Loading...
HomeMy WebLinkAbout040-1322-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 600346 State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 30760055 Permit Holder's Name: City Village Township Parcel Tax No Bryan & Stacy Wonsmos TOWN OF TROY 040-1322-10-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /cgs " Z GS 19.28.19.2174 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 5 CAPACITY STATION BS HI FS ELEV. Septic /Z60 Benchmark Al, Dosing C6~iMioO 1,60 AIT W 1 od{Z , ~O 7~p . ~J Bldg. ewer Holding SUHt Inlet Boa s s 9i• St/Ht Outlet TANK SETBACK INFORMATION 2p~j r3 3~J ~7~ 5, 7 TANK TO WELL BLDG. Vent to Air Intake ROAD Inlet /Z Septic 9f ZDOO 27 L Dt Bottom 87.7 Dosing f Header/Man. ✓ ~ L~ f 5r Aerat n Dist. Pipe Holding Bot. System 3J-0 cost- ~ 3-a3 lc~l • 1 v , PUMP/SIPHON INFORMATION Final Grade A~ Manufacturer Demand St Cover GPM ZOUO g4. 7 Model Number ~t b 16-01 TDH Lift Friction Loss System Head T Ft .0c Lc.S~ Forcemain Le gth Dia. ~ Dist. to Well ` i N 1 21) SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trench PIT DIMENSIONS NqOf Pits Inside Dia. Liquid Depth DIMENSIONS l V r„ U ri SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: g 1 C40' A j /I 4 - UNIT Model Number: DISTRIBUTION SYSTEM "~~f J y`j [Herder/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s e_1 gth Dia Length c I Dia /'lf Spacing `7 --7 p ~r I P G~' wwo 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 _ ~ rI ;J] Yes i I No Lj Yes/ ~ o COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: t y Location: 387 PEACEABLE HILL RD ~ ^ y 1.) Alt BM Description = ~jed/ l !1 2.) Bldg sewer length = Cr-3 T - amount of cover = J 1P/ Plan revision Required Fj Yes No Y_ J - - - - , /r / Use other side for additi onal information. '-Il• ii- L {IW~: SBD-6710 (R.3/97) Date nsepc ure Cert. No. 1~ 140 ETU ,`FO" ~ f I~ ? ~o p L `fir L~7Ij Industry Services Division Counts c ~lCr= 1400#r o s}qn t - 4 ~ MV P = 53707-7162 Sanitary Permit Number (to be filled in by o.) $ Madison, WI Sanitary Permit Application ° State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit _3 '677 to~Z5 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POINTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondar C? ~r ~0-A6 (\IQ 1 t \ 1 , m poses in accordance with the Privacy Law, s_ 15.04(l)(m), Stats. ~ V 1 t 1 1. Application Information - Please Print All Informatio Property Owner's Name Parcel # G1 S~ S V~( Y Yl C1~ D- 1 Z l- Proper Owner's Mailing Address Property Location • j ( Govt. Lot City, State ~I Zip Code Phone Number y,, Section / circle o DWW - YIN r, - KN G I \ IS -1 17~~1 T Z~ N; R CEo W~j II. Type of wilding (check a that apply) rk Subdiv Sion Name I or 2 Family Dwelling -Number of Bedrooms CAL Ad Bloc i V v; ~ V V l ❑ Public/Commercial - Describe Use ` ❑ City of ❑ State Owned - Describe CSM Number El Village of TJse~ owm of 6 k L+n \ r- III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ 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) Oil ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil )!~Aomrd < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Applicatio ate( dst) Dispersal Area Require DispersahA'~rea Propoj System E(levati//on ~C 1 ( 4.z~~ VI. Tank Info Capacity in Total # of Manufacturer v Gallons Gallons Units a U 71 72 cs ca New Tanks Existing Tanks Al _ ~ d_IJ K~ Jam-( a C~ v v n w U a / Septic or Holding Tank II -l Dosing Chamber; VII. Responsibility Statement- I, the undersigned, assume responsibility fo installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Sig ~tprc MP her Business Phone Number F _ ! ' LL~~"1 Z 715/~l Plumber's Address (Street, City, State, Zip Code) S c`~ 5 rJ P. ~tq C " ew- V Count /De artment Use Only proved C7,'iven v Permit Fee Date sued Q Issuing t Signature . co Reason of Denial $ / U IX. ConditS easons for Disapproval (il~~eP al cell rntlst ap be s ~_Ic;•s' *.+zlntLN 9%, per 3'>wagement plan o iaed by plu+nbe • 2. `All elfMir k rect,iW,^.ens must LL ma..rte u:e 0 all plK POOMW Cod+.1 tr l-a~ Attach to complete plans for the system and sulTia to the Co ty only on per ess than /2 s 17 inches in size SBD-6398 (R. 08/14) 13 R-q A t~ ~~~~C*1 B'U'D N S h~u S L+ CTCAL-~ f pl-CAI Ivl i ►U ilk s s O I L r ~'~►IL~ S' S f Z~ Ire (,e 17 C Y r JA- i~lml zz Z --6 of s/1"R/C pii a /cc, f ~ a 5 c. 'l ' 361t K DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN HOLMEN WI 54636-9466 Contact Through Relay "i 0 S http://dsps.wi.gov/programs/industry-services P K) www.wisconsin.gov Scott Walker, Governor ILS?10^1 P~~~ Laura Gutierrez, Secretary March 15, 2018 CUST ID No. 223242 ATTN.- POWTS Inspec.'0r JEFFERY V FOX ZONING OFFICE JEFF FOX CONTRACTING & SEPTIC INC ST CROIX COUNTY `.iPIA PO BOX 565 1101 CARMICHAEL R.D DRESSER WI 54009 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/15/2020 Identificatio Numbers SITE: Transaction ID No. 30;'6005 Bryan & Stacy Wonsmos Site ID No. 847332 387 Peaceable Hill Rd fication numbers, Town of Troy Please refer to both ider St Croix County above, in all corres onde 'e with the agency. NW1/4, SE1/4, S19, T28N, R19W FOR: Description: Four Bedroom Mound System \ Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1752240 Maintenance required; 600 GPD Flow rate; 23 in Soil minimum depth to limiting factor fr ')m original grade System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pre-isure 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 systerr, 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 all code CONDI requirements. AP No person may engage in or work at plumbing in the state unless licensed to do so by the Departmem per s.145.06, DEPT OF stats. F l:DFESSIO The following conditions shall be met during construction or installation and prior to occupancy or use. 5I A,10N OF INI Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • A copy of the improved 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. r 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. • The owner of a POWTS shill be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with _his chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absc,rption system or any of its component parts malfunctions so as to create a health hazard, the property ow ier must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making th om necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer cif 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. f 1 The above left addresse( shall provide a copy of this letter and the PO WTS management plan to the owner and any others who are respon5 :)Ie for the installation, operation or maintenance of the PO WTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewe, , Division of Industry Services WiSMART code: 7633 (608)789-7892, Mon Fri, 7:15 a.m. - 4:00 p.m. jerry.swim@wi.gov cc: Edwin A Taylor, 'Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 addresse- shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responF )le for the installation, operation or maintenance of the POWTS. Sincerely,, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer , Division of Industry Services WiSMART code: 7633 (608)789-7892, Mon - Fri, 7:15 a.m. - 4:00 p.m. jerry.swim@wi.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE MAR ~ ~ L01$ Project Name: Bryan & Stacy Wonsmos Owner's Name: Owner's Address: 7742 Jolelyn Ave S. Cottage Grove MN 55016 Legal Description: NW1/4 SE1/4 S19 T28N/R19W Township: Troy County: St. Croix Subdivision Name: Troy Overlook Lot Number: 10 Block Number: Parcel I.D. Number: 040-1322-10-000 Plan Transaction No.: rfONALLY ROVED AFETY ANO Page 1 Index and title AL SERVICE^ Page 2 Data entry Page 3 Mound drawings STRY SER Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications - - Designer: Jeff Fox License Number: MPRS 223242 Date: 03/08/18 ) Phone Number: 715-491-3458 Signature:. Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11112), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 7 Mound and Pressure Distribution Component Design i Site Information R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for fecal coliform of 36 inches. 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 3.00 Site Slope 100.00 Contour Line Elevation (ft) 23.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? - e Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 2.50 Orifice Spacing (ft) = 8.33 ft2/orifice 2.00 Forcemain Diameter (in) _ x. 120.00 Forcemain Length (ft) Does the forcemain drain back? Y _ 92.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 19.57 Forcemain Drainback (gal) 8.68 Vertical Lift (ft) 80.40 5x Void Volume (gal) 2.28 Friction Loss (ft) 99.98 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 29.66 System Demand (gpm) 17.45 Total Dynamic Head (ft) 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 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator Treatment Tank Information Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gavin (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) lifetime Filter Manufacturer 22.00 Dose Tank Volume (gal/in) 8 Filter Model Number Weiser Manufacturer Project: Bryan & Stacy Wonsmos Page 2 of 7 Mound Plan and Cross Section Views T J i1' /1.0• ,B'- _ Observation Pipe K O n oil A .1. W ::1 B 3' . L Mound Component Dimensions A 10.00 ft E 16.60 in H 1,00 ft K 9.08 ft B 60.00 ft F 9.50 in I 15.00 ft L 78.15 ft D 13.00 in G 0.50 ft J 6.54 ft W 31.54 ft 600.00 (ft2) Dispersal Cell Area 1500.00 (ft) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.88 (ft) - H G 1 ..rrrrrirrr;;r;;;r rrir;,r.....rrr... I F Dispersal Cell 101.58 (ft) Lateral 101.08 (ft) Invert Dispersal Cell Elevation D a 100-00 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on Topsoil Cap ® a 1.5 ft Page 4 for number, size, and spacing of laterals. rrrrir;r Subsoil Cap ~ . ~ ~ 0 /r~~ Laterals are equally © ASTM C33 Sand ~ / F spaced from the Typical Lateral distribution cell's Tilled Layer = 4) 0.5 ft © Aggregate 'a o centerline in the distribution cell (AxB). A 1P Project: Bryan & Stacy Wonsmos Page 3 of 7 End Connection Lateral Layout Diagram Lent«r rh.-;etei. r_.vgr r3e P. E'.iirrrrn_i•.n •w Turn-uPvi ball ;..a R.a .-.r c(~anout plop. ( x. P All Inter ar srv 1.3 rt<• ai lt-4X __41 #-i { o,- drill d C'n t}r;. Gr_,teon-. .F t}y,, t vt4r31 e*Ir~alt~ 'R.~s-ern' - crtar 1>. t.r._rn 3u_C,h 40 F`tn. per .>R<T_=,ileL Pc,rre mare aonnecti-, •:ta t?r c.r r; to m.ar f01d it an - } pornt. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.54 ft Lateral Length (P) 58.42 ft Orifices per Lateral 24 Lateral Spacing (S) 3.33 ft Orifice Density 8.33 ft2/orifice Lateral Flow Rate 9.89 gpm Manifold Length 6.67 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 17.45 ft Forcemain Velocity 3.03 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 E Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Ca acity 800.00 Gallons T Volume 22.00 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 18.92 416.22 C B 2.00 44.00 P♦ ump off elevation (ft) C 4.54 99.98 92-91 D 10.90 239.80 D Total 36.36 800.001 1.1 ' Dom se tank elevation (ft) 3" Bedding under tank. 92.00 Alarm Manuafacturer Rhombus u ° - Alarm Model Number MJ Plugger Pump Manufacturer Zoeller Pump Model Number BN 152 Pump Must Deliver 29.66 gpm at 17.45 ft TDH Project: Bryan & Stacy Wonsmos Page 4 of 7 Mound System Maintenance and Operation Saecifications Service Provider's Name Jeff Fox Phone 715-755-2461 POWTS Regulator's Name St. Croix Cty Zoning Phone System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 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 years Effluent Filter Should inspect and clean at least once every 3 ears Pump and Controls Test once eve 3 ears Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested eve 1.5 years Mound Inspect for ponding and seepage once every 3 years 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 mound component manual. 2. Dispersal cell aggregate conforms to SPS 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 mound 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 6-8" Diameter Lawn Threaded Cieanoui Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Bryan & Stacy Wonsmos Page 5 of 7 Mound System Management Plan Pursuant to SIPS 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 [SBD-10691-P (N.01/01, R. 11112), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01, R. 10/12)] 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 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 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 Department of Commerce. 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. 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 BOD5, 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 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 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. I Site Search m Zoeller Pump Company Page 3 of 3 `u K L M W u- 50 PUMP PERFORMANCE CURVE MODEL 151/152/153 it 4 14- 45 953 12 40- 35( 10 152 _ 30 ate.. 8 151~~ W- c~ 25 Q 6 20 10 I 2- 5 it 0- 10 20 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 014508 I http://www.zoeBerpwnps.com/en-na/distributor/sitesearch?search=152 6/2/2017 ) LE LETC1\LC: C.; fav4 tv,\ ►iUij f~4~►~t/ Sjklr-S fc-t i 2.~ t.J~12 y~ b✓ I Z 7. `o so'~\Lc 1 . ~i 1 9z 0 - l o~~ / - 1 00 N 0 vi 04 o LO , o o. ' oo ~ 00. OO F-4 Ln o 6 Q o 00 N ~ o W NO Q CD C6 w w --N 00 ~o C:) LLJ U Q I n , w r W ~O ~ o r- ~ I I C ;O \ 1 00 co ,Zz_*9 LZ 11 «-~2,9 l° l0 N / o O I D~ 0. 1 \ Ln _ O 1" Y 10 co ~o ~LL: Q~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer j1~JaV~~ Mailing Address-] -14 z ~J (2N A V~ J\\ at C Ut !ti *V f Property AddrtS+s V1 ~ ~ (Verification required from Planning & Zoning Department for new construction..) City/State 0 M ~ 'M Parcel Identification Number U40 - , J Z-Z- 10 " DP LEGAL DESCRIPTION Property Location '/4 , Sec. _~L, T ~N R(~L W, Town of Vt)V Subdivision Plat: NIL, y ~ ► , Lot # ~ Certified Survey Map # Volume Page # Warranty Deed # (before 2007)Volume Page # Spec house ❑yesOno Lot lines identifiable [1yesE]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 affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(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, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the 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 statements on this orm are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by viprt~lre of a war my deed recorded in Register of Deeds Office. Number of bedrooms / ~TURE APPLICANT(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 warranty 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) Nvi„,s] SOIL EVALUATION REPORT ' #1980 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and ,mil percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 1 v V Please print all information. Revi ' ed By ; , Dat Personal information you provide may bed roe p{ppEE~jQrivacy aw, s. 15.04 (1) (m)). ti / i7 i Property Owner ~~dd GGLvJ Property Location ' Tom And Renee Patnode Govt. Lot na NW1/, SE1/4, S19, T28N, R19W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# 225 Cty Rd F 10 na Troy Overlook City State LipCa one umber City Village Town Nearest Road Hudson WI - 31-0525 Troy Cty Rd F _ New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: na _ Parent material Limestone uplands covered by glacial till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 101.41 ft based on contour line elevation 100.00ft. Minimuum inches an recommendations: of ASTM33 mound sand. g Boring Fil Boring # Ground surface elev. 100.00 ft. Depth to limiting factor 28 in. Pit _ 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 10yr3/1 none sil 2msbk mfr Cs 1c 6 8 2 10-28 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6 3 28- 10yr7/4 none racturec Limestone na na na .0 .0 I I Boring 2 Boring # Pit Ground surface elev. 100.00 ft. Depth to limiting factor 23 J in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistency Boundary Roots GPD/ft2 in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 *Eff#2 1 0-10 10yr3/1- none sil 2msbk mfr cs 1vf .6 .8 2 10-23 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6 3 23- 10yr7/4 none =racturec Limestone na na na .0 .0 i Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 1150 L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: ' CST Number David J. Steel 248956 Date Evaluation Conducted Telephone Number Address Steel's Soil Service 994 200th St. Baldwin, WI 54002 10/312006 715-760-0347 SBD-8330 (R.07/00) Property Owner Tom And Renee Patnode Parcel ID # pending Page 2 of 3 Fi-1 F Boring # Boring Pit Ground surface elev. 99.20 ft. Depth to limiting factor 25 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#z 1 0-11 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 11-25 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6 3 25- 10yr7/4 none =racture( Limestone na na na .0 .0 I ❑ 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 I I F-1 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 I Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SsD-8330 (R.07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Tom & Renee Patnode 994 200`h St. CST-POWTSM NWl/4,SE1/4,S19,T28N,R19W Baldwin, WI 54002 Lic. 4248956 Town of Troy, St Croix Co. Direct 715-760-0347 Troy Overlook, Lot 10 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations BI = 100.00 ft B2 = 100.00 ft B3 = 99.20 ft B4 = 0.00 ft i - . r~ q6' 1 ~,Cj Zt`I r. f 6L 4c A vI 7~ "IX 1 S/cam to I lv ✓ ZONED: AGRICULTURAL "NORTH LINE OF THE NW 4 OF THE SE 1/4: - S 8922'18" E o0 ' 1285.54 w N 00.47'38" E 22.41'' - 166.00' 514.39' - - ~Afl-lM-A$IIILLL~--HIS LOT~I D 264.18' ?0. \ a> 10 i 1 C'4 LOT 13 ' X` W Qc '►j~ p ~J co r~2 8 2 222-94! - -t - - _ v . I N;BA ,-030 C6 23.36'` ti LOT 1 tLOT ~2 ;10 i C-4 10) w 6'3 \ CV -I LOT 10 \ ~ LOT 11 ` v I y 104 - v 'i z~ - - - ~~S .66' ~a X44 00, 188.80' 79.04'00-:~ - / h' X98 `'1, EAST 267.84' Nlb g3' EAST 267.84' , 2 y v ri rod' % - - cd o I- O 85.71 O 162.95' 19.1 T 6-1 , - o - D~ z z- -126 cP_ \ \ 'r.y 34. N I J.~Vr -P• ; hr's ,Z, f • .6 00 w 9r E 2 I~ I ° N~5 I ONSERVATION I EA~EME - x c,+ r 25 Y 77 11-~ _ I " ~t LO1 Aa'. W in,,