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HomeMy WebLinkAbout024-1014-70-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 605014 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City village Township Parcel Tax No: Z&Z Land LLC TOWN OF PLEASANT VALLEY 024-1014-70-100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 08.28.17.80B TANK INFORMATION EL VATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , Benchmark 1 / Alt. BM Aeration Bld Sewerl Holding - - St/Ht Inlet -7 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt InI~L__ Septic ~ry"'1) Dt Bott r~n Dosing Header/Man. a Aeration Dist. Pipe Holding Bot. System , PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM f ~G) > ! Model Number c TDH 11-iift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well - SOIL ABSORPTION SYSTEM BED/TRENCH Width LenAh No. Of Trenches--., PIT4.5TMt14S.QNS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ l SETBACK SYSTEM TO P/L BLDG ~ WELL LAKE,/S AM LEACHING ManufactWef: INFORMATION CHAMBER OR Type Of System - i UNIT Model Number DISTRIBUTION SYSTEM , y Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake t~ Pipe(s) Length a Dia_ Length Dia Spacing ) 7~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / Depth Over xx Depth of Seeded/Sodded <N xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx El Yew o ❑,-yee No t COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1696 CTY RD N 1.) Alt BM Description 2.) Bldg sewer length - amount of cover •2>n Plan revision Required? ❑ Yes ❑ No Use other side for additional information. L 17_ _ I l 1 irk ,7 SBD-6710 (R.3/97) Date I ors igna ur Cert. No. PPPPP-., r &Whysayk=Dwigoo county ` o1B 1400 E Wasbinow Ave 5T MOX S ~y 2 3 1 PO. Box 7116612 7 S.aiary Permit Number (b be Med in by Co.) 53 - - yplfi C0\" oPmef\t • A... CY~✓ I Number iizy Permit Applicat' SteftTreasec In aecardlmoe°~srs3332ttz) Vlrn Adm. c«ig.hwAsionafth&Jotmtodxappnapri~MeSrw+amm nwunit is vwptmW prior to abfemmS a aaermy permit Hate: Apptiraams borms for dto"owed POW M ere n etemwed to pryoa Addmat tifdi t>tra a.sRitg atidreas) the ikpetiansd of Stilt ty and PraPe Iv", 0 StxvkM FWvMd Momation you povik sm y be and for aeaandtry t ea .dr~e.rrrel~ Si. to Sb% l69'~ { N L AppOcafto Idrrow" -Please Print Alllmliemeed l Prape dy tlwnds Nam pard t c0 ~)W- • pz4-/flay-X -4A41 Ropoly Sand: MaRing Address Praperty Lotatim &Iq e-T 11. Z cloy Lac city, Bette z p code Ptrone 13eaeber 9E !k . w, section 14AMMON.6 ~,tt1 Syvi~ ~bz-33~-3~(0~ 2s, x. P. !-~`~Z Type *F 8~ (eieck all Oat apE4CZ Lae # 1 art Fam* Dadkg-HuabaafPrxlSubdkisiarttiatre Emorh i Afik /Q Atte © %"iWe iW -Dwmbe lJae -J Q city of ❑ owned- DFmebe tin csm Nkia- ❑ vmw of 3 ; Cetu, l 7 Q tJna ,~(wf3 fa T. of PrrEtrS~4.v~ I.S~t ~ _ Cal-- HL Type of F atei (Clredc ate box on lire A. Casapiete Beer B KappiitaW a A. D tiew syeaem Rapbaertrad syttoeo D ~ Tate Re~ieooiaert oily ❑ otLor lieei~ao to Syatma (e~ttla) IL US Permit I end am nofil a xpaatioa Unaa iv. T otr wn an u.t Riot i~eoa inea ro-[katnnr ❑ Praeerieed h{i.onnd D At (aeade ~t hoe d? za n ate.rmc sea Ow -l<24n. of atswable and~n liotaies T - ~ c-WIParaet t ©rreaeeameat narioe ( t~f V. AM Itelirrrrpttisc DOW FIDWONNO Dmw Apldiaeon DWMW Am Requited (a!) Disperast Area (So syatmt F]wa6aa ✓ ~ D ~ load 6 1915M 92.5 o . zs VI. 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Vvic t GLOM °T7,>JK, IS F `N I w F , e e ~wR z { y 7 PAGE 1 OF 4 In-Ground Gravity Plan 10 e 0 index & Cover Sheet ~ G e~ P qty t Carnportent Marxla► R'ereWMs: CCO~X P° e\oP~e Version 2.0, SBD-10705-P (N.01/01, R. 10/12) 5 \y o~ Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: FIL-T K sPccs PGWTS Application for Review -FA,yK RC_s Soil Evaluation Report & Site Ma T~V RLT94TOK Sf'cC s ABED SEac TA/'UK Project Name / Description Owner Name(s): r TNc= / ~,7E VE- J& ti-4 Phone: Zt,z - 5511 - 3, ~..i _ owner Address: j~,bq G :T~ / . ~4A.M Al o v i CO-~ Zip: Project Address: f 1 y~ c_ r Af Govt Lot: -5E 1 /4 of 5E 114, Secfion S , T :---Ile N-R 17 E ❑ or W Township: PLEA 5,UJ VA ALE'/ County: 5 Tf, CKD►K Project Parcel ID t>214 --1,14 -7 ,,a-_ Designer Information Designer Name: , AKV ~ -HuPeV-rzT Phone: i77 DesignerAddr+ess- ZSly97 K1N6 rzTHuR`s Cf I)MR WX Zip: 5y8 E-mail: h0l({s(-~erJeslan ro-)oiLf I wK.eom TI'iissp stamp. License Number: sq - oD 7 `gig r~~ Remarks: ; - - NARK' J MuPT l i~a9 ~~fif~R FALt,g,,: ~~aa.araa~•~' ~~0 n Signature: ///VZ ' Date: /Z-, Z-) ~7 ,y wpy. ip= Zia. 4' ~c~"`"i': a 4' "'R ~.F• ~I'~ FTPW . ~'A}.~ F}1.4 ~ V y •+.+m.-•' Nw& 4~ s ' ASt'KC ~I,. D a Stu>~s£ ~o, acs rn q s/ 1 49 z SE T V,) czs ~ott~^PA F ,a r A P ' 1 ' OOAV!~ 'P, 146 -40 t .r i a h- y° T Ear F ~.9 ' C,N~A ~~cA X PAGE 3 OF q z .0 ro m W W ttD~ ~ w E ._I z C Q(jJE Z CL Y CL L = W 2 W m s` N 5; CL E 2 .Q E W Zo V ce. V ~ Q S' B CO) 5 = w_I a WU Qw0 ~~~C i>✓ o a z m ~ E g rn q a U ICL IiN n Z V v E Y~ a V ~ it 11 CE CL w cc z3 o; ;~m > I v o o c Cf) 4) 0 Y o A k ~ v d i off, ~f m a` 3 • 0 co) C~ ~d I I .c s m U U - ~ m I I _ I 1 U -5 0 CL I'Ll \n 0 CL Q~~ E~~~ ~ V p I I 11 fl y fl ZL M w V c T m .0 D cc > ~ I to a ~ 0 U) a > w _ I a fl! W s 3 i I `n I _ w Z~ le a I I W N C co o cp Q W ca C 'a m a 11 w w I I W n d v, .i .I m I 4. W II ~ ~ mI Z C) PAGE 4OF4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Disoersal~ Area ORgratingLknits: Design Flow = gpd; BODs 5 220 mgL-"; TSS S 150 mgL" , FOG < 30 mgL"' Insoecbon Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, eta) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (ie., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exuding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., purrs re-cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (113) the ligtdd volume of the tank(s) or as required by local ordnance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent ~611 shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solid according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383-55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Phone: Local - s.. _ . government unit: ST CI~GI~C Cru~it~T. C`CMMQA) rTY LEffi hone: Local gone t unit address: -j!4 a A ~/tJ ZIP: Sam/ - Any detective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. CoraitfinAgrncy Plan, In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. Si► corn Abandonrwnt ff use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code_ f t Z r IF - O Z t G3 i rn m K3 ~v i w N ~aaets~~~ur ,Tl O ~ N C7D ~i Z suaresa ~ 9b Owa is JSN ! ISW11 rn I ZU-1d 'ON 1300W rust 9,a'onawa NO R-nd 13 5fl1N6MN dMo Y 3~f1S Y $9119NLLV7D7 FyNdMpli 3~LL ~dA&I i wAvT1/1~1M 't 3h01 W7LLVTk15W d~viurore~aoe _ _ 3>0 N ~ 1 m311"LL7n rn `b' `"S&` o v u' --1 Z N 1YIDi WM l8NYdMOId M z c3~$ dfl N mI~ cn T~.1 O a T\d ~ .tom Cr o O ~ w O t5! ~ 1 ~ rnCO C-) t➢h09ZtM :31L4 9518-5Zc-ooe d \ r 'UnOd 1 ' 3LV4 00/00/00 - 31do og/-i s UA '>ooa N3atvn of AMH sn 9iam W Q i1ff1M/Y4 OIld3S =anoa-3a .o-,t=.ti t 3lV~S d~ ~A9 t~dao _ \ w ~ Q V ca 0 W W J C.) fY 0: V) M V 3 p d z d m IN t1 m o 12 o a v, W an Q o cwk < o cid a z a Om a ~Fh% z 0 V) a. W_ a LLJ 3 O W O~ QJ J N Q mU Z L-L w F- W) U) D Q aqp O mI n w ti WW C3 CS j a O~ U a s °o M QOM ~ON co OF- = tnO Y 0 a s O Li vwiN mDIw M aQ Q9 ° z ~r Liz NW N O o Fw"QQ F Q Wa Wo z N~ N \N~..~N ..~0 k F 1 0 t- ~V Z 1n= tam x~ N ~....CO ztq . °~f- Zr~ Y c~ o~ W{n zd° °QOOQ4OOWQ~ Zc Q 2~0 U OOU 0 Q Mx N ~3momm 3:Fnn •c .rc~ Q$.. zOQ z ° ~o J J o z z _ a ota- v Q w I a i N Q .6£ O W I , K Of SNo .4 W Q L do 4,m V J N W .9£ Q N W~ a W o svo \g .5 do BO N Z V W OWN < .to Sd . ZS w to Y z FQ- 60."z f PAGE 40,'-OF 4 In-ground Gravity Management Flan QL) PMAt~I1'• (C it1 D The owner of tolls 3 urWmW gravity system WW be rase for ate p wpeterai operataori and m~ainlonanoe pwstxt so mquN+ennerds of SPS 302-3814. Wises. Ate. Coda py~ to SP5 383.522 (2), Wisc. Admin. Code, cis sydern 4W be corakk red a human health ha zed 6 not ~ accordance with this approved management plan. Furtherrritre, a8 inspection and mWntenarnce actinn as be parb"ned by a rspisssnsd POYYTS is rtribwr in ° . acoa daricewith SPS 383.52 (3), Wisc. Admin. Code_ o' 7 Dosip flow (lL gpd; ®OL>►a 220 mom. , TSS S 16D mW; FQQ S 20 Og#: 1 T EY JRY 3 YEARS 9 O type of use I m o alga at syalern o nuisance Mona (is. odors, user complaints, oft) m o mechanical maTunrlionn (Le., pumps, valves, 3 WK floats, era) 1< o rnaterisl Won (Eat., leadrs, breaks, conodtion, ) 3 o solids vokirie in anaerobic trvsrbtiert twnla(s) any done appurtertarios(s) (i e., datnbnhllort ► tltup trams) o rteglent or improper use (ie., erg des gn proud activities, etc'.) ° o extent of pondirg in won Calf prior to m o closing irregutadles If applicable (Le., pump floret swag seltirgs, ak) Cn o electrical ccmpornwft - if appiic (/_B., wR111$,I CGnMIaCGpng, wmb mW coi*ob. timers, aNows, ek) N_ o distrAwtion Iataroi or iater8l orifice pk g" {rneiwwe lakwW dotal pressure - congas to design sp n) o surfam de arge of efilnent ar sewage #i bpdc-up' into eeru►ed Iftbawm2befim AWA181 3 YEARS (or when necew4wy) ° shall be pvneped by a saptage oa along opa *w kamsed under s. 281.48 Wis. Stets v hu #w vokone of solids a the ) sooeer (Am one~ (4!3) the liquid vokeno of that toed*) or as required by lost ordnance. Dbposal of s1W be pursuent to NR 113, Whr- Admin. Code. o S ".(IlurLsi VINN be inspected oval 3 and shes be cleaned what nary b ramie any AM, nn soft ar "Crirg to manufadxEWS A aervking parrlod vA alarays be greaslm #w 12 i Spsaor n makftnance m pm ~ tie submitled to p "w tocai 9werwimt unk in acodtda me whit SM 383.66 Wbr« Adn*L Code- fb*m a W or maffiuw*~xn tar: Nettie of individual or company- ,_i_•___ - - _ Phaaec Local gow9rr "We unit.,.-. 5 f o Loc:d gcrrerrr<rrent urrl address an, Z1P - `rig{(}/~o Any deftebw pl,rt of Oft Syslem OW be repak d, or removed p ouard to SPS 383.51 (1). Mac. Admin. Code. Repair or n4geownert of fw'lsd or 14"OTOrctionir g shalt owngfy with SPS 383. wiac. Admin. Code. No product for chemical or ptnysical restoration dthe maybe used unless afgroved by the department in accordnee with SPS 384, Wlsc. Admin. Coda. In the event that any fated treernent component of oboe PE)YYTS ain not be repaired, it sha l be reptac:ed pursu nt to a plan aWynbed W the appropriate agency l r reviewano Mmmat. A fated in-prorW drsp'a W cornpownt maybe abandoned and reph oad by a cods-cwitpiyirng dispwW in a pre-delermirned area of suwtable sots. I 9 use of tonne POWS is dmWinded. It shell be sbendonetd in accordance with WS 303.33, Wfsc. Admin. Code. ATE. I Ile Quick4 Plus Standard Chamber 44ers maximum strength through ik$ two center structural columns. I 4i F his chamber can be installed in 36-inch-wide trench. Like the 'rt Original line of Quick4 chambers, affvrc advanced contourin z rt'r ~ apability with its Contour Swivel X: r onnectiolIT^° which permits turns ,3p to 15-degrees, right or left. It is -?iso available it hour-foal lengths to -)rovirlp opfimal installation flexihility 'he Quick4 Plus All-in-One 12 r7(.lcap, and the Otuick4 Periscope Two center structural columns offer increased ~IId are available with this chamber, Advanced contouring connections pr;aviding increased flexibility in Latching mcchanisvi allows for quick installation system configurations. Four-foot chamber lengths are easy to handle aril InSf f Supports wheel loads of 16,000 Ibs/axle with 12" of cove: r ...w.- s w Size Piuts' A{!111 34"W x 53'"L x 1211 fl 'tl „ r~g.cg~S «t (864 mm x 1346 mm x 305 rnrn) May be used at the end of chamber Allows for raised invert installations Effective length row for an inlet/outlet or can be 1 gpo directional inletting 48" (1219 mm) installed mid-trench -12" raised invert is ideal for serial Mid-trench connection feature allows applications Louver Height construction of chamber rows with 8" (203 mm) center feed, as an alternative to inletting at the ends of chamber rows Storage Capacity Center-feed connection allows for 47 gal (178 L) easy installation of serial distribution i systems I l" Height i Certified by the International 0.6" (15 mm), 5.3" (135 mm), Pipe connection options include II ~ Association of Plumbing 8.0' (203 mm), 12.7" (323 mm) sides ends or top and Mechanical Officials (IAPM(D) " APPROVED in