HomeMy WebLinkAbout026-1290-22-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
600249
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]
Permit Holder's Name: City Village Township Parcel Tax No:
OEVERING HOMES TOWN OF RICHMOND 026-1290-22-000
CST BM Elev: Insp. BM Elev: BM Description:_ Section/Town/Range/Map No
22.30.18.1475
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 15 Benchmark
Dosing , Alt. BMZ.,1(J /43.5
{aeration v ^ _ Bldg. Sewer f -7 9 Q
Holding St/Ht Inlet Q4 ~i -7. St/Ht Outlet SpJ -7, Z
TANK SETBACK INFORMATION S O
TANK TO P/L WELL BLDG. eno Air Intake ROAD Dt Inlet S s
'411. 411 1 t l7 ~ ~y
Septic / A&- I Dt Bottom
J a , ;x"53 ~ - /Z - Z_ 3 -
Dosing O j /53 9 Header/Man. t 7(o / d 9
Aeration Dist. Pipe / 7~- /63 q,J
Holding IL Bot. System
z . °1 /b2 ~ `dam
PUMP/SIPHON INFORMATION Final Grade ip [J~ cm[
Manufacturer Demand St Cover 7
_`ct td°'W,~i GPM w 7- ZV,
Model Number /aZ. ,
TDH Lift Friction Loss System Head TD
A 144 1 , 3
Forcemain Len th a Dia. r/ Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Length No. O Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS Dec,
~SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type,OX Systegv: A • ~U /7 UNIT Model Number:
l'
DISTRIBUTION SYSTEM o
Header/Manifold Distribution x Hole Siz~_// Ix Hole Spacing Vent to Air Intake
Pipe(s) Q I Z
Length \S- Dia Length D Dia Spacing l ~
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx ;Seed d/Sodded xx Mulched
Bed/Trench Center f Bed/Trench Edges Topsoil 1 Yes F' No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1401 129TH ST
1.) Alt BM Description = /t
2.) Bldg sewer length =U y G be
- a
mount of cover Plan revision Required? Yes No Use other side for additional informatiDate 4InsepCert. No.
SBD-6710 (R.3/97)
County
Safety and Buildings Division f
'2 1 D 201 W. Washington Ave.; P.O. Box 7162 Sanitary' Permit Number (to be filled in by Co.)
`Madison, WI 53707-7162
~ Stale Transaction Number
Permit Applic ,3/67Z~ 3
In astcordance y .21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
is req ired * raining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Adliess (if different than mailing address)
the ~ of Safety and Professional Servies. personal information you provide may be used for secondary
ages in accordance with the Privacy Law, s. 15. 1) m), Stats. i
0
1. Application. Information - Please Print All Informatio Parcel #
Property' Owner's Name
zz- 60b
Property Owners Mailing Address Property Location
0 Govt Lot
e? 7 r / f - I
C r R
City State ip Code Phone Number Secti.-2
/ circle e)`-
ek-t L C f T3L2-N, R/_~-- or W
II,Type of Banding (check all t at app y Lot #
Subdivision Name
r 2 -Family Dwelling-Number of Bedroo / r 7 n /
Block# ~~C/1~ ✓ /V
❑ Public/Commercial -Describe Use D City of
CSM Number D Village of
❑ State Owned Describe Use/ own of - l C
rZ .t a
111. Type of Permit: (Check only one box on line A. Complete line B if applicable) /
A. System D Replacement System D Treatment/Holding Tank Replacement Only D Other Modificati n to Existing System (explain
bList Previous Permit Number an¢ Date Issued
B. ❑ Permit Renewal t Revision D Change of Plumber D Permit Transfer to New / ~J
Before Expiration Owner ~JL.' c7 (L~
IV. Type of POW'I`S System/Component/Device: Chec all that apply)
D Non-Pressurized In-Ground D Pressurized In-Ground ~lJ.~t-Grade ❑ Mound > 24 in. of suitable soil D Mound < 24 in. of suitable soil
❑ Pretreatment Device (explain)
❑ Holaing Tank ❑ Otber Dispersal Component (explain)
V. Dis rsal/freat nut Area Information:
Design Flow (gpd) Soil Application Rat dsf) Dis ersal Area Required (s Dispersal Area Proposed System E vati
VL Tank Info Capacity in Total # of anufacturer o
Gallons Gallons Units h U ti
New Tanks Existing Tanks
U ~ P cn 'c. G
Septic or Holding Tank +t f(~
Dosing Chamber,! c?
VII, Responsibility State nt- F, the undersigned, responsibility for installation of the POR'T'S shown on the attached plans.
Plum 's Name (Print) I PI b ignature MP/MPRS Number Business Phone Number
2, z
Plumber's Address (Street, City: State, nCode
L 2,
z-~
VIII. ounty/De artment Use Only
Permit Fee Da Iss Issuin ent Sigh
proved S
Reason for Denial
DMLCondi Q rt~}¢approval 3~ t~ide
I 111
uisy~er. s+, cell rnust all be s ir;,s f it C
ss per -nar.3gement pl&n o doe 1 'uv .jluinbe:. e w
2. AU settArk rest "!IeMs rrlust tic, mairt4il':6<3
per vppknWs cwlo ! ;(d!'.WX0-
Attach to wmpkse plans for the system and submit to 11 County only on paper not less than 812 z 11 inches in size
SBD-6398 (R. 11/11)
i
System PLOT PLAN
PROJECT Oeverino Homes ADDRESS 1433 Cemohous Ave Suite A New R ichmond Wi 54017
SE 114 SE 1/4S 22 IT 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
k
SYSTEM ELEVATION 101.8' 5/8/18 3
DATE BEDROOM
CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
I
r
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
BENCHMARK Y.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter
r❑ BOREHOLE (DWELL *R,R,P, same as benchmark €
I
294' Property Line E
E
e
i
I
to 129th St.
t
Pro 3 Bedroom
House
Huffcutt Combo Tank
2% Slope M ,
B-1
❑
i
B-3
101'
101.8'
B-2
102'
Property Line
140th Ave
~~VAATArtn, DIVISION OF INDUSTRY SERVICES
y~~' Toy 2331 SAN LUIS PL STE 150
ooh 1 GREEN BAY WI 54304-5211
i S, Contact Through Relay
y'o~` P S K http://dsps.wi.gov/programs/industry-services
v wuvw.wisconsin.gov
RO~ssro"41", Scott Walker, Governor
Laura Guti6rrez, Secretary
t. ,
May 30, 2018 ;
I
CUST ID No. 226900 ATTN: POWTS Inspector
SHAUN R BIRD ZONING OFFICE
BIRD SELF STORAGE ST CROIX COUNTY SPIA
1432 120TH ST 1101 CARMICHAEL RD
NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708
SLL
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/30/2020 Identification Numbers
Transaction ID No. 3107243
SITE: Site ID No. 849550
Please refer to both identification numbers,
Oevering Homes above, in all correspondence with the agency.
1401 129TH St
Town of Richmond
St Croix County
FOR:
Description: At-Grade Q Bedrooms - New Construction)
Object Type: POWTS Component Manual Regulated Object ID No.: 1763466
Maintenance required; 450 CPD Flow rate; 110 in Soil minimum depth to limiting factor from original grade;
System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), 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.
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site.
• With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped
prior to homeowner occupancy.
• Wastewater generated from contractors cleaning of equipment and tools and/or left over construction
products shall not be discharged into the drains discharging to the private onsite wastewater treatment system
(POWTS). Waste generated shall be properly disposed of on-site or off site.
• Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to
prevent matting under the dispersal area. All loose organic material to be removed from the POWTS Dispersal
area.
• Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches.
Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil Proper soil
moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire,
the site is too wet to prepare If it crumbles site preparation can proceed If the site is too wet to prepare, do not
proceed until it dries.
• Divert surface water from POWTS Area.
SHAUN R BIRD Page 2 5/30/2018
• All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
• Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c)
• Tank Installation to follow all manufacture's recommendations.
• Pump Floats to be set and verified per approved plan Any changes may result in pump resizing to meet
TDH and GPM Specifications.
• Verify property line(s) prior to installation.
• Well setbacks to meet chs. NR 811 & 812.
• Areas that are occupied with rock fi•agments, tree roots, stumps and boulders reduce the amount of soil
available for proper treatment. if no other site is available, trees in the basal area of the at-grade must be cut off
at ground level. A larger till area is necessary when any of the above conditions are encountered, to provide
sufficient infiltrative area.
• SPS 383.54(l)(e) The management plan for a POWTS shall specifically address the servicing mechanics of an
aerobic or anaerobic treatment tank or a holding tank where either of the following conditions exist:
1. The bottom of the tank is located more than 15 feet below the elevation where the servicing pad is located.
2. The bottom of the tank is located _moi e than ,150 feet horizontally from where the servicingpad is located.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter including; inShuctionS 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 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.
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. All permits
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 snaking 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
This Amount Will Be Invoiced.
When You Receive That Invoice,
Please Include a Copy With Your
Tim Vander Leest Payment Submittal.
Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633
(920)492-2214 , Mon- Fri, 6:00 a.m. - 3:30 p.m.
tim.vanderlees[(ii wi.,_,ov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M.
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date:5/8/18
Owner:Oevering Homes
Location:SE 1/4 SE1/4 S22 T30 N,R18 W 1401 129th St. Richmond
Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07)
Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12)
Page#
1. Cover Page:
2. At-Grade Plot Plan
3. At-Grade Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9. Filter Specifications
Attachments: Soil To
Shaun Bird _
Signature r
License number 2 900
Page 1 of 9
PROJECT Oeverina Homes System PLOT PLAN
ADDRESS 1433 Cernohous Ave Suite A New R ichmond WI 54017
SE 1/4 SE i/4s 22 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
I
SYSTEM ELEVATION 101.8' DATE 5/8/18 BEDROOM 3
CONVENTIONAL AT-GRADE XX)C I
CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter
BOREHOLE
r ~ (DWELL *H.R.P. same as benchmark
a
i
294'. Property Line
to 129th St.
s
Pro 3 Bedroom
House
Huffcutt Combo Tank
2% Slope B.M.*
B-1
B-3
101'
101.8'
B-2
102'
c~ O Property Line
140th Ave
Site Cross Section and Plan View _
At-grade System Sloping u
- 1
M - -i Dimension Feet h
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E -
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Slope
L s
17 .:1 = Plowed Clean aggregate 0 = 4 in. sch. 40 pvc
A /2 to 2 /2 in. dia. e
t _ ;I basal area rti{ti ' ' observation pip
i
Lateral with 2" Topsoil Cap
aggregate over pipe Observation Pipe
With Cap
Geotextile
Fabric
L tir r•!ti~ Ft Lateral Invert
L•ti ti $~';:1: r:r:l:r:r r:r+l:l• Topsoil Cap
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C
Slope Direction
GENERAL INSTALLATION: The at-grade area is staked out along heo9 and plowed with a
vegetation is mowed and raked off the site. The basal area (L x W) staked moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to
form a 1/a inch soil wire when a sample is rolled between the palms of the hands.. The A x B area is
covered by clean aggregate deposited overhead by a backhoe.. Special cafe must be used when
placing the aggregate to minimize compaction of the plowed surface. After' the topsoil cap is placed,
the entire at-grade is seeded and mulched to promote vegetative g . 'Wh, limit erosion and protect
from freezing. The observation pipes are perforated in 'the lower 6 =inches- and secured in Place-
03/05 l ' Page. S_ of
Pressure Lateral Layout
One Lateral - End Manifold
Threaded
Cleanout
Lateral Turn-up Plug
Force Main E
X
L Long
Sweep
90
Bend-
' Pressure System Construction
Df
Distribution Network S ecifications r
Laterals are constructed of Schedule 40 PVC
Lateral Diameter 3 pipe. Orifices are drilled perpendicular to
Orifice Diameter In the pipe with a sharp drill bit and face down.
X Orifice S acin
Ft. Lateral turn-ups terminate with a threaded
E
ngth) plug and are enclosed in a 6-8 inch
L ateral Le cleano
Force Main Diameter a diameter lawn sprinkler valve box accessible
Ft
Force Main Le Ft.
from finished grade.
• • • • Grade
6-8 Inch Lawn
Sprinkler Valve
Box
r -
Page of
03/05 lgj
Specifications
Cross section And PUMP Performance
septic-Dose Tank a
Pump
umber v 4
Tank Manufacturer PUMP deIN
Tank Model Number Mangy'
Total Tank Capacity 6 J ~arm Modal Number G-
Max. Bury Depth G
Switch Type
_ c Head (TDW ` Feet
Total Dynasni
Filter Manufacturer Elevation Head
Filter Model Number S~
Distal Pressure '2'
Network Loso -
aired Force Main LOSS Sb
Minims pump performance eq
Gplvt @ l s Ft TDH Total
Outlet Manhole N*n. 4" Above Grade With Manhole Mira. 4" Above Grade
Looking Deuce. Inlet Manhole With Locking Device
Seemly Mounted r
< 6" Below Grade Sealed Watm t ght war-proof 1
Junaction Bost
Figished~Grade ~
'm MPP t
Vent 12" Disconnect
Above Grade Means
With Vest CAP
{ is
pullet Filter ►
Wet --I r .
Baffle : .
Inlet
A
Switch S and Reserve Capacity `
Weep
Tank Vohune GPI = B .l Hole
<
Volume Gal. . .
Dimension : Inches
(reserve) A;
' < 2 Off Elevation C
alarm) B
Ft •
Q
. (dow) c : Bohm S
Elevation
D;
Total '
a i•:::::':'~>:*: i'i':.'.•. a'a'1:':.'::: la>:': <'i< < < , :::a a < . < . < . < a a < . < , a < ti': i::''<':: i is i.'."::,
tank is bedded and back filled in accordance with the
GEr1ER.AL INSTALLATION: The Wdose
as f by the nv~nufacturery not
manufacturer's product approval specifications. Maximum dWfh of eve effective rocking device (padlock)
be exceeded without prior Approval. Manhole covers exposed to wade
installed. piping at tYte inlet and-oudet is of approved material, commeted to the tank with watertight f1tings, and
leis on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC W bridge the tank
• is sealed watertight. Electaioal servi lies with NEC 300 and Comm 16.28.
excavation and the sleeve page ] of~~, ~
02/05 LJ
i
-SERIES 3
28®
1/2 hp Submersible Effluent(Sump Pumps
The Uberty 280-Series provides a cost effective "cnid- ' Pe/ fpmmnm C ff&. 280-%%dC5 r
12 z
range" pump for on-site waste water systems, liquid 40
11
waste transfer and co martial heavy-duty sump pump
35
applications that require higher; head or more flow.
30
Designed around Uberty's unique "Uni-Body" casting,
the 280-Series will provide years of reliable perforrnance. m I
25
All Models Feature:
• Vortex style impeller permitting passage of solids 1 5
to = 10 3
• 416 stainless steel rotorehaft 5 2 i
• Permanently lubricated upper and lower ball bearing 0
• Epoxy powder oostfinish 0
• All fasters - com melon-resistant stainless steel 0 5 10 15 20 25 35 40 45 50 55 60 65 70
U.S. Gallons Per Minute
• 1)r Di a i T TT
• Stainless steel bottom screen - easily removable 0 38 78 114 156 192 228 270
• Maximum fluid temperaftnw.14W F. LitersPer Mnute
2804kwies Cord Lengths Dimensional Data:
Model X10' 25-(-A-- 3J' 50, Weight 29 lbs.
280 Standard Optional nal 11:11,,al Heigh b IT
281 Standard OpftW Optional optional major 1A kM 10- (model 287)
t
283 Standard Optional Optional WA
287 standard optional WA WA Minimum Sump Diameters:
Model 281, 283...14-
10' cord length standard on all models. For optional Wrath, Model 287 VMF...10-
add - 2, 3 or 3" suf ixto model number.
Example: for model 280 with 36' cord, order 2803 Factory switch Model 281, 2ts3 Model 287
VMF
settings Motor Specifications Turn on level 13- 9.50
A hp 60 Hz 3450 RPM Turnoff level T 4.0"
Oil filled, t onnally protected
Permanott Split Capacitor The Model 283 *atures aidae adkotaWe wkwan* Twat DifrereMid oat io-
8( 0 damps (115V) h w pipe or rraxred g poka vertical float rwdei 287 Is not
4.0 amps 08/23DNO lbw
I Mode12S7
Vn(o odel 280 Model 281 Model 283 ~
anual, Wide angle Wide angle VMF~ F-SerNe
switch float switch float switch netic float for
with quick- with series node fl pits -
disconnect (piggy,-~ will operate in
plug
a 10' diameter
sump
c us Cer dfied
9padRcatlonsa•su6jactm d+engerimwe~wtios.
LiberYpumps • 7000App1e Tree Avenue • Bergen, New York 14416 Phone 800-543-2S50 Fax (5851494-1859
www./fbertyptanps.oam urT2=RM7
5
POW TS OWNER'S MANUAL & MANAGEMENT PLAN Page of
ILE INFORMATION SYSTEM SPECIFICATIONS `
Owner / Septic Tank Capacity OW 13 NA
permit # Septic Tank Manufacturer ❑ NA
ESIGN PARAMETERS Effluent Filter Manufacturer yr 13 NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units A 'Pump Tank Capadty v i ❑ NA
j Estimated flow (average) !3-~ al/day Pump Tank Manufacture
i Design flow (peak), (Estknated x 1.5) aUda Pump Manufactu
1 Soil Application Rate al/da le Pump Model 0 NA
Standard Influent/Effluent Quality Monthly average" Pretreatment Unit
AIA
Fats,- Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter s
Biochemical Oxygen Demand (BODE) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other.
;Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) <_30 mg/L ! -Grade ❑ Mound
R
Fecal Coflform {geometric mean} 5104 cfu/100mi ❑ Drip-Line ❑ Other
a
!Maximum Effluent Particle Size 76 in dia. ❑ NA Other. ❑ NA
Other. Other: ❑ NA
.'Values typical for domestic wastewater and septic tank effluent. Other ❑ NA
IAINTENAiNCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: s(s) (Maximum 3 years) DNA
(Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume ❑ NA
!Inspect dispersal cell(s) At least once every: m onth(s) (Maximum 3 years) ❑ NA
--lean effluent filter At least once every: orttfr(s) O NA
Inspect pump, pump controls & alarm At least once every: El month(s) S r s ❑ ~
.
Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA
par(s) A
ME At least once every: 13 El year(s) (s) NA
bih- ar: '
❑ NA
MIAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal cells shall be madeby 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
ixmbined 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.
'T'he ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
hegulatory authority.
When the combined- accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of
the 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,
bnd 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 within 10 days of completion of any service event
2
P of
START UP AND OPERATION
acted have the contents toftthiP
For new construction, prior to use of the POWTS check treatment cell( tank(s) If high concentrations are pnting products or other
may Impede the treatment process and/or damage the dispersal
tank(s) removed by a septage servicing operator prior to use. s
System start up shall not occur when soil conditions are frozen at the infiltrative surface. will b>e
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will l face discharge of discharged to the dispersal cell(s)
in one large dose, overloading the cells} and rr ersuiaR9 obackup r parr restoring P to
To avoid this situation have the contents of the pump tank removed by a Septag controls to restore normal levels
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump
within the pump tank. the area wlthln
F
Do not drive or park vehicles over tanks and dispersal.cells. Do not drive or park over, or otherwise disturb or compact, F
15 feet down slope of any mound or at-grade soil absorption area. performance and prolong the tffe of the POWf:
Reduction or elimination of the following from the wastewater stream may improve the p
antibiotics; baby wipes; cigarette butts; condoms-, cotton swabs; degreasers; dental floss; diapers; disinfectants; fat foundation drakn
(sump Pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting producgs;
Pesticides; sanitary napkins; tampons; and water softener brine. a
ABANDONMENT I
When the POWTS fails and/or is permanently taken out of service the following steps shall betaken to insure that the system is ProPet Y
and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:.
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
c
• 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
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code cornpildint
replacement system: systeim.
❑ A suitable replacement area has been evaluated and may be utilized: for the location of a replacement soil absorption three m. 4ed
The replacement area should be protected from disturbance eland Failure compaction
protect the replacement aras ringed will result in the nded
setbacks from existing and proposed stricture, lot with the ratan in i
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology 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 a n as
st be performed to locate a suitable replacement area. If no replacement area is available a holding tank may
a last resort to replace the failed POWTS. removal of the biomat at the Infiltrative
d and Mounce Reconsrtructions of such systems must~comply with reconstructthe rules in effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS ENT TANK UND R ANY C RCUMSTANCES. DEATH MAY RESULT. RESCUE
ENTER A SEPTIC, PUMP OR OTHER TREATMENT 0
r
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS i
POWTS INSTALLER POWTS MAINTAINER
Name Name S~
{
Phone Phone 1>
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name ~jb>
Name
Phone Phone
This document was drafted in compliance with chapter SPS 383.22(2)(b)(%d)&(f) and 383.54(1), (2) & (3), W. isconsin Administrative code.
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~ County
f~ Safety and Buildings Division d
<9 County 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
t Madison, W1 53707-7162
b0091 9
cR it Application State Transaon Number
J ' acanr~n x!27 ( , is. Ad. Code, submission of this form to the appropriate governmental unit
for state-owned POWTS are submitted to Project Address (if different than mailing address)
is required P1'1'oT fo obtaining a sanitary permit Note: Application forms fo
4
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
es in accordance with the Privacy Law, s. 15.04(1 m), Stars. yl7 / (/2 ~ . , J
1 L Application Information - Please Print All Information < 1.
t~ Property Ow='s Name Parcel #
U.- 61, fs e
Property Owner's Mailin Ad s Property location + 3C ^ `4 ~1 i SS
~3 lot
r City, State Zip Code Phone Number Section L
( t j . C7 T1_5 , ale
~Y E W
[~2 T We of Bu' ding (check all t t apply) Low -
Subdivision Name
Family Dwelling -Number of Bedroo CX&
Block#
El Public/Commercial -Describe Use f ' ❑ City of
CSM Number ❑ V_ e of
❑ State Owned -Describe Use
t ~ own of
III. Type of Permit: (Check only one box on line A. Complete line B if applica e)
A. stem ❑ Replacement System ❑ Treatment/Holding Tank Repla only ❑ Other Modification to Existing System (explain)
B. ❑ PermitRenew•al 11 Permit Revision han ofPlumb Ci ransferto New List Previous Permit Number bpd Dateued
Before Expiration ` H f 0
IV of POWTS System/Comp onent/Device: Ch k a that
N -Pressurized In-Ground ❑ Pressurized In-Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ H.k ng Tank ❑ other Dispersal Component (explain) ❑ Pretreatment Device (explain) el
V. Dispersal/Treatment Area Information: %
~w (gpd) Design SoApplication Ratc(gPdsf) Dispersal Area uired Dispersal~ 70posed (sfl yst_ ~ jFl
Q
Cs f LG
.VL T
ank Info Capacity in # of Manufacturer Gallons Units
m
New Tanks ExLs ing Tanks m o = a°'i a m
Septic or Holding Tank
Dosing Chamber
VII. Responsibility Statement- a undersigned, ass esponsibility for installation of the PORTS shown on the attached plans.
PI bar's Name (Print) Pl wab er' Mature MP/MPRS Number Business Phone N ber
PI ber's Address (Street, ity; State,
+r-=->
VIII. County/De artment Use Only
atur;
Permit Fee Da Issued Issuiri . ent Sign
PProved ❑ •d
er Given Reas r Denial
it %WMpproval/Reasons for Disapproval
1. Septic tank, effluent filter and u ~J V flare A,
dispersal cell must be serviced /maintained I'^1
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per app i ca 2 cod rtair~~ p~ for the system and submit to the County only on paper not Tess than 8 r2 z 12 inches in size
SBD-6398(8 11/11)
System PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
S 1/2 SE 1/45 22 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CR61X
SYSTEM ELEVATION 97.7/97.5/97.3 4.5' below grade 10/17/17
BEDROOM 3
DATE
CONVENTIONAL )00( CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 156 # of chambers 57
,BENCHMARK V.R.P. Top of
survey iron ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE WELL *H. same
0 R. P. as benchmark
294
Property Scale is F = 40'
Line
Vent unless otherwise
` >6„ Quick4 Standard noted
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
12
4' Long
34" t-rade at Sys e E ion
Pro 3 101'
Bedroom 102'
House
ST 25 A1t.B.
90' B.M.
30'
B-1
2% Slope
5'
3-3' X 78' cells with > 3' spacing70' B-3
20' Vents
All piping shall be ASTM SDR 30/34, within B-2 109'
10' of tank, piping shall be ASTM F891
140th Ave
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 10/17/17
Owner:Overing Homes
Location: S1/2 SE1/4 S22 T30N,R18W 1401 129th St. Richmond
r Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Leaching Chamber rpss Section
4-6. Maintanance an dontingency Plan
7. Filter Cross Se t' n-----
Signature i
License nu erf 226900
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 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 ~ A(l 102.0'
Vent A Ale Grade L
4' 4°° 4,
~ -30/34 Septic Tank
4' Long 5' 4' Lon3 4 " Grade at System Elevation 3 4 Grade at System Elevation
Spacing- 5'
3-3' X 78' Cells
Observation tube/Vent
Same on other end To be located on end of Cells
A
B
System elevations: C
A-97.7'
B-97.5'
C--97.3'
19 chambers per cell
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity / al ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
3ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms 5 ❑ NA Effluent Filter Model ❑ NA
i Number of Public Facility Units j1-NA Pump Tank Capacity al NA
j Estimated flow (average) aUda Pump Tank Manufacturer NA
1 Design flow (peak), (Estimated x 1.5) T3 v gal/day Pump Manufacturer NA
Soil Application Rate aUda /ftz Pump Model NA
i
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODs) Q20 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) 530 mg/L n-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L _XNA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other:
iMaximum Effluent Particle Size 3k in dia, ❑ NA Other. ❑ NA
(Other. Other: XNA ❑
'Values typical for domestic wastewater and septic tank effluent Other ❑ NA
AINTENANCE SCHEDULE
Service Event Service Frequency
❑ month(s)
linspect condition of tank(s) At least once every: ears (Maximum 3 Years) ❑ NA
(Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA
linspect dispersal cell(s) At least once every: ❑ eart(s) (s) (Maximum 3 Years) ❑ NA
,~Y
Clean effluent filter At least once every: ly month(s) ❑ NA
,Xlyear(s)
Inspect pump, pump controls & alarm At least once every: p yea(s)s) NA
l lush laterals and pressure test At least once every: p year(s)s) NA
ether. At least once every: ❑ month(s) NA
❑ year(s)
ether: NA
MAINTENANCE INSTRUCTIONS 1
!Inspections of tanks and dispersal cells shall be made 'by an individual carrying one of the following licenses or certifications: Master
iPlumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must
linciude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
czombined 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
-egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (f6) or more of the tank volume, the entire contents of
{:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
ICI 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 authorityMthin 10 days of completion of any service event.
pap of
START UP AND OPERATION nt tank(s) for the presence of painting products or other chemicals thot of the S che& treatme are detected have the contents of thf3
constrion, For new impede th r trey prior to Process use
and/or damage the dispersal cell(s). If high concentrations tment may tank(s) removed by a septage servicing operator prior to use.
at the infiltrative surface.
System start up shall not occur when soil conditions are frozen is restored the excess wastewater will ble
During power outages lw r levels. When power th surface di stew of eftluenl
tanks may f r above normal highwate result in the backup
the
to the d'rspersel ms(s) in one large does, overbadrng the cell(s) a and may Servicing operator Pnor to restoring Power al to tid levels
To avoid discharged this situation have the contents of the pump tank removed by Septage the pump controls to restore norm
effluent pump or contact a plumber or POWTS Maintainer to assist in manually operating
within the pump tank. disturb or Compact, the area within
Do not drive or park Vehicles over tanks and dispersal cells. Do not drive or park over, or othervvise
~
15 feet down slope of any mom or at-grade soil absorption area. antibiotics; baby and prolong the We of the e P4V1rf
er stream may improvethe performance
'
Reduction wd v4pes; es; of the fokbwin9 from the -,cotton reasers; dental floss; diapers' disinfectants; flat foundafton drain
cigarette butts; -condoms; cotton swabs: deg meat medications; oil; pang produt~s;
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; pesticides; sanitary napkins; tampons, and water softener brine. scraps; ABANDONMENT is
permaneilrdy taken out of service the following steps shall betaken to insure that the system is propetly nce with When the POWTS fails and/or w Comm 83.33, Wisconsin Administrative
Cade:
and safely abandoned in compy
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
wag Operator.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage
removed or their covers removed and the void space fitted with soil,
. all tanks and pets shalt be excavated and
• After pumping
. gravel or another inert solid material.
PrWnt
CONTINGENCY PLAN the following measures have been, or must be taken, to provide a code corn
If the POWTS fails and cannot be repaired
replacement system: soil absorption syste~ri .
A suitable replacement area has been evaluated and may be utilized for" location replacement
stet result in the aged
/ The replacement area should be protected from disturbance and compaction and show be infringed upon iO ro d
setbacks from existing and proper structure, lot lines and wells. Failure to Protect the replacement a am will with the a e;l in
for a new soli and site evaluation to establish a suitable replacement area. Replacement
effect at that time. advances in POWTS technologK a
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring
holding tank may be installed as a last resort to replace the failed POWTS. lure of ft
site
soil and
POWI
#on ❑ The site has not been evaluated to identify a suitable replacement I f plm~ Dais available a holdi g tank may be installed) as
must be performed to locate a suitable replacement
a Nast resort to replace the flailed POWTS.
soil absorption systems may be reconstructed in place following removal of the biomat at the inflttrative
E3 Mound and o gradenstnrctions of such systems must comply with the rules in effect at that time.
surface. Reconstructions
<<WARNiNG>> NOT SEPTIC, PUMP AND OTHER TREATMENT TANKS TANK CONTAIN
UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A
ENTER A SEPTIC, PUMP OR OTHER TREATMENT
PERSON FROM THE INTERIOR OF A TANK MAY BE DI FICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
S INSTALLER POWTS MAINTAINER
~ Name a~.
Name L cr.<,.- ✓ :Phone
17=
L
SEPTAGE SERWCING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name ua ~g
Name ~ - Phone
Phone 1)
This document was dratted in compliance with chapter SPS 383.22(2)(b)(%d)&(fl and 383.54(1), (2) & (3),1Msconsin Administrative Code.
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