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HomeMy WebLinkAbout020-1395-45-000 (2) St. C lx PRIVATE SEWAGE SYSTEM s':n,.r; nov c~laoq c ~ se^ INSPECTION REPORT Sanihuy Perm I NO. (ATTACH TO PERMIT': 615412 GENERAL INFORMATION StatC Pla-. ID tJa Pcrsc-,.-.1win :it v.. t..r.rr la: t~t, pu.p -s'" n9 a:v Law, s'.1:4!'i, i. Carl & Heather Herman TOWN OF HUDSON ar`n'Ta.r,:, 020-1395-45-000 sM Ece. I Insp. 3fA flra I1N :)n.-.eulnu:n bV ` Sma V al N.. {70 door an W • 25.29.19.2439 TANK INFORMATION ELEVATION ATA IY"- rdANUFACTURFR CAPACITY SIR IIO\ HS HI IS ELEV. Sepfic Bcichirark L I oo. G SS'1 1 7 1 .4¢~G~t SLP•o ~TCr eldg Sevrcr Hold~rg StVHt 19 el SUHI Oude TANK SETBACK INFORMATION IANK TO I'11 rJ?I I HI Di; 'e•enl tO Au Inca<c ROAD Ot In el SepIIC f 7 1 DO t rnl &Nlmr Dnsiny ~ Header.4,7an ~ ~ ~r Aeration Dist Pipe Z r~1 ~ C. Ncddh:g Det. System . , ti .Icy q'(IaSG 3.5} ~PUMPISIPHON INFORMATION O r • IG de D3.~5 IL 1100 L9a~draat.rer Den,ana S: Cover aPa, h lZ.ol I 11 -36 Idodel Nun•De• ~ TDH Lift d Frcion I as Sysit,-ii ac TD I ~ i~ZLA I N I)- I # Fo'eernan, _(nII Dia. 'j I I A; ll ,7100 1 SOIL ABSORPTION SYSTEM BED.'TRENCH _t f _rnp:h \u ✓1 Tmnclres PIT DIMENSIONS `m ~d = t: ns d Uz cID _ DIMENSIONS ar SETBACK SYS I Etol 10 ?tL G - BI DG t J%.. L,,KE.'STRFAI,l LEACHING Ma^ulacturcr. INFORMATION - CHAMBER OR C/ vpc G' Sys:cm. UNIT Lic7ol N.nxr. DISTRIBUTION SYSTEM 1,01V Hz det Ien: tC A r'"I -cle Sze Spacing _ na:h_ Diu ;...q _ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Sysloms Only ® ~.-1 t T z. ( Ceptn 6.r•: t I - CcoP c` I I sccdi 5 ..did rv',ulchza ne r Gc,tc- IiaGtrench Ed es T it S L-:• vns NC Yrs NC COMMENTS: ilnolude code discrepencies• persons p•esent etc': Inspection #1* Irspeclion p2. Eon-cw~utn ao~dcc~ D"Id"4*M - P(~y Location: '33 REGAL RIDGE I mew I ; A t ern resc:ripn:r:t = 4Ukoh N Sif Wr CC~Je✓ l 2. D cg sever length = 4tI N G arram' of cnw:r = ar Icroson. Required? Yes No othe'side for a:lditizinal u•.tcrh 'IC•h Mr~ ST. CROIX COUNTY ZONING OFFICE: CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic andior dose tank presently serving the loltoNvin} residence: (Street address)- -?3 S CA((` ~-l(CJ-e, located at: /a, Section Town N, Ran gee W, Town of St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system'? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes 'tank Capacity: Construction: Pretab Concrete , Steel Other Manufacturer (if known): ll.' 1 F Jc: l~ Cc w Cg r f Age of Tank (ifknown): t Permit number (i f known) 4ty af 00 ell, (LiLiPltm b'el Signature) (Print Name) ,`I''( Ij lZ S ~ 3 F (Title) (License Number) MP!MPRS /3 fr1 (Date) Form to be completed by licensed plumber (Dept of-Safe(y and Professional Services Chapter 305 and s. 145.00, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin ;l(iministrativc Code.) Rev. 2/2012 sar.xrai'tir - "lots - ~I J Y, + r(A, Industry Services Division Stcmix 1400 E Washington Ave - P tianilaly P.O. Box 7162 Permit Nullifier (to he filled in Its (o) Madison. WI 53707-7162 Nrs ( State Transaction N umber Sanitary Permit ~lpplieation Filil_ In a c rdancc subs ion ofihis loan to the appm ~ , is teyuind prior to ob ainmr t . unl rrv pcrmll NulcJJl the Department Safely ;uid Putlewonal Sers ices Peronal infarmaiion sou pmvrsle may be used Inn secondary. 1'nncet Address indifferent than mailing address) T + +w a»c' In acct rd,ut c w•pr Ihr 1 r,tayy' I aw 1 1 < 11Ji 1)i nir %tat,. - - - - Sarno p I/ I Application Inform / t~Plcasc Print All Information Parcel # 793 Propertt owner" _ - - _ ) Car; K Heather Herman 020-139545-000 a s, aet. M~, aN39 ~Pmpert y Owner's Mailing Address Properly Location '+i Regal Ridge Govt to( t). State Tp('cdc I Phone Numhcv .\N"ri, SW Section 25 Ildson. WI 54016 124N Nocfeonel II. Type of Building (check all that apply) / _ of a R19Ft~W ❑ I of 2 Family Dwelling - \mnbei of liedr..ont, ( 'l5 SubdrviSion Name D 3 \ ❑ PubadConurtercial Deserihe Cse Block it, ❑ State Owned Ucacnbc LSc ❑ Cily of T SM Number ❑ village of 2 t'S 1- C ? / 1.15 (D of Hudson `I I. Type of Permit: _ (Ghe(. _one stn o A. Complete line B if ap licahle) - r I ❑ \cw Svslcm ®HcPlAcemuu 1\sI[nl 1 7rl'a1n1Cn(I h IJinp, ianA Itcphwcmcnl Only El ()[her Modification to Txi%unp. Syslcm (explain) B. I El Pemw itencwal ❑ Pcrmil Hrvni-m ('hange of ❑ Pemm Transfer to Nc iuu. Pemti[ Number arul hate issued Bcforc l:xpaauon Plumber Owner 46333ti, 71222W5 I -h e o7-PZSa C_ om onnUDevicc Check all that a ff h - - - Non-Pressurized In-(jround Pressurized In-Ground ❑ :114iradc [j Mound -24 in ofsuitablc soil L] Mound 24 in of suitable soil dffig-E3IIf)ther Dispersal( bmponenl lexplsin) ❑ Pretreatment Device lcsPIM11) r S.OtiS V Dispersal 1 lrea(me Area Information: 1 Die y~ 9}--- Ucsig Ilnw (gpdj z Ue p in Soil ApphmI1ol~ I Dispersal Area tired Is I Q - spnal Area I✓r o ,d Isfl S •atc 96 ilcvalion - - 6110) ka U,t pd;}1 s/ 111 85? 90X1 hT x' C VI. Tank Info apa m or T - - - - _ Gallons I ° c oral Uof u v _ L Manufa Per 3 LiniLC - - ('allons ~ ~ c I S i B ~ I--:tislmg lanky ~ J tI New 7an 'CPnc or Iloldille 1'anA 1200 1200 1- Wieser Conciele.. ❑ ❑ ❑ El Q I hrsings tff#--- 1 - $00 f -I ~ N~icsa'Concrelc A~Q ❑ VII. Respon ponsi hilitY Statement- I, the undrrs rsigned, assume reslamsibitit_% fur installation of (he YON' IX shorn on the attached plans. ['[out her', Name 1I'll n0 - Plum s Ig ore , fsIP;M1'RS Number Business Phone Number John arri tei d 2237W 714-760-0,186 Pl nltx,t s Address rSOCCI, City Stale, Zip Cudcl 58G v lle\ \'icss Trail, Somerset, lV1 54025 - VIII. unity/DepartmentlNeOnIs \ppnwcd npprtyx1d Permit „Fcc Dd Udat ks d I Issuin ell Signatu - ~na lm n R a rn fur Iemal ,lUU • Zr 1\.Condi§Xr fir\(I!rt i, rRelSOnst'nrDisapprm'al 3~ /'1. I 1. Septic lark r' to ;r 1 ullel. u per narayemen p r. p•c iot 1 Lv Nlwnhe:. I QtJ sC,. ~(i 44A Ct1 L,/Pu 2. Al aMMnk nKV,11et en s Ima11 n~ urtrir,[ : J I » pr 1pFiIct1E1! uIA! ; .M•nsrsi. Strach to complete plans nor the system and suhmft to the (bunny only on paper nor Ire man a vt s 11 inchr. in .irr - NBO-63981; Rol: 14) SYSTEM PLOT PLAN A Deign =10v1. F..Y.ga!gns/car Project Name. Herman 4 Bedroom Septic Attacn besign flow catculalll for Protect Annress. "3, <oaa Rr,1pv _ commercial Plans. rr B10, Symbol - 80.4 7-evatlor 100 ne Ptpe Matona!s : AS-hr Stanch J Scale' 1" = 6C B10 Description. _'x o' garage ooo. sil - Tfl 384 36, S 384.30-5 C 60 _ 910 ? 2L B1.12 Symbol i j 611 Elevation s2 e' SCI 40 ..y-; AS-M D256b BM L)csc nort Tut., of u5 rs~ 4' 3034 P'JC ASTM :)3C34 Slope Gradient o' TesteC Area ASIM D!795 Well Symbol W apphCablei Notes Note- 0 c J d 1 I a I1~ ii c ~ ± , Well i 4 Bedroom Drive J House Garage 3PA1 Garage i Ezls;mg WLP1200B00-MR / SepnGDase Tank \ 50 - 2" Scr 4C Force Matr 1 - 1-Fxls'.ng -3 x704 QUICK 4 venrh E!.=94.80 G. % i Exisany -31x92 QUICK 4 ll E''..=95-60' ~ / 73-orcoosed 'x90 EZ Flom trend E..= 9520' ~ T4-Proposedxx9C EZ Flow Tench E..= 95.80' / O / T1 T2 ~ ~ O ~ i n ~Z~~X.C~' ICI ~roPerty lme~ CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Herman 4 Bedroom Replacement drain field Owners Name: Carl & Heather Herman Owner's Address /33 Regal Ridge Hudson, WI 54016 Legal Description: NW1/4, SW1/4, 525, T29N, R19W Township Hudson County: St. Croix Subdivision Name: Scenic Hills Lot Number: 45 Block Number Parcel I.D. Number 070-1395-45-000 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Septic & Dose Tank Specifications Page 4 Effluent Filter Information Page 5 Dose Tank Cross Section Page 6 Pump Curve & Specifications Page 7 System Sizing & Cross Section Page 8 E2 Flow Information Page 9 Management and contingency plan Page 10 Septic Tank Maintenance Agreement Page It Warranty Deed Page 12 CSM or Plat Attachment 1 Soil Evaluation Report Designer: John Schmitt Licnese Number: MPRS 223760 Date: 7/20/2019 Phone Number: 715-760-0486 Signature: j>y ~ -2 In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Page 1 SYSTEM PLOT PLAN Project Name: Herman 4 Bedroom Septic Design =la" 63o ga°ons day N Prolecl Address. 733 Regal Ridge Attach design flow calculations for BPA1 Symbol: • BM Elevation- 700.00 wmmeroal plans. Pipe Materials t ASTM Standard Scale 1" = 60' BM Description; Top of garage do a T ables 384.30-3 & 384.305 0 60 9o 120 BM2 Symbol; BM Elevation 92,60' 4" SCH 40 PVC ASTM 02665 BM Description: : rev of a3 rec+ 4' 3034 PVC ASTM D3034 FEZ Slope Gradient of Tested Area. (8%1 Z' SCH 40 PVC ASTM D1765 15- Well Symbol (if applicable) Notes: Notes N /1~d9ER~ i'(ie Ti d ~ ' Jy a O a C C i J f ~ O. ° i a i I Well 4 Bedroom House Garage! Drive i BPAJ Garage i Existing WLP7200/800-MR / SepbciDose lank 60'- 2'- Sch 40 ,,,CCC,,, Force Main J61 T1-Existing -3 104' QUICK 4 trench E1.=94.80' B%T2 -Existing -3 x92' QUICK 4 tremch El=95.60' T3-Proposed 'x90EZ Flow trench El.= 96.20' T4-Proposed 'x90 EZ Flow trench El= 96.80' q 'P/ T99' ` e1B T2 I / 101 _ Properly l.me i ,JS: 4 6%, 'NJCH \ III 1Y 01 l~. z a +-c,: ~ '3tye x u.;'oe :ar~o lVf1NVW OLLd3S -..r a3a 313UD000 13531M 21W-008/OOZIdIM O W ~ w J v v H Q & a 0 co p W =O J d U Q w U~ W N N a m o Fa w O O k' d3_ O Vl Q ° J w Z N V) O~ ~Ow N~ ^ K 2~m Q H z of O ° C Q Q Jln OM O~Q 22 F7 d w4 W Omm OJ QJ JJ Q U mJ O <LL > o a a< N F J U Q G O Q CL NO MU) WWWw OU O dW O~ N i Q 0 U J LL OWN 0 NO v~ y ~ a s O O 0 v 0 OD Qa QWN ! = Z 00 L/.L .p \ v 0 0 9 0 w 0 Fl- m t~I (V Q~ Q (0 its \V Nv t0;-: IQ~NQ ~N w0. 2 Y OW M: no W 00 ~Z~ fnwV U~ ZO ml :>o wN rN ow O_N tiinO ~OH~~;or O¢y O0w ¢ V, wFN Oo wO w OD 0 CL C, x ~Y ,IoO<ww°w a" <c0< u c~ <vwo ~ o Z'Sm Um2 J SMD 3 F O ZO U CGy Ow Q 2 J J J o 00 Z O< U t-- 0 ITI 2 Z J J a U .y ~ J O Q _ (J Z n ..6£ ~1 > d C 1 r \ 1 II ( ~ II II II I o I N l r.l N u 1 > Q o J I ~ .9£ ~I ~i ~ < I I' I X N ~v I ~ w a I w a i II~ I I~ w V V 2 .lo ~ I .96 V ~ CIC3d a sv (n Y 6 H Page 3 MAINTENANCE INSTRUCTIONS ~ ~ USA 100 13001600 33' PAGE 2 0/ 2 The interval for servicing septic tanks is set by state and local code. Throughout the United States. there is a wide difference of opinion on what this interval should be. but most regulatory agencies suggest two to five years. The Zabel filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtually self-cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFilter@ alarm, you will be notified by an alarm when the filter needs servicing. 97 7, AN: Step 1: Step 2: Step 2: Locate the outlet of the septic tank Remove the tank cover and pump the Firmly pull the filter handle and slide and remove the tank cover tank if necessary to prevent any solids the cartridge out of the case. from escaping to the the drain field when the filter is removed. Note: Servicing any Zabel filter septic tank pumper or installer. Case tr7odei filter be sure and spray clearl the outlet opening before replacing the filter StE~ StE~ Step 4: Step 5: Residential Applications While holding the cartridge over the Insert the filter cartridge back in the Certified toANSIINSI- access opening, rinse off the cartridge case, making sure the filter cartridge standard 46 with fresh water, being careful to rinse is properly aligned and completely all septage material back into the tank inserted in the case. Replace the septic tank cover. Gepyriyrtf 20 N, Pprybq lnc All riyhh-rcserveC I'r00uCt'sl COVp IC~DV C~e.~r rnnm;:S arzU./Y InfE/na'vondl pafCnf~ O;hcrUSanl;ofemdUOna7 pafcnfe may D2 penJmq Page 4 PAGE 5OF6 SEPTIC / PUMP TANK SPECIFICATIONS 4"0 1,1,1 F;w (No Scale) .10'I'rum no Idlnq f rxJdnd mdsl cenrply dl•r 12" Min or 2.e 9 accv. SPS 316 anC NFG No rslanli-~ od Flood Eleuadi r Exlond mar• ola riser as neu>ssury, (Iyniglj 'Nealhefpmor App,rom~d .anelg0 Be% Vr• I l'. Aapmved Larking Manhole IMPORTANT: I Atn blaming Label Attained (lyvicalj Archer tank(s) as necessary TI-Conduit pursuant to SPS 383 .3(81(8) 4' ktn. or 29 flaaom I C Cut shed Flwd rlevnUUn it - Vz ypical) Airtight Seal F ini:ahuc G•ade Quick Usccnecl a 1fl"Mm. CAPACITIES @ gal/in - Depth (in) Volume. (gal) A 18 400.32 vm1 p Anpm eel Ji• Is hill B 2.0 44.48 A H01e ApprcreC Ppe 3 it onto JON! Ground I OYra~-. [Cl 4 88.96 ' 0 Ala••rr D 12 266.88 B I I PUMP-OFF ELEVATION = 83.60 ft Pump Tank Liquid Level = 36 in r,n INSIDE BOTTOM Force Main Diameter= 2 in L _ V an k ELEVATION = 82.60 it Force Main Length = 60 It a' AFprn.~d Bedding Male-al Bereal--ark Vertical Head = 14.4 ft Force Main Void Volume = 9.78 gal + Min. Supply Head = 0 ft [Cl Total Dose Volume TDV = 88.96 gal/dose + FM Friction Loss = 1.55 ft L (5X total lateral void volume < TDV < 02X design now) + (force main drainhark volume.) + Fitting Loss" = 0 It `(min. supply head x 0.3) MIN. PUMP DISCHARGE RATE = 20 gpm = TOTAL DYNAMIC HEAD = 15.95 ft LL PUMP TANK: SEPTIC TANK(S): Volume = 800 gal Total Volume = 800 gal Manufacturer: Wieser Concrete Manufacturer(s): Wieser Concrete Pump Manufacturer: Gould Install approved effluent filter at the septic tank outlet Pump Model: EP04 see a[ra:fed nnmr immediatelyuupstream of the pump tank inlet. ControlsiAlarm Manufacturer: Existing Filter Manufacturer: Zabel Controls/Alarm Model: Filter Model: A-100 Float switches containing mercury are prohibited. Page 5 -in y 1 I I ~ 1 tl'e' ^1.11C Wastewater METERS FEET 10 9 30 _ _ 5 GPM 8 ILL~~~~-2.5Fr 25 7 Q w X U v 20 a ' w z 5 ~ - ~ 0 15 J 4 O EPOS ~ 3 10 EP04 / 2 j V 5 0 00 10 30 40 50 GPM L 0 2 4 v 8 '0 12 m1/h CAPACITY MODEL INFORMATION Minimum Minimum Minimum Minimum Maximum Shipping Order No. HP Volts Amps Circuit Phase Float Switch Cord Connection o On Off Basin Solids Weight Breaker Style Longlh Connexion Level Level Diameter I Size Ibs/k Plco tN04'1 No Sn cci io 1115 MA T ja ✓an;:al 1S 2~; 9 Piggyback? , - i ~ cPC411A I 01 de -Angle 10 _ l h--- 12" 6' - 15' 21 i9.5 i 5 12 20 _ _ ' Pli.a i EP04l':F 20 1'h" A•larua. Manual 15' 2019.1 i 4 ho sw :.1 EP0411AC P49Yhack. 20 1~h" ! 12" 6" 1~ 21/9.5: '"Al de Angle EP0412 1 PIO'r'? 10 11/21, Marua- Manual 15' b<' 20/9.1 230 6 10 No 5w•--'n r ~1u5' tch r 20 1'h" Manua' Man;;-al 15~ 20/9.1 FP0412F S•m: E PO5I IF Iv PI59cn 20 111.•" m3nuai ,Man.lal 1s' 22i 1C 115 13 20 EP0511AC .5 Piggyback? 20 Pk 12'= 6- 15' 23; 10_t ' c'. An71e -P95 ''F ~ 2-.n ; i 10 .I 'ft 16y" L1ar~u ',zn.,al ly ~2! 1C Page 6 v PAGE 3OF4 c: N ty g N J r L_ co C _ r U j u. of a) C E R c w .0 O 'Lu E ay I z o a) U c o c O? N c T m i~ ~ c Q v~ ~ ~ 1] a ••m 2 n > > C r O w ~ ~ ism O c N x xt 2 `m ~ r, g iy N 'o CID U N O ° = g. X m a Q c ~ ¢v cn O = m N O L O G ~I N > V W 0) U ;C II _ 0 II II = W_ a a N c) o a w = d < > a ~ ~ I II I ~ Z Z Q m I cc w m O L m Q W O r€ c I I a a~i Z fn d c 6 I II I d fA r acn 3 c L I I CL Q W CO } U) C ti z m. I m O U) p J C m a II I a w Q LL ~ c L3 dLT I I II .2 2 J 2 N U o I CY) Q U I II I! v (n N a U o @r m I r- c r W N _N a dW 0 0 C .t I I v O Q N I O II II II X I~ I J l`C I C C V f 7 7 C N a l u d o J IM 0 CID m U 14x.2 I I w w n Q U C (D a a N N % rn I I o Lo cQ ~~H J t <-n ev I I U U @) a V C I-~_~ a I I w v 0 0 Z 2 a`: = H I II Of 'O CY) ] _~x L o = I I W w e n _ o v o N CJ d i C7 W = rn w Q ~w~ I I z w Cc H> (.5 II F- 0 Q- _j Zcn I I Z n Q Q o I II I - rn o FU ECL E ~ I JI ~ L - Page 7 Installation Instructions for m1 EZf down EZ//Wr Systems in Wisconsin by INFILTRATOR Wisconsin Department cf Commerce., Safety and Buildings 5. The Absorption area (SI ) necessary for a given site shall Division, has reviewed the specificaliors and/or plans for this be e ied based on maximum daily sewage flow (GPD) and product and determined it to be in compliance with chapters the Permeability for the site. If certain criteria is met, the Comm 89 through 84, Wisconsin Acmin. Code. and Chapters FISA song can be used in Wisconsin, resulting in a 40% 145 and 160, Wisconsin Statutes. Al sites must meet the Site smaller drainficld. & Soil Corditions & Locations & Isolation distances as noted in local regulations. 6. Place EZflow bundle(s) in the EZflow conrguration ap- proved by system aesign permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in lar site. The top or center-most bundles containing pipe center bundle in 5' or 10' lengths) and 1203FIP (3-12' bundles are joined end to end wiV- an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. additional aggregate only bundles that may be required, should be butted against the other aggregate-only bun- A single pipe bundle contains a four inch perforated pipe sur- dles and do not require any type of connection. rounded by FPS aggregate and is held together with poly- ehtylene netting. A single aggregate bundle contains aggregate 7. The top of each GEO cylinder contains a filter fabric pre- only and is h---'d toecthcr wrth polycthylcnr_ netting. manufactured in between the netting and aggregate. The fabric is inserted to prevent soil intrusion. The installer Materials and Equipment Needed shall make sure the the GEO is positioned upward and is • F/flow Hurdles in contact with the fabric contained in the adjacent cyiin- • EZfov: Gectex:lc Fabric der before backfilling. • EZro•.v Intemal Prue Cujplcea ; • °Ipe for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a • Hackhoe/Fxcavator level trench in all directions (both across and along the Trench bottom) and should follow the con lour of tf,e ground Installation Instructions surface elevation (uniform depth), with all continuous The instructions for installation o' EZflow products are giyr_•n adjoining 10-fool cylindrical bundles placed end to end, belas•. This product must be installed in accordance with stale fr central bundle distribution pine interconnected, rule. defined in chapters Comin 82 through 84, Wiscens n Ad- wit-out any dams, stepdowns or other water stops. minist,ative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design 9. The trench top shall be graded such that water will not manual. pone. Hacklill should be seeded or sodded immediately after completion to reduce erosion. 1. After the local health department has determined srnng, configuration, and layout for the E7flow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved or mark wi<h paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or careful to set correct tank, invert pipe, header line or dis- other obstacles. tributon box and trench bottom elevations before instal- lation of pipe bundles-. 1 1. E-PS aggregate is lighte, tnan water, therefore, it might be expected that natural buoyancy forces would tend to 9. Remove Plastic EZflow shipping bags prior to placing ; cause EZflow assemblies to float out of ground when bundles it the trench(es). Remove any plastic bags in the pending occurs. Field experience has shown, however, trench before system is covered. ; that this is not a problem when systems have a minimum of 6' of soil cover as recommended by manufacturer. J. This product must have geotexble fabric that meets re- quirements of s. Comm 84.30 (6) (g). Ws. Adm. Code, installed directly on lop of the product and extend rig 1203H-GEO down along the sides of the product to a point at least six inches frorr the bottom of product. eotextde ; - Eiarrier Idate•ial 4. When installed in a trench, the trench should be dug to a width of 36 inches. This not only saves labor in excava- For, but also provides better load-bearing capacity after -A backfillirm is complete. . Page 8 PAGE 4 OF 4 In-ground Dosed-Gravity Management Plan IMPORTANT: The owner of this in-ground dosed-gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc Admin Code. Pursuant to SPS 383.52 (2), Wisc Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin- Code Maximum Dispersal Area Operating Limits: Design Flow = 600 gpd; BODE 220 mgL"; TSS 5150 mgL'; FOG 30 mgL' Inspection Checklist INSPECT EVERY 3 YEARS type of use age of system nuisance factors (i a odors, user complaints, etc ) o mechanical malfunction (i. e., pumps, valves, switches, floats, etc ) material fatigue (i e . leaks, breaks, corrosion, etc ) c solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i,e . distribution r drop boxes) neglect or improper use (i.e . exceeding design capacities. prohibited activities, etc ) extent of pending in distribution cell prior to dosing dosing irregularities - if applicable (i e„ pump re-cycling. float switch settings, etc ) electrical components - if applicable (i. e., wiring, connections, switches, controls. timers alarms, etc.) distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) n Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance- Disposal of contents shall be pursuant to NR 113. Wisc. Admin. Code. Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period 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 individual or company. John Schmitt Phone 715-760-0486 Local government unit: St. Croix County Community Development Phone 715-386-4680 Local government unit address: 1101 Carmichael Road, Hudson, WI ZIP: 54025 Any defective part of this system shall be repaired, replaced. or removed pursuant to SPS 383.51 (1), Wisc. Admin Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383. Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384. Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383 33. Wisc. Admin Code Page 9 ST, CROIX COUNTY SEPTIC TANK MAIN FENANCE AGREE:ME;NI' AND OWNERSHIP CERTIFICATION FORM Owncr/Buyer Carl & Heather Herman Mailing Address 733 Regal Ridge, Hudson, WI 54016 Property Address 733 Regal Ridge (Verification required [rota Planning & Zoning Department for new constn:ction City/State Hudson, WI parcel Identification Number 020-1395-45=000 LEGAL DESCRIPTION Property Location NW , SW Sec. 25 , `I' 29 N R 19 W, Town of Hudson Subdivision Plat. Scenic Hills , tot # 45 Certified Survey Map # , Volume Page # Warranty Deed # (betbre 2007)Volume Page # Spec house DyesElno lot lines identifiableOyes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION hnproper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists or pumping out the septic lank every three yearsor sooner, it needed, by a licensed punper. What you put into the system can allacl the function ol'the septic tank as a Iteatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix Counry Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Departtent 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) aficr inspection and purnping (if necessary), the septic tank is less than P3 full of sludge. liwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set I'urlb, heroin, as set by the Department of Safety And Prolcssional Services and the Department of Natural Resources, Slate of W isconsin. Certification staring that your septic system has been maintained must be cotnpleted and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration dale. IAvc certify that all statements on this f m ace true to the best of inyinur knowledge. live amlare the owner(s) of the property described above, by virtue of a wama v deed recorded in Rcgistcr of Dta.ds Office. i XdinlI*r./4ft' beil;irp~ms _ 'SIGNATURE OF APPLICANT(S) DA'Z'E ""'Any information that is mistepresenled may result in the sanitary permit being revoked by the Planning & Zoning Department. s+• 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 ;`rte warrant%, deed. (RE, V. 04/12) `^rb 1 49 1 69 f .~I4b fag i 70 / 3 swarv~w I I ~ mo•. SUDI I I aura af.Aa(S ',lath a ra; ars / ;;j, o 1 5 69 '+~x o':nu - ,i ~'.~ae ~ r •w~ _w.e / `ir ~sy.~'-_~ ncwum _ _ _ 'I r / r I -0],y Yf lvfMM1Y.,~I I~tb II u,v..-. my - _ - ~ [\I I jar eh~ nx.. n.a / nen w.x YiO:°` ` t 40 j 44 S ~ i 45 u ; 48 ( ~ I I +m. nn zm_~w~r ~ _ i 43 i mlss 9o r* 1 x ~ nay/.;.-Irs _ ~ a~~n::,ts l 47 ~ i~ r s nz.::u tt 5. 6~ Ipa~ 'e+ipauu 26W.51' I rtrnnnwe N88'12'16'E 2830.M' ,,..-uuc.MV.ana~,+.:. s Page 12 oO "y . Croix wnoorob pepsrtmnt 01 Conanorcr. PRIVATE SEWAGE SYSTEM St _ Safety ii Building DIMIM INSPECTION REPORT senllary Perms N . 463338 0 GENERAL INFORMATION (ATTACH TO PERMIT) state Plan ID No'. Parsonal Infw"Iavon you P=A v may be 1 ;0d for secondary p.. as IP vocy Lmv, s 151)4 (1 Km) Pert Holers Nanw- City village, X Taxnship Parcel Tax No. Hudson Town of 020-139545-000 CST Bal Etev: Insp. BM vev: BM Des SectbMOwnlRangeJl4ap Ho: ZR 1. - uipllonZ Ceti/v d Z,61 25.29.19.2439 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS F1EV, Sapdc 7 OO O V Benchmark Dosing (J (J AIL SNI p L~'. I l I ` &dg. Sewer Aerabo Holding J~CX svNtinlet D 3/;.1 -p gb• StRrt outlet '-•f TANK SETBACK INFORMATION WE BWG. vnm re, Air lnWaa ROAD Dt lniel TANK TO Se T + 1 sit' { ~ 7 - Dl Bottom 1Q • q+ ~6 - Z2 Q~• YJ O / HeaderiMan Dosing Aeration Gist. Pipe Holdirg _ Bot. System F'•.Aal Grade PUMP/SIPHON INFORMATION G(O6 vTA* rT s-e r Manufacturer Demand S~er I z•S 2 • 0 f txrl G -7 Model Number Q Nfr~l -03 TOH LM hnct~Ory.~usa System He Ft N>Cr I Forcemain t e ` 7 Dia~ rr F. to we# I SOIL ABSORPTION SYSTEM 2(a4 2 PIT 8 o. O<PIIA- In810e [ka. uW Depm BED/TRENCH Wldm t to•+,)fh Nn. (31 Treoct~ms r~ DIMENSIONS z 2,}• _ KE/STREAM LEACHING s1sAl: rsr t SETBACK SYSTEM TO KL 8 WEL CNAMBERO ~Yh INFORMATION T System' 7 I ' Nodd Number IBUTION SYSTEM 43, Vent 10 Ae Intake QELI H )Meryrgd Distnbutlm t z Hole Sire xllde Spackg LeAgt _Dia,. LervJlh__ CIASPBG'r___ _ 1J Y SOIL COVER x pressure systems Only u Mound Or At-Grade Systems Only M ned Copp Den, DopW Ow lot [wMh e,1 la SeedeaSodded Bad: T alch Corer I f BeerTronch Edges Topsoil h i~ Yes L _ No Yes No - llsspection#t: inspection COMMENTS: (include code d scrependes, Persons present, etc.) DICI Parcel No: 5. ,28.19.2439 Location: 733 Regal Ridge Hudson WI 54018 (NE 114 SW 1/4 25 T29N R19W) Scenic Hills lot 45 1.) Ail BM DsscdPtlon _,p st/ ~ 2.) Bldg sewerangth=GjCt 'N - amount of cover ~I`~4L !1 1/ ~ ~ 7K P{An revision ReOUired't ~ Yos No -7, ' Use other side for additional information. to W IAsextoes ture + can No. SBO6710 (R 3097) ~j1s/w + l llruri 4),trYlQ2' ~ 'Q'Lq'Y~ . 3 MUConsn Deparbriem of Commerce SOIL EVALUATION REPORT Pape of Dlvielon of Satetyand Stxldinpe in aaordwioe wM Comm 85, Wis. Adm. Cade CaJMy Avach contuse, one plan on paper not less man a 112 x 11 Inches in size. Plan most aititde, but not limned to: verbal and hotzanbl reference poex iBM)• daeutan and Parcel LD Percent slope. scab or dimensions, north arrow, and location and distance to nearest road. L ~-all Date Please prhlt all Information. Peru" lwumnWonyar m i tmy au.etbru dwy PxPOSet(Pn taw s. 15.o1(11(n)1 a-' Prop"Owrwr Property LO 4tlon _ God, lul /JC 1/a 114 S T Z N R E( .M JdJAC W-6-4 Property O s MaNkg Addrea9 LM a Slonk a Subd. , or fSMp L'a it/ 1; 5 e 115 U Csy U village ug luMi Neaeat Road E E c, m - O id n New carwwdloni lMo: Resldrtntlel! Ntxroer of beaoonns-_ Code delved design sou rate Aso /l O D _ _ GPD ❑Replaoentetd ❑ PWec or mmmercial - Desatbe: parent Parent mebdel -1111 Rood Plain elevation It appkabbe -.Arm/ A X11 SySiew, elieu. yS,o° us! ❑ Sonnit 51 ® Pit Ground surface elev. LL! V -rt. Deo to I nWnp lector in Sol Rte Norlmn DWM Dorrtriert Radox DesMotion Texture Stntchre Cort4stence Soutdwy R00b Gr. Sz. Sh. •ERNt M. Mtmaetl Ou. Sz Cord. Caton o-Z to 32 Cs 2 z-- - S~ ml~ c 1 ♦ _ a 1 9So Or, z ❑ ~ c~~ go" a © Pit Ground sixfece ela. 1.7, Z h. Depth to kM" in. tailor- Sal ReOa Red= Cmscduw~ Tetatxe Structure Consillerioe Satsxbry R 1 'ES02 Gpuff Depth • ~ y ` In, Murrsea Ou. SL C.orri Color Gr. Sz. Sh. -L ♦ ly ~ siG/ zm5 ♦ r Z-11 r C r 0-1 r H Q a > arid Tss .30 < tso mpn. • Etstwrt fR • OM < 30 rrgA. and Tss < 3o ngrl. • Ef k wY at - SOD 30 1_220 mprl arid IST Niertier CST NIM. Pdrt) ° S3 Sc Date eA*wton c« axsw Tekpf orie N niter Property Ov 41.'NdrNta_,e-t_ Paroel ID tPegs --(L of M v e p Sorft Gmurd surface elev. 101- 60 It. Depth to Iim*V lades G R98 Horlam Depth Domirml Color Redox Dworiplon Taxdxe Struck" Consistence Boundary Root GPDRP in. Mussed Ou. Sz. Cad. Color Q. Sz. Sh. 'E"i 'EM2 1v-Q- I wi(31.3 Sr ( ZlrtS~~C r GS C "5- Z ~a• - L r L 5 o v~ -;t- ❑ ~ fl Bo*Vtl El soft h~ Sol Rate ❑ pit Grates tattaca etev ft DOW p in. Halms Depth Dw*wd Red=DesoiOw Texan Seucdxe Corrsistenoe Bardary Room GP" In. MurnM Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#i 'EM ❑ BaYq p ❑ B ❑ Grwrd surface Olev. h. Dspthlow,ftwg tsctor._-.In h Sol Hate pit Hodson 090 Derrdnard Redo DescrWOM. Texdre Sklxh" C allstence Bwxley Roola l *012 Gr. Sz. Sh. 'Etft1 E0i2 in. Muh9e1 QU SL Cad. Color ' Skeet e1 o I300r > 301720 nglL and TSS >30 1150 r~ ' Elrhxrrd 02 • BOD, 130 myL and TSS 1_ 30 my'L m an8 access services or _ Assistance The Department of Commerce is an equal oppomn c&mice oma pthe rovider and employer. If y 15 need peed material in an altermta format. please roauoraa+en i 1 i E 1 IG ~ i~ t n'' it i y i Al 1