HomeMy WebLinkAbout042-1004-50-030
ev1=•_.=r~r ~,~',:.^tr°.°n"';:^m"''°` PRIVATE SEWAGE SYSTEM St. Croix
Su'ev: anc fs~ild mn 7rv 5 or
INSPECTION REPORT :~nn c"~ Pe'n"' W
;A-AC:H I;' PERMIT' 605942
GENERAL INFORMATION stale Pan It: N:.
Fe•::nn.,!in MrmAl on i ~ li o :n,: t . uses lnr se;onder: purpos IPlrva-,v _ n..: t. 0¢ c- 3153858
Fer•-:t Iijiow'S Norm r~l!•r V 130P ToWnS^.iF Marc 1 Ta) N0.
Roscon Properties TOWN OF WARREN 042-1004-50-030
"'ST Btv1 E cv 1x55 Blvt Elev Btvt Drscruap ±eclnn'i nwnrRanoc7 tar N4
j~~ L3 c ~yDrt 03.29.18.37A-03
TANK INFORMATION ELEV ION DATA
I YP: PAANUFAC T LIRER t CAPACI'Y STATION BS FS S 3. 11/6,41.31 %a =LEbV
Sepll C Bencnma4 ;e>a D
[)eslnC s 666 .At1 H V
~j Hld- se vet /0.I ri3.21
i Hrtlnvln SL'Ht Inlet
io, Sz.4f
TANK SETBACK INFORMATION
i'ANK TO P1 'uJCC_ BLDG. Joni :m In:a+e ROAD DI Inlet
Sepn:: 0_7 ` 1C Dt Fonorn
15 *7 75 1:5 lq
1,e'abor Ds', P¢a: 3 15 /66 • Ito
Holdmq Rot Sysle~ 19.30
Final Glaoe
PUMPISIPHON INFORMATION Z (S ~0~,~(0
Demand St C er / 1 L14
Manufacturer .
16 r GPlvt ~J '/J ! O
6A fie!.±4 -7
Model NumDe' j U
2
'TDH I II(f Fneilon Loss System •tea:t TDH :3 x
I1 r U
rarsmalo Lcrlyth Dia. 711 as: r. well /
SOIL ABSORPTION SYSTEM
BEDITRFNCH Ndd:i, Lc-0, W Or'rer.;:nes 0 PITDIMFNSIONS v= Df, iC :nsae?~ :p.id ~e:rtr.
DIMENSIONS 1T,r 7~ `
SETBACK S",Sl' M is Pi- J BLDG WFI t ..AK=rSTREAM LEACHING Nt3nuiartare:
INFORMATION CHAMBER OR
/A
'yl. O'':vs•e" v r, UNIT 1.1ooc•I NVnbe'
L /U{ryJ~
DISTRIBUTION SYSTEM
--net P.ar d9lr; [n.1.t :hc' x Ho 'P Sae f I x HOIe $nan"q Ve CAA' Ir1al^
Len , 31 Z
V 1
m:C. Ci1a en01` 4:rac rip
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
1.71711 Q 1en'n 1eP'n xr occnuolSnoneS xx Mu:r:hEd
µ:'C'Tl •nCF !.Rote' / • 4/_ i~cc T:• n T
COMMENTS: ilr0uoe _o^de dtscrepena//es_+persons preseo~ or: inspector Insaearor #2
Location: 1189 21ST Si " u ~o~ F^OV..~ ✓v'y.~ ~
1 All HM Desctiption = S 0~✓ V
Hop sewc, length - I n n Q
amount ount o` cover = ~ q?i ~ d h 0_ 1/x/y►x/I+
\ / r
:"fan levlsror Required? Yes NO 6 -7
Usc' other sloe lot addlttonal rnlormatror. _
D'a% In;eu' Squ^ urp Curt Nc
Saiery and BuIdings Dlmsicn
i~+r
E
?r.' B S } 201 L1C V:'85'rnglvn Ave.. ['.O box Sari::n) ?etmrt t;lmbe' t~ b: 11ie~ in by Co)
S ' maalson ✓ `I ,3_ 77 152
~r 1
lion Nkautict
aiulat Fc it Applica ion
ut.'~ '+axwlrh^t"t'``' d r nve r-1P cictir : J.li.JLAl carte
erx!n c',
in
Yrn't AJOrrss d ]vTacnt It:m nwhn-,
r regmrn7 pmn „ u i~ J r t F ::.m v :pb s r C na.V f'V Vale ',cane' l i X ~il~n v r,
r Ypv's cr J. rsv n 1 r -R'cn r +rwtian V'ou pro' rdc Mn 1. r°.'
a.. _
ease." I Of0t 2t
(rt]r,V,.~ m oN.r[.,t ma .h C l1T -L7-
l '1VDlicatiun lnfoLmanun-Pleau Print Nil ll ln[ot matluo I f's s:r -
it •~rina aName
[~S,!.L~ ~~C7, ~ ` ---1 Propel ixdicm p3,.Z9.~38!! ~10
Tnt - 2
t-2a Stmt. W `{.`_L`,'` I t 7I~ t(~~ndc CSdI. I=T.nn: Ntnultc; ~ rv4J 4: ~ a Haan `J . i
e ~/~J1fy ' - ' / ~ ,1 ~ I ~ J lclc ncl j
r\ p
tl. ype of Budding (chock all that appla)
c~ I'1b3:risioc Name
o, "ly ~)wclliag \ nb r o' - n. ~.J
[j ?uMir:Com¢<r: .,t DrsclectI.c D CO of_
►tOVk~ ~ II.~r` ~+J~ J". .
' $alC l}xneL DeccnDe') x
t P
awr of
Ill TyPe 'beck only one box on line A Complete line It if aPOCII I
T
t }.:rem .-FePlaa-n rL ~rar. I .unertlia{i ":mk 4cpt:u-o•m:nV ❑:-tCt tlU.icNr nia desslino S}~trn+:cxpiatei
Lra n ,Walre, ano lkue IscaeL ,
- _ - Pmvoa CCm
~B. ❑ alert Remwzl C , f v.nc f ea e.:,e t 1JIr°r. nt u m h ( 1 U Pc=11 C.ansfa I,. \.a
Bel t -X'r .ilrbr'. C1M9a
R' lrpe ofTON Ica SVSlem lumpolwnt. Deuco r c !si
in A o u. nd - ~+r..:dc~~ 1u-VL ut. of wrt..ble ;oii i..l ism t '?4 u: f wiabk. Vol
LIi~+laa+.ra'rc '_~:ln cr llrpc _m. eJ 1, caplariT _ ?tcocunent Dr,"
V. Dis enelTre eni area IUIOrm tin: _ L -
Lr reT FS n<Ij -)ec ,y. Sell ADo .w iw Rate, FTspenu key :ne f.' 1 DLC e I A:w P xc' FI S rt m Ple.'~oY _
7C?'J ✓ - J_ ICJ 7J / iI
11. 7mak Into afa r:y. IV - LaI 101' M:uruia:,usc* -
I at,
l Il l'LS { I'~~r p O ,~I
II J TN'y. - F='S[ILt''I r ~ I -{II- ~ 1
VrYn c t I I! ai. ~ ~~~7' ~ r N-~I ~ i--
rJ
allanon u: Crc POR?} shown oa tlrc aRachr4 {anus dusmesc ?bow NwlA
R. ! e"pons'bilrh' Statelne L the andrnrgnen n rraponsibrblV for 1011
a".'!.4priS VUmba
P:umgqe _mc ftcur P: ..imd¢<
PI mb .Haas t,uea Up. $ ro, -lip __71
..Tlrpartmeut Use OuIV -r
V6 Countv
T.;^.prtFe: 1 -)Et~4~c LtYJm /~~4, 'ej
eflccn H IMt n o (O/Lr1 L
._i r Celt ^n5l del O t, v MA4,1~r V~tlr~+
.xr 1Trr.ayemen. p~~r _ :w w one.. pt.)d'`!/t- Vow
j 2. Ali seSbltgl PICW".: Ma c M ,,t r o l
as pff twkitil CJYAI i 4urf rl Tait Ie`tp -
Aaua .I ..pU. plan tar rt.. :rrm mJ snDmi: H,e <'omU Vnl• Wav my W Wru A s 1 i iorde m . /t
S13U-tu9&.-8.11111) Q„(Z►j /A I
System PLOT PLAN
PROJECT Rosc:on Prooerties ADDRESS 1253 Awawkeo Trail Hudson Wi 54016
NW 1 4 N:^,' l i -[S 3 29 N IIL 18 IF TOWN Warren COENTY ST. CROIX
SYSTEM ELUATION 99.4' U 9.+18.%18 BEDROOM 3 '
:1'It:
COQ\ 'ENTIONAI, A'P-f:RADG XXX C0\%'LN'I'10NAI. LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 AISSORPTION AREA 900 $ of* chambers none
RENCIINIA RK Y.R.P. top of survey iror ASSIRe1T. ELEN'ATION 1110' Filter Li]eDme Filter
❑ BORI'.IIOLF (D WELL "I1.R.P. same asbenchmaek
a r
Caic = i r~Y = i v
Area 15' below system is to
remain undisturbed
Pro 3
Bedroom
e
Hotsc
B-2_
og I
2% Slope
99.4
2 Acre Lot 99.5
3
Huffcut'. Combo
R I
439 Property Line
Grading is to be done to divert
run-off away from system
121st. St 1 g
1? f 7
DIV;SIGN OF INDUSTRY SFR`:ICES
3824 CHLLKSIDE LN
HO: IALN %M 54636-9466
D con:a::t I hrouyn Relay
\'S P $ wtp.iitlsps wi goo. proyrams?industry-seMre
i i vr.%NV W scersin 90v
Scott Walker, Governor
Laura Gutk5rreZ, Secretary
October 14, 2013
CLST ID No. 236900 ITTV' pOh -IS lu.vpcctor
SHAUN R BIRD ZO\I\G OI 1 ICE.
BIRD SELF STORAGE, ST CROIX COL NI I' SPIA
14:2 1_'0411 ST I I0I C'.ARMIC'IIAEA. RD
NE %%r RICHMOND WI 54017-6409 HI DSON WI 14016'703
C•ONDI I ION %I. APPRON %I. r
PLAN APPI 0%At. EXPIRES: 10:1412020 Identification \umber
-Il'ansaclion ID No. 3163858
SITE: Site ID No. 354269
Rosecm Propcrlics Please refer to loth identification numbers.
Lot 10 121 S I St above. in all correspondence with the
-Town of Warren agency.
St Crui\ C'ounh
\\\'1, 1, \\\'I4, Si, 129N, R13\\
FOR:
Object I ype: 110\VTS Component Manual Regulated Objst ID No.: 1719019
Maintenance required: 450 GPD Ilow rate: Systengs):.At-etude Component Manual, Version 2.0. SBD-10354-1'
(N.03 07, R. 112), Pressure Distribution (ompo nenl Manual - Ver. LO. SBD- 10706-P I.N.01X01, R. 10: I:'.): Effluent
I ilter
The submittal described abuvc has been reviewed fix conlbrmamc with applicable Wisconsin Adnninislratke
Codes and Wisconsin Statures. I he submittal has been COMA IIO\AI.LY APPROV IA). This system is to be
constructed and kastud in accordance with the enclosed appruvtxt plan., and with any component ntanualls)
referenced above. the owner, as defined in chapter 101.W (10), \Visconsio Statutes. is responsible for compliance
wilh all code requirements.
\o person may engage in or work at plumbim, io the stare unless licensed to do so by the Department per x.145.06.
stars.
The following conditions shall he nrcr during construction or installation and prior to occupancy or use:
• 'I his system is to be constructed aid inclallcd in accordance with the approved plans and with publication
SBD-10354-P(N. 0' 07).
• t he pressure network is to he constnhc+,cd in accordance with publication SBD-10706-1i IN 01!01, R. 10 121
entitled "Pressure Distrihution Component Manual Iur Pr irate Onsita Scw;i_c Systems" and hased on pipe
sizing methods contained in Small Scale Waste Manavement project pl Ni,Xtiml 9.6 entitled Ik-sign of
Pressure Distribution Networks Ibr Septic Lank - Soil Absorbtion Systems.
A copy of the approved plans. spccificalions and this letter shall be ou-site durin ~ construcion and open to
inspection by authorized representatives of the Dcpariner.r. which may include local inspectors. All permits
required by the state or the ks:al municipality shall lie obtained prior to commencement of
construction installation operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise makinc lhect ncccssn5 ter code ompfancc As per <I;tc stars 101.12t21. nuthinp. in this revic+c
shall retiree We dcsiLncr of llte respon.ibililt Inr J sic nine a sali• huildimU. Al11CMrc, or component.
Inquiries concerning this correspondence may he made to nic at the telephone number' listed txlow, or at the
address on this letterhead.
I he above Ic[I addressee sh,dl provide a copy of this letter and the I'M T5 management plan to the o%+ner and any
others who are responsible till' the installation. operation or maintenance of the PM I S.
Sincerely, Pee Regmrcd S 250.00
- This Amount 14 ill Be Invoiced.
. ` 1-~:•"~' When 1'ou Rcxivu That Invoice-
' Niattlim Men J.~11Zell J Please Include a Copy With )'our
Wastewater Specialist , Division of Industry Services Paynicnt Submittal.
(715)310-0107 - WiSMART code: 7631
Itlallhcw.jirrlienin;wi.ROV
Cover Page
Shaun Bird
Bird Plumbing Inc. - 'E D LY
1432 120th St.r ETY AND
New Richmond Wi 54017 pF. SERVICES'
pIV'ISIO~V~ t~yUSTKY SER~kES
715-246-4516
-ONDENCE
Date:9120/18
Owner:Roscon Properties
Location:NW 1/4 NW1/4 S3 T29 N,R18 W lot'121st. St. Warren
Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07)
Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12)
Paget;
1. Cover Page
2. At-Grade Plot Plan
3. At-Grade Cross Section
4. Pipe Cross Section/Pipe Layout
i
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance nd Contigency plan
9. Filter Specific tions
Attachments: Test
Shaun Bird
Signature
License n 226900
RECEIVED
V`° 24
Page 1 of 9
System PLOT PLAN
PROJECT Roscon Prooerties ADDRESS 1253 Awatukeo Trail Hudson Wi 54016
NW 1/4 NW 114S 3 1'1' 29 N/R 16 W TOWN Warron COINTr ST.CROIX
SVS'I'I:Nl ELEVATION 99.4' 9;18;16 BEDROOM 3
U:Vf E:
CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE: DOSE 1':\NK SIZE 630
MOUND SFI''ITC '1':\SK SIZE
iIOLDING TANK SIZE LOAD R:A11% .5 ABSORPTION AREA 900 # of chanrbersnone
BENCHMARK V.R.P. top of survey iron ASSINnt ELEVATION loo' Filter Lifetime Filter
❑BOREHOLE 0WELT . x11. R. P, same as benchmark
Scale = 1/4" = 10'
Area 15' below system is to
remain undisturbed
Pro 3
Bedroom
House
B-2
99'
2`.0 Slope
99.4'
99.5'
L Acre Lot
B-3
Huffcutt Combo
B-
Grading is to be done to divert 439' Property Line
run-off away from system
121st. St. 197'
,~f7 ~ J
At-grade System Sloping Site Cross Section and Plan View
r ,
1 -
t t Dimension Feet
CC I
.afr::~i~;::{;:'::'.:.~};r;:rr::i'}}}:'.~:.~-}~;•.}i}'}:-:~~r`}'?}}7}:}:-:'r`}'r'r:~r:-':r'r:-'r'r:•i:'•.: -
t (:-'ir-'i 'i-'i 'i :'i :'iii:'i:•rt:;.:.}_•:.};:•:.::.::::::::::r}:.::.::.r}::.i:.: }::•:}::•:}i}:}}: :r':: I H
E':; ; • { : 1~6B 15
11 p C
_'.o
i
I
L -.o
I
I
I'
t _
I
I
I
~
C; 1.l l
1. z z?-
F s
` I o B W -
F-.-- - --13 -
_ 1. °•b Slope 12-~
- 1 - Plowed Clean aggregate
in. sch. -F0 p v c
basal area to in. dia.
observation pipe
Lateral with 2" 'topsoil Cap
i
aggregate over pipe
Oeotextilc Observation Pipe
Fabric With Cap \
- I opsoil Cap
1 n.
Ft Cont~ni
~1 - • • ~ J J~`. Ste- - r'
r. L: r r 1 ice`
Slope Direction T
GENERAL [NSTALLAHON: The at-grade area is slaked out along the design contour. Lxisting
vegetation is moved and raked oft the site. The basal area it, x wj is staled out and ptosJed with a
moldboard or chisel plow. Plowing nary not proceed it the soil is wet enough at the plow depth to
form a `,%a inch soil wire tifien a sample is rolled benveen the palms of the hands. 'I he .A x B area is
covered by dean aggregate deposited overhead by a hackhoe. Special care must be used when
placing the aggregate to minimize compaction of the plowed surlace. After the topsoil cap is placed.
the entire ar-grade is seeded and mulched to promote vegetative growth, limit erosion and protect
liom freezing. The observation pipes are perforated in the lower 6 inches and secured in place.
(13i0.5 Lgj Pa oc , of
Pressure Lateral Layout
One Lateral - End Manifold
Threaded
Cleanout
Forcc Main Lateral Turn-up 10 plug
L - Long
i
f' Sweep
:90
Bend
i
1 G ~~1. Pressure System Construction
-Distribution network Specifications
lateral Diameter "L In. FLitcrak are constructed of Schedule 40 PVC
Orifice Diameter 3 In. pipe. Orifices are drilled perpendicular to
t (Orifice Spacing) In, the pipe with a sharp drill bit and face down.
1. (Lateral Length) i Lateral turn-ups terminate with a threaded
_I-orce Main Diameter ln.~ cleanout plug and are enclo.wd in a 6-8 inch
Force Main Length diameter lam sprinkler valve box accessible
from finished grade.
• • • • • • •
• • • • • Gradc • • • • • • *<-7
i~
6-8 Inch Lawn
Sprinkler Vahe 0
Box i
i
f'
- _ . - Er[
n
1f
01.'04; hu Page of L_
Septic-Dose Tank Cross Section And Pump Performance Specifications
Tank _Manufacttuer K4 P Pump Manufacture
(nP Model Nurnber _Lz
Tank Mode
- k
LTotal Tack Capacity t ( f Q- - Alarm Manufacturer t/ c ~ 2 ( _4 ~'4z
L Max. Bury 1)e pth - Alarm Model Number
-D
11 Switch Type C_~ (l=ate/ (xX_ . i
1 ilter Manufacturer _Toud Dynamic Head ('l'llII) -Feet
- - -
Filter Model Number - - Elevation Head I~
- I)istai Pressure _ i
Network boss
Mintmtun Pump Performance Required Force Main i.o _ L7--
J _GPM l (a r j Ft TDH Total ~t- ~1. - Outlet Manhole Min. 4" Above Grade With r D `p
hocking Device. Inlet Manhole ~9 Manhole Min. 4" Above Grade
< 6" Below Grade Settled Watertight Securely Mounted With t.ocking Device \
Weather-proof 1
---i Junction Box J
-Finished Grade - - - -
lin Vent Min. 12" Disconnect
Above Grade Means
With Vent Crap
I f Outlet Filter
i- I - ► -
Inlet ' .r-_--- 'Inlet Baffle - -
- A
Switch Settings and Reserve Capar ity
--Tank Volume - 5- (iPl - Weep
Dimension I ches Volume t_ial. B hole
(reserve) A' 6
(alarm) B 2 Off Elevation C
(dose) C / Ft
Bottom
(dead) D _ j fj Llev tion
Tots] yrL F1
rT,,.., ter.-•-
(;ENF,R.AL INSTALLATION: The septicMuse tank is bedded and back filled in accordance with the
manui'acttrnr's product approval specifications. Maximum depth of bury as specified by the manufacturer may not
be exceeded without prior approval. Manhole covers exposed to Grade have an effective looking device (padlock)
installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and
laid on stable soil to prevent settling or sagging. 't'he force main is sleeved with 4" Sch. 40 PVC to bridge the tank
exuavatil;n w d the sleeve is scaled watertight. Electrical servlcF+omplies with NEC; 300 and Cumm 16.28.
C_
`
0:!/05 i_1 Page of/-
28OMSERIES
112 hp Submersible Effluent/Sump Pumps
The Liberty 280-Series provides a cost effective "mid- Per fonnance Curve. 280-Series
range" pump for on-site waste water systems, liquid
{ 12
waste transfer and commercial heavy-duty sump pump 40 _H4~ 44
applications that require higher head or more flow. 35 11
Designed around Liberty's unique "Uni-Body" casting, 30 9
the 280-Series will provide years of reliable performance.
All Models Feature: U. 25 VT 6 4)
a
• Vortex style impeller
15 6
up to 14° permitting passage of solids 15 5
Z103
• 416 stainless steel rotor shaft
• Permanently lubricated upper and lower bah bearing 5 _ 2
• Epoxy powder coat finish 0 0
• All fasteners -corrosion-resistant stainless steel 0 5 10 15 20 25 35 40 45 50 55 60 65 70
• 1 W" Discharge U.S. Gallons Per Minute
• Stainless steel bottom screen-easily removable ~t-F - '~--T - I F
156 192 228 270
• Maximum fluid temperature; 140' F. 0 38 78 114
lJters rs Per Minute
280-series Cord Lengths
Model 10' 25'(-2~ 35'c~ 50'(-~ Dimensional Data.
280 Standard _OOtiortal Optic! _ option HeigM:y Wght: 29182.
13"
281 Standard- Optional motional Optional Major Width; 10" (model 287)
283 Standard Optional C!ptiormL___ WA
287 _ s 224ar, Optional _ wA WA Minimum Sump Diameters:
10' cord length standard on alt models. For optional lengths, Model 281, 283...14"
add "-2,-3 or 5" suffix to morlcl nurnbcr. Model 287 VMF...10"
Example: for model 280 with 35' cord, order 280-3
Factory switch Model 281, 283 Mode! 287
settings VMF
Motor Specifications Tum on level 13" 9.5"
i4 hp 60 Hz 3450 RPM Tum off level 7" 4,0"
Oil filled, thermally protected
(PSC) Permanent Split Capacitor Tw Model 283 leaturvs a fully adjustable wide-angle float Differential
8.0 amps (115V) adjustments can be ni cio easily by tethering the float to the cits-
4.0 amps (208/230V) change pipe or other mounting point. Vcvtiwl float model 287 is not
adjustable.
O` Model 280 Ile
Model 281 Model 283 Model287
? Manual, Wide angle
Wide angle VMF.Sedes
i no switch float switch float switch Vertical mag-
with quick- with series netic float for
disconnect (piggy-back) smallerpits-
l plug will operate in
a 10° diameter
sump
s S00
c us Certified
sP~.x~mo,a,w w Wryr wiu,ow
Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 19416 • Phone 800.543-2550 Fax (5855) 4941839
www.libertypumps.com copy,g t a uborty PUmp~ Inc. 2017
A nghC~ u192d0dr10517
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Fage _,pr_
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner
Pererit# -'Z`t~C'✓~✓_I,1i7g,r!~ Septic 'anRCapactty ; at ONA
7T - jI Septic Tank Manufacturer
- 1 ( NA
DESIGN PARAMETERS Effluent Fitter Manufacturer U NA
Number of Bedrooms NA -Effluent Filter Model
0NA
Number of Public Facility Units y.~ NA Pump Tank Capacity
sal ❑ NA
Estimates flow (average) ' -
t ~r al/dav Pump Tank Manufacturer NA
Design now (peak), (Estimated x 1.5) l1 J <1J~f1~
/.~I allda Pump Manufacturer 0 NA
Soil Application Rate - -
gaiid ye °urnp Model ~n r -7 NA
Standard Influentrffluent Quality
Monthly average' Pretreatment Unit
A
Fats, Oil & Grease (FOG) 53C mg/L 0 Sand/Gravel Filter C Peat Filter
Biochemical Oxyger Demand (BOD,) 5220 mglL U NA 71 Mechanical Aeration O Wetland
_ Total Suspended Solids (TSS) x:150 mg /L C Disinfection U Other:
Preheated Effluent Quality -I Monthly average Dispersal Cell(s) C NA
Biochemical Oxygen Demand (BOD;) <-30 mg/L ❑ In-Ground (gravity) 0 In-Ground (pressurized)
Tota, Suspended Solids (TSS) S30 mg/L '?4] NA -Grape
~ N NA Mound
Fecal Coliform (geometric mean) _;t cfu/100m1 ❑ Drip-Line C Other:
y-
-
aximurn Effluent Particle Size J¢ in dip. ❑ NA Otoec ❑ NA
NA
_ ZI NA
'Values typical for domestic wastewater and septic tank effluent Other U NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
!Inspect condition of tark(s) At least once ever M month(s)
_ y' ~Kl-year(s) (Maximum 3 years) O NA
(Pump out contents of tank(s) When combined swd a and scum a uais one-third ' ❑ NA
9 q (f~) of tank volume
!Inspect dispersa' oelf(s) At least once cvo ~ ❑ month s)
ry' year(s) (Maximum 3 years) ❑ NA
-
Clean effluent filter At least once every: - j mcnth(s) NA
rspect pump, pump controls & alarm At least once every: C' month(s) -'I NA
-lush laterals and pressure test At least once every: C month(s) ❑ NA
Qthec - - - - - ' ,8.~ear(s) _
At least once every . ❑ month(s)
❑ year(s) ~A
I)ther: -
NA
MAINTENANCE INSTRUCTIONS
,inspections of tanks and cispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master
'lumber; Master Plumber Restricted Sewer; POW7S 'nspectof. PO'VVTS Maintainer, Septago Servicing Operator. Tank inspections oust
`nclude a visual inspection of the tank(s) to Identity any missing or broker hardware, den'ify any cracks or leaks, measure the volume of
7ombined sludge and scum and to check for any back up or pording of effluent on the ground surface. The dispersal cell(s) sha!I be
usually inspected to check the effluent evels in the observaton pipes ane to check for any ponding of effluent on ;he ground surface.
the pending of effluent on the ground surface may indica'e a failing cond non and requires the immediate nctrficaton of the local
regulatory authority.
iVhen the combined accumulation of sludge and scum in any tank equals one-third (Yu) or more of the tank volume, the entire contents of
he tang shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
,idministralive Code
-I other services, including but rot limited to the servicing of effluent filters. mechanical or pressurized components, pretreatment units,
and any servicing at intervals of 12 moriths shall be performed by a certified POWTS Maintainer.
service report s.hal be provided to the local regulatory authority within 10 days of completion of any service event.
Page _ of
START UP AND OPERATION
that
For new construction, p^.or to use of the POWTS check !reatmznt tank(s;• for the presence of painting products or other chemicals
may impede the treatrment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thH
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.
Dur!ng power outages pump tanks may `ill aoove normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels
within the pump tank.
Do riot drive o- park venicles over tarks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within
15 feet down slope of any mound or at grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POtMG
antibiotics, baby wipes; cigarette butts: condoms', cotton swabs: degreasers; dental floss; diapers: disinfectants; fat: foundation drain
(sump pump) water; fruit and vegetable peelings gasoline; grease, herbicides; meat scraps; medicatioes; oil; painting productO;
pestcides, sanitary napkips; tampers, and water softener bsne.
ABANDONMENT
When the POWTS fails and/or is permanently taker out of service the following steps shall be taken to insure that the system is properly
and safety abandoned in compliance with chapter Comm 63.33. Wisconsin Administra5ve Code:
• All piping to tanks and pits shall be disconnected and the abardoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly 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
It the POWTS fails and cannot be repaired the following measures have been, or must be taker, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be ulllizeo for the location of a replacement soil absorption systelm.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requited
setbacks from existing and proposed structure, lot fires and wells. Failure to protoct the replacement area will result in the neled
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule, in
effect at the; time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technolog✓ a
holding tank may be installed as a last reson to reli the failed POWTS.
❑ The site has not been evaluated to'.dentify a suitable replacement area. Upon, failure of the POWTS a soil and site evaluation
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.
/Idylound and at-grade soil abso ption systems may be reccnshucted in place following removal of the biomat at the infltraave
surface. Reconstructions of such systems must comply with the rules in effect at that time..
<<WARNIl
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO 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.
ADDITIONAL COMMENTS _
POWTS INSTALLER POWTS MAINTAINER
m e Sir Name kPNa
it "e Phone ^e r -
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY,
Name ;
i
Phore
Ths document was mafice n comp iarce with chapter SPS 383.22(2)(o)(i)(d)&(t) and 383.64(1). (2) & (3), Wisconsin Administrative Code.
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SEPTIC I ANK. N1AIN'T "NAN(+ ,ttiRh;l-"NII N I
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LRSHIP CFRTTFICATI( N FORM
OvnterBuyer J_ S L'r l J /Ij, ~f o-"Q
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Mailing Address t 3, > 3 --A-4-JJ~-klkk-7 - I ~ . - .
Property Address ` c--.-L2 S T" -e IE--'+- - -
(Veritication required from Plaaaitq Zoniag Depa:I nent lot new construction.)
Cityistate Parcel icicnl:ficxtion Not thci_
LEGAL DESCRIPTION
Property Location t"~~✓ ~Ad , Sec_ 1'Z j N TZ 6 W, Town oi' Ct/Cj e,.✓
Subdivision
Certified Survey Map ;f 01 C! J V(iunte Page ?
Warranty Deed Page if
Spec house yes no 1_0l low identifiable }'es no
SYSTFM NLAINTE.NANCE AND OWNER CFR'C1P1CA1 ON
Iinpropcr use and ntaintetnurce of your seplir. sash+m e.ruid :e~.u't m its prrmaune hufwe !n handle wastes. Pu>pra
uraintcnmrce consists of puspinr out dtc srpue tan'. every three yrtr; at, sonnet. n needed. by ❑ hernsed pumper \'r'k~a you nui info
the sysleirt can allect the fanetton of the septic tank as it tleatntew stage in nie. waste disposal systim Ownci rttehrtenaace
resoonsibili ies ate spceflierl in bt bnnn. X I. j2(i) and ut C'baptcr I? - St- Conx C:o mfy Saauaty Unfinancc
The properly owner agr ecs to sobullI to St. Clots Cour.ty Phoning !o n mg. Dep;trim -ta a u-rtrticatiou foutt signed bV the
owner and by a rnastet phuaber,.)ourneyinan pttanber. ic3bu,ted plumber or a hceu;ril pnntper venlyn:;; that (1) the on-Site
wastcwater disposal systein is in proper operating cabdiuoa author (2? alter nfspec:ion and pnmpmg (it nccessi ry), the septic tank is
h- .,-,s than 1:3 Rill of.sludgc.
Uwe, the undursipwkl have read the above: rr<pnn-no-nl, au,i egtec ;o ;:v woon Ihe. private sewage disposal a;'lern with the
nandards set forth, horein- as svt by file Depai[ow tt of t=rnuunt cn aad the Ot,parlt*,m; of Nalurai Resources, Sta!c of Wisconsin.
Ccoilicauon staring that your septic systCnt has bocn iraintai icd must he compJctod and tenumcd to the tit. Ctoix Count,, Planning &
Zoraug Depaitutcat within 30 daps of the drrec year cxpiranon date.
I-we eerutp that all statements or this fonu 5uc trio to .be best of tny;om knowledge. Irwe etre'arc the ovwr(s) ofthe.
ptupvm described above. by virtue of a wa uv decd recotded to Register of Di,. ~e Oftirc
Number of bedrooms
S n .A(N*I; ON APP LICAN-1(S) DATE
*44Anv information that it; mistepleseured nw° resuil u: [he sanrtaty permit he.inp, r,.-yoked by file Pianninr, R Zonmh Depamnent. s::ks
Include with this appacation a recorded warranty deed fiom the Registet oi' Deck l iflice and a copy of the curhlied survey map if
teference is niadc it the wananly deed.
(R13V. 08105)
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wsuinw.,DepartrnentofCommerce { CSIJlHNH$$Y6R./KE1E Paged
Division of Safety and Buildings -
m accordance with m 85. Wis. Adm. Code -
Attach complete site plan on paper not less Man 8 X12 x. fit - in size. Plan must (:CO1x1ty `
include. but not hmeed to: vertical and honzontalreference point (BM), direction and Parcel I. D..~iv~I- o
percent slope, scale of dimensions, north avow. and location and distance to nearest road. D • `2'•W"i"r- 70 v
Please print all information. Reviewed-by
J /l Date
Persona intomu you Ww may be wed for sscondsry exposes(Povxy taw, s. 15 04 (1)(m)l.
Property Owner Property Location
I< < l Pf K QA L (,C, Govt. Lot MLJ 114p..1,0 114 S T N R a E or
Property Owner's Mailing of Block # Snbd. Atri
to
/1 w CSC
IBS K ~r
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G!Y State zip Code Phone Number City ❑ Village Jf Town earest Road
DI ( ) (4-10 r /'?1
Construction use,15~-Residential/ Number of bedrooms Code denvud design flow rate z{-)y/6r 6 - . GPD
❑ Replacement Public or commercial - Describe:
Parent material 'i. Flood Plan elevation d applicable R 1 V-14 General mnvnents
and tacortmendations:
System lype_.0l0f System Elevation
Boring # ❑ Boring / (f r
M FL Pit Ground surface elev. 1t. Depth to lim" factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff
in. Munsel Ou. Sz. Cont. Color Gr. Sz. Sh. •EB#1 •Eff#2
1
❑ Boring
Boiling # # Pit Ground surface elev. ry l R. Depth to 1"" factor
Sad Applij Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Fe
in. Munsell Ou. Sz. Cont. Odor Gr. Sz. Sh. 'EH#1 'Eff#2
1 7-
7 1
7
• Effluent #1 = BOD. > 30 < 220 mWL and TSS >30 < 150 • rMuent 02 = Boo. < 30 mg/L and TSS 130 nxyL
CST Name (Please Print) S' ture CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address , Date Evaluation Conductod Telephone Number
1432 120th St, New Richmond, WI 54017 < 715-246-4516 J
~I
Property Owner Parcel ID # _ _ _ J Page _ L of
/ r r -
Boring # Boxing
41Pil Ground surface elev. ft. Depth to limiting factor
Soil ANPticVton Rate
Ronzon Depth Dommnant Color Redox Description Texture Structure Consistence Boundary Roots GFDM
in, Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'E1f#1 •Eff#2 7 17
`j~--0
❑ Boring # ❑ Boring
❑ Pit Ground surface dev. _ ft. Depth to limiting factor . _ in. Sod licatiom Rate
Horizon Depth Dominant Color Radox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu Sz. Cont.Colo Gr. Sz. Sh. •EH#1 •Eff#2
F] Bonnig # ❑ Bong
❑ Pit Ground surface elov. _ ft. Depth to lenitin factor n.
Soil Application Rate
Honzon ')epth Dominant Color Redox Description. Texture StrucMe Consistence Boundary Roots GPDff
.n. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •E##1 •Efl#2
Effluent #1 = BODr > 30 < 220 nxyL and TSS >30 1150 mgA- • Effluent #2 = BOD) < 30 rr9t and TSS < 30 RVIL
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.
seDUwlx.eooy
Soil Test Plot Plan
Project Name Roscon Properties S]12+yj Bird
Address 1253 Awatukee Trail
Hudson Wi 54016 CSTM #226900
Lot 9 Subdivision Date 2/15/18
NW 1/4 NW 1/4S 3 T 29 N/R18 W Township Warren
❑ Boring, Q Well PL Property Line County ST. CROIX
BNII or VRP Assume Elevation 100 it. Top of survey iron
Same as Benchmark
Scale is F = 40'
unless otherwise
noted
8299'
21i Slope 45'
99.5.
35'
10'
B-3 1 ' 3-1
S
439' Property Line
197'
1221st. St.