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012-1076-70-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 600336 State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 3018570 Permit Holder's Name: City Village Township Parcel Tax No Jeffrey Linn TOWN OF ERIN PRAIRIE 012-1076-70-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: k - ' 36.30.17.555A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. $ Septic . 0 I~ l.,J► P, a( a.s Benchmark / Z0 J 7_ 166 Dosing I& F~[t. BM ~O l b~ SZS Bldg. ewer , Holding St/Ht Inlet 67.65 ~o •35 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLD ent Air Intake ROAD Dt Inlet \ Septic 33 f Dt Bottom V 0 ~dGo.33 Dosing ` g / Header/Man. . Zs ias. 7s Aeration Dist. Pipe L Holding IT- ~•Z7 f~~. Bot. System Z. 35 / 45.5 PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cov II GL GPM Model Number '75-85 ~wto~~ ` L75 v6,Y. ;7g All IJ Z5 2- TDH Lift Friction Loss System Head TDH P7, 14-55 Zs . I, 1,71,o 1 Forcemain Length I Dia. t/ Dist. to We SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth \ DIMENSIONS 4,5 9cIv SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Qf/~ystem: ~ CHAMBER OR 400 '_7 7 w?. UNIT Model Number: DISTRIBUTION SYSTEM -Size [Header/Manifold / Distribution x Hole Size x Hole Spacing Vegh)o Air Intake Pipe(s) ` 26 ngth I ZS Dia Length 58, Dia ? Spacing " 3; Z •5 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx . tf Mulched Bed/Trench Center / Bed/Trench Edges Topsoil 6 ~s L] No ~es No COMMENTS: (Include code discrepencies, persons present, etc. Inspection #1: ) A-~~s Inspection #2: Location: 2048 120TH AV Q` 1.) Alt BM Description 4 2.) Bldg sewer length = ~S - amount of cover = k 42, Plan revision Required? ❑ Yes No Use other side for additional information. SBD-6710 (R.3/97) Date Ins ctor's Si ature Cert. No. CO co v a w ~ J O.,d co n S~ S3 R 8^, 7d ~ n x I f f a ~ w ° n a 93coI 1 1 1 1 W o C4 ca v p V p nsx99 sst;z;;A- I I I! 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Washington Ave., P.O. Box 7162 Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) t NOY ®B 201" ` T CROIX COUNTY ~op , llt~ 33 JdMMUI~dT~1t F mit Appi~ Y9s State Transaction Number In accordance with SPS 383? 1(2), Wis. Adm. Code, submission of this form to -mental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owr,. -iitted t Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may ;cond Z p 8 ,/yG purposes in accordance / b with the Privacy Laws 15 04 I m Slats .7 I. Application Information -Please Print All Inform Property Owner's Name ( Parcel # Property Owners Mailing Addre s Property Location eJ / QJ"c`i~rc>✓/7iarsC Tom,'/ Govt. Lot q l.Sctci-Spam/iy City, State Zip Code Phone Number 40" L •s,~ ''/s, SJ.v Section " +X+ 4- ~ Sr~~ J"- (circle on~g~ It. Type of Building (check all that apply) Lot # T _O N; R -mow J I or 2 Family Dwelling- Number of Bedrooms N L Subdivision Name i sl Ch Block# ❑ Public/Commercial - Describe Use N d Ni4 ❑ City of ❑ State Owned - Describe Use - IV ( CS Number ❑ Village of _ 1 ~V M n Town of III. Type of Permit: (Check only one box on line A. Complete line B i applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) i B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration u Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ` ❑ • Non-Pressurized In-Ground El Pressurized In-Ground 11 At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil N ❑ Holding Tani: El Other Dispersal Component (explain) Pretreatment Device expln~~'t j R "G eVN1*7`Asr N Dis ersal/Treatment Area Information: To iiV e ri; / dkP ' dm !74., I4 Design Flow (gpd) Design Soil Application Rate d~D Dispersal Area Required (s Dispersal Area Propose f) System Elevation d .S~" s~ 3o D ,3 9d.r~ VI. Tank Info Capacity in Total of Manufacturer Gallons Gallons nits y+ U U ~ U New Tanks Existing Tanks U R N IJ n s ?v Septic or Holding Tank O d ` OO , x Dosina Chamber p[ us C ©b o /.~aa/tae t~ ~0,~6o X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the PONVTS shown on the attached plans. Plumbers Name (Print) Plumbers Signature ? MPIMURS..Nomuber Business Phone Number i cA,wl s7-4r, 2:.O le TLS = ~--.5 3 Plumbers Address (Street, City, State, Zip Code) O S?"'. .~/set, o r7~~ lti,~ JJ d~ VIII. Coun /Department Use Only K Approved Permit Fee Dat Iss dd Issuing ent Signature ❑ er Given Reason enial $ 01~ v ( IX. CondiBll61' I"EiRfReasons for Disapproval t ` 1. 5eptkUrk, eiflwnt iilte- vn1 3 ~cQ11~ / 0 l rust all be s c Gt.1 . ' . ^L G.J -ts p ~ar3yemen! plan pro nag i vv t ~ae~. J ~ 2. -AD sse!ba, k rPC4:IW!t'."MfIL'S~►U~i t1e t a t,,. , .E=f n per Vpiic,)bl! r 36 / vdinaM&I. / _ „ ` 4 _4~ Attach to complete plans for the system ands mil to the County+only on per not less" n 81/2 x 11 ipch v►J~,Q~ ~/~J'62. ~5 ~~1~i1~ SBD-6398 (R. 11/11) _ - A-AM PdWC 'C-of /d Ijv _40 Win v am* aZA C~orX uiiT ~ -t r ~ ~ ~ 0 10te- ~a7L-?a- Dap ! N mQ POSED h CI&-A 0tXT nE(R C.oDC 4ZdATdoAl New W CES \ ~F (L1"Qf{~j ~f Cd F 1~ o Ali ■■~~■■1 &A41-0M PiAAA BM= ?Ab P'or Et-~J:Zr_ FSoX i N~ CLEAtJDt+~T ~S~k-M~ fCJ.~D` _ COI~G `S. Di~r~NOT Co^^P,nc SnJSULf1TE PtctZ R-~ f~f;~r4 T O~ ~LS~ Wr 6N #2r- mKOUWD d° v ~ 51,t~~LE Fad, ~ .~eLL, a►G jvrADt v 14 $E mo- o ¢ 1e a lu s ~ n AJ ~n j /~oEPT~hT~ DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 31 Contact Through Relay http://dsps.wi.gov/programs/industry-services ,/!w" www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary November 06, 2017 OF SA CUSTIDNo. 224832 ATTN: PO WTS Inspector "'JAL ZONING OFFICE MARY JO HUPPERT ST CROIX COUNTY SPIA 28497 KING ARTHURS 1101 CARMICHAEL RD 71o, DANBURY WI 54830 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/06/2019 Identification Numbers Transaction ID No. 3018570 SITE: Site ID No. 844428 Jeffrey R. Linn Please refer to both identification numbers, 2048 120TH Ave above, in all correspondence with the agency. Town of Erin Prairie St Croix County SE1/4, SW1/4, S30, T30N, R17W FOR: Description: GeoMat Mound (4 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1734768 Maintenance required; 600 GPD Flow rate; 15 in Soil minimum death to limiting factor from original grade; System(s): Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12), SSWMP Pub. 9.6, GSF Mound Component Manual (August 2016); 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 mound area • Divert surface water from POWTS 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. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 MARY JO HUPPERT Page 2 11/6/2017 , • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • 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. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Any changes may result in pump resizing to meet TDH and GPM Specifications. • 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 mound 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(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, 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 MARY JO HUPPERT Page 2 11/6/2017 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • 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 ad is located. 2. The bottom of the tank is located more than 150 feet horizontally from where the servicing ad is located. • Verify property line(s) prior to installation. • Puma Floats to be set and verified per approved plan Anv changes may result in pump resizina to meet TDH and GPM Specifications • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. if no other city is nvailahla trees in the hagal area of the mnnnri mligt hP piitt off is 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(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 dtim a This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214, Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vanderleest@wisconsin.gov GeoMat MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Owner Info ~ Project Name: JEFFREY R. LINN @ D Owner's Name: (SAME) UCr 16 2(111.1? Owner's Address: 6699 ORCHARD RIDGE TRAIL i WV11 C ES OODBURY, MN 55129 Property Info Property Address: 2048 120TH AVENUE Legal Description: SE SW S 36 T 30 N R 17 W Township Erin Prairie County: St. Croix Subdivision Name: NA Lot Number: NA Block Number: NA CSM#: NA Parcel I.D. Number: 012 - 1076 - 70 - 000 Plan Transaction No.: Index Pages Page 1 Index and title Page 9 Tank cross sections Page 2 Data entry Page 10 Plot plan Page 3 GeoMat mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Ma Jo Huppert ````~~Udrutu®ftA Itt►uf,J~7 - ense Number: 1859-007 Date: 10/14/17 a Number: 715-426-1775 Signature: MARY J4 Designer Stamp: HUPPRT ate isconsin Approval Stamp: D 1859 RIWR FALLSe % WI f• Designedw,"WI ZZ Synergy Systems L.L.C., GeoMat Mound Component Manual (Edition 1, 2017), (N. 4/17), SSWMP Publication 9.6 Design of Pressure Distribution Networks f or ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10112) GeoMat Mound Edition 1, 2017 Page 1 of 10 Mound and Pressure Distribution Component Design Site Information R Residential or Commercial Design N ISD Required? _ 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 6QO.W Design Flow (gpd) 8.00 Site Slope 103.85 Installation Contour Line Elevation (ft) 15.00 Depth to Limiting Factor (in) Reason For !SD 0.60 In-situ Soil Application Rate (gpd/ftZ) 80.00 Contour Length Available (ft) Distribution Cell Information 6.50 Cell Width (ft) -__~i.750niv 60.00 Designer Input Cell Length (ft) 2.00 Dispersal Cell Design Loading Rate (gpd/ftZ) 60.00 Dispersal Cell Length Required (ft) 2 Influent Wastewater Quality 1 or 2 Pressure Distribution Information E Center or End Manifold Are the laterals the highest point 2 Number of Laterals in the distribution E Y 3.25 Lateral Spacing (ft) network? 32.95 Forcemain Drainback (gal) If N above, enter the elevation (ft) 0.50 Forcemain Filter Loss (ft) of the highest point. 2.00 Forcemain Diameter (in) 202.00 Forcemain Length (ft) Does the forcemain drain back?~ Y 92.00 Inside Pump Tank Elevation (ft) 0.156 Orifice Diameter (in) (e.g. 0.25) 2.50 Orifice Spacing (ft) = 8.13 ftZ/orifice 4.55 System Head (ft) x 1.3 ~j 12.68 Vertical Lift (ft) 2.97 Friction Loss (ft) 20.70 Total Dynamic Head (ft) 52.76 5x Void Volume (gal) Z~// i 85.71 Minimum Dose Volume (gal) ~D I/ 25.85 System Demand (gpm) Diameter Selection Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x f 1.25 2.00 1.50 x x 3.00 2.00 x 3.1 x Manufacturer Information Treatment Tank Information Effluent Filter Information _ 12000 Septic Tank Capacity (gal) Polylok Inc./Zabel F' er Manufacturer Wieser Concrete Products, Inc. Manufacturer Z Filter Model Number Dose Tank Information Gallons/Inch Calculator (optional') r 800.00 Dose Tank Capacity (gal) Total Tank Capacity (gal) 22.24 Dose Tank Volume (gal/in) Total Working Liquid Depth (in) Wieser Concrete Products, Inc. Manufacturer gal/in (enter result in cell DoseTankVolume) Project.- JEFFREY R. LINN Page 2 of 10 i Mound Plan View T 3 J 1/10 B ❑ Observation Pipe . K:: -T s A W L - g: . L Mound Component Dimensions A 6.50 ft E 15.24 in H 1.00 ft K 9.66 ft B 60.00 ft F 14.50 in 1 11.76 ft L 79.31 ft D 9.00 in G 0.50 ft J 5.95 ft W 24.20 ft 390.00 (ft2) Dispersal Cell Area 1095-39 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6100 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View GeoMat Dispersal Area Observation Pipe 12" ASTM C 33 sand as GeoMat required for Geo Mat Distribution Cell component GeoMat + 12" ASTM C-33 sand H. G 106.81 Finish Grade Cover Material 105.68 Lateral Invert Elevation f 104.60 Dispersal Cell t Slope 8.0 Elevation Contour Elevation 103.85 Tilled Area Forcemain In situ soil In situ soil Shading Key 1 © Topsoil Cap 2 Q Subsoil Cap 3 ASTM C 33 sand (F) 4 Q ASTM C 33 sand (D) 5 r-->I Tilled Layer 6 Q Geo Mat See details on page 4 for number, size, and spacing of laterals. Project: JEFFREY R. LINN Page 3 of 10 End Connection Lateral Layout Diagram urn-up w al valve or cleanout plug / 1st orifice located at Z Z JAII orifices point down p Laterals & force main of PVC Sch 40 per SPS Table 3 x,.30-51 Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.50 ft Lateral Length (P) 58.75 ft Orifices per Lateral 24 Lateral End (Z) 1-25 ft Orifice Density 8.13 W/orifice Lateral Spacing (S) 3.25 ft Manifold Length 3.25 ft Lateral Flow Rate 12.92 gpm Manifold Diameter 1.50 in System Flow Rate 25.85 gpm Forcemain Velocity 2.64 ft/sec Dose Tank Information I,,, , ~ e and ~<ak•r ti~ht Y:~I 1" \ rnird, o", F I I. aril al M,~ 16 x 1( l/pn'-d It ire. l non ( Ii Cll it -urcC .-.0 b, Control .hied „t IlluCnt being d..1: <i t )pii°r..d "°tIct Forcemain diameter „i,t r~l I dt<~ 2 In. and -aQ1 .,td iciil ticM ir:n6rt Sim / Tech Filter STF 100 1/16 Ill; h t ;u r alarm,'; Pump ()n I loaf J Pump off elevation (ft) Pump ()I l I loal• Hump 93.00 Dose tank elevation (ft) 92.00 I1exldini-, under etnl Dimension Inches Gallons Wieser Concrete Products, Inc. A 18-12 402.93 Capacity 800.00 B 2.00 44.48 Volume 22.24 gal/inch C 3.85 85.71 D 12.00 266.88 Total 35.97 800.00 Filter Manufacturer Sim / Tech Filter -71 Filter Model Number STF 100 1116 Alarm Manufacturer SJE Rhombus vl,~ Alarm Model Number AB Tank alert Pump Manufacturer Goulds Water Technology, a xylem brand Pump Model Number PE 41 Enter fitter model number Pump Must Deliver 25.85 gpm at 20.70 ft TDH Project: JEFFREY R. LINN Page 4 of 10 GeoMat Distribution Cell Media Layout 6.50 Cell Width (ft) 1.63 Sidewail to Lateral (ft) Distribution Cell Cross-section Arrangements Component Legend O Distribution Pipe With Pressure Lateral L. j Orifice Shield 0 Turnup Enclosure - - - - - Pressure Lateral GeoMat is covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.50 Cell Width - A (ft) 60.00 Cell Length - B (ft) ~+.i ~+.+..-+F.rf .yr±:,:,-41~+.>!+.;,!~, 4~g ~.!Ti,'r r+►Ir :Tr "r'~"..!"' f" .~nti-r-r~y ~+i: ?+r i~lr ''~^i4~rt''i'4'i" }y~J! `y"I"l" '~.1+' ~.FT4 ~*T'T -*"~I~'i ~+Ta ' - Typical Dispersal Cell Sand Cover recommended Distribution Lateral o Orifice Shield Pipe Dia. _ Approved Infiltrative Fabric GeoMat Component ~iTM 33 ;;~xf. ' - - Infiltrative Surface/Plow Layer Observation Pipes Shading Key / I 0 Topsoil Cap Toilet Flange Q Subsoil Cap Reber 3 ASTM C 33 sand (F) 4 Q ASTM C 33 sand (D) 1" Min 1 Min g © Tilled Layer j ~ Geo Mat Clot See details on page 4 for number, size, and spacing of laterals. Project: JEFFREY R. LINN Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name ____s_r__Septic.._-Se-_.-_rv..-_..ice..______._~... Phone 715- _42_5_.~ sDarrell' i -1025 POWTS Regulator's Name St Croix County SPIA - Zoning Office Phone 715) 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 30 mg/L Septic Tank Capacity 1200 gal Maximum TSS 30 mg/L Soil Absorption Component Size 390 ft2 Maximum FOG 10 mg/L Type of Wastewater Domestic Maximum Fecal Coliform 10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 ears Effluent Filter Inspect and clean as necessary at least once eve 3 ears Pump and Controls Test once every 3 years Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested every 3 ears Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the Synergy Systems GeoMat Mound Component Manual Version 1, 2017. 2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component Manual Version 1, 2017. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail 6-8" Diameter Finished Threaded Cleanout Lawn Sprinkler Grade Plug or Ball Valve Box Lateral Ends at Last Orifice Where Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Distribution Lateral Lateral Cleanout 3 Feet Project: JEFFREY R. LINN Page 6 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (Synergy Systems L.L.C., Geomat Mound Component Manual version 1, 2017, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. 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. 28148, 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 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to 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 Wisconsin Department of Commerce. Pump Tank The dosing (pump) 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. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. """'No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.-** Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound'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 mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound 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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 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 3 years. 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system 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 mound 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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: JEFFREY R. LINN Page 7 of 10 Wastewater METERS FEET 40 MODELS: PE31, PE41, PE51. PES1 HP:.33-40-50 35 . - 10 2 GPM 30 PE41 FT 25 PE31 - 9a.70 of a 20 E 1Q- 15 - 10 F c c 0 0 0 10 20 00 40 50 60 70 GPM 80 0 5 10 15 m3/h CAPACITY PERFORMANCE RATINGS PE31 PE41 PE51 Total Head Total Head (feet of water) GPM GPM Total Head (feet of water) (feet of water) GPM 5 52 8 61 10 67 10 42 10 57 15 59 15 29 15 46 20 50 20 16 20 33 25 39 25 0 25 16 30 26 35 8 -key u,AIW PAGE 3 w 53. D AS 96" A REQD 41' _ a Cz A W v ri~qp CD -1 y m 0 3' 44' g` I D r' i { aO ~ m W. -n o p m~ l A N 1 g UP OW 4' CAS , I no, U v v D 39' -Zi 0 p D 1 ~ 1 Ir m A C D° Z O c Z Z O >y a v z 7A~0- ~rN*Ia Z $7C O (A7 p$Z 041- Z a 0 t=- *1y6 ODD Cp vx A m =N N 'O ~0a;w, a Spy ~S= ~F_z o-, M~ ~r~nc P z wN - vc~a~"Zm rw Q; 4' O ~Ego>19AFriOZ6 C> ff v7 ~ v a 0 Nu ;lm r w I -i i* ~r.. O :o c, m ago v a V 2• =A> Am q IA tAt*iw j ~mUt- - 00 >0 a oz c: 00 R' w 0 -0 0 ~o z A 3~ C z ZZ p y~ > y jo 21 P Z;o -a -n 20 CIO -1 rn M U) 'IU= o O O p 3 ~ v0 a a M ~ z r Z z cn WLP1200/WO-MR rrl -n --4 SEPTIC MANUAL DANE; JJMMY 2oto DAM - \ Z W3716 us ►~wY 10 MAOM Itocx. w1 547M ° REVISED JAN. 2010 800-325-8456 Hm- [pug IARW QAj1J sMt ►,v sE~ 'OF ruE wAmm so" r c. 3~ 7-30, A 1 ~ 7©w~11 eF Ex, j~j ~re~iw~ , ~ I] ~ CKnIX 7 i ZaY $ ~zD;~, , f,,~vui: 9, 9s0 f1cK~-s 11712- /D7G.-?A- Uop Nor& l o~ ~ b CLEMOU-t Per< Goc;E Lp~Tto1~ OF WCL- N~w wt~s o I ~oolc~AQ o Apo. G~IF4~CN'7r4A1~{{~ o °'cy S a SID a 4; ttr oT i -toP of p ti " "ate It ibM, FADPbrt et-r=aRIC >3ox flSkan6b /crT.~7D ` ~ CLEAtJO~.iT PCR - COOG Do NG7 f0 T Tn3SLLATE PER nIZT sP w.,~.e . \ bZ.IQ 3l , 12 V Q6 O SAtlAeE FOR STOKE & PAS D l fl'A~ + v L1 $EDROOn~ 8s. Da ~ y U a N • a ~ Q AQE.~ S 'Jae RECEIVED ST. CROIX COUNTY SEPTIC T ki MAT ANCE ACTREE_l, N DEC 0 Zu r ST. CROIX COUNTY O~'NERSF~' CER.Tt~ICATJON FORM COMMUNITY DEVELOPMENT I~_ D uyer -P x'70 i- Mpg Address U -fig N. T ~r Propa ty Address -?-0 ^ ~ f c~ ,vez L,c on r~:a i--d from Plarming & o a anent for new construction.) Nr- Ciiv-'Staxe Parcel Identification Number Qr I ~ 10'7e- ;7Q - c) n 2 LEGAL DESCR TTION _ 7- l3' a. r. y-P ~.rr t* ~1rt Prop To caflo~t Sec T ..5 0 N R 1 Vii, Town of Su3diN ision Plat: Lot Cert ed Sun ey Map 'olu e Page T Warranty Deed 1~ ' cam (before 2007)Valune , Page.# Spec house D yes;Kno Lot lines identfable C yes D no SySTEM NL4WTE'!?_NCE ADD OV17 R CERTIFICATION Improper use and maintenance of your septic system could result in its •p-ematur e f0ure to handle wastes. Proper ai -aance consiss of pmmpmg out ;he septic tank evey th ee years or sooner; i needed, by a hcemsed pumper. Vdhat you p'rt Into ties °s` can affect he fun on of the septic tank as a °ataent stage in the waste disposal system Owner mamMa-'ante r°sporsi5iiities are specined in §SPS. 383. 2(1) and in Chaps--r2 - SL Croix County Sanitary Ordinance. T "he property owner agrees to submit to k CYom County Planning Zoning Deparment a --a cation fo_on, signed by the owner and by a master plumber, }o=eyman plumber, restricted plumber or a liceme pumper ver'uyingg that (I) the on-sim wastewaler disposal system is in proper operating condition and/or (2) after inspection and pzTnping (if necessary), the septic tack is less than 1/3 full of sludge- 1?we, the undersigned have read the above requirements and agree to mai-ot7in the p*ivax:. sewage disposal system with fue standards set forth herein, as set by the Department of Safety And Professional Services and the Depw went ofNat¢ al Resources, S of Vv is omsin Certifi:;a on sir g tat your septic system has been maintained must be completed and retumeed to the St Croix Cate Planning & Zoning Department within 30 dqs of the tha ee year expiration date. ,we cr=y thai all statements on tbi~ four are true to the best of my/our lmawledge. L'we am/are. the owner(s) of the properly descnbed abave, by virtue of a war: aniy a: ed recordedm Retrist.,°r of Deeds G~ice. -N>:rmber of bedrac}jas " OF -,2j;VhIC-A2\TT(S) DATE ***Any- imfarrnation tha: zs misrepresented may result in the samimly pe.*mit being ltvoked by the Planning & Zoning Department Include vi i; a his application a recorded wa-arty deed t-om the Register of Deeds 0:5ce and a copy of the rd ed survey map if reference is made in the w&-rau--- y deed- (REV. 04/L) N 3 Q Zt~Od \ C! pp~ oopp .Z/1 It-.U M .O V N r+7 cV ^ S3MB-Ak/M S3NA-). 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N ~ ar„y O G r ♦ ~ N IR-H Z { o 1 { _ F MV313 Q J W F- W 993 J.N3WdOl3A3(i AimnWWO` ,ol-,6 A1N(100)aml0 1S I.! 07, b 0 030 ®3/ \'333 $ - ,,..~ne 'dHb7br'+,~= ; w°Zi`744 3c, Wisconsin Departmen ~ajq + )Professional Services Division of ~~,,dd SOIL EVALUATION 'REPORT page 1 of 3 in accordance with SPS 383, Wis. A ode Attach co ` County ST. CROIX M mplQt l J ~ V~OA 11 " than 8112 x 11 inches ' size. r 11 include, bu nontal reference t (B Parcel O l - 1076 - 70 - 000 perce nts dimensions, north arrow, and locati .,oad. C`' Please print all information Revi by Date Personal information you provide may be used for secondary r Q~~ y Law, s. 15.04 (1) (m)). 77 ~4~ 1 Property Owner 3 Property Location El JEFFREY R. LIMN Govt. Lot SE 114 SW 1/4 S 6 T 30 N R 17 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or M# 6699 Orchard Ridge Trail city State Zip Code Phone Number r1ci Village Town Nearest Road Woodbury, MN 55129 ( ) 120th Avenue New Construction Useo Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD 13 Replacement Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable Add- ft. 's General comments and recommendations: Mound System - 1.75 ft. sand fill 0.4 loading rate .(.0 fi EC A1.AT 1❑ Boring # Boring • Pit Ground surface elev. 102.10 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ;Eff#1 'Eff#2 1 0-10 7.5YR2.5/3 sit 3f-msbk mfr cs 2vf-m 0.6 0.8 2 10-15 7.5YR4/4 sit 1 fsbk mfr cs I of-m 0.4c 0.6 3 15-20 7.5YR4/4 f1d7.5YR5/6 sl Ifsbk mvfr 0.4 0.7 Horizons 2& 3 have some gr/cobs F2] Boring # 11 Boring 105.00 18 • Pit Ground surface elev. ft. Depth to limiting factor in. Soil Iication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu_ Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-8 7.5YR2.5/3 1 2f-msbk ds as 2vf-m 0.6 0.8 2 8-15 7.5YR4/4 sl If-msbk ds as Ivf--m 0.4 0.7 3 15-18 7.5YR4/4 fId7.5YR5/6 sl If-msbk mvfr as 1of-m 0.4 0.7 4 18-28 7.5YR4/6 f2d T5YR5/8 sl Om mfr 0.2 0.6 some gr/cobs all horizons Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signa re' CST Number MARY JO HUPPERT Hollister's Soil Testin &Desi Liz - 224832 Address Date Evaluatio nducted Telephone Number 28497 King Arthur's Court, Danbury, WI 54830 09 - 28, 2017 715-426-1775 SBD-8330 (ROT 13) Property Owner LIMN, Jeffrey R. Parcel ID # 012 - 1076 - 70 - 000 Page ` of 3 ❑ Boring # ring 105.00 15 ■ 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 7.5YR2.5/3 I 2fsbk ds as 2vf-m 0.6 0.8 2 10-15 7.5YR4/4 sl Ifsbk ds as Ivf-m 0.4 0.7 3 15-20 7.5YR4/6 f2f7.5YR5/6 sl Ifsbk ds Ivf-f 0.4 0.7 some gr/cobs ❑ Boring # H 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 H Boring ❑ Boring # Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicati Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L SBD-8330 (RQ?'13) A I" Pd ge 3 • - 1" Oft ON F. p~ JAI VF THe :SWV" f mac. 3b, 7"3ont A~~~v°. "tnw-~l a~ Ev meow) ae.►Aj 1 +~ArR~c~ .sr L7 ~ -Pit uf.t7 v -:ter r, Zo`/ ~zo t ~950 Ac"'F_-s ,o~~->o- Sao Non* ;i{ED I Q { h a C -top of s BM= PAD FOR E~EcTi~~ F3vX ~knnEb ioo.~o` f i t l02.00~ ~ 13%A 4t2~ Q+KOUAIb SV Kk-A dE FOR V) ` 57AKE C f'F4:Q5r--Z ~ f _ ~eLUNG ~ o Aa' v c{ SEDR~pr~ ~85.D~/ II i f 1 P t t o ~ ~to • OC a N 1?n l~'1 A vE, y~ 1 ~ r a: 3 ezn+kA X;JQ 5 StT~ i wr- L.;Lj ~ Uf ~ r^ f i f ' d + tD l•.L~ ee ~ ~ • ~ W . Q .t N wym in _ a