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HomeMy WebLinkAbout030-1026-20-000 Vuisconsm Depall°e,n rf ^-erre PRIVATE SEWAGE SYSTEM S,110ya•rdB...cingI:vsu- St. Croix INSPECTION REPORT Savtorr Perm: No GENERAL INFORMATION (ATTACH TO PERMIl 606906 Pcl3 state Plan it; No. C 9a nt^'r Otic" you p'Jwtlr_ "'ay De U3ed lCf SP.COndary pLrpOSeE. ~ WI':aC'j Ld:: 5 ' i d4 1 J: 3162164 permit Heidi S'da-e Cly V'.laga TorvnShlp Palxl lax No. Gary & Anne Hoinze TOWN OF SAINT JOSEPH 030-1026-20-000 CST 51,1 I_ nF Eler DM Dewip:ion Serhp =rvm'Ran?e+61ao No. lV r r~ 06.29.19.104C TANK INFORMATION 1• ELEVATION DATA TYPE N4ANUrACIURER CAPACITY STATION RS lit FS ELEV. Soon-Berichma,lk Dosing ~J`n~pp v,_l 4 / ~J All. BIx1 r. ~K-CA ! p j. A e~ 1; f` I of 11 Bldg. Sewer 164--7 Hocing SUHI In'et TANK SETBACK INFORMATION S!1 II O,ltlet ` I ANK TO P;~ WELL BLDG. rerl A, Ir' ake ROAD Dt Inlet Septic /g DC Bottom / 7 ioa y voe 1 5 Dosirg /a6/ -7 100 Heado,+Nlan 5 7 92 Y Aeration D st. Pic v I S,7 9z.9 Holding Bct. System PUMP/SIPHON INFORMATION Fh a Grade .14 1 P.IanL'acturer r f Demand St Cover Opt, 14,44 faludel Na•rher 7G'J~ IDH LiRT_ Friction Loss Syst H { TDH FI p Jx Q s.q GIZ.7 F^.rcemain LCr.g:~~ ~Dia.~l Dat lu e',nl lob / SOIL ABSORPTION SYSTEM 6 T BEUTRENCH "Vitir Lengtr No O' re ruhe PITDIMENSIONS Nc 01PIS h15ice Dia Iq..~tl[br_I- DIMENSIONS 7:r SETBACK SYSTEll P,.L BLDG V.F_LL LAKE:STREA61 LEACHING !danuladure'. INFORMATION CHAMBER OR T'i Pe 'Jt,,`~'~s em / ~ l a~ >16 v4 A- UNIT f0 Je' Nimbe,' DISTRIBUTIONSllY1ISTEM 1•Icoour rviamfcL DiS 1711-7r x rln. (.~Y !I r'pe:c( 1f eS¢e_ y/ xlc'e Soa f Vur~prlr• 4.a Lcnytr' ! Ura_ len9.1. -74 UW Spacin5 SOIL COVER x Pressure Systems only xx Mound Or At-Grade Systems Only Drph Over Depth Cv!•r !:x Dcp-h n' xx Seecpc loaded xx Pdulehetl -ec; Trem:- Can:c' f He11 lrcnCh Fjges 1 7, :5,111 t C4-. ~ 'yes N> ?5 'Nn COMMENTS: QrClude code disc,caccaes, pe,sons present. etc ; Irspect on a ; C ~~6 Inspection 42. `4,~b OWN Location: 1130 37TH ST G(~,a , l I.: Alt BM Descnpt or = 1 0~415IJ<A.. Z5 `yd-,~ 2 j Bldg sewer length = 70 I~ 'IAw C0 n dw - amourt of cover = an +l {0'7 p, `FL s.. SCaL .eVOL .09 ✓ Plar revision RepureV Yes No 't I ' c~ Use other side for additional ❑dormation. ` I zD j~ _ lp Oate/~/~ Inse Ir.-I r.o 9^rK Safety and on Ave., C). Bor. 201 L"u , :^tassington Ave., Box 715e l t •I me r rcrmn Nwnba tm be liCcd r by f'a, 10 d V, 5 7-V R !SO t s:~r Ta esinn mbc - Sant n Permit Apphez tion t !r ac.rn[4S u1 PS 1Ht t, r w n. Tarr l ud< \Ublra.,sl r t t Is tt: PPtoYn.rt o. ~nm<o d urf I` O -1-~ _I l u rcau n:d' ~nr t yl(tµrunq.e - mtrt V. x t ~~<t rvm, r to -,u-kd P W 1 u . uacou.,. ;n F;.~ e .h ll9*tvr+i+aL~.r xd 't~ftt~i-:;3. tirvle my s:tl .1Mm.r:iun _ to }rl vi:k mar br osc fx sr ~rdary I ess [ :ti:lerrnt ~uu 2ai;inC a:idrtts': ~_Ju+tt!'<"F a onlanec w.th Nc Yncw Iau 15 .41 s,x 444/36 4,L I "LPP icanou In(ormanon P se Print til Infonua n - - - p nV V Pw cd~ arc.- Q3>1o< b--a Property Owneri Maim dl n> -I ,yc;ty L,zauen (~1~1 Lot TLrF t--,:c !'Corn )`u¢bcr LA,/ Pp, r Building (ebeck all [bar applvj ( p - ---If7 _ J- P / , tr +j~.1~'rm;,IV [rudliu_ ♦nnbcr o•4c "II _ :voolr; $aatlt\•utnn t.alnc. //fir . ~ P bft~ C,m•ner I J - U'_cr he . c;. I~~.r~u^^ ~ - ' 11 • J I~ Staz Ouacd - D1n ,h ;,xc C ti Xun:FFr une of K 75 Tnf.Q 5 _ ~ll Type of Permit: (C Complete line R if applica_ble_! J - n r~( .-~t`r<u'lYal<xl Fgo.'YCKCt $VYtin LI IrcJQnttCi_.I\,.n T. yk i.C(alS.nt ihriV Ud= M:rd:5cm00 n.:;x* $ !~-lt Aug ytam lexP::rq~ R i J i'arnlt l\Cl caul I - nut amsren-- r G- ,va °rtr~ i l I ~p,l it Iv.^,5let ii \cN List Y2+'rOUS Perfan VOmlx-,ri Da 'SSOtd Rc4'.r F~pn con R 7.\pe of POw T`, cvetem.f ouQmrenLDe\ice: (t beck all tiv_t ~lt'i ~ ~ j~-~r 1i fKU,lr`C L- ."J'Id I }Tl.:c,;r1Z.d 11 iOLL9v♦ I liA. di Lt fswtaUle'til ICAound ,.Sin ofnntaMc I loAvn^ l r{ L UL ns7xisa14•n4n I nl nPlamY bRC+nnn'mDc I c (crcnhw) V Dispersal-rrrat `nr 1r ea Io(ormaunn Lkgen!-I r.~~ni tPpmar<tvtr ~Uzpc:.:11 _:ca Fc uirr~i' Uup.. grta ',P: n Flevacwo/ ~7. 'l'ank Info Cz a'rt1m _ ' : +II'n> I Told n cf I A!nnof :u:er t ~ --r'- i-nl. nL'nIC: Feu aau 1 4trw WI6m T.uk ^JL , L J - r yTl ResNonsrlnbrn Statement- r - - II-.. for nndcmt:nrd_xvum pon.ih 6n fo' iu'blfanou of rh<P(lp 7\ shovel: nu rIN xttxched plans k~i s?::line iPril p i Ylua r - n:rr \ !rtYFS Vt wt+n k~sWcs- Y~ me Cimnbc 1 labs 5 Aott~xi 31 ttv7h artment L w Unty ppurvrd IJ(ry• ~r'¢n 4c r1A. Lr _.--.I L\mul n .iylmrm LX. Condiri nos for Drsapprmal 1. .hrk.elfi n:like- m-I [,tfv~N.~":gn5 .+/k. ~pl.~y~~aJGaSL L-Gy.Q.I, ntspe+: ; erll aI' be Ir S'_ rat t'-( is per arar 3yerrer pl , > -cM Lv plu nDer. Qfe, I NA t_ A4• ' 2. All sMback recLlw ^en s mlr,A t:, t 2,1& IY.t raper +pplcnDl~uY..;/ rd 1r ' -aL - - ♦ttacb i< c mpKr y.am to "he +?mro uA aubmir i pc Cvu~ult oo Pu nu: . rna 1.^.: ~ inches m vtt •~~l~f~~a SBD~19X iR Ilrlll I System PLC)T PLAN PROJECT Gav rlein/c ADDRj:ss 402 Windover C4. NW Vienna VA 221,80 NW 1i,t SE l13S 6 rT 29 VR 19 W TOIAN St. Joseph couN'r1' ST. CROIX Sl'STE~I EI,F1':1'1'IUN 92.3' 9!72:'18 4 D:1Th BEDROOM CONVENTIONAL A'I'-GRADE CONVENTIONAL LIFT HOLDING TANK HOUND XXX SLPTIC TANK SIZE 1205 Gallons LIFT TANK SIZE DOSE TANK SIZI: 705 HOLDING TANK SIZE LOAD RAT'F '.0 ARSORPTION AREA 600 9 or chambers none 11111, BENCHMARK V.R.P. 604tOrno` garage siding ASSUME ELEVATION lull' Filter Lifetime. Pilfer ❑BOREHOLE (D "E", -II.R.P. same aS benchmark 6Q0' 100 1130 Property Line 89.5' 90.5' 9-,b' B-2 _ 2 Scale =1/4" = 10' Area 15' below system is to II II remain undisturbed Grading is to be done to divert ❑ run-off away from system 5`-b Slope B-3 I 91 .3' 1 to Garage ` Tc 37th s4. _ / i iuffcutt ST 3 Combo Tank 0 -xisting 4 Bedroom 7,6 Well ouse OVJ ~ O Oid systom is to be pumped and buried y # ` w- DIVISION OF INDUSTRY SERVICES 2331 SAN I UIS PI STE 150 _ GREEN BAY WI 54304-5211 S _ Contact Through Relay P nao +Idsps wi goy+prcgrams+industry-services S S w•vw wiscons'n gov F Scott Walker, Governor Laura Gutierrez, Secretary S, plcn bcr 20. 2013 C I IST 11) No. 2 20900 17T1'. Poll IS Inspe, 1w* SHAUN R BIRD /ONING OITICL BIRD SELF STOKAGL ST CROIX COON "FY SPIA 1412 120114 ST 1101 CARMICHAEL RD NEW RICIIMONI) WI ~-101?-6101) Ht DSON WI 54016-"08 CONDITIONAL, API'ROV:1L PLAN APPROVAL EXPIRES: WY26+2020 Identification Numbers Transaction 11) No.3162H~4 SITE. Site 11) No. 84083 _ I leililc please reter to hush identification numbers. 1130 3?111 St above, in all correspondence wilh [tie agency. Town of Saint Joseph 11 Croiy ("oulm NW 1 : 4. S L I 4,"S6. 1'29\. R 1911 FOR: De,criptiow Replacentcm Residential Mound Ohfect l ype: VOAi, IS Component Manual Iteeulated Object 11) No.: 1793169 %lawmiance required: Replacement system: 6011 (;PD I low rate: 21 in Soil mininuun depth 10 limiting factor front ori_aial grade: Syslent(N): V9ound Component Manual - V'er. 2.0, SRI) -I(1691-P (N.01 01. R. 10!1''-), Pressure Distibution Component Manual - Ver. 2 .0, SBI)-10'(16-P (N.01!01. R. 10!12): Effluent Filter I he utimatal dcscrihcd allow has been reviewed for conlurnnmcc with applicable 11•isconsin Administrative Code: and 11'isconsin Slatutes. The submittal has been COADIIION;A1.1.1' ;APPROVED. This system is to be constructed and localcd in accordance with the enclosed approved plans and with aril component manual(s) referenced above. He owner. as dclincd in chapter 101 0](10), Wisconsin Statutes, is responsible for compliance with all code rnquircnlenls. \o person nmv engage in or work at plumbing, in lire stale unIc,N licensed to do so by the Department per s. 14~ 116. Scats, the Iollowing conditions shall be met during construction or installation and prior to occupancy or use: Key Items- POWTS Design Approval • This system is to he conslrucled and located in accordance with the approccd plans, the '\lound Coulpuncut co Manual for I'mate Onsite Wastewater SN,tcros Version '.0" SRU-10691-p(N.(11OF 1 and the Tresurc Distribution Component Manual lot* private Onsite WaAcaatci I reanuenl Syslcnls Verion _'.0" SBD-10706-P I N,0101 EPT • An% tall grasses, leaves and shrubs shall be cut :hoc and removed prior to tilling the surface for installation t PR FES D ISI prevem ntalUn_~ under the dispersal area, ~ • Prior to construction of the dispersal area, check the moisture content ofthe soil lo a deptt of 3 inches. Smearing and congtac(ine owner soil will result in reducing the infiltration capacity ufthe soil. Proper soil ntoislure content can he delennined by rolling a soil sample hclwccl: the bonds. If it rolls into a I'1- ntch wire. the site h too wet to prepare. ]fit crumhlc,, site preparation can proceed, If the site is loo tvct to prepare, do not proceed until it dries. • Insulate building seller beyond 311 feet per SRS 382.30 (1 1)(c). • Provide surface water diversion around the Ircalntenl lankc and mound dispersal emnponenl. SII=.I Iv IL ItIIZ.? I'::rc' 'i .'n -i R • 'I he owner is responsible Kor the ope:£niun avid niainA•n;etcr of d:e I'malc on,itc wa,tcw ater urauncnt scslcm (PO\k FNj .n accorihmce with SPS 383 :md the approved management plan • The owner of it PONN TS shall he responsible for ensuring IItat access opening covers remain locked or secured esccpt for in,.pmioit :vac a:t:ion. tmo niauouv of ..•ni~ iuP prrpo, • Owners shall receive a copy of the appropriate operation and maintenance manual and or owner's manual for the P(_M I S de,cribed in this approval. • Provide it cops of the approved 1'0%%TS plans and this letter, to the nw ner. A cope of the approved phms.,pecilicatioins and this lelter.h;ill be on-like durut*U construction and open to inspection by n.thori/ed rcprcscnlatives of the DvImitrnent, s+biclt nlav include local in,pectors. All permit, required by the state or tire local municipality shall he oblained prior to cnmmencemenl of conaruction installation operation. It, granting thi, approval the Division of Incfusirv Service, reserves the n_ht to require chanaec or additions should conditions arise makim_ Utem neccssmq for code compliance. As per state stilts 101.12'('_). nothing in this review ,hall relieve the designer ofthc responsibilip lot designing a ,ale building, slrucl.tlrc. or component. hupniries con erning this correspondence may he made to tine at the telephone number listed helove. or at the address rw this Ielle ad. I I e ab ~loli a dressce shall pro ide it copy of thi, letter and the POW TS management plan to the owner and any ,t rs, wd re re ponsible I6r the installation, operation or maintenance of the POW-I-S. rc y. I ee Required $ 250.00 This Amount Will Re Invoiced. When You Rtt'civr That Invoice. - a Mager Please Include a Copy Willi Your P 1aslewa c Sl •c' di t . Division of Industry Sere ices Payment Sohmiltal. It ,US h?.I_ N SO, ton I, i:no a iw - 3: 15 p.m. WISMAR F code:.633 reac'Iv.lint .Iak%i.¢ov :C: Edwin \ la~,or. \4;a,tc~~aker Spccialia. ( I o i I- ;.IN I. Mon-Iii. S:nll AAI - t:;(t I'.M Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 9.'12'18 Owner:Gary Heinze Location: NW1/4 SE1/4 S6 T29N,R19W 1130 37th St. St. Joseph 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 4. Pipe Cross Section/Pipe Layout n r.`~^ qr LY 5. Pump Chamber Cross Section 6. Pump Curve Fk7Y '4 7-8. Maintance and Contigency plan 'r 9. Filter Specifications and cross section Attachments: Soil Test Shaun Bird Signature- License number 226900 Page 1 of 9 JF L System PLOT PLAN PRO.IF:c'r GarvHeinzc ADDItEss 402 Windover Ct. NW Vienna VA 22180 NW 114 SE 1/4s 6 rT 29 N/R 19 w'TOWN St. Joseph COUNTY ST. CROIX SYS ENE ELF:VA'TION 92.3' 9.12! 18 4 DA"fE BEDROOM CONVLN FIONAL AT-GRADE. CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 Gallons LIFT TANK SIZE DOSE: TANK SIZE 765 HOLDING TANK SIZE LOAD RA7 E 1.0 ABSORPTION AREA 600 0 of chambers none It I-ACHNIARK V.R.P. Bottom of garage siding ASSLrh►F: ELEVATION ton' Filter Lifetime Filter ❑BORE11OLE OwELL KII.R.P, samP,asbenchmark 10 690' 100 1130' Property Line 89.5' 90.5' 91.5' 6.2 Scale =1/4" = 10' Area 15' below system is to remain undisturbed B-1 Grading is to be done to divert ❑ 5 run-off away from system Slope B-3 91 .3' B.M. Garage To 37th st. Ci7 0 Huffrutt Combo Tank 0 Existing 4 Bedroom Well ouse C 0 Old system is to be pumped and buried Mound System Cross Section and Plan View 1 Dimension Fcct t t 75 A, - 1 r t F L, T i c S t I 11 - J t t ~ Z t -K2 t j - T. 4/ 4- K _ _l z 9~-O/. SIB i - -I ° Topsoil AS 1 \t C (1c an a<:,rcgate - -I in. Bch. 40 pvc _ Cap Maleri tl ;and till - to m. dia. observation pipe. Geotevtilc - \ II Fabric i I. q _ owed Surface Ft Contour Slope Direction GENERAL INSTALLATION: the moun.l area is staked out along the desisn contour- 1Fistine, veeetation is mowed and rd ed otl the src. I he mound basal area (L s W) is plowed with a moldboard or chisel plow. 1 lowing 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 betw=een the palms of the hands. ASTNI C-+3 quality sand is placed inunediately 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 trust be used when placing sand of less than one loot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed. the entire mound is seeded and mulched to promote vecetalkC growth. limit erosion and protect from freezing. The observation pipes are slotted in the lower 0 inches and cured in place wiih rebar or a closet tlangc. 10 '0? ILI Page o PresSLit'c Lateral Layout Two Laterals - - End Manl f-old f- - Threaded Cleanout I ateral Turn-up ► Plug Manifold M I - Long Force Main / Sweep 90 Rend -Distribution Network Specifications Pressure System Construction I ateril Dtarnctcr 2, lr. lan,fuld Diameter Z In. FPL;11, ls arcconstructed of Schedule 40 PVC Orifice Diameter Zn. Orifices are drilled perpendicular to rifice Spacing) e~ In. the pipe with a sharp drill bit and face dovNri ~1, (Lateral Leng(h) Ft. Lateral turn-ups terminate with a threaded j M (\4anifold Length) _ Ft. clcanum plug and are enclosed in a 6-8 inch Force Klan: Diameter In. diameter lawn sprinkler valve box accessible Farce Main Length - j i k 1. Irom hnished l1radc. - i - ~ 0-8 Inch Lawn Sprinktet-Vale ~ Roy Pz.gc f~_ of 03:'05 Igj Septic-Dose Tank Cross Section And Pump Performance Specifications 'rank Manufacturer t Pump Manufaeturer t ^ Tani Model Number ti , S7 Pump Model Number J Total 'l'ank Alarm Manufacturer '.ll' ylax. Bury Depth J Alarm Model Number - 7- - Switch Type Filter Manufacturer Total Dynamic Head (TDH) - Feeet f4 filter Model Number j ' I Elevation Head FDoMinimum Pump Performance Required roe MFt TDH j al Outlet manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted Weather-proof l - Junction Box - - Finished Grade Vent Min. 12" Disconnect Above Grade Means With Vent Cap ( Outlet Filter Inlet Wet Baffle A 14 [Switch Settings and Reserve Capact~ Weep Tank Volume = GPI B Hole Dimension Inches Volume Gal. (reserve) A ~v. Off Elevton C Ft C ? Ft Bottom D E^l'evation (dead) D Tota1~L= 7 the in accordant a with not GENERAL INSTALLATION: The septic/dose tank is bedded and back fillod manufacturer's product approval specifications. Maximum depth of bury as specified by be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) and ngs installed. Piping at the inlet and outlet is of approved force material, connected to the tank esin is sleeved with 4" Sch. wi40 th PVC tobridge the tank laid va stable soil to prevent sealing sagging. The fcomplies with NEC 300 and Comm 16.2:.. excavation and the sleeve is sealed watertight. Eledri~ servec 05 page of 0 u 280-SERIES 112 hp Submersible Effluent/Sump Pumps The Liberty 280-Serics provides a cost effective "mid- Performance Curve. 280-serilois' range' pump for on-site waste water systems, liquid 40 12 waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. 35 11 Designed around Liberty's unique "Uni-Body" casting, 30 - the 280-Series will provide years of reliable performance. Q) 25 - 9 U_ 20 I T _ All Models Feature: m 6 _ 6 • Vortex style impeller permitting passage of solids (0 1 Up to Y4" T 5 • 416 stainless steel rotor shaft 10 - 3 • Permanently lubricated upper and lower ball bearing 5 I 2 • Epoxy powder coat finish 0 I 0 All fasteners - corrosion-resistant 0 5 1 stainless steep 0 15 2025 30 35 45 50 55 60 65 70 • V Z" Discharge U.S. Gallons Per Minute • Stainless steel bottom screen - easily removable 0 3 I T I 156 192 228 270 • Maximum fluid temperature: 140'F. 78 114 Liters s Per Minute 280-Series Cord Lengths Model 10'___ 251-2) 35~(-3) so'(-5) Dimensional Data: 280 Standard -Optional _Optional _ Optional Wight: 291bs. 281 Standard Optional- Optional Optional Major Width: Major 10" (model 287) 283 Standard Optional Optional _ N/A 287 _Standard Optional _ WA _N/A Minimum Sump Diameters: 10' cord length standard on all models. For optional lenylhs, Model 281, 283...14" add"-Z-3 or -5" suffix to model number. Model 287 VMF...10" Example: for model 280 with 35' cord, order 280-3 Factory switch Model 281, 283 Model 287 settings VMF Motor Specifications Turn on level 13" 9.5" Y hp 60 Hz 3450 RPM Turn off level 7" 4.0" Oil filled, thermally protected (PSC) Permanent Split Capacitor The model 283 features a tulty adjustable wide-angle float Differential 8.0 amps (115V) adjustment> ran be, made easily by tethenng the float to the dis- charge pipe or other mounting point- Vertical float model 287 is not adjustable. x i• Model 280 Model 281 ~11 ii Model 283 a, Model 287 u Man, Wide angle ual ag 1 fr Wide angle VMtical m no switch float switch -W float switch Vertical mag- with quick- L` with series - netic float for disconnect 4 (piggy-back) I~ smaller pits - ^ y plug - 7 will operate in a 10" diameter sump c ca-us Certified Jpccirctryot~,uv::u: r:c?to Farcy. wiltxrl npp~.;. Liberty Pumps • 7000 Apple Tree Avenue"- Bergen, New York 14416 • Phone 800.543-2550 Fax OWN 494-1839 www.libertypumps.com Q,Fryright 0 Ubemy PUn>{sss: Inc. 2017 1,)~ ae nghC reserved. LLIT 7000 FKWI7 ' POWTS OWNER'S MANUAL Sr MANAGEMENT PLAN e:+yo_ er FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity S L N-- al ❑ NA Permit it Septic Tank Manufacturer 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer NA Number of Bedrooms y ❑ NA Effluent Filter Model ❑ NA Number of Commercial Units NA Pump Tank Capacity all ❑ NA *A,2,-2 Estimated flow (average) 1 0 aVd Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1 S) 4,, aVd Pump Manufacturer ❑ NA Soil Apprication Rate aVda /ftz Pump Model QNA Influent/Effluent Quality Monthly average` Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Fitter ❑ Peat Filter Biochemical oxygen Dernand (BOD,) 420 rng/L (I Mechanical Aeration O Wetland Total Suspended Solids (TSS) 5150 m9/L ❑ Disinfection r7 Other: Manufacturer Pretreated Effluent Quality _A Monthly average'' Dispersal Cell(s) Biochemical Oxygen Dernand (BOD,) 530 mg/l, ❑ In-ground (gravity) U ground (pressurized) Total Suspended Solids (1 SS) 530 mg/l. 17 At grade Mound Fecal Coliform (geometric, mean) 510' cfu/100mi ❑ Uri ine U Other. Maximum Effluent Particle Size Y. inch diameter values typical rut dotnrstic (noncomm.rdap wastewater and septic lank effluent. Values typlrml for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every U months ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume Inspect dispersal cell(s) At least once every O months iLTyear(s) (Maximum 3 yrs.) Clean effluent filter At, least once every ❑ months year(s) Inspect pump, pump controls & alarm At least once every ❑ months • . ar(s) ❑ NA Flush Iattrals and pressure test At least once every U months ear(s) ❑ NA Other. At least once every ❑ months ❑ year(s) NA anor. At feast once every U months ❑ 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, POWTS Inspector, POW I S 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 ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a tailing condition and requires the Immediate notification of the meal regulatory authority When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechir cal or pressurized POWTS components. pretreatFment components, and any other maintenance or monitoring at it ervals 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 darnago the dispersal cell(s). If Iriyh concentrations are detected have the amtenls or the tank(s) removed by a septage svrvicing operator poor to use. n 0 I-~ Page --of START UP AND OPERATION for the presence of painting products Or other chemicals thO For new construction, prior to use of the PONfCS check treatment tanks} may impede the treatment process andlor damage the dispersal C@11(s) If high concentrators are detected have the contents n i I' . ator tank(s) removed by a Septage servicing oper prior to use System start up shall not occur when soil conditions are fl at the infiltrative surface. During power outages pump tanks may `ill above normal hlghwaler levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) In one large dose, overcal ing the cell(s) and pray result in the nackup or surface discharge of effluent, To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to tt,ie effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels w 15 ithin the pump tank. fee compact, the area within hy mound tanks and Do not drive or park t down slope of vehicles grade dispersal cellls area not drive or park over or otherwise disturb or comp ill Reduction or ellmination of that following from the wastewater stream may improve the oertormance and prolong the Ida of the POWT3: antibiotics; baby wipes; cigarette butts; condoms', cotton sweats; degreasers: dental floss: diapers;~'~ectra l odfal: foci painting rain (sump pump) water; fruit and vegetable peelings gasoline, grease, herbicides; meat scraps; pesticides; sanltary napkins: tampons, and water softener brine. ABANDONMENT When the POWTS fails andlor is permanilly taken out of service the following steps shall be taken to insure that the system is propel y and safely abandoned in compliance with chapter Comm 83.33. Wisconsin Administrative Code: • Ail piping to tanks and pits shall be disconnected and :he abandoned pipa openings sealed • The contants of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the 'OYVTS faits and cannot be repaired the following measures have been, or must be taken, to provide a code compfpnt replacement system: 0 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area shou;d be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing arid proposed structure, lot lines and wells. Failure to protect the replacement area will re~h i the In for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply nf`ec; at that time. ❑ A suitable replacement area is not availabe due to setback andlor soil limitations. Barring advances in POWTS technologN a holding lank may be. Installed as a last resort to repla(:c the failed POWTS. ,ELI The site has not been evaluated to identify a suitable replacement area Upon failure of the POWTS a soil and site avaluation I~-must be performed to locate a suitable replacement al if no replacement area 'a available a holding tank may he installed) as a last resort to replace the failed POWTS. removal of the biomat at the infi!tra ive surface a Reccnst ~cbnns Cfsuch systems mustncomplywith he n ens in piece in effect at following that thnr <<WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO N DIFFICULT ANY CIRCUMSTANCES. ANCES. DEATH MAY RESULT. RESCUE 0= A ENTER A SEPTIC, PUMP OTHER TREATMENT TANK PERSON FROM THE INTERIOR A TANK MAY BE ADDITIONALCOMMENTS_ POWTS INSITAAL/LER POWTS MAINTAINER f CCs - - Name Name =D1r - Phone Phone - - SFPTAGF- SERVICING OPERATOR PU PER LOCAL REGULATORY AUTHO Y Cr NaTe/ 7 1~-E e O Prone Pho' K--~ 5 C I This (1ncull was drafted n corrpllarce w-th chapter SPS 383.22(2)(b)(.)(d)&;f) and 383 54(l), (2) 8 (3), 1,61S ma Administrative Code. ~r` I ~ I i ~ ~~~I~ 4L l I I I.J Imo'-~-~ i ? L 'f✓r e ~]d 41 f F ` y S 'r. Cv i 1~ ST- CROIX COIIN'I 't SEPTIC I'.~N k >V4ANI1'sAf?1V'CG :'u REh'AQN~I ANl) OWNI;IZSIIIP CIIR'1'ff~1C;l'I7t iN NURIVI t)wncr..Buvcr IJCt ~ Mailing Address _((_l7 Property Address (Vcnfic'atiou regniruk, f! Gill Plartnirtg 7uuing Dapto( nent tot new consuuction.) - - - C't I Vl;Stat(: - Parcel Identification Number 0(, l~pL_Otrz) LEG:U, DESCRINJON Property Location" Z"- R W, Town ot~J` J(.)S u Subdivision - - - of 4 Certified Survey Map . Vr lufnc Page Warranty Deed # Volume Page f t Spef house ycs no Lol fine. identifiable yc.> o SYSTENf MAINTliNA.NC:E AND OWNER CERTUICATION Improocr use anti ina nucnaucc of your septic S,, atcm could ICiAdt in its fintniautre, failure to handle wastes. Proper rr:ainterraucr consisls of pumping out the srpul.: an:c cve, y Ihrcr yntirs or sooner. I needed. by a luxnscd pumper- What you put into the system can atlbet the function of the septic tank as a trralmetn sttgc to the was n disposal system, Owner tualydenance responsibilities ate specif ied or QConun- 89- 2(1) and at Chapter 12 St_ Croix (%r tnty 6autnu,v Ordinance The property owner gQtrrs to Sumull In St. C;oIx c;oonry' Plemn,e Xt Zoni mg Dcparlrteni a ec:uficaliou form, signed by the owner and by a truster pl'rmbet, joutncy-man Pluto- -r. trstrtded plu:nbt.r or a b,-- T,ecd potuper ventytng that (1) tic Oa-site - wastcwalet disposal system " in Proper olwamng condition and+or (21 after iuspcc::ion Will putrpuik (i1 necessary), file sep:lc tank is less than 1: i full of sludgy I 'wr, the unficrmf red have leadt:m at t 'c rrdpmr n•rn7S . mi rctec to Geur.lain the [)rival,: :cwaye rispusal =ySiern wnd: (hc tnrrd l(IN set forth, herein r„ set Cy the Departure nt of<ouunct-c and the i)cparrrn-or, of N'atmid Resoor cs, Suety of Wiscirnstn. ( eroftcation sUIriug that your septa systcaa has been maintamcd durst be completed and rrluntnd to the St. Croix Comuy Planting & Zoning Denditutent within 30 da}s of thr three year cxphauou date. - 11we certify that all stalcrnru s et: is Torn %rc o w to h .hest ofuwoui I nowledgc. lava andare the rwuet(s) of die property described above, by vii bar i a c rrnla drer, tee ride. il: Ret?tstcr of Den Is Offire. N cr of droorns / - 1-r - PPLIC.ANT(S) uAT E '"Any information that is tnisn:presrnrrd may reshlt h: ncc sanrtaty peunit being o vokcd by the Planning & Zoning Dcpatrmcnt. Delude with this application a .ecordrd waiiam-, deed form d•:c Re(;isrct of Deeds (.fficc and a copy of the eerufied survey map if teference is made in the wananiv deed. (REV. 08)05) i; ,r 1 r CST"a o f ~s - as 9 s Wisconsin Department ofCommeke $OIL EVALUATION REPORT Page_ w_ Division of Safety and Buildings to aeoortfMG#wrt4 Comm 85. Nis. Adm. Code County Attach oomplete site plan on p" (lot lese-main ~6 112 x 11 inches in size. Plan must J 1 include. but not limited to veaicMand honvnotal reference point (BM). direction and Parcel I.D. I} Percent slope, scale or dimensionS• north arrow, and location and distance to nearest roar. Please print all information. Revie by Date Psnwnnai irAdmaeon yW pOnOe may Do osa0lor aecorWary parposex (Privacy law, s. t $ M t p rmlj Property Owner property Location L7 C" r r n Govt. Lot N;j 114 J C. 1.4 S T Z N R E (or Y Property (Tuners Maili ress Lot 1) Block # Subd Name a CSNU; off- (u> o ` f.J LAJ I So af- Cdy State Lp Code Phone Number C] City ❑ Village 534wn Nearest Road E e~ U 2Zt$o (x GNC1 JAS? ❑ New Ccn5truCtion Use: stdeneal I Number of beGOOms _ Code derived design Mow rate fD GPO Replacement [:j Pu-Nc or commercial - Describe- Parent matenal _ Flood Plain elevation if applicable / ry, General comments and recormhendations. system Type ~J Lev System. Elevaoon_L~_!/ Boring N Boning 17 1 Pit Ground surface elev ft Depth to limiting facia in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fF in. Munsee Ou. Sz. Cont. Color Gr. Sz. Sh. ~h 'EfNrt •Eff#2 Z A 77/7 Boring 0 [ Boring (7~ c ❑ Pit Ground surface elev.(01 ft. Depth to limiting factor n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD."F in. Munsell Qu. Sz. Con( Color Gr. Sz. Sh. 'Ef'Fet •EffN2 Effluent R1 = BOD. > 30 < 220 mg/L and TSS -30 < 150 ' Effluent iy2 = BOD. < 30 ng1L and TSS < 30 rrg.'L CST Name (Please Print) S ture CST Number Bird Plumbing. Inc. Shaun 13ird - 226900 Addws Dula Lvalualion Conducled 10oplwno Number Z~x 1432 120th St. New Richmond, WI 54017 J_ f 715-246-4516 Parcel ID p _ Property Owner Page - of SonrgR Boring 3 c pit- Ground surface elev. lL~f Depth to limiting facto n. Soil licatiwt Rate Honzon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPD1ff in. Munsell Ou. Sz Cont. Colo Gr. Sz Sh. 'E"l 'EfW2 "04 4-1 Boon N ❑ Boring - ❑ Pit Ground surface elev R. Depth to limiting fades in. Soil Application Rase Ho on Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPDfP in. Munsell Ou Sz_ Cont. Color Gr. Sz. Sh. 'Etfp1 'ENp2 F-1 Boring # Boring - - Pit Ground surface ebv- K. DopM to limiting factor in. Sad Application Rate rtiorizon -lepfh Dominant Colo Redox Description. Texture Structure Consistence Boundary Roots GPOAf in. Munsell Du. Sz Cont. Color Gr- Sz Sh. 'Eff01 'Ef #2 Effluent pt = SOD, > 30 < 220 mgol-'and TSS >30 < 150 mgt ' Effluent #2 = SOD, < 30 nV?L and TSS < 30 rrxyt 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. sxo-u~>.;a ami Property Owner Parcel ID # Page o' Bourg # 55-Boring a R p#- Ground surface elev. 7-0, _ h. Depth to limiting factor -2V _ in Sal Application Rate Horizon Depth Dorninanl Color Hedox Description Texture Sbxrtwe Consistence Boundary Rods GPD1fP in. ManSeell Ou. Sz Cont. Color Gr. Sz. Sh. 'E##1 'E##2 m Z i - I I Boring # ❑ Boring - - ❑ pit Ground surface eluv f;. Depth to limiting factor - _ _ m. Soil licahon Rate Horizon Depth Donmant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh 'Eft#t 'EB#2 ❑ Boring Of ❑ Boring Ground surface elev. ❑ Pit It. Depth to limiting factor In. Sal Application Rate Horizon 'lepth Dominant Color Redox Desatpoon. Texture Structure Consistence Boundary Roots GPD#F in. Munseh Cu. Sz. Cont, Color Gr. Sz. Sh. 'Ef#it 'EM ' Effluent #1 = BOD, > 30 < 220 rtxyL and TSS >30 - 160 mgt ' Effluent #2 = BOO, 30 rrtglL and TSS < 30 mggL 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 608-26ti-3151 or TTY 608-264-8777. WUlnbfx GM! Soil Test Plot Plan Project Name Gary Heinze Shaun d Address 402 Windover Ct. NW Vienna VA 22180 CS P.1 #226900 Lot Subdivision Date ` /12/18 NW 1/4 SE 1/4S 6 T 29 N/R19 W Township St. Joseph Boring Q Well PL Property Line County ST. CROIX BN1 or VRP Assume Elevation 100 ft. Bottom of garage siding System Elevation 92.3' 'HRPSame as Benchmark 690' 100 1130' Property Line 89.5' 90.5' B-2 91.5' Scale is 1" = 40' unless otherwise noted 12 acre lot B-1 5% Slope B-3 ❑ R.M. ' Garage To 37th sl. ST Existing 4 Bedroom V`~+ House DW 0