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• PRIVATE SEWAGE SYSTEM St Croix
INSPECTION REPORT Pen•ry e•�•x•
GENERAL INFORMATION ATTACH TO PERMIT) pl°mo H. 817701
wE PANYLP1 vr[M [pM11
Bm 8Rebecca Davidson cp an.x
N•TOWNeOF HAMMOND c ° 018-1090-51-100
IRIA11cOmect Mi
16.29,17 716A
TANK INFORMATION Z ELEVATION DATA
TYPE
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Conventional POWTS Index & Title Sheet
Protect Name. QY/OISow-13yeolroo➢ro nwa/G' ivltiu-I SP�Sa'ljl�Gl`
OwnorsNamc I3rµ CC. yYF,CTV �4V/ SOP" ferl.
owner aaaly.:: 96/ 17670j 5}. f%amMor7 �/ sYols
Site address. c✓✓t C.
Project friction
Subdivision: CSM al, (//-
Legal odoriaion: S,J% // j
Panel n a: I logo-V- roo
Page 1 Index and Title Sheet
Page site Plan
Pond Dispersal Cell Sizing Calculations
Paget Dual 7lCeltkros pi0k
lufavaler"Q-4" Chanber$TedlteatlVLLa
Page n Septic Tank Crt Section
Page8 PILSystem PLgem"t525 Planent P{Iler Cross Section
Page8 System MarTank
Plan
Paget CanaTenk or UtiItilvegu Agreement
pagepagelo rental Mico for Uti5wli0n of PxituaSeplic yank
page II Werra Map
page 12 Warranty Deed
Attached Soil Evaluation Report
Maser Plumber_
Dale Hua/sac. MP
Credential T220853
Signori ;C .e
�i
Lr
/L/( �
Date'. —tI
Page10[12
Lolga pmaaam to In Gr Sail nhmmrian Compmim,M..W Cr 40WRnmbn34 Sp0.1WD9P(Polar)
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Davidson 3 Bedroom Dispersal Cell Shinn Calculations
1, (3 bedrai100 gallons enua ated flow)(1.5 fee I go sector) — 4500e UN des en Oow
2.Infinitive capacig of native mil-0044gonigg it
3. Absorytion arcs required 112500 soft
4_ Absorption area as propowl
Infliction "Quick4"-2(00sgR. PISApercbambec Infilan "Quick4"endwps-520sgR,GISA.peir
1, 125,00 sq. A—(3 pair endospsN520)-1,109.40sq fl.
1,10940 sq. P 20,00-55,47 chambers required
Numbuofthri 3(d 19 Chambers per "par (57 cbmnbers Won /
Trench wthib'. 283' ✓//
Trench length: 7900'
Tench spacing'. 900• on
Trial smm eam w 6trench spacing'. 21 Of's79Wte
Pg.3of12
Davld5o r
SOP lacemenI IN -GROUND DOSED -GRAVITY DISPERSAL AREA
Stepped Elevation Trenches with Quick4 Standard-W Chambers
Sy5fer 3-ft Trench (down -sizing credit)
'as
v' TYPICAL TRENCH
11 SOIL covea 1 CROSS SECTION VIEW
No Scale)
mI
Europe minimum 0 fl
Highest Trench Lowest Trel(as applicable) separation aeMeen Irantlies.
System Elevations=9650 ry; 9650
X.
95.50 ry. ry.
ry
cuµk6 Srandsrd-W
�itl'+�
r End Cap (Shaw location
of inlet mmlet pipe connector on plan viau-)
TYPICAL TRENCH
(nobw)
�m �nr.
ou< PLAN VIEW
No Scale)
(Itypii
eulckG Standard W Chamber
In
swi
w
INSTALL PER TRENCH.
Sara by i anyway 1")
O
19
3800
III
pmmanimm+nwcwmyainawaons
T
deal Ste-W@m W Eloismamcer-
fl=
to
+ 1 pairsoferq cal@6WEIS/iwir=
52
fl'
= Proposed EISA par trench=385_2
n' Required mutation Andy =1,125.0¢' Distribution Method:
x 3 trenches = Proposed Total EISA= 1, 155.6 ry= branched manifold
INFILTRATOR The QUICk4® Plus
water e,r.... I Standard Chamber
The omck4 Plus Standard chamber
oilers maximum strength through
Is two center structural columns.
This chamber can be installed In
a 36-ineM1-witle trenc„. Like the
original line of Ouick4 chambers,
it offers advanced contouring
capability with its Contour Swivel
Connection^ which permits turns
up to 15-degrsirs, your or left. It is
also available in four -foot lengths to
provide optimal local flexibility
The Ouick4 Plus All in -One 12
Endcap, and the West Periscope
are available with this chamber,
provision increased flexibility in
system configurations,
jow
Maximum Strength
(664 am x 1346 min x 305 mm)
Effil lunpth
48' (1219 mi
ma.er Neigm
e" ban rare)
Stearns Cape"
47 gal N8 LI
mdxnem
0.6" i15 ram), 5.3"f135 ram),
8.0"f203 min), 12 T' (a
min)
APPROVED in _
QuickG Plus Standard Chamber Benefits:
Two center structural columns offer increased stability and superior strength
Advanced reassuring connections
Latching mechanism mlows for quick Installation
Four -foot chamber lengths are easy to handle and install
Supports wheel loops of 16,000 Ibs/axle with 12" of cover
Bull Plus All -in -One 12 Endeap
Benefits:
• May be used at the and of chamber
row for an Inletioutlet or ban be
installed mld4rench
• Mid trench connection reduce allows
construction of chamber rows with
center feed as analrernative to
Imaging at the ends of camber rows
• Centerfeedconnection allows for
easy' Installation of serial distribution
systems
• Pipe connection options include
sides, ends or tap
OuickG Plus AII-in-One Periscope
Benefits:
Allows for raised Invert installations
* 180° presented lnletting
•12"rel Invert is ideal for serial
applications
cents by the Internal
A voodsn m Plumbing
antl Mechanical
1APcMal
! \
Oat wthan(\ /j
QUick4
OOIck4 Plus SUntlaN Chamber
I lot 0R, II e! It. 11 III OII��
—lV
(WI Plus All -in -One 12 Enu caP
PRIME dol
FRONT VIEW
puin Plus All -In -One Periscope
ar
ALL IN ONE I A H SCOPE
Con ""'"
]JO�4
SIDE VIEW
qy ELF Aro MP ELLea n e eµmmibcohyrod Veimm.ned m nSol or pram e
XFOALLOPPRIMIClocrairthrutchns :WE ImEary
mral
OF be UT
'HERE ARE NO PATE P SPACES of PATH �PF� MAP HER Ut Of DOW NO
SE d 4
of MAE of proyfuchoor me TONS Mor ALL mWer Col, off, or A coner MR. or
Able I e lot On If to I to or the An, or the Pop P,�F one In OLSON, NOW HNpNh
m'l
op�"
•//// mM For
the
or by Mae lend Ma Sol So It �'N�A NA, ALL Modayany �V�E nt�CME
NO by applem to any parry Of loan ME SWAS MOWN
NO BOX 71
INFILTRATOR. "."Itownser � mrONE in p
~gyp m "Made and, �M1. .ate ..�.
PDL 'D a ..
11525 Effluent Filter
PL-525 Filter
ThePL-525 Filter Is rated for lyfli GPo(gaionsperday)makinga
nme of the largest filters in isda+a. care
525 heathenish 1/16" filtration slats Like the fertile PCt]2,
the Polylok PL-525 has an antomanoshu[ off ball
nstalled with every fr er- When the site, is .,moved krtle
mirg, the ball will float up ma rampantly shutoff
the testat®r in the output won't move the pM.
Pram re..
06" Filtration Slats
• Rated for ID,Dbo GPD f,allonePat relay)
10,000 GPD kin.
y bM
• H5[Inca, feet of l/16' irtmebn
Are I PVC
•Attepss4 and 6"SC1[A at pipe
tnmvum Flmall
• Built In try dellecor.
• Automalicsem-tei ball, men filter'.. oempved.
• Ali, m....... Play
loomGlnt
• Accepts PVLeatemvn handle
.,As 1 uta l let,,,,
Ideal for residential and commercial wazk Flmvs up to
o� Le`.. c
I JD gallons per day(GPD).
Iderfenslmx
I music the inlet of the spur tank
IF o in, tank cover and trump tank ffcarbon e
3Give the .fit eering to the 4 or 6 outlet pipe if
Ipre
isp.iww�e
fiefueri mdumber _sq opmngeve
lerlyhok E,mind&Lot,orpie of pipe cvmeln.ar.
ra
ilnsut h fL L25 fille. into'its housing
Replace 1arm" Le'HAIL tank cover.
Coupled to
R
Po 25 at
TM1e PL5" 1 relent FFlren v411 upurae art ...emly for
ellyarsundo normalconditionsbefore requiring
..ea ... i It n rerananended that the fdtee be cleaned
.very time the conk w Dompi or at leas[ c,ci v [Flee
years It he, invmlled Idrer contains an 111 alarm,
the amno wd l be nml had by on alai he rvcan the filer
}•., a
Deals whicing. `-ervidngshnuld be done by a rertini
G [xn l
f
septic fork W taper oriooks,
Ancorroce
snn atom,:
]. mare the ,,flat of the septic Dark
2prepare tank cover andpump tank 4 y_
3. Don[ cona plumbing when filter d.
_
4Pll PL Sb-t'dg outfthe reasons;
5.Hose oft(1 r the septic tank. Make sure all '
voice fall bk" retire tank.
A Insert the filter mrttldge No kinto fee housing making
Surethe N er is pl'opnlY aligmd and completely I^TID'i
pievni norm
9. Replace and whole septic tank cover
mam.m mreal urh aw Aare into emona land
Politick Inc, 3Flat"ld Blvd. Walllnnutd, Cr P641 Toll Free,' F777659565 Fre 21I3189.8514 role, ralylokarm
Conventional Septic System Management Plan
Pursuant to SPS 383.54, Wis. Arm_ Cade
Genera
The conventional septic syswn sbnll be operated in accordance with $Ed N2384 W Is. Adm. Code, and shall be maintained
tiac
cordance an with Component manual SBD 10705-P To 01 ad1). All local and/or state Coles pertaining to fractionfractionamaintenancvntl maintenance rupeting shall he complied with Questions on the operation or maintenance of the system
should be directed to theimmlling plumber, Jim Thompson at(715)24&Tl67 or St Croix County Zoning placement at
IS 15)380-4680.
Septic Talk
Septic ink Smicing mechanics comply wit SPS39354(1
bottom of tank to be < 15' below service pad elevation. IT,
auresed at east once every too yews by inspection_ Tbest
the nick exceed l l3 to liquid volume of the tank. The cant
1 A, Wis. Atlm Coaa.by an mdr,idualceffie ces
not removed athe time ofa biannual assessment mvintonei
needed to maintain less than 113 scum and sludge awumula
ensure proper operation e filter cartridge should not be[
that Thmay sloegn of the filter when removed from itr endmsi
iwd ifte alarm d aetival6d. Seme tank manholes me
everyone d soundness. Access openings used for Service.
serv
ice. anAny opani ; deemed unsound defective, or same,
thandiam
No immoral
morn In should
eter ver hallenter
be secured to uns damonto
abandon eunl shoeld can mon danceepec tank as dungeons
abandonment he a di an of biological
al o wmmcal ac Wu
omlnentProdu The addition ,shallbeap approved
meptic achieve
Dta. peanma are need the, shall be aeproved ter septic
ow.Saw
.
tank lobe 1pWed with in 150' of service pad, with
when on If the septic tank and cut let filter shall by
nand; shall be removed when the sludge and scum In
day tank shall be disposed of In accordance with Nit
Coder c 281.43, Stets. If do contents of the tank ere
T shall advise the owner of when service will be
as The outlet filter shall be cleaned as necessary to
As provisions are made to retain scuds in me had
ust be replaced Faposed access openngs greater
to on,, an ammemm or nnayohai en can me the tank
be fic2em that Hoard cause death. Septic tank
when the tank is no longer used as oevIS
septic tank performance is geuually not required. If
Oepaor t of Commence, saky and Earnings
Soil Absorption Cell
Taus a, strobe dead not be planted directly came $oil absorption Sider- nfi area eboveandaroundtesyStemshou:9
be send¢d and mulched as nmmavtopresent o"g, and revive some degree of frost protection. Tfird(other than FOR
veguarve are" . aceJ ever the system is I. be avotoad Soil compaction may owner aeration of the tnfilmdve surface
wimm and our nesysen and call mai frost penetration during cola weather months. Coal weather ieta0v0ona
(October duch) di aa¢ thatin, so stem bear its invJG¢d for rust protection.
Influent quality into tberystem may not exceed 220kri 0O0.9, 150 MO/L TSS, and 30 mg/L TOO. Influent flow may not
excetl maximum design flow Specified in the pmnit for the candidtien.
Observation pipes within to dispersal cell mall be checked for eHbreat money Pending levels shall be hundrted to me
ownm_ ravels above 4 inches Indicate an Impending hydraulic failure volumma; additional, more frequent monlmMg
Con vPv
If the earn tank or any of'ns components become defective the lank or component shall be repaired or replaced to keep me
system in proper operating condition. Excess," pending within the d6persel cell will beeliminated by Installing a new soil
absorption cell to bring the system into proper opeating condition.
Pg8 of 12
w�varfaaye n
edema Addmo ` G 7 '�+
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LEGAL ()N
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SLbdiv w KNIS Is+ AAJI.uot# sl
Ce WSurvey Map# 64415Z Vole 8 pw# 48
Wt tyD # Volwie Pvae#
Spec bout ❑ ym)o no Lot G iCmti6ebla m(ym O no
symm usrNr A m
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mYe.e(wmWW am tln eepktivtewymm Y�Qavm.iroadM6y.IvmMP®Fa. Wlml)w ryl wo me eyFam
m� �� '<oarde epee not a.eamAwgvm Ae wum dLpoeetMmm
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pmpa�.n,pmmm..ma0).nam.Pmam.mP�^a(v�a).m...Paa mt#�m.o to mu arslmP..
Zhq m<�e=mwec e..n.m m.m.....immmu.m wm m ®n,um m. e.f..m �+s alwl m� «im ac.em.m:
uwau �.�� �mrmm�amunx mmP��me e�mm�saa.cmazeeme �r �'^'"
"warm. mRe a.pmdaoe.m. �e
mmunme DP AePu� DAM
QW RMte CA ON f mOOwm�(v)af
1 (wel vuarYlY<vll Ylmev Of& fmm monfi6emResm fau)tooaMiBo (we)w(w)
oGeM buThE dwe.61'vime o(v xm�miy dW mnAMu RaOau of Mdv Olive.
9 IA'OIBP OF APP 11OAIE
...... Ay of tim tlul 4 mlomPummnmy mill On meumulY pamnbeuYrtva4.dq'meZmlo6 .......
.. fatloav MW roY vPWwW¢ v.mPMovm.^q 4W 6m ma P.e®ncorDade O®w
•caul' Mmemd#MemeY mW IfeabamxY ®de W dv mmvly lml
ST. CROIX COUNTV 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) TF/ /76'& SV located
at 55LO 'd,d o, Section 16 jown�N, Range_ L7 W,
Town of -,(a &noo cl , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform toches quirements 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: us gallons Na minutes
Tank Capacity: A000 600 Cal
Construction: Prefab Concrete x Steel Other
Manufacturer (if known):
Age of Tank (if known): _
Permit number (if known)
Dale Hudson
(Licensed Plumber Signature)
(Print Name)
MP so 220853
(Title) (License Number) MP/MPRS
(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
r
%UVRTE SEWAGE SYSTEM St. daH
INSYECTIGN REPORT aMMSS 0
GP PAEUL.IINFpORMAVON IATTRCTTO PERMIT)
I nNs.mbubbotlrvwµs lPisyW.+6n I+Ntl.
� � iun.b 01StSMd11LW
G.Nlawo ero.. _ x.mmNna T..mm
TANK INFORMATION ELEVATION DATA
MM
mmmu"
SOILABSOHPTIOH SYSTEM � (JIL_�..fu/
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COMMENTS: IR ffixmbaeaRma®.prmnu N®.�N Vc,I Imro m.10IJa6" IVNdq+n`r _
LxYbn: MIIM NEW RIMINI IN SEAR" IN RE IM 16 MR RIM) PIru. N IS W 74 I PM Na 1NH17,714
IIra RMo®Mm.3T. Ca1HN Z�Nr/,aa1 VS.JI I,S(pgx..GGue TS&n
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P.n,.mwn R.N, s /0 2zs oz. —:71 L ON, NIL
_n 2,
tiles 6". 0.�
10 yxM tTuaPLa,. I
6dl 241%.9.
\ 3WW02 i
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1 IT lJ ?%F P
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scnlc S sf ctPA.
cua 14'4
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TAN" NAuurwTURCK
tee a[n or ooscs: s A 4i
TANK Gat: It' Lau '*K"OUs
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