HomeMy WebLinkAbout020-1021-10-100 (3)Cocoa.coul
PRIVATE SEWAGE SYSTEM St
smn..d e.Im.e o.um INSPECTION REPORT nFalse x. 615448
GENERAL INFORMATION (ATTACH TO PERMIT) Pa. m x.
ur lPn IINmry
CTWIGmup lnc Cey=e TOWN OF HUDBON L..x 020-1021-10-100
e= ... eMp F.PUP 1 `ande'1dalNo 96B-f0
TANK INFORMATION 40 ELEVATION DATA
TYPE
.n. Ac
CAPACITY
I000
STATION
IEV
In
u06
u"4 I
xmao
I
ill
•B
Dolt
AIL Be 1i
3.-I
Aerated
of Sdoor
6
Hai
6aN{Ink{ I
.�1
TANK SETBACK INFORMATION
N
TANKTO
PAL
WELL
ITDGrmuIll
Septic
T
'[No
Sol
m
dif
It
7.00
J
u
s PIVaI
qV
Nes,
O
Hl
B.I azalem
i
new crane
9-
PUMPISIPHON INFORMATION
.W
J
1 corer
/y
U/
m. avalem Maaa
p
ma
Le.mnl
9r
BEnEOGUHS
PITDIMEM�n
NO pop.
Inside Dip
.0
D ION
III
if
I
"If1W�
e1Dc
urELL
KF/STREAM
m
l 0call
"ORMATION
mpsr� 1r�PL I•
4SYSTEM
L5l
UNIT
Idead'
(�—
DISTRIBUTION
t r
S.
Too So.
conn�OI.�
ea
a
SOIL COVER any
Duna oruGneeaboddi ony
d'
pal
COMMENTS: (1.uue=ooe= elssreee.ake Pecal Pm t1Io) canal IN
L BUCCUTCHioi RD Je\�2 �badLI rd"
At ON D,.oIeII�.. f4ls iIm 3F� t+«a^ G�.F�W *nYh.
zlaas��i=�em• tN"
Renrevran AequreavUpsocardideasorad,d=..Cm� o..NODOI
e.ry L�Na
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WON
SYSTEM PLOT PLAN
Proiecl Name'CTYV Group
°"°'"'"0°°°
N
ms. ,
�wa.a.w.mww.e
m
aw s� aue� new
w.Nw.w�is
ose �rw.zw
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ww. a.aeaeaao
w
ep a..,a,, em Im�oaer
amww
ommz
aw n.=wam Tepw..N
51ReptlWAo wi) 0
w xer
Properly Lim
t
R
@
PmceM Lice
T1 T]. T3. T< 3
X 55' U Fb Twn ea El.=9i 3P
�r
Garage
PmwsW WLP-MR
w o
wl Pdylok W5
,6 tn9
WO
Bt
GaWn Tan
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3
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CONVENTIONAL COMPONENT DESIGN
INDEX AND TITLE PAGE
PNIM Name: CTW Group Inc 5 ge0man 5ectic System
Owners Name. CIW GrouplKOryorrtl0
Owner's Address 718 Mccutcheon Road
Hudson, WI 51016
Legal (iescriptmn. Ni Ni SEA, T29N, R19W
Township Hudson
County St Cr01a
Subdivision Name. NA
Lot Number 1 Block Number
Parcel 10 Number 0201021d41
Plan Transaaam N0.
Page 1 Index and tltle
Page 2 Plot Plan
Page Septic Tank SpecHaMlons
Page Effluent Filler lnlormatbn
Page 5 System Was & Cross Season
Page E2 Flow Information
Page 2 Management and banbmgen[y plan
Page Septic Tank Maimeronre Agreement
Page Edsting Tank CertifCa0can
Page 10 Warranty Deed
Page 11 CSM Or Plot
Attachment I Soil Evaluation Report
Designer John Scbmtt b[nese Number: MPRS 22370
Date 8/18/2019 Phone Number 715J60-04e6
Signature' ( Uw
In6rouM Sml Absappan COmpoMnt Manual Verswn 2 05813107 1`IN 01/01)
Page 1
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 and/or dose tank
presently serving the following residence:
(Street address) namo;uaheon Road located
at: tow `/4, Rw 7s, Section 15 , Town N N, Range 19 W,
Town of Hudson 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 x
(if no, skip next line.)
Approximate volume or length of time gallons minutes
Tank Capacity: toot
Construction: Prefab Concrete x Steel Other
Manufacturer (if known): wseoerconuete
Age of Tank (if known): as was
Permit number (if known) Basin
John smmm
(L' ,nsed Plumber Signature) (Print Name)
MPRS 3337W
(Title) (License Number) MP/MPRS
if
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s 145 06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev 2/2012
Page 9
SYSTEM PLOT PLAN
Protect Name. CTW Group DespFic, oaGPD enPaware» a 1xx.eeiral9®m9M1mMeuNrx
pwmah mapor
SCBN N
MIimw Bmwton100W I.-
W
pTitan; ABI
Be Umscipd n Bam dwel on 100.F3'
C® pllon Topdwl
6o 8w,la, M artlubla) I1 x)
OW
Property Line
It
F
2 Procerry iaz
e
T1, T2, T3, TO 3' X 55' U Flow Trenches El = 913P
s
Fc Garage
Proposetl WLP-MR w o`
wl Palylak 525
61 iffahng 000
Gallon Ta
i�MBM2
WN41
.{jOt B3 �.b House
T4 T3 T1
hL 17 10 orlvewav
B2, N
M MC ulcheon Roatl
r CAST -A -SEAL
INI£1 WT£i
x
uNR BAD
WLP1000—MR
TANK SPECIFICATIONS
w xsws
RAL z 1
SDTTW sEM•M r
cowl v
ANIH E W M RIELAST CAK 7 M4
NEgR MT M y 11V DD
IEUDTx IW D
MDTH m'DO
MD-M INIET az' 0 D
UWD � x'
MEIGHT 6.780 IHS
INIET AND WTIEP
P LAST-A-S SOOT ON EQUAL
CAS a.. CA I -A -SEAL BOOT OR EWAL
INLET NG Wl T BASTT£ AND ML1
MSDWSIN. SCE DETML 00
(OTTER STATES SEE LHAR»
UQUID GPAa Tr 27M LPL/IN
A"NO TANK.
W TST NtlE %11N4i11
ALNu LAPACITM 1.W5 GAILCNS
LOApNL DEDON 9 V UNSATURATED X4
TANK CAN BE USED AS
S M/ mo E / PUYP m SpItM
00H : NK CEMN 0 No BAR)
ANK. YN LESCN /10 SINULPIRAL i1RER)
WsT zm TANKS
ELN CUSTOM TANKS CONTACT ME OTILRER
FOR APPROVAL
raw
PT! VlPC k
PL-525 Effluent Filter
PI-5z Filter
The PL-525 teller as ntN foe IO,WO GPn W]om per day) making tit ore of the Lug,,thmen in ere du ]thus
S251inau fM M 1/16' When
slob le, Ne Polylok p41II, Me Polylok pL525 t u an d tempor shu[cff Intl
msrollM the
eancient oot leavthee
hlRrueemovM foedeenm&the Mil will treat up and temporarily shut off
the system an the effluent wow t leave the tank
reamers.
• Rated for 10.000 GM (Were per day)
• sss hnnr fail of I/16' filhaoon.
• Aaapb T' and 6" ECH D 4o pipe
• Built m gas deflector
• Automate shu4nff ball when filter is removed
• Alamo anemnbdlly
• Accepts PVC extension handle
PLssslnaanatnn
Ideal Nr n=idmaig and barren lwaste Raw, be or,
10,00 gallon per day (GM)
1 Lowe,the outlet of lhesepur tank
1 Remove be tank cover and pump tank If recmary.
3 Glue the filler housing W ua V or 6" outltt pipe 11
he filler is not em eria under the saris opening urea
Polylok Fxtend 6lnk or pine of Into, to umber filter
4 he,ert the P1,525 filter mtocs housing
5 Reduce and facie the super tank rover
PL-sss Mamtenawe:
The PL-525 Effluent Filters will operate effuranly, for
serval years under comes] mMilrore tdore erywnng
dwrr ng, It u recommended that the (deer b, leaned
every here me tank ¢ tumid, or at least every now,
years If the w1aIIN filter ronlvre an optional alma,
the owner will be notified by an alarm when the fiber
wade sewoctng Screening should be done by acerebral
veto, mnk pumper, manager
I locate eye court of eye sere, uM
3. Remove tank ewer and pump tank if sentiment,
3. Do ma use plumbing when filter he removed
4 PMI PL58 cartridge not of the boost ng
5 Hose off fiber )vet the septic took Make tom all
sohds fall back into sabre tan,
611sen thefilter rartrdge beck ute the lacing nuking
saw the Near a pnl*+ly ar®udd ma comlitelYm
Replace and sure screw tam cover
1/16" FilHatiun Blom
Wcee he
towocep
n lno e
�oaomx� _ r�lnamsar
® xarlutael w tow as
alyn,smM
10,000 GPD
1°°"®"I
� ampia r PVC
Fmw� 11max
Thiylaw Iawl & Best hit. "'I"! ready inaciv
3pwmfId Bhd WWlmgfnrd,LT WW Toll Frcc 8T17659565 Fax hD28f%514 wxxltolylokmm
PW AI
IN -GROUND GRAVITY DISPERSAL AREA Wbeer conc%re T"(S)r.W...
Uniform Elevation Trenches with EZ1203HP Bundles ,ao„r Tma(,(„,,,
3-ft Trench (down -sizing credit) moo w loco
H.W.,..•r.....f
PONbk
El�.asvne+e 525
mcw+rn TYPICAL TRENCH
CROSS SECTION VIEW
1 L (NO $CRIB) MMWAi PPE MTNL
/ M s
Prov{]e mNimum3n
OYWI) saperauon eerxaen lrarcM �a *��
TYPICAL TRENCH Ism.Iw'rbaNa�auelagm+eebmpen w..l •sib ���
PLAN VIEW (NO Scald) 4.e 0 o-..ee......•
Parr w uwN mwrmro. I�.-0 B
(Vpk p IbY"/I
B- n
IbP�O
INSTALL PER TRENCH: EZ1203H &11dB
(boll
5 plan eudin®wre Eu "-2T nj
a 1 sn ewnl.s Ol zs re Elsw.w. 25 P
�P�opmsl ElBA grbwM. 725 n' RwulraEIMI1V P ,1071 P DlyblDu WMM:
a4 bantl ,PmIxWTa EISA=1100 W ErencBeBmOnif010
Installation Instructions for
�ir,.u_
EZ/tda„Systems in Wisconsin
�EZ�f
, 6
..........................................................................................
Wisconsin OepaNnent of Commerce, Safety Ford BOIlMrgs
5. The Abdul n(iroy svry for a given sled shall
ehas renewed Me actua lions end/w shot for This
be sled based on maumum daily sewagi(GPD) and
set end communed 4 N m in consist Mh cnapter5
Me PermeWmty for be Bile, If center, cM as me, Me
Comm V Through E4, Wisconsin Pdmin Cede, and Chapters
EIS4 sil can to peed m NhPF bouts in a 40%
145and 1 W Wumain stalwas At snm must make TomIIj$
smaller downed
a but Came mma 3I rc.en., a met-n docanas as mobol,
local regulations
5 Race EZflw ouni in Me EZAkr cmfigu ehn q'
ports b1 system design puma sposel for Me fibil -
The apposed products was 12 fih (31T bundles Mh died in
hr site The top or amber -mast funded containing pipe
center bundle in 5' or I Imgths) and 1QMHP(3-12' hurtles
are joined end N sd wth an interne pipe couplet My
wIM pipe in each bundle In 5' Or 10' kngMs
aadLmal aggregate only bundles that may be rrymrad
sowed to ended aganst Me other aggregalamnly bun -
A single ppe bundle corm as a lour mN perforzhd side sur-
des and do net require any W Of connector
rounded by EPS sigagale and is held together win per
Mtykne net" Acargo a9grtyate, WMe ¢roes eggnal
'! The top of estlr GEO ryfMer mows a fiMr fade pre -
only same, food together Mr, pabeMylme nerank
ma+ulMwN in buMttn Me hall and agarpte The
fats[ is rnoel W between sal rnwsm The mealy
Mwelas and Fqulpmem Nestled
5W make sure Me Me GET) i5 pmrdmed before anda
• Enfil punched
in emhct rAM Me fats[ antmned in Me mpmend Pan-
• Uri Centel "I Fabnc
der before buckfilLrg
• EZflow Internal Pipe Couplers
• Pipe for Header and Inlet
8, The Ull CraMWd Systems smouN be ndtd M In a
• Reckha/6unlo
uner tal in A daMkns tWM wrss and along her
bemrAbodan7 and or ldowtnecmlwoaf Ne9muM
Fawenm tmeuanan.
swan postal (unamrm deyM). rind a nominal
The mstmams for m allahm of EZnou preen as gems
adsol lo-fomt ryllnamca species EL[etl ma It and.
btlow This product must m estalkd in azasdance wth state
with cmuN bundle diem Wtlm Ppe enteewnnecb].
rules defined in cMplers Ceram 82 though B4, Wisansm Ate
witted any dams, sYepdoesi m onerwala stew
msuative Code, and Chapters 145 and 160, Wlsconer.5M1-
ute4 us prep as the bond health departments arrenl desgn
9. The tench to shall be thereof such that weRr all not
hal 1,
send. Backlpl should he seeded or nodded immediately
afln ca'np'ehm Is'Form vovon
I After Me It heats de{umnnl hod; deMmerN Ful
configuaal entl anyone for Me EZfisv systems, stake
10. EZIex EPS lynches we MJY and net fa in based
d mink with, pant Me lkagn of hndees and lines Be
4Mhed on; may be Federal OF aibis, ductless
veWl to For connect tank, even pre hater, Nine or has
oMn . options
fuom tnc end trench bottom planel before mtMl-
labw of pipe bundles
11, EPS aggregate b Ifightle than water. MCMwe. It might
ee expected Mat rectal Woyal fetes wool tend to
2 comae pul EZAow shipping begs poor N p'ecmg
cause EZAcw compiled to Mb ed M ground wfil
bundk5mlMtrench(es)Remweany plaztic bagsin Me
Pending awns. Feld wpensx has sham, hoseer,
fettle before system rs cohorea
that the rs For a pdesn stsn systems not a normal
d fie of sd coer as recpnmmMl by meNxWre.
3 This polai must M1art gwtexnle 1s[rc Mad meets rem
summers of s. Comm &.30 (6) (g). W Ado Code,
iodate dactly m top of she product and man ding
100311-OEO
tlwm alma to sides of Me pmauci to aselnt at least is
mums then Me bottom of product
H mMkJ
4 NTen [waked in e trend, the LnrA should M dug to
e o d M endn This sly ssres bM'n mom
lam
n. out also Miterm wonted Ioaa4,mnry mkry, ajt>
Too.
b ckil G amWHe
...... .__.
al
........................................................................................_
PW 6
In -ground Gravity Management Plan
The deal McInyround gn system Mall be responsible fix its deNshOl operation and maintenance purousnt to
requlranmb of SPS 382-38e, Ai Mmin Code Pursuant to SPS 383 Q (2), All Ad min CWe, this system shall
be tgtWweS a human neelm manor R opt melmeircd M wricim rce with me apprwM management Olen
Furfonnom, all lnaprom and maintenance ami illae shall be performed by a raplsteM POINTS Melntelnar in
a oommano wed SPS 38352 (3), Al Mmin Code
S%ximum D%penal Am Overal LMMS:
Dei Flaw= 750 gpd; BODs5220ml TSS515emgL"; FOG 530 MQL
Inspecthon Checklist INSPECT EVERY 3 YEARS
ype Huse
o age Otrygem
• fades Ala cows, use complain%. etc.)
• meorace lmalfuni(i a, pulps, vahea, entree, rate, etc)
omtlM& fatigue (I a. lase. break. WrtC>•on. Nc.)
Wilds vdvnam amid lreatmem tanxp)and any davoutmn eppunenancend p e. d randwom I drop Areas)
e nglecl or improper use ro a exceeding detign upacidespmhlbftW anises. arc I
e edam of Wndmg in dismWmm cOl poor to hang
n dalrgmegulames dapplicable (ta.. pump recycling. Most ei sidings etc)
oeleNicaA ¢mpOnenle-aapplinote(re mmg.Wnneri swdcnee. cmbde. bmev.alamne, eW)
dielnbuEm lalxd of lateral wtflu plypire (messure Lateral dulal presure-Con ere ro Mean WY.iMWdon)
in rol dAWhwge of celwm or Maage badmsmo ebuqure served
Maintenance CheckAbt MAINTAIN EVERY 3 YEARS (or "on necessary)
O Seodc and dse opol Mall be pumped by a cabled whole servlclrg operator Imeneed under s. 2810 War
Stals. whan Ile volume of enM In Me nnxp) sensors onaUAN (1n) Me Alould volume of tM foods) or
as rapeed, by, boat adrvcer Dispmal of contents mull be pssuanl b NR 113, Wes; Adorn. Code.
o EMumt IIters Mall bemsdoll gwya years and shall be GeanM~ nenswery to mmcve airy
axumNelof WNds xcaminp IomanNxYurMs apxifrcauons. A aervigry paint will9waye be greats Cum i]
mwNns
Sysbm mslnferurwe rpprM shall lessuMnlasd tothe properbul pwemman unN In ersaNenovMh
SPS 383.55 W%c. Admin Coda Report arty cmnpanaM hours or malluncNonon
Name oflMNldual w cdmpary John Schmitt Phow 715-760-0486
I.oral pwemmem and St. Croix County Community Developement ghee 715-386-4680
LoaAtwermnmtpnM eaerssa 1101 Cammchael Road, Hudson, WI zip. 54016
My daketalve pan of Mb system 4ull be hade ircQ replaced, or removed pursuant to SPS MG 51(1), Wac, Mmin
Code. Re}uv Or replarsmeM of isle maXumilonYg mnportnh Mail Comply wed SPS W, NNo Mil Code
No pmducl for chanlol or physical restwatlon of the PGNTS may be used miss approved by Me department In
bxoNance with SPS 3M Wen: Adman Code
In Me areal that any tiled treatment Wri mnMt of Mlle Pi moll be repsed. M shall be regal pursuant to
a plan submitted to the appropriate agency for review and rotational A %Ilea Inlmund dlepersl cmnponent mry be
abandoned and winded by a Coasmmplying dispersal cwnponent In a pine-0Nammed am M suitable al
Sys%m AttaMpnmen[
If use of this POPS is dismntlnred, It shall be abandoned In acconni with SPS 383.33, Wsd. Mmin. Code
Page 7
ST. C RUIN COUNTY
SEPTIC TASK ki I: NANCIr AGREEMENT
1ND
0%ri I I P ( I RE IH(A IION IORM
Ddner,Buyer_LT
Mailing Addrc,r 4E'=,IG hl <h��t{✓,J�CL�'�.il.d. �5:>, I'1{.(nIE. Yttj.
1'mpcn, Aakdol 718 McCutcheon Road dl 9NrlE'
I\eril rrymMfmm%an nyt/nr Mmem eIXnIll.n mn.
Hudson, WI Panel ldennr arena Sta r 020-1021-10-100
LEGAL DESCRIPTION
Propt location NW,. NW �A.1 14 129 NR 19A Endo or Hudson
luMLu.ion Plel _ — Inl b 1
('errilled Dunn M4PM _._.__ ballume____,_ Pink
Wurrvnh Deed M._ iFelare2(N17I\plume Page
pea lt11kol n I I Lon Wenu(Wle Oanl]w
STNTE.M MAINIENANCE AND OWNER CERTIFICATION
linpriki and III Aas ¢pw euld re la prcmn m faJ un to lanJlea Pi
.I pm pm A ounM1c"All drd 11dl pore PIII n ul link
e)"tthe ILm I'IIN sspuaInto na in Tire eJdpt..I, Cmmnlannea
ncary
... IN....naryalieJ mit%}Et Sry ll aN Ilk( M1ndo 11 � 11 t meal4 map Ordmanu
The, pook,.rtie, union I, al4raI nned/nnmr lkpnnae
anem s ndioon. "I'm nngmf eae
o" too And bi aric plumbuumhrnBred Fnwi plfloret o Inert romper mfi mu Ilan l l l IIInn+ne
d a,pin uu kirk ,ii1�m III or afar - I maavvn naM Wmpnpufmutup l the real III, it
In, limn l T full of All
I xe Iba undmrynod Ill rud I11C Erna wllun mrnu And A$rare to ..null All it range Aiarywl... or And ILe
udol or fin Lertm morelb)in' llCMnmull of Sn411\kk'mluuoml Sm'ian nod In, fail of Nandi Rnondir
red, o1Nlss ImPILm Well, mlua Feu iN ma re elpleled and of mtlm 4 Cma
('a oPlmo ah/onntoI)imamx ,[he II did u l ll J......A noon aW
xeCmoR lMl allamCOl Ind fwmne ma,lmLC It al mpnnmkJSC u1\IxC ammlh.m m`X9nnle
pogo) Jinni iron In smut of/ nn died m..vdeJ on Remnn of Ikeda I ail
\umber of bedrm 5
51 IRI DF APPLIC ANTIS � - DATE
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