HomeMy WebLinkAbout020-1357-18-000 (2)
County: St. Croix
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division INSPECTION REPORT Sanitary Permit No
(ATTACH TO PERMIT) State Plan ID No: o
GENERAL INFORMATION
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit 61der's Nam D f , City Village I~' ``'chin Parcel Tax No:
AP A- DZa - Q66
CST BM Elev. Insp. BM Elev. BM Description: Section/Town/Range/Map No_
. / Zd~Z~
X63 . d-ar.k 4- Z'3. z.9
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic /aoa Benchmark 163.470
07
' 2! z Alt BM ; ►LA_
e~hj
Aeration Bldg. Sewer
Holding St/Ht Inlet
St/Ht Outlet ~Y
TANK SETBACK INFORMATION /63 ' 76
TANK TO P/ WELL BLDG. ent Air Intake ROAD Dt Inlet
Septic / 36 7 / DtBottom
Dosing Header/Man. IN • 7
Aeration Dist Pipe ` Z
. Z ioo S
q
Holding Bot System 9 < Z. /00 q
Final Grade /ds !J
PUMP/SIPHON INFORMATION JAJ Manufacturer Demand St Cover rat, Z , 167-(o,
Model Number
~j - -
7Forcemain F coon Loss System Head TDH Ft
Dia. Dist. to Well
Leng
SOIL ABSORPTION S STEM
BEDITRENCH Width Len No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Liquid Depth
DIMENSIONS 78^
SETBACK SYSTEM TO E lP/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. ~1
INFORMATION CHAMBER OR
Type Of System: UNIT Model Number.
ell _WW_
6.Q- 7"t
Zl (av.+~•
DISTRIBUTION SYSTEM 17
Header/Manif~d Distribution x Hole Size x Hole Spacing vent t 'r IhI%ke
Pipe(s) E
L _ Dia Length 'Dia Spacing
O W~-
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over ixx Depth of jxx Seeded/Sodded xx Mulched
Bed/Trench Center 5.7 Bed/Trench Edges Topsoil ~ ~XaL-Z No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location. ! / Ne~+.f ~V, q: ~6GIC., A
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover = Jat 1 _ I 1
~ f vz~0!
Plan revision Required? Yes No 17 3
Use other side for additional information. 1 Insepc i Sig ure Cert. No.
Date
SBD-6710 (R.3197)
- mom
//rr
Industry Services Division County c C ! ( `
. 4~. 1400 E Washington Ave
x,, €t
P.O. Box 7162 Sanitary Permit t umber (to be filled in by Co.)
Nil
IOV = ( M t53707-7162
, W IX COON MEN'C ---.j p
State Transaction Number
Sanitary Permit Appl. _5
In accordance with SPS 383.2 S(2), Wis. Adm- Code. submission of this form to the appropriate go mental unit
t'
s required prior to obtaining a sanitary permit Note: Application fours for state-awned P{)GM are submitted to Project Address (if different than mailing address)
E flee Department of Safety and Professional Services. Personal information you provide may be used for secondary
.u n, in accordance with the Privacy I aw., s. 15,04(1)(m), Scats.
1. Application Information -Please Print All Information (G•~~ /
Property O ancr s N rnu Parcel # GJt
A,
Propcrtrty Owner's Mailing Address Property location 'art
Govt. Lot I
City, State Zip Code Phone Number Section
ircle one
f T fq N R 14F Eocw
11. "Type of Building (check all that apply) Lot !r
Subdivision Name °I or 2 Family Dwelling-Number ofBedroon"
Blocky GiIL°,(?Cf~i G~ %S
j ❑ PubHGfCommercial - Describe Use. ❑ Cit3 of
I
C1 State Describe Use CSM Number ❑ Village of
I Orvtaeu' - _
E 1 ^ / `t s T l N/ J Town of
? III. Type of Permit: (Cho iue A, Complete line B if applicable)
A.
❑ New System Replac mcnt System TreatinenttHolding Tank Replacement Only ❑ Other Modification to Existing System (explain)
I )3. ❑ Kermit Rene,,+al ❑ Permit Revision 11 Change of Plumber ❑ Permit Transfer to Necv List Previous Permit Number and Daze Issued
Before &xriratioa 0oner
V e of PCI6VTS /Coin oneotlllevice: Check all that apply)
Non-pressuriv:d In-Ground Pressurized In-Ground ❑ At-Grade C3 Mound > 24 in of suitable soil El Mound <2 o uitable soi[
❑ Raiding Tank ❑ Oth Dispersal Component (explain)_ ❑ Pretreatment Device (explain
t Dis rsallfreat entArea Information;
Design Flow (gpd} Design Soil App:icetion Rate(gpdsf) Dispersal Area required (s Taispctsat Area Pro a (sf) System Elevation I
Vf. Tank Info Capacity in Total fi of
Gallons Gallons Manufacturer
Units
t:tistinz
ow Tanks
N TazI's X, 6C ! / ~ / ` • J y , ? "v' y
sepc a r eL i sir r G. f flf X
VII. Responsibility Statement- 1, the undersigned, assume re'Sponsibilih° for installation of the PONVTS shown on the attached plan&
Plumber's SignaturetpllvlPRS Number Business Phone Nmnb2t
f Plumber's Name. (Print)
I'lumber's Address (Street, City, St te. Zip Code)
VIII. Count l e ariment tlse Only
Approved - vcd Permit Fee Date Issued Issuing Agent Signatur
y85, 7
Chw von Reason for Denial
IV Conditions of ,ApprovallReasnns for Disapproval
SYSTEM OWNER: t I ( e+t bettl M L)s
3 / N~ 8~2 N
1. St (ptic tank, effluent filter and b( COwt/I Ql~'~ i-~ p,~d -to
dispersal cell must be serviced. / matntamec!
as per management plan provided by rll -"'i et Uk eXIS74711 AWn 77i((I~C j2lQ
r-l~ark remtirf~.ments must be malntaiiiea j
c- appli A,LZathltt ca>.~i~i rGfe$t6e system and submit to tine Cuunty oury as payer a at Irss thsn S• c I t i-hea in xiEe
, 013y"r 741110
Ale-
N
SI3t7 G393 (i 08114)
WT.
It
lhcl 4a (e
Ira 15
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:
~ l ( =1 ia C, located
(Street address) r
at: G 1/4, (,U} 1/4, Section , Town : /N, Range W,
Town of r4; L-,,i , 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 appear(s) to be functioning properly,
Most recent daze of inspection or service
Did flow back occur from absorption system? Yes No
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: 1_:
Construction: Prefab Concrete Steel Other
Manufacturer (if known):,;
Age of Tank (if known):
Permit-number (if known)
(Licensed lumber S`,n ture) (Print Name)
t t
(Title) (License Number) MP/MPRS
(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 1 13 Wisconsin Administrative Code)
Rev. ?l?O1 2
PAGE 1 O 4
Gravity In-Ground Index & Cover Sheet
Component Manual Design References:
Version 2.0, SSD-10705-P (KW01, R. 10112)
Pg 11 of Index & Dover Sheet
Pg 2 of Plot Flan ~
Pg 3 of 4 Dispersal Area Cross-Section & Plan View
P 4 of Management Plan
Attachments: Enclosures:
PCB S Application for Review
Soil Evaluation Report & Site Map
Project Name Description
Owner Name(s): , ~ I I? rt, It C ) i `'~S Phone:
Owner Address: 5 `t G'LhL i,{ (1[ { t i''. zip:
Project Address:
W,
Govt. Lot:. 114 of ~ 1/4, Section 1-5 , T `i N-R E F or
'onshi: can:
Designer Information
Designer Marne: ,'V~ Phone: ;-75
Designer address: ri i rv~ kTNtt C'f. ("JI zip: 61 &~5c
~(i` tzYc € 5t f6` Ce t~G f 0 C t ga~xre"servedf p rb?s~f~stamp.
E-mail: This
:en Number. I:3~t C'G'I - `
fern rlk
og
S 4pa i
p1#ah 440.4~
Date: ~ 7
Signature:
do nature MoMd On each Umfted copy.
NOTICE: 'lease provide the fallowing:
A. plan view sketch showing everything within 100 feet of the system.
Two horizontal reference points to center of septic tank manhole cover.
Show alternate benchmark, if applicable.
PLAN VIEW " i f-- j i df Ar'
~v Cat"'t
j~oRrad J 4~A T{~rnkti ~t V. (00,00
le, ,
1:4 A4
I
~ II
.
2t
-
" y
3 tawW<ca
FM
r«.vss+ Ftaa+P ~
J r-t + w JCJ 4~ 9b' t lYr+e' '>8
3(~°514~'vc 4/ C }Lx iG iCr.c
S ~
f M
U°
\ Vg
INDICATE NORTH ARROW
f
TF-w
k s
........~..A.~~z __.>=Ew~.,.~~ . ,e _ _ ....~....~~_E.,~...,,Rx.. _ . ~.e.Aa ~,.d...,...-.e,.~.,....~..~ ...E .a.,,..._._..... _.u..__.._,a _ 1 re
S Tarok(s) Mtrurtac ue .
IN-GROUND GRAVITY DISPERSAL AREA
Uniform Elevation Trenches with Quick4 Standard-W tubers Septic Tw*(a)Vckm s):
-ft Trench (down-sizing credit) Gal ~ ~ 901
-Effluent Fptsr Ma mdacuren.
1 Effluent Filter Model tr~ S:e.
L
mdn 12,
SOtL COVER ttypadl
tr
TYPICAL TRENCH
GROSS SECTION VIEW
I tty (No Scale)
, Provide minimum 3 fit
System Elevation ft separation between trenches.
(typical)
Quk:k4 Standard-W
w1 End Cap (Show location of inlet 1 outlet pipe connection on plan view.) s ~t~ TYPICAL TRENCH
ttrvic-al), f P_ PLAN VIEW
f (No Scale)
a A=30ft
r------- - _ - _-1 tMafl -~J
41
tfYi) Quick4 Standard-W Chamber
INSTALL PER TRENCH, mw by ln, ycpi-4
( sys WM bye.) _n
I t tnsta5 ptnm-~taai to rtranut~actv+era &~iructk,ns.
QtAck4 Std-W @ 20 fe i=lSAlc hamber= f ft' p
t Pairs of end caps Q S fe EISAlpair= fe
= Proposed ElSA per trench= ~f ft' Required tnfiltr donArea= J' it Dlshibution Method:
x trenches = Proposed Total EISA
n J
-7 L4~:7
_ '7 ~.'~'f t r ~ J_ ~7C.~ ~ tip'; •~-'~`If t~~ ~ C~ d rf ~ ~Y~ ~
r
3 17/(~ fJ r4,1 t 1(11 f~
PAGE 4OF4 ~.e
i
'in-ground Gravity M a t Plan
Ti ie owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
i=urthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
;accordance with SPS 383.52 (3), Wisc. Admin. Code.
iMaximum Dispersal Area Operating Limits:
Design Flow gpd; 8DD3 < 220 mgL"'; TSS 150 mgL-1; FOG 30 mgL"
Insoection Checklist INSPECT EVERY 3 YEARS
c, type of use
o age of system
o nuisance factors (i.e. odors, user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
material fatigue (i.e., leaks, breaks, corrosion, etc.)
solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
extent of pending in distribution cell prior to dosing
o dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.)
o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.)
C distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)
surface discharge of effluent or sewage back-up into structure served
relaintenance Checklist MAINTAIN EVERY 3 YEARS (car when necessary)
a Serrtic and dose tank(a} shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats, when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
c Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System; maintenance reports small be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Dame of individual or company: Phone: 7 i . 7 s;
r
Local government unit: (f 1 k s / Pll4ne: II - a1' 7 t
Local government unit address:
zip:
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.
S.ysterva Alaandonrrsent
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
«,-:,ate ~ ` i r ..4>,A
10
i K 3§. 'W " c3 r h N A ~
ray~
7' -
,4" Standard Ulan ; ber,i+ n 36 de tranchh
al -
ui;d is idea: for curved or straight systems. It features the
rutent-pending Contour Swivel Connection which perr-nits
'urns up to 15~, right or left, The lviultiPort endcap allows
multiple piping options and eki-ninates pipe fittings. The a
chamber's four-foot length provides optimal installatiol7 ;
n 7
Advanced contou,ing connections swivel up to 15', :x-
right or left
Latching mechanism allows for quick installat.on
_rAl
Four -fool. cnanders are easy to handle and install` ` r
The Quick4 Standard G han,uer suppors wheel loads of _
w
36.000 lbsr`aXle with only "2" of cover
Ce~lirted by the International Associaion
/a
. I
of Plumbing and Mechanica? Officials (lAPM0) Rai"
Tear-out seals on inlet ports prcvice a tight fit to the p:pe -
cirh° -noldecf-in inlets/outlets a Io;,,,
for maximum pioing f exioi ity g,.
Eh?)litlat2S NL,.^~ ifttingS
F1t5 on either vnd of the Cu!ckLI Standard >Cha-ber
APPROVED in
W04 Standard Charn
r
1 i w = 1~ t r' ~J r }
7 ( y ~I ti i
34 - - - - 48
tEFFECTIVE LENGTH
Mult4;"GY't EndGa 3 - -
1s t r
FROM VIEVI SIDE VIEW TOP VIEW .
Typical Trench V1ety INFILTRATOR WATER TECHNOLOGIES STANDARD LIMITED WARRANTY
ial Tire structural integrity of each chamber. endcap and other accessory n}antfiactured b.,
infiltrator (-Units'), iviten installed and operated in a teacnfiela of an onsite septic 5yste.r.
tv5 FACx-lu TOPSO4 accordance with infiltrator's insEruct;ens. is :varranted to the original purvlaser 4 Holder j again$E
Cefective mateneJS and r.'orkmanship for one year from the date that the septic permit is issued for
< me sep? t system scntaining the Unjis Frot<ded. tov:ever. that if a septic permit is not required by
COLER BY f appticab!e ia',% the warranty period rrifl begin upon, the data that installation of the septic system
DES(CN t comet rcas_ To exercise its vlarantp rigAts Hofdar must notify fmfiltrator in tinting at its Com orate
{ f t`- h a.quart s in pfd Saybrook. Connecticut y:ithir fifteen 1151 days of the a iegec defect. tnfif*,rator
f t ~ / t rti~l supply epracemiint Unite for Units determined by Infiltrator to be covered by this Limited
tNVERT Viarrant infiltratoi s liability specAcaily excPUCYes the cast of removal and`er'nstallaticn
0 tie Unts.
3a ~SPAC tdC PER CODE 3.t tbl THE U%1JTFD WARRANTY AND RMECIES IN SUBPARAGRAPH tai ARE E Ct USWE.
os :a='~"~ 7gERE ARE NO pTHER 4VAR?ANTIES WITH RESPECT TO THE UN TS. if'GLUD7 NO
IMPUEO VVARRAIWI S OF MERCHANTABILITY OR FITNESS FOR A PAR19GUL ttR PURPOSE
tni This t.imited %'n rar,ty sf,afi be vo,zi if sry on'r of the chamb2; system is mark7f'c:tUrEd by
anywe oth-r Yvan infiltrator. The Limited Warranty does not extend to incidental, ccnsequertiai,
spacial or indirect damages. lmdtratar sPall not be cable for penalties or I:quidated ciarnages.
Size 34"W x 53" 1 x 1 P"H including loss of production and profts. abor and materials. overtread costs, or other Iostes or
(864 lam x 1346 (711'71 X 305 mm) expenses Incurred by sa Holder or an), third party, Specifically excludec frotn Uma2d Warranty
- coverage we 6amage to the Units due to ordira*y v:ear and tear. alteration. scctdent. misuse.
Effective Length 43'r (11219 mm) =Dust or neglect of tie Units: the Urns being s+ub;ected to vehicle traffic or other conditions whth
Louver t~ t, c~ a-a not permuted by the instatlaticn fnstructtans: failure to wa.,ntair the minimum ground corers
n~I~i7t p'~ (203 mm) wit tprtp ;n the irstapamfi instructions, the placement of improper materials into the system
F ~a ` co',taine;g the units; failure of the Units nr tire septic system, due to 'improper siting or improper
Storage Capacity a3 (c2~ (163 S'Zing. tXCt5 }':d;BT usage. im3ro0ergrease disPrsai. OrimprOoer Operation: Ofany' Other
J evert not caused by Inlotramr. This Urt,2ed Warrants/ Shalt be void if the Holder f8' JS to COMPly
ith all of the terms set forth in this Limited Warranty. Further, in no event shat] infiltrator be
invert NBIgII g" (2033 1T tF1 t} responsible for any lass or damage to tie Holder. the Units_ ar am' third part}• resulting from
instatiation or shiomant. of from any produCt IiabiGty claims of Holder of any Inird party. For this
Umuted Warranty to apply. the Units trust be installed in accordance r.itn all site conditions
required bf stata and local codas: ail otter applicable tars: and tmtirtrator s installation instructions.
{dl No representative of infiltrator has the authority to Change or extend this Limited Warranty,
170 ,arrant app;ee to an} party other than he original Holder.
Tr:e abo?'e represents the Standard Limited Vdararty offered by intihratof. A iimited nt:mber of
e @u~nrss Park Poad Stde`a and court!ies have different t~aaanty requirpm2nfs. Any purchaser of Units should contact
P.o. Bo, 7S8 !nifltrtor's A:; pora:e Headciuadena in 0!d Saybrook. Connecticut. Plot to SLCtl Pi'Jrchase. to
0~d Sag-,rook. CT 06-;75 obtain a copy of the anp7icabie warranty, and mould carefuttyreed that vrarranty orior to trs
660-5 1 -70¢0 • Fix S60.577-7001 purshase of Units.
1.800.221-4436
tivy,Nt.lnwlraionvater• 00 rl
U ~sanL' 1,759.uo'' S.nt? 631' S 1 a 88. S 3 o Ot t o uit..t59. 0 54 t.5v3: S.TS6.' 03 .ohs "7d' S &3~J i5-ta Canrc'r::n Pa emu: 5.3^<a.9e9 2 00-1 Sue other Wt2n5 fading.
5: 40
En ,*-f.'~"ic'.C's'. ECt13M.O°. Q a`~d Sk{le.YkY.44«` 5rC rtyr...er.. to rr3rfam a'/.5 of i mito,"later Ta:hno,o-yaes. tnh7JatOr s r~-s5¢red tt'2~9tttar% in F,2 c!- tre`hr'~ar
y*JUN' T h1x1og:e5 is a r3y11i:eretl tratlar ~ rk m r.tealco- .
Grt,rrtr SP er tit,on, tom, 'U.,cr... p3 kCU UUf "f lay' Giopt. -Vl and sr -crrtack are traaerngrks of onf+.tratar 1"let sr Tecnno'
Contour, M,c+oleac111119. PeryTuf1, te1,1
PafyLok is 2 t adam2 x c! Poi,'Lak, tnc- TUF-T TE u a ra rite. trndem > of TU -71TE. 1,1C. Ulma Ftib is a ttu mark c EPE € k C. ()-)5 0613
20t31rtfi?f;atcr th^ater Tecnno'.mry es. ILG. P!i rights ras2,,•eW, Pnnttd kp U.S.!.. _ _
SAFETY AND BUILDINGS DIVISION
Plumbing Product Review
P.O. Box 2658
Madison, Wisconsin 53701-2658
r TTY: Contact Through Relay
Scott Walker, Governor
Dave Ross, Secretary
September 26, 2013 (Revised November 13, 2013)
INFILTRATOR SYSTEMS INC.
GOVERNMENT AFFAIRS DEPARTMENT
4 BUSINESS PARK RD
PC BOX 768 C i 06475
OLD SAYPR00 .
Fie: Description: LLACHING CHikitlPIER
Manufacturer: INFILTRATOR SYSTEMS iNC.
Product Name: QUICK 4 STANDARDAN
Model Number(s): QUICK 4 STANDARD - VV
(EISA for chambers with or without fabric = 20.0 5Q, ft.,'chamberaE~SAefar end of end cap=
8.0 s . f#.l air of end caps, Laying length am er = 4.U IT., Lying FOR BED
fit.. Width = 34 inches, Height = 12 inches, Max. depth of bury = 8 ft.,
INSTALLATIONS, MAx. DEPTH OF BURY IS REDUCED TO 48 IN4 Open Bottom area =
9.64 sq.ft./chamber, 3.5 sq.ft./pair of end caps)
Product File No: 20130191
The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance
with chapters SPS 382 through 384. Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin
Statutes.
The Department hereby issues an alternate approval to s. SPS 383.44 (5)1,al & 384.5 based on the Wisconsin
Statutes and the Wisconsin Administrative Cede. This alternate approval is valid until the end of September
2018,
This approval supersedes the approval issued on 1`24/2008 under product file number 20070551.
This approval letter shall be incorporated with your previously approved plans and%or specifications approved under
product file number 20070551.
This alternate approval is contingent upon compliance with the following stipulation(s):
® This product must be installed in accordance with the manufacturer's printed instructions, product approval, and
plan approval. It there is a conflict between the manufacturer's instructions and the product approval and/or plan
approval, the product approval and/or plan approval will take precedence.
@ When this product is installed in a dispersal cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter, this product must receive wastewater having a BOD5 value between 30 and
220 mod/L and a TSS value between 30 and 150 mg/L.
Z When this product is installed in a distribution cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter, this product must be installed in individual excavations that create a row of
chambers that are horizontally separated from other rows in other excavations by at least 3 feet. The 3-foot
measurement is measured between the closest outside edges of the leaching chambers.
» When this product is installed in a distribution cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter,. the distribution cell design must allow at least six inches of ponding in the
chambers without back/"low' of wastewater into the drainpipe that discharges into the chambers.
i'
r:Oe Ref: 13019'02.G,OC
INFILTRATOR SYSTEMS INC
Page 2
September 26, 2013
Product File No: 20130191
6 When this product is installed in a distribution cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter, this product must be installed in a distribution system, which has the top of
the distribution cell at or below original grade.
When this product is installed next to each other in a distribution cell that is NOT sized based on the EISA rating
stated in the regarding block of the product approval letter, the effluent distribution area is equal to the length
times the width of the chambered area. The use of geotextile fabric in this type of installation is optional.
When this product is installed with geotextile fabric on the sides of this product in a distribution cell that is sized
based on the EISA rating stated in the regarding block of the product approval letter, the geotextile fabric must
meet all of the following specifications:
Geotextile shall be non-woven
Weight shall be 0.35 oztsq yd to 1.5 ozlsq yd
Apparent opening size (AOS) shall be 20-30 U.S. Sieve (ASTM D-4751),
The department is in no way endorsing this product or any advertising, and is not responsible for any situation which
may result from its use.
Sincerely,
Glen A. Jones, 1v1.S.
POWTS Product Reviewer
phone: (608) 267-5265
fax: (608) 267-9723
email: glen,jones@wi.gov
Private nsite Wastewater Treatment System Management Flan
Septic Tank And Gravity In-Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number lZd
Number of Bedrooms 3
i Design Flow - Peak ( pd)
I Estimated Flow - Average (gpd)
Septic Tank Capacity (gal) w
i Soil Absorption Component Size (ft2) - ` z _e L
Type of Wastewater D mastic
'table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow -Peak (gpd) r-es
Maximum Influent Particle Size (in) 1/8
Maximum BOO, (mg/L) 220
Maximum TSS (mg/L) 154
Table 3: Maintenance Schedule
Septic Tank Inspect and/or service once every 3 ears
I Cutlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Wank
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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the se and outlet filter shall be assessed at least
once every 3 years by inspection. Th cautlet f r shall be cleaned as necessary to ensure
Rroper operaticn. 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
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