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HomeMy WebLinkAbout020-1269-50-000 (4) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 605029 GENERAL INFORMATION 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: Eddy C & Richard Burt TOWN OF HUDSON 020-1269-50-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ~ co 1 A t, G 5 21.29.19.1329 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic + 4-+ r uv r Benchmark Z Q 0 /'oG ~CPi~~ r Alt. B Jam, F. (J." 5 `l • 92.68 4-i -14A 'r,i - Aeration (/~!Bldg. Sewer •5t , w t 1~i~► r4~,,. i t ~ T"= Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet °I • ~1Z-9 TANK TO P/L WELL BLDG. en o Air ntake ROAD Dt Inlet ►I Sept' i -56 ~4 a Dt Bottom 'j )P O~ / Header/Man. ElQsAQD- 3 mh Cho F;, t 1 7 9a . L Aeration Dist. Pipe 776 • Z Holding Bot. System Z, qAQ. ZS, 47• Z PUMP/SIPHON INFORMATION Final Grade A 9,6 • $ Manufacturer Demand Cover `I Z 0 GPM S /J Model Number TDH Lift Friction Loss System H Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTIO SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 1 76 7- ~t. % ~ J~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactur /~~1 INFORMATION CHAMBER OR Type Of System: + Z-7 76 156 UNIT Model Nur~l) ~ DISTRIBUTION SYSTEM Ss d f- l 7 Header/Manifdd Dn x Hole Size x Hole Spacing Vent to Air Intake P ipe(s) ft-- - - tj00 Length Dia_ Length Dia Spacing -5- - I i SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/ odded xx ed Bed/Trench Center + 2 Bed/Trench Edges Topsoil (p J ~ '4_~ Yes ❑ No ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 500 PRAIRIE LN / - j 1.) Alt BM Description C.~ ~l~ 2.) Bldg sewer length = + Q - amount of cover = ~x t 1 l ~p~-j~~ Plan revision Required? ❑ Yes 1 1$ 6 2 7~ Use other side for additional information., , L4 Date IActorr's ature Cert. No. SBD-6710 (R.3/97) IOU - du I 35- txvmm 1400 E WoMmom Ave cRoj K i { ,JUN 0 4 2018 P.O. Idolt 1162 M*diao's, WI 53707-7162 P=t MMWW (to be MW by Ca.) ix County Community A rmit Application saae : tm aloe with 3Y9 3&321(21, Qra Adm. Code. shmiaeim aftktis fam to tie appsuprime f ,it ' a mquaod pna to obukkiq a swimy paw 4- APO-tbm farts Ix s0as"Nued FOWTS a* K*M*ad m the Department of Sedety and hdbu a W Sizriaxs. Pss mW mtmsuim you 1~ Mary be used for sat mdlay t~°~°d1 Add" {if cliffiasax thsa mialisg addnm) m xx xdlm wilt far UK S 15-0411,91 Simi L hmfmr~d" - rates rraa AM h*,=wm ct5 ~i7h rR rE t: ft Me~ Propaty C vww"a Namc i Paecd e EDOy C. ~ RICHARD &(97T 0~-1W-Sn-00 0 Pfoputy 'vMsihmSAddmn z gZ H wY , 3S Lncstion - 19 r 1 Coy. Stage zip Coda KnaAbar GovML t Let DSbA) a - 5 f7/ Al hl y, _AR Y, Seam -?,4 "V IL Type of Swul g (&Wk an tbot a lr) T N, R _Lt_ E I or 2 Family Dwdlieg - NuvttbW of r` 3 to W Sut#ivww;G; © RtblicJCoe>morepd-UearnbelJst H{Od[t j ~f} 11>(v I1 t~~ Q City of 11 Sbt- Owned - DDwmU Lim +I -f 13 vdiew of Z \ 'br- 4. J ~ / ~ / Tovm of Ci.pr.5GN1 III. Type of Pexaait; (CLtadc sate aa► 0trc A. Car pkb tits B if apNiaaLia) A. ❑ Now Sym m lieplaatatertt Sym- ❑ TtaatufOZ~°'6 T..k RP6oamauc Only ❑ C)etm Aiodii5cgtion to TixigiEaa SyataR taxptafn} EL D P- Rif its a vat 13 r?~mic Rev== Q QwW ofP6rasaber a rrmrfi, to Now 7/'~,ag xmmbw mid n.s Reuss Bafnre a*rabw 7V IV, T efPONM V Naa?rpssurirsd i:..Gty ©pmwx rnd in-4roemd 13 Ate O stnmd > 2t is tit ie -r-, <?A io of suitable sail ~tJ'S xadiag r Dtaptxatd C-V-m K (o*iniA DQIWG. FILTEQZ"~t11~. rc~J1t'Pr t Denm{explmjm Y, DaPauMmOket Am khnaaa** Design Flaw (a) Daaaipn SW Ap wmftm Rai lmpavd Am RRgaked Iliapetse[ Arai (s0 System FlevatiaR ti D 7 lo~fL. 94, o o f vl TRRk Ish caps city m Tana! r of Galiom NOW T,wis Prigtir TrOca t ialltled units j VIL RmspwmApWy Stabseeaat- 4 toe awRrttiis* autatt far h0bued" ei fire PC1rY is sites. eR n,. P Nam {Prime a ° Nrmabw BUWAM r Pltoge Numbs {fR( 2Z ct~3 j ~~S_ 5?c~-285+6 's Ad&m (Sti( City, &We, 4 coat) 5 E. Nt S7 . Ci4+~7'T Gti11 ?Z ~✓v • G 7 / S $ O for jemm r '61% v:o ce li must all be sii% Ic:?s -its er. mpor.Taar3gement plan p!o rideh by p u nbe.. 2. J1fitt!ellt~rdr ne~;it~st:sen,s tntrsE t,r: r,.~.,rt, ir.e aR pK t~~bla cridro ! ti:rd;~i,~~ AaU1gY sesuq~igr lYrg igr a►g gVIM art ararrit gs M Cagref set) w pass so bw ftaR art ail to bw k do SB D-b398 (R.. 08124) PIM PLAA t1da3 Y j`) IPA TOv2s'su P L` sew SEC. s;j N-R tulpR:SS sj y as Si. C.-t oi-- LUJh=, k-J.5CGNS11,; ✓✓VV~ 1~ ~jj~MV \ n sUB?Ii-jS=JFt K_r. s 4z+ d LOT LOT STZ3 :f~7 l~CrrrS PL i I 9*1 ~ ~ '~V' ~ $ r ~ lttD+ c,~r~R C M : oD (~k-Atr~~e vu/ f7~rsc ~ ~ 3 I tJ. ~ 1 DIVE'TER r s4 E s 4~ 73 tl ~ U t{-ts•-ji , i Fl ARRow Elevation of vertical reference point: /Q3•p` Proposed elope at Site: Sw S°SiIf TALC: ?ta'ufsei¢rer: LL)4 1 a C.-,- Number of rings used: ie Tank manhole cover elevation: Tu=ck Iz:et Elevation, Tsnk ^.atlet Elevation: btaber of Eeet fro; neareEt k:ric: r'raet,o Side Raar, G) l f Q , feet t From nearest propaaty l ne front: JSida~Rear, 2 _ feet flumbar of feet frcat: -well 4 a` uLld~tg: ~S CTacluGa LtIs =formation of the above r_ t plsa) ( 2 reference dine=siaa~[~ to "ptlc task) In-Ground Gravity Plan Index & Cover Sheet CWOMW v SBo io7 fro R. a12) Pg 1 of 4 ndex & Cover Shut Pg 2 of 4 Plot plan Pg 3 of 4 Dispetxsl Area Crops.-Sec#ion & Plan View Pg4of4 Management Plan Aftachmerft* ~ ~1 r R s~<s POW M l# m*m for Review rk - So11 Evalu ' a#>!on R ~ Stfie Ma FtU-t-tx T N 5 fS >&Kic TAJ ' eA7-T {ou S P409 J~t J NOV ON F I L~ ' Projout name I Description .~to W G57" Owner Name(s): EDDY C. RetiA?,b 1 , R-r Phone: Owner Addra m: ice= N wy 3s~ r~ urns rr1 Zlp: _ 5Voi Prood Mdt+erss: 5 &i r, L tints 4 QOHt< Lot: Id Of N 114. Secbw Z t , T µ t E or wM Township: f 1 uDs an} County: 57 c RtxX ! Project Pamel ID S.- I PO 0 Digner Information WWgnar Name: -MAM cc Phone: ?)S ©esigner A+ddt+ess: 2-iq 1 /tit A&r +u_Rs Cf a~.... ap; _ ,5yB Cr E-mu: h Q u sitriesiati Thu 4~ wi.. •.tfir L k-ense Number t S" - a0 7 F~ • stamp. Remarks: 40 I'Ii1PP 4 i ~ FAfig~ ?y Shure: Hate: j Feat PLAA TG;~M ~ SEC. a 1 T ?I_N-R-~1(~X& ~ P~ r'MT `w/ A7}DR:SS . I Si. CRCL. CQU.t~, WISCGNSIN nLtt//J 44~ iW~V/ VV'~'~~✓ S7$DMA:ONt,:vr r. u,,, LOT 7~~~ 11 ~Uj LOT ST2S 0 l~t't".5 / PL NN ZL'it X yryli j f a IP 7 t tltiz lea OF cF r i- ~q LD Aoni,u~F,~r~r~ (Stsr"foht' 9 ai?t , S o s:yy I ~ ( ~ i } I=} 3'xp0'Tw.•tlcWt3 , r ~ ; ~ f '4LI ~ N ARROSJ i 36>~ Elevation of vertical reference point: (QJ.Or Proposed slope at site: %T S--f SSrTIC TANK: Manufacturer: UJi t c.r Liquid Capacity. Q O J2 gL,_ Ntmber of rings used: e~ Tank manhole cover elevations Tank L-aet Elevation. Umk :aclet Slervatian: i NL.^oer of feet from. neatest- R.:Adi I'rott10SideoRear.@ feet- Frorc nearasr propazty l ne iYont, 3ide,~R.r,O 47~ feet Number of feet frox: well ` a tttld:ttga ~Sr Clncl"a ch.,a inforsation of the above ;..s:t plan)( 2 reference dinension to "Ptic tank) (WEST L-07-) PAGE 3 OF 4 9 Z a (3 t!s Z - ~ ~ it it V4 ..,j CY r r r r x O a a own PAGE 4 OF 4 !n-ground Gravity Management Plan IMPORTANT: The owner of ft u kt-ground gravity system shall be responsltie for Its perpetual operation and mu*Aanart:e punwant to mgccirerratts of SPS 382 3&t, Wisc. Admin. Cade. Pursuant to SPS 383.52 (2). Wisr- Admin. Cade, this system shall be cansWered a huaw hm b hazwd # not n ftned in a=tdance YA ft approved marragwiwit fin. Furtttannore, all iaspection and mehtenance ad#vitiee shall be performed by a registwrod POWTS Malnhibw in accordance with SPS 383.52 (3), Wisc. Admin. Code. MWtttum Dispeml Ares 4O@ra*w r L`knfts: Design Flow = gpd; 800j:5 220 mgL'; TSS 5150 nvW; FOGS 30 m9L-" kapection Ch+rckllst INSPECT EVERY 3 YEARS o type of use o age of system o nuisenoe factors (i.e. odors, user complaints, etc.) o mechanical matftmcdm (Le., pumps, valves, wAtche% floats, etc.) a material fatigue (i.e., k%*s, breaks, corrosion, etc.) a solids volume in anaerobic treatrrmM tank(s) and any distributim appurtenance(s) (i.e., distribuiiorn tdrop boxes) o neglect or improper use (i.e., exceeding design capacitias, Prohibited acliv tkm etc.) o exterd of pornding in distribution cell prior to dosing a dosing rarities - if applicable (i.e., pump re-cyclka float switch settings, etc.) © electrical components - if applicable (i.e., wiring, connects, switdms, caonnbols, timers, alarms, etc.) o distribution lateral or lateral atifloa plugging (meast" lateral distal pressure - compare to design specsfficeticxn) o surface diedw9a of eftie nt or sewage back-up into structure served AAahntemage Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o se2& and dose ten(ds) shall be pumped by a certified sept%p swvidng operator licensed under s. 281.48 Wis. Steft when the vdolurne of solids in "to**) ex+cea4s onatt" (113) the liquid von ung of the tank(;) or as required by k=W orr5na ce. Disposal of contents shy be ptmmnt to fit 113, Wisc. Admin. Cade. o Effl t fiitsft shit be inspected wary 3 years and shall be detained when rrscsssanry to rertmve any a=mL afied solids according to mam adurWe speaf horns. A servicing period will always be greater than 12 months. 4 SysWm maims reports shall be sub mitbd t* the pr+apar local pov wnma#%t w* in aecordsnw with SRS 383.55 Wise. Admin. Code. Report any con ponent %b um Ot mat hMCtion to: Name of individual or cxmpaw. A OVAL 0 V= D -SSMC U--,nI W Phone: -7D"3-k:a3 7 loci gavarnmer.demfi Cf2fltX COMMt,~t DEVE PyM N"T' PtECxno: 7~~- 3 !o- Laval governmen# unit address: H u DSO , WLT- zP: alf)I ~y Any defective part of thie system shah be repaired. replaced, or ramoved pint to SPS 383.51 (1~ WOc. Adrnin. Code. Repak or replacement of faded or rn8ftMflortrng corrPW" is shelf oorroly *ft SPS 383, W#sc. Admin. Code. No product for Chem" Of Physical rAStombm of the POWTS may be used uniess app"wed by the department in accordance with SPS 384, Wisc. Admen. Code. C0ntkM21ncy Part In the event that any failed treatment component of *is POWTS cmw'ot be repaired, it WIW be mpravad pursuarrt to a plan submitted to the apppriate agency for review and approval. A faded inVotind dispers;W cxmnportent may be abandoned and replaced by a Dods-complying dispersal oog nponrint in a predeternnirned area of suitable sacs. S3MftM Ab*0d2nrn0 if use of this POWTS is discontinued, it ahaq be abandoned in accordance with SPS 383.33, Wisc. Adman. Code. Quic~r4 INFILTRATOR' The Quick4' Plus Standard Chamber _'OuickAl Plus-,r~ The Quick4 Pfus Standard Chamber offers maximum strength through its two center structural columns. This chamber can be Installed in a 36-inch-wide trench. Like the original line of Quick4 chambers, it offers advanced contouring capability with its Contour Swivel Connection TM which permits turns up to 15-degrees, right or left. It is also available in four-foot lengths to provide optimal installation flexibility. The Quick4 Plus All-in-One 12 Quick4 Plus Standard Chamber Benefits: Endcap, and the Quick4 Periscope • Two center structural columns offer increased stability and superior strength are available with this chamber, • Advanced contouring connections providing increased flexibility In . latching mechanism allows for quick installation system configurations. • Four-foot chamber lengths are easy to handle and install • Supports wheel loads of 16,000 Ibs/axle with 12" of cover ,i Maximum Strength Quick4 Plus Standard I ~ Specifications size Quick4 Plus Ali-in-One 12 Ertdcap Quick4 Plus All-in-One Periscope 34"W x 53"L x 12"H Benefits: Benefits: {864 mm x 1346 mm x 305 mm} • May be used at the end of chamber • Allows for raised invert Installations Effective Length row for an Inlet/outlet or can be • 180° directional inletting 48" (1219 mm) installed mid-trench • 12" raised invert is ideal for serial Nv - • Mid-trench connection feature allows applications 3MERm Might construction of chamber rows with 8" (203 mm) center feed, as an alternative to inletting at the ends of chamber rows StaMa Capacity • Center-feed connection allows for 47 gal (178 W easy installation of serial distribution systems invert "ht Certified by the tntem banal • Pipe connection options include 06" (15 mm), 5.3" (135 mm), Association of Plumbing 8.0" (203 mm), 12.7" (323 mm) sides, ends or top and Mechanical \ Orfiaals(IAPMO) APPROVED in