Loading...
HomeMy WebLinkAbout012-1038-50-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: .St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan I D No 600355 : Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)] 3078389 Permit Holder's Name: City Village Township Parcel Tax No: Mitch & Amber Ortner TOWN OF ERIN PRAIRIE 012-1038-50-100 CST BM Elev: Insp. B` Ele : BM Desriptio } Section/Town/Range/Map No: =V Q o fii,•` 16.30.17.246B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION _ BS HI FS ELEV. Septic L4^ r, , Benchmark Y o g- Alt. BM CV hsa- - AA bon Bldg. Sewer q plding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet f , + 10 62r, TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeratim _ Dist. Pipe Holding Bot. S~ystem4_-/ FF • In Slim Final Grade PUMP/SIPHON INFORMATION ~ Manufacturer Demand St Cover { GPM ) • Model Number (ji F6-7- 0714 V eJ TDH Lift- Friction Loss System Head, TDH Ft Forcemain Lengt¢.. Dia. ,~,v Dist. to Well ~a ,rte .',✓lt i~> SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT RIMEN NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 4 SETBACK SYSTEM TO P/L BLDG WELL LAK /STR M LEACHING Man cturer: INFORMATION CHAMBER OR Type f$y)tem:N - t t / -JII UNIT "Model. Number: DISTRIBUTION SYSTEM [Header/Manifo ldDistribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 1 , -2 ngth Lengthi Dia j. <T Spacing~~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over I Depth Over T-De thof Seeded/Sodded xx Mulched d/Trench Center Bed/Trench Edges soil U,)--l N. Xz5 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1535 170TH ST i4?Q (J~ 1.) Alt BM Description = 10 0 r !Q 2.) Bldg sewer length = 7-61 - amount of cover Plan revision Required? [:]Yes ❑ No i)) Use other side for additional information. LL 9 Date Insepctor's Sig atu , Cert. No. SBD-6710 (R.3/97) -3 A ifv - County Safety and Buildings Division St. Croix 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 r ~ l~lb 355 w~ ti to Sanitary Permit Application. State Transactii'o)n Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to Uapp mate governmental unit 6 / e6 is required prior to obtaining a sanitary permit. Note: Application forms 4tYP state-owned POWTS 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 secondary purposes in accordance with the Privacy Law, s. 15.04(t)(m), Stats. 1535 170d' St. 1. Application Information - Please Print All Information Property Owner's Name / Parcel # Mitch & Amber Ortner 012-1038-50-100 :1 ut Property Owner's Mailing Address Property Location + .301, Govt. Lot 1535 170th St. NW y,, SW Section 16 City- State Zi Code Phone Number - - ( P (circle one) New Richmond, WI 54017 (715) 773-0091 T 30 N; R 17 E or W 11. Type of Building (check all that apply) Lot # (91 or 2 Family Dwelling - Number of Bedrooms 5 Subdivision Name Ol O)C. GO CJ Block # CSM Vol. 25, Pg. 5803 ❑ Public/Commercial - Describe Use r [I Na City of ❑ State Owned - Describe/Use CSM Number ❑ Village of N~ ® Town of Erin Prairie 943535 -7. f~ CJ r..-.0Q. 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 er to New List Previous Permit Number and Date Issued ❑ Permit Transf t Before Expiration Owner IV. T e of POWTS System/Component/Device: Check all that apply) o v ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ®Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable so ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: PolyLok PL-525 effluent filter Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Required (sf) Dispersal Area Proposed (sf) vation L0 gpd/sq.ft. ASTMC-33sand 2.06 12" above 750.00 Gpd 0.6 gpd/sq.ft. native soil 1,250.00 sq. ft. 2,044.64 Sq. Ft. 91.00' contour V1. Tank Info Capacity in Total # of Manufacturer Y Gallons Gallons Units New Tanks Existing Tanks ~`A U N w o a. U s s i :7 G 7G Y J Septic or Holding Tank 1,585 0 1,585 1 Wieser Concrete X Dosing Chamber 950 0 950 1 Combination ST/PC X V11. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number William Schumat Z~~` MP 227990 (715) 386-2131 Plumber's Address (Street, City, State, Zip Code) 1070 Scott Road, Hudson, WI 54016 VIII. County/ eartment Use Only Approved ❑ rove Permit Fee Date sue Issuin ent Signature ven Reason for Denial GLIa GV 01 $ IX. Conditi~p~ e easons for Disapproval 1. Sept tack, e7fltur 1#W 3 \ ~~bl i ~-+IOJ~ l Y\ f. G J uisper.•s,t cell r WA dfl Lre4k1l 'm t yJ C as per , rtal :semen! plan plDft byIuinbe . f e T n 2. Ai(:ltetk~:k rect,;irMern INf11f1,Les lair,G i;` ` 6~~ ~ ~ e n per swiicW4 cs*:1'.Minarr - J S J ~ ~ r Attach to complete plans for the system and submit to th ounty only on paper n t less than 8 I/2 x I t inches in size SBD-6398 (R. I1/1l) /'ate ~tf~ CC /4 a le, A 6-X,3 L-,~ c~ +^oc c /e e k,. P/opascal rrto~,d a.f,xs, e9 'r //s, ,~~X 6a~G~+P w~ ~ S`,ria0.o' di•SP.cr.1~CGd. S;;X l6 ~ ~v/s/32 'ar+F'c~,S S~cc.dwE..Z.53,' 5~. 1,30 lr4o t//,) ds~'~ lea„ /~~o.~ls ~ /y~~x s/9.35/' nt f~ g~,.c6~O~frrer ~.~<,/t r r(sul~« e/ev ~x 9zt cv' 1.535-17 1 .,d~ s~oi~ t ~2^ cibu~e q/.oo v/. 2✓Wz 5,7 SBo-3 ~o El, Cs~ ~wYs~.swys; 5c~ !G, . 3o~r., E ~l C'IDrX L'n•~ u)l• 07 t3q' 9/' 0 /oc/. o/y/o,2y-sz o I , + 93 I I 95 ` , P~oPd.S.cd SyS~-` q,re~ • r ( + 97 Co.,Eow r ,d, i I ( II ~ i ' I( I~ 32 i G+I i ( f 1 j i I ( 1 t 1 i , f ~ ~ 1 1 w LP /s6s/QSO c~~s b;,,a ~8~``' ; ; i i + p, C.P j~C. 4sr amcd lr v` S;r/RtCrI.'~ /Pd/yCoC~L-S2S i + li 1 6,-/ O rG dn /oo.oa' "flSTK-d /7BS oF•~in on 61 A~oPox cl ~t 5~ a/ en c.L ~a v'/mil PL(~in~ d~ E)4$'~i~ WLfI ~.,de w a. y V 0 0 DIVISION OF INDUSTRY SERVICES i-~AtzruF . 3824 CREEKSIDE LN \'v,, HOLMEN WI 54636-9466 Contact Through Relay JJ S a P http://dsps.wi.gov/programs/industry-services $ L www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary March 21, 2018 CUST ID No. 227990 ATTN. POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016-7302 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/21/2020 SITE: Identification Numbers Mitch & Amber Ortner Transaction ID No. 3078389 1535 170TH St Site ID No. 847559 Town of Erin Prairie Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NWIA, SWIA, S16, T30N, R17W FOR: Description: Five Bedroom Mound System / Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1753340 Maintenance required; 750 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code r"ONt)ITJ requirements. ApPR ' No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.I45.0 pT OF stats. PROF'E.SSI01'i The following conditions shall be met during construction or installation and prior to occupancy or use: CAE lwu ~'t'~t.~10N 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.~~ ;i • Inspection of the private sewage system installation is required. Arrangements for inspection shall be ma e 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. • 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. 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 addressee shall provide a copy of this letter and the PO WTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the PO WTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard MM'SSwii/m~- 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. James K Thompson, Ace Soil & Site Evaluations • 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 addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others whn arP rPSnnngiblP for the, inctallatinn nnPratinn nr maintPnanrP of the PQWTC, Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Sfwii/m~- POWTS Plan Reviewer, Division of Industry Services WISMART code: 7633 (608)789-7892, Mon - Fri, 7:15 a.m. - 4:00 p.m. j erry. swim@wi. gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. James K Thompson, Ace Soil & Site Evaluations MOUND AND PRESSURE DISTRIBUTION COMPONENT D1G,K Residential Application INDEX AND TITLE PAGE Project Name: Ortner 5 Bedroom Residential Mound Owner's Name: Mitch & Amber Ortner Owner's Address: 1535 170th St., New Richmond, WI 54017 Property Address: Same Legal Description: NW1/4 SW1/4, Sec. 16, T.30N., R.17W. Township: Erin Prairie County: St. Croix Subdivision Name: CSM Vol. 25, Pg. 5803 Lot Number: 1 Block Number: Na Parcel I.D. Number: 012-1038-50-000 Plan Transaction No.: 4ALLY "ED Page 1 Index and title zTY AND Page 2 Data entry SERVIG f Page 3 Mound drawings Page 4 Lateral and dose tank ' I Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan ~ Y_ Page 9 Soil evaluation report Page 10 Mound Construction Considerations Designer: Bill Schumaker License Number: 227990 Date: 03/13/18 Phone Number: (715) 386-3121 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), 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) Pagel of 10 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 500.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 750.00 Design Flow (gpd) 10.00 Site Slope 91.00 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 7.50 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? Enter Y or N (C or E) c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 6 Number of Laterals of the highest point. F__ ~ 0.156 Orifice Diameter (in) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft2/orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 84.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 7.58 Vertical Lift (ft) 94.31 5x Void Volume (gal) 8.02 Friction Loss (ft) 110.62 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 64.62 System Demand (gpm) 20.15 Total Dynamic Head (ft) ,U.- Lateral Diameter Selection Manifold Diameter Selection 1 ~~n in. dia. options choice in. dia. options choice 0.75 1.25 f V~ 1.00 1.50 1.25 x x 2.00 x x 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 950.00 Total Tank Capacity (gal) 1585.00 Septic Tank Capacity (gal) 38.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 25.00 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 950.00 Dose Tank Capacity (gal) PolyLok Filter Manufacturer 25.00 Dose Tank Volume (gal/in) PL-525 Filter Model Number Wieser Concrete Manufacturer Project: Ortner 5 Bedroom Residential Mound Page 2 of 10 Mound Plan and Cross Section Views T 1710 B J * Observation Pipe K W B I ❑3 • L Mound Component Dimensions ft B ft F 9.25 in I ft L ft A A12-00 ft E 21.00 in H [Aft ft K [Aft D in G 0.50 ft J W 750.00 (ft2) Dispersal Cell Area 2044.64 (ft2) Basal Area Available 7.50 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 93.77 (ft) • G j F 92.50 (ft) Lateral Dispersal Cell 92.00 (ft)-*l - Invert Dispersal Cell t . Elevation D s < ! q t= 91.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key c T Dispersal Cell See lateral details on 0. - Ir 11 Topsoil Cap a 1.5 ft Page 4 for number, size, w c Subsoil Cap and spacing of laterals. ©0 ASTM C33 Sand Laterals are equally c F spaced from the 0 Tilled Layer 0.5 ft Typical Lateral ¢ distribution cell's Aggregate o e centerline in the © - A distribution cell (AxB). Project: Ortner 5 Bedroom Residential Mound Page 3 of 10 Center Connection Lateral Layout Diagram F~wc*main connect vaateeorrarossaom old* p *t_ - Laterals areid#Mr,at S S + • Turn-up vWball vatva or x-- ut2 23 L aks Moro tY t h 40 PV aleas gut yal' ptft SPS Table 384,3x- H s drab#d on th# baxttcm tat the, dat#rad. Number of Laterals 6 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 49.34 ft Orifices per Lateral 20 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft2/orifice Lateral Flow Rate 10.77 gpm Manifold Length 5.00 ft System Flow Rate 64.62 gpm Manifold Diameter 2.00 in Total Dynamic Head 20.15 ft Forcemain Velocity 6.60 fUsec 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 -t- _ Tank component is properly vented F- Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacity 950.00 Gallons Volume 25.00 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.58 514.38 B 2.00 50.00 C Pump off elevation (ft) C 4.42 110.62 84.92 D 11.00 275.00 D Total 38.00 950.00 1 11 Dose tank elevation (ft) 3" Bedding un er tank. 84.00 Alarm Manuafacturer SJ Rhombus Note: Switches Alarm Model Number SJE 1011421 containing mercury may not be used in Pump Manufacturer Goulds i this system. Pump Model Number WE07H Pump Must Deliver 64.62 gpm at 20.15 ft T D H Project: Ortner 5 Bedroom Residential Mound Page 4 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name `_-Bill Schumaker Phone (715) 386-2131 POWTS Regulator's Name St. Croix County Zoning Dept. Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 750 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 500 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1585 gal Maximum TSS 150 mg/L Soil Absorption Component Size 750 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 every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years 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 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 SIPS 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 Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Ortner 5 Bedroom Residential Mound Page 5 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 [SBD-10691-P (N.01/01, R. 11/12), SSWMP Publication 9.6 (01/81), 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 BODS, 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 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. Project: Page 6 of 10 GOULDS PUMPS Submersible Effluent Pump 3885 PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion-resistant Single phase: ■ Bearings: Upper and Specifically designed for the stainless steel. Threaded • Built-in overload with lower heavy duty ball bearing following uses: design. Locknut on three phase automatic reset. construction. • Homes models to guard against • All single phase models ■ Power Cable: Severe duty • Farms component damage on feature capacitor start rated, oil and water resistant. • Trailer courts accidental reverse rotation. motors for maximum Epoxy seal on motor end ■ Fasteners: 300 series starting torque. Motels •'/3 and '/2 HP - 16/3 S1TOW provides secondary moisture • Schools stainless steel. barrier in case of outer jacket • Hospitals ■ Capable of running dry with.115, 208 and 230 Volt damage and to prevent oil • Industry without damage to three prong plug. wicking. Standard cord is 20'. • Effluent systems components. • 3/4-2 HP -14/3 STOW with Optional lengths are available. ■ Designed for continuous bare leads. Three phase: ■ 0-ring: Assures positive SPECIFICATIONS operation when fully • Overload protection must sealing against contaminants Pump submerged. be provided in starter unit. and oil leakage. •/2-2 HP - 14/4 STOW with • Solids handling capabilities: ' bare leads. 3/d'.maximum. MOTORS AGENCY LISTINGS Discharge size: 2" NPT. ■ Fully submerged in high- ■ Designed for Continuous • Capacities: up to 140 GPM. grade turbine oil for lubrication Operation: Pump ratings are Tested to UL 778 and • Total heads: up to 128 feet and efficient heat transfer. within the motor manufacturer's CSA 22.2108 standards TDH. recommended working limits, By Canadian Standards ■ Class B insulation. Assoaation • Temperature: can be operated continuously cip us File #LR38549 104°F (40°C) continuous without damage when fully 140°F (60°C) intermittent. submerged. Goulds Pumps Is lso 9001 Registered. • See order numbers on reverse side for specific HP, METERS FEET _~,~.f.__ voltage, phase and RPM's 13or SERIES: 3885 SOLI available. 35 1 120 ` IRPM: 3500 &DS 1o;w -J 7T 1750 FEATURES 30 loos 5 Fr L. 1 90 ■ Impeller: Cast iron, semi - < 25- open, non clog with pump out i 80; i..... I L.. } I vanes for mechanical seal ~ 70 F-- ` ; protection. Balanced for } 20 60 smooth operation. Silicon ° as bronze impeller available as 1 s 50 o~x..:.... T an option. ° 40T- t...,.... 10- LAIE ■ Casing: Cast iron volute type for maximum efficiency. 5 2" NPT discharge. 10, L 1 I a Mechanical Seal: SILICON r. ,_-_J_-..... . ; . I j. i...._ 0- 0 CARBIDE VS. SILICON 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 GPM CARBIDE sealing faces. 0 5 10 5 20 25 30 35 m3/hr Stainless steel metal parts, CAPACITY BUNA-N elastomers. Goulds Pumps © 2002 Goulds Pumps O O ITT Industries Effective October, 2002 63885 www.goulds.com 1104 /BD''` fv Q A ~XiS Eihe r~r a t~/Q a p/'o astal /Xo~nda.t.25.e9 Y//B.~9, /3o't-~o `xa,/e~ VV = d~ w/7 S',ria0.o' d:,SPusa/Ced. js;X <6) ~.+-zX 6at~~+P o/is~'r lw~ar, /c~~~lS a„E /Yfl~,r. ~/9.3s~' ryt ~ gf~,•c6~O~fn~ 'U/r/32 `urr~''cc,5 S~accdwE..Z.s3,' /S3S/70~SE.~ .s-rr,~ i tr.~'r< surer ce ~/erg aSv ~.ie 91. cv' ~1~ c~irw~ d u,)/. syOiJ 1t ~s' u.6o,fe qi. oo' er~-beu.- !o E/ Csn ✓u~.z5,/~'~ S~-~ Cel6rx eor404 B7 gs' 9/' Q /oc%Oi2 sa-/od r , r r e ito& A l(~ Cines a,-e ' 93 I rr 95 ` , P~o~ 3.~2/ sySfe.~ areo~ . r ( ~ 97 Co„-Eocw 1 ~ I f rr ~ 1 v r , r ( I 9q r r Z`lv~v ,(r h 1 u r f i ( SySf~ t ( 1,, r r ( ~,1 r r 1 un t r , r ~ t 1 ( t t 1 1 r f i I 1 f 1 2( ~ , r 1 f t propost-d I,v,cst,- ~.ncru(4 ;8 P o!`/ um~d t lov" 4" S,T. /P. C. ~J/Pd /yLoC~t -SZS r ~ r ~ 1 1 ' ~jct ` ~ 1 1 /CIO PI•~ . e~{/u to ~."/i~L/a 5.1 Ot/P I r ~ 1 1 , S/"ASTff-d /7d5'3-4~- `/dP✓.C'. r 61 ,GAIt:. Cg./Yf 6a66om or-6--r, on rn Qa~of ~ . 11 ; Sl1Cd. ~ l~v~ = ~OD.GO,' dwostar S iJCal~aa.,. S. al enc{, ~a vim! p,~,c%~J ~ E-Xr's~G~ wclr Z~, ,lewQy 0 h~ d t1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mitch & Amber Ortner Mailing Address 1535 170th St., New Richmond, WI 54017 Property Address Same 1535 1-76Pk !9--ree+- (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number 012-1038-50-000 LEGAL DESCRIPTION Property Location NE '/a , NW '/4 ,Sec. 05 h 30 N R 19 W, Town of Somerset Subdivision Plat. Na Lot # 01 Certified Survey Map # 943535 Volume 25 Page # 5803 Warranty Deed # 980998 (before 2007)Volume Page # Spec house ❑yesElno Lot lines identifiable Dyes❑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 is form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a w rranty deed recorded in Register of Deeds Office. Number, of bedrooms 5 SIGNATURE OF 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) s~T Wis. Dept. of Safety a ~~,QEOv ~ OIL Page of and Profession J , Division of Safety and Buildings r4afth SPS ` - "Qqe County Attach complete site plan on paper not less than ~((~~jj inches in size. Plan must Parcel I D. include, but not limited to: vertical a ~,1 'M), direction and f~/2_ ~0 3~ J~~- l00 percent slope, scale or dimension t i~, Nsl tion and distance to nearest road. C/ Review by Date Please print all information. Z Z Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location / n j LG/i~ C4 knz ev0/. f -A e*- Govt Lot / YP 1 /4 SW 114S T N R17 s (or) w T Property Owner's Mailing Address Lot # Block # Subd. Name or M# , Nearest Road City State % Zip C(o~d~re~ Phone Number ❑ City ❑ Village ®Town / ~O ff J t (YI~iC~lq►Bndr a~`<<`e LSD GPD (~C], New Construction Use: 51 Residential / Number of bedrooms Code derived design flow rate ❑ Replacement ❑ Public or commercial - Describe: k Parentmaterial erP'IZ4 fir''df Flood Plain elevation if applicable tt General comments 13otSe M o ~ m O C t. rat e 2<1 and recommendations: ❑ Boring Boring # Pit Ground surface elev. 2, 3 ft. Depth to limiting factor < y2 in• Soil lication Rate ® Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots ff#1 GPD/f~2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. l p_ g 3114 /j/ SL 2#7?,- 14p,41 czs 2 !~1 0,6 .5,'4 2r,S,bk /71 F~ C w 2 o, 6 4 8 3 9 yz 7,s~`~ si 4114 ICS 659 /h~~ C C, /v o, s it d Y y2- 81 7,s'YK 6 /f'R ~8 S of ❑ Boring # 87.- ft Depth to limiting factor in. ❑ Boring Pit Ground surface elev. < 33 ® Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots R ff#1 GPD/ft2 in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. as ~M 0,6 /'0 /M O's- C C- 3 2 6.33 7 s7'R 6 NA 9sr L/ V, -7,,QR-5~76 OSf M OAP- C) Effluent #1 = BOD > 30 < 220 m9/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD s < 30 mg/L and TSS < 30 mg/L SignaturQ~~ CS Name (Please Pmt) CST Number I ( GGsv~'~ " ~,J 15r (r G" Telephone Number Address Date Evaluation Conducted 3 98- Mof U e- .Sam eTc.y Gum s-~o2s 3-02 f- / 7 71.5-- 2 Y7- 30203 SBD-83_1•0 (RI .1/1 1) Property Owner ktc4 ~-A M Gtr O! (n er Parcel ID # 0 l Z' /x•30 ~ ~6~ Page ~ of a Boring # Boring '077, pit Ground surface elev. 6 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots GPD/ft z in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. D S /~Y/1 4114 -54 f#1 « f#2 2111 Py /A 4r z n? 0,6 l o 3 z9 yo > 79 `~/6 f/FSYR s/ s L ms6.~ fir c w 141 0,c/ 0.7 Y ~/f - ~1 /Oy/t % c psYR FS Os Tvr- 0'r D Boring # Boring ® pit Ground surface elev. Depth to limiting factor < 2 1 in. Horizon Depth Dominant Color Redox Description jTexture FStructure jiost~pence oundary Roots Soil GApplica PD fttion Rate in. Munsell Qu. Sz. Cont. Color z. Sh. ff#1 ff#2 D- g m r 2~ o, 6 C, o Z S z .'G /n s.G k /yl ~'r C M 1, 6 C~, 3 2y 6 y 7,sy,( T d. V 7 GI/ Y AYR r c 2P S YR r oS R-n Boring Boring # pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Soil Application Rate Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. « f1 « ff#2 Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L « Effluent #2 = BOD s < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. 5$D-8330 (RI 1/11) Property Owneri tC~ ~^/~El ~Cfne/ ParcellD# ©~Zr ~~•O r~ page G of Boring # ❑ Boring a ® Pit Ground surface elev. O 6 it. Depth to Unlrting factor in. Sal ~ppllcation Rate Horizon Depth Dominant Color Redox Description 'texture Strm►cturea ossistance Boundary Roots GPD/ft I In, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ` ff#2 p.:g /0,Y s~ ~ni+ hr 4r z 0,6 2 W-11 S-Y -~/y & ;G. ems, C c~. 4/4 or 4 8 3 29401 r=, 6 r OR' s~ ms~~ J~ c u- /74, c0.7 Y 10- 51 /anZ C e prrx FS ns p -,7L tv~ 0'r 11.4 i Boring # ❑ Big L ' I Q Pit Ground surface elev. 07- ft. Depth to limiting factor in. Sal licalion Rate Horizon Depth Dominant Color Redox Description Texture Structures onsistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 I D~ YR z &,f u zM a 6 1,0 yd y 7sYRYe, /-/F Stk 0~ S~ 11nsa10-- MP/ 1 r'. 5.V or 7 6y S Iz rp% 1& C x p YR e-* D I _ Boring # E] Boring S Ground surface elev. ft Depth to limiting factor In. ❑ Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistance Boundary Rools GPD! in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#t 102 * Effluent #1 - BOD >30:_< 220 mg/L and TSS >30 :5160 mg/L. * Bflluent #2 =130D ~ ^ 30 wKA and TSS < 30 rng/l. The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SM-8330 PLI Ul i) OWNER rian Name &W h ,tln~tr D~f~er BPage 3. of 3 rn Address t SJS'r ITo s"r ST Paamell Alew Ac~srnon~ 5'Y0t7 CST 23I3I4 Date Benchmark 1 7aP I ~ucQ~pe /CAD, O 64. )Benchmark 2 &7* M T,'n D A S/ e-f loo . E ❑ Soil Boring i Suitable Area i i" = X40' Scale 'r ~ I I I IF*I 3 3' }I I- it 4, ~j -'f ID 1 ► r r f • t t A a } . t e o F D ► , r t A r - All, I s ` f ~ rt