HomeMy WebLinkAbout030-2069-80-000 (3)
::el:.r I,, t PRIVATE SEWAGE SYSTEM St. Croix
lately and BuJC:nd C , so-
INSPECTION REPORT "1401Y`".....
615325
GENERAL INFORMATION iATTr+CH TC PERM I[:
le sOnat in'c'nan<- vr.u pmmet-'rwy OO used for 5e.nna::ry ~,.rPCSCS?•vacY -sa' s li U:. i'
11arrr Hod, 'n'Ja-u- ~qY gllag0 Tcwnshp; °a¢el-a. No'.
Kent & Jani Johnson TOWN OF SAINT JOSEPH 030-2069-80-000
uv i nsP Blt_.ee RIA ❑c::.:n;."'- ec!mvtoonRtae~rrhtap N.
36.30.20.611 B
rr' - n~
TANK INFORMATION ELEVATION DATA
TYPE 41AN„FACTIJP Ij CAPACITY STATIO\ DS HI rs E: V.
V
Septc Bencaatark
l l) 01.10 It OO i
Ccsing r ( - All. Br;l
Aerai I Bldg Server y go.
H::Idivq St-'I it Inlet
- - - - - In 616 D
TANK SETBACK INFORMATION SvHtOLtlet IU 90
TANK TO ?~L 'P1&11 BLCG. "cn m. <-/n =/.e ROAD D•. Net
Septic 7/ O J D: 3o:;om
Dosing - Header.-Man
Aeration Dist. Pine -
Holding - - - - - Bol. System
II
PUMp/S PHON INFORMATION =inal Grade
x.7811 'C,ILrcl DHr 1C S1'.over
Pon I~L
Mude Nxubt-r'-
-CIf Lift F~r:h ss Sy's!em Head IGII ht 141
FefC, Lvn: t'l
SOIL ABSORPTION SYSTEM
BED RENCH math r. ~m Vn 01 Trenches PIT DIMENSIONS Nc. Ot Pits nsida Do in.. ~;1 tic Olh
DI 1.1 ENRSIONS
SETBACK ~SYSTUII , Lf•.KC-TREAM LEACHING ,,favkir~ INFORMATION CHAMBE?TOR
f f U;?tr-r r UNIT .MSdr N rrtr
DISTRIBUTION SYSTEM
Headc Va-cl; _ l:.a Uq'n:: le $~e xH Ir_FaC^j_ 'Je^ I to r'. If lnlak-
r:qh Ca ~ '-eJa Jig 9oac -o _
SOIL COVER x Pressure Systems Only xx Mound Or Al-Grade Systems Only
-iepID O ea' Jccih C'oer ax DOpih Ot as Soaccd+Sodced :x 1.1 , :z ed
gnd: 'rencn L;?-lei E10,5 - Yes NO
COMMENTS: (NOlude code dlscrcpnn:acs, ne'sons o!esent etc: InsFecuon a-. Inspection a2
Location: -2-8 27 [H 87 CA -t Lr~ 1-j
1.i All Std Uescnphon =
2; bldg serer length
- ar•rounl cl oover = fL-J ./V~ I ~ I/ ~7
':an revison Required? Yes No L
use. other sde for aal:flt1o1al Irf0fM1Jnn. 719/ 19 gin(lV
p eb -
5
-13
Il'tl h..
t •;,'1 - Irdustfy Services Division lllr `t °n"
I D 1" 7400 E Washington Ave
OS mrtxn Pc mil NumhLr flu he filled in h} Cu I
PSK~- 'O. Box 7162
Madison, y"JI 537(17 76' 3z L
s )ImC I rynsacllun V matte
~~arrtt,3t'~ ?t,Yti'tT'l rlpplicatio
I..... F-n,c wnh ~rYxSll ) fl r , J ,ub1 u , n thd n' f th pr pn Lc I II
IIt RJ plLL 11 FIII l t11 1\Illt t' \I tb:rli 1! 1 - , rn I I. rC uhllltl c to '
th 'p ri nt I r t I r I 1 ,nal a 1'o I rd noun a -u In,o iJe arv, uw eunJar 1111 of \ddress U`d4 crcnl ISxn mailmil addrem)
Iuq cn: lccldm..,.m m In I n, I IU1 ~d:) 12782''tit,ed
I Application Inhrtur n - 1'Irau Print All Informxlion
I i -rt I "I , ^ I I - Parcel a
! n @ ....61C has '.r 020.2(•KAX(1.011
- 3,I o.
li I'; n;tns Owrx•r'> A14i1 F12 Address Proptel, I_ucaloll
1 -'79 27" "Urect
GUVt LlN
i m Vale %Ip(odc Phone Nunllfer NW a,, NF ls. Sccuon 76
Ilu~s•r:. l\ 'I 54PIh I - - - (Clrclc Vrkl j
T 3aN RNI1 orA
11. 1 rpc of Building (check all that apply) Lot
2 I xI ol, I1or11mg I•I Hcdns,o, suclemsion Name
NA
I'uhhc'(l'•mmcr.rd I:cxrlhu lJx Blocks
f ❑ (h, 01
"le, l ......J - Ilc,a dA: .c - - ❑ Vdluge of
CS Al Swuhr
EX,b~ 14 WY_J(Gju) _ ' Iirwuuf SI lutph
I11. Ir vPe of Permit. If beck (I one hot on line A. Complete line If if applicable) Nc,",,mn ❑ I(aplaccnc:I S, slcln QIrerumc-It' I iolGm; I ink kcpla.cmcnt
Only ❑(alm Modih:acun;o l imStmg S)mcrn leaplaml
It ❑ I' m1 Iti: "al ❑ I%tra: (":eon ❑ ('hw'6c, f ❑ Poun'I nmsln I., No, I,,. 1 rc,lou, Pcrmll Numbcr and Dale Issues
'hh.cc I,pn1I•n Ilumhcr _ _ rn, let ! 13e3M, 10-21-1989
I\ I• pc oI PON-fS N\slcmComponent'Uevicc (Check all lh_a_l I ph) ml'rc, a Ind In-G:I un I ❑ res,uriM hl-Grumld ❑ AI-4 redo ❑ \found -24 m. of suduble soil ❑
Muund < 24 in of>uilahle soil - - -
I IJu1g Lulk (ahc Ih,, usni I cntp.Krd lexplaul) Dnwdly [1 P:ercaunuu Desire (Csplainl
\ I)igrersnl/Tr almcnl Area lnfornla lion:
I ) sign I Iow igp 1 Uc 1 C,.I \l ph aeon Dislnr)ai A1ca Kcymnd Is4 ~i. Uupcnal :\rea I nrpssrd np ti)slem 6Ievmion - - -
1. funk Info t nl near in
Gallons Ilxal n of - i
1 \tw Iachlrcr " 7 V s j 7
(iallon+ LoiLY Pa
\Cw dell,) I:.u11 :Y lllrkf
ti n x i1c IJ In t'-I ani III II - _ I N'wc er ('unucte Q ❑ l ❑ ❑ C_
I, m ( i,mi her n ❑ ❑
\ 11. Responsibdits' Statement- I, (hr undrrmgned, a,samc rr,ponsibilit) for installation of the I'ON' I S shown on (he attached plans.
Mond . ~aew r; Nell !`.wnl I.Sikual \1P: NIPRt Numbe, Ihlcrnc,s Phone Numhcr
John Skh11ill i 751 J fkc '37bU 7I;_70H086
F•lumhcr's Addr;- strxl. i_1•n, >tatc /gr(,Oci
1586 Volley 1, 1 rail. NIrnc¢,:. N'I 5-W24
\'lll. ounN'i Dcpartmrnt I'se Ono'
Appnw cd csc Pennll der 27~ Dal 1-ti 1>,uu h_rn: Sign tire
CunJ1I e lul s fur JT[ - %nplarrolal
al ~
\ Q ~ 4
f
4-
el . IRe r
utµrl:':,, cHl nv,c all pn ttI?y /1 /1
'n per,rlarayemm' plil ae7 W pilwnoe:.
2 All atw* rK W nsm mu-it cd „rt. it 4pR Pffliftlill in., 11 :o um:yl.n pbm ror do. "'War and a,ornn la d.rI .n only n11 Pa Prr nrrl lea Ilan a 1¢ , 11 moor. rn.or
SIN )-lrIyXIKl~"1-I
1
S Y S -E N! PLO- :1-AN A
Pi• r 4S(
Projec: Name Jo-:nso-it - - <--N4
p ^I >ttacr' aesip Pow :ai .ilabpn: !u' -
r„ P.. Atl^.res 2'r Sma.. CUmmerdz'. Plans
_ W
9A91 Svrrbo - Pip= `,tet?•.as: 0.5-N IapGarC Szale: V = 5~,
iN DG".Cr1('lip' 'dpEg 3'•:.?C-i F. .i?4 3L-i: r
oC 9C .20
3M• yr cl < S,- <ASTt C'2P8_ v /
I . /
yAA )e fipur. F-Iit 3CY p
Slone edi_P: stv.. uz -tin/
'Nell Symaa i'aoblr aPiu
NPIPa' Nom:
it
Prppent Line
I
I
i,
I a ii
= J
Fsshn H~
rte. a / ❑r':'nets
Fwc~_sec vet=`ono-r~~'. ~ senr.xn I etie:
Prope•P' "_:ne
r'~iCOPY
CONVENTIONAL COMPONENT DESIGN
INDEX AND TITLE PAGE
Pro;eC: `.arne: Johnsen Replacement Septic IanK
Owners Name: Kent & Janelle Johnson
Owner's Address 1278 27th Street
Hudson, WI 54016
Legal Description: NW1/4, NE1/4, S36, T30N, R231A'
ownshio St. Joseph
County: St. Croix
Subdivision Name: NA
Lot Number: 1 B'.ccK Number
Parcel I.D. Number 030-2069-80-000
Plan Transaction No
Page 1 Index and [Uae
Page 2 Plot Plan
Page 3 Septic Tank Specifications
Page 4 Effluent Filter Information
Page S Management and contingency plan
Page 6 Septic Tank Maintenance Agreement
Page 7 Warranty Deed
Page 8 CSM or Plat
Attachment 1 Scil Evaluat.cn Report
Designer: John Schmitt Licnese Number: MPRS 223760
Date: SJ27/2019 Phone Number: 715-760-0486
Signature:
In/Ground Soil Absorption Component Manual Version 2.0 SBD 10705-P IN. 01/01)
Page 1
SYSTEM PLOT PLAN A
Project Name: Johnsont FIC"' 4`'9"`"''°ay F~~^'
- A,ttal t. design now calculalions for
Prgect r.Cd'C55 1P8 Fh JVeel onnmfrcisl plays v
?Ml S,,nt-l ~ Pipe Materials r ASTM Standard
Seale 1" 50'
L'N Desaipl on Tables 384.30 3 8 384.30-5 . =
0 80 90 120
RfA2 Symbol Q 4• SCr14: PVC AS-M Ii
HIM Description 4. 3014 P,IG AS-M03034
S-opa Grad er-1 M l ostod Area 15
Melt Symbol ii' apalRablel
`.Otea' Noll
Properly Line
i
I
I
7 y
J
~ L
1
a hxisl,cc 1:570 a: h'r Existlrc 5C09a Ion
Dryw0ils 'y ~
3 1
Propose;l VULP9000-MR/ Bedroom m l 1
ere!eL Dcveaal~
Property Line
rIIIL 'l t.- .J; ~Ci CC 'Ilda i> N n:,q . 1\ ?rt A4i .I
313H0003 0313 ltl 143
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w„ t.., Effluent Filter
l il!. r
..n 52fi Filler is rate, for !0,A10 C,PD (ga 11.1 ns p_i day) making it one of the largest linen in its Class. It has
linear Icet of i f It," filtrtion slots. I ike the llolV1nk Pi.-122 , Ow Polt lok PI -525 his an automatic shut-off ball
:nsl.dled with even• facer. Mien the'illrl is ivmol cd Ior cleaning, the Imll will float up and temporarily shut off
d:e It st,•nl ,o t I I C ctfluent lum't ICJrc' the tank.
Alarm ,t+:lch
• Rated for III„100 GPU (gallons per (IJUa. ~ IupNnnaq
~25linearfeet of 1!16" fiItIa(ion . 10,000 GI n,!
l+u• l5 TPVC
4` and W SC:HFI 40 i;•, .---1 eerpls I "
P I~. Gvauton F [and nJ IV
limit in gas deflector.
"U6lnl0tiC shut ol: bill When Idler a 11•111.w1'd !RY
Ci
W-7 aautj her
'.I nm nc rr„i11111 ~ 4.
t t.
\.,elh I''C. extension handle. k! 1%%IGI'U
t.i
eal Inc rrsldatlal and Convnercial waste Ifols's ul: to 525 1 vVar FI
- 1 it 1 I n
i 00gallons 1x•1 daV (GPI1{. f T-'~ °~1 Filtran,m51,t,
I kwate the nutlet of the septic lank.
item eve the :ank lover and pu»p a n k it necessarc. - -
1__11.-0"kn r
t lie the filler hous.ng to Litt? .1" or o Cotta plpC 11 s I 111 4 1 h-1,,.
th.' tiller is not centered under the access opening use a
\ilvlA F,tend & Lek or piece of pipe tocenter filter
t. In,ert the PI--5_5 filter Into its housing. - - -
Cerim.ed to
Replace i ,td secure the se tic lank cover.
- 1 ® NSFrANSI Standard 66
t \ 1.I:nb n."n,...
Fhr PI.-525 Fflluent Filters will operate efficiently for '
ntv era[ ae ars under normal conditions before requiring
I ICII IIg, It is rrconunended thal the filler be c1cink-,
every tints the tank is pumped. It at least evert three
years. It the installed -ilter ccnta:ns an optional alarm,
the ub nee Will lc notified ht ill. .11,11111 When the IIhDI'
• - - Gas LN41cetor
need, vervi, in,;. L.rrvicinl; sic, uld be done fit a rrrt:iwd
septic tank punlpel or utsrl I •r. 4ntumauc
SIIUI.Oll Pall
L Locate the outlet of Ule ept4 tank.
2. Remove tank ever and pump lank if necessary. _
3. Do not use plums ing wheal titter is removed.
4. Pull PI -525 cartridge out of the housing-
5. Hose off filter over the se pt:c tank Make sure al' nor,
solids tall back Into septic lank. .
I). inert the filter cartridge back into Ow housing 111A,InS•
' t u n ,1: r d s i J'
,UW the Eller is prula•rk aligo,%l and e oo Ivtele tine: IrJ L,k. 7., i...'I k Br,l purr,,crept Gslly m+Iall,
Rt'p61c e and ,l•<ll n• ,t'I1:C tank . ov, I the ~O,a rtl'atof'I +,Ylleh and aiarlll. sm., a•t1+nr* Ianwe
Pkdy.ck. Inc. ? 1-airfield R:cd, N;dlmglurll, (-1 I)b472 [till Prcc: 877.765.9W Pax: 2II3.2S4.,N514 u'wn.pohlokcum
PAGE 4 OF 4
In-ground Gravity Management Plan
IMPORTANT:
The :)caner of this ir-g'ot.nd gravity system shall oe respons ble for is perpetual operation and maintenance pursuant to
reqjirements of SFS 382-334. Wisc. Admin Code. pursuant to SPS 383 52 (2), Wisc Adm n. Code this system shall
be considered a %niar health hazard if no: ma.ntainec in accordance with this approved management plan
F.rr:hconore, all inspection and rna ntenance activities shall be performed by a registered POWTS Maintainer in
accordance w th SPS 383 52 i3s Wisc Admin Code
Maximum Dispersal Area Operating Limits:
Design Flow = 450 gpd; BODS 220 tri TSS 150 mgL'; FOGS 30 mgl
Inspection Checklist INSPECT EVERY 3 YEARS
type of use
age of system
nuisance factors 0 a odors, user complaints, etc I
mechanical malfunction (i a pumps. valves, switches, floats, etc.)
material fatigue ti e., leaks, breaks, corrosion. etc)
soods vo,umc in anacrodic Veatment tank(sl and any distribution aopurtenance)s) (i e., distribution / drop boxes)
neg ect or improper use t, a exceeding design capacities, prohibited activities, etc }
extent of ponding in distrbulion cell prior to dosing
dosing irregularities - ' applicable (i.e, pump re-cycling, float switch settings, etc }
electrical components - if applicable (i e. wring connections, switches, controls, timers. alarms. etc)
distribution lateral or lateral orifice plugging (Treasure lateral distal pressure - compare to design specif cation)
su-face discharge of effluent or sewage tack-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumoed by a certified septage servicing ope,alor rcensed under s. 281.48 Wis.
Slats when the volume of solids in the tank(s) exceeds one-third (1i3) the liquid volume of the tank(s) or
as reyuuec by Inca o•dinacce. Disposal of contents shall be pursuant to NR "3, Wisc. Admir Code.
c, Effluent filter(s) shall be inspected every 3 years and shall be c eaned when necessary to remove any
accumulated solids according to manufacturer's specifications A servicing per od will always be greater than 12
months
System maintenance reports shall be submitted to the proper local government unit in accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of inc .idea, cr corrrpa•,~ John Schmitt Phone. 715-760-0486
Local government unit: St. Croix County Community Developement Phone 715-386-4680
Local government unit address 1101 Carmichael Road. Hudson, WI ZIP 54016
Any defective part of this system shall be repaired, replaced. or removed pursuant to SPS 385 51 (1), Wisc. Admin.
Code Repair or replacement of faded or ma functioning components shall corply with SIPS 383. Wis Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department 'n
accordance with SPS 384. Wisc Admin Code
Contingency Plan
In the even: that any fa led treatment component of this POWT S cannot be repaired. it shat be replaced pursuant to
a pan submitted to the appropriate agency for rev ew and approval. A failed n-ground dispersal component may be
abandoned and replaced by a code-complying d spersal component in a pre-determired area of suitable soils
System Abandonment
I` use of ti-IS POWTS is discontinued, it shat, be abandoned in accordance with SPS 383 33, Wisc. Admin. Code.
71
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- CST - o
os Il'I x$'999"SOIL E LUATION REPORT
P r rte.;rra•~; - l-n re 'ag= c' i
irtl? Srhrr r:f SCr. "'es'tng mC
pM; E^C 4 r` 1 n t^'
Sly' r Cuu~:±
;l7rp>, 1P S'1~ per n 5. man 5 ~tii1 lD'~~1 must- - St UI D x
It" .c.SiCa araTn0nial fee ra+Ep~nrl°rI (!-eztlor Anil
Cr a!i J' n an5u'.5. 151h a rJV: all ..u r ar7 s:a7re t0 nearest roao Parxi U
6302" PO -000
- - ^ Please print all information- ue.'awe a. Date 05116
1] v,- r -ATT. C4 S 9_J9']9 'rJ( =Ve°. { n' C _ _ 'rlb
_ . ,7v.•ner FroPery _o-atan
irson, Kent A. d Janelle N1. (Govt Lot N114 . NE r r S3 /710N R20'J.'
car? Owners Va I ng Add-eas Lit # elor, k S.,or. N;,me or Cqr
27(h Slreel NA
- 5'ate -iG .;a? Phene %un`DCr
Cny: II.a9e c.. r Near st Rcad
tiujsoc 54,',1C> S1.Jos?ph 27Th Street
- •Jew Gonstructl." -se. Res'oerI ~ Njroer of reO.=o ns 2 Code acnved design '.ar rate 300 GPI)
el:'lacement o„pl,r, or romnerpal - UeSC'ibe -
'a: cnt ^ aierral OutwaSh (~-hetek Onamra Seaesl F'COa plam elevation •f aop'waule NA ft
-reral -on-n:en:s ..'at r_ r ^Ir r-ai cfl9 m H; I + I 4Q11 raI ro
~ KOmmor7aLUns S` I~., it 5 Wa..- c4"
' I
-'~C i/rt .J at 3 5'c:.., d I), /ck; ~ +o Is, Y-1,v,. c A /I ~:✓o.. c.<IJ
1~ Bx rg It
9xiny _ Z I .,rcnc surface elec R Depin :o tmIhng'actr r Sit J.pphcation Rate
sr Depth Jin ,ant CL4cr Redoa :iescnpuan Texture structure consaterce Eoundary Roots GF0 m k ursell Cc Sz. C]nt CClor Gr Sz Sh - -
1 1 Rock -
-1 P. Ira 1,6
/m)() -'I . 1, r •r_r e I I',IRcI. . .L r Ii f = ! r ~ SVl I d It "i.r=r+ tar r•wl M;Fe ww
c-2- ,n/dD i..,;2-4 T- T
r JCnrg
2 J 3oang a
SW'a Ce 2>r_'v' it _'aptn to hRlgiP y^ (aCICr in SOC App, n'. anti nate
Jetnn Dcnnnar'.t Col^' Rea_x Desa, r1dr• Tex1.'e JI4.c:, Ccnsistc Ce vJJM1tl3^j Poets
IF Mot se!I Ca 52 Cont. Color Gr Sz Sh 'E+s' 'En=2
0.12 : lit' ROCK
12 48 10yr6,'4 none s Osg rnl
ri
iris Soil oroing ,vas ccmpteted frc!n rh2 nfi.[at :i sur'ace '.C• a oep:n cf 4S manes m the drvwell. This on•sIeu a:s^. acpe>r< ro v,w had
_ I/4 7-e /Z zy
ir zr
EHlut r. = 61.1' +'t - r2U mg l and TSS ~T^ - = a00a S30 it r and TSS < J^ ..rS L
J-, Te P ease P Irt >~s 'am•c~ CST a-r-r
or❑, J S r•m~n 2274
Tom- STG- 194
AS BUt LT SANITART SYST"l rEPORT
ON= 2~ANK n F Nng c'3otj' TOWNSHIP `3t . ~u )e l2 j3SEC. „T 3QN-R_
ST. CIiUIt CCUWI'i, WISCONSIN
ADDai.N
SDLDttISTON Lor LOT SIZE
PLAN VIEW
Distances and dimensions to meet requlrmento of ILHR 83
SHOW EVERI'I'ULUG WITHIN IUL FEET OF SYSTEM
DQywfus
398
89.80
yf, 89.87 ~i
9 - ' A9.9y mot - J.7.2
90.1y
SY89
3 ~ED+~ovn, l7.-
I
Hon,,
~N
• rr tt--INDICATE NORTH` ARROW
NRNh7NRRI DeaCrlbe the vertical reference rrint used Ln U'T IOU rUN N U) G-*
Iv
Nleotfen of vertical reference polnt7 100. _ Proposed slope at sitar 'I la,
SMIC TANRI Hanufactutert JIS- 0111 Ow 1.1;uld Capacit,t 1060 ) TT
Number of rings usedt _ Tnnk mnobuto cover elevations
Tank Inlet Elevatloni_ _ Tank OuLI:.I Ltevationi '
Number of feet from near" I L^adi Front,O e.Lv0 Rear. O feat
Irom nrntaat Ptup", . i.Ltc 3 Prnnt.l )+I d.-.ORss[,O_ feet
r" CHAMBER
Manufacturers _ Liquid Capacity:
pump/Siphon Manufacturer: Pump Mae
Pump Models
Elevetism of Inlets _ bottom of tank elevation'
pump off witch elevations Snllone per cycles
Alarm Switch Types
Alarm manufacturers ~
Number of feet from nearest property Ills c: Front, O Side, O Rear,0 Ft.-
Number of feet from wall:
Number of feet from buildings
(Include distances on plot plan).
SOIL A39ORMON SYSTEM
"a I Trench t.
Lengths Number of Linea' AT" Built'
Widcfis
Fill depth to top o[ pipes
Number of feet from nearest property line: Front, O Side. O RuT.0 t•~~
Number of feat from Wells
Number of feet from bulldEna,s 1
(Include distances on plot plan). _ w CR y~ N ~''1h 11
X&SPACK PIT i ' nt4h
7
I Peas Number of plot Diameter
~ U
bottom of sumpse pit alums ions "s~• ~
Llould depths ~
I
At" builts 0
Nag tithes a drop box0 or distribution box0 been used en Bay of the sbs * set'
absurbtle's sytams4 (Check one).
HOLDING TANK
Capacity[
NemYlactY[er
Number of rings used$ Elevation of bottom of tanks
Elwatlen of Inlets
Bide. O Rear. OPt
Number of feet from nearest property lines Trent. O
Number of feat from wells
Number of feet from building:
Number of feet from nearest roads
Alarm Manufeoturert
Inspector:.
OL I JAI 19 Plumber on lobs ~30V'Rti.
Dstedt y ~11 ~ 7
License Number: 7 7
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