Loading...
HomeMy WebLinkAbout018-2011-92-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 600251 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 3007304 Permit Holder's Name: City Village Township Parcel Tax No. south pine builders TOWN OF HAMMOND 018-2011-92-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: q3, I p g- i CS 30.29.17.1101 H TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark 3, G q(e 9'9.,o Septic ~1G v tf- 1 3 !7 Dosing Lawv~ 3 Alt. BM / IL,, Lo✓ '3`' 13, Tpn 1 Bldg. Sewer '44 q Holding St/Ht Inlet 7,Z SsR 5 ~ TANK SETBACK INFORMATION SUHt Outlet TANK TO l ~L WELL BLDG. ent to-Ail Intake ROAD Dt Inlet Septic 7.50 wo / Dt Bottom ff Z o G Dosing 7 5O~ A)04- / Header/Man. Z f q3 Aeration Dist. Pipe Z g 9,17 Holding Bot. System A4,0 -7 kef Final Grade X PUMP/SIPHON INFORMATION 7 Manufacturer / Demand St Cover ZOL1. GPM 11~ ~4 311 q3.l, Model Number BA) '/5z' 7,"7 ( -9A 9 6 V C, Ly Q ct z "7 TDH Lift Friction L~ s8 System Heady TDH/ g, 0 7 tJ (o J o / Forcemain Lengtn+ Dia. 7 ° Dist. to Well /1/ Ya z SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Tre r#f es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 12- 166 oye SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ~e Type System: em i UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution / Ix Hole Sized x Hole Spacing ]VeW(Air ake Pipe(s) Q Z ~ v / Length Dia Length p Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only P1 , Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~`L Bed/Trench Edges Topsoil ~eYes ❑ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /2113li7 ,In1s'pection #2: Location: 792 152ND ST c-r ~o6-~ I,J~ 1.) Alt BM Description = I 1016 11 Vk 2.) Bldg sewer length C - amount of cover = 7 y Z 6 A ac5(Iu1C1~ Plan revision Required? E] Yes No ' ' ~ ~31 Use other side for additional information. Date Insepct s Sig ure Cert. No. SBD-6710 (R.3/97) aV County r. folD Safety and Buildings Division 2119 e'~ 201 W, Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) g ® Madison, Wi 53707-7l e2 pplicaiion State Transaction Number A 3~0 In accordance with SPS 383 submission of this Corm to the appropriate governmental unit L is required prior to Zb a t Note: Application forms for stale-owned POWTS are submitted to Project Address (if different than mailing address) _ the Department of essional Servies. Personal information you provide may be used for secondary 3 purposes in actor the Pri vacy Law, s. 15. 1) m), Sats. ~(t S L A lication Information - Please Print All Information Property Owner's Name Parcel 4 r N~ Property Owner's Mailing Address Property Location 3 t1,) q . o 1 + 01 ~67 ~.(IQ/~ ~ "~l G4 ~ ~ Govt Lot City, state r r Zip Code Phone Number y, Section > 0 X T N; RE W iI. pe of Building (check all that apply) ~ Lot # / 2 Family Dwelling -Number of Bedrooms Subdivision Name F Block # El Public/Commercial-Describe Use ❑ City of illag ❑ State Owned - Describe Use CSM Number ❑ V' e of _ t x l of ` III. Type o Permit: (Ch only one box on line A. Complete line B if applicable) A' 1~ew System ❑ Replacement System ❑ Treatment/Flolding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner W. Type ofPOWTS Svstem/Com onent/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Gr At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil El Holding Tank El Other Dispersal Component (expl ) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed,( S em Elevation VL Tank Info Capacity in Total # of cturer u Gallons Gallons Units 2 New Tanks Existing Tama o a y m m to L~. Septic or Holding Tank - '77-Dosing Chamber VIL Responsibility Statem 1, the undersigned, ass responsibility for installation of the POWTS shown on the attached plans Plum " 's Name (Print} Pl er' ignattue MPlMPRS~Number s iness Phone N b / Plumber's Address (Street, City, State, _ip~ode VIII. County/De a Use Only roved ❑ roved Permit Fe/e~ Date sued Issuing lent Signature Sly L/ ^ DL Conditions of ApprovaMeasons for Disapproval YSTEM OWNER: J 1~9 ~r ,~ts ~t 1. Septic tank, effluent filter and dispersal cell must be.service_dmaintained as per management plan provided by plumber. All se aC requireme E8 system and submit to the County only on paper not leas than 81a z 11 inches in size as per applicable code/ordinances. SBD-6398 (R. 11/11) n P~RTDIVISION OF INDUSTRY SERVICES ~y' rGn 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay P http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary .A :I October 23, 2017 V 'J "F A.F ET CUST ID No. 226900 ATTN POWTS Inspector AL i~ SHAUN R BIRD ZONING OFFICE BIRD SELF STORAGE ST CROIX COUNTY SPIA 1432 120TH ST 1101 CAR-MICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 l~ CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/23/2019 Identification Numbers Transaction ID No. 3007304 SITE: Site ID No. 844041 South Pine Builders Please refer to both identification numbers, 152ND St above, in all correspondence with the agency. Town of Hammond St Croix County NW1/4, NW1/4, S30, T29N, R17W Lot: 92, FOR: Description: At-Grade (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1732468 Revision; Maintenance required; 600 GPD Flow rate; 37 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. SHAUN R BIRD Page 2 10/23/2017 , • Divert surface water from POWTS Area. • 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 resizin2 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 fragments, 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(1)(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 more than 150 feet horizontally from where the servicing pad is located. 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 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/ope ration. 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 a 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 , Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov Cover Page Shaun Bird, Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:9/29/17 Owner:South Pine Builders Location:NW 1/4 NW1/4 S30 T29 N,R17 W L 152nd St. Hammond 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 Test f Shaun Bird Signature i License number 226900 Q i 02?T Page 1 of 9 { System PLOT PLAN PROJECT South Pine Builders ADDRESS 7610 Webster St. Suite 15 Hudson Wi 54016 NW 1/4 NW 1/4S 30 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 93.0 DATE 9/27/17 BEDROOM 4 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of 1" pvc Pipe ASSUME ELEVATION 100° Filter Lifetime Filter ❑ BOREHOLE (DWELL *H.R.P. same as benchmark Property Line Scale = 1/4" = 10' Well is to meet all WDNR setbacks Property Line Area 15' below system is to remain undisturbed 4% Slope B-3 14. 92' ❑ Hu utt Combo nk Pro 4 Bedroom House 93 ❑ to 152nd St. B-1 B-2 94' Grading is to be done to divert run-off away from system Property Line NB.M.* 301' Property Line i 1 C'i At-grade System Sloping Site Cross Section and Plan View _ 7"n 777 E Dimension eet L L• . L L L L L L•L ~ L ~`•L L L•~•L L L L•L L L•L•L L L L•L ~ L L•L L~ L•L L L j ,.:LjL~S~•ti LrL~4 L~L~~:•L:L:L%tifL?ti ti L:ti:~rti Lrti Lr~rLrS~:LrLrLJL~ti ti LfL?LrLJLrL... .B r J•J•J•r•r•J•J•J•J•J•J r r•J•J J•r r•r•J•J•J•r•r•J•r•J•J•J•J•J r•r•r•r r J J•J J r L L•L•S.•L•L•L•L+L L L'.'L•'L■L•L•L•L•L•~•L•L•~•L•'■'~•L•L•L•L•L•L•L•L•L•'L•L•L•L•L L L i { 'L:'~jti ti ti:'L?L?ti ti~'ti~LrtrtirLrti•~'L':•y~~'.~1:tii1~'L~'L~L L?L?tirl~~tirtirS?1~ti.~'L?'.?~jtijti~'L?LJLJL 1 1/6 B rL:•L:L:'L~ti•'.~5•~L~ti~ti?ti~1~'LfS.jt~ti~ti~ti ti:ti irti 'Lrtj'L:L%ti?1~:ti~1~~'•.~ti~tijL•Lr~iL?LrLfLJLr~ 6 { r~:R:1:ti:~:~.:ti~L 1•~ti L~'.~ti,L~ti~ti•L?'~.~1?ti:tir'Li~?ti ti Lrti•L:'.:'L:ti~S.~L~'.~•ti ~:'L:tit'~~ti ~?ti i.. V r J•r•J•J•r r J J J r r r•r-r•r•r•r•r•r•NAr•r•r•J•r•r•r•r•r•r•r•r•r•r•r•r•J•r r r• W A { ~'~'L■~.~.~•L•~•~•~•L•L•L•L•L•L•L•L•~•~•~•~•~•~•~•~•~•~•L•L•L•L•~•~K.L.L.~•~•L L•~ '.?~?1j■ti,ti ~?ti t?tijLr~Lr'.r~,ftir~L:tiiL:'.~'L~ti ti,'•t~rti tijtifti ti ti ~rti ti:ti:ti tirtijtirtij'Lr{rti •L~'L{ 2.0 { - r .r•r•J•r•r•r•J•J•r•J•J■r•r r r•r•r•r•r•r•r•r•r•r•J•r•r■r•r•r•r•r•1'•r•r•r•r•r•J r r• { { r r ri='r~ r r.r~1.... ~r,r:r r~r~rtir r tiJtis';} r,~rtirtiJtii r,r r,r r r r:r:rtir~r r rti { L•~•L•L•~ 'L L•L•L•~•~•L•L•~•L•S•~•~•~•~•L•~.L•S.■~•'L•L•~•~•L•L•~•~•~■.ti.•y■~•L•~ L ~ { r•r•r•1'•J••1 r r r r J l•r•J•r•r•r•r•r•r•r•r r•J•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r r r ~r~r F 0.5 { J:f:r:r:i rtir rtir:r~r rtir:r■}tir•r~r r:r:r~r~•r■r~r J rtir:f:r~r~.'r t~r:r:r~r~r f/r E 5.0 { ftir,J,jar%'~rtir:',t:',}:'rLry~••'r1r r~%1'tir~r r r r:r,r~1~r r r:f~ryrtirsftir 1 r~,r r r r~ { Jtiry111 11.t~r1J~1~r~~':r:J:f~:r~r~Jtir r~r rte! ter r~f~f r~r r+r~r r:f:j:PLJ' r r~rLr~J~{ CJ 1.0 .•L■L■L•L•L•L•L• rti jLr~r~j~f~r~1,~Jy ~rLrLJSjtifLrLfbrtir jLJL~tiJLJ~• JL'rL'1`Ld•rLr J■ -'~r•r•J•J•J•r•r• L•L L•L•~•~ ~ ~ L•L ~ L L•L L L LA L L L•L■L•L L■L ~ ~ L L•L 776 { 1 /6 B / W E B Slo e ~ L { - = Plowed ati = Clean aggregate = 4 in. sch. 40 pvc { basal area rtir~ 1/i to 2 %2 in. dia. observation pipe L Lateral with 2" Topsoil Cap aggregate over pipe Observation Pipe Geotextile G With Cap Fabric .•:r r•rti' • Ft Lateral Invert r•r J r•r L ti•L•L•~•b 'i IR + fi~ iN ~P a Topsoil Cap r ~•r•r•r•r•r• r- `r:r~J~r%r~J~r• ~i• ~ ~f ~ i.1 ~ s,~ r~~~r~J6f.•L,~,L, ti,'L•ti•~.L.L.1,.~•L•L•L ~ ~ ! r ~ p ~~~1~~y~I4 L•ti•ti r•J•r•r r•r•r•r.r•r ~•r•r•J•r•r•r•J•J•r•J•r• r.. rti~1'~r~, I.' :tire ftif:'•L•~j':j:r~r~r~J _1 rL': ~.ti.L.L•L•L Lw, Ft Contour ~rtir;.•;. L .•L•~ - • ~ ,r,f,J,jarLr.,r.J•J• y1..J_r J~•_r,~.r•.Srti ti~ti~'~r f~r' -•a~lw2:~r:r:r:r:J•J•J•r•J•J•r'r'r'r'r'r'J ..,.v.,-~~..7,,e,~s;,'L,a'.L•L•L•L•:~ftir r 1~r,`r'r . L•L• , D Plowed Surface Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 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 care 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 growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches. and secured in place. f~ 03/051gj Page 0 Pressure Lateral Layout One Lateral - End Manifold 4 Threaded Cleanout Lateral Turn-up -0 Plug Force Main X~ L Long Sweep 90 Bend so r w e Pressure System Construction Distribution Network S ecifications Lateral Diameter Z In. Laterals are constructed of Schedule 40 PVC Orifice Diameter -5-13 7_ pipe. Orifices are drilled perpendicular to X (Orifice Spacing) In. the pipe with a sharp drill bit and face down. L (Lateral Length) Ft. Lateral turn-ups terminate with a threaded Force Main Diameter In. cleanout plug and are enclosed in a 6-8 inch Force Main Length _5"K) Ft. diameter lawn sprinkler valve box accessible from finished grade. Grade •••••••::0::. 6-8 Inch Lawn Sprinkler Valve Box I Page of 03/05 lgj - Septic-Dose Tank Cross Section And pump Perfonn.ance Specifications PUMP Manufactm~ Z Tank I mufeturer pump Model Number 'Tank Model Number < Alaim Mamma Total Tank Capacity Alarm Model Number Max. Bury Depth switch Type l C ~ Total Dy~nic Head (TDB -Feet Filter Manufacturer ~ Elevation Head Filter Model Number Distal PreSsure Nk joss uired Force Main Loss 0 Minimum Pump ~erforinauee GPM: @ Ft TDH Total ' Ip Outlet Lvkahole ilrfin. 4" Above Grade With Manhole Min. 4" Above Grade Looking De~ice. Inlet manhole With Locking Device < 6" Below Cn'ade Sealed Watertight Securely M unted weather-proof Junction Box ~ ~ w~ ~ ~ r~ s rr ~ ~r a Finished-Grade Vent Min. 12" Disconnect Above Grade Means • With Vent Cap :a <s > Outlet Filter _ _ - - - - - - - Inlet ~nlet Baffle A L/4" Switch Setngs and Rmerva Capacity Weep Tank Volume = i GPI -74 B Hole Gal. Dimension : Inches Volume (reserve) A. - Off Elevation C (alarm} B: 2 • : 13,:;r Ft Bottom (dose) C ? Elevation D (dead) D 5 Total ; Mllr • < : < a aTi i s < < t < t t <>t,<>t <>s>.>a> > ><r• t: o<>•, <1 ><>a>i a>i 1•i i :a>{>{•t>s t><>! i•1 t 1 1 < 1 >;i<>.;>: <>a•::: >a>< t o < a r 1 a/>a / a t a < t a GENERAL INSTALLATION: The septicidose tank is bedded mad bade filled the ~ with of manufacturer's product approval sp@ciScations. Maximum depth of bury as spaded by th be exceeded without ppor alpproval. MarYhole coven mposed to grade have an effective loclcinB device (padlock) installed. Piping at the inlet and'oudet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Soh. 40 PVC to bridge the tank excavation avid the sleeve is sealed watertight. ElecUt-al service mplies with NEC 300 and Comm 16.28. of_7 02/05 L page - TOTAL DY PERCMly~ D/CA. ACIT'( EFFLUENT AND DEWATERING HEAD CAPACITY CURVE MODEL 152/153 MODEL 152 153 Liters 1 Col. ; Liters L Feet Meters Go.. 50 5 1.5 69 251 77 291 153 10 I 3. i 61 231I 70 ! 265 40 15 4.6 53 201 61 231 12 152 20 I 6.1 1 44 167 52 197 o j 25 7.6 34 129 42 159 30 301 9.1 1 23 87 I 33 125 v 8 22 85 o J _ 11 42 20 40 12.2 - - o Lock wive: 138.0 r (11.6m) 144.0 Ft. (.4n) Dti506 j 10 i 0 20 40 60 80 100 I 5 1/a GALLONS LITERS 80 160 240 320 - 3 27/32-Ir--- 7--, 5/8 1 0 1 FLOW PER MINUTE ! ; 27/32 ii I I CONSULT FACTORY FOR SPECIAL APPLICATIONS _ -r Q 3 27/32 • Timed dosing panels available. I t Electrical alternators, for duplex systems, are available and supplied with 1 an alarm. I • variable level control switk hes are available for controlling single phase systems. are available for variable • Double piggyback variable level float switches level long and short cycle controls- - • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. i L 12 1/6 7"~1521153 Series j ;I 5 1/6 1521153 MODELS Control Selection j Du ien I Model voRs-Ph Mme? s S i s 1 2 or 3 N152 115 1 Non 8.5 r 8.5 uded 2Or3 InG BN152 115 1 AtM 4.3 1 2 or 3 E152 230 1 Non 4.3 Indu ed 2 013 . SE152 230 t ° 2 or 3 SELEC710N GUIDE N153 115 1 Non 10.5 1 back variable level float 10.5 ircluded 2 or 3 BN153 115 2 or 3 1. Single piggyback variable level float switch or double piggyback 5.3 1 £153 230 1 Non 5.3 lnquded 2 or 3 switch. Refer to FM0477. B£153 230 1 °pm 2. See FM0712 for corned model of Electrical pitemator E a duplex (3) 225 used as a control activator, specify P o cAtmoN All tnstatladoo of controls, protection devices and wrong should be done by a qualified 3. variable level control switch 10-0 All eechical and safety codes should be followed including the most or (4) float system. licensed electrician recent Naional Electric Code (NEC) dodthe Ocoupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered intone design Of every Zoeller pump. kWLTO: P.O. BOX Man~factrxe*saf.. Louisville, KY 40256-0347 SHIP 70: 3649 Cane Run Road QTY peas SNCf ~y3rq ° Louisville, KY 40211-1961 £ ® (504 T78-2731.1(600) 928-PUMP + Q//~fl `Q FAX (502) 774-3624 h1YPJyn'wr+'.z°ell~ com `L~ ed. © Copyright 2000 Zoeller Co, All rights j Is S o 4~u POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner .nom Septic Tank Capacity d-.5" I ❑ NA Permit # Septic Tank Manufacturer /716 A 7ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ,16 NA Effluent Filter Model ❑ NA Number of Public Facility Units qL" 'Pump Tank Capacity j al ❑ j Estimated flow (average) 6 aUda Pump Tank Manufacturer - i i Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer e ❑ NA i :Soil Application Rate ! aUda /ftz Pump Model -5" ❑ NA i i Standard Influent/Effluent Quality Monthly average" Pretreatment Unit 'Irw Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 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& ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) G30 mg/L / - \ - de 13 Mound Fecal Coliform (geometric mean) 5104 dull00ml ❑ Drip-Line ❑ Other iMaximum Effluent Particle Size 3k in dia. ❑ NA Other: ❑ NA (Other. NA Other. ❑ 'Values typical for domestic wastewater and septic tank effluent. Other ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency linspect condition of tank(s) At least once every: anth(s) (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (Ya) of tank volume ❑ NA Unspect dispersal cell(s) At least once every: month(s) (Maximum 3 years) ❑ NA ear(s) Clean effluent filter At least once every: month(s) ~ ❑ NA y ar(s) Inspect pump, pump controls & alarm At least once every: month(s) ❑ NA ear(s) I%sh laterals and pressure test At least once every: ❑ Month(s) ❑ NA e r(s) T)ther. At least once every: month(s) ❑ NA ❑ year(s) ether: ❑ NA MAINTENANCE INSTRUCTIONS :.Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of immbined 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 I•egulatory authority. I,Nhen the combined aocumulation of sludge and scum in any tank equals one-third (Y6) or more of the tank volume, the entire contents of j:he tank shah be removed by a Septage Servicing Operator and disposed. of in accordance with chapter NR 113, Wisconsin Administrative Code. INN 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. la service report shall be provided to the local regulatory authority within 10 days of completion of any service event 0 T". Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thelt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thp tank(s) removed 'ay a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will ble discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenlL To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehides over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT,$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting product1s; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safety 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. • The contents of all tanks and pits shall be removed and properly 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 compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systeim. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requhled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologlr a holding tank may be installed as a last resort to replace the failed POWTS. e site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. ound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative su ce. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS - POWTS INSTALLER POWTS MAINTAINER Name Name Phone 7 - Phone 7l 1-6WA SEPTAGE SERVICING OPERATOR P PER LOCAL REGULATORY AUTHORITY Name Name f E x hone Phone ./J P2K - This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. + i A A I S•1! i I 4 i i t ~ u. J 6 I L7(1> cr) o ao P oo I ! .z i O "I f LL- i QO 1 w• m a Q ' ~ N ? a ~ I Q J CO v ! Z 3 O CL U p LU i i III 1 i t i SOIL EVALUATION REPORT pop t~c.I motaedwy.na ECEN +.t•• Csmnearp,Vft A4= Cuft Cawegr Io xWd a etat ram wan a us 11tON Apadt aa,~plae;;p. em pper 1'atoa{ W. ttdudr. Md ltot seat ,eo,i. pe►oetdrktpe.atwls tkde t'~ Udb~a tprtagy taw. R 9 1 ' • ptepmty a W NUJ 130 T29 N nit Eta GU& 114 Ulettit p BnbtL or s Mtt5lnp Lot ptopsdy E c ~ ~ h ~ 5th / ~ ao c~ea PA*Mmnt ~.NewCatatrirrdion us«~lootdenael, t+lwedeat of tesdtoans cede de,bed ttoegte rhnv ante t7 O ptddta ar comtnatdol • Deeeatbe: a a ,IN~Idc _ 1~.._.. R Hood Plain alm slkm PI panatd atetetlel t I ~ O"o;0011ana1110 r ~~cc!• r and leowwwwatbms: f Sr ~e v i s 00 tlotb~g hti E p PIt Otwntd *W cc elov.'i J • - d. mdft 1acWr . g~ liealbst Rabe Toone Sbudwe Cwrobteace Oowdoy tlutsts tk IF, Dopth DombumaCdbt RadarDatottptmn Or.8ZSh 'EWi 'Eftlt4 h. Mumma . Qu. Sz. Cant Cow Y or. I e. i rJ c S . ~t `r El ta`f'a tirowutswiacoeW. Sol Rate lh> km Depo Oot~otd CWw Redlo DemOtbn TtwOuee 8buduie Ccnstsletace tlautttlery Ruins SL C;rA COW Or. SL Sh. •Ertit tR MtinseD tlu. V w -Z- tam- Aibk- L -L-~ • EfJlua t ii • BOO it 3n! x20 cgA. and Too 3,30 =180 •Ott 02 ~ BOO 130 sled Tab S 30 Ada e CST CST None vbm pdaq L?ale (gnthlvAd Tale tRte @hate6er Address ` y 7/ :5 7t'p•.:. I I v7i P.w to PRO ❑ o~ daNplg taawr soa raw 3 ~ t~latlndtxLllacaetav.~~.~. • • c~wh S Pit _ Roots Cmhmwwm . Ytadure or. SL Sh. *IM Holm Dep41 Domes Cow till! COW 2 L1~, r,n~'f c 2 5L 1 r i I 801111Q / ❑ ®aMg R Oepth to TA101 l tadol - bl Rsge 0 p4 Taxwe sumo" Cnlxlb~a Bowxiwtr Roots Italimn Daa1P -EMI Dspth Don"t Radx Of. StSh. ~ g 4u. W- Qmt tbbf i I soft 0 Q ph C www "Own dw. . N. owl, to tInum indw IWO f Hal wtton DopK► O RalmcDomm m TOWS SVUck" Colddwm Boo+x~ry '~Lt 'EIpIZ amilent ts. RIIxISOO (UL Ss Cant t:o>or pf. SL Sh. s ~0 720 algll ead TSS>30 5150 ' t:llMxx>t tt2 a WD,590111A mo TSSS M mg~L- £Rll"#I IMSa 5 sx o nr{ a" cmpluyo~ If yon wad sssiatanco to scam was or at 6826WISI ITY 603"264 'fha lfopsrlmewt of Cotnnwsca to a4 squat appanm~ sip tx antsct tiw ticpatulent yr .7- med aatesiati in an $U mla* format, P ' soaalxrulansr 1'ACiL• ~,VF~ . HAML': S'Eri's~~...._ IA)i'N~Z..1.1itiAl. i)li:il tll'1'1tJIJ~I~JN•1.oMJ1~•1.S3e'1'L~,P1,R,1 1:(~u?® I SCAM EMA ION:._ 10 0 .O ! tiht 1 DESCR319'101'I:,30-4--O,. Xr_P!(C_- fi - 13M 2 QCSCIZlPT1UN: -b~ s. 1 ~`~vc.. SYSTuhi C. LEVA'TwTd SYS' mm.1'YI'ti: Ae aZ,,o a 11 • L. e~ DATE: SIGNATURE: - - h O, ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O'VVNERSH [P CERTIFICATION FORM Owner/Buyer Mailing Address X/0 Rip" q, Property Address 22: ~ 2, ,.t . (Verification required from Planning & Zoning Department for new constrmction.) 0/' City/State Parcel Identification Nuiiber LEGAL DESCRIPTION Property Locatiz'/20 1/a ,Sec.-~~ , T Z~N R W, wn Of C~- Subdivision~~'.1~/ff~ Lot # Certified Survey Map # Vc: iume Page # Warranty Deed # It z✓ ~i / - , Volume , Page # Spec yes no Lot line` identifiable ( y" no SYSTEM PENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper a>auntonaum consists of pumping out the septic tank every three years or sooner, if needed, by a licensed puaper- What you put into the system can affect the function of the septic tank as a treahnent stage in the waste disposal system. Owner =Mknanoe responsibilities are specified in §Comm 83.52(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 foarrm, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pamper 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. Vwe, tlbe undersigned have read the above requirements and agree to rmuntain the private sewage disposal system with the standards set forth, herein, as set by the Departn entt of Commerce and the Department of Natural Resources, Stale of Wisconsin. Certification stating tbat your septic system has been maintained must be completed and retuned to the St Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all stets on this 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 warranty deed recorded in Register of Deeds Office. Nu of bedrooms SiC&ATURI~ OF PLI 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 dw certified survey map if reference is made in the warranty deed. (REV'. 08/05) ~l~t' wo 2„c-ga.a,o~Y I~1Fys 7G - 9ccs-oze-puv i- I r ~ Cana uea Ma.ouv Ntlltl 'S3214Ntl 31, uUOD u1.0-e z x ~NOI1dIbOY]0103COYd ~A0030[AOYd SON[MWO 53~ QE3° o° ''ll ~ rpm ~k wa ■ <3 I,, 0 i 71 ®o o Z 4 111 Id I x iLLIL ®D~i®D l Vill, I ~I I Iii II i I i II I ~ 0 ~I II''II DD ~ ail I I~ I 01101 lll, 0a 1 I ~0 IIiI z ®0~®® Q ~ II Q I I . 1~ D > w w i~_ III w w I z z 'I~ III II w o I Jo001 LL ❑oo ❑Od O I~~ I I ' i l li , I I~ iI I I DI, I iI ll~j Z i 4 r w sit= I~• 3u ~a II ii i! ~ III LL o~= Fw~f <a e3 26' p~G III o~n m t7~ ~ v s~Na , ~7m5 n z All qt z 2a' 4 0 o z z 0 Z SD ~a~m8 ry -o-I > gig ;I i Ir; oI~ h~"o o2~1 - 2z•-a' 2s6• 29 24' 26' y A .o ~ na F-Jj g~ 55 S .g 77 as ,I 3 $ n I z I I lHill A N II .'.III Z N I. I a E n n (7 2 °i 0z m o m 5 z It I I` I - 2' M~ 22'-J 3IC' t 25'-8' a~ ~$5S OMWINGS PRO 60RIRTION: ' z ,on LLC ANDRESE ALAN o, _ B-Dirt Construction LLCr ' Andrew Ranweiler ~C M m 218-820-5736 an { N drewOb-dirt.com 0/1 0/201 z 11 as Parcel 018-2011-92-000 1AM PAGE 1 OF 1 F 1 Alt. Parcel 30.29.17.1101 H 018 - TOWN OF HAMMOND Current XST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 08/18/2009 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - STOUT, RICHARD O RICHARD O STOUT C - BAST, KERNON J KERNON J BAST 1353 AWATUKEE TRL HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description 792 152ND ST SC 2422 SCH D ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.730 Plat: 5648-CSM 24-5648 018/2009 SEC 30 T29N R17W PT NW NW FRL BEING PTS Block/Condo Bldg: LOT 92 EMERALD ACRES 1 ST LOTS 36, 38, 39, 40, & 42; NKA CSM 24-5648 LOT 92 (2.730AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 114) 30-29N-17W NW NW Notes: Parcel History: RETIRED 2009 FOR 2010; LOTS 36, 38, 39, Date Doc # Vol/Page Type 40, & 42 EMERALD ACRES 1)ST 08/18/2009 902245 24/5648 CSM (018-2011-36; 018-2011-38, 018-2011-39; 06/16/2004 766092 2597/300 WD 018-2011-40 & 018-2011-42; (1051, 1053, 1054, 1055, & 1057) TO CSM 24-5648 LOTS more... 2012 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/11/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.730 32,400 0 32,400 NO Totals for 2012: General Property 2.730 32,400 0 32,400 Woodland 0.000 0 0 Totals for 2011: General Property 2.730 32,400 0 32,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ii REPORT Page of Wi" consin Department of Commence F Ti ,~L Division of Safety and BuflcJAtgs i mm 05, Wis. Adm. a Counly in accorrx-e wr 1 C('- zo, plan n1unAM Altactl Wngilele sit plan on impel rot less lhrni 117_ x 1 1 seasi include, h dnot thrilled to: vertical and horizontal felence point (BM), direction an Palml I.D. percent dupe, scale or dimensions, nollll allow, nd IoitiLQf+dll llEs(nnc© to nvatel toad, ' ~O / /_%6U J d Please print all In ~~n~ i edby - Date Personei b/omrnllo i you provide may be used for secondary pmpoaas (piivncy L. e. o. 1) (nr)). ~ / l Jf Properly Owner Ptoperly Location r> ti, Govt Lot 114 ,^,j t,; 1/4 S f 2_`-~ N R VI E (or ~W Property Owner's Melling Address Lot # Ulock # SuW. Name or CShifl _ -~j - r r _-ey-(Ad Yf'°~_15` l ~ck~t 1t "i> - City State Zlp Guile Phone Nw! nber ❑ Cily ❑ Village 64-1 own t learest Road _ 1-~~..~C1`:~n ► (;yl i `3-~OL~ i (ll~~ ~->~~-{~~3I c:~n~rl` K~~-~j-____ _LC~~._I~ci_. ~_T '4-Uaw Conshuctial UswtXlTesideutial / Number of bedrooms _ _ CWo derived design flow rate GPD Replacement U Public or commercial - Describe: Parent material Flood Plain elevation if applicable General comments f S/~'H't -elet . 1W, C' and reconmlendalicxls: Y _ ('C` ✓1 ~ 'til t'J' f Boling SC- Bwiny # ~ rya~l Ground surface elev.l ==t_ L I. Depth to limlliny factor _-3.___ in. - Soil A plicafion Rate Horizon DepR, Dominant Color Redox Description Texture Stiuctule Consistence Boundary Roots -_GPD/IP in. Munsell Qu. Sz. Conl- Cokrr Gr. Sz. Sh. 'Elfttl [if#2 Boring # u Boring < ® pit Ground surface elev. It. Depth to limiting factor Soil Application Rate Ilorizon Deptll Dorninwit Color Redox Description l exture Structure Consistence Boundary Roots GPD/fe in. Munsell Old. Sz. Cont. Color Gr. Sz. SIT. ( 'Eff#1 'Eff#2 c S- 1 v-~ `J Effluent #1 = BODS > 30 < 220 oxd/L and TSS >30 < 150 my/L ' Effluent #2 = BOD~ 3U my/L and l SS < 30 my/L CST Naive (Please Prfnl ~Signatuie CST Number+ Address- Date Evaluation Conducted I elephonq Number Z~~ 7 Parcel ID it _ f 1 - gage of Properly Owner _ ❑ Boring -2-L A Boring tt Depth to limiting (actor c )-l -ill- L ( W-pit Ground swface elev. _ Sol n t(tlicaUmr Rate Horizon DepUr UorninanlColor RedoxDescriplion -1extol © Structure Consistence Boundary Roots GPUf(F Gr. Sz, Slr. 'Ef(111 'EIIH2 in. Munsell Oil. Sz. Coot. Color - - - rnk_ Z_ - -L t L 2m _ - -s s-- C2 1~y s-- 3 -x 11)4cf-h (0 Boring El Boring # ft. Depth to limiting factor LJ _ So fl /l pit Gromd surface elev. pplic ation Rate Horizon DepUr Dmninant Cokx Redox Description lexture 51ructmo Consistence Boundary Roots _ GPDtlF in. Munsell (An. Sz. Cont. Color Gr. Sz- Sh_ - - 'EfIH1 'Ell#2 E ~ Boring Boring # Ground surface elev. ft. Depth to limiting factor . n. ❑ Pit Sol Application Rate Horizon DepUt DmnhrantColo' Redox Description lexture Structure Consistence Boundary Roots GPD/IF in. Munsell Qu. Sz. Cont. Color Gr. Sz_ Sh. 'EfIHt TIM Effluent #1 = BODS > 30 < 220 rnglL and TSS >30 < 150 nrglL ' Lffluent 112 = BOD, < 30 mg1L and -1 SS < 30 rnglL 7 he Depattment of Corn netce is an equal oppottunity service Provider and employer. If you aced assistance to access services or need ruatetial in an alternate format, please contact the department at 608-266-3151 or "ITY 6(18-2(A-8"177. snn ruts rn.vtiaq 1~n~,e 3 ~)r 3 NAME: 5~~~-k- _ SCALE: I„ (3.,~t ELEVATION: (UC>, C? _ - - BNI I DESCIUP1-1()N:_1kp-(24 -,<_~Pv~_. _ _ f 19 a I _ ~ec'~_ 3 d I3h1 2 ELEVNI P )N: L BM 2 DESCRIP I'IO11: puG p.'p e SYSTEM ELI:VNI It )11: - X00 SYSTEM TYPF. niou 0 b,iQ ~ , qy~' .r 20 SIGIJ TUiT:.--- - I)A"I I, -l' 3 ~7