HomeMy WebLinkAbout020-1380-34-000
YVsrnrs it Dcoa't-'en: C'Cit -°-vice PRIVATE SEWAGE SYSTEM Cun:y. St. CfOIX
t:'lvi and 8-leing Divs -jr- INSPECTION REPORT Sani:ay , er-• T Nc
;ATTACH ?O PGRP:IIT 606935
GENERAL INFORMATION State Pt iDN,
Pe Bor'al -fw-annn you p'oade mai ne, Ucvd'c' SCconga'y CUr:rseS i"i,:apj Ld» a.' i ea ;1 r:
'cr-'t Homers N'amC.
CAj 'v' 'age n Pal T.;x Nn
Jeremy Parker TOWN OF HUDSON 020-1380-34-000
I
CST3VElev 1 J-5a BMLev. BIADi Dlicr SccLen+Tcwnr RangeMap Vc.
160 M 1 11.29.19.2360
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 1Z
es.,~ At: BMF~
Aeranor Bldg Sewer yy
He cint F 2.b5 ~~'L
- SVH; Into!
TANK SETBACK INFORMATION TVl Outlet 7-5
TANK TO t'tL WELL BLDG V r Irlall ROAD Dt Irlet
Sep: C ) 5a -
3fl goo , Dt Boacrr,
Dosing
Header!F.9an
/02.3
Aeration
Dist Pipe.
Holding Bw System F(~
Final Grace
PUMP/SIPHON INFORMATION Lo 4 /O~. 3
lctandfac:uror Donlan- St Carer
GPM /z,3. ye
Nlcdo~ Nr.moer
/ l s /u1.35
TDH I_iF f nclion Loss System Heal TDFL- N
1 ~,lo /00.3
Foroema r' l e wl Cisl. iD Nir I
SOIL ABSORPTION SYSTEM y,Z5 IS. Z. 173• Z<-
/b$. 6
BED.-TRENCH -lln . erpUr Nn DI r'•: nc-e- PIT DIMENSIONS No. Of Pits. Irside Da. Liq.,id Deatn
DIMENSIONS
SETBACK SYSTEM TO (J PiL BLDGII WELL LAKE:STREldv1 LEACHING IAanctact.r `
INFORMATION Type O' Sater- 2t ) CHAMBER OR
7 IJ7 7 / v UNIT Jc V_m
Co
Q
15
DISTRIBUTION SYSTEM 1 HZZ~ Jrj
z0Z
Heace.'; Man l~IC f G;rit..tic' xliotesize +.I ce Spacing •c~~1..ttu Art l~take~
_ncth~ ❑ a I e-q:n _ Dig Spam'.;
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
17.1. 0- -)el Cc'
f- xDeo' u f
Seeded+SOdCCC ImJ'TrerCh Ccnre4 xa NuP^uc
r en:lrencr Edges IaDscI
Ycs Na Yes No
COMMENTS: ilrclude code clscrepencies persons present, etc) InspecUOn Ht Inspection #2.
Location: i PACKER CF< r
acl. ar-
j Alt BM Description =
2 j Bldg seiner ill = Al %-33 37
- arno,lnt o' cover = I /I Q
> 44 2 e er.1CJ`
Plan revs on Re0l q 4.
Yes No 1' 'Z 1 /
Use other s de for additional infonna!,on _ v
SBU-c'70 iR ~f9~1 Da1c Irsep-lc"sS a'.ire r:crl Ne
Sfl~ ao)B _ 3l -
I
Safely and Buildings Division County ..TT•
201 W. Washington Ave., P.O. Brut 7162 Smeary Patent Number (e be mind c by Co.)
► f MsdtsO(t ➢W 53707-7162 q -
t q j; ( (5 S
~
~ I
- - lUdc Traosacdan NZff
I A19 - -Sanitary Permit Application
in aaxadance with SPS 39311(21 Wix Adm. Code, mbcwo= of dw fan to the appoo(ma r govmwmrd
u tequoed prig to obravrmg a momay panne, Now.. Appbcaooa forms for sustc-owred POV67S art suietitoed a Prol= A trdtdwam than mulios addrow)
the Dopwtmant of Safety selProkssia d Soviet. Parsutut mfineao:a you omvde env be used fix secondary -Del, purpoets ir, wcardasre with tic Privacy :aw s.:5.01(1 m) Stma Ir
LP'r ✓G
L Appficafioa lafonaation --hease Print AD Infa matioa
PrcarY_Qwnar's Nacle Parcel f
ire a r ce Y D2-0- 13S- 3l -00
6 f>'t Govt Lot
City.pt~~e zip Code Phone Number ~.i-7
'4, section
-{1 KC~5 0-Y-N
T 2 1 N; R ( EaW
IL Type of Building (check ag that apply) / 1') fat e
a 2 Panay l)wytotg - Nuclear Of flock s `1 .3
S I I , _
C' CLU~'H'l r Jar Kt.car Biat A GfC` `7r
1 JPubleKatsnrcat-DracTeex Doc.# ~0666(~
❑ City of
❑Sme Owned -Ducabe Use CSK Numbs ❑VMW ce 1
Town ar 5
Ill. Type of Permit (Ckwk only one box on fine A_ Complete lice B if appfimbk) p
A. )~-New Synem Rrplasmw System [ Trotmem tfoidmg Tact fen, )awmam Only Od,v Moaifvmon to Eumtrg Sy,oon, (monet)
❑ Pavmi: Renewal C Perm! Revisioo p o: Plumber 1 Patent lraafer to New• lis Pnn- Parout Number and Dan lserd
Relate Fxpimtion clw" P So L4S b - t I l g
W. Type of PONM Syefom/C maUDevkc Check all that apptv)
Prr ..zcd ht-Ckou d ❑ Pteanmed ft-&ou d C Al*:bde _ Mound > 2e is of stiubie aoC ❑ Mound 24 in of sunable xel
C NoU4 Took Othea Dispma; Canponan: (cxpwn) ❑ Protestant: Des (00401) 1
V. D' Trateneat Area Lformatirm:
Desist Saud Applictian RseeZmisf) Duxsal Area RmIa
Oman /IFlaw
(sf) Aspusalaall Am+Proposed ( I Syyftc'evaboo oil
3.
CL ICJ ~.1 SS-I
VL Tank lab Capacm M Total A of 1 a
Cdlau 'ualiaae Ihms ~~p 1 ° C /5 )1 u 5
Kt Tank, cos Tewa I ' ~Jly''
TT / Y
Sage w gall Tan! f - -
Dow" annon
I
i VIL Rea ibl ' Statnmat- f, the undersigned, assume reApgasibility for' men of Me POWs flown a the aWe►ed
i Plum (Pnkl) Plumber' WI%WRS Number R:euhww:e Phone Nvmbat
elm 23131 ~cs{~~2-SZb
,jDhr-\
rat
VIII. Cou /D artmat L1u Oa
Approyd C epPem"a Permit Fee /Dan inuad, semi stpunus
-
o t>m tRraoa>o Demo 85 r O?D
DC. Coadhkma of ApprovaMaroas for Disapproval 3
J 4 c2vn~lrt ~k~a / e /J
1~~,a~P+M y)j~~u•yvl. J,U~_,U,f.r ~t.}sY~C sys.Ge.., r
w+MpIP we two ~prn pre. kr wccevd~,~ faS ca zal `7a ~eal~
odwatananna
.Pr mommorow .Y;wtt r `CYMr rif r Pa. wee I. v t It x It 6" ie ass
~l"~'9e-r--
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SBD•6?91(R 1111) 1. ft w Ink, *akin or eM
dkW.ta, *A rtswt at
3tfl4fti i
sat par.narayarnen! pVan p'o tided by plumber.
2. AN Ylbw* aep.ket:nras must tw ramartred
as pet eppkWR co& f .rdinmloes.
SITE PLAN
j wa I< E-'' "
NW';a SW'; Si I1' 9NikI9W - j (n
Hudson township
St. Croix county '
I . FGFND
K- back hoe pit
• - grade elevations
contour 4;,
No DSPS ',81 set back
-
nrobtcnts
y
Serale F, - 40' except
I - v\
where indicated t„, s, t
1 4f
Lot 34 of i" .addition.
of Homestead Plat Ut. e
.?I 'A. C. a AJ-' /yob
colts ft bN 90a l;Icv. ci8.0' thru 95.0'
c its;
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9~ K7
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project: PARKER pa,e 8 of 8
cop,
I I.'gal.Y
Wisconsin "ON unJ tint Alnn:. Dill vw,
70 U tt'a.h nttWn Ale 11.II Ihn :le.?
Department Mlle(Y and lint 1'nn.rl NantlnnWlA• Iit4J uhY I I. I
{ : !l I`. ll;ulivtn ttR;1`117. ?I~
Professional Services 1
~az State Sanitary Permit Appliica ion
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r pr t'ppicri* CrI6. 1. McYalrt;
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l
V;isncrsin Depa'tm=n: ct rr^^-sr•e PRIVATE SEWAGE SYSTEM Cc.mry St. Croix
.`:n'et': d: tl N.tJrm:: U v¢ma
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION (ATTACH TO PERP~IIT) State Ptah ID No$
Pe-son-lingnmat an•irt.nrr;dem.t;. sed far e_.n9ary G--rp-islPi v,cy t~~lspu•jnnll
n-rm I -4_Idrr'r. Namr- CrY `di age Tvrmsh P P::rre T..=., C.
Jeremy Parker TOWN OF HUDSON 020-1380-34-000
CS' 3t:. Cn I'1sD. Brad Ele•:: 1 Br'I Descnl Seel onr Lyrs~ lYmgerh9aD i
11.29.19.2360
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACI IY STATION BS HI FS ELEV.
Sel Benchmark
Dosing A I. OM 10 %
Aeration B;:g Se)Hodmg S'r •
TANK SETBACK INFORMATIONI'l II le'
TANK 10 PIL 'e^:FI 1 BID 'dbnl to A hcaa ROAD It Inlet4c
Septic Dt Bottom
Dosing Header.Tvlen.
Aeration Dist Pipe
Holding Bat Sys;crn
Final Giadc
PUMP/SIPHON INFORMATION
Marufactjfe• Demanc St Covet
Gl
Mcoe: Numoer
TDH Lilt F'o::h rn I css System Head TI)H Ft
Fo,cemar Il th Da, Cisl tr V;ell
SOIL ABSORPTION SYSTEM
BE(EITRENCH '7ud:F ll !.c CI Tren PIT DIh1ENSl Nc OI P Is nSi:e Dia. L qu J Dcptr
DIMENSIONS
SETBACK SYSTEM TO PiL l l''; LL LAKEiSTREAla1 LEACHING lvUni.ia ci: Per
INFORMATION _Ir 0`,, Ste MBER OR
IT ro1Pd9' N,tmher
DISTRIBUTION SYSTEM
ITCj-.1V' ,lamlcln U-_A 60,n x F. 7r, ,Ho pacng vent to Arlntane
Pipe(si
<nqm U3 1P.~rh Dia Sr arin:
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over G-p:h JVC' uUi J' xr SeeCpr, :Sanded x. Mu erne'
Ile,. Tranc'Ce'ler Bed e'er rh Ecges Tr: .oil Yes Vc Yc•s j Nn
COMMENTS: lint. ude code I srre:enaes perssrs present, etc i inspection 41 Inspe Ion C2.
Location: 647 PACKER DR
1 I Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? Yes No
Use other side to, addiCOra Wcrrraticn.
Cafe InseCrrprS Siar antre ::ec No
SBPe: la iR 3ro-
I Sfjlti 318 y~
ce~
Wisconsin - G
I L IN and 13nilJrn Dilinoo
°III W ' uhln trm :1,c P.O. Roc 1ti_' SmularA I prnil Vumhcr to he tilled in b, Cp )
~)eP~{I'llTlenl S£lte~~ and Tv~', a 24~~ \ Ihcun, A 13-0 It
Prollessiional Seryi es
- -
State JJt same Planumber
Sa14 PP Ica ion
n 11hm dfcJ I u l to 111 ♦I IS . S,JI ' I, J ( d, 'uhnu, tun Of 1111, li.uu lo the apps pnale w,vernmcnlal Tolle ddle,s lit difl lcnl than mailing address
unit is rcywr J pu r tit 1 uan • a alw to p unit. N, R aPP11 .muu I nn t l [al, owed 14 R1'TS alc /
-uh hr'urlm nl d Sates, and I r hsiorl ll S nK<s. I : , IrJ m&mn nom you purv:dC N
ma,' h o "d I t>cc, uJan pull o>cs m ac rdalw ,ulh the Prig I , I ,l?'Ll. I ling, til:,ly _
-I,, p 'cation Intortalatioll • se Print :111 Infnrmaliun
I'ropcoy Ownvr's ilm- 4ddnis -
Pill,I ' IACalron
~
III. Ili I ]:.li (n),'I Lot
('ily. Skill: %ip Cildc I'll Numhcr 1~ U _S U Sccticat I I
II TyIre of Building (check . that apply) a I tin • _
W Jxl tin
nr 7 I',uuil, Ow,llin• Aundxla ledronms_ Iuit
1, 1
/ vk l: •
I uhhe'f'nmm,. ,Ld Ik>cnh, IAc
s%I Number \dle• Of
stale Owncd lkscntsc 1 m rte-
Type of Permit: (Check only one bu in I -A.
Congdcle re 13 if: tilt
\ f XNtw 1, s'hnl K' pll,uueul Sv:0.m -
l re•:In:en• !Jmg l:mk l ,o Cut Unh 1 ryl lhcall,n l Ixutin SN,tem
13 I I Permit Kcncwldl I I . unn RCUVIOn h- r of c I ml cr K i> ,wn, I coon Number mid Pale Issued
Iklurc 1 ,pogo nl Plum t )Unn
I~ I y to of 1 OW TS Sys tem. (Check all tlta"ply) - _ I - 3 r y*^~~
Non -I'r wlvul Imin and I'ns>w iynl In (local _ All vdc Mound -,'-I no liable ,if Mound 'Nin n(zuimnle wit
loWn", Tan. -(liner Ul>per>ul Compo luill "Auull
1',ulroatmcm 1lovicU csplainl
Del rr>:J• treat cnt Area Information: -
f U I tFl:m irp,lt Ik>Ipn Sml :\pph, an, ;K pd+lr Ui.(x n;J ,\rua Keptirc ' Ui+pu,d ltda l'rnpn.c 4sli S,aun llleeauon
VI. Tank Info I (apt tic in~ lr I I Nunthr M:umlaclurcr -~I nlab Silt Sled I fiber I'ht f c
( all n ( uu> pl'llnitc ( n"Co: 'on*Inlclcd Glass
V,
r-,I- I nI_
S pbc Il..l.l:nr
I I \\n. (onrrr!c \ TIK
I1. Responsibility Statement- , the under, ierled, assun nspun,rbdity for in,lxllalinn of the I'U\1"I'S sho on the attached pl
1,11,1111,C1 \ Vam l ans.
11 rinll Plum , umatm 1 V>I'r\11 KS Nnmh'r -
/nrI' f4lUllllO Mini: Nundmr
I-III I~U~j -
`(J 44 l~~ lh~ 'll 1~~~(t
I'lunlhcr's :\ddl,+, ISlr,cl, ('its, talc. lip < , c;
_\1h\2 ( (ll. II. \I(n loci. \kl }'>i
VIII. Count) I)MMIrttuc Use Only _ -
:1pp d I1_>1 vcJ f I Ptunil Fee - - Dal • Ixsn • Ic>w rnt Sipnntu
l,cu wll Kca>.m7R- S K/
n `f 0S 6~2/ Jg i _
IX. Conch Reasons for Disappro,'at 1
$V$1 3J ~act.wke ~a ~9 r
amc, atnz,e twAr MA /
Li cea r?USt all 3'ti\1G:•5 n.t'nl K '
K par macagerreM. pliin pro •loa l by 1,.nOe.*.
2 N 1!!ba k retairer,en;s nuat Iti ,:.:girt, r (d
M per pFaimWit cods
L Uuah tom pIrw plam, Un be( "'oo, a:d,1 4rt the ayvam'm I' Ver ml Ir„ than SV2 , l l inehti in vm -
,u
PRIVATE ON-SITE W ASTE HATER TREAT]1ENT SYSTEM (P wrs)
New construction site
Index and Title Sheet
OWNER: Jeremy Parker
PROJP.CI NAME AND SYSTFVl 1 YPL: Parked Conventional system
LOCATION: Street Address Parker Drive
I egal Description N\\'1 4,541 1 4,SI I,T29VRI9\\'
lownshiplCounty Gilmanton Wwnship. BuITalocounty
CONTLN'I'S: page l: title page
page 2: owner's manual
page 3: start up
page 4: reports
page 5: tank detail
``\x(11111//~~ page 6: filler information
rj • ~y?~~ page 7: dt.vn field cross section
=acs Page 8: site plan
DP,SIGNER: Lan I, Pcrc Resting LLC.
Ph: 71'664-8184
LUMBER: Chris IZud SIGNED:
Rud Plumbing. LLC
CRl*DLN'1'IAL NUMUR: NIP23107i DA FL: April 26. 2018
page I of 8
O\VNFR: .Icremy Parker ph.
POWTS MAINTAINER: Rud Plumbing, LLC ph. 715!495-8586
LOCAL REGULA TORY At I'I'I IORITY: St. Croix County Zoning ph. 71 ~t386-4686
InlluenU'effluem quality (values typical for domestic (non-commercial wastewater and septic tank effluent) fats, oil
and greases (FOC i)<30mg. L. Biochemical Oxygen Demand (BOD)Q20nm%l., total suspended solids
(TSS)QSOntg.I.
STL• FENI SPECIFICATIONS
Four bedroom (600-GPD) single family residence
Proposing 1250gal WeiserConcreteseptic tank
Proposing Polylok 525 septic tank filter
tvvo distribution cells, .aft. X 9011. wit ARC 36
,oil application rate 0.7sgft, area required 85 sq.fi.
absorption area credit 25.0 per 5ft. chamber, proposed area 900.0q.R
(component, trust comply with DSPS 384 code and be installed per manufacturers specifications)
UI-:SIGN CRITERIA
SBD-10705-P (N.0IM1) "In (;round soil absorption component manual" Version 2.0
'aLUNTEN,4NCE NIONITORING SCHEDULE
Inspect condition of tank(s) at least once every year (maximum 3yrs.)
Pmnp out contents of tanks when combined sludge and scum equals P, t of tank volume
Inspect dispersal cell(s) at least once every year
('lean effluent filter, (septic tank) at least once every year
project: PARKER page 2of 8
For new construction, prior to use of the PC )N'TS check treatment tank(s) for the presence of painting products or
other chemicals that may impede the treatment process andior damage the dispersal cell(s). If high concentrations
are detected have the contents of the tank(s) removed by a septic tank pumper prior to use.
System start up shall not occur when soil conditions are frozen at the inf illrative surface.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required
reports. 'I'hc quantity and quality of lite wastewater stream will affect the performance and longevity of your
POWTS. 'the installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the
wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment
devices and fiwndation drains should be discharged to the ground surface whenever possible. Note: This does not
include laundry waste, showers, dishwater, etc.
This systcnt is designed to handle domestic strength wastewater, however the disposal of food based greases and
food solids such as those produced by a garbage disposal should be minimized. 1 oilet tissue is the only paper that
should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary
napkin, condoms, cigarette bulls, should not enter the system. Chemicals such as petroleum products, paints,
disinfectants, pesticides, etc. should not be flushed into the system as they can seriously damage your POWTS
systcnt.
Maintain a regular steady flow by spreading laundry washing Ihrou:hout the week. Avoid traffic over all systcnt
components. Compaction Of snow over the dispersal unit may cause it to freeze up.
INSPf.CTION'S
Inspection shall be made by an individual carrying one of the fiillowing licenses or certifications: Master Plumber,
Master ['lumber Restricted Sewer, POWTS Maintainer or Septic tank pumper.
Septic tank component inspection must include it visual inspection of the tank to identity any missing or broken
hardware, identify any cracks of leaks, measure the volume of combined sludge and scum and to check for any
backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be
scaled and!or locked upon completion of service. Any defects shall be promptly, corrected. Exposed openings >8"
in diameter shall be secured with an effective locking device.
When the combination of sludge or scum in any tank exceeds 1,•'i or store of the tank volume, the entire contents of
tank shall be removed by septic tank pumper.
The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacture's
specifications. Provisions are to be made to retain solids in the tank. Filler cleaning may be necessary at more
frequent intervals than stated in the maintenance schedule to keep the system operating.
In-Ground Gravity Con- onent Dispersal Cells inspection shall include recording the levels of ponding, if any in
the observation tubes and it visual inspection tier any evidence of surface seepage or discharge. Any discharge to
the ground surface must be promptly reported to the regulatory authority. Ponding at depths >75% of the height of
the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring.
Sic filter at cleaning. Remove from tank, hose filter off back into septic tank, then reinsert filter into
canister.
project: PARKER page 3 of 9
I'? \!~T UP
nor new constru;aion. prior to use of the Pt )NN TS check unatmem tanks I lift the presence of painting products or
ether 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(o removed by a septic tank pummper prior to use.
System start up shalt not occur when soil a,nditions are trorcn a: the infiltrative surface.
)II!-i"A H( )'IN
I'he properry owner is responsible for the operation and maintenance of the POW TS and submission of required
eport . The quantity and qualuv of the wastewater stream veil I affect the performance and Iongevily of your
POW I S. The installation of water saving appliances and fixtures alone with prompt repair of leaks reduces the
wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment
devices and foundation drains should be discharged to time ground surface whenever possible. Note: Phis does not
include laundfA wasic. showers, dishwater. etc.
Phis system is designed to handle domestic strength wastewater, however the disposal of food based greases and
food solids such as those produced by a garbage disposal should be minimized. toilet tissue is the only paper that
should be discharged into the s}stem. Other non-biodegradable items such as baby wipes. tampons, sanitary
napkin, condoms, cigarette buns, should not enter the system. Chemicals such as petroleum products, paints.
disinfectants. pesticides, etc.. should not be flushed into the system as they can seriouslN damage your POWTS
svstcm.
Maintain a regular steady Ilmm by spreading laundq washing throughout the week. Avoid traffic over all ssstcn,
components. Compaction of snoav, over the dispersal unit may cause ii to freeze up.
INSPF,C'I TONS
Inspection shall be made by an individual carrying one of dx following Iiccusc~ or c;- ification,: ytaacr Plumber.
Master Plumber Restricted Seaver, poN'1 S !`faintainer or Septic tank pumper.
Scptic tank component inspection must include a visual inspection of the tank to identify an\- missing or broken
rardw<are, identify arty cracks of leaks, measure the volume of combined sludge and scum and to check for arty
backup or piamding of effluent to the round surface. Access openings used for scn ice or assessment shall be
scaled and/or locked upon completion of service. Ali\ defects shall be promptly corrected. Exposed openings; >9"
in diameter shall be secured with an effective locking device.
When the combination of sludge or scum in am' tank exceeds 1 or more of the tank volume, the entire contents o`
:ank ;hall be removed b} septic tank pumper.
Hie outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacture's
~pcci t ications. Provisions are to be made to retain solids in time tank. Filter cleaning may be necessary at more
frexmCrtt intervals than slated in the maintenance schedule to keep the s~-stem operation.
In-Ground Gravity Component DiTersal Cells inspection shall include recording the level, of ponding, if an) it-
the observation tubes and it visual inspection t?rr any evidence of surface seepage or dischartc. Any dischar:!c to
the around surface must tic promptly reported to the regulatory authority. Ponding at depths of the height of
the component may indicate overloading or impendine hydraulic failure necessitating, more frequent ntonnorin!..
S°pti: titter at clcanin,_,. Remove froth rani.. hose filter off back into septic tank, nivn reinsert filter into
canister.
project: PARKER paps of N
U-PORTS
Reports for maintenance. inspections and monitoring shall be submitted in accordance with Conmt83.55 \Visconsin
Administrative Code.
r•. 1). N'I)(1N'l1F"; r'
\Vhcn the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that
the system is properly and safely abandoned in compliance with DSPS 383.33.
l.) All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
2.) 1 he contents of all tanks and pits shall he removed and properly disposed of by a servicing operator.
3.) After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void
space tilled with soil, gravel or other inert solid material.
Ct)N'lINGFN(_) ' IT N
Ifthe PO\VTS fails and cannot be repaired the following measures have been. or must be taken to provide a code
compliant replacement system:
X, suitable replacement area has been evaluated and may be utilized for the location of a replacement soil
absorption system. The replacement area should be protected from disturbance and compaction and
should not he infringed upon by required setbacks from existing and proposed structure, lot lines and
wells. Failure to protect the replacement are will result in the need for a new soil and site evaluation
to establish a suitable replacement area.
suitable replacement area is not available due to setback and/or soil limitations. Barring advances in
POW IS technology a holding tank maybe installed as a last resod.
site has not been evaluated to identify a suitable replacement area. Upon failure of the POW 1'S a soil
and site evaluation must be performed to located a suitable replacement area. If no replacement area is
available a holding tank mayhe installed as a last resort.
i mound and at-grade soil absorption systems maybe reconstructed in place following removal of the
biomat at the infiltrative surface. Reconstruction of such ?VSICnr5 must comph with the rules in cifect
at that time.
~i•..,.......11 I'..i ..1.\i\'-.r.,i ..itil.+.•LL~I~:~I.
1, K 11, N7 OXYGEN. DO NOT ENTER A SEP'I IC. PUMP OR OT1*' R ' FREATMEN7" 1
)FR ANY CIRCT N4STANCI.S. DFATII N1 \Y RFSF1 I'. RFSCI I I'I:RSON ERO'tl
project: PARKF1t page I of 8
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L1 j z1 Filters
PL-525 EFFLUENT FILTER ( MMERCa`f;:--i
i, y1oF Inc Is plc,as ma fd I,s
1%• CO t erCdf fill r to its )listing f!
i~ a,rzG r e.R1u_nt .ilta,s, i he f 1
=_-=`25 is rated for over 1p,000 GPD alarm
'
i•;73iICr.S par d2v' mailing it rnc- of I accessibility Accepts PVC IIf
:ha iaigeSt-OminefC.-;2i -tiia (S In It6 extension handle
'SS. .t has 52n linear feet o` 1~'HF' =
i ation s:n'c Like trlc PohA-,k ( x
r l i K. ,he ne.>f Golyio PL-525 has
riDIY t shutoff hall int,ailed 525 lineal feet
r , ev-' a it•2r. Whu!! the `llt is
( of 1:1L" - S #t~
_iTtO\~ if Cie2ilinii, the bell will 1 filtration slot-c Rated foi over
-l0 t UP aI amol r fi Y 10,000 GPD
- t rr it t~ affil ~la!li Ol/07t
is ,t S 1- ank. NO other filler On
the market can maize that cla;rri! ~ Accepts 4° & e
I SCHD.3e Pipe \ 1'
FCC.:
n
The PL-525 Fr': ert Filter should - }
operate efciantly'nr savora! yea:; --l
under nor .al conditions before
r,=qu:rind c4aaninc. It is rec'um-
rrrded taut the ,`,it_r be cleaned `
a V`,!; time the tank is oume',•'d of
;r[ least averi% thrae years. If the t t' 1`•; r
i-stalied 5!te( ccnntains an optional
alarm,, the owncr will be notified
Jy an alarm vVi1ell the Hite, heeds
Y-<p-
3crvIcmg. Servl I should be ~f Gas de(letYOr
none 7y a Ccl ttfl d septic tank Automatic shot-off
L),J.npar or installer. f - hall when filter
is removed
i Locate the 01,06at of the pr J i P:1 n. r ~7 sill .
srp.i .
tank. t .oJf.6
2. .amcve tank cover and lxunP - - - - -
lank if necessary.
~LfiiOli: 1. Locate the outlet of the
Do rot c!se plumbing vrh
- Septic t3nY,.
triter is removed. 11 leal 'Or (eside-tlal and cOM 2. Remove the :.a r! cover -:ILA
4. P;LI PL-E:25 Cs:;t of :;he hou mr. r" a c!ai waste MovV$ aP to PllmP tank i- n)e _-eSSarv.
si:n ; -
- _ ~,sf i`,!.`- J r 10!:000 ',32l Or:S pr'at' 8y iGPC'! 3. Glue the ilitur housing t- t,i;
ter ar ti:•9 septic 4° or OUtiet of n if the
CAi lr- sore all solids fall F '
litter is not centered Uniar mt;
:mc, se-'ic i -11
• ` aCCesS f paring use a PoP,'i06
v. fn art th 2 t Iter os.tridae hacF Extend & Luk or piece of uip=
i-t the I:ousing ma?zing sure , center filter.
-'ter -ropariy aligned am k. Ir1SBit the PL 52 filter iw-,
tai! is housing.
=Pit k ,o.• 5- Replace l r ti: ar
CROSS SECTION - not to scale
All two cells identical
observation pipe Finish grade all cells 101.0'
or
vent pipe (12"
above grade)
12" of filled
material
- -1
3tt of
Natural soil
System Elev.
98.0'thru 95.0'
>31`t of suitable soil
System installed using
TOP VIEW
not to scale
front of cell
_ - " 4" header area
Sch 3034
vent at end of cell -
end of cell ti
observation
(Per Cell) 18 chambers X 25 credit = 450.0sq.ft. 450.0sq.ft. X 2cells = 900.Osgft
proposed 900.0sgft. 857.14sq.ft. required
Two cells (identical)
3ft. by 90ft.
project: PARKER
page 7 of 8
PL 5.225 EFFLUENT FILTER - FcP; ln!:, is pleased to add its
nazi :o^lmercia( filter to its existing
ine of quaiity effluent filters. The 1
PL-525 Is rated for over 10,000 GPD Alarm
(gallons per dayi making it one of accessibility Accepts PVC
the largest commercie'.l filters in itS extension handle
crass. It has 525 linear feet of 1116"
;dtratinn slots. Like the Polylok
".122. the navv Polylok PL-525 has
an automatic shut off ball installed 525 linear feet
%%,ith every filter. Whan the filter is of 11116" `
emcved for cleaning, the ball ovill filtration slots Rated for over
'oat up and felr,porarily Sfwt off 10,000 GPD
the System SO the Effluent Won't
leave the tank. No other filter on _
the market can matte that claim/ Accepts 4" & 6"^_
SCHD. 40 Pipe \
The PL-525 Effluent Filter Should i
operate efficiently for several years
under normal conditions before ~
ri.quiring cleaning. It is recom-
mended that the filter be cleaned
ever, time the tank is pumped or
at least avery three years. If the
installed filter contains in optional
alarm, the owner swill be notified
by an alarm when the filter needs r
servicing. Servicing should be Gas deflector
i,nno by a certif ed septic tank
. Automatic shut-off
ipur?per or installer. E hall when filter
is removed
I . L 0-ate the outlet of the ! ! s. P:aonr Noe 6,n1s,•..;
--;;tic tank. s;>;11.Wto
1. Remove tank cover and pump -
tank if necessary. - 1. Loca±e the outlet of the
3 Do not Lisa plumbing when - septic tank.
filter is removed. Ideal for residential and com- 2. Remove the tank cover ;md
;1uH PL--S25 out of the housing. mercial VIARte flows up to pump tank it necessary.
S. Hose off 61t=.r over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the
4" or 6" outlet pipe. If the
tank. t,iake sure all solids fall filter is riot centered under the
back into septic tank. access opening use a Polylok
G. Insert the filter cartridge back Extend & Lok or piece of pipe
into the housing making sure to center filter.
he filter is p.operly aligned and 4. Insert the PL-525 filter into
ompletehf inserted. its housing.
? R-; dace septic tank -over. 5. Replace the septic tank cover.
~r,.~cct ° }lRf-Fer H cF P
f~
SITE PLAN
rev N e~
i\\\";:&S\\'SIIT29N%R19\h 1
I Judson township - -
r
St. Croix county 1,0
ITGEND I
X back hoe pit
i - grade clevations
contour 30 t y ai
, 40
l +~~4 ctes)
No DSPS3Riset back
problems - - \
Scale 1" 40' except
Micre indicated
0 ,ty~
Lot 34 of 1" Addition t 1 -1 /;r
of Homestead Plat I ~
3.?1 A.C. ( a;
ff
I04SL
? cells aft by 90ft
X o ff!'
Llcv. 98.0' thm 95.0' I y n, c ~C°
162,1
p, y
~p {7
Ok, Z: A' e 11
project: PARKER page 8 01*8
ttt naryf / DIVISI[:N Ur INDUSTRY SERVICES
PIu nL^ni Produoa Renew
D P.O. Box 7302
•S P~'MaCll$UII. SNisoon,.n, 53701-2658
TTY: Contact Through Relay
Governor Scott Walker Laura Gutierrez, Secretary
Jude 8, 2017 - - - - - -
Ii IL TRA T OR WATER I FCHNOLOGIFS LLC
JONA I I IAN KAISER
4 RUSINFSS PARK RD
PO BOX 768
OI D SAYBROOK C 1 06475
Roy Description.- I LACHING CI IAMRFH
Manufacturer. INFII TRATOR WATLR TEC14NOLOGIFS LLC
Product Name: (trans id 2948106) BIO DIFFl1SER-- ARC 36, ARC 36 end cap, ARC 36 SEC
Model Number(s): ARC 36 (modified) and ARC 36 SPC (side port coupler)
(ARC 36 FISA WITH OR WITHOUT GEOIFXTILE 2004 FABRIC - 25.0 ft.';CHAMBFR.
I AYING LLNGTH = 5.0 FT.. WIDTH - 33.75 INCHES, HEIGHT _ 13 INCHES: MIN. DLPTH
OI BURY = 0.5 FT.: MAX. DEPTH OF BURY = 8 F I.. OPEN BOTTOM AREA = 12.0
fl'iCHAMBLR K 2.35 Sf!LF: AND ARC 36 SF1G EISA 4.5 fl.'!UNIT, LAYING LLNGTI I
1.17 FT.: OPEN BOTTOM AREA =2.7 V.,'SPC IJNI 11
ProdUCt File No 20170155
I he specifications an(For plans for this plumbing product have been reviewed and determined to be in compliance
with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 146 and 160, Wisconsin
Statutes.
The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative
Code. T his approval is valid until the end of June 2012.
1 his approval supersedes the approval issued on June 11, 2012 under product file number 20120233.
1 his approval is contingent upon compliance with the following stipulation(s):
• This product must be installed in accordance with the manufacturer's printed instructions, product approval, and
plan approval. If there is a conflict between the manufacturer's instructions and the product approval andtor plan
approval. the product approval andror plan approval will take precedence.
• When this product is Installed in a dispersal cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter. this pr0d,rc1 must receive wastewater having a BO')., value less than or
equal to 220 mgil , a TSS value less than or equal to 11>0 ieg,:l and .a FOG value less Iran or equal t030 mgA
on a monthly average.
• When [his product is installed in a distribution cell that is sized based on Inc LISA rating slated in the regarding
block of the product approval feller, the distribution cell design must allow at least six inches of ponding in the
chambers without backflow of wastewater into the drainpipe that discharges into the chambers.
• When this product is installed in a distribution cell that is sized based on the EISA rating staled in the regarding
block of the product approval letter, this product must be installed in a distribution systern, which has the top of
the distribution cell at or below original grade.
• When this product is installed with geolextile fabric on The sides of this product in a distribution cell that is sized
based on the LISA rating stated in the regarding block of the product approval letter, the geolextile fabric must
be Reemay Filtration Grade Spunbonded Polyester Style No. 2004 fabric:.
• When this product is installed with the ARC 36 SPC. side port coupler, the design of the distribution cell shall
take into consideration the FISA rating for this accessory as stated in the regarding block of the product approval
letter, for each SPC unit.
lac-;4 m4.1 1,4"1 d,+"r. '701~,sozDMc
Infillrator Water I echnologics I I C
June 8. 2017
Page 2 of 2
Product File No.: 20170155
The department is in no way endorsing this product or any advertising, and is not responsible for any situation which
may result from its use.
Sincerely,
Glen W. Schlueter
Fnvironmental Engineer Plumbing Product Reviewer
Depariment of Safety and Professional Services
Division of Industry Services
BURN M of Technical Services
(608) 267 1401 Phone
(608) 267-9723 Fax
glcn.schlue'.er(,twi.gov E-mail
ST. CROIX COUNTY
SEPTIC TANK MAINTENANC'F AGREE MENI
AND
OWNERS] IIP CERTIFICATION FORM
0%vncrd3uycr_ , t_f> l 1' ->G- _
Mailing .Address `tL
Properly Address _ Cn`17_~[EC .-,k w r
(Verification required li-am Planning K Zoning Dcpaattncnt for rtes instruction.)
City,!State Hu(,4, SoeJ Parcel Identification Number r? t• - I-s -~oi_c
LEGAL DESCRIPTION
Property Location N'tt.; '''A Sec. 1 1 T_ N R_, q W, Town of t~ u„1 ;C J-\
Subdivision Plat: 'A'
°
- (~a,1 Earn ~?L -tc> ,Lot#
, Certified Survey Map # _ , Volume Page #
Warranty Deed # (before 2007)Volunic _ yyyyyy~~~~ Page
Spec house 0) es~at Lot lines idenlifiahlc//wves❑no
SYSTEM MAINTENANCE. AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature fail urc to handle wastes. ]'rope
mafmcnanec 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 al'Ihc septic lank as a treauncut stage in the waste disposal system. Owner maintenance
responsihi lilies are specified in §SPS. 383.$2(1) and in Chapter 12 - SL Croix County Sanilan Ordinance.
The property owner agrees to submit to St. Croix County Planning K Zoning Department a certification form, signed b.' the
attner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
stewater disposal system is in proper operating condition andkor (2) after inspection and pumping (if necessary), the septic tank is
e,., than I i 3 full of sludge.
]Ave, 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 ol-Safety And Professional Services and the Department of Natural Resources.
stale or Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Crisis
County Planning K Zoning Department within 30 days of the three year expiration dale.
I: kvc ccrtiN that all statements on this form are true it) the best of nq•/our loge. ),'"y urvarc the owner(s) of the
propctty descrihcd above, by virtue ul'a wary nY deed recorded in Rcgislcr of Dec )fhce..
Number of bedrooms
4 b(d(J
SIGNATURE OF APPLICANT(S) DATE
1ny information that is misrepresented may result in the sanitary permit being revoked by the Planting K Zoning Department.
Irudode with this application a recorded warranty deed from the Register of Decds Office and a copy of die certified survey map ii
rctcrence is made in the \variant\ decd.
(REV. 04/12)
All •14 CORN['
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AVJN~'.. Y
'puN tr v. vi
1
35 %G
'-101 Sa_-)
/ LC'
I
31 CT 3? A v
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_ 1 01 29 - -
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I VIII III II. III VIII I'II III '
8 5 2 1 9 9 9
Document Number Document Tito Tx:4442139
St. Croix County 1066618
BETH PABST
REGISTER OF DEEDS
Occupancy Affidavit ST. CROIX CO., wI
RECEIVED FOR RECORD
_-yCfe.22~r_{~ ~r 06/18/201809:57 AM
Name - (Owner) Typed or printed EXEMPT
being duly sworn , states, under oath, that: REC FEE 30.00 i
PAGES: 1
He/she is the owner/part owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume N/A Page N/A Document
Number 1063374 St Croix County Register of Deeds Office: Record Aroa
A parcel of land located in the NW % of the SW % of Section 11, T29N - R Name and Return Address
19W. Town of Hudson. St. Croix County, Wisconsin, being duly described '-6d~- H, 11S,d Q_
as follows (include lot no. and subdivision/CSM or detailed legal H~ 1~~ WZ pl
description):
020-1380-34-000
Lot 34, I lornestuad 1" Addition, Town of I ludson, St. Croix County, Parcel Identification Number (PIN)
Wisconsin.
As owner of the above described property, I acknowledge that a Private On-site Wastewater Treatment System
(POWTS) serving the primary residence is sized for 4 bedroom(s) with a design wastewater flow of 600 gallons/day
(DWF is based on 150 gpd /bedroom li a 2 persons per bedroom). A maximum of 8 occupants are permitted; if the
number of occupants exceeds the maxitnum for POWTS design, the system will be undersized to accommodate
increased wastewater flows and/or contaminant loads and may be subject to premature failure. I also acknowledge
that I will make this information available to any future parties interested in purchasing this property.
Dated this « day of
R. ,
X,
r *
AUTHENTICATION ACKNOWLEDGMENT
Sgnalure(s) _ STATE OF WISCONSIN )
)as.
L Croix County I It authenticated this day of Personally came before me this day o
t~a FF ~~~p
V V~lt
TITLE. MEMBER STATE BAR OF WISCONSIN to me known to be the person( ecuted t
(If not. instrument and acknowledge e.
r~1f ~ ~C O~ SU
THIS INSTRUMENT WAS by § 706 ORAFTED BY
i7 f71\
Community Development Department St. Croix County
~
* qRY Q 02
Nola ublic, State of Wisconsin
(Signatures may be authenticated or acknowledged. Both are not My Commis Ton is rmanent If not. state expiration date
necessary.) Date X at.
St. Croix County 1066613 Page 1 of 1
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Plismrsir JepartmentofCommeroo SOIL EVALUATION REPORT page 1 of 3
Div srcn of &rety and Buildings in accordance With Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
County iLta::h complete si!e pal at paper not less than 8'i: z 11 inches in sue. Plan Host St. Croix
i:7ude but not lint led to vertical and haieoold reference point (BM). direction and
,e cent slope, scale a dimensions. north anew, and location and distance to nearest road parcel ID
please print all information. / 020-1012-40 ID# 11.29.1548" Z c
Re4newed By Date
Pr-nc~rl ~I.r~xm rv~rrn nir'n'ay Ue url Mr.irm:m pvr:.~.;cres 15.(411] i,a; - .V fem. • /4 s
Property Owner Property I ovation ~~~"'\\\111lllUUULLi -
Iller5 m j NW 1 i4 5W 1!.1 S 11 29 NR 19 W
Property Owners Mailing Address Lot # Block # Subd. Name or CSW
P.O. Box 151 34 1st Addition To Plat Of Homestead
City Stale Zip Code Phone Number City Village ✓ Town Nearest Road
I ludson Wt S4016 (715) 3862769 Hudson Packer Drive
✓ New Construction Use ✓ Resxfenhal i Number of bedrooms 4 Code derivod design flow rate 600 GPD
Replacenxnt Punic or commorcul - Describe
Parent material Glacial outwash Flood plan to.-Micn, if applicable na
General comments
and recommendations.
Boring # Boring Cat ,Adll~ FT1 io
e Pit Ground Sudaco elev. 107.91 K Depth to fimiLng factor >126 in i Sol Application Rate ``g
Harm Dept, Doorman Coo, Redox Deschoton Texture Strcc7we cwsister,e Roundary Roots GIDDY
1 018 1Oyr2/1 none sl 2fsbk ds as 2fm,lc 0.5 0.9
2 18-32 1Oyr4/4 none sl 2fsbk dsh cs 2f,lmc OS 0.9 L
3 3242 1Oyr514 none sit 2msbk dsh aw Ifin 0.5 0.8
4 42-90 10yr5/4 none s & gr. Osg dl gs 0.7 1.2
5 90-128 10yr6/4 none s Osg di 0.7 1.2
❑ Boring # Boring
pit Ground Surfaceelev 107.02 ft- Depth to limiting factor > 126" in Suit Appi cation Rase
Honzon DePth Deninant'cia Redcx Desc~,lion -cxture structure. Consistence BaLrJaTy Ra,IS GPDIfl'
1 0-4 10yr4/2 none sl 2fsbk ds aw 2fmc O.S 0.6
2 4-21 1Oyr4/4 none Is imsbk ds cs 2f,1mc 0.7 I-1 • 7
3 21-63 1OyrS/6 none s & gr. Osg dl gs 1fm 0.7 1.2 7-
4 63126 10yr5/4 none Osg dl 0.7 1.2
Effluent #1 = BOD 30 220 mgrL and I SS X30 < 150 m9A) ' Ef iuent 92 - BOD 30 mgVL and TSS •_30 mq'L
CST Name (Please Print) Si ore: CST Number
James K. Thompson 3602
'bale Evaluate n Conducted Telephone Number
Address A.C.L. Snit & Site Evaluations
Osceola, an 51020 '1 9/18/00 715-248-7767