depth to limiting lade 36 in. Horace Sod Application Rate 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 10YR2/2 - sil 2fsbk mvfr cs 2vf-co 0.6 0.8 2 4-26 IOYR4/3 - sicl 2fsbk mfr cute 2vf-co 0.4 0.6 3 26-361 7.5YR4/3 - sl 2f-msbk mvfr `1 36-46 7.5;;4/3 t2f 7.51'84/4 ~ 1 v1=m 0.6 1.0 sl Om mfr - lvf-f 0.2 0.6 ❑ Boring # © Boring 99.87 38 Q Pit Ground surface elev. ft. Depth to limiting factor in. VGPD/fF ' Rate Description Texture Structure Consistence Boundary RooHorizon Depth Dominant Color Redox lo. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 'Eti#2 1 0-4 10;;2/2 - sil 2fsbk mvfr cs 2vf-co 0.6 0.8 2 4-16 10YR4/3 - sict 2fs&abk mfr cw 3`r('-cp 0.4 0.6 3 16-42 7.5YR4/3 - sl 2f-msbk mvfr cs lvf-m 0-6 1.0 4 4248 7.5YR4/3 flf 7.5;;4/6 scl Om mfi 0.0 0.0 Effluent #1 = BOD > 30 < 220 ng/L and TSS >30 < 150 mgjL ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L. CST Name (Please Print) S' CST Number MARY JO HUPPERT ollister's Soil Testis &Desi / 224832 Address Date E Conducted Telephone Number 28497 King Arthur's Court, Danbury, WI 54830 12 - 28 - 2016 715-821-1440 SBD-8330 (807/13) Property Owner SWANSON (Buyer.OUWley) Parcel ID # 040 - 1303 00 - 037 Page 2 of 3 Boring SO Boring F-31 El - Pit Ground surface elev. 99.52 ft Depth to limiting lector 38 in. Depth Dominant Color Redox Description Texhme Struclue Consistence Boundary Roofs PD/itr Horizon r*EEffff#l Application Rabe in. Munsell Qu. Sz. Cant Color Gr. Sz. Sh. •Efl#2 1 0-5 10YR2/2 sii 2fsbk mfr CS 3vf-co 0.6 0.8 2 5-20 10YR4/3 Sid 2fsbk mfr Cs 2vf-co 0.4 0.6 3 20-38 7.5YR4/3 - sl 2f-msbk mvfr Cs lvf-m 0.6 1.0 4 38-43 7.5YR4/3 SCI 0m mfi 0.0 0.0 -Ed= ❑ Boring # Boring Pit Ground surface elev_ fL Depth to fimiting factor in. Horizon Sal Application Rate Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Mansell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Ef1#2 Boring # Boring Pit Ground surface elev. ft Depth to limiting factor in. Horizon Depth Dominant Color Redox Soil Application Rate Desorption Texture Structure Consistence Boundary Roots GPDM in. Mursell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eft#1 '0102 ' Effluent #1 = SODS > 30:5 220 mg& and TSS >30 S 150 mg/L ' Effluent #2 = BODS < 30 mg/- and TSS < 30 mg/L SBD-8330 (1107;13) i V1 A t~ x4`~ ; , ha. ~ 3 ~ avg.. ? ~ '~~g~ f . ` i •k^,+ ~g en.~` - n P ~.r -:emu x It 4 e kC ; :Pr lk, 47- t x ~ y Sit wa e.-~~~ T N o Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County 5T GAL' Ol r Attach complete sit include, but not limi EROSION CONTROL PLAN must be Panel I.D. percent slope, scam completed before sanitary permit issuance R 'ewed by Date e Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). Z-t~~ I 0'2 (6 Properly Owner Property Location or p T'O OD ►J3 ffR T-~fl 1 /C~ AJ~G'" rlM. Govt Lot Al ) AM S ~ 114 S ~L T 2 N R /I it (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# l0 O t S CA ULL AU.R- • 37 IVAL"O r Kill City ~N( R State Zip Code Phone Number ❑ City ❑ Village (.0 Town Nearest Road 6-PPOE HT3; MnJ 5S07(P (C SI) zy8• 10f~ 7-ROy so. GfouER ` F 0 rte, New Construction Use: Residential ! Number of bedrooms 3 r Code derived design flow rate 0 r OZ~ GPD ❑ Replacement ❑ Public or commercial - Describe: _ tA Parent material , h ~ 55 e p't r _ q f~ 7~/•fl5 Flood Plain elevation if applicable ~tl ft. t General comments -Z' and recommendations: • ~j 'i¢ 5~~I~ cS01 ,t1d 1-,e- /VOVivP syS iC~ 16 -Fill NN a Boring# Bang 1019. gv ~z 5. S. ® Pit Ground surface elev. ft. Depth to limiting factor n. Sal ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff _ "10 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Etf#1 'Eff#2 4. 3 L ~f s6o~ c~u 3 fl- 9 - 1s /r yR IL shoe CS, / • 2- • 3 v57. zz jo Ye SQL 2A ,d,e .wf-f% ~S i~ • s v~ 3 • S ~•S cs~ OtS L0, 4n io y,2 S/ Boring It p Boring /0 0-92-- 21 s s s ! ® pit Ground surface elev. ft. Depth to limiting factor in. Soli Application Rate V ! C~- xS^.+~ 1G S;iJ 2,t?~S $~~:Y~i~ o~~ ~':3 tip}SZSS~' ~~13 i2.31s ' '.d2~13 i:~£A4:3 €t L' IJ SRt3,lti J~iJ53~5 1b..'tt#I"i U`a,:€ ! ; ~iLLja' ut. a.; -WAU F)£ > SSi Pue -Ow ()E 5:500B ~ a Wanlit3 „ ~ aq': p m< ss`r ou? Jt}it; 'Como s~-' Fps ) i - al* -Al h111 ~irA4-I TDDl7 ~ ~ S TED7~ / PrOp'O y Cm"er Parcel v 3 Z 3 Page of 8" a./~ I Ground surface elev. f!. Depth to limiting factor Soil Application Rate f la?izon Depth Dominant Color Redox i3escxifation Texture StrUCAM Consistence Boundary Roots GPDff in. Munsetl tau. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 Z S /d 1 s iL / ~S r2 CS / . z . 3 ao /p i z~ I,,, Cs 1111e, YV /_0 vie 61 C die Baring ~ Salina Q pit Ground surface elev. Depthtc,limiting factor i,,. _ Soil application late j t 3orizon Depth f3ominatat Color Rix Flescxiptiora Texture Structure Consistence Buuradary Roots GPL munsett Qu. Sz. Gant. Color Gr. Sz. Sta. `Eti# t °C~ ft 2 t q e F Smug # Boring E _ Pit Ground surface elev, ft. Depth to lim ` . actor in. S~ ication Rate Horizon Depth Dominant Color fRedox Description- Texture Structur Consistence Eatirradary moots GPt31ff x in, munseli Qu. Sz. Carat Color Gs: Sz h. 'Etf#3 `Eff#2 Baring Baring # pit Ground surface elev. ft. Depth to lirrtiting favor in. S~Gg acatiora Rain. p extasr> GF x Mn DepoD m3nant t A Redox Description- Sbvck re ConsistenceBoundery Roos pDfrf a tra. Munseft Qu. Sz. Cunt. War Gr. Sz. Sh. `Eff#l ' 'Eff#2 r