Loading...
HomeMy WebLinkAbout191-1019-40-000 , Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 597492 GENERAL INFORMATION State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, S. 15.04 (1)(m)] 2988606 Permit Holder's Name: City Village Township Parcel Tax No: CLARENCE HUBER VILLAGE OF WILSON 191-1019-40-000 CST BM Elev: Insp. BM Elev: BM Description Sectionlj~rn/ r/Map No: • 2, 6/1 51, r [[~f 35.29. .118 TANK INFORMATION ?j L1.5' IN O 1) ELEVATION DATA /--7 102-75- too. a TYPE ' ex/✓ ~AN fJFA- RER CAPACITY STATION B~ f HI, FS Septic,. 7 WI 'h Benchmark 3. (J~ AV-3 yf 3 V Dosing Alt. BM ew+S 6,iprV- I D rr 9e^ Bldg. Sewer 2 , F I- J T~~ : e CCU jID_bb 5 FTaTMTIr _ ?tJ1 nle t TANK SETBACK INFORMATION outlet q.,35 TANK TO L1 j_ WELL BLDG. Vent to Air Intake ROAD Dt Inlet / Septic p V~~ f-5v' d ! Dt Bottom 12.7 80,3 Dosing M "1 Header/k%rl ~F-y ? Aeration Dist. Pipe 8.-7 Holdi Bot. System PUMP/SIPHON INFORMA O N~ ~er►W o~SC Final Grade 19, 2.1 Manufacturer -~'V Dem nd~ St Cover Q ' ~CiR C~ GPM V. z Model Number la I C31, 1VT C 3 9 TDH Lift Friction Lost System HeadS• n jr TpH,.11 Ft Forcemain Len 1 Dia. 2:1 Dist. to WeIS t till +-0 0 Jr ve SOIL ABSORPTION SYSTEM BED/TRENCH Widt Length I No.Jrench PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR O Type tem. 339 43 f UNIT Model Number OJ jj 1 ..1 ISTRIBUTION SYSTEM a►f ader/Manifold A/ Distribution, ~j x Hole Size s / JxHoleSpacing i jVo e Air Int e 2 3 P 3 ' 0 1 v Q~ D { Length- Dia Length Dia Spacing 13 V SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded If fx Mulched Bed Trench e t B,, !Trench Edges Topsoil N, es L ]No COMMEN rg: nclude a discrepencies, persons present, etc.) Inspection #1: 16S i 7 Inspection #2: Location: 750 HWY 12 u-j L 1 ;-j 1. Alt BM Description ---t ` 4- 2.) Bldg sewer length = W \I Q 6U •s 1.1; w `~/Q ~J - amount of cover = \ C O `~r , ki l ~DRIA H' wile OW all ! 1 „(a Plan revision Required? Yes I] No LL VSBD-6710 se other side for additional information. Date Insepctor's Signature Cert. No. ( ~ V~ j~ N S v - 'D1c i 1 - uc Industry Services Division County 1400 E Washington ve SSt Croffix ~ Sanitary Permit Number (to be tilled in by Co.) PA5A P.O. Box FZ~iA0/~ L1RSBJ Madis~162 Sanitary Permit App 1 ati y State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form l appro i~~ ll Unit 2988606 is required prior to obtaining a sanitary permit. Note: Application forms for sta t e submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information yoL, used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats S 750 US Hwy 1. A ication Information - Please Print All Information Prof O& ~r~s y[amg Parcel # 4se Huber \,~.~Gl 191-1019-40-000 Property Owner's Mailing Address Property Location , 2326 9th St. E Govt. Lot City, State Zip Code Phone Number NE ~ SW y4, Section 35 Menomonie, WI 54751 715-233-0304 T 29 N R 15 (circlF °n 11. Type of Building (check all that apply) Lot 4 1 or 2 Family Dwelling - Number of Bedroo s 3 Subdivision Name Block # ❑ Public/Commercial - Describe Use ~C4 ❑ City of ❑ State Owned- Describe ljte CSM Number X Village of WIISOn J _rt_DF '~A~40 L'j •7 ❑ Town of 6 111. Type of Permit: (Check only one box online A. Complete line B if applicable) A. ❑ New System X Replacement System ❑ Treatment/I Iolding Tank Replacement Only ❑ Other Modification to Existing Svstem (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. T' e of POWTS S stem/Component/Device: Check all that apply) N, pv ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade X Mound > 24 in of suitable soil ❑ Mound < 24 in, of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dis crsal/Tre ment Area Information: Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Re fired st) Dispersal Area Pro sed t) System Flevation 450 .6 450.1 450.1 98.17ft VI. Tank Info Capacity in Total of Manufacturer Gallons Gallons Units o a New Tanks Existing Tanks ° v - Septic or Holding rank X 1150 1 Lewis Bjork LLC X Dosing Chamber X 700 1 Lewis Bjork LLC X VII. Responsibility Statement- 1, the unde&m-e_~- sume sponsibih y insta a ion of the POW" CS shown on the attached plans. Plumber's Name (Print) Plumber's . na re MP/MPRS Number Business Phone Number Lewis Bjork y 253976 715-231-7375 Plumber's Address (Street, City, State, Zip Code) E7818 Count Road E, Menomonie, WI, 54751 VIIL County/De artment Use Only Approved o d Permit Fee Date sued Issuing A t Signature ZLA wilcxGivcn Reason -Denial 24[17 IX. Condit eas tor, isapproval a per tom`"~- plats proAded by plumber. 2. `Jtt a n ' Mua1 be mwvta irxd w par appliottbla c o& / ad'+natlow. 04 Attach to complete plans for the system and so it to the Couillity only on paper not less than I/2 x 1 'nches in size SBD-6398 (R. 08/14) t)29 i ~N Ae-,l l' 5V CHECK BOX AS APPLICABLE. ECK BOX AS APPLICABLE. SOIL EVALUATION Scale: 1" = 30' SYSTEM PAGE 2 OF 8 SITE MAP 0 30 45 60 LOT PLAN PROJECT NAME: 17 52 DESIGN FLOW: 450 GPD Joe Huber Attach design flow calculations for commercial plans. PROJECT ADDRESS: 750 Hwy 12, Wilson WI 54027 ~ Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) N Sanitary Sewer: 4 / 3034 BM Symbol: BM Elevation: 100 2 Sch 40 Force Main: / base of g 5 j w BM Descrlptlo Indicate north by IMPORTANT: Slope Gradien 5 Well Symbol (if applicable): Q drawing an arrow Show ground eleva 'on contours at suitable intervals. of Tested Are on the approprite line. 82 'r6mi L L.-,-~ , r~ S i ~ L x7at&,v DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD o/, \9\ HAYWARD WI 54843-6462 f Contact Through Relay (3i i` http://dsps.wi.gov/programs/industry-services ~www.wisconsin.gov \~s 0- Scott Walker, Governor Laura Gutierrez, Secretary September 01, 2017 CUST ID No. 253976 ATTN: POWTS Inspector LEWIS C WORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 COUNTY ROAD E 1101 CARMICHAEL RD MENOMONIE WI 54751-6637 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/01/2019 Identification Numbers Transaction ID No. 2988606 SITE: Site ID No. 841760 Joe Huber Please refer to both identification numbers, 750 Ush 12 above, in all correspondence with the agency. Village of Wilson St Croix County NE 1/4, SW 1/4, S35, T29N, RI5W FOR: ITIONA Object Type: POWTS Component Manual Regulated Object ID No.: 1722534 COIN" Maintenance required; 450 GPD Flow rate; System(s): Pressure Distribution Component Manual - Ver. 2.0, SBIklp V~ 10706-P (N.01/O1, R. 10/12); Effluent Filter ANA PROFS ~F SAF ~ OF IN~us~ The submittal described above has been reviewed for conformance with applicable Wisconsin i is Avi and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to b constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above.I The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 7 A copy of the approved plans, specifications and this letter shall be on-site during construction and open to~~,.,..~ OOR° inspection by authorized representatives of the Department, which may include local inspectors. All pen I s SC R 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 y, This Amount Will Be Invoiced. When You Receive That Invoice, Edwin A Taylor Please Include a Copy With Your Wastewater Specialist , Division 0t 1 dustry Services Payment Submittal. (715)634-3484 , Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 edwin.taylor@wisconsin.gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Joe Huber - Mound Design PSG S Owner's Name: Joe Huber Owner's Address: 750 Hwy 12 Wilson WI 54027 715-233-0304 Legal Description: NE SW 35 29 15W Township: Springfield County: St.Croix Subdivision Name: 2 acres LY Lot Number: Block Number: SIONAL SER`jjCEs Parcel I.D. Number: SERVICE Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot plan Page 10 Attchments : Effluent filter / septic & dose tanks /manhole Page 11 Soil report Designer: Le~yis Bjork_-.- License Number: 253976 Date: 08/09/17- Phone Number: 715-231-7375 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 11 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) r~ Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 ~ Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 450.00 Design Flow (gpd) 5.00 Site Slope 97.001 Contour Line Elevation (ft) 22.00 ; Depth to Limiting Factor (in) 0.10 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 70.00 Dispersal Cell Length Along Contour (ft) = 6.43 Cell Width (ft) I 1.001 Dispersal Cell Design Loading Rate (gpd/ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.22 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 3.75 Estimated Orifice Spacing (ft) = 11.84 ft2/orifice 2.00 Forcemain Diameter (in) 30.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 4.89 Forcemain Drainback (gal) 8.00 Vertical Lift (ft) 62.92 5x Void Volume (gal) 071 Friction Loss (ft) 67.82 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 24.90 System Demand (gpm) 11.66 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in, dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x ( x 3.00 2.00 x 3.00 x I Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1150.00 Septic Tank Ca th paclty (gal) Total Working Liquid Depth (in) Lewis Bork LLC MManufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.001 Dose Tank Capacity (gal) orenco Filter Manufacturer 18.85 Dose Tank Volume (gal/in) Bio-tube IFilter Model Number ~Lewis Bjork LLC Manufacturer Project: Joe Huber - Mound Design Page 2 of 11 l Mound Plan and Cross Section Views T s: a 1/10 B f J Observation Pipe ..L31.. A W g I L Mound Component Dimensions A 6.43 ft E 17.86 in H 1.00 ft K 9.36 ft B 70.00 ft F 9.50 in 1 9.81 ft L 88.71 ft D 14.00 in G 0.50 ft J 6.41 ft W 22.65 ft 450.10 (ft) Dispersal Cell Area 1136.88 (ft2) Basal Area Available 6.43 (gpd/ft) Linear Loading Rate 7.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.96 (ft) H G t 1 F Dispersal Cell 98.67 (ft) Lateral 98.17 (ft)~ - Invert Dispersal Cell Elevation F D _ j , rr~• x 97.00 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key CL -7 Dispersal Cell See lateral details on ®Topsoil Cap c = 1.5 ft Page 4 for number, size, 0 Subsoil Cap w o and spacing of laterals. Laterals are equally 0 0 ASTM C33 Sand.' F 0 Tilled Layer c y 0 5 ft TvDical Lateral spaced from the 0 Aggregate v c distribution cell's centerline in the A distribution cell (AxB). Project: Joe Huber - Mound Design Page 3 of 11 End Connection Lateral Layout Diagram Laterals centered over the A & B dimension • = Tu rn-u p m' ba I I va Ive or of es n out plug P Mlaterals dentical IF x-~I Holes drilled on the bottom of the lateral equally spaced onnection via teeor cross to maniFold at anq point. Laterals Morcemain Sch 40 PVC per SPS Table 384.30-6 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.81 ft Lateral Length (P) 68.58 ft Orifices per Lateral 19 Lateral Spacing (S) 3.22 ft Orifice Density 11.84 ftz/orifice Lateral Flow Rate 12.45 gpm Manifold Length 3.22 ft System Flow Rate r:::2:4.90 gpm Manifold Diameter 1.50 in Total Dynamic Head 11.66 ft Forcemain Velocity 2.54 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and No SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented F- Alternate outlet location Forcemain diameter Lewis Bork LLC Manufacturer 2 in. Capacityl 700.00 Gallons Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons R siphon device A 23.54 443.68 B 2.00 37.70 C Pump off elevation (ft) C 3.60 6772 90.67 D 8.00 150.80 Total 37.14 700.00 D Dose tank elevation (ft) 3" Bedding un er tank. go._ Alarm Manuafacturer SJE-RomBus ; Note: Switches Alarm Model Number [520-002A containing mercury ` may not used in Pump Manufacturer Zohler this system. Pump Model Number 152 Pump Must Deliver 24.90 gpm at 11.66 ft TDH Project: Joe Huber - Mound Design Page 4 of 11 Mound System Maintenance and Operation Specifications Service Provider's Name i Lewis Bjork LLC Phone 715-231-7375 POWTS Regulator's Name St. Croix County Phone 715-386-4840 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1150 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450.1 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 years Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for pondin and seepage once eve 3 ears Cta~~er! Lewis Bjork for Pumping Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Joe Huber - Mound Design Page 5 of 11 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan if the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 11 9 928-(i3,GIF (.IPE(;IMA(;I:, i 50 x lt65 PIXELS) - SCALIiD (9l'Y.) UTTPS://F1)N.OLF.APA1117A]).(;O)I/RTII'/TOOLS/9:3928-(i,3.(;IF I ,d or_ L u, PUMP PERFORMANCE CURVE :-5;ILl- MODEL 151/152/153 50 4 45 153 _ j - - - - - _ 40 i r °r 35 10~ S%L 30 - ~ I $ ~ 25 151 i 0 F-- 6 20-- 15 1 - 1-_ - - 2- 10 R 20 30 40 50 60 r 0 80 90 100, GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE o'r''''b' I OF 1 5%27%2016 10:47 All 29 s-~ Irvl - S CHECK BOX AS APPLICABLE. XOX AS APPLICABLE. SOIL EVALUATION Scale: 1" = 30' SYSTEM PAGE 2 OF S SITE MAP ° 30 45 60 LOT PLAN PROJECT NAME. Er F-Z;T 52 DESIGN FLOW: 450 GPD Joe Huber Attach design flow calculations for commercial plans. PROJECT ADDRESS: 750 Hwy 12, Wilson WI 54027 Pipe Material / ASTM Standard (Tables 384.30-3 $ 384.30-5) N Sanitary Sewer: 4 3034 BM Symbol: BM Elevation: 100 FT Force Main: 2 / SCh 40 BM Descriptlo : base of horizontal siding Slope Gradien Indicate north by IMPORTANT: of Tested Are 5 Well Symbol (f applicable): drawing arrow Show ground eleva 'on contours at suitable intervals. on the appro roprite line. 11b AZA6 647-zo" -T:55C&~s ®6,i~tc fix, %A~ - ~'f f 1125 3~~ v~ k rood 14 ~ 3~ g2 #CVVE~ ----~~E N - p, s~ _ ` 6. R2 r IZp i ~ A L vpARTnTO J DIVISION OF INDUSTRY SERVICES s ~L- PO BOX 7302 Q 9- MADISON WI 53707-7302 l s P K Contact Through Relay y~ s ~y http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~O~SSION AV ~ - Scott Walker, Governor Laura Gutierrez, Secretary May 19, 2017 Identification Numbers Transaction ID No. 2944957 Site ID No. Please refer to both identification numbers above, in all correspondence with thea enc . CUST ID No. 253976 , LEWIS C WORK LEWIS BJORK LLC E7818 COUNTY ROAD E MENOMONIE WI 54751-6637 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/31/2022 Re: Description: SEWAGE TANKS, CONCRETE Manufacturer: LEWIS BJORK, LLC Product Name: (tyrans id 2944957) SEPTIC, PUMP OR HOLDING (TANK AND ADAPTOR) Model Number(s): LB700, LB1150 (700 AND 1150 gals.) [LB700 BASE TANK; LB1150 CONSISTING OF 3 SECTIONS WITH THE 450- GAL. ADAPTOR AS THE MID-SECTION] [38 IN. L.L., 18.85 GAL/IN.; 96 IN. MAX. DEPTH OF BURY, 335 OR 551 GPD WHEN USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER; TANK DIMENSIONS = 66 IN. L X 36 IN. W X 54 IN. H; ADAPTOR DIMENSIONS = 66 IN. L X 36 IN. W X 24 IN. H] Product File No: 20170151 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of May 2022. This approval supersedes the approval issued on 6/28/2012 under product file number 20120193. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • All manhole covers terminating at or above grade must have effective locking devices. • When this product receives wastewater from dwellings, it will produce an effluent quality with a maximum monthly average value for BOD5 of less than or equal to 30 mg/L, TSS of less than or equal to 30 mg/L TSS and F.O.G. of less than 30 mg/L. CONSTRUCTION PRODUCTS TUF TITF C-3) tiF Tuf-Tite Riser System Safety Lid in 6" Tall Riser 4 screws included with each Safety Lid Access hole allows pump-out without removal 1 Concrete Lid" - "t with handle. Use the Safety Pan to cast your own n con- ~ Safety Lid Top and Bottom View your own lid G H, ~n it 4SY X tow '~,6✓' ''n x'66" "°+E For safety the 6d can be filled with concrete- Our 'Concrete Keepers' lock the concrete into the lid 24"-RISL-FLAT-SL is made (Close-up view) with 2 sets of screw holes for proper alignment in 6" tall and 12" tall risers. i , 24x12 Available in 4 diameters. - Size Part No. Qty / Carton 246 12" 12-RISL-FLAT-SL 38 16" 16-RISL-FLAT-SL 30 i Safety Lids sit on Riser Ledges 20" 20-RISL-FLAT-SL 20 with matching screw holes 24" 24-RISL-FLAT-SL 17 I 12-RISL-FLAT-SL in 16-RISL-FLAT-SL in I 20-RISL-FLAT-SL in 24-RISL-FLAT-SL in 12-RIS-GREEN 16-RIS-GREEN j 20-RIS-GREEN 24x12-KEEN 3 3 I I Tuf~ 4( 00 F1 uri f60047 ne ex TITE :9,; 1g 01) Ca 0"neo Biotube@, Effluent Hiftefs 1r= , ms -soo~as-sea3 ~ Installation, Operation and Maintenance Instructions FTC Models and All Base Inlet Models U.S. Patent s. 535 / 443 Installation Instructions: The Biotube Effluent Filter is suspended in the septic tank by the 4" outlet pipe. The filter is composed of a vault body that will be fixed to the discharge pipe and a removable cartridge that consists of the Biotube filter cartridge and the extendible handle. 1. Test-fit the effluent filter on the 4" out- let pipe without gluing. Make sure that it fits plumb. Any existing outlet tee will have to be removed. ~ M. A:< 2. Ensure sufficient clearance for trouble- free servicing of filter cartridge. Install assembly near the tank wall to reduce any stresses that may be caused by maintenance. Sufficient room between the access port and filter should be provided for easy removal of solids from the tank. The cartridge will need to be removed and cleaned while the tank's solids content is being pumped-out NIN-Fr-FTM-1 Rev. 13, ©12/02 Pagel of 4 ' i ALARM SYSTEMS i {S) sepuc ftVF'r0Cft In n. "Observer 50-0" Series Indoor/Outdoor Alarm Features & Benefits • NEMA 4z Thermoplastic Enclosure • Large Alarm Condition Indicating Light O • Audible Horn rated 85db @ 10' • Alarm Test-Normal-Silence switch • Automatic Alarm Reset • Supplied w/Cord Grip for Float Switch Installation • Includes 15' Mechanical Alarm Float ° & mounting tie strap • 6' Power Cord with 115 volt plug MUME T • Suitable for Indoor or Outdoor Use • Two Year Limited Warranty • Available in both High Water & Low Level Alarm versions Dimensions 3N- RV O 3~ eA M*11~ ,2q 64 ftem" ~ {F POWER CORD (SIDE) 22Wf PLllt~ *Note: Consult the factory for other available options. Septic Products, Inc. 1378 Twp Rd Ashland, Ohio 44805 Ph: (419)282-5933 Fax: (419)282-5943 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Joe Huber Mailing Address 2326 9th St. E, Menomonie, WI, 54751 Property Address 750 US Hwy 12 (Verification required from Planning & ning Department for new construction.) cit /state Wilson 191-1019-40-000 y /State Identt ication Number LEGAL DESCRIPTION Property Location NE '/4 SW '/4 Sec. 35 T 29 N R 15 W Town of Springfield Subdivision Plat: Lot # Certified Survey Map # Volume Page # Warranty Deed # (before 2007)Volume Page # Spec house ❑yes❑no Lot lines identifiable ❑yes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(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 form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on is form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a rranty deed recorded in Register of Deeds Office. Number of bedrooms 3 SIGNATURE Of?APPLICANT(S) DATE ***Any information that is misrepresented 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. 04/12) c5T-aoO _ Iqa RECEIVED 3 Wisconsin Department of Comme cEP t 9 2D SOIL F2RAOQSBJPA5A page 1 of Division of Safety and Buildinur, CRO1X COUWTY D ~Yih Comm 85, Ws. Adm. Code NVTY ,OMM County St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Q/ ~/V _ZA percent slope, scale or dimensions, north arrow, and location and distance to nearest road. V Please print all information. Revd by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / z Property Owner Property Location ■ Joe Huber Govt. Lot NE 1/4 S 1/4 35 T 29 N R 15 E( r) W Property Owner's Mailing Address Lot # Block # Subd. Nam or CSM# 750 Hwy 12 - - 2 acres parcell city State Zip Code Phone Number ity village Town Nearest Road Wilson WI 54027 ( 7)15-233-0304 Hwy 12 New Construction Usef -1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD El Replacement Public or commercial - Describe: NA Parent material Loess over till Flood Plain elevation if applicable IAA ft. General comments Install 6.43'x 70' rock mound cell , with up-slope edge sand fill , 14" on the 97' contour , use .6 basil loading and recommendations: 7~.,. 11 Boring x F11 Boring # a , Pit Ground surface elev. 97 ft. Depth to limiting factor 22 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 1 0-4 10yr3/3 sI 2fgr mvfr gs 2f .6 1.0 2 4-6 10 r3/2 sl 2fsbk mvfr cs if .6 1.0 3 6-12 7.5yr5/4 sil 2fsbk mvfr gs if .6 .8 4 12-22 5yr4/6 grscl 0 - - - .4 .6 5 22-30 5yr4/6 ft floyr6/2 scl 0 - - - - B2 Boring # Boring 96 22 ® pit Ground surface elev. ft. Depth to limiting factor in. Soil A plication 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 0-4 10yr3/3 sl 2fgr mvfr gs 2f .6 1.0 2 4-8 10 r3/2 sl 2fsbk mvfr Cs 2f .6 1.0 3 8-12 7.5yr5/4 sil 2fsbk mvfr gs if .6 .8 4 12-22 5yr4/6 grscl 0 .4 .6 5 22-36 5yr4/6 fIfIOyr6/2 scl 0 - - T Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L " E #2 = B < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signat _ CST Number Lewis Bork 253976 Address Date Evaluation Conducted Telephone Number E7818 County E Menomonie W1 54751 7-27-2017 715-231-7375 Property Owner Huber Parcel ID # Page 2 of 3 FB3 Boring # 3 Boring 97 24 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 1 0-5 10yr3/3 - sl 2fgr mvfr gs 2f .6 1.0 2 5-8 10 r3/2 - sl 2fsbk mvfr cs 2f .6 1.0 3 8-11 7.5yr5/4 - sit 2fsbk mvfr gs if .6 .8 4 11-24 5yr4/6 - grscl 0 - - - .4 .6 5 24-30 5yr4/6 fIftOyr6/2 set 0 - - - - - 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 I III Boring# Boring Pit Ground surface elev. ft. Depth to limiting factor in. F-1 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fly in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330Test (R.07/00) N 219 CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. (f~r,SOIL EVALUATION o Scale: 130 30 45 so ❑ SYSTEM PAGE 2 OF 3 SITE MAP PLOT PLAN PROJECT NAME: 7 6Z DESIGN FLOW: 450 GPD Joe Huber In design flow calculations for commercial plans. PROJECT ADDRESS: 750 Hwy 12 , Wilson WI 54027 1 Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) N Sanitary Sewer: 4 / 3034 BM Symbol: * BM Elevation: 100 FT Force Main: 2 / Sch 40 BM Descripto : base of horizontal siding Slope Gradien Indicate north by IMPORTANT: of Tested Area 5 Well Symbol (if applicable): drawing ro arrow Show ground eleva 'on contours at suitable intervals. on the approprlte line. 7 6'25 --3 V-04 4f ev.--i4 R; G mL ; r b eti -opE N - 7f f 2 r ~ 5/co L