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HomeMy WebLinkAbout030-2126-90-000 - . Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County- St Safety and Building Division Sanitary Permit No: INSPECTION REPORT 597461 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)]. -7 Permit Holder's Name: City Village Township Parcel Tax No: CHRIS AND DAWN SODERHOLM TOWN OF SAINT JOSEPH 030-2126-90-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: • a7 25.30.20.1033 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER t CAPACITY STATION BS HI FS ELEV. • .7 Septic t SN Benchmark 05 /,'J• 17, Alt. BM /07-0 LAJ T-1 15 Ll a k. Z S J Aeration Bldg. Sewer a- 7•L /03. 9 7 Holding St/Ht Inlet 01. Z'Z /0Z . 72 St/Ht Outlet c TANK SETBACK INFORMATION 1•6 7 TANK TO PfL+ r WELL BLDG. ent Air take ROAD Dt Inlet Septic Dt Bottom ~ Dosing Header/Man. ¢-7 Aeration Dist. Pipe / (p • %7.44 Holding - Bot. System 7 V • y .H L PUMP/SIPHON INFORMATION Final Grade 5. gap, Al 9'3'q Manufacturer Demand St Cover /O*i. o~ P, GPM Tyr 4:~ Jw • -s I rr Model Number E ~~~a®e~.. T ~Z. YZ ~c•L.7. ~p TDH Lift Friction Loss System Hea T D H Ft Forcemain th Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Leng No. Of Trenches PIT DIMENSIONS No. Of Q4t• _ Inside Di=m Liquid Depth DIMENSIONS 3 fe SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuf ct~renr` INFORMATION CHAMBER OR 11'11 ~ UNIT Model tuber: ~K Type Of System: 166 Ga DISTRIBUTION SYSTEM dJ ZZ 16 Z i L "JS Header/ManifollI Distribution x Hole Size Ix Hole Spacing Vent to Air ntak ]Pipe(s) J A Length Dia Length Dia-"---,!,,_ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over 1xx Depth of xx seeded/Sodded xx Mulched Bed Trench Center 7 A/ S Bed/Trench Edges ` Topsoil Yes, No Yes No i COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1337 BIRCH PARK RDG 3 Pd. C ~ 1.) Alt BM Description = 64S 04.0,- 2.) Bldg sewer length - amount of cover = d e.LQ Otto`' , 1111-7 Plan revision Required? Yes No 24, y Use other side for additional information. Date Inse or's Sig ure Cert. No. SBD-6710 (R.3197) courtly Safety and Buildings Division R:R EIVED 201 W. Washington Ave_, P.O. Box 7~ v Pe I mber (to be filled in by Co,) 1 7 2n 17 Madison, WI 53707-7962 Saner' Permit Number (to be lied in by Co.) 7A `~v OjNST. X COUNTY A ~9 Lit[ -OMMU • _ , State Transaction Num ems- M M L~nda rnce whit SPS 3832I(2 Wis_ Adm. Code, snbr 3VN9P red priorit ob S 38 a can' r 6DSJ4SK6 'mental tacit artment of Safety and Profess orpial Servie~ persnnoon you provide may be used for s/condary ~o~ Addrrss (if di#ferent than mailing addre-7 s in accordance with the Privacy Law, s. 15.04(1 (m), Stats. 33 L Application Information - P e Print All Information / V i r~~ fit f Property Owner's Name Q Parcel Property Owner's Mailing Address 3 l G; Property Location o? a. ao . 1033 Lily, State tM o Lot Zip Code 1 Phone Number F'I 4 it A) Section (circle one) YL Type of ilding (check all that apply) Lot Y F_ or W ❑ I or 2 Family Dwelling- Number of Bedrooms Subdivision Name Block # ❑ Public/Commercial -Describe Use N ❑ City of ❑ State Owned -Describe Use CSM Number ❑ Villa_ge of k~ ZZ~-Z~ C Town of__ d1e TII. Type of Permit. (Check o one boa on line A. Complete line B if applicable) New System Replacement System Q Treatment/lioldine Tank Replacement Only ❑ Other Modification to Existing System (explain) B ❑ Permit Renewal ❑ Permit Revision D Chaoge of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner t I'V. of POWTB S stem/Com onent/Device Check all that apply) Nron-Pressurized In-Ground ❑ Pressurized In-Ground ❑ AL-Grade ❑ Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other ispersal Component (explain} ❑ Pretreatment Device (explain) V- Dis rsalTrea ent Area Information: Dest~rt ;1„v (gpd) Design S I plieation Rat lf[. 0() 01 ~ DispersalLAma Required (sfl Dispersal Area Pro posed ( S _Elevation j VL Taak Info Capacity in ~QQ fa urer / j TOW ~ of Maaufacntrer Gallons Gallons Units S r; Nmy Tanks Existing Tacks U Y ° a al~, ~ZS L ° y ~ Septic or Holding Taut; yy cr.. U ~ ~ w C7 0., Dosing Chamber V IL Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) y 1 is Sign e / I2S Number B mess Phone Number Plum is Address ( t , City. State, Zip Codc d 9 Gl P~) L. I \j VLYI. Coun !De artmen se Only r } Approved Permit Fee Da Issued Issuing A Signature Reason for Denial 8 ! 1; 30 1-7 M Condit 6lfr easons for Disapproval j ,epttr tank: : tiller ehd / ~ GZ~ /a~ t3lsperaierH nrnust hurt en b soi tct s ! r.+~ i >20 A0 V1 n a,, Z~ 1 f" 'per glair . pment plan proviaed UY plumber. 2. i~'1t~ 5~~lkis k:tantt.ir^,cti I as Per WkwAils ca;tdw, / -rtfilla►nra>R. Attach m complete plans for the SySTC1n and svhrnit t0 the Conn no! on 4' Y r~Per not i~ than 8 r2 z l I IneLeS is size SBD-6393 (R_ 11/11) I L CONVENTIONAL CO,M ` i~ONdENT ©ES(GN Re yidential Applic8fk)n j INDEX AND TITLE PACE Proje~ct Name.- K1 f AA~C G) ~Y~ Owner's Name: Owner's Addess: Legal Description: S ~ 1 S Township i County: Subdivision Na r,e 1, ] K..Z.I.~ pk Lot Number: CA) / Parctal 1'n Number ~wQ~ V - ~ ).1 ~ r V Pns Z plmt Phan Page 3 a~ ~3n7 Slz. n & Cross-,SeFc*agn j Par ? Fltar Spacs page 5 Mirrtenan'cP ln.;rarrr~ai >i~ Pane C) Manage Pacle r St- Crtsix Gie Tank IVixi 4tartcQ For> Page 8 Warranty Dead P e 9 _ Csivs or Plat N chmems: Sail Tast & House l~T a;s Dci'iE 4c)ci Liense Number.F"hano Number t~esigned PursusnF ion Component ~ianua! 4nr_ p ODUI"S Version i.f? SBQ-467q'5~P';fJ.01/04}. Page 1 1 Akme C-66 5 5oa (,TV) mtes+ r * W-iol L4 a9 W - VLev i3 I a TG d~ CUFV ► ,fir r oo, - x y 4,45-0170 x x r o - - ~ d $ ?A m ~ 3 i za -A V T - 1 10 / _ i 0 0 W 'p m 1"~ w o 90 - _ D else ~8 GARAGE~u g`_p~\$s\ yRO; n~ sFOn O <f O r 8~ - i^\ al\\ os5~ Rs a a s ° o €a o~oo o m -n \ \8 350 'e- ~ - ~ o 0 o ° 22 o ° as ~ ~ ~ - ~m a z m - p_ z0 + + ow~~ ° p ~Ni^ s a; ° w n' 10 ZO zm ~MW 5 5Qy O~ y~3 :S V) xA z~ o ~c~ o NI IA 10 a o \ Z ° exuwFS ` O t o ^ 3 O o 2z o mo m W ~ 2 o m I ~K h" ~ulledute .gip ~ ► . ~ tt PVC Vert Final Isracle VVIO) va- t Cap " ~ tt i_es~ni~ ~ t ra Syvem Elevation r Cl-zarr~bem Tm-nch 4 Mal1 ~j rl ~rt Shia. Vent Jr Observation Pipe Trench 2 Nearer Trench 3 ufP-Olumr And Model EISA Rating _Q 4 _ -qr~ +t ae. c#tarraber Soil Agpi'rcatiori Pate 90 Design Soil Apphccajion safe EISA q rows o;_ chtt►~s ecf. pkqe of °rt? ~T at P OT-It MMN&ERT Mfi NUTA 9- ANAGA-' E T PLAN" at,~:~r ~-hYi\ 5 1 it m a~e}a a Tar}l..C%mirpv I alb - € !A E~ersrsit i P o Tank maadit.AKtd r ~(r( tP NA Mar?hn ra>Mtrae U u R MA tf ~ A r E11L rrsfsrr of ?ac?i:~n,s M KA F-vwat ~ .Sr Made[ I Number 4 S i:1Et~ t k:4 NA " Rump ?Emk capazity CIA Eof Ru~tt tnot I v ~yd pump Tsr[;cL~.la°sr rdA stErtta"e tca!n tsvaral?°! Darin iivar f pit}r ; s2in r,ad r vU V iJ~+ E'um ~11dYttS~$r& PEA a [ urlap Made! MA SpEI ~.s~slfu,a In "I'm ~ lf•l ~t?~tl~ ,i.'~AdBCd 3,i¢1LreT1'h~YluBiT: O.Lr9?L'}r 1+:ar;'k'Ziy ~IEY$~Gp' i PrL~2?21tYiM: l.€1iff: ~ !~A Fes, ufI ra; t ) 4 1='i 4,TdjGraval ITUtar R pati2 Flhar i icrGhaml~ l t3x3;~~ rs ssnMnd t~ rn~ R NA 0 F~is ~T~f Aeration TsataS Lrt?araad ~ €€c3s { S, 0 ANA ~te2~ad ~rar~rt ~t:it~iitat. ' MarrihlV avars~,e a ! LSi&~:BrS¢1 ~a€E43} "r'" R ft~lartst;~fi t~r~sst,~T~ed3 X13 n cfl a B,tn~G,~uttd ;~rav'"# ~E~aheniras€ ~~~~;3t1 ~ctnsn~ G31aJf~1 ds IT SS# I 1= M MA R Ax-Gads is ai ►~tai'~.+aprr:dsd Ez. LSfYfAf;F1C ri'f2'!~ ~'t~:L ~12t'S`~~r~€ sl Ca1r ~xa t 5 =mrt R EtiA diia, NA . R ri1A p.J9aXi[ iLTYt m usm,81,166 3Ez 3 SEA q iwMhar; rltYrar: R MA t ar gb; r n I '~r' ~ti3=+uL` 1N75"'iy.V42'E~ar .'^.rlt1 ?+t""4.~. :5;1!G.ESSc,.4. - ~~€LtGu ~ ~ nril~fE>sILI; ;.t to T"~ . taarssy. _ 'rte. At= ygass) M NA s i A; isa9t crzB sverr, yS T IrISGQ k aandt m ~sf t nlc(sl u?i+l 011r, crsntar~d o; tarrkl # IVhm care WInad s1!idg~ a~ ;"M. e SSie sa ~{rtii Rpw} of aeon vraiwmE fl MA Y i~ g t~l k" 3 WIt tst + Y rs# ' 0 NA tnapaWt lisp rsas r!a€!~s} At Ienat craa Every: s"-sl Gi MA isaut ts;ir;s a;tarv. ~ t. 21M. Citaa!~ r~~"fiLtsi~t ilk~• - 1~ . . p :z ensas VAN! G~f ~ffi~iP Ir!s ac pu4<S iiZfa Lantrcla 4 aia= RA E b Tr-M. At IL%2. g caner P vary-; ~ - _•;{~3i F1usi; la==e1 3 arts ?i -M . Y MA ©zEiar: A iasv. or Vert; MA a wt•11an i m roftaform M § A~ liiVt E. -aada by an €ra> Fradu mare one of tho ftiftw-,In Hugn w o TM me. T _ s sal w R . inspsaaftn . a f NrYk Ond d $Pr~ o R~€lu `ra' W!rder, ~ !'.r~ALI i r'7 I7L.r}~iik~~i r, r any araQkasAr t9!~ ~ ~ r RFraxri~`~ ~a~? gi cska~ {ter id~~~ tar 1'i~mYrer: 41Fa~L'sr °b:,-tn~sr Mct as 4xr. ir{siserzzft reuse i7~~iwt, s v1w;Ri iraapse-c!" of t; a mr<?cis# to t!SerrCE an1 rt~fsstn~ et sfRU3,,-vI- am tht grau id aur1806, r samars tha vc>?tar U rsF dt~Fxi>s111 swdTa and sq%rm sr;d tt~ cheer Far snv >~ask tip Or gmaftq M. to ih'~k ~Dr any. p~ftlg T s shsli ba v" IV im!~sa+~d chewk Thp r liz Savo€s ii'o- taa aissas ttrs eitirs^ r t£ 4a and rsgtairas t€i~ the du.psmei li1s} pettId v4rfars may In6M. ~ eta ar!~ on t ho c~s sLrrf-cs~ The,an ~irt o .f oa $f1Li8l1s an the u~ irnmed-jals r,Gtiftsd an .he I'm9l mda-tni aukboriilt, _ 1s aL. ~}sis n ~'°~tird. t~'"} or $ of phi= k vaSwE~e, BLS entire .a . rt 3 r• tart Man the oca!T►tsinsd so~ala`itsY~igt3 0- sludge end s~Ltrrl In t eE-~ ar and d35p~~'d ~rsFdsFlsa with Rhaptar CV t3 I I 3, a a ervil tFtB+er~ ~can~.sazts of t:ye ~tar•.{ shaft >7e rwrinved by MIS=nain A.dmintetrAenre Cie. Mattaet>xi if All ~'ti~sr sett~v9, 't~ct~tO~ttg' Idtl% !1~ }itY'ilC~4I 4Ytrr s~arVtGir~9 ~'i a~ iLtarr filters, rrtanYtar:i~ef ar ts*~;r~ur=~xf ~C'~6>?4s; p. units, and any mv1drt-m at intsrvsis A 911 rnctnil?s, srt&Il tae performaa by er.+v'tf~Za!~~'~WT I~;irtat- A3nri)cr,, -sTm , 51181. ;rs prdvided Im the Eacai rsmula arv m-tilnrtty "AffaUn 10 dwvs d mcm.19ta't,~t &T aP~r mr-Ma ~~te~x, o~w t~)fl t) or n»w Constructicn prior tM use Of tha P -WTS aheck trasxinerit'tank(s) for :ha PMsanae cf Paintrrua. radetft. that rnly rrmpede the treatrrman' proCeSS and/Or ub MMI ehS d~isper-4 call(si, if high car-,cer~r~at~~as a s~~ t i he the anxar~rs (if the tank(s) rB oved by a seu"Lago selvicliug opamtor prior to use. SYstarr, s't-M up shall not occur w'rtsr, sail ccrtdirions ala frgzen at -,he dmul'tiM-1ve surPaco. Durinry pov:>a: auto 9_._ pump zanks rnity ;iii aaova nomrial highwatl~r !;:vets. Wrien power in restared the.sxW- M WitatawtIlsr will ba discharged to the cuspsrszf call(s) in aria iarga dose, overloading the call(s) 2nd m result Yixe isee P l~ the cOntarrrs of affluent. 1'c removed by a Se • w or out;ac~..ciscl arga of the pul.ap tank power to the effluent uent pump nr cantatt a FlUrnbar or P01AITS Maintalnar to aslsy is any. rya m-g Operator Prior to ntroalsl o restore narmai levels w1ith(n The pump tank. P3r2tirrg the pump mzonxr ici Bu not drive cr park vM;Jo;as over tanks and dismsersst cells. Do net drive cr park over, or otherwtae d' rb or camrpmznro the area within 15 feet down slope of anv mound or at grade scull Ebsorption area. Redu=lon or eizminatimn of the following fram the westewarer stream m. ey improve the • erf0flTirdlee t MW S; arrtiksiatirs; baby wipes; rtgrerette butts; cOndcmris; co~ttrn swag 4 ds;ressarA djaj pretlming_ f-e !all the foundation drain (sump pump) water, fruit and vagetobld eslin s• n . cir~ h Main ( MQ lapmars; di~adf6 tmys; all, pelnr!ng products, pestidss; military napkins, trr?mpar-gym; and wet sn~an lar brieesa; erfaicinas; mgr medic ono; all, ARAl1IF3m'3m`iIm=mIIEN Wher, u the FOVVTS fails acid/or Is par many ntly taken out of service the following steps shall pia takfn-To irm3urt the syatemrr is property and sa Iy Abandoned In aomrrpliencs w:th cha- r Comm ES-33, Wiscons4l. Ad-nmistra ive Oda: * Aim piping to tanks and Alts shall be discormrmeoted and the abandoned a cs opaninss sealed, m The contmx of all- tanrm and pig shat be rernaied and prapariv dispmad Ot by a Sete Safvwurig Cpara-tan Amur p np!'g: a;: maks and gigs ,a! be s=a;rtee and ,orr,ovad or -l b:r coV rams:wand and the vo%r space filled t ITb sail, graval mgr anather inert sol"'d mxmetariel. C*N-MNWiNC's' PLAN I€the PCrWTS <all3 and vannzt he ra irsd the folfcwltr rneasts:es have hear, or mza.i be r eplaeamsmsnt s st3rals t-ksp, to provide a owe camrtpilant N A suitable mpla.ament area has been evaluated and may be utilized for the lonsdan of = 7 sa,:j M- sy3tarrm, T ha repleee meat area ahaulcl Tae Pro-M:Tad from distmbance and comRmpaetlon art[ should r tat be nir n ad a~ t-lon required sa~tbarrlm front &XISC112 anti pmpnsad sVructura; ii;1,• Mies avid vralls, Failure to prat the raplacarn n4 area Will result it tm e tt2sd for a new sail and site evsiustlon to ssTabiish a suitable raplacaman't area. Raplaaarnent g';~3terfms must Comply with the nines in grant at -drat time, G A suitable replace-merit area is not availaitle ziua to setback and/or soil llmnimaons< 99tringr advances in POINTS tachrelogy a hBlmilrc Tank ;ray he installed as a iest reEnmt to replace the faced POW & S, Ct The site has ncx hamn evsluatad to Idcntlfy a suitable raplscomarit area. Upon :a?lurs of the PO a sail and elta evalluation must be per,"arnied to locate a suitable rariacement area. If n0 replacemsmsmrt area is available a ~o(dine tank may be instsiisd as a last resort to raplacs the feflad POW T & Cr Mound and et-grade soil abmrptian systems may be . maconstruated In pl fallmawing rersov.ai msf the b10MGt at ,ha infiltre*_'mve surface. Recartstru44ians of such sy&tam& must, comply with tha rules in We= at that-fima, <<WARNING>> SEPTIC, PUMP AND 07W-l3 ` REA"i"lylM7. TANKS MAY CONTAIN U't'lM GASES ANDIOR INSUFFM. JW TER A SEPTIC, FLU P OR OTHER TPIMAI'i EN-1 TA-Ml( tJi DSI ANY ORCUM8 ",4NOM MAT-w- ~3 5~ Do N07, PERSON FROM TIRE' INITF ? OR OF T-4 NX 41143f 3E DI: FII:ULT OR IIV POSSiS. It7il~5r 3~cvr~SE°z . R');$Lttiw ~ F A A001 VOVAL Cl7MM WT5 FO INSTALLER I Name l'Ci6S llliAll~I'AIIL;. i~ y'r h Names ~ Pi?crms ~ 'Z j ~ ~ ~ - ~ 1 l PFirrn>a 81-13 'AIM S'ElsvTICING OPERAI O MU-13-011) mx iCr-A. ArCUi ' t~ !Vrna D Xrt ) I m- t,tr h Na e m a7 EPIM': - , w S i J s Phan's , i T hie daaum=,^ wam: drafted ir aArs;sHsrte= wzl: c'7a-~rar 1c r Qorn m 84,22{2Nhit2;? + _ ' h R' & 3 R) (j, 1rVisconsin r AdrnimVstrztIve uOd3.