HomeMy WebLinkAbout040-1171-30-000PRIVATE SEWAGE SYSTEM
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INSPECTION REPORT
GENERAL INFORMATION
(ATTACH TO PERMIT)
TANK SETBACK INFORMATION
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N ILWACD RD
3
CONVENTIONAL COMPONENT DESIGN
Residential ApplRelim
INDEX AND TITLE PAGE
Project Name'.
owners Name'.
51E/JN IFtKR CLi PMAN
OwnersAddress.
SOg COF tG EN-( c�
;D/A. 5 W l T�fOZZ
Legal Descrite en'.
5 E. %y �/ ul '14' S 36 f O8 ,(J ZO
Township
county:
SubdivfMon Name:
Lot Number'.
Parcel ID Number
30 —D 60
Page t Index and lido
Page 2 Plot Plan Ir 'aaw
Page System being &Cross -Section // (,jw to
Page Filter Specs
Page Malntenance4ntormatlon
Page Management Plan
Page] id Chole CN6eptic Tank Maintenance Form
Page Warmth, Deed
o-
_
Page TANK
AttacM1men Zoll Test &House Plana
Desl9netl
�
j/Plumber: li63'^ )IM44/t Llcense Number: /f�� 2Z6S�97
Date:
/—z4{—/q Phone Number GeLebgjO
signature
n
oevgn.a P,,,+^l to Na IMmane
sml Nesoryaon cpmpanom Manuel her POMS Verson 2.0 Sell al 01/mt
Paget
10
N
+ + + + , + +;
+
+
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+
+ --
+
+
+
+
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+
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+i + ,41
+
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cn
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++
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6
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--
T--�---j =
N ILWACO RD
1 or 2 Family Dwelling In -ground Soil Absorption System 13-cell CCo�nvI. enonal) _
oallywardewater Flow CVVF) _ �doroe�re�sf/ x ISO galiewbedroom= OUCI eaVaay /`, LL?
Oeal Loading Pate lDLR) or Soil wdiMmOl"IRate-�4— gpa/R° (per 3P3 Table 383.44-1, 2, its)
Required Distributor cell area =DVVF (no/) gal/dari_6 goal = QO Rs
a Chambers= Required Dlstnbutlon cellarea ®0 !Is^fie R'/unit /EIISSA= ChambersL�
Chamber Manufacturer and Model: /NF/L+aA+o2 Q F K sc i%[*MAR
Actual Darhmon cell area = prom ed cell area /Qil1 tt` + 13T— R°/ unit Ell End Cap Pair=or'sCe Fr'
Cross -Section In -ground S II Absorption System (3- II)'
l� a- schedule 40 PVC vent pipe with vent cap
r lz Inches minimum I12 Inches minm�
11 pI k L57—ft 13 Final Grade(FG)
sR TI FG S.% h R FG LZl-
IncM1es Sall Cover
inch Chamber Height
Trench I System Elevation Trench System Elevatlon Trench 3Sy-stem Elevatio
n
7! ✓•IR tt �R '--�'tt 36 Inch to llmltlngfactor
Trench
Separation
Plan View In -ground Soil Absorption System 13-cal
Trench 1 Matlity
3RUMMMMEMMMOM E header/
design as
ttI Leaching Chambers f r 0 needed'
ll a� Trench 1
ti a mm Header
sm. 3o3'f
Trench 3
n
RWlth end camps
Draw Q for a Venn aii for Observation Pipe above, They will be located / Rfrom the end of the cell
Vent pipes shall be Schedule 40 PVC and extend at least 12 Inches above Finished grade.
Observation pipes that extend above finished grade must also be 4 Inch Schedule 40 PVC.
Page cf
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BEST fO'FlLTES
POWTS OWNER'S MANUAL &-MANAGEMENT PLAN
FILE INFOMIATION SYSTEM SPECIFICATIONS
Owner �� g( Sa tic Tenk CapaclN IEso eel ONA
Penn eptle Tank Manufacturer W(etc 0NA
_.... oa. u._.n"....... ONA
Values Nplwl for domeou reawmar and seine tank WNW
Effluent Filter Model
O NA
Pump Tank Capacity
BO o
pal O NA
Pump Tank Manufacturer
W/EiEa
0NA
Pump Manufacturer
,jOULO
0NA
Pump Model
QE r//
O NA
Prefreshment Ualt
O Sol miter
0 Mechanlesl Aeration
❑ Disinfection
0 Peat Fiber
0 Wound
❑ Other:
DNA
Dispersal Cell(al
Oln-Grountl 1prevlty)
0 AtGrade
0 Drip -Line
0 NA
❑In -Ground 1pmasudzed)
0 Mound
0 Rhen
JNen
0 NA
Nut.
❑ NA.
)the,
0 NA
paced conditlon Oi fenklal At )sere coca wary: 3 9 earrel al (Maximum 3yean ❑NA
Pump our contante of tanklel When combined sludge and voum equals one4MM 1$1 of tank volume O NA
Incisor dispersal cll41 At least once every: 3 0 articlmonfore) IMNImum S years) 0NA
Clem eOntenifltter At least once every: monuf omer ONA
Inseam pump pump controls 6 alarm At least once every:' 3 9 emlaj ei .ONA
Flush laterep and pressure wart At Inrt once wary: 3 ®. enlal sl 0 NA
leant on eery: 0 aerial a) ONA
Omen - DNA
MAINTENANCE INSTPUCFIONS "
Inspections of Onk and dispersal calla shall be made by an Individual aenyNp one of the following Iowsas or aenlfloatlona:
Meawr Plumb, Metter Plumber flwUlated $l POWfS impactor, POINTS Melnbinep Storage Scoffing Operator. Tank
Inspections must height a visual Inspection of the tankb) to Identify any m@tlng or broken hardware, IdenNiy any cracks or leaks,
measure Me volume of Combined sludge and scum and to check for any back up or pending of affluent on the ground surface.
The dispawal O$d la) shall be visually Inspected to check The effluent levels N the Observation pipes and to check for any pending
of affluent an the ground surface. The pending of effluent on W ground surface may Indicate a falling conditlon and requires the
Immediate notlNcaWn of One local regulatory authority.
Men the mmbinsd accumulation of sludge and scum In any tank equals ona"Ihlyd 1 k) or more of the tank vclum4 line entire
contents of Me fork MW be removed by a Sepwpe Sarvleing Operator and disposed of In accordance with chapter Nfl 113,
Wisconsin Administrative Coale.
All other services, refusing but not limited to the awfldng of effluent fitters, mechanical or pressurized companenb,.Pnomlifinent
units, and any servicing at Intervals of 512 merge, shell be Performed by a certified POWTS McNtalner.
A grvict report shall be Provided to the local regulatory authority within 10 days of eompletlon of any service event.
START UP AND OPERATION
For now conauvMon, prior to use of the POINTS check treatment tanklal for the presence of painting products or other chemical!
that may aank moll
the
treatment
tape ssand/or
o damage Me stop 'MI ce11181. If high concentrations are detected have firee content$
of tor
System Ran up shell not Occur when coil conditions us fromen at the Infiltrative sutlac
During power outages pump tanks may fill above normal hlghwrtar(Well, When power is restored the deal wastewater will be
Elechargid M the Elepanal coddled In one Imps dose, ovedoetlNp the oulllal and may Man,* in the backup or surface discharge of
effluent, To avoid His situation have the contents of to pump tank removed by B Saptage S r prtor prior to restoring
power to me effluent pump or contact a Plumber or POINTS Mentalnrt M assist In manuallyoperating the pump controls to
restore ormL levels within the pomp tank.
Do not rinse or park vehicles over tanks and disposed calla, Do net drive or pad over, of otherwise disturb or compacp the area
within lE feet down elope of any mound or aCprade soil absorption area.
Hedul loh m elimination of the following from the WasbWatal$Us= may Improve Ibo parfarmence and prolong We life of fie
POINTS: antibiotics; baby wlPO ; cigarette butom condoms; cotton swabs; daproaaere; dental floss; diapers: disinfectant; red;
•4yfoundedon cloth bump pump) water, molt and vegetable peelings; gemllne; grease; herbicides; meat acrspa; medications; 011;
pool produeMedealleldea; sanitary mpklm ; tarl and wmarseftwer brine.
ABANDONMENT
pWhen the roperly andD�Iy abandoned In S falls and/or Is compliancteytaken Out Of with chapter Comm 83.3t do3, Wisconsin Adminollowing steps istrative Code:
Inenne system Is
e All piping M tanks and Note shall be disconnected and the abandoned pipe(MOMMge sealed,
s The contents Of all tanks and pits shell be removed and properly disposed Of by a Sal SorVlclnp Operator.
e After
"M 0�gan all
Tanks and once another tort sold mmashall
be excavated and removed 0r malt all removed and the Vold apse@ filled with
CONTINGENCY PLAN
If the POWYS fells and cannot be repaired Me following measures have been, or must be taken, to Provide a code CORMIS a
replacement"manh
❑ A suitable replacement area has boon evaluated and may be unwed for the IocadOn of a replacement sell absorption
system, The replacement area andbe protected from dubturul and companion and should not be Infringed upon by
ae real rbscka from existing posed suucNn, lot lines and wells. Failure t0 pmma the replacement area will
result In the Read for a new soil and Site evouBtlen to establish a suitable replacement area. Replacement ayateme mule
amply with fie rules In effect rt that time.
O A suitable replacement area is not available due to Setback small soil limitations. BnMe advances in POINTS
technology holding all may be Installed as a last reach M replace the felled POINTS.
❑ The site has not been evaluated t0 Identify a MIMNa replacement ame" Upon failure of the POINTS B sell et$Io
evauetlon ea be performed to locate a suitable replacement area. If no replacement area is available a holdingk
may be Installed as a lest raort to replace fie felled POINTS.
❑ Mound and Broach sell absorption systems may be reci mlstaRed In Place following removal of the blemet at the
Infiltrative surface. R@mmtructons of such systame must comply with the Mies In site" at that time.
<<WARNWO»
SEPTIF PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. BO 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.
PO�WTS INSTAµER 1PO—Y?-S MMAI�NTAI�NER��
Name KO R�`2 %I C-L Sor1 I Ponel
Phan. 'lI Phan.
GEPTAGE 3E0.VIGINO OPERATOR (PUMPER) LOCALSEOULATORY AUTHORITY
theme $d H^rS'N Sit^'(+wMo n/. Nuns if !#Ole Zo✓( j
Phone 7/5--773-581(
This document was drafted In compliance win chapter Comm 83.I113)0NtINI art 83.5401.(2) re 131, Watchmen Admllnmeme Code.
C Ombina [Ian Se pGiC: Tank and
Pump CHAMBER CM055 SECTION AND SPECIFICATIONS'
VENjv
T CAP. ACA PRDOI
U[TI OU BOY
PCI APPAOVCO LOCKWL
'C0. VCMT PI
• ':ID ' /ROM DOOR.. ,4WLCOV%jLC CSEL
L0.BEE.
viUDOW OR lR C5N f
,,a? c10N PIVE\ AUL,raTAMC
+ u/H+ ALtlT LmP L .V C
Co
,
- WAIN.
I&AI N. L ��
ROVIOEI I
IULCT A ArmxT SEAL j jI
I III APPPROYC0 JOIN
APPROVED JDIu zPmeLpEnL I III WE.x. PIPE+r
W/ccx nvc oa rAAAAAvggqgqC she
consCFuc CIon _I U ALMA
hall Comply Rich N
ILRd 03.15 and 33. 20 ° I I
oN
PU MPS -/
OFF
0 CONCKCTC `
qw
- RISC& UNIT PEKA17ED ONIF TALK MAANUFICTNACR HAS SUCH APPROVAL S ♦ 9COpFCA
IAL
Ow"
SEPTICi SgCCIFICATIDAI$
Cost
Tnu HS MANWACTNRCR,' M i CR NWbCA OF DOSES: _PLR we
TAUK 9nc: � 4AK DAS D05C VOLUME
eRh AANOFACTYRCR: S'S .161.1' o SNTC& NCLu D14D OACKFLOAN 2 6A"Ou3
AOR OCL DUMBER: w /0/ CAPACMES: AL ? 31 WCACS OR 11L 6ALLOy5
5WFTCN TJFCL Le4-< a=? INCRES-09 �1(///�/0Z� cquous
PUMP MANUFACTURER:_. Q�D/Vb� C:�Im HE50K/�W�pZ� NLLOJ5
MOOEL AUAOEX{ _/614� 0• IAC NES OR[�Ya 4ALLO Ui
SWITCH TYPE GLOM- WrT. PUXPANDALARt AACTO6C
MIUIMUP%DISCHAR6E RArC—$6_CPtt IMrALLEO ON 5CFARATC CIRCUITS
VCKTICAL 06FERENCC OCTNKU PUMP OFF AWOXISTRIBUTIOU FIFE_ /iw SENT
+ nI U IIZUh NCTNORK 50 PPLY PR[SfUAVC/.:... .. Q FEET
f S FEET OF r00.CC MINX 9�/IFo nFKICTIOY FATOR.. a, s FEET
TOTAL MI /IC� HEAD o L¢i_ FEET
As per.nanufac curer ZOP CP , gel/in.
PPR-12-2005 16:M F GuSN FM HUV 1
[QGOULDS PUMPS
APPIIIAITON3
Spoolmi; ugnedmrNe
foMomd am:
• M intr Symms
Effl• imPhone g 5ysmms
•IGW%eeemelpae Sysfemi
•mee OIOWINag
• �eonnRdng wmd
MmN
1a
Y
0
REl
vamp—Genwl;
• Omthalge:l M. NIT
Teroto
• Mormon,
mold DQo
when
maximum, mMnuom when
eellow"a rye.
• Solitls M1aIrn"w
mmlmum sphere.
• Automatic models indudea
0oatsPdMl.
• Malwa medet; available.
• Pumping antir fee
pmanmdaRmmne.
PE31 Pump:
• Madmum pool Z5'M" M
• Madmum head EE'3DH
PEMavamp:
Madmum head: 29'1GPM
• Matlmum heatl:29'RN
PE51 Pump:
• Madmum head: 37'OGPM
W • Mmum head:3)'IDH
715 386 61" Pol
Submersible (�
Effluent Pump
PE
MOTOR
Growl:
• SIngle phase
60 Hem
• 115 and 230 vatts
• &LLNticemmOveRmtlpm
Ons 9 fiMarnanla0srese[
• (less ed cesi n.
• Ogh stmWign.
• she. engrh m2on mel
heft.
PHI Month
• .33 HP, 3000RPM
e Shaded
p
• Shaded pole design
PE41 Motor.
•1150m3230 L;
•MCdw 230w1m
51 Moto.50 r
PE51 HP, 34
•115 an 230PPM
• I cil"I 30 w1m
• PSCtltslgn
HAMM
•(ormslon mallard
Model
• GPI Iron body.
• lhmmoplastie hnpller and
Calif.
• Uppu cleave andcrover
ading
hearydufyball beeWg
¢uuV Nort
•Motor bpennanemly
mMmmdlorwendetl
$whceIde.
la
•Poomm enalim mnWuom
oppeeraado
•Pll rae'ngvre Me
wnddiscoew of t
Imb No motor
•kngA
mmiz ,horda Wwer
nMYy elRy Well
ai30vo ing
115 wHgrounding
plug.
• fnmpkle unit ahmvy only,
poMbkana mmpan.
•mmmkknlfmand
s smml,
eeram'C BUN4 andfainleu
enel
•SmMlesf Rcelfuhnen.
"Clo"IIVINGS
SA's
Taredm UU]6and
CAL 2211 N MaMyda
aY4xia�ad•9'641Wavi
fl6iWWe
Como Prop k ho wal nglmM
o s 10 1s odh Goulds Pumps
u..mv
.,w 10°0 ew.uu <&ITT Inelustnes
i 1 L-
INVERT3P a f04• INVERT 9IdLIYs�J
—{ 48 �FF�nnLp
INVE6eSi9;2RI 5 to
`W
Quick4 Plus Standard Chamber Specifications
Sza(WxLxH).._.,_.,.. 34' X 531 x 81(86 cm xl 35 cm x 20 on) Inveh Height _,_........8.319"
EHedlve Length _..I 1 11 1 1 1.. _... 48' (122 cm) IS 4 cm, 22.8 cm)
4r
INFILTRATOR"
5 Rushee Pi Road • P0. Box 958
Old Saybrook, CT 06495
860.5999000 • FAX 850.577 7001
800.221.4436
waist. i n fI tratorsystems.00m
C ST. ROIX COUNTY
AN T. RO
SEPTIC TIENANCE AGREEMENT
AND
OWNERSHR+CERTIFICA'rION FORM
owantTayser Jennifer Chapman
Ma;wgsidare,e 508 Crescent Street, River Falls, WI 54022
properly Addreas� 2 3 O N. I Iwaeo Road
(VaiGmlim required ffum planning&Zoning Depenmewfor n<w construction)
Cityrsmre River Falls, WI comet Identilbortion Number 040-1171-30-000
LEGAL DESCRIPTION
property Lanfuni SE i NW fsSmc36 128 NR20 w, Town or Troy
Campbell Survey Map is
Warranty Deedp��(.J.J� (before 2007)Volme _/ page#
Spec house Oyw[jo Lot lines idemtfinble DyesLlrno
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and optimistic efyemseptic System ooulduesult la its premawe 6llme tohache rws, pvspv
mraw M1cofProming out The snow minNrcveed
k every e years or screw, ifeq by a Imposed pointer Wnatyonputlnto
0 systemean rsaRttl Na fuuemlon ofthe scp2iCbuk tr a traam 1 sbge Attie wancal ansaly oudin Owns maimmenw
raponsbJines ere SpeciPW in j5P5.383.Y1(1)mdtiCltepler l2-SLCmix Counry3auNery OMi,unp.
The property owner Taxes to submit TO St CTOIx County Phnuie& Zmng Department a certification form, signed by one
super and by a mastic plumber joumeyman plumber, restricted plumber or a liuemed pumper veriying din (1) she wuite
waslewmu&sevvpl aym® is m prever opom%g mndllw and/or (2) pRer inspection oW pumping (tfnee(ssery), the septic rtmk Ts
Iess Nan lq fidl o(eludge.
Cast the wderslgoed have read Tire above morremmts and ago to maintain me private sewage disposal system ork the
sundaNs an toed, herein, as set by the Department of Safety And ProRssional Services antl the Deprom a dofNrzail propops,
Spite ofWiuouda (s ption steting That your optic system has been mawbwed must be completed antl tetwuea to rate St Croix
Gwry Plannng & Zm6ns;Depamnent within 30 Gaya of the Three yen expiration date.
I/wecWCy Nrtelf vapor wNis minare Wetoet mestonofPr MoOffice.I/weaMarttha owneQs)ofPoe
propertydeac,ibea ahrve, by virtue ofewerr ty dred recmaetlm Aegis[tt of Pretax (Itfice,
Number of bodrooms
L/ R/O APN ICANfi(S)
D DATE
*^Avy mfotmems'that's posanesaaW may Trash TO Na satiety permit being mvaked by the Planning of Zonlag Ocpartment
relendsithis a pplicationa gtendd wementy deedhom We Ragismer ofDeeds OlEceana acopy of We cwtifieA smvry map if
referencee Is seas III me wawany aua.
(TlEv. pant)
1
zz
d�
sus®
� Csr-aolg-a9a
C3-,mwPmwoMm�Y�8 p,a:
T SOIL EVALUATION REPORT
' N""'U 10
In®NvvxxXM15P6]95.VM /d�m�. fob Cma%
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