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HomeMy WebLinkAbout008-1056-20-300 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CirOIX Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 600241 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2986465 Permit Holder's Name: City Village Township Parcel Tax No: JOAN LARSON TOWN OF EAU GALLE 008-1056-20-300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 19.28.16.2788 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width t ength No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution Ix Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over rxxDepth of 77ded Mulched Bedlrrench Center Depth O Edges oil Yes No `Yes ' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 2149 30TH AVE 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes E, No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Count SAN - -'3q 9 ' RRr.~w EIVEfV Safety and Buildings Division St. Croix 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) cwt P Madison, Wl 53707-7162 OCT 10 2101, 6,,46 ZZJI IA Www- State Transaction Number p~.)t Aye In accordance witthh0SYM8321(2), Wis.. Adm. ode, submission o ~~~~~~~~~~+KVT 2986465 is required prior to obtaining a sanitary permit. Note: Application forms ice( Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for seconda / purposes in accordance with the Privacy Law, s. 15.04(l)(m), Stats. ry 2149 30th Ave. 1. Application Inf rmation - Please Print All Information Property Owner'V # Joan L008-1 Property Owner's Mailing Address Property Location ' . l~ 2149 30th Ave. Govt. Lot City, State Zip Code Phone Number NE_'/a, NE 1/4, Section 19 (circle one) Baldwin, WI 54002 (715) 220-8306 T 28 N; R 16 E or W IL Type of Building (check all that apply) Lot # Subdivision Name ❑ 1 or 2 Family Dwelling - Number of Bedroom 3 Block# ~a Public/Commercial - Describe Use ❑ Na ❑ City of Or I ❑ State Owned - Describe Use CSM Number It) # of ❑ Village of WTown of Eau Galle l~ k o EZ III. Type of Permit: (Check only one box online A. Complete line B if applicable) p A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber FOw it Transfer to New - Before Expiration IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil / ❑ Holding Tank ❑ O er Dispersal Component (explain) Pretreatment-Device (explain) V. Dis ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (st) Dispersal Area Proposed (sf) levation 450 Gpd 0.4 1,125.00 sq. ft. I ft. 104.5 V-W-L vve I Eeitr VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a U cC U V ~ N ti T III New Tanks Existing Tanks ~A o °r Y ° Septic or Holding Tank I leser C crete W LP X Dosing Chamber 0b Na m 1 Combination ST/PC X VII. Responsibility Statement- , the undersignep, assume responsibility ,installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's ' gnature MP/MPRS Number Business Phone Number James K. Thompson MPRS 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zi ode) 340 Paulson Lake Lane, Osceola, WI 54020 VIII. ount /De artment Use Only Permi;ate slued Issuin ent Signature Approve $ o Z SI I ? iven Reason for Dent IX. Condift )Reasons for Disapproval ~I v~ s tJ V I~jb p` rk, erflmn Lifter vnd 1. I'll kept " W :+t cell must aA be ; I c ,s , r nt :r ec It f)ISN2 ' `C erAol. 1* per ipa.rageMent plan p c, naed try plumber. , 2. 'IM per ai rkmW~ers~n s moot tr rL r it:E i / EXI+Sfi~ ~o W'✓ kV ~ Gl f'J u vl ~u C4 as per a~ppNettbls colt.-- ! crd;reano e,.-. `1 ° Attach to complete plans for the system and submit to the ' unty only on paper not less than 8 1/2 x I I inches in size SBD-6398 (R. 11/I1) 3 o-:~'AvC . ~'0 4.+ Lsz -sari r op z/y9 3a ~ ~dc ( o , 5jcp< T ~oc_/, b'c~9-rctS7-~o-oc~ lr 13 7° ~'~_°.''~C•' ~'t (C 4rvu IUr~o`Jll ~ e ~ ~O G ff cic 5 r 104 a(. a i. e (A J 1 . ~ v- ~ w~cco (o~rK~C'c.n6,}tivE/'v>-, s- 2 g vu t o f ed l.~c Eo be ~oiD~ccEcd Q wC 3~~ b ~ u s 14 w N I ~I II I ~ I~ co..,,ary wr DsPs 3e .3o i I _ i 1) I SEE C©RRESP , O1JCcl~CE &V bt r4A&d A P 8 E REP~i1L ~ ~S►/KoME weU ~ ~R~qT-E!C '~L~ 3 RcbMs Y Mound POWTS Index & Title Sheet Project Name: Larson 3 Bedroom Replacement Mound Owners Name: Joan Larson Owner's address: 2149 30th Ave., Baldwin, WI 54000 Site address: Same Project Location: Subdivision: Na Legal Description: NWY4NEY4, Sec. 19, T.28N., R. 16W., Town of Eau Galle, St. Croix Co., WI. Parcel ID 008-1057-60-000 Page 1 Index and Title Sheet Page 2 State Approved Mound Design Page 3 Septic Tank Maintenance Agreement Page 4 Septic Tank/Pump Chamber Cross section Page 5 Filter Cross Section Page 6 Certified Survey Map Page 7 Warranty Deed Attachments: None Mater PIu er Re`Ncted Service: James K. Thompson, DSPS Credential 430021 Signature:- Date: CC-Z. Page I of 7 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01) x7.vrF.~T DIVISION OF INDUSTRY SERVICES ° 3824 CREEKSIDE LN HOLMEN WI 54636-9466 3 } Contact Through Relay http://dsps.wi.gov/programs/industry-services 9 www.wisconsin.gov Z6 tU 16~0 ssro~~tis~ Scott Walker, Governor Laura Gutierrez, Secretary August 23, 2017 CUST ID No. 30021 ATTN: POWTS Inspector JAMES K THOMPSON ZONING OFFICE ACE SOIL & SITE EVALUATIONS ST CROIX COUNTY SPIA 340 PAULSEN LAKE LN 1101 CARMICHAEL RD OSCEOLA WI 54020-5413 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/23/2019 SITE: Identification Numbers Joan Larson Transaction ID No. 2986465 2149 30TH Ave Site ID No. 841463 Town of Baldwin Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NW1/4, NE1/4, S19, T28N, R16W FOR: Description: Three Bedroom EZFlow Mound System \ Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1721474 Maintenance required; Replacement system; 450 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System(s): EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); 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. c~ The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code APF requirements. DEPT OF No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, PROFESSK stats. 0 F I The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • The existing POWTS shall be abandoned per SPS 383.33, Wis. Adm. Code. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. JAMES K THOMPSON Page 2 8/23/2017 • 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Fee Received $ 250.00 Balance Due $ 0.00 4prard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsm.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm JAMES K THOMPSON Page 2 8/2312017 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should Per conditions arise makiuig diem necessary : r code compliance. As Per state ;tats 101.12(2); nothing in this review 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 Fee Received $ 250.00 Balance Due $ 0.00 rard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swi-Tn@wisconsm.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm EZflow0 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Larson 3 bedroom replacement mound Owner's Name: Joan Larson Owner's Address: 2149 30th Ave. Baldwin, WI 54002 Property Address: Same Legal Description: NW1/4 NE1/4, Sec. 19, T.28N., R.16W. Township: Eau Galle County: St. Croix Subdivision Name: Na Lot Number: Na Block Number: Na )NALLY )VED Parcel I.D. Number: 008-1057-60-000 + ETY AND Plan Transaction No.: SERVICES } 6 TF?Y S LETT +r~~ ~ , 4L Es Page 1 Index and title Page 2 Data entry Page 3 EZflow mound drawings 4/ Page 4 Lateral and dose tank °_fvDENCE Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Site Plan Page 10 Attached Soil Evaluation Report Designer: James K. Thompson License Number: 30021 Date: 06/13/17 Phone Number: (715) 248-7767 Signature: 5-- Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, 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) EZfloi,v Mound Version 3.0 (R. 3/1/12) Page 1 of 10 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 13.00 Site Slope 104.00 Installation Contour Line Elevation (ft) F-T10-5--.0-01 Contour Length Available (ft) 30.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 6.00 Cell Width (ft) 3, 4 5 6 7 8 9 or 10 Only 80.00 = Dispersal Cell Length (ft) 0.95 Dispersal Cell Design Loading Rate (gpd/ft2) 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 cr e) E Center or End Manifold 3 Lateral Spacing (ft) If N above, enter the elevation (ft) _ 2 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 2.75 Estimated Orifice Spacing (ft) = 8.28 ft2/orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y _ 97.25 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 4.55 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 6.83 Vertical Lift (ft) 71.93 5x Void Volume (gal) 1.04 Friction Loss (ft) 80.09 Minimum Dose Volume (gal) 12.43 Total Dynamic Head (ft) 31.23 System Demand (gpm) 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 Gallons/Inch Calculator (optional) Treatment Tank Information 602.82 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 51.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 11.82 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 602.82 Dose Tank Capacity (gal) PolLok Filter Manufacturer 11.82 Dose Tank Volume (gal/in) PL525 Filter Model Number Wieser Concrete Manufacturer Project: Larson 3 bedroom replacement mound Page 2 of 10 Mound Plan View 1/10 Observation Pipe _ J K r rr ~r;rs r s s,~r rr III r r %r r r r=r r rr A W I B z 3.... :a L Mound Component Dimensions A 6.00 ft E 15.72 in H 1.00 ft K 8.72 ft B 80.00 ft F 12.00 in T 14.17 ft L 97.43 ft D 6.00 in G 0.50 ft J 4.27 ft W 24.44 ft 480.00 (ft2) Dispersal Cell Area 1613.45 (ft2) Basal Area Available 5.63 (gpd/ft) Linear Loading Rate 8.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 106.50 (ft) H G F t Dispersal Cell 105.00 (ft) Lateral 104.50 (ft)-►~ - 6 Invert Elevation Dispersal Cell: Elevation D . ' 104.00 (ft) Contour Elevation 13.5 % Site Slope Typical Dispersal Cell Shading Key See Page 5 U Topsoil Cap > Q Approved Geotextile Fabric Cover 2 " Subsoil Cap (L V 6 2.0 ft 73 [ 0 ASTM C33 Sand Tilled Layer L .C U) r, r r r r 5 0 EZflow Media °i Q1 F (a o 0.5 ft r=r.r. s.$.r• See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: Larson 3 bedroom replacement mound Page 3 of 10 End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below * = Turn-u p v.Pba ll vatvo or cyan "tpl ufji I' P i list oritir-* loud at Z kX tip s P OWA up except every 5&1 we gourds dooi,n tor drarr age. Form m4iri oionriK€ of via tc-p or ctc~~ t~ rswn~Zi4 at ar~y pv~rd, Lartwsix 6, fe=rc* main or PVC . h 40 All laterals i #erd al vvkh wifrces et uz 'y sNa-ed, per sn r.#1& U430,5 Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.80 ft Lateral Length (P) 79.20 ft Orifices per Lateral 29 Lateral End (Z) 0.80 ft Orifice Density 8.28 ft` /orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 15.62 gpm Manifold Diameter 1.50 in System Flow Rate 31.23 gpm Forcemain Velocity 3.19 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight E-lectrical as per NEC 300 and ► SPS 316.300 WAC 4 n min Disconnect --tt- Tank component is properly vented Alternate outlet location Forcemain diameter Wieser Conciete Manufacturer -:A 2 in Capacity (302.82 Gallons -T Volume 11.82 gal/inch A _ Weep hole or anli- Dimension Inches Gallons B sipr,on device A _ 31.22 369.07 B 2.00 23.64 C Pump off elevation ;ft) C _ 6.78 80.09 98117 D 11.00 130.02 D Tot- al T 51.00 602.82 L Dose ,ank elevation (r.) F--- Bedding And Backfill As Per Manufacturer 97.25 Alarm Manufacturer ;SJ Rhombus Alarm Model Numbeii 1011421 Pump Manufacturer 'iZoeller _ Pump Model Number,BN1r 51- Pump Must Deliver 31.23 gpm at 12.43 ft T D H Note: Swit,,f es containing mercury may not be used in this system. Project: Larson 3 bedreom replacement mound Page 4 of 10 DZflow® Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements 6 ft Wide Component Legend SR1-7A Bundle - 5 ft or 10 ft lengths 1~< SR1-12A or EZ 1201A in 5 ft or 10 ft lengths <'~1 A SR3-12H or EZ 1201 P or SR3-12H in 5 ft or 10 ft lengths 4" Perforated Distribution Pipe With Pressure Lateral Inside Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 80.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 6ftWide - - End Manifold - Project: Larson 3 bedroom replacement mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name Jmaes K. Thompson I Phone (715) 248-7767 POWTS Regulator's Name St. Croix County Zoning Dept Phone (715) 386-4680 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 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 480 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 every 3 years Effluent Filter Inspect and clean as necessary at least once every 3 years Pump and Controls Test once eve 3 years Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years 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 EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. 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 Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins 1 Long Sweep 90 or Two 45 Degree Bends Same EZflow Synthetic Media Diameter as Lateral 2.11 Feet Distribution Lateral a Lateral Cleanout Project Larson 3 bedroom replacement mound 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 ts component manuals [EZflow Mound Component Manual 8/20/07, 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. Sept ~ or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Axcess openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemea insot nu defeCf,ve, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secu,ed by ar, effective locking device to prevent accidental or unauthorized entry into a tank or component Septic Tank The septic tank shall be wa ntaned by an individual certified to service septic tanks under s. 281 48, Stats 7 he contents or the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fiber snEdl 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 mtn an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an mpending continuous alarm. The septic tank shall have i:s contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume cf the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner es 'o when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank TI e addition of biological or chemical additives to enhance septic tank performance is generally not required However if such aroducts are used they shall be approved for septic tank use by the Wisconsin Department of Commerce Pump Tank ne ccsing (pump) tank snail be inspected at least once every 3 years. All switches, alarms, and pumps shah be tested ro verity xoaer operation If an effluent filtef is installed within the tank it shall be inspected and serviced as necessary . If the force man has a ,veep 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 Vo trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mor nd shall oe seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for )egetatr.e maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within she mound and snow compaction in the winter will promote frost penetration- Cold weather installations (October-February) dictate that he mound be heavily mulched as protection from freezing. nfluent 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 ng, 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 7esign flow specified in the permit for this installation Rte pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommenaed that each lateral De rlushec of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test vhen the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal ,is,ribution within the dispersal cell. Obse~i-aation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner and 3m le~e',s above 4 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 n r,rope, operating condition if the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be in mediately cp aired or replaced with a component of the same or equal performance. f the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or ep aceo in its' present location by increasing basal area if toe leakage occurs or by removing biologically cioggea absorption and iispersa! media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Fage 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. ~ruject Larson 3 bedroom replacement mound Page 7 or 1 J PUMP PERFORMANCE CURVE MODEL 1511152/153 TOTAL DYNAMIC HEAD/FLOW 50- PER MINUTE 14 45 153 EFFLUENT AND DEWATERING 12- 40 MODEL 151 152 153 35- s X- 1 Feet Meters Gal. Liters Gal. Uters Gal. Liters 152 = t0 v 5 1.5 50 189 69 261 17 291 10 3.0 45 170 61 231 70 265 8 151 15 4.6 38 144 53 201 61 231 25- S 20 6.1 29 110 44 187 52 197 6 , 25 7.8 16 61 34 129 42 159 30 9.1 - 23 87 33 125 1.2. '13 1 t5 35 10.7 - - - - 22 85 4- 111 t0 40 12.2 - - - 11 42 Shut-of(Head: 30fL (9,1m) 38 R (11.6m) 44 fl. (13.4m) 2 5 0145069 0 10 20 30 40 50 60 70 80 90 100 cu wNs t11FRS C 40 80 1 0 1GO 20O 2 0 260 s RAW PER MINUTE 014506A Model 151 Models 1521153 1 3!.23 (ZTORY t . 41 ~ Kr•wt u al CONSUL FOR SPECIAL APPLICATIONS 67M 61w - 7718 4518 327131 4A • Tuned dosing panels available. • Electrical alternators, for duplex systems, are available and 37re $ 32, a2 supplied with an alarm. 18 ®l 32;,22 • Variable level control switches are available for controlling ® 37/8 single phase systems. i_ • CouUe piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qv&-Box available for outdoor installations. See FM1420. • Over 130'F. (54•C.) special quotation required. 15111521153 Series 1111116 12 V8 15111521153 YODELS Control Sdecdon 4odd 41&to Amps Simplax Duplex 434 5 ,s N151 16.0 1 2 or 3 BN151 16.0 Included 2 or 3 E151 23.2 1 2 or 3 BE151 23.2 Included 2 or 3 SK2d44 N152 18.5 1 2 or 3 B152 18.5 Included 2 or 3 E 152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 f1153 115 1 Nan 10.5 1 2 or 3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Nan 5.3 1 2or3 SELECTION GUIDE EEl53 30 1 Auto 5.3 Included 2 or 3 1. Single pggyback variable level float svntch or double piggyback variable level :lout O CAUTION switch. Refer to FM0477. All installztion of controls, protection devices and wiring should be done by a quahried 2. See FM0712 for correct model of Electrical Alternator E-Pak. fieeased electrician. All electrical and safety codes should be followed including the most recant Nabonal Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. - - MAIL T0: P. 0. BOX 16347 Lousvlk, KY 4 02 56-034 7 Manufacturers of.. r5 d, SHIP 70: 3649 Cane Run Road sk Louisvllb, KY 40211-tve PUMP i ' ~,V,rP~+os SNCE /9~9~ o (502) 778 2731.1 (800) 926 hrtp:Hwww.zoe11ercom PUMP CO FAX (502)7743624 © Copyright 2004 Zoeller Co. All rights reserved. IV~- z/y9 3o EP,gd<. /dw;~, cJ~. 5 yooz _ ~Jevr~rlEl~f; Sec iy,' ~ seat., ~t'.i~ w Tn. a~ Emu 6a!(r S f cp< ~~rv~w~L : T o { /a-~ b'ca9 - ictS7- ~o -ate cy. 1 3 W S S k~ ~t (G,p Jf G 7 c. o cic s t(r Q~eq fFss~..,~cc✓elac! =loo.co.' v~ ~ - ~ . P-pZv-~ U~sfi~.ibancl ~ rcq yds. ' \ -Lour ~ w rcc+ lacnir(/1 C'c..tib,ha~'~F-~ tic ir(-D 178 sue- sw P.d.c, c I of 6- wee /:nc be pio£ecEcd I Q M I T~ lf5 ~ p ' i 'i I I i ~I S/ ~f(STa~ 303 5~ bu r l d; ~ 5<<.,..~ C--A v/y LJ D S PS 38 ,I I y 1 SEE C4R1?ESPp~JG'~'r . tr~Ct 6-C bt REPtAG b KI~Ho.~E cX1S~~y LHAV A( A)v I EX~~Ei✓r. 9nzdc e(.c~ ~r~lycs_. 3 0t-Av ~-o a„ Lasso,-, !or off. /y9 30 ,4 d< . ~cY GJin, u~ ~ SS~~O,Z 'e-16 4-C; T~. o~ Eau 6411e Mwk/ T aacS-1c6-7-&o-oav too. 84 J ~ 63 e4t 6-e 1 ~ 7/trS b~u5L Ia'jK a v I i l I ~ Y/ / 1 0 ~i I' I~ EXi:S E; CV we ~o 3 N~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Joan Larson Mailing Address 2149 30th Ave., Baldwin, WI 54002 Property Address Same (Verification required from Planning & Zoning Department for new construction.) f -340 City/State Parcel Identification Number 008-1-57- 69 QQQ0__ LEGAL DESCRIPTION Property Location NE ,/4 NE ,4 , Sec. 24 , T 28 N R 16 W, Town of Eau Galle Subdivision Plat: Na Lot # Na Certified Survey Map # Na Volume Na Page # Na Warranty Deed # (before 2007)Volume Page # Spec house Elyes0no 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 eptic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 3 days of the three year expiration date. I/we certify that all statements on thi form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warr my deed recorded in Register of Deeds Office. Number of bedrooms ce SIG ATURE 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) Co. 3 air d M-009/0001M :3 13 95~g-5Z~-008 6~ 6C)od-1SOd Vol 3100 00 00 31y0 OSLbS IM 'NOOa N/3~01VW Ol lMH Sf 91L4M ; O~ n3a ~t/f1NdW 3I1d3S w :anod-3ad .,0-,[=,4/l 31VOS dOM :AO NMVaO 313HOUa11 M]531M \ m-009/00ow D I LLJ ry w w F-{ Q Ii < z coo J w O w O Lo Q } U Q U I N m Q m z D O F o w Q (J) o U w r w a IL o z O 00 Li. OP < u v of D U H Q r-) Tjzct C~ t~Q m O Q z z F a w Q 3 (.L. U < Z J= J J Q U m j Z Q v j w 0 o Q-U o I d j q0 0 mcwn wHW Q Z OU S C) o vi Jww D w z ZZW 2J# 00c o e m J Q E 0 cn C c (n O w Y ~OpO V) mNW O) O Q U IL ~p Q I (V c N f O L- J W QI Q W kQ- Lj d\ Z Z Y~ f \ rn w U to w U c~ ! Q N~..J..••~ZJ.. ~(nW Ozw U N W UW OLLI V) w FN i Q cn ..0cr F ..30= ~Y 0OLLJ a w m F N O p0 1 Z L z3mC) -i;~m Qd a° o z v Of 00 :2 J J Q z >Z in E CY f~ O Z Z 0 O< U i w I Q N i e cr) Q H U w p WZ 1- > O ' Li =D g w w i` W - - - W > > t N W 0 o L'i Q \ O J 0 I U 9 1 w „S rl9 I w Q \ m / I U cl~ L'i O I d O N I w J Z_ - „L5 L, a173~! Q SV ,f69 Q cn Y_ Z Technical Specifications PL -525 EFFLUENT FILTER ^1 T BALL CHECK _ - - EXCEPT b :MG L: j. °ORIN ET t .NBA 1435 DUT_E-BUShING E: CEPTa 40 4C 1 r I /y - ~ o Na i s 23 *V / / ,ILA 7 18 3, C F ;I _-525 R HOUSING ~ , PART IA 01 a2- 25 j ALA ERA: rOUSIhG P(k'PRGPY_EP : - r i JL'LE T BUSH11,G - PVC ~ DPL ' a 4 1 r oa ='=xcePr, f oaT sW„+ t e frt i4~DtE ~-(TENPiM g: I _ I :~offroS-OT' t [ n - SO)(ET EXCEPTS 0455o ^ - 3PLL POSY ROD OPENING LA , a 15u7 yy J!_'rWK "L-525FI'LLHC-~R:~ILGE - - I~' P4Z? NG K141.52 A-ER! AL - PCL'YPRCP "LE NE ; i ~V00% CSC -~c ~ - a,3 ~ Wisconsin Departm ac~ Professional Services Page 1 of 3 Division of Industry S rvices n [A r• SOIL EVALUATION REPORT GQ0A GR(~~ `Q ordance with SPS 385, A County 4 St. Croix Attach complete site plan t ess RGvvthan 8 1/2 x 11 inches in size. but not limited to: verti o Wolzontal reference point (BM), dire an r- C019- Parcel D. scale or dimensions, north arrow, and location and distance to near d ~O 008 1 7-60 000 Ref #2465 Please print all information. Rev ed by Date Personal information you provide may be used for seconds ur ot~~ Law, s. 15.04 1 m ~d Z T Property Owner Property Location ❑ Joan Larson Govt. Lot NW % NE '/a S 19 T 2 N R 16 E (or) W Property Owner's Mailing Address Lot # Block # Sub f Name or CSM# 2149 30t' Ave. na na na City State Zip Code Phone Number ❑ City ❑ village ® Town Nearest Road Baldwin WI 54002 (715) 220-8306 Eau Galle 220th Street ❑ New Construction Use: ® Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD ® Replacement ❑ Public or commercial - Describe: Q'!%-f-, Parent material Glacial Till Flood Plan elevation if applicable na ft. General comments and recommendations: Site suitable for mound POWTS. Recommended infiltrative surface elev. to be 104.50' at 6" above 104.00' contour. 1❑ Boring # ❑ Boring ® Pit Ground surface elev. 104.02 ft. Depth to limiting factor 30" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/3 none Sil 2fgr mvfr cw 2vf,f 0.6 0.8 2 8-22 7.5yr4/6 none sl 1msbk mvfr cw 1vf,f 0.4 0.7 3 22-30 7.5yr4/6 none cosl 1 csbk mfr cw 0.4 0.7 4 30-46 7.5yr4/6 f2f 7.7yr5/8 cosl 1 csbk mfr cw 0.4 0.7 5 46-52 7.5yr4/6 c2d 7.5yr5/8 scl Om mfi 0.0 0.0 27 Boring # ❑ Boring ® Pit Ground surface elev. 104.00 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/3 none sil 2fgr mvfr cs 2vf,fm 0.6 0.8 2 10-24 7.5yr4/6 none sl 1msbk mvfr gw 1vf,fm 0.4 0.7 3 24-31 7.5yr4/6 none cosl 1msbk mvfr cw 1vf,f 0.4 0.7 4 31-41 7.5yr4/6 f2f 7.5yr5/8 sl 1 csbk mfr cw 1 vf- 0.4 0.6 5 41-56 7.5yr4/6 f2d 7.5yr5/8 scl Om mfi - - 0.0 0.0 Effluent #1 = BOD, > 30 220 m /L and TSS > 30!5 150 m /L Effluent #2 = BOD, > 30:5 220 m /L and TSS > 30:5 150 m /L CST Name (Please Print) Signature CST Number James K. Thompson t t r`7, . 30021 Address ate Evaluation Conducted( Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 December 21, 2106 (715) 248-7767 SBD-8330 (R04/15) 3 Boring # ❑ Boring VIII/ ❑ ® Pit Ground surface elev. 101.38 ft. Depth to limiting factor 35 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft' In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0-12 10yr3/3 none sil 2fgr mvfr cs 2vf,f 0.6 0.8 2 12-24 10ry4/4 none sl 1 msbk mvfr gw 1 vf,fm 0.4 0.7 3 24-35 7.5yr4/6 none sl 1msbk mfr cw 1vf,fm 0.4 0.7 4 35-47 7.5yr4/6 f2f 7.5yr5/8 sl 1 m&csbk mfr aw 0.4 0.7 5 47-55 7.5yr4/6 f2d 7.5yr5/8 scl Om mfi 0.0 0.0 Boring ❑ ❑ Boring # ® Pit Ground surface elev. na ft. Depth to limiting factor )Nn. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 -Eff#2 1 0-8 10yr3/3 none sil 2fgr mvfr cw 2vf,fm 0.6 0.8 2 8-18 7.5yr4/6 none sl 1msbk mvfr cw 1vf,fm 0.4 0.7 3 18-32 7.5yr4/4 none cosl 1csbk mfi cw 1vf,f 0.4 0.7 4 32-46 7.5yr4/6 f2f 7.5yr5/8 scl 1 m&csbk mfi - 0.2 0.3 5 Boring # ® Boring / ❑ Pit Ground surface elev. na ft. Depth to limiting factor <8 in. ✓ A' Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 10yr4/4 none sil 2mpl mfi as 2vf 0.0 0.2 2 3-8 10yr3/3 none sil 1fsbk mfr cs 2vf 0.4 0.6 3 8-24 7.5yr4/6 mfd 7.5yr5/8 sil Om mfr cw 0.0 0.2 4 24-53 7.5yr4/6 c2p 7.tyr5/8 & sicl Om mfi 0.0 0.0 c2 10 r6/2 * Effluent #1 = BOD, > 30<_ 220 mg/L and TSS > 305 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30:5 150 mg/L 5c"'/c x/yf.30fe,gde. 6,16'CJI/7, 604 SSIOD2 gw~i~7E~J See iYT18~. 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