HomeMy WebLinkAbout276-1043-70-101
'Nsans n Depanmeni r-1 Co-erce PRIVATE SEWAGE SYSTEM CCjnty: St. Croix
;ialey 3ntl I1AC mg U viS~Cr
INSPECTION REPORT Sanitary PC mn N
GENERAL INFORMATION (AIIACH10PLf2PalTj State Plan IltN 605116
Personal in4fma:ion Yrs :rmv do may tr used for secondary purorses IPnvaey Law S.'5 C411`,1 in.1
Pefmn H, TrI, Namr CR,• Village Trw.rship ParCe fax No
Richard & Linda Warner CITY OF RIVER FALLS 276-1043-70-101
JSI JVL-w Iron Bid Flue RDA Der,%-,pdort SCdrnvlomn Rarge: WlJp No
/6Z> ~a 6~ d~ n 36.28.19.322P-01
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER ,ti7 5 CAPACITY STATION BS HI FS ELEV.
Septic n .O Ber.rhmark
W;ilerr-r~ Al L" ,o /600 1 Z.3Z A?,? j~ 166
G j P. (O f~ Szs AN BN1 J s'' 97• Z,3
Aeration Bldg. w
e(,,,~~ Sz5 97 • SZ
Holding St Ht In'. 4N S7 -5 , /
TANK SETBACK INFORMATION StiHl Outlet Sr 33 9(~ .~9
TANK TO P!L 'uiH.L f3LDG. c • ' Air make ROAD DI Intl
1
Septic Dt Bottom
Dosing Headerbtan
6•76 94ill
Aerahon - Dist Pr.:e /ryy
Holding Bel System
Final Graac
PUMP/SIPHON INFORMATION 3 •
M.an.ltac'urer Der an:f St Cover
GPM Model Number k~ Ir.V-~ r
r G• 55.y ~
1UH LiN Fnct:on Loss Syst~ TDH Ft
Forr-emam Length W-11
7
I 7`f• 25
SOIL ABSORPTION SYSTEM
BEDITRENCH 'uNd'n Lcn~tFl N,.OfTreo,^s PIT DIMENSIONS N,.O`P1, 11 4u iJ tiTt.in De:,m
DIMENSIONS 3 1(-e- ,G
SETBACK SYSTEM TO PiL `•l BLOC WELL LAKE:STRLAPA LEACHING tolJni.lz ct..re•
INFORMATION CHAMBER OR
T1p' O' t;ystc^• UNIT IvlCdei Namrer
UdW \ ~ I ✓ J
DISTRIBUTION SYSTEM tip S'S j ji 44 .'j fi~v
Feat-r'Ia1711i`r, L,~ I Lilt, U P n a L, 3,<C x No Sl ng Van Flake.
LcnyP' O~ Lergth Ciao `)~q6'y
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
CepP' Ovct fi-p'h !)ver ❑epln cl w SewnenrSonder, d OCd
Bed:Tfencn CRn'e' / IieJ:'eprr b:QCS _ T'=: SJi ` YES No Vey IN.
COMMENTS: {Include code discrepancies, persons present. elc.i Inspection p1 / Inspection k2 YT
Location: 1322 RIVERSIDE DR aL~ r"R ~L, r
1 t Alt 810 Description = ' f a!
2.; Bldg sewer 'et = 4- I tp 1'7 a h nln /~f'(nJaGGG'
-amount of cover = ` /s 'YaC G~ai ~s~ ~O 1 I ;1
Plan revision Required? / Yetis I No v ~y5. SKL
Use other side for additional information. / ,P 1 C r r
Date In. :C-'s S J%-C Con No
S6D GF10 iR 0i5?i
r
SAN 171
l E:: ausUy Services Division Cou*
400 F Washington Ave ST• C'K C 1 X
P .O. Box 7162 Small Permit Numba (to be fillet in b)' Co.)
edi+on, WI 53707-7162 '0~~
~'hand% 1~N r
' State Trunsoctan Number
Windt,- Omit Application _ _
In aemrdancd math SPS'36331(21 - (-edq wbrnm wr of Mrs farm to the appropriae ltm rnmetml unit _
is rer♦ and prim to cony permit. `tole Application forms fw statcrtmncd PDWTS arc submitted to Project (if different than mailing addoss)
the DepatmwaoMA&ty and Protimmvial Services. Penoi al mformamn you provide may be used for secondary
, [
run set axondence meth the Mrv Inv s. I S. I m Slats. /V h 17QI QI ~j
1. Application faroraratiaa - Please Print All Infisrmetlem
Pacela lie.
fto(+eny fTintt's Name
Klct{RrzD H. LtNDR LL,WAKNEr1 zt(~ - IcL( -3 7V loI
Propcny (lwow'a Mailing Addrna Property Location a . I Q as '
)52L T wiEo1 5)DF_ 09,1VE Govt. Lot
C'it). State Zip Code Phone Nmrba Section 3K'
R t V [rZ f~A LL'i VL_i C J Z (circle wte
11. 'fy of Bnildina (cbeck all (kat apply) Lot M T Z $ N, R I b w+
7{~I or 2 Family (rvrllmg- Number of Bell 3 , Subdivision Name
. p-"
❑ Rd+lic/Cwnmercia7 Decnte tlse Block
Vilyd KW &K VAIL~
❑ Slutc Owed -Describe Ux t CSM Numbs ❑ Village of • r r
1 OA sr Lf ✓ L/'SLL ❑Town of 5
Ill. Type of Peron: (Check oa C Complete Use B if a ' bte)
A
❑ New S)Ztem R.0-n mil S) suvn ❑ tntoldmg Tank Replacement Only ❑ Glhcr Mndificamn to Emoting System (ezplam)
B. ❑ Pemnn Rencmal Ptrmil Rmstam ❑ oumgc of Plumbs ❑ Noah frontier to New I'st Previous Permit Nranber and Dab Isued
Before Expiation (herCr
I1,'. Typt of POWI'S S miW sent(Devire: Cbeck ad that O
Y 33 No.Prinoamu e) h Ground ❑ Pressvnzed In-(;round ❑ At Wit ❑ Mound _ 24 m of amiable spit ❑ Maed ! 24 in. of suitable wil sezsh
S
❑ Bolding'1'ank ❑ Other Diayerml C'rvnrxaneaa (ezplan),~(D~ )~CLYGC'K F/L ]~/L ❑ limtrownima Device (explain)
V. DbQrnaYl'ra t Area Infotmatien:
Design Flow (gpd) Design Sat Applaatian Rate( Dispersal Atn ftequrred (st) Datpwsal Meer Pngxacd System Elevation
'
</5U A(L 7SO 75v 95.~J3 9 ID
V7. Task Info Capacity m Total # of
Mamrlactura }
Gallons Gallon Umu
N. Tooke Fv bag 71okx / /Z ~C p
0 0.L` y„6 i
styrir ar.NCtie(e~als 'ILIC> t~C r ft,l' jC
Daamgcarnser .
1,71. IleapOSSIblity Statement- 1, the aaderaigard, wam woo for satallatao of of POMTJ more w see ammcam pad
Plumber's Name (Print) Mu Si +NP/MPRS Number Bminece Phone Number
!vl )CNh RcD WftcA ! q 3i 33U 7l5- yLS-6zoU
Planber'S.4ddrets(SUmL CO). Stale. Zip Code)
;04-~'5 C_7.-If - sS ~I+i BALL (,>T {c?
VIII '"at /nejr.rime.l l!ae Daly _
App"cd ❑ .spproved PermittFFee IhQle hwin gau Si
60
er Givrn Rcaxxi fi •nial S
-1%. Cn.dit , alth.'cn:
X,. likes . en fnrnTDiaspproval S f -
t. t
aisprfawi CH MUSt All be s,i - : c '
S471" ,tl`I,1O~de/LI~2-3) 06 LA
es per ,;rW,4, men! plan prep ia. Q_
~ ~i
2. All xcf. 'Itl~{~faE'Iarll7 must L1, rt. Pt rJ• per f'PPIMIN Ctm4' /:Mi;tlbY.r:1. T D ✓1W15 I Z f O\
errs ro ro.rplele viam tar ee Ttrm err rralr Ne C wy r prrr sat ter. u.. s vm .1 t Iran. is ebr
Gait.(' OJt,<. ~ ~w~ponR~
SBD-6398 (K 09/14) A9
V
t ^
- X11 ~ n, \r,
\A\ /
,P
i
n
- „i
Al a~
r~ / ~ ^ Tt
rJ
PAGE 1 OF 4
In-Ground Gravity Plan
Index & Cover Sheet
Component Manual Design Reforences:
Version 2.0, SBD-10705-P (N.01/01, R 1012)
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Dispersal Area Cross-Section & Plan View
Pig 4 of 4 Management Plan
Attachments: Enclosures:
Tank Specs _ POWTS Application for Review
Filter Specs Soil Evaluation Report & Site Map
Project Name / Description
RICHARD H. & LINDA L. WARNER
Owner Name(s): (same) Phone:
Owner Address: 1322 Riverside Dr., River Falls _ Zip: 54022
Project Address: (same)
Govt. Lot: na NW 1/4 of NE 1/4, Section 36 , T 28 N-R 19E❑or W
Township: CITY: River Falls - County: St. Croix
Project Parcel ID 276 - 1043 - 70 - 101
Designer Information
Designer Name: Mary Jo Hup_pert Phone: 715 _426 _1775
Designer Address: 28497 King Arthur's Ct., Danbury, WI Zip: 54830
E-mail: hollisterdesign@outlook.com qr
License Number. 1859-007
Remarks:
NU"rP::t?T
D 1859
FINER FALLG,;
40,
Signature: Date: June 25, 2018
Origiria 99e1ure required o 0-h suemdled copy.
X ` h
c i
0
- 91
r.
i
m PAGE 3 OF 4
?0 7. °W 0
J Z, m aG EY O
N O
w
b 1 O C
CL 7 £
a zN n
S Q' N J o" > N
~ w 1~ R uU ~ > oR I ~is ~ 3 ~ C
LLI
U ,a d co
f° M1 m N a C
f/J W ° n m % m c C 1
c•) a a c
_T A 2
f
LL I II I N `r ~ L O o
Ln Lo
moo) N O I-d I I W t`
W ~ II I
L I I F ~ II
U > e7 N I m a U)
iZ Z I o w
_ _ = I II
m
(n
N m
JU E m EF
C QW o m a 5 I I a
7 U)Z aC x' _ Ra I II I p W
H
Q O .c
W a U) O (6 d Q
~W/ O a Q C~C nbb $ I I a w.
LL. 2 ~ N O q I ~ I ~ I I
Q O 'd 8
O n I
04
rQ U - I I L)
T- W c G
I to
-r- N
m
d~N a~ I ~I I II
(n
y y
x
= co
} Cl)
o m9 ° I I
Ln QQ) T I I T) 0 z
C: J R a I I = N N w
w v
0 t3
O W d o v
~E WWI II
CAL > I II I ~
I
1
_j Z Co
z
c¢~ a Z p II -
a a I +
PAGE 4OF4
In-ground Gravity Management Plan
IMPORTANT:
The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow = 450 gpd; BOD5 5 220 mgL-1; TSS 5150 mgL-'; FOG 30 mgL"
Inspection Checklist INSPECT EVERY 3 YEARS
n type of use
o age of system
nuisance factors (i.e. odors, user complaints, etc.)
mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
material fatigue (i.e., leaks, breaks, corrosion, etc.)
solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution ! drop boxes)
neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.)
extent of ponding in distribution cell prior to dosing
dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.)
0 electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.)
U distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)
U surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Slats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submitted to the proper local government unit In accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Michael ROdewald, Bettendorf Exc. Phone: 715.425-6200
Local government unit: ST. CROIX COUNTY COMMUNITY DEVELOPMENT Phone: 715-386-4680
Local government unit address: HUDSON, WI ZIP: 54016
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383. Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
z
x
IA
53r AS REWIRED
L
i 4Y
O
2,
e
1
O
4" `3' i
0 4' CAS ?
{Qa
ti 3_-
5• 2
> I
2 UP 7?*
4• CAS \
J ~
4 39' ` N
>
Fn rt
~Z ; Tz z 9g~0 o oho
g~ r*~
~ ° j ~Z > Jm NHS ~
a g~o':K O
z g ° I g~ c r O
o l° t :;o
X z
g o
m V)
~o c
DH ~ r ~ A v
r
v
T N1PIODD-NR CMC~TE w arf., s~ mv.
SEPTIC MANUAL W"s uS HWY 10 MAM ROCK W 54750 DAiE 00 0Ah . -Pant
? 800-325-8456 wpm"
INSTALLATION INSTRUCTIONS ff'
l
" PL-122/PL-525/PL-625 FILTER
it
INSTALLATION INSTRUCTIONS
w CPO
rL Z
W-
t Step 2: Step 3:
~.A, Bofute I>. 1t1.1 u, it r 11 1,.:
,ver :in'~ , n. n;a 1-r:'. Eder housr:g rni in 1" c-il r'( p: pe outlol f;lpo.
t6l Mako sure that the housmy (B) h}seft Iha 6uer caruxtdy w J i<
- G~fifird to r
wartu+~ srnnanrn pc,sthoned so --1 hou ~ny mfeu y , rE rGe , Ira
removed from the tank fur cartr uqe , prof h afigr• d arq
nm r,:nre Ind s... it _:or
MAINTENANCE INSTRUCTIONS
- r
-
WEI
t ~ ~ ~ I t I I ~r
l
Step 2: Step 3:
•...i;.' Rrar4o'Je tank rnr2r f. ;n!. I. fA Insnrl ~i,r• filly
■ • NOT USE PLUMBING WHEN FILTER IS _ the fist^r i~ ..rli r~
PUII the (dteY out ov the huu_il~y_ - proc~ -
• _ R)tinse oft the !Afar nvar the sapir, tank. and completely inser L.c.
USi RUBBER GLOVES Mike sure all solids fall hack into tie (B? Replace sep{i< n.t
1 WRIFN CIFANING FILTER s nlict-ink.
.l'6w.'4 a -
j• „
t, 4k
MIA,
OA-
• t':. 1eS ur, c1W(,t tC Ill i'4d. '.,,1. ICI c:!>.-,i_. ur IItsl+v •ijlx_inrlct:' vnd i:Iool
• Modular construction allows c:onfiquiations to match trench dimensions for most system shape" and sizes
• Fng,neeied for optimal sloiage ,and abs iptlon efficiencies
• Auilily to coniuur along sloped ,iies and aruunci been of I:auJscauing
• Lightweight systern is nerW.l for repairs aril linht ioh silos
• Easily hand carried into onsition reducing Gme and labor
• 5 or 10' lengths with sirnple snap, inlemal coupler:.
• Easier cleanup at the job site wilt, the elirnrnation of sione
• Kinufartured from reryrlr•il rnaten;-iI s rather than a rnl,icd na'ural resour~ e
• A wide variety of diameters and cor tigurat-ons to meet any installation professional's need,
• Approved m many jurisdictions with ar. increased elf ciency rating, reducing drainfield ;Ile
• Backed oy the ieader in ;ne on.i tc wastewater fndu stry
♦ E Z
INFII TRATOR
For technical assistance, installation instructions or customer service, call Infiltrator Systems at 800.689.7759.
qy INFILTRATOR
4~ V
je Pipe Systems ;al Systems
1 dC 1 P- r) 1002H-GE0 12021-1-G70 i 90(' I GE: 14!10'- GEC,
• M
S
aK M1 r ' n
i;~•d Jfsi ,
Vertical Systems
it- '.rl(lh'd-liFO ~r:44•_.!lt -r i_,. I i ..:..r-:I-'„L'_.
J 'E C1 1202V-GE0 12OC-V Gtr, 1' 031 GE0
GEO 1203V-GEO 1402V-Gt0 1303T-GEO
"pwe.fO iC ar i ! J" hri e; stools. Bvd r..n w : A,-ate the rmme+, at bundles.
.i~ i[`(IPfWNI( UP01 G:In1ip 9WI'Ufcr 9r•II -~r$L?.Iloilrn
r :.::v -n->,u:e i1F., m w•Irl d pla,.al✓v ox h t...on wjx h he e, r<laiie i vu1Y'n Mc .orracared p',ne.
.np.• ncl ,nap6r;; ax:d cb<' r•r{L.•'.emantr:.'' ntifM11 rai?5.
a =kn +r~iiaY+silb,utl 1 ht nvh: n Rgly s ) •g^ItOpfid~•ur~raSP
r
1 I rl 1 - - C T
INFILTRATOR
~.1 ; i'81~ rid • r.:. s;,. ;ra;
0 o Sayhrc~k, CT C)6475
L:., , . . , , ~ , ?,F.0.5?".?(?.".Q • tltX ?FJ1.577.%CXi1
800.689.7759
www.ezftowip.com
www. infi ItretorsystemS.c0m
For technical assistance, installation instructions or customer service, call Infiltrator Systems at 800.689.7759.
Inl lllm . i i~ _ I )......i i. ~ -dri:•, $)x'afxx ln:
- El;'InYdM4
`~~snarut~;~~ SAFETY AND BUILDINGS DIVISION
.T.- Plumbing Product Review
BO. Box 2658
'y`i Da ,L' Madison, Wisconsin 53701-2658
TTY: Contact Through Relay
v
Scott Watker, Governor
,'o'Fa•~nnn~-'.~ Dave Ross, Secretary
October 11, 2013
INFILTRATOR SYSTEMS INC.
GOVERNMENT AFFAIRS DEPARTMENT
4 BUSINESS PARK RD
PO BOX 768
OLD SAYBROOK CT 06475
Re: Description: LEACHING SYSTEM, POLYSTYRENE AGGREGATE
Manufacturer: INFILTRATOR SYSTEMS INC.
Product Name: EZFLOW DRAINAGE SYSTEMS
Model Number(s): EZ1203H (3-12" bundles with pipe in center bundle in 5 ft. or 10 ft. length).
EZ1203HP (3-12" bundles with pipe in each bundle in 5 ft. or 10 ft. length).
E71201P (1-12" bundle with pipe in 5 ft. or 10 ft. lengths), EZ1201 A (1.12" bundle
containing aggregate only).
EZ0701A (1-7" bundle containing polystyrene aggregate only in 5 ft. or 10 ft. lengths).
EZ1203H-GEO (1-12" bundle with non-woven geotextile fabric installed at 180 degrees on
the upper side of the bundle, pipe in 5 ft. or 10 ft. lengths).
(EISA of EZ1203 H, E21203H-GEO or E21203HP in 5 ft. lengths = 25.0 sq. ft.iproduct,
EISA of EZ1203 H; EZ1203H-GEO; EZt 203HP in 10 ft. lengths = 50.0 sq. fl./product,
Width = 36 inches, Height = 12 inches, Max. depth of bury = 8 ft.).
Product File No: 20130145
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 alternate approval to s. SPS 383.44(4)(a)l.a.; 384.30(6)(k) based on the
Wisconsin Statutes and the Wisconsin Administrative Code. This alternate approval Is valid until the end of
October 2018.
This altemate approval supersedes the approval issued on 4!10/2012 under product file number 20120139.
This alternate approval letter shall be incorporated with your previously approved plans and/or specifications
approved under product the number 20120139.
This alternate approval is contingent upon compliance with the following stipulation(s):
• This product must be installed in accordance with the manufacturer's printed instructions, product approval, and
plan approval. It there is a conflict between the manufacturer's instructions and the product approval and/or plan
approval, the product approval and/or plan approval will take precedence.
• When this product is installed in a dispersal cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter, this product must receive wastewater having a BOD5 value less than or
equal to 220 mg/L, a TSS value less than or equal to 150 mg!L and a FOG value less than or equal to 30 mg/L
on a monthly average.
• When this product is installed in a dispersal cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter, this product must be installed in individual excavations that create a
dispersal cell that is horizontally separated from other dispersal cells in other excavations by at least 3 feet. The
3-foot measurement is measured between the closest outside edges of the product listed in the regarding block
of the product approval letter.
SBD 10564E IN. 1 057) File Ref: 13014502.DOC
INFILTRATOR SYSTEMS INC
Page 2
October 11, 2013
Product File No: 20130145
When this product is installed in a dispersal cell that is sized based on the EISA rating stated in the regarding
block of the product approval letter. this product must be installed in a dispersal system, which has the top of the
dispersal cell at or below original grade of insitu soil.
• This product must have geotextile fabric that meets requirements of s. SPS 384.30 (6) (g), Wis. Adm. Code,
installed directly on top of the product and extending down along the sides of the product to a point at least
6 inches from the bottom of the product.
• This product may be installed in dispersal cells in place of stone aggregate specified in approved POWTS
Component Manuals or Department approved systems. When the distribution cell is not sized based on the
EISA rating, the dispersal cell area must be equal to or greater than the area required for stone aggregate.
• This product may be installed at a depth that exceeds the maximum depth stated in the regarding block of this
approval, when the manufacturer provides in writing that the proposed installation depth is acceptable for the
individual installation.
• The following stipulations apply only to the EZ1203H-GEO, 1-12 in. and 3-12 in. bundles with non-woven
geotextile fabric installed at 180 degrees on the upper side of the bundle, pipe in 5 ft. or 10 ft. lengths:
1. When installing EZ1203H-GEO in 5 ft. or 10 ft. lengths, the product must be installed with the geotextile fabric
facing upward.
2. When installing the 3-12 in. bundles, trenches must be excavated no wider than 42 in., with a 36 to 40 in.
trench width preferred. (Although EZ1203H-GEO is not, to date, recognized in the EZFLOW Mound Component
manual.)
3. Geolextile fabric meeting the requirements of s. SPS 384.30 (6) (g), installed directly on top of the product
and extending down along the sides of the product to a point at least 6 inches from the bottom of the product.
When installing model F11203H-GEO, the fabric width shall be at least 5 ft. wide.
4. When installing the 3-12 in. bundles, bands used in transport must remain intact during installation.
5. Pipe connectors are necessary for the transition between differing pipe materials (e.g., polyethylene
corrugated piping and PVC pipe), meeting s. SIPS 384.40, and must be used to assure piping does not separate
during construction and backfilling. (Example: Include pipe connector such as AC-VCOUPLER-4 for both
Schedule 40 and 3034 PVC 4 in. pipe.)
• For gravity distribution of wastewater, the distribution cell piping shall meet the following conditions:
1. The cell units (bundles) shall be 12 inches in diameter 1 inch.
2. The cell units (bundles) shall be manufactured in 5 and 10-foot length sections, 2 inches.
3. The 4-inch pipe within the bundle shall be certified as complying with ASTM F 405, Standard Specifications
for Corrugated Polyethylene (PE) Tubing and fittings.
4. The 4-inch pipe shall be offset from the center towards the top of the bundle whereby 5 to 6 inches of
aggregate is located between the bottom of the pipe and the bottom of the bundle, and 2 inches of aggregate is
located between the top of the pipe and the top of the bundle.
5. The 4-inch pipe shall be connected by an internal coupling device to allow continuous connection from one
bundle section to the next.
6. The end-to-end gap distance between pipe containing bundle sections, as measured from the straps fixing
the netting to the pipe or from the face edges of aggregate on adjoining bundles, shall be no greater than
3 inches.
7. The header or manifold pipe connected to the 4-inch pipe within the bundle shall be at least 6 inches above
the infiltrative surface of the distribution cell, or the 4-inch pipe within the bundle shall be connected to the
header or manifold pipe using an adapter that raises the invert to at least 6 inches above the infiltrative surface.
• The EISA rating reduction may be used in dispersal cells less than 36 inches in width.
1. The maximum excavation width of the dispersal cell is 42 inches for a 33 to 36 inch bundle.
INFILTRATOR SYSTEMS INC
Page 3
October 11, 2013
Product File No: 20130145
• Otherwise as permitted in this Alternate Approval, the stipulations of the in-Ground Soil Absorption Component
Manual for Private Onsite Wastewater Treatment Systems (Version 2.0) October 2012, ]SBD-10705-P (N. O1/01;
R. 10/12)] apply.
• A copy of the manufacturers' installation instructions shall be onsite and available at the time of installation-
• A copy of this alternate approval shall be onsite and available at the time of installation.
• Additional information is included as attachment(s) to this letter; see attachment A.
In granting this alternate approval the Division of Industry Services reserves the right to require changes or additions
should conditions arise making necessary for code compliance. Nothing in this review shall relieve the manufacturer
of the responsibility for designing a safe component into the built environment.
The department is in no way endorsing this product or any advertising, and is not responsible for any situation which
may result from its use.
Sincerely,
Glen A Jones, M.S.
POW IS Product Reviewer
phone: (608) 267-5265
fax: (608) 267-9723
email glen.joneWwi.gov
LOT 2
LOT r
~ ! Y
130
SKit'S'g < ' ' Y.. d
Y c y"
Parcel 276-1043-70-101 Valid as of 06:25.'2018 09:53 AM
Alt. Parcel 36.26.19.322P-01 CITY OF RIVER FALLS
ST. CROIX COUNTY,
WISCONSIN
Owner and Mailing Address: Co-Owner(s):
RICHARD H & LINDA L WARNER
1322 RIVERSIDE DR Physical Property
RIVER FALLS WI 54022 Address(es):
1322 RIVERSIDE DR
Districts:
Dist# Description Parcel History:
4893 SCH DIST RIVER FALLS Date Doc# Vol/Page Type
0100 Ct IIP VALLEY VOTECH 02,232006 (1 a 0 i WD
8030 LAKE GEORGE 051231991 469641 903+220 WD
03 ,25,,1987 423663 772!531 WD
Legal Description: Acres: 0.000 03;25+1987 423662 772:530 WD
SFC 36T28N R7 9W NW NE CSM 2522 LOT 1 more-
(FORMERLY P561 E TN TROY) EXC NELY 38FT
AND EXC AS DESC 772/530 INCL. PT LO... more.
Plat Tract (S-T•R 40'A 1601/4 GL) Block/Condo Bldg
' 0522-CSM 02-0522 040-77 36-28N-19W NW NE LOT 01
2018 Valuations: Values Last Changed on
04:23/2018
class and Description Acres Land Improvement Total
GI-RESIDENTIAL 1.260 95,500.00 233.500.00 329.000.00
Totals for 2018
General Property 1.260 95,500.00 233,500.00 329,000.00
Wuodland 0.000 0.00 0.00 0.00
2018 Taxes
Taxes have riot yet been calculated.
Key
Primary
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
7.
Ownerf9uyet h ~(iMKf) 4 ~-t ~J~!1 ~{}r41~.ti~7
MailingAddress
Property Address-1 -
(Verification required from Planning g Zoning Department for new boa)
City/Static -jK iv rh FA&->, tA) Parcel Identi6wtion Number 17~, _ ~C 13 7D - /0/
LEGAL DESCRIPTION
'
Property Location 1,, w V., Nt y. , Sec. . r- . T Z2~ NR i ityy
IOW, TINT& of i ilcK F yltt
Subdivision Plat / Lot #
CertiiSed Sarvey Map # 4~ Volume Pam # -~)z z
Warranty Deed # G J C06 7 (Worn 2007)Volr®e Page #
Spee home, Ample lot lion idmdifmb[yesOno
SYSTEM MAINTENANCE A OWNER CERTrMCATrON / V
Improper tie and naiuemauce of you septic system could sewn in its pre nature failure to handle wastes. Proper
eaimermaocz consists of pumping our the septic tank every do= years or sooner, if needed, by a licensed pumper What you put into
the system can affW the fiaction of the septic tack as a trealmeat AW in the waste disposal systeu Owner mumi0enaoce
responsibilities we specified in OSPS. 393.52(1) and m Chapter 12 - SL Canix County Sanitary Ordiumce-
Ilia properly owner agrees to sabout to St Cmix County Flaming g Zoning Department a oaVfieafion fimm signed by tie
owner and by a master plumber. journeyman plumber, restricted plumber or a licensed pumper verifying the (1) the on-site
wastewater disposal system ism proper operating eon"on and/or (2) after inspection and pumppeng (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe, the undersigned have read the above mrpimments and agree to maintain die private sewage disposal system with the
standards set forth, herein, as sets by the Department of Safety And Professional Services and The Depatmeetof Natural Reooeroes,
State of Waeottsm. Cerbficxbon strong tlut you septic system has bow tmiffiimd vase be completed and returned to the St Cmix
County Pln mug g Zoning Departmenl within 30 of the three year expiration date.
Uwe certify that all stafammd on this we true to the best of my/lour knowledge. Uwe amlare the ow *s) of the
property described above, by virtue of a dead mcordad to Rgpstrr of Deeds Office
.
Naaber of bedrooan
SIGNATURE OF APPLICANT(S) DATE
"*Amy information that is miaepraxated may result in the saoi-y permit being revoked by the Planning g Zcnnng Deparmoeat
Include with his application a recorded warranty deed from On Repsmx of Deeds Office med a of the cwbfied
copy survey map if
reference is made in the warranty deed
(REV. $442)
- I `C ST- oo ie- (1
Dino n o i ~~mvrcec yS*_V{79,dl, S Jr c.: ' J.~'
SOI REPORT J s~ Page of 3
eocoldance with SPS 383, Vtis Mm. Code
- County Sf.CROIX
Attach complete site plan on nape- not lets than ~ 12 x I I irches in site. plan roast
include, but not limited to; vertical and tiotwantal reference point (BM). direction and Parcel I.D. 27 10,8 70 101
percent slope{ scale o{ di,mension3..nat6 arrow, and location and distance to nain"t -oud.
Please print all information. Howe d ny DDa"tee In
Persona 4onnail on you pcade may oe wed forsoconda-y eurpo4m(Privacy iaw. s. 15.04(11: m)) D O
Property Owner Property Location
R1(:tIARL) H. & itNDA l.. W ARN11R Cost. Lot NW 1,4 i3 1!4 /S36 T 28 N ri 19 F (or) Vid
Property Owne's Mailing Address Lot M#
I1?? Riverside Drive 1 - 1522
City Stale 1p c& Phone Number Elv'INe Et'n"n Nearost Road
i River Falls, l W'1 1 54022 I ( ) _ _ _ _ _ Riverside Di ivc
New Construction User. Heoidw)tial i Number of bedronrrr, ' Code denvod d"n inw rate _ 450 CPO
E] ReVacement Public or cummeraa. - Cescirbe.
Parent material sandy orawash Flood Flair elevalon d appleable M.
General eanmeryts. Conventional In ground Trenches 0.6 lording rate
and recommendaanns.
t~l
Bonny, conductedtcverifysoilconditions. 4,I:DN.
1❑ Boring # E Boring
P,: Grwnasurfaeeelev 98.43 n. Depth to lmrting factor.- -"h4- In
Sal Application Rate '
)Mnrar Corti Dominart Color Redox Description Texture Structure Consatonce Boundary Roots GPDflF_
in Munsell Ou- Sz Cont. Coto- Gr. Sz Sh. 'E##1 'Eff#Z }
-.1 0-18 IOYR2`2 I 21'ebk I Es 0.6 0.8
2 18-?3 IOYR3r3 sit 2.abk its - 0.15 0.8
4 23.34 10YR4;'4 - cl 2fabk dsh - OA 0.6
4 34 58 7.5YR3:4 sl -1klyk its 0.6 1.0
5 OR•R4 7.5YA5,6 s 05g dt 0.7 1-6
07
_1t
a BOnng
F7 Boring # /~10
L ® Pit CrourW sr.rlauu elev. r. 1 oi, r. to Imiarg factor 7 S =in,
}Sal Application Rate
Horizon Depth Dominant Colon Redoz Description Torture Structure Consistence Boundary Roofs GPDrR
in. Murseli Qu Sz. Cart. Color Cr. Sz. 3h. 'EfFRt T02
I -v is R Y z- z!->I, - - n. V/
1
EMuent #t = BCD > 30.<_ 220 inak and TSS >10 < 150 mgrL ' EMuen' #2 = BOO 30 yW.- and TSS < 30 r igA
c.ST Name (Please Prir1t) Si CST Number
NLNRY JO HCPPERT Hollister's Soil Testing,&Dcsi n % 224832 i
Adoress Date Evrriuaflefi Condo Telephone Number
28497 King Arthur's Court, Danbury, W1 54830 06 - 13, 2018 a 0%-/! 715-426-1775
-_r~f~ SH13 %1fii(RUiiD)
D.open' O,, nc Pareol ID ---7A- ~>r .3-•7t'-~c~ ,nyv of
H::nn9 ~
U k onnG p i t 7
pit Grcand surlacu ulev. Depth to fim'tng factor in. Soil Aa L-ation Rate
!1orIzon Dopth Dom nanl Cola, Rodox DoscmIDC'i Texture StruUarc ons',sterlee Bor.ndary Rools _ GPM
in. Mini Ou. Sz. Cont. Colo, Gr. Sz. Sh `f#t `yt2
1 1z. ~L rnyp V5 gli svK d 5 - rv G.g
3 gib- 30 !o Yk 'I/y- J-41 t
-77-
R:ring I - -
Hurniy q -
pit Ground si elev. ft. Cemh to lirnnmg facto: in
tiad ~c;:'uiaUOn Hate
Hor¢on Depth Dom rant Colo, Roeox Description Texture StrucLUO onsistence Boundary Roots GPD;ft '
ir. I•.tunscll Ou. Sz. Cont. Color G. Sz. Sh. ' '(=11?:Y
i
0 Boring
Bnrn, H Pit. Ground surfece elev. Death to limit ng factor in-
Soil Acalication Rate
Horror Depth Do-ii rant Color Recox Desr!pIiQl -exture Stmchve 'oni oundary Roots GIM '
.r. Idunsell Qu- Sz. Cont. Cale, Gr. Sz- Sh. "I. ffY)
' Nlluen: 81 =HOD , >30< 270mn1ari ~150 mg:L ' Effluent 107 = HOD . 30 mg:L and TSS < 30 mg+L
The I)cpr ol'Salet% and Pro l'caional Services is an equal opporl unity service pms idcr and cniployer. II'Nor need assist.i to
aces; services or real nutteriv in an aaemate toxin al, contact the deparun;nt at 6US-366-3151 or I TY through Rc.a°.
giehAvz> Liven L~
WAgti-t-R
~3Z2 R~vEreSiD~ tae.
/ ZA, -/(43-70- /GI
Y
r
'U 3
F Si pfd
A cc
a 4i ~ ~F art _
S M
C;
cY
Wisconsin Department of Safety and Pr Services -1 C d dc) I 0 1 /
,Division of IndusltrttBa lgCa n
it IC,LI~ $OIL EVALUQL.Q~L wc1F~T Page of t
r2 S ZQ1fl actor anoo with SPS 383, Wis. Adm. Code
j~LN County SLC'ROIX
Attach complete site plan on paper nor less than 112 x 11 inches in size. Plan must
include, but noNirnited to; verljcal aud,honzontal ference point (BM). direction and parcel LD. 276 _ 1043 - 70 . 101
percent slope. scale or gimonsiops; north - all location and distance to nearest road.
Please print all information. Reviewed by Date
Personal information you orcvde n'ay oe used for secorcary pr,rpos. s (privacy 1 aw, s 15 LW (1) enl)
Property Owner Property Location
RICHARD H. & LINDA L. WARNER Govt. Lot NIX 1/4 NE 114 S 36 T 23 N R 19 EE((o))WW
Property Owner's Mailing Address Lot if Block # Subd. Name or CSM#
1322 Riverside Drive 1 2522
City State Zip Code Phone Number ity ❑ Village Town Nearest Road
River Fall, WI 54022 ( ) Riverside Drive
New Construction UseQ Residential; Number of bedrooms 3 - Codo derived design flow rate 450 GPD
El Replacement Public or commercial - Describe:
Parent material sandv UUIw'ash Flood Plain elevation if applicable IN A ft
General cornmenrs Conventional In-p!round Trenches 0,6 loading rate
and recommendations:
Boring conducted to verity soil conditions.
FT] Boring # O Boring
❑ Pit Ground surface elev. 93.43 ft. Depth to limiting factor '84 in.
Soil Application Rate
Horizon Depth Dominant Color Real Description Texture Structure Consistence Boundary Roots GPDfft
in. Mansell Qu. Sz. Cont.Color Gr- Sz. Sh. 'Etf#1 'Eff#2
1 0-13 10YR2i2 1 21'sbk ds 0.6 0.3
2 13-23 10YR3r'3 `d 2I'ahk tts 0.6 0.3
3 23-34 10YR4r4 cl 2fabk _ dsh 0.4 11.6
4 34-68 7.5YR3i4 - sl 2tsbk cis 0.6 LO
5 68-84 75YR56 s Osg dl 0.7 1.6
Boring # ❑ Boring
F-1 El Pit Ground surface elev.--,--,-.- ft. Depthtolimiting factor in
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in Munsell Qu Sz. Cent, Color Gr. Sz. Sh. 'Eff#1 'Etf#2
Effluent #1 = 800 > 30 < 220 ml and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/- and TSS < 30 nVL
CST Name (Please Print) Signplpr CST Number
MARY JO HUPPERT (Holliste's Soil Tcstin &Desi n) ~GI u ~ 224332
Address Date Evahr I Conducted Telephone Number
23497 King Arthur's Court, Danbury, WI 54330 lib - 13, 2018 715-426-1775
SRI>-x 130 (RO'i I
N C!
> C N .O 3
M 3
o. ~ o o. N"N
i U 0 N N
2
LL A
iy ~ u u d } 0 0 '4
N v > ^M = u N
N
I Q s ~ lE ~ N x c
II _~,YI may./' GTi o "N
EO r i p ~ ~ F O 6
'c `oFCr b' ~ ~ V ~ ~ a yo~
c
E 79
❑ • V ~ ~ y N rye.. z ~ U
C N C ` - F v a d O
.C C 'L
en c
d d ❑ sA t o
u u u Z ~ lap u
U G u y.
u u u t u~\•~~ '
Z o 0
❑ 5 ~
U A y C ~ ~ J¢ O W ~1 ' J C C
w G r~~ a 1•/ 7 O V
rj o N y
o 1 V 'AbA''
e~-N C WD Q
❑a
z
3 O
n
`o Od, (A
W W I~1 ~ ~M-
O r
F L
W
Uw
o ~ z-
w o o'
8 S2 I S2 U= z0
w
F
z W -
z G a
O F' W C 'r z _ N
Ow ` Q ¢ J r O ` m
o 0 w r d 'E c o ~ m ~ R d D
7. m 2, L J U
O O .f W d' u- Q LL l O 6 J N' V U J W N
N .r I~ y N LL W 1J U S IL z' O V S w d
City of River Falls Application f(cS - f~
GENERAL Permit Application Parcel - - -
Permit Type: ❑ Construction ❑Deck ~JGaragc(Detachcd) ❑Shed ❑Electrical ❑Erosion Control ❑IIVAC
lumbing ❑Driveway ❑Lighling ❑Moving ❑Razing (Demo) ❑ Roofing ❑pool, I ❑Sign - ❑Elec.? J
Zoning District: Setbacks(Feet): FrontSide_ Rear _ Left _ Right_
Project Address: SAwv
Owner's Na1llC: Mailing Address: - Tcl.
-
?C_IC~t~Nul b✓il2~erZ 1322 Jj,reLsipe 1~~2 cell
U'Z7~'-z a7
Ruad10Q-( Q=a;= Y'atM I holing A,kires• - - Tel.
Gall
HVAL.S:cmtracloc Lic.ifatY Maibng Address- Tel.
Cell
Electrical Contractor. LmaCiaru# Wittig Address Tel
Cal
plconttaetor - I icACena Mailing Address Tel.
yLJ -re ZAP
t~e6~eK~~~~ rKCM~d~ 9313x1 a85- ou RD S's Cell ors-~Z/-G2
Project Description AREAINVOLVFD• LIVING sq. ft. DECK sq. ff.
_ GARAGE: X
/aCl /l /7P?~~fcanaraa../--.)et&, e AS .SPWP! /J aOef Ast 4. 6 / Aid n
Y,.~)h~ _ ~a _ Porn/
S1- L-fU1x QOC.Izt' 7 4V(wt 1A111L zASf!f~_-. hNl y ~l' 6h5)!6
Estimated Project Cost (Labor + Materials) I $1~w
I ague w comply widr nll apphuh)c axles, xtstmcs, and ordinances and with the coadojons of this permit. I mtdcnland That issuance of nc~ pnmit ucatp no Iegel
liability, express C.niphal,,er the state w municipality, and comfy that the above Inlurmatrnn is accurate. V 1 am an owner applying fur an ure;on cortrol in
umnmoinn penni,, I hne aad the yaW iauq statemad mgatd:n}: aunractm Inx,x ial rapunsibilip• nn the mcuu side I enprvssly grant the bmldmg inspector, or the
in.pcaor•s awhonzcd agent, pcnni,inn in cnia the pramws fcr which this petmii is sough during regular business hours to inspect' me work described above.
Applicant Name (Please Print) it~Ine L k? -Jew AGlJ_ Date: I?_iel ; 20/y
11FGI1':til:R4EERACK Signature _
Conditions s perrnn is iuued pursuaat to the following condflious. Failure to comply may result in suspension
Approval Conditions or revocation of this permit or other penalty.
-
Q4~
Please call at least 24 hours in advance to request all required inspections. 715-426-3426 or 71SA26-3427.
O FOOTINGS (OPEN) ❑FOUNDATION WALLS,
ROUG11-1N: O CONST,__ , 0 PLBG_, O HVAC__-__, 0 ELEC,_, ❑ INSULATION-
E3 FINAL (OCCUPANCY) INSP. DATE: INSPECTOR: _
Permit Fee: Permit Issued By:
- CENSLiS CODE: 1901 -
Permit Fee: 5 = - Check C8s)l-- Inspector: myj
s
Receipt
Total: S V:MsPLCIAORMSMUI n1"'Peaxrrt Date'
APPt1LA--)hLWLxLXALIMa1 I Am
Utility Application & W/S Lateral Request Forms completed