HomeMy WebLinkAbout026-1294-18-000
:^nsconsm Depar.11iof Comnl PRIVATE SEWAGE SYSTEM `'o`nty St. Croix
Safety one Bu Ids -.a Oi•:Ision
INSPECTION REPORT sarnary aer-t No 605153
GENERAL INFORMATION (ATTACH TO PERMIT) Sate Plan ID Ne
Perse•ia 1---a-d- you p•Jeide rcay he uSed fC secondary 00r00s¢S IP'vacy Law, S 15 De r•j;m;I
Perna: is NJ°C Cry V Inge Tavnship Paice Tax Nc
Oevering Homes LLC TOWN OF RICHMOND 026-1294-18-000
CST BM Elev I Insp FIM Elev 81"1 Description Sect an:T",nAangeRdao No.
/ 620 661 ('u. 28.30.18.1500
TANK INFORMATION ELEVATION DATA
TYPE NTANU°ACIURER CAPACITY STATION BS HI rS ELEV.
Septic Berchmark
J rJAl Ft !•6 /66,
nri~ Alt BM
'I r i . 7 /d
F; 4 L.I CQ,~` ~ ~atn LD
Aeration Bldg. Sewer t Z. ~O 6
Ib cilig SVHt Inlet rr
TANK SETBACK INFORMATION SUHt Outlet
~ /fJ(o • 3
TANK TO P4. WELL BLDG Vent Alrhea!.e
ROAD Dt Inlet
64-e,^
Septic 521I15 , D: Bo:tem
Dosing N(~ Heaoer~Ma•i C •I _ /00`
AeraUOn - Dist. P pe V (1W /~'J
Holding Bet System /Q I
Id, 8 PUMP/SIPHON INFORMATION Fina' Grade d • 2i /al i
Nlanifact.rer Demand St Cover • -7
GPM Ce 1 -
Model Number J / (0 .S
TDH Li't N~cFon Lcss System I lead TDI Ft Q 1
Fercemain l isl to Well 7
7. 7
SOIL ABSORPTION SYSTEM ~Q. • 7• t 2.4 /03 • 7
BEDJRENCH Nvct- I cngi- Nn 0f Trenches PIT DIMENSIONS NJ 0'i Ins.co Ill Liquid Depth
DIMENSIONS 3 7 .3
SETBACK SYSTEM TO Pit. BLUG WELL. U1KEtSTREAPa1 LEACHING Maru'aUurer
INFORMATION Tyne /`f Sys:em~ / CHAMBER OR .S u...I
f UNIT Mode. N.meer:5 r
DISTRIBUTION SYSTEM J 71 ZZ. S
neadeNt,'Jr rol;Y Dlspit..Unr *Hole5<C ><Hole Si ng Vent to Air ta~j ~fP:u:sl ~ I-
ola. ngth O ` Le•ia:F Oia Spacir'g
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only d 16 Deplr' O'er De eY O'ee• '.x Depth of u: Sucscci vv.:Odd I xx Mu JWC
BedTrerch Center Ded,Tlewb Edges ICJSJII Nc Ves Nn
COMMENTS: !Include code d -.screpencies, persons present, etc.) Inspection p1. Inspection 62
Location: • 16; 134TH AVE C ~ a A- S
1 1 All BM Descr t or _ f'• F•~^• I ' //jj..~~
2.1 Bldg sever length = ' W QJ4L i Jti C~ O✓t
- amount of cover aQ
I$ On -
Plan revision Required? Yes 100 (
Use other side for additional Ir*ormatlon. - 3 I__ _ _ ✓
Dare Insepcc' igratura Celt. No.
S8D e7l3 Ili 3:9r:
Safety and Bui dings Drmsior. f,)1
8 ' f 1 si 201 1V,
i1+as: ington Ave ?.0. Box . "I6 Sari.vy ?crorz ~umbc fb, :Jie.: m by Cn i
hlpaicnn V9 `_37j; 1n2 I r .
L ~b515
swlit46 eT it Applleatuon t see I LU3 be
s urwoic w 3: SY? sf' t -::dr l _ vh.u -i i l i- 4'-
I "'m Ic d c -1.Y -'pi nc ':v -=U: tml !
gcired rt s. CLF.valnr a .mi:m pcnu 'vole ;\1rpLsu.,uo ..,rm for s.al.1 wurC 1 ~W : S uc subttvtied to P:cje.t Address (tf diSocm uum nwlinp aoiL~si
N il^garunwt t Sale and' e sn.tu: Sr`i~ 7snnJ .ulu cua[i.e V'• rpv ek u;a\ be stied IV sewn" -
Ftrn s.-s :r a ordancc z,Ih th fn 41:/, rx[)
1 kpPlicatlon Informanon Ylcase Pnnt1f1 Information
1 pan' C*•vrcr s \a-n< - / Yc:
} o_q¢rp Jwo-r I Ma4m9 Ad&LG Pruprt. I xation
7 pl
( 41~//--.~~+-.~ vo/)[ tat
J S N/( I 1 Zi? :.Ve :beat 4 etua =1~' Su:uco I_ 01 fI Tvpc of Building (check 311 that appl) ' n. T -JON.
-(J-
- - subs ~?slot, , nc
Fcvei Uwcllii;~ dauiFrc: of lkcn:ca
mi^lL,
!'d ^ 1~_
Ui ,ti n
t~
t MIiC.~ l~ ('iry n;
.SblVUraF,c (]l'iLLae~r el
~Mbl
~a,.f5 mho of - Luti' _
3 - 12
III. Ty x Permit: (Check on[. on on ILte A. Complete line B if applicable)
"7 . ~-a r _ i'O ^r
t Ss a kcl' v; meat Svsce:a I , - Inantrk- Ids r T i : t: pia -r -ot -)oiy ❑ R.hu Aloducm.oa L: =nSnI Systan (exp:wnl
~ I
It it F nrnr k nca c¢tl ii c i iat'_c _.t Yti.rb-r - _-..:cw L:n 7revious Yetma!:umber aid 1'a L.sucd
_ Y-mrrt T.aa.s t ~ _ Q
Ikf,.a Exptra icn v^wr7 - ' /3 ~
I ' arc of PUN r- m•f_nmponcuL Uah t<e \CLe k 31111ut ap~h i _L _ ~
V <rF•ers crlr nrhou to.e n 1 r uW my mde .I Mound - 24 m ,t mt-ool ml Mound 24 In. A sonzle sod
1 f Idm • a -L L cnS sprt ,d -n : ..^.eu-. .U rot llcvivc xplain)_ -~rj L f~N 1'^~'
\ UlspersalTre enl Area lufori I -
1 .u at
tP I T Gr t l.I Opp L: ~t.i~r u.l U p. ^'1 t 1t . u 5f F.3pc.-sl A.tta ittposed is <.rRem E 1
\ .Tank Into of al,u: -0 x:,f 1.f.muta.-rurer
l il) nv :rdf: ns 7ms u c c
~<w Tack-, o u z t;
' L- I:LYCDt' ~ I I
VU. Bespmisibthty Statement- I, the uudenrhned, axsu It poosihflity for Installation of the PUNTS shown on the attached plaaI
p' is sdan c Dot; Ylcmbc ' ?-uurc !viP:VU'fs l:ua)hcr kttime~; i'bevrr htenber
!uIntxr'. /JWrss isrce:,U Sras,-.p
t
V'111. uon:Depamnent Lse Qnh'
Txrmr Fv Date l x,wa su t : pa Y`F' .
roved ~r w
s i9/`d :
rkctxa.'or Ceniat
IX. Conditions of ApprovakRe sons for Disapproval / n
s 6~.f6
- auaeh M eeupkte pi'^` for the sntrm and ;vb.s m tar Coaon ooir oo Npe+ on: II uuo S .e . It im hn m vx
SRU-oils Ik. ; !i I :1
Soil Test and System P1,0T PLAN
PROJLCT Dever n<i Hones ADDRESS 1433 Cernonous Ave Suite A New Richmond Wi 54017
NW l14 SL 1;4s 28 !r 30 N:It 8 Ar To%NN Richmond cot: \TY ST.CROIX
SYSTEM ELEN'ATION 99.4'99.0! .6 3' below grade 10'16'18 BEDROOM 3
CONN'1;\1I'lo\AI. XXX CONVENTIONAL I:II"1 IIOLDING TANK
n1oLND sLrTlc TANK SIZE 1000 galions LIFT' TA\K SIZE DOSE TANK SIZI:
HOLDING 'LANK S1/.L LOAD RA'I'L: .4 .0SORPTION AREA 1125 0 of EZ-Floi~s22.5
BENCHMARK A R.P. -Up o" SUfVey iron kSSITNIF ELEA'A7'1ON 100' Filter Lldetirnc Filter
❑ BOR1,1101L: O R"ELL °H.R.P, same as benchma*
all' Propet-n Linc
Scale = 1/411 = 10'
,(l.
cats
e lls \cidI ipaLiT) U 0' B-;
B-_
10'
- t~
Cci Slo:x.
r\ ILI
B_1 40'
10'
. r
I
~ ICJ
Pro 3 1
Bedroom }0
House
:1C Wiping shall Nf aS7:N9 SllR '10''', aia:ir
10' o- tank. pipini: shall he AS'I M F891
134th Ave
Soil Test and Svstem PLOT PLAN
Pltgllt(,T Ooverina I lomes ai)URI•:ss 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 114 SE 1/4s 28 /'r 30 N/R 18 NVTONNN Richmond cpUN'ryST.CROIX
s N's'rENI ELEVATION 99.4./99.0. .6 3' below (trade 10/16/18 3
DATE. BEDROOM CONVENTIONAL )0XX ✓ `r I CONVENTIONAL LIFT HOLDING 'TANK
i
.N10LND SUPTI(' •1•,1NK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING 'TANK SIZE. LOAD RATI•; .4 ABSORPTION AREA 1125 # or EZ-Flows22.5
BENCHMARK v.R.l'. Top of survey iron ASSUME ELEVA'11*10S 100' Filter Lifetin)c Filter -
El BURI•:IlOLli O 15'F,I-L - Il.lt 1'. same as benchmark
B.~9
220' Properly Line
Scale = 1/411 = 10'
,0.
Vents
3-3' \ ?S cells wilh >3' spacing 40' B-3
B-_
10'
Vc' Slope
10'
B-I 40'
10'
25'
Pro 3
Bedroom
All piping shall he AS'CN'1 SDR 30/34, within l louse
10' of lank, piping shall be AS7:M F891
134th Ave
- ~ 8 201$ ~~I
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page o'
Division of Safety and Burdings - ,
- 11 w a I ht
m 85, Wes Adm. Code county
Attach complete site plan car paper not 1e55 than 8 112 x 11 iriches in size. Plan must <'-5-7 / f
include, but not limited to. vertical and horizontal reference point (BM), direction and Parcel 10,
percent slope, scale or dimensions. north arrow, and location and distance to noarest road. -f
Please print ail information. Revie by - Date
Personal adormalion you Provide may W used ror secondary Purposes (Privacy Lew. s. 15.04 (11 Imp. IV
Property Owner Property Location
t J
Jro r r L A Govt. Lot Al ~ 114 1:4 _ p T N R/ E( r) W
Property Owner's ailing A r Lot # Block # Subd. tr#t
x-j
City ,q Suite_ Zip code Phone Number ❑ City ❑ go own Nearest Road
r New Construction Usd~Residential I Number of bedrooms Code derived design flow rate GPD
Replacement F1 Public or commercial - Describe:
❑
rent material Flood Plain elevation,!appfiubie/_[V
Pa
General comments
and recormlendatfons. - ,7-- Z
System Elevation _
System Type 6-7
FF1 Boring If ❑ Boring 7 Vitt & pit Ground surface elev. «.Z r.. Depth to fimiung facto _ m.
Soil iretion Rate
Horizon Depth Dominant Color Redox Desciroon Texture Structure Consistence Boundary Roots GPDtff
in Munsell Ou. Sz, Cont. Color Gc Sz Sh 'Eif41 •Eff#2
1 r-IZ- ,°LZ-
75/
I
t '
1t
Boring a ❑ Boling
pit Ground surface elev. v R. Depth to limiting facto o in.
Soil icat.w Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrff'
in. Mansell Cu. Sz. Cent- Color Gr. Sz. Sri 'Eff#1 'Ef 02
7
J-l L 'l CL - 77 .w
S /Ml in Ar
41
-Vf
S M c~ ,
Effluent #1 = BOD, > 30 < 220 rr1dL and TSS >30 1 WAA~ • Effluent #2 = SOD. < 30 m 1. and TSS < 30 mi
CST Name (Please Print) n _ GST Number
Bird Plumbing, Inc. Shaun Bird 226900
Adares~ Dale Evaluation onducted le.lephune Number
1432 120th St, New Richmond, WI 5 715-246-4516
Property Ovrner _ _ Parcel ID # Page of _
a Boring # ❑~7711 Boring
l7~Pit Ground surface ern/v.c it Depth to unvting factor / ~2 in.
Soil ication Rare
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff
in. Mun5e0 Ou. Sz. Cant Color Gr. Sz Sh •Etf#1 'E"2
1
rf
❑ String If ❑ Boring -
❑ Pit Ground surface elev _ ft Depth to hmrhng factor in
Soil Appli Rate
Horizon Depth Dominant Color Rados Description Texluro Structure Consistence Boundary Roots GPD.Tt'
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh •E##1 •Eft#2
❑ Boring # ❑ Boring
❑ pit Ground surface elev- k Depth to limiting factor in.
Shc ication Rate
Horton 'tepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD#f
M. Munsell Ou. Sz. Coot. Color Gr. Sz. Sh. •Etf#1 'EBf2
' E#luent #1 = BOD, > 30 < 220 mgt and TSS >30 < 150 mglL ' Effluent #2 = BOO, < 30 mg4. and TSS < 30 mg4
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.
sanrtvrn kwa
Property Owner Parxl IC k Page _ o
Borng Z ❑~II Bonrut /
C lT pit Ground surface elerv//.C h. Depth to limiting factor I m.
Soil icatvon Rate
Horizon Depth Dominant Color Redox Oescnpron Texture Structure Consrslunce Boundary Roots GPD4f
in Munson Ou. Sz. Cont. Color Gr. S:. Sh 'Eh#1 I •Eh#2
5 v I j_
'1 S c ,ter I
Lw"Yl
ff
~l Boring # ❑ Boring
❑ Pit Groune surface elev Depth to limiting factor in.
Soil App1~:,aLOn RxE i
FlOnZon Depth I Dominant Color Rooox Description Texture Siru.-ture Consistence; Bounoarv Roots GPD/N'
in Muncell Ou. Sz Cont. Color I Cx. Sz. Sh 'Ef F..1 •Eff#2
I
i
Boring I I I
❑ ❑ # Boring
❑ pit Ground surtace elev. h. Depth to limiting factor _ in.
Soil Miation Rate
Horizon -lepth Dominant Col Redox Dosapbon. Texture Structure Consistence Boundary Roots GPOHf
I in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. •Eff#1 'Eh#2
I
i I
I
Effluent #1 = BOD, > 30 S 220 mgt and TSS >30 < 150 ffwA • Effluent #2 = BODE < 30 mglt and TSS < 30 mgt
Inc 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 608-264-877.
sxo-r nn,x Mpl
S~ru ao18--a?_Y--
Sateh an n 1ldin s Crolsn
x 1 0~'. s" - II I 201 W trdasatngton Ave 0 Box 7162 ' Saci;ag ?ennn Nlmbc sic be ttGcel in b+• Cs,
Madmon 99 537D7-7152
-
P
Saaill,ars PermII ^ ppll( Stu lrml tin tier
III /...n'Wau.wm'.YSr5~~1 I ~1> dln ~~hll r: Li. t.L •rnprsc ~:^rnel Imll _ -
grirr, rrrp.ha Utl aaw!va pcr.al Nut \I:fh. rt.,m•. tnl mot.-»ue:. fi W'S UCSULI,m AG• Pro .el .Acme.. ( a diffci . alan:uau.a, add:as
th L^Pwtcl m 1 S n v ni s.~ n i>u. S•••vve.. •n nd n ' Lariat v a .I'0.JC G,31 t need kx e u.:
n ms , n i +rdslct + tL h P..+a~~ ' u _ @n I i a 1 Stns 7
I kpplic3ti n Info, matron Please Fnnt All lnfurmanoa r
G~ ~~,r f~ ab- ra5y- i$-000
fr per-. ( mailing .v . CTN!,x•..u,n29.So .ig.TSdo
r,, S!m. ~ 1 Cac ^ 'bone; tnnxr
"I c"
II T+'pe of RudJing lehrrk oll t apply)
m,ul :>M¢Ilia.. -umber oiS d: ulec SI_vimtm\n
G/R• Q~ ~'r IiI, ci n / ~~LJ~bEX~
~Al
City of-_
CJM Vitr.9er V.,
: of
_ ~ ors E A A
111r}pe I'ermir. Lbeek only Pr ii on line X. Complete line H tf apphcaMcl •
Nrx SySt= I I it.piwemm[ SV!em 7r,-.,m, .ou F, pla.r is j Orha }.fv;t'sNl Mtn .k. voi; SV 4-v iexp::v:i
- - - _ - i _ - ~b1 i'Irvinac Pernc Nmnber ad Date Issued
R. I lauu f nesl ❑ I'emv: 6rl sox 1 ?I:nlyrl bc! -:u',tc r 1be
cvste,n7Cumnnnene!Device: ICbecf: all m
. ut`~asvc;•1 Ir-V-x1:161 `.6:;:_ of: it N, soil LI \i fond m. efm.table wi:
Lo:diu .:Ir r 1 P-1 -:n n t <jnimnI _ _ _ -I I'la rn ^al .x+i : iclcpi
1)~7.is ersal Irra rut Cna Info
rmaboA / 1'
kLy /a{ v ( "«X Q~
I Fax, ai; _o.. ..[I App .,,n r. I^ Dr.pr. II; +I+ u.1 L.. r. Dsp
~V ~ Its S~~S.L~/zI`
S'f. Tank Info I 1 T m x lur.L z of MWMT,a=rCT
-ll z ;talons 1!.la
i I M :.lr.'w-: 4r~• nA 7'_.. a V d I
Sw~
I
VH. Respenstbtbly Stareme L the undersigned, :ISSI respuo-mlhty for installation of rb<PONAT shown no !be attached pt=u _
P:runxr Vam< fYmli Plca.n. ^1.aNm - - - fl 'C'RS 'Inibrt Rusma.. ',11 NomI
(
72.mcer s A'Llrcs ibc9, Lv S; 4.: 1: iA- _
~ ~~0> ~ Leo / /✓`~t<' ' ~ ct/_ !
uat,'De artmrnt Use Only
1
eC }atL' SnL r)LIL^ :nl J17'l.L'ifrr
• 4'P` I ~ I ~ ~ 9 //y/f
LX. C'ooAUtl f. l!'lrr3 nS,yyteppraval
u:~per:'.I CIA Must all be •."•.k:rs ! a+t tn~~ J ~ 1 s - ~ d~"~
es per „w.agemen! plan p:,. naen by Vlwnbe.. nd~t✓r b~ /
2 M IfQbffl( reckjeer^en:5 min;t uo r.~ar•.t; ir.c1 /9r
m per sppdoMm cods ; :rcl lhnctt.
_ - 1aa:Y U: rnmpW:r plv~ l:., rt -n-c d sobni: y lix Cpuot/ aul. p,w n 1 s,beo A 1 " 11 so<Lo, ,
SIO-c3yr;rc : !.I V /Y~gtn~ZAoUY:2
kwtrl,t-W L►
Yr~1 k'~ IM~`p+~ ~
System PLOT PLAN
PROJECT OMIOri10 Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW J. i4 SF 1 J4S 28 ;'f 33 N!u 18 NN TORN Richmond COUNTY ST. CRO!X
SYSTEM ELEVATION 105.5x105.0 104.5 2.5 bolow• q°ade 826118 3
):NTE BEDROOM C'.ONN'ENTIONAI CONVENTIONAL LIFT' HOLDING TANK
VtUl'ND SEPTIC' TANK SIZE 1000 callons UYT TANK SI'/_E630 DOSE TANK SIZE
HOLDING TANK SIZE LOAD RItTE .4 ABSORPTION AREA 1'25 Y of EZ•f.'lo,..,22.5
Ilk BENC'HNIARK V.R.Y. Top of survey iron ASSL:VIF. E,LEN'ATION IOU' Filter L.:fetimc Filicr
❑ BOREHOLE 0 WELL -H.R.1'. same as Dencnmark
s7• 230' Property Linc
Scale = 1/4" = 10'
60' 7'- Slop;:
100'
?0 X ?5' cells with ; S
.y
lUS'
yen V
Vents 40 6„ Quick~l Standard
B 2 of Cover Leachin Chamber
with 20.0 ft2 of Arca
S.6tt^2pair of end caps
Huifcult Combo Tani. 4 Lon- 1
162' Grade at Systcm Elevation
4..
0'
Pro
Bedroom
House
`X
kJ
P
all pipine shall be iASTM SIDR 3034. within
l0 of tank. piping Shall be ASTM F39!
1 34th Ave
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 8/28/18
Owner: Oevering Homes
Location: NW 1/4 SE 1/4 S28 T30 N,R18W 1160 134th Ave Richmond
System type: In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Pressure Distribution Manual (version 2.0)
Pagers
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
8. Dose Tank Pr ss Section
9. Pump Curvle
i
Signature `
License nu er 226900
System PLOT PLAN
VRo,►F.cT Oevorino Homes ADDRESS 1433 Cernohous Ave Suito A New Richmond Wi 54017
NW ll4 SE 1/4s 28 1T 30 NCR 18 w Tow, Richmond COUNTY ST. CROIX
SYSTEM ELEVA'r ION 105.51105.0.!104.5 2.5' below grade 8.•''26"i 18 BEDROOM 3
DATE CONVENTIONAL C10NVEN'1'IONAI. LIFT XXX HOLDING TANK
1000 gallons I.11A TANK sl/',l•.630 DOSE TANK SIZE:
MOUND SEPTIC 'TANK SIZE.
IIOLDING TANK SIZE. LOAD RXIF. •4 ABSORPTION AREA 1125 H of F.Z-Flows22.5
BENCIIM,1ItK V.R.I'. Top of survey iron ASSLNI ? ELEVATION 100• Filter Lifetime Filter
❑ BORI•:IlOlk: O WELT. *II.R.P. SameaSbonchmark
57' 220' Property Line
~ Scale = 1/4" = 10'
60' 7 >"r slope
106'
70' B-3 3.3' X '75 cells with >3' spacing
IO,r,
Vent
Vents 40' >6" Quick -1 standard
11-3 of Qncr Leaching Chamber
with 20.0 ft2 of Area
Huffcutt Combo T:1n6 4' Long 12" 5.6V2/pair of end caps
162 Grade at System Flevalion
10.
Pro 3
Bedroom
louse.
All piping shall be ASTM SDR 30/34, within
10, of tank, piping shall be ,L%SI'M F'891
1 34111 Ave
n c O
a m ~
2 LL u
n u w
_ C7 c ~
Y
O/~
ib ^V _
f i
O ♦ LL
r
c u >
CL w 0
N
m (D cn
75 C O
0 ti• N Q - a
L -O v U
C r - ~v a' 1-
II 6)r ` 1
Cr
(p S4 11
v g m
G If
LU > 41
I 1o N C O
L OV Z # O
z
V _ y
W ` V .::I 1r j 0 N LL
U co
L U rn
G1 A' ' :o t v o
d H
m. O co
CJ i I N U` ~
1 - r a ^
C
0 0 3 ^
l< C7 it 0
/A J9 W
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page-of-
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner /
❑NA
Septic Tank Capacity emhit Septic Tank Manufacturer Z NA
!)ESIGN PARAMETERS Effluent Filter Manufacturer `1~ nCd p NA
Numcer of Bedrooms - If NA Effluent Filter Model ❑ NA
Number of Public Facility Units `fiAA Pump Tank Capacity NA
gal
Estimated flow (average) _
d
_ ~i rl ay_ Pump Tank Manufacturer NA
Design flow (peak), (Estimated x 1.5) r `X gallda Pump Manufacturer NA
- - - v
Soil Application Stile Qaldaylfh Pump Model D NA
Standard InfluenUEfftuent Quality` Monthly average- N-etreannent Unit C NA
Fats, Oil & Grease (FOG) =:30 mg/L Ll Sand/Gravel Filter C Peat Filter
Biochemical Oxygen Demand (ROD„) 5220 mg/L = NA D Mechanical Aeration D Wetland
_ total Suspended Solids (TSS) 150 mgt- Uisinfection O Other. !t
Pretreated Effluent Quality Nionthl -
y average Dispersal Cell(s) DNA
A
Biochemical Oxygen Demand (BOD,) <30 mg/L n -Ground (gravity) D In-Ground (pressurized)
Total Suspended Solids (TSS) <30 mg/L ❑ Al-Grade Mound
Fecal Colifonn (geometric mean) ! =-10' chLI100ml \ D Drip-Line ❑ Other.
-
Maximum Effluent Particle Sze ;6 rn dia. 1 NA Cxher. L: NA
'ZAK(A other:
_ U NA
'Values typical for eomastic wastewater ano septic tank effluent OtFec - DNA
MAINTENANCE SCHEDULE
• Service Event Service Frequency
Inspect condition of hark(s) At least ores eve O month(s)
y. !ear(s) (Maximum 3 years) D M
Pump cut contents of tank (s) - (•s) ~I When combines sludge and scum equals one-third of tank volume ❑ NA
'nsoect dispersal cep(s) I At least once every: r D months} (Maximum 3 ears
7L~year(s) Y ) O NA
;lean effluent filter (
At least once every. ( year(s)
A
nspect pump, pump controls & alarm At least once every. ZI'micilth(s) NA
- - - - - _ -I year(s)
I=lush laterals and pressure test At least tl month(s)
once eve
ry: D year(s) _ At least once eve D month(s)
every: D year(s) ; NA.
G NP.
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be wade by an individual raoyinq one of the following licenses of certifications: Master
?lumber; Master Plumber Hestncted Sewer; POWTS Inspector, POb\'TS Maintainer, Septage Servicing Operator. Tank inspections mist
iinclude a visual inspection of the tank(s) to Identify any rn ssmg or broker hirdwae, identify any cracks or leaks, measure the volume of
xmbined sludge and scum and to check for any bade up or pending of effluent on the ground surface. The dispersal cell(s) shall be
visually inspected to chock the effluent levels in the observation cipes and to check for any pending of effluent on the ground surtace.
the pending of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
-egulatory authority.
✓vhen the combined accurnu ation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of
he tank shall be removed by a Seplage Servicing Operator and disposed of in accordance with chapter NR 113. Wisconsin
Administrative Code.
All other services, including but not limited to the se"tong of effluent filtrrs, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of <_12 months, shal' be Ferfotrned by a certified POVITS Maintainer.
k service report shall be provided to the local requ:atory authority Rathin 10 aays of completion of any service event.
Page _ of
START UP AND OPERATION ucb or other chemicals thr-A
For new construction, Prior to use of the POW S check treatment tank(s) for the presence of pal are detected have the contenLS of the
may impede the treatment process and/or damage the use dispersal cell(s). If high concentrations
tank(s) removed by a septage servicing operator
System start up shall not occur when soil conditions are frozen at the infiltrative surface will be
Dunng power outages pump tanks may fit above normal highwater levels. When power is restored the excess wastewater will be
discharged to the diispetal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge
Servicing Operator Prior to restoring P~ to ft of efflueniL
effluent ow this pump or sir contact a have the Plumbber er or or POof the punt tank removed by a operating the pump controls to restore normal leves
WTS Maintainer to assist in manually e alty within the pump tank. the area with'"
Do not drive or park vehides over tanks and dispersal cads. Do not drive or park over, or otherwise disturb or tompaM
15 feet down slope of any mound or at-grade soil absorption area. and prolong the life of the pOWT~i:
Reduction or elimination of the follow rug from the wastewater steam may improve the performance drain
antibiotics: baby wipes: cigarette butts; condoms: cohort swabs; degreasers: dental floss: diapers; disinfectants; fat; foundation ucg
(sump pump) water: fruit and vegetable peelings: gasoline; grease; herbicides; meat scraps; Medlcado^s; oil; painting P
pesticides; san'3ary napkins; tampons: and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permartentty taken out of service the following steps shall be taken to insure that the system is propel v
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 fined with soil,
gravel or another inert solid material.
ant
CONTINGENCY PLAN code compliant
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to Prm'~e a
rep/a1cey~ant system: ant sod absorption system.
~C.f A suitable replacement area has been evaluated and may be utilized for the location of a replacer"
` and should not be infringed upon by requlried
The replacement area should be protected from disturbance and compaction ment area will result in the need
existing and proposed structure, lot lines and wells. Failure lure to prated the replace
fortta from
must comply with the rules in
for a new new soil and site evaluation to establish a suitable replacement area. Replacement systems state
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologV a
hang tank may be installed as a last resort to replace the tailed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. if no replacement area is available a holding tarok may be installed) as
a last resort to replace the failed POWTS.
❑ Mound and at grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at dud time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO N
A CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A
ENTER A SEPTIC, UMERO OTHER ROR OF A T TE MAY BE DIFFICULT M
PERSON FROM THE
DDITIONAL COMMENTS _ - . -
POWTSINSTALLER pOWfSMA1NTAINER
Flame r~z✓ f >
Name
Phone 'k;- [ Phone
SEPTAG' SERVICING OPERATOR PUMP LOCAL REGULATORY AUTHO ITY
Name
Name ~/T^.l~ r-~ J - -
Phone J Phone - - i
This document was drafted in corntpliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 353.54(1). (2) & (3), Wiccomsln Administrative Code.
L
1\
} ~ h
T ~
k y \
t +yz -
81
j
I
8 n ~ I j
N
-131
Septic-Dose 'l'ank Cross Section And Pump Performance Specifications
Taril, A4anufauurer PIIITIp Manufacturer e-,
Tutk Model Nvurnbcr g Punip Model Number
Total Tank C tptuty ~j Nlarm b1 mufacturer Li
tLJ2J 3 t.
Max. Bury Depth Alarm Model Number
- - Switch TNpc/~E~h i C
Filter AIanulacturcr - 1 Total DNnamic Head (TDH) - poet
Filter Model Number Elevation I katl
C/
I )islal Pressure
Network Loss - -
Minimum Pump performance Required Force Main Loss
J GP\i u I v !Et 7'DFI Total Z9•
OUllet Manholc Min. a" Nhrwu (trade With
Dian Mtn. nAbove bade
l ockmz r)c%ice. Inlet V'lanholc &it
6• Below Grade Sealed Walertit+ht Securely Mounted ~''ith Locking llevice
Weather-proof
Junction Box
- rinished Grade - - - - - t
Vent Min. 12" Disconnect
Above Grade Means
With Vent Cap
Outlet Filter
Inlet Baffle
inlet :t---- r--- -
switch Settings and Reserve ( pu.:it . 1
l attk Volume - ! j (;PI _ NVeep
Dimension Inches Volume Gal. B hale
(tcscrve)A x 5 36'•
(alarm) B 2 - > > orrEleeJon C
[
(dose) - C - Pt 0-4
7• Ronom
(dead) ~ll~ p F.Icvation
Total l~ L E O i rte', % Ft
GENERAL INSTALLATION: 1'he septic;dosc tank is bedded and back filled in accordance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer ntay not
he exceeded without prior approval. Manhole cowers 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 watertight fittin' N, and
laid on stable soil to prevent settling or sag pt The force main is sleeved with 4- Sch. -10 PVC to bridge the tank
exuacauun and tits slacc is scaled walcrti~ht Filecua el service complies with NF(' +'00 and Comm I6.28.
0'_!0i I..l Page _ol
250=SERIES
1 /3 hp Sump/Effluent Pumps for Professionals!
ALL MODELS FEATURE: MOTOR SPECIFICATIONS:
• Rugged 1 /3 hp motor, oil filled with 1/3 hp 115V 5.2 amps 60Hz
thermal overload protection. Thermally Protected & Permanently Lubricated
• 1/2" solids handling. (PSC) Permanent Split Capacitor
Maxirtlurn Fluid Temperature: 140°F
• 1-1/2" discharge.
• Hermetically sealed motor and switch cavities, DIMENSIONAL DATA-
and pennanently lubricated bearings. Weight: Model 257:20 lbs.
• Liberty's UNI-BODY casting - a solid, one- Height: 10.5^
piece housing that eliminates the lower motor
seal ring found on other pumps. Major Width: 9.6" (manual model 250)
• Epoxy powder coat finish PERFORMANCE CURVE
• Vortex style impeller for superior PERFORMANCE CURVE
solids-handling. Made of high temperature 25
engineering polymer.
• Fasteners - all non-corrosive stainless steel. 20 - s
• 416 stainless steel rotor shaft. ~ °
LL
15
250-series Cord Lengths ti a
10
Model 10' 25'(-2) 35'(-3) 50'(-5) - o
250 Standard Optional Optional _ Optional ° s _ e y
251 _ Standard _ Optional- Optional _ Optional
253 Standard Optional-Optional NIA 0
257 Standard Optional N/A N/A o 10 20 30 40 So
- U.S. Gallons Per Minute
10' cord length standard on all models. For optional Icnglhs, _
add "-2, -3 or-5' suffix to model number. ;to ns ms - tee
Example: for model 250 wdh 35' cord, order 21,)0-3 Liters Per Minute
EFFLUENT MODELS
rlf iR
'tl u _ i f
rr~ ~ •
r k` 6 _
Model 250 Model 251 Model 253 Model 257 VMF
Manual, no switch. Quick-disconnect Wide-angle float with VMF switch, magnetically
wide angle float. series (piggy-back) operated vertical float -
inercury-free. plug, allows manual operates in a 10"
wal operation of pump. diameter sump.
A
S" Certified ,af~e~ czmik:au<m . I:., Ibr llnihel ;;alas and C~natla
Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839
www.libertypumps.com ~a;,.,,~~;m:,Ln~n•rr.mpr..~o,:.sr,lr
AI nghs rep wed. I LIT25-co R111 7.
S1'. CROIX COUN'ry
SFPTIC1•ANK v1Al1VTL\ANCP,ACiItHHMENf
AND
OWNERSTUP CERT'1FICATION FORM
Owner/Buyer JL r t11, m ljlli
r~ / n - -
-
Mailing Address - }/1_~J-i ~,i1/!_B-C~GO._
Property Address .tI ]/l V - - -
(Vctification regnirui fiurr planing k'Z,omnR Deportment for new construction.) - - -
City:!Stalc - - - - Parcel Identification :Number Qup - /zgl~t
LEG,U, DF,SCRIPTION -
Property L.ocatiot ( /t
~~-j - 1 '/.r; see - > T 1. N It &W, Town of k~lctt-
Subdivision
Lot #
Certified Survey Map # -
- - Volume Page #
Warrauty lleed H ,/1 - - -
- - (f.~ - - - , Volume - - Page #
_
Spec house _ es no 1-ot line,: identifrnhl `ye. no - -
SYSTF.114 VL4INTE.YAICE AND OW VER ChRTIFICATION
linpruper use and nutintenance of your sepiti: systeha could result in its premaiurn tellurc to handle wastes. ]+ropcr
'he sv uau:c consists of puny.»nk. out the septi:: tank every Uhnee yaars nr somrrr, rf needed, by a licensed ptmyhe[ What yon not urtv
the system cart affect the function ofthe septic tank as a treatment stage in the waste disposai system. Owner rnauitenancc
aasporisibililics are s]>rcifird in §Cottmh. 83.i2(l) and n: Cl:aprer 12- tit (:u+ix Cunnty Sanitary ( fnhuance.
fhe owner
lum agrees to submit to St Croix C:omna ]'lanuahg rX, Zoning llep ttVrtcul a i:er ificatiou lou
owner and by a mastsyplumber; iuurneyttuvh plumber, restricted plun!Ijer ur a licrusea pumper verifying thou f f) the. on-hit':
less st than lihim U:i full of disposal slsyudge, stem is ill proper operating ,,nl(itnm and/or (l,) after inspection and 1tonPin!; (ifnecessahy), tt srgt.rri by thr
r'she septic tarrlt is
llwe., the uurlrrsigncd have read the above requir in ne, and agrrcn io r wielaur the private se.wagc disposal system with ti,
standards set torrh, herein, as set trv the
Cc iti fication sra tmfi that yo or sep 6r. syr~estemphas arrtrrenbeetnm oI aC inommeh ce arul the The artmmrant
P o fiatrrza! Resources, Stute of Wiscousirr.
tained most he cornp;etedd f tettnncd to the St. Cmix Couub; ,on,it Planning A,
/.tnting Department within 31) days of the thrix year expiration dare
.
I/we certify that all sWralientc on this torn a-c litre to the (•cst of mytoiu knowledge. Uwe an/ate the owner(,) of tie
property described above, by virhte of a war ty deed recorded lit Register of Dceds Off ice.
Number of bedrooms
/TUNA'1'I) OF APYLICII JT S)
UA'i-F.
"'Any information that is misrepreseutexl rt ay rasul! in the samtary permit being revoked by ibe Maiming & "Zoning Department
Include with this appheadon a recorded warranty deed ]tom the 12 gister of Deeds Office and a copy of the certified Survey map if
roterence is tnadc in the wart anrv deed.
(RM 11S/O5)
/0
U 2.12 acres -
92,174 sq. ft.
z
Z L.B.O. 975.0 N.W.E.=973.Q
S
0 0
rn o
S89"56'27'w 521.07'
N
220.00' 301.07
20
19 Q ~
>'99 acres 0
/
1.94 acres 1V o 17:
CIt
q" ft. 0 84,451 sq. ft. a 1.67 acres 1.82 ocres
u f
72, 898 sq. ft. 79, 363 sq. ft.
I....... u / yy
U
.
_ l /
--C14 ~ X1801. ry
N7T I}4 j W
196 40' i'
04 ] ,
C17 A 286.12• 300.53'
- 379'12Or G73 586'40'24 W
58.43'! 286.12' -
17~j CiB N86'40'24"E 300.53'
~6~' • -113T7 J 187.36 ;o
O \
o FI
N i:l
Q
- •_I M - J I
Q
.n
t
i '
ill I - - l~.'I'
ca 4-
f
~I.
,
r, I{!„ ~ OFF ~ ~ ~
• i
I
1
t i
SO
0
l~
' Misconsin Depalbnent of Commerce SOIL EVALUATION REPORT pag . j-_ f _Y
Division of Safety and Buildings
Li accordance w!Ih Comm 85, Kris, Adm. Code 1 - C - - RU
l
Attach complete site plan on paper not less than 8 tit x 11 incnbe Iiyf" County st
y{,yr
include, but not limited to: vertical and horizontal reference Poin! (Bid), dlredirtn pyG,y I D O ~.7 - _
percent slope, scale or dimensions, north arrow, and location anal distance to nearest road.
Please print all information. Reviewedgyy~.; Date /
Personal information you prov,Ce may be usud for sucundary p.xpuses (Pr:aacy _ax. s. t AA (mQ;. (Glivv, 1 1 (J
Property Owner Propeliy Locali n
~ 1k 21145E 1i4 Sag Tau N H Lior
Gercd , SM y
Property Owner's Mailing Addr~ ! e! A Blc:k k i Subd Name or CSGUf
III 10c) 90 e• NW ~ Plat o F Rich nv& A«<s i
C.ly Stale Zip Code Phuno Number L] Cay ❑ `Adlage ® Town Nearost Roac
F-1K Rr,/eR I ~1Ni $5330 1 (7rellYI-8888 R;CAN111 nlc~ 13 `I T,
i)4 New Construction Use: 7Lg Residential lNumber of bedrooms Cod tlenved design Pov: aatc GG
~JD
❑ Huplacemonl ❑ Public or commurlau' - Describe:
Q G r
Parent material (7 u~y~C~ .S . I yN-) t K Flood Plain e!evaeon if d{>phcabfe
General xmmonls + VS S't e/'TrGrL~1 L~ 1 1'D v' C!u -",-t . S-
5e
and recommendations 5
: ;
T. t (104.11') T.30C)3.o..;?') T,S(rol•93') T 7 ~loo.b9
"103.6 4>') ---:4 t lox,y7') l ' i _ IO,~lo1.31')T e Cloo.ol,,Donny r V~- 1 b I ~f
Boring k Q~
pit Ground surlace elev. j (I, Depth to limiting factor -n_ in
' So.l Application Rave
Honzcn Depth Dominant Ccbr Hedox Description Texture Structure Consistence BoundaryRoots GFDiff
in. Mu, ell Ou. Sz. Coe!. Color Gr. Sz. Sh. - 'ENk1 'Effk2
is _
l f 1
'
Boling k E] Bcnng p C~ C
/ I l O,~ O_ I(J
u pit Ground surface elev. ft. Depth to limiting factor in
Soil A IicaL^n Hale
Horizon Depth Dominant Color Redox Descnpton Texture SLructufu cunslstonce 6oundary Hoots F
in. Munsell Cu. Sz. Coll. Color Gr Sr. Sh 'Eflk1 E&2
✓ Ic
II
C L I
Effluent k1 = DOD > 30 < 220 mVL and TSS >30 < 150 mg+L ' Effluent 02 = BOD < 30 rn A and fSS < 30 mqL
'T Nano (Please P - Signalur Q --CST Nvm!x
1 a.rlG . %t-nrl o5joZ.1 ? N
-Add( G s Dale Evaluation Conduced Telephonb Number
ar ,r;~ wz ; 715 x48 3588
a
`Property Ovrner Gerfxlt6 SY>1 Ak Parcul IDp
I Bating K ❑ Boring -
I pit Ground surface oleo. l b ~-9 D tt. Depl!r to limiting factor in.
Sod n ficatica Rasa
Roots . GpDitf - -
Honzon Depth Dominant Color Redox Description Texture SUVC!vre Ccnsisten^e Boundary
in Mori Oil Sz. Cent Color Gr. Sz. Sn. _ 'EH71 _ 'Efiq'1.
II ° f- S
Soong # El Boring
l -L t'JLh
pit Ground surface cloy fl Cepth to limiting Iaec( in.
Suil ACOI ;.,Lon Rate
Honzor: Depth Dua inapt Color Redox Ooscnpf.un Textclc SUUC:ure Cunsistenca Bot.ndary Ruuts
in. Munscp Ou. Sz. Cocl. Color Gr. Sz. Sn. 0F.'Ci4t '61Ir,2-_-I
~ ❑ Bering Bonng If Ground surface cloy. It. Depul to limiting factor in
❑ pit Rate
[titiozon Depth Dominant Color Rodox Des;~ipilon Texture Structure Consistence Boundary Roots GPDtff
In. Munsell Ou. Sz. Coat Color Gr. Sz. Sh. 'E!`ri' FH;ii
-
E'!lueut Pri = SOD, > 30 < 220 nuyl. and TSS >30 < 150 Elfluenl it2 = SOD, c 30 nugfL and TSS < 33 Irg1
The Deparhnent of Commerce is an equal opp ortuaay service p:uvidcr and employer. II' you coed assistance to access services or
need material in an alternate format, please contact the department a: 605.266-3151 or TI Y 605-264.5777
Y]U U'>ix~'y1i
1 ~
Property Ovazr VerQ,l'h Sr~l-~~ Farce. IDH_ ,-4, C:~x -A
Bonng
Boring k _
L~~J" pit Grounc surface elev. ! r • It. Depot In limiting raror _ w.
_ .:::~pllca:ion Hale
tionzon Depth. Dominant Color Redox Description I -ex(ure ' Structure Cons stoncu Boundary ~ Runs GPU"`~
m. Munsell CL. Sz C= Color li Gr `z Sh. _ - 'FffY.' Ef(a<.
y
❑ Spring
9onng r ^
f r
_L ?I: Ground surta-e e,ev. ft. Geplh to I.miting facba, ir. Sc~ nl Apuu~bor Rase
ilorzon Depth Dominant Color Redox Dcscnptior Texture StrUdL'C Consislence. Bxnoa %ioots '7F-rtt
M. Munsel Ou Sz Cont. color Sz.
Ft r
Going }7 Bonn;
G .
II r0 nd SUrfaCE Cieti.
~l pit IL- Depth to Ism l,:10 factor In
l-
Soil A.p71C;:LJ~ Rate
:lor:zon Depth Dominant Color Reaux Description 7ex:u-e S:r,leture Cunsisienee Bix dary %iocrts 3n:)*
in. Muriel' Du. Sz. Cont. Color Gr. Sz. Sn 'E't%'``-flc2
Effluent #1 = BODr > 30 c 2201rr~Lr_ Pad TSS >3C < 150 mgr. ' Effluont P2 = 9DD1 30 mg.;_ anc 7 SS ` K mry't
Tnc Dcpa. lment of Commerce is an ceual opportunity service provide; and employer If you necL amstance lC access services it
need material it an altcmatc i'ormat, Please contact the depanmcn: at 608-266-?151 or 'FT"' 605'_6:-S7'7.
YJJ-01:U;n CCfj
aere) QaSe- 3 ~
Nw'/~StY,~Sec,a~373oo? P 9W
aao
5'7
Imo' 1--~ ~ ~n
`-~s 105. (,0
X01..90
40' _ - E
Do,ou
\j e- Yrk +
rv\
~ .s Qa ~D8,5`d ~ gy ,os,c,d
o ~ o ~ t
~Nra'/y SC%y sec-';q' 730K)" rJ SUD /Ot
Scc ~ e, 1 p C Sfi OZ4 ;L to
tat '
5-7 y C
tpo
f
log,44r -
~U
N
6n'1 IDO.oO V2r'~.+ 1~or+ a,
r r~ U'i gm a, 99,35' ~cr~ ~r~ N+
V-)
i J,
Qa 6y i os,~,e ~
4 a lo8•S4 ~ ~ ,
1 2 ;
f
~b ~