HomeMy WebLinkAbout026-1306-00-010
:v.~~:on:an navn:nn,.•m o•Cnmrsr PRIVATE SEWAGE SYSTEM C:ou^t' St. Croix
dof:+panc 9uildinp JivSion I
INSPECTION REPORT a ..taly Pwm l NO
GENERAL INFORMATION (ATTACH TO PERM] I i Ir DI:1n In nn 607062
.1
For and ^fJnraOOr y0. Jronat rt:ry nr nand Ini ccccnpary ourpo5ec'i'ma: Law f r4 1 ii rn it
n,t Ilnldc: Nan'c ^n5' Villapr T m =-ir Parc:nl 7ax'.n
Oevering Homes TOWN OF RICHMOND 026-1306-00 010
FHA lieu n3p 61.' c eu' 641 ❑e.^.crip:nr inrbo:r"o~mRanpcN: F P,n
<b e , D, ! 3 c~ 18.30.18.1617
TANK INFORMATION ELEVATION DATA
-YF•E NlnN.1FA(: 1 UR=R n CAPACITY STATION BS HI rs -LE,,
h P• I
Dosing AII. Hilt
d,.-tl,~ 1 - ~1llt! I.So (~o.`rY7
FeraN6n Kldq SewerPJf
cLcFS 13,18
I loldlrry- SUHI Inlet
TANK SETBACK INFORMATION SUH:Outlet
D
TANK 10 P7L V.F.: Ri lG Ve=t to Alf Intake ROAD DI Inlet
7!n
Septic lyr 75 , Dl Kotern--
y
Dc^.ing HeaderlMan
Aeration D:s: '.rw.
Y-
Ho.dmq Rot System
- - "final Grade
PUMP/SIPHON INFORMATION - QJ
k7anufaep•Ie,l 4-D-, 1 manc S: Over
'fMonet NumherT D- I d' Fndiori Los:. System I luad Fr FJ4x411ai1' ! Cnulh nia. C s'.: t.+sAtlL
I ~a~' rt~ (QJ~•
SOIL ABSORPTION SYSTEM
BED/TRENCH LSidtn Lc-pe^ Ho. moor:. PIT D ENSIONS NC Ot Prts inside Dia Leuid Ueptr -
DIMENSIONS r I\M _
SFTBACK SvS7FP.1 TES: PiL KI DG WELL Jl rSl R_AIa1 L CHING Man.4aClure-
INFORMATION CHAMBER OR
(---O V~~✓•Q`~-f'(,Awo~ ri ~ ~1 I. ~ UNIT MOOR I~rmCe'
DISTRIBUTION SYSTEM L(2,A,p
HeacervMdrClc .MI NInnrl x -ode Svc x 1•olc Spat rp Vent to Alf Intake
41, PiJki>; _ of SEUQ~
7 Je Lenptr
""ffil
SOIL COVER x Pressure Systems Onlyr xx Mound Or At-Grade Systems Only
Depth cvar O,:11, ) cr zx::epe: of xx 5nroed'indad xx hlownnd
Rai Cn ~r-stn' / FS<Y II" 'i I t;p:e:: - TODso
/ Y'es - ~c_ Yes Nc
COMMENTS: (Include rode disc.regencies. persons presenl. elc.) Inspection Inspem on #2
Location: 96E 164Tr1 AVE
• i Alt 70A 7escriptron = ~-i I rcb",~•( ~ C-, to C,t 1
2.i BIC1C sewer length = 7/J
amount of cover - 'x,11
Plan revision RequireG/ Yes No
Use other side for additional Information'
Ddm tae.
~~1w-~c1 ~-06
, nmt)
I I t Safety and Build:ngs Division
U -
x t t 2CI - Washingfan Ave. P C. BOX 902 Svnitan' Perrmi V•mfbcr (m be filled in b) ..c )
S P Madtso;. V4 5370'-7162
62
Ir TIM..; ti nNumber
Sanlt<ir~ Perlfcatlon ~ -
In acc,ed=n with S PS T i ' W, 0. I t tub c nrsu r I this - vm Om appr.rrn: -
is ¢animd p rn 6 !,t m scvvcr x n.t i „y:. ..nt.a fiats .tas-~wr~d . , ~ ale suornned u~ ?rjeuy Ad:h as iif olllrent mm::wriiiur addressi
the Dc,&vnaa of Safc:y and tlafo Tonal Se•v-c I -c:. aI trinmtman.mp n.oc maq :x cud :or sc.:onda
1..RApplic tion'nfo mati ?rPhtsiseP S l Ipm S6
I Application Irnnoe Please Fnnl All Informuv__
s Nam. I f / 7arccl h
~v e F~1S~ - L I DZ ~n - 6(0 - OD - LY b
Prma•y cranes hfml t+s ! ?lalxtn' l.Kan:n
Ut, Sta:c ~1 1 Phone . : h^r~ ~ Sc,: hm
V 1^ If ' \
Wes- 01 az
11. Type of Ruilding (check all tha v n [ y W
sukiwion Nam.
anvil Uaclhaa Number u' iScawcn:c D /
ir'tuSiu•Y:ortmcsiv: ihs.:nbe (!u_y(;G
J o :i•y o:
Sla+t Ovruc! D scrhe Usc GSM kumbcr iI \01l'e of
2__,p;$t Cpl\s ~AJ I%K ' 2L C~5 o vu( -
5L'lype n tC (Check only one box on line 4 Complete line B if applicable)
A_ SY'9cn L ticpl:uxrmrn cyrtcm T _avnaml{ Id:u_ ..utk K pl :.m, rnt (iolV ❑ Chnv hltn:iti~la r• b (~xtsttq- Syslnm le%p:am;
N I /Lir. Pr MM YCSan l:um(bw /d D qls ve[
amt Transfa tc New
l_IerwtR. 'v; .-nu: Fevw-n Ya.V /~lOl--_ _t
i Rdtr Lx =a on
7
_ a 0c9 L
~R Tv v>taaf Om nnent.Devicc; ichevk all that app la) .f/z,r
-Ncsiw i. d Ir+n>t n tJ -m ::.r Ir ' round A!111--. Mec'^ - i 1 Ascic.ble coil tJ t Punt 124 m. >f suilabic soil "v--
- . t p t . ^_.cai o tt caytmr ❑ PrcII atrn--t..)ca':<t<%pain:
V. DixpersatTreatment Area [utormahon:
g/n IF'lcrz•'_np. /
il. yphcatirxl Kn:r ds9 Du nal Mca.C ui:alt jUic :crd4mn oe tl lrnvnllo:n~fuu-
rV'I. . - y
Tank Info tb fd ant ~muY:: n.m
..(raft rns ~ iialloi t'mts ~ 1 o c
ticw .arr. tuau•T:.nl- ~ ~-1 ~ - C u y
rye,
VII. Rnponsibililr Stateme t 1, the underutart at c rmpuustbibty for tuvtallamm of the POWTS sbowu on the attached plans
:lu i'manur S3Y M?RS ':umbx duca:ss Phone Nanntber
7j
':tymba- Aducss:surf, :Irv i d.g{
231
Z _x.112 -eJDL~-
VM uuatvi Dr artmeut I-se 0"],
_
Appnnxdti,~nw.. I m~.rf is !>nt 'Lsu dI lsuln_ .cot Si^-..im:Ine
1 - Uwv ' a3
IX. COndlns)(v asousfor Divapprov al
V
1. 5ept(n tack. aRllcte titer rro1 r. . j\ 6 (ate: t1d-C_. w net
tiis)xne:,t een o~! do be •;_rrIc:'s ) v • L~•- G
per i5 MW,3ff en' plin G;.. ,.I•,.nce~ 1 , a
2 ANA~ ~ t'k nKUncNne min;t w,-irr.: d t
4owt1 hcoew T,9A_
netrcb to ;noy4tc ylam ter the zrstem and sabmir w Ib<CeuotY oolY oa paper not Irv. tWc S t%z 1 mrbc in zsse
4\ ~cca..wA
Soil Tc,t and Svstcm PLOT I'I AN
PRoj c'F' Oeverina Homes _ ADDRLSS 5433 Ceriohous Ave Sjite A New RlchrT101d''.°e1 5401'
NW 1,4 SE 1 ~ 4S 18 11 30 V it 18 la -rows, Hichrnond COUNTI' ST. CROIX
SYSTEM ELEVATION 95.0! 4.8' 5 below Uradc 5'9!19 BEDROOM 4
DATE
CONYENT10N41. XXX f~,, 2' L CONVENTIOAA1. LIFT HOLDING TASK
1255 ca:mns LIFT 'CASK SIZE DOSE TASK SIZE
MCItTND SEI'1'IC 'I: . K SIZE
HOLDING '1':1IiE tiIZ1; LOAD (LATE ABSORPTION ARIA 891 " of chambers 44
BENCHMARK N'.R,P. Top of electrical `lox ASSL NIF L'.LI~PVYION 1110' Filter l.ifetime Filter
❑ BORLI101.F O "EAA, ~ H.R.P. Sane as non nrnard
x24jGrade Scale = 1/4 " = 10' ,i, k4 Standard
aellin- C'h;miber Proper.% Line
h IQ of :Area
ft^'ipsdr o end caps
at Svstein Elevation
'
i
Town Road
13 '
Pro 4
Bedroom
House
;0'
80'
S'T
B- I
In 2W
2-3' X 90' cells Frith >V spacing
1 4th Avc BA 1 I 00,
lQ)
WiiscorwnDepartinentorCommer«,' SOIL EVALUATION REPORT Page of
Division of Safety and Buddegs - in amod8rfr'.6'w11fi!Ctyi61ii95~l~
~~Jis. Adm. Code
County
T
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited to. vertical and horizontal reterence point (BM), direction and Parcel I.D.
percent slope, scale or dimensions. north snow, and location and distance to nearest read. /36(a " 66 - Ol
Please print all information. Rev a by Date
Paraonar srif maeoe yw erw•ea maY lw uaee fa secerwary purposes ,Privacy law, a 15 04 (1) tm))
Property Owner Property Location _
Je fI I Gov! Lot 11'6V4 T D N R E (or w'
Property Owner's Maili ddress Lo( # Block # Subd. Name CSM# J ;ry
1(4-2.3 C F t ;,t-: alt"/:S
city T-~urte Lv Code Phone Number ❑ City ❑ Village 11 Nearest Road
N I,w Lit "J ( ) c l .dam
New Construction Use'g[Residenbal I Number of bedrooms Code derived design flow rate GPD
❑Replacement ❑ Pv'-,r~Vr commercial-Describe.
parent material DLA9'7'~:-f" Flood Plan elevation if applicable ft.
General mmendt5
and ree S , J3t' 1 s• ; utX
and recommenmEens: 4
SyslerTypc 4Pl"UC45ysromElcvati,:rjS•t-~
F fl Boring a p Boring
Pit Ground surface elev. Depth to limiting factor y in.
Sill Application Rate
Horizon Depth Domnant Color Redox Description Texture Structure Consistence Boundary Roots GPD.•YF
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Effr1 'EfHt2
C~ 0.31 Z- n < f C, 1~
Lr-~- L- ~E
IL' _
4
i
(
t
a
Boring Boring J
W'Pit Ground surfaceelev.! f, h. Depth to limiting factor / Ll in.
Sill App;,calron Rate.
Fkxtzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNf
in Munsen Our. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 i 'Effr2
Z 5
n
i
' Effluent ri = BOD. > 30 < 220 nWL and TSS >30 < 150 ' Effluent k2 = BOD• < 30 nv,%t and TSS < 30 nx;
CST Name (Please Print) 1 i a e CST Number
Bird Plumbing, Inc. Shaun Bird / 226900
Addross Date Lealualion Conducted folophone Number
1432 120th St. New Richmond, WI 54017 ✓ 715-246-4516
Pmperr,; eN.rar Parcel ID# _ Puyu ___o!-. _
i ~1 (aims # ❑ Boring
I . J I ❑ pit Ground surface elev/o n. Depth to limiting factor~ x,.
Sail lic hcri Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJrf
in. Munseli Ou. Sz Cont. Cola Gr. Sz. 3h. 'EN#1 'Eff#2
i G-1z 1Z- S ! 4,2
Z- 12 f-
i 5 ^5 ill m
it
Boring # ❑ Boring -
❑ pit Groundsurfaceelev.___ Depth to limiting factor in.
_ Soil Application Rate
Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Rawls GPD,Tf
in. Munsell Ou Sz. Cont. Cola Gr Sz Sh. 'Etf#t 'Eff#2
Boring
Boring # Pit Ground surface elev. ft. Depth to limiting factor in.
❑
Soil Application Rate
Horizon 'Tepth Dominant Cola Redox Description. Texture Structure Consistence Boundary Roots GPDIIf
in. Munsell Cu. Sz Cont. Color Gc Sz. Sh. 'EN#1 'EB#2
Effluent #1 = BODE > 30 < 220 no, and TSS >30 < 150 mgtL ' Effluent 112 = BOO, < 30 mgL and TSS 30 mgt
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact die department at 608-266-1151 or TTY 609-264-8777.
Semq)M a amr
Property Owner Parce. ID Page
Boring # ❑ Boring 1
0 Pit Ground surface elex// l- C2 ft Depth to limiting facto 11 : n
Sore, liratgn Rate
Horizon Depth Donunant Color Rednx Desorption I Texture Structure Consistence Boundary Roots GPDtff
in. Mansell Ou Sz Cart. Color Gr. S7. Sh ! 'Eff#1 'Eff#2
Z-
12 S ^
Z -Z lr~ -f' ! i
!
A
Boring 0 ❑ Boing
❑ pit Ground surface elev. ft. Depth to hmrtrng factor in
Saii xuraLOn Rale
Horizon Depth Dominant Colo Redox Description Texture I Structure Consistence Boundary Roots GPD,tf
in. Munsell Qu. Sz. Cont. Color Gr 8z. Sh. 'Eff#1 'Eft#2
I
i '
I
i
I
i
❑ Boring # ❑ During
❑ Pit Ground surface elev. It, Depth to limiting factor in
Soil ADolication Rate
Horizon 'lepth Dominant Colo Redox Description Texture Seuc Lure Consistence Boundary Roots GPD/If
M. Munsel Out. Sz Corn Color Gr. Sz Sh. 'Eff#1 -Eft#2
I
Effluent 41 = BOO, > 30 < 220 mg'L and TSS >30 < 150 mg(L ' Merit #2 = BOD, < 30 nrKA and TSS < 30 nr VL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
Seniucac")
Soil Test and System PLO PLAN
PKo.)F.c'T Oeverine I lorries ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 114 SE 1/4S 18 I'r 30 NIR 18 W TORT Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 95.014.8' 5' below grade 5 9;19 BEDROOM 4
CONVENTION,11. XXX a~, 22 bS~~~L CON%rEN'110NAL LIFT HOLDING TANK
MUI1Np SEPTIC 'G. ~K SIZE 1255 gallons LIFT TANK SIZE, DOSE TANK SIZE
HOLDING TANK SIZE LOAD IL4TE .7 ABSORPTION %R[-'% 891 h of rhanthers 44
BENCHMARK V.It. P. Top of electrical box ASSUNIE ELEV V110N' 1110' filter Li(etimc filter
❑ BOREHOLE (DWELL "II.►t. P, same as benchmark
Vcttt
Scale = 1/4" = 10'
>~i,. ~uick~l Standard
of Cover I.cachin;, Chamber Properly line
with'_0.0 It2 of Area
5.6ff l/pair of end Caps
4' Loner 1`,
Grady at System Elevation
4'
Tob N n Road
B-'
Pro 4
Bedroom
Ilouse
30' B-3
f1'
40'
5'1'
20' B I
2 X 90' cells with >3' spacing 25•
1541h .Ave B. M.:^ 100'
I
s4v-ao,I-o(y
X Safety and 3:ardinas DiVts,Or
s < ` 201 Vv Washington >ve P BOX ; t. L Samue +e:mi: ywnx:.w tr fi"ri :r ~a c
Sp F j Madison, ✓'I 53r -r 152
~ Sane '
iwry Permit App4cati
ac<::nd:m-c witii Sl'~ _'II'l. `155 Adrn a <:dc. sohmissnm. of Ihc: Dore. In :hc e?propnac
L rcq..imi pro r.o nhaemmt a mmt~, pe=n t ",c. fr•In fa s[a1e awncJ i J t uc s^Lnived a !'-weal Address if daerent than marine add=
m 7>Z+:mt r eel .f Wery and N xcss,onal Ynlc. k'rnun u in.1 ration you p rculdc n:r o; w d fo- sc nn,- I.$
[ur acs i. ,,dan-c'h:fi tb 1'iivacv 12u 5 1 .141 : hYl~ S .s- -1.r•/
f k plioanon lnform.,ion Please Fnut All information
~ / Par_d a
f'IOVaty llwncr's Ik _ ""'oery: 'n 19• 30,19 ' 1417
.
I ~ C
L y r . ,rt / •(1 A"2
! . :,l.tJl- ,W♦- _ j c.oY, F.o
f,t171. ta¢t i.Ys !.ry ('xc Tb.+ne 1;umhcrF -.'I i,m
U. )•pe of Building (chick wll thut uppl)'1 ~ ! •^11 V I
n - Family Dw 111a. t:waber ..-.f R<orouna Sob~Lv, , m .Crone 7,Q
❑ i'ub!ic•'Cummn; iai - L1rs:.rt< 11sc ~,y~„Y -
k,uagc or _
❑ Jta!e CTwned UcsmM lse v~'•11 b-t
Tnwm of !C
❑l. T}•pe of i__ ((-.heck only ne box on line A. Complete line B if a li - 26
4. f C :ern: Repi:cenmt Sysrc•r i .,r •rne -t~ln^ pa:s:mi •'ril - OLha igodilictuon m Ezlztin~ Sy me:n 1";,' ml
- _ - - I ` _ _ Lix Presnous Fc::nut::mmber and DW Issued
B I. I i m Prnewal . I Pami[ I(e~_ci:n: ❑ i rt ~ 7 zl oJo New I'
Frpe~f£ORrf :S'9~ata~n Cnmpnoent,•Ue,•ice: ll6eck 1 that a Ivl
~Y~-MI I': ~ssu. unt lr. Cr,.un,l )IF'r's Mp ee-. iroud ❑ c rade ~1.]c<cnl ',Sm ~rf uit~>le .ail Lt(ound-24 ,n. ci mitrblc snJ C ~
/ Iii Main,^-sniOCb:r Ui perm ::,.npnneuiapl ,i Ll Prrre:mnclt_7n:c<iezp;zul__
17.
A. UispersxLTrrat ut Arex [oformahon• _ _ P z _
~ICSj'a Flan ~;pd; [ks,,~ Sod .+?pli canon ;gpds : L.uycrsal Area Scq.ve l ~sf f1i: :sal :area Aoposed s1j S, v= Ei
L -Z- A-3
V1. Tauk Info - - atacin in .al a-of - ktvn.:"rff I
(aq n. ;hlcn :7nismrI v-~ u
Scylicai>+diae Tank
Ttt
P+cnc c'Fa+ctn I
Il Etaspums,bdn} Slu ment- 1, the td. 2s re_sponsibilin, for installation of the POWTC shown on the arraehed plums
^l~br's \ un, k Imt t - I I'6r a < i I:rc `:IPA 5urmba ~R¢su,es; ?aoneN her
j~
Ptimber?4umasiY.reft ats vq L,p
yI71. -ounlv!Ur )xr2ment Lse Onb_ QAe, n
IX Condrriew&TQ18 V*W;isons for Usapplaaal 1. ode
a»pel cell .'t d!I be _ If
n per jar nernen. plxn p vet Lv plwnue..
2 AYae!Mrkl'Kt1rr.?arrYsm,sdw:-.arl:it:c".
L rspq AcrbVe uY,f ; :r f utl t.
- - -
nmaeb to eompMr Pau+ (vr rbe ezrem aed mbme u. for fonnrv om}y m paper my In Wae ! t^ a 11 ieeben m s,n
SRD-6398iR 11:111
1
System PLOT PLAN
PROJECT Oev(!~inc Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
114 SE 1 r4S 18 !T 30 N/R 18 W TO),I'N Richmond C,Ot7NTF ST. CROIX
St'STEFI ELEVATION 941!94.2 5' ooiow Grade 4! 15/19 4
DATE ISI1UR00N1
CON\'EN710N 11. >M CON'FENTIONAL 1.111' HOLDING 'CANE
MOUND SF:1''1'IC TAKE SiLE 1255 ga'ions LIFT TANK SIZE DOSE PANE SIZI'.
HOLDING 7-ANK SIZE LOAD RATE .7 ABSORPTION AREA 891 #c o1' chambers 44
Ilk BENC'H1vt.A RE F.R.P. Top of 2" pvc pipe ASSCDIF ELEVATION IOD' Filter Lifetime Filter
❑ BOREHOLE (D WELL -If.R.P. same as oenchmark
Scale = 1/4" = 10'
Properi\ Line
B . M.'°
B-I It
Vent
5 7' Vents >6'' Quick4 Standard
of' Cover Leaching Chamt~c
with 20.0 ft2 of Area
5002ipair of end caps
4' Long ~ -
Grade at Svstem Elevation
46' q
46'
2-3' X 90' cells with >3' spacing
13-2
R3
99 ST
30'
Pro 4
Bedroom
House
f 41h avc l11i pining shall be ASTM SDR 30!34, within C ()P y
10' of tank, piping shall be ASTA4 F891
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi54017
715-246-4516
Date: 4/14/19
Owner:Oevering Homes
Location: NW1/4 SE1/4 S18 T30N,R18W 966 154th St. Richmond
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintance and Contigency Plan
- 7. Filter Cross Secti
Signature
License nu 4226900
System PLOT PLAN
PRo•IEcT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 1/4 SE 1/4S 18 /'1, 30 N/R 18 w TowN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 94.1/94.2 5' below grade 4/1 5/19 BEDROOM 4
DATE:
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE. LOAD RATE .7 ABSORPTION AREA 891 N of chambers 44
BENCII.NIARK V.R.P. Top of 2" pvc pipe ASSUME? ELEVATION 100' Filter Lifetime Filter
❑ BORF,IIOLF. (D WF.LI, h11.R.P. same as benchmark
Scale = 1/4" = 10'
Property Line
B.M.*
B-1
57' Vent
Vents >6" Quick4 Standard
of Cover I-caching Chamber
with 20.0 ft2 of Area
5.6ftA2/pai r of end caps
4' Lone 12„
Grade at System Elevation
46' 3 4..
46'
2-3' X 90' cells with >3' spacing
B-2
B-3
99' 2)'
- 'T
30'
Pro 4
Bedroom
house
154th ave All piping shall he ASTM SDR 30/34, within
10' of tank, piping shall he ASTM F891
i -
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
I
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates To be >1' above grade
/ Finish grade elevation
/ Typical Installation i 99.1
Vent Grade Vent
j 3 X30/34 Septic Tank 3
5' Lone . I 5' 5' Long t,.
Grade at System Elevation
36" Gradc at System Elevation
i
Spacing
2-3' X 90' Cells
Same on other end Observation tubeNent
At end of cell
A
B
22 chambers per cell
System elevations:
A 94.1'
B-94.2'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _ of
i-ILE INFORMATION SYSTEM SPECIFICATIONS
i Owner Septic i ars ;;apadry 1 al ❑ NA
6_ Lam':
r
C Permit#_ - Septic Tank manufacturer k` LINA
DESIGN PARAMETERS Effluent Fier Manufacturer ~ir J p NA
Number of Bedrooms \A Effluent Filter Model ❑ NA
I Number of Public Facility Units ; NA Pump Tank Capacity _ JaINA
Estimated flow (average) aUda Pump Tank Manufacturer i Design flow (peak), (Estimated x 1.5) /_r boa Pump Manufacturer Soil Application Rate C -~ULPump Model
Standard InfluenUEffluent Quality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) i s313 mgiL ❑ Sand/Gravel Filter 3P
eal Filler
Biochemical Oxygen Demand (BOD,,) _220 mgiL U NA ❑ Mechanical Aeration ❑ tland
Total Suspended Solids (TSS) 5150 mgiL ❑ Disinfection ❑ Other.
Preheated Effluent Quality Monthly average Dispersal Cell(s) U NA
Biochemical Oxygen Demand (BODs) X30 mgtL ins-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) -30 mgiLNA L1 At-Grade E Mound
Fecal Cokforrn (geometric mean) -104 cfw-i ooml LI Drip-Line ❑ Other:
+Maximum Effluent Particle Size %s in dia. f] NA Other. ❑ NA
Other.- A Other: NA
'Values typical for domestic wastewater and septic tank effluent Other E NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
II Iinspect condition of tank(s) At least once every: month(s) ~ ea s (Maximum 3 years) :J NA
:Pump out contents of tank(s) TVVhcn combined sludge and scum equals one-third (k) of tank volume ❑ NA
--r---- -
inspect dispersal cent(s) At leas; once every: ❑ month(s) (Maximum 3 years) ❑ NA.
--month(s)
Clean effluent filter At least once every: y -year(s) O NA
❑ month(s)
aspect pump, pump controls & alarm At least once every: CI year(s) NA
1°lush laterals and E month(s)
pressure test At least once every l NA
_ ❑ year (s,
-
~Jthec t ~ ]month(s)
At least once every - NA.
year(s) -
NA.
MAINTENANCE INSTRUCTIONS
inspections of tanks and dispersal cells snali bo mace by an individual carrying one of the following licenses or wilifications. IvtaG(er
Plumber; Master Plumber Restricted Sewer; POVVI S Inspector, POWTS Maintainer. Septage Servicing Operator. Tank inspections mast
include a visual inspection of the tank(s) to Identify any m ssing or broker, hardware. identity any cracks or leaks, measure the volume of
^„ombined sludge and scum and to check for ary bade ju or pending of effluent on the ground surface. The dispersal cell(s) shall he
visually inspected to check the effluent levels in the observation, pipus and to check for any pending of effluent on Uie ground surface.
The ponding of effluent on the ground surface may indicate a failing condition, and requires the immediate notification of the local
regulatory authority.
When the combined accomuiation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of
fie tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
(Administrative Code.
All other services, including but not limited to the servicing of efruenl filters, mechanical or oressurized components, pretreatment units,
find any servicing at intervals of 512 months, shall be performed by a certified POyVTS Maintainer.
A service report shall be provided to the local reguatory authority mthln 10 days of wmpletion of any service event.
pop _of
nt tank(s) for the presence of Painting products or other chemicals that
START new AND OPERATION are detected have the contents of the
may For new impede de the t the treon,atment prior to use process of' he and/or POWTS damage tide diissP~~~ cell( s). If high concentratio
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface. will be
surface excess wa wastewstew Of ater s
ewer outages pump tanks may fill above nomal highwater levels. When power is restored the
discha p oeU s in one large dose, overloading the oeil(s) and may result in the backup or disCharge
to this
have tank removed by a SeptaW Servicing Operator prior to restoring power
To avoid this situation will b.
the contents of the pump rating the PUMP controls to restore normal levels
affluent discharged is pump or the anon dispersal
contact a Plumber or or POWTS Maintainer to assist in manually ape
within the pump tank. disturb or compact the area vrtthin
Do not drive or park yehrdes over tanks and dispersal cells. Do not drive or park over, or oltarwlse
15 feet dawn slope of any mound or at-grade soil absorption area. the POWTb'
fat life found of the PO drain
Reduction or elimination of the following from the wastewater stream may improve the parformance and d(~ prolong prolong the
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floes; diapers; di infeons oil; pfound iondt>cin
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps;
pesticides; sanitary napkins; tampons: and water softener brine.
ABANDONMENT the following steps shall be taken to insure that the system is props tY
and When the safely POWTS abandoned fails in ancUor c comorn is permanently penn with chapter taken out of C 33 service
Wisconsin Administrative Code:
• Ail piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil.
gravel or another inert solid material.
CONTINGENCY PLAN code compliant
If the POINTS fails and cannot be repaired the following measures have been. or must be taken, to provide a
replacement system:
T-" suitable replacement area has been evaluated and may be utilized for the location replacement infringed absorption by r system
e . not The replacement area should be protected from disturbance and compaction and should ment area inged d rlm by the need
the rule: in
setbacks from existing and proposed structure, lot lines and wells. Failure Replacement s must campy within
for a new soil and site evaluation to establish a suitable replacement area. system
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologic a
holding tank may be installed as a last resort to replace the failed POWTS. failure of the POWTS a sot and site evaluation
❑ The site has not been evaluated to identify a suitable replacement area. Upon
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the bionnat at the mfittralive
surface. Reconstructions of such systems must comply with the miles in effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO O
DIFFICULT OR Y CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OK A
MAY BE TANK, UNDER
ENTER A SEPTIC, PUMP OR OTHER A T TREATMENT
PERSON FROM THE INTERIOR OF
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Name il_ ^ g k
Phone / Phone r~
SEPTAGE SERVICING OPERATOR P PER LOCAL REGULATORY AUTHOR"1 Y - -7-777-7,477777
7 4 Name .
Name
Phone _ Phone
v
Administrative Code
This document was drafted in compliance with chapter SPS 383.22(2Hb)(f)(d)a(f) and 38354(1), (2) & (3). Wisconaah
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ST. C:ROIX COUNTY
SEPTIC TANK MAINTENANCE AGREI• M-HNT
AND
CIWNERSHIP CEICHFICATION FORM
Owner/BuyerP~(~: f.,
Mailing Addre s
Property Address
('Verification required born Phatuting & Zoning Deo nt for new construction.)
C'itylState Parcel Identification Number(
LEGAL DESCRIprION - - - - -
Property Loc tion / i , / JC=Si
C7 ✓G - %a , Sec. ~ ~ , 'T / L NR 1 y tiy, Towlt oI (,~1 C
Subdivision
Certified Survey Map #
, Volume; , Page #
Warranty Deed #
- - - - Vvltune Page #
Spec house 1b no Lot ;iuee: ident~ahlp~ye- no - - -
SYS''EM,VIAIIVTENANCE AND OWNLR CERTIFICATION
t"Inopet use and trraintenanec ot'your septic system omdd rtsrdt in its premature. failure to handle wastes. Proper
ntatulenauee consists of*paolping out the scl nc lack every three years or uuurer, it needed, by a licensed pumper. W hat you put uuo
the postern can ac the function of the septic tartan as a t ,bal,terer ti stage in the waste disposal system. Owner rnaiutenance
responsibilities are specified in §Cortms. 33.52(1) and m Chapt 12 - tit. Croix County Sanitary Ordinance.
7 he proprerty owner agrees hr sobndt to St. !_}oix County I'lantwtg t5: Zoning 1)cpttrrmeut a cenificahon tbnq signed by die
nwnrr and by a master ptumher, intuncyaum plumber, dcstlicted phinihar or a liremed punsper verifying that (1} the on-sit,.
wastewater disposal system is in proper operating, condition and/of (2) after inspection and ptmtping (itneressary), [he septic: lank I.
less than lt9 full ofshidge.
flwe, the undersigned have read the above tequirc:rrrrnts and agree to Inanition dre privato sewage disposal system with the
sumdards set Ruth, hmcin, as set by the Department of I onunen:, and the Departnre t of Natraral Resources, State of Wisconsin.
Certification stating that your septic system has beer. maintained roust he cornple(ed and returned to the St Croix County Planning &
Zoning Department within 30 days of the three year expiration date
Uwe certify that all statcuu:nts oil this forut are true to the best of my. lon' knowledge. Vwe ant/aie the owrser(s) of the
property described above, by viirrtne off' ranty deed rectirdtxi tit Rcgiyter of f)wds Office.
Number of bedrooms \
lJ~-~~- I)r'_t
~rSl(INA'PL OF APPLICANT{S) - - / !1
DATE
"`Any information that is misrepresented tnay result in the sanitary permit being n:
yoked by die Planning &I.otting L4,-partmctu.
Include with this application a recorded warranty deed trots the Rcglsl,.r of Deeds Office and a copy of the certified sot vey map if
reference is made: in the warranty decd.
(REV. 08105)
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* 1.522 ACRES SEE EASEMENT
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` iscon5/In SOIL EVALUATION REPOF~;T _3_-~.3) #1485
Department of Commerce in accordance with Comm 85, Wis. Adm. bode Page _ 1- of - 3
Division of Safety and Buildings Schmitt Soil Testing. Inc.
County Attach complete site plan on paper not loss than 8% x 11 inches in size. Plan must St. Croix
include, but not limited to. vertical and horizontal reference point (BM), direction and Parcel I D
percent slope, scale or dimensions, north arrow. and location and distance to nearest road. 10
Please print all informatyon. '
Rev By _ Date
1)e. nal information ymi provide .may be used for. a hoary purposes (Prrvary Laws lM (t) (m1J. -
Prop" Owner I RE. rope location f`
Sienna Corporation ` Govt L t NW1/y; SE1/4, 518, T30N, R18W
Property Owner's Mailing Address Cot # Block # Subd. Name or CSM#
4940 Viking Drive Suite 608 F 1 h 10 The Glens Of Willow River
City ;late Zip Cod Phone Number.. / C Village Town Nearest Road
Minneapolis MN 55435 Richmond 95Th St.
New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GIRD
Replacement Public or commercial - Describe:
Parent material Outwash Flood plain elevation. If applicable na It
General commenls
and recommendations: Area is suitable for a conventional system with a 0.7 gpd/ sgft rating. Possible system elevation for Area
1 is 95.7'-
F 1-1 Boring # Boring
Pit Ground surface elev. 99.10 it Depth to limiting factor 115+ In Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP_ _D_1tt'
in. Munsell Qu. Sz. Corn. Color Gr. Sz. Sh- •Eff#1- •emn
1 0-9 10yr3/1 none sit 21'sbk mfr as 2m,lf .6 .8
2 9-21 10yr4/6 none sid 2fsbk mfr qw if .4 .6
3 21-27 1Oyr4/4 none scl 2ntsbk mfr cs lvf .4 .6
4 27-60 10yr5/4 none grcos Osg ml Cs .7 1.6
5 60-115 10yr5/6 none s Osg ml - - 7 1.6
/ I
-4-- -
2 ] F Boring Boring
# te
Pit Ground surface elev- 99.62 ft. Depth to limiting factor 120+ in- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOW
In Munsell Qu. Sz Cont. Color Gr. Sz. Sh. •111141 •E11#2
1 0-10 10yr3/1 7 none sit 2fsbk mfr as 1m,2f .6 .8
2 10-14 10yr4/3 none sid 3msbk mfr gw 2vf 4 6
3 14-24 10yr3/4 1 none scl 3msbk mfr cs lvf .4 .6
I ~ I
4 24-5 G 10yr5/4 none grcos i Osq ml as j .1 1.6
5 65-120 10yr5/6 none / grcos Osg ml t 7 1.6
y~. wi
' Effluent #1 = BOD? 30 < 220 mgt and TSS >30 < 150 mgfl ' Effluent #2 - BODS <.30 mgfL and TSS <30 mgtl
CST Name (Please Pnnt) Signature. / i CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond. WI 54017 9114/2006 715.2472941
Prop" Owner Sienna Corporation Parcel ID # 10 Page 2 of 3
❑ Bonny # Boring
Pd Ground surface elev. 99.25 ff. Depth to limiting factor 122+ in Sod Application Hale
Horizon Depth j Dominant Color j Redox Description Texture Structure jConsistence Boundary Roots GPDtft'
is Munsell Qu. Sz Cont. Color Gr. Sz Sh. 'Fff#t 'Entt2
1 013 10yr3/1 none sil 2fsbk mfr as lm,2f .6 .S
2 13-26 JOyr4/4 none Sid 2msbk mfr a 2f .4 .6
3 26-34 10yr5/4 none grlcos Osg ml cs lvf .7 j 1.6
4 34 52 10yr5/4 none grcos Osg ml a 7 I 1.6
5 52-122 10yr5/6 none s Osq nail 7 1.6
_ 4 i,. ~Tr t t I _ rl
06
r 7
1r tt
( .
❑ Boring # Boring W2 IV
Pit Ground surface elev. ft Depth to limiting factor in. Soil Application Rate
Honzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtW
in Munsell Cu. Sz Cont. Color Gr.Sz. Sh. 'ER81 •Ett#2
I
❑ Boring # Boring
Pd Ground surface elev fl. Depth to hrndmy factor in. Sort Application Rate
Horizon Depth Dominant Color Recox Description Texture Structure Consistence Boundary Roots GID&W
in. Munsell Qu Sz Cont. Color Gr Sz. Sh. 'Eff#1 -Eff#2
I
Effluent #1 = SOD, > 30 < 220 mg+L and TSS >30 <.150 mgrL ' Effluent #2 = SOD,, < 30 mgtL and TSS < 30 mglL
The Npartment orCornmerce is an equal opportunity service provider and employer. If you need assistance m access services or
need material in an allemale format, please contact the department at 608-266-3151 or 1-1-Y 608-264-8777.
.%a" Hilo IN (o➢x)1
Sdvrrlt 50 TW#q, Inc.
Page of -7
C onducicd bv: Conducted For:
Schmitt Soil 't'esting Inc. Name: Sienna Corporation
I homas J. Schmitt, CS'I' 327429 Address: 4940 Viking Drive Suitc 608
1595 7'-nd tit. Cite, stale, zip: Minneapolis, MV 55435
new Richmond, Wl. 54017
Phonc: 715-247-2941 Subd.Namc: I'hc Glens of Willow River
lwnalutc. a:G'~ ~..-.w7 trot No.:
Legal Dcscrihtiou: I SI? 1 4 S 18 T30N IZ 18 W
Backlioc pit Township, County Richmond, St. Croix
A Bench Mark El. 100.00"l'op of 2" pvc pipe
0:11tcrnutc [3cnch Mark lil. /~7y? 'fop of / S.<«
slope--(:' 1 r ' Contour Linc F.I. N/+ (_'ontour Line Len A/✓/~\
\ 41
Pty ~~j~a
Scale I " - 40'
H
` LP~~ 9SS.9~
y
Y
1 Iii. Suil anJ SIIC valuminn was mmplc o tultill a>unmK mmuncmcnl. It nmy nr may n(n tv in a Imation >uiliblc for you uu
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