Loading...
HomeMy WebLinkAbout040-1318-00-026 v-1-i min Depadmert of Corni PRIVATE SEWAGE SYSTEM County St. CrOIX SafBfy and Bui dv-g 0...sron INSPECTION REPORT Sani:aryPerini! No 606944 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No Persona nfe•mwien you pleVICI• map W , sec for secondary purposes lPnvacy Law. s 1S Da il)imil 3172975 Pefm,t I•.c de+'s Warne cL•j Vi age Ta~ensh,p PalceI Tax No'. Creative Homes TOWN OF TROY 040-1318-00-026 CST i3M 1-1e:'. 1Insp BM Clev BM Desc•ipaon 66 ir.mTwmvRange-^Aap Va /oeZ, - Z(of~ 11.28.19.2101 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 5 CAPACITY STATION 6S III FS ELEV. Septic 'A Ben hmark J L 1 12~b &-7-(o i 5 dro dgz.3 Dosing 1 - r~ D Alt. Blv1 -7.4% `Q16Cor`v.~ - f A& al Bldg. Sever •I L Cc /Z• ld7K Hcldmg St:Ht Inlet ` TANK SETBACK INFORMATION SL•HI O.rlle! TANK IO PtL~_ ::'ELL BLDG I Vent la rlrlakn ROAD Of In el c.Aj ` SePOC J I^_ U: Battom ✓b /VJCf 2J 1 /S.~ /67Z.3 Dcsirg 30) T Heade"Man. /•9 lO Bb.~L Aefaton Dist Pipe I • q `O g` • t Ho aing Bel System Z. U /&F6 •y PUMP/SIPHON INFORMATION F ral Dade O q / pq7 Mamlfacturer Demand St Cove, I p jam. Yt.f GP0.1 . It, Goa 7. O ~Q lo1odel NUmbm << a. ro,.r 3.V 0~4 r.4 i~YS 5'z- IZ TDH Lill Friction Loss System Head TDH Ft /3.$ 3 • r Fo•ceman 1 Lergth "Z r 1 U1st 'v SOIL ABSORPTION SYSTEM BED;TRENCH sYidrn ,.urgth No. O PIT DIMENSIONS ND 01 11 is 1',nsiae :)a. L qu d DCpln DIMENSIONS 8 75 SETBACK SYS]Elvt TO P:L BLDG WELL LAKE(SIREAId LEACHING o.tan.dadurer. INFORMATION CHAMBER OR lype Syster UNIT 1.1 Deel Num Der. 1 DISTRIBUTION SYSTEM muse", Var fnl,-*/ 11 Distributic-; F xhceSize xf tole Srac ng Van i•Inla 7 Lc•q:r ~ Dw Z Iangtn ~L U a Z Spa_ing L SOIL COVER x Pressure Systems Only xx Mound Or At-Grade systems only Uentn Over DcpA 0:'er zx Deplh cf xx Sculled,Bedded xx Mulched Bcd;T'111& l;ente• I Bed -ercn Ecgcs Te:$JIl ( ~ s No ND COMMENTS: rlnclude code discrepancies persons present. etc. i Irsoec:ion #1'. /J ' Inspection Q2: Location: 485 SUMMIT RIDG - 9!'~K~ F JlI~- l 1 ;All BM Description = C.d t P i 0 W J J'~, 2 y Bldg sewer length = ZeF - arnouneunt of cover 7 42 a ,•~b.•S~ 11y' ]7 Plar revision Requ.red? - Yes ~o + I $ ~Qr , 1 Ilse other side fo• addi:.onal information. - - - I Date Insepcor'- - gn inrre NO SLtUE:' u iS 9;9'1 u - - - m ~r q a ~I g~ } Z f+ 2Qtu :safety and Euli..f.ngc i vc rc 0 }r 2:11 Nash! Ig 0^ Ave., ~ . box 162 I, S.ici.rry : crmn Nomb no k fil;rd W..'nl I '-IS P S 1 I MaJ sur.. ',A r 5271-7-7162 R itnL f~Ra ]itv', tiulrt::et Sanium Permit Applic.atitm a 'Crz II S I rs S m C L a I of h.•lo-m[ n 2D•ropi .cc mrc l.:imrt 2;~.. 1 q i.,:I ( r nm a saanan m o t m ut w M 131DK,xne. H A S ac ~ubu ❑r d l.• { u:,c [ Aavn: J nU,tccn[ Iha aw.tre aadrasi t p n' a en me 1 of Imna ~r} (r".•r.d I 1 m.uliuu 17 ns r!. ¢;n be LLe fr. se s .:ate' - tu[ ,'i titan+^'•V.RnC 1M1.G1'Lu -LIp.TI G_J1. - - nr ~ L 1 \pplfcanon Information Plrxse Print 411 lofonunc •~<< " m't-/~ `'~j / R Fl 1 , ul r \3RK Far.c P ~~Pc~ . won Ira8.1191 Clio txr}Cxr Mtibn~ d:cSS pMN n 7 ~nf ~o~ 0t,~ _ lot 'i,y, Sram iF iwe Yhmxr Nuu:ben C ,:nen l'~y i ir.lc T pt of B me i Ch ll cbm nVVI) ✓ " ' n' n - - h arch D c :!u IY/wn":. V^ L✓, fu..iiuLoclmc; ci:i Ih~•nic t:nc ~ `A tiracil»r n- ac<bpiTb~. ~q_ _ _ I 11 T_v r (Check only one box no line A. f ompletr line B if applicable! r 11,; N"'.:cyxa:777'r Ir.:cn:I '1-1.; c.-..,i F:yixna•ot lmis L':rPrr ~f. it :'s l Fxi-:iueSYr~l,rllolnni Lam'Fs,,w -:rmuc tiutioer anc Dal lssacr• / f 11 4 t x'aI I I m:u1 k s u' c f- n -r u' 1 .bcr i Yr.-¢ut":atuty L, tires i' I 014nC I\'.Type of PO N'fti Stilt of Component Tlevire: ICh_eck all that a-ml 1 T" • - n . nLnc T m u` 111911C Oil M m. of svl:aolc soJ I :p .:ti..V ID 'alnLLR I- I I Dlwr. aol "•t CR`~ o z acrt sp a¢ ❑ Pn:+ rl e.n Ucvlu xpt.uo;_ _ ~{~^-yI~~" ~ ~I t DrsLw.rsIl Irca cnt 4r ey lnformRtio ~ Iu. i. F I ur ~ aril 4p,:vu~TCsV¢•': t L sf/^a4 t 1 ~..u j Du/zlSai Veih: wC_yil I~ stn' Un- u Yf. T:mk Lt L, uy m iom. X of Mmu!amrrn IAn\c FU}aera"nAt ~ ( ~ - u L? q r rA~ If ✓ h i .r/nc :i I6nr Tvd: ~ I --i='Li-`~~_~- " ~ ~ - - 1 VII. Respo siblli" SLtemeu - the uudrrs@ned, us capon ilnhry b>r insrallano o! I;x I UN I~ boxu oo thr amchc6l lao.~ - - nu P1111: r I (•.m' c ^nau-ro if ~Lr•K t:uvbvK Bustucss Pbum Ymrb^- ❑1 (aunty.-DePartme"t I sc llnly Appr !'r rart Fc I Da:c sun! l.I. iw ANna'it.:rsw: 06 IY. CoodltiEalsCSIVawus for Disappro. al I4G~ i 7. SeptN:tlsrk.eilLCn llto trn1 3, Jl` pull As pel arcell 3 emetallbe _Irs '+s per o :Iar3yemen pl<n p•c. Diu: 1 b~ lu noes. r 2, All w.tbxk recur-': en, i must Lc.- ml. is t i \ as PW p ktbl! cne.,- nmca to camplev ph.. [or the>r>mm and anpmn w tLr Sounr. only on'pnynr na In> r6au s v: a I I iubo w sve ~ Le11 ry~ 1 S3Cti398 {P. I l:: l 1 f ^ ~{,~j ~ System PLOT PLAN mto,HLcT Creative Homes ADDREss 70' Commerce Drive Woodbury Mn 55125 NW i,4 NE I;4S 11 ,,1' 28 NiR 19 51 TOWN. Troy COUN'fyST.CROIX SYSTEM Ll F%ATION 1085.0' 10;6x18 4 DATE BEDROOM CONVEN'HONAL 1T-GkADE CONVENTIONAL LIFT HOLDING TANK .lllons LIFT'IA\K SIZE DOSE TANK SIZE 76S MOUND XXX SI;I'1'1C TANG SI%E HOLDING TANK SIZE LOAD IL.4'1'L 1 .0 ABSORPTION ARIA 600 # of chambers none BIACHNIARK v.R.11. top of survey iron ASSt NIF, ELEN Al ION loo' Filter Lifetin)c Filter ❑ 1101WH )LE 11 ELL ° H.It.I,. same as benchmark Grading is to he done is divo,l 1,0x34 run-off away from system 1 Acre Lot 1 C82' (,D R_9 B Scale = 1/4" = 1 n' 11 1 B-26A ~ Properly Li'1P- - 6": Slope Area 15' bclow system. is to remain undis'urbod B.M. Summit' Rj ige B-26C I Huffcutt Combo Tank Pro 4 Bedroom liouso Property _ines Well is to meet all VJUN.r3 setbacks DIVISION Or INDUSTRY SERVICES 2331 SAN LUIS PL STF I GREEN BAY WI 54504-5211 -l _ Con:ac! Tnrouyh Relay `S - hill, .idscs..v yov~pro:rams~mctusxy-services P S vI Wisconsin ycv `c' Scott Walker, Governor - - - Laura Gutierrez, Secretary t)clohcr 17. 1tIIX CLIS I II)So. 226901 17.1 1'!111'7S 11:1prr114 SIJAI IN R BIRD ZONING 011 ICI BIRD SFI.P STOKAGI( S I C1(OI\ ('01, 's FY SPIA 1432 1 2011I ST 1101 C \R\11( HAI L RD NI-:W RK IINIOND WI W01'-6109 HLDSON Wl i III 16-7708 ('ONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRI'.S: 10;171I21120 - ,v - Transaction ID No.31?_) SF1 F: Site ID No. 854683 C realise) /ones Please rel-cr to both identification nuntbers,- 4fti Swnmit Ridge above, in all comes ondence with the acencv. 1 own of Tro\ St Croix County N\V 1 4, NLI•1, SI 1, 128\. It19W FO K: Description: 4 BEDROOM fv101IND, *1-YPICAI. Object Iypc: I'MI Compuncnl A4anu;d Re,ulated Object ID No.: 1801182 Maintenance required: 600 GPD flow rate: .'.4 in Still minimum depth to limilin fi ctor front original cradr: Systcmisl: Mound Component Manual - Ver. 2.0, SRI) -10691-P (N.01!01. K. 10!121, Pressure Disu'ibukon Component Manual - Vel' ..'ASBD-111706-PIN.OI 1) 1, R. 10 12): FfIluern Filler The submittal described above has been reviewed for conformance with applicable Ak isconsin Administrative Codes and Wisconsin statutes. The submittal has been C'O\DFIION.ALLY APPKOVFD. this syaem is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) rclcrenced above. hire owner. as delmcd in chapter 101.01(lo), Wisconsin statutes, is responsible liar compliance with all code rzquircments. No person ma\ en,a,e in or work at plumbing in the state unless licensed to do so by the Department per s.145,06, - ,lats, _ The tollowjng conditions shall be met during construction or installation and prior to oecupane, or_ use: It is reconuucn let/ to fence off dispersal area prior and during construction to :n uid duwrh:utee; compaction and use of the site. • \\ith acts construction, it is recommended not to aclivate the pump in the dose lank until the tanks Ire pumped prior to homeowner occupancy. \%astevIaler generated from contractors cleaning of equipment and tools anti or left-over coustrocfion product' shall not be tlisettarred into the drains disch:11I to the private ensile ,,;nlc,,:ovr [I'aluctit svNrm II'fIAAI ,I, \N 11'(c _cneralud slt III bu properly dispnsrd of on-rile or IT suc_ • .Any tall grasses, leases, and shrubs shall he cut short and reinmed prior to tilling the surface for instahation to present matting under the dispersal area. • Prior to construction of the dispersal area. check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity ofthe soil. ['toper soil n:oiaure content can be determined by rollinv a soil sample between the hands. If it rolls into a lit- inch wire. the site is loo wet to prepare. It it ci umhl:;, rile preparation can proceed. If the site is loo sac/ to prepare. do nee procccd until it dries. Y I'11. RIt IN lf Pare) ?nIIIS colic o1 tl)c upprovc~l h ans, epccilications and this letter shall be on-site during consovetion and open to iupcction r.u;horin•d reprc,ewatives of the Department. whist) may include local inspcetors. All permits i e~;aircd by the s:a to or the local numicipality shall be obtained prior ur commencement of Couwvction~inaallation`operation. In ranting this approval the Division of Indu,trv Services reserves the right to require changes or additions should conditions arks making then) necessary for code compliance. As per slate stats 101. I'_t'_ i. nothing in this review shall relieve the designer of the responsibilih Ibr designing a safe building, structure. or component. Implies concernin;, this correspondence nlay be made to me at the Iclcphonc number listed below. or at the address on this lCricrhead. the above left addressee shall provide a copy of This Ie0er and the PO W TS management phm to the owner and any others who are responsible for the installation, operation or maintenance ofthe POWTS. Sincerely, _ I ee Required S 2 i0A0 } 7 his Amount \k ill Be Invoiced. When You Rceeive I ha[ Invoice. T7Ti J 1Na_ner L Please Include a Copy With Your N astcwater Specialist . Division of Indrutrv Services Pa%InCut Submittal. I(10S 1i984f17 Ii. N9on-fri. -:00 a_m. -;i Sll Itm. WiSNIART code: 76i n:+vk ceagncnFi wi.xov CC I-d\%in A Taviur. Wastewater Spec i;dut, (71516.14 _5484. Mon-In. 8:00 A.M. 4:.50 1). %1. Si 1AUN K 131KI) Ngc 10 : 'P6 1% A copy of the approved plans. specifications an. this letter cnal* he on-cite during construction and open to inspection by authorized represzmtalkes of the Department. which max ' include local inspectors. All permits required by the state or the local nmnicipaiity shall be obtained arior to corttmerrenrew or' construction !in,tal lotion+operation . In granting this approval the Division of Indusm Scr% ices reserves the right to require changes or addnions ,]ionic'. cnndi:ions arise making them necessa-% for code compliance. Ac per state stars 101.'3("1. nothing it laic revieU' shall reiievc the designer of the responsihihb for designing a safe building. structure. or component, Inquiries concerning this correspondence may be made to me al the telephone number listed below, or at the address on this letterhead. The ahovc left addressee shall provide a cola' of this letter and the POW'IS marta^_ement plan to the owns-and an7 others who are respon,ible for the installation. oPeratiou or maintenance of the POW] S. Sincerely. Ice Required S 2(1,08 l This Amount Will Ile Invoiced. When You Receive rant Invoice. --'T'Rv15 I _ner L= Please Inuu.n a Copy \4 ith Your W: tematcr SpcOahst . -)ivision of Industr\ Services N nicnt Sub,nitta:. vr. n, l..ui. ~ . - tra e 1 . wagneri a' wi. vo v cc: Edwin A Taylor, Wastewater SpceialisL i + l: i G3=.?1F4. Mon-fr.. 5:00 AM -4:30 P.M. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/5/18 Owner:Creative Homes Location: NW1/4 NE1/4 S11 T28N,R19W 485 Summit Ridge Troy 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. Maintancel&nd Contigency plan 9. Filter Specifi t ons and cross section Attachments: S ' est Shaun Bird Signature License nu er 26900 J Page 1 of 9 PRO.IIa'1' Creative hlomes System PLOT PLAN A[)PRESS 707 Commerce Drive Woodburv Mn 551,25 NW 1;4 NE 1/4S 11 rf 28 N/R 19 IN TOWN Troy COUNTY ST. CROIX SN'STE:M ELEN'ATION 1085.0' 1016./18 4 UATF: BEDROOM CONVENT 10NAL AT-GRADE CONNTNTIONAL I.IVI 11OLDING TANK iVIOCND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE, 765 HOLDING TANK SIZE. LOAD RA IT 1.0 AIISORPTION AREA 600 # of chambers none KENCnMnItK v.R.P. top of survey iron ASSUME I1.1-NAT1ON 100• Filter Lifetime Filter ❑ROR1,11O1.E OINITLI• *11.R.1'. SameaSbenchmark Grading is to be clone to divert 1084' run-off away from system 1 Acre Lot 1082' B-26B Scale = 1/411 = 10' B-26A ~ Properly Line 6%* SIoPC Area 15' below system is to remain undisturbed B.M. Summiot Ridge 0 B-26C Huffcutl Combo Tank Pro 4 Bedroom House Properly Lines Well is to meet all WDNR setbacks Mound System Cross Section and Plan Vie i _ • Dimension Feet J I , L I F " I z N\,-j~ K 1 --n - - - Slope - 4 1-1 - 1 op.oil \STNI U- ('Ic rn ~~r patty 4 in. sch. 40 pcc 1 I Cap Mttuenal .and fill to ' in. dnt. oh ervahon pipi Gcotextilc - r-- G H fabric z F owed Surl tee u ti Ur U~ r~(7t Pt Contour ti Slope Direction GENERAL INSTALLATION: the mound area is staked out alon, the design contour. Exisling %cuetation is mowed tmd raked off the site. The mound basal area (I. x \V) 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 !~i inch soil wire lien a sample is rolled between the palms of the hands. ASTM C-> quality sand is placed immediatel' after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one WE thickness to minimize compaction of the plowed surface. After the topsoil cap is placed. the entire mound is seeded and mulched to promote vegetative erowih. limit erosion and protect from freezing. 'fhe observation pipes are slotted in the lower G inches and secured in place vaith rebar or a closet flange. lllil_I' Igj page ofj Pressure Lateral Layout Two Laterals - land Manifold -Threaded Cleanout I ateral Turn -up m Plug Manifold '1 r+ Gm- ~,l I I _ ,J x \ * $ - I - - Lon,, Porec Main sweep 90 Bend Distribution Ne- work Specification Pressure System Construction l atcral Diameter lr:. 1 Manifold Diameter In. Laterals are constructed of schedule 40 PVC Orifice Diameter In. pipe. Orifices are drilled perpendicular to X (Orifice s acing) - In. the pipe with a sharp drill bit and face down. L. (Lateral Length) 7,)L Ft. Lateral turn-ups tenninatc with a threaded M (Manifold 1 cngth) I t. Cleanout plug and are enclosed in a 6-8 inch Force Main Diameter ? [n, di rmctcr lawn sprinkler valve box accessible - ' Furcc Main Lengtb front finished grade. Grade • 6-8 Inch Lawn Sprinkler Valve Box / L) p,-c oil pros Igj • Septic-Dose 'Wank Cross Section And Pump Performance Specifications CI ( Pump Manufacturer Tank Manufacturer ! 4 1, 71 ^y Pump Model Number v Tank Model Number Total Tank Capacity /aS ~ Alarm Manufacturer iQc^vi _ 1 ✓ j lvlax. Bury Depth I Alarm Model Number _,2L Switch'fype Lim Filter Manufacturer Total Dynamic Head (TDH) Neer Fiiter Model Number Elevation Head Distal Pressure 3 _ Network loss II ~Minimum Pump Performance Required Force Mam LOSS j (7 Upm @ L- jUPM@/ L-, j Ft TDFI Total Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole Securely Mounted With Locking Dcvice <6" Below Grade Sealed Watertight Weadtec_proof i Junction Box - Finished Grade - - - - Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter Inlet Inlet Baffle A y; S~wtitch Settings and Reserve Capacity Weep _Tank Volume Hole B Dimensions Inches Volume Gal. .I (reserve) A / . 27 1 (alp) B 2 O Elev~tri~a C (do se) C > / a ,J ~Ft Bottom Elevation D D J' f (dead Ft 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) and the tank fittings installed. Piping at the inlet and outlet is of app Thhed ce mate resin is sleeved with Swith 40 PVC o brid@e the tank laid on stable soil to prevent settling or sagging. plies with NEC 300 and Comm 16.2:1. excavation and the sleeve is sealed watertight. Electrica"mt com Page of 0210 l,7 280-SERIES 112 hp Submersible Effluent(Sump Pumps The Liberty 280-Series provides a cost effective "mid- Performance Curve: 280-Series range" pump for on-site waste water systems, liquid 40 12 waste transfer and commercial heavy-duty sum 1 applications that require higher head or more flow. pump 35 11 Designed around Ljberty's unique "Uni-Body" casting, 3p 19 the 280-Series will provide years of reliable performance. -301 1- 8 25 N All Models Feature: 20 - 6, • Vortex style impeller permitting passage of solids 15 - 5 up to Y" = 10 3 • 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball bearing 5 I - -2 • Epoxy powder coat finish 0~= 0 • All fasteners - corrosion-resistant stainless steel 0 5 10 15 20 25 30 35 4 45 50 55 60 65 70 • 1'/•" Discharge U.S. Gallons Per Minute • Stainless steel bottom screen - easily removable 0 t 3 38 - I 78 114 156 192 - 228 28 { s 15 270 • Maximum fluid temperature: 140'F. Liters Per Minute 280-Series Cord Lengths Model 10' 251(-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 - wn Minimum Sump Diameters: - 10' cord length standard on all modc4s. For optional lengths, Model 281, 2$3...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" g.s" % hp 60 Hz -1450 RPM Turn off level 7" 4.0" Oil filled, thermally protected (PSC) Permanent Split Capacitor 1 tw Model 283 tmturos a fully adjustable wide-angle float Differential 8.0 amps (115V) adjustments can be made easily by tethering the float to the dis- 4.0 amps (208/230V) charge pipe or other mounting point. Vertical teat model 287 is not adjustable. ro- r 4 Model 280 Model 281 U Model 283 Model 287 Manual, Wide angle 1t - Wide angle VMF-Series n0 )s mag- witch float switch float switch Vertical with quick- with series I netic float for disconnect (piggy-back) " smaller pits - plug - - I will operate in V - a 10" diameter sump cSx .ttrnr~o us Certified srx,:rc„xiUV me r..ri,.e w cruvrgr w,rnn rrouc:. - Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839 wwiv.libertypumps,com t:nnyrinht Liberty P.,im Inc. 2017 All tights rese wwJ. UIT'-000 MSM 7 i POWTS OWNER'S MANUAL & MANAGEMENI PLAN pagc___or-__ FILE INFORMATION SYSTEM SPF.CIFICAI IONS Owner Septic Tank Capacityd 5 S~ -Dal f 7 NA Permit 7 Septic lank Manufaurer yr U NA DESIGN PARAMETERS Effluent Filter Manufacturer 0 NA Number of Bedrooms cf CI NA Effluent Filler Model ❑ NA Number of Commercial Units &NA Pump Tank Capacity ~ al NA Estimated flow (average) L{ flaUda Pump Tank Manufacturer Design flow (peak), (Estimated x 1.5) L t7 gal/day Pump Manufacturer ❑ NA Soil Application Rate aUda tie Pump Model ❑ NA Influenf/Efffuent Quality Monthly average' Pretreatment Unitq Fats, Oil & Grease (FOG) 530 mg/L U Sand/Gmvel Filter U Peat Filter Biochemical Oxygen Demand (UOD,) 420 mg/L U Mechanical Aeration U Wetland Total Suspended Solids (TSS) 5150 m /L Manufacturer O Disinfection U Other. - Pretreated Effluent Quality n NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (UODS) s30 mg/L ❑ In-ground (gravity) U Jn-qround (pressurized) Total Suspended Solids (I'SS) ;30 mglL ❑ At-grade OMound Fecal Coliform (geometric mean) 510' cfu/1001111 0 Dd ine ❑ Other: Maximum Effluent Particle S¢e , inch diameter Vakres yplcal fur Aonus@c (noncommertlap wastewater nnA septic tank effluent Values typlnl for pretreated wastewater. MAINTENANCE SCHEDULE: Service Event I Service Frequency Inspect condition of tank(s) _ At least once every O months year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scorn equals one third (Y,) of tank volume - Inspect dispersal cell(s) At least once every ' -~;U months year(s) (Maximum 3 yrs.) Clean effluent filter At least once every O months -Q year(s) Inspect pump, pump controls R alarm At least once every 'U months /,(+year(s) ❑ NA Flush laterals and pressure test At least once every -_:~U months ear(s) ❑ NA Z- At least once every ❑ months U year(s) U NA other At least once every ❑ months U year(s) U 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 Sower, POWTS Inspector, POW1 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 pending of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to cfleck 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 fading condition and requires the immediate notification of the local regulatory authority When the combined aocumulation 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 accordance with ch Nf2 113, Wisconsin Administrative Code. The servicing of effluent filters, mech nical or pressurized POWTS components, pretreattmenl components, and any other maintenance or monitoring at ilervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service 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 of other chemicals that may impedr. 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. I - Page- of _ of paining products or other chemicals tnz I START UP AND OPERATION h for the resence For new construction, prior to use of the POWTS check treatment tanks, p may impede the treatment process andlr damage the dispersal (:ell(s). It high concentrations are detected have the contents of tha tank(s) removed by a septage servicing operator prior to use. System start h.p shall not occur when soil conditions are frozen at the infiltrative surface. Dwing power outages pump tanks may ill above ronnat Ngriwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and my result in the baCKUp or surface discharge of effluent. To void is effluent pmmp or situation a ePlumber for POWTS Ma n ainerc to retrieved by a Seplage assist in manually opera Servicing the pump controlsoio restoring normal levels within the pump tank. Do not drive or park vehldes over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area wdh r 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the, ion drain antibiotics; baby wipes; cigarette butts; condoms; cotton swabs: degreasers; dental flo"; diapers: dislnfect dications;s~ts~ f oil; painting fond mVS; (sump pump) water: fruit and vegetable peelings, gasoline; grease; herbicides, meat scr; me pestlcidoem san;tary napkins; tampons; and water softener trine. ABANDONMENT When the POWTS fails andlor is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance vrth chapter Comm 8.4.33, Wisconsin Administrative Code' • Ad piping to tanks anal pits shall be disconnected and :he abandoned pipe openings sealed. • I he contents of a! tanks and pits shall be removed and pioperly disposed of by a Septage Servicing Operator. • Alter purnpirg. ail tanks and p.ts shal• oe excavated and temoved or their covers removed and the void space fillod with soil, grave` or another inert solid material. CONTINGENCY PLAN I` the POWTS faits and cannot be repaired the following measures have been. or must be taken, to provide a code comphlint replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location or a replacement sou absorption system. The replacement area should be protected trom disturbance and compaction and should not be infringed upon by requiijed setbacks from existing and proposed structure. lot lines and welts. Failure to protect the replacement area will result in the need for a new soil and ste evaluation to establish a suitable replacement area. Replacement systems must comply with the rule-1 in effect at that time. U A suitable replacement area's not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tack may be installed as a lass resat ,u replace the failed POWTS. _lhe site has not been evaluated to identify a suitable replacement area, UDon tsiiure of the POWYS a soil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is avai able a holding lank may be ins;alledl as a last reson to rep ace the failed POINTS. Mound and at-grade soil absorption systems may he reconstructed ir. place following removal of the biomat at the infiltrative surface. Reconstructions of such systems most Comply with the rules in effect at that time <<WARNING>> SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWYS INSTALLER POWTS MAINTAINER . Kama 6cc ,-yip / Name - --11 T - k-PI,onel 'L J Phone ~j SFPTAGE SERVICING OPERAT~PUMPPEER) LOCAL REGULATORY AUTHORITY Name ~ ~i„~.~YC% Name J, )U,:_ Lr Phone Phone ~/J j5' - / Guy This document weS dmfletl i~ curnpl:anc+: •ni~n rnaptcr .SnS 38991{7)(o)(";(d)sif5 aed 381ti40). (2) & (3). W u:onsdh Admini lr Code. y .i iw 1 ~ . o K ~ X11 F y l{ U ~ ~el 1 fi ; n t ' a ST. CROIX COUNT sFp,rj(, TANK Aril) r OWNERSHIP (TRI'll'IC'A111, N FORM Ovviier/Buyer t? I, 1~ Lro S Q,~j NlarlluF Address ` _10 D1 YA_ f Y_ 12 Property Address 41 s u "i ~ fon (V (,iitication rcgeired (ion: Planting & iug DrpaiT. e rtui i:c vnnsl:ucuon j - City-state - Parcel kicnLficationNurliter ~ 1.E(=Al, DESCRIPTION Yropcrty Location v 1 _ / J~ Subdivision YdLs~ _t _ . - - - - Lot # c4l Cer-tified Sttrvey _VCap _ - . Vtdumc ,Pane;! _ Warran(y Heed # Volump Page # _ Spec house. yes Fit; I ol lOw identitiaole 0 1 SYSTEM MAINTENANCE AND OWNER CERTTFICA'1'1(^ Ingtroner use and maintenance of voin- gxic system could iesull in its pn•niatutt ktdure to handle wastes. Proper utamtenauce consists of pumping, out the septic rank eve: y thtei yea, - u sooner. ii ueeded. by a hcenscd pumper. What yon ptu into the system can afflict the, functioi of tlu septic rank as a treatment sta to is the wasiv &sposal system. Owner maintenance rzspunsibi}flies are specii:ed in §Conmr. M'i-r•.2(I) and m chaptcr :1 - S! i'roix C'.; mw Sandary f>rd manor.. 'I he, propc,rty owner aprr , to submit to St. Ctnix County I'lann.ng 6 ZOn ll n Dcpeir}ncnt a cc,nlicatiou font, signed by the owner and by r master plutnner, j.nuaoy man plmu te,, rcautcteei plumt+cr of e he-r~,ed pumpm oenfyine that (I) thr on-site wastewater disposal system is in proper operating condition ai;Cor (2) attct inspect; ion and I n aping, (it necessary), the septic rank is less than 1:3 full of sludge. irwc, the undersigned have rear. !lit ahovc willat .utc•nis and lvv to rnainunn The private sou ag,c disposal =ystern wilt the stamhuds set fm th, Iroretq as set L, the }Jcl:mtrucnt o'"<: orrmuza:: and the Ootri anaet or Natural Kcsoute'rs, Stale of \'Viscottsiu. Cctnlicauut+. stating that your septic system Icts been maintained tmrt be complerJ and returned ro titr St. Croix County Planning & Zoning Dtpartincut within 30 days of the three year expnation datc- Lwe certihl that all statenicuts on tit' t -+r a ne in.^ a: ow by t of aiyrbur know•l,ci,e VIA 'C arn~aru the ow-ner(sl of (tic pmpertY described alxrvo by eulne ofa sr tanl} decd nx o;drd ui Rr iste! cl'1)rals Ohice. Number of bedrooms l 116NATU7 ATAPPLICAN7(5) DATE 4-1 Nary wimma;in t that is misrepwwritcd n:ay resuit nt the saudmy pcm)it beutk o voked by the Platniin} h Zoning Department. *:^s Include with ails application a recorded warrant' deed hour the Regis;cr of Deeds Olliec and a copy of the certified survey map if reterence is made tit the warranty deed- (RIN. OR/OS) 17AS.F.S % N%1032 S Gy/ bV ILV 44.935 ,yN/ p \ ~Cq4 pM op h \ 'O N 1 % / Gj .'R' gyp. CqS . Cq p ~ I 2` 182.22' G ^ rn 88000' 00" E 354.04' 00 NOTES: 1. AL' 16 - ~ / / 4U; 10 j~ 2°j ' NN Hul 1.014 ACRES 1 v/ 019,, 1.206 ACR=SN' MAI 44,172 S.F. ,52,540 S.F. c~! 3 SH OUTLOT 3 309.96 - ^ lq z~ S 9~6 i °0 / 2. TH' 00" E 341.80' N 1 o ! li vS °OO y JB ~32~~~p o DEVELOPED CON.S1SM''VT uNj ] Il 0° ohs h WITH THE PRELIMINARY I j f„ 1 1 0 00. N b6 r- 0 PLAT APPROVED BY THE 17 M ri 96.82 TOWN OF TROY BOARD ZO 004 ACRES I j GO°E ON JULY 14, 2005. I~1 \ ~ir183°oa I 3. BU 3,754 S.F. •_._.I I 1 ` \ 9 cc 58°00' 00" E Ali r + 26\s7. r M 325.69' w 4+1 -...-...-.-.I t ~1 I - cl) ? v~ 1~ 33,133' 1 n1 Q~ ! qty 4. NO 30 ACRES 1 1 cn I 6 I o o sP WA 335 S.F. y N Ni Z~a, N^ 1 Np~ Iwo ry `fl:~ IN t ° C - 0 AL EA w ° Cu 50' 00" 1 o 143.32' L. 45 10' 1 00, W 342.010' v o o p lp> Sg? 00„ J o° i v^j. ~•~9q• F 5. A 19 , ° ~ eol° 25PE 151.041 ACRES J fMt 1.002 ACRES )o ' z 2 ,330 S.F. lp> &X2 6 0~ 43,631 S.F. of Np of a TH 80 315.01' o ~Y 122q> o 6 s o• 88°00' 00" E o 0 ~7 32' q ' yN a 0 rn o . THE I 1 ~.`34>6 11750, f 7. ALL u( 1 j RES I I 24 / F. R=80' 6) ty THE f 2 \ 1.08CRES co / 8. NO 12 8 C,) 47.044 S.F. /Q. 109.62' OR 31~ y 8 5 0 3 \ S G I c o • W s \ , j N S 88°52' 58" E D i S OG„ E / J i\~ L C38 Z :5--•c_----~~.~\~"c o° I \ ~i .~"~..9$_n" USE I I I' ~C~'yJ' AOtll M I 1~ ~ f rn'' III I ~ i ~,I IIL' i? I it BFI r i t ~'I ~I ❑ r '1-~f'~~I it I I I~ 11 I I j~ I I . -1> z ~lu ~ Q ~ ~1CJ r, ~z 3 _ 7Z I I I ~I O, nv'i J ' lll- L.-H _v 7 1~ Cl9 z eh ~ tc I eaa'•pyo y; ~ y 11W - nly~ yy~ 111 rs,~ < y, `a AG'a1 : . ".N I 1 ~ J'1 r I_IVL,P 'L mod" f\1 ' 4 ~ ~ a) ~I ( ~ S t f f Z:~r ~i < N dd r° ~ zi YPw t t ; v S z 13 r •E 'f`7 ~ ~ ::r: ' M n t' ~ j Tm i P I f •~r - P x~ ~ ~ y E E f~ `r ' i S' • 17 n~ M pa tie t a a .ra ' m • 1 ..r ' .:isconsnl)epanmemat r mean SOIL EVALUATION REPORT Diviscn of Safety and -Rfwdi-s Fagr. _ o. 3 Ili arrordarylit~irilh C$nm ttv.•• Ws Adm. Code ji County Attach <:umplete site plan cf paue; Les than ti tit x 11 inC}iBSef,&i4e Plan nest ST. ('ROIX n,clurfe, out not limited Io v¢ wal ai 1 hrr unla! •efrrenr,u point iBro11. :1neC.ion antl Parcel I C percenlslope. scaly: or dimes --curs n. rtl-.-i ow, axl k.-anon al7dMntan Ce tunearest road. \(1) ~---7 P16ase print all inforrnation. Reviewed n Dale i'Prsoral inbrTa'iun yn: •ovidu niay h- sJ, i_r ,..,rpos-S Frva:Y ~dx 'd tf)Imii ~ - ~ Propeny Owner Property Location \OR'Ilf O:1KU'FA ST:1'll? 1 i\'IVl?RSIT1' i:o I.co Heskar Govl.: or \W Iff \1' I1 V4 S 1 9 - N R C ior; VV Pro rty C)umer MJiling Adtlress !of # Block # Sabel Name or CSMT. - Rodh. Beskar, Hole, & KrueCer SC, 319 N. Moon Slrcet `6 111115 of Troy CJy Slate -Zip Code Phone Number _ . :ity E]Village town Nearest Road RivcrF;alls, WI 54022 f ?l) 435-7381 - I~-:.-~: - ~W I Coulee 'frail 1 1 • New Constriction _ i(1n flow fate ❑ Use Residential; Number of bedrooms (;Ode derived des - (,O0 CPI) ❑ Renlacement ❑ Puu!ic orconirnercial Iivsrribe. Parent nlatenal_ - IOCSS O,cr fill- Flood Plain elevation dapplicabto fl 7eoeral comments - and recwmmenclarons' Mound System i.00 III and }ill 0.6 loading nice j Y, L (If pre-treahnem system - below ground drip-irrigation 0 8 loading rare) Borelo Pit Groundcurfawelev._ W,-193 B. Depth to iwIllyj factor 3' Ili _ _ Soil A Cation Rate Horizon T Depth Dominant Color Rndox Doswiptlon texts crud-arn Corplxlnnoe 9oundn Roolrl ppp/fr in rdunsell du. Se. Coral. Color Gr Sz. Sn_ 'EHit1 'Fff#2 1 0-13 IoYR3:2 Nil 3fKr - -nab nn'fi at 2%f-In 0.6 O.R 3 13-1,' 10}Rt!3 - sit , _fabk mfr _ es Ivf-m 0.6 0.8 1- 26 ]01 R1'4 sit --'fmahk mIF Cw Ivf-n1 0.6 0.8 4 36-33 10Y R3;1 xl Iflbk in fr as Ivl=m flit OJ 5 33 .10 10YR7;3 .21' 1o1'R4i6 - Is (hn nrvli 0.5 1.0 - I IUrIZnnR 3,3 ,u 41w,c ~nnc Fn. ❑ Boring # Bonny I11R3-32 I; 2!, Pit Ground surface elev. _ A. Depth to 6mding factor in. _ Soil ApDIiWUOn Rate Honzon Deptn Dominant Color Redox Description a,,I,1,&,hk Structure Consistence Boundary. Roots _GPD'Yf _ in tdcnscll _ Oa do Cont. Color r Si- Sh :3 I 0-10 i0Y12: - nix fl ai ?c1 m 0.6 n,y I n 10'26 10l'R. 1'4 sit ^fabk :n Fir as IYfm 0.6 0.9 6 30 MAO nit -4 . !d I trnt»:e sit fabk ' z+ IY1 f Il.G QS rl 30 40 IOYR3'4 mod 1L156 sit 'fabk mli I as IYf f 6 S6 N 5 4U-4.1 10YR1* ,3 m2d MYR5:6 fs 0m mvfr 1 - 0.t 1.0 1 Horizons I-4 fis.c s,mc z:. Effluent #1 - hUU 1 30 < 220 mg'L and TSS >30 < 150 mg1L ' E#!uonl = ROD <30 ox3ri and TSS . 30 mg:L I CSr T Nerve Wlease Print) Signatur, e - - CS. Nuntf~ - hrv to Hollister „0,11 Adnmss _ hate Evaluahor - ndumed eleph ,e Number W9S: 69(nh 1cr.ni-c. Ri , Falk. WI ,1(122 05 - '6 9I i ,i ~2lr-I??s~ Properly Owner \DSU fLot 261 Parcel lll # IPcndmg1 Page of 3 IT] Boring # Q 1 nr 2! (1 Na Ground surface elev _ fl. Depth to limiting factor 24 in. - SoB_ A. ,iicalion Rate Nonzon Depth Dominant Color Rodox D esaription Texhne Structure Consistence Boundary Roots GPDrfV In. Mansell Qu Sz. Cont. Ulm Gr Sz Sh 'Eff#1 'Cff#2 1 0-II WYR 2 - sl 2f-nia&sbk fill 'T a11 2vf-m (1.6 0.8 iOYR3:4 2fabk _1111} cs I%f-ni 06 0.7i 3 7-24 .5YR3%4 sl 2f-1nabk n;ti cs ivf-rn 071.0 4 211 _'r IOYR5 :6 _ c_'d 10YR;:x c ]lirbk 0.0 1,10 Sum- gr in _ all horizon.. f l Doing # El Boring u n pil Ground surfae:e e.'ev. II. Depth to limiting factor Soil A (-Ation Rate Haizon I~pth Dominant Color Redox Description Texture Structure Cons'steo- Boundary Roots GPDNt in, in. Munsell _ Qu. Sz. Con;. Color Cr Sz Sh 'Eff#1 'Eff#1 - - - T- 0 Bonito I Boring # - -J ~ I°II biuund sujaa; c:cv. _ fl. Uen:h to limiting factor it - Soil A virai,oo Rate ioozon Depth Dominant Color Redox Dcs(atplion ' Toxture Structure Consistence I'lounda Roots QPD ry Yf' in. Munwl Qu. Si Cont Color Gr. Sz. Sh. '[fl#1 'ER#2 _ - - _ III E-luert _ ~C:J 33 < 2c3 mWI anc T56 X30 < 16, mod • EflL,ent #2 - 901), < 33 mg+l and I SS < 30 mg+L 1 ho D) pat Inieat of Commerce is an equal ophnrtunirv service prodder and -mploVer. If "oil need assist an-^ to acre- s scrvic:es or nzi:d nndcr'ai is all nhcrt cane liar tat. plc i+: eoueet th- ,4),r!mcn N14-N,6-.' 141 I I Y (r A ,I S?-, Vie. Plot Plan for Hills of Troy Page 3 of 3 Town of Troy, V. Croix County, Wisconsin Lot 2(: I 40 ft. Legal Description 2 ft contours _ -;lic E '44 Backhoe pit I r iw ¢ 27 I L7 /il \ \ \ L o 0-278 6-266 ~L I B-26A / - - - N ® 6L io9ti 9 E y 1 ® 6-27A i e-2sc Y i ~ II , 26 ~ -.~I r✓. ~ ( _..')1