HomeMy WebLinkAbout038-1069-10-110
~rvi, j.in Ueperl U of Co~nme're PRIVATE SEWAGE SYSTEM C0`n`Y St. Croix
,a"d Buil Cing C visicn
INSPECTION REPORT Sa nary Permr na
ATTACH TO PERre11T 605131
GENERAL INFORMATION f slate Plan ID No
Petscra '1-j- a0c- you r,:we may be .:sec tot secondary purposes :nrmac Law, 5 .1s on 0t zntl 3132972
Pe'°i; HJICet 5 Va-'e Ciry Village Tcu-sh,a Paree Tax Np.
Scott & Nadine Clark TOWN OF STAR PRAIRIE 038-1069-10-110
CS- T" Ee IrsP BM EIe'.• BM Deso'Ipaon Sac:wm'Tawrv RangeVap No.
d0 Yvy~ cST 17.31.18.293A-10
TANK INFORMATION ELEVATION DATA
TYPE 1dANU-ACTURER CAPACITY STATION BS HI FS ELEV.
c
r
Septic Tn 0 Benchmi
Dosing Cevh C~a "`TL ~pp All Brv1r~L
FId n 4-t ~ , BlgSewer
SUM Inlet
8 • S 97
TANK SETBACK INFORMATION SUHI Oatle: \ \
TANK TO i~iL Vu'ELL BI. DG. Vent to Ainn;a.c ROAD D: Inlet
P A,
Septc 67 5 7 _ D: Boacro 9J. 3
I2•ti
Dosing 7 5 Headedratan
Ac•at on G Z•z 166.5
Disl. Pipe
Z •Z 146,5
Held rg - Dot Svstern
- - ~ . Z.q
PUMP/SIPHON INFORMATION Final Grade I. Z, larr S /
Manufacturer Demano
GPM St Cover
Z- -7
l tvtodcl Nu.mbee
ZS"O 3, IGZ.7 1,.k ~g K
TDH 1-4
17, F•iU.on Lcss System Head TDH
yz•
Forcemain Length- Da7 r L D sl b tNe l I~
to
SOIL ABSORPTION SYSTEM
BED/TRENCH Voot- LLmgh,,/ C No.U Ten<. 5 PIT IM IONS No. O`Pas Insou Dia Lyud Cepr
DIMENSIONS la
SETBACK SYSTEM ''Q TS P.1 SLUG bV[LL LAK R[ ref LEACHING t.'ar ulacturet
INFORMATION 11 -,G Syslent 4Z CHAMBER OR
I IY/!!0✓ /xk LL1 UNIT Nltdel Number
DISTRIBUTION SYSTEM a TL Iz~ J T ; ~
roan, M.-in folr Oist'iL-lior 1 x har 'ice x H;lo Sa2c•I
P,,e 11 g t Ven A' In
` -7 ? L ✓
>enst^~ ❑a 2 L-gth~ •7 Oia_L Soacirg-3. 3' ~ Z S Gem _
SOIL COVER x Pressure Systems only xx Mound Or At Grade Systems Only
Jcath G:x xx _eoth a` xx See de:d snlned xx Matched
Gc:1'?•e^cn fence 1- 7 Bee:Trencn Cdgcs Topsoil (
! Vey _ No - No
COMMENTS: fill code discrepencies persons present, etc) Irsperior #1 fi z1I, Fr-T / ^/sp -1e- a2 W f7 /~cj
Location: 9952.7TH AVE F/~ /ate` C{~,~,l,~y (-•o s.~ts 0.0",
~Gln
• ; Alt BM Description =
2 ; Bldg sewer length = 57 a,nt.2~
- arri of cover = /1 y
7. on c~!/mot 2J f"1ZS ?
Plan revision Requited) i Yes 1 NO (0$2 ~f 7~
Use other side for additional rfotmation.
SBD :'.-l Date InsepclUr Sgnntu 'ter Na
dS•n R „i
Irv )z
tea) Safety arid Build:nss Jivisicn
nl -
~ 3 s D' I 201 1'J. YJeshingto' •".vE ? C.. BC% X152 Smu[::.•s Prncn NIaID,^, ito D; tsLa: in by c.. i
SpS IUO 09 "16 Ma~tso: 'PJ' G: t?0L
~A <l `J
Sy'arl to ,-P~rmlt Applic,atl 2-
I. .r a.:c:mtar w1 a U5 N I Cu.. {n Cad....: I u.'rn..Silw. r ve .r J.e apinvl nzc -vcvti ti unrt 3 ~3 ~q • ~f i. mq.:i•r f p 1 i,h•ouwog a culrr, penlur
Vex ; W-Lsu0^, bzm5 L: a._v .-.awn:d i':'~U?S me so6naved r, Yc.iux A~44asx ,.i di Yaent tltan nal irf aidre^.ci
li iY.pmtnan :f Cafc:v avd 'rafr lo:.a. \e-c•ic Pec ral kf smrnLn _ m rov[dc :.ta< nn usal fn- sc.on:a'}' '
I Appl r ~wu tan o .n.1 .it P x F le a 11 CSII u o `I tc. - _ ~1 / r) 1 7 `
a Prior All Information -
~ t Pars)
KT• N 9PF
1 r•°t'v t rwuv-s MSmI hr✓ Y
v cl' \J:1=55 I Fk:rxl'} :nwou 1 T J 1, i g- a 15 A.-
, J Z3 S 'l'l.I A-.~ I fi yL.JS ill
Salioa
Stare Z,ip l'tie Phorr. t`untr L-. r:
11. Ty e of Buildin T _ b/ F r M
. p R (shark all [hal ap
. faro 'Dwc(()cg Nn'nx.a GcG1 cmt lutd\slon Karr _
Blo n P
ok e.6
YltAir C rrleresi arsaine Use g of S'atc Vw Ira I)rs'= h 1'.:c t :'Sid V•rrjn \ ii.4e of
- _ - ~c L~CZ l
I I - awn n:-,
;il.'I'v a rck only one bD% no line A. Cutnplete fine B if applicable)
r
'~+'SY'Slrn IR<placeman S}ucn I Trcnmco 1 .:.u.,l~~kl .In. <mrn-tioiv ilathc ModiScnnx G: Exisliug $}stemlcs;9au
B. I ; I.i-Pr.vinls Yerinr, Number avd talc issued
I Wt t nc-wv J 'erml >ier 1 h+urci I m re- ' J 'mLit L:vafa a \:w
` ~ I Qw9Q / ~
Pse mFxl Ia~.:: I CC__
- W. TvPe of PC1R' IS S,,Ivi [u,u poncnt/ Devitt (Check 211 Lh Iap h" -
Nan hcsr .:r' [r,-:ir uu' hr. u v i- ;r.. I J I .r -'ir. _ Mov L\) _-24 of sui.ablc »i!
. fia7dm_ r,vil. i~tuc. 1sfx:~I ~ uI .n.m_ µxylam) ! Firtr runma 1k„uc' ayla:n,I ~U~ y[l
V. Dis ersal'Trea[ment Arer lufurmation:
Drsi3 flu. mil :,,a;v. Jwl :\pylcan m Y. 1s(, :uycnJ V 1 9 t sped 'sea i4 pu.ed "I S Nal: Iilevanuu
to 1,75 17>0
VL Took Into i ansm I o" Ntmufa..au;r c
tLl ,r< rlan aniri ti
1:.. .a Ws
att.
l .uqc L L
VII.f[rspnnsiDlliry'titatemeut-Ctbr muleni uassume rr.ponsibiliry Ga vuullarion of the l'byy"1Sshowr[oo fh<anachen plain j -
1
Phnibn 4000J:rss fsr, n' S Lp c ;
yyV~UIL Couun Deparrnrent Ise Onh
/s.rApproaed Fii appn f~-ac)~Q~.
~._1I,~
IX l.oudltlons of Ap y' m for Disapproval ~i_.. ~A,5+ b 50' LlrtOV., k.1~W~
SYSILN:'',WdNI k Li llA.r-la y✓[ [b~ 1. Wr'~ ~U. erCJZ~ r
1. Septic ink. efflUl r idt~ r an" ~
nispcr ~I . II mt I l c ei . yer. n nta n i 1
d t•~ C.~"~ rte.
"`4
2 ,,1)I
___..5``~a(•rFTi~ll'~$151"~,(ifil0l {el' pn.l r~,Ufl~.v(~~~~n suU~~.nwrEc n •luprr not lca n.,; l.r-oms.a~~`}.
II setback rcqv cm nt, rroM h~ malnr,. m :1
as per 3p;dice5'e cud~uurdiracous,
OD-h?9S R 1 1 ; L'.
ST. C:ROIX CO11N'I' Ik'
SITIIC'IANKNIAINTI-N1\N('1 A(iRl;VN4LN"I
AN 1)
(_)WNFRS111P ("I~;R1'11,1CAT'LC!N FOR NI
,U - -
L1aililip A(ldress
Properly Addfess +e, J
(velilicauonrequiredF.utuPlanning &ZoningDepatiarmtotnctv;on+lntlcuon.)- - -
Cify,'Stale_ - - parcel Menlitication Nut iher lJ 7 ! 7
r >r:c.Al, DESCwrTtoN _
propart Location r~^
rr_- r sec. R l- W, Town of
Subdivision:
Lot n
Certified Survey Map ;E
- - 1'C11tt[CC Pape,4
Warranty Deed
- \VOnInic J . Page
Spec. house yes ne I of ime". Acruff allc rr was n:l
SYSTEM MAINTFNANCF AND OWNER CFRTIFWATION
Itnpfoper use and ntaintcaanee. of your septic c\ sl .m ^ouid tc.,ult In its punfantre tadim co hwidlc wastes. Proprn
marrrteitanee ec:nsisis of puttyr'.ge out the septic tank evcr tl`rea years or sooner it needed, by a licensed pumper What you peat utlc
tile. system can abort the lancnon of the septic. tank; as a treatment stage :n the waste disposal systent Owner maintenance
responsibihhes we. specrticd u: §Comin, 83.52(1) -iad fit Ahaplcr 1:! St. Cars C uoi. Sanitary Ordnance
The property owncl agTerz to subtnu to JI. C'totx Counth plannm,g & zoning Dcparimcnt a c:crtihcation tbrm, signed b_y the
owner and by a rnaster pl.unberg is umv'yucan plumber, rest wo-d plumber o, a licer;sed pu;ttner vcl hying that (1) the on-site
sfewaler disposal System is in proper upei sling coud:uou and of (,,after inspection and pumping (itnecessaryi, the ;optic r::hl;
lc,,~ than i%3 full of sludge.
hwr, the undersrrned bro. v tcati !iw ahoce rryuircuunw: and agree to rnaitrarn rite priv;tte sewage disposal system will- rim.
iaud:rrds set touh, Lefcln, as set by t'Ic, llrPznlmcot ot(:onam iec attd the Deparltrent of Natural Ur.somem, State of Wiscomm.
C er,ification stating that void septic system _~a, been haiutamed must be completo.l and rennned to the St. Unix Gummy Plantar &
/o:nclg Depantrent witht❑ 30 da°s of the three Year cxph ,non date.
li wo c-citity that all state"rnents on s foim an true to ihc ha s( of m) out 6.uc. lrap.a.. Ir.vr andalr the ohvci i s i of the
operty described above, by vin lac ofa
pr manly deed teco;ded in Kcgnster of Den.. Is Office
'-J
Nu er of edro(lni' - -
SMN:AJ RF Ol' xPPLICAM(S)
DA'l'P.
"''rAuy mforminiort that is misrepresented nay result tit the sanitary' primit :):mv i* vokea b tar PGanim' & 7.omn,' Dcpaftnruir.
Iuelude with this app;icabon a nX.orded cetirtantg deed 1-out tic I(cgistu of LJr.rdn 14tee znd -a colry of the cetn5ed €ueve•, nuip d
rcfercnre is made m the wv anty deed.
(R},Y. ligms)
DIVISION OF INDUSTRY SERVICES
_ 10541 N RAND I RD
D HAYWARD WI 54643-6462
Con:ar.1 Through Re:ay
P htlp 4dsps wi govipcograa,.s,indtstry-scviccs
wMN.•nisconsin.gov
Scott Walker, Governor
Laura Gutierrez, Secretary
August 03, 2018
CUS I ID No. 226900 A7-GN: PON'7S Lre'nr•;1ur
ZONING OFFICE
>IIAUN R BIRD ST CROIX COUNTN' SPIA
1 13? 120111 S'I 1101 CARMICI[ALL RD
NEW RICHMOND l4 `I 54017-6109 HUDSON WI 54016-7708
CONDITIONAL APPROVAL -
PLAN APPROVAL EXPIRES: OW012020 Identification Numbers
Transaction ID No. 3132972
SITE: Site ID No. 851?46
Clark Please rcler to both identification numbers.
17] 11 .Ave above, in all corresEondence with the agency.
Town of Star Prairie -
S: Croix Co n1tN
NF Ii 1, SE1 4, SI7. T3 IN, R18W
FOR:
Object T ype: POW I S Componett Manual Regulated Object ID No.: 1 M569
Maintenance required; 350 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, SLID -10691-P (N.01?01,
R. 10!12), Prc<sure Distribution Componcm Manual - Ver.2.0, SBD-10;06-P (5.01!01, R. 10!12); Effluent I ilter
The submittal described above has been revie.ved for conformance with applicable Wisconsin Administrative Codcs
and Wisconsin Sratutes. I he submittal has been CONDITIONALLY APPROVED. This system is to 01c. constructed C,OA
and located in accordance with the enclosed approved plan< and with any component manual(cl refere cad above.
I he owner. as defined in chapter 101.01(10), Wisconsin Statutes. is responsible for compliance with, I codkt~pr OF S AP
requirernents. AF
A copy of the approved plans. specifications and this letter shall be on-site during con<tniction and Idditions n to DIVISI N OF I
inspection by authorized represcnlalives of the Depmtnent. which may include local inspectors. Aernlits
required by the slate or the local municipality shall be obtained prior to commencement of
construction? installation! operation.
In er<ulting this approval the Division of Industry Services reserves the right to require changes or sh 1
conditions arise making them necessary for code compliance. As per state slats 10 1.12(2), nothim4in this review S
shall relieve the designer of the responsibility lift designing a safe building, structure. or component. E
Inquiries concemine this con-espondence may be made to me at the telephone number listed below. or at the address
on this letterhead.
The above let! addressee shall provide a copy of this letter and the POWTS mana,etnent plan to the owner and any
others who are responsible for the installation. operation or maintenance of the PO1V'FS.
Sincerely, Fee Required $ 250.00
'this Amount Will Be Invoiced.
When You Reccivc Thal Invoiec.
Edwin A I ayior Please Include a Copy With Yoar
Wastewater Specialist , Division of Industry Services Payment Submittal.
I715)6-',-1- 348 4 . Mon-fri. 8:00 a.m. - 4:30 p.m. W ISMAR I code: ?633
cdwin.taylor4r'vvi,; ov
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 7/3/18
Owner:Scott Clark
Location: NE1/4 SE1/4 S17 T31N,R18W 217th Ave Star Prairie
Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section IL Y
4. Pipe Cross Section/Pipe Layout "USED
5. Pump Chamber Cross Section ~ 'RY ESSIO SERj %W S'. ^ ✓ IL
VICES
6. Pump Curve
7-8. Maintance and Contigency plan
9. Filter Specificat' ns and cross section
Attachments: Sail est ON ENCE
Shaun Bird/
Signa
Lice se n ber 226,900
Page 1 of 9
System PI_.OT PLAN
PROJECT Scott Clark ADDRFss 523 15th Ave S. Saint Paul Mn 55025
NE 1/4 SE 1/45 17 /T 31 NCR 18 w TOWN Star Prairie COUNTY ST. CROIX
SYSTEM ELEVATION 99.7' 7/3/18 3
DATE BEDROOM
CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING 'IANK
MOUND XXX SEPTIC TANK SIZE. 1000 gallons LIFT TANK SIZE. DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RA'C'E 1.0 ABSORPTION AREA 456 # of chambers none
BENCHMARK V.R.P. Top of 3./4" pipe ASSUME ELEVATION 100' Filter Lifetulic Filter
❑BOREHOLE O WELL *II.R.P. sameasbenchmark
- 217th Ave
ootll St 7
B-1
Scale = 1/4" = 10' e a B- 99,
2 acre Lot 98.7
9 8'
Grading is to be done to
divert run-off away from
system + B-3
(5' 4% Slope
~tt4~;j, B.M.'
_ J
Area 15' below system is to remain undisturbed
Huffcutt Combo Tank
Well is to meet all WDNR setbacks
Pro 3
Bedroom
House
Squaw Lake
Mound System Cross Section and Plan View
? . -
I I Dimension_ i i:eet_
t A I j o
T ' 1
t
1 ~ G
rL4 t --~i - C7
l i i 1 -~.5• l~:
J
L
j
1
~K 711
t-- - - - L - T Slope/ j
- 1 = Topsoil -AS fhI C-33 Clean aggregate = 4 in. sch. 40 pvc
Ca Matenal
_ p sand fill /s to 2 /z in. dia. Q observation pipe
t_ -f--
CTeotextile z i - ~ - _ 1I
Fabric
7 ht
i~
a ~F ~ F
Ft Contour Plowed Surface
6
Slope Direction
GENLk4,L INSTALLATION: The mound area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The mound basal area (I. x W) is plowed with a moldboard or
chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a S'. inch soil wire
when a sample is rolled between die palms of the hands. ASTM C-13 quality sand is placed immediately
after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care must be used when placing sand of less: than one foot
thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound
is seeded and mulched to promote vegetative growth, limit erosion and protect from free-zing. The
observation pipes are slotted in the lower G inches and secured in place with rebar or a closet flange.
10.'0 i 1 gj Page ~ of
Perforated Pipe otfoll
110
(nit via"
(PtrfOro4a
PVC P.D[
a
/ear Utz Moles Located On bottom.
•re Ewtaay S00[ta
~ dG 0,
PVC Force Maw
fIRyT llq,t M/xT t0 CertfyG}oaf`
PVC
Marufpa Pipe
La S'f'It p o;ar..grt,p,
Not
Dislr.bullon P;Pe Layout
P Ft.
R 3 F4.
I~O~+ x 3c Inches
Signed: / MtY 24-2 _ Inches
License Hol
Number ; e Diameter 311 / Inch
Date: Lateral
/~j Inch(es)
te: Manifold
Inches
Force Main - Inches
# of holes/pipe
Invert Elevdtion of laterals C11, Z Ft.
L~
Septic-Dose Tank Cross Section And Pump Performance Specifications
"rank manufacturer _ Pump Manufactuuer L I L
Tank Model Number ; Pump Model Number .
Total Tank Capacity y G Alarm Manufacbzer i1 S 4~• W
Max. Bury Depth Alatm Model Number
Switch Type ~
Filter Manufacturer Total Dynamic Head (TDH) - Feet
Filter Model Number' Elevation Head X-12
Distal Pressure
_ Network Loss
jvlinim,+m pump Performance Required Force Main Loss
7 GPM (i Ft TDH Total
Outlet Manhole Min. 4" Above (Wade With
Locking Device. Inlet Manhole Manhole Min. 4" Above Grade
< 6" Below Grade Sealed Watertight securely Mounted With Device
Locking weather-proof
Junction Box
Finished Grade • • . • • . .
t r
Vent Mm. 12" Disconnect
Above Grade Means
With Vent Cap
Outlet Filter Zy - -
-
nlet Ia lei Baffle
A
Switch SeWp and Reserve Capacity
Tank Volume GPI Weep
B Hule
Dimension. Inches Volume Cal.
(reserve) A 360
(alarm) B 2 3 p Off Elevation C
%r dose) C7. > r~ - 40 Z Ft , Bottom
(dead) D G y 'S~ D Elevation
Ft
r~ r~ ssrr,-.c ~i~rr:; z~~n ~rrr?zp'•,~ ~??]n74-ST. ;T,+. ',l'::::::::
GENERAL INSTALLATION: The sepdcldose tank is bedded and bark filled in accordance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the ma°udevice r tray not
be exceeded without Prior approval. Manhole covers exposed to grade have an effective locking device (padlock)
installed Piping at the inlet and outlet is of approved material, connected to the tank with "ta tight fittings, and
is sleeved
laid on stable soil to prevent settling or sagging. The force main with 4" Sob. a40 n PVC to bridge the tank
Eiectiical servi mplies with NEC 30U and Comm 16.28.
excavation and the sleeve is sealed watertight
02105 U Page o
2S0-SERIES
112 hp Submersible EffluentJSump Pumps
The Liberty 280-Series provides a cost effective "mid- Performance Curve: 280-Series
range" pump for on-site waste water systems, liquid 40 _
waste transfer and commercial heavy-duty sump pump 1 72
applications that require higher head or more flow.
35
j } 17
Designed around Liberty's unique "Uni-Body" casting, 30
the 280-Series will provide years of reliable performance. 9
25
6 m
All Models Feature: ILL zo 44
• Vortex style impeller permitting passage of solids W 1 5
up to a/ µn = 10
• 416 stainless steel rotor shaft 3
• Permanently lubricated upper and lower ball bearing 5 71 1- 2
• Epoxy powder coat finish 0 0
• All fasteners - corrosion-resistant stainless steel 0 5 10 15 20 25 30 35 P45 65 60 65 70
• 1 Discharge U.S. Gallons Per Minute
• Stainless steel bottom screen - easily removable -I ___f 1 f a -1
• Maximum fluid 0 38 78 114 156 192 228 270
temperature: 140' F. Liters Per Minute
280-Series Cord Lengths
Model 10' _ 2e (-2~Ls) Dimensional Data.
280 Standard Optional optional Optional weight 29 lbs.
281 Standard - Height 13"
Optional optional Optional Major Width: l0• (model 287)
283 -Standard Optional- Optional WA _
287 Standard optional _ WA WA Minimum Sump Diameters:
10' cord length standard on all models. For optional lengths, Model 281, 283...14"
add "-2, -3 or -5^ atrfr0( to model number. Model 287 VMF...10"
Example: for model 280 with 35' cord, order 280-3
Factory switch Model 281, 283 Model 287
Motor Specifications settings VMF
Turn on level 13" 9.50
hp 60 Hz 3450 RPM Turn off level 7" 4.0"
Oil filled, thermally protected
(PSC) Permanent Split Capacitor The Model 283 features a dully adjustable widc~tuiglo float. Differential
8.0 amps (11
4.0 amps (208✓230v) charge pipe or other m~ouming easily Poiby leltienrig the float to nt Verlical float Model 287 is not
adjustable.
r
Ino ode1280 Model 281 Model 283 Model 287
anual, Wide angle I Wide angle VMF-Series
switch float switch ` float switch Vertical mag-
with quick- with series netic float for
disconnect (piggy-back) smallerpits-
'plug will operate in
a 10" diameter
sump
C8nFE0 sA®
C us Certified
sptdroc, .%Lblectwm w.n,rn ,
liberly Pumps • 7000 Apple Tree Avenue • 3ergery Mew York 14416 • Ptrwre 80o-543-2550 Fax (sim) 490 1839
www.libertypumps.com Copyright a Uheny PRmrpa. inc. 2017
AlIngnts mscrved. 11111`2000 FIXM 7
'9o4.%
i
POWTS OWNER'S MANUAL & MANAGEMENT PLAN pave lot_
FILE INFORMATION SYSTEM SPECIFICAl IONS
Owner s l E r 1~~ Septic Tank Capacity
at A
Permit # Septic Tank Manufacturer - A
DESIGN PARAMETERS Effluent Filter ManufacturerA
Number of Bedrooms Nq Effhrertt Filter Model A
Number of Commercial Units A~JNA Pump Tank Capacity A
Estimated flow (average) avda Pump Tank Manufacturer A
Design flow (peak), (Estimated x 1.5) C~ aV Pump Manufacturer ' ❑ NA
Soil Application Rate 1_7 aVd Pump Model
Influent/Effluent Quality Monthly average' Pretreatment Unit
Fats, Oil & Grease (FOG) S30 mgA. O Sard/Grgvel Filter O Peat Flfler
Biochemical Oxygen Demand (BOD6) 920 mg& O Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 m /L O Disinfection O Other.
~p Manufacturer
Pretreated Effluent Quality / Monthly average ' Dispersal Cell(s)
Biochemical Oxygen Demand (SODS) 530 mg/L O In-ground (gravity) I7)n-ground (pressurized)
Total Suspended Solids (TSS) s30 mg/L O At-grade >*Wound
Fecal Colifonm (geometric mean) s1O4 cfu/1(lOml O Drip-line O Other.
Maximum Effluent Particle Size Y. inch diameter Values typical nor domescc tnommrrxnerdar) wastewater era
mplic tank effi a
Values typical for pretreated a tawater.
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every ]O month year(s) (Maximum 3 yrs.)
Pump out contents of tank(s) When Combined sludge and scum equals one-third of tank volume
Inspect dispersal cell(s) At least once every _~>O months jyear(s) (Maximum 3 yrs.)
Clean effluent filter At least once every _ fr O months ac(s)
Inspect plump, pump controls & alarm At least once every J ❑ month r(s) O NA
Flush laterals and pressure test At least once every JO month . 0 year(s) O NA
otter: Al least once every O months ❑ year(s) NA
At least once every O months O year(s) NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or
certifications: Master Plumber, Master Plumber Restricted Sewer, POWYS Inspector, POWYS Maintainer, Septage
Servicing Operator. Tank inspections must Include a visual inspection of the tank(s) to identify any missing or broken
hardware, Identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up
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 check for any pending of effluent on the ground surface. The ponding 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 any tank equals one-third or more of the tank volume, the
entire contents of the tank shall tie removed by a Septage Servicing Operator and disposed of in accordance with ch NR
113, Wisconsin Administrative Code
The servicing of effluent fitters, m"rucal or pressurized POWYS components, pretreattment components, and any
other maintenance or monitoring at ifRervals of 12 months or less shall be performed by a certified POWTS Maintainer.
A servicg report shall be provided to the local regulatory authority within 10 days of completion of any service event
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 that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a Septage servicing operator prior to use.
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 11110
may impode the treatment process and/or damage the dispersal cell(s). If high ooncenlrations are detected have the contents of thi;
tank(s) removed by a septage servicing operator prior to use.
System start up shelf not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may 'ill above normal highwater levels When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent
To avoid this situation hove the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to ttye
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels
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 within
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 fife of the POW] di:
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 product:
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWiS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propelly
and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• Ali 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 oe excavated and rernoveo or their covers removed and the void space filled with soil.
gravel or another inert soiid 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
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need
for a rrew sdi and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruled in
effect at that time.
❑ A Suitable replacement area is not available due to setback and/or soil limitaWns. Barring advances in POWTS technology a
holding tank may be Installed as a last resort to replaco the failed POWTS.
The afte has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a son and site evaluation
m be performed to locate a suitable replacement area. if no replacement area a available a holding tank may be installed as
a last resort to replace the failed POWTS.
X Mound and at-grade sail absorption systems may be reconstructed in place following removal of the blomat at the infiltrative
s rface. Reconstructlons of such systems must comply with the rules in effect at that time.
<,WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POINTS MAINTAINER
Name ?
Name 1~
?hone j , , , t - r Phone
SEPTAGE SERVICING OPERATOR PU ER LOCAL REGULATORY AUTHORITY -1I
Name /ICT
Name
i
Phone Phone J D Gd L~
This doQimerM w8s drafted -:n comp pence with chapter SPS Q383.22(2);bX-)(d)&(f) and 383.Wt), (2) & (3), Wisconsin Administrative Code.
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wlscon4nDepartment of Commerce SOIL EVALUATION REPORT Page 01
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Cafe -
Covtry 1 x
Attach complete site plan on paper not less than 8 V2 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. O p /Q6 ^
Please print all information. Re Y / Date \ 1
Pe l a,bneH.a, you pe " may Ee used for saear,d.y urpm , (P.a Law, s. 15.04 (110^1)
property Owner Property Location ~1 2
l r Govt Lot 114 114 S l / T J N R I E( )W
Property Owner's Mailing Address Lot # lock # Subd, Name or CSM#
S-4
City State Zip Code Phone Number ❑ City ❑ Village J~v7own Nearest Roa
Pal in 1~ 5 0„2'( ) r' d 7'
S a
Cmstrlwtiorl Use, KResidenbal / Number of bedrooms Code derived design lbw rate GPO
❑ Replacernent ❑ Public or commercial - Describe-
Parent material Flood Plain elevation if applicable _L✓ R.
General comments
and remrtvroridatons: Q,
System Type System Elevation__GG~ [-.(I
y~,y~vO
Borrig # r❑hSwing
6L Pit Ground surface elev. i--4-` R. Depth to firiErg factor 6 n. Soi cation Rate
tlormon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMF
kn. Munsee 0U. Sz. Conn Color Gr. Sz. Sh. -Effk1 •Eff#2
Z - o S/
3 g s S. Sl n1 1W 2
acting Ground slrfacn elev R Depth to limiting favor gl' in. ~ caaoZ Rate
a# °
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
In. Munsea Du. Sz. Cont. Color Gr. Sz Sh. 'E8#1 1092
1 0- U Z. 2-
• Effluent IM = BOO, > 30 < 220 nxA and TSS >30 < OA& ' Effluent 92 = Boo, 30 ng4 and TSS 30 mWL
ST Name (Please Print) CST Number
CST
Bird Plumbing, Inc. Shaun Bird 226900
Date Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 _ 7- -3 715-246-4516 _I
Parcel ID Page or
Boring Property Qvner _ _ - -
# ❑ Boring
® Pit Ground surface elev. J_LS~ n Depth to limiting %ct% 2-- in. Sod Rate
Botexlary Rods GPU4F
Horizon Deptt Dominant: col Redox Description Texture Struct re Consistence
in. Mutrsei Qu. Sz. Cont. Color Gr. Sz Sh. I 'FJpt1 •Eflt2
Z r5 S
t
F-1 Boring # ❑ Boring - -
❑ Pit Ground surface elev. Depth to muting factor in. Sod Kato
hloruton Depth Dominant Redmu Desctiption TexGre Structure Coreisterx:e Boundary Roots GPDff
h Muraell Qu. Sz Cont. Color Gr. SL Sh. •ERift 'Eff#2
❑ Boring
Boring # ❑ Pit Ground surface elev. ft. Depth to lim" factor in.
Sol Awlication Rai
Florimn 'IBptlt Dumnarrt COW Redox Descriptiat. Texture Structure cor stenre Baudeny Roots GPDIIF
m. Muria" Ou. Sz. cortt color Gr. Sz Sh. 'EM 'Eff#2
Emuern 01 = BOD, > 30 1220 nxyl. and TSS >30:< 150 nglL ' Effluent #2 ^ WD, 30 nIS& and TSS _ 30 rnglL
The Department of Commerce is an equal opportunity service provider and cmployer. if you need assistaoce to access services or
need material in an altematc format, please contact the department at 608.266-3151 or TTY 60&264-8777.
seoarwraacoi
Soil Test Plot P1
Project Name Scott Clark aun B**
Address 523 15th Ave
S. Saint Paul Mn 55025
CSTM #226900
Lot Subdivision ate 7/3/18
NE 1/4 SE 1/4S 17 T 31 N/1318 W
_ Township Star Prairie
❑ Boring Q Well PL Property Luce County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe
System Elevation 997 =HRpSame as Benchmark
217th Ave
100th St.
B-1
Scale = 1/4" = 10' e 9 99'
2 Acre LoL
98
B-3
N,
B.M.* 4% Slope
97'
Squaw Lak
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of
Division of Salty and Bq/dings.
maohor ante with Comm 85, Wes- Adm Code
County, f
Attach complete site plan on paper not less than B 12 x 11 inches in size. Plan must
include, but not limited to. vert cal and honzontal reference pant (BM), direction and Parcel 10
/
percent slope. scale or dimensions. north arrow, and location and distance to nearest road.
Please Print all information. Reviewed by Date
Penovi inronoaaon you wowde may W used fw secondary purpasas (Privxy Law, s 15.04 (1) (m))
Property Owner Property Location
( Govt. of V4 1!4 S / T N R L LE t< N
Property Owner's Mailing Address Lot # lock # Subd. Name a CSW,,
r
c" -4-)f-
City Slate Zip Code Phone Number ❑ City ❑ Village ;gown Nearest Roa
5- &Jfmr-l S Od'( ) d
Constiucli Use Residential 1 Number of bedrooms Code derived design flow rate -y>
❑Replacement Public or commercial - Oesmbe:
Parent material„ Flood Plan elevation i! applicable
General mnrrlCrltS
and roCeflvnendatims; I, (V'/1 f
y4lern lype /~C 4.,/ ^ System Elevation ! C/I. [ / -
1 Boring # ❑ Boring
a pit Ground surface elev. r 1I If Depth to hmibng factor L71 in.
Sal Application Rate,
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD..ff
In. Munsell Qu Sz. Cont. Color Gr. Sz. Sh. •E##1 •E##2
J
3. s S S /
All',4 A-114
1rj
Boring # rC] ~/l Boring
LEI pit Ground surfaceelev / 6L_L711 Depthh to limiting factor .2 n.
Soil iration Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff
in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Ef1#1 •Etf#2
E#luent #1 = BOO. > 30 < 220 myL and TSS >30 < • Effluent 02 = BOD, < 30 r11gfL and TSS < 30 nxyi
CST Name (Please Print) CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Addruss Ua;u L•:aluuluu !:nn:focfen TgepnonC N.ImeOr
1432 120th St, Neva Richmond. W1 54917 j 715-246-4516
- 73
Property Ovmer Parcel ID p _ Page -of
Boring ft ❑ Boring OIr,
pit Ground surface elev. !_6- ff. Depth to limiting factor- in. FsodApplication Rate
Horizon Depth Dominant Cela Redo, Description Texture Suucltae Consistence Boundary Rods GPDtff
in. Munsell Ou. Sz. Cont. Color Gr_ Sz Sh. 'EBNt 'E6#2
❑ Bonng 4 ❑ Boring
❑ pit Ground surface elev. _ R. Depth to limiting facia in. Soil dication Rate
Horizon Depth Dominant Cola Redox Description Texture Savetwe Consistence Boundary Roots GPDRf
in. Munsell cu. Sz. Cont. Cola Gr. Sz Sh. 'Eftpt -Eff82 11 Boring
❑ Boring 1♦
El Pit Ground surface elev. _ h. Depth to limiting factor, In Soil ica6orr Rate
Honzon 'lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM
M, Munsell Ou. Sz. Cont. Colo Gr. Sz. 3h. 'Effp1 'Efia2
Effluent pt = BODE > 30:S 220 mg,L and TSS >30 1150 mg4 ' Effluent p2 = BOO, < 30 mgll and TSS < 30 mg7L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
snr~nmrx am,
Soil Test Plot PI
Project Name Scott Clark awn l3'
Address 523 15th Ave
S. Saint Paul Mn 55025
CSTM 4226900
Lot Subdivision ~ato 7/3/18
NE 1/4 SE 1/4S 17 T 31 N/R18 W
Township Star Prairie
Boring 0 Well PL Property Line County ST. CROIX
BN1 or V Rp Assume Elevation 10o ft. Top of 3/4" pipe
System Elevation 99.7 *HRpSameas Benchmark
217th Ave
100th St.
B-1
Scale = 1/4" = 10' e E B 99,
2 Acrc Lot
❑ 98,
B-3
R.M. 4% Slope
97'
Squaw Lalk
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