HomeMy WebLinkAbout030-2000-40-000
PRIVATE SEWAGE SYSTEM - " -
INSPECTION REPORT °1L^r =,l tx
4, 4p
GENERAL INFORMATION T': real "r tl
:eL °lal, II: nc:
-orona inmra;a mc~m-ra;rrs-. tar •.::orosr.:. n- react _ar-..:~;t:. 1,4
IPe'^u( Ha.::ni': N:r^° Ci:r 'Allape I:.xn•:-c Pare Ian N,-
n.iG~ >ol~~ VNOF ✓fJ k 0~- 10)- -
t.}: 11 V.i rer 91i JC5.nr:on / ztuoniluxr'.:angr'rdaD Nc
~ r. o~ al 3, a. 9_. 36o L
TANK INFORMATION ELEVATION DATA
T"'= I:d4N l!. AC.TI:RF .PAJIw :A 1:)N REE
I
SerAic ILe+'cLmarl.
G~ er eti /z 5o S' 35 05.3 Boa
„ ; t fi t. oc~v st•: fatA LO L %8 FS
51Nr Jude'.
TANK SETBACK INFORMATION
4.V L'_ C_ n ert: t: t^ rZi~ U. I u.:'
~4 Il /0. vjoo~ 45
7 50 ~0 3(e I[: n Iy 05
.:S InO / / I'ie^ tel'rr.
9 S~Q~ 9 -7. os
;i~CtCl':c r iio'. :w•Ft ee'.
elk,
'JMP!SIPHON INFORMATION Or, t t~ ~~Lrt ~0 1 "(rerr n Co~e~ 3 6-
1 9 S. B
SOIL ABSORPTION SYSTEM 7 • p
3~D~N-.~i Yemlh I;r np;r Nc :11 I rrnvn:::- P.' DIMEV ,IONS r v ne ae C'~e. _mv
]IMEh . „s 3 9~ Ild Z e I ~
rA N t;-;1 r F'fL 3. _ _='~1 : F:641:' I =4CHIhC u~nrr
.NJ ]R 1GLION I nHAtdS-F O.
Y :Ir^t~, ~ 5~ / D Nri UNIT I:.c-Q_'v ••c.L 1 ~JfA
~L~ I O
DISTRIBUTION SYSTEM _ 23 5'e X14, 2~7 AJ, rd-~1141✓s
SOIL COVER x ?ressuri, System only - xx Mound Or A:-Grsdc• Systo.im 0nN-
C-:,1 - r u. -Pp:: o' I x 1>nc 1 - fv,mce
1,d it
COMMENTS: pr ewo•_ ccdc dixc-ecanr=.r. p~m.anc.. present. ;a~ j :rn:perfior : r /,~y~7 Irspr.:non :2
Loratmr.' Z (~~y NJ X~ 4 K
2 6L ,:I Rfs!!)er.clt,bnr' Gfeeti- 1 • C.i-lam Q SL /
- ammiril n' cover -
°tarr revisior R`:Ltir~ _ Yes ! 7 ,
-'n t:he sci!: 1:c acid Imal !n1--mattor. _ f
1
1►
GCU*
y/~~~ • 1400 a Waswnoon Aw
P.O. Box Msdisom W15577162
(/r/~RQ m /rt N!mb/c (to be 6tkd mby Co.)
l 1VG ! (/S
Sanitat " it Application SmrT}asaa4mNwrba
in WwWw oe wKh SPS 313 MZ): ifYie ('add, submi of dw fo w r6e,pprtyri,a. pNam =W Ltat AJA
is mg-ed prid w obft.,& y e permit Nac Applonan forms far svbowed POVnS ac ab!ralted b
aaaarg akYm)
the Dap t of S,SUr egad Su.sc¢ Pers,W isdvmaodn yw provdc tory he used dr ad,eey pew aedRSx (lfartraam
to axUdlmtcC vacy Law S. IS. 1 ® sets
1• , Iloa L.7em,tlow _ Plme Prim All,.f r>,.... e, N C-)1 . / Pefe-k '
Nay c r N.a a
~ Pacd ~
PrVcft 0 ~ - Malmg Address
'5,3.:c>4 f AKE hn ~pt*yh,lan 33.30.19_ oc
city. slow zip calla Plow Nubs Govt. tat
l~ vV _ Y.. secbae
c n(~! _ ~ ore -
liV`4 I LP 7 5' Z (cock
11. Type of BrrYdiC (ebeeb d that apply) la a T K R b
91 err 2 Family Daeltmg- Numbw ofHadteoa/ SbdiYmoa Kane
❑ - /rIV
lLblinlCamrencyl- I)m!>,e lls
- Blocks
❑ city or
❑ Serb Owed - D=mW (he _ CShf Iirmhv
r_j lls Ll-j TeMer_
III. Type of remiC (Cbeelt are bas w ire A. C.mplele Rae B dapplatable) - omq A_ O NewLLROWWTWO SYarm ❑TmaaaYm}loldarg Tack Replac®my q>h' ❑Oihv bdodifcWOn
to ~Sysem (aWlan)
❑ PermParma It w O chmar afPksber O Aaaa TlemfiY m NAY owner 'ejr-
,
NO-D-P'(essa®d hMeoud ❑ Prcsssrmed b~(mm~d ❑ Atfinde ❑ Mamtd> u a ofmaable mil ❑ Mmmd < 24 in. oraoabk nail
Otlmr rwprm Campaernt ❑ Dcvioc (ash)
V. Ala Isbrmwa:
DesW F'bw(gpd) Design Sod Appliatiew Daparal Asa Ragrraed (st) Di:pmal Area (SO Sysaa~ Flnatim /
L-OD rV.7
VL Tank Iai 7. r f> 5 yl r ✓
Cpaiy n Toed a 7~ `II..,ZJ
of
Calbns Mamfacpaer
Gtlin Users
NOW Tab
tvYq Tae"
a o
Sgee err J'M' f r r I 6 14 m tl rs'. a
Oasag X,
~ 7 NF rG- ,
VQ. mempamanky
8 4 the aasae W baer6Wa ttae PON7i Yew. r ti aMarW pas
Market 'aN®e(Prioq Nugbe's Sign1we
Nrmbc R~aa Pare N®6r
TN TicIKf.t)G.S f , zzUa s7 715- 579-zero
Pk® , Adams (stns. city, Sly, 7V coat)
S7 CA~7-r' Ina, 574 7z
Vm GemodyMenarimmest time voy
! P+saa ice Ora ) g
s
Reason rw Dmia, /Z
Ix CesdaTtiM
:pr
tihpelra~ CA must ell tL be 3)
s^~.+u5 rut'Rls:~
as per,7arnemen! plan pro,iden W ylwnbc. r~ , GO
2. Ap gelMx:k rer~iwr-erws mu::t ue re,r:4.ire : I"^
as par Ppgll J"A ax5! i :rdlulcel.
Mara mcaaiew pas. Palo se galm w seaahre err ca.rr wb ee P7w r r are ra: is rrM r ~
SHD-6399 (R OSA4)
Plot Plan Page ZZ of ,y
PROPERTY OWNER:= --DiEII ;J 1" = 40 Ff.
(except where noted)
i ecal Description: Pr-L-. LL<AT(-.-p W THE NF y aF TtI F .J ` IA^ND
ti'i ='EC->j
U
_ =-~.>zld~ee pit
13Ca P,.-Kf -rC ' OF 7_ o L1 = t~01,AY~
~l~112r~`~S,tit_ X31 P=ret LAKE R.cA1 > L) ~=-yOC,+' 40 C4XJ_ Z`~ yrv~ /i~r~s
North
i ~ _ / „ n:~ o;=:r yr -A-5 ttG
7 ~ Y hl
` r
i
- - _ fir-- -
Site location:
10r,N c o. p.
X -y~c
yet c•Y, t/ rzs 'I ~ ~ %
7~
`-f l~ PAGE 1 OF 4
in-Ground plan
Index & Cover Sheet
Compw" UbmW Design Relhrenoes
Version 2.0, SBD-10705-P (N.01101, R. 10N2)
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Dispersal Area Cross-Section & Plan lriew
Pg 4 of * Management Plan
Attachments: Enclosures:
-Twit- OTeR acs i POWS Iicetion for Review
wr, ; ~cz Soil Evaluation R & Site Ma
ttP S"'EC5 >&P-11C TAn7K .,+V4-'9-EMEA;r7
Project Name / Description
Ownermame(s): ~.A/y;CE M. DccnhAn
Phone: 7~ S - J~_~_
Owner Address: 53t tIC--KCh Kf- F; L).
•`jea A~s: l EbAME
Govt Lot: - N E 1/4 of_ nJ wl 1/4, Section , T -'i N-R~EQor WR
Township: 1r. =f'N
courKp: 5T c Roe~C
Project Parcel ID yam; _ o pc,
Designer Information
Designer Name: AJAt<~) J> flutyo<T Phone• ~!S _ _
Designer Address: ZkLI97 K,A1&AgTHNRS C+ 1 Na ~~+1 a aP
E-nude: diolUerdes
l~n C, p,.t+lnnK. Coin -nom ~ ~`,k~ "
her. p .w ~mF.
Lk:ense Num I - 0 7 Y v ~d,L
Remarks: ' f' "Any
U 188"9 c
RIVE Fes;' x.
Signature: hl~~ % ~ c _,~zC ~n~m~rw~rz-L) i e
o~~,~„r Date _ : i ~~f/ ~S'
aaenrimd mw. r
Plot Plan Page e-of-z/
PROPERTY OWNER: J ,1IdE M bTcAJAAJ 1' = 40 Ff
(except where noted)
t ND
Legal Description: Pc L. CetAtC-p IA-1 rllE N1IE~/4 of TiFE NtJrr SEC. 3.3^ _ wt
L1 = t3orti,+r~
'i A3 RAW TCWA2 OF :~W SosEPH Sr. CR-V)c LbL A)TVr
WiS~OVSin . E T31 PEW-19 LAKE R_ pgn p3o_ AooD 40- pog
North
I
lumtarr•.'~sn )
i
'Tie
ciG9 ",4,w .uKI 1
If U?-nred, Lpr.7rli ~a`WN\I i
1,c a. ~~-F3.=% JC~~(rei -ror'rF rir£->9 Su MfC.i C~, l.~
&1'S1 w.~..c
/alto' _X,STU VX 'fop LC rnri't-~wK Coves
r
~z'o y~2 la~.yp
i Vr
Site location:
~4A:N 6 D. i
<•.r,
2 ru
- ~ wvr-
~J
3c ~
1 vl r-Xr /T"w,;k(wl)Mwobdiiiir
IN-GROUNDOftkW DISPERSALAREA
ll{b tour Elevation Trenches with QLicM Standard-W Chambers soft TMM eiwi.erkk
3-ft Trench (downsizing credit) I=X' W - ow - Orr - od
Eiaiiit FW M..&c .
rM-f6eV
FJYrA Fier LNAktA K-tt"~-'
~ 1T
IMkM (.l` f~.t (_!Rl.
TYPICAL. TRENCH
CROSS SECTION VIEW
(NO Scale)
Provide nw*mm 3 a
Systere Elevatimr ft seprim between eorrMs
GAck4 SW.I.C 'N _
vii Ero can (Snow toraemr of inikt r wrest pipe m.Wlon m~Wn viw..) v mr` TYPICAL I F2ENCH
PLAN VIEW
(No Scale)
JA=~ 3.0 It
B=
(bPlvll Sterderd-W Clamber W
mpdi O
INSTALL PERTRENGt LLB i rnrreems,~.w -n
' _ ~rr•n.r nn..rewskeidbw A
Oiitt/ S16W a 20 fe E6AktM*w. AL; Y
+ ' Pairs or erq ~ Q 6 X Emvpalr= M
= P".Ac EISA w ~n h ie Re,.ked kdMMMM Area= Dlstrbutlon Method:
_ )CSEL~
- ' trenches = Proposed Tots) EISA = e' .MR I.U i c - L C~•
Q7 I'r71 ~M,.vintu
;7 7C tl'~A vuOT
fi' y 3 I,(AV5 Al(A;,MUM
~-D7A 4
7' r 1
7
In-ground Gravit Mana eme PAGE 4 OF 4
Y g nt Plan
IMPORTANT:
The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 38152 (2), Wisc. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan
F urthermore. all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wise Admin Code
Maximum Dispersal Area Operating Limits:
Design Flow= 600
9pd; BODS 220 mgL TSS 150 mgL'; FOG 5 30 mgL''
Inspection Checklist INSPECT EVERY 3 YEARS
type of use
age of system
nuisance factors (re. odors. user complaints, etc.)
mechanical malfunction (i.e., pumps, valves, switches, floats, etc )
material fatigue (i.e., leaks, breaks, corrosion, etc.)
solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i e distribution /drop boxos>
neglect or improper use (te exceeding design capacities, prohibited activities, etc)
extent of ponding in distribution cell prior to dosing
dosing irregularities - if applicable (i_a , pump re-cycling, float switch settings, etc.)
electrical components - if applicable (i. e., wiring, connections, switches, controls, timers, alarms, e!c i
distribution lateral or lateral onfice plugging (measure lateral distal pressure - compare to desiy!t specrticatron
surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
SWic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s 281 48 bvis
Slats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113. Wisc. Admin. Code.
Effluent fnlter(s1 shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than Z
months.
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wlsc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company ADVANCED SEPTIC INSTALLAT Phone 715-703-8337
.
Local government unit: ST. CROIX COMMUNITY DEVELOPM Phone: 715-386-4680
Local government unit address: HUDSON, WI ZIP 54016
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admix
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc Atlmin Codc
No product for chemical or physical restoration of the POWTS may be used unless approved by the department ui
accordance with SPS 384, Wisc. Admin Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre determined area of suitable surds
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned n accordance with "'PS 3e3 83. s
- dnnr Codc
GRAVITY-DOSED PAGE 4 OF 5
SEPTIC / PUMP TANK SPECIFICATIONS
A-" Vv Pbe (No Scale)
>,o a nnn
WS 3% Wd NM 30D
App-ed (lypa/) w+san.,p,o, F ssMSmb dear ss nacaL~Y.
IMPDR rANr: VON Aprsuwd Ladd6q Mm v„ W
AnChur IW*(S)as
rwEegWy 'wwdnBlMr+coo AIR,bd
twrumt to SM 3IM43(a)(g)
r'►ati arzn n moa
EaWeye Flood Elsa
PW-0
V'rI iO" bwmse
CAPACITIES Q 7GF Cry
Moab
D"th (n) VolWme (gal) v My P-a
A no '7/'. 70 B IuW
2.0 1 I n Depth = in
S. 3() A I (eeb. iacl~,)
~l.. ( SQ B L .roo
-a.
Pump Tank Liquid Level in PIANi'OFF
"M ELEVATION = It
a.&
Forcer Main Diameter =
~.~..~t' VAND INSIDE BOTTOM
ELEVATION =
R
Force Main Lertg[fl a ~jl/ ft s'~w'°.r'ewvsrrA.l~ren r~
bRqdjnL Bury fotce main b" Ma fmast Ere or
mtikC.
as nacesmy PuBtrettt m 1L' PS 382.30(11x. wAC.
10 Total a Vokrnne V z 74•. s'c - ;cL 7 & `s j`> ~(cs~
jwj
--~2 )saUdosa p/
<_aZx ote,esw-Np liC) ~/l~ 00 1.7G9$ . O(p G.I
_~cD
~ ~A[''K W d'erXwMe) " ~o
Vertical Li[
i- 7
- D
PUMP
TANK
god L l t57(•t,~
Volume /060
~FPTI- C--- T-~Sr
Total Volume = (z-,.;U ~
Manufacturer
Pump Manufackgw
Pump -M ~ ts..re.o~.p, t lnst~ mowed effluent Tdterat the on. r: tonic ou8wt
ContralWAlam, Manufacturer. laly uostrBa err the
Manubmww Controls/Aehm Modal: 7FcN
mrrr+trr,,,, „ Filler Modek
NFILTRATOR'° IM-1060
• Strong infection molded polypropylene
construction
e . 64,
• • Lightweight plastic construction and
inboard lifting digs allow for easy
i delivery and handling
t • Integral heavy-duty green lids ft.;•.
interconnect with TW I- risers al iA o pe
riser solutions
Structurally reinforced access po:ln
,7 k eliminate distortion during installation
y'`#f.;tr and pump outs
• Reinforced structural ribbmq arc
fiberglass bulkheads offer dd tiunal
siraigth
Can be installed with 6" to H"
of cover
The Infiltrator IM-1060 Is a lightweight strong and durable septic tank. • Can be pumped dry dun.rr;
This watertight tank design is offered with Infiltrator's line of custom-fit pump-outs
risers and heavy-duty lids. Infiltrator injection molded tanks provide a • suitable for use as a septic: tan, ,..n l;
revolutionary improvement in plastic septic tank design. offering long-term tank, or rainwater (non-pc-oblo) tn....
exceptional strength and watertightness. • No special water filling requiromer ils
Inlet Side are necessary
4y • The tank T,ay n on( k; 1,,d s_iiahlc
TANK CUTAWAY lint ltrator
TIN Rvc - native od. n fi'la'.i<~i li h,uf.nn
Sysl~.r - for ,qu dar,:,..
Partition
baffle wall
HEAVY DUTY LID
a _ CUTAWAY
r
RHn1orcJ
24' tnn :'oral
S g
+rv Structural
bulkheads
MID-SEAM CUTAWAY
Heinforcc,i vretcr by r.ii,,: .rn
gaskFtex7 curtn,-prior
IM-1060 General Specifications and Illustrations
The IM-1060 is an injection molded two piece mid-seam
plastic tank. The IM-1060 Injection molded plastic design
rJ I t t
allows for a m1d-seam Joint that has precise dimensions f ! ^ 1~r A
tor accepting an engineered EPDM gasket. Infiltrat • r * )
or 's
r)asket design utilizes technology from the water industry
1 '.S_fr
to deliver proven means of maintaining a watertight seal
The two-piece design is permanently fastened using a q
series of non-corrosive plastic alignment dowels and ~I II f ,i: rp
locking seam clips. The IM-1060 is assembled and sold
through a network of certified Infiltrator distributors.
Must be backfllled and installed in accordance with TOP VIEW
Infiltrator Water Technologies, Infiltrator IM-Series Septic
Tank General Installation Instructions and for shallow OV111 '
ground water conditions reference the Infiltrator IM-
Series Tank Buoyancy Control Guidance.
I i J I I lit ill
Please visit www.infiltmtorwater.comAmages/pdf/
ManualsGuides/rANK01-pdf for the latest information. ! il"~ i'
~IyY6 ~ll~l"I~IiI
working Capacity 1094 gal (4141 U 11~ i J~ +
l(fal Capi - 1281 gal (4812 Q END VIEW
Airspace 16.5°ti
I ength _ "'(3226 mm) „9XM. , ,1'..111::
M p
Meth 62.2" 1580 rr wµnr mn:.ul Xekarwuans
f 1
LYrfgth-to-Wldlh Ratio 2.3 lot C iMX9w1
Height
54.7" (13a9 until (r '
_
Tua,1t1 I wvel 44- (11 ~ lI
16 rem)
Inver! Drop (76 mail uX:naaaa luolao ~uv9~M~" fff
r.ln ec rlnw nl
Rbargktss Supports p I II
an X
.Urr
Comparlrre its f or 2 h"mvi um Burial Depth _ 48" (1219 rem) SIDE VIEW
Ma mum Burial Depth_ 6" (152 mm) - -
Maximum Pipe Diameter -
6"(152 mm)
Wei ht - IANK 1ll:1 I rl`,'i yl.
320 Ios (145 kg) I (Al F
TANK
INt1RIOR Y - 'I
eF'~
Ar16NMFN! IJ
FH)YYFI
.11W rR-, Prk FObd j HAI
V O. 11c,.::gq it
Oki Cnyhri k OI N 75
INFILTRATOR 1`" MID-NEIGNr SEAM SECTION
noaxz11 , o ats
W W W.Inallrnlorawalm.mm
US YnIpX9 i.)]91i1i1 UV,411, IT Y:5_.IgX. 1.Yi.U1'. »JI t 15. SJ y 5 t fl;" - If_ i)3yy,: )Q 5.Q?J Wti C -nn, Y' 12"9n : II W !%rp lyYry•C 1.'
QM.k•..»y'i1MMfr"Iw r'rl ed htlml h I YAXOI Vf 't hdx! 16X. M' I: Irol -...ln:'+
(:prlu MrIIAI,, Yq. l'16V1u11 Ohm1yr o M1I h'lubyl` r :.1.911-Vl 1-I uklgrsn irN3X+LAI h. cvae.4rr
1'MVf/F h T it wXJA [11" "'Ll. .a M11bYv 1+1 \ 'k U-11 I YIXIN, ^n'r, rx. ml; 1, 1 arltt.).vY I lfl hr.pn ll:tlrr ttt'r.4n)r....
y ...lrc:ll h fu
rwy > 1l:xMrnvh:+111, I a lb] i
. 111 i .a X.rry..,•F II YA If
n al@ Mfrtab 1V.11r. latrldc.n- 11 C..J r ."fV1Xr r_rvd P I'rirXd H 0 9A
INFILTRATOR 1060-GALLON TANI( VOLUME
UQUIU VOLOMT It, TANK COMPART 4:1
TOTAL UOUIU AT INUKAUGHMM
I uri IIT VORIMI IN iME A7
INVI(A'f.(IHF:CdA COIdvAR7Mf NCA COMPAATIM;l
-0741 vu
inihrt fa4mn (i9Hnn: 4ollvs
U 0 0 ' 0
I _ i 7 2.1 1.1
3 749 ~ 17.9 - S.U
44~-=--1- 79 ] _ i.18
S GiA 4.C i.l
ki.ri 669 274
69.9 31.0 _ I
R 124 N 44 0 ° 3
9 _ J-1 9.S OTT
l0 172. Pi-_ 11..2 516
11 UG 8 111.: G 4
1
147,7 77 ZI 5 _ - I - 73 F
I(AA
-
J ~ ~ l1G / --yl fd.! f7I
14 ISM 901
L' i1d.U 191.7 ; 99.1
16 '?J.I 214.7 IOS.L.
- SO.f '335 114.f
1 19 403.2 dbA-H :34!.
919.7 786.4 191.1
11 4;L.7 30.5 152.7
[2 4x7./ _ 377.5 167.7
-]3 1170.7 340.6 - -1703
:1 S3x.t 3SP.8 179.4
SI.S] 7//.I _ ]18.L i
54 SH-1.3 195.'. 19].11
:G7 i_7 ~ 414,1 7010 I
'x (d4. _ 437. i•_ 71G.d
-"1 uN.s _ _ Ailll 72'i
+0 -_N•l0 •1697 ?747_
it 731.-1 4R1.'. _ +1.1
; I --sOS.7_ 7:7.4 _
211 761.8
7J 812 d ,a 1.L - 8 _
IS 8391 559.4 7]'17
16 HG:7 5773 2846
892. _3 9 t.1./ 79/ •1
411.1 412.2 _ 30b 1
,9 744 n W,a
I0 - 9]lt 1 fv14'J _ _3214 _
ni Y)s9 _ v619 3310
12 CRO.1 - 4 .10.1
I_ I0P'.1 -_691.3 14A4.
07110 ]713 110 / v
011' 731./ 365.6
746.8 ]73.4
l4 - 1;2c.2
I / I14d 1 141!1 _ 3R0 7
IP. 1143.2 775.5 381 l
iv _ IIxLI 7AR.4 J94 i
J 1702.3 ROiJ 7008
1 1770.1 _ 473 A 4041
_ r
a~~rta~ua DIVISION OF INDUSTRY SERVICES
/R.
PO BOX 7162
\D $ MADISON
l Is hnP:kdsPs.vf,gov!{xogramslndu,,,t y_services
L _ www.vrisconsin.gov
u rr a\-
Scott Wafter, Gowrnor
Dew Rose, Secretary
Idenli ication Nunihcrs
iclnhr. r,~, ~ i ; Transaction tO No. 2602118
Site ID No.
I'Icau refer lu Kith identification nutnhers,
. `w in all correspondence with the a encv.
il iSl IUAo I .inr-P
1) :AVID LENTZ
GOVT AFFAIRS DEPT INFILTRATORZ WATER
I'!-:CHNOLOGIPS I I.C
RC'SINESS PARK RD PO BOX 768
ILD SAYBROOK (T 06315
!'LAN APPROVAL F.XI'IRF_S: 10/31/2020
Rc: Dcscoption: SEWAGE TANKS, THFRMOPLASTIC
Manufacturer: INFILTRATOR WATER TF.CHNOL(XiIES LLC
Product Name: Sl "[C, SF.PT'IC/SEPT'IC. SEPTIC/PUMP, PUMP OR HOLDING (Iran id 2602108)
Model Number(s): IM-1060
(1060 GAL. ONE: OR 2-COMPARTMENT THERMOPLASTIC SEWAGE TANK:
1247 GAL. ACTUAL CAPACITY WHEN USED AS A HOLDING TANK; 713.1!156.7
GALS.: INJECTION MOLDED POLYETHYLENE OR POLYPROPYLENE RESIN, 2.
SECTIONTANK WITH MID-LEVEL SFAM)
144.0 IN. 1, L.. 6 IN, MIN. AND 48 IN. MAX. DEPTIf OF BURY: S07 6 G P.D. WHEN
USED AS A SEPTIC TANK: 141.6 G.P.D WIIEN USED AS SHITIC7PUMP TANK
BASED ON A
3 YR. SERVCEF INTERVAL FOR RESIDENTIAL WASTEWATER: SEE TABLE, I
FOR TANK CAPACITY IN ONF4NCH INCREMENTS: TANK DIMENSIONS (OD)
= 127 IN. L X 62.2 IN. W X 54.7 IN. III
Product File No 20150226
The specifications and/or plans for this pluuthing poxloct have heen reviewed and detennined to he in compliance
with chapter SPS 182 through 38.1. Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes.
The Depart wnt herehy issues an approval baud on the Wisconsin Statutes and the Wisconsin Adnunisuative Code.
This approval is valid until the end of October 2020.
This approval supersedes the approval issued on 4/10/2012 under product file number 20120143.
This approval is contingent upon compliance with the following stipulation(s):
• This tank must he designed to withstand (tic pressures to which R will he subjected.
• The manutacturer must keep at the manufacturing plant a set of plans and specifications beanng the departutent's
stamp of approval. The plans and specifications must be open to inspection by an authorized represcuta6vc of
the department
• Installation and sen•icing of this product must he io accordance with the manufacturer's instrucmxts_ % copy of
the manufacturer:, in.aallmion :md servicing instructions must Kc given to the owner (it the .system,
26021118 D.AvID I FN-17 Puge ,
law:tts
\('hrn this product receives wastewater from dwellings mid is used as a septic lank, it will produce an effluent
rprd fty with a uraximmn monthly average value for BODi greater than 30 nig/L but less than of equal 10'_20
TSS greater than 30 mg/L but less than orcqual to 190 mSJL and P.O.G. less than or equal to 30 mg/L.
R .fore this product is installed a warning label meeting the requirement of SRS s, 384.25 (8) (b), Wis. Admin.
t- de must be securely attached to the manhole cover.
• Tht, lank is approved to use the following:
The tank is provided with 3 pons on cacti end (one from each side, one for the lank end) used for inlet and
-ct!ct piping, depending nn ste condiguration(s);
four-inch diameter inlet and outlet piping. Schedule 40 or SDR 3S
Department-approvrd effluent filter installed in accordance with the product approval fin the fitter including
,i putperly a7cd and located access opening for service and maintenance.
Inlet/outlct Pipe water tighutcsa is provided through the use of a rubber gasket, Scrco Septic-Ti(o gasket. Sec
,.uik scull penetration detail in attached docuntemis)-
Mechanisms for pump electrical connections front riser lid or other locations in nser must he completed tar
. ~ unirm:mce with the riser manufacturer's instillation instructions.
Umopatihle risers include 24-inch-diameter riser products -Infiltrator TW Riser, E%set by Infiltrator,
PflvloOO, [tic.. and Tuf-Titc(•) Corpurahtiun: ,,deer state-approved nscn rcconuuended by Infiltrator. Maximum
i,,i height is as per the state-approval and riser manufacturer's installation instructions.
• :S 111 cDING: Tank bedding consisting of native soil twidiout rocks or prrnrustons) in-4-inch depth of granular
~,.rtrrial--pea stone, sand or gravel. Anti-huuyancy control measures may be requited if the IM-1060 rank is to
iu~ installed with less than 16 urchcs of snit hackfill cover and the seasonal high groundwater table has the
n r.cnual to rise above the elevation of the tank bottom. (hhcrwise, no control measures arc required. If the
,c,norial high groundwater is higher than the elevation of the tank fwuorn at the time of installation, coverage
i:h at least 16 inches of soil backfrll cover will eliminate the need for anti-buoyancy control measures. I or
<J1 k;ill depths of less than 16 inches, die need for anti-buoyancy control mcasuirs must be determined based on
i,.,, ktill cover depth and height of groundwater above the lank hodom. If the groundwater table has the Potential
-.1, i i,e above the elevation of the tank bottom, sec the attached docunrcnt(sl for information on the types of
c,nlirols and applicable backfill and groundwater conditions.
• I:;\CKPILL, Backlihl with suitable native soil. 11 native sot is unsuitable, replace unsuitable liachnn with
ratrihle soil Suitable soil includes soil textural classes dvfincd in the United Stales Department of Agriculture
van! mangle. Suitable soil textural classes :see ha ced on the tank Installanou dep(h, as measured Guru it coshed
;?.idc 1o the top of hunk. See detailed information on backfill suitability, tar the attached docuure rn s).
• %dd munal information is included as attachment(s) to this letter: sec attachment A, B and C.
"I he department is in no way endorsing this ptoduct or any advertising, :ntd is not responsible for any situation which
may result from its use.
Sincerely.
Glen Jones, NI's.
POWTS Product Reviewer
phone: 1('(18) 267-526i
fax- (6081267-9723
snail: glen jones(swi-gnc
The DSPS is committed to service rsenlrn,c V,,it inn ,nn cc if
't'a'cov:' nut v~,im inne..r nu J.i~l,.In :,u,io T-i,.ahnl U_u nn
HEAP CAPACITY CURVE r/o o
MODEL *9B• 4 5/8
u
3 S/8
i 6 70
• + +
15 O
a i
1 4 3/16
o to
9
3 J~
s- -
TD) I
1 1/2-11 1/2 Wt
o-
uivc --T-T
0 r0 160 2a0
FLOW psi 30011E
intl. 98 60 CVC E
Feel Was i.Sss -1
f n ~a m
n a a. a.
a e u a
12
.a a u a
m w.~ a
4 3/16
inr
CONSULT FACTORY FOR SPECIAL APPLICATIONS
Flecincal aikwnabom for dipfmi sys1er16, aie aiallabla and Variable level east saiY I ale avail" fair shmpe
supplied w4tl1 an alarm- aid Baea Plane spasms.
fleU1a *w allai s. for duplex systems, we aveie6le - f)mdit p4aboa variable level Boat swBdlas am avarable
VIM m wlalaiit alma WINNOWS. for variable lava)"cycle contrda.
.-SECTION alaOF j
Standard all WeigW 39 lbs.-%H.P. yamioparde0 tom aeJ~lolasidEeooar.dlmbdr9rad (i(
•9sYSt 6~a1 P. z 9~93e p~ped<vr4rieedaMwAbLidaef•piyafsa.abab YvsL onescomm
amt~'!L giaabFa0177.
who" shomploK
6ae tts t A~ to 1.1&7 4. Sae FMWIZbrtarirOa"CIEW riAaasria.
11~ 1 lea 9A 2i2a6 3v446 6. ~Do~i 104UM ir613 m a cord alwbr•pdr d*IK P) (4)
Oa6 290 1 /Yb 47 1Q1aY - s raa(4>iwl JPaR fws'am ha[trnr6ery6oaiedlonafv~lb
F9a zw 1 e4s. 4.T 2a.2aa .._3>4a5
vwp4oAglw. oosr~b+lDaOat.
7- Two P) Ids iP+K trarergKmer.yoa o.p6o..
.,.\IIr10N
Fwidoiifmisliirbbrwarawirboay~Yaatli 11 3iiab tad83iie' . At inslaa•Oimdtodlds. Piotedion aevkn aiM OUieg ssa160a 036r a1a py6bi
RDAf.9piotASaOar. rriv: a~.~.n,i.~vi~i..wr~l.;oiaAavimr~6e.sod6erro9emarmrru~m,i
8434ragasiL9GlrlalfY1B111CgaS,Tas.P1~/±R1t p POWERED Dr-_SiGik~
Fair unusual cmxn mm a reserve safety bcim is eagffmmmd **D the design of every Zoeller pump.
- a4a a[ P.Q am Iwo
lad.0%KV 403 4
~r~r~avvV ia4ak1A 4~it1A1
Arowrrrm•ad~i PUAlP !Q ~ - ~PAWW .i%Z,1~9
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) t r+/<b "-,10 _ located /
at: /VG ''/e, NW Section Town_~;5C__N, Rangc /f W,
Town of i. . TCt:f'Al St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes No--,--
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: ) <',50
Construction: Prefab Concrete Steel Other
Manufacturer (if known):
Age of Tank (if known): .
Permit number (if known) 41
KVI-It #Wt8V65
(LPlumber tgnature) - (Print Name)
i
(Title) (License Number) MP/MPRS
I
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
ST. CROIX COUNTY
SEPTIC TANK MAMMMNC E AGREEIy( NT
AND
OWNERSEUP CERTIFICATION FORM
Owtner/VU!h*-_ - ^;ti CE A, bftjU A
Mailing Addmn '5i t P'Cti L A K4 h D.
Property Address _ I S/},bk e )
(7rerdcabm regoued (tour plamaeg g T4®a Lor oe~r mop-)
CAY/SWC_j_WF\5tAj S Parcel k6dificationNumber _(230-2_0t)J).-yO-oGD
LEGAL D crREHON
Yroperty Locafiau ~;t_ , Nt l~ y, Sec. i3 . T N R _V W, Town of ST. ~CiEPH
Subdivision Plat:
I.ot # Certified Sari Map tie Volume -
Warranty Deed # / 9l -s a, 1
(before 2007)Vohmte Hy8 Page # y ~Y
SPee ham° ~'n~ Lot lion idanti6abWoyesCloo
SY. 5TEM MAINTgNANCR AND p n u micum
mainemeI Ana and >~mtum of yog smti, Sya m could re.~lt is its Pie failure b Yee
Pig out the agrtic tack CII~three liners Preps
Y yrats or moon- if
the systela can affect the finetim of Ibe wpae tack w a tieemom[ in the wage • dispo®1 by a tem. 0
rrsponsibilidw are system. Pb
fwd in ¢SPS. 393-52(j) and in C]eplur 12 - - SL Si Croix County $aotfaty thdmmcn Y.
'Ile property owner
06cuit I* ldta lab S r. -m ComaY ero g Tmm6 pmt a ovsi6a fivm, signed by the
owmr and by as atader Plumber. ~ to
-watrl dirpasaf system;s;o ProPeT eP°daG condition i =andFor (2) o d4 r um (2) ar erge or a licensed p wd'Puatipun perg ngfret (I) the on'sito
less than 1/3 full of slad®e, inslincbm and pr (if °tlYl. rho septic fink is undaugued have read standards /v, forll4 ~ The the shove "nutrameaft aid agree to
maedrn the pnvste sewage ~ system with the herem, state of W
sconci L Ctl66Ohet y The Mpe trams of Sefty And Prafemond Sev;ces and the Ikparfinew of Mat" a-
g dal your septic ayatem be been "he St Cr.
CovttY Pla®;ng At Zoning Dgwftmw within 30 days of the three yew cxpind med moss be d ~ 1emOed to the St. Croix
I/ow by virt e o f o mpart~ ~ In the bent of omyAour fDu laov =Were ownv(s) of the
ProP~Y described alsor'0. - dtxd ttxadcd a Rcgtsocr of Dtxtts OlStx.
Number of bednean
r. ~ 1=a at3:~
~SIGNT TURF OF APPLICANT(S)-~ ~
DATE,
" Any :mom tbe;s mwVt-WW tsd aey mu* o the terry Pmt being rooked by the Pieara6 g Zooieg De pmem at
Include .with dw appbc.bM a recorded wara y deed fiorn the
Register of Deeds Office and a copy of the mrtified survey rasp if
reference is wade in the warranty clued
(RZV. M/12)
• 1Msconsin Department of Safety and Professional Services U I - aD/
1)ivision of Industry Sirvicus o /
SOIL EVALUATION REPORT Page I of 4
*Tmolltdance with SPS 383, Ws. Adm. Cade
A
County S f. C'ROIX
tf>irh cbrnplete seta p, n an paper no: IES Than 8 1/2 x 11 inches in size. Plan must
trirslgde beta Ithrit ao t' verbca' and hnazontal reference point (BM), direction and parcel LD, 0 0 - 2000 - 40 - 000
ptrcentsSI scaleordim sions north arrow. and location and distance to nearest road.
lease print all ifl/OrMation. Revie by Date
'>;7~rsonal ;nlpdF {ewou woMe may rte mea for secondary purposes (Privacy Laws 1504(1)(m)) i8
ref°perty,C¢F Property Location ❑ ❑
JANICE. M. DOONAN Govt. Lot NF 1/4 N 1/4 S 33 T 30 N R 19 E (or) W
!'Pop Owner's Mailing Address Lot# Block# Subd. Name CSM#
531 Perch Lake Road
State Zip Code Phone Number
Hudson it'/ ~~Ilaga own Nearest Road
W l 54016 ( 715) 222 _0364 Perch Lake Road
New Construction 4 600
Use Residential f Number of bedrooms Corte derived design flow rate _ GPD
~E Replacement ❑ Pubic or commercial - Describe-
Parent material _ sandy - _ Flood Plain elevation if applicable __NA - It
[:moral cerranenLa
and recommendations: C iamenuonal In-ground trenches 0.7 loading rate
z~x
Boring # ❑ Boring -
Q Pit Ground surface elev, 104.00 _8. Depth to limiting factor 92 in.
- Soil A iration Rate
HonzW Depth Dominant Color Redox Descnpbon Texture Structure Consistence Boundary Roots GPDfIF
in. Munsell Ou. Sz. Cont. Color Gr. Sz- Sh. 'EfW1 'Eff#2
1 0-10 I0YR2,12 sl 21sbk mv(E cs 3vf-co 0.6 LO 1
2 10-24 IOYR33 sl If-msbk mvfr
es 2%,F-co 0.6 LO
3 24-92 7.5YR3,14 s Osg dl Ivf--f 0.7 1.6
some gr
Boring # E] Boring 10250 94
❑ Pit Ground surface elev. 8. Depth to limiting factor in,
Soil A ieation Rate
i-r,nzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRF _
in. Munsell Oo Sz. Cont. Color Gr. Sz. Sh. •E1101 'Ef#2
1 0-29 10YR33 S & I 0sg mvfr 0.6 0.8
29-94 7.5YR3i4 - s Os' dl 0.7 1.
Horizon I is fill. ru.nc gr
1 i
Effluent #1 = BOD. > 30 < 220 irg& and TSS >30 < 150 mgA- • Effluent #2 = BOD, < 30 rrWL and TSS c 30 mgrL
CST Name (Please Pnnt) Sig CST Number -1
MARY JO HGPPER f (Hollister's Soil Tessin &Desi n 224932
Address - Date Eval n Conducted Telephone Number
28497 King Arthur's Court. Danhur5•. WI 54930 10- 24, 2018 715-426-177`•
Pn0c N1'O.v-ier i)nolldn. 'an;~.Ai, '.I ~O-?gUll-111 (y),
Fir eL:J aF ?age _ ut
r~ Boring # Ej Boring
Ground Surface elov. 99.00
E] Pit ft. Depth to Fruiting facto -96 in.
Horizon Depth Dornnant Color Retlox Description Texture Structure Consistence Boundary Roots Sal GPD ff n Rate
in. Munsell Qu Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'EfW
I 0-10 IOYRI.2 %I 21'sbk&gr mv(Ir
II 0.6 0.R
2 10-33 IOYR3.3 sil 21'sbk mG 0.6 0.9
3 33-96 7.5YR14
s Osg ml 0.7 1.6
sonic &T.
I
r
I Boring 0 Boring
Pit Ground surface ales R. Depth to Fruiting facto in.
Soft Fcation Rate
Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPD/k
in. Munsell Qu. Sz, Cont Color Gr. Sz Sh. •EfWt •Etf#?
I
~I
I
I
- -i
Boring
Boring # -
I.~
Pit Ground surface ales- ft . Depth to Fruiting facto[ in.
lonzon Depth Dominant CPRn ption Texture Structure Consistence Boundary Roots Sail FGPDcat/Rron Pat, in. Munsell Color Gr. Sz. Sh. 'Eff#1
•Ef#t2^
i
E111uaa'. >r1 ° 1
FCC 30 - 220 3'L x:, 3n I ric,L ~
- 9111ent - BOC 1 Lea 30 ~xv..
Plot Plan Page -I of `Y
PROPERTYOWNER:_ - IntilcF l`1 L~<< IAA 1"==40 FT.
(except where noted)
Legal Description:_PCL CCGA-te-D !.U 7iiF NEV4 CF 7ifE Vb~~! sEf--. -.5 l ] __t)rvJD
tJ --tncawhae pit
r\e IL '7CN'A' OF ST Sp SFI°f{ C fyly- P~ClLI.4i.~
C'c Lt ti r1/
0
.=3_?! C~c'tif 11 C 1KY K(A n U=C - yCCO yC+ CZ,-) `~4> 0 <1NICFs
North
- - - -
Imo WN~
p Guy<r.-! 9nj' Cr r'Ir`= '
' /tl7.7.0' rF "d r~r~ -lpNK CGVEr'
loy4e'
i
r
y ,
Site location:
P~
AW'N Kc o.
~ - tilte
AIZ
-iy ~ 33
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t.,. ~ ♦s sit ~~nr
a.
r . aaa
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X
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_rt
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a
171 • r:}(~,t a ~ i¢, to
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id
ANKJ
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