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HomeMy WebLinkAbout036-1052-40-100 County: St. Croix PRIVATE SEWAGE SYSTEM Sanitary Permit No. 600213 Wisconsin Department of Commerce INSPECTION REPORT State Plan ID No: 2993183 Safety and Building Division (ATTACH TO PERMIT) TION Law, s.15.04 (1)(m)i. Parcel Tax No: 1 052-40 100 GENERAL INFORMA u purposes [Privacy Township personal information You Provide may be used for secondary P rP City Village TOWN OF STANTON Permit Holder's Name : V v Section 7ownlRangeIM22-31.17.326B TAMY WILLIAMS-STA Elev! BM Description ~ Insp. BM Elev. i o CST BM Elev: ELEV ION DATA FS ELEV. STATION ~ ~ C it _ HI ~ TANK INFORMATION CAPACITY d~ TYPE MANUFACTURER Benchmark S 16 t-`~ Lf / ✓ Jl Septic Alt. BM Bldg. Sewer es+p9- n yc ~ ~ ~t . K. -r Aeration St/Ht Inlet Holding St/Ht Outlet TANK SETBACK INFORLATIOBLDG. Ventto Air Intake ROAD Dt~t -,r TANK TO P/L } Dt Bottom J Septic <r-Li f 101,9 Header/man- Dosing Dist. Pipe Bot. System Aeration Holding Final Grade ` St Cover PUMPISIPHON INFORMATION Demand P-TE / GPM Manufacturer J~ v Model Number ! - TDH Ft System Head Friction ~s / 1~y ! f 6 _ . TDH Lift t61 Dia Dist. to Well . . u Forcemain Length~,! <y Liquid Inside Dia. ' PI NS No. Of Pits SOIL ABSORPTION SYSTEMth No of Trenched Manufactur BEDITRENCH Wldth / 1117 1, " " ~y , I LEACHING LAKE/ TREAM CHAMBER OR DIMENSIONS t/7 PAL 41 BLDG WELL UNIT Model ber. SETBACK SYSTEM TO 1 INFORMATION Type Of system: 7 I tr Vent to Air intake ` I r x Hole Spacing ~ x Hole Size DISTRIBUTION SYSTEM; HeaderManifold Distribution t. pipe(s) - / y L( Dia Spacings - stems Only '7 Length x(Mulched / y-Dias Xx Mound Or At-Grade Seeded1sodded Yes No Length x Pressure Systems only xx Depth of I - s IJ No SOIL COVER Depth Over / Topsoil Depth Over t Bed Trench Edges Inspection ! 2' -french Depth over Center Z etc.) Inspection #1: i COMMENTS: (Include code discrepencies, persons present, Q/oLJ P/6 alp Location: 1765 210TH AVE 1.) Alt BM Description = 2.) Bldg sewer length CSrC Y , Ktl<t~-~r~Etz li - amount of cover = f."{. 4o ~ I - I ^ Cert. No. U ~V o f 7~ Plan revision Required? . 7 Yes No Ins Si t o Use other side for additional information. Date SBD-6710 (R.3197) i -~"~o~~ 55" rV 17 391 Cowtry S~ X61 1q a ety and Buildings Division e i 209 W. Washington Ave-, P.Q. Box 7162 Sanitary Permit Number (to be filled in by Co.) CEIVED Madison, Wt 53707-7962 ~Q p~ y , '~SJ0.N~t a,~ Permit Appli E State Trannsaacction Number In accordance with. Code snbmiss;• - C J 1 Q11 1 1 ' is required pr; LWW Ap . Q f r ""'bmitt resit v G ruWT5 are submitted to Proj= Address (if different than mailing address) the Departmerlf! ery and Professional Servies. Person ,u provide may be usdd for secondary u ores in accordance with the Priv , Law, s. 25.04(1 (m, • .acs. j L A lication Information - please Pont Alt Information Property Owner's Name r 'I t Parcel n A* W~~'IUM5 -S~A~ZA3~) Dbri~ S gnz)Ns~ 43G- ~6Sa- b- (k Property OwneessI(M,ailmg ddress y i • v a 1 0 ` v Property Location 1 ~a . ; ~ - T S-12 VF; City, State Govt. Lot Zip Code j Phone Number Nr, flew e' y 7s section (circle oone r TL Type of Building (check all that apply) Lot # T N; R E or W ❑ 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block!: ❑ Public/Commercial - Describe use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of 1 t 11 Town of S' U0~1~ 04 1II, 'T'ype of Permit. (Check only one box on line A. Complete line H if applicable) New System ?(Replacement System ❑ Treatment/Holding o „ Tank Replacement Only ❑ Other Modification to Existing System (explain) B ❑ Permit Renewal ❑ Permit Revision 0 Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner TV. of POWTS S stem/Cam onenUDt vice: (Check all that a t ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ Ai-Grade Mound > 24 in- of suitable soil ❑ Mound < 24 in_ of suitable soil ❑ Bolding Tank ❑ Other Dispermi Component (explain) Pretreatmerrt Device (explain) V_ Dis rsaUTreatment Area information: Design flow (gpdL Design S Application Rate(gpdsf Dippers Area Re wired s 9 (fl Dippers Area Proposed (sl? System Elevation t 1 Sv lov).5 qso toy . .64611 14.7 !0-56 VL Tank (info Capacity in oral 0 of Manufacturer Gallons Gallons Units ° c 1 Nevi, Tanks a -isting Tanks ° U a a~ ✓ t% CS Cl. Septic or Holding Tani; QbV Dosing Chamber n ~Mt~O tot S VLL Responsibility Statement- L the undersigned, assume responsibility for installation of the POWTS shown on the attached Plumber's Name (Print) plans. PI is ign MP/MPRS Number Business Phone Number ~irir ~ b~►l~e-e r i y~~ _ Plumber's Address (Street, City. State: Zip Code) O.,~/(~ I s ~nS~U l~' 014 VM. Coun /De artment a Only PAppmved Disapproved $etmit Feeo Date,,I~ssuued Issuing A. t Signature ~ ven Reason for ial V10 I TA., Conditions of ADproval/Reasons for Disapproval w SYSTEM OWNER: ~O Fws4i.-t l 'v V, d O l 4 b~ d9 Per (fd A. .~j~ 56A QV fk E ck 1 ✓ t 1 1. Septic tank, effluent filter and Lt `T COyot~s dispersal cell must be serviced-/ maintaned as per management Ian provided b plumber. 2. All setback requirerrMfRtt4 tmw-oite gvmw irlft sysmm and submit to the Cuouty only nn {raper nut lass thin a ~r_ s t t inches;n s;re as per applicable code/ordinances. SBD-6398 (R_ 11/11) i~C~;~?t~s.:Rl ~'Y'~'l'?~3 YLs~~t~t~:~9"-.i • l ~~;J. r p 1 lbw► b'( ~ p a «p 1w ar l ^e a f y U ?I u $4 0 MA Permit ~aptt4 Tank manttftrmx l,~l Ltn 17 It1,4 Misr AW. v--hmWbr WA Number C"T 2z Z, ` Pump tank Cepa t NL, nber of r'~ liY reairty U."N~ i MA Burn BI P MA p ~ EMz', W u~ ~l NA d irw ea !lo taverar_ret ! b b std z arar ~Q j 7~sigr :i3vi (Pesltlr ehs2ir l d :.~1 D sllt~ p ?itnts: 9~t`di'8" 2lu'. In G A ' M MA Stall A_PPR,;a'',~an AR92TR ctl *at E Pump 11/t.= I~ Nei i; Stzridard I-~ ftwnt$' T'Ivant aus?yr fLdarnty PvsrsRs* a F.*~~aa meix: Unit Fa°~, oil & Cry tF~ al ~0 MO ~eordteFaucl Ftt~r Q Psi Filter Q Yv z aiYt~! Ai reon ~ ` V6 i Slachermoal axvgan Den! °nd t~~lss:l ~z~t3 m13 NA Total SVZ75 er:6a Scuds t [ ) • 'l e2 .~t:~ 0 NA lll±arrvhY avars w a wisparsal 1M~ltisl wr:?4tea rirt?rt tt ii rif3 %ldram,rlaad3 Clt~Yhani at ;~lrg~n xat;tzrd (BQD t mgti } 0 In Ground igravito in lrrt~rrat tt M 14AI iii^Cwda facitf i nt lrl: :dsd Saws t s 5; ~tg th& .a•~ulTfii~t~ii ' NF-:Fe-mat catwcvan tigsz TaBgla mam I - . NA ' Lt$~~ n~l"oiCt- tg r,13, 'I1I d I~~hEr, T NP M7tCtY i r~rac { Q YdA g 0 MA. ' O~it6r= .,x 4,r~~~x~r$t4Y ~^v~ = °_.7z e _~Iva; 4. ~''~tUL',fi+ ~rtui.`St 1TC tSp-tOSusr _ . cNiPt3{`•41~'`4tyllf%l~la 'tFF7~i9 lr.aEtti1. At is9qt cmaS Vary, ar, - s „I tnsaect aanl ct; :a rkE~! P$ ll~til~t a>RrrtlYi~ta~i slta~igs 070, Sum . s t l~ 4 rzt tJel a tarn vr~ictms l MA Pta'rcp ryert ecsntai + at tatYkia} 1 4 ~ t ° qt rs4 0 MA t At t^asx Or.' au rl . (rtspa : dis a rsat nallta} i a ~ } M MA i At lest aM* a;esrV- . BF 5i. C6aan r~xxitte s; fit°r p tittA a A' i-sst enag WaVv! yq!!; t 5 c~ntrttis a ala= ~ lltt? 11sPect pUM11• , pzsrn,a Y ~d ilr tai At. lei Once F-VarlIt { i ° Fl?..~h fw1a1'sis 3t'i~ ~~a>aYD a~9% I"•S ~1`Bk7~t~l l~ 111J1'•. Q2Aar: AT isP9, ~srtIm PVsrV-' M 14A t f ~ t ~ga~va, t~era ~ a~rtl~ttra~4arss: !il•14~41Qi'~iliF±3 inep cLRertu df artlas and d=t ~stl 's r*ad5 gay 27i Irgu3~it~u~ r~rP~3~g one of GPs (3,(58rTor, mr& J.astar Plumhef, MAS"sr Fk,; Tjber reaxrla ad R eY} r ~34:~d i inel sRxk rl i ~Z3Fri3 ' + £t . aratrM car t$ai~~- 4t F ;~t u praun starf Cc,. i spe'~ fires rates i7~~lr d s j~3stsai iss¢As~ esta at:~lta wsr;lt(sl to i*lerr l all, nltssfio or uctk l h mmamiro the vex z mf acribino sliAge fM" snR~s ar d to ahectr fmr sny &Wk Zi dr fast;s c fiF: h 9>~i ~ .T t~ ~,t ltna nllo dicp9T i Ills} she i Ewa iti3tt~ity mr gact sd tg 6h0l ki"a i fltz 1e,1613 in uh 0 ~0t4 pt ~f }i iLlfln" an li! { U 91di~a'bB~ zandln@ pf ef= l;mt, an ft, grptlfY~@ R. t78 rna lt»~i m $ rBillr3i? LSri 1i4r1 slSd Y&CitilCes CI T~e imrrtedlak6 ra id~sati»» o; .ha 1wal ms s' authwit-Y. VVIIsn the nrmmhin-ed scsntat wlstlon 01 sludge and snur-ri 1A ally Wlk squeals ni't ;ord. { } or m of ha i` n?r v44=, 9, The ari:tire c=rrzents of ,:Ta .ark shati iYe reiraved by a Ggptaaa Sour iCirlg oparAT-or and d!"wd vf In a ard's>Yse mddth oh ptw NR 113: to?isrcnain A.dm1>Sisti'at'raa ~tu3e, ; i~'"y,'r6~,4=: Ail o hsr stet , tt=tr~Ndin.~ Mt sias Ua'A01n 4he sarvioing q), Q;iwant Mars, ma+aimrf1GPl tar : a. i t G~rti''C"a.I TTt~ pt'naY. units, arml any sertiIem-1t$ at i1%rv19a ras X29- m a ft, shall be prformad by c 4}Tc- ',C nt CPS LII~°_'L7Y}( P..,t, tbnriz/ v*ltln IQ Ca rs d rmn, ~Y'i'a'fk'3t" &I v mY.%a ' -T.• :1n u} f~ gr?i^?j is°C)f t r;y`i ;Y? wCl! 8L~ tiD n,-RYAJ ,l1'~} rzJr new -.0J1strucrlon, prforTQ case a¢ the P{ WT'S check -,rep-,Merit tank(a) far the presence raf psTnt -prflch:~is_ tat zrtlter rrhrsrnfcaf3 that may impede the tree aas[tt l)rs~aESS artdlgr msEa :its disparsal call(S), if high concento'do tg am datamnd heva -1119 CiT ti~ntw of the MIMS) removed by a !Mptagp ;astir OIng Operator Zrlar to use. Sv'sterrr, start up shall not aaccur vvhsn soli cendMt ons era froaan at the ?niliXrs;.Iva aurPars. Du; it (aDV3e: out«gJ?« pu np mica rosy fill above camtai high-at>ar iweia. wren power is restored the :SX ZoMa wa6taw.1t r will bo discharged to The Wspn sa# cell(s) in one iarga doss, overloading the c?tlis) Lnd nsa~r resttfr Ln ff3& irac ~ . effluent, 70 avoid "'Y's situation i~teve the cantatas of the pumptans removed by a Sag 147tt ~p or 91srxew~ c~?scl~args a; power to the effluent g=p or aontatt a Plumber or POWT5 Maintainer to assis~ in mans2Lry aisaratinthe cr pump 1urnp controls to ntrolsi.,c restore normal levels wf hfn The punip tan:c. B t_ Do neat drive or park ire .colas over Teaks and dispersal calls, Do net drove cr /earl/ Over, or otherwisa d'gkurb or caJp_ct~ the 2raa within 15 felt down shines Vi any mound or at-grads sill abscrptian araa. Redu Lion or alimfiation of ire foliowirrg fra rn the oratewater sxraatn may improve the Pefflormaiaee and ordleng_tho 11,46 of tile i'l W-118'; antiblotirs; baby wipes, cigarette butts; condoms; cotton sw,a}?s; osoraasars; r!$rt 1 flassr zliapars; dis?rtfa6totlm 'fAv foundation drain (sump pump) ware , front znd s~eg Caftta paaingar, gasalina; arsaza; harbirides: mslat zam" u, medl6912dns; cll: patntirg prcducts; pastlcides; sanltsrV Inapkins, Tnmproim and wa Er seftane.' brine, *r v i%iD Ct5 MEN ',char, t.:e FOWTS f4511S arrftr Is pe, ranantly taken out of service t^s following steps Shan lie taken. to j"I ; tlJa sm, a pr cp=_rly 2nd safely Abandoned in compliance by th Qha r Comm S3-23, wisaaonsln AdmfnlstratTva me., Ail piping a>a tanks and pits shall be disconnected and the abandoned pipe openings sIvaleeZ. The contents of T!, ,n m and pin- She" be ramove.` and "UzP3riv l,(1zPzrt d af, 5)r a SeI scnv"i C.l~_ rc a"'"~= ' ftrr pz rp1-c, }:i ranks and s"IM be excavated a*„ :arnoved or their covarts ra>q zved said *he void -apaoe Med with rii, gran i ar arttath Fner solid maaterlel. ;:std"ro~`;f two he PO-WTS falls and canrs ti be rapairsd the following measures have bean, or miss" be taksp, to pravide a cads carnpifant l2W21°,itiii*. systan, Suitable r lacment area has bean evaluated and may be alined for the )acattaa of are 32~ sys-,arn. Tf+.s replanetrert area ahcuId he prone cted Tram disturbance rind complatton ana shou!d not Inft ng ~by raquired sgtbarks from a4Wr-12 and przposad struCturs, i?at Riles Emd welts. Failum tO pact art tile, rais)scsrrrariv area Will result ;r 1178 need far a nsw sail and site eVEluETTan Ta s_r-tabiisn a suitab:a s'o lac tnri*rx area, Replaoarnerrt sy3gtems MLS1 co:r;pf+r vu h the rules to effect at that time. p G A su:tahle raplaoenan, arse is not available aline to aaa'tback, and/or soil lirnii 1100, 5an'Itt~ evanceaa in POINT$ tachrology a hofdlcg 'trirtk 1.tay he tnsteiled as a last resort to replace the fetled POW 8. ~ 1] Tiis site has rat Kann evaluated to identify a suitable replacament area. Fdporl M;_Ture of the POW T as soli rind aIta; evalwarl an mug-, be per°armed to Inaste a sultabla rarlacernant arm. If no replaceMent area is evellabis a -ho ding tank may be irmtsiled as a last resort to repfeca the fafl>a>d POW T S. D mound and at-grade sail abmrpticn systart:s may ha raconstruaa s-d to plane -"OHOwIng removal of the bfoti at as the it*litrative Surfaca. Recdttstru*tions of such ayrtarnt; talus-, corripTy with tha rules In affect ati that-tirna. SEPTIC, PUMP AND >DTIi~_-'R TF1EA-TM..RNT- TANKS MA.y fr"I NT- AIN e.MAL GASSES ANI IOR IMTRO NOT riil'3ER A SEPTIC, PUMP can OTHER TUATMENT TANK UNDER ANY C1RCISW-,AN t. C-ATIR MAY ' j7j. OS-A DdE IF A PZrj$ON FROM ' YPE i[i TEI fOR OF A T;,:lJX IMA`ir R51711F ZCULT OR IMPOSSIBLE. ~5~3E'e . 1~;S~tIS CIF A AD 01 i 8ONAL COMM WTS r-OWTS INSTALLER N2mA ~+t-{ -t k E hams Phone i ? 1STL ll- 6112 iVama i.~~AL ~sCts~. ~ agsgs+~,'.~'H~s~t'Y Name Ph= l I?i2 CO^4 g 'wr rjr~ t Fhasns I J 3 / Ir. ~~i'"~rr,••...".E iN't?: G.'"tc ~£c,' i; 1 ~i, ;~r a ,a1, 4rt/iscars;x, r tads. ~c r,axstra4?ve Technical `Specifications PL-525 EFFLUENT FILTER (C - 61.7 BALL CHECK -EXCEPTS 6"SH01U FOR IN.ET EXTENTION 157 14 35 ~ ~ 11 r i~ V:J4.-ET BUSHNG EXCEPTS i SOb C 86'SCh 40 610 ass 'J I Sts ,I -I--+ 3302 ~i x I PL-525 FILTER HOUSING 183d PART NO. - 30142-525 MATERIAL HOUSING-POLYPROPYLENE OUTLET BUSHING - PVC 6.5 BALL - HDPE 16 -SOCKET EXCEPTS FLOAT SWTCH i T 1 4 1D.i3 - EXCEPTS I'SCi 40 t0.64 FOR H'DLE EXIEN➢Olv j j - 624 ~l .,3C' OF 1,16' o" SLOTS 7. y r 47 - SOCKETEXCEPTS 604 1 BALL PUSHROC r-- CPBiNG - - s - 0 7.09 I I I p OF'ENPIG r y 0i L - ~K~ 19 02 1224: i ~I POLYtOK PL-525 FILTER CARTRIDGE PARTNO,- 30141-525 i MATERIAL-POLYPROPYLENE 3 NM-M/000ldR:31Ia 95 8-5Z~-008 0 \ :aMod-isod 31V0 00/00/00 31VO 09L~9 N1 'NOOa N301VW OL AAH sn 9LLcm ,df1NdW OIld3S w O Via 313H0003 13531M od-3ad „0- 3 ,1=,4 t 1VOS dOM :l.B NMVaO = ~an \ W4-009/00O Ld-m 0 LLJ N Li J U H Q Q o > D U co O W C) Q 0- V) m w U*) d z pci~ F a. o w r1 m O E op l7 > W o z 0 p oF- w w~ v Z w co a w ~C 0 Q Om ova z_z a w~ ¢ F-i 0 0 o Z L W OQ QJ2 ¢ U M~ z 3> J G! OW HW ~Q V) F O w > v z c) O M V) W W W U D W Z z V) U a a o C) U O D e m J Q ~ p VI 00 co Vl O Y Q a -~0 C-4 ¢ ¢W~ a0^ O N 2 O CO Lj- p d M O w H M W r cp Q U d z NOOOH_10ni FW-NQ ~NQ N~ co p d\ ZZ 6i~ O LLJ ~e fi`n` -j JQU ~?N Z N W F UU Z~ p ~ ~nWW"`O roz J- FD F- Dcn cD pia ww M J N Z U D V) O~ vi..o~0 32r- O¢Y p0w ¢ w mFN o 0-Jr zF-_0 zv¢ zNO O z w w ~x N~ w EDLN~J a4o a O Z Z3mUm2J~}G]J3 O Z U wX mO J 7 ¢ Y > z p Z Z m Q OUP U H J W V) 1 I H Q W p U `z = d > O d D ~ 2 d z II ~ ~ I~ I I ~ I:• o jl - Ic ~ 11 II I N ~I II I > I I I > Q 11 J ~ J~ ° J I I 0- I I „9s _ I w ° 01- LLJ 0- w (n x Cl-I II ~m II II ° Q II. s „e~ f `II Q II 1 ~ ~ I I I~ l N I p • I I o U t') < w Z J ¢ z_ m Zti w ao3a Q „95 s v Y z DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 c Contact Through Relay F+ a~ http://dsps.wi.gov/programs/industry-services w / www.wisconsin.gov ~~ssior +LS~r Scott Walker, Governor Laura Gutierrez, Secretary September 08, 2017 CUST ID No. 222904 ATTN: POWTS Inspector JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 STATE ROAD 35 N l 101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/08/2019 Identification Numbers Transaction ID No. 2993183 SITE: Site ID No. 842278 Tammy Williams - Starzinski Please refer to both identification numbers, 1765 210TH Ave above, in all correspondence with the agency. Town of Stanton St Croix County NW1/4, NE1/4, S22, T3 IN, R17W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1724718 Maintenance required; Replacement system; 450 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/O1, R. 10/12); Effluent Filter C0'v.J The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes ~PP~d and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This systeiln is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) refere &eSAFEC`~ ANA The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance witliwo e pjVjSION OF 1 requirements. A copy of the approved plans, specifications and this letter shall be on-site during construction aril open to fi 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. SEA CORP, In granting this approval the Division of Industry Services reserves the right to require changes or ddditions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing i' 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 r Fee Received $ 250.00 - } Balance Due $ 0.00 Edwin A Taylor Wastewater Specialist, Divisibn- f Industry Services WiSMART code: 7633 (715)634-3484 , Monday - Friday 8:00 am To 4:30 pm edwin.taylor@wisconsin.gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application x INDEX AND TITLE PAGE Project Name: Williams - Starzinski 3 bedroom residentail mound Owner's Name: Tammy Williams - Starzinski & David Starzinski Owner's Address: 1765 210th Ave., New Richmond, WI 54017 Site Address: Same Legal Description: NW1/4NE1/4, Sec. 22, T.31N., R.17W. Township: Stanton County: St. Croix Subdivision Name: CSM Vol. 27, Pg. 6151 Lot Number: 1 Block Number: Na Parcel I.D. Number: 036-1052-40-100 --gALLY Plan Transaction No.: jED IONA~, SERVICES ~F DICES Page 1 Index and title js-~R~( SER Page 2 Data entry / Page 3 Mound drawings f Page 4 Lateral and dose tank / Page 5 System maintenance specifications Page 6 Management and contingency plan v NC~S Page 7 Pump curve and specifications S Page 8 Site Plan Page 9 Concave Deflection Calculations Page 10 Attached Soil Evaluation Report Designer: Jim Boumeester License Number: 222904 Date: 08/19/17 Phone Number: (715) 386-9020 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), 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, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 10 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) 4.50 Site Slope 94.78 Contour Line Elevation (ft) 27.40 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution I I Pressure Disribution Information network? Enter Y or N (C or E) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 2.00 Estimated Orifice Spacing (ft) = 6.08 ft2/orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? ~Y 86.50 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 8.58 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.80 Friction Loss (ft) 73.91 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 30.48 System Demand (gpm) 15.88 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x J 1.00 1.50 x x j 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 603.36 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 16.76 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 603.36 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 16.76 Dose Tank Volume (gal/in) PL-525 Filter Model Number Weiser Concrete Manufacturer Project: Williams - Starzinski 3 bedroom residentail mound Page 2 of 10