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HomeMy WebLinkAbout020-1306-70-000 (2) 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 ID No: 600373 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: Timothy Schwartz TOWN OF HUDSON 020-1306-70-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 83 a 004-1c,+ 27.29.19.1529 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C ~ 1 Z60 Benchmark /d e7- y Alt. BM 69 1.9 /QIj • 5? Aeration ~L^dt- Bldg. Sewer 1~ Holding ( 1/, St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet (P4 /6 jt $3 TANK TO P/ WELL BLDG. ent t Air Intake ROAD Dt Inlet TT 5 DtBet' 00-k- f //3 i. 63 Si 60 56 7 -7 16 ra~ *7`8' _15 61 I 77 Head~jer/Man. 9 -7 9 ,7,7 7 Aeration c7 Dist. Pipe I Holding Bot. System PUMP/SIPHON INFORMATION Final Grade 7.7 111. 57 Manufacturer Demand St Cover GPM (22~ Go.► 3C{- S 1 I •47 Model Number 16,-7 7 TDH Lift Friction Loss System Head TD Ft cN •c'7'7 Forcemain Leng Dist. to Well • / 7, 7 / SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenc s t PIT DIMENSIONS No. Of Pits Inside Dim` Liquid Depth DIMENSIONS 3 / (3 X 1_ _ N SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manuf~turjK INFORMATION Typ/~Of System: CHAMBER OR t.OO~o Ap 17 NLL UNIT Model ..~GJ~~ DISTRIBUTION SYSTEM ~1 g f 51el 6& Header/Mani f~Id Distribution x Hole Size Ix Hole Spacing Vent o it In e Pipe(s) ::Ij r Length ~Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed Trench Edges Topsoil No ~°~-eg_ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 716 ORIOLE LN &v~ea ✓ l ve, ~ r%tP40AG J 1.) Alt BM Description r f G64eA~., At.: 2.) Bldg sewer length = _;154.1 ! try ap r:." - amount of cover = ~x I -'o~~~G. ~ J +'F+ Plan revision Required? ❑ Yes "No L a 1 b Use other side for additional information. ,J 1 C ~v SBD-671 0 (R.3/97) Date Inse tor's S ature Cert. No. A T Y Stvioes Division t , } P.O. &ta 7162 APR 2 6 201$ Mftfison, M 53707--7rCz sar>ssaty Ptcsnit Nlanbes (w be fjjW in co. ) ~0b373 'nf unit Applic ticu~ swe savic Pena coat i POW15are ~MMW to t Add (i£Iffinu:t om bs a&bm) + lae with the priv Law s. t S. m You Pw* any be usod fat ftmko I. 1z1fe n astios - Pie** Privet AN i f p' Y Kk~+le+t's Vwne ti MEN (Jl b Tr~~rnY -4g SeN+~r~RT~ 1 Parcda9 r(3+~+aerIs l 020- 1 & /Ir op'tot-c- ~,hX~ yL~oon -1 ' , ' , S `l City. State zip Cade, govt. Lot G(bsaN r ~ J r., sc so«;on ZZ 12. Type ot'BaWasg (s'it=k ait first B7 apply) L.ot T 2 9 N; it A or 2 Family Dv elling - N,,bw of ~ 5 Subdivision Nacre 0 A'l~ti`dc°amer ca'I - Drsr, ~ uss ~ta2 0104 gl Zc.Lt Cil YL1~ !i 1 ~ 3 ~ ~ Q State t}Nnod - 0 City od Drsca~~ Use Ns>~er 3 0 villw f UTMD of III. Type of Penwil: (Claoek owe bax M Uw A. C A. Bee B if 2B v~-- 0 New sys.„ t ~p++rrn system L} T"sw Itlfio3ring Task tiep Ck* ❑ p Mode6carinn to Edamg S O k D Pa,~it Reviaibn Barre Ev'jbw chmp of Pttlmber D P..i, Tr..Z m Ntw List Previous pamit cad Data b&W of PO Osvnar 1i'1'3 slBiilat ZQ ~t~f ~`~H'- /94'y >,*Graa ti O lio&itne -rank Pmm`d tn-Grusx! 0 At trade D Mourd > 24 m. ofslrilable ao17 D hsaard < 24 at of lliairetael comp new (ems) D > S ~0 F; t k V. Arcs lattr/^rnsfes: DesW F'low' (Spd) L'lMp Staff Applitaa M DWsal Are, RwpnW { 7.50 0. y Arm itY Toael # of cAtLkft Now Tsks &99* Tasks GoLAom umb al v y m W V 5'l© f2A0 YD LAJFe S VI! Rsst Ststeaaeat- 4 silo I'lw/~n//tier's Namo (Priatt) Plumber's 8 *r 10304800" of tie 1"C)'w s sioe•" va ties fly, t~E1 T~4 77i} / o5 1 f >k MPRS Number Be>$neas p6orre Ntariber rs> Adam (Suvxj~ Cyr, saw zip c«rc) 2 Z a -~5 7 7l S S - 2 S 51v use App-ed D sPpprovex i4tm# Fee Doe Give Raa9on 1X. for DaAQ S J 0O Lf 2, o I C for t We IIW.gglK11fat1. plan pro rj~ bV plufibe . ne!Mrk n+c h+lr:wrws MOM W I-A trrre.: a i* h coat t :,n1i .A1~6l. AaaeA fr eN4t,¢* Olin Ar d, "sus W Nirit 4 ~s C +'aa'~IY Pow art >b« $r. t tR = r 1 :ws 1"J" SBD-6398 (R 08/14) 3 C'J.ECT . -`H-00 7 •stt.TP~ -.~a1 4j 6P.{pCQ}J Olt UQ NIt{3R~ ~rk~N 41 100, re M o1(6WSrM~ JvtltP; {Jt~) ) S ~~ti1 41C N M1 P APP is $b~ frON, 54 p,} f t . RON 2 y; ~y A~~ t t ' 7 Y . FRESH AH- INLET, AND 0DGMA111 PZDS - ~enc~ss .SCCTION Approved Vent Cads Minimum 12" Above l }t+n ~ /Gkm/o ~X►sTtN~~ Final y3 ~px Above pi.pe~ ; 4" Cast Iron To Final. Grade vent Pipe In-Ground Gravity Plan PAGE , OF 4 Index & Cower Sheet Version 2.0, s8[-10705-P (N.01101, R. 10/12) Pg 1 of 4 Index & Cove Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-section & Plan View Pg 4 of 4 Management Plan Attachmrents: nci res: Nt=rL-VZATVR PQWTS lication for Review Soil Evaluation Report & Site Ma PM wtx< lL 5 P F..~'S ~ ~~Z? -S & 1 TA-14K AI Project Name I Description Owner Name(s): '1 r It o FHY S, Se--H 1VA RT , ptfone: t wrwAddress: - 7)& DR1arm` LANE I~uD,~od _ZIP:__ 1{d/~ Protect Address: (SAM O Govt. Lot: 5E 1/4 of S E_1/4, Section 27 . T 2q N-R ~q E or W Township: rt17S~ County: 5T, CRoIX Pr*d Parcel ID DAD -13U1o- zo- 000 Designer information Deelgrw Name: ,LIA&V -NRee -rzT Phone: ?1 - 44Z6 "7z:L- Designer"dr'e": ZV19 y Kaald n ttr2TkuRs Lf. ~Jw ")ZJP: $s0 E-mail: &U i 4e.r'J~r~,,~ K - eom Stein This sp stamp. License Number: ! 8~ - [gyp 7 RemaricS: ~ y~lR}z►~G7V) ZC INGa StREa1 4sr VA rJQ: it ~t v~ t ls. MUPS RT X445 A FALLgL. Signature., Date. zoig' on eadWoubmftd 0 war.. L PO t JEC~ tNAM N S , / -ad z : , OK, o45 LAiU,:~7 c,~` • ' ~yt ,t Mle~ VOKP h tr~f T `N3 mtv: lots Ue Ns AP r'aKt~'g ~J, ~ L7 ~ S~fD iA0, ! t1 ~f~GiM P~ t } 4f, f l }V1 Pf, 8~Sa c7a ` :K r e Y. it - . FRESH AND OBSItAVAJ-16jil _ CROSS SECTION - Approved Vent Cap Minimum 12" Ab ve (1--XtSiI/Vc=) k Fin I -~3 ry, /o t , vj y 3 ~x Above-Pipe / Cast Iron Ven To Final Grader t Pipe GE 3 OF 4 Qa.Z ~ v 9 .t w 214 f 1 a 1,L! co co 0 - F- a eC s m G. e PAGE 4 OF 4 In-ground Gravity Management Plan lNegarm; The awner of this in-ground gravity system &NA be na">ossi a for its perpAef oper+s 00 and mW tertance punstmnt to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to WS 383.52 (2), Wrsc. Admin. Code, this rt"" SW be considered a human heat hazard if not maAsined in accordance with thins approved man anent On. J:!twd more, an vwpecbon and mwtww" admbes mil be pstfatmed by a reakWred POWM M&WAniner in ac wcdwtm with SPS 383.62 (3), Vftc. Armin. Code. Design Flow : S1) gpd; WQs S 320 rngi.''; TSS S IN rng ; FOG S 38 ragl..'' in , 2 04SPECT EVERY 3 YEARS o type of use o We of system o nuisance factors (i.e. odors, user complaints, etc.) o mect3ardc al maffunction (i.e., pumps, valves, switches, floats, eta) o material fatigue (i.e., leaks, breaks. corrosion, etc.) a solids vWurne in anaerobic 008&t taxcic(s) and any distribution agpcxrtenarx*s) (i.e., distrib0on t trap bocce) o neglect or improper use (i s., Occxtedrn9 design , Pied activities, etc.) a extent of ponding in distrbub n cd prior to dasirg o dosft irregs*lar1~ - if (i.e.. pump recycling, float switch settings, etc.) o eiectrec ai components - if amble (Le., waing. oo ntchrts, cons, tuners, ,etc.) o distribution laWW or Wer'ei oritim plu*V (messtue la►blrad d *w pressure - compare to design spec119csLort) o surface discharge of effluent or a back-up hito sbuctum served WinteaAMCIM .1 NAIMTA N EVERY 3 YEARS (or when ne+ce$WrY) Uft IM #M tanW14 shall be purrtped by a certified xWtap servicing operator licensed under s. 281.48 Wra Stats. when the v+ok#me d soflft in the WOW encesds on*~ (113) dw ilquid voiwrw of Vw taU 140) d' as rec ed by local ordnance C* --ass! of c:onterrts shaN bepursuont to NR 113, Wisc. Admin. Code. o EMUgnt if~li WWI be inspected emV 3 yea m and shag be Cleaned whawr nary 10 rertaawe any accurnuh*ed solids sccorc&rrg to mani#adumes spe ations. A swvx*V period win airrmtys be greater than 12 mordm SysUm nwire*nance ropoft s be su6Kreltssd to the proper loci goerenerresnt unit In avecx+d>c "with SPS 383.58 Wino. Admin. Code. Repot am ccrm#ewsart fad#um or maMmiction loo: Name of irk or company: I?b' IU r~q f 411 phone: l5 ~ ?D,-S337 Local goverrsnextt unit: & I/AUNI V~,1LZPM~7 Phone, '7) 5 3`bb yb~~ ZIP: 5~foi~ WLT Local government unit address: U C Any defective part of this system shall be rte. repiaoed, or r+smovrd purwant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacerreent of laded or n WWbW* g nft shag with SPS 383, "sc. Admin. Cade. No product for dia mical or physical ree4mtm of the PMM may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. g2own ol!ecer P- I" In the evient that any failed treatment connponeret of this PQWTS ca nrvt be MW"d, it SW be MPWced ptrrsusx t to ~ a plan submitted to the appropriate sgency for review and approvW- A failed in-ground d r" ~P may abandoned and replaced by a code-tompt~rirtg dispersal went in a pm4st+ermined arm of sum suit. if use of this Pows is discontinued. it shall be abandoned in arx ordance with SPS 383.33, W4sc. Admit. Code_ #WC*4 The Quick4 Plus # F # T R 1~TC~ h?' Standard Chamber The Quick4 Pius Standard Chamber offers maximum strength through I its two center structural columns. This chamber can be installed in a 36-inch-wide trench. Like the original line of Quick4 chambers, it offers advanced contouring capability with its Contour Swivel ConnecUonT*1 which permits turns up to 15-degrees, right or left. It is also available in four-foot lengths to i provide optimal installation flexibility, The Quick4 Plus All-in-One 12 j Quick4 Plus Standard Chamber iBenefit : ! Endcap, and the Quick4 Periscope ( Two center structural columns offer increased stability and superior strength are available with this chamber, f Advanced contouring connections providing increased flexibility in Latching mechanism allows for quick installation system configurations. Four-foot chamber lengths are easy to handle and install i Supports wheel loads of 16,000 Ibslaxle with 12" of cover r { G ~ E Maximum Strength Size Quick4 Plus All-in-One 12 Endcap Quick4 Pius Alt-in-One Periscope 34"W x 53"L x 12"H Benefits: Benefits: (864 mm x 1346 mm x 305 mm) May be used at the end of chamber • Allows for raised invert installations Effective Length row for an inlet/outlet or can be 180° directional inletting 48" (1219 mm) installed mid-trench • 12 raised invert is ideal for serial Mid-trench connection feature allows applications Louver Height construction of chamber rows with 8" (203 mm) center feed, as an alternative to inletting at the ends of chamber rows Storage Capacity Center-feed connection allows for 47 gal (178 L) easy installation of serial distribution - - systems Invert Height Certified by the International 0.6" (15 mm), 5.3" (135 mm), Pipe connection options include association of Phtmbing 8.0" (203 mm), 12.7" (323 mm) sides, ends or top and Mechanical O Officials (IAPMO) APPR©VED in vr)