HomeMy WebLinkAbout040-1265-20-100 (2)
^;swnsr. Depanmerl of Commerce PRIVATE SEWAGE SYSTEM '`"'rr' Sl. CfOiX
Safety anc Bw ding Dwrswn
INSPECTION REPORT sar'tary :'er-1 NC
GENERAL INFORMATION (ATTACH 10 PERMIT) 605194
S;a:c pan D No
Pem.1ral irfwrrot on ym. orcvice pray be used ter seojneap' purposes IPrr:acy Law s :5 C4 :11: 3154460
Pu, - t Holder's Name Gly V lage To.vnsh p Parcel 'ax No*
Karyn L Bye & Calvin C Dietz III TOWN OF TROY 040-1265-20-100
CST ElY Elev I-sp. Blvt L ev. 3M Des^iption SCpLUnITOWrVRange,Map Nn
16.28.19.1434A
TANK INFORMATION ELEVATION DATA
TYPE fo:ANUFACTURER CAPACITY STATION BS HI FS ELEV
Septic s ` Benchmark
Dosing SCC> Alt 13n~
Aeration `f a ,OA D .44-0 Bldg. Sevie.1
U 47 XiJ
Ho':cing SL'Ht Inlet
SUHt Outlet
TANK SETBACK INFORMATION
TANK TO RL ELL LUG 4•n: b Ar nta-:e ROAD Dt Inlet
till Deck-
Septc / r, t, Dt Bottom
JO Z. 7
Dosing HeaderAla'i
x/ _L
Aerat on Dist. Pipe 7 v7
b$ 94.-7 1
Hold.ng Bot. Systcrr
79
t-f .
PUMPISIPHON INFORMATION Final Grade 3.6!5-06,71 ~
h:a,tulaclurer / Del S Ccvr
l„3' o.3~S GPM - g'Q .O
Adodei Number { 14 W F /
TDH L ll Friction Loss Sysle r ad TDH F
17' 01 z 4-7 1 4 zs
Force-ram I.en thl 1 Dlazr1 nat:u'.Nc'I /O✓
e -
SOIL ABSORPTION SYSTEM
BEDJRENCH Jrm:h Lerg:h No zn I DIMENSIONS No Of PUS Ins de Dia n.e Il.v;'.'n
DIhIF.NSIONS /a &0 O ` _
SETBACK SYSTEAd TO ~ PiL BLDG l'VELL LVAKE!SI REAPA LEACHING M.1%facfuler
INFORMATION CHAMBER OR
ystem' 1T.5 / r UNIT Mcdel Nv-'bw
6~J V
DISTRIBUTION SYSTEM
It-eadet Ma-irb,d Ciseibul on x H01e &~es x 110Ie SD0Crrg / In AR Zj
L Pipe;si !p `
Ler91r3 .7 Ira Le-geft J ! r Da Ze7 Spaei-3-3 •5 3 V
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only w
flep'h Over Depth Ovcr xx Ueptr b' xx Scede:f+Svldcd vx Mu cc
9ca.Trenc-.^.en!e• Jr Z$ Bed:Trench Fdges Topsef y -,~~zy~_. Nc No
COMMENTS: ,Incldde code 'I sc epencles pe•sons present etc; Inspect or a' inspection it
Location: 322 GAVDY CANCER CIR ( ~
1 ; Alt BIv1 Desc•Iptron = 5~ • ,G`°d~" 6"`~"d`
2.;1 B.--a sewer Icngll• = VJrc~ ✓L ' a j, - amount of cover = I 7 _
Plan revs on Regm'ed? Yes )<NNo'
Use other s ce for addit,onal internation. Uafc Ir'vp . "s Sigr _ Cc-
t Nu
°f"6' 13 iR 9
GOULDS PUMPS Submersible
Effluent Pump
PE
MVM.SPECIFICATIONS MOTOR FEATURES _
Pump - General: General: ■ Corrosion resistant T
• Discharge: 1'h' NPT • Single phase construction.
• Temperature: 104OF (4000 • 60 hertz ■ Cast uon body.
maxarnum, iontinuou-, whFn • 115 vnlm ■ Themrrmleslir impeller aryl
fully submerged. • Built-in thermiil overload pm cover.
• Snhds handling: temDD with automatic reset. ■ Upper sleeve and lower
maximum sphere. • Class B insulation. heavy duty ball bearing
• Automatic models include a • Uil- IW design. consimction.
APPUCATIONS float swrtclm. • High strength carbon steel ■ Motor is permanently
• Manual models available. shaft. lubricated for extended
Specially designed tor the
following uses: • Pumping range: see PE31 Motor service life.
• Mound Systems performance char, or curve. • 33 HP, 3000 RPM ■ Powered for continuous
• FBfuent6osing Systems PE31 Pump: • 12.0 Maximum amps operation.
L-A
• Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole dgn ■ All ratings are within the
working limits of the motor.
• Basement Draining • Maximum head: 25' TDH PE41 Motor
■ Quick disconnect power
• Heavy Duty PE41 Pump: • .40 HP, 3400 RPM
vy h' A~ cord.20'stardard length,
Dewatering • Maximum capacity: 60 GPM • 7.5 Maximum amps heavy duty 1613 SITw with
• Maximum head: 29' TDH • PSC design NEMA 5-15P, three prong,
PE51 Pump: PE51 Motor. 115 volt grounding plug.
• Maximum capacity 70 GPM • .50 HP, 3400 RPM ■ CnrTlete unit is heavy dirty,
• Maximum head: 31' I DH • 9.5 Maximum amps portable and compact.
• PSC design ■ Mechanical seal is carbon,
METERS FEET ceramic RUNA and stainless
4 . PE41, rE41, PE51 Steel.
■ Staink ss strrl fasteners.
II o ' .l_ 2 GPM
AGENCY USTINGS
- 1 _ ,T
w
S _
v f ; 0S
< 20 Tested to UL 778 and
} C - r (SA 222108 Statdanis
By Gvadw Saod,ras Azu b=
15 - _ r I -'--F ode#11B 9
0
~ - - - - - I camsholps5aD9001 t
1D
H
:
D D 0 10 20 30 40 SO 1 t10 70 GPM 80
C 5 10 15 M° Goulds Pumps
CAPACRY
c~002 Co Ids wm ry ITT Industries
- ~j~<< ~`ti - HN-aolF v?o
Counts
/J!P e x Safety and Buildings Division St rro*x
/i7 9 I ~y 1 9 ZQ1a 201 W. Washinglon Ave., P.O. Box 7162 Sanitary Pctmit Number (lobe filloi in by Co.)
/
\$p~ Madison. W 53707-7162 ,f
s, 4at5/9 `
u.
tilatc Tmnsacuon Numbty
Sanitary Permit Appli~atio
In accordance with SPS 181'_II a \41s. Adm ( 2xle. snhmoxmn of this loom In the appruprialc tgove n i s lit 31544G~~
is «vpwrd In im in n,N:nninv:r suntarv ix-mul Nole Appl rcaron loons fur state-owned POWIS are suhni to Prgccl Address lit ddtc(ent than mating address)
the Ih purtiica ; t ~ale:r a,J I m«ssimi;d Ser s. Pets rml information you provide may be used for secondary'
tj ols mr;ti rla .whthv live-v I aw v U 04(I km), StaLS 6t I s
10AncfrC•r
I / Ile than Information Please Print A rmatkrn ~
PnrF, (hvnar'> M1;nne -Parcel k Joe
Karyn L Bye & Calvin C Dietz
040-1265-20-400
111.9
Prupcrty Vwne's Mailing Address Pmpcrty Location I'M
322 Gandy Dancer Circle Oot Lot
Coy, Slate Zip Codc Phone Number NE SW 5,. Section 16
Hudson WI 54016 28 Wovle One)
- - - f_ _ _ N. R 19 P. or V,
11. Type of Building (check all that apply)
I or Family DwOlim; Numberof Bedro,I `L! 73 Numiv iyon Name
1 km Glover Station 5th Add.
l -
F1 PuhbuCommcraal - Ikurih 1 se
r CSM Number ❑ \'Jlagc of
i ISta:c (hvncxl- Ih~xntx~llsc or L_ A _
X~V1 I-l7 town of Troy
Ill. Type of Permit: (Check y one box on line A. Compkte line B if applicable)
A New system Iteplaccmem System I I I-realmenutlnldmg Tank Replacement Only ® Ivv, Nfwidh:mon to Exotme System Iexplam)
replacement of mound bed
B. I Permit Renewal rl I sums Revision F i Changcol'Plumhcr ❑ permit leanslcr to New I .,J Trevino, tremor Number and Dal Issued
Refire P.xpualron Owner 430212 Aug. 11 2003
1%.'t a of will-us S stemJl'om onent/Device: (Check all that apply) i I Non Pmssurwed Iii Oaxmd 1-1 I'o~suriic;l h, Omt.... I LI At Gnxlc GI Momxt>-'_4 in ofsurlahlcwrl
❑ Mound- 24m . ofawlabk-snit
Bolding, lank :J (Iho nislersal t omlrxrcnt (explain) F I1'mlrmment Ikvrcn lexplan) - t
1 Dls wrsxVtre menl area Information: _ _ _ _ l
fh ien plow It'Ptl Delon Sort Applicahui anygpds0 Dnpasal Area Rexpriu Ill) Oislx:rsal Area posed 1) N)'ACm 6:IevaUat i• -
600 0.6 1000 104. 9 b 99.40
- - - ---m -
V I. "tank Into (ap~crq' m 'I I 1 4 of NlawhwYUrct
Gallons Gallons II... r. = c g
New TanL. lxrslmy, Tanks v V
Scpoe;r 11'Qu , lank 1200 1200 1 ser Concrete_ x -
Ik,sme Uh.ml"r 800 800 1 Wieser Concrete I
VII. Responsibility Statement- 1, the undersigned, assume responsibility for iasWllatioa of the POW 'I S show. not the attached plan. _
PlumM1cr's Name (Prim) I'Iw r S~l•n:vur PrNIPRS Numlvi Runmcsx Phone Numhn,r
M
Ct/Z 920173 1 715 07-1630
Plumk s,Nddrtss ISI . Ctrs', State, Lip Code)
N7988 920th St River Falls WI 54022
INVIII.-"Unt)l 1lcpartment 1-ne On to
Apprnccd. r e - Permil Fee D.ucI d /-Q I Signal
1111r] rn., lia,to far fh,nat I S G TO ' ~ L7 / O
IX. Condo caspns for Disapproval x l f
{ 1. ephc ark, a'flcc rr '.•.tte-; n•i 1~ / [ A 1 rt ~~p,~
dJC`1(,
ulspz- "vll r.i:>t ml be _rrIc?s' n,: i;tIa. fiL V (~Ery\.bJ rkOr~*M' ' I 1
!a per ,.tar ayenien- plan p-orioen W alwnbe:. are, 1 ti P
2. All aelbs.-.k recurs' ^ans maul uc r. aiM: k.t
r par ?ppricnbls cafe! f crd vPlr af.
xnnsn in complete Bans for the s)strm and saM.it to the coote only oa paper tart its% mar a 11 x 11 iceno in sue
SRU-t, 1'lx IR- 11!l I t
_ - - - ( scalp-1:1"=-5Q •JC~-
uC ~t1PfY r O:
rr-s P; I<
i I`ti G~``r'clG!!^c'GC ' '!!f
~ C
ICJ^r_Ot-`~
1 /
O;z
lb"
r
L
JI
L '
J i ~Ln,--
FI24"
57
j1
V,
yE?evations shoyr. are esisting ground elEVationS unlass otherai_e nc':ed.
2. install 4" observation pipes Aith approved caps. ( Z required).
Septic tank' to i.e L n i(1J gallon capacity manufactured by
Y~JI~`S~2 Gi Ciz `1^~ 'vJ/ -1BoD ZK55rL ~J-nLT
Beach mark S -8U`J
ca ware: around system to prevent, pondi^g at the uphill sine.
cu,i.,'.,:..... DIVISION Of INDUSTRY SERVICFS
I C54' N RANCH RD
HAYWARD WI 54843-E462
t D S Contact Tiroigh Relay
P http:Rdsps va yov:;aagran•siindustry-seprres
S -.~u voscorsln. q--.-
Scott Walker, Governor
Laura Gutierrez, Secretary
September 13, 201 F
C :ST I[) No. 22':8:? 4l7;% Po'.f?.S D;e:^e.t(,r
\I~IRY )O III:PPFRT ZOMN6 (ILL ICE
HOLLIS I LRS SOIL. TFSTING .l DESIGN ST CROIX COUNTY SPIA
_'849' KING ARI HURS 1101 CARNIICHALL RI)
D\NBURY WI 548:0 HUDSON \VI 54016-7708
CONDITIONAL APPROVAL - -
PLAN APPROVAl. EXPIRES: 09 112024) _ Identification Nuulbcrs
Transaction ID No. 31.54460
SITE: Site ID No. 853696
Karyn Byc Please relbr to both identification numbers,
132 <iandv Dancer Cir above. in all correspondence with the agency.
Town of"Erne
St Croix Counh~
N L.1: C. S W I 4, S16. T28N, R 19W
FOR:
Oi`iccl l'ypr. POW'IS Component Manual Regulated Objcct ID No.: 1796118
Maintenance required: Replacement system: 600 GPD Flow rate: System(si: Pressure Distribution Component Manual
- Ver. 2.0. SBD-10700-P IN.01!01. R. 10~ 11): Effluent Filter
the ,uhmirtal described above has been reviewrd lift conformance with applicable Wixonsin Administrative Code,
and \\'isconsin Statutes. The submittal has'necn CONDITIONALLY APPROVED. 'I his system is to be constructed
and located in accordance with the enclo,ed approved plans ai:d with any cnnlponent manual(s) referenced above.
T he owner, as delincd in chapter 101.01(10), Ai'isconsin Statutes. is responsible for compliance with all code
requirements.
\'u person may enrage in or work at plunibin, in the state unless licensed to do so by the Department per s.1~15.06,
A copy of the approved plans, specification: and this letter shall be on-site during conuruction and open to
inspection by aulhorii.ed reprewntatives of the Department, which may include local inspectors. All peunl >
required by the state or the local municipality shall be obtained prior to commencement of C`Q
convtruCtioni installation operation.
p-~
In granting This approval the Division of Indushy Services reserves the right to require changes or tops sho nA ' OF SAFETY conditions arise making Ihcin nccc,sarp for code
cunipliance As per state stats 101.1.'(.' nothing in thi eview' DIVISION 0
,hat rchuc the designer of the responai ility for designing a , de buildin , structure, or component.
Inqun Ic, concerning this correspondence mac be made to me at the telephone number listed below. or af~the address / f
nn rho letterhead ; LS
I he above left addressee shall provide a copy of this letter and the PO W TS management plan to the owner and air)
others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required S 2.50.00 CO~
~r I
C Ihis Amount Will Be invoiced.
When You Receive"Fha;lnvoiee,
Ldeti' r favlor Please Include a Copy With Your
\ka,tewater Specialist . Division of Industry Services Naymcnt Submittal.
115161-1-:1484 . Nion-1}i, 8:00 a.m. -.1:30 p.m, WISMAR F code: 7633
cdw in.laylora'w i. goy -
t
GeoMat OUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Apphraton
INDEX AND TITLE PAGE
Owner Info
Project lame: KARYN L BYE & CALVIN C. DIETZ III
I
Owner's;Name ___(SAME) Owner s;AddrVW 322 GANDY DANCER CIRCLE
HUDSON. WI_ 54016
Property In
Property Address: (SAME)_
Legal Dfscription: NE SW S 16 T 28 N R 19 W
TownshI Troy County. ST. CROIX
Subdivi4ion Name: GLOVER STATION 5TH ADDN.
I.ot NuMbec 73 Block Number. NA CSM#.
Parcel IJD. Number 040 - 1265 - 20 - 000
Plan Tr4insaction No.:
Index Page
Page 1 Index and title Page 9 Tank cross sections
Page 2 Data entry Page 10 Plot Plan_ _
rage 3 GeoMat mound drawings Page 11 Construction Details
Page 4 Lateral and dose tank
Page 5 Distribution media
Page 6 System maintenance specifications
Page 7 Management and contingency plan _
Page 8 Pump curve and specifications 1 f
MARY JO HUPPERT A\~t~g~ rise NumbervQPR~ _
Date'. 09103/18 - ~a l umber _ 7~
/ I)7DUS7-Ry SERVICES
4L SERVICES
5ignatu e. 7 MARY IJO
Design r Stamp: - HUPPG AV of consin AApprovalp:
D1
ivYEA F °t~ cS uesgnen e. i'••
Synwby Systems L-L.C., GeoMat Mound Componen{ M nual (Edition 1, 2017), (N. 4/17),
sSWi)FP Publication 9.6 Design of Pressure Distribution etworks for ST-SAS (01/81) and
Pre sure Distribution Component Manual Ver. 2.0 SB -10706-P (N. 01/01, R 10112)
GeoPAat Mou d Edition 1, 2017 Page 1 of 11
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
R Residential or Commercial Design ISD Requued7
400.00 Estimated Wastewater Flow (gpd)
1.50 Peaking Factor (eg. 1.5 = 150%)
600.00 Design Flow (gpd)
5.00 Site Slope
98.40 Installation Contour Line Elevation (ft)
24.00 Depth to Limiting Factor (in)
0.60 In-situ Soil Application Rate (gpdtW)
100.00. Contour I ength Available (fl)
Distribution Cell Information
9.75 Cell Width (ft) 3 25, 6 5 or 9 75 Only 60.00 Designer Input Cell Length (fq
2.00 Ihspersar Cell Design Loading Rare (gpd)ff) 6-0-700 Dispersal Cell Length Required (f0
2 Influent Wastewater Quality ( I or 2)
Pressure Distribution Information
E Center or End Manifold Are the laterals the highest point
3 Number of Laterals in the distribution
3.25 Lateral Spacing (ft) network?
24.47 Forcemain Drainback (gal) If N above. enter the elevation ft)
0.50 Forcemain Filter Loss (R) of the highest point
2.00 Forcemain Diameter (in)
150.00 Forcemain Length (f) Does the forcemarn drain back)
82.70 Inside Pump Tank Elevation (ft)
0.125 Orifice Diameter (+n) (eg 0 25)
3.50 Estimated Orifice Spacing (N) = 11 4 /orifice
6.50 System Head (ft) x 1.3
15 99 Vertical Lift (R)
1 50 Friction Loss (ft)
24.49 Total Dynamic Head (ft)
56.58 5x Void Volume (gal)
81 05 Minimum Dose Volume (gaq
21.01 System Demand igpm)
Diameter Selection
Lateral Diameter Selection Manifold Diameter Selection
m dia _ options choire in. dia- options choice
0.75 1.25 x _ x
1 00 x 1 50 x
1 25 x x 2 00
1.50 x 3.00
2 00 x
3.00 x
Manufacturer Information
Treatment Tank Information Effluent Filter Information
1200 00 Septic Tank Capaa_tY (4a1j Polylok Inc./Label Filter Manufacturer
^T Wieser Concrete Products, Inc (Manufacturer 100 8 X 26 1800 GF'D~Filter Model Number
Dose Tank Information Gallonslinch Calculator (optional)
800.00 Dose Tank Capacity (gal) Iola) Tank Capacity (gal)
22 24 Dose Tank Volume ( al/in) I dial Working Liquid Depth (in)
ieser Concrete Producs, Inc Manufacturer galiin (enter result in cell DoseTankVolume)
Project Page 2 of 16
r-
_ Mound ftn Vkw
-1
❑ J
Ob
servation Pipe A
F--j
W I
B _
❑ Z
3
L -
Mound Component Dimensions
A60NRO ft E in H 00 K 6.98 ft
B ft F in I L 73 96 ft
D in G OSOft j 413ft w 21.19ft
585.0 (ft') Dispersal Cell Area 1023.53 (ft`) Basal Area Available
10 0 (gpd/ft) Linear Loading Rate 6 00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
GeoMat Dispersal Area
Observation Pipe
1 AS N1 C , 3 sand as GeoMat
required for Geo Mat DisVibution Cell
cornpone Geo STM C-33 sand
t
100.48 Finish Grade - - Cover Material
99 48 Lateral Invert h:levation
98.40 Dispersal Cell slope 5-0
f.levation
Contour Elevation 98.40
Tilled Area
Forceniam
In situ soil
In situ soil
Shading Key
I Topsoil Cap
2 Q Subsoil Cap
3 0 ASTM C 33 sand (F)
J Q ASTM C 33 sand (D)
5 Q Tilled Layer
b Q Geo Mat
See details on page 4 for number. size. and spacing of laterals.
Project Page 3 of 16
End
0- rt"n.up wl[a rave or cimmut plug
All orifices point down G` Fir
h
P (~J
i I.=fals K force m.un of I'VC Sc8 4(
per tips Table %430.1) r 1
Number of Laterals 3 Orifice Diameter 0 125 in 1 / (
Lateral Diameter 1.25125 Orifice Spacing (X) 70 It
Lateral Length (P) 59.60 I Orifices per Lateral 17 i
Lateral End (2) 0 40 Orifice Density 1147 /onfice
Lateral Spacing (S) 3.25 It Mandold Length 50 If
O
I aleral Flow Rate 7-00 pm Manifold Diameter 1.2 -n
System Flow Rate 21-01 , pin Forcernam Velocity 2.1 - fl/sec
Dose Tank Information
:
Fm,:mm~in N:xn:Ux
2 in.
i . r n.: l I,,.n x
ip,r i1. a:• npalreq Wm (111
- 83.49
JJOSe line elerx IIII
8270
Dimension Inches Gallons Wwser Concrete Prodncis, Inc
A 2083 .4631 C2Daci 80000
S 200 44.4 Volume 22 2 galbrich
C 3.64 81 0
D 9.50 211.2 f
Total 35.97 800.
Filter Manufacturer Sim /Tech Filter
Filter Model Number STF 100 1116
Alarm Manufacturer SJE RHOMBUS
Alarm Model Number B Tank Alen
Pump Manufacturer Me rs
Pump Model Number ME 40
Pump Must Delver 21.01 pm at 24.4 TO) I
Note. Switches containing mercury may not be used in this system.
ProgecC Page 4 of 16
I
GeoMat Distribution Cell Media Layout
9.75 Cell Width (ft) 1.6"s Sidewall to Lo eral (It)
Distribution Cell Cross-section Arrangements
Q - _ G
Component Legend
Cli Distribution Pipe With Pressure Lateral l r Onfloe Shield
rumup Enclosure - - - - - Pressure Lateral
GeoMat is covered with approved geotexille ethic as per the their product eppicl 16
Distribution Cell Plan View Layout - Typical
9.75 Cell Width -A (ft) F-60-0-07 Coll Length - n (ft)
411-
Typical Dispersal Cell
' isa'Cv`~r r-..'nrn.M: Onlrl.rr rai .~._a.
RIF Gra - 1
I~ (MiMtl LprYYMi
1.' .l'l 1I1\
ICI O ~ / , IKrfnFe:Vkn Vly~ln~
Observation Pipes Shading Key
b t I Topsoil Cap
, Subsoil Cap
r"
w,e„y I ASTM C 33 sand (F)
I ASTM C 33 sand (D)
r Mn : Tilled Layer
Lear
Gen Mat
See details art page a for nurnmr, size, and spacing of laterals.
Frro r KANYN L. BYE d CALVIN C. DIETZ III Page 5 of 11
I
ound System Maintenance and Operation Specifications
Service Provider's Name ULBRICHT PUMPING Phone 715-703-8337
POWTS Regulators Name St Croix County SPIA - Zoning Office Phone 715-366.4580
System Flow and Load Parameters
Design Flow- Reek 600 gpd Maximum Influent Particle ;izeF_ 8 in
Estimated Flow -AveiIage 400 gpd Maximum 8005 30 mgl,_
Septic Tank Capacity 1200 gal Maximum FsS 30 mgrt
Soil Absorption Component ize 585 fe Maximum FOG 10 mgiL
Type of Waste ater Domestic Maximum Fecal Coliform lOE4 cfw100 ml
Service Freauenrv
Septic and Pump ank Inspect andfor service once every 3 years
Effluent filter Inspect and clean as necessary at least once every 3 years
Pump and Con rots Test once eve 3 ears
Alarm Should test periodically
Pre55L11 U System Laterals should be flushed and pressure tested eve 3 ears
Mriond Inspect for pending and seepage once every 3 years
Miscellaneous Construction and Materials Standards
I Ubservaiiu I pipes are sl tted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as
shown in the Synergy Sy terns GeoMat Mound Component Manual Version 1. 2017.
2. Dispersal cell media con rms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component
Manual Version 1, 2017. Media is covered with an approved geotextile fabric.
3. All gravity and pressure (ping materials conform to the requirements in SPS 364. Wis. Adm. Code.
4 Tillage of the basal area s accomplished with a mold board or chisel plow.
'1 he mound structure an other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost
penetration.
Lateral Tum-up Detail
Diameter Finished T Threaded Clednout
Lawn Sprinkler Grade \ Plug or Ball Valve
Pnx \y
:.atcral Endsat LastorifieWhere -
.,ruble Length Cleanou Begins
Long Sweep 90 or Two 4S
`Degree Bends Same
Diameter as Lateral
Dui:;ribufion L:a eral Lateral Cleanout
1.3 Feet
Project K,-.R r ^1 L. F' F & CALVIN C- DIETZ III Page 6 of 11
Mound System Management Plan
Pursuant to SIPS 383.54, Wis. Adm. Code
Gorging
This system shag be operated in accordance with SPS 382-84 Ws. Adm. Code, and shall maintained in accordance with its component
manuals [Synergy Systems L..C., Geomat Mound Component Manual version 1, 2017, Pressure Distribution Component Manual Ver. 2.0
SBD-10706 P (N. 01101) and SWMP Publication 9 6 (01(81)) and local or state rules pertaining to system maintenance and maintenance
reporting
Septic and pump tank aba donment shag be in accordance with SPS 383.33, Wis- Adm. Code when the tanks are ro longer
used as POWTS components
Septic or pump tank man le risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assassin ~nl shall be sealed watertight upon the completion of service. Any opening deemed unsound, detective, or
subject to failure must be repL iced. Exposed access openings greater than 8-inches in diameter shall be secwcd by an effective locking
device to prevent accidental unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be aintained by an individual certified to service septic tanks under s. 281.48. Slats. The contents of the septic tank
shall be disposed of in accor nce with NR 113. Wis. Adm. Code. The operating condition of the septic tank and outlet filer shall be assessed
at least once every 3 years b inspection.
The outlet flier shall be eared as necessary to ensue proper operation, The filer cartridge should not be removed unless provisions
are made to retain solids in th tank that may slough off the filter when removed from its enclosure, II the filer is equipped with an alarm, the
fitter shad be serviced if the alarm is activated continuously. Intamitent filter alarms may indicate surge flows or an impending continuous
alarm
The septic tank shall hay its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the to k are not removed at the time of a trlenrral assessment, maintenance personnel shall advise the owner as to
when the next service needs o be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required, However, if such products
are used they shall be appro d for septic tank use by the Wisconsin Department of Commerce.
Pump Tank
The dosing (pump) tank at be inspected at least once every 3 years. All awtches, alarms, and Iwmps shall be tested to verily proper
operation- If an effluent filter installed within the tank it shag ber inspected and serviced as necessary. If the force man has a weep hole, it 15 should be noted if it is
functi or during pump operation, and if not. it should be cleaned.
411"No one should ever erd r a septic or dose tank since dangerous gases may be present that could cause death.""
Mound and Pressure Distribution System
No trees or shrubs should planted on the mound. Plantings may be made around the mound's perimeter, and the mound shag be
seeded and mulched as nece ary to prevent emston and to provide some protection from frost penetration, Traffic (other than for vegetative
maintenance) on the mood i not recommended since soil compactor may hinder aeration of the infiltrative surface within the mound and
snow compaction in the wine will promote host penetration. Cold weather installations (October February) dictate that the mound be heavily
mulched as protection from .ezing.
Influent quality into them nd system may not exceed 220 rnglL BOD.,, 150 mg/L TSS, and 30 mtl'L FOG for septic tank effluent or 30
mgll BOD;, 30 mgfl TSS, 1 mg/L FOG, and 104 efu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution ystem is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solid at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the
system was installed to deter ine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the
dispersal cell.
Observation pipes within a dispersal cell shall be checked for effluent pending. Ponding levels shag be reported to the owner, and any
levels above 4 inches consid red as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of @s components become defective the tank or comporwn shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, ump controls. alarm or related wing becomes defective the defective component(s) shag be immediately
repaired or replaced with a c mponem of the same or equal performance.
If the mound component f its to accept wastewater or begin to discharge wastewater to the ground surface, l will be repaired or replaced
in its' present location by incr acing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and
related piping, and replacing id components as deemed necessary to bring the system into proper operating condition.
See Page 6 of this plan fo the name and telephone number of your local POWTS regulator and service provider.
Project. KARYN L. BYE & CALVIN C. DIETZ III Page 7 of 11
I
s
ME40 Series
4/10 P Effluent
and rain Water Pumps
Perf rmance Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
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CAPACITY GALLONS PER MINUTE
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7107 Myers Parkway, Ashland, Ohio 44606-1923
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K3326 7191 Printed in U.S.A.
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SEPTIC MANUAL E JAN =)u W zmo wtE. -gout
E~ CHC~E~E LFXLE- in
\ z wins US Hwr 10 MAIDEN Roof. w Sg50
° REVISED JAN. 2010 800-325-8456
- - - - PLOT PLAN
.pace !D
S~ c t
' Scale
'7.5 a
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Elevations shown are existing ground elevations unless otherwise noted.
Install 4" observation pipes with approved caps. ( Z required).
Septic tank to be %xLp_Q/Soo gallon capacity manufactured by
W\~_S~\Z C Ctt.~ W/ A-1$~0 Z•'PB~? r-~~T'LS?_
Bench mark SSE U
Divert surfAce water around system to prevent ponding at the uphill side.
I
I ,
Construction Details
KARYN L. BYE & CALVIN C. DIETZ II
322 GANDY DANCER CIRCLE, HJ')SON, WI
040 -1265-20-100
The aggregate and piping will be removed carefully along with 4 inches of the sand.
The contaminated aterial will be disposed of properly. The bottom of the clogging mat appears to be
/
It just below the aggregate.
The County Zoning Specialist will complete an on-site visit during the removal and to inspect the ASTM
C33 sand before sand is replaced.
Eight inches of ne~ sand to a total of 12 inches minimum will be placed on the site. Replacement
irnateriah will he in ccordance to the Wis. Adm. Code SPS 383 along with this plan approval.
I
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNFRSI 11P CERTIFICATION FORM
Ownerr''Buver Karen Bye & Calvin Dietz
Mailing Address 322 Gandy Dancer Circle
Property Address 322 Gandy Dancer Circle
(Verification required from Planning & Zoning Department for new consmuction.)
City/State Hudson Wi 54016 parcel Identification Number 041-1265-20-100
LEGAL DESCRIPTION
SW 16
Property Location NE ,/1 . -
'A Sec. - - . 128 N R 19 W, Town of Troy
Subdivision Plat:Glover Station 5th Add. Lot # 73
CertificA Survey Map N , Volume-, - Page 4
Warranty Deed # V 2021 P (before 2007)Volume 2021 • Page #243
Spec Imuse I7yes0ho Lot lines identifiable ❑ycs❑no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed. by a licensed pumper. A'hal you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities arc specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
the property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form. signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I ) the on-site
wastewater disposal system is in proper operating condition andor (2) afler inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe. the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County Planning & Zoning Department ithin ill days of the three year expiration date.
1: we ccrti fp that all statement on this firm are true to the best of my ntu knowledge. Uwe am`are the owner(s) of the
property described above, by virtue of warranty deed recorded in Register of IhtJs Uflice.
Number of bedrooms 4 f
0c,1UC
SIGNATI OF PI, (ANT(S) DATE
•Anv information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register ot'Decds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 041 12)
R19W, TOWN OF TROY, ST. CR
I 68
I -
l 69
I
I
70
Q,I 66
71 Hudsor
\ School Dlss
I ,
„ E 525.99 \
7 - 335.99,
72
-li g0~ 2.652 ACRES \ \ \
cr _ 115.513 S.F.
S' S~• \
h ` `1S'\ \00•,
ro I N 7343 , 20„ W ~o \ GB 43 \ /
t
n Z
Ki 1 i 81 c !s pp \
_ O•
i I ? Z j.~ 96 \
1 _ Sp' 'm, ti OO `S1'
N 74 = 73 '921
2.762 ACRES
2.516 ACRES%
~ LP 120.325 S.F.
?so,. \109,602 S.F. 1 fG~ W
\ / iv n
yq fNENT y i C~
o
• ~ ~'Sqo ~ $ SE'f~p fTpRIVOR ry~
AY 1sp• ~M 0 75,
I
79
3.065 ACRES I
So r, n •tik Q~ 133,498 SF.
k6Q'~rd 6°j NORTH LINE OF
of HE SE / f'W ~F~
a 7 6 GQ'~, 190 THE SW 1 /4
=80' ' 15
112,126 S.F.
1 J~ ~•'1 c
YaL 1552ma 403
LAND TRANSFER FROM LOT 73 TO LOT 74
PLAT OF GLOVER STATION FIFTH ADDITION
TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN.
~P/oj
r
NW CORNER 72Wo C! 4~S
OF LOT 73
POINT OF' s 79'iry20„ -
BEGINt" 4 se•~
z ~ w L
V_ ~ 7 H 3
N ,
O O~ O
Y
f 0
Y
74 73
V
y Fl " 2.527 ACRES /
2.751
ACRES
119,854 110,073 S.F.
S.F. REMAINING
AFTER TRANSFER AFTER TRANSFER <
Q~
C;
P~
75 y O
~O
GP
R=80' / o
ww0
W W f
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LEGEND w Q
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c 1" x 24•• IRON PIPE WEIGHM Nr4
1.68}'/LINEAR F007, SET. <z
20Jo
• 1 • • RON PPE, FOUND. a y~
Li
Mrw
~,(MWNNNpn
IXHIBR SCALE IN FEET
~`ScoAt Nry
JAMES D. l 0 50 100 200
FILKINS
Si: J6 ALL-STATE- WMRMTIDNAL
R ER FALLS.
vii
OGDEN ENGINEERING CO.
SUF.'?,'° Z3 ' y DATE: 8-22-00
Ci il
Engineers & Land Surve ors
113 W. WOL.t SL, River Fag, WI 54022 99-2380
(715) 425-7631 -
U/ / ( r7 SKEET 2 OF 2
R19W, TOWN OF TROY, ST. CR
68
I I /
l 69 / ,
Aj
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66
Hudso
7~ ~ 1
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I E g25.999P~
N 79°35' 56 33 \ , \
I 9'1 I 7 2 \ \ \
50 - 2.652 ACRE
p \ \
S \
~ 115.51 3 S.F.
o
79*
50
O 6 4
Z N 343.8270 W n ~S~• BPo 3
' `o Ir7 3 r, ~y o ti
74, ry
~ 2.762 ACRES
2.516 ACRES 'u 1 120.325 S.F. f ,~h 4
?s \109.602 S.F. ,n G ~v
POR
/s Sf ORiV Gay 'JJ G~^~ DSO o
CTAd j WAY
II / / z
i 'f \ 1h x?. c°v C~G~ 3.065 ACRES I
O) y.. ~1
~ o s`ti k QP, 133,498 SF. i
NORTH lW OF
6 GQ 906 THE SW 1/4
2.574 ACRES 15~2c, °~k
ST. CROIX COUNTY ZONING OFFICE.
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that 1 have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address)322 candy Dancer Circle located
at: NE SW Section 76 Town 28 _ N, Range 19 W,
Town of Troy St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will confirm to the requirements ol'SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service 8/302018
Did flow back occur from absorption system? Yes _ Nox
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: 1200
Construction: Prefab Concrete x Steel Other
Manufacturer (if known): Weser Concrete
Age of Tank (if known): 2003
Permit number (if known) 430212
Darrell Hubbell
(Licensed Plumber Signature) (Print Name)
Boss 221073
(Title) (License Number) MP/MPRS
09/192018
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
Wisconsin Depadment of Commeres PRIVATE SEWAGE SYSTEM Covdy. St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary PemitNo: 430212 0
GENERAL INFORMATION (ATTACH TO PERMIT)
tale Plal 1D No.
Personal inlandlion you frovWe noy be used for sop)rWary purposas tPmaoy Lew, 5.15.04 (t von)). Z = -r-ws.
Permit Folder's Nanw_ City Villele X IovrtnhiD Parrnl Tax Vo:
Dietz, Calvin Troy Township 040-1265-20-100
CST BM Elev Insp. SM Elm'. BM Desrn~°A Sodionfl` wt Ruri9e~Map No,
d d Yn / -d-^ 16.28 19.1434
TANK INFORMATION EL ION DATA
TYPE MANUFACTURER CAPACITY STATION BS Hl FS ELEV.
Septic Benchmark
h L- I uo 8at1 y. 0 D o
Dosing t l Alt. BM
Aeration Bldg. Sewer (A,) .,301
Holde•g SVHt Inlet l(A) • 2.0
TANK SETBACK INFORMATION SIMI Outlet J Tv
TANK TO P!L WELL HL. no, Vent to Air lntako ROAD Dt Inlet
Septic ~ Dt Bottom 5D + 16. 0 Ld.`j0 g'2
Dosing I 1 f Header/Man. 3.1Q 1
1010.22
Aeration _ Dist. Pipe !A/ \ 3.`(m IUD - 2'.O 1
l 2
Folding % Bet. System d r
T4•H t_ro
/2 {
PUMP/SIPHON INFORMATION Final Grad ~ k.x
iise
Jq co-'r I"'
Manufacturer Demand St Cover A r
0 13' .03
Vdl ~t.S p4-~ cPM •100
\,k odel Number
9 Lift Friction Loss System Head TDH l F,
Foroemain Len At •Dia. II Dxt to wdl h
SOIL ABSORPTION SYSTEM ]C
telles W Wtn 1 Length / No. Of %welba PIT DI1.1ENSIONS No. a Pr's Inside Diu Liquid h
NSIONS 'O 0 b
SETBACK SYSTEM T BLDG WELL LAKEISTREAM LEAC G urar
INFORMATION CHAMSE
TYOa Of Sys-am: ~ r Model Nuntw
DISTRIB TION SYSTEM r^^ l_ e -te 1♦teeD ' nilul it Distnnmion r -1 q x 110103142 H
r x ole Sfgw nu Vent to
Alr Intake
rivets) U 1 p r q
LonOth_-____ , Dha Z. Lengln •5a w I• Spouh.p~ p
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
uepth Over Depth Over 'L' xx Depth of xx SeedaLSocded xx Muldted
nedRnnrh fxhJe BedRmhwh rdyus Tomil
Yria I,.I No Yes NO
Inspection #2: z
COMMENTS: (include code discrepencles, persons present, eta) Inspection #1: r-10
t 73 Parcel No: 1628. .14
Location: 322 Gandy Dancer Circle Fr1ur`tc-on. WI 54016 (NE 1/4 SW 114 16 T28N R19W) GI At'
f V L
i.)All BM Descnplian 5:'r .,nnn.Wr•- QYt.(A..a
2.) Bldg sewer length - 3 1 4) W±~' ~ ak./ ~gt~Ye dL~Q,
- amount of cover = ) ~A* f% ILL
Plan revision Required? Yes K
No it Use doer side for additional information. /I_ ! v
Date Insa Can
SE1D8710 (R 3197) tor's Si mr . No.
-9L 1552►IGE 401
AFFIDAVIT
STATE OF WISCONSIN )
) ss.
COUNTY OF ST. CROIX )
C. M. Bye and Dennis R. Schultz, being first duly sworn, on oath deposes and says
that:
1. They are the owners of lot 73, I.D. M 040-1265-20-000 and lot 74, I.D. M 040-
1265.30-000 being part of Glover Statiou, fifth addition, iocated in St. Croix
County, Wisconsin recorded in volume 7, page 94 of plats as document N
624447 in the St. Croix County Register of Deeds office.
2. Lot 74 has added to it a parcel described in attached Exhibit A and shown on
the map attached Exhibit B and lot 73 has deleted from it the same described
parcel as shown in Exhibits A and B. After transfer of said described parcel,
lot 74 now contains 2.751 acres and lot 73 contains 2.527 acres.
3. Henceforth, the above described parcel shall be included with and be part of
lot 74 and be excluded from lot 73.
4. The addition is a transfer exempt front Chapter 18 of the St. Croix County
Land Use Regulations, pursuant to section 18.05 (A)(3).
5. The purpose of this affidavit is to notify the public of the addition and
deletion of the resulting parcels.
C. M. Bye' - -
Q~-a-~ -
Dennis R. Schultz
Sscribed and sworn to before me
day of 0%fr}</, 2000
Q p~ Document Drafted BY:
C. M. Bye
10
r
g~
Notary Public
di O~••. ; ~ounty, Wisconsin
O'73 M61 mmission expires 08/03/03
701. 1552w 402
OGDEN ENGINEERING CO.
Civil Engineering and Land .Surveying
113 WEST WALNUT STREET
RIVER FALLS, WISCONSIN 54022 FRANCIS H. OGDEN. P.E.
TELEPHONE g FAX: (775) 425-7637 JAMES D. FILKINS. P.E.
JOB NO. 99-2380
Client: C. M. Bye and Dennis Schultz
P.O. Box 167
River Falls, Wisconsin 54022
! DESCRIPTION OF PART OF LOT 73 TO BE ADDED TO LOT 74, PLAT OF
GLOVER STATION FIFTH .ADDITION, TOWN OF TROY, ST. CROIX COUNTY,
WISCONSIN
Pail of Lot 73, Plat of Glover Station Fifth Addition, Town of Troy, St. Croix County,
Wisconsin described as follows: Beginning at the Northwest corner of said Lot 73; thence
579°10'20"E (Beanngs referenced to the Plat of Glover Station Fifth Addition) 96.47' along the
North line of said Lot 73, thence S 10'49'40"W 212.54', thence N 13°35' 10"W 233.41' along
the West line of said Lot 73, also beinc the East line of Lot 74 of said Plat to the point of
beeinninu.
This parcel contains 0235 acres, more or less, being 10,252 square feet, more or less. Subject
to easements of record.
This description and map are intended to add one parcel to another resulting in a single parcel,
and is exempt from local subdivision regulations per Section 236.45(2)(1)3 Wisconsin Statutes.
I certify that this description and accoinhanvine clap are coiTecl to the best of my knowledge
and belief.
-
Date: August 22, 2000
ames D. Filkins S-2246
+`~ttw7~'mnnimi.,
\a.~e gG0At,~
JAMES D.
FILKINS '
&2248
RNER FALLS,
WI
EXHIBIT
Sheet 1 of 2
AUSTATPMFPMATICD A
i
VUL 1552PAu 403
LAND TRANSFER FROM LOT 73 TO LOT 74
FLAT OF GLOVER STATION FIFTH ADDITION
TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN.
-NW CORNER 72
OF LOT 73
POINT OF- 5 9'10.20»
BEGINNING .4 '
4 ~ t VI
uTry 3
N
O OnYfr
_ tl r
A 73
N N
74
w " 2.527 ACRES /
2.751 ACRES ' g 110.073 S.F.
119,854 S.F. REMAINNG !v
AFTER TRANSFER AFTER TRANSFER
G~V
JJ *
`n `jJ•
V`
~G
P
75 V>
Q~
0
R=80' / Z
oon
w:g
u>a
KUU
0a
LEGEND mot
0 1" x 24" RON PIPE WFK'.l NG vla~~
1.68r/LINEAR FOOT, SET. 2-10
it
• 1" RON WE. FOUND. w=a
mf N
Ua„R~In~Nry SCALE IN FEET
,ao`SGpNS~o„ EXHt61T
o so 100 200
JAMES D.
FILKINS
$ = ALLSTATV 0MRMT10NAL
FINE^rr1
otir0 SUf j " OGDEN ENGINEERING CO. DATE: 8-22 00
iiryy`L Civil Engineers & Lwd Surveyors
113 W Wa t SL, A..., FA. vn 54022 99-2380
(715) 425-7631 SHEET 2 OF 2