HomeMy WebLinkAbout038-1239-07-000
Alscensin Depannwnt of Commerce PRIVATE SEWAGE SYSTEM Courr> -St. Croix
Sa+efy 3"d Smldtng D`wisicn
INSPECTION REPORT sa-itari Permit No.
GENERAL INFORMATION (ATTACH TO PERra1T> 606939
Slate, Pan ID No
Pcsonal iniermaton i~~ orGwAe may Ce used for succndary pwpcses ;PrivaCp t a:v s. a C4 i l;fml 3163859
Perm I Holder's Name City Village. Tnwrsnip Parcel Tax No.
Matthew Lyons TOWN OF STAR PRAIRIE 038-1239-07-000
CST 2V Flev I Insp. 31.e Elev BRA Descna on. Sechu'7-o.vn Ra"ye:Map No
GSr 17.31.18.1268
TANK INFORMATION ELEVATION DATA
TYPL MANU=ACTURER QQ __``SS CAPACITY STATION BS HI FS ELEV.
Septic , f JF~G~ /•o Bench•rara
fT .L(..:.7. /0410
Dosing `o f l.0 (OV All. 61v1 F, Z-
L~ ~~J_ ~•iL Bog. Sevier b
~~78•Z
Hold ng SHt Inlet
99 c.. 3
TANK SETBACK INFORMATION SUH! ouvet
TANK TO /a P: WELL aElwlll~ ROAD D: Inlet
7 \
Septic f n Dt Bottom
/(f A O
Dosing Heaoer.N9an/OZAeration D St. Pipe Holding Bot. System g 16 It
,
PUMP/SIPHON INFORMATION Final Grace 3. 1 /63.1
Maudacterer Demand St Cover
ioe.z
(bet GPM t ra.. C-l
Model Nj•rbo• ~I Cov)Ao
TUH It ii Fr.c:ion Loss System He d TDI I F
.G $
Forcenlam Leng:n I Dia. f Dist a N;eu
L~ Zf
SOIL ABSORPTION SYSTEM
BED:TRENCH Otictr f Lrngln no O`Tj~ache PITDIMENSIONS No. O'Pits Inside Da tew Dep!h
DIMENSIONS ~d y S /1 N_~
SETBACK SYSTFM TO PiL BLDG :HELL LAK1,:SI REAM LEACHING Ma-u'aCUrot
INFORMATION i,.F- O' 'ste- CIIAMBER OR
! 16 33 UNIT Mocel Numoe~
DISTRIBUTION SYSTEM ,V T
• ICadcrlMaml4d D,:rbuton rl•ez>:ve3 { xdce Soacirg
~ O r( 'dui Blnta
7 Pig., z,` S S r_ 36
v
Len;br_ra L L.-ncth_ C a Sp.!c. nq ~ l/
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only °r
Deuth Cvct ~Cplh Crier xx Deplt or xe SeeCedrSOdceC xx Mulched
Bed+Lencr Ccn!c / r '7 Sec Tre.ncc Frill ` I.,
, Vsr, 1 /4 1 No " j No
COMMENTS: ,Include code d,screpenctes, persons presert etc ; Irsoec:ion #1 I r ZI p II''Wc-t er 02
! P~or.1 N•
ov`
Location: 2194 92ND ST I I . 64k,"
1 ) Alt BM Description = Ffrlt... L
2) Bldg sewer length = t Cry
1^ ~ ...L rS
- amours of cover = Z44 _ - - Lrro~
Plan remsrcr Required? Yes o III t,1 q 1 Y, p`,I~ s
Use other side for additional information.
Date InsepCtdrs S nature Cctt. w
sPr - as 18 3 Sy
I gT` ~ I I I, iafety na BUildin s .J c stor
221 ✓s. ✓Ja hl~ -:Ave- ? Box (
,a, 9 Saet.uV ernie !:cmbc m be tike r b'
PS Madlsn.'JJI 537^7-'152
i Santtnn P~rmjt ,A licatt<
or4utvntyk SI'b 383171'Yu::..irnur. =but r~[t ci ~.I .t i ucnI ~ 4~s__- -_JI
t: gii::Y/yo•r et. U'.Su•~as"mtt.ac' W >tc.. ban..f tu, ta:e tc •t ,une..to I :r~le_ .s; ent tl:m~nailt t_.nu~s?
[ _kp2sbss S>:nc m 1 t>Ic?smn:J \rn Yt-c ttal irhn in4 iv pt"oviti Wr r mzq 6c u:ec tot :r.^pndan' ' ' 7Q
Information - Please 4:1 Tirol. J
IApplication
Print All lofot mad o _ _ _ ~J['/•
r Tern Os. t r: m: D ~ -roa•, e, ,
L^ l ~
io-
rhopcny Own t M:n:m~
J'.it'♦ Sime i;de fton: NuJlb::
If Type of Building lob --~Np /clr or _I
If tel cck all that appl '
2 Far~au Dc>ci:`.ug 1`mn ,c, t Rcaoo. J - lutw;vt>rc¢ 5acnc
'~I (•::bli.a=<m.^tercial - iiese:il¢' ~ s:._ -1
sY~i ll of _
Seale CMt A Destrb: l ::c _ / - CSM hurnbar ' \ ih c n:
31. Tv e (C'hrck only one box online A. Complete Iin applicable) Go♦M1t,..t~
VRan _l Kep]a:naa: Systas j ?reamsoo~ I' i ,q :i Rcplaaaxul Cmn' ❑ ckj= M.w' Iicao0a u F'.xisV4g SNA= (=plain;
ij Femtit Rcnrwi I lj i'c=11 iaevulnn i hz.ne of (I t 4 v- 1, Permit Trvnfa is Yew y Lm Precious Paxan Vmobc and DaL• icunt
Rc[ w I'zp;racoo _ '-V`sa"
IT' i_y_pe of POtA 135vs[em'<.wnpoucnc Devtcr: (Check all that apph_ - I Qvv Vr l
n-P:< o ...d L, Cr. nivd _I 1':csswc' i' ircu;r d ❑ At I1,A r -,-wad -'.a n:. of mw.hk sou _ Moun 24 in n) s,wablc soil
I harp ml '.ll` , (>v - I c.il o r rxpla. - - _ 7.m ronerl ]m .e earluu~~
A Dtspers,t l rea ent Area (nfospiati.m a(,
_ r~_ _ a•• '
Ckuy Ffva ~i I Unt 1 J.~I Pii.s alu ~.hf Uisirnul v hryi.Ur ! l)u-+rt-' Y:...r rc, t lvslur, levancrlr
v
N'I. Tank Into •:.aaTm - - I cal a„t S ,t
' atlas ~irJ'.ans Ln.G Y ~ I.
~it ~F
Her-
Respotlcshtlm Slatrme L the undcnigocd ,t me responsibility for m,Wlauoo of the POP 1\, sh,we oa the attached plans.
1 Iii t'c \_r v Tf-, RS runita deemce. Phi- r N~^r.. oer -
2-7 Z
r outltv.'Ucparmsent 1 se 01dV;
t r t
Donn r Ira Dzae "Su "J sat me ni Clgua!we
-of _ p ,t t t idz9 /S
1\. C--ti ~ ~by Casons~)or Diyapprmal q\) ! k t -
a lcS: tie `t11 / er OOOiii 7kdMHa
-a spw m call cruet all ¢e e. "_s •
uv cIL.noe j^
is psr grayernent plan :ieh
hl~lFW
All por k lwlili cod mutt l,tl r.. rt -I f ~~.W +
Fdvlde cri M nn1eoa
Y of iipppntir
- _ _ Vtacn t a•wykk ha4> fn: tip. s >I<m anJ ;uFmtl m the lounD unl• '
snn-s?vs !x 11: n ;
System PLOT PLAN
PRO.I I?r r Elatthsva I vars ADDRESS 2'94 92nd St. Nets R c;hmond Wi 540'7
tJ1h' I q Nth' 3i 4, 17 I 31 . N.'R 18 tt' TOVI N Star Prairie c'ouvrY ST. CROIX
SISTENI ELEN':VI'ION 101,8' 9/19r 18
DATE. BEDROOM
CONVENTIONAL ,AT-(:RIDE CONVENTION A I. 1.11'1 HOLDING TANK
NIOUND M SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE. DOSE TANK SIZE 630
IIOLDING 'I ANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 N of chambers none
BEN(*IIA4ARK V.R.P. Top o'2" pipe
Assonn r.LeVAT10N loo' Filter Lifetime Filter
❑ BOREHOLE MA.I. +II.R.P. SH'ilF, aS benchma'k
393 Nroporty
inc-
Scale e = 1/4" = 10'
Well s t-, meet alt VV')NR setbacks n,PH
92nd S
t.
.Area 15' bekrr, systcrr• is lc
omain a^distu bed B-2
Grading is to be done to
divert run-off away from
Huffcatt Cornbo Tank system
f~ B-3 ❑
? • Sioae ❑ B-1
1.5' Acre Lot
101
453 Property Line 100.8 f
100'B.M.'
06
Op
I
`~(isnrelFi:- DIVISION OF INDUSTRY SERVICES
pro 3824 CRLLKSIDL LN
HOLMEN WI 54636 9466
> S _ Cortact Through Relay
hap l'Cspf. vii pn'✓+t:a)arauu71neu5lry S"ces
'.!1 a%w, •eizcunsn gov
r trs..
Scott Walker. Governor
Laura Gutierrez, Secretary
October 14, 2018
C'I "SF II) No. 326900 1TTV: P0117S In.cpecnw
SHAUN R BIRD ZUNI\(i OI-FICF.
BIRD SELF SIORAGL ST CROIX ('Ot':N I'i SPIA
14332 LOTH ST 1101 CARMICHAEL RD
NF.W Rl('H\IUSD AVI „Io17-6109 III DSON AAI 5401ti7708
('0NI)1'll0\ M. %1"PRO\ %I. -
PI.:1N,\PI'ROV AI.1 PIRF:S: III,14121120 Identification Numbers
transaction ID No. 3163859
S I I E, Site ID No. 85427(1
Matthew I.\ons Please refer to both identification numbers.
`194 92ND St above, in all correspondence with the
lbwn of Slar Prairie agency. -
St Croix ('ounly
N\\' 14, 14, S17, 1 3N, R I S\\'
FO R:
Object I ype: I'M I'S Component Maruml Re_elated Object ID No.: 1799021
Maintenance required: 4' 406111) Flow rate: Sysrcmis): Mound Component Manual - \'er. 2.0, SBD -10691-P
(N.01!01, R. M Ll. Pressure Distribution Component Manual - Ver. 2.0. SBD-10700-P (N.01!01, R. 101 L): Lfiluent
Filter
The submittal described ahovc has been re\ icwcd for conformance with applicable l1'iNconsin Administrative
Codes and Wisconsin Statutes. The submitted has Ken COMA IION'ALLI' APPROV ED. This sv'stcnt is to Lx
constructed and located in accordance wilt the cnelosed appraced plans and with any component manual(s)
referenced above. I he owner, as defined in chapter 10I.Olk 10), \Visconsin Statutes. is re.ponsible for compliance
with all code requirements.
No person may engage in or work at plumbing in the state unless license.] to do so by the Department per s. 115.06,
scats.
I be titllow'ing conditions shall he met during construction or installation and prior to occupancy or one:
• ItiiN system is to be constructed and located in accordance with the approved plans and with the "Pressure
x\alcr 1 ieatment Systems Version 2.0" SBD-10706-
Distribulion Component Manual for Pri%aly Onsite Wiwx
I'(\.OI:(II).
• 1111% system is to be constructed and located in accordance wilh [lie approved plans, and the "Mound
Component Manual for Private Onsite Wastewater S)'stenu Version 2.0" SHIM 0691-I'(N.0101).
• I he pressure network is to be conwocted in accordance with publications SBD-1000-P(N01+01) "Pressure
Distribulion Component Manual for Private Unsite kk aslewalcr I icmntent Systems - Version 2.0" and or the
sizing methods of publication "SSW MP Publication 9.6 Design of I'ressurc Distribution Nox\ork.N Idr S I -SAS
101!811".
A cope of the approved plans. specifications and [hie letter shall be on-site during construction and open to
inspection b) authorized representatives of the Department. which Inay include local insp"lors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction! installation' operation.
SIIAI N R BIRO
In "ranting this appnrval lho Division of Industry Service. rcscrvus the right to require chances or additions should
conditions arise making them ncccsaxry lire code compliance. As per laic fats 101.1'1.'_ I, nothirr_ in this rev icw
shall rcheye the desicncr oflltc responsibility for designing a sale building, structure. or component.
Inquiries concerning this correspondence may be made to ntc at the telephone number listed below, or at the
address on this letterhead.
The above tell addressee shall provide a copy ollhis letter and the I' 7 FS manapoment plan to the owner and any
other, who are responsible for the installation, operation or maintenance of the PON'1 S.
Sincerely. Pee Required S '>0.00
This Amount \V ill 13c Invoiced.
When 1'ou Reccke that Invoice.
/ Matthew Alleb 1a1l L72o Please 111eluile a Cnpy N iih Your
\Va<iewater Specialist , Division of htdustrv Services Paym mt Submittal.
(71S)i40-0407. WiSNIARI code: 7633
matthcw% Janzcn 41 'wi.gov _
Cover Page
Shaun Bird
Bird Plumbing Inc. ~c
1432 120th St.
New Richmond Wi 54017 p' 'rE55tON'~~ tdICES
Pn ~C „i!\S41ii f~~
715-246-4516 ON S~E
Date: 9/19!18
Owner:Matthew Lyons
Location: NW1/4 NW1/4 S17 T31N.R18W 2194 92nd St. Star Prairie
Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9. Filter Specifications and cross section
Attachments: Soi Test
Shaun Bird Signature
License number 2 0
REGL=M Page 1 of 9
SCF 2 4
INDUTnY SEr.
Svstem PLOT PLAN
PROJECT Matthew Lvons 1DDREss 219492nd St. New Richmond Wi 54017
NW 1/4 NW l/4S 17 /T 31 N/It 18 11' TOWN Star Prairie COUNTY ST. CROIX
SYSl'ENI EI.ENATION 101.8'
D:1TF.9i 19,18 BF.DROI)NI 3
CONVENTIONAL :11,-(:R:1DI,. CONVENTIONAL 1,11, 1, HOLDING TANK
N7 1000 Gallons LIFT 'TANK SIZE DOSE' TANK SIZE; 630
(iNp XXX SI~.PTIC T:1NK SIZE IIUI.DING 'L'ANK SIZE LOAD RATE: 1 .0 ABSORPTION ARE,-, 450 N of chambers nOne
R UACDNIARK V.It.P. Top of 2" pipe :1SSI:NIE: EEI•:vA*r10N 100' Filter Lifetime Filter
❑ BOREHOLE 0 WELL "Il.lt.I,. same as benchmark
44
393 Properly Line Scale = 1/4" = 1 Or
Well is to meet all WDNR setbacks Pro 3
Bedroom 92nd St.
House
Area 15 below system is to
remain undisturbed B - 2
Grading is to be done to
divert run-off away from
I luffcutt Combo Tank system
B-3
1 • % Slope ❑ B-1
1.5' Acre Lot
a
101'
453' Property Line 100.8' /
100'B.M.` t
99'
i7 r
Mound System Cross Section and Plan View
fib---
Dimension Feet
1 t t 13
T t - t
t t D ~c7
\1' i t t F
t t ~ [1 1
t 11 t r 7
K - B 7
L - - - Slope 0/4
-Topsoil ASJAI C: - Cleans tg-rcgatc ~ 4 in. sch. 40 pvc
_ , Cap Material and fill to' to dia. observation pipe
GCotextile = C ~ H
Fabric
F
1L'L - f'Im ~d tiurl+ie"rr
Ft Contour
Slope Direction
GENERAL INSTALLATION: The mound area is staked out alone the dcsig:t contour. Existing
%c-ctation is mo%i cd and raked off the site. The mound basal area (L x W) is plowed with a moldboard or
chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a inch soil %aire
when a sample is rolled between the palms of the hands. AS YNI C-3)? quality sand is placed immediately
alter plowing. Sand is placed with a tracked machine keeping 12) or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care must be used when placing sand of less than one Ibot
thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound
is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The
observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange.
'2 0
1U 0; lgj Page --D of
Per foroI ea PIPI Otfoil
/0
En6 Vitw
I~Ptrlaaev /
y' PvG P Pe
Mats LOCDItE On !Doom.
Art Equo"Y $DVCec
L /run Ur.CL '
V 10 */v
iQ~ 7 0 f
PVC Fercv Man
I' fIRBT MOIL NaxY ra CanrvC}'c"
PVC /
/ Morvlav PiDt
O Oyr.~wr.on
P.te
4 DisIrlDUll7n ?:7! LDyOVi P Ft.
R R.
X Inches
y;- Inches
Signed: Hole Diameter -;11 4'Inch
Lateral Inch(es)
License Number:
Manifold Inches
Date: Force Main 3- Inches
# of holes/pipe
Invert "Elevation of Laterais~~Ft.
Septic-Dose Tank Cross Section And Pump Performance Specifications
Tank Manufacturer C4 I' Pump Manufacturer I
Tank Model Number i t?cn~ 'v Pump Model ?lumber U
Alarm Manufacturer (Al t~i`< < (z
Total Tank Capacity - z 3 0
C Max. Bury Depth Alarm Model Number s_ v
Switch Type ; C n4 f4y
{ Filter Manufacturer Total Dynamic Head (TDH) Feet
Filter Model Number Elevation Head 1-
Distal Pressure ,3, S
Network Loss
Minimum Pump Performance Required-~ Force Main Loss
[
G GPM @
! L , , Ft TDH i Total _
Outlet Manhole Min. 4" Above Grade With ~ roe Locking Device. Inlet Manhole Min. 4" Above Grade
< 6" Below Grade Sealed Watertight Securely7NEbw tad With Locking Device
Weather-proof -
~-i Junction Box
- - Finished Grade - + - - -
t
Vent 12" Disconnect
Above Crrade Means
With Vent Cap
Outlet Filter
Inlet - Wet Baffle
X. X
A y~,>
S~ttings and Reserve Capacity
W CUP
Tank Vohtme GPI
B Hole
Dimension. Inches Volume Gal. _I
(reserve) A j f
(alarm) B 2 -]11 Off Elevation C
n ~d J Ft Bottom
(dose) C
11 (dead) D D Elevation
ry% Ft
Total
GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the
manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not
be, exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock)
installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and
laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank
excavation and the sleeve is sealed watertight. Electrical service gomplies with NEC 300 and Comm 16.2:1.
Page of
021051J
280=SERIES
112 hp Submersible Effluent/Sump Pumps
The Liberty 280-Series provides a cost effective "nild- Performance Curve: 280-series
range" pump for on-site waste water systems, liquid
waste transfer and commercial heavy-duty sump 40 12
Y-tY P pump i . _
applications that require higher head or more flow. -11
Designed around Liberty's unique' Uni-Body" casting, 30 L I-. 9
the 280-Series will provide years of reliable performance.
~ 25 I 8
All Models Feature:
20 6 En
• Vortex style impeller permitting passage of solids cc 15 - 5
LIP to Y" .
10
=
• 416 stainless steel rotor shaft 3
• Permanently lubricated upper and lower ball bearing 5 ` 2
• Epoxy powder coat finish 0 - 0
• All fasteners - corrosion-resistant stainless steel 0 5 70 15 20 25 30 35 0 45 50 55 60 65 70
• 1'//" Discharge U.S. Gallons Per Minute
• Stainless steel bottom screen - easily removable - ' 1 - I -
• Maximum fluid temperature: 140'F. U 38 7 78 r114 - 15 56 192 228 270
Liters Per Minute
280-Series Cord Lengths
Model 10' 25'(2) 351(_3) 50'(-5) Dimensional Data.
280 Standard Optional Optional Optional Weight 291bs.
Height: 13"
281 _ Standard_Optional Optional Optional Major Width: 10" (model 287)
283 Standard Optional -Optional _N/A _
287_ Standard Optional- WA _ N/A Minimum Sump Diameters: -
t0' cord Iengbi standard on all models. f-or optional lengths, Model 2II1, 283...14"
add "-2, -3 or -5" suffix to model number. Model 287 VMF...10
Fxample: for model 280 with 35' cord, order 280-3
Factory switch Model 281, 283 Model 287
scttings VMF
Motor Specifications Turn on level 13" 9.5"
hp 60 Hz 3450 RPM Turn off level 7" 4.0"
Oil filled, thermally protected
(PSC) Permanent Split Capacitor The Model 283 features a fully adjustable wide-angle float. Differential
8.0 amps (115V) adiustmcvtts can be made easily by tethering the float to the I.
4.0 amps (208/23pV) charge pipe or other mounting point. Vertical float model 287 is not
adjustable.
-z.
Model 280 Model 281 #
Model 283 Model 287
Manual. I Wide angle Wide angle VMF-Series
no switch y float switch l I float switch 1 Vertical mag-
444 with quick- with series netic float for
disconnect
l (piggy-back) smallerpits-
plug will operate in
Ik' z a 10" diameter
sump
ss $R~
actRED
c us Certified
`YE C;lcA:¢, a e wbji¢r'O ch;mm wmour ~ Wc.
Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (1494 1839
www.libe
rtypumpS.com copyright c Lttxxly Pumps. Inc. 2017
air nghr,: rx%m. vd. LUT 2000 RV 17
I
POWTS OWNER'S MANUAL & MANAGEMENT FLAN parse-__ot___ ,
FILE INFORMATION SYSTEM SPECIFICATIONS
F ner Septic Tank Capacity a[ 13 NA
ermrt Septic 1 ank Manufacturer .
i r
DESIGN PARAMETERS Effluent Fitter Manufacturer
Number of Bedrooms O NA Effluent Filter Model 0 NA
Number of Commercial Units L'INA Pump Tank Capacity A
- rep T ~ at
Estimated now (average) 'eT',,~ aVda Pump Tank Manufacturer
Design flow (peak), (Estimated x 1.5) j U aUd Pump Manufacturer
O NA
Soil Application Rate [J aUday II2 Pump Model - - O NA
InfluentlEffluent Quality Monthly average' Pretreatment Unit `NA
Fats, Oil & Grease (FOG) 530 mg1L O Sand/Gravel Fitter O Peat Filter
Biochemical Oxygen Demand (BODS) 420 mg/L O Mechanical Aeration O Welland
Total Suspended Solids (TSS) 5150 m /L O Disinfection O Other
- -q Manufacturer_
Pretreated Effluent Quality rl NA Monthly average'' Dispersal Celf(s)
Biochemical Oxygen Demand (BOO,) !0 mg1L O In-ground (gravity) ❑ -ground (pressurized)
Total Suspended Solids (TSS) 530 mg1L O At-grade Mound
_Fecal Coliform (geomebic mean) 510' cfu/t00m1 ❑ rip-line [ I Other.
Maximum Effluent Particle Size , inch diameter Values typlml for domestic (non<emmerdal) wastewater and
sep4c lank effluent
Values typical for pretreated wastewater,
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every v U months -94ear(s) (Maximum 3 yrs.)
Pump out contents of tank(s) When combined sludge and scum equals one-third (,I of tank volume
Inspect dispersal cell(s) At least once every = rl months ear(s) (Maximum 3 yrs.)
Clean effluent filter At least once every O months J-al(s) -
Inspect pump, pump controls & alarm At least once every ^ O months -1~ yr a (s) C.I NA
Flush laterals and pressure test At least once every = U months Oj e s) O NA
OUher. At least once every n months O year(s) NA
At least once every O months U year(s) O NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the follovnng licenses or
certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS 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 failing condition and requires the immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (g) or more of the tank volume, the
entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordan(w, with ch. NR
113, Wisconsin Administrative Cade
The servicing of effluent filters, mech-nical or pressurized POWTS components, pretreatgment components, and any
other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer.
A service report shall he provided to the local regulatory authority within 10 days of completion of any service event.
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other
chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are
detected have the contents of the tank(s) removed by a septage servicing operator prior to use.
Ps9e _ of . _ _
START UP AND OPERATION
For new construction, prior to use of the POWTS checs treatment tan'c(s) fo the presence of painting products a other chemicals the t
nay 'mpedo the t-eatment process and/or damage the dispersal cell(s) it high concentrations are detected have the contents of th,2
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may 511 above normal ti ghwaler levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) In one large dose, overloading tile. cell(s) and may result in the hackup or surface discharge of eff.uenlt
to avoid this situation have the contents of the puma tank removed by a Septage Servicing Operator poor to restoring power to trip
effluent pump or contact a °mmuer or POWTS Mainlainer to assist in manually operating the pump controls to restore normal levels
within the pcmP tank.
Do not drive or park vehicles over tacks and dispersal cells. Do not drive or pane over, or otherwise disturb or compact, the area within
15 feet down slope of any mound or at-grade soil absorptior, area
Redudiah or elimination of the following tram the wastewater stream may improve the perfomtance and prolong the life of the POWI 3,
antibiotics; baby wipes; cigarette butts; condoms, cotton swabs; degreasers: dental floss: diapers; disinfectants; fat: foundation drain
(sump pump) water; fruit and vegetable peelings gasoline; grease; he-Dicides, meat scraps; medications; oil: painting products,
pesticides; s. mtnry napkins; tampons' and water softener hone
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is prope-ly
and safely abandoned in compliance with chapter cornm n..3.33. Wisconsin Adm'nislrelive Code'
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealer/.
• The contents of al tanks and pits shall be. removed and property dsposed of by a Septage Servicing Operator,
• After pumping, all tanks and pits shall be exravated and removed or their covers -emoved and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the Wowing measures have been, of must be taker, to provide a code comp) rlnf
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location o' a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requited
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comoty with the nxleal in
effect at that time.
❑ A Suitable replacement area IS not ava table due to setback and/or soil Iimilations. Barring advances in POWTS technology a
holding tank may be installed as a last reszln to replace the fai;ed POVtrS
fie site has not been evaluated to Identify a suitable replacemen( area. Upon tailure of the POW fS a soil and site evaluation
)Jmlmt be performed to locate a swtable replacement area. if no replacenteni area is avai'able a holding tank may be installe.".' as
a last resort to replace the faded POINTS.
/ und and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltralive
- , '
surface . Reconstructions Of such systems MI comply with the rues in effect at that time-
<<WARNIll
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Or A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Name -
Phone J 7 Phone
SFPTAGF SERVICING OPERATOR P APER LOCAL REGULATORY At1THOR1 Y
Name ;t r l Name V<
C-
Poore Phone
Th,s document was drafted in calel nce with chaoler SPS 383.22(2)(b)('t(d)8ifl and 383 5411), (2) 8 (3), lAJ:s<:orI Administrative. Code,
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Z)WNERSHfP CFRTIh`t(',1'f1t_iN FORM
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(.)whet.%13uyer _ ~~0
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NfafJing Address
-AJCCI~/ WD 14~~ -5411
Proper(} Address Vqq
(Verilwmion required `loth Piaru,i:rg Loninp L1Te ae - r
t hrrneyv ronsnuction) - - - - -
Parcel Identification Nuvrbcr t)
I,E(:.AL IIESCRIPTION
Property Location /Li,r /
.41-111 _ '/t ,Sec. _0 N R 14', Town vl
Subdivision
- !t - - - - - Lot 7
Certified Survey Map # V,, hinic I fl,c
Warranty Oced #
Spot house yes u I or rite,,, idenLfiablc )-es no -
SYSTEM MAINTENANCE AND OWNLR CERTIFICATION
Improuei use and manu;nauce rd 'your sct:Uc sy;sL::u could resutl it, its Pr ~matnre failure to hand!! wastes- prop,,
ntatntenaucc consists orpmnpmg out the xcpn uutk cvei y d;t , years or sooner. if Deeded, by a licensed pumper. what yon put into.
the system call atlcor ine funclioir)I the septic tank: a% a l c aimcm stage in the w.:, e c(isposal systeuL Owner cnaintcnancc-
responsibilities a:e spe.: died in o(.onnn- 83.5?(1) and in Chapter 12 - St. C mix Ccanty Jarman' Orditratlce.
The propcity oa¢,er ap;ecs to subtnd to'+[ Croix c runty Pi:, untie & /.o -j mr; Ueparlinrn: a v cinfieatiun form. slgned by the
owner and by a nmster plmnbrt, joumaymarr phnnbe m,tric act plumbor m a licensed pumper vet trying that (1) the on-site
wastewater dispmal systcur ism proper operavut 'nndltioc author (7. aiict mspce:ion and ptunpmg (it nccessanf), the septic tank is
icss than Vi till ot'slud(;e.
I:.ve, the uudertirned hr:vc read the above rrtµurcln, nl d[O a tCe to .^.van tarn the private sewage dt rosal system with the
land,rd.1: set firth, herein; as +er by the Deparrima WC OUn ,c.,:r. and the Department o"Nautnd kcsoin es, Sta!c of Rriscnnsm.
Cellilrcation stating that your septic system has been mamtamed mull be complete-: and rehrmcd to the Sr. Croix, County Piamnny &
Zoing Depaturicnf s0lim 30 nays lit the three. year expiration daft
hwe cernry that all statements on the.- orn; air oar a> rho hest ui'nty;otu k newlcdj;r Uwe cmJare the owner(s) of the
property described above, by vie luc of a w•ar' nt1' dc;ed recorded in IZcgeaat of llrr.os Office
NuM geroLff,droll/ms
JI((\A'f . OI•' APPI,IC:AI~"T(tij - - ,~~~'r~'.[
DATE.
"""Any ininrruacion that Is rnismpresented may resu.i m d;c sxmtvy' peml[ brink o-voked by'the Planning Zoning Depannfanr, exx
inducie with this appacatjon a recouic'd wattamv deed torn Ihc, Rtl>,isicr of L)evd_- (.-fGec and it copy of rite certi ird survey map if
reference is nude in the warranty d_•ed.
(REV. 08105)
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1262
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of
Division of Safety and Buildings in accadance with Comm 85, Wis. Adm. Code Tom Schmitt
Attach complete but not site plan on paper not less than ntal rf x 11 iihes n sloe. Plan must County
St. Croix
include, , but not ImdeO to. vpdical and Ixurcpnlal etmmnce point (81Ai, dreclan and - - - - - -
percent slope, scale or dimemsions, with arrow, and location and distance to nearest road. Parcel I. D.
~;y '1~ L, L•''U
Please print all information. Revieirred By Date
Fe vl olmnetm I% mcWv Tiw do Uscd for R Jaiy p1ao IPtvary I.~ S Ib 34 11 Q9jl
Property Owner Property Location
Grand Properties, LP 1 NW 1/4 NW 114 S 17 T 31 NR 18 W
Property Owner's Mailing Address Lot # 1 Block # Subd Name or CSM#
712 Rivard Streeet, Suite 300 7 Squaw Lake Estates
City State Zip Code Phone Number City Village ✓ Town Nearest Road
Somerset WI 54025 715-247-5900 Star Prairie 92Nd St.
✓ New Construction Use ✓ Residential i Number of bedrooms 3 _ Cate derived design flow rate 450 GPO
Replacement Public or commercial - Describe.
Parent material Glacial Till _ ~7 Flood plain elevation, if applicable na
General comments a{-y7rtt _ jCI,?S•Vnee Sr ^LV /1eecl 1/-e frenfMr, rf >/6'4x-4" 4-/
and recommendations: Area is suitable for a mound system. System elevation is 101 50' based off of contour line established at
100 90'. Slope is 5% Depth to limiting factor is 29'
Boring # Boring
✓ Pit Ground Surface elev 101.15 H. Depth to limdin fades 30
in . Sod a
9 - - - FP "won Rat"
Horizon Depth :)cmrant cobr Rrxk)x Cesrin,co lexlure Stnxlure :Je~sister'ce x.:-day Pads GPUttt'
-Eff#1 'Ef1#2
1 0-6 1Dyr3/3 none sl 2mgr mfr as 2m.2f 6 10
t
2 6-16 1Oyr4/4 none 51 2msbk mfr gw 2f .6 1.0
3 16-30 1Oyr5/4 none sl 2msbk mfr gw 1f 6 1.0
Aidi
4 30J6 7 Syr41(i 1112d iv ;`r fi, t I sl ! 1 msbk mfr - - ! 4 7
Boring # Boring
✓ Pit Ground Surface elev 101.05 w Depth to limiting facia - -29----in. Sort Application Rate
H«von 11aHn Ikminant(Anr Redox Dcsaiptrr: I Texlc-e Shixaure Conssterce Bovoaaiy Rools GPP.,"P
'Eff#1 'Eff#2
1 0-8 1Oyr3/3 none sl 2mgr mvfr as 2ni .6 1-0
2 8-29 10yr4/3 none sl 2fsbk mfr 9w 1f .6 _--10~
3 29-54 75yr4/6 ---III ld'T5r6 sl 2msbk mfr .4 .7
Effluent #1 = BOD 30 < 220 ma'L and TSS >30 < 150 n it • Effluent #2 = BOD < 30 mgiL and TSS < 30 mWL
CST Name (Please Print) Signature. CST Number
Thomas) Schmitt "L¢r;~-> 7 zu_? 227429
Address Tom Schmm Date Evaluation Conducted Telephone Number
1595 72nd St New Richmond, WI 54017 7-~? C C y 715-247-2941
Property Owner Grand Properties, LP Parcel ID # Page 2 of 3
Borng # Boring
✓ Pit Ground Surface elev. 99.77 it Depth to lima,ng factor 29 in.
- - moil A{>FJ,wlon Rate
-lemon Dcplh JommarlCabr RedoxCeserplien -exture Sh,.Cme CCn Mence E3cun61ry Roots -silJ).YPIJ,~7
Ef#l 'Ef#2
1 0.7 10yr3l3 none sl i 9mgr mvfr as 2f 6 1.0
-
7 7-18 10yr4/4 none sl 2fsbk mfr 9w if .6 1.0
3 18-29 t0yr4/G none sl 2msbk gw mfr _ 6 10
-:6
4 29-72 76yr416 m2d 7 5% r6 7.Svr6,, I sl 1msbk mfr - - 4 7
❑ Boring # Boring
Pd Ground Surface elev _ ft. Depth to limiting factor in.
- So, Appl¢a6cn Hale
I+v¢cn Jep!h Dominam Coley Redox Descdplion Iexlure Shuclure COrrssten. tbundary Rools GI'C'FfF
'Eff#1 •Eff#2
❑ Boring Bonng
Pit Ground Surfaco clew. h Depth to Imiling factor in
tioil rFC ' e]u n 9d'e
~laizon Deplr pcn'irm,n Cob, Redox UC Clvky? 1Witte Snu---Ime I (:ws,slence 30,^dary Rcr. Si QIItf
•Eff#1 'Eff#2
Effluent #1 = BOD 30 < 220 mg1L and TSS >30 < 150 mgrL ' Effluent #2 = BOD, 4-3Q R)gll AM TSS < 30 mgfL
The Depannienl of Commerce is an equal opportunity wn ice provider mid enipk)%vr. If you need as iip to Derr to x c sen lCe rx
need m iterial in m i alternate 7tmnL please contact the drp irtnunt at 608.266-3 1i I or Ill' (dIS•1(r1-A?'
Page 3 of 3
Conducted by: Conducted For: Ref. No.
Schmitt Soil and Site Evaluations Name: Grand Properties, I.P.
Thomas J. Schmitt, CST 227429 Address: 712 Rivard St. Suite 100
1595 72nd St. City, State, Zip: Somerset, WI. 54025
New Richmond, Wl. 54017
Phone: 715-247-2941 Subd.Name: Squaw Lake Estates
7-Lot No.: 7
Legal Description: fiL,; 1 /4 /Vcd 1 /4 S 17 T31 N RI 8W
Township of- Star Prairie, St. Croix County
Bench Mark El. 100.00"Fop of 2" pvc pipe
Alternate Bench Mark El. AV--?-?'"op of 2" pvc pipe
Sktpe=__5:g_ Contour Line El. IOC • i.7
Contour Line Length
Scale 1" = 40'
t
/L ~~~`2{tea ~~ic n J) 4 ,
9 ~il~r~o
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l „ ~ \ 1 4 I \ +~jr
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9Syy ql \
A/C -~t / / e// -fie//cam r~ , ` /✓/a y 6 /Je ec/r~//~
C~rC/~r Tu Vic, /eat /ytch/nc~ ~i f GI~.Ynq~1 j.
/VcI /yJ.6r'~' cr ~G'U ✓Oc'Y~"cs
This soil report was done to fulfill a zoning requirement. No permanent lot markers were in at the time the test was
conducted. The area in which it was done may or may not be suitable for your use, or in the location shown.