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024-1042-50-060
. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St Safety and Building Division Sanitary Permit No: INSPECTION REPORT 605031 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 3018575 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. City Village Township Parcel Tax No: Permit Holders Name, 024-1042-50-060 Joseph Koury TOWN OF PLEASANT VALLEY CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 5 $ 13-3 CIS 7- 33.28.17.275A-10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~JaGJ /I C,,-~ Benchmark L 161,2- 9$~ Dosing C L 1 3 / ~a Alt. BM ~1Ia. Ga / q 9 T • 3 p ~ Q 1O Bldg. Sewer S ~o Holding St/Ht Inlet lJ $ qS~ er( St/Ht Outlet ~ TANK SETBACK INFORMATION TANK TO A P; ~ WELL BLDG. ent t it Intake ROAD Dt Inlet Septic Dt Bottom Dosing 1 r / Header/Man. 5 T$ 71 '50 SI (P 3 Aeration Dist. Pipe Z 5 9 $ 7 Bot. System Holding Final Grade `r 5 q 9, 7 S PUMP/SIPHON INFORMATION Manufacturer Demand St Cover L e I GP'M)r T. -7 9ro Model Number 7 zgV D TDH Lift'' Z. Friction ossr 'System Headq TDH't t0 Forcemain Length Dia. Dist. to Well / 7b Z SOIL ABSORPTION SYSTEM BED/TRENCH WNo. Of enc s PIT DIMENSIONS No. Of P tls Inside Di Li quid Depth DIMENSIONS 5 7 C SETBACK BLDG WELL LAKE/STREAM CHL EA IN AMBER OR Manufacturer: INFORMATION Z 7 ~ Z =ZZO UNIT Model Number: DISTRIBUT1- aFcJ x Hole Size x Hole Spacing Ven Air Inta Header/Manifold Distribution i I 9 J N Pipe(s) L~ 311 Length Dia z Length I Dia Spacing_~ 1- 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only xx Mulched a Depth Over I Depth Over xx Depth of xx Seeded/Sodded Bed/Trench Center f Bed/Trench Edges --ems Topsoil Yes El No m[] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ /G/ J ~ Inspection #2 ~ad~ Location: 1780 8TH AVE 1if C a ~..J lt BM Description 1.) A 2.) Bldg sewer length = ~ I J 4- q 5 Pf d - amount of cover = " Ci Ire Plan revision Required? ❑ Yes '1N0 I Li$ v Use other side for additional informatioon.III L~i_lnseepctor's Si nature Cert. No. SBD-6710 (R.3197) Date 280=SERIES 112 hp Submersible Effluent(Sump Pumps The UbertY 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. 11 Designed around Liberty's unique "Uni-Body" casting, 30 9 the 280-Series will provide years of reliable performance. 25 8 All Models Feature: U- 20 s m ~ m • Vortex style impeller permitting passage of solids 15, 5 up to = 10 3 • 416 stainless steel rotor shaft .........acz, upper cI d lower baii gearing • Epoxy powder coat finish 0 0 • All fasteners - corrosion-resistant stainless steel 0 5 10 15 20 25 3b 35 10 45 50 55 60 65 70 • 1 h° Discharge U.S. Gallons Per Minute • Stainless steel bottom screen - easily removable I F T l i 0 38 78 114 156 132 228 270 • Maximum fluid temperature: 140° F. Liters Per Minute 280-series Cord Lengths Dimensional Data: Model 10' 25'(-2) 35'(-3) Weight: 291bs. 280 Standard O 'oral Optional Optional Heighrt:13" 281 Standard Optional Optional Optional Major Width: 10" (model 287) 283 standard optional Optional WA Minimum Sump Diameter= 287 Standard Optional WA WA ° 10' cord length standard on all moclels. For optional lengths, Model Model 281287, 283 VMF 1.140" add °-2,~ or 5" suffix to made! number. Example: for model 280 with 35' cord, order 280.3 Factory switch Model 281,283 Model 287 settings VMF Motor Specifications Turn on level 13° 9.5° % hp 60 Hz 3450 RPM Tum off level 7° 4.0° Oil filled, thermally protected (PSC) Permanent Split Capacitor The Model 283 features a fully adjustable wide-angle float Differential 8.0 amps (i 15V) adjustments can be nude easily by tethering the float to the dis- 4.0 amps (208/23014 chargepipe e or other mounting point Vertical float model 287 is not tnMo, odel 280 Model 281 Model 283 Model 287 anual, Wide angle Wide angle VMF-Series switch float switch float switch Vertical mag- with quick- with series netic float for disconnect (piggy-track) smaller pits - plug will operate in a 10° diameter sump c CHOus Certified Sp~ae=*%=tto ehange witlqut wti - - Lrberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 1441 e • Phone 8Q0-543-2550 Fair (585 434-1839 www.libertypumps.corn CopyrghtOtbedyPwWg trc.2M7 AG rights reserved ulr 2000 M6R7 6 POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page FiLE INFORMATION SYSTEM SPECIFICATIONS Owner f n Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer ❑ Nh 3ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA j Number of Bedrooms 3 ❑ NA Effluent Filter Model ~r I ❑ NA j Number of Public Facility Units ANA Pump Tank Capacity / b v al ❑ NA Estimated flow (average) al/day Pump Tank Manufacturer ❑ NA i Design flow (peak), (Estimated x 1.5) ~ J12 gal/day Pump Manufacturer ❑ NA Soil Application Rate ' ai/da /ftZ Pump Model o2~U F-1 NA Standard Influent/Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) S30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland T..L C , nolr~ V%aI l luspedeu.Sids (SS) <1 W nrg/L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA i Biochemical Oxygen Demand (BODs) 530 mg/L ❑ in-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) <30 mg/L t-Grade El Mound Fecal Coliform (geometric mean) 5104 cfu/100ml NA ❑ Drip-Line ❑ Other. (Maximum Effluent Particle Size 3a in dia. ❑ NA Other. Other. El NA NA Other: ❑ 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 every: ❑ mont(s} ears (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume ❑ NA (inspect dispersal cells} At least once every: 11 onth)s) ears (Maximum 3 years) ❑ NA (:.lean effluent filter At least once every. ar (s)s) ❑ NA Inspect pump, pump controls & alarm At least once every: 3 ~~~)s) ❑ NA {=lush laterals and pressure test At least once every: ❑ year s)s) ❑ NA ether. At least once every: ❑ month(s) tither: ❑ year(s) ❑ NA ❑ NA MAINTENANCE INSTRUCTIONS linspections 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 iinclude 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 ivisually 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 •egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of :he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. IqI other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, And 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. 1 County Safety and Buildings Division nn e I 4 ' 201 W. Washington Ave., P.O. Box 7162 Sanitary permitNumber (to be filled in by Co.) .fir 018 Madison, Wl 53707-7162 f= X052 7y 2" d x Cot! ntY State Transaction Number t r enC ermit Applicatio Wrs -Adm Code, submission of this fo , In accordance with SPS 383.21(2) n is required prior to obtaining a sanitary permit. Nom: Application fortes for srare-owncd POWTS are submitted to Pro Address (if differe,it than maiIin,,, adnddres-s-)__ the Department of Safety and Professional Servies. Personal information you provide may be used for secondary -7v0 c3 urposes in accordance with the Privn Law, s. 15.04(1)Lm), Stais. L A lication Information - Please Print All Information Parcel Property' Owner's Name ' ~ Property Owner`s Mailing Address property Location 33- Govt. Lot / Z City tate ✓ V Zip Code Phone Number 1./ISO,/. Section "14 T L, a N; or W IL,Type of Building (check all that apply Lot # r--- ~ Subdivision Name 2 Family Dwelling-Number of Bedroo ~IQ.uG~~.Lp ❑ Public/Commercial -Describe Use Block # ❑ City of CSM Number ❑ Village of Q State Owned - Describe li se r own of fn X S TH. Type of Permit: (Check only one box on line A. Complete line B if applicable) >:r A. Q System placement System TreatmentiBolding Tank Replacement Only ❑ Other Modification to Existing System (explain) q~~1ew List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner N. T of POVVTS System/Com Component/Device: Check all that a 1 nd < 24 in. of suitable soil ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil -'111 Q Holding Tank ❑ Otber Dispersal Component (explain) _ ❑ Pretreatment Device (explain) r De gn rsal ens Area Information: De rsfl Elevation sig Flow (gpd) gpd) Design Soil App ' on Rat (gpdsf) Dispersal Area Requir sf) Dispersal Area Pro System VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ° v U o New Tanks EXL=ng Tanta ~ 1 ~ d ~ ~ ~ Uv, v cn i:. C W Septic or Holding Tank Dosing Chamber 9 VII. Responsibility Statemen I, the undersigned, assu ponsibility for installation of the POwTS shown on the attached plans. p utb¢r's Name (Print) Plumber' ature MP/MPRS Number Business Phone Ninober I / Plumber's Address (Street, City: tare, Zip Cod r ? I 7 71 A,- 1 r i unty/De artment Use Onlv Permit Fee Date Lssu Issuing ent Signature Approved ❑ ~ / en Reason for Denial L IX Condi ,sons for Disapproval 7 . 5' . rk, a ttm iHte.. eh i 3 uFtpWmAt cell must all be s icas ' ~t r ec as per.'tarAgement pl&n pro nae i t,v r, iwnbe:'. (,d -tom , 1 I 2. All ufwk Must ae1--imt:e.e _.1 --G n,~--+ar~~ cSV~~C.- ✓ as pw #XHwbis cod. ,.rtfnar s; . G✓hd~ Attach to complete plans for the system and submit to the County only ou paper not an 8 12 z 11 inches in size 6V d SBD-6398 (R 11/11) !5) 6, System PLOT PLAN PROJECT Joseph Kourv ADDRESS 1780 8th Ave Hammond Wi 54015 N= 1/4 NE 1/4s 33 /T 28 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 98.0' 1.5' sand lift! DATE 10/12/17 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 40 Acre Parcel Scale = 1/4" =1 O' Property Line/Fence Line ~aL( pp ell i° o Old System is to be pumpedd buried tom. - 11 D~ - 1110 5~l Existing 3 ayO Bedroom House 35 Grading is to be done to divert run-off ID away from system 97' 96.5' Huff cutt Combo Tank B- 96' B.M.* o ~ ❑ B-3 Area 15' below B-2 system is to remain 4% Slope undisturbed 8th Ave cam. ~ 9EpAR7,~1E~ DIVISION OF INDUSTRY SERVICES 'til rofi 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 Q Contact Through Relay S ` z P http://dsps.wi.gov/programs/industry-services ?y\ w/ www.wisconsin.gov Scott Walker, Governor n~O SSION l b~. Laura Gutierrez, Secretary November 07, 2017 CUST ID No. 226900 ATTN: POWTS Inspector ZONING OFFICE SHAUN R BIRD ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD G,.~z NEW RICHMOND WI 54017-6409 HUDSON WI 54016-7708 7., CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/07/2019 Identification Numbers Transaction ID No. 3018575 SITE: Site ID No. 844482 Joseph Koury Please refer to both identification numbers, 1780 8TH Ave above, in all correspondence with the agency. Town of Pleasant Valley St Croix County NEI/4, NE1/4, S33, T28N, R17W FOR: Description: Mound System (3 Bedrooms - Replacement) Object Type: POWTS Component Manual Regulated Object ID No.: 1735151 Maintenance required; Replacement system; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original 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); 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(l 0), 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. All loose organic material to be removed from mound 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. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan Any changes may result in pump resizing to meet TDH and GPM Specifications. • Divert surface water from POWTS Area. • 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) SHAUN R BIRD Page 2 11/7/2017 • Tank Installation to follow all manufacture's recommendations. • 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 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 i This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your yment Submittal. Private Sewage Plan Reviewer, Division of Industry Services PaWyment Submittal. code: 1. 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm SHAUN R BIRD Page 2 11/7/2017 • Tank Installation to follow all manufacture's recommendations. • 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 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 am_ 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 Payment Submittal. Private Sewage Plan Reviewer ,Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tim.vanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 11~qIECBVE r01~' Cover Page OCT 16 iii'lj8TRY SERVICES Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 r G~ Date: 10/12/17 Owner:Joseph Koury Location: NE1/4 NE1/4 S33 T28 N,R17W 1780 8th Ave HAmmond Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section ✓ 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9. Filter Specifications and cross section Attachments: Soil Te Shaun Bird Signature License number 22 00 Page 1 of 9 System PLOT PLAN PROTECT Joseph Kourv ADDRESS 1780 8th Ave Hammond Wi 54015 NE 1/4 NE 1/4S 33 /T 28 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 98.0' 1.5' sand lift! DATE 10/12/17 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of steel fence post ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 40 Acre Parcel Scale = 1/4" =1 O' Property Line/Fence Line Well o Old System is to be pumped and buried ST DW Existing 3 aO Bedroom House Grading is to be done to divert run-off away from system 97' 96.5' Huffcutt Combo Tank B- 96' B.M.* Area 15' below B 3 B-2 system is to remain 4% Slope undisturbed 8th Ave Mound System Cross Section and Plan View . Dimension Feet J A 1 B J 1 1 D T ~r;.,:; ;:.:;:ti:;:.:;:.:;:ti: r {{.ri.:tirSr1r1rY1{.r.:.r.r.{.r.r.r.r•r•r•r•r - riif1f r1r4r1ryryr•r ti+l~M 1:5: J:t r•r•r~?• r:i•i•+•r• s ti isiryriririr1f ti.M1.y. yr1r~r 1.1.1• ~ jr r•r•r•r•f•r%rM1fyr4+yr ~ E r f:~ 1 1:ti:ti~1~ti t \~1 1 1f1~h~\11~•~ / •1 •1•ti•1.1.1.1.1•ti•ti.~.ti•y. fY•f.f.r•r.r•r•r•r•r•r•r.r•f.r.r.r.r.r.r.r.r.r.r.r.r.r•r L 4'~•~.•ti•ti•l•ti t r•r•r•f 1 .'y'%1.. f•r.r•r.r.r.r•r•r•r•r•r•r.r.r•r•r•r•r~f:i:i~i:i:i~i:r' r~J~flrti.t.ti.ti.h.ti•ti.\.~..ti.ti.l.t.ti.ti.ti.ti.4:ti.L.ti.4. I ~ W r•r•r•rY•r•r•r•r•r•rvr•r•f•r•r•r•r•r.rY F S 1 t G 1 Z, _ S I H 1 1 I <1 I 1 _1 1 J 1 1 1 K 01 i ♦ L L Slope 1- = Topsoil = ASTM C-33 , r = Clean aggregate = 4 in. sch. 40 pvc 1f1rti Ca Material 0 Cap sand fill /2 to 2 /z in. dia. observation pipe Geotextile G H Fabric D E Ft Contour Plowed Surface Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is vet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. r~ 10/071gj Page -of Pressure Lateral Layout Two Laterals - End Manifold .4 Threaded Cleanout Lateral Turn-up 0 Plug Manifold M X L Long Force Main Sweep i. 90 Bend r G^~ ~ Distribution Network Specifications , Pressure System Construction Lateral Diameter In. Manifold Diameter _ In. Laterals are constructed of Schedule 40 PVC Orifice Diameter in. pipe. Orifices are drilled perpendicular to X Orifice Spacing) In. the pipe with a sharp drill bit and face down. L (Lateral Length Ft. Lateral turn-ups terminate with a threaded M (Manifold Length) Ft. cleanout plug and are enclosed in a 6-8 inch Force Main Diameter In. diameter lawn sprinkler valve box accessible Force Main Length from finished grade. • Grade 6-8 Inch Lawn Sprinkler Valve Box C Page _ of 03/05 lgj Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tank Model Number c: Pump Model Number -Total Tank Capacity Alarm Manufacturer c/t? " Max. Bury Depth Alarm model Number L Switch Type Filter Manufacturer ! Total Dynamic Head (TDH) - Feet " Elevation Head Filter Model Number j, Distal Pressure •-Network Loss Minimum Pump 'erformance Required Force Main. Loss GPRti Ft TDH Total outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole Securely Mounted With Locking Device < 6" Below Grade Sealed Watertight Weather-proof Junction Box Finished Grade - " - " -i Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter ---,_i _ x Wet Baffle Inlet A " - t . 1/4" . and Reserve Capacity Switch Settings Weep GPI B Hole Tank Volume = S Dimension Inches Volume Gal. (reserve) A , C Elevation B ° 2 3 Off (alarm) X, Ft Bottom (dose) > D Elevation (dead) D ~J Ft Total I septic/dose tank is bedded and -beck filled in accordance with the GENERAL INSTALLATIt3N` The septic fied by to ~ufacturer may not manufacturer's product approval specifications. Maximum depth of buiv as specified device (padlock) be exceeded without prior approval. Manhole covers exposed to grade have an effective lacking roved material, watertight fittings, and connected to the tank with installed. Piping at the inlet and outlet is of approved force main is sleeved with 4" Sch. 40 PVC to bridge the tank laid on stable soil to went settling or sagging-. lies with NEC 300 and Comm 16.211. excavation and the sleeve. is sealed watertight. Electrical service complies Page of 02/05 L) r- TOTAL DYNAMIC FEAD/CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUENT AND DEWATERING v3 MODEL 152/153 , 152 153 MODEL M 50 Feet kleters Gol. I Liters Gol. , Liters 5 1.5 1 69 251 77 291 153 I 10 ~ 3.i 61 231 70 265 12 40 152 15 4.6 53 201 61 231 20 .1 6.1 1 44 167 I 52 197 S 30 25 7.6 34 129 I 42 I 159 ; a 8 30 j 9.? 1 23 87 i 33 125 Z , ! _ i i2 b5 l I 20 42 40 12.2 - 1 1 o ! ) - Lcc Voive: 138.0 Fi. (1?.6-n 44.0 ;t. C3.4m 4 ~ oiasoa 10 I 0 20 40 60 80 100 GALLONS 6 1/4 LITERS 0 8O 160 240 320 _ 3 27/32 i L, 5/e FLOW PER MINUTE i 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS • . o 3 27,32 • Timed dosing panels available. T • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable r-- I i level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 12 11/5 -11 1521153 Series 1521153 MODELS Control Selection 5 1/5 I Model Volts-Ph Mode Am s Sim lex Du lex i r N152 115 1 Non 8.5 1 2 or 3 SK20e4 8N152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Inclu:ed 2 or 3 N153 115 1 Non 10.5 1 I 2or3 SELECTION GUIDE BN153 115 1 Auto 10.5 Included 2 or 3 E153 1 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE1 E153 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. p CAUTION All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex licensed electrician. All electrical and safety codes should be followed including the most or (4) float system. recent National Electric Code (NEC) andthe Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual canditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Mamdf cturersof _ SHIP TO: 3549 Cane Run Road Q~rLTY W'5.l/HCF lgpp ZD - '~s® Louisville, KY 40211-1963 PU (800) 928-PUMP l,O. (502) 7-7&-2731 FAX . (502) 1 774-3624 http://www.zoeil er. corn © Copyright 2000 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE YNFORMATION SYSTEM SPECIFICATIONS i Owner :To _(ta Septic Tank Capacity al ❑ NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms I:] NA Effluent Filter Model ❑ NA Number of Commercial Units NA Pump Tank Capacity al ❑ A Estimated flow (average) alfda Pump Tank Manufacturer Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer ❑ NA Soil Application Rate al/da /ff Pump Model ❑ Influent/Effluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) S30 mg/L ❑ Sand/Gravel Fitter ❑ Peat Filter Biochemical Oxygen Demand (BODS) 420 mg/L ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 m /L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average" Manufacturer Dispersal Cell(s) 001- - Biochemical Oxygen Demand (BODS) 530 mg/L ❑ In-ground (gravity) _K0, round (pressurized) Total Suspended Solids (TSS,) S30 mg/L ❑ At-grade /und Fecal Coliform (geometric mean) 510` cfu/100m1 ❑ Drip-line er. Maximum Effluent Particle Size Y inch diameter - Values typical for domestic (non-commerclao wastewater and septic tank effluent Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months ar(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every ❑ month ar(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months ear(s) Inspect pump, pump controls & alarm At least once every ❑ month ar(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ear(s) ❑ NA Other: At least once every ❑ months ❑ year(s) NA Other: At least once every ❑ months ❑ year(s) NA MAINTENANCE INSTRUCTIONS Inspections 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 combined 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 (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. or pressurized POWTS components, pretreatgment components, and any The servicing of effluent filters, mecl other maintenance or monitoring at intervals of 12 months or less 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. START 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 that 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. Page of START UP AND OPERATION othe hElt oftth0 For new construction, prior use of the P d~a Check d spersaltcell(s) tank(s) If for the presence of painting high concentrations are d to ected have thercontenchemicals may impede the treatment process and/or g 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. wastewater During power outages pump tanks one large above noal , over oadig~eecell(s) land may r suit in the backup or surface ischarge of efflulebnl discharged the dispersal cell(s) i 9a dose power to thie To avoid this is situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring p 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 POWT$: 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 producils; 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 properly and safety 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 wil, 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 comp iron 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 requirled setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nfled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule:i 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. The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation m be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installedl as last resort to replace the failed POWTS. /Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative ce. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNiNG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL. GASSES ANDIOR 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 r.~ Name Phone j r Phone f K J SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY Name C., f r 'r. Name Phone % ~2, Phone 7 ) - L 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. W3 32_ P _Q r~i tllY. lI t ~~iflfl: I F j 1- ~o m-- ~ P O ~ I fJ J Qo C ~ Q O h vi D f N~ Q ~ u Q z co 3 O w c Y a ~ I 1 L _ (J ST. CROIX COUNTY SEPTIC TANK MAINTENANCE t',GREEMENT AND O ERSH[IP CERTIFICATION FORM: Owner/Buyer aU - - Mailing Address Property Address (Verification required from Planning & Zonnig Department for new construction.) n. City/State Parcel Identification Nur:aber 2 - J J LEGAL DESCRIPTION Property Locatio~ 1/a jj~ , Sec. T Z~N R Town of Subdivision - - , Lot # _ Certified Survey Map # / r ~ c 't lame Page # Warranty Deed # Volume , Page # Spec house yes no Lot line:; identifiable yes 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, ii 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 wasl:e disposal system Owner maintenance responsibilities are specified in Womm. 83.52(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 ins ection g p 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 b m, by the Department of Commerce and the DePartrnent 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. I/we certify that all statements on is form are true to the best of my/our knowledge. I/we anJare the owner(s) of the property described above, by virtue of a rranty deed recorded in Register of Devils Office. o N±oflbed > OF APPLICANT(S) DATE hat is misrepresented may result in the sanitary permit being rovoked 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. 08/05) RIB/ Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and BuildingeCT ` 4 Z J 1 i in accordance with Comm 85, Wis. Adm. Code l Attach com ete site la OUNTY inches in size. Plan must County pl p :at~ 1 inches in size. Plan must include, but not limn I P1tCe point (BM), direction and Parcel I.D. t~ ~y percent slope, scale or dimensions, north arrow, and location and distance to nearest road. j V 49 Please print all information. Revi by Date Q Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). Z P operty Owner Property Location y~ ffL2 V,~ i:1 Govt. Lot 1 /4 ,1 A S /-3r 6 N R E (o W 0 5 LL F rty Owner's Mailir)d Address Lot # Block # Subd. Name or M# y w , 7 © 4 tom' State Zip Code Phone Number C. ❑ Village . Town Nearest Fjpad ~ji~ t~ o CL G `C ~ rL! lam' .Ilia F,ig~ [b Construction U'fse esidential / Number of bedrooms% Code derived design flow rate GPD Iacement~~C~- ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable r ft. General comments and recommendations: System Type ~9 L J V~-r 1 System Elevation ' 0 ~4 Bori # El 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 GPON in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 C J r. r r r 6 2' lcz~ Boring # ❑ Boring r- Pit Ground surface elev. ea 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 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 nVL 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 54 --~r1 715-246-4516