Loading...
HomeMy WebLinkAbout026-1121-15-000Wsconsin Department of Commerce PRIVATE SEWAGE SYSTEM i..my. St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 615423 GENERAL INFORMATION State Plan ID No Personal information you provide may be used for secondary purposes (Pnvacy Law, s.15.04 (1)(ni Permit Holder's NameCity Village Township Parcel Tax No: Oevering Homes I TOWN OF RICHMOND 026-1121-15-000 CST BM Elev: Insp. BM Elev: BM Description Section/Town/Range/Map No: 4A. / T _ _ 1 05.30.18.730 INFORMATION TYPE MANUFACTW CAPACITY Septic J Dosing O 1 � Holding TANK SETBACK INFORMATION TANKTO /L OI WELL BLDG. em Air intake ROAD Septic Zc ( 1 ZOI Dosing �J �•V 7 37 Aeration Holding PUMP/SIPHON INFORMATION qV remain (Length IDia.Z Iuis1. rovven ,y„ 5L n AM0^M0TI^kI CVCTCIIa\I CVCTCMI '��SS/L ELEVATION DATA STATION BS COA HI I W .'i FS ELEV. i cx� Benchmark . , I, 7 10 10 o AIL BM Bldg. Sewer G , L A rq • Jt7 SUM Inlet '78 77 b o SVHt Outlet ` Dt Inlet ` Dt Bottom Header/Man. 3. JS ItDL Dist. Pipe ' 5 D Bot. System ,J 7 Final Grade SICrl;�el1 ? �> Z•%g 16Z. Costa out IAL. 2 — n --7? = tn7. Sfi BEDRRENCH Width ^ t Length G PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS LVC '5 1 _J SETBACK SYSTEM TO P/L IV JBLDG JVVELL LA El EA EACH G M of lure C AMB R O INFORMATION Type Of System Z: T x IT odel ber'. 7h0vn rM10T0101 IYl^IJ CVCTCaa Header/Manifold �.)1 —7 ,• J G Distribution ` 1 Pipe(s) Z' "' x Hole Size s / x Hole Spacings L Van�)!rp� Air In ke ! Length Dia Length Dia -Spacing enii ! nllco - RA --A ^l rinlu r Depth Over 'I Depth Over ru Depth of xx Seeded/Sodded Bed/Trench Center Bed/Trench Edges Topsoil OK,Yes ❑ No Yes J No 41K e COMMENTS: (Include code discrepencies, persons present, etc.) Location: 1710 107TH ST 1.) Alt BM Description - 2.) Bldg sewer length = Z� -amount of cover= ,;,/is'I Cri _nn Plan revision Required? E Yes bN o �c.5a -7 Use other side for additional information. Date SBD-6710 (R.3/97) 1^,� 1 UZ Inspection#1: /Z /3 !Q Inspection#2: 6-L6 Jsz) 4, * Comtty 44 ZZ 4 Safety and Buildings Dhds'lon ` SeaitarY Permit Number (m be sited in by Co.) '- r tt 201 W. on Ave,,P.O. Box 7162 Washington Madibon, WI 53707-7162 15,f Z 3 A8ermi Appliqatio Seats Transaction Number b 1 �i � /3 / in accmdma wit SPS 38321a),. Wis. Aden. �qde, sub ion of this foam to the approp att gwamnenta Project Address (if diSetwt than mailing address) is requited pnor m obtaining a sanirmypermiL i� on forms fx statcowned POWTS are submitted m Poe Department of Safety and Professioml al taforotation you provide be used for sewmdery momoses in aaada er, with the Law, s. 15.04(1 m Stats. ` ! L A Nation Information— Please Print All Information Property Owner's Name C^e0(I �., PnW * Qa6—nab- Is-000 Property Owners Mailing AdNus A Prnpeny Locraon 0S. 30. (4 77 36 C ySauon City. State ZaP Code Phone Numbery„ e,� 21 , 5 ( k T N; R W ELType of Braiding (check all that aPPIY) � � A �— Subdivision Name iCi 1Famdyl)welliog-Number of Bedrooms i' a // b�C �, �� Bl«k ❑PublidCoannccial—Describe Use — I� O r-- of ❑Stone Owned —Desmbe Use / ) CSM Vtllegs of J❑City Number v X G 7 J �r i� Tower of 1U. eck only one box on line A. Complete line B if applicable) IfM System Replacement Sysem ❑ TroamenUHolding Tank Replacement Only 0 Other Moddicanm re Existing System (explain) B_ o Permit Renewai o Permit Revision ❑ Chmge of Plumber ❑ Permit Traottato New latt previous Pamir Number and tram ksntd He M Expiration Owner IV. Type ofPOWTS 'ComponenNDeviced ✓ i ACIV r ❑ Nun-Pressmiud la -Ground ❑ Pressurized Inliround ❑ At oaod> 24 m. of suitable soil c and <24 io. dsuitahle soil ' ❑ Holding Tack ❑ Other Dispersal Cnmpoomt (explain) Prebemnent Dever (explain) t V. Diu Vfrea rot Ara Inform do . Das (gpd) Desip S� Appli" Ryte(pdsi) ft Dispersal Area Req ' ( Dis ^ Pr ( S El ! f �t,�v I2� 1Z c� 1, VL Tank Into Capacity in Gallons Total Cmiloas 4of Umts Mmufacnuer y Cp � /` L�. �f • i � .Y 2 N ' ."i rn � i L 0 m G Naw iavks Ezisuogiarb Septic or Holdirx Tads J'� - lbsmg Cbmber VII. Respole ib'Rty Staten t- L the undersigned, as4e responsibility for installation of the PORTS shown on the attached plans. 's Name (Prim) Plan ipaome M AAM Number Business Phone N ut� Phimber's Address (Street, Cry Statc, Zip Code VIM ComovADeloartment Use Oder Approved Pamh LFFasec S Gw •� Issued i C, S �5 f Issuine iven Reason for Denial IX Cond" uprove] 1.tsitse9p t iiiWet::;a cr8 t:wnn tali be sM•.teas,l+7r- - t f rA dA �nswa�OaJ••• k1♦+ah_ as per;ryrayerrun!plan p.-odam bypltanbe!. 2. Ail eelbw* lreq.Ovnem,% mud ue N per#VPk 16h C1301 I cKinala". 0 /Ci Attar w ..Pr pun for me ssrem ave M-Ir ra roe I-snq ows ea papa um ,a> 11.j �L Lel�_ SBD-6398 (IC 11,11) esr"r V✓� �'Rse jw * .t_. s> �n a� s � L_ :A- ��ra PROJECT Oeverino Homes System PLOT PLAN ADDRESS 1433 Cemohous Ave Suite A New Richmond Wi 54017 SW 1/4 SE 1/4S 5 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROD( SYSTEM ELEVATION 101.8' DATE 7/1/19 BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND )00( SEPTIC TANK SIZE 1000 gallons LEFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL .H.R.P. same as benchmark 101, Property Line Brl B.M.'100. 100, 2% Slope B-3 Property Line Area 15' below system is to remain undisturbed Grading is to be done to divert run-off away from system RIWOM Pro 3 Bedroom House Huffcutt Combo Tank 0' 40' 80, Well is to meet all WDNR setbacks Scale = 11/4" = 10, 107th St. August 6,2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2021-08-06 Plan Review: PWTS-081901317-C SHAUN R BIRD 1432 120th St New Richmond WI54017 SITE: Oevering Homes 1710 107th st. Saint Croix Richmond FOR: Object Type Object Type Descriodoe: 450 GPD Maitenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.v i.govfpmgmmslindustry-services wwwmisconsin.gov Tony Even - Governor Dawn Crlm -Secretary Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01/01, R 10/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-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 the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.01/01). • The pressure network is to be constructed in accordance with publications SBD-10706-P(N01/01) "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 ST-SAS (01/81)" 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 constructionrinstallation/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 stats 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, / W r Matthew Allen Janzen Wastewater Specialist, Division of Industry Services (715)340-0407 m atthe w.j anze n Ri- w i. eov Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Cover Page Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Date: 6/28/19 Owner:Oevering Homes Location: SW1/4 SE1/4 S5 T30N,R18W 1710 107th St. Richmond Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specifications and cross section 8-9. Maintance and contingency plan Attachments: soil test n Shaun Bird Signature License number Page 1 of 9 PROJECT Oeverino Homes System PLOT PLAN ADDRESS 1433 Cernohous Ave Suite A New Richmond WI 54017 SW 1/4 SE 1/4S 5 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 101.8' DATE7/1119 BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE: DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none Ilk BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION loo' Filter Lifetime Filter ❑ BOREHOLE O WELL +f1. R,P. same as benchmark 101' Property Line Bc1 (B.M.•100. 100, 2% Slope B-3 Property Line Area 15' below system is to remain undisturbed Grading is to be done to divert run-off away from system 0_RM Pro 3 Bedroom House Huffcutt Combo Tank 0' 40' 80' Well is to meet all WDNR setbacks Scale = 1 /4" = 10' 0+5 107th St. I Mound System Cross Section and Plan View t?,.-----,------------------- --- - - - - -- i Topsoil Ej = ASTM C-33 = Clean aggregate Cap Material sand fill /z to 2 '/z in. dia. Gco . e Fabric6mrs t - ,—Ht-— F /Og Ft Contour E Slope Direction O= 4 in. sch. 40 pvc observation pipe /J� 8 Ft GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x V) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a'/. inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/07lgj Page e�) ofl�_ Pressure Lateral Layout Two Laterals -- End Manifold Man rvl�u rvinw n Z�? � r• � -�' e� a tit ,r (!,�t,�f r� ,/�"�� Distribution Netwdrk Specifications Lateral Diameter Z In. In. 3 jr join. oZ In. Ft. Ft. T_ In. Manifold Diameter Orifice Diameter X Orifice S acin L (Lateral Len M old Len Force Main Diameter Force Main Length 03l05 lgi 7 ded out ig Sweep 90 Bend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral tam -ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. •• • • • Grade 000*00 6-8 Inch Lawn Sprinkler Valve Box Page V of5 Septic -Dose Tank Cross Section And Pump Performance Specifications -1MG�,� Filter Mantrfteturer Filtor Model Number r Minimum Pump Performance Required J D GPIvL Q 1 /S �, Ft TDH G Inlet Outlet Manhole lain. 4" Above Grade With Looking Device. Inlet Manhole < 6" Below Gr'ac% Sealed Watertight Switch s and ]reserve Capacity Tank Volume = S GPI Dimension.: Inches Volume Gal. (reserve) A' o2Y, s 3 6 alarm B : 2 3 (dose) C ! S (dead) D 3 Total jq7, O r u . ,.:. ... tli qy f1j- � Total Dynamic Head (TDH) - Feet Elevation Head Distal Pressure 3• c� Network Loss Force Main Loss Total Manhole Min. 4" Above Grade Bottom Elevation &/s F1 GENERAL INSTAU ATION: The sel t"'dose tank is bedded and back filled in accordance with the manufacdnees product approval specifications. Maximum depth of bury as, spedW by the manufacturer may not to have an effective locking device (padlock) be exceeded without prior 4PPr'oval. Manhole coves exposed grade fnd installed. piping at the inlet and outlet is of approved maietW, corm to to the taiilc with watertight ngs, and laid on stable soil to prevent settling or sagging. The force main is sleeved with V Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical servi lies with NEC 300 and Comm 16.2tt. 02105 LI Page S Of/ - 280-SERIES 112 hp Submersible Effluent(Sump Pumps The Liberty 280-Series provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. Designed around Liberty's unique "Uni-Body" casting, the 280-Series will provide years of reliable performance. All Models Feature. " Vortex style impeller permitting passage of solids upto%" • 416 stainless steel rotor shaft " Permanently lubricated upper and lower bail bearing • Epoxy powder coat finish • All fasteners -corrosion -resistant stainless steel • 1 y." Discharge • Stainless steel bottom screen -easily removable • Maximum fluid temperature: 140'F. 280-Series Cord Lengths Model 10, 25'(-2) 35'(S) 501(-5) 280 Standard Optional Optional Optional 261 Standard Optional Optional Optional 283 Standard Optional Optional WA 287 Standard Optional WA WA 10' cad length standard on all models. For optional lengths, add "-2, -3 a-6" suffix to model number. Example: fa model 280 with 35' cad, order 280-3 Motor Spec cations '/. hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (115V) 4.0 amps (20 1230V) Performance iiufY@: 28ii-$@/17@9 ........................ /u■■■.m■■■■■■■■■■/ snow ............................ Me I t U.S. Gallons Per Minute 38 78 114 156 192 228 270 Uters Per Minute Dimensional Data: Weight: 29 lbs. Height:13" Major Width:10" (model 287) Minimum Sump Diameters. Model 281, 283... 14" Model 287 VMF... 10' Factory switch Model 281,283 Model 287 snin s VMF Turn on level 13" 9.5" Tum off level 7" 4.0" The Model 283 features a fully adjustable widrsngle Boat Dlaerendal adjustments can be made eastty by tethering the lloW to the dis- charge pipe or otter mounting point vertical float model 287 is not adjustable. c J 'If e- r Model 280 Model 281 Model 283 IWide ai with quick- with series li�no switch float switch float switch disconnect -plug C us -e • I Model 287 VMF-Series Vertical mag- netic float for smaller pits - will operate in a 10" diameter sump Uberly Pumps • 7000 Apple Tree Avenue " Bergen, New York 14416 • Phone 800-543-2550 Fax XW) 494-1839 www.liberWpumpr.com C0VA to Lmerty RMV%eID.2M7 Aed"mewwd. Lur20D0FMn7 4 0 0 4 a A POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ,of �...........�.,..r SYSTEM SPECIFICATIONS FILL nVrvramaa t lull — — — -- Owner Septic Tank Capacity ZL7Er0 al ❑ NA Permit # USeptic Tank Manufacturer DESIGN PARAMETERS Effluent Filter Manufacturer i) r `gyp NA Number of Bedrooms 3 ' O NA Effluent Filter Model ❑ NA Number of Commercial Units Pump Tank Capacity 630 al O NA Estimated flow (average) j(77p gayday Pump Tank Manufacturer NA Design now (pgak), (Estimated x 1.5) UAaf/day Pump Manufacturer ❑ NA Sol Application Rate r /fl ayd ' Pump Model Z L7 ❑ NA Influent/Effluent Quality Monthly average* Pretreatment Unit Fats, Oil & Grease (FOG) 530 mgfL O Sand/Gnivel Filer ❑ Peat Filter Biochemical Oxygen Demand (BOD,) g20 mg/L O Mechanical Aeration ❑ Disinfection ❑ Wetland ❑ Other. Total Suspended Solids (TSS) 5150 /L Manufacturer Pretreated Effluent Quality NA Monthly average— Dispersal Gen(s) Biochemical Oxygen Demand (BOD,) 530 mg/L ❑ In -ground (gravity) ❑ In -ground (pressurized) Total Suspended Solids (TSS,) !�30 mg/L ❑ At -grade ound Fecal Cotiforn (geometric mean) 510' Cfu/10om1 ❑ D ine ❑ O er, Maximum Effluent Particle Size a inch diameter Vaues typlal for dome:tic (^ FCIM wastewater end Values typical for pretreated wastewater. MAINTENANCESCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 3 O month ear(s) (Maximum 3 yra.) Pump out contents of tank(s) When combined sludge and scum equals one-third (y,) of tank volume Inspect dispersal cell(s) At least once every J ❑ mon earls) (Maximum 3 yrs.) Clean effluent fifter At least once every /, ❑ months ;s�ear(s) Inspect pump, pump controls & alarm At least once every 3 O month ear(s) ❑ NA Flush laterals and pressure test At least once every ❑ month earls) ❑ NA At least once every ❑ months ❑ year(s) P NA curer. At least once every ❑ months ❑ yean(s) NA MAINTENANCE INSTRUCTIONS t Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintahter; Septage Servicing Operator. Tank inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware. Identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent On the ground surface may indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechjlnical or pressurized POWTS components, pretreatfinent components, and any other maintenance or monitoring at iriervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event - START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high conceqtrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Pape _ of _. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thclt may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are delected have the contents of the tank(s) removed by a septege servicing operator prior to use. System start up shall not occur when soil condlgone are frozen at the Infiltrative surface. During power outages pump tanks may fill above normal hlghwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose, overloading the cells) 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 tlye 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 not drive or park vehicles over tanks and dispersal cells. Do not drive or perk 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 Ice of ft POWTB: 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; herbioldea; meat scraps; medications; oil; painting produc*; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to Insure that the system Is propery and safety abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property 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 Reed with soil. gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code complaprt replacement system: ❑ A suitable replacement area has been evaluated and may be utillzed for the location of a replacement soil absorption system. 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 lines and wells. Failure to protect 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 ruled in effect at that time. ❑ A sukeble replacement area is not available due to setback end/or sop limitations. Barring advances In POWTS technology a holding tank may be installed as a last resod to replace the felled POWTS. —X--Zhe site has not been evaluated to Identify a suitable replacement area. Upon (allure of the POWTS a son 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 Iasi resod to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomst at the Inflhralive Reconstructions of such systems must comply with the mice In effect at that time. <<WARNING>> 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 O� A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POMITS INSTALLER POWTS MAINTAINER Name 1�, Name �Fj/ et 1 Phone %)S — Phone SEPTAGE SERWCING OPERATOR P MPER,), LOCAL REGULATORY AUTHORITY Name Name _ Phone 7�,r Phone This document document was drafted in oempllanos with chapter SPa 383.22(2)(bX1)(d),(ft and 383.84(1), (2) 9 (3), Wisconsin AdinlnNhshe Cede. Wisconsin Department of Commerca SOIL EVALUATION REPORT Page __of_ DMsIon of Safety and Buildings Attach complete site plan on paper not leas than 6112 x 11 Inches In size. Plan must include, but not Gmlted to: vertical and horizontal reference point IBM), direction and percent elope, scale or dimensions, noM arrow, and location and distance to nearest road. Please print all Information. Pareanam' fM I Yon You ero,"ae mry M ua<d la rsweMe7 mxxamaet (Prt.aoy law, r. ta.et (m) (m)). Paioel I.D. Reviewed by Date Pmaperly 0vrter \ Property Location Gov. Lot sLj 114 SgiA S T 30 N R I g E( W Pmpaty OMW 3�/C/ d « Block « ar CSM« /) ZALAlf aty��77 c State p Code Number {c.r ) C'. ❑ Rage T Roa IC) Construction U P. Rasidendal / Number of bedrooms Code derived design flow rate Y�ii GPO ❑ Replacemnenl �" (�►/,5 P blic or commercial - Describe: ___ __ Parent material cos Y$a�J Flood Plain Nevabon If appliceble N l� ---- 1L General comments and recommendations System Type rn A wi d System Elevation�� �w SaNy « ❑ Being 2 Pit Ground surface slave It. Depth b limiting tailor 3 in. Sol Application Rate Horbw Depth In. Dorrnant Color Muresl Redox Description Qu. Sz. Cont. Cow Texture Structure Gr. Sz. Sh. Consistence Boundary Roots PDW 'Eff«1 'Elf«2 5 ems— Z -3aIou,— C i Bdrkg « Boring Z '''r '7 p ig—pit Ground surface elev.1DI (Ih. Depth to t miting factor _� in. Soo ApplIcssilion Rate Hodxon Depth In. Dominant Color Munsel Redox Description Qu. Sz. Cont. Color Texture Structure or. Sz. Sh. Consistence Boundary Roots GPDRf 'Eff«7 I 'Eff«2 0-11 e c�J i ' Maim in • 5W. > 30 < 220 MWL and TSSMA 150 mglL ' Effluent RL a BOD, < 30 mgk and I ati < 30 MWL CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird �"�^ 226900 Address Date Evaluation Conducted Tebphons Number 1432 120th St, New Richmond, WI Vol t,<-3p -� 9 715-246-4516 Prope tyOwner- ® Boorg# Parcel ID N Page —d_ ❑ Boring ®-Plt Ground surface alev/w✓ V ' Depth b ti r&V factor Z in. Rate ■�3�r7MWF1F RMI „� © "— ■ril �I� rap ��� MMMWWi 7TrIA�rnN=WT .COMMA✓ �rr� ❑ ° ° Ei°° ❑ Pit Grouts surface elev. R. Depth to IiriUng fadar in. Sea MOarJtlon Rafe Effluent pt - BOD, > 30 < 220 mgtl. arts TSS >30 1150 trot . Effluent e2 = SOD,_ 30 mgrL and TSS 130 mWL 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 TIY 608-264-8777. Soil Test Plot Plan Project Name Oevering Homes Shau Address 1433 Cemohous Ave Suite A New Richmond Wi 54017 Lot 15 SW 1/4SE Subdivision Partridge Run #226900 19 1/4S 5 T 3� N/R18 W Township Richmond 0 Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft. System Elevation 101.8' County ST. CROIX Top of survey iron • H R pSame as Benchmark ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address_/ Property Addrm4 (Verification required from Planning & Zoning Department for City/State LEGAL DESCRIPTION Property Location,/z� r/a Subdivision R, r � b 1 V `l 4Q, St - Parcel Identification Number Q 40 /21— 6-000 '/, , Sec.,, T 3 GIN R-AW, Certified Survey Map # Warranty Deed # ' �`'/ Spec house/_/no Town of C Volume Page # _ _, Volume Page # Lot lines identifiab IK ye no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 §Comm. 83.52(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(l) 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 requirernents and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce 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 form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a w 1amy deed recorded in Register of Deeds Office. Number of bedrooms J 0 IGNA T LFtVUFFAPPLICANT(S) O /. 5 / DATE/ ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning At Zoning Department_ *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey snap if reference is made in the warranty deed, (REV. 0tt/05) ACRES a �' N89'S5'31"E 2 0.20' ! 1 I I N _._._._._.� t I I 1 w 7 Sq. FL o L._._._._._I n�O I 1 1 1$ L 1 : 22tr 0 1 I '1 a[-0,lc� Im a 1.032 ACRES ♦ ♦• m 1-004 ACRES I I I 44,967 SQ. FT. 43,714 SW FT. `1 i I I S89'55'31"W 243.60' C y 9: N89'55'31"E 280.20' I I a. 15 i N o ; c♦ 1.009 ACRES • ! M N ! 23 o, 43,948 SQ. FT.' II N I e a 1.061 ACRES N69 r W w 3! : N W 3 / 46',217 SQ. FT. 10 6'1�•. I 1.025 ACRES "o -Opp W Z cc N N 44.$66 SQ. FT. rn S89'55'31"W 204.54' 1 I p p I SEPTIC SYSTWIS'i 1 N z i L50, EASEMENT I0ON r'-----'-:_i = ----------- 1n TO LOT 10 1 -R I ~ I N89'55 31 E 0.20 O ! S89'5 31 "W 246.53' C 2 1 0 m I I I q L.---------1 it I: P I .......... 1 1.047 ACRES o 0 14 ; 24 I 45,612 SQ. FT. 0 N n rl I _ 1.034 ACRES : 1.005 ACRES I 45,033 SO. FT.: 1 I ; 43,789 SO. FT. 89'55'31"E 204.54' N8955'31"E 26b.20' ! 589'55'31"W 249.38' I N 1 1 1 I 13---loo' I ! too'--• L 1 i 25 '♦ ^ 1.038 ACRES: ♦- �A 1.013 ACRES n 45,210 SQ. Fk. 1.015 ACRES ;`> 44,124 SQ. FT, 1 44,221 SQ. FT. ♦ �ptp o6 1 1 40 3 S89'55'31 "W 260.20' ! I ! f ____ 1 _______ J ® O N 1 16i it FT ijya�jl'I`I O 7 1 ry u i O q�rRa ww� _IRWI9VY Y� • �� y{]) ws ima�]y{a 'si !g �____ I __ __L__- I I I I I I I 1 I I 1 I I lase so. vr. 0D ©D ©m WMA -------------------------- ------------- 1 I ' I I ' ------------- 1 ' i ------------------ i f�l I wll I 1 •11 i (I L ; , m ' ________ am a1 rn 0 JUL 01 2019 I C- Wisconsin seBunCommerceOIL itVALLI REPOR • Page _of_ Wisconsin Department o1 C Idings ,. mvaxxorwnw vnu uxrmr ate, vria. nuns. k.uue C.._ ��;, n-...�. Attach complete site plan on paper not ess inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest mad. Please print all information. Panonal infomratmn you I=a may be used fm secondary purposes (Pnvacy Law. s. 15,04 (1) (m)). Canty L Parcel I.D. o Zoo Z� ^ �J _C•-� Re ' by Date $ /� Properly Owner O Property Location Govt.LotSG� 1/ 5C1! S T 3v N R g E( W Property Owners Mailing Addr 3 of # Block # or CSM# 4 C-/1 .r City j] r Staate/ Zip Code Plione Number ' ❑ Nillarest Road OWWConstruction Us Residential l Number of bedrooms _ Code derived design flow rate Y»D _ GPD ❑ Replacement P blic or commercial - Describe: Parent material c7& Flood Plain elevation if applicable General comments rJ ` and recommendations: �i G System Type ! r l fZ�i.(, System Elevation /0 1, O , t ❑ Bowing Ill Bong # g pit Ground surface elev/0// 0 ft. Depth to Whiting factor V in. Soil Application Rate Horimn Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDRf 'Eff#1 'Eff#2 q Z- --30 — C L.r Boring # Boris tik-pit Ground surface elev./O'��[L��. Depth to limiting factor L in. Soil Application Rate Horizon Depth in. Dominant Color Mknsell Redox Description Ou. Sz. Cons Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDMf 'Eff#1 'Eff#2 c.t.J l .��Z. EMue it #1 = BOD. > 30 < 220 mWL and TSS _ 150 nglL ' Effluent #2 = BOD. < 30 mglL and TSS < 30 m g/L CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird �1 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 017 �j -30—/9 715-246-4516 Property Owner Parcel ID # Page —of — ■ Depth 'Effluent #1 = BOD, > 30 < 220 mg+L and TSS >30 :! 150 mglL 'Effluent #2 = BOO, < 30 mg& and TSS < 30 mglL 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. SBQ93"(RbV ) Property Owner Parcel ID # Page _ of Effluent #1 = BOO, > 30 1220 mg1L and TSS >30 < 150 mgfL ' Effluent #2 = BOO, 130 ff9t and TSS < 30 mgk 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. sao-uw(c ) Soil Test Plot Plan Project Name Oevering Homes Shau. Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 Lot 15 S W 1/4 SE Subdivision Partridge Run p #226900 19 _1/4S 5 T 30 N/R18 W Township Richmond Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft. System Elevation 101.8' County ST. CROIX Top of survey iron . H R PSame as Benchmark