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HomeMy WebLinkAbout010-1063-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: &6Sc~~ GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)) 2 Permit,Holder's Name: City Vill e Township Parcel Tax No TOWN OF /6 1663 - 36 -6r CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 746 Benchmark Dosing Alt. BM l~e 'off 766 5 9~ 9 14ergEief+ Bldg. Sewer C4 ems... o~ 3 $'9.1 Holding SUHt Inlet ffy8 s:9 St/Ht Outlet TANK SETBACK INFORMATION I, 7 W7 TANK T O P/ WELL BLDG. ent j Air Intake ROAD Dt Inlet Septic r b Dt Bottom C I Dosing header/Man. 57 7.3 A/ 7 / Aeration Dist. Pipe y~ 7 7 Holding _ Bot. System C Final Grade 3• PUMP/SIPHON INFORMATION Manufacturer errand Si Cov -7 'y• e~ U GPM J O J 7 I Model Number 36 q3 TDH Lift Friction Q! (p Los , System Ha TDH %91 -3 i's Forcemain Len 4t,./ DiaZ Dist to Weli SOIL ABSORPTION SYSTEM BED/TRENCH [6idt. Length No. enche PIT DIMENSIONS No. Of Pits inside Dia. Liquid Depth DIMENSIONS SETBACK SYST=M TO ✓ C~ P/L BLDG WELL LAKE/STREAM LEACHING Manufacture- INFORMATION Ty `System : CHAMBER OR pr UNIT Mode! Number DISTRIBUTION SYSTEM Header/Manifo/ Distribution x Hole Sf-e x Hole Spacing ve ' Air Inta Length Dia LDia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded jxx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes I_ Ne J N.] COMMENTS: (include co discrepencies, persons present, etc.) Inspection #1: -71z,3 Inspection #2: i ~ Location: / . - 5P V'AT 6-0 1.) Alt BM Description = 2.) Bldg sewer length - 0 SAN- ~ t, ~ V 7o, amount of cover = 106 J rinsepctor's ~ ; ,4 6a j IL (4010 6:x A Plan revision Required? Yes 7 Use other side for additional informa Date Signa e Cert. No. SBD-6710 (R.3/97) nn 1 p \ dt I r~..C. . ~e M ~cJ S tr--' - l U; County Safety and Buildings Division St. Croix _ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) \ S P (,g 12 2M Madison, WI 53707-7162 ~ {fig "''i3~ Wt~ I it Applica _ (11 f- State Transaction Number t In accordance vvii SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may he used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1. Application Infor tion - Please Print All Information Property Owner's Na / Parcel # Matt Wetzel ( 010 -1 D (P Property Owner's Mailing Address Property Location c= 2580 130th Ave. Govt. Lot City, State Zip Code Phone Number SE y, SE /4, Section 26 Glenwood City, WI 54013 612-704-0535 T 30 N, R 16 (circle on H. Type of Building (check all that apply) Lot # X 1 or 2 Family Dwelling- Number of Bedro s _ Subdivision Name Block # ❑ Public/Commercial -Describe Use ate" ❑ City of ❑ State Owned - Describe Use/ CSM Number ❑ Village of & e 5~) 17)L) LQE X Town of Emerald O✓ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System X Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner Oft 10-W 0% IV. Type of POWTS S stem/Com onent/Device: Check all that a ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound < 24 in. of suitable soil El Holding Tank El Other Dispersal Component (explain) ❑ Pretreatment Device (explam V. Dis ersat/Trea ent Area Information: . Design Flow (gpd) Design Soil Application Ra (gpdsf) Dispersal Area Required (sI) Dispersal ea Proposed (sf) System Elevation 300 .6 CIO t.; - 4 ~ VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o o New Tanks Existing Tanks c Y x, ors ~;r ~U Ll~ Septic or Holding Tank X 700 1 liewis Bjork LLC X Dosing Chamber X 700 1 Lewis Bjork LLC X VII. Responsibility Statement- I, the undersigns esponsibi ty r instillation of the POWTS shown on the attached plans. Plumber's Name (Print) P m s Signa re , MP/MPRS Number Business Phone Number Lewis Bjork 253976 715-231-7375 Plumber's Address (Street, City, State, Zip Code) E7818 County Road E, Menomonie, Wl 54751 VIII. oun lDe artment Use Only Approved isapprove Permit Fee Date I sued Issum ent Sign re LLA, C)6 caner Given Reason for vial $ V IX. Condi easo, s for pisapproval 'A V71 t. eptio tank, t:itiLCM, II~o- en,t 3) / ~ol/t,aj ro ~ e ois pemf , cell must Al C, V~ ~'1Ot 'alr per i-narsgement plain p! o riaerl Uv plumbe. are, f ~f ~1 ~ / 2. AY ee1Mi )rreict.intrteno manlt to rr,< it c C•t ` ~ Attach to complete plans for the system and sub it to the County only in paper yspn 8 t/Z 11 inches in sue SBD-6398 (R. 11/11) I i IA- 4A I i "V ~^rr 1 i +r M^ d~ Jor I-- a $ w 71 It r` f t ~ F ~~w rM bj DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 r GREEN BAY WI 54304-5211 Contact Through Relay P S http://dsps.wi.gov/programs/industry-services 2 w' www.wisconsin.gov r)FFJ:S70 T/ Scott Walker, Governor Laura Guti6rrez, Secretary July 09, 2018 CUST ID No. 253976 ATTN.• POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751-6637 HUDSON WI 54016-7708i_ CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/09/2020 Identification Numbers Transaction ID No. 3123796 SITE: Site ID No. 850936 Please refer to both identification numbers, Matt Wetzel above, in all correspondence with the agency. 2580 130TH Ave Town of Emerald St Croix County SE1/4, SETA, S26, T30N, R16W FOR: Description: Mound System (2 Bedrooms - Replacement) Object Type: POWTS Component Manual Regulated Object ID No.: 1783849 Maintenance required; Replacement system; 450 GPD Flow rate; 12 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/O1, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/O1, R. 10/12), SSWMP Pub. 9.6; 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 (10), 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 LEWIS C WORK Page 2 7/9/2018 • Insulate building sewer beyond 30 feet per SPS 382.30 (1 1)(c) • 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(l). • 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 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 (608)516-6134 , Mon- Fri, 6:00 a.m. - 3:30 p.m. tim.vanderleesti wi.~_,ov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Mon-fri, 8:00 A.M. - 4:30 P.M. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN A iApplicatio"Y ¢yti INDEX AND TITLE PAGE ,UN 2 ~ 2018 Project Name: Matt Wetzel - New Mound Design Owner's Name: Matt Wetzel Owner's Address: 2580 130thave Glenwood WI 54013 612-704-0535 Legal Description: SE SE 26 30 16 W _ Township: Emerald County: St.Croix Subdivision Name: NA Lot Number: 1 Block Number Parcel I.D. Number: 010-1063-30-000 Plan Transaction No.: Page 1 Index and title: Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot plan Page 10 Attchments : Effluent filter / septic & dose tanks /manhole Page 11 Soil report Designer: Le ' Bork License Number: 253976 Date: 06/20/1 Phone Number: 7,15-231-7375 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Pagel of 10 Mound and Pressure Distribution Component Design Site Information (R or C) r Residential or Commercial Design Note: Sand fill (D) calculations assume a { Estimated Wastewater Flow (gpd) Table 393-44-3 in-situ soil treatment for fecal coliform of 36 inches. 1.50' Peaking Factor (e.g. 1.5 = 150%) =0.00 Design Flow (gpd) 4,001 Site Slope 93.00; Contour Line Elevation (ft) O Depth to Limiting Factor (in) 12!10 0.60' In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 50 00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd/ftz) 1 ! Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network?= r1t~a or ({_r i e` Center or End Manifold 3700 Lateral Spacing (ft) If N above, enter the elevation (ft) Z Number of Laterals of the highest point. _ 0 250. Orifice Diameter (in) 3.75 [ firnate±;J Orifice Spacing (ft) = =11.54 f:2/orifice 2 00 Forcemain Diameter (in) 135 Q0 Forcemain Length (ft) Does the forcemain drain back? _Y _-J 86.00 Pump Tank Elevation (ft) k >>fie~r Y or N 3.25 System Head (ft) x 1.3 10.60 Forcemain Drainback (gal) / 8.83 Vertical Lift (ft) 44.48 5x Void Volume (gal) 1.28 Friction Loss (ft) 55.08 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 30.29 System Demand (gpm) 13.37 Total Dynamic Head (ft) gnat dal Diameter Selection Manifold Diameter Selection tions choice in. dia. o tions choice 0.75 ! 1.25 x r 1.00 1.50 x x 1.25 2,00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (c ptional) Treatment Tank Information Total Tank Capacity (gal) 700.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Lewis Bjork LLC Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700 00] Dose Tank Capacity (gal) orenco Filter Manufacturer 18.85 l Dose Tank Volume (gal/in) Bio-tube i Filter Model Number Lewis Bjork LLC ;Manufacturer Project: Matt Wetzel - New Mound Design Page 2 of 10 Mound Plan and Cross Section Views J 1/10 B Observation Pipe - 1 -K 0 r5i A W I. B - -o L Mound Component Dimensions A 6.00 ft E 26.88 in H 1.00 ft K 11.74 ft B 50.00 ft F 9.50 in z 12.04 ft L 73.47 ft D 24.00 in G 0.50 ft J 8.82 ft W 26.86 ft 300.00 (ft2) Dispersal Cell Area 901.99 (ft) Basal Area Available E 6.00 (gpd/ft) Linear Loading Rate 1 (ft) 1/10 B Obs, Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.79 (ft) H GI I F Dispersal Cull 95.50 Lateral Invert 95.00 (ft)-► Dispersal Cell Elevation D 93.00 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 1[] }Topsoil Cap 1.5 ft Page 4 for number, size, F22 Subsoil Cap ;i 0 © 0 ~ and spacing of laterals. 'Tilled C33 Sand l Laterals are equally Tilled Layer 0.5 ft Twical Lateral spaced from the the F distribution cell's © Aggregate a centerline in the A distribution cell (AxB). Project: Matt Wetzel - New Mound Design Page 3 of 10 End Connection Lateral Layout Diagram Laterals "were overt the dimension ♦=Turn-upvwball valve oraleanoutpiug P All laterals are f.ienrical 14 X 9I Holes drilled on the bottom of the lateral squally spaced S Foree main connentfon via tee or nro9s to manifold at anu point Lateral) & forcemain Sch 40 PVC per S P S Table 384 30-11; Number of Laterals 2 Orifice Diameter 0.25 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.04 ft Lateral Length (P) 48.48 ft Orifices per Lateral 13 Lateral Spacing (S) 3.00 ft Orifice Density 11.54 W/orifice Lateral Flow Rate 15.15 gpm Manifold Length 3.00 ft System Flow Rate 30.29 gprn Manifold Diameter 1.50 in Total Dynamic Head 13.37 ft Forcemain Velocity 3.09 ft/sec Dose 'Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ♦ SPS 316.300 WAC 4 in. min. Disconnect - Tank component is properly vented E- Alternate outlet location Forcemain diameter Lewis Bork LLG Manufacturer 2 in. Capacityl x'00.00 Gallons T Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 24.21 456.42 B 2.00 37.70 C Pump off elevation (ft) _t d C 2.92 55.08 86.67 D 8 00 ;l 150.80 D Total 37.14 700.00 Dose tank elevation (ft) Bedding un er tank. F--8-6-0-01 Alarm Manuafacturer ;SJE ROmBUS _ Note: Switches, Alarm Model Number 1011421 r _ containing mercury may not be used in Pump Manufacturer IZohler this system. _w Pump Model Number 152 Pump Must Deliver 30.29 gpm at 13.37 ft TDH Project: Matt Wetzel - New Mound Design Page 4 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name Lewis Bjork LLC Phone; 715-231-7375 POWTS Regulator's Name St.Coix Phone 715-386-4820 Systern Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1150 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic j Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Ins[:Iect for ponding and seepage once every_3 years Lewis Bjork for Pumping Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured In as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce 'rost penetration. Lateral Turn-up Detail Finished • • p 0 • . . Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution _ Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: -New Mound Design Page 5 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD 10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706_P (N. 01/01)j and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. 'The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The fifter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the fifter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tans; shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filler is installed within the tank. it shall be inspected and serviced as necessary. Mou%l and Pressure Qlstributlon System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 ML for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continnencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump.. pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 10 150 Series Effluent Pumps Zoeller Pump Company https://www.zoellerpumps.com/en-na/products/sump-effluent-pumps/ef... C!~ W W PUMP PERFORMANCE CURVE 2 U- MODEL 151/152/153 50 14 45 153 12 40 35 10 152 v 30 z 151 0 8 25 g 20 R. 15 4 ~ r~ r 10 2- 5 0-- 10 20 3 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE Chat now 8 1 of 5 6/12/2018, 11:04 AM t JA - All wg~ a E ; ,n N ~3 -8 P ` v~ " CD ~l~oEt~aT•nr`V DIVISION OF INDUSTRY SERVICES \o~ PO BOX 7302 1P~ MADISON WI 53707-7302 3 } MIS i Contact Through Relay 9~( P S http://dsps.wi.gov/programs/industry-services \ www.wisconsin.gov sS1( Scott Walker, Governor Laura Gutierrez, Secretary May 19, 2017 Identification Numbers Transaction ID No. 2944957 Site ID No. Please refer to both identification numbers, above, in all correspondence with the agency. CUST ID No. 253976 LEWIS C WORK LEWIS BJORK LLC E7818 COUNTY ROAD E MENOMONIE WI 54751-6637 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/31/2022 Re: Description: SEWAGE TANKS, CONCRETE Manufacturer: LEWIS BJORK, LLC Product Name: (tyrans id 2944957) SEPTIC, PUMP OR HOLDING (TANK AND ADAPTOR) Model Number(s): LB700, LB1150 (700 AND 1150 gals.) [LB700 BASE TANK; LB1150 CONSISTING OF 3 SECTIONS WITH THE 450- GAL. ADAPTOR AS THE MID-SECTION] [38 IN. L.L., 18.85 GAL/IN.; 96 IN. MAX. DEPTH OF BURY, 335 OR 551 GPD WHEN USED AS A SEPTIC TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER; TANK DIMENSIONS = 66 IN. L X 36 IN. W X 54 IN. H; ADAPTOR DIMENSIONS = 66 IN. L X 36 IN. W X 24 IN. H] Product File No: 20170151 The specifications and/or 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 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of May 2022. This approval supersedes the approval issued on 6/28/2012 under product file number 20120193. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • All manhole covers terminating at or above grade must have effective locking devices. • When this product receives wastewater from dwellings, it will produce an effluent quality with a maximum monthly average value for BOD5 of less than or equal to 30 mg/L, TSS of less than or equal to 30 mg/L TSS and F.O.G. of less than 30 mg/L. Tuf-Tite Riser SY5,tem ,f I 9° ~ S~FFay' r F , ~f . with »@ :>kk: L U t3 r 1~,syv. > < fety Lid 1` la, 6e u & 2 P. Cf PC-ns. Green' !aril', fety Pan 9 Y" x All Riser - or F 1,4 id t t h ~ ~ I fall Riser _ i :52 r t€'iS ds of s~sspended scuds f-om effluent, helping extend . * ~ ai:lfi?td ife_ They have the flow ar ee of a futt-size fitter in a sma. nackage for shar"t sen~tlc tams- Biotc-;be FT-Series Base Intel Effiu, `IlterS cr-e ins aLted oT- the Sdiedute 40 or Type 3034 outtet pIp2 v or exi=ting tank, They c'iome' with a filte'r• cartridge, PVC h, i in exte =dib, FVI I-ia; dip. Art optionat ow-t~ law pate is avail,a, -is7~~B r ~t~'v- +l 7?L~C1el_: ,.i:revent t fiiuel"lt ~ C; 71 f'1t'~'"cis55ng '.i i=: if 't clc,45 inch (LCCI-rl nr,,)n Inal tlti r an-le ter -inch (356- 7I-n) Elites height standard 2-Inch (558-mm) housing height, standard 3-inch ( 3 - m m , ~ or 'I/I6-inch ? l.5-n,m) filte - rresh available {tet'dC -J,-Ae h:a v.: s'ma to ctean 4:YUIi ia' (Nerf'i 4 ~;Ld rGliCa.J l~ :ptionai flow: eLbow awiiiabte for high-tevei alarm assembly gh eveL alarm asse?m!,D.,f orrered separa ety 3duct Sheet > -hn cat Data Shept > ST. CROIN COUNTY SEPTIC TANK MAINTE:.NANCE-: A(IRI L N-VIEN"I' AND OWNERSHIP CI RTII=ICATION FORM owner/Buyer Matt Wetzel Mailing Address 2580 130th Ave. Property Address 2580 130th Ave. _ (Verification required fi•otn Planning & Zoning Department for new construction.) City/State Glenwood City, WI Parcel Identification Number 010-1063-30-000 LEGAL DESCRIPTION Property Location SE as , See. 26 I- 30 N R 1 6 W. Town of E=merald - Subdivision Plat: , Lot # Certified Survey Mal) # _ Volume Page # Warranty Deed # (before 121.007)Volume Page # Spec house0yesEluo Lot lines identifiablc2yesE]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 )grumping out the septic tank ever, three years or sooner, if 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 waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(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 veritying that ( I ) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is Ic.<s than 1 /3 full of slud2C. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the tandards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, Mate of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix t_'ounty Planning & Zoning Department within 30 days of the three year expiration date. Lwe certify that all statements n this farm are true to the best of my/our knowledge. Uwe ant/are the owner(s) of the property described above, by virtue of warranty deed recorded in Register of Deeds Office. Number of bedrooms 2 SIGNA LIRE OF APPLICANT(S) DATE fin} inlonnation that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. iar~lr.riic v%ah this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if rcferencc is made in the warranty deed. (REV. 04112) Z aJ Ill ~Wisconsin Department ifComm ~Sclg 12 SOIL EVA DAMN PORT P;to 19 age I of 3 Division of Safety and Buildings U t in accordance wi h Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on pa0ernoGt~lg a th -1&~ 4-i inches in size. Plan must include, but not limited to: wettlca~ A('J-liorifon aT I reference point (BM), direction and Parcel I.D. 7-10t3-30-000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Review by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 =Q Property Owner Properly Location Matt Wetzel Govt. Lot SE 1/4 SE 1/4 S 6 T 30 N R 16 E (or))WW Block # Subd. Name or SM# Property Owner's Mailing Address L;Y1 2580 130th Ave part > 3 acre City State Zip Code Phone Number []Village Town Nearest Road Glenwood 'WI 54013 ( 6J2-704-0535 130th ave -Rwwrald New Construction UseG) Residential / Number of bedrooms 3 Code derived design flow rate _ 450 GPD Replacement Public or commercial - Describe: NA Parent material Loess cap over till Flood Plain elevation if applicable NA ft. General comments The first two pits north of existing system are A+ 0 , I moved east / moving from Freeon silt loam to Magnor Silt and recommendations: loam , also moving away from surface storm water relief area. B1 to B3 are consistent A+6 . Install , 6 ' x 50 ' rock cell mound , 24" sand fill on the 93' contour . ZO'~2 Bl Boring # u Boring 1 Pit Ground surface elev. 93 ft. Depth to limiting factor 12 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. _*_Eff#1 *Eff#2 A 0-6 I Oyr3/3 none seen sil 2fgr mvfr Cs 2f .6 .8 E 6-12 10 r6/4 none seen sil 2fsbk mvfr gs ]VIM .6 ,8 B 12-26 10yr6/4 c2p5yr, I Oy r6/2 sil 2msbk mvfr gs if 0 0 B 26-36 10yr6/4 c2p5yr,10yr6/2 sil 0 - - - 0 0 C 36+ 5yr4/6 scl 0 B2 Boring # Boring 92 12 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication 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 A 0-6 10yr3/3 none seen sil 2fgr mvfr cs 2f .6 ,8 E 6-12 1O r6/4 none seen sil 2fsbk mvfr gs 2VIm .6 .8 B 12-23 10yr6/4 c2p5yr,10yi6/2 sil 2msbk mvft gs 0 0 if/lm B 23-36 10yr5/4 c2p5yr,10yr6/2 sil 0 - - C 36+ 5yr4/6 scl 0 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 . d&,:< 30 mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Lewis Bork 253976 Address Date Evaluation Condu ed Telephone Number E7818 County E Menomonie WI 54751 6-11-2018 715-231-7375 t Property Owner Wetzel Parcel ID # Page 2 of 3 B3 Boring # ❑ Boring 93 13 Pit Ground surface elev. 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 A 0-5 10yr3/3 none seen sil 2fgr mvfr cs 2f .6 .8 E 5-13 10 r6/3 none seen sil 2fsbk mvfr gs 20m .6 .8 Bt 13-26 10, r6/3 c2p5yr,10yr6/2 sit 2msbk mvfr gs lf/lm 0 0 Bt 26-37 10yr6/3 c2p5 yr, I Oy r6/2 sil 0 - - 0 0 0 C 37+ 5yr 4/6 scl Boring # LJ Boring ❑ a pit Ground surface elev. _ 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 F-1 Boring # Boring - ■ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A IiGation 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 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department 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 TTY 608-264-8777. SBD-8330Test (8.07100) 4M x 'ca tV «tr1 ~ L~ ~ ~ ---n. d~ 1 C-A 44 r f \0 ~ t 1 i m r~ ~Q n Department ofCommbFCe, O ii LU18 tPOIL EV A ION' REPORT paye of Wisconsi Division of Safety and Buildings if, accordance h Comm 85. Wls Adm Code Ciounty Attach complete site planDripaperrk le' $ inches in size- Plar must include, but not limited fix vertical and horizontal reference point (BM). deection and Parcel 1.0 . percent slope. scale or dimensions. north arrow, and location and distance to nearestroad. % y~l L' ^ Please print all information. Rev1 by Date / GG P.non.l inbrmuon yoe prov~oe may be nsea rw secondary purp0~1E (Pnvyq UA , s 15 OM (1) (m)) - 7 LO / O Property Owner Property Location J C_ L \ Govt. Lot j 1t4~ 114 6 T J N R i 6 E ax W Property Owners Mailing Address -1 p Lot # Block # Subd Name CSK40 S u ~ J l-~.kC•L r ~ t n^ City State Zip Code Phone Number ❑ City ❑ Village T m Nearest Road ❑ New Construction se Residential! Number of bedrooms Code derived design flow rate C _ GPD Replacement ❑ Public.orcontrnercial Describes Parent matenal ~1..tJr 1 Flood Plain elevation if applicahe General corrtrnents and recormrendations: Svsfem Tycc a ,,,1.:. System Elevation Bplrlg p ~5II &onrtg Q I / V~ Pit Ground surface elev. ~ fl. Depth to limiting facto Soil tication Rate Horizon Depth Dominant Color Rodox Description Texture Structure Comistence Boundary Roots GPD" In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eft# 'Eff#2 1 , 1 Boring # E] Boring ® Pit Ground surface elev n Depth to timlting factor 1 in Soil I:;a6on Rate Horizon Depth Dominant Color Redox Desrnpbon Texture Sbucturo Consistence Boundary Roots GPDNf in. Munsell Clu. Sz. Cent Color Gr. Sz. Sh. 'Eff#1 '£ff#2 w Effluent #1 = BOD. > 30 < 220 mgtt and TSS >30 150 AC,L ' Effluent #2 = BOD, < 30 mgtL and TSS < 30 m(y'L CST Name (Please Print) Signature GS f Number Bird Plumbing, Inc. Shaun Bird 226900 Addr?yes Dale F-mluaton Conducted Telephone Number 1432 120th St, New Richmond, VJI 5 017 715-246-4516 Property Owner Parcel IDa Page ---of- - a Boring a f❑71 LELBoring pit Ground surface elevU - It. Depth to Ilmitirlg factor in. Sod Application Rate Horizon Depth Dominant Color Redox Descnpt on Texture Strclure Consistence Boundary Roots GPDXF in. Munsell Du Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Efla2 n Boning a ❑ Boring ❑ pmt Ground surface elev fl. Depth to limiting factor in. _ Soil licatgn Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell 0u. Sz. Cont- Color Gr. Sz. Sh 'Effat 'Effa2 ❑ Bonnq Boring a Pit Ground surfaceelev. ft. Depth to limiting factor - in. ❑ Shc ;cation Rate Horizon '7epth Dominant Cdor Redox Description. Texture Structure Consistence Boundary Roots GPDlff M. Munsell Ou, Sz. Cont. Cola Gr. Sz. Sh. 'EfBt1 'EIfa2 Effluent a1 = 800r > 30 < 220 mgt and TSS >30 < 150 mgtt ' Effluent a2 = BOD, < 30 rn44 and TSS < 30 m91- The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate formal, please contact the department at 608-266-31 51 or TTY 608-264-8777. titlnlllp Ix 6%1 Soil Test Plot Pla Project Name Jennifer Wetzel Shy Bird Address 2580 130th Ave Glenwood City Wi 54013 O TM #226900 Lot Subdivision Datd' 5/31/18 SE 1/4 SE 1/4S 26 T 30 N/R16 w Township Emerald Boring G) Well PL Property Line County ST. CROIX BN1 or VRp Assume Elevation 100 ft. Top of well System Elevation TBD *HRpSame as Benchmark Scale is I" = 40' unless otherwise Propcity Line noted vent A +0 Soils Septic lank location unknown 50' B-I B 2 SS 75' F-1 4d Existing 3 Bedroom B.M.* 35' House 3(l' 50' 40' 150' Well 13-3 130th Ave