HomeMy WebLinkAbout040-1326-28-000
county:- St. Croix
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division INSPECTION REPORT Sanitary Permit No: 597494
(ATTACH TO PERMIT) State Plan ID No
GENERAL INFORMATION
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]
Permit Holder's Name: Parcel Tax No:
city Village Township 040-1326-28-000
DCCI INVESTMENTS TOWN OF TROY Section/Town/Range/Map No
CST BM Elev: Insp. BM Elev: BM Description: ^ ► i \ I G5 -r 17.28.19.2220
1(JC
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
OY1'~.z1 F'l~ S Alt. BM i W
Bldg. Sewer b
Aeration
Holding St/Ht Inlet 2. '57,%
- St/Ht Outlet Z ,q q 7 • ~j
TANK SETBACK INFORMATION
TANK TO P/~ WELL BLDG. ent ~rIntake ROAD Dt Inlet
Dt Bottom
Septic 16 /63 8 54
Dosing Header/Man. j C? g.3, s
Dist. Pipe V'7, 1 g ~ i '3
Aeration '7 y 3
Bot. System 7 Z 3
Holdi 9 Z
Final Grade ~ ~
PUMP/SIPHON INFORMATION
`e3 L+
Manufacturer Demand St Cover 3.0
GPM
Model Number
TDH Lift Friction Loss System Ft
Forcemain Dia. Dist. to weu
SOIL ABSORPTION YS EM
BED/TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No Of Pits Inside Dia Liquid
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CHAMBER LEACHING Manufacture
INFORMATION Type Of System I r t s /16 J _ . 1 UNIT MOAN' m
.(1 4
DISTRIBUTION SYSTEM
x Hole Size x Hole Spacing Verb to it Intake
Header/Manifold! Distribution O~
L~ Pipe(s)
Length_ Dia y Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Mulched
117 xx Seeded/Sodded
Depth Over xx Depth of
Depth Over s No es No
~ Psoil
Bed/Trench Center Bed/Trench Edges To
Inspectiopi fad Lt I
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: J, 6
11 1,1
Location: No Address Avail ble [y~=ATJ 01-
1.) Alt BM Description = A~~-
2.) Bldg sewer length
- amount of cover `~d
Plan revision Required? Yes No j r I 1s - J'
li 7 L
Date Cert. No.
Use other side for additional information. L - Insepctor's Si ture
SBD-6710 (R.3/97)
a~ -
rr18 K Safety and Buildings Division Cotuttyl ,
1 -7 EIVED 241 W. Washington Ave.; P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
> Madis ,1M 5 07- 2 6
~L 7 Y9
01 ~~~~~~SuT~ ~N~~~y ermit Appliea ' State Tra o N her
In accatl '4J1ffi51~5 T. submission of this form to the appropriate governmental unit
the required prior to obtaining a sanitary permit. Note: Application forms for stare-owned POWTS are submitted to Pro ect Address (if different th mailing rress)
Department of Safety and Professional Servies. Personal information you provide may be used for secondary
2urposes in accordance with the Priyacy Law, s. 15. 1 m), Stam O C_J✓]
L A lication Information -Please Print All Information ~f J
Property Owner's Name
P~cel 1 j `
Property Owtie-s Mailing Address Property Location ?.g r
f, \J 6 J - GoLot
City, State Zip Code Phone Number
I~ e1- 1. ,/X Section
le: o
II. Type of Building (check all that apply) T G N, R /-r or W
/ 2 Family Dwelling-Number of Bcdroo r 2 Subdivision Name
i[A Block #%(u ~
❑
APublic/Commercial - Describe Use W
~OG1se, q ❑ City of
❑ State Owned - Describe Use CSM Number V-diage of
Z >u a- 124- ZZ
W. Type of Permit: (Check only one box o line A. Complete line B if applicable)
System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner ^
IV. e of POWTS System/Component/Device: Check all that apply) d
essurized In-Gr d ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Jdrer Dispersal Component (explain) JS✓ ac~5
❑ Pretreatment Device (explain)
V. Dis rsal/Trea ent Area Information:
Desi Flow ,
gn (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required IN Dispersal Area Proposed (sf) System Elevation
VL Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units
New Tanks Exisi ng Tanks a m v J _ „
N/ o a m m
3epric or Holding Tank t-- ~ U
Dosing Chamber
VII. Responsibility Stateme - the undersigned, a responsibility for installation of the POWTS shown on the attached plans
Plumber's Name (Print) Pl s ignature MP/MPRS Number Business Phone N her
Plumber's Address (Street, city- late, Zip Code)
~d d 1 !
nty/De artment Use Only
proved tsappr Permit Pee Date ued Issuing. t Signature
carom for Denial
IX. Condt pproval
as a ePrk; tX;t~ai'rl t,V' ub
6ai 06A
Attach to twmpkle ptaas for the system and submit to the Coup only on County paper not Less tha 8 in x I i es in rim
SBD-6398 (R. 11/11) ff~s P
System PLOT PLAN
PROJECT DCCI Investments inc.. ADDRESS P.O. Box 445 New Richmond Wi 54017
SE 1/4 NW 1/4S 17 /T 28 N/R 19 W TOWN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 93.0/92.6 5' below qrade DATE9/17/17 BEDROOM 4
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44
BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
224' 55' 23' 62'
47'
Scale = 1/4" = 10' 55' ~-A~'V 95'
2-3' X 90' cells with B-3
>3' spacing
98 B-2
5
12' -1
00
Pro 4 9/ B.M. *
Bedroom
House
Valley View Trail
Vent
157'
>6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end cap
4' Long 12
Grade at System Elevati n
34"
All piping shall be ASTM SDR 30/34, within
" 10' of tank, piping shall be ASTM F891
Cover Page
Shaun Bird
r Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 9/17/17
Owner:DCCI Investments LLC
Location: SE1/4 NW1/4 S17 T28 N,R19W Lot 24 Meadow Valley 1st. Add Troy
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Leaching Cham er Cross Section
4-6. Maintanance,,,,~ ~ Contingency Plan
7. Filter Crosse ion
i
Signature-
License nunI r#226900
System PLOT PLAN
PROJECT DCCI Investments Inc.. ADDRESS P.O. Box 445 New Richmond Wi 54017
SE 1/4 NW 1/4S 17 /T 28 N/R 19 W TOWN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 93.0/92.6 5' below qrade DATE 9/17/17 BEDROOM 4
CONVENTIONAI. XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44
BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE 0 WELL *H.R.P. same as benchmark
224' 55' 23' 62'
47'
Scale = 1/4" = 10' 55' 6% Slope 95'
96'
2-3' X 90' cells with B-3
>3' spacing 98' B-2
5
ST
J/11111
12' -1
Pro 4 B. M.
Bedroom
House
Valley View Trail
Vent
157'
>6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end cap
4' Long 12
34" Grade at System Elevati n
-14 All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 98.0'
Vent G rade Vent
,A~30/34 Septic Tank
ALo 4" 3'
1 5' 5' Long 1
36 Grade at System Elevation Grade at System Elevation
Spacing- 5'
2-3' X 90' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
22 chambers per cell
System elevations:
A 93.0'
B-92.6'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
PILE INFORMATION SYSTEM SPECIFICATIONS
Owner e Septic Tank Capacity /is al ❑ NA
Permit # Septic Tank Manufacturer - ❑ NA
3ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
❑ NA Effluent Filter Model _ 0 NA
Number of Bedrooms
Z4 /0
Number of Public Facility Units Pump Tank Capacity al NA
j Estimated flow (average) G C.) gal/day Pump Tank Manufacturer NA
1 Design flow (peak), (Estimated x 1.5) ~<< aUda Pump Manufacturer NA
1 Soil Application Rate aUda /fly Pump Model NA
Standard Influent/Effluent Quality Monthly average" Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter O Peat Filter
Biochemical Oxygen Demand (BODs) 220 mg/L 0 NA 0 Mechanical Aeration 0 Wetland
Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection 0 Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA
Biochemical Oxygen Demand (BODs) 530 mg/L n-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L \ ❑ At-Grade 0 Mound
Fecal Coliform (geometric mean) 5104 dull 00m1 ❑ Drip-Line 0 Other:
!Maximum Effluent Particle Size Ya in dia. ❑ NA Other. 0 NA
(Other. NA Other: 0 NA
"Values typical for domestic wastewater and septic tank effluent Other ❑ NA
IAINTENANCE SCHEDULE
Service Event Service Frequency
❑ month(s) (Maximum 3 years) 0 NA
linspect condition of tank(s) At least once every: ~ ea
r s
(Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume 0 NA
(Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
year(s)
Clean effluent filter At least once every: 0 month(s) 0 NA
ar(s)
I nspect pump, pump controls & alarm At least once every: 0 month(s) ❑ NA
I=lush laterals and pressure test At least once every: 0 month(s) ❑ NA
0 year(s)
Ither. At least once every: 0 month(s) ❑ NA
❑ 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 inspections 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
lxmbined 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
1egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third ('Ya) 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 avithin 10 days of completion of any service event.
Page of
START UP AND OPERATION ducts or other chemicals thi {t
For new construction, prior to use of the POWTS check treatment tank{s} for the presence of painting detected have the contents of the
may impede the treatment process and/or damage the .dispersal cell(s). if high concentrations are
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. will bia
b►e
During power outages pump tanks may fit above normal highwater levels. When power is restores the excess wastewater effluent
tank the removed cell(by s) and may result in the backup or surface die
discharged the dispersal cell(s) in one large a Septage Servicing Operator prior to restoring power to the
To avoid this ssituation h avethe contents of the dose, pump overloading
the Pump controls to restore normal levels
rati
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually ope n9
within the pump tank. disturb pip, the area within
Do not drive or park Vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise
'15 feet down slope of any mound or at-grade soil absorption area. the fife of the POWf:
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong
antibiotics baby wipes; cigareft butts; condoms; cotton swabs; degreasers dental floss; diapers; disuifedants; 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 propetly
and safely abandoned in Compliance with chapter Comm 83.33, Wisconsin Administrative Code:.
e 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 code cornplint
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a
rep system: of a rep suitable replacement area has been evaluated and may be utilized for the location
should Hotta regained
The replacement area should be protected from disttuba and compaction will result in the nHed
setbacks from existing and proposed structure, tot lines and wells. Failure to protect the replacement armustea comply with the ru n in
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Baring advances in POWTS technologK a
holding tank may be installed as a last resort to replace the failed POWTS.
❑ The 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 installedl as
a last resort to replace the failed POWTS.
❑ Mound 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 TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE 0 A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name ! Name
r
Phone ,J) - # J'> Phone) i
SEPTAGE SERVICING OPERATOR UMPER LOCAL REGULATORY AUTHORITY
Name I ✓ ~Y / Name ~Ly l l LlJ Il 47
Phone j ~ ;~of Phone
This document was drafted in compliance with chapter SOPS 383.22(2)(b)(%d)&(f and 383,64(1), (2) & (3), W%=Wm Administrative Code.
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Department < r1~ 1 #1886
is Safet! EVALUATION REPORT'k w` -Q I y,
P $ Comm 85, Wis. Adm. Code Ok 4 Pale 1 of 3_
Profession 5VBJOESECE9
BO -nklk cokN Soil Testing, Inc.
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must Countys'(. Q
rlTi St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Paf
Please print all information. ReLd Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). VIP Z/ '
Property Owner Property Location
DCCI Land Planners Govt. Lot 11/4, /ey 4, 17, T28N, R19W
- - - - - - - - - - -
Property Owner's Mailing Address Lot # Block # I Subd. Name M#
1505 Hwy 65 P.O Box 445 24 1 Meadow V f Troy 1St Addn
City State Zip Code Phone Number City Village Town Nearest Road
New Richmond WI 54017 Troy Meadow Valley Trail
New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement
Public or commercial - Describe:
Parent material Outwash plain (PillOt Series) - - Flood plain elevation, if applicable NA
General comments Area is suitable for a conventional system with a 0.7 gpd/sgft rate. Install system on the contour 4 feet below grade. Slope of area
and recommendations: is 6%.
1 Boring #
F-1 I Boring
Pit Ground surface elev. 97.99 ft. Depth to limiting factor - 98+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence~ Boundary Roots G_ PD_/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
- 1 0-16 10yr3/3 none I 2fsbk mfr as 2vf 0.6 0.8
2 16-27 10yr3/4 none sil 2fsbk mfr gw lvf 0.6 0.8
3 27-33 10yr4/6 none sil 2msbk mfr gw 1vf 0.6 0.8
4 33-48 10yr5/6 none Is Osg ml gw 0.7 1.6
5 48-98 10yr6/4 none s Osg ml 0.7 1.6
2 Boring # Boring
Pit Ground surface elev. 97.69 ft. Dept to limiting factor 97+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-13 10yr3/3 none sil 2fsbk mfr cs 2vf 0.6 0.8
2 13-28 10yr4/4 none sil 2fsbk mfr
gw ivf 0.6 0.8
3 28-37 10yr4/6 none Is lcsbk mvfr gw lvf 0.7 1.6
- - - - - - - - }
4 37-80 10yr6/4 none cos Osg ml as 0.7 1.6
5 80-97 10yr6/4 none s Osg ml 0.7 1.6
-S-,
-
Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Efflue #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: - CST Number
Thomas J. Schmitt 227429
- - - - - -
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd St. New Richmond, WI 54017 6/22/2017 715-760-1978
SBD-8330 (R.07/00)
Property Owner DCCI Land - Planners Page 2 of 3
- - Parcel ID #
Boring
3 Boring # pit Ground surface elev. - 96.02 ft. Depth to limiting factor 99+ in.
- - Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
-
-
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~*Eff#l Eff#2
1 0-12 10yr3/2 none I !I 2fsbk mfr as 2vf 0.6 0.8
2 12-20 10yr4/4 none sil 2fsbk mfr gw 1Vf 0.6 0.8
3 20-30 10yr4/6 none sl lcsbk mvfr gw 1vf 0.4 0.7
- -
4 30-68 10yr5/6 none Is lcsbk mvfr gw 0.7 1.6
5 68-92 10yr6/4 none s Osg ml as 0.7 1.6
6 92-99 10yr6/4 none fs Osg ml 0.5 1.0
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/ft2
in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. *Eff#1 *Eff#2
I I
I
I
I
I
Boring
Boring # Pit Ground surface elev. ff. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure IConsistence Boundary Roots _ GP_D/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. *Eff#1 *Eff#2
!
i
I
I
I
Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BOD5 < 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-8330 (R 07/00) Schmitt Soil Testing, Inc.
' Page 3 of 3
Conducted by: Conducted For:
j i
Schmitt & Sons Excavating, Inc.. Name: DCC1 LandPlanners
Thomas J. Schmitt, CST 227429 Address: 1505 Hwy 65
586 Valley View Trail City, State, Zip: New Richmond, WI 54017
Somerset, W l 54025
Phone: 715-760-1978 PID: Pending
Signature- -Lot No.: 24
Date T Legal Description: SEI/4 NWI/4 S17 T28N R19W
■ Backhoe Pit Township, County: ~rgoy/, 'Township, St. Croix County
♦ Bench Mark 1 El. 100.00' Top of 2" PVC Pipe. MCAno~ (64LL E Q 7~ p y ~S f AlAO/Y
0 Bench Mark 2 El. 95.99' top of 2" PVC Pipe 7
Slope= fo 1o
Scale 1"= 60'
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