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HomeMy WebLinkAbout026-1135-11-000 (2) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) , 600253 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)] 3000743 Permit Holder's Name: City Village Township Parcel Tax No: JILLIAN FRANKO&BRENT KRUIZENfi TOWN OF RICHMOND 026-1135-11-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ev f to 1, (fig, 24.30.18.941 TANK INFORMATION EL ATION DATA TYPE MANUFACTURER CAPACITY STATION s~ to, HI FS ELEV. y Septic ~p(10 Benchmark l)0 Dosing Alt. BM U I J q Aeratio T.-,4r- aos~ ~y y (?3. Ht Inlet ~ ~ _ 1 / St/Ht Outlet TANK SETBACK INFORMATION - TANK TO P/L WELL BLDG. Vent o Air Intake ROAD Dt Inlet Septic / I t f >r Dt Bottom 4© 64 o (-r,6 I Dosing Header/Man. Aeration Dist. Pipe ~ ~Y c..F.o~{ 49• y BotAkystem O f p - C4 Final Grade PUMP/SIPHON INFORMATION 3. sq 4c> o~d Manufacturer Demand St Cover GPM Model Number 's V4/' s C C( 03 ; [Forcemain DH LiftQFriction Loss System HTH~ Length (-/?'I Dia~✓E Dist. to well/ / r` SOIL ABSORPTION SYSTEM BED/TRENCH Width! Lenatb No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth 'b &0 DIMENSIONS ~ [j SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Sys t UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ,14 / Pipe(s / / Dia Spacing_. ` Length (f.6 Dia Length) SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil/ yes F No 'Yes iJ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1422 144TH ST 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes ❑ No I j ! ff~ u Use other side for additional information. Date Insepctor's Sign ure Cert. No. SBD-6710 (R.3/97) 5Irv--1c•n -3'70 ~eers~e}~' County Safety and Buildings Division St. Croix 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) S P S (`i cc, Madison, WI 537 -71611~ f~ S.T. CROIX LOPME 10 1*. ~*.S,G Sanitary Permit Awol • ~ State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submiss the appropriate governmental unit 3000743 is required prior to obtaining a sanitary permit. Note: Applicat s for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal iruormation you provide may be used for secondary u oses in accordance with the Privacy Law, s. 15.04(I)(m), Stats. 1. Application Information - Please Print All Informati(ifi 1422 144th Ave Property Owner's Name Parcel # Jillian Franko Kruizenga & Brent Kruizenga 026J135-11-000 Property Owner's Mailing Address Property Location 3 T L1 1422 144th Ave Govt. Lot City, State Zip Code Phone Number SE V, SE y<, Section 24 New Ricmond Wt 54017 T 30 N, R 18 (circlE ore) H. Type of Building (check all that apply) L ® 1 or 2 Family Dwelling -Number of Bedrooms 3 11 Subdivision Name Block # Evergreen Overlook ❑ Public/Commercial -Describe Use ❑ City of ❑ State Owned Describe Use CSM Number ❑ Village of / ETTownof Richmond /D k C -.0 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System )kl Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: (Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground (X At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 i f suitable soil ❑ Holding Tank El Other Dispersal Component (explain) Pretreatment Device (explain)__ tJ.f 4. 7 I V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate( sf) Dispersal Area Required (s Dispersal Area Propose (sf) System Elevation 450 .50 900 900 98.70 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 0 9 0 Zable A-100 -0 V .E4 11;~ New Tanks Existing Tanks cc o y 8Z u. C7 a. Septic or Holding Tank 1000 1000 1 Weeks X Dosing Chamber 750 750 1 Wieser X VII. Responsibility Statement- I, the undersigned, ass a respo ibility fo 'ns Ilation of the P TS shown on the attached plans. r Plumber's Name (Print) Plu s Signa MP/MPRS Number Business Phone Numbe Y~ ~,A_6ei48443 1 651 Plumbers Address (Street, City, State, Zip Code) 927 150th Street Roberts W. 54023 VIII. un /De artment Use Only Approved Perrmit~Fee Date ~jsued `7 Issuing ent Signature wner iven Reason for ial /4 J ~ 1 IX. Condi WA~ eason for Disapproval 1-4--% 1. S*ir,tark, E;#tcc~: ~ilte-a~n,i Cb 1- v sper:. -i cell must dll be : ic,fc+s 1 ntc t.( as per ;a,r3gement plan p c Jae l bV plumber. /1tir~r 2. All sacEbW* nec4j".t.vm6 muut ue m .H, [lic,! as PK o bM o wk 1 y.rdinawn. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) 0 v 00 of ro ? ct- N N ~ U ~k W o L o U ti O J LLJ M U N In ti a O N w U ~ 'W b4 ~ "C3 Oq -Z cn C o b W 1-4 N Ln H W Q W ~ N N ~ W N 'Z3 o ry ~ a A O a o1 b o ~ o ~ O N a ~ L7 E h a` N °J ~ a a C7 II oo ° U o ~ ~ z h ~ 0 0 o II ~Z7 ° o~ 'r ~ ti ~ w ~ ~ II w ~ c 9 ~W mQW yR~wH o e w ~ O ti R U U ~ c ~ W In b Q II V v t Cij~ O V] C!] 'l7 ~r gg i cam, 4-. ~ m.9 R O O O a1 Vil {I o WHHA.. ~~~P~x7a`vr DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/programs/industry-services _ www.wisconsin.gov Scott Walker, Governor ~FZSSfO Y` Laura Gutierrez, Secretary October 03, 2017 ` CUST ID No. 224059 ATTN: POWTS Inspector :z a KEITH E STONER 23220 WOODCREEK RD SIREN WI 54872-8728 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/03/2019 Identification Numbers Transaction ID No. 3000743 SITE: Site ID No. 843451 Jillian Franko Please refer to both identification numbers, 1422 144TH Ave above, in all correspondence with the agency. St Croix County SE 1/4, SE1A, S24, T3 ON, R18W FOR: Description: At-Grade (3 Bedrooms - Replacement) Object Type: POWTS Component Manual Regulated Object ID No.: 1729858 Maintenance required; Replacement system; 450 GPD Flow rate; 50 in Soil minimum depth to limitinE 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. • 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. • 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 reducinz 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. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan Anv changes may result in pump resizinp, to meet TDH and GPM Specifications. • Divert surface water from POWTS Area. • Well setbacks to meet chs. NR 811 & 812. KEITH E STONER Page 2 10/3/2017 • 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. • Verify property line(s) prior to installation. • 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 fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. 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(l). 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/installati on/op eration. 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 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 Wyment S code: 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest r wisconsin.gov I KEITH E STONER Page 2 10/3/2017 • 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. • Verify property line(s) prior to installation. • 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 fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. 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 PO WTS 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 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 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Payment Submittal. Private Sewage Plan Reviewer ,Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tii-n.vanderleest@wisconsin.gov AT-GRADE AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application Level Site INDEX AND TITLE PAGE Project Name: Jillian Franko Replacement At-Grade Mound System D Owner's Name: Jillian Franko Owner's Address: 1422 144th Ave. New Richmond WI 54017 i Legal Description: Parcel in the SE1/4 - SE1/4 Sec. 24 T30N-R18W I Township: Richmond County: St. Croix Subdivision Name: Evergreen Outlook Lot Number: 11 Block Number: Na Parcel I.D. Number: 026-1135-11-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 At-grade drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Designer: Keith E. Stoner pHSI 1/G~)cense Number: 1575-007 Nne Number: 715-653-2324 Date: 09/10/17 iITONER % EITH E. Signature: ~ Siren, D%ksignWigursu8nt to $e At-grade Component Ma4.a4~NY!WAW%stribution ,146; r P TS SBD-10854-P (N. 03/07 , R, (/Az) Pressure Distribution Compo'r ~V,0 . 2.0 SBD-10706-P (N. 01101) and 2/~ SSWMP Publication 9.6 Design oNetworks for ST - SAS (01/81) Version 6.0 (R.03/12) r _ 2 ZO ; Page 1 of 8 At-grade 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) 0.00 Site Slope 98.70 Contour Line Elevation (ft) 50.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) 10.00 Cell Width (ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Pressure Disribution Information network? Enter Y or N (c or e) C Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 6 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) Not a final calculation 1.92 Estimated Orifice Spacing (ft)= 1.97 Actual (ft) 2.00 Forcemain Diameter (in) 60.00 Forcemain Length (ft) Does the forcemain drain back? ~Y - 90.00 Pump Tank Elevation (ft) Enter Y or N 0.00 Filter Head Loss (ft) 6.50 System Head (ft) x 1.3 9.79 Forcemain Drainback (gal) 11011 8.20 Vertical Lift (ft) 84.73 5x Void Volume (gal) LaV 'l0 3.79 Friction Loss (ft) 94.52 Minimum Dose Volume (gal) 18.49 Total Dynamic Head (ft) 56.85 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 Designer 1.00 x 1.50 must select 1.25 x x 2.00 x x one lateral 1.50 x 3.00 diameter 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weeks Concrete] Manufacturer gal/in (enter result in cell B50) Dose Tank Information Effluent Filter Information 750.36 Dose Tank Capacity (gal) Zabel Filter Manufacturer 20.28 Dose Tank Volume (gal/in) A-100 Filter Model Number Wieser Concrete Manufacturer Project: Jillian Franko Replacement At-Grade Mound System Page 2 of 8 At-grade Plan View I 1//6 B f Observation Pipes (2 typical) D rD r r T Jy~`( LT Z' T S T f r..?_ t1 T r h' ~i +"LT 1~ TL tfL.ftl P L T T f. '.d x Y W L r a, rs ,f r L r rL r r .r r .r r r a Lr ` x r ITT rxTT rxr rxr rT-. t" A TLT T'. J 7 ~ TLT T TL T TL i .f -.rxr1 5x T r - T •d S L % t T T T f .r"+, T f ti ' T J ra r r - L r a rti L LT Lr s r' T T''.r''; bT ec" T r- r T f LJ d t d .„L= L 4 .JLJ r r d L • B D At-grade Component Dimensions A 10.00 ft D 5.00 ft [N(gpd/ft) (r"t2) Dispersal Cell Area A x B B 90.00 ft W 20.00 ft (ftz) Total area (L x W) 1/6 B 15.00 ft L 100.00 ft Linear Loading Rate At-grade Cross Section View Aggregate Dispersal Area Finished Grade 100.47 (ft) Observation Pipe w/ End Cap Lateral Invert (ft) Typical Lateral See Details 99.20 ::y.::•.x. ;s x„ Geotextile Fabric •L.L"'..... L"•,.L=•.+L=L.+., L....,.. 4r•. L:L:L:;,. .TL ;r^T"t*T„T=T„.'"T•T•r"T^T=T •T=T~.r=T+T~•~T•T.T •vT*T Lrt~ L L p•x1 L L L L L~ f ti L l,,t 0.0 % Site Slope 98.70 (ft) Contour Elevation Shading Key Topsoil Cap Tilled Layer Aggregate See lateral details on Page 4 for the number of laterals, size, and spacing. Laterals are equally spaced from the centerline of the distribution cell. Two observation slotted pipes constructed of 4 inch sch. 40 PVC pipe per cell are installed and stabilized as per the component manual instructions. Geotextile fabric meets requirements of SIPS 384.30(6)(g), Wis. Adm. Code. Project: Jillian Franko Replacement At-Grade Mound System Page 3 of 8 it Center Connection Lateral Layout Diagram Fotco mai n corsrra otion ui r t*# or r o$s to maaufoid art arq poW,. t atecalt are xiar~tit at P * = Turn-u p lost b* l l *m lv*,5r I(- X y xr, Latetaris 6 face man of P C: a+ch *0 aiout►outplug gor SPS Tsbk 304,M-6 Ho*, d0*04 on thr bottom of 91h# lapwit Number of Laterals 6 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 1.97 ft Lateral Length (P) 44.33 ft Orifices per Lateral 23 Lateral Spacing (S) 3.33 ft Orifice Density 6.52 ft2/orifice Lateral Flow Rate 9.47 gpm Manifold Length 6.67 ft System Flow Rate 56.85 gpm Manifold Diameter 2.00 in Total Dynamic Head 18.49 ft Forcemain Velocity 5.81 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter Weeks Concrete Manufacturer _ ii 2 in. Ca acit 750.36 Gallons Volume 20.28 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 18.34 371.92 B 2.00 40.56 C Pump off elevation (ft) C 4.66 94.52 91.00 D 12.00 243.36 D Total 37.00 750.36 11 Dom se tank elevation (ft) - 3" Bedding under tank. 90.00 Alarm Manuafacturer S.J.E. Rhombus - Alarm Model Number Tank Alert 1 Pump Manufacturer Goulds Pump Model Number WE05H :T Pump Must Deliver 56.85 gpm at 18.49 ft TDN Project: Jillian Franko Replacement At-Grade Mound System Page 4 of 8 At-grade System Maintenance and Operation Specifications Service Provider's Name Powers Sanitation Phone 715-246-5738 POWTS Regulator's Name St. Croix County 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 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 900 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 ever 3 ears Effluent Filter Should inspect once a year and clean once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test monthly - Pressure System Laterals should be flushed and pressure tested eve 3 ears At-grade Inspect for pondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SIPS 384.30-1, have a watertight cap, and are secured in as shown in the at-garde component manual. 2. Dispersal cell aggregate conforms to SIPS 384.30 (6)(i), Wis. Adm. Code. 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 at-grade 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 \ ~1 6-8" Diameter Threaded Cleanout Lawn Sprinkler Plug or Ball Valve Valve Box Distribution Lateral 99.20 ft Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Jillian Franko Replacement At-Grade Mound System Page 5 of 8 At-grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SOB-10854-P (N. 03/07), SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01181)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. 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. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall 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 with an alarm the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of ti;e tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the state. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-grade and Pressure Distribution System No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the at-grade and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent 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 mg/L BOD$, 30 mg/L TSS, 10 mg/L FOG, and 1 Q4 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 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 in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Jillian Franko Replacement At-Grade Mound System Page 6 of 8 I LOP TL Wastewater P&ge 7 of 8 APPLICATIONS • SJTOW or STOW severe duty oil and water resistant Specifically designed for the following uses: power cords. • Homes, Farms, Trailer Courts, Motels, Schools, •'/3 - 1 HP models have NEMAthree prong grounding Hospitals, Industry, Effluent Systems plugs. • 1'/2 HP and larger units have bare lead cord ends. SPECIFICATIONS Three phase (60 Hz): Pump 3 • Class 10 overload protection must be provided in • Solids handling capabilities: /a" maximum. separately ordered starter unit. • Discharge size: 2" NPT. • up to 140 GPM. • STOW power cords all have bare lead cord ends. Capacities: • Total heads: up to 128 feet TDH. • Designed for Continuous Operation: Pump ratings • Temperature: are within the motor manufacturer's recommended 104°F (40°C) continuous, 140°F (60°C) intermittent. working limits, can be operated continuously with- • See order numbers on reverse side for specific HP, out damage when fully submerged. voltage, phase and RPM's available. • Bearings: Upper and lower heavy duty ball bearing construction. MOTORS • Power Cable: Severe duty rated, oil and water resis- tant. Epoxy seal on motor end provides secondary • Fully submerged in high-grade turbine oil for lubri- moisture barrier in case of outerjacket damage and cation and efficient heat transfer. to prevent oil wicking. Standard cord is 20'. Option- Class B insulation on %3 - 1'/2 HP models. al lengths are available. • Class F insulation on 2 HP models. • O-ring: Assures positive sealing against contami- Single phase (60 Hz): nants and oil leakage. • Capacitor start motors for maximum starting torque. AGENCY LISTINGS • Built-in overload with automatic reset. Tested to UL 778 and CSA 22.2 108 Standards By Canadian Standards Association File #LR38549 ceS METERS FEET 40 130 SERIES WE U*E75t1~1._,. s ? 120 (SIZE: 3/4" SOLIDS, 35 J. ;RPM: 3500 & .17 1105 - I ; W kt, GPM 1. < 30 100f t s --i- _ f ! l I Q w 25 ' _ . = 80, WEI U 2 -70 Q 20 0 I 60 y V{~E6S i Q 15 50 f- 05H, y O f 40 10- 30 034 dE2I Vf0 fe31 - - 5 Y , 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 GPM I I I I I I 1 _1 I I_ I I I I I 0 5 10 15 20 25 30 35 m3/hr CAPACITY PAGE 2 0 a ~ rt• I N ~ O QO O O ~ U O ~ • K J Ci ~ ~ ~ O J i {vim r }raj 'tv n Z ^4 v! ` ('~`I ~ ~ Q ~ Y~ ~ N h~C O ^I N bo s m - ti W U N N 'ti O oo V ONO O O ~l ? r4i O U O ~ N a ~ C7 E L M ~ U N V O ~ CV ° II oo ° u p U o ~o a~ .r o~ ~ a V ~ ~ nn o o ~ o o II C7 ~ ° g sL J a .ti o CIJ max' ~Qw i(%~ o " W rl) O~ ~ R U U~ ~ a O I~ N 3 •O V] U] 'L7 Ct H O O o > i1. L1. p W 17- 1 I~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Jillian Franko Mailing Address 1422 144th St. Property Address Same (Verification required from Planning & Zoning Department for new construction.) ('itv/Stale New Richmond W1. Parcel Identification Number 026-1135-11-000 'LEGAL DESCRIPTION SE SE 24 30 13 Richmond srroperty Location _ t/., , _'/4 , Sec. -'T ITT R_ W, Town of Subdivision Plat: Evergreen Overlook 11 Lot # Certified Survey Map Volume Page # _ Warranty Deed # (before 2007)Volume Page # Spec house Dyes +CDto Lot lines identifiable Eyes[]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 aflect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 353.52(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, si-ned by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I ) 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. Uwe, the undersigned have read the above requirements and agree to maintain the private see, age disposal system %vith tile 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 septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statement on this form are true to the best of my/our know•led c. I;we am.-'are the owner(s) of the property described above, by virt ue o a warranty deed recorded in Re<-ister of Deeds Office_ Number of bedrooms 3 S ; , ATURE OF APPLIC.AN"I (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 ~ arranty 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) r Z i FOUND 1" STEE. S N 1 /4 CORNER SE' TEMPORARY CUL-DE-SAC EASEMENTS (TO BE REMOVED UPON NORTHERLY EXTENSION OF ROAD) ~ rn SE1/4-SW1/4 SECTION 24 p n 38"W 1300.25' ° rn zK) 292.00' t +iv / ,y LOT 10 0 LOT 9 48764 SQ. FT., ° ° o 1.12 ACRES to z~~ eo n 48764 SQ. FT. qa 1.12 ACRES `D o JOINT JOINT co S89-40'38-E 292.00' S89'40'38"E 292.00' tri ry o LOT j ~l LOT 8 o ` 0 43800 SQ. FT. °o' 43800 SQ. FT. ° 1.01 ACRES o! 10 11.01 ACRES p A, i CN c o i S89'40'38"E 292.00' - 4 S89'40'38"E 292.00' I Z ci a W ,p O o' r- W e. o° 0 4 LOT 12 'LOT 7 fl o I w tn 3800 SQ. FT. 44800 SQ. FT. r- t°n - _ 1.01 ACRES. b ;7 1.01 ACRES 0 O ° b I (D i S89'40'38'E 292.00' S89'40'38"E 292.00' LOT 13 0 U) 43800 SQ. FT. I w ° o LOT 6 `n q- 0 1.01 ACRES 0 o f I\ BENCH MARK TOP OF ° 43800 5Q. FT. M 3/4' IRON PIN ELEVATION 1.01 ACRES p 996.51 (ASSUMED) zZ z_ J S89'40'38"E 292.00' S89'40'38"E 292.00' F- LOT 14 LOT 5 Q to 0 45846 SQ. FT. ° o ° TEMPORAR 1.05 ACRES ° 43800 SQ. FT. 1.01 ACR S CUL-DE-St ;EASEMENTS JR EMOVED L ASTERLY S89-40'38-E OAD 16 .00' ) 141ST AVENUE SEW40'38'E 510.92' 38" ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address 1422 144th Ave New Rchmond wi. located at: SE 1/4, SE '/4, Section 24 , Town 30 N, Range 18 W, Town of Richmond , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service August 15 2017 Did flow back occur from absorption system? Yes No x (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: 1000 Construction: Prefab Concrete X Steel Other Manufacturer (if known): Weeks Age of Tank (if known): / f ;Pennitumbe (if know) St \ Keith Knudtson (Licensed um er Signature) (Print Name) 648443 (Title) (License Number) MP/MPRS 10/25/2017 (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division i z t INSPECTION REPORT Sanitary Permit No: 404984 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 Itym)]. Permit Holders Name: City Village Township Parcel Tax No: Collova P.C. Richmond Townsh[ 026-1135-11-000 CST BM Elev: Insp. BM Elev: / BM Description: ;14A A 3 - 'n •4~• de-e'4" 9L a. 1` lye TANK INF RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic B nchmark -93 -3 taD (o?,. 99• W / Dosing BM Aeration Bldg. Sewer 46 . S p I Holding StMt Inlet r s br r TANK SETBACK INFORMATION St/Ht Outlet 8 . y~ QS• 33 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 3(. 1 3 Dt Bottom Dosing L` r~ ~ ~ aQ Header/Man. S , ~S ~Y • ~O Aeration ) ® Dist. Pipe Holding Bot. System 3.~9~ 3.9a' Final Grade + PUMP/SIPHON INFORMATION 310 9 9.9 Manufac urer Demand St Cover GPM Model N her TDH Lift ction Loss System Head TDH Ft F main Length Dia. o e SOIL ABSORPTION SYSTEM NC Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth aft DIM 1 "-:w raft. 16 1 SETBACK SYSTEM TO /L l BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION OF CHAMBER OR f 0 pl " T ~ YPe System: ) UNIT Model Number. I DISTRIBUTION SYSTEM . r/4) Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia 11-671%;W- is Spacing ? SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: O l * 0 3 Inspection #2: Location: 1422 144th St. New Richmond, WI 54017 (SE 114 SW 114 24 T30N R18W) Evergreen Overlook Lot 11 Parcel No: 24.30.18.941 1.) Alt BM Description = Ww` 4btnv,4P..5~ 2.) Bldg sewer length= - 3} - amount of cover = HZ .r Plan revision Required? No 04 I SBDUse other side for addition / Inse ors Signature Cart. No. Date - -6710 (R.N97) ~ iteu[.ava~la,- +M~l- L /zco r , i n -S7-c2o 17.►9d Wisconsin Department 00„i1Dervices Division of l6dustry Sei SOI VALUATION REPORT #3241 SEp 121017 Page 1 of 3 in acc_ 85, is. Code Keith Stoner CST Olx COUN.TnY'~c~t-[' Attach comple' ~p c.tio an 8%x 11 inc~-e8Q t County St. Croix include, 1~I~fiNR~kf tb: vertical and horizontal reference point (e~~' ` -•d percent s ope, scale or dimensions, north arrow, and location and distan cM -ad. Parcel I. . ~N 026-1135- 1-000 Please print all information. r Revie d By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). te Property Owner Property Location ?~rl eF Jillian Franko Govt. Lot SE1/4 E1/ , S24, T30N, R18W Property Owner's Mailing Address Lot # Block # Subd. Narife or CSM# 1422 144th Ave 11 Evergreen Overlook City State Zip Code Phone Number n City ❑ Village Town Nearest Road New Richmond WI 54017 Richmond Same [J New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD G ] Replacement L_ I Public or commercial - Describe: Parent material Sandy Loam Till Flood plain elevation, if applicable NA ft. General comments Propose a 10 x 90' At-Grade mound dispersal cell with a system elevation = 98.70'. Centerline of cell staked onsite. and recommendations: F-1 I ~L~ Boring # I Boring Pit Ground surface elev. 98.67 ft. Depth to limiting factor 52 /in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 A 0-10 10YR2/2 - sil 2msbk mvfr cs 3f-co 0.6 0.8 2 10-16 10YR3/4 - A 2f-msbk mvfr gs 2f-co 0.6 0.8 3 16-31 10YR4/4 - cl 2msbk mfr gs 2f-m 0.4 0.6 4 31-52 5YR4/4 - sl m mfr gs 2f-m 0.2 0.6 5 52-80 5YR4/4+3/4 f2d5YR5/8 sl m mfr - 1f-m 0.2 0.6 #5 - with 6" bands of massive sil Boring # Boring Pit Ground surface elev. 98.61 ft. Depth to limiting factor >55 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR2/2 - sit 2msbk mvfr cs 3f-co 0.6 0.8 2 10-17 10YR3/4 - sil 2f-msbk mvfr gs 2f-co 0.6 0.8 3 17-26 10YR4/4 - cl 2msbk mfr gs 2f-m 0.4 0.6 4 26-29 7.5YR4/4 - Is Osg ml gs 2f 0.7 1.6 5 29-46 7.5YR5/4 - s Osg ml gs - 0.7 1.6 6 46-55 5YR4/4 - sl m mfi - - 0.2 0.6 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 * ffluent #2 = BOOS <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number Keith Stoner ? 224059 Address Keith Stoner CST Date Evaluation Conducted Telephone Number 23220 Wood Creek Rd Siren, WI 54872 7/19/2017 715-566-0900 SBD-8330 (R.07/13) Property Owner Jillian Franko Parcel ID# 026-1135-11-000 Page __.Z _of 3 Boring F3 Boring # i Pit Ground surface elev. 98.49 ft. Depth to limiting factor 50 i . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10YR2/2 - sil 2msbk mvfr cs 3f-co 0.6 0.8 2 12-19 10YR3/4 - sil 2msbk mvfr gs 2f-co 0.6 0.8 3 19-29 10YR4/4 - cl 2msbk mfr gs 2f-m 0.4 0.6 4 29-35 7.5YR4/4 - Is Osg ml gs 2f 0.7 1.6 5 35-46 7.5YR5/4 - s Osg ml gs if 0.7 1.6 6 46-50 5YR4/4 - sl m mfi gs - 0.2 0.6 7 50-57 5YR4/4 f2d5YR5/8 sl m mfi - - 0.2 0.6 j Boring Boring # Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring F-I Boring # pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 CS ~ ~~2 yo i * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/L 0 ~o y c, ? rr R N of O ao O O ~ V ? M U W 0.1 ~ p ~ 3 Owl p J W c ° w v1~ ` o q (z Ln -Ile N tj N v q ~ ~ N W 0 e 0 a ~ 0 ~ b ~ F- E M .L N t•" ~ ~ N y II 00 F o I~ 3 N ti U C., a~ z o ~ ~ ~ o II v ° o ~ E W o) Y O V1 N to II N O C 00 00 06 V) .q V C, Cl Q\ 0.g ce II II O O O k" f~ 0 0~ W W 0.1 01 F- F- Cam- ~ ~ II • ~ i