HomeMy WebLinkAbout020-1024-20-000
Wsconsm Department o' Ce---erce PRIVATE SEWAGE SYSTEM c.c,wl St. Croix
Safeiv and Audcinq D e sn-
INSPECTION REPORT San tory Pemut No
(ATTACH TO PERdITi 605084
GENERAL INFORMATION Stale Plan ID N
,ersondt irform.it on ic'.. prcu de ray C used for seo3rcary porpnses [P-,,a .y Lave 5 15 04 1)!"":
Purrs l!Iolder'S Name: C ty V llage TownO`ip Par,xl lax NO
Oevering Homes TOWN OF HUDSON 020-1024-20-000
CST BM E ev. 1 losp BM Elect Bl.1 Lt. Py:m Seaic mTwvn: Range!.ta{: Vr.
GD 14.29.19.105E
TANK INFORMATION ELEVATION DATA
TYPF t,IANUFAC111RER CAPACITY STATION BS HI rS ELEV.
Septic t)~ ~ZSS Benchmark
G u r (P
All Bret
1.51 /dy
Aeration Bldg Sewer Al. S 161.5
Holding Salt Inlet
S-S(o ieo•7~
TANK SETBACK INFORMATION Sli tII Oulle: S 9 /oo 'FS
EANK RL V^111- BLDGVe Ir L'.te R')AD Dl nel Z 2
, Dt Bottom Header NInn D st. Pipe ong Hot System '
~'9 9S Y
L.na Gfadc
PUMPISIPHON INFORMATION /Q / • 7
Nlanufaaiurer Demand St Cnve
GPha / el ld
C_.O
Model Number
TDH 1-:11 Fncticr Loss System I lead TDH F:
Forrkma~n I Lon;th Da C 51 to
SOIL ABSO PTION SYSTEM
Lr _i~ dC)c:M
BEDfTRENCH 'dre!l- LengP- N, CT lirur. r.r PIT DIMENSIONS V.. Cl tits Ing fie NI
DIMENSIONS I Z7 ^7 ~ L f . I \ ~ l_~
SETBACK SYSTEM TO f IPil f JBI DG, L'•/LLILWL LAKFSTRFAM LEACHING !.lsrufacturct r I I '
INFORMATION CHAMBER OR •
yOf SYSIan UNIT 6lpcel Nmr
(~D>. Jt... , Vvs y~
DISTRIBUTION SY TEM p~ D cG~d /✓S
Hee]e'. Ver f,l'), Dis VibdliU'r + I'e e Svc x •1u a• Sating V `11 Qi w l 'akE
yr
I e-.u:n ~ Did T Lengn Da ~ SVar ng
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only V
For, Ovef / 1 1 Depth C'cr xx Oepl If x,. SocroemSotlded xx tdubhec
6e ]Tc'sh Ccutt•r 15 ReaTrcncr Edges ` toF;o'tK5 Ne
COMMENTS: {Include code discrepenc es, persons present, etc.? Inspection #1 Inspection #2
Location: No Address Available
F-.
i Alt BM Description = I IL.-
2.? Bldg sewer length = I~~IV C Zip
- amount of cover = r
[,,an revision Required? [ Yes >(No Q
Use other side for additional information 1
Oa:u InSepctgr's Sigr . 're. Cert. No
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zl I ~sP 207 W. Washington. Ave P 3ox 7162 S~,my 2etrm Number (te be f.ll
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r_ 1 Madrstx:. WI 5370 -7162 J~
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Sdi1113i~' ~CIII1fI Application - SratrTrwsa=onNuntbe: -
j a a..carr=nx with S S :3' I 1 w :s. Ada c& uhme tun or ILL /.-m to the apprainu le govemns.ot,d AA
quited nr to btainvrg 5.'u` it'u1 Pe'"nu Nate 4 L r [ srts for sat:-uwneG POWT$ ye <u:zruur: tc :toe :,d:!rea: iif ddI= khanroaibag ad&M$'
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II Type of Building (eZk all tha app 'j ?crt n - Tx/ N~~ y_ or W
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t ;yur • t ~r icxplan 1 ?reveavnma Devta ter.piautl
Y Uts crsaLTrca art Area informatuo ~ _ - J /
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NT Tank Info C,paclty in Total a of Mmuracturer
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Il ICesponsrDrbly Stale---m//reyrrut--- k for uvdenlgord, x\smnz ..oou_biGry for Install: vnu o the POK !5 shown On the attached planx-
Plu.nlxa sName Pnml 7
+I=aM's.' me N,'AU'RS Numbs ~ Busmcts Phmx 2~'t¢vber
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Pha0cr'S Address /Star. C.ay, S=, LAP U+drl n - - /
~•ll ountdDe arttnent Use duly _
ApPInv.1appr^'~ SWQ'; ~I D~'i.~ur~^ Q_.ssua en: Si;.vnce
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1R. Condrtlaw; (AiWSWk sous for Disapproval f -
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SBp 0?98 (R !!in)
SYsteni P1.01' PLAN
PROJEC"I Oeverinc Horses ADDRESS 1433 Cernoho.ls Ave SJllo A New Richmond Wi 540'7
1±4 SE 1 4S 14 1 29 Nru 19 RN TORN Hudson COLINF) ST.CROIX
SYSTEM 1A,E%AT10A 9S.3~98.0t97.?' S' bobw graoe 7!15!18 BEDROOM 4
DATE CONN'EN'TIONAL XX'X CONVENTIONAL LIFT HOLDING 'I AM\
1255 gallons LIFT TANK SIZE DOSE 'PANE SIZE
MOUNT) SEPTIC 'T'ANK SIZE:
IIOL.UINC TANK SIZE 1.o.%E, lu'rE .5 1BSOR1910\ AREA '2'6 # of chambers 60
BENCIfM,1RK N-.R.P. Tod, of survey iror ASSUME ELEVATION 100' Filter Lil-etin,e Piltcr
❑ BORE1101.1. O NN'ELL ° H.R.1'. Same as benchmarK
160' Pn>pcrt~ Llne Scale IS 1 = 40'
1 to_ unless 011101A ISO
doted
.nts B
,11, - 'rt S'' cell; allh >3' spasms
3 iL
i
kR
o'
140'
6 ;r I
-10 "0'
ST
R-_ Pro 4
I00' 10 Bedroom
lot, House
Vent
,.6:. Quick-4 Standarc
otCovcr Leaching Chamber
with 20.0 ft_ of Area
i.6fr''2'pair o end caps
Gacir. Pass
4* Lone 12
Gradc at System Ewc anon
All Piping shall he AS FM SDR 30.+34, within
10' of tank. piping shall be ASTM F891
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 7/15/18
Owner:Oevering Homes
Location: SE1/4 S 14 T29N,R19W Future Lot 8 Hunter Hills Hudson
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cros ection
4. 6. Maintance a ontigency Plan
7. Filter Cross Se ion
Signature_
License nu er #226900
System PLOT PLAN
PROJECT Oeverino Homes ADDRESS 1433 Cornohous Ave Suite A New Richmond Wi 54017
1/4 SE I/45 14 /T 29 N/R 19 TOWN Hudson COUNTY ST. CROIX
SYSTEM ELEVATION 98.3/98.0.97.7' 5' below grade 7/15/18 4
nA•rr: BEDROOM CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SHITIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE 'TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1216 N of chambers 60
BENCHMARK v.R.P. Top of survey iron ASSUME ELEVATION too' Filler Lifetime Filter
❑ BOICEHOLE O WELL * 11. R. P. same as benchmark
360' Property Line Scale is F = 40'
103, unless otherwise
Vcnls B-1 noted
3-3' x 82' cells with >3' spacing
M.*
0'
5'
B-3
140' 70'
6% Slope
20' 30
B-2 ST Pro 4
100' l01' 102' Bedroom
House
Vent
ji Qniek4 Standard
Leaching Chamber
with 20.0 ft2 of area
Gavin Pass 5.6ft^2/pair of end caps
Grade at System ) elevation
34'
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 cells
Quick 4 Standard
Lcachin2 Chamber with
20.0 t12 of Area per
Chamber 5.6ft^2 pair of end plates To be A' above grade
/ Finish grade elevation
Typical Installation 103.3'
Vent A91 Grade Vent
4 X30/34 Septic Tank 4
4' Lout t 5,
4' Lone f
Grade at System Elevation
34" Grade at System Flevalion 34"
Spacing 5'
3-3' X 62' Cells
Observation tube/Vent
Same on other end To be located on end of Cells
%A
B
System elevations: C
A-98.3'
B-98.0'
C-97.7'
20 chambers per cell
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page, of-
=ILE INFORMATION SYSTEM SPECIFICATIONS
wrier G I, ~~\l` Septic Tank Capacity J I ❑ NA
Pe mit # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer .21 1J~ ❑ NA
Number of Bedrooms _ f ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units c1 ~6 NA Pump Tank Capacity - f al NA
Estimated flow (average) ` 0 ~aVday Pump Tank Manufacturer 4NA
Design flow (peak), (Estimated = 1.5) t~L gaVday Pump Manufacturer - -
Soil Application Rate j gadday/ft2 Pump Model Standard InhuenUEffluent Quality Monthly average" Pretreatment Unit A Fats, Oil & Grease (FOG) X30 mg/L
❑ Sanc,'Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (80D5) <220 mg/L G NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L Disinfection ❑ Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) 5_30 mg/L 1..• n.Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 15.30 rrg/L 7~w u At-Grade ❑ Mound
Fecal Colifonn (geometric mean) 510° cfu/100ml ❑ Drip-Line C Other
Othe-
~Max:murn Effluent Particle Size Jk in dia } ❑ NA
Other. NA Other ❑ ~
'Values typical for domestic wastewater and Other
Septic rank effluent. U NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect corxlitiun of tank(s) At least once eve'_ ❑ ear(s) month(s) (Maximum 3 years) U NA
(Pump out contents of tank(s) When combined sludge and swm equals one-third (h) of tank volume ❑ NA
_7 ❑
Inspect dispersal ceY(s) At east once every: omt h(s) ears (Maximum 3 years) NA
Y O--
month(s)
,Clean effluent filter At least once every: ❑
l f ~ ~ ~ ❑ NA
! nspect pump, pump controls & alarm At +east once every: ❑ month(s) u NA
+ ❑ year(s)
=lush laterals and pressure test At least once every: C month(s) ❑ NA
- 11 year(s) -
ther: ❑ month(s)
At least once every: ~ ears ❑ NA
tither - - Y._ O
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications. Mater
iPlurnberi Master Plumber Restricted Sewer; POWTS Inspector; P0ArrS Maintainer, Septage Servicing Operator. Tank irspections must
include a visual inspection of the tank(s) to identify any missing or broker hardware, identify any cracks or leaks, measure the volume of
combined sludge and scum and to check for ary back uo or ponding of effluent on the ground surface. The dispersal cell(s) shall be
visually inspected to check the effluent levels in the observation pipes and to checa for any pending of effluent or the ground surface.
'rhe pending of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
-egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of
the tank shag be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
4dministrative Code.
V other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units.
Isnd any servicing at intervals of 512 months, shat' be performed or, a certified POWTS Maintainer.
i berviw report shall be provided to the local regulatory aut.4onty rnthin 10 days of completion of any service event.
Page - of
START UP AND OPERATION Painting uproducts or other chemicals tt>tlt
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of ace detected have the contents of thb
may impede the treatment process and/or damage the dispersal cell(s)- If high concentrations
tank(s) removed by a septage s"cing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface. excess wastewater will b e
During power outages pump tanks may fit above normal highwater levels. When pourer eis restored the a surface discharge to effluent
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup to the
effluent pump or contact tank removed by a Septage Servicing Operator prior to restoring paver
avoid this situation
to assist in manually operating the pump controls to restore normal levels
cone ad ha a ve Plumber ft umbber er Or or is of POWTS the Maintainer pump tank
within the pump tank. the area within
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or Comp
15 feet down slope of am mound or at-grade soil absorption area. the life of the POWfB:
Reduction or eimination of the following from the wastewater stream may improve the performance and prolong
antibiotics: baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dented fkxts; diapers; disinfectants: fat: foundation drain
(sump Pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat swaps: medicatiats; oil; painting Produces;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely 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 seated.
• The contents of all tanks and pits shall be removed and property disposed of by a Sepiage 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 code cortlpfi8nt
1' the POWYS fags and Cannot be repaired the following measures have been. or must be taken, to provide a
replacement system:
] A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The from disturbance and compaction and should not be infringed upon by required
rioted
8 replacement area should be protected
setbacks from rom exf site and proposod structure, lot lines and aces. Failure to pooled the repisoa meat area wit result with in the the rilruleal in
for a new $oil and site evaluation to establish a suitable replacement area. Replacement system must comply effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Bening advances in POINTS tachnologN a
holding tank MY be installed as a last resort to replace the failed POWTS.
❑ The site has not been ev usted to identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluation
most be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
removal of the biomat at the infiltrative
❑ Mound and at-grade soil absorption systems may be reconstructedles in placed that time.
surface. Reconstructions of such systems must comply wth the <<WARNING>>
SEPTIC, PUMP ENTER A SEPTIC, PUMP OR OTHER TREATMENT TREATTANKS MAY CONTAIN LETHAL GASSES MENT TANK UND R ANY CIRCUMSTANCES. DEATH MAY (RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS _
POWTS IN ER POWTS MAINTAINER
Name
Name Lr'
✓ -
Phone
SEPTAGE SERVICING OPERATOR LIMPER LOCAL REGULATORY AUTHORITY
Marna r7. « '77=-
Name /
l J
Phone Phone ~ U
This document was drafted in Compliance with chapter SPS 383.22(2)(b)(')(d)&(q and 393.54(1), (2) 8 (3), Wisconsn Administrative Code.
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ST. C:ROIX CO[1N'CY
SEPTIC TANK MAINTENANCE AGRF.FMFNT
ANT)
(-)WNERSIIIP CERTIFICATION FORM
OwnedRuyer J(ET) l-/
-
Mailing Address
ProperiyAddr(ss _ _ ~74t/~~✓~
_ ~i^ee _ l
(Vrrificatton required from Ptanuing & 7.orung I)epartawn( for ne ronsn»c- ^n.) - -
Mme!/''ddtt/^^f
City/State - - - - - - Parcel Identification Number
LEGAL DESCR(P'I'ION
Property Location Ya C
S %a , Se[cT Z / N R / W, Town of-!Y4
Subdivision
- - Lot #
U
Certified Survey Map # Volme Page #
Warranty Decd # l u 1~ t~ - --1- - -
- - , Page
Sper.ltousc es no tertlinesidentifiabl yr• no _
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
trrgrroper use and nraintenaeee of your septic system could result in its premaunc failure TO ,rope,
rnaintenaner. consists of 'Pumping out the Septic tank every three years or and le wastes. I
h
soo[tcr, if needed, by a licensed put
the system can affect the }irnrtiou of the septic tank as a treatrnent stage in the waste disposal
resp)nsd)ilities arc specified in Co raper. What you out oleo
§ - rout. 83.52(1) and n: Chapter 12 St. Croix Cannty S'auftaryyt rd won inamtenance
I'he Property owner agrees to submit to Sr C'rorx Crrmnty Planning %otting Drpertment a cenificatiun turn,, sign
wastewater rd by the
owner .rod by a urastcr plumber , journey2rutn phrrnber, restri<:[ed phnnber of a lhz:nsrd pamper verifying drat (d) }trc t disposal system. is in proper operating coralition trod/or
(2) after insp sitr.
less than U.3 full ofsludge. PCtion and Pumping (if necessary), the srphc tank is
]sett the undersigned have read
standards the above requi[.ena,nts and ag,-ce to maintain the private, sewage disposal system with the
%Itrtrnfiing I)epasetrhLturth, atinneut here within in, as set by Ure beparnner,t of t;umrnen:r. and thr- 2)cpartrueut of-Natural licsow. d State of stern Hain.
Ccttilication stating brat ntn septic system has been maint sired must be wnrpleted and returned to the St_ Cnrix County planning
30 days o1'ihe three Year expiration date
fy St
propt.•rty i/we described d a r that bnvu, all by v v-
irtue oftcn[rnts a o' warrthis form ate true it) rho best nfnry,'our knowledge. Iiwe anriare the owner(s) of U,r
.a/anty4cd recorders nr Regislcr of f)Cetis OlTicc.
Number of bedrooms-~
7 i//
r~•C'~---_ pmt _ -7
TUNATF JOF APPLICCNT(S) " DATE
"Any information that is rrtisrrpresented may result is the
sanitary permit being rcvnkcd by the planning & Lnrung I)eparnncnr
lnchide with this application a recorded warranty deed flan the R gister
reference is made in ti of l)ce is Office and a u,py ol'the ccrtiGul survey [nap if
n warranty dead.
(RF. V. 08/05)
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Wisconsin Deparment of ne ee SOIL EVALUATION REPORT Page of _
Division of Safety and Buildings I
ip acmJarlcewdh Comm BS, Wis. Adm. Code
county
Attach Complete-zits plan onpai5er not less than 8 1/2 x 11 inches in size. Plan must
include. but not tlmitod to. vertical and horizontal reference point (BM), direction and Parcel P ~l
Percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Z6 c6c)
Please print all information. Re by Date
Personal iW Iwn you Ixoree maY be used for ae try Iwrpwes (Pmacy Lx , 4 15 04 (1) im))-
Properrty Owner Property Location
o e- jJ t n I Govt. Lot 114 1! S T Z N R E W
Property Owners Mai' r ss 1 Lot # Block # Stbd. or
cdy to Zp Code Phone Number ❑ Ca: ❑ V ge Town N~iarost Road
PeLi
Construction Use residential /Number of bedrooms} _Y__ _ Code tledved design flow rate , y-__ _ GPo
❑ Replacement ❑ Publw Commercial - Describe: _ Parent material
/-f/~,A/r_ S~✓ Flood Plain elevation if applicable Xo~ A..
General comments
and Ie00mYMrdatial5:
System System Elevation_ 73,0
Bonng r~I Boring
Si Pit Ground surface elev. f
a L, ` ft Depth to limiting facia in.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/(P
in. Munsel ou. Sz. Cont. Color Gr. Sz. Sh- •Efkf 1 'Eff#2
P4
Z
I
a Bai # Boring _
"Pit Ground surface elev. ^ I R- Depth to limiting faGor
Sod Application Rate
Horizon Depth Dominant Color Reciox Description Texture Structure Consistence Boundary Roots GP - I
in. Munsell Q1. Sz Cont. Cola Gr. Sz. Sh / 'Eff#1 •Ef#i2~
a L; A 7, 7,
F-71
I
it
I
E18uent 01 = BOO. > 30 < 220 m04 and T >30 < 1 • EIHUe = BOD- < 30 mryL and TSS < 30 mqL
j CST Name (Please Print) gnatura CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Toleptwno Number
1432 120th St, New Richmond, WI 540 20 - 715.246-4516
°roperty Owner Parcel ID # Page of
Boring If ❑ Boring !
® Pit Ground surface elev. l ~ att. Depth to iinaGng factor -,Zz-.LL I. Soil ication Rato
Horizon Depth Dominant Color Redox DescnpWn Texture Structure Consistence Bowrdary Roots GPD/ff
in. Munsell Du. Sz. Cont. Color Gr. St. Sh. 'Elf#1 'E}f#2
- J, - 1 - Lt tit- ~ A
Boring# ❑ Boring
❑ Pit Ground surface elev. 9. Depth to Immng factor in.
Soil Appiieadon Rate
lionzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDflP
in. Mansell Co. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Efl#2
Boring # ❑ 80"
❑ Pit Ground surface elev. ft. Depth to firming factor in.
Sod Application Rafe
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD#t
1 in. Munsell Do. Sz. Cant. Color Gr. St. Sh. -Eff#1 -EIf#2
' EMuent #1 = BOD, > 30 < 220 mglL and TSS >30 < 150 rtg& • Ef Kjertt #2 = BOD, < 30 mg& and TSS < 30 mqL
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Soil Test Plot Plan 1
Project Name Oevering Homes Shay Bid
Address 1433 Cernohous Ave Suite A
New Richmond Wi 54017
C'S'ti #226900
Lot 8 Subdivision Hunter Hills Estates Date 6/15/18
1/4 SE 1/4S 23 T 29 N/R19 W Township/Hudson
Boring Q Well PL Property Line County ST. CROIX
BN1 or VRP Assume Elevation 100 it. Top of survey iron
System Elevation TBD `HRpSame as Benchmark
160' Property Line
103'
B-1
20'
5' 40'
B-3
0'
140'
6t'(, Slope Scale is 1" = 40'
unless otherwise
R-- noted
100' lot- 102'
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