HomeMy WebLinkAbout032-2136-90-000
Aiscon41n Department of Commorcc PRIVATE SEWAGE SYSTEM county: St. Croix
Safely and Buiding Divls on
INSPECTION REPORT Sanitary Perm4 No.
(ATTACI I TO PFI2MI I) 605121
GENERAL INFORMATION Salle vla^ ID Nc
Pemc-al inlormabnu .union nny he used for seconcary;mposes;Pmacy Law, 5.15 C4 r1l(nol
Penmt ydccfs'.amo C1y VBinge loans-ip Pornnl T:Ix No
Andy & Melissa Chapman TOWN OF SOMERSET 032-2136-90-000
liM Elev: Insp. q;4:,_ Bkl t)esa:plon Scclont'nwnntanye.'MaF No'.
4-3 Gs( 13.30.19.1211
TANK INFORMATION ELEVATION DATA
IYPL MANUFACTURFR CAPACI IY STA110N BS HI FS CLEV.
Septic Renrhmalk .6 /652 Z~
x
Dosing All RP.1 b~'Q
O
dLGJ 1 UA.
Aak*m Bldg. Sewer
.S b6r7
a'l 44
Holding SUHt Inlet &.4 •t
TANK SETBACK INFORMATION SUM Outlet G•7
TANK 10 •'I PiL tWF t Rl D("' e to ar make ROAD Di Inlet
Septic DI Bnthan
/V \
Dosing I Ieade0man. 4 9-7-1
Aeration DISI. Pipe r • O
Holding Rot System 4', -75 ''Y
Glade V
PUMP/SIPHON INFORMATION Final S'5 91 •-7
Manufacturer Demand St Cover ,f 02 Q
crrl T a
Model Number
T Dl I Lift Friction I oss 3ystcm I ICaU I DI i Ft
Forcemain 1 c S1. to ovell
SOIL ABSORPTION SYSTEM
BED/TRENCH A.0. I Length No Trcn.~DW PrTDIMENSIONS No. Of Plu: inside Dia. Uqud Death
DIMENSIONS 3 r!eAc"
SETBACK SYSIFNh 10 P1L BLDG WELL IAKFISI RILAM LEACHING manwaculRr
INFORMATION I OI ste CHAMBER OR
Y Y 165 A ( UNIT flode mxr:
f% I Wit
% DISTRIBUTION SYSTEM ( Z74-7-7~2 IdS
1lcadnfkl:norold if Distnbutior. X Hole s¢c x Hcie Sparc 19 4'nr to r Intak
Length_ no _ _ t rnyl' Dia Spacing _
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Sysloms Only
11 Pte Orcr Depth Over U Depth of xz sccccd5odded xx k1UICBCA
Iiee:Trench Ccntol Q , 4 9ed-Ire-ch Edges Tuoznd ~ yes I No ~L2s No
COMMENTS: tricib to none d sacpencies• persons present. etc) Inspection #1 / Inspection #2 l
Location: 1564 84TH ST L
1.) All BM Descf plion = I
2.) Bldg sewer length = "'.A, ~-fe,
amount of cover = ! ✓n' ,a~•~ v /
7 yIZ Q 4 fX/ 1X/J s ' Ill^• ~w~
Plan revision Required? Yes x0 it 7 7~
Use other side for additional information. I'f C~ -V ✓
Date Insepdo SlgnaWr Cetl No
SBD6710( 197)
Svstem P1.01 PLAN
PRo,rr.cT Ancly Cnaoman vm)RE.ss 1564 84th st. Now., Richmond W; 54017
SE 1 4 NW 1:4S 13 :T. 30 N.,R 19 .o\\N Somerset CO( .NTY ST. CROIX
s\vSTEN1 ELEVATION 94.593.5 4.5 below arade t3.11 8 5
DATE BEDROOM
CONV-IINTIONAL XKX CONVENTIONAL LIFT HOLDING 'IANK
MOI:'XD SICPTIC TANK SIZE 000'630 LII"f' TANK slZt. DOSE TANK SIZE
HOLDING TANK SIZE LOU) RATE ARSORPTIOX .AREA '091 k of chamhers54
BENCIINIARK P.R.Y. ?op of suvey iron ASSI~NIF ELEVATION w[r Filter Lifetime Filter
❑BOREAOLR: 11.R.P. same as benchmark
)1 Y,,,_,Lrl, I.in. Scale = 1/4" = 10'
13.nt.
66' 69' Propet", I.inc
Elevation of B 2 does nn malt; sense.
visited sit,. this drawing i mod accurate
S4th St
02'
~6' Pro 5
5(i' B-4 Bedrootn
house
- y
B-3
I a s
80 Af
vans
98'
10' 10'
B-1 B
Vent Huffcutt
X 110' cells with ;pacing Combo ST
0., Qwck4 Standard 105 Shipu
o[ Cover Lcachin~ Chamber
with 20.0 ft-' of Arca
C,_IA1 pair of i.nd Caps
Lon, 1 2
Grade at Systcn- Elevation
All piping shall be ASTNF SDR ;0,:"4. within
10 of tank, piping shall be AS 'I M F891
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 8/3./18
Owner:Andy Chapman
Location: SE 1/4 NW1/4 S 13 T30N,R19W 1564 84th St. Somerset
Manuals Used: In-ground absorbtion system (version 2.0)
Pagen
1. Cover Page
2. Plot Plan
3. Chamber Cr s Section
4. 6. Maintance Contigency Plan
7. Filter Cross tion
Signature T
License num r#226900
System PLOT PLAN
mzo.I1CC'I' Andv Chapman :1DDItl;SS 1564 84th St. New Richmond Wi 54017
SE 114 NW 1/4S 13 i'r 30 NCR 19 w rOwN Somerset COt1NTY ST. CROIX
STS'1'1•:M F.LIiN':1'I'IUN 94.5.93.5 4.5' below grade 853/18 5
DATE BEDROOM CON%TNTIONAL )00( CONVENTIONAL LIFT HOLDING TANK
MOUND S1a97C 'I':ANK SIZE 1000:630 LIVI TANK SIZE DOSE TANK SIZH
1101.1)ING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1091 $ of chambers 54
k BENCIINIARK v.itx. Top of survey iron ASSUME ELEVATION 1110' Filter Lifetime Filter
❑ BOREHOLE O RTa.1, -11. R. P. same as benchmark
491' Properly line Scale = 1/4" = 10'
B.I.
66' 369' Property Line
Elevation of B-2 does not make sense.
visited site, this drawing is more accurate.
2
S4111 St
10°• B-5
36' Pro 5
56' B 4 Bedroom
House
100' 4, 21'
B 3 1R'
Vents
98 ' 10'
B-1
B-2
Vent I Iui fcutt
2-3' X 110' cells with >3' spacing Gumbo ST
>6" Quick4 Standard 1W(' Slope
of Dover Leaching Chamber
with 200 112 of Area
5.611^2/pair of end caps
4' Long 12"
Grade at System Elevation
34"
All piping shall be. ASTM SDR 30/34, within
10' of tank, piping shall be AST M F891
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of area per Chamber
5.6i'l^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 99.0'
Al.on GradeVcnt
/30/34 Septic Tank 3
5' i' Lon- I
Grade at System Elevation
36" Grade al System Elcvanon
Spacing 5'
24 X 110' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
27 chambers per cell
System elevations:
A-94.5'
B 93.5'
Fill OWNER'S MANUAL & MANAGEMENT PLAN Page, of~
ILE INFORMATION SYSTEM SPECIFICATIONS
Ovn r
Septic Tank Capacity F"' NA
Septic Tank Manufacturer U NA
DESIGN PARAMETERS Effluent Filter Manufacture" ..l ' NA
Number of Bedrooms 11 _
_ J VA Effluent Filter Model 11 NA
Number of Public Facility Units -
JJJA Pump Tank Capacity JA
A
Estimated flow (average) - T - - - - Purnp Tank Manufacturer A
Design flow (peak), (Estimated x 1 5) gaut ay Pump Manufacturer A
Soil Application Rate - avdavifi7 Pump Model
Staard InfluenVEffluent QalifJonthly average' Pretreatment Uni; Fats, Oil 8 Grease (FOG)_30 m L ❑ SanciGrave' Filter ❑ Peat Filter
Biochemical Oxyger. Demand (BOD,) s220 rri ❑ NA D Mechanical Aeration C1 Wetland
_ Total Suspended Solids (TSS) x150 mgi- ZI Dis.nfection
Pretreated Effluent Quali U Other
tY ~ Monthly average Dispersal Cell(s) -
Biochemical Oxygen Demand (SOD: L NA
) -30 my/L ❑ In-Ground (gravity) ❑ In-Ground
Total Suspended Solids (TSS) --30 mg/L NA (pressurized)
C At-Grade .Mound
Fecal Coliform (geometric meant) <104 cfcil100m1 _ El Drip-Line ❑ Other
Maximum Effluent Particle Size , m dia. ❑ NA othec -
OMer. - G NA
NA om~r
NA
'Values typical for domestic wastewater aria septic tank effluent. ot•~ef- - - -
❑ NA
NIAINTENANCE SCHEDULE
Service Event Service Frequency
inspect condition of tark(s) At least once every: ❑ month(s)
ya s (Maximum 3 years) U NA
'Pump out contents of tanO k s - "
- '.Mien combined sludge and scum equals one-third (%r) of tank volume
- - G NA
;inspect dispersal cell(s) - -
At least once every: p oath(s)
(Maximum 3 Years
year(s) ) O NA.
Clean effluent filter At least once every: 91month(s)
- -
Inspedpum - ---,Lf _year(s)__ ❑ NA
p, pump controls 8 alam, - At least once every: C1 menu(s) ❑ NA
=lush laterals and pressure test - - (J - - - - -
- At least once every: C month(s)
-Jthec Q year(s) NA
_ I At ;east once every - - - ❑ man h(s) - - -
year(s) - NA
NA.
MAINTENANCE INSTRUCTIONS
dnspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications. aster
'Plumber. Master Plumber Restricted Sewer; POVv7S Inspector; POW-S Maintainer, Septage Servicing Operator. Tank inspeoti s mast
include a visual inspection. of the tank(s) to identify any missing or broker hardware, identify any cracks or leaks, measure the volume of
i;;ombined sludge and scum and t0 check for any back up or pnnding of effluent on the ground surface. The dispersal cell(s) shag be
visually inspected to check the effluent '.evels in the observation pipes and to check for any pending of effluent on the ground suaace.
the pending of effluent on the ground surface may iraicate a fading condition and requires the immediate notification of the legal
,egulatory authority.
When the combined accumulation of sludge and scum m any tank equals one-third or more of the lank volume, the entire contents of
he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113. Wisconsin
Administrative Code.
IAJI other services, including but not limited to the servicing of effluent filters, mechan,cal or pressurized components, pretreatment units,
I3nd any servicing at intervals of 512 months, shall be pe formcd by a certified POV TS Maintainer.
q service report shag be provided to the local regu:atory authonty within 10 days of completion of any service event.
Page -of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals the it
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) reproved by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are from at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent
To avoid this situation have the oonteMs of the pump tank removed by a Septage Servicing Operator prior to restoring power to the
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal leves
within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area with n
15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT$:
antibiotics; baby wipes: cigarette butts: condoms; cotton swabs; degreasers; dental floss: diapers: disinfectants; fat, foundation drain
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produdls;
Pesticides; sanitary napkins: tampons; and water softener brine.
ABANDONMENT
When the PDWTS tails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• 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 Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
rep ent system:
itable replacement area has been evaluated and may be utilized for the location of a replacement sod absorption systelm.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requfilad
setbacks from eAsthg and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule:t in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluation
must be performed to locate a suitable replacernem area. If no replacement area is available a holding tank may be installed as
a last resort to replace the failed pOWTS.
❑ Mound and at-grade sot, absorption systems may be reconstructed in piece following removal of the biomet at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
<MIARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANWOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Name
Phone / 7- Ll~ Phone J l
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name ,A "I I
Name
Phone Phone
This dDcWx n was drafted in compliance wrh chapter SPS 383.22(2)(b)(')(d)&(t and 383.54(1), (2) 8 (3), Wisconsin Administrative Code.
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SEP] IC J*ANKNIALN'f1 N~ ACF.,ViR1-- 1i}'N'f
AND
t>WNE S1111r C}?RTIFWATl( INFORM
Owneril3uycr 1]~1 c
Mailing Address IS 0 VY`t~ q V - - - - -
Property Addre.. l 25 ~J Y(4
(Verittcation require({ hoot ?lanniny..l. I l i lhr ueew consfrnction.)- - - -
CAV"Statc: - - - - - puce: I(ientiticationNur bcr v l~~
L.FGAL DESCRIPTION
Properly Location - • Qt(_- IV I, Sec J ->I
%U, 'I-own
- - -
Subdivision
Certified Survey N1ap 11
l - - - - Vr lulrto - Page
Warrauh Deed # -A - - - - Palle 4'
- = Lohun
Spec louse ves
ve. no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and ominreuance of your septt.; sys:crn conld result el its pn•nr.-uurc failure to handle wastes. Proper
maintenance oonaisls of pumpigk out lire septic tank eve: v thn:c years or sooner. ~t needed, by a licensed pnnnrcr. What you put into
the system can affecf the firncuon of the septic tank as a treatment stage in the was.e tbsfmal system. Owner maintetwn-e
responsibilities are specified in gC'omrn_ 8; _i2(1) anal w Chapter 12 Sf. Caoix Cm:nty ?anttary Ordinaucc.
The propwty ow ter agrnos to submir to St. Cmi+• I our.ty PI ru ,e & 7(in Im, Department it cct I ficarion form, signed by file
owner and by a ma.mcr plumber, joamryman plurnba, rcV r red pluo,oo c: a iieer sed pumper vet (tying that (1) the oil-,I to
wastewater disposal system IS in pmpc r operafing condition an`4nr (2) after r--rspr: ;:ion and p:tmpmg (ifnccessaty), the septic tank Is
ie,s [tall L3 foil of sludge,
Pwc, the trndcrstgued Im.c read !hc.:hove rcyurrertun t anti ivrrt o mainhur Ilse private scv,ape disIroSal systr,m w•rth flee
staluuuds set fneth, hareir, as set by the Dcpatlmcnt of Commrr•.r and Ilt, .reparun.-ni of Natnrai ResonreC, State or NViscousru.
Certification statinpthat your septic sys'ern Into been rnnintatn.d must he compicto! and returned to !ire tit Croix Counry Planning &
7ornng Depatlmem withm 30 days of the three year exl,u'aLon date.
I: we cereh that all statements on dos ,nn are tnrc b ma b_lt or my:our 1,row1kdw. Uvvv anetnt: the awmct(s) ofthe
property deserihod above by ..itive of a wary Irv deal wao:dcd tit Keytster of Dees office.
Number of bedroorn5-~: 4 _
4SIG,t~AruR C APPI.
ICANT(ti) ~ l
DATE.
.
«**Any intomratiort that is misrepresented rent' result it: rfic sanitary pettnit bculp r, :voiced by the Pisaning & Zomog I )epar(III «
Include with dos application a n•couled tvatrar.ty deed Item the Kep_•is(ei oCDrr-ds ( -Ificc and a eopv o: rile certified survey map if
reference m matte in The waitatnv deed.
(RFV. 08105)
C"'~NE NORTHEAST QUARTER OF THE NORTHWEST QUAR-
T I; gz y ALL IN SECTION 13, TOWNSHIP 30 NORTH, RANGE 1
- SCALE 'N I t.'. ingh = 1V0 I<st
- - ------------N01'02'29"E 26
'M1EST LINE Of 1•11- SE 1/4 Cr T-1 NN 1/4
99 60'
t - ' - L All.. AL. _,y_ +L,y_ _Y_ `
742.37 T
EXISTING WETIAND TING 1AETLAN~
Hw
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N.wL1z
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C3AINAGE EASEMENT o
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Yesconfr. Department o(Commmce SOIL AND SITE EVALUATION -
Division of Sanity and Buildings Page of _
t n:r.:au of Integrated Services in accordance with Comm 83 09, Wis. Adm. Ccae
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must county
include. but not limited to: vertical and horizontal reference Ix,int (BMI, direction and
f-_gi!y
percent slope, scale or dimensions, north arrow. and location and distance to nearest road. parcel ID
k
G) 7 J i b '~Ii `~1 (J C
APPLICANT INFORMATION - Plea9e print all information. Reviewed Date f
Pcs,-wl lNurrrwnon you proi0ereay he. osM for aecmd,r, :mrP;c,w iPrP„icy Law e 1' fti (m;iL v•~ IL t ~r~U0
Property Owner Property l nrauon
L
GOvI. Lot j~r 1:4 f, ~ ir4;S -v T .-z NR Property Owner's Mailing Address y, LOt k Rlcckk Sufxf. Name or CSMp
CL Y Zip Code Phone' 'm er
N ' p U City_ _ Village (2~ Town Nearest Road
Now Construction Use: 1ERes..dental + Nund:er of bedrooms. Addition to existing building
l J Replacement C Public or commercial - Describe:
Code derived daily flow 4z,&' _ gpd Recommended design loading rate % bod, gpdrfiz , j trench, gpd.,'W
Absorption area required _ 9 bed, ftZtrench, tt2 Maximum design loading rate ~Zbed, gpddt"' . K trench, gpdAt2
Recommended infiltration surface elovation(s) _ -1 It (as referred to site plan benchmark)
Additional designisite considerations
Parent material Flood plain elevation, it applicable
S - Suitable for system Conventional Mound In Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system L+J s U u L~ s L u 0 S❑ U ',A s LJ U L1 s LA U L s IZi u
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD112
in Muns011 Ou. Sz. Count. Color Gr. Sz- Sh. Bed Trench
12V X Ad
Ground x _
elev. i/S X G~/ AL-
_ 3.- -
Depth to
limiting Il r y
factor r
:14_S in.
Remarks:
Boring #
l
- - - O- S 12x-'211 44
Ground
elev.
ft. 41
Depth to
limiting
factor
in. Remarks:
CST Name edse" hnt)~ Signature - j Telephone No
Address Date CST Number
vaaseaWOWNER SOIL DESCRIPTION REPORT if
r / 9
BoringM ftWM oepN Domlant GOlm Monlaz nu Swc... sbw Pouts Noon; [ti{ Ou. Sz.CmL COInr W gp T
ti
~FSf
c~"om 3 _
le 2" rj~ '7
Pogn m
mr
bpor
7ljQJn.
Remarks:
Boding #
- F
Guts
mNmem
n n"r
>I°' Remarks:
Bon:w Gann Own"an cm, M"nla, Muw,11 Gu SZ emt Wlw n Er S, Sh wn:Ina".. e"u"mrv Rwu
. . Ban TreOw
« /e t
QE f/l
We,
~CLGR
g.pmw
Wi nB
-q
Jf~'^ RemaMS:
Boning #
4
aw
nau. a
Bwm to
menc
iww
Remarks:
S80 83b IR 9901
PROPERTY OWNER i SOIL DESCRIPTION REPORT
:z - Page - of
PARCEL LD.# -
Boring # 'cordon Dboll', Dorvolan: Co.:rr Mottb:a I Texture SlruClure
::!:nsslen;:e Bounoan• Roots
in. blunsell ()u Sz Con: Dolor ui. Sz. Sh_ Ek+tl Trench
L 1 1 J`
Grourid
elev. ;r - -
Depth tc
irtniliny
tactor - -
Remarks:
Boring #
Mound '-f_y~~~,v - _
a
DuDir to
limitinc
`actor LE t
Remarks:
Fionzor Depth Dominant Colo• Mollies S-uoture C,pDyt<
in. Munscl Ou. Sz. Cont. Dolor exture S. S• Consistence Boundary Roots
Bed Tf"c!I
Boring # _
Guavid j "
It.
Depth to -
li.•nitiny I r
factor
Remarks:
3onng #
I
.round
nl=~
?opts to -L- - - -
I'Mitno_
Mclo'
___or'_ Remarks-
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