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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 600390 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 3098375 Permit Holder's Name: City Village Township Parcel Tax No: Oevering Homes TOWN OF SOMERSET 032-2174-04-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /00 S m I 22.31.19.1459 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ^ 5 CAPACITY STATION BS HI FS ELEV. Septic 3 Benchmark G c~ 4714,_ 6 1660 4 L~7 ~0 S / dc~ Dosing „ i Alt. BM Gd,N.bo s G~ 1 3,1S 1e1. ZS Bldg. Sewer $ Z / Holding St/Ht Inlet C1. Z q5 • a 45 TANK SETBACK INFORMATION St/Ht Outlet \ TANK TO P/''L WELL BLDG. vent t Air Intake ROAD Dt Inlet SDJ` - It Septic 2-4 XJ4 75 Dt Bottom 05 Dosing Z' / 75 / 1 - Header/Man. Z.3 /6/ . 9 Aeration Dist. Pipe Z •"3 161, C15, Holding Bot. System 4 1ao Yc Final Grade 7 PUMP/SIPHON INFORMATION Manufacturer Demand St Coverer ` GPM h;~t~ cJ 3•(~ ~d~. Z Model Number 2$b CaN,~vr 3• ~ I TDH Lift Friction Loss System Head TDH Forcemain Length Dia.Z i' Dist. to Well SOIL ABSORPTION SYSTEM N 3 BED/TRENCH Width Length No. Of renc e PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 L (76 O SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION / CHAMBER OR Typeipf,System- L /1~ UNIT Model Number: DISTRIBUTION SYSTEM C%A/X Header/Manifold ID istribution Tole Size ( Ix Hole Spacing Ven Air In e Pipe(s) Length Di a Length 11 Dia~ Spacing z 0- 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only a'"" Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 7 Bed/Trench Edges \ 1j opsoil 1 ~s E, No Yes No 1 T COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: r•1a, r -66+{,`, Inspection #2: Location: 2014 57TH ST ~ 1.) Alt BM Description = 06 W 2.) Bldg sewer length = 75 I_ rl - amount of cover = n n ^a~ ~ S d ~ o.X,X. I r Plan revision Required? ❑ Yes No Use other side for additional information. ~P 1 ✓ v I LD % SBD-6710 (R.3/97) Date Insepct s 4re Cert. No. SAS'-o~~l o90 County Safety and Buildings Division 4'~ v '2<) l 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) s AY 2018 ' M n, 537 -7 State Transaction Number _ it Appli om- Unit a In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit h 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 maybe used for secon n purposes in accordance with the Privacy Law, s. 15. 1) m , Stats. G) L A fixation Information - Please Print All Information Parcel # Property Owner's Name (33L -a ► 7N o L/ - 0o 0 Property Owner's Mailing Address Property Location a , 01 Q r F u t Govt Lot City, State Zip e Phone Number t J Y., Section L L-- ' circle I-) i~.~ 1.~ ~AA✓f ~ ~ ~ ~ T N; R or 4J rn~. R. Type of Building (check all that apply) Lot Subdivision Name j 2 Family Dwelling -Number of Bedroo ❑ Public/Commercial - Describe Use J~ ❑ City of Ol~~ CSM Number ❑ Village of ❑ State Owned -Describe Cise)•___~ own off--- 765 III. T e of Permit: (Check only one box on line A. Complete line B if applicable) A. SysK ❑ Replacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System ( gin List Previous Permit Number and Date lssuell B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer :to New Before Expiration Owner IV. T ofPOWTS System/Com onent/Device: (Che sll that a 1 ❑ Non-Pressurized in-Ground ❑ Pressurized In-Ground ,t-Grade ❑ Mound 124 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Pretreatment Device (explain) ❑ Holding Tank ❑ Dispersal Component( pI ,lber V. Dis rsaVTrea ent Area Informat Design Flow (gpd) Design Soil Application Rat dsf) Dispersal Area Required fl Dispersal Area Pro sed (sf) System Elevation 1t'7 r C7~ j i v~ V L Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a 2 ° a = J New Tanks EnB T o 1G U vz P v Ci Septic or Holding Tank ~ l Dosing CSamberi r7 ~i,/ VII. Responsibility State nt- L the undersigned, responsibility for installation of the PORTS shown on the attached plans. Pl s Name (Pript) Pl er grtature MPRvIP~RSCNumber Business Phone N limber Plumber's Address (Street, City, State, Code. Lip EEL untyJDe artment Use Only Permit Fee Date sued I Issuing. Signature PProved ~ p S 06 5 l Cl Owner Given Reason~oT Denial IX Condi taPWWWQ; ck t flt E-nons for Diiss pproval t Sept 3) ` 4~Vvb A. ti . llfte n St?21 5a. Crl! si all be lc s ! r~,,a•Irit-Lr g,L AS per :3gemen' plan -u tae 1 by plumber. Gt 2. Al rec,t it-t:^en s meat Le l~: rtt, ir.E : / t ~fo as Pw WFiiCt'lbl±: V>dl l c.rrf',rtnrn:R?. , Amacb to complex plans for the stem and submit to the County only on paper not less than R 1r_ x 11 inches in size SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SW 1/4 SE 1/4s 22 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 101.0' DATE 4/15/18 3 BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale = 1/4" = 10' 3 Acre Lot 57th ST. Well is to meet all WDNR setbacks Pro 3 Bedroom House Grading is to be done to divert run-off away from system 101.5' Huffcutt Combo Tank B-3 101, 100.5' Area 15' below system ❑ is to remain undisturbed ❑ B-1 2% Slope B.M.* B-2 >300' Property Line , c is o p n hg,'-S Pul7 NNS sageioosse/ u!llnsaoj -DRY NVId 1503NH1S 3SnOH a~/si/ro aeu minis ww ~-+a..w..~... ~+.A...,.w , ~ r ~ ~ • _ ~ r e~/cz/ro am arox mddru say ro 'i.a.m~ .xae+u . A 30018 NMVH 83A18 '-V iOl STRO l0-2l S3NOH ONI83A30 ~ / WHISAS UVNIONOOJ A1NfIOJ XIONJ / Is IHl Ol MJNAN243N 3Ntl SONINtl38 / ego 5a G z se a w ° O O aom ~~wO a Zm~nUd °m:Iwo / 1a a~ omo z o ap LL W ZUw ~ A6 O ^ o / \ / \ ! E-_ oo~ ~ ~~6 \ 55~ ~ a W - U qpy 6 a r o \ p o. N 3 N ~ a $ m~ m - 16 se 8 / Z g56 e I p Y o a `v~J Z _ EY o/ ti N ~ \ \ I N ~ ~R 3g~~j wFO m a~b ~/}_p?D ow - 1~J ' O "ww~ V Qw3 0 3 ,FN \ \ w q 1 w,w c? o ° Q I aNm \ \ a u V o a ~ 0 N I \ \ O N / m m 0 r w z 0 wz a p° o Z 5 Z "g oo o> \ V.\ J Z I O W J w w Q J rSS O z °X w w z O m ~l r- E O m rc~ z ¢ a yz rm2 \ ro w o o az w z m ow~o O m r- z amo m 'ao\ l J° D o° o Fo m mw °9s "OS / Z Q o a m 0 m f n N N i n \ \ / W z o z z o W o3orc°p \ \ ~X~ ~Op \ y' 1 H ~ JI I w o LL) 0 LLI ) Q V D P 0 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 s Contact Through Relay http://dsps.wi.gov/programs/industry-services o i www.wisconsin.gov -ssj - Scott Walker, Governor Laura Gutierrez, Secretary May 09, 2018, t'f 3 SAFETY CUST ID No. 226900 ATTN: POWTS Inspector )F ~ e .~3iQNAL SE ,Y SHAUN R BIRD ZONING OFFICE - BIRD SELF STORAGE ST CROIX COUNTY SPIA 1432 120TH ST 1 101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/09/2020 Identification Numbers Transaction ID No. 3098375 SITE: Site ID No. 849028 Oeverin2 Homes Please refer to both identification numbers, 2014 57TH St above, in all correspondence with the agency. Town of Somerset St Croix County SW1/4, SE 1/4, S22, T31N, R19W FOR: Description: At-Grade (3 Bedrooms - New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1761008 Maintenance required; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade: System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. I I?)_ PreSSUrc Di,trihutioll 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 Cosies 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 the POWTS Dispersal 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. • Divert surface water from POWTS Area. SI IAUN R BIRD Page 2 5/9/2018 • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Pump Floats to be set and verified per approved plan Anv chany-es may result in pump resizint! to meet TDH and GPM Specifications. • Verify property line(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • 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 at-grade 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. • SPS 383.54(l)(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 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 ofthe Department, which may include local inspectors. All pcrmit~, required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services Wi Payment S code: 1. 7633 (920)492-2214 , Mon- Fri, 6:00 a.m. - 3:30 p.m. tim.vanderleest'u;wi.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:4/15/18 Owner:Oevering Homes Location:SW 1/4 SE1/4 S22 T31 N,R19 W 2014 57th St. Somerset Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance a ontigency plan ificati s 1 9. Filter Spec Attachments: Soil st b Shaun Bird Signature i License nu er ?6900 I i Page 1 of 9 System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 r SW 1/4 SE 1/4S 22 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 4/15/18 3 DATE BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION loo' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale = 1/4" = 10' 3 Acre Lot 57th ST. Well is to meet all WDNR setbacks Pro 3 Bedroom House Grading is to be done to divert run-off away from system 101.5' Huffcutt Combo Tank B-3 ~ 101' 100.5' Area 15' below system 0 is to remain undisturbed B-1 2% Slope B.M.* B-2 >300' Property Line f) At-grade System Sloping Site Cross Section and Plan View E i~ I: t Dimension Feet I:. 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L•L•L•'L•L•L•'L•L•'L•'L•L•'.•L•L•L•L•Lr r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r•r.r'•1"r'r•r'r'r'r'r•''•';'r•''•r'r't''r/-~ L•L•L•L•L•L•L• L•L•L•L•L•L•L•L•L•L•L•L•L•L•YL•L•L•L•L•L•L•L•L• L•L•L•L•L•L•L lJ 1.0 r•r•r•r•r•r•r• ~.r•r•r•r•r•r•r•r•r•r•r•~'•r•r•r•r•r•r•r•r•r•r•r• r•r•r•r•r•r•r• .L•L•L•L•L•L.L• L•L•L•L•L•L•L•L•L•L•L•L L•L•L•L•L•L•L•L•L•L•L•L •L•L•L•L•L•L•L I ~ L dZ7 E 1/6 B W - E L B 1 L % Slo e - = Plowed ati• = Clean aggregate = 4 in. sch. 40 pvc _ basal area Z;- 'h to 2 '/2 in. dia. observation pipe Lateral with 2" Topsoil Cap aggregate over pipe Observation Pipe Geotextile With Cap Fabric r rtirtir•r•• •rti• /rte. j~ F1 Lateral 1!ivert i.LLLL•L• J' r r r•r•r• r•r•r•r%r r~r•r r Topsoil Cap Z L•L L L L L•L•L• L•L•L•L•L•L•L•L•L L L - r r r•r•r•r•r•r•r•r l•r•r•r•r•r•r•r•r r r r r uj¢". L L L•L•L•L•L•L N L•L•L•L•L•~•~•~•L L L L L j r r r r•r•r•r•r•~ F r r•r•r, r_r_r•r_r•r ,r_f. r•r L L L L•L•L•L•L•L L• •L•• ' -•~~•s.f r•r•r•r•r•r +r r r~ Ft Contour .5 f ~ 1., r, .r•.r.r.1'•r•r•r•~• .~-•1'+,..=r.ri'.Rrti .'r•r'r•r•J'•r•r•r•r•r•r•r LPL ~L•L•L•L•L•L•L•L•L•Y Tom- D Plowed Surface Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands.. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative grovvth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/051gj Page 3 of Pressure Lateral Layout One Lateral - End Manifold .4 Threaded Cleanout Lateral Turn-up -0 Plug Force Main X L Long Sweep 90 Bend- a r d f-e& Pressure System Construction Distribution Network Wecificatio Lateral Diameter Laterals are constructed of Schedule 40 PVC Orifice Diameter pipe. Orifices are drilled perpendicular to X Orifice S acin) the pipe with a sharp drill bit and face down. L Lateral Length) Lateral turn-ups terminate with a threaded Force Main Diameter cleariout plug and are enclosed in a 6-8 inch x accessible Force Main Length 5 diameter lawn sprinkler valve bo from finished grade. Grade Q::::::::::;::::::•: 6-8 Inch Lawn Sprinkler Valve Box 03/051gj Page of Septic-Dose Tank Crass Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer G _ Mode d2 V Tank Model N Pump I Number umber 11u~i - Total Tank Capacity c 3'J Alarm Manufa~r Max. Bury Depth Alarm Model Number L Switch Type C E Filter Manufacturer / Total Dynamic Head (TDR) - Feet Filter Model Number Elevation Head Distal Pressure a 5 Network Loss Minimum Pump performance Required Force Main Loss • GPM: @ Ft TDH To Outlet ivlanhole Min. 4" Above Grade With ~ b Manhole Min. 4" Above Crrade Looking De~tice. Inlet Manhole D With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted Weather-proof Junction Box - - Finished Grade . Vent Mire. 12" Disconnect Above Grade means With Vent Cap Outlet Filter i - - - - - lnlet inlet Baffle - f t Switch Settings and Reserve Capacity 1a„ Tank Volume = l GPI Weep -74 P <a Dimension: Inches Volume Gal. B Hole (reserve) A; 7 j (alarm) B' 2 Off Elevation C pl ?r._ F. (dose) C ?7, Bottom (dead) D D c Elevation Ft Total r< :t. 444444444. '<.•.~•>•>•>s`a i 1< iey •a• ` t a ••a a t 1 <~<<~ a a t < r to ca li a;<~t;aataa~a'<aa`syaa at <T<T >aIa>a'a a a a a a a . < a•< a'a < a s a t a e•l•< a'a a < t l t t i<<< t•t•< 1•t•< l>1•l •t•1•l•a'{•1>1•t•/•.•i a GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without PPOr approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and'outlet is of approved material, connected to the tm k with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation ahd the sleeve is sealed watertight. Electrical servi complies with NEC 300 and Comm 1628. 02/05 L l Page o 280mSERIES 1/2 hp Submersible Effluent(Sump Pumps The VbertY 280-Series provides a cost effective "mid- Performance Curve: 280-Series range" pump for on-site waste water systems, liquid 40 12 waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. 35 11 Designed around Liberty's unique "Uni-Body" casting, 30 9 the 280-Series will provide years of reliable perfomtance. m 8 All Models Feature; v 6 • Vortex style impeller permitting passage of solids = 15 5 up to • 416 stainless steel rotor shaft 10 3 • Permanently lubricated upper and lower bail bearing 5 _ 2 • Epoxy powder coat finish p 0 • All fasteners - corrosion-resistant stainless steel 0 5 10 15 20 25 3 35 40 45 50 55 60 65 70 • 1 h° Discharge U.S. Gallons Per Minute i _i • Stainless steel bottom screen -easily removable 0 38 78 114 156 192 228 270 • Maximum fluid temperature: 140° F. Liters Per Minute Cord Lengths Model 10' 25-(-2). 0 501(-5) Dimensional Data; weight: 29 lbs. 280 standard Optional Optional 281 Standard OptlonW _ Height: l3" Standard Optional O nal Major width: 10" (model 287) 283 Optional WA 287 standard Optional WA N/A Minimum Sump Diameterw 10' cord length standard on an models. For Model 281, 283...14° add "-2, -3 or-5" suffix to model number. mss' Model 287 VMF...10" Example: for model 280 with 35' cord, order 280-3 Factory switch Mode1281, 283 Mode1287 settings VMF Motor Specifications Turn on level 13° 9.5■ %2 hp 60 Hz 3450 RPM Turn off level 7° 4.0° Oil filled, thermally protected (PSC) Permanent Split Capacitor The Model 283 features a fully adjustable wide-angle float Difl 8.0 amps 015V) adjustments can be made easily by tethering the float to the dis- 4.0 amps (208✓230V) ~ pipe or other mounting point. Vertical float model 287 is not adjustable. '7 ~r Modell 280 Model 281 Modell 283 Model 287 Manual, wide angle Wide angle VMF-Series W41 no switch float switch float switch Vertical mag- with quick- with series nedc float for disconnect (piggy-back) smaller pits - plug will operate in a 10° diameter sump c CH-Us Certified a6 subpxtto fU18fW 4YOmut n06C9, Liberty pumps • 7000 Apple Tree Avenue • Bergen, Mew York 14416 • Phone 800-543-2550 Fax (585) 494-law www.iH2ertypumpr.com coWVft@lJ1 tyP=Mtr-=7 ap ~ytas reserves l1ff o Mn 7 6 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner v f Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer ❑ NA XSIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 0 NA Effluent Filter Model ~r 0 NA Number of Public Facility Units A6-IA Pump Tank Capacity v al ❑ NA j Estimated flow (average) avda Pump Tank Manufacturer 0 NA I Design flow (peak), (Estimated x 1.5) 61J12 gal/day Pump Manufacturer y ❑ NA Soil Application Rate - gal/day/le Pump Model -1 p NA i Standard Influent/Effluent Quality Monthly average" Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Fifter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA ❑ Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) :5150 mg/L M Disinfection 0 Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BODs) 530 mg/L 0 In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 m L iNA t-Grade ❑ Mound Fecal Coliform (geometric mean) s104 cfu/10om1 0 Drip-Line ❑ Other: iMaximum Effluent Particle Size Ya in dia. ❑ NA Other. 0 NA Other. Other: NA ❑ NA `Values typical for domestic wastewater and septic tank effluent Other ❑ NA IAINTENANCE SCHEDULE Service Event Service Frequency (Inspect condition of tank(s) At least once eve 0 month(s) ry: ears (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third of tank volume ❑ NA ilrnspect dispersal cell(s) At least once every: ear(s) 101 (s) s} (Maximum 3 years) ❑ NA 'Clean effluent filter At least once every: a r(s)s) 0 NA Inspect pump, pump controls & alarm At least once every: 3 eoa~ (s}s) 0 NA 1=lush laterals and pressure test At least once every: 0 month(s) 0 NA ether year(s) month(s) At least once eve ❑ NA ry: 0 year(s) I~ther.- 0 NA MAINTENANCE INSTRUCTIONS Ilnspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of immbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (36) or more of the tank volume, the entire contents of I:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 0-P 9 Page of SMART UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thElt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will ble discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTG: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dralin (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propetly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requirjed setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nded for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruled in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology/ a holding tank may be installed as a last resort to replace the failed POWTS. has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evalualon must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. Mo d at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative _dp surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNI NG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone -1-71 d 2 SEPTAGE SERVICING OPERATOR PU ER LOCAL REGULATORY AUTHO Name Name D Phone Phone J 8 This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. D~ i I i h cl i. I s 4 i I 4 i. i i -o v C!) i i 6 ljj t J>. LU Q; w~ v o Q i N a; U Q 3 U G ~ LU 0 CD i ~ I.. 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I ° g I I 1 z l I A A I I I I - r xn I I I I I I I I I I I 1 1 M ~ I I •r a~. • w z I I- S i ~ I v I 1 I I ` I 1 I I I I 3 1 I l ^F I I sa c3nnu.uoov ~ +r ~ 1 I p I I ' i I t u. o I I I 1 I I I I I 1 ~ I I I I I 1 I I 1 I I I 1 qq rn3xn rnMa3~vm Y~a Y E~ :ba 5~i 88 ~>7 OEM - ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICA'T'ION FORM Owner/Buyer Mailing Addreq IL I Property A ddres (Verification required from Planning & Zoning ep nt for new construction.) City/State _ Parcel Identification Number LEGAL DESCRIP'T'ION Property Locations 2 7 N R C~ la ,Sec. C Town of JJr Subdivision Lot# Certified Survey Map # , Volume Page # Warranty Deed # _ Vollune page # _ Spec house Dyes yes no Lot lines ident~a-SYSTEM `no -SYSTEM MAINTENANCE AND O`R'NER CERTIFICATIO>~1 improper nse and maintenance of yourseptic system could result in its premature failure to handle wastes. Proper pumping out the septic tank every three years or sooner, if needed, by a licensed the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner responsibilities are specified in Co pumper, What You put into i, § mm. 83.52(1) and in Chapter 12 - St. Croix County mtenance The Sanitary Ordinance. Property owner agrees to submit to St. Croix County Planning & Zonin De owner and by a master plumber, ,lourne g partment a certification form wastewater disposal system is in proper Plumber, restricted plumber or a licensed pumper ve ,signed by the less than wastewater 1/3 ~ of sludge. operating condition and/or (2) after inspection and pumping g (it (if that necessary), the on-site the septic tank is l/we, the undersigned have read the above requirements and agree to with standards set forth, herein, as set by Department he above of Co maintain the private sewage disposals stem standardise stating that your septic system has been rmnerce and the Department of Natural Resources, State of Wisconsin the T-'°~1g Department within 30 days Of the three maintained must be completed and returned to the St" Croix County Planning & Year expiration date. Uwe certify that all statements on form true to the best of my/our Imowledge. I/we am/are the owners property described shove, by virtue of a w are anty deed recorded in Register of Deeds Off-ice. of the Number of bedrooms IGNA OF APPLICANT(S) ~ l T 5 DATE Any information that is misrepresented may result in the sanitary permit being revolted by the Planning & Zoning Department. fnelude 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, ° p t (REV. 08/OS) :Z LOT? 7 z O ' 3.151 acres TO O.H. W M. 16j, or \ 74 1 \ 6 b L gk~'` LOT O 3.02± acres g5~' \ \ TO O. H. W.M. \ A", S \ N \ \ s LOT 4 C13 C: \ ~'pd 3.02f acres TO O. H. W M. \ o ` ~A2 49y o4~ c \ \ r .Np i Qy z91.Sg _ y \ x......... g ' / / _ ~ ° J. 031 acres \ 1 N / O / o ro TO 0. H. W. M. sSA _ ♦ \ y - \~0 4 it tjt© 20 A Wisconsin Departmen~o%tt $OII EVALUATION REPORT Page of Division of Safety and uif((tjjmgs in ccordance with Comm 85, Wis. Adm. Code curt County Attach complete site plan p ,ggWp WT4s han 8 1/2x 11 inches in size. Plan must include, but not limited to:- orizontal reference point (BM), direction and Parcel I.D. _ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). f r Property Owner Property Location Govt. Lot 114S C-- 1 /4 S ^ T N R E ( rr)W Property Owner's Mailing A ss Lot Block # Subd. Name CSM# City State Zip Code Phone Number ❑ City ❑ Village own Nearest Ro New Construction Use: Residential / Number of bedrooms - Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: Parent material z'r Flood Plain elevation if applicable /tom l~ ft. General comments and recommendations: / System Type /T _ System Elevation Xe~ ! , n Boring # FT ❑ Boiling S pit Ground surface elev<!/~~ ~ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 4 Boring # ❑ Boring ~ s PI Pit Ground surface ele/vF lV4 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 -Effff#2 ak Jlr 4/ lOL 7 Y, 2 7, ly'a Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30:5 150 ' Effluent #2 = BOD. < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 % d 715-246-4516 Property Owner _ Parcel ID # Page of 1E Boring # ❑ Boring Pit Ground surface elev. t ft. Depth to limiting factor in. Soil lication 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 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ❑ Boring Boring # F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application 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 1220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BODS < 30 mg& 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 (RAM) Property Owner Parcel ID # p of Boring # ❑ Boring © C] P, Pit Sol Application Bo Ground surface elev. t 3 ft. Depth to limiting, factor _3 in. Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Etf#2 o-lL 101,r)17- 4_r , G s ----.5 / 9LAIL / Z71 e 4 -7C~ Al l - 3 Y7 A" F-1 Boning # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHf= in. Munsefl Qu. Sz- Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ❑ Boring F-1 ❑ pit Ground surface elev. R Depth to lirr>ititing factor irL Soo Application Race Horizon -)epth Dominant Color Redox Description. Texture Structure Consistence. Boundary Rods GPDRF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = SODS > 30 < 220 nglL and TSS >30 < 150 mgA- ' Effluent #2 = BODS < 30 mgA_ and TSS i 30 mglL 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. SOD4330 (8.6100) Soil Test Plot PI Project Name Oevering Homes S a6n irct Address 1433 Cernohous Ave Suite A / ~ ; New Richmond Wi 54017 CSTM #226900 Lot 4 Subdivision River Hawk Ridge Date 4/15/18 SW 1 /4 SE 1/4S 22 T 31 N/1319 W Township Somerset County ST. CROIX Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft. Top of survey iron 101.0' *HRPSame as Benchmark System Elevation Scale = 1/4" = 10' 3 Acre Lot 57th ST. Pro 3 Bedroom House 101 .5' B-3 101' 100.5' ❑ B-1 2% Slope B.M.* B-2 >300' Property Line _ RECEIVED Wisconsin Department of CommercQ L EVALUATION REPORT Page of Division of Safety and Buildings 0 ` C 1 8 2i! in accordance with Comm 8$, Wis. Adm. Code County Attach complete site plan on paPe~ not le\s~;/ ~~~~i~hes in }size. Plan must - include, but not limited to: vertical tandho r61 W" , direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q 3,~ - D y Please print all information. eview Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~0 0 Property Owner Property Location Z-5 Z Govt. Lot 1/4 5 1/4 S~ T =j N R(or' Property Owner's Mailing Address Lot # BI # Subd. Name or City Stag Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road New Construction Use Residential / Number of bedrooms Y Code derived design flow rate L - /FC GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ? ft. General comments and recommendations: Boring # Boring ® pit Ground surface elev._~ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 J .1 lam' 1 _ l G Al I Boring # Boring )Cy pit Ground surface elev. ft. Depth to limiting factor _ J in. Soil lication 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 L Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L Number CST ~rne (Please Print) ll JSig Lure ~I / y '6 L L Address Date Evaluation Conducted Telephone Number Property Owner /11~_c I D 1 Parcel ID # _ Page - of Boring # ❑ Boring E ID pit Ground surface elev. 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 r 9-17 ' - C' ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF 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 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 Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BODS < 30 mg/- 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) 0WNE` Page 3 of 3 Brian Parnell Address CST 23 t') 14 Date 2- Benchmar, 1 CD/_~ Be!lc i!.;a1 ~ . ~ /y!s i ~ Z~ ~S t Soil Borlnz _ Sn!table ~~rPa F = 40' Scale LOI , - - - hI , I ! i j 1 I 1 T- ' ~ I ~ r I 'I r- I I i , JJJ ~ ~ ~ ~ I ~ I i tu( )y I' I, I I I i ~ ~ I i r I ~ I I II j t ~ ~ I r T -T + - -r-T I - ~ - - t ~ ~ I ( I i , 'v`udNLi. Page 3 of 3 Brian Parnell Address CST 231314 Date l> c: Ccl/4el- SeIICl1L~a1_ti Lv~C u Soil Ecril12 1 = 40, 5c"ile ~r • ~r ~ i ' i 11 I I , T ~ i - 7v i I t I I I , -7 T- - - I. I I Gua I I I , I