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HomeMy WebLinkAbout018-1068-10-100 ionr r. vvlI Depan-eme+eomM.erce PRIVATE SEWAGE SYSTEM ~ .St. Croix Sa`et7 a'n PUiitlm, D'Yi$IC'1 -'r \ 1 INSPECTION REPORT r Stir lap; Peter Na 605076 GENERAL INFORMATION rAI IACH I;) PERMIT) _ State Plan ID No °e'S'Jllal udOnnal Jn rr Ir-; Iv ~'Jy DC USed fur se'rlncarI, pdrpo5e$ iP: vaGy Lav:. s Is p{ 3120527 Perm l -lolner e. N, m. CiPJ Mare "'nSr IV rarilr1,ax No -I_ Estate of Delores Hawkins TOWN OF HAMMOND E_ 018_-1068-10-000 CS' Pl;. Flan p.:':, 61x1 Elev HM Oecn ippo•1. 5ertir. ^,'?oan+RangeTAap ne 11 1. 1 _ 30.29.17.466 TANK INFORMATION ELEVATION DATA IYPF AtANUEACTORER CAPACITY '-ATI(''N Ds HI FS ELEV. Sects Benchmark , Dosing J~w~ba v IOy All. Bfvl 496,3 • L; Ce AA-Z_ Holding SIh ' IIIII't TANK SETBACK INFORMATION sUHI Oi.rct ~ TANK I) ':VF I.I_ BLDG . Aa Intake ROAD Or Inlet \ br lhw, sopt,c /,S9 D' Bottom W, Z 9 1. 5 Doslrg I I HeaderWan. W o 3-7 /oo D.st P,1:.= Hcldirg Bot System 9$ G i / Final Grade PUMP/SIPHON INFORMATION 2.7 /d/ "danufact.uer Demand St Cover • 7•d::de Nurnher ZV4) TDH LA Fgchor Loss Syxlen: fFlead TDH Ft /0'S /.o wel) - Fo,cemair Length z l89 ~ - SOIL ABSORPTION SYSTEM BED~TRCNCH Le-g-h N, O• :h- PIT DIM NSIONS nc Of p 1; m, Da L qu 7 rcpt DIMENSIONS /L /W SETBACK SYSTEM TO l•~ PL /rHti M; V:.I I I AKF tS I RFANI LEACHING Iv10n INFORMATION Iy CHAMBER OR ' P r){7 ~'i SlCni- X) _ /I C? ZIC UNIT Mc do N:mbcl. DISTRIBUTION SYSTEM O I af^' 1 Hcada+6na-ibld Ois'ribu'icr y xlbcS~ny , / %Ilole SpeC7 Ve oAv n I nqt- L ✓ Lerglh__- Da Icngt'/O J~a Spas. n9 SOIL COVER x Pressure Systems Only xx MOUnd Or At-Grade Systems Only L=FIi' J' v (he.pt- O ff L^plF of x'.: SeCCeN ;ontletl %x MUl~bec bed^ e .h t:enter + W Iu.:Jl li _i ch L7ges ~pscl - COMMENTS: Include cafe d screpencies. persons presert. e'e.,: Irscection #1: Inspec'lion C2. Location: ibb2 iUIH AVE r C_C c^ 4 6._ I.1 At Btv1 Desc•iption = 11 'L.) Bldg sewer length = /G - amount of cover = a• ( n '6_"I a 0I Plan revision RCyUVCW? I Yes I7~Nfo R Use other side for addibona~ InformaB n. 7 9)b III j rare :^r. r' iq^~ati.re Coo nc S3De'h? iR 5+9'r Cow Safety and Buildings Division 01 Vu- Washinglo^ Ave., P.U Box 7162 Sai.:vy Pertnn Ntmiba im a nhed N b} Co-) > ;,s JUL 0 5 2018 $ ~ Madison,-tJl 53707-7162 0050 7 P f J tII11L A.~7~)11C3L1O[1 S=T'' nas+Ylnn t:ninba L a...cwd'n. iL ~l'S i8 1 ti I-r ').a•a:bai i... al .•c:. fa n,d -7_ i~ feel iirnl 7 r; ~ [n +h•.air-tnY a.mi.mV Pem'i Vot<. .4pp t'ab)xi rxi ~ : ta.tvw:t.J J t S me wbn.iIIed to P:ojaR Addrrs: ;i! 'fferent dean mauin€+w~rasi r Jrp:nt~v .f Safety std "t+iesrnxts. Scsits. P:;s_mal info u-tioa tou p-oviJr sw. 1>w:d fx sc.andazy ~r [-n cs y 3,. ar tvx;c attt th f -•'acY w 1J.Gt41 )im St.. s. - '!.•irK~-- I App6cahon Ltformattun Please Print All Information _ Q 7 '.ircm :Iw•r z7:arw _.IµI ) 'c / t e'ma1N ~~U~/(y,~~}~-'y~~-p~~-~"-'~~VO-~~ Property Uwtc:'s 43ilinf. Aa hrc Property Location Q1 a 1 I /jl ryy' , - ~ , „ynt 3 of 6 Zipr,(t Phew Nmrl>s SQ y,C $n:Uw - - - U. Type of Building (check all that apply Lot a - . '1 or 2 Zanuiy ITvtllin8 Na:nba of f3coru; IS SLLldl"1SIGn Is.= lock FubIi~CStom<rc:a!-:ra:iec lace GCR. n - - Stncowned - Dcsonl.Us' CSsGNmnirr Ntlu Cal 111. type of Permit: !Check o me .4. Complete line H if applicable \ Gnrts SY-. tent 'cpla';x iiv1'-n T: raon:n tc:wnt.7c:k1 ~I'ouot::)d~i:)dra Mod:`_irVicx: to sting system (explain) and Rat Lcsucii / it -j pemn Renewz i Perron Hrasioc i i Chalnc of lta'xv - mrt T:ancer to New lid 14 . Type of POWTS S\auu•ClootoaenLrDtvice 1'J M 7:un-I If 'rt.ari:cJh cir..und Ii iirwri[..d m Gn• t-)ride Muccaa` swr wle soil I it rtr Ju'pecsal Co¢yronro;:expbrni Mcemnem DM,,:(txplain;_ V. IN sptrsaLTrra I ent Area Information: gpph I:i.(ocnd .aca N.quac<!=tl Dispersal AttaF -~~+-"t) >4srm etn lcn - -T-~ 11 A ' y a• A on bcmw /l / \1 Tank, into iapacm,u Tots eof I A1anu:aataa w _ _ Gallons iinlluat l.ma _ 75 1.5 2 n \~a:~ ~ -1'sooE IL-_ _ ~ N 1 ~ I w o f ~ I o I - tgmcR Heirtrrr Taal ~ - - - L l- T NIL Rraponsibdrty State t t- L the uodrraienrd umc respoouttnhiy for insWiuuun of be PUNK IS sbown on the attached plant. _ Srr^vinnr M1f2.NfPRS Nomba Rusm"s Pbet. N er e eo~ `he ;s dwSu -t r t.=-.`tpC rl}rl)eparrment L.se f/uS__ _ J 1Pp:m rd Cewpf_ kcmit FeeDax Ls M.. ssuinc cut S~y.+atwe X_ f~llyy~ r tom cx~ 7 /le f$~- - IN. Condn_d~ x ous ~Fo7 Fl ppros' d T. dln 1RC 5 bl Uh~•el:'in cell muut dll ce Spl_^5 : ,'lltc., eC es per .aar.ayemen pl nn a iaf br rlu•nher. f 1 ..E~ CAO 2. Ail mftm k rec•U" ens riint w a.rL lf M pa 1pp71 irw C436I 1 UdALV tt r ~d r„lot~ - - Anara u e plme pram fo- to ct:ten• and >uU:n C-omry od} o' ypr+oor ku rLoo t_ :11 reehe~ ie vx k~ rll-L--'~`_ 1'1.`I'__ t e_ (~~1• I~"L*f r~ yl.Uial OL-LL ti SBD-6398 t~, 1 1 r'::) System PLOTPLAN PROJECT Chad Deraos ADDRESS 1552 70th Ave Roberts Wi 54023 SE 1/4 SW 114S 30 PT 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 99.7' 5/31/16 4 DA'Z'E BEDROOM CONVENTIONAL AT-GRADE W CONVENTIONAL LIFT HOLDING TANK 1255 gallons LIFTTANK SIZE DOSE TANK SIZE 765 MOUND SEPTIC TANK SIZE i HOLDING TANK S17E LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter I ❑ BOREHOLE O WELL •H.R.P. same as benchmark Scale is I" = 40' Proposed Property Line unless otherwise noted 2.0 Acre parcel i _ Wea II ~ Old system is to be pumped and buried ln~p(\d, Grading is to be done to divert run-off A(A away from system ST Failed Existing 4 system Bedroom 100' I House B-3 99.7' 230' eo. ` 160' of building sewer I t Cleanout to be installed 99 Alo at 95' from building I HUffcutt Combo Tank B-7 i 3% Slope I Area 15' below system is to remain undisturbed B.f iy* 70th Ave "w•VU ar yt._ DIVISION OF INDUSTRY SERVICES v. `c \%N, 2331 SAN LUIS PL STE 150 GREEN BAY WI 54004-6211 yl• 1 0-+~ Contact through Relay \sPS f~l hap!fdsps. wi gov/prograns/indusiry-services ` ~~'~j wvvw.wiswnsin.gov \Fr~~TSStO~AL%/ Scott Walker. Governor Laura Guti6rrez, Secretary July 03, 2019 C'US I ID No. 226900 ATTN: 1'011"I:S' Inspector SHAUN It BIRD ZONING OI'FICL ' BIRD SELF STORAGE: ST CROIX COUNTY SPIA / 14 12, NEW 120TH S'f 110 l CARMICHAEL R NF1V RICHMOND WI 54017-6409 HUDSON SON WI WI 540 5401 1(1-77 708 v/~*'t•Orh_ CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07i03!2020 Idenliliealioi Numbers Transaction ID No. 3120527 SITE: Site ID No. 850631 - Please refer to both identification numbers, Chad Deraus above, in all correspondence will the a enc 70'111 Ave Town of I Irmmond St Croix County SL I i4, S W I !4, S30, ' -29N, R 17W FOR: Descrip(ion: A!-Grade M Bedrooms - Replacement) Object Type POW I'S Component Manual Regulated Object ID No.: 1782322 Maintenance required; _Replacemcnt system: 6041 GPD F'hrly rate: 38 in Soil minimum depth to limiting factor from original grade, System(s): Al-grade Component Manual, Version 2.0, SBD-10854-P (N.03;07, R. 1/ 12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, It. 10!12); Effluent Filter 'l lie submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. I he submittal has been CONDrrlONALLY APPROVED. 'I his system is to be constructed and Located in accordance .with the enclosed approved plans and with any component manual(s) referenced above. 'I he owner, as clelined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plunthing in the state unless licensed to do so by the Deparonenl per s. 14 S, 06, slats. llie following conditions shall be met during construction or installation and prior to occupancy or use • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. • Prior to construction of the dispersal area, check the moisture content of fhc soil Co a depth of 8 inches. Sinew ing and compacting of wct soil will result in reducing the infiltration capaciit of the soil. Proper soil nleislum content can be determined by rolling a soil sample between the hands. I f it rolls into a 1 i4- inch wire, the site is ton wet to prepare If ;t_crumbles, site preparation can >Vrocecd. If the site is trio wet to prepare, do not Voceed until it dries. • Abandon Existing System per SPS 3833; • Pump Floats to be set antl verified tern approved I l.ur. Aaq rhan2cs may Icenlt ill pomp I csizing to meet TDII and CPNI Sneeifncntions. • Divert surface water from PO WT'S Area. • Well setbacks t0 meet chs. NR 811 & 8 1:?. SI IAI_ \ R BIRD Pxec 1 7(712018 • All piping shall conlonn to SPS Table 381.30-3 and SPS'fable 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (1 1)(c) • Tank Installation to follow all manufacture's rccommendatimts. • Verify property line(s) Ilium to installation. • Arras Ihit t arc occupied miih rack hapnlt•nts, ore roots. stumps and boulder reduce I11, amount of sod ain ilnhle tur proper IaeaOUcut_ Poll other site is available. trees in the bas:d area of the at~atdc most be em oil It uruund Icvcl A huger lilt area necessary when any of the above conditions are encotw(cred. to provide sdfli, tent infdo'ative 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 owners manual for the POWTS described in this approval SRti 383.54(1). • In file event this soil absorption system or any of its component parts malfunctions so as to create it health ha/aid, the property owner most Ibilow the contingency plan as described in the approved plans. A copy of the approved plans, specilkations and this letter shall be ou-:its during construction and open to inspection by authorized Ieprcsentatives of the Depart nett, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction: instal lit ionioperation. In printing this approval IIIe Division of Inds su y Services reserves the right to require changes or additions should conditions arise making, them necessary for code compliance. As per state slats 101.12(2), nothing in this review shall relieve the designer of file responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be matte to meat 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 T+ii zzzzi/q:jer•/ 'Phis Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your 'I-int Vandcr I.eest Payment Submittal. Private Sewage Plan Reviewer, Division of Industry Services WISIvIAR-I code: 7633 (608)516-6134 , Mom I'ri, 6:00 a.m. - 3:30 Imn tin.vandcl ccsVri,%a=. vo, cc: Edwin A Taylor, Wastewater Specialist, (715) 6 34-3484. Mon-fri, 8:00 A.M. - 4:30 11.M. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:5/28/18 Owner:Chad Deraps Location:SE 1/4 SW1/4 S30 T29 N,R17 W 1552 70th Ave Hammond Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and CorNgency plan 9. Filter Specifications Attachments: Soil Test Shaun Bird Signature License number 226 0 i I Page 1 of 9 System PLOT PLAN PROJECT Chad Deraos ADDRESS 1552 70th Ave Roberts Wi 54023 SE 1/4 SW I/4s 30 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX i SYSTEM ELEVATION 99.7' 5/31/18 DATE. BEDROOM 4 CONVENTIONAL-- AT-GRADE )00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT' TANK SIZE DOSR TANK SIZE 765 IiI HOLDING TANK SIZE LOAD RACE .6 ABSORPTION AREA 1000 # of chambers none BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL 'H.R.P. same as benchmark Scale is 1" = 40' Proposed Property Line unless otherwise noted 2.0 Acre parcel i OWell Old system is to be pumped and buried Grading is to be done to divert run-off away from system ST Failed Existing 4 system Bedroom 100' House B-3 99.7' 230' 180' of building sewer Cleanout to be installed 99' at 95' from building B-1 Huffcutt Combo Tank B-2 39g Slope Area 15' below system is to remain undisturbed B.M.* i 70th Ave i W 1 At-grade System Sloping Site Cross Section and Plan View I t a E r 1 L -t L L L L ti t L t\ 5 5 1L t 1`t L t L L.T"L.y ti-ti.ti.ti L.1 L 1 L 11.E -.-I Dimension F pet \r\ry{•f r r r r f! r r r };f r r f r r f r f r•r•r•r r r r r J f• jtfL}L}Lr4J1. 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J r•. •.1 •-•.L•t-•..•. t•L{L 1Jtr rt Lr-r•r•:.: .:.J.: .j. t{} L.t 4 Syr J : : : .r f : : : r.r : : f r.JLftlL JSf}l1'S, '..•.\.t.•~ r•f.f •r•r f .T 7 ~ t L\ L} 1 M1 l\ L-} t i t }•L I J l•: I' 5.5.1.5 M1 \ \\Y'{! 1 iti LrtrLjt {Jtf f Jtrtr4rLftf rtlLr1?tf1f~rM1 }~l r J\ L1L ••I G 1.0 t t t L•4•t E L L7 - tihl3 v W 2--Z, - - - - - B----- E 4- r L - % slope a" ] e s i t ?I = Plowed = Clean aggregate t .1 basal area '+r to 2 in. dia. 0 - 4 in, sch. 40 pvc observation pipe Lateral with T' Topsoil Cap aggregate over pipe Geotextile - - Observation Pipe Fabric G With Cap \ • ^ 1't Lateral 1rlV2rC .-1•},. . ,1,• 1.:.:: :-r-r•r•r-r• J.f I Topsoil Cap f-J.r.: :r:J:.•:?: C t-L.`.. L.t.1.L1a{~{L ..L. L•{: ' ? Ft Contour lt•L.L~ti i•..•. r•r•J•f•J.r / - 5.5.5.5••. ,y Plowed Surface Slope Direction GENERAL INS'FALLATION: The at-grade area is staked out along the desigd contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a i moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to i form a Y. inch sail wire when a sample is rolled between the palms of the bands. The A x B area is covered by clean aggregate deposited overhead by a backhoe.. Special care must be used when placing the aggregate to minimize compaction of the plowed $tuface. A ithe topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative grobk* limit erosion and protect from freezing. The observation pipes are perforated in the lower 6-inches and secured in place. 03/05 lgj Page of i Pressure Lateral Layout One Lateral - End Manifold f- Threaded Cleanout Force Main Lateral Turn-up J--* Plug L--- t--- Long Sweep i 90 E Bend I i Distribution Network Specifications Pressure System Construction Lateral Diameter Z In. Laterals are constructed of Schedule 40 PVC i Orifice Diameter 311• X Pipe. Orifices are drilled perpendicular to Orifice S acin In. the pipe with a sharp drill bit and face down. 1L- ateral Length) _ _ Ft. Lateral turn-ups terminate with a threaded Fore? Main Diameter Z In. cleanbut plug and arc enclosed in a 6-8 inch Force Main Len 5 Ft diameter lawn sprinkler valve box accessible from finished grade. I Grade p:; jj VIII 6-8 Inch Lawn Sprinkler Valve Box i i C 03/05 Igj Page L~ of Septic-Dose Tank Cross Section And Pump Performance Specifications j Tank Manufacturer i P Matwfectwror I -TME , _N/ Tank Model Number ! 5-17 Pump Model Number c2 U - Total Tank Capacity ( - Alarm Manufacturer Max. Bul Depth Alarm Model Number - - Switdt.rype e i Filter Manufacturer - Total Dynamic Head (TDH) - Feet r Filter Model Number Elevation Head Distal Pressure 3 Network Loss - Minimum P=P Perfotvsance Required Force Main Loss /tJ ~~1 GPM /j / Ft TDH Total - , / Outlet Manhole MftL 4" Above Grade With I C> Looking Device. Wet Manhole Manhole Min. 4" Above Grade I < 6" Below Orade Sealed Watertight Securely Mounted wah Locking Device \ " Weadiff-proof I ) \ } !unction Bar ♦ j - - Finished Grade - _ tom- : I Vera Min. 12" Disconnect Above Grade Means With Vent cap a. -A (Met Filter Inlet ~.r inlet Baffle - I switch Sotto A _ - $ and Reserve Capacity 1/4' Tank Volume = OPI Weep Dimension: Inches Volume Gal. B Hole (alarm)) B 2 of Elevation C t (dose) C' S J 'r D, 2 Ft # q Bottom j D -E - S- D Elevation 1 Total GENERAL. INSTALLATION: The septic/dose tank is bedded and back tilled in accordance with the : maradwtorer's product approval epooifioations. Maximum depth of bury as specified by the mam4oh rer may not be exceeded without prior 4pproval. Manhole covers exposed to grade have an afieotive kwkiag device (padlock) installed Piping at the Wet and outlet is of approved materiel, connected to the tank with watertigfit fi bags, and laid on stable soil to Prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank { excavation and the sleeve is sealed watertight. Electrical service cypmltes with NEC 300 and Comm 16.2$. 02/15 Ll Page ~ of Ii 1 I 280-SERIES 112 hp Submersible Eff/uent(Sump pumps The t ice' 280.se11ss ProWdee a coat Offacn i ranWpwopkron-eftewa~y~ ve •mid- Pedonn8n" CurV BYE, Aquid 40 280`~;g 1 wealsirargterarbComi emiel heavy-duty sump pump apickatiors>a 12 euirehigher head or mopa flow. 35 Deftned ttheM4srlft will~vide~ of casting, 30 11 reliable i Perlo ~ 25 9 All Afod&ls FeaWrq. T s i • LP ,A* limber Pem t rig Passage of solids $4 15 5 • 416 stainless st,esl rotor shaft x 10 5 Pem~ lubricatOd upper and 10wer ball bearing 5 3 finish 2 ,1 K' Comoslon'rasistant stainless steal 00 5 10 15 20 25 30 35 40 46 SO 55 50 55 70 Discharge U.S. (axon Per Mmub9 • Stainless steel bottom screen - easily removable I--r Maximumfhddtempard4ae:14(r F. a 38 78 114 166 192 226 27,o 28041arlee Cord Length. Liters Per M'ewte Model 1a 1- 280 zs 36'f_6at aslona/ Data: .a ;oral OpUdonnallaa6onr Weight: 29 tbs. 281 t3terderd Fieigfrb 13- 283 . amndard OptorW onal Motor Wktft 10° (model VWnW 287 SW'dwd OD6or~ w WA - A4/nimum Sump Diameters ' h"A endmau n Od-IL Fbropawry s Irvum ' Model 281,283-- '14- ern, 29D MM 35- 290-3 Model 287 VMF...10- f motor S Factory switch Model 281, 289 Modal 287 Pec►Ilcatlons VIV 11P 601st 3450 RPM Turn on level 13' . % 9 6• t Oil filled, thermally Protected Turn Off level 7• 4.0' P- Permanent Splitcapacitor 8.0 amps n„ L10" nnae • 4.0 amps Mo&r23OV) are a wpl~ I Model 290 Model 281 M us4 awttch wide angle del angle Model 287 float switch float Switch tch ~ Ve tical ap with quick- float map. with series disconnect (Piggy-baclQ smaller phs- ! Plug will operate In a 10• diameter U.S SUMP D o. y~.Certified dMaibWS~,••bFp,4r.„p,•b•„eYO~ flbeffyPUMPa •7000Appfa 7hpe Avemm . , New yor* 14416 • Phone 800.543.2M yid MM 494-1888 cwrdddeu,.gn••P86h eZl7 ady,s,,,awd. un'aomrosn7 i i i POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page __oT_ ILE INFORMATION Owner' SYSTEM SPECIFICATIONS Penult # - Septic Tank Capacity S S- ❑ NA Septic Tank Manufacturer SIGN PARAMETEtzB NA Effluard Filter Mamftdure Number of Bedrooms r _ O NA ❑ NA Effluent Finer Model ~i Number of Public Facility Units 13 NA NA Pump, Tank Capacity Estimated low (average) Z~ - aj ❑ NA r Design flow (Peak), (Estimated x 1.5) 60 aft Pump Tank Manufacturer NA 0U Pump Manufacture r Soil Application Rate / ❑ NA Standard I - allot /ft Pump Model WfieQY - v ❑ Monthly average- Pretreatment Unit ~ Fats, ON & Grease (FOG) S30 mgfL Biochemical Oxygen Demand (130D.) El Sand/Gravel Filter 0 Peat Filter 5220 mg/L U NA 0 Mechanical Aeration P O Wetland _ Total Suspended Solid s (TS- s150 m L retreated Eflluem Quagry Monthly 0 Disinfection O Other, average Dispersal Call(s) - Biochemical Oxygen Demand (BOD6) 530 mglL 0 NA Total Suspended Solds (T) 130 miyL ❑ In-Ground (gravity) 0 In-Ground (pressurized) NA Fecal Cogfornm (geometric ;4,t-Grade El Mound mean) 510 cfu/100m1 0 Drip-Line ❑ Other. iMaximum Effluent Panicle Size OtMr - kin cite. ❑ NA (Nher. - I - - - - OMer: 0 NA Values 1 1 for domestic Wastewater and - 0 NA sePtlc tank effluent Other. - WNTENANCE SCHEDULE I] NA Service Evert 1 Inspect condition of tank(s) Service Frequency ' _ At least once every; ❑ moM s Pump out wnteds of tank (s) When combined r(s) (Maximum 9 years) p Nq C sludge and scum equals one-third (X) of tank volume Inspect dispersal cell(s) O NA At least onca every; - mordfh(s) Clean effluerrt filter - ar s (Maximum 3 years) 13 NA At least once every. month(s) I nsped pump, Pump con6cls 8 alamh as 8) 0 NA At least once every: 1 ea s NA (s) ❑ blush laterals and pressure test . At least once every: 0 month(s) qhw: ar s NA At least once every: 0 month(s) - ~ther. a) NA MAINTENANCE INSTRUCTIONS O 1 i nspedions Of tanks and dispersal cells shall be made by an Individual carrying one of the following licenses or certifications; ter Plumber; Master Plumber Restricted Sewer, POWTS Inspector p0yv1-S Maintainer, Septage Servicing Operator. Tank Inspections must Incklde a visual inspection of the tank(s) to identify any mlasing 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 I Visually Inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface f The ponding of effluent on the ground surface may indicate a falling condition and regulatory authority. requires the immediate notification of the local When the combined accumulation of sludge and scum in any tank equals one-third (K) or more of the tank volume, the entire comenta of Itre tank shag be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wisconsin 1 Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical Or Pressurised corhpOnerds, pretreatment units, and any servicing at intervals Of 512 months, shell be performed by a certified POWTS Maintainer. , A service report shag be provided to the local i regulatory authority within 10 days of completion of any service event. j i i it Pep -of-, START UP AND OPERATION For now construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or otter chemicals tNt 4 may impede the boetment 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. System start up shell not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will by discharged to the dispersal cell(s) in one large dose, overloading the oell(e) and may result in the backup or surface discharge of effluer L To avoid this situation have the con%t<s of the pump tank removed by a Septage Servicing Operator prior to restoring power to this effluent pump or contact a Plumber or POWTS Malydalner 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 calls. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or et-grade sod 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; dogreasere; dental floss; diapers; disinfectants; fart; foundation drain (sump pump) water, frail and vegetable peelings; gasoline; grease; herbicides; meat seeps; medications; oil; painting produclic Pesficldes; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to Insure that the system is propejty and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shell be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Sepfage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with see, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a Code compilgrd replacement system: ❑ A suitable replacement area has been evaluated and may be utiilzed for the location of a replacement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be InMnged upon by requi(ed setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the nried for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruled in effect at that Urns. ❑ 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. -VThe ate has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sot and ate evalua'on bst be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. Mound and at-grade sal absorption systems may be reconstructed in place following removal of the biomet at the ini iltrathre surface. 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 ANDK)R INSUFFICIENT OXYGEN. DO NOT j ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A 6 PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS ii POINTS INSTALLER POWTS MAINTAINER Name a„~, Namel 72T Phone _ ,T--- Phone J SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORY AUTHOR llama r ✓ Name LA~ Phone Phone /.j 3pj X C 0 - - This document was dialled In o molance with chapter SPS 383.22(2)(b)(1)(d)b(f) and 3815s(I), (2) & (3), Wisconsin Administrative Cads. f p P 1 N P El - 1 t 1{ f a ~ cn g c; ' J ft~ w ni 7 IL it iL F _ N H D I YUY b Q v £ z u o N { ST. CROI Y COUNTY SFP"f IC'FANK MAINTENANCI rt(iR f IvILN''f AND f (w~~~' OWNLRSUIP Ct.RTIFICATR tN FORM Ownerll3tiyer_ -._e"U-O 1~ 1 U NlailinR Address LS _ u 'lam < Property Atktross Is, ~'q~ (vcr L _.-p - p-- - - - crifaatiun rcywred from I'lannm K Yoniu Uc. a tnenl for r~w cor~ctionJ - - CItylState_ _ ParcelklcntificationNutibet' G~ t LEGAL DESCRIPTION Property Location S4 s';'3 0 L n N R 1 W, Iowa of Subdivision 1 Certified Survey Map V('111ine Pagc h f;j Warranty Deed $ L -l Volume S Page Spec house yes no Lot lino: identifiable roe; 3 no SYSCF.M MAINTENANCE: AND OWNER CERTIFICATION Imprwcr use and mairtleiiancc of vuur septic svstcmi could result in its pr:xnahae faihuc u. handle wastes. Proper m,uiitetance consists of puntpmig out the septic [atilt c ,v three yeai:c or sooner, o needed, by a licensed pumper. What you put Tutu die system can a@cct the function of the septic tank as a trrafinent slage in the wasic disposal system. Owner maintenance ,cspoiutbiliiies a:e spccifterl in $Comn). R3.i2(1) and w Chapter 12 - St. Croix Cuuniy Sanitary Uuhrwncr, 7hc property- owner agrees Io submit to St. C'roa Ceuay Planning S; 7^x. mg Department a ccrt$icatiou 1-orm, signed by dtr owner anti by a roaster plurnher, Journevman p:um,bcr, resun;icr plundn,r or a licensed punyrer vcnf)•tng [hat (1) the hat site wastewater disposal system is in proper operating coutboon andr'oi (2) after tuspcc:ion nod punWing: (if necessary), the sciloc lank is less than U3 fill) of sludge. Vwc. the undersigned have icad the abocc teyuuemenls acid agree to tmaintam the private sewage disposal system with the standards set Both, herein, as set by the Department of Coutuxice and the Department ol'Naturai Resources, State or Wisconsin. Certification sating that your septic syslcm has been maintained must be completed and returned to the Sr. CrnLY County Ptannmr, & lotung Deparlrrnmt within 30 dews of the three year cxpuauoa dtle - Uwe certify that all statements n this form arerote to th, best of myiour k nov.9edge.. ttw•c anda:e the uwnet(s) of the property described above, by VIltuc of vananty deed recorded in Register of Dee,.ls OITic/y/ Number of bedroom S[ 'NATURE OF A11AA :ANT(S) / - DA"11; -**Anv hrforiradon tl;at is t usrepresented owy result in the sa:waiv pcmit being n•voked by the Planning & Zoning Departmcar. Include with this application a recorded warranry deed Sour the Register of Deeds Gfficc and a copy of the certified suivey map ii reference is made in the war tartly deed. (REV. 08105) r~rL•i'1,"--~1-~~111 x C5T-ra7Gld _~.5.~. ill P4L wisconsnDeparonentof Cornmarcjl'A{ 0g Za`$ S~IL EVALUATION REPORT Page o'_ Diosim of Safety and Buildings I ataccon"nte wdh Comm 85. Wis. Adm. Code J f AdaU complete site plan m pl5pe[514k)at121hen~E77Tx 11 inUes in size Plan must county . x - indude, but not funded to vertical and horizontal reference point (BM). direcam and Parcel I.D. 1/1, percent slope. scal6 or dimensions, rwNt snow, and location and distance to nearest road. ~.~d Please print all information. Revi etl by Date Ptllanal irnamaeon yw ww,Ca may ba anal tW raoondary fi. o a6 (PnvaCy Uw. 6 15 oa (1) (r ih / e. I Property Owner Property Location Li tt-. 1< cS~f L~ - GtM. Lotj F lii, C✓ ,l S ?r N R E( W Property Owners Mailing Address Lot 11 Block 11 Subd Name # City Slate Zip Code Phan Number ❑ City ❑ Village 7 Nearest Road ❑ New Construction Use Residential f Number of bedrooms Code derived design flow rate _ GPD g3iReplacement ~~77 fF7I'Public or commercial - Describe Parent material -C 3CC' _ Flood Plain elevation if applicable w AL- R. General comments aid recommendations: Systole Type %'C!/A-~ System Elevation L , , Boring # ❑ Boring c 1 .pit Ground surtace elJ / R. Depth to limiting factor in. Soil Appliration Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDTe in. Munsell ou. Sz. Cont. Color Gr. Sz. Sh. 'E"1 'ERIf2 -i_ ILAI rA +7 d-~ t S L- M N/ 71- Boring # ❑ Boring 711 Z7R. Depth to limiting factor S V in. erGround surface elev. Sell licabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIIt in. Munsell Ou. Sz. Cont.Color Gr. Sz. Sh. 'ER#1 •Etf#2 J . 31 L / / fy ' nw 2 i ' Effluent #1 = BOD. > 30 < 220 mill. and TSS >30:5 150 ' Effluent #2 = BOD, < 30 mg,4 and TSS < 30 rrg2 CST Name (Please Print) rr CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401 y- ✓G 715-246-4516 Property 0vmer Parcel ID # - Page of a Boring # ❑ Boom d- J, pit Ground surface eloyf - tt Depth to limiting facto S n. Shc Application Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistene Boundary Roots GPDiTF in. Munsell Ou. Sz Cont Color Gr. Sz. Sh 'Effp1 'Ef#i2 Z d, v ❑ Boring # ❑ Boring ❑ pit Ground surface elev. It Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Ou. Sz. Cont. Color Gr. Sz, Sh 'Efl#1 'Eff#2 ❑ Bering Boring # Ground surface elev _ ft. Depth to limiting factor in. ❑ pit Soil Application Rato Horizon 'yepth Dominant Cola Redox Description. Texture Structure Consistence Boundary Roots GPD41 in. Munsell Ou. Si. Cent, Cola Gr- Sz. Sh. 'Effp1 'Eff#2 Effluent #1 = BOD, > 30 < 220 mgt and TSS >30< 750 m9,L ' Efficient #2 = BOD, < 30 m0- and TSS < 30 mgl- 'I"he Ucpartment of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or T-fY 608-2fst-8777. ran-ns ~a earn Rnpwty Owrw Psroal 10 # ewe a_ mtror © O s«tw ZZ Ph orou deufia eb~ rt Depth In 1YN6np tenor! b, IAadaon Depth Don**M rAgm Redoz Descrom Tmmae SeuWe Carrleeena 8a1 Rase h Mw=g Du. Sz. Cad Col. Or. SL Sh. eoxwwy Roan .gpry 0-13 D l ~s z - _ 3 s Av- -Z t I! ❑ 6ethpl ❑ BOllnp I ❑ PH Gnouclaurtaoeelev. R Depth to "ft taapr 4r. Horizon Dept In. h 0 ~ Coju Rsd=Deaa"m T~due Skunk" CarWswe Rawl Rb GPDA! Ra0° au. SL Cant. Color Gr. Sz. Sh. *EM -sm D a ❑ BoM1p ❑ Pit Grauai aurtap eNv. R Dplh In amum lacbr h Horizon Rai In. Redar Deaerl Texture Or. S+ re Conelelence ew,drN Renkk&kMl y oQPDW n. SL Cwrc Color caw Gr. z sR •EOM AC11 SM.> 30 c 2M n*C and TSS>30e 150 mpA_ •E*mt I2-SM.130 myl and T83 _ so mpt The DcParmwm of Commerce is an equal opportunity service provider cod employer. If you need aasiBtM= W accen servieet or need mitarial in an alterme fomma, please wract the department at 608466-3151 or 77Y 606-2644777. eweuea~ I i Soil Test Plot Plan , Project Name Chad Deraps Shaun ird Address 1552 70th Ave Roberts Wi 54023 CS 2?fi9(l0 Lot Subdivision Date 4 /18 SE 1/4 S W 1/4S 30 T 29 N/R17 W Township Hammond ❑ Boring Q NVcll PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of power box System Elevation TBD *HRpSame as Benchmark Scale is 1" = 40' unless otherwise Proposed Property Line noted 0Well Sr Existing 4 Failed Bedroorn 100' system House B-3 230' 99, B-1 B-2 3°a Slope B.M.' 70th Ave