HomeMy WebLinkAbout042-1098-60-100
Yssconsir Depacmem of CrImrm.rcc PRIVATE SEWAGE SYSTEM ~u ly. St. Croix
S31efy anC Ru Id nn DrviSion
INSPECTION REPORT Sa'rrtary Pemm NC
fATTACI-I TO PERMIT) 605053
GENERAL INFORMATION Stat Par DNc
Pemnra nh rca'IO•yan rfno,;o may C. isms bn secondary p_.p-uses IPrvary -aw. s IS U-1, ~ - Ll) - / L
Pr'rni'. Hc'.de's Nan'~C CCy Vi last' "o.vwi,ir Pa'l'l lar Nu.
Richard Stout TOWN 0FJ4AUUQND
':ST WI FI,, Irso . BM E er'. BIA UesG iphc t Sec',icnrT^wn: Range~t.!ap No'.
TANK INFORMATION ELEVATION D A
TYPE LiANUrnCTURCR 77 CAPACITY STATION BS HI FS ELEV.
Septic L BerChrttark
1600 3' 163
Dosing C6 w~pp Pv Dodd nit en+ ~11&a Go 2,4 9
Bldg. Sewer ~ 7 p
rl I F: l v
Holding SUHt Inlet
9. 16. 73 77-r
SUHt Onllrl
TANK SETBACK INFORMATION \
TANK TO ( 'V.+-II HI 1)(11 'enl cnrtl,lake ROAD Dt Inlet
SeryBc: 5a ^ ` U' BuCOm //r 3 . /
Dosing !rf O Hcader+Man.
O ~p•3 `I r7.
Acnatton Ust. Piper
110 `ing Bot Syslerl 10
5.~, elor.,~
anal Grade
PUMP/SIPHON INFORMATION •d 9Y• 7
PAanclactwer r
Demand St Cover C~CT
IG 4-
L r LOe1 PM 2.4
Mnipl Nt-rin=r 7570 (J,Q T 7.3 y
' DI I LB F'iet On _ Z .°iystcnl Hoad TOS'S' t ) -7,( y3. 3
J p C13• ~
Fo'cemam Lcno / Dia If Dist 7
. Dv_n '
SOIL ABSORPTION SYSTEM
BEDrTRE NCH V:in1r I.cro;t-- Viz %I lien%ps VII DIMENSIONS No. D' P15 msice Di.; LTA d DcpL•1
DIMENSIONS
SETBACK SYSTEM TO P1 BLDG VILE LL IAKF:STREAPA LEACHING Manufec r
INFORMATION Tyr, O'Syste- CHAMBER OR hArde N.,mheZr
66 O/6 Li
yJe✓~l 24 ICI UNIT
DISTRIBUTION SYSTEM .S 17• S d- 7- = Ze
Ne:.tler'foL=.nitc~ / C st T-1," 5'u•~ n he ^ 5,z9 x Hole. Spar ng Vcn' a A r I r h P.
tie,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 5 Aa:~a.. A -117
De ptn r . r I DepAr O'.~ x.: Ce•pe ,1 x Pef.~G$ntlded xx M,irhe.7
ttemII.n.' erter Z Be 9rTre rcn Etl9e. ToFx .s No Yes No
COMMENTS: ilncclludecode discrepencies, persons presert e:c Inspection 41 nspealan a2
Location: 793 152ND ST YI -1 1e.,.. O T.~
1.1 Alt BPA Description = if J'
2. i Bldg sewer length = 74i
- amount of cover -
Plan revision Req-.,irea? Yes X No 7Y
Use other side for atldihonal informanor) L v (~I (.J ✓ I Ir7
Dale rose tx s 5rur urc Ce9 No
SBD.B- 1 J iR nr4?,
Safety and Buildings Division
r mri ?amtt Nuaa,cno Fc nhcr. in bT
t )
'07 .J. VJashl'igta•: Ave. P.3 Bcz ;tot S
~l$PS 1Jl`U %43d:so Vr- 5370' lb
ttaw.Q/ -
Trm:+su:no Nrvnbx
Sanik Permit Applicat.isa l
L -.:Ja 171 ~ :S 1 1 i'i- -d 1 t n.Sa1 s 1 '1 t - Ina [Lc apPr gnat gc vrzrucud vcrt _ _
1 n, 1i M, 1 v to S.irm a oi=9 penrl n¢ 0.po'I av a m+'oi tac - wtKd A )W 0: ac Snbr1 cd t. I'n:.a'1 Address (il 1 riucn: v.er1 n,a111't_:wbgs'
1 Xpm:uu Saien and'1 cssn.as Smic. " _ ,.Hal u.lmv.:.1 rv f 1 p.;!n id, vw x us .d ur Swom:ay~
rt[ .yain.a. .danac'a1th lh I •sx::, c I ali:n etas. _
1 Application Information Plisse Print All Er, afiou _ -_4 -
r a~. •^T vwan s F.m' o~'i8'-''s'c`ar'-r_s _ - _ ?rte ry lwti>u C•) t/ - ~ C`~. cj - ~ l
-
1 (~~u..'f W i.~---i~ J~~ 1..
~i y, S'.ale LFr xic Pbon- Nmhcr f1>/ ti Srnoe
I ya of Swfdut>; (check all that apply -
I s 1 - 5sGC1v ion Namc I
• Fatnihi =nx'elhac
}'ucfialcT~laci:d - Lr.>r, the I s: " Co, of _
:-SMNw16a - - Vdlmc of
S:ffic 1Jwaed - Dcui'r Ise ' ~
Ga751:4C.
:11. Nix of Permit: (Check nnlg out ho on line A. Complrle line N if applicable)
Qr-
Astnn Rcp:acnuc S}scly 0 T2ca^or_^.L I 1 6u. '.:uik Rq Ixclacot uo' I CYho Ftodlii::a: on I rxr :in7, SCnnu 1cxPl:u:'.
Ii. V na1 henewal T'm:u: Raianr I t l,c ,t - Lin oir wus F'eu:lit Nw»x anC La¢ lssuec
L r itu.l r ,
r~ 3d 1 s. nanoc } T1 ante 1 hew
IV - 'Componen (Check all that appl,')_.. - ~ ~ • • ~ "4, <
Nno-P:esncved ir-Gr<cu'. I - '1rs>wtixJ u-iiruarc L I .;Pli:.rdr Mara n d x1:11_11 11 F.oua:. ` 24 in of tuaaerie sot O ~S
i i.mo s1 her.+- -•.Tp nn'(rxyhln ?rn: vn11>N icei mlam), _
V Difpcrsal7reatment -krea Information AL LP<C/ G~Cft~/
lrp llou t- - xrol. rh mo, -pdi Di-F~~• a Pecu:lw .11 Ds -d ca 14. x-d isf) S"Ieo• Cio'a:un -
Z ^ r
VI. Tank Info apa-m u: Iota. Kuf .!zoV .u(aeouer /
-,alorw I'm
:.cw T:aAx
VV
VII IT4ponsibility Slal ent- I. the underslgne ss or resp:nrsibihty for iwtallano -n off The POW fS sbown oo the altacbed I iaaL
u l.a's \ane Prim': PI1 s!..!m=c \fY;v'ILS Numhet --7 B- ?aun N ber r
c
I .oUUrv,I)epaft Cnt Lsr Unh _
-crmi,frt.-_~ Pte ed L. i:, a5igra?
: , s 96 , co g'~ Sl
- ~ r Dcm.J '
P:Condt t japprasof
4n I n '
uhtiar:.n ern Host all ss -x"-ro1t!iaLti 3) &&D as par marayernen'. plzn mo ti eQ by p e Y~G1MQi Oba~llk~e +1'll/~/✓•' + aiVAIVC~s
2. A0 toNlisr;k rxun~^ens mual uc ra nlciiii'r.e
n per apFi!G:bl.
4:a:h ro u:mp y Tam fur Ne ryrtem and >uLmn u, be. Cuunry nnN ua W Tr+oa lees rbuu R v: a I: ioebo .o >ux
y~ ,~r~, ~ Imo. P
Soil Test and System PLOT PLAN
PROJtic°T Richard Stout ADDRESS 1353 Awalukee Trail Hudson Wi 54016
NW 114 NW 1145 30 /T 29 N/ti 17 W 'T'OWN Hammond COt1NTY ST. CROIX
SYSTEM ELEVATION 94.5,''94.2193.9 DATE 8111118 BEDROOM 3
C0NV1sN 110N :N1 .11'-GILNDI? CONVT;N'I'ION,%I, LIFT' XXX 1101,DIM; TANK
1000 gallons LIFT TANK sI/.F;630 DOSE 'TANK SIZE
NIOLND SEPTIC TANK SIZE
1101,DING 'T'ANK SIZE LOAD RATE~ .4 ABSORPTION AREA 1125 # of EZ-Flows22.5
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 1110' Filter Lifetime Filter
❑ BOREHOLE O WELL *IL R. I'. same as benchmark
44-, Slope
13-' 97
5'
10 3- X 75' cells with >3' ,patting
R
98,
0.
40'
HUffCUtt Combo Tank
- 0'
35•
Vents B-1
90'
Pro 3
Bedroom
House
265' Property Lino 40'
1'_0' P.L.
517' Property Line
I ~ b ` I ' :I~ucr.
I I I
m
i
I
10 z,
:%J ` \ 3 u J
Septic-Dose Tank Cross Section And Pump Performance Specifications
Pump Manufacurre
T~ank~lantzfacttuer - l Number ~~J ✓
Tani: Model Number Pump Mode
A farm Manufacnuer
i Total Tank CaPaciry - f c. - ~
r Alarm Mode} Number
Max_ Bury Depth Switch Type
Total Dynamic Head (I DH) - Feet 7
' Filter Manufacturer , ia. ~ ~ ~
g}evation Head
i oilier Model Number
_ Distal Pressure
Network Loss
Pump P Minim erformance Required I Force Main Loss r
- - - GPM4 I Ft iT)ri j iTotai
Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade
\
Locking Device. inlet Manhole Securely Mounted With Locking Device
< 6" Below Grade Sealed Watertight Weather-proof i \l
t l f/
Junction Box
- Finished Grade 1
Vent Min. 12" Disconnect
Above Grade Mean
With Vent Cap
outlet Filter
i
net Bale
inlet 4----
TA
Switch Settings and Reserve Capact_ttY Weep
I
~ ~-Tank Volume GPI Hole
g
Volume Gal.
hes
Dimension . Inc
a j-. I
r(reserve) - y pg}exertion C
(alarm) B 2 F4-*' Ft Bottom
(dose) C FIev 'on
} .
(dead) D ,7 i
Total i t' - _j 7
, , , ; : < < < , ; •
GEN Y AL is bedded and back filled in accordance with the
INSTALLATION: The septic dose tank fled le the manufacturer may not
factwer s product approval specifications. Maximum exposed depth of dbury as by e have an emotive locking device (Padlock)
manu to grade the tank with watertight firings, and
be exceeded without prior approval. Manhole covers
intalled. Piping at the inlet and outlet is of approved material, connected to 4" Sch. 40 PVC to bridge the tank
laid on stable soil to prevent settling or sagging. The force main is sleeved with 300 and Comm 16 L S.
excavation and the sleeve is sealed watertight. EleMi~} service complies with NEC of
Page
02+0~ L)
•1 ~
E
Hill,
D -
S
I
rr T. f- e-3~= I k x
Ell,
r.
` n \
S
250=SERIES
113 hp Sump/Effluent Pumps for Professionals!
ALL MODELS FEATURE: MOTOR SPECIFICATIONS:
• Rugged 1 /3 hp motor, oil filled with 1/3 hp 115V 5.2 amps 60Hz
thermal overload protection. Thermally Protected 8 Permanently Lubricated
(PSG) Permanent Split Capacitor /
• 1 /2" solids handling. Maximum Fluid Temperature: 140°F '
• 1-1/2" discharge. 4
• Hermetically sealed motor and switch cavities, DIMENSIONAL DATA:
and permanently lubricated bearings. Weight: Model 257: 20lbs.
• Liberty's LINI-BODY casting - a solid, one- Height: 10.5"
piece housing that eliminates the lower motor Major Width 9.6" (manual model 250)
seal ring found on other pumps.
• Epoxy powder coat finish PERFORMANCE CURVE
• Vortex style impeller for superior PERFORMANCE CURVE
solids-handling. Made of high temperature 25
engineering polymer.
• Fasteners - all non-corrosive stainless steel. 20 - 6
• 416 stainless steel rotor shaft. m
LL 15 5
C
250-series Cord Lengths a a
~
x
_Model 10' 25'(-2) 10
35 a
m
250 Standard Optional Optional Optional I°• 5 _ 2
r
_251 Standard Optional Optional Optional
253 Standard Optional Optional N/A 0 0
- - 0 10 330 40 50
257 Standard Optional N/A_ N/A U.S. Gallons Per Minute
10' cons length standard on all models. For optional lengths, _I - I
add "-2,-3 or -5" suffix to model number. 3 3E 78 114 lib 142
Example: for model 250 with 35' cord, order 250-3 utarc Per Minute
• I
It
tIIM I-y ii tly
J
Model 250 Model 251 Model 253 Model 257 VMF
Manual, no switch. Quirk-disconnect Wide-angle float with VMF switch, magnetically
wide-angle float, series (piggy-back) operated vertical float-
mercury-free. plug, allows manual operates in a 10" -
operation of pump. diameter sump.
Dua safety cmld. ation for
G➢FF7 11S Certified theunitw Stetesand Canada.
Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839
www.libertypumps.com Copyrigel 1.0oty Pumps, Inc, gel
rillryhts rosean'ed. ILII2SC0R5:11
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System PLOT PLAN
o ROJt:CI' Ricnard Stout ADDRESS '352 Awatukee Trail Hcdsor Wi 54016
NW 1 ; a NW l14 S 30 ;'1 29 R 17 Are 'I'owN Hammond coum) ST. CROIX
SYSTEM ELEVATION 97.J'9'.8'9,'.7 S.6' bclouv (lracie 6;14;18 3
DATF BEDROOM
CONVENTIONAL AT-GRADE CONVENTIONAL LIFT XXX HOLDING TANh
MOUND SEPTIC TA\I: slZl1000 Gallons LIFT TANK sIZE630 DOSE 'IA\K sIZK
.
HOLDING TANK SIZE. LOU) RA'Z'E .4 ABSORPTION AREA 1125 # of EZ-Flows22.5
ill BENCHMARK A.R.P. op 0`1" pvc pipe ASSrNH: I:1.1*A AT'ION 100' Filter Lifetime Filter
❑ BORF:II01,1: 0 WELL. ° IL R. P. same as oenchmark
351' PI'O:LL'.ITY LOC'.
ys.5
Huflcutl Combo Tank
2n slope Pro
Bedroom
House
=40'
B-2
B-2
0.
60'
Vent.
100'
00 43
tl.n4 r
X ::ells )xllh >Y spacin«
il" Pro e.I'R Linc
,fl.
Wisconsin Department of commorce~ SOIL EVALUATION REPORT Page _c+
Division of Safety and BuNdings
in sccordente with Comm 85, Wis. Adm. Code
Ccwnry
Attach complete site plan on Paper not less than 8 112 x 11 inches in size. Plan must
include. but not limited to* vertical and horizontal reference point (BM), direction and Parcel LD / p
percent slope. scale or dimensions, north arrow, and location and distance to nearest road D /l-
Please print all information. Ravi by Date
Personal inlomal.on you {provide may "used lw seaoedary pwprnes (Prnacy Ls.. s 15 01(r l iml;
Property Owner Property location
Govt Lot ~A 1/ tt ~ r4 Z2 N E 1 ) W
Property Owners Mailing Address Lol # Block # Subd Nan - Z7
. a
City State Zip Code Phme Numtwr City ❑ Vi age Nearest Road ^ T,7__
Now Construction tlse Residential I Number of bedrooms Code derived desgn flow rate GPD
❑ Replacement C~ PuW~/11c a commercial - Describe. 7
Parent material - -Flood Plain elevation if applicable ` ~ fl.
General comments ~U-fiCX7
and recommendations.
7- . r
Systern Type I /~-(A~ System Cle,~atiun QY J e~
Boring # Boring Ci
P I A Ground surface elev.(_s,_- _--1 fl. Depth to limiting factor k in.
Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOIft'
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, 'EB#1 'Eff#2
ll l
I
1
Belling # Bourg
J71 __P y Ground surface elev It Depth to limiting facto
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD.rft
in Munsell Qu. Sz. Cont. Color Gr Sz Sh 'Ell#1 'Em#2
Ili
I /A
• Effluent #1 = BOO. > 30 < 220 rrKyL and TSS >30 < 1 ' Effluent #2 = BOD- < 30 mgtL and TSS < 30 mq!L
CST Name (Please Print) IyuT2'-- CST Number
Bird Plumbing. Inc. Shaun Bird / 226900
rldrress Date Evalealmi Conducted Telephone NurriJor
1432 120th St, Nev: Richmond, WI 54017 715-246-4516
Property Owner Parcel ID # _ Page
Boring Al c❑t~] Boring
lL/`pit Ground surface elov. ft Depth to limiting factor is ~y Appltion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in, Munsell Qu. Sz. Cant Cola Gr. Sz. Sh 'E##1 -Ftf#2
zy-< _
a Boring # ❑ Boring
❑ Pit Ground surface elev. If. Depth to limi" factor in.
$QI ) i(ahon Rate.
Horizon Depth Dominant Color Redox Description Textwe Structure Consistence Boundary Roots GPOM
in Munsell Qu- Sz. Cent Cola Gr_ Sz_ Sh. 'Eff#1 'E##2
F-1 Bonng # ❑ pit Boring
❑ Ground surface elev, it, Depth to lending factor in.
Soil Application Rate
Horizon ')epth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPDfff
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'E@#1 'Eft#2
' Effluent #1 = BOD, > 30 < 220 mgt and TSS >30 < 150 mg/l. ' Effluent #2 = SOD, < 30 mWL and TSS c 30 mgt
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 die department at 608-266-3151 or TTY 608-264-8777.
SM11M M &M1
Property Osner Parcel ID P. Page of
❑ Boring
Bonng #
Bpit Ground surface elev. / l/ tl. Depth to limiting factor in. Soil -Applr tim Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO#f
in. Munsell Qu. Sz. Cont. Cdor Gi. Sz. Sh •EH/#1 •E##2
L
r i
1
i
Boring # ❑ Ekirin9
u E] pit Ground surface elev. - fl, Depth to IirrtiOng factor in. Soil -AP.- Rate
Horizon Depth Dominant Cola Redox Description Texture Structure Consislonce Boundary Roots GPD,tF
in. Munsoll Qu Sz. Cont. Cdor Gr. Sz, Sh 'Ef'#1 •E8#2
D Boring# El E] Pit Boring _
Ground surface elev. _ fl. Depth to limiting factor in.
Sod licatlm Rate
Horizon I 'tepth Dominant Redox Oescripten. Texture Structure Consistence Boundary Roots GPOM
m. Munsellcol Qu. Sz. Cont. Color Gr. Sz. Sh. 'E##1 'EH#2
EMuent #1 = BODr > 30 < 220 mg4. and TSS >30 1150 ni ' Effluent 92 = BODr < 30 rrKA and TSS < 30 nxyl
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 TiY 608-264.8777.
seo-a»o a rmnr
Soil Test and System PLOT PLAN
PRO.Mc,I, Richard Stout ADDRESS 1353 Awatukee Trail Hudsor. Wi 54016
NW 1, 4 NW I,4s 30 IT 29 N!R 17 w To14N Hammond cot v'ry ST. CROIX
SYSTEM ELEVATION 94.5'94.2193.9 IL1TE 8;11/18 BEDROOM 3
CONVENTIONAL AT-GRADE COA%EN'I'IONAL LIFT XXX HOLDING TANK
NIC1t1Np SEPTIC 'r .1NK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE'
HOLDING TANK SIZE LOAD RATE .4 ABSOR19ION AREA 1125 n or EZ-Floas22.5
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifciimc Filter
❑ BOREHOLE. O 41'ELL `II.R.P. Same as benchmark
410 Slope B-2 Q-17'
i 3' X 'l' c:.IS with >3' ~pacilw
10'
B-3
10'
Ilutt'cuu Camho Tank
8 30
..1 r .
Vcnts 1
90'
Pro 3
Bedroom
House
265' Property Line. 40'
120' Y.L.
51 Properly Tine
gym- J i' ] O[_ 1111',' t y t -41 - Cotmb ~sj I'- _ Sz;ety and Buildings U:vts,on
P-O. Box 7162 .Sanimey Petmrt mtbc (to be filled m by Co.)
201 Vu. VJashingion Ave. Nt
Madiso sM 53707-7162
~ SP I \ ~ 7 2O1H it a s III, ~d5653
i l ~ U Scar T: seas=voo h^~mbes
~F
Sanitary r riq Apfhl", i
lr-accun4m c writ BPS 3R: I 1i, c=l Ad= C. naffs I . um the apprVtt S we smti4MIT
Ti rey..iral p -rt n nh .untrt ~ canary ncrzott :e a 1irm5 fu: s'eG-1eNwned 110Ni$ are ubnv..c t.. ,!'tuft:: Address (S diH= eoe than mai:iog add:ets~
the IY'y'arimnl 1 Safn'y au I f ,lcslunal 1C S Pm•.val mfo=utt a you mo,tic Teti, be wed la sr.,ondsn'
pub- ox. v a...w tans wit b Frivaty I^aw J{ i pia S,a6. _ ,
L Application Information Please Print All Information
Prepr-} Owns s N=,!
j Ihopertv Ounce S. g Add= _ ,/f Praltery ;ncauwQ 0. GeV[ Ize
7
C:m' Sm:c / lip Code m Pion: Nebo ✓''l ys~'~ r;, Secum _
J
11. ypc o(Building (check all that apiply) /
Subdivision ?.amt
V(Ti_1w Family DweWn_e Number of Bair ~xns
_ 131•. f.:..- _
6k
f
- AabbUQ~rmcrcial- Descohe Use
_ _ _y-,, _ C.iry of
Of I
Sw:e Owned fhsvbe Ilse I
III. Type of Permit: (Cbeck only on ox on line A Complete line B if appli
-4 1tcw Sy, em ~i Replaamem Systrx aramrut u~ n„'i t _.rtin' .hiv C Otitrr Mociticanoa To i'x:mny S)s (explam)
B i-i Prevtous Pctma Nwhbc and Pwe Issued
Pcmit Keoewal I. ~ Pamtt Ken swr. ~ t'tzn_ ed Fl 11=t l taw^.,-min NM Aefxe Fxpi: auor. (,wet
-J O~J
IY-}' of k OR f5 SvttemrComVOUeuo'Device: ICh a th - PI)1 - ~ -
_ Foo-P-asru. 7 b 6, t-ra I ' !'msutrnl a-G,xicd ❑ . C Mccul'> 2-' in of suireblc sod [J Mouad <'d /D
liaomgn.A lrLhu ) q~s1 (:rni van: Icxplaiti"Meaunent I>cDn 1-1- re&t ent Arear2 on Q ~1~ J
Ika~ien~F7o)w gp^) / Is ewSuilybcnt KmJa(a,1tt I Pixp/: alp c:,Rcgua c:Yl f l>etpesa A n <a1 : 1yxtmk:Icv
S mutawm ~ 3
Vl-'tank Info C ai auN in u of 71
GAIT,,, bJjou
I ow l.Ima a E '
l.c fml i::vmc T'^~ - v {^lt t( " L 3 ,
. ~ I ~ tL V .r v ~E I41.n a:i:au - - J L I
- JI
VD. Responsibility Statement- I, the undenigoed. Amu r poasibavv for wVilauoo of the POWN sbown on the areecbed plans.
P'umo Name lMna) ?itwc<'.. . a:rc SIM WKS Number I Business Pbone 'tnnbe
}hnnl,a•s o css lStrct'ttn State rp Cade; I /1
VTII.~ouatylDepartmcat Use Unh
!I[JC'1~- ruFG Dato tad Istamg. i5i~murt
~pprmed i"'si'taVR S
i I
l i a I' c.^.'tm nc ~ tctial /lL~ p
IX-Condor ons for Dis- pprmal ~1 ,7D r 1 r
i I Sept- tank, N - 7 11/r ~f
u#nust ell be v.r, Ir>s , vOul~ ✓~~}[-JL
o1P" -
as p?f ~arAgwxM plan? 4'IUrl UV "Li'Ue 1 I ) ~j•
2 AN settw*fi OW.-Onts fnwA w.atrt,n..
M per rpFia" 0*& :fffwaeu.
wm<a w cumVletr VI>m Ier ebe ~.aem zn0 whmn u the Conan mFy m taper av: kn du E to a f 1 i.cha m f
SBD-6398(R. Ilil1) -
LSG~t/e~ l
System PLOT PLAN
PROJECT Richard Stout ADDRESS 1353 Awratukee Trail Hudson Wi ;,4016
NW l: a NW 1145 30 i'T 29 N!R 17 AV TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 97.9.!97.8.`97.7 1.6' below, grade DA6114.+18 RLDROOM 3
'1T';
CONVENTIONAL AT-GRADE CONYLNTIONAL LIF'T' XXX HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gaiions LIFT TANK SI7.E630 DOSE 'TANK SIZE
HOLDING TANK SIZE LOAD RATE .4 ABSORPTION .AREA 1125 # of E:Z,-Mlows22.5
BENCHMARK Y.R.P. Top of 1" eve P[De ASSUME ELEVATION 100* Filter Litetinic. Filwr
❑ BOREHOLE O WEI..1. » 11. it. I'. same as benchmark
I
14;1' Property Line
9S.i.
Huffcutt C0111b 'Lr k
Siope Pro 1
Bedroom
House
4 '
5'
50'
60'
Vents
100'
B-1
B.N1.'
X `S cells with i' spacin-
l?' Propc,l~ Linc
J
:=0py
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 6/14/18
Owner: Richard Stout
Location: NW 1/4 NW 1/4 S 30 T29 N,R17W lot 91 Emerald Acres Hammond
System type: In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Pressure Distribution Manual (version 2.0)
Pages
1. Cover Page
2. Plot Plan
3. EZ Flow Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
8. Dose Tank Cross Section/
9. Pump Curve
Signature-
License number #226.9f10
System PLOT PLAN
PRon-,('I Richard Stout ADDRESS 1353 Awatukee Trail Hudson Wi 54016
NW 1/4 NW I/4s 30 /'I' 29 N/H 17 W To11'\ Hammond COUNTY ST. CROIX
SYSIENI ELEVATION 97.9..97.8197.7 1.6' below grade 6114/18 3 BEDROOM CONVENTIONAL AT-GRADE CON VENTION Al. LIFT XXX HOLDING TANK
1000 gallons LIF'T'TANK SI%E630 DOSE TANK SIZE
MOUND sEY"1'IC 1:1NK SIZE
HOLDING TANK SIZE LOAD RA'Z'E .4 ABSORPTION AREA 1125 N of EZ-Flojvs22.5
BENCIINIARK Y.R.P. Top of 1" pVC pipe ASSUME ELEVATION too' Filter Lifetime Filter
❑ BOREHOLE O F1'ELt. ' ll. It. P, same as benchmark
351' Property Line
98.5'
lluffcutt Combo Tank
2% Slope
25' Pro 3
Bedroom
House
40'
B-?
35'
B-3
60' 50'
Vents
100'
99.5' .
_ B-1
35'
B. M.
3-3' X 75' cells with >3' spacing
517' Property Line
70'
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page-of
1=ILE INFORMATION I SYSTEM SPECIFICATIONS
Owner Z, r Zl~l Septic Tank Capacity r Z 1 G NA
Permit # Septic Tank Manufactures r r 2 NA
'DESIGN PARAMETERS Effluent Filter Manufacturer G NA
G NA
Number of Bedrooms ❑ NA Eflluert Filter Model
Number of Public Facility Units -~_A Pump Tank Capacity al G NA
Estimated flow (average)~-, gaUday Pump Tank Manufacturer ❑ NA
t ` Pum Manufacturer 0 NA
Design flow (peak), (Estimated x 1 5) J_~ J _-gal/da p
Soil Application Rate avda tff2 Pump Model T_ f t/ O NA
Standard Influent/Effluent Quality Monihly average' Pretreatment Unit
Fats, Oil & Grease (FOG) 530 mglL a Sand/Gravel Filter O Peat Filter
Biochemical Oxygen Demand (BOD,) ,220 mg/L 11 NA G Mechanical Aeration G Welland
total Suspended Solids (TSS) 5150 mgiL ] Disinfection G Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) U NA
Biochemical Oxygen Demand (SOD,) 1530 mgrL In-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) s30 ml l 4-NA G At-Grade ❑ Mound
Fecal Colifoim (geometric mean) I s1 0e efu/100m1 G Drip-Line G Other:
iMaximum Effluent Particle Size y in dia. G NA Other. - - n ,VA
Other - 'NA Other _ GNA
Other L] NA
'Values typical for domestic wastewater and septa tank affluem;.
MAINTENANCE SCHEDULE
Service Event Service Frequency
inspect condition of tack(s) At least once every. - G month(s) (Maximum 3 years) G NA
[pump out contents of tank(s) When combined sludge and swm equals one-third of tank volume ❑ NA
- p month(s)
[inspect dispersal cell(s) - At least once every: year(s)_ (Maximum 3 years) G NA
.Clean effluent filter At least once every - " G month(s) ❑ NA
flyear(s)___
J month(s) NA
inspect pump, pump controls & alarm At yeast once every: - ! rGlyearl
-lush laterals and pressure test At least once every: [I r(s) NA
year(s)
❑ month(s) NA
At least once every: ❑ year(s) _
ether NA
MAINTENANCE INSTRUCTIONS
inspections of tanks and dispersal cells sna:l be made by an individual carrying one of the following licenses or certdn:atiuns Master
Plumber; Master Plumber Restricted Sewer; POW. S inspector: POWTS Maintainer. Septage Servicing Operator. Tank inspections must
iinckide, a visual inspection of the tank(s) to identify any missing or broker hardware, Identify any cracks or leaks, measure the volume of
cembined sludge and scum and to check for any bacik uo or pending of effluent on the ground surface. The dispersal cell(s) shad be
visually inspected to check the effluent levels in the observation pipes and to checvk for any pending of effluent on the ground surface.
The pending of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
regulatory authority.
When the combined accumulation of sludge and scum in ary tank equals one-third or more of the lank volume, the entire contents of
the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113. Wisoons:n
4dministrative Code.
I%I other services. including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
~ service report shaft be provided to lire local regulatory authorty within 10 days of completion of any service event.
Page _ of
START UP AND OPERATION or
For T now U e ANI other chemicals that
on, Prior to use of the POWTS check treatment tank(s) for the presence of painting products
"acted have t contents of the
may impede the treatment process andlor damage the dispersal cell(s). If high oorhcentratior>s
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface. r>wer is motored the ehccess wastewater will be
Pourer Outages pump tanks may fill above normal highwater levels. WIN p in the backup or surface disc herge of effluent-
During discharged to the dispersal Cell(s) in one large dose, Overloading the cell(s) and may Sent in th back Or prior to restoring power to the
To avoid this situation have the corderds of ft pump tank removed by a Saptage rating the Pump controls to resrore normal levels
affluent pump or contact a Plumber or POWTS Maintainer to assist in manually ape
within the pump tank. disturb or compact, area within
Do not drive or park vehides over tanks and dispersal calls. Do not drive or park over, or otherwise
t5 feet down slope of any mound or at-grade soil absorption area*
rtnloaerices; and pre~g to We of the POWT$:
Reduction Or elimination of the following from the wastewater stream may improve the Per;co disinfectants; tat foundation drain
buts; condoms; cotton swabs; degreasers; dental flossv icati oil; painting products;
antibiotics; baby wipes; cigarette gasoline; grease; herbicides; meat scraps: medons;
(Sump pump) water; fruit and vegetable peelings; g
pesticides; sandary napkins; tampons; and water softener brine.
ABANDONMENT ce the follow ng steps shall be taken to insure that the system is P"Ily
When the POWTS fails and/or is permanently taken out ve Code:
Wisconsin Administrati
and safely abandoned in compliance with chapt®r Comm of 83.33, service
• All piping to tanks and pits shall be disconnected and the abandoned Pipe openings sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Sarvrran9 Operator.
• After pumping, ail tanks and pits shall be excavated and removed Or their covers removed and the Void space filled with sell,
gravel or another inert solid material.
CONTINGENCY PLAN or must be taken. to provide a code compllJnt
if the POWTS falls and Cannot be repaired the following measures have been,
replacement system' a rplacement so l absorption system.
-4-A suitable replacement area has been evaluated and may be utilized for the tociltlOfi of Of a1`enot be Infringed upon io requited
The replacement area should be protected from disturbance and convection end tnent area will result in the ted
bush lot lines and walks. Failure ent area. to proted the
Replaceherd systems must own* with the rules in
for setbacks from e3dsfing site and proposed structure,
for a new soil and site evaluation to establish a suitable rePlacemacem
enetY at that time. advances in pOWiS technology a
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring
holding tank may be installed as a last resort to replace the failed POWTS. evaluation
❑ The site has not been evaluated to identify a suitable replacement area. Upon lure of the pOWiS a sal and be site installed ev evaiua as
roust be performed to locate a suitable replacement area. If no replacement area is available a holding tank may
a last resort to replace the failed POWTS. removal of the biome/ at the infiltrative
❑ Mound and at-grade soil absorption systems may be reconstructed in place following
surface. Reconstructions of such systems must compty with the rules in effect at that lime.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL. GASSES ANDIOR INSUFFICIENT OXYGEN. DO O
ENTER A SEPTIC, PUMP OR OTHER PRCUMS •ANCESDEATH MAY CULT. RESCUE O~ A
TREATMENT
BE TDIFFICULT ANK UNDER O IMPOSSIBLE. MCI
PERSON FROM THE INTERIOR OF A TANK M
ADDITIONAL COMMENTS
POWTS INSTALLER - - POWTS MAINTAINER
EtE-- Namry~ PhI
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
i Name
Name Poona J ? ,
y J
Phone
This doamemt was drafted in Odrmptianee with chapter SPS 393.22(2)(D)(1)(d)&(q end 3a3.54(i), (2) a (3). Wlecorhsm Administrative Code.
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Septic-Dose 'Wank Cross Section And Pump Performance Specifications
Manufacturer
t ; l- T~ Pump
Tank Manufacturer
Tank Model Number v Pump Model Number >
r
, Alarm Manufacntre r > c
Dotal Tank Capacity m
-Max. Bury Depth Alarm Model Number 6
_Switch Type
Total Dynamic Head (TDH) Feet
Filter Manufacttreri ti
Filter Model Number I ' Elevation Head 12
- Distal Pressure
Network Loss
Minimum Pump rerformance Required Force Main Loss -
cip > Ft TDH Total
OaRlet Manhole Min. 4" Above Grade With / Manhole Min. 4" Above Grade
\
Locking Device. Inlet Manhole pj lGtounted With Locking Device
< 6" Below (Trade Sealed Watertight Weather-proof 1
Junction Box ~J
Finished Grade - - - - - t~ "
Vent Min. 12" Disconnect
Above Grade Means
With Vent Cap
l Outlet Filter ~y -
Inlet Ir met Baffle
A
4 Weep
Switch Settings and eCapa!Hty
Tank Volume GPI B Hole
Dimension. Inches Volume Gal
(reserve) A ! >
Off leyation C
(alarm) B 2 Ft _ Bottom
(dose) C D Elevation
(dead) D - l Ft
Total L Fc
With the
bury as and back specified fillbyed the accordance manufacturer wmay not
GENERAL INSTALLATION: The sepaicldose tank is bedded
manufacturer's product approval specifications. Maximum depth have an effective locking device (padlock)
be exceeded without prior approval. Manhole covers exposed to grade the tank with watertight finings, and
installed. Piping at the inlet and outlet is of approved material, connected laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 300 40
and PVC to Comm x
bridge . the tank and the sleeve is sealed watertight. Elec#tcal service complies with NEC
Page of .
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ST. CROIX COUNTY
SEPTIC TANK iMAfNTE,NANCE i~GREKNIENT
A Nil)
OWNERSHIP CERTIFICATKiN FORM
Owne,T/Buyer Y 1 ~'u
Mailing Address
Property Address__
(Vctification required frum Planning &Zoning Dcpantnear for new d stmciion.)
City/State _ Parcel Idenfiiication Nut lbor_'_ _/71,3tq -
LECAI, DESCRIP"PION'
Properly Locatioit T N R/ , Town of c(/y) /Yl~'
SubdiNzsion %
Certified Survey Map ll
Warranty Deed # - - G Volttmcrj,5 , Pa e h C~
Spec house y ; no Lot linty ideutibable cs no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic svsrem could result in its pr.-manure failure to handle wastes. Proper
maintenance consists of pumping out the septic lark eve, y thtec years or sooner, I needed, by a licensed pumper What you put into
the system cartatlcet the, function of the septic tank ac a trcatarent s;~ge in the was'e disposal system. Owner maintenance
responsibilities are specified in 4(.onmt. 8352(1) and m Chaprer 12 St. Croix Canty Sanitary Ordirmuce.
The property owner agrees to submit to st. Croix County Plantar.- /.rrn ng Dcpaicmenr it cetufication form, signed by the
owner and by a master plumber, jowueyman plurnbct-, restricted plumber or a licensed pumitaci vet ifyrrg that (I) the on-site
wastewater disposal system is in proper operating condition andior (2) after inspeadnon and pumping, (if necessary), the septic tank i<.
less than 13 full of sludge.
tiwc, the tmdeistgued have read the about re<prrrcmcrits and agrei to r.mortaur the private sewage disposal systom with d:c
standards set firth, herein, as set by the Department of Conrrdecrcr and the Drparimcrit ol'Naturai Resources, State of Wisconsin.
Ceniification stating that vow scpltc system has been maintantcd must he completo..l and remind to the St. Croix County planting &
Zoning Departmut within 30 days of the three year expiratcoa dale.
liwe cerufy that all statements on the force arc uur to Orr best of ntyiow knowledge. I/wc atniale the owner(s) ofthe
property described above, by virtue of is war my decd Icoorded in Register of Deeds Office.
Number
of drooIlls
it Tlltli OF APPLICANT(S) DATE
"**Any intrrruidon that is uasrcpuesented nuny result nn the sanitaty permit being r-voked by the planning & Zoning Department.
include with this application a lecnrded warranty deed t:om fhc Register of heeds Office and a copy of the certified survey map if
reference is nnade in the warranty deed.
(RF.V. 08/05)
Parcel#: 018-2011-91-000 Cd II,•,:I-'
PALL 1 OF 1
Alt. Parcel 30.29 17.11010 018 - TOWN OF HA.MMOND
Current X ST. CROIX CCJN7T,'::1S:.~N3 N
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
08r182009 00 0
Tax Address: Owner(s): O =Curren: O.vler, C - Crrcrl i:o :r::re
0 - STOUT. RICHARD 0
RICHARD 0 STOUT C BAST, KFRNON J
KE2NON J BAST
1353 AWATUKEE TIRE
I, U JSON 'e^JI 54016
Districts: SC = School SP = Special Property Address(es): ' = F'nr~ary
Type Dist # Description ' 31 52NC S"
SC 2422 SCH 1) ST CROIX CEN I PAL
SP 17(30 V11TC
Legal Description: Acres: 4010 Plat: 5647-GSf,124-564/ C18120Di)
SEC 30 T29N R17W PT NW N'vV FRI. BEING Block/Condo Bldg: LOT 91
EM..ERALD ACRES 1ST LO I S 43 & 44; NKA CSIA - -
24 5647 L01 91 (4.010AC) Tract(s): (Sec-Twn-Rng 40 114 160 1141
3(; 29N-17'':V NW Nle%;
Notes: Parcel History:
RETIRED 2009 FOR 2010; LOT 43 D44 Date Doc # Vol/Page Type
EMERALD ACRES 1ST(018-2011- 08i18i2009 902244 4+b(54' -'n
018-2011-44, (1058, 1059) 10 CS10 24 5647 121 7i2C04 '8288' +42 f'I i.1
LOT91:018-2011-91 (1101G) 06;1(5!2C04 766092 259:300 AD
i
2012 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 0,31 -2010
Description Class Acres Land Improve Total State Reason
RESIDENTIAL Gi 4.010 38.3130 0 38.3CC NO
Totals for 2012:
General Property 4.010 38,300 0 38,300
Woodland 0 000 0 C
Totals for 2011:
General Property 4.010 38.300 0 38.3(:1
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 U 1J C
W, ."nshiDopladIIIe0tof C J IL LVALUATION IZLPORF Page U11
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