HomeMy WebLinkAbout020-1355-05-000 (2)
"'r =r PRIVATE SEWAGE SYSTEM L 1. Ct'llr:
INSPECTION REPORT =e:ni mr: 9
GENERAL INFORMATION Inl ' " Pf RM T' `F
r-mr,...:n aP'U•bJF frd'+DC PnrI IC .nala'.1 u'b..c' I_:
cm:tt halor.... f.:m~.. Siry :1i,aPC ~a~m;m( _ ~arccl'nv Nn I
41 OWN OF o - l -DS-cXt~l
;l BL1 Ere.; bn:n h!; E. er Big scnooor f 5ecten ~an._•kanpaaf^,n I~r
y ' S S 1e-
TANK INFORMATION ELEVATION DATA
-VP_ JATy',:JT, IJ'. F. I -I Fc =1"r.
W, ~s~f 7000 e._ .nm; r 90 /6 . 9b s~
I.It CAN1a 41I. GM
Cr t ~ ;
X.a
e.
:.,t in
~t
TANK SETBACK INFORMATION ::tit 7.40 `llo , S f
-;IN . T' = .;ELL P-._-):_ I Au l^L•e~ FILC 191
fur'
o~ll y SoT 2-1 J - - I a~fI' G• o
>501 9b 36' 50 r r;.;l.rl
"itlina
PUW,'SIPHON INFORMATION 166,5k
°r;rr~ -_.T _____Y ,
SOIL ABSORPTION SYSTEM
BcDgR!:: [PIT DIMENSIONS G: 1-r~c':(a_ .:owu Cenl-.
DIIdhNSION$
SFTRACK 1 I`i - .Y._'S -F!Li~(.' :.c4GNIN, 1.1n-alsctu'c: //''''11 1~~
Gc T-H1^: x.Tir
IN=ORMATION `r, c.;gtPrc: ,.-onlI - Or1AMBER OF
LJ.tiJ~,v.7~-'0.~~^~' •/p UNIT I.1cc°.j!_ J ~ ~ r1
DISTRIBUTION SYSTEM c(+ 3
SOI_ COVER x pressure Systems Only xx Mmmd Ur A' sraar- _'VsteMS Drily
-
r.nr...".: o: -11-p, COMMENTS: oi::i,de conF mscre:nev-im Fcrsun, wLs_•:n'. cv_.'. f Ins: , soy. a r Irspec a-~ F'" 77-74
I acanan: / r~ev-' r u.0. / j4A. V G•~Jt r l~~j ~-•~•.j,
_ ;?Ing arv: c' -'nett - GsC'~ ~ ~ ew d
r - N !1 19 is 683~f 7
.11 ...1d' I:r ttti.llorral n ~r ritlipC.
i;Puu:u 'tie
SAN - 20 11Z - 3LK
- In6i*y Savwm D(vilibn cmaay
1400 E W
tshutgla, Ave
- \ P.U. Hnx 7162
Madismt WI 5 1707-7167 StWZY PaO1) Nuo6Q (m 6e Ma in by co.)
- .l~~A 100(0 ~7 40
In am Swwa{gdmr . P it Application SafeTrwaKtionmxnba
weh SPS 3)3,2I?4W@J Cade, athrnisam of Wo fotm m the eppopnele ginemaafal uut 4JA
cattocd ~ o6t~iS w,. a4 y Pa t No Appbo farm fu smbowwd rowrS ate mikeutted m 0-) Addloa (ifdAm tbtsa tmiEstg dmm) / /n/
the SO" SavicM 11 atfaalmm Yatt
Ptw'de M" be ued for zoudoy
m law a 13 . I m Staet
the Pfrywy ~T
I IaAr -t-- 1•Imae rrwt An I b md.' M o UL
~.Iu ~tlJtil flt~' L- JY(ff lc~71 Petcdf /C - 35~- I S r'~
Awaly Oww's Now" Addma
$ I h .4'i ~I~ NFL Ptttlarry Loalion a ~ . a . ~ I
City, state zip Code Plume Ntmtba co.t. to -
11. Type ofsulu le(aiaek A dot apply) .-r Ida T C~ N; R Eor
/ w 2 Family Dwdiiaa - Nanbu of Badtmon Su6divoion Nacre
❑Pt"MCoombeiol- DbmLe Uae la rte. Blorrka '~I~/(il~/ LT1L-C
❑ City of
O ' Owtad - Deaatbe Um rr CSM Nm6w ❑ VMW of
Tim" of_~1_Ct L--
11L Typo f Pkrsalt: (Cbech a.ly box as me A. Cwmpkle Mw B if appBdble) oriQ_
A. ❑ Naw Sygsa =1011=_ Ttum.m1 "d-S Tmk Replaolmmt Otdy ❑ Uer Modifivtian m a," SyY®(erpYia)
R. ❑Pamir Rauwd 0❑Qrngd Pkmba ❑Pund'lY~smNew laa PIv Ptrmq,7Numbwand Dtfe
hud
Bette Fnpv w Owm - `I q Z
(on& an dw Amy?
ktd^iotnd 0 F1ca4ramd ).-('mad ❑ AKk.de ❑ Mad > u n of mobb mil ❑ Mwd 124 0, ofa.Ybk ail G I ~(~J
❑ Nuking Took ❑ oaten Dispnwl Cmipome ( _ _ P'me.eioaa tkvm: ( ` ' ( `•(c`,a' t-)' T
V. Aosa lafoom odow: - -
D=V Flow (Wd) Dmgm Sad AMbmm Digiel,t Ams RoWff d (st) Di W®1 Ata -d) Sylmm F7evtmm GC V-1,
'L1 -1)"
VL Taftk lap Cyweity n Taal 1 d
Calla„ Callaia Ikuts (I I dGl, l~'sti'J~Cti
!ilea Tasb Fasfeq TSm
-SaPec a.L.se.gTA ~ h t ~ 7 ~,A62. . ~ c.+ x E_ ~ ~ S
Deena Chahar
VII. ROTOM&MY Sb ommt- 1, re a.dwaaa{ aoo~ /w insbAh Rea of IM P()WPA ra.sra as Me macaw pkaa -mmPNOWAlIft PI 's Now (Print) Phaelm'3 Sig "e M"MPRS Ntmiba
Budge Pbme N®btf
7H T1VIA)6-5 2Z4D3~ 7/S-~7y-Z85~
Pam 's Addrs (Burn, Cny. stae, lap (:ode)
DS E. N( S . c,*C7T Wi s47a
vn U.
,-W i Pa~~m[[k rj Dw Q I~
4 R. f. Dtmd i s ~7$6 7
Ix C
J ll 2 1. U rP S Il~<._._ r_ / ~NyQ_e1A- /
35.](eR'P❑ pl r Jai JV JipPDe:. V
2 AN m4tw* rec;~ir.~^ePS m-r;t u.e ca:rt, is c
Uper deade codi!;rA'r,Aic;.e. G-
MYra rafrW Mw. i. sa gene r.m.a w rs Caw.y w! )rPrr sw a.r swa tp • ll 1.raw la.ts
SBD-63" (R 09/14)
C"'i r~_1r rte,%'vl~ rfcN/= ~Gh[t- LCT /SCANT AVF
.:./S7G/'r1 Vii.- 'S-P~' jlJ•GE'y~"!Ci ~;'i; ~_'r~~5
`,ej►~---- jsr 7-93, z/' ? , /n 'n N c F Lc 7-
57h~Ee" . fcc. ~e
1
K_ 4 F~.
- 2 Ef uEci r1J-, _
i ~ rl t ~ :AO_rT'eh ~ .T r2 r N t hr E ~ -
i
~ I
~ - u if
1
e'
i
i
\ Ov
` ;1
PAGE 1 OF 4
In-Ground Gravity Plan
Index & Cover Sheet
CwWonerd UsmW DeSW lfatmr xw
Version 2.0, SSD-10706-P (N.01 o1, R. 10112)
Pg 1 of 4 Index & Cover Sheet
Pg 2 of 4 Plot Plan
Pg 3 of 4 Dispersal Area Cross-Section & Plan View
Pg 4 of 4 Management Plan
Attachment : Enchxnwes:
y~Fi~TK~rcrt sPEcs C a cx POWTS APPlication for Review
F'rtrEk L n,vtii-7C~K cc, Soil Evaluation Report & Site Ma
IL-FL-t\ `,7v-ze ` 5FP71C TAtiK Aae -^e-V►
Ds~
Project Name / Descripum
tt
OwnarName(s):'F,.'P ;ErJ`("=l r~/rC-J2 . ,U`~ai~i7~~aPhone: 51 -
Owner Address: > c r av~ T A e. OUO s e VJ C..1 zip: -,5-1/0/ (p
Project Address: Arv.~~
Govt Lot: 1/4 of F 114. Section- 11 , T ;xL N-R F2 E0or WH
Township:- F~6W50.N
county: ,,r. c Rdxx
Project Parcel iD s
Designer Information
Designer Name:./'V 1 AF V -S -fl Aeec-rtr Phew: 7►5 ~E _
De819nwAddnws:21iN9'I Kwg AKTHwis of L)Aygule t.g
~~r ap: - 6`18"Sp
E-mdl: hol(isFerdesic~n oufIVOK C+ an This
stamp.
„license Number: _1g5y - CO 7 q,J
1 ~V V I}
Remart ~ !y «.rstc c * rf•~Ai~Y
~IPR FAL.L,Stc
N4
Signature: f16 "t Datie: /0- Zvi K
'mowed COW
/,/)ADDta,,+A/ /YoN/t rl Het LC7- `d/S,6e)gA1T A)V,E
z.~/~ ceps
Sys?t/Y/ CG= _ SeACE/'y =ic'
yy.5a' z93.2/' -f3,M.TcP of Lo T"
A(f. 2 M, Tap of Lo`F
S~oK~ E1.- I0011957A+~E ~L=1oe.gO
xcC.OZ ~
$ 2 i Bq?,yy/
0 pt I F_
lID0 F67Ele csANNI ' h -R - - - - f~~ ' I
N• pvif
~S xS4 ~ o "T~ T 1 101 ~ rDC.~! .
a -"C R r N e k E S
3'kSG,-4 5 ,q-tNs'~xBfas E*N
~ c6 , T 0T W
41
h~.
ct~f %i_ AVEI~,uc_
q -7ralX CF ffG~ (~b~ I 1
N 4
a"~
r rf~: 5 c~: `1
SK* =me(.) R!f , 7bM" r
IN-GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with Quick4 Standard-W Chambers Sloe Taa(a)"Xae(sk
3-ft Trench (down-sb*V credit) Via' -ad
Efo+ wu.
! F -t M_
- l _ ew.w rtr.wme i
n.~
s~ wvEk -
m
TYPICAL TRENCH
- - CROSS SECTION VIEW
(No Scale)
Vk*
Pmdda niinwn 3 It
• Yti V)
System Elevation ft saprelimbam-M lrendm
PYIkml)
ar-xa srandaa-w ow.ge*~ lc. TYPICAL TRENCH
End Cap (Show Mellon of inlet / allot nonneedon an plan vkw.)
Pfpk~*PLAN VIEW
Scale)
--~f Tf----- -
- - -
pp rl D
~r------- ~r-- - •
B.l II m
(typ") 4 $ ~ (3lelnber w
INSTALL PER TRENCH: p.raq bab+vbN T
_ r., Irliapea,wlbaawacea~*bl~d.~ p
'~J o kk4 sww a 7o K Emvdw bar= -~J 6'
} 1 Paba d end caps @ 6 X BSNpab- fe
a p.p.w ELSA per aeneh - 3-2t, re RacluMed In111ballon AN - VT>'-fS 1, Otstblatlon Mellwd:
x v- trenches = Proposed Trial EISA= a' -Llflr' 1 FG ~D
X71 L a -I
,
KLI
%
In-ground Cale PAGE 4 OF 4
vity nagement Plan
j
I owner d 0" ieywpad WawAltr syalsu 00 ba'aapoeabla roe w'i pwetpaiwt aparaem' and neitr'r'oa pureurt to
MW*WM'b of SRS 382.984, Wtaa Mate. Cade- Pu'w'wt b WS 38352 (2). Wtuc AdetiL Cads; Nds apalem dW
be Oonsid.ed a hsaun lean Warta W FM r'einbi'sd In accordance UM ttts appra ed nw'tepeawnt piwk
Funtemtme, ar' I-n and niairmanos arlliea atW be parkrard by a ragiMefed PpMla Mdrdal or in
aoomAMM UM MS 3!9 52 (3). Wier-Adath Qode-
Daeat P9sar a M60 tips 90De S!B ttVla; TSS S In uWO; FOG S 38 wVa
typo of tee WISPS EVERV 3 YEARS
o apsdeydwn
o miaree facba (Ld. Odam leer aim)
° "ed'ani'ai IMMAMAcn ("L. PutP4 wauae ar - - blow al-)
° rr'1, "hwuuw(Le.bale.bade am'oeim' dc,)
o elide voiwe in twwaltc seaaawt tadOW and any to 10 , app'abnawe(y (ten, drbuem/dmo negeot or bpuwpw uee (Le. ®acee ft deed' atpwAW pwltbited INSAIea, etG) P bates)
o exist d Pomlig in dlebb'icn ad prior b during
° amino i"apudees - rappsuble (Le, pump M-cv wg, foal a'tth sawrok aim)
o° dir'bueo' -rappiicable (Law wiwig aseedme, awe~i'es coon ti"wt, "o)
dlectur" kftdorlabMo'ieePM4gg'g (maasaairsddWp'aawen-campwweID Ig'sp ditoOn)
o auNoe
of atbst 4w aeawye belt-p ido sb'alae saved
MAWAM EVMV 3 YEARS pr athnt aeoaseet»
O Stab aM' 11'a vobwn UNIRIONLOOLUg"aluM be PWM@d bva aedWad aaplepe savicig opawbr 'under a 261.48 Vft
A7d -d by locd anbfwme a•+p a°ab a pwmm ttr rl.pa) it
~ piepoadd amensahaeie pearrt b~eR 113`~Wis¢~Meta C`d .
o ENNUMARMW
ahae be i'apdad wary 3 Vera and ales be chiral ubw wawoenerr 10 MU MM any
OOMnWsbd Mktg
n'a'e'Q °O°°"*V tD+rentgad~ser e Specilcuborm A sw' iw=g pglpd vAriawyr be Beeler 1hw' 12
SPS 3t1 IiSAdaQn. Ca'lapu/a~taas'poea'tfafiwar and'a'rlignfxNOR in aaxordrnoa oft
a
tMwnedi'dlefWeltrarn'pw'y ~J~/i_^ _ ~r°', i
LOcW ~S7 t~2DlX COI11AliWl7~ DEUELnoMEAI T Plum e 716- 3Sb-L!(W
Locd 9m a""Mt uniad3aeat f-tu DSOM - Ili 2P: ~
Any asi dko pet of oft ayata ahd be rq eiud. repWK Q removed Fn wt b WS 3E3,51 (1j YM L Aftk
Cade. Rqm* or rop~awtltrti afftiled air mWMd W ft cmWOnetk dal oota * vM SP8 3R& W t A, coda.
NO Peodur2l r dva WAi orOVMW'ee- m9on d 6te POMiS euy be tied tetbee sppabed Wft depwbest h
aoowdwme vM SM 384. WYr- Admh Code.
Conresae~.. Plm
a tta" wtr'dbd b t'e d lieae"ewtt cow4wa ttt dt to POWTS taaa'otbe wpdrs4 R eM/ be tepboad pteww't b
aPP~OP~aapr'clforarw4wandapPn Afded'
abandoned and'aphcad by a oodeaomp~ry dtpged aeutpcnerK n e p'e de~j~ ~ ~ r~teag&mW he
It use Of Oft POWTS is discort4aiad, It shd be Wmn&'ed in aoomaa"ee wM SPS 383,E Wtsa Admix Code.
WN14
ATOR° The QuickC Plus
Standard Chamber
The Quick4 Plus Standard Chamber
offers maximum strength through
its two center structural columns
.„~^!yy \ \ x ,
rhis chamber can be installed in
a 36-inch-wide trench. Like the A7
A P
original line of Quick4 chambers,
it offers advanced contouring
capability with its Contour Swivel
Connection's which permits turns
up to 15-degrees, right or left. It is
also available in four-foot lengths to
provide optimal installation flexibility. li
The Quick4 Plus All-in-One 12 Quick a',Aber Benefits:
Endcap, and the Quick4 Periscope ! Two center structural columns offer increased stability and superior strength
are available with this chamber, Advanced contouring connections
providing increased flexibility in . Latching mechanism allows for quick installation
system configurations.
• Four-foot chamber lengths are easy to handle and install
Supports wheel loads of 16,000 Ibs/axle with 12" of cover
Maximurn Strength 1 40&
.~iek,t Plus Standard Chamber
Size Quick4 Plus Ali-in-gne 12 Endcap Quick4 Plus f.: '
34W x 53^L x 12^H Benefits: Benefits:
(864 mm x 1346 mm x 305 mm)
May be used at the end of chamber - Allows for raised invert installations
Effective Length row for an inlettoutlet or can be 180° directional inletting
48" (1219 mm) installed mid-trench 12" raised invert is ideal for senal
Mid-trench connection feature allows applications
Louver Height construction of chamber rows with
8" (203 mm) center feed, as an anemative to
- - insetting at the ends of chamber rows
Sege CWWRY - Center-feed connection allows for
47 gal (178 Q easy installation of serial distribution
invert !bight systems
International
0.6" (15 mm). 5.3" (135 mm). Pipe connection options include AssnCat on of l
Sides, ends or t0 ~echn s Plumbing
8.0" (203 min), 12.7" (323 mm) P and Mechanical
Officials (IAPMO) \u
APPROVED in
Quick4 Plus Standard Chamber'
-.-A• J I- UF[CTM LENGTH
Quick4 Pkis AI-in-One 12 Endcap -
~WS MU':41L H TIC H Mlnl
R m AcFs
_ 1 1 I_-C l~_~! - 1 9•INVEFT
3]• -
FRONT VIFW qDF VIFW
QuICk4 Plus Alt to-One Periscope VISMM.TOR WATER TECItlIOLMES. LLC PIM;LVATOR-)
Pa bdibai. Wdar Tadasbba, LLC STANDARD l WTED DmWidd WARRWY
pal 1M ANCNal "0911, d l5>ril das e . b Vc Flaela nmaldW Pllyslyrt:e n*w oft.,
aos, 5.y ntanASbzb t by lb`' ala EUteH-). NMI inva nn b,,bm n a wxbhain d an
01A 4 N HS 0119aa upx ay¢tr1 n a:W011'GO Nab hlaralw•e rrMlrlinn, n I.ararlnl lb Iha u wss,
AI l-(MALE rH(6COPF dpCM CIN:IV'1 vs mind:. m I,,S p a Ibuv 1>p w an yew Morn t si V Int
/ Ia60' SWN4L)~ l seplk puny( 5 e ha d. sopbc ".,I.a '.q "trod . pw JbS yic nmiS dui II a Scplk
PISIpA IS Mt mg red by WpkaNe hN,. ft ,,,1VN1bIY Iw" M hoW uImb pm "m nd n11AB
i hvl d 'N" Sepf system ConEnHICIA To cease ds wannly:411•s IShot mat ndiry M.
- { In any al M Gunwale HesWlurls n (ad ~yb mF l:ntaXlcal NtIR.i ra10pl Ilhi dis, d
I1 IM dboM d~ YMra(o• ~ it yply plat-..t (hits Mr IN:rt (.b.nW by MM(ata S, M
m W by lAs l idler( Warta ty l Nnald S Ga[AIY (Ir.~4asy sinchaluY ym coM of renxrval>Irl:
Q r i 1` 19 y MYERI ° sah own d IW Onto,
17
WTHE OASIFO WA ly AMiW WDIFS IH :AXVWGRAPH 1.1 AHE MI US5 THUS.
e--~~I• f ~,-`;f / ARE NO 011117R WARRANTIES WITH RCSPECT TO IM WdIS. WX;LUDK3 H RN-EO
_ - y4AC.MIlIF S W M lI ,;IMtI LIIY OR tITNESS NOR A PMIK7JLAn PLWOSL
_ ICI Ills I imI W Wan-nty snit b roy A urv pal GI dar dw11u sy:.lptl d IrOMAYaaIAd DY mynm
CIIM IIU'1 hlml
SO
axLril Aam In IlY shgI not f b be e Wtk- S lo, pe alMln 10 Axley A, CNUmiRgoS rIS i(llli(Nal. V loK I of
pnS . hNlrebc toy mattd5 ayMmd o, e0haid eoiesaH P or
or tMer o0w 1 best, .
4 POArst l atl PWac HNlor an a vyayeea WIb ncvrW M
1(l' S Uhh a try bl ynary I:ar1Y. Clr I.yy aacbaatl born Lyn Wamay 0nruayn a0 (IvtI to
b• INS Us1s An to ad Naar ttl tea, dltlaym, serident- yn msuvr, abrae v nltr}*a nl: :he U>as
1 •.~--1 - - - Ulu' u++s b'N Rosecloo In nifick bsltc P opn• Substations IYnich ate not pranalW by let mtaF
oon EahYapys; ta(ue h nlantan this bS nanl yaatl coYPi eea forth n the b151aaabon rmmc.
bbnl d)e plu"II"oni of inprpPa nwmid5 No the sym. w,l--9 yab Inds, Naala of tlc Units
I ea septic a AM,"m hvWPIN 0.9 a rnTa(Tfer So" asr . tax nail, ySIVIN Ya
IF." 6Wrvt. a arpOpw rXrfr~ a any olnv warn not ..d by htaty. M51 utvtw
t4aratry shin a 0XI d are Ilnkla Talk 10 CW0V amI NO of 0% lens aN 10ra10INS L1mlIW
'.valrany. Fupla. vi no nraA sNl YlMbakx be (e.ydlsside br try loa a daare¢ b ale Roper.
7w Lkft a any livid pab tapRap 50m Fmi laic, n >fipnreAl er bon sly plods( L"y
Ia,m 01 Nbpa by any aAd psdy. Ea WS La WWanaty 1o apply, lbe lords mst be iNSIAWh
•-nnLlnx>aIN A dlo c(sxia- ns* n by stile an0 Was ea , W WIa appkabis la". any
tlrlaata's rptalad}1 S,ab Chop,
v. rL.:l A No reyanMWiN d 1>Ynsky no the SUIT y To c of or Aland INS Lmaed Wardnly. Ntl
r n~. ,r.e •artrN vpka :0 WY nmt than the clam( NNulyor. the abo,n lepreeras pN slardary
{ CN .'.>y[roo5, a.r ueti> L biW War y nfkuoy by aAalra)v A IinH>y nrnEt of clalu-abd Nxnov, bnw UMalrrl Wn
n l ! . , aCP 1„-ro1)0 - "o a 511-I001 ( rv -gwnr IS Arty pravMear d UNa anoW m(aaa IrlY:aora (i•porale Ik>aAwlm h
sdObaJS-aaaB (Ad Satsaol.A_ (ivlahti(aa, stria W hard( puchaK, to obtain a ropy ddle a pplkap[ Nansay. tKl
vNNw.rnlakaserywlbcmm shaad(vaAAynilbw rltrw.-Ylsoo, m sla (wdradUrvls
a ISn.M\snnp(In 4r1,. Awm, s, In 1. 115 1 II1r..15n S IISRt:SIM.mYW?78:.mm. Waabn Armint-Dp,p4f V'M'w (MVytNraM pYryrq
I.V:r:en. Cryrlr.'n Oo -1 ea av:e~]:load b~rv~::.l1.aI®:rurllber TrehNlopR. Mmnn 4 o rbrWM ss n nFr:rr kr1.1eI NyNIbfrlWOgea O arwI In.v.e_vanuec. c.
:...m,.r.~:..a,.:.s.:.rr,,:r~n nom.-..~..:~..,r r.v:,...I Vr.L::,:. c>. ul.(>rf:lM.9r~l.mr me'arNyVlcna seeAaerrelwnaair.rv w.Ir.. r«w+.aeaas.
a, r ~ • ~ r~_...,...r n+.,. a 11T11 16 Will Vp lv V'o-`.,Aql, It. Al.,pn..ea'nyl.Gbtd 1 'r5:. Pllrap cCl(
it
~;k>ti--^P-- \ DIVISION Or MUSTRY SERVICES
~4'~ PO BOX 1162
t5;e ~p\t MADISON WI 53707-7162
1 _ Cfnh4el Thka1(jh Rey
`'y`\ ` r ~ ~/A}~a-rwVmfi•aJra^BnnWSIrY•sevlcr.^
\~~\'~R`~__ Mnw.wiscrosn.9uv
som Winne., o~
U*" "",I, Sawagary
MeY 08, 2015
CU.ST ID No. 1316956
DAVID IF.NT7
GOVT AFFAIRS DEPT INMTRATOR SYSTBM.S LNr
4 BUSINESS PARK RD PO BOX 768
OLD SAYBROOK C r 06475
-U-6 r~ooh Numbers _
Trmelim ID 1Vo 2534224
Rote tD Nn
He: Descrohon: LEACHING CHAMBFR Plnx refer to bah dentirkwioc nhmhhvs,
Manufacturer: INFILTRATOR SYSTFMS ING. ebow. in s11 coriwrr _ndcrnw.. wkh the _
Product Name: OUICK4 PLUS STANDARD, QUICK4 PLUS STANDARD LOW PROFILE (LP)
LEACHING CHAMBERS AND END CAPS (trans. id 2534224)
Model Number(s): QUICK4 PLUS STANDARD (INCLUDING QUICK4 PLUS ALLAN-ONE 12 ENDCAP
WITH TOP, END, OR SIDE PIPE INLET CONNECTIONS USED SINGLY OR IN
PAIRS AT ENDS OF CHAMBER LINE, OR AS A MID-CHAMBER LINE
CONNECTOR) AND QUICK4 PLUS STANDARD LOW PROFILE (LP) (INCLUDING
QUICK4 PLUS 8 ENDCAP WITH END PIPE INLET CONNECTION USED SINGLY
OR IN PAIRS AT ENDS OF LINE; AND QUICK4 PLUS ALL-IN-ONE 8 ENDCAP
WITH TOP, END, OR SIDE PIPE INLET CONNECTIONS USED SINGLY OR IN
PAIRS AT ENDS OF CHAMBER LINE, OR AS MID-CHAMBER LINE
CONNECTOR)
OIIICK 4 PIA IS STANDARD, DIMENSIONS: 53.0 M L. X 94.0 IN. W X 12.0 IN H.
MAX. DEPTH OF BURY= 8 f -
(EISA for chambers with or witlhaa fabric - 20.0 sq. ftJdwnber, EISA for Quidc4
Plus Alt-in-One 12 Endcap installed at to ends of a chamber row = 2.6 sq f Vend
cap, EISA for Quicr4 Plus A*4 One 12 Endcap installed in-lino wl8yn a chamber
row - 3.6 sq. Wend Cap; Laying WVlh of chamber - 4.0 ft_, Laying length of Qtacka
Plus Allin-One 12 Endcap Mutakc! at the end of a chamber new - 1.5 ft., Laying
Length of Ouidc4 Plus Ab* One 12 Erdcap W*WJ ed in-line within a chamber row
0.9 fL, OUICK4 Plus Sbwxlald Open Bottom area = 9.72 sq. flJchamber, Qufdk4
Pius A I-ROne 12 Endcap kntailed at Ow end of a chamber row Open Bottom area
- 3.1 eq. ft./end cap. Ckjk*4 Pka AB-i r,43ns 12 Erdcan installed in-line whNn a
chamber row Open Botlem area 2.2 sq, ttJw d cap; SEE ALSO ATTACHMENTS1.
QUICK 4 PLUS STANDARD LOW PROFILE (LP), DIMENSIONS: 52.0 IN L X 34.0
M_ W X 8.0 IN H; MAX. DEPTH OF BURY- 8 IL
IFISA Ior chambers whin or whtwxK fabric _ 20.0 sq_ ftJchampef; EISA (Of Qu(ck4
Plus All-in-One 8 Endcap nstaied at the end of a charrlber row - 22 sq. mend cap:
F I.SA for Quiek4 Plus Al-wr -One 8 Endcap k3talled in line within a chamber row
2.0 sq. gland rap. EISA for Quidk4 Plus 8 Endcap Installed at the end of a chamber
row _ 0.7 oq. "nd cap; Laying length of charrhbers _ 4.0 ft.; Laying length of
Quick,! Plus All-in-One 8 Endcap WMWW at dw end of a clamber row = 1.1 fL;
Laying length of Quick f Pkre A)I-Mhha 8 Endcap installed trfYne within a chamber
row : 0.9 fL; Laying length of Ouick4 Pkm 8 Endcap nsldlled at the end of a
chamber row = 0.4 ft; Qhpckrt Pkrs Standard Low Pro/ifa Open Bottom area . 9.77
Sq_ rUchamber, QLk k4 Plus At-n-One 8 Erdcap khsUdled at Ow end of a dhambor
row Open Bottom area = 1.4 sq. rtlerd cap; Quick 4 Pkn AI{wi-,One 8 Endcap
installed in line within a charrhbor row Open Botlam Area - 12 sq. ftJerd cap; Quick
4 Plus 8 Encica fe irhsmaed M the end of a chamber row Open Batton Area - 0.4 sq.
ft lend cap SEF. ALSO ATTACHMENTS)
Product File No: 20150111
2534224 UAVn>U:NTL PwZ lwpw
The specifications and/or plans Ica t#tis piirnbing product have bow, reviewed and delerumned to be in
compliance with chapters SPS 382 through 384, Wisconsin Adm restraf+ve Code, and Chapters 145 and 160.
Wisconsin Statute.
The Department hereby issues an approval based on it% Wsiconsin Statures and Me Wiscons it
Administrative Code. This approval Is void untill the and of My 2020.
This approval supersedes the approval issued on 11/11/2014 under product Ise number 20120137.
This approval is contrgem upon compliance with the kAovrng stipulation(s):
• This product must be irtstalbd in accordance with the manutectuar's ptaNed instructions, product
approval, and plait approval M ittere Is a conflict between the marufadureft instructions and the product
approval and/or plant approval, the product approval andror plan approval will take precedence.
• When this product is installed in a dlsparsel cell that is stied based on the EISA rating stated in the
regarding block of the product approval latter, this product must receive wastewater he" a BOW value
less than or equal to 220 mgt, a TSS value 9035 than or equal to 150 mgrL and a YOG value less than or
equal to 30 mg/L on a monthly average.
• When this prOMw-t is installed in a distribution cell that is sized based on the EISA rating stated in the
regarding block of the product appravat letter, this product must be installed in individual excavations that
create a row of chambers that are horizontally separatod from other rows in other excavations by at least
3 feet. The 3-fool measurement is measured between the cbses10ut5idC edyeS d the ICaChirtg
chambers.
• When this product is instated in a distribution call that is sized based on the EISA rating stated in the
regarding dock of the product approval letter, the distribution colt design rnLw allow at least six incites of
paling in the chambers without backAw of wasfc ler into the drainpipe that Q.vt'Orges inn the
chambers.
• When this product is installed in a diambutien cell that is sized based on the EISA rating stated in eta
Mgardng block of the product approval letter, MIS product must be tivaeLed it a wort system,
which has Mae top of the dsebulion cell at or below original grade,
• When this products installed with geaextiie fabric on the sides d this product in a dis"xitimh cgs that is
stied based on the EISA taping stated in the regarcli g block of the Ixoduct approval letter, the EISA
feting with fabric must be used to sae the system.
• When this product is installed next to each other in a disftu0on cog that is NOT sized based on the EISA
rathtg stated in the regarding block of the product approval later, the dfluent distribution area is
the length lanes the width of the chambered area. The used aural to
is optional geotexlie fabric in that type of installation
• When this product is vastaged With geotextie fabric on the sides of the product in a distribution cal that is
Sized based on the EISA raft staled in the regarding block of the product approval *tW, the geotextile
fabric, must meet all of the tollowhlg specifications:
Geotaxtie shah be non+*ovam
Weight shag be 0.35 Ozfsq yd to 1.5 oz/sq yd
Apparent oponing sae (AOS) shag be 20.30 US. Sieve (ASTM [?•4751).
• t-or mound designs, we the manutacbaer's propriety mourn, component manual for this product line.
• For mound desgns, see the manufect ref's propriety mound component manual for this product line.
2534M DAVID UNM vas3 S"15
The department is in no way endor" on product or any advertwng, and s not respenei zoa for any sihravm
which may result from ft u3e.
sffxwoly.
Glen Jonas, MA
POWTS Product Revlewer
phono: (608) 267-5265
W-. (BOB) 267-9729
emak gfen4onws4pM.gov
The DSPS Is oommit%d to servke excedence. Vmft our survey at
www.Surveym onkey.com
nf, iitPture filtel
d9gtt a th` m:q N p:,A srtNVfa.Mf flgua: gttt W `4 f Wk:. R!M 71G: iF7 AM.kalyw, II t 68. rg
: ',t:li:!IttN!VS, Nt1a4 HIknIM UAIr~eIIXIWICIA:r`hf:uq:rµrle Ct~Sy'ehEMi"M tM[dr,InF'::I _
: :zrBege villwil Aarzlnrgnefianm!knngn mrecaw/1ec.ph'MgmruF~-.V.-,s's`n~:'. na::;l~ _ ~
r.::•`glM trero[ka, adrrryxrrnrx J.I.+v~iP.O;rap~lmalc[trn ZM palPlr •.,.,p`r;: .-s Pa IDmrt:
^„ri ttn CRrh(I,. au Bflxro'JIl~aea4Ueft}f.!/!G. s9J mC!:Ee'41Rlar cr:.
Sint Pic, r Fiii p=
YI 'ra :!`y rx.x ,I. .:•'c~' lL^, pr.:a: l l'L Wprlb:,+.r., it a'rrLar H'g:n YIYJOf.4s 611n
...n;:er!ans rogvo urrnS. CI^n-rr',c'. m!he p•tkme;4f!';m!ffis uv Lw<nl. n? it
I
l
I
I
1 _~r
Heavy-Duty Outlet
P.r I..,,: pn_illrc. eas at acrd 5_~-ri.n..-mn In [n:d:
'+•6 • s-CGaI !MeAralsp, m.!el Erpr! (,fnlOFt wrl.lY~i
'-':f^' ~•''I•r'IiS Mq'r'at111M.1'.t [t%4!rfg SPI V'J
Mulded-in Support Hubs
!Ir: hL: nn:1•,1',-,I r. GvrlcOSpm<rgt_{C•':1A'qt. sf odhFSSRr. `alp;'=:r[i. of Irc [arY.yer
f
Superior Designed Filtering Unit
iM IIHVy.nl N.m MaxrEi-.: ~4m•. b: tl4'1 sxt m. qr.
,amM•meYrg:bn:x MSn gelm lrfd :+:1 'K ng.a
y1gllY,f~~. I,.KKf%telMtr,rtetfllirlR,Ur' Anhtsr
o C7
c N J
J
w N
N
acs z 3a
a: IE
r e. 4 4
V N,
Z , ~ W o C
W U) r M It
a= W
UJz < OW
V $U*
DLu ~O a~
a U- U- m ~
Q m w
,o
o Zw m
as c
as
Qo
W
0-0 aw ~a c Sx
~ : s
U
z O
U
°o 0
rn
N
N N
ui il to
i
O
i ~ Q
W
W
N
N
~ Y r,,. y m x N
"w."• ~ • . s g. c v
0 m N
i
O ~ Z ik
r- L:
M O
r:
CA i
I` 0
I V 4eNf
to
p
a
WO.
HF-t
N
Y ~ t
C
i
Cf)
Wig:
N
N to
0)
O - L6
N N
1
O
N '
a
SONV7 031.LY7dNn
g 1Z NOILI36 40 H1 3S 3N1 d0 3NIl LOV3 s a
a it Zt. AMH *S•n LV Z86 3 ,109 39,.00 S t3XV.10tOSn)_ o
=t 0116nd 3n1 Ol a31V01030 F S IZ NOl1D31a
0 00'OZZ l0'LOE Z9'99l - 63NL00 3§
9 £6•Z69 M.091L9. N
_CN
g _ S y
N $g
w ~eOy N St d r w of
` ~ ~H F~ 8 8v N M
y5~ N01•{13•E
^v X3+19366 N
CO N o3 i o `
A! . v V 67.62 N
Z A
S g 301'41'13'W c
ss y ry' co
Pig C;
8
g G4~ ~s p~ 6V
~b
N h $ ~ a~zN Ag. 2~g 8 fit, r ~
xr
r~oer.a S B ryy ~ _ n lit
s a
Npp' 27 41" E 273.82 1p~ ~
gG J g n^
s 00.2 i'-w T~3.as , V $ $
cuoesnc wtz y
(O ni rY~ ,Q p
~N3^w e tl 11l Q w Q'. p.
cz B t7 1 \ Co i t .CC .E[
t 1 ~ 1 ii
1 I
4 1 ~
A p
L
17 -T
IVaow ai~g€ 1 r N s ` o
ll tO W ~o -Cp
8 ° V~'~`' n n I v '01 L6 W
f/1 l N W
LO'L" a ` ! a
E9'09Z 9Z'l9£ site 96'4ae
oosti>
60.096 M.££I19.00N' f3.049
Z107 N138 3H1 !O NOS 3N1 so 3181163M a3iwmmon m x
9107 '89Lt 39 dd '931Nn7OA
VLSb131dlVdd JOltf7d dVkV A3A8nS 031d112130
JO 4107
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S) /
Fhis is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address) located
at: t V4, 1/4, Section , Town- N, Range I c j W,
Town of LL (f rA 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.) minutes
Approximate volume or length of time: gallons m
"Tank Capacity:
Construction: Prefab Concrete Steel Other
Manufacturer (if known): V lU f'
Age of Tank (if known):
Permit number (if known) q 5 qH
(I.icerised )dumber $tgnature) (Print Name)
(Title) (License Number) MP/MPRS
(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
I
ST. (-IROIX COUNTY
SEPTIC TANK MAW rENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owneri~ityit __~:1~:Ef~ I E/V ,I ~ J E~til F=F_K~ ,'~DD1C~:A.~
Mailing Addmm I g~5 6,KANT Ay EAof
Propaty Ad&m /,5A4 E)
(VerifiestanA required from Planning t Zomg Dapmu mt for mw mom mogul n.)
cz11-r S-1L~-W(~
c;ity/Stme ItUr)5~y y PmxrJMmti5mtionNumber
LEGAL DESCRIPTION
Ympaty Location 5E '/e , 5t , Soc. )1 . T Z-L_N R_/~EW, Town of )q U 55t -A,'
Subdivision Plat ~I DA Pt}FCE Lot #
Certified Sarver Map # f Volume Page # -
WarraatyDeed # &1(before2009)Volume lyJr Pageir
spec house Dyftl~ Iat lines idmtifiabt OrsOno
SYSTEM MAINTENANCE AND OWNER CER97F1("A (W
Iogroper use and raimbmm a of Your AQtie system could ran& m its wemrnre fidure to handle wares. Ropy
v,sieteeseca cooam otpumpins am the mwbc tank awry Iun yeas or sooner. if waded, by a licaeaed punyor. Whatyou pat into
the system can affect the fmctim of the septic tank as a ocatevet stage is the made disposal aysteur owner ®meoaum
rspoeabilibes are spao9ed in §SPS. 383.52(1) and is Chapter 12 - SL Croix County SniEay Order.
The psopaty owoer agrees b submit to SL Ctoa County Plating is Tmmg Dryartdeet a careficstioa larva, waved by the
owner and by a master plunher. iorroaYmn limier. •osaieod plmber or a licensed ponper verifying that (1) via on-am
Watitarater dnpoaal syamm a m proper opora4ng coodttiou aedbr (2) after iaMxtion and psimptiag (dunoesry), the septic link is
less than in em of sludge.
vat, the mdesgned have read the above regate.eoa and sgrx to miosRain rho pnvdo sewage &spead system with the
staodardn set forth, heron, an act by the Department of Safety And Pmfeooae l Services mod the Depveee nt of foal Reamer,
crState OfVlrmeenm CuliSotion d" that your septic aI - - hw been aoaettwasod now be completed and returned to the SL Crook
County "timing Q Zoning Departskeul within 30 days of the torte yea expiration date.
Uwe catcfy that all nalenmaats t to are true to the belt of tey/our bwwiedge. )hve aatlare rtes owtaa(s) of toe
ptopetty tlemettied abae, by vwtm of a deed rerarded im Rceistrr of Dee& OHice_
Nwtw6er of beararas
z
SWYNA OF APPLICANT(S) DATE
" Any iodbreaerim that is miarclanaeeaed cry resit in the snitary penpit being m,61ted by the Planing t Tuning Deprmneot.
include with dos applitabon a recoedod .wraoty dead firm the > of Deeds Once nod a copy of the carolled survey reap if
tofmtac a is made in the warranty deed
(RSV 64/12)
LO
4TTF.D LANDS CEKTIFI_F.L
TEMPORARY CUL-DE-SACI VOLUME
EASEMENT
7E 626.85' ( ( R N89033-42-W )
16 66.Od 1183.22' 110.00 304.1
/DRAINAGE/ n
EMENT / A C N Z M L1=S8937'19"E 39.96' ANGLE
WATER + C POINT
WATER = 920.0' r 'w m p C3 m 1 rrJ
I~ 0' N No D T L1 / 187,896 square feet
s' e?p7 ~eT Z' (2.018 acres) 4
N79.1a~ a °o ,Cn:Incl. temp. cul-de-sac Cl) m 82,770 square feet qb' 112,558 square feet
`y N I ( 1.900 acres) ( 2.584 acres)
-4 v excl. temp. cul-de-sac
w w •.I
novel N I N :E PONDING /DRAINAGE
EASEMENT N
6;6' Ni HIGHWATER
23' I <~oi ELEV. = 920.9'
Ju)
\ ~o N ,,oww
~e
d \ \ V6
i
53 \ \
'off 20'X 66' joint
330,. 90° driveway easement
s? O 600 33 \
BENCHMARK= 16d NAIL 2y~ F~ 0 o
IN 14 ASH, ELEV. = 923.08 B~ 4i2'~ogbs6/oq 01 „
~88
°a00. I ry p~,0 T O O~ \
~~o~jS•.• ~O~~TyFA 3S~••"
20'X 66' joint • 0 F UB • 0
feet driveway easement yo ' 3S </c, 04
vJlscansin Department of Commerce
Snlor/ and Buildings Divisor: PRIVATE SEWAGE SYSTEM county:
INSPECTION REPORT X
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary3PprrtutNb
Personal information you proviso may be used for secondary purposes (Privacy 3.15.04 (1)(m)I
Veryoytlfo)dec'i Name: _ I-7 i SUN - Town of. State Plan to No
CST17B1MLElee;~ SAMmsp BM Elev.: BM Descnpbon- SUii Par<etT
Or t7O,Ur JV9 1355-05-000
TANK INFORMATION U E`tEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
l as , v
Dosing ` g r
Aeration Bldg. Sewer r :,s
Holdin
St/Ht Inlet 3 qb-Q
TANK SETBACK INFORMATION St [it Outlet Y,BO ~I,
TANK TO P/L WELL BLDG neintake ROAD
Septic r , e2 ^ NA
Dosing NA Header / Man
Aeration NA Dist. Pipe 5 I -u
O.D 2(r
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufact er and (o-Zo
Model Number GPM
TDH Lift Iction S stem TDH Ft
L
Force -n Length rowel i
I
SOIL RPTION SYSTEM I
TR width c Len h No f renches PIT No Of Pits Inside Dia Liquid Depth
3 .2y _
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING
~t
INFORMATION Sys em, 3~ t `~1 CHAMBER M e Num
OR UNIT
DISTRIBUTION SYSTEM
Header'Mani old Distribution Pipe s xHot e Sue xHO espacing Vent To Mr Intake
tenyU(~Q,Q{ Uw _ Z f Lengts_ _ Um Spacing _ I q O
SOIL COVER ~1- x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over bepUi Over xx Depth Of xv Sewbd,Sodded xx Mulched
Bed! Trrnah Center Bed/ Trench. Edges I lopes n Yea f7 No n ve. 0.
COMMENTS: (Include code discrepancies. persons present, etc)
7TION:sFii21•zg.19.2071 815 GRANT AVENUE - HOMEPLACE LOT 5
O
^ n lb6^(/°s~`{S/~Cr- ' `UrsC_-
WZ~ OR
#j
II~ Plan revision required? ❑ Yes ~No n
Use other side for additional information z 4 7 (
SBO.6710 In, 9/97) Date Inspector's Signature Cent No