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034-1039-20-100
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 600380 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1)(m)]. 3076242 Permit Holder's Name: City Village Township Parcel Tax No: Allison & Nathan Zielsdorf TOWN OF SPRINGFIELD 034-1039-20-100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: rJ "v 1 G5 T 17.29.15.2588 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. K Septic nn 70 Benchmark C~ 0c) 760 - Dosing Alt. BM -ew .`5 0 Ck- 7dd l.~cQQ + )5. ZS ,F5• (,5 ,4ea2t+eN Bldg. Se r Holding St/Ht Inlet r TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ; Dt Bottom ~ Zo 5 (o S • i Dosing Header/Man. T) i0t~, 2z Aeration Dist. Pipe q? 4C~, Holding Bot. System U PUMP/SIPHON INFORMATION Final Grade Manufacturer I ~4 Demand St Coves,. ZO I tC/~. GPM 1-11, ~3 `f Model Number (3l~ ; 34`6 $ C 4r z."1 19 TDH Lift Friction Loss System Head TDH t Forcemain Length Dia. Dist. to Well, r7- /7 LJ H, a o SOIL A SORPTION SYSTEM BED/TRENCH Width Jengtr°• n „ No. Of Trenches! I PIT DIMENSIONS No. Of Pits Inside Dia. Li uid Depth DIMENSIONS' SETBACK SYSTEM TO P,%L"- BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION" CHAMBER OR Type Of stem: J~ UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution Ix Hole Size Ix Hole Spacing Ven t Air Intake Pipe(s) r:. r 7 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 zz Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes L-1, No Yes S /7 /S v COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ OP/0 Inspection #2: 1/D Cj 6 Location: 2857 CTY RD E 69 (eevA G d k)C 1`5 LA_-j 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes] No Use other side for additional information. L Date Insepctor's Signature Cert. No SBD-6710 (R.3/97) QID F! (n County Industry Services Division St. Croix ' APR 19 2018 1400 E Washington Ave Sanitary Permit Number (to be tilled in by Co.) TM ° ti, $ P P.O. Box 7162 Madison, I1~ /„~~1 Q~ St. Croix County l!/ J U zip, Community Devela meat Sanitary Permit Applicati n State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission ofthis form to the appropriate governmental unit -30 7 & 44d is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 (m), Stats. 1. Application Information - Plea tint All Information k1857 Count Road E I r Property Owner's Name UI) Parcel # Allison & Nathan Zielsdorf 034-1039-20-100 Property Owner's Mailing Address Property Location N13594 10th St. Govt. Lot City, State Zip Code Phone Number NW y, NE /a, section 17 Clear Lake, WI 54005 715-781-6108 (circle on T29 N; R 15 Eo W 11. Type of Building (check all that apply) O e tot # 1 or 2 Family Dwelling - Number of Bedrooms 4 Subdivision Name Block # /cm ❑ Public/Commercial -Describe Use p ❑ City of CSM Number ❑ Village of ❑ State Owned - Describy Use / 6-(o7 X 10 e ~Srn ~o~ Z03~ XTownof Springfield OA I L. 111. Type of Permit: (Check only one box online 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 ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) 0LA- 0 Non-Pressurized In-Ground ❑ Pressurized 1n-Ground ❑ At-Grade X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Tree ent Area Informatign: -7 It Design Flow (gpd) Design Soil App n Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation 600 licat0 , /5 u) /1 (o(v. VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o v New Tanks Existing Tanks °c v v d✓ V1 ~wLC , a U i n u C 0. Septic or Holding Tank + 1 tC I Dosing Chamber i VII. Responsibility Statement- 1, the unders ume nsibility for insta ation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' MP/MPRS Number Business Phone Number Lewis Bjork 253976 715-231-7375 Plumber's Address (Street, City, State_ Zip Code) E7818 County Road E, Menomonie, WI, 54751 VIII. County e artment Use Only Approved ❑ C?i Pe rmit Fee Dslued Isnatu Am& ven eason for Denial $ G IX. Condi eas, s fA : isapproval nn t. 3) C 'ar~~ fdt~ ti wern° n CA t:wst do itA as per mar.3gement plan ppotidett by pltbnbe~. A- r 2, All ft%& * roc,OFT.:nemn mu t be: r• nt: it:e,l as per Apombl ctxk/•:rdina:r;o= Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x I1 inches in size SBD-6398 (R0313) } DIVISION OF INDUSTRY SERVICES r.. 2331 SAN LUIS PL STE 150 GREEN BAY WI 54 304-52 1 1 s Contact Through Relay http://dsps.wi.gov/programs/industry-services tr www.wisconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary March 21, 2018 CUST ID No. 253976 ATTN: POWTS Inspector +s y,,. l LEWIS C WORK ZONING OFFICE LEWIS WORK LLC ST CROIX COUNTY SPIA E7818 COUNTY ROAD E 1101 CARMICHAEL RD MENOMONIE WI 54751-6637 HUDSON WI 54016-7708 ~.Z CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/21/2020 Identification Numbers Transaction ID No. 3076242 SITE: Site ID No. 847383 Allison & Nate Zielsdorf Please refer to both identification numbers, 2857 Cth E above, in all correspondence with the agency, Town of Springfield St Croix County NWI/4, NE1/4, S17, T29N, R15W FOR: Description: Mound System (4 Bedrooms - New Construction) Object Typa: POWTS Component Manual Regulated Object ID No.: 1752413 Maintenance required; 600 GPD Flow rate; 17 in Soil minimum depth to limiting factor from orip_inal 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), SSWMP Pub. 9.6; 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 f LEWIS C WORK Page 2 3/21/2018 • 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 ,7;m &,wVil oC eel 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, Mon- Fri, 6:00 a.m. - 3:30 p.m. tim.vanderleest@wi.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. LEWIS C BJORK Page 2 3/21/2018 • 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(I)(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 horizontallv from where the servicing pad is located. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan Anv chanaes may result in pump resizina to meet TDH and GPM Specifications. • Argnc thst are occupied with rnrk fraamentc_ tree. mots- stumps and bmilderc rPdnne the amniint of cnil 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/op eration. 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 Pavment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WISNLART code: 7633 (920)492-2214, Mon- Fri, 6:00 a.m. - 3:30 p.m. tim.vanderleest@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 (v,~zj ° `t Project Name: Allison Zielsdorf - New Mound Design Owner's Name: Nate & Allison Zielsdorf Owner's Address: N13594 10th Street Clear Lake WI 715-781-6108 Legal Description: NW NE 17 29 15W Township: Spring Field County: St. Croix Subdivision Name: Fourty Acre parcel) Lot Number: na Block Number: na Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot plan Page 11 ATT. Filter, Manhole, level alarm , soil report Page 12 Tanks used Designer: Le .ems,. < License Number: 253976 Date: 3/06/18 Phone Number: 715-231-7375 Signature- Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), 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) Version 7.0 (R. 03/2012) Pagel of 10 Mound and Pressure Distribution Component Design 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 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 600.00 Design Flow (gpd) 10.00 Site Slope 98.00 Contour Line Elevation (ft) 17.00 Depth to Limiting Factor (in) 1.00 In-situ Soil Application Rate (gpd/ft2)(, Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 6.67 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 L Y Pressure Disribution Information network? Enter Y or N c`, Center or End Manifold 3.34 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 3.50 t c Orifice Spacing (ft) = 11.54 ft2/orifice 2 0 orcemain Diameter (in) 2 orcemain Length (ft) Does the forcemain drain back? Y 78.00 Pump Tank Elevation (ft) F nte, ` 3.25 System Head (ft) x 1.3 32.62 Forcemain Drainback (gal) 2 Vertical Lift (ft) 81.20 5x Void Volume (gal) 4.9 riction Loss (ft) 11 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 4.08 ystem Demand (gpm) 29.66 Total Dynamic Head (ft) 3 > v Lateral Diameter Selection Manifold Diameter Selection G~ ! in. dia. options choice in. dia. o tions choice ZLJ 0.75 - 1.25 x 3 ' 1.00 _ i 1.50 x x 1.25 x 2.00 ~x 1.50 x x ~ 3.00 (J 2.00 x 3.00 x _ Gallons/inch Calculator (optional', Treatment Tank Information- Total Tank Capacity (gal) (2) 700 Septic Tank Capacity (gal) ' Total Working Liquid Depth (in) Lewis Bjork LLC `Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.00 Dose Tank Capacity (gal) orenco Filter Manufacturer 18.85 Dose Tank Volume (gal/in) Bio-tube 'Filter Model Number Lewis Bjork LLC _ Manufacturer Project: Allison Zielsdorf - New Mound Design Page 2 of 10 Mound Plan and Cross Section Views T 8 1/10 J Observation Pipe . . - 5 K '11 O ❑ A W .:.:.:.:.:.:.:.:.:.:.:.:.:.:...........:.:.:.:..:.:.:.:.:..:.:.:.:..:.:.:.:.t::::: - B z Mound Component Dimensions A 6.67 ft E 27.00 in H Aft ft K 11.13 ft B 90.00 ft F 9.50 in 1 ft L 112.25 ft D 19.00 in G 0.50 ft J W 28.48 ft 600.30 (ftz) Dispersal Cell Area 1966.50 (ftz) Basal Area Available 6.67 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.38 (ft) G t H F Dispersal Cell i 100.08 (ft) Lateral 99.58 (ft)---11 Invert Dispersal Cell Elevation E D ❑ a 4 98.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key fl I - Dispersal Cell See lateral details on 10 Topsoil Cap c = 1.5 ft Page 4 for number, size, 2Q 0 Subsoil Cap 0.0 0 Q and spacing of laterals. ©0 ASTM C33 Sand ° / - Laterals are equally `5 F spaced from the Tilled Layer m 0.5 ft Tvpical Lateral m distribution cell's ©0 Aggregate o centerline in the * A * distribution cell (AxB). Project: Allison Zielsdorf - New Mound Design Page 3 of 10 Center Connection Lateral Layout Diagram Force main ronnecrion :9a tee or cross to, manitold at any point. Lateral= are identic al lip -T. p S Turn-up w4ball valve or r X-4 . ;:r2' Y~ 4) Later r l: Z tOrcBnlain rh 4t7 F d"C aleanoutplug I I I per SPS Table 3,4.30-_5 Holes drilled on the bottom of the lateral Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.54 ft Lateral Length (P) 44.25 ft Orifices per Lateral 13 Lateral Spacing (S) 3.34 ft Orifice Density 11.54 ft2/orifice Lateral Flow Rate 8.52 gpm Manifold Length 3.34 ft System Flow Rate 34.08 gpm Manifold Diameter 1.50 in Total Dynamic Head 29.66 ft Forcemain Velocity 3.48 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 EAlternate outlet location diameter Lewis Bork LLC Manufacturer 2 in. Ca acit 700.00 Gallons Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 22.10 416.53 B 2.00 37.70 C P♦ ump off elevation (ft) C 6.04 113.83 78.58 D 7.00 131.95 D Total _ 37.14 700.00 m Dose tank elevation (ft) 3" Bedding un er tank. 78.00 Alarm Manuafacturer SJE-RomBus Alarm Model Number 1011421 containing mercury _ may not be used in Pump Manufacturer Zohler this system. Pump Model Number ,140 Pump Must Deliver 34.08 gpm at 29.66 ft T D H Project: Allison Zielsdorf - New Mound Design Page 4 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name Lewis Bjork LLC Phoney 715-231-7375 POWTS Regulator's Name st. Croix County 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 220 mg/L Septic Tank Capacity 2 700 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.3 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 eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Lewis Bjork for Pumping 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 Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Allison Zielsdorf - New Mound Design 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), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] 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 SIPS 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 BOD.5, 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 10 150 Series Effluent Pumps I Zoeller Pump Company https://www.zoellerpumps.com/en-na/products/sump-effluent-pumps/ef... U) K cc w w PUMP PERFORMANCE CURVE MODEL 151/152/153 50 14 45 153 _ ~r 12 40 35 10 152, o 30r Q 0 8 25 151 J H 6 20 _ 15. 4<<;, 10 'ilk N 2- 5 0-- 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 2 of 5 2/21/2018, 10:05 Ali PUMP PERFORMANCE CURVE wl PUMP PERFORMANCE CURVE PUMP PERFORMANCE CURVE SUMP / EFFLUENT MODELS LL EFFLUENT MODELS 3/8", 1/2" & 3/4" SOLID PASSING CAPACITY 3/8", 1/2" & 3/4" SOLIDS PASSING CAPACITY 412 a 1 MODEL 48 55 72 I 76 98 1371139 140/4140 151 1,52 153 4 191 Feet Meters 1 Gal. Lifers Gal. Liters Gal. u{ers Gai. I Liters Gai. blem i Gal Liters I Gal, I Liters 1 E. I Liters I Gal I Liters i Ga' I Liters a 5 1 29 10 43 ! 163 38 144 50 1 189 1 72 ! 273 1 941 352 86 326 50 189 I 69 1 261 1 291 10 3.1 1 22 83 34 129 30 114 1 40 151 61 231 79 299 80 303 45 170 61 231 70 265 3 12 15 4.6 10 38 1 19 72 14 53 30 114 45 1 170 1 64 242 1 73 276 38 144 53 201 1 61 1 231 120 20 6.1 ! - - - - - - 17 ; 64 25 95 36 136 66 250 29 110 44 1 167 l 52 197 3 19s 25 7.6 - - - - - - - - - - 8 3G 59 Z23 16 61 34 129 42 1 159 11 41 s8 30 3 40 I 12.2 22, 87 33 1 125 I - - - - - - I 11 42 n 50 15.2 _ _ _ _ 1 - 60 18.3 32 10 70 21. - - - - - - 1 - - - - - - - - - - 80~ 24.4 - - 10 90 27a . 3 I _ _ - - - - - I 100 30.5 9s 1 I _ _ 110 90 120 36.c - - - - - 1 - - - - - - - - - 39.E I - - - - - - ' I I _ _ ' - I I I 2 fis I Shut0- l -od Heac18 ft.(B.oml 19.25 fi.15.9m 7 I i . 18ft~.om) 25 RL .oml 23 ft.(7.0m1 I + 26 ft.(7.9m1 60 ft.1.a2m1 I 30 ft.19.1 m1 I 38 ft.l11.8m1 ~ 44 R(13.4m) a w 2 80 165 4165 75- 70- 16114161 163/4163 1 165/4165 185/4185 186/4186 - 18814186 189/4189 191 o 2 41163 Gal. I Liters Gal. Liters Gal. Leers Gel. Liters GaL Liters 1 Gal "tds Ga. IMF, Lll- 65 1 " 100 379 61 231 81 231 - - 56 220 145 549 145 549 ! 45 170 23' 61 - - S8 220 1 140 1 530 140 530 45 170 1 eU 161 BS 322 60 231 1189 227 61 2341 - 58 220 134 507 135 571 45 170 I 99 55 4161 41 _ 79 299 59 223 II 60 227 - I _ SE ' 220 129 484 131 496 45 770 70 65 5-. 2 _ 59 223 I I 58 0 122 46e 125 473 45 770 1 1400 62 _35 So 6 14 Z2 1 - 206 56 220 50 85 322 ~ 220 116 439 120 4545 170 41'16 45 170 46 - 172 55 206 70 285 58 220 104 394 91'3 45 170 418 1 8 20 76 33 1 I 25 45 _ I 50 i 189 I 57 ^.90 56 220 90 341 97 3641 45 170 I r I _ 15 - a 39 14E 32 12' S8 220 1 269 85 322 45 0 y 8r Z' it ^q i ' 9 I 34 1 52 197 51 193 I BS 261 4 2 162 3 - - - - - 10 38 - - 45 170 26 1 106 ' 51 j 193 45 I 170 31 717 2 8 34 6129 4 1 45 170 35 1 1 - III - - _ - 6 _ 8C . 64 40 151 41541 I 15 7 ~ 114 I I 30 I 85 _ - 25 14 1185 I - I - - - - ' - 21 T 7E - Is 31 j S6ft(17.1m1 66 ft.(20.im) g9 tt.(26_am/ 73 ft.(L'.3m1 116 F<(34 ml 91 fl(27.7m) 1101t.(33.Sm) 137 fLf41.8m1 2b- 15- 009922 1 ®CAUTION Model 18514185 should not be subjected to 441 72153.55 7s 1371 less than 30 feet TDH. 157,591 1381 NOTE: For Pump Performance on Model 112, Industrial column 0 10 20 30 410 50 60 70 80 90 100 110 120 130 140 150 explosion proof pump, see FM0219. GALLONS LITERS 0 80 160 24C 320 400 480 56C FLOW PER MINUTE ww SEWAGE AND MODEL 211 284 266 267 268 270/4270 28214282 28414284 292/4292 29314293 294/4294 29514295 DEWATERING 241 80 - 7s 7- - 21 Ill 6 1 2a 111 - - - ill 2F1 FF "I I 22 I - e ! - r 70 - I - I I _ - I z "cs zt n z t 711- 15^ 60 I ,ro1na I is nno 2 lisa" 414141 009904./m 2 I e 5 I I I I :J 16 I. I I I I - 1 I I I i I 1 ' se Z I O 14-, ag I ! j I a 2951 1 O 12 40 1 H I i i PUMP PERFORMANCE CURVE °-1 D SEWAGE MODELS I S 25 2 SOLIDS PASSING CAPACITY 265.1 282 270' 1 I I 6 20 '26. b I I I I I 15- I I ! I I 10- I I I I I 2-1 5 I 21' 641 A CAUTION 2 ' . 11292 28 4 oo i o ' ~.4. 2.,5 Model 293/4293 should not be CI ' 10 20 30 4 C 50 60 7 0 80 90 100 1 1 0 120 ;30 140 150 16C 1T0 780 790 200 210 220 subjected to less than 15 feet TDH. - GALLONS LITERS 0 80 160 240 320 400 48C 56C 640 720 800 FLOW PER MINUTE © Copyright 2003 Zoeller Co. All rights reserved. 6 CHECK BOX AS APPLICABLE. HECK BOX AS APPLICABLE. o SOIL EVALUATION Sale: ao 40 so eo SYSTEM PAGE 2 OFD SITE MAP ~T PLOT PLAN PROJECT NAME: 102 DESIGN FLOW: 600 GPD Allison Zielsdorf Attach design flow calculations for commercial plans. PROJECT ADDRESS: County E S17 Springfield TW Pipe Material / ASTM Standard (Tables 384.30-3 8 384.30-5) / N Sanitary BM Symbol: BM Elevation: 100 FT Sewer. 4° 3034 Force Main: 2" / SCh 40 BM Description: Top 2" iron Pipe Slope Gradient Indicate north by IMPORTANT: of Teeter Area: 10 Well Symbol (if applicable): Q drawing an arrow Show ground elevation contours at suitable intervals. on the approprhe fine. 49 SIQ~e +0 11, 95 4160 ~ 47 1D , a, b h W N~ 615 T 2,5 377.E \ a \.k C r i t S ♦ E4\y d L)aa -7 a7 1 `s ~ u{, 1 ~~s fi I f' •6 TF li (,i.. r1J (j i y 1 ~ ~xi rli t., ra y ~ t T" Po i... C:. rl cu < 'Q ~ y y tr, tz' !7j.. f'••- z" > r 141 Tuf-Tite----Rlser Svstem >.m t s' ' R, x . F, 5" r ~ A t t F- R~~ . RE.GNT Cfl full, Cd"?Qf,YS. Tank Al er t ® PB Indoor Alarm System (Auto Reset, Battery Backup) The Tank Alert° AB indoor alarm system monitors liquid level conditions in lift pump chambers, sump pump basins, holding tanks, sewage, agricultural, 61ters and other waste applications. The sleek design of the alarm features a user friendly touch 'E■~ pad with colored LED indicators for easy visual detec- tion. The alarm horn and red LED indicator activate fora v high water alarm condition. Once the condition is cleared, the alarm automatically resets. The green LED indicates 120V primary power to the alarm. If primary power fails, the alarm continues to work due to 9V battery backup. SIiFNCF ' NEMA 1 rated enclosure for indoor use • Automatic alarm reset rJ • 9 VDC battery backup with low battery chirp • Colored LED indicators: SIGNALING • Red alarm k~1« LISTED z88x • Green power on • Alarm test switch Installation Diagram • Horn silence switch battery door i "test" button • External terminal block for easy Aoat installation "silence" button _ l " Includes 15' SJE SignalMaster° control switch alarm" light • primary "power on" light • Alternative Aoat models for high and low level alarm • Optional auxiliary contacts for remote devices attach float switch here mounting e e - ° e • flange power cord 1011421 TA AB, High, 15' SJE SignalMaster" 91 www.sjerhombus.com Toll Free 1-888-342-5753 Phone 218-847-1317 ?X136J6-l D7bus RavC2113 DIVISION OF INDUSTRY SERVICES PO BOX 7302 ~P MADISON WI 53707-7302 Contact Through Relay s p http://dsps.wi.gov/programs/industry-services ' www.wisconsin.gov < sE~ Scott Walker, Governor Laura Guti6rrez, Secretary May 19, 2017 Identification Numbers _ Transaction ID No. 2944957 Site ID No. Please refer to both identification numbers, above, in alI_ correspondence with the agency. CUST 11) No. 253976 LEWIS C I3JORK LEWIS WORK LLC E7818 COUNTY ROAD E MENOMONIE WI 54751-6637 C'ONDI'I10NAL APPROVAL PLAN APPROVAL EXPIRES: 05/31/2022 Re: Description: SEWAGE TANKS, CONCRETE Manufacturer: LEWIS BJORK, LLC Product Name: (tyrans id 2944957) SEPTIC, PUMP OR HOLDING (TANK AND ADAPTOR) Model Number(s): LB700, LB1150 (700 AND 1150 gals.) [LB700 BASE TANK; LB1150 CONSISTING OF 3 SECTIONS WITH THE 450- GAL. ADAPTOR AS THE MID-SECTION] [38 IN. L.L., 18.85 GAL/IN.; 96 IN. MAX. DEPTH OF BURY, 335 OR 551 GPD WHEN USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER; TANK DIMENSIONS = 66 IN. L X 36 IN. W X 54 IN. H; ADAPTOR DIMENSIONS = 66 IN. L X 36 IN. W X 24 IN. H] Product File No: 20170151 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of May 2022. This approval supersedes the approval issued on 6/28/2012 under product file number 20120193. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • All manhole covers terminating at or above grade must have effective locking devices. • When this product receives wastewater from dwellings, it will produce an effluent quality with a maximum monthly average value for BOD5 of less than or equal to 30 mg/L, TSS of less than or equal to 30 mg/L TSS and F.O.G. of less than 30 mg/L. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer Allison & Nathan Zielsdorf Mailing AddressN 13594 10th St_ Property Address 2857 County Road E (Verification required from Planning & Zoning Depart ent for new construction.) City/State Glenwood City Parcel Identification Number 034-1039-20-100 LEGAL DESCRIPTION Property Location NW ~/4 , NE '/4 , Sec. 17 J29 29 N R 15 W, Town of Springfield Subdivision Plat: , Lot # 1 Certified Survey Map # ,Volume 10 Page # 2945 Warranty Deed # (before 2007)Volume Page # Spec house 11yes0no 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. tiwe certify that all statements o this 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 -ar•anty deed recorded in Register of Deeds Office. Number of bedrooms 4 SIGNAT RE 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) Page 1 of 1 g._._. E i i BEDRO" , 2 MASTER BEDROOM A.TcF1 R 1 €"x.1"l-1-7 10141'x Uz~'~'" 1?-1" z 1ss a S a f WA P EDR~ ow $ 3i . { ~ e 'Lai 2-CAR GARA4'E i r 21'-T 23-f 1F.FT m. I~FACE I (i ~ OVEREC P 1 N M p~ 1 https://ww,A'.wausauhomes.coliz/uploads!ii-nages~"loor-plans/previc"s'lldr 180- 1.- 1 p g 4;2/2018 -CEIVED Wisconsin Department of. Commer, SOIL LVALOATION REPORT Page of Division of Safety andpk~clins In accordance with Comm 85, Wis. Adm. Code County 1_ t Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must T w,A" include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. el q percent slope, scale or dimensions, north arrow, and location and distance to nearest road. D~T " / " 2-o - dM Please print all information. Rev'e by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). L Property Owner Property Location IC (T`/ Govt. Lot 1 /4 r 1 /4 ` T [ N R ~E (or) Property Owned Mail' Address Lot # Block # Subd. Name CSM# CAY 1 State Zip ode Phone Number ❑ City ❑ Village fig-T11 Neafest Road 93-New Construction Use: Residential /Number of bedrooms L Code derived esign flow rate- GPD ❑ Replacement Public or commercial - Describe: Parent material Flood Plain elevation if appl' ble t ft. General comments t~A^a / ZO and nx=nrnendations: n r` ~n T aVt System Type /~11 Y►~ li 4,1i~ 4 System Elevation. ❑ Boling Boring # Pit Ground surface elev. ft. Depth to limiting factor in.. F*Efff#l 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#2 K-1 3 5~ 21> Boring # ❑ Boring pit Ground surface elev. 7 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 2 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/- ma/ CST Name (Please Print) ure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 540 - L 3 7 715-246-4516 L Property Owner _ Parcel ID # Page of [-7-]+ Boring # 2 Boring Pit Ground surface elev. ` ft. Depth to limiting factor ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 J F77 I T E 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 GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Sal ication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff 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 rng/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. SBD-8330 (8.6/00) t Property Owner.__,__,_ Parcel ID # Page of a Baring # Boring (11)4/ -7 Pit Ground surface elev. , 1 ft. Depth to limiting factor t Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fp in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `EIi#2 L ! Ong # 0 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, •Efi#1 `Eff#2 Boring # ❑ Boring - ❑ Pit Ground surface elev. N. Depth to limiting factor in. Soil Apolicatiori Rate Horizon '7epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff on. Munse" Qu, Sz. Gott. Color Gr. Sz. Sh. 'Eff#1 `EAV2 Effluent #1 = BOD5 > 30 < 220 tttgtL and TSS >30 < 150 ffV& ' Effluent #2 = BODE < 30 mg/t_ 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 T'TY 608-264-8777. SBU6J}0 (R.GgUI Soil Test Plot Pl4~!',~3 r Project Name Nathan Zielsdorf Sird Address N13594 10th St. `Z Clear Lake Wi 54005 -77 1 C V,1221100 Lot 1 Subdivision Date /23/17 i N W 1/4 NE 1/4S 17 T 29 N/R1 5 W Township Springfield Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" pipe System Elevation TBD *HRpSame as Benchmark Ct~$r1F.~ 350' 70' B.M.* 30' ~ 96' 98' Scale is 1" = 40' 95' 97' unless otherwise B-1 noted 0 B-3 5 10% Slope 0 0' B-2 Property Line