HomeMy WebLinkAbout026-1008-50-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 605002
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 3098466
Permit Holder's Name: City Village Township Parcel Tax No:
Tamara Hiben TOWN OF RICHMOND 026-1008-50-000
CST BM Elev: Insp. BM Elev: BM Description: ^ / Section/Town/Range/Map No:
G' 5 I(~~J( 03.30.18.31 H
TANK INFORMATION 166 ELEVATION DATA
TYPE MANUFACTURER n CAPACITY STATION S HI FS ELEV.
4 5 100 5 /oa
Septic Benchmark 161. L /C50
Dosing Alt. BM
Aeration PhLl. k
5 Zen, Bldg. Sewer 1,51
Holding - SUHt Inlet c(
TANK SETBACK INFORMATION SUHt Outlet
TANK TO P/t WELL BLDG. V to Air Intake ROAD Dt Inlet
Septic ' Sa ~ ~ ~ Dt Bottom
Dosing ! 56 / U Header/Man. ~s
1 -7-5 36 . 8
Aeration Dist. Pipe 7 5 g
Holding Bot. System '17 y~ ~6
Final Grade 7 '76 ' g
PUMP/SIPHON INFORMATION
Manufacturer Demand St Cover C
9~0 /
6Ul j a, GPM ~r 3'(0
Model Number
6Y6Z6, C -o~r 6 . C15, /a
TDH Lif~ ~ Friction ~oss=d System He dG~ TDH
Z
J D✓/
Forcemain Length DDist. to Well 7.,!
SOIL ABSORPTION SYSTEM \
BED/TRENCH Width p Length NePIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS I b 74 •e 1___
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION Type Of tem:, CHAMBER OR
4 ~ 3 UNIT Model Number:
o vV
DISTRIBUTION SYSTEM a
Header/Manifold Distribution Ix Hole Size Ix Hole Spacing V )n Air In ke
Pipe(s)
`gyp S /
LDia Length /J Dia 11:5 Spacing
/ v
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of j xx Seeded/Sodded xx Mulched
Bed/Trench Center i , Bed/Trench Edges \q Topsoil NS~ Yes E] No Yes ❑ No
-7 1 1--1
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Z. Inspaj
Location: 1730 125TH ST Ro j 1.) Alt BM Description = C v" J POW
2.) Bldg sewer length =
- amount of cover
Plan revision Required? ❑ Yes No
Use other side for additional information.
Date Insepctor' igna e Cert. No.
SBD-6710 (R.3/97)
_ 544 --~2()) k-- /off
County
4Q~ Safety and Buildings Division St. Croix
D S 01 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
PS 1 Madison, Wl 53707-7162
MAY 16 2018 s &65 ZZ
C0$AJ.,Ar~p+,~1~X~ p~ State Transaction Number
,R1R~Itcy-v$' licat'
In accordance with SP is7 m. Code, submission of this form to the appropriate governmental unit
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
u ses in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1730 125th St.
1. Application Information - Ple se Print All Information
Property Owner's Name Parcel #
Tamara Harrison Hiben 026-1008-50-000
Property Owner's Mailing Address Property Location 0 J irl
1730 125th St. Govt. Lot
City, State Zip Code Phone Number
NE SW Section 3
New Richmond W. 54017 30 1 ~(eircle one)
T' N; R E or®'
H. Type of Building (check all that apply) Lot #
® I or 2 Family Dwelling -Number of Bedrooms 3 Subdivision Name
IQ~/v,e Block# 11k -r 6
❑ Public/Commercial -Describe Use
❑ City of__ _
❑ State Owned - Describe Use CSM Number ❑ Village of
/b ~ .7~ Town of Richmond
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) X J
A.
❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal [I Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit AA Number ~ and ~ Date Issued
/
Before Expiration Owner
IV. Type of POWTS System/Component/Device: (Check all that apply)
,
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ® At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (expla'
V. Dis ersal/Tre tment Area Infor tion:
Design Flow (gp Design Soil App ation Rate(gpdsf) Dispersal Area Requ d (sf) Dispersal Area Pro ed (sf) System Elevation /
.1 1 450 .6 750 750 95.10
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units / o a
.2
NewTanks Existing Tanks poly-lok 525 4~ a
aCJ nn n wC7 FE
Septic or Holding Tank 1000 1000 Wieser x
Dosing Chamber 600 600 combo x
VII. Responsibility Statement- I, the undersigned, assume responsibility fo installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber` Signature t MP/MPRS Number Business Phone Number
Keith Knudtson 648443 651-470-1737
Plumber's Address (Street, City, State, Zip Code)
927 150th St. Roberts W. 54023 ,
VIII. un /De artment Use Only
Permit Fee Date I ued Issuin ent Signa
Approved Disapprov
, S Z1
Amer Given Reaso r Denial
IX. CondiAMIt easolis for Disapproval
1. Septil rk a flu ne Ae-6nd A~DC 631 Ley~aJ. t
u sues: cell must all be sw tc^s'.' rite ~ s::r g~
As per -nararjement plan p! u naert by plumber. f t
Z. AN ftftwk rect.it'amens mlrst iwr«amt; Avl t n
is per ftV8 MW4l Cad, / :.MlmArAy. 4) +,j4v-r~
Attach to complete plans for the system and submit to the County o on paper not less than S 1/2 x 11 inches in size
SBD-6398 (R. 11/11)
Page 8 of 8
,fli, Wetland IL
0 20 40 +l~ Elev. 95600'
Graphic c / 1 inch = 40 ft Sanitary Site Plan
/
For: Tamara Hiben
Parcel in the NE1/4 -SWl/4
Sec. 3 T30N R18W , 94.00'
Town of Richmond - St. Croix County /
Flood Plain/ / 95.10'
Proposed 10'x 75' At-Grade Mound Dispersal Area
w/a installation contour and system elev. of 95.10' / 97.00'
4 Acre Parcel Existing D.F. / 6% /
Vent
Proposed Wieser Concrete
WLPI000/600-11LR Combo Tank /
w/a Poly-LokPL-525 Filter / P/L
94.80' /Open Yard Site
Existing Concrete Septic Tank
Inlet = 91.68'
#2
F BM Proposed 2" Sch. 40
Existing 4"Bldg Sewer '
PVC F.M.
BM #I
atio
Walk-Out
Basement
Elev. 955.00' I FN# 1730125th St.
296' to West Pi • WELL
Three Bedroom Home
Note: Abandon failing sanitary system per
SPS 383.33
Garage
Elevation Data
BM# 2= Bottom of Siding Elev. = 100.22'
Grade @ Proposed Combo Tank = 94.80'
452.00' P/L
A BM = Top of Concrete Patio on Center of Curveed Edge
* HRP = Same
ASSUMED ELEV. = 100.00' ' c `Mrs
n
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL STE 150
s
GREEN BAY WI 54304-5211
Contact Through Relay
http://dsps.wi.gov/programs/industry-services
S www.wisconsin.gov
Scott Walker, Governor
Laura Guti6rrez, Secretary
May 10, 2018 '0 i :
t'TOFd
CUST ID No. 224059 ATTN: POWT.S Inspector.-.
KEITH E STONER ZONING OFFICE -
KEITH STONER SOIL TESTING SANITARY DESIGN ST CROIX COUNTY SPIA
23220 WOODCREEK RD 1101 CARMICHAEL RD
SIREN WI 54872-8728 HUDSON WI 54016-7708 rte/
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/10/2020 Identification Numbers
Transaction ID No. 3098466
SITE: Site ID No. 849048
Hiben Please refer to both identification numbers,
1730 125TH St above, in all correspondence with the agency.
Town of Richmond
St Croix County
NE1/4, SW1/4, S3, T30N, R18W
FOR:
Description: At-Grade (3 Bedrooms - Replacement)
Object Type: POWTS Component Manual Regulated Object ID No.: 1761061
Maintenance required; Replacement system; 450 GPD Flow rate; 44 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. 1/12), 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.
• 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.
• 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 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.
• Abandon Existing System per SPS 383.33
• Pump Floats to be set and verified per approved plan. Anv changes may result in pump resizing to meet
TDH and GPM Specifications.
• Divert surface water from POWTS Area.
• Well setbacks to meet chs. NR 811 & 812.
• All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
KEITH E STONER Page 2 5/10/2018
• Insulate building sewer beyond 30 feet per SPS 382.30 (1 1)(c)
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• 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 -round 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(]).
• 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 u%~ ncr ;ind ~m\
others who are responsible for the installation, operation or maintenance of the POW] S.
Sincerely, Fee Required 5 2 50.o0
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 Wyment S code: 1. 7633
(920)492-2214 , Mon- Fri, 6:00 a.m. - 3:30 p.m.
tim.vanderleest'dwi.<,ov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M.
Keith E Knudtson , Knudtson Plumbing (Plans Mailed To)
RESIDENTIAL AT-GRADE DESIGN
Pressurized - Sloping Site
INDEX AND TITLE SHEET s
Project Tamara Harrison Hiben Replacement At-Grade
Owner Tamara Harrison Hiben
Address 1730125th
New Richmond WI 54017
Legal Description NE1/4-SW1/4 Sec. 3 T30N-R18W
Township Richmond County St. Croix
Subdivision Name Lot No.
Parcel ID Number 026-1008-50-000
Plan Transaction Number
Index sheet Page 1
Calculations Page 2
At-grade drawings Page 3
Laterals and dose tank Page 4
Specifications Page 5
Management & contingency plan Page 6
Pump curve & specifications Page 7
Plot Plan Page 8
5W
Designer Keith E. Stoner License Number Designer 1575-007
J STONER '
Signature D 1575 Phone Number 715-653-2324
Site, ~
Wis.
Date 04/17/18
/ti9agned pursuant to:
At-grade Component Manual Ver. 2.0 for POWTS SBD-10854-P (N. 03/07), 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) Q. J
Version 7.0 (03/12 ~Page 1 of 8
PPS
PRESSURIZED AT-GRADE DESIGN
At-grade Design Worksheet - Sloping Site
Flows and Site Data Entry.
(r or c) r Residential or commercial?
300.0 Estimated wastewater flow (gpd)
450.0 Design wastewater flow (gpd)
6.00 % Site slope
95.10 Contour elev. below lateral (ft)
44.00 Depth to limiting factor (in)
0.60 In-situ soil application rate (gpd/ft^2)
Distribution Cell Information
(1 or 2) 1 Influent wastewater quality
10.00 Linear loading rate gpd/ft
10.00 Effective absorption width (ft)
10.00 Max. effective width permitted (ft)
75.00 Aggregate length (ft)
Pressure Distribution Data Entry
(c or e) end Center or end lateral connection
1 Number of laterals
0.156 Orifice diameter (in) e.g. 0.25
Not a final
calculation 2.00 Estimated orifice spacing (ft)
2.00 Forcemain diameter (in)
2.08 Forcemain flow velocity (ft/sec)
40.00 Forcemain length (ft) y or n y Does forcemain drain back?
87.80 Pump tank elevation (ft) y or n Are laterals at highest point?
4.55 System head (ft) x 1.3 NA
6.97 Vertical lift (ft) 6.5 Forcemain drainback (gal)
0.38 Friction loss (ft) 34.0 5x Lateral void volume (gal)
0.00 In-line Filter Loss (ft) 40.5 Minimum dose volume (gal)
6 11.90 Total dynamic head (ft) 20.4 System demand (gpm)
Lateral Diameter Selection Gallons/Inch Calculator (optional)
Pipe diameter Design options Design choice Total Tank Capacity (gal)
Designer 1 in Total Working Liquid Depth (in)
must select 1.25 in Gal/in (enter result in cell G46)
one lateral 1.5 in X X
diameter 2 in x Treatment Tank Information
3 in x Septic tank capacity (gal)
[W] ieser Concrete Manufacturer
Effluent Filter Information Dose Tank Information
Pol -Lok Filter manufacturer E60314 Dose tank caacity (gal)
PL-525
EEd Filter model number Dose tank volume (gal/in)
er Concrete Manufacturer
Project: Tamara Harrison Hiben Replacement At-Grade
Transaction Number: Page 2 of 8
AT-GRADE PLAN VIEW
D -t
1/6 B Observation pipes (2 typical) 10.00 ft
D B 5,00 ft
1 /6 B 12.50 ft
C 12.00 ft
W C D 5.00 ft
E 2.00 ft
L 85.00 ft
D B W 22.00 ft
A x B 750.00 ft^2
L
Cap
= Total aggregate cell A x B Typical obs. pipe.
Slotted in the lower 6", and
= Plowed area L x W anchored securely.
AT-GRADE CROSS SECTION
Svnthetic fabric cover
96.89 ft Finished grade
Lateral elevation
invert elev. 95.60 ft S
Observation pipe
at aggregate toe
% Slope
Surface contour Is. 6 85.10 ft C A '
and system D
elevation
=12 in. topsoil and subsoil
over aggregate and tapered to toes. Plowed layer
below L x W
= 6 in. aggregate below
pipe(s), and 2 in, above pipe.
Project: Tamara Harrison Hiben Replacement At-Grade
Transaction Number: Page 3 of 8
,
PRESSURE DISTRIBUTION AND DOSE TANK
Lateral Diagram - Center Connection
P
Last her dk to + cap k- X Laterals & force main of PV Sch 40
a&' d no eia b~xtwn O~e laverag per SPS Table :384.:30-6
equaft spaced • = Turn-upw+ballvaKteorcleanoutplug
Lateral Specifications
0.156 Orifice diameter (in) Center Lateral connection point
X 1.97 Orifice spacing (ft) 1 Number laterals
38 Orifices/lateral P 73.88 Lateral length (ft)
20.4 Lat. discharge rate (gpm) 1.50 Lateral diameter (in)
2.00 Forcemain diameter (in)
20.4 Sys. discharge rate (gprn) 40.00 Forcemain Length (ft)
11.9 TDH (ft)
Typical Pump Chamber Layout
Approved manhole cover with
Weather-proof warning label and locking device
junction box 10 Final grade 4"
disconnect
Tank component is Alternate
properly vented q--, outlet
location 18" min.
Electrical as per NEC 300 and I~ Approved
SPS 316.300 WAC outlet
Tank full joint
= Inches Gallons JA Provide 1/4"
A 21.5 361.3 weep hole or
Alarm on antisiphon
as B 2.0 33.6 B device.
E C 2.4 40.5 Pump on
o D 10.0 168.0 88.63 ft C
Totals 35.9 603.4
Pump off
D
Bedding under tank ~ 87.80 ft
Goulds _ Pump manufacturer SJE Rhombus _ Alarm manufacturer
EP04 Pump model number Tank Alert 1 Alarm model number
Project: Tamara Harrison Hiben Replacement At-Grade
Transaction Number: Page 4 of 8
At-grade System Maintenance and Operation Specifications
Service Provider's Name Powers _Sanitation Phone 715-246-5738
POWTS Regulator's Name St. C4roix County Zoning Phone 715-386-4680
System Flow and Load Parameters
Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 750.0 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 years
Effluent Filter Inspect and clean at least once eve 3 years
Pump and Controls Test once eve 3 ears
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested eve 1.5 years
Mound Inspect for ponding and seepage once every 3 years
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SIPS 384.30-1, have a watertight cap,
and are secured in as shown in the at-grade 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 at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
6. Areas within 15 feet of the downslope toe will be protected from compaction.
7. All other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07).
Lateral Turn-up Detail
Finished
Grade
Threaded Cleanout
6-8" Diameter Lawn
Sprinkler Valve Box Plug or Ball Valve
Distribution`
~ Long Sweep 90 or Two
95.60 ft 45 Degree Bends Same
Diameter as Lateral
Project: Tamara Harrison Hiben Replacement At-Grade
Transaction Number: Page 5 of 8
At-grade System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD-10854-P (N. 03/07), SSWMP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (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 SPS 383.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be
assessed at least once every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the
filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products
are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
At-grade and Pressure Distribution System
No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the at-grade 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 at-grade 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 at-
grade be heavily mulched as protection from freezing.
Influent quality into the at-grade system may not exceed 220 mg/L BOD5 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD5 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test
when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any
levels above 4 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 at-grade 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 renovating the biologically clogged absorption and
dispersal media, installing new piping, and replacing other 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.
Project: Tamara Harrison Hiben Replacer Transaction Number: Page 6 of 8
Page 7 of 8
MGOULDS PUMPS Submersible
Effluent Pump
EP04
EPO5
3871
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
grade turbine oil for tic enclosed design for heavy duty ball bearing
Specifically designed for the lubrication and efficient improved performance. construction.
following uses:
• heat transfer. ■ Casing and Base: Rugged
Effluent systems
• thermoplastic design provides AGENCY LISTING
Homes Available for automatic and
• superior strength and corrosion
Farms manual operation. Auto- resistance. a- Canad O"
StwKWds
• Heavy duty sump matic models include
• Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end
• Dewatering assembled and preset at the for efficient heat transfer, in "C" or "F".)
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover. Thermoplastic GouktsPimpsisISO9M BoMued.
FEATURES cover with integral handle and -
• Solids handling capability: float switch attachment points.
/4" maximum. ■ EP04 Impeller: Thermoplas- N Power Cable: Severe duty
• Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant.
• Total heads: up to 31 feet. pump out vanes for mechanical
• Discharge size: 1'/z" NPT. seal protection.
• Mechanical seal: carbon-
rotary/ceramic-stationary,
BUNA-N elastomers.
• Temperature:
104°F (40°C) continuous
140°F (6010) intermittent. METERS FEET
• Fasteners: 300 series 1 °
stainless steel.
• Capable of running 9 30 S GPM
dry without damage to $ r[~~2s rr
components. 25
a° 7
Motor: _
• EP04 Single phase: 0.4 HP, v_ 6 zo
115 or 230 V, 60 Hz, 1550
RPM, built in overload with z s
automatic reset. 1 s
• EP05 Single phase: 0.5 HP, 0 4 EPOS
115 V or 230V, 60 Hz, 1550 3 10
RPM, built in overload with EPOa
automatic reset. 2
• Power cord: 10 foot s
standard length, 16/3 1
SJTOW with three prong
grounding plug. Optional 20 0 00 to 30 _ 40 so ePnn
foot length, 16/3 SJTW with
three prong grounding plug L
(standard on EP05). ° z 4 6 a 10 12 m3/h
CAPACITY
Goulds Pumps
E 2001 Goulds Pumps ITT Industries
Effective May, 2007
83871
Page 8 of 8
ili, Wetland ~L
o zo 40 lkl- Elev. 956.00'
Graphic Scale (Feet)
1 inch = 40 M Sanitary Site Plan
For: Tamara Hiben 412.00'
Parcel in the NE1/4 -SWl/4
Sec. 3 T30N R18W / 94.00'
Town of Richmond - St. Croix County
Flood Plain/ / 95.10'
Proposed 10'x 75' At-Grade Mound Dispersal Area
w/a installation contour and system elev. of 95.10' / 97.00'
4 Acre Parcel Existing D.F. / 6% /
/
Proposed Wieser Concrete Vent
o /
WLPI0001600-MR Combo Tank /
w/a Poly-Lok PL-525 Filter P/L
94.80' /Open Yard Site
Existing Concrete Septic Tank
Inlet = 91.68' BM #z /
E Proposed 2" Sch. 40
Existing 4" Bldg Sewer
PYC F.M.
BM #I
Patio
Walk-Out
Basement
Elev. 955.00' ' FN# 1730125th St.
296' to West P2 • WELL
Three Bedroom Home
Note: Abandon failing sanitary system per
SPS 383.33
Garage
Elevation Data
BM# 2= Bottom of Siding Elev. = 100.22'
Grade @ Proposed Combo Tank = 94.80'
452.00' P/L
A BM = Top of Concrete Patio on Center of Curveed Edge
* HRP = Same
ASSUMED ELEV. = 100.00'
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer Brent and Tamara Hiben
Mailing Address 1730 125th St.
Property Address Same
(Verification required from Planning & Zoning Department for new construction.)
City/State New Richmond Wi. Parcel Identification Number 026-1008-50-000
LEGAL DESCRIPTION
Property Location NE '/4 , SW '/4, Sec. 3 _J30 30 N R 18 W, Town of Richmond
Subdivision Plat: , Lot #
Certified Survey Map Volume , Page #
Warranty Deed # (before 2007)Volume , Page #
Spec house 11yesElno Lot lines identifiable Elyes[:]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.
1/we certify that all statemefa n 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 warranty deed recorded in Register of Deeds OI(iee.
Number of bedrooms 3
SIGNATURE OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 04/12)
Csr_a~l~- s
Wisconsin pepartment of Safety and Services
bivision of IndustySe SOIL EVALUATION REPORT
Vi_, - Page 1 of 3
`,C4 ~ 4 2~1 in accordance with SPS 385, Wis. Adm. Code Keith Stoner CST
~ ~
Attach compI rs'ife plan on paper not less than 8/: x 11 inches in size. PCounty
St. Croix
include, but not limited to: ic> ril aAOhozontal referencoint BM) iercent slope, scale of fi arrow, and location dis t road. Parcel I.D.
p ® 026-1 08- -000
Please print all information.
-
Y
Revie By Datg Z!
Personal information you provide may be used for secondary purposes ( aw, s. 15.04 (1) (m)). 7 'ID Property Owner Property Location
Tamara Harrison Hiben Govt. Lot G11/4, /W Z" T30N, R18W
Property Owner's Mailing Address Lot # Block # Subd. Nam or CSM#
1730 125th
City State Zip Code Phone Number City Village Town Nearest Road
New Richmond WI 54017 Richmond Same
EJ_ New Construction Use: L-_] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
['v Replacement U Public or commercial -Describe:
Parent material Till Plains - Dolomite Sandstone _ Flood plain elevation, if applicable NA ft.
General comments Propose a 10 x 75' At-Grade mound dispersal cell with a system elevation = 95.10'. Pipe contour staked onsite.
and recommendations: A-C
Boring
ell-
F 1-1 Boring # P Ground surface elev. 94.35 ft. Depth to limiting factor 44 in.
Soil App ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-8 10YR2/2 - sil 2msbk mvfr cs 3f-co 0.6 0.8
2 8-19 10YR3/4 - sil 2f-msbk mvfr gs 3f-co 0.6 0.8
3 19-27 10YR4/4 - sl 2msbk mvfr gs 217-co 0.6 1.0
4 27-38 7.5YR3/4 - Is Osg ml gs 2f-m 0.7 1.6
5 38-44 7.5YR3/4 - sl m mfr - 1f-m 0.2 0.6
Bedrock at 44"
Boring
F2 Boring # ,
Pit Ground surface elev. 96.35 ft. Depth to limiting factor 48 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-7 10YR2/2 - sil 2msbk mvfr cs 3f-m 0.6 0.8
2 7-18 10YR3/4 - gr sl 2msbk mvfr gs 3f-m 0.6 1.0
3 18-26 7.5YR4/4 - gr Is Osg ml gs 2f-m 0.7 1.6
4 26-48 7.5YR4/4 - srs Osg ml gs if 0.7 1.6
5 48-68 10YR3/6 f2d5YR5/8 sl lfsbk mvfr - - 0.4 0.7
Bedrock at 68"
• Effluent #1 = BODS> 30 < 220 mgA. and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 s 3O mg/L and TSS s 3O mg/L
CST Name (Please Print) Signature: CST Number
Keith Stoner h;A f,~k 224059
Address Keith Stoner CST Date Evaluation Conducted Telephone Number
23220 Wood Creek Rd Siren, WI 54872 10/5/2017 715-566-0900
SBD-8330 (R.07,13)
Property Owner Tamara Harrison Hiben Parcel ID # 026-1008-50-000 Page 2 of _ 3_
~ Boring
3 Boring # Pit Ground surface elev. 94.10 ft. Depth to limiting factor >55 in.
S Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. r6l. #2
1 0-8 10YR2/2 - sil 2msbk mvfr Cs 3f-m 8
2 8-18 10YR3/4 - sil 2msbk mvfr gs 2f-m 8
3 18-28 10YR4/4 - sl 2msbk mvfr gs 1f-m 0
4 28-55 10YR4/4+5/4 - grsOsg ml - if 0.7 1.6
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/ft2
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/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
o
" Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/-
r
t
Page 3 of 3
0i Wetland 6,-
EIeV.956.00'
0 20 40
Graphic Scale (Feet) /
1 inch = 40 it Soil Test Site Plan
/ 412.00'
For: Tamara Hiben
Parcel in the NE1/4 -SW1/4 / /94.00'
Sec. 3 T30N R18W
Town of Richmond - St. Croix County
B #1
Flood Plain/ / 95.10'
/ 97.00'
4 Acre Parcel Existing D.F. /
B # 2
7zo /B #3 60
/ o / P/L
Existing Concrete Septic Tank
Inlet = 91.68' ® /Open Yard Site
BM #l /
E Proposed Combo
Tank Elev. = 94.80'
BM #1
Patio
Walk-Out
Basement
Elev. 955.00' FN# 1730125th St.
296' to West P2
• WELL
Three Bedroom Home
Elevation Data Garage
B# I = 94.35'
B#2 = 96.35'
B#3 = 94.10'
BM# 2= Bottom of Siding Elev. = 100.22'
Grade @ Proposed Combo Tank = 94.80' 452.00' P/L
ABM = Top of Concrete Patio on Center of Curveed Edge
* E RP = Same
ASSUMED ELEV. = 100.00'
Backhoe Pit October 5th 2017
Keith E. Stoner CST# 224059