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HomeMy WebLinkAbout030-2161-19-000Wisconsin Department of Commerce Safety and Building Division GENERAL INFORMATION Personal information you provide may be used for PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) [Privacy Law, s.15.04 (1)(m)] I�oumy: St. Croix 061900833-C Michael & Jane O'Farrell ITOWN OF SAINT JOSEPH 1 030-2161-19-000 CST BM Elev: Insp. BM Elev: BM Description. Section/Town/Range/Map No: 24.30.20.3202 TANK INFORMATION ELEVATION DATA . 2 10i Z { L3T3 TYPE MANUFACTURE CAPACITY Septic j -�•,� /• Wlefi�� Dosing ,j AHra ion Holding . a TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Ventto Air Wake ROAD Septic 7 25 I �01 S / _ Dosing %LS O h y V Aeration Holding PUMPISIPHON INFORMATION Manufacturer O Demand Model Number 1v 1 k �� TDH ift Friction Lo(6�1ss System Head TJH� Ft C/� . Forcemain Lengttvg b\ Dia, t) Dist to Well ` SOIL ABSORPTION SYSTEM STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer StlHI Inlet (o•b 9Z-7- Ht Outlet Dt Inlet Dt Bottom deN an. - LI 1-7 01(o.(� Dist. Pipe 4• I-1 ci&. O 3 Bot. System (y� __lI Final Grade St Cover Z. tJ 9 `• i N to qqr r 4� DIMENSIONS DIMENSIONS Width ) Lengtl�51 No. f Taenehe G PIT DIMENSIONS No. Of Pi Inside Die Liquid Depth SETBACK INFORMATION SYSTEM TO Tystem: pe Of Sy I PJL I BLDG &,y I WELL 7 > I I LAKE/STREA DLEACHING HAM MR OR Manufacturer. Model Number: DISTRIBUTION SYSTEM C-.nIrW'1 HeaderlMan old J t 11 I.� Distribution �I% Pipegs) (� x Hole Size�n j 1 O 1 x Hole Spacing I Vent Air In ke Length Dia Len th Dia S acin 1! p g� r `a' r J 1 SOIL COVER+ t,. Y PrRRRIIra SVRtRmIR Only v: Mound Or At•Grada Sustains Only 11" V II A41btror Depth Ove ad/Tr% r v Depth Over Bed/Trench Edges ' I \ xx Depth Topsoil-- /) zx Seeded/Sodded Mulched No \ as 0 No'ges ® QOWMENTS: (Include Code iscrepencies, persons present, etc.) Inspection#1: qt�/ 7 O/ 20 Inspection#2: Location: 275141 STAVE 1.)AltBMDescrption=�i1'* �u� 2.) Bldg sewer length = S - amount of cover = A tt Plan revision Required? Yes o 1 �� Lwj Use other side for additional information. SBD-6710 (R.3197) DaEe Insepctors Signature Can. No. /n1T S ti -I . /'_ - ',w.n I F�-JCA Safety a d Buildings Division County (., 20 W. Washington Ave., P.O. Box 7182 Sanitary Permit Number (to be filled in by Madison, WI 53707-7182 Coy ymenttj 60 nix " ermit AppUatio Q/ State Transaction Number In accordance with SPS 383. ), W is. Adm. Code, submission of this firm to the appropriate governments unit . 0 lP 19 00 $ 3 - C is required prior to obtaining a sanitary permit. Note: Application foma for state weed POWTS ere submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 m Stats. f/ �-- 1. Application Information — Please Print All Information ProperlyOvv?wbanen , Parce�3o—a�p�— 1 E1s cY�wa+ j wo & 0 1�laR�6 LL II �q —oV(� Property Owner's Mailing Address _ Property ►.neaunat a 4. o, d o - ao p, i, % 8v 6 ANY P IL 1 I Z . Govt. Lot 5 y,• 5 6 V., Section � City, State Zip Code Number Phone Number ` �, (\) �•� SSI/0 T, 3 y N, R ,,,. eirdeE j H. Type of Building (check all that apply) Ole t]� Y,1or2FamilyDwelling—NumberofBedrooms `'i 9 Subdivision Name h4—. ingoflAQax 0 PST Block # ❑ Public/Commental — Describe Use (s ❑ City of ❑ State Owned — Describe Use ❑ Village of CSM Number --rnJIJc.�t� b-Town of SY Pill x 7:51 a! _ III. Type of (Cheek only one box on line A. Complete line B if applicable) X A. New S ysiem ❑ R laarnent System ep y ❑ Treatment/Holding Tank Replacement Only ❑ Other Mottifiratan to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ❑ Non -Pressurized InGround ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 in. ofsuitabk s Mound <24 in. of suifebte soil ❑ Holding Tank ❑ Older Dispersal Component (explain) ❑ Preueatme I V. Dispers&VFTestmAt Area Information: , Design Flow (go) Design Soil Application (gpdso Dispersal Area Re (So Dispersal Area Pro po s System Elevation / (06 V L Tank Info Capacity in Gallons Totar Gallons e of Units Manufacturer �` U 5Y2 7, New Tanks Exiring Tanks Septic or Hakim Tank ZOrj6 Donna Chrnber B00 1 -to V/I. Responsibility Statement- 1, the undersigned, assume responsibility for stallation of the POWTS shown on the attached es. Plumber's Name (Print) P 's Si re M S Business Phone Number .JCFF , 1 I/ ZZ 2 Z 15-755--Zy41 Plumber's Address (Street, City, State, Zip Code) P O. ,� o s,65 -- FsSe2 tnuf 1105 el VIII. Coon /De artrnent Use Onl PPmved ❑ Permit Fee D Iss Issuing t Signalttre $56 g r- ❑ ner en Reason for Denial t DL Condi #4V*gEA/Ressons for Disapproval 3 CM .� � � doz.- 1. -'4*W, tank, erflufm dlter an .1 liiv��ev:•� CA mL�l ull be y. , . Ic,s ; r,: `nt_res; ; n C�t-1--CsX ✓`/l �"4 "'�' • qa par marayemen! plan 0, u maea by plu.nbe;. 2 M atlDarnk r�urnaTenns mast uu ies:,rt;ir a a' as per opriicnbis cu& / cMiralnosr. Attach to complete piano for the systect and submit to the County only on paper not t. than 8 tzt a l i Inches In size 0 SBD-6398 (R. 11/11) it IS NIP -- I �lw 5 r7 N 2J All 0 Z19{fil3 -49 -,95q�l -If C-NEUT"f -7 h�j- k7-5 f7tj 3S b(! A f-7 Zmw �JrRlj yS jv W 10.j 3f-\,qr r 3%kw Is 1, P$,. June 13, 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2021-06-13 Plan Review: PWTS-061900833-C JEFFERY V FOX SITE: MIKE AND JANE FARREL Adams STJOSEPH FOR: Object Type Description: 600 GPD Maiten4nce Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/pmgramsflndustry-services www.wisconsin.gov Tony Evers - Governor Dawn Crlm - Secretary Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, slats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01 /01). • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.0I/01). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NOI/01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for STSAS (O1/81)" A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be 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 making them necessary for code compliance. As per state scats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, i Matthew Allen Janzen Wastewater Specialist, Division of Industry Services (715)340-0407 matthew.j anzen;Lawi. Rov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Conditionally yCd,$cpw2rfi6?; •'c:��::4�c.yti;�;, APPROVED INDEX AND TITLE PAGE DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Protect Name: Mike &Jana Farrel'` -4�� Owners Name: Owner's Address: 11780 Great Oak Trl. N SEE CORRESPONDENCE Grant MN 55110 Legal Description: SW1/4 SE1/4 524 T34 NIR20W Township: ST. Joseph County: St Croix Subdivision Name: Orchards of St. Croix Lot Number: 19 Block Number. Parcel LD. Number: 2-1421=000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications RE G�ZVEO 13 2019 MAY SEvIGGS i1t�Ju���Y Designer: Jeff Fox License Number: MPRS 223242 Date: 05/08119 Phone Number: 715-491-3458 Signature:'/_ �jl Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10601-P (N. 01101, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101, R, 10112) Version 7.0 (R. 11112) Page 1 of 7 Mound and Pressure Distribution Component Design Desian Worksheet (R or C)1 Residential or Commercial Design Distribution Cell Information i 76.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpdM2) Y1 Influent Wastewater Quality (1 or 2) t 400.00 Estimated Wastewater Flow (gpd) �...__ 1.611; 600.00 Peaking Factor (e.g. 1.5 = 150°.G) Design 'Flow'(gpd) ' 0 0 L-AM00 Site Slope (°r6) Contour Line Elevation (ft) Depth to Limiting Factor (in) r 0.60. In -situ Soil Application Rate (gpd/ItZ) Pressure Disribution Information (C or E) ea Center or End Manifold 4.00 Lateral Spacing (ft) 2 Number of Laterals 0.156 Orifice Diameter (in) 2.33s Fstimated Orifice Spacing (ft) _ Fgrcemain Diameter (in) i 40.00i Forcemain Length (ft) Pump Tank Elevation (ft) Note: Sand rill (D) caloula6ons assume a Table 383-44-3 in -situ sell treatment for fecal coldorm of � 36 inches. 8.00 Cell Width (ft) Are the laterals the highest point in the distribution s'_® -Y�! network? Enter Y or N If N above, enter the elevation ft of the highest point. L 9.38 0orifice Does the forcemain drain back? Y- Enter Y or N 4.55 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 6.88 Vertical Lift (ft) 67.41 5x Void Volume (gal) 1.00 Friction Loss (ft) 73.94 Minimum Dose Volume (gal) 0.00 12.43 In -line Filter Loss (ft) Total Dynamic Head (ft) 34.46 System Demand (gpm) Lateral Diameter Selection in. die. I options choice 0.75 1.00 - j 1.25 _..... 1.50 x x 2.00 x i x j 3.00 Treatment Tank Information i 1250.00 Se tic Tank Capacity (gal) exi gT � _ _ Manufacturer L Manifold Diameter Selection in. dia. o lions choice 1.25 x 1.50 x t 2.00 3.00 Gallonsflnch Calculator (optional) ~ Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information BOO.00i Dose Tank Capacity (gal) ;lifetime Manufacturer s 22.20( Dose Tank Volume (gal/in) 8 ! _ -Filter Model Number Weiser ?Manufacturer Project: Mike & Jane Farrel Page 2 of 7 Mound Plan and Cross Section Views : :;: Obsavaton Pipe ,._: : ' — K '•'•:1 %:{s^�:r: i;;TYi:L 's' }'yti:{i{.�. x }� r y ;y i �.r.r} .?T`Ef}Li'�;;;'i'}. i}�}}7Akat?}. "S,,.t`''4it{L 1: $;:j{i{iCiG'SC C:':tt•...r. ,S.'S{tv'•'•'.'.' ,•.:.Srr. f { {r {}1r �:ii. i"{S?°' b i;. Y... � j{} S{• i 3tr�}��ZtT ` � _.:. 1 A {•. 1{i�SX.+''il; {Ct i{ti•1%1.1.5 f 1�''t4 •LK /. .1 t• t{� B N. L Mound Component Dimensions A 8.00 ft E 24.52 in B 75.00 ft F H. in DI 13,00 in G 0.5Dft 600.00 (fe) Dispersal Cell Area 8.00 (god/ft) Linear Loading Rate H I 1.00 ft K 1 10.07 ft r 15.63ft L 1 95.13ft J 1 5.24 ft W 2 8-8-71 ft 1772.46 (ftz) Basal Area Available 7.50 (tt) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 97.08 (ft) iF A�spersel Ceu 95.28 (ft)—►• — Dispersal Cell © i; Elevation D • F Af '"il'-:: �.� i_1-,v._� �A 3A•. •� t�.i �x�7�' Nir �5�`iw'.�� 12.0 % Site Slope Shading Key 'a a Dispersal Cell 0 Topsoil Cap 2� rrrrrrr Subsoil Cap © ASTM C33 Sand ® ® Tilled Layer © }•':r}, Aggregate 94.20 (ft) Contour Elevation Geolextile Fabric Cover See lateral details on T Page 4 for number, size, and spacing of laterals. Laterals are equally F spaced from the distribution cell's centerline in the distribution cell (AxB). Project: Mike & Jane Farrel Page 3 of 7 End Connection Lateral Layout Diagram Laterals oenterea over the A u ly aimenston •=Torn -up a+ be l valve or olasnoutpiug I F— P f All laterals are identical IE X— l Hol as drilled on the bottom of the lateral S aquallg spaced i Force main confremlon via teem oloss to manifold at mtt point. Laterals &fmcemain Sch 40 PVC per SPS Table 384.30b Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and --I► SPS 318.300 WAC Disconnect Tank component is properly vented Weiser Ca acif 800.00 Volume 22.20 Manufacturer Gallons gal/inch Dimension Inches Gallons A 19.81 439.68 B 2.00 44.40 C 3.33 73.94 D 10.90 241.98 Total 36.041 800.00 T A i B C Alarm Manuafacturer 1rli ombus W� .. �.Fin...,_.......,..,_...___.......__..—.-_.._� Alarm Model Number %MJ Plugger Pump Manufacturer 'Zoeller Pump Model Number BNB 152 Pump Must Deliver 34.46 gpm at 12.43 ft TDH Locking cover with wamkV label and looking device and sealed watertight 41n. min. Alternate outlet location Forcemain diameter ---1 2 in. Weep hole or anti - siphon device Dose tank elevation(8) 88.00 Note: Switches containing mercury may not be used in this system. Project: Mike & Jane Farrel Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name Jeff Fox Phone! 715 755-246-241LL� 1 POWTS Regulator's Name �_ �ST Croix County Zornng _ Phoned r System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 118 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Service Freauency Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Finished •............ Grade ` 19 6-8" Diameter Lawn Sprinkler Valve Box Distribution Lateral Lateral Tum-up Detail ............. 0. Threaded Cleanout Plug or Ball Valve Longg Sweep 90 or Two 45 oagree Bends Same Diameter as Lateral Project: Mike & Jane Farrel Page 5 of 7 Mound System Management Plan Pursuant to SPO 383.54, Wis. Adm. Code General This system shall be operated In accordance with BPS 382.84 Wis. Adm. Code, and shag maintained in accordance with its' component manuals ISBO-10691-P (N.01101, R. 11112), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01101. R. 10112)1 and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shag be In accordance with SPS 383.33, Ws. Adm. Code when the tanks are no longer used as POWTS components. Septic a pump tank manhole risers, access risers and covers should be hhspected for water tightness and soundness. Access openings used for service and assessment shag be sealed watertight upon the completion of service. Any opening deemed unsound, detective, or subject to failure must be replaced. Exposed access openings greater than 84nches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry Into a tank or component. Septic Tank The septic tank shell be maintained by an Individual certified to service septic tanks under s. 281.48, Stalls. The contents of the septic tank shall be disposed of In accordance with NR 113, Wis. Adm. Code. The operating cendltion of the septic tank and outlet filter shag be assessed at least once every 3 years by Inspection. The outlet filter shalt be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solds In the tank that may slough off the fitter when removed from its enclosure. If the filter Is equipped with an alarm, the titer shag be serviced If the alarm Is activated continuously. Intermittent fitter alarms may Indicate surge flows or an Impending continuous alarm. The septic tank shall have Its contends removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank It the contents of the tank are not removed at the time of a Iderimal assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation In the tank. The addition of biological or chemical additives to enhance septic tank performance Is generally not required. However, If such products am used they shag be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. AM switches, alarms, and pumps shag be tested to verify proper operation. If an effluent fitter Is Installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distfibuton System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shag be seeded and mulched as necessary to prevent erosion and to provide come protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since sot compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather Installations (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality Into the mound system may not exceed 220 mglL BODs, 150 mglL TSS, and 30 mglL FOG for septic tank effluent or 30 mg1L BODs, 30 mglL TSS, 10 m91L FOG, and 104 ofu1f00 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified In the permit For this Installation. The pressure distribution system is provided with a flushing poird at the end of each lateral, and It is recommended that each lateral be Hushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine t orifice clogging has occurred and if orifice cleaning Is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Pending levels shag be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent morltorkrg. Continency Plan lithe septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be Immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced In Its' present location by Increasing basal area Iftoe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system Into proper operating condition. See Page 5 of this plan for the creme and telephone number of your local POINTS regulator and service provider. Pretreatment Units The Information and schedule or mananagement and maintenance for pretreatment devices such as aerobic treatment units a disinfection units are attached as separate documents and are considered part of the overall management plan for this system. u n PERFORMANCEPUMP MODELSt \OMES=MOVINEMON lnela 0 f0 to lA 110 ivo as m FIONPC1151werF CONSULT FACTORY FOR SPECIAL APPLICATIONS These systems are not dsSgW for Exploslan Proof Environments. Please coneun fadory for special opllons aW requtremenla. Maximum spere6ng temp Wore rertga Pump: 13V (WC) SwWL 170- (7S50) CHOOSE A PREPACKAGED SYSTEM: Includes Pump,10-1526 end 10.1520 pee below) 949-OW5 N57 Pump .3 HP 940M N152 Pump A HP 940-0007 N163Pump .S.HP BUILD YOUR OWN SYSTEM: N57 Pump .3 HP N152Pump .4 HP N163Punlp .5 HP page 6 of 11 y TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENrANO DEWATERING MO DFl 57 152 163 eW lama C*, I um 00L I sakes0e.I on a IS A 1 IN Y At n 20 11 1 a1 HI ffi is n a at 01 u as tar rA a/ a to 30 420M usa- - - - u 0 table In as ItA ue Il♦m 10.1527 00 SmerWPump Switch -10It. cad w0h Relay. 10-162e 03 Smar*Punp SwSch - 2D fL oord wllh Relay. 10.1670 OR Smar* Pump SwIth - 20 R cord whhout Relay (requ'ues Control Panel). 10-1526 01 SmerMAlarm System YM Ughts. AucNe Alamsand Dry Contacts. exv IUN 4 Alllrl.l'tanatlOe of Wntrola, prdeotlon devkes and wiring should hedene by a quabYed ticensed 0lectrklan.Aft lecincalendlelclyeooes5nould be followed Including themosl mcenlNrtlanal Emnrw Code (NECI and the OoOLaarNeal Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety fades is engineered into the design of every Zoeller pump 0 Copyright 2005Zoeller Co. All nphra reserved. MICE -1 'TA\,jC Ici r % Kr_ mzx) F L Sw,)L( 5c IJ14 S z,4 T -3LI NIR Zo vV 5-r --T- yg AV-1e, RNSC bF LIV�Clt t:i SbIL 3t. R J k Li 14 13 615 C(6 Lz IAC Nq- 41 it 1v ( ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mike & Jane Ofarrel Mailing Addr ss 730 Wildwood Rd. Apt. 302, Mahtomedi, MN 55115 Property Add 275 141 st Ave. from Planning &Zoning Department for new construction.) City/State HOUIt011, WI 54082 Parcel Identification Number 030-2161-19-000 LEGAL DESCRIPTION Property Location SW 114, SE '''A, Sec. 24 , T 30 N R20 W, Town of St. Joseph SubdivisionPlat:OrchardS of St. Croix Certified Survey Map # Warranty Deed # Spec house 11yes4o Volume Page # (before 2007)Volume , Page Lot lines identifiabl4yesono SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # 19 Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warragtf+deed recorded in Register of Deeds Office. Number of bedrooms— SIGNATURE OF APP CANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) LB 0 --917.0 LOT 20 132,510 SQ. FT. 3.042 ACRES I L.B.C.=917,0 LOT 21 130,854 SQ. FT. 3.004 ACRES ---------- ............ . L.H.C.=917A LOT 22 L.B.C.=917A 0 A4, CA \1 SEM6,11,w �3 A 6 BA*Egzgjs CIP L.B.0.=930.9 LOT 19 136,420 SQ. FF. 3.132 ACRES 410.38' 1199.28' S89'05'45"W 1288.06- 50U 11NEOFTHFSE114 LOT 21 WOODLAND HILLS S'r24 LO1 131' 3.0: S89*05'45"' 6S'f - Zorn{- v18 SOIL EVALUATION REPORT "\:F_ '�' Department of Safety and Professional Services �� , Division of Safety and Buildings Reeoo in accordance with Comm 85 Wis Adm Code #1876 Page 1 of 3 Geo Tech Soil & Site Evaluation, LLC txs . Attach complete site plan on paper not less than ref x n ipgppp (ilk? p rPlaO must include, but not limited to: vertical and horizontal referen t r� f��libn and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all infortnatiorW. CROD( COUNTY w.vwr�urry ne�IC�nq,�F1,R Personal information you provlde may be used for secondaypoTeMs�rnrrvac &,,9P'V t7) (m)) County St. Croix Parcel I.D. D - Reviewed By Date Date (Z l G Property Owner HARTMAN HOMES Property Location Govt. Lot NA SW1/4, SE1/4, S24, T30N, R20W Property Owner's Mailing Address 744 RYAN DRIVE #102 Lot # 19 Block # NA Subd. Name or CSM# ORCHARDS OF ST. CROIX City State Zip Code Phone Number HUDSON I WI 1 54016 1 715-377-1555 ❑ City [—]Village ® Town Nearest Road St.Joseph JaIS 141STAVENUE ® New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ® Public or commercial - Describe: NA Parent material LOESS OVER TILL Flood plain elevation, if applicable NA ft. General comments Replaces 6/1/2005 sal report. Requires a 6' sand fill mound component. Maximum basal SLR = 0.6 (eff #1). System area has 8- and recommendations: 23% design slope along flagged contour. w LAAJDW-C ERMr11T��6Efa1W j;WW -1 rss"AacE .., Ate ®Boring -t—j11-tVfmt4o- a •CLl1W Boring # ❑ pd Ground surface elev. 100.00 ft. Depth to limiting factor 32 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' '0101 'Ef#2 1 0-4 10YR 3/3 SIL 2 F SBK MFR CS 2F-C 0.6 0.8 2 4-18 10YR 4/3 UIL-LOM 2 M SBK MFR GS 2F-C 0.6 0.8 3 18-24 7.5YR 4/3 FSL 2 C SBK MVFR GS IF-M 0.4 0.8 4 24-32 SYR 3/3 SL 3 M SBK MFR CS 1F-M 0.6 0.8 5 32 40 SYR 3-4/4 F2,F-D 10YR 5/3 7.5YR 5/6 1 GRIPS L 0M MFR 1F 0.2 0.5 Z Boring # ❑ Boring ®pit Ground surface elev. 100.00 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consisten Boundary Roots GPD/fP 'Eft#1 'Eff#2 1 0-3 10YR 3/2 SIL — — 2 3-13 10YR 4/3 SIL 3 13-31 7.SYR 3-4/3 SL 4 31-35 7.SYR 3/3 C2D 10YR 6/3 7.5YR 5/6 GRFSL - ' Effluent #1 = BOD s> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODs < and TSS S.30 mg/L CST Name (Please Print) Signature: CST Number William J. Bergh 227819 Address Geo Tech Soil & Site Evaluation, LLC Evaluation Conducted Telephone Number 11091 30th Avenue Chippewa Falls, WI 54729 9/15/2015 715-577-6838 SaD.8330 (a.i 1/11) , Property Owner HARTMAN HOMES Parcel ID Page 2 of 3 3 ❑ Boring Boring # ® Pit Ground surface elev. 98.00 ft. Depth to limiting factor 28 in, Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary, Roots GPD1R' 'E1t#t 'Eff#2 1 0-6 10YR 3/2 SIL — — 2 6-15 10YR 4/3 SIL — 3 15-28 7.5YR 3-4 GRS 4 28-34 7.5YR 3/3 C2D 10YR 6/3 7.5YR 5/6 GRFSL ❑ Boring Boring # Pit Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary. Roots GPD/ft' -ER#1 •Ea#2 El Boring Boring # ❑ Pi[ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. I Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr, Sz. Sh. Consistence Boundary. Roots GPD/ft= 'Etf#1 'ER#2 Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODs <30 mg/L and TSS -�-30 mglL The Department of Safety and Professional Servicese is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or 7TY through Relay. ceo Tech Soil s site Evakiad^ LLe M-8330T061, OR 11/11) N W E S SCALE 0 30 60 4AaEss sruxM oRs=Raa6E1 WILLIAM J. BERGH WISCONSIN CERTIFIED SOIL TESTER DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227819 THE INFORMATION CONTAINED WITHIN THE ATTACHED SOIL REPORT IS NOT TO BE USED DEPTH OF ANY THIS POWTS COMPONENT IS NOT DESIGNED TO RECENE THE ADDITIONAL WATER GENERATED FROM ANY WATER TREATMENT OEMCES BUILDING SEWER MUST COMPLY WITH SPS 382.30 WAC (11)(C) LOCATION OF WELL MUST COMPLY WITH WDN R CHS. NR 811 & 812 BENCHMARK ELEVATION =10D.0' - BASE OF EITHER FENCEPOST e LOCATION OF SOIL BORING(S) o LOCATION OF SOIL PIT(S) * NO APPARENT SPS 383.43 SETBACKS ® DESCRIBED LOCATION OF LOT LINE 19 LOCATION OF RIGHT-OF-WAY ® CENTERLINE OF DESCRIBED ROAD SS'AVAP ABLEL.ENGTH FOR POINTS DISTRIBUTION CELL 141ST AVENUE CUL DE SAC ae1 = pt oq REUSE OF WCUMENTS GEO TECH, LLC JOBSITE INFORMATION: ORCHARDS OF ST. CROIX This oawmem has peen dery and hr a wecifin aapli Air use. A,my 11091 30TH AVENUE HARTMAN143RDA HOMES NW-SE-2430-20W LOT#19 mliiaMnoI NaAdrewW eppmadd she ai nalbe,, CHIPPEWA FALLS, WI84729 143RD AVENUE $T. JOSEPH TOWNSHIP PLOT PLAN Geo TecN,LLC Uneppro+ed uselathe sole ULC PH: 1715)723-5555 FAX: HOULTON, WI ST. CROIX, WI mWmRbAryallheuneuNorimtluxr smell: blllyMsvaMewatarpraxwm PARCEL DESCRIBED AS 81 AC. �CEjV tL APR p 5 2J"l ) Wis. Dept o l Services PORT AMMUN in accordance with SPs 385. Wis. Adm. code Attach complete site plan on paper not less than 8 112 x 11 uncles in size. Plan must include, but riot invited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Prlsonat inlommuon ym ismWe may be used for semridary purposes (Privacy tav, s. lied (1) (m)1 GovL Lot City Il 19, --w ll ['S'T--aci-7 _ 0 y 6 Page --/— of Reviewed by r / // 11 the —1ll0/—/9 —em 1148WT ;^NR-9AE 91 New Canebucbcn UmO ReefdanIM / Number of bedrocrrrs Code derived design flow rate GPD ❑Replacement ❑ PuW ord/eI 00mr -Deavbe: Parent material art A,)6,P 7 /( Flood Plain elevation iiapphade ft. General comments and recommendations:d .�►.o•'5 %s- •/�`�r rdr 9—�s �.r esi nBoring #Bonry n8ofrg if o a �II WWWA WOM�M t>K'1=HOD >30 < 220 ffQL and TSS 530 <150 mgIL #2=BM G30mWLand TSS <30m9L CST . ( t) signature CST Number 7�= v Address pate Evehreryom Conducted Talaphone Number -i 7917 - sHD4330fRl1/I I) Property Owner Parcel ID # Page _of ❑ Boring # ❑ Boring ❑ tit Ground surface elev. it Depth to limiting factor in. Sal lion Rate Horizon Depth Dominant Cobr Redox Description Texhae Structure onsistence oundary Roots GPDIR in. Munsell Qu. Sz. Cont Color Gr. Gr. Sz. Sh. fflit if#2 Boring# ❑n Boring Boring # El8O g ❑ Pi[ Ground surface elev. R Depth to limiting factor in. Horizon Depth in. Dominant Color Munseff Redox Description Qu. Sz- Cont Color Texture Structure Gr. Sz. Sh. ronsishance undary I Roots GPD/ft fHt1 2 Effluent #1 = BOD s > 30 < 220 nxA and TSS >30 < 150 mglL ' Effluent #2 = BOD 5 < 30 mgfl- and TSS < 30 mg1L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer, If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. 58D8730(RI III I) Property Owner Parcel ID # Page —of 1 ■Boring # Boring ■pit Grumd surface,elev. Depth to MM Effluent #1=SOD />30<220mg&and TSS>30<150mgfL •Elfha:nt#2=BOD !<30mgfLand TSS<30mglL The Dept of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate f0tm2Lt, contact the department at 605-266-3151 or TTY through Relay. saD-esw(at « 1 p f j l l i I � I � i �E i 4 -I -;--- I I LA! I ! I I I I ! 1, I I 1 1 - - -