HomeMy WebLinkAbout030-1019-60-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes IPnvacy Law, s.15.06 (1)(m)J.
Permit Holders Name: City Village Township
Gene and Heather Eike I TOWN OF SAINT JOSEPH
CST BM Elev: Insp. BM Elev: BM Description.
TANK INFORMATION IC,'-Acx r- 74a A—L-
TYPE
MAN FACT ER
CAP AACITY
Septic
Well
Dosing-756
Co
V
r ►
01 o S25
TANK SETBACIdINFORMATION 0 W14
TANK TO
PIL
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
85'
>50
53`
55N
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer
Demand
GPl
Model Number
�� 151
/
TDH
Lift V1
Frictio os
System Head
TD
r .I
u
Ft
Forcemain
Length 1
Dia. �t,
Dist to Well 1
SOIL ABSORPTION SYSTEM
BED/TRENCH Width I Lengtl+ �r I
DIMENSIONS '�^/ /L
SETBACK SYSTEM TO F
INFORMATION
SYSTEM
ELEVATION DATA
TATION
BS
HI
FS
ELEV.
Benchmark
O . O
I00'
DO. D
All. BI1C-}-p.pr
1
Bldg. Sewer
St/Ht Inlet
'15
.Ks
ti J D
SVHt Outlet
Dt Inlet
Dt Bottom
ead Man.
Dist. Pipe
%
► I
Bot. System Ij7kll!V AA f411 !I
-1
Final Grade
2.6
^
n
St Co
r
514
`1 yr 8
CHAMBER OR
UNIT
HeaderlMangold
2, !I
Length Dia
Diunbubon
plPe(s)
Length Dia Spacing
x Hole Size
x Hole Spacing
Vent to Air Intake
i t ends
SUIL GUVLK x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over ,
Bed7Trench Center ,1
Depth Over
Bed/Trench
Edges
\ n
JI / j1
xx Depth
Topsoil
of I
2rl
xx Seedetl/Sodded
xz Mulched
PI
COMMENTS: (Include code discrepencles, persons present, etc.) Inspection #1:51�9 r-70 Inspection #2:
Location: No Address Available _ // k� h, N �,� 4wJn ,,,� �r
1.) Alt BM Description = -f1 1-ter /CO ' Y` 'fin C bw S f*w A& I
2.) Bldg sewer length = IZpN C L IO)
- amount of cover = Govtr it ® It i-vN' I t1 Sri
Plan revision Required? ad tl? ❑Yes [n. No �^ 1\ j i
Use other side for additional information. dU ,_ IUI-
SBD-6710 (R.3/97) Date Insepctor SigrtaltuTre Cart. No.
sAN-a+iq -39y
41 %,
County
r ��,lJ D
�/
Industry Services Division
St Croix
Sanitary Permit Number (to be filled in by Co.)
s
L
1400 E Washington Ave
\ _
NOV 15 2019
P.O. Box 7162 a
Madison, wrl 537 j7162
l 77-70S
it Ir
Ilk
S;arritai snit Application
to Transl ction Number
In accordance with S ion of this form [ore appropn
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to
Project 4ddress (if differem than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Priv Law, s. 15. I m Stats.
^t Jew A %�'
1/`/ t /�/-d'�►
1. A lication Infor tt — Please Print All Information
Property Owner's Nam
Parcel # C— —
Gene Eike
030101960000
Property Owner's Mailing Address
Property Location Q
450 Rive Rd
,a
Govt Lot
SE yes, NW yes, Section 5
City, State Zip
Code Phone Numbs
Hudson WI
54016
T 29 N; R 19 W
11. Type of Building (check all that apply) ^ Lot #
Subdivision Name
®1 or 2 Family Dwelling- Number of Bedrooms 4 2
ak (yD Block#
❑Public/Commercial—Describe Use -
❑ City of
\_
`
CSM Number 2
[—]State Owned —Describe Use t/
❑ Village of
n,�ll—
®Towof St Joseph
n
iJ17 L a() 25
III. T : ( ec only one b x on line A. Complete line B if applicable)
® New System
❑ Replacement System
❑Treatment/Holding TankReplacement Only
[—]Other Modification to Existing System (explain)
B.
❑Permit Renews
Permit Revision
❑Change of Plumber
I_p'ermit Transferto New
List Previous Permit Number a Date Iss
Before Expiration
Owner
(at 770
IV tem/Com onent/Device: (Check that app51 ly)
Non -Pressurized In -Ground ❑Pressurized In -Ground Unt-Grade ❑Molmd > 24 inLI----o11f__suitable sod ❑Mound < 24 m. of suitable soil
nmftwftwj�Disperse! Component (explain) L p-beatment Device (explain)
V. Dis rsal/Trea ent Area Information:
Design Flow (gpd) Design Soil Application Rate(gpd
Dispersal Area Required (at)
Dispersal Area Proposed (s
System Elevation
60C .6
1000
1020
90•
VI. Tank Info
Capacity in
Total
# of
Manufacturer
Gallons
Gallons
Units
0 8
New Talcs
Esuting Tanks
P
(�/ ! d
Septic or Holding Tack
1250
1250
1
We' r Com 'nation
Dos:ng Chaoiber
750
1 1 1
750
VIL Responsibility Statement- 1, the undersignundersignedl a ume responsiliNty
for iastallation of the POWTS shown on the attached plans
Plumber's Name (Print) Plu sSignature MP/MPRS Number Business Phone Number
679002 715-418-1608
Darren BjugstadTOA4-11A'� 1
Plumber's Address (Street, City, State, Zip Code)
1385 13th St Barron, WI 54812
VI . Coun /De
artment Use Only
Approved
Permit Fee
Date Issued
sui eSignature
SqV • p6
y
rDenial
DL Co b1 WY&EPA/Ressons for Disapproval
1. Septic tank,
effluent filter and c U
dispersal cell must be Egrv_ ce_d,J maintamed
as per management plan provided by plumber. 5s
2. All setback requirements must be maintained 1
LA,
as per applicable code/ r i mh.c e1'S
q
51
Attach to complete plans for the system and au 't to Me Counrty 1yonly p11n pope of less t S M I I I inches in size
8 �Y •
SBD-6398 (110313) �\ d fj, �p�„_ .�-� jer t �.f, ',j D • 1�J
J � �` Vd
80,
IN Scale 1" = 80'
Gene) and HeatterEike
Brdiw
me River Rd.
Nail in
Hudson, WI 54016
Tree
030-101960-00D
SEW NWL4 S5 T29N R19W
DARREN13JUGSTAD
139213THST
BARRON, WI S4812
® —
LIC679pD2
B2
94.6 93.1
83'•
81 • •r
BM 100' •••••' 94.3
Net in ••'• .,:rp=,
Tree
y'RF
'AR
6ME
NYumnM
Y4bYelm
r r �
iww.�em.wr
vm>.ewer
River Road
Property
Une
U 1'Toode,
Driveway 1 Y•li
w
M'
w'
Owner Name:
Owner
Plumber:
Bjugstad Excavating
1392 13`h St
Barron, WI 54812
715-418-1608
M
/.!
z(7,"-Z
3. CS r FVa
4.CSr5,�r AL I---
6. Gti �[ Sjkcr
-T
11/14/2019
Go gle Maps 450 River Rd
PI
450 River Rd - Google Maps
JL 8taiser Constwown V
and 8laiser Pools,'
a
mnure Q C Midwest Tuft
>rabon ConnecRor
n
C �
1 �450 Rwer Ro.at r'
AN. Rd Rber Rd ' AN. Rd Rive ad RNw Rd Rner, Rd
Nelsad Farm Parking Lot
v
Go :gle I
Map data @2019 1000 h
hops:/Iwww.google.com/maps/p!ace/450+River+Rd +Hudson+WI+y{016/@45.0289767,-92.715995,15zJdata=!4m5!3m41lsOx52b2b4Oc26655eb5:Oxfe7b4ed7417756ed!8m213d45.0283359!4d-92.7112... 1/1
POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page _of
FILE INFORMATION
Owner , I IG.
Permit #
nFRIGN PARAMETERS
Number of Bedrooms
q
❑ NA
Number of Public Facility Units
NA
Estimated (average) flow
CIO a
al/da
Design (peak) flow = (Estimated x 1.5)
�00
al/de
Soil Application Rate
Vda /ft2
Standard InfluentiEffluent Quality
Mo y a g
Fats, Oil & Grease (FOG)
0 mi
Biochemical Oxygen Demand (BOD5)
s220 mg/L
❑ NA
Total Suspended Solids (TSS)
<150 mg/ '
High Strength InfluentlEmuent
�Moly average'
Fats, Oil & Grease (FOG)
t30 mg(L
Biochemical Oxygen Demand (BODs)
a220 mg/L
NA
Total Suspended Solids (TSS)
2:150 mg/L
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (BODs)
<_30 mg/L
Total Suspended Solids (TSS)
530 mg/L
�NA
Fecal Coltform (geometric mean)
5104 cfu/100frtl
Maximum Effluent Particle Size
In die.
❑ NA
Other:
-
❑ NA
MAINTENANCF RC41Fnt1LE
SVSTFM SPECIFICATIONS
Tank Manufacturer
❑ NA
¢{ Septic ❑ Dose ❑ Holding Vol. / 2S0
gal
Tank Manufacturer
❑ NA
❑ Septic 0 Dose ❑ Holding Vol. %S O
gal
Vertical Distance Tank Bottoms) to Service Pad:
ft.
Horizontal Distance Tank(s) to Service Pad;
ft,
Specific servicing mechanics must be provided if vertical
Is >15 ft. or
if horizontal Is >150 ft. Specific instructions to be provided on back.
Effluent Filter Manufacturer'rwy L't' L
❑ NA
Effluent Filter Model S 2 !%--
Pump Manufacturer
❑ NA
Pump Model
Pretreatment Unit
Manufacturer
)4NA
❑ Mechanical Aeration ❑ Peat Filter
❑ Disinfeclion ❑ Welland
❑ Sand/Gravel Filter ❑ Other:
Soil Absorption System
❑ NA
gCln-Ground(gravity) ❑ In-Ground(pressurized)
❑ At -Grade ❑ Mound
❑ Drip -Line ❑ Other.
Other.
❑ NA
Service Event
Service Frequency
Inspect condition of tank(s)
months) (Maximum 3 years)
At least once every: 3 ear s
❑ NA
Pump out contents of tank(s)
((When combined sludge and scum equals one-third (Ya) of tank volume
❑ When the high water alarm is activated
❑ NA
Inspect dispersal oell(s)
At least once every: 3 ❑ months) (Maximum 3 years)
ear s
❑ NA
Clean effluent filter
At least once every: s(s)
❑ NA
Inspect pump, pump controls 8 alarm
p month(s)
At least once every: 3 ar s
❑ NA
Flush laterals and pressure test
El
At least once every: months)
❑ year(s)
Other.
At least once every: mO s(s)
"A
Other.
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shaft be made by an Individual carrying one of the following licenses or certifications: Master Plumber; Master
Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). 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 a
check for any back up or ponding of effluent on the ground surface. The dispersal wills) shall be visually Inspected to check the effluent levels in the
observation pipes and to check for any polling 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 treatment tank equals one-third (9) 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 chapter NR 113. Wisconsin Administrative Code.
All other eervioes, including but not Iknitod to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing
at Intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority vAmin 30 days of completion of any service event. (rev. 9/16)
Page _ of _
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals that may Impede the treatment process end/or damage the soil dispersal cell(s). If high concentrations are detected have the
contents of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will
be discharged to the dispersal collie) In one large dose and may overload them resulting 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 the
effluent pump or contact a Plumber or POWTS Maintalner 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 park 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 life of the POWTS:
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain
(sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meet scraps; medications; oil; painting products;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to Insure that the system Is properly
and safely abandoned in compliance with chapter SPS 383.33, 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 properly disposed of by a Septage Servicing Operator.
• After removing contents, all tanks and pits shall be excavated and removed or their covers removed and the void space filled
with soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized 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
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result In the need for a new soil and eft@ evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances In POWTS technology
a holding tank may be Installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil 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 last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomet at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNING>>
TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT OXYGEN TO
SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT.
ADDITIONAL INFORMATION
POWTS INSTALLER. POWTS MAINTAINER /
Name ,.rc,,, �(,,?f —� Name or/�y /ram
Phone --- �� �'� /6O� Phone 7/T y/'_ (jOY
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name Name Ce Z
Phone — Phone 7/. -+319 — /Or
This document is intended to meet minimum requirements of SPS 383.22(2xb)(1Hd)&(f) and SPS 383.54(1),(2)&(3), Wis. Admin. Code.
ZDr0rWFmnNP0Wia1WWTSM&1@W 1Ran(Rev. vane)
BO'
N Scale 1" = 80'
HeaffmEike
BM 100'
.River RO.
Nail in
Ne .WI 54O16
Tree
0 10193D000
SEIM NWIM S5T29NR19W ..
DARRENBJUGSTAD
139213THST
BARRON, WI 54612'-
LIC679=
B2
94,6' 93.1
93'
96' •' 'i 91'
B3 ••
96'
B7
BM 100 94 3
Neil in � ��••.•
Tree ,.
d�
yai wa.
w..om.u.nm
Driveway
7
M'
w
River Road
Properly
Line
wla
w
in
W1250/750-MR
TANK SPECIFICATIONS
DIMENSIONS:
WALL.• 21/2"
BOTTOM: 3"
COVER: 6"
MANHOLE: y24" I.D. PRECAST CONCRETE RISER
HEIGHT: 88 O.D.
LENGTH: 155" O.D.
WIDTH: 86" O.D.
BELOW INLET: 53" O.D.
LIQUID LEVEL: 48"
4" CAST -A -SEAL WEIGHT: 14,860 LB& SEPTIC
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL
GASKET, CAST -A -SEAL BOOT OR EQUAL
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #10
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 27.66 GALAN (SEPTIC)
16.12 GAL/IN (PUMP)
LOADING DESIGN: 8' 0" UNSATURATED SOIL
4" VENT
paOUTLET
Y)
PUMP PAD
ITANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
TANK CAN BE USED AS:
SEPTIC/SEPnc, SEPTIC/PUMP
OR SEPTIC/SIPHON
COVER: MIX DESIGN JS NO FIBER)
TANK: MIX DESIGN /10 (STRUCTURAL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
Lu
F
W
C �
C Lo
00
m
n
3
OF 1
A
A
6.5"(16.51cm) SEALEDBALL
MATERIAL - HDPE
POLYLOK PL- 525 - 625 CUTAWAY
BALL PUSH ROD SECTION A A
FACTORY INSTALLED
MATERIAL - FILLED POLYPROPYLENE
4" AND 6" FACTORY OPTIONAL BUSHING
INTALLED PIPE OUTLET (FOR 4- THIN WALL PIPE)
MATERIAL - PVC PART NO.30142-R
OR OPTIONAL FLOAT SWITCH
(FOR 110 MM. PIPE)
PART NO.30142-EUR
Quick4 Standard Chamber
Mul iPort EndCap
FRONT VIEW
Typical Trench View
SIDE VIEW
AT
QuickV Standard Chamber
Size
Specifications
34"W x 53"L x 12"H
(864 mm x 1346 mm x 305 mm)
Effective Length
48" (1219 mm)
Louver Height
8" (203 mm)
Storage Capacity
43 gal (163 L)
Invert Height
8" (203 mm)
INFILTRATOR'
water technologies
4 Bushes Pak Road
P.O. Bon 76e
OW Beyaook, CT 05475
880b77-7000 • Fa JIROWY-7oo1
1-800-221-4436
vrww.lmmlaetorwasneom
Qaick4
TOP VIEW
INFILTRATOR WATER TECHNOLOGIES, LLC MNFILTRATOR9
In tbata Water TaeMobgMw LLC STANDARD UWTED DmhftW WARRANTY
W The etrudural integrity of each chamber, andrap, EZflow expanded polystyrene ad/te other
aaeasofy menufadured by Infiltrator (Units'), when installed and operated in a leadifdd of
an welts septic eYstem in accordance with Inftmtwb bnstrucbone, is warranted to the original
purviteax rHolder-) against defective materials and workmanship for one year from the date that
the septic permit is issued far the septic system containing the Unit; provided, however, that If a
septic pemYt Is not required by applicable law. the warady, period will begin upon the dale that
installation of the septic system commenccts. To warciss its Warranty rights, Hider must notify
Infiltrator in wnkg at its Corporate HeadWartae in Old Saybrook, Connecticut within fifteen
(15) days of the deged deiced. Mdlrata we supply replacement Unts for units daemined by
Infiltrator to be covered by this Limited Warranty. hDbaoes IiebUlty specficrey exdudas the cost
of removal and/or Installation of to Units.
(b) THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE DOLUSNE THERE
ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS, INCLUDING NO IMPLIED
WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c) This Lamed Warranty shd be void I any pan of the clamber system is manufactured by any-
one otter Ihan Intuit. The Limited Waaiy does tier extend to incidental, COnsequsraa, silo-
vial or Indirect darnapea. Infiltrator sW nut be lade to paWfles or Iouldated damDm. Including
lost of production and Profit, labs and materut, overhead toes, or other losses a expenses
Incurred by the Holder a any third party. SpedficeYy, excluded from Untried Wafaay coverage
are damage to ma Units due to ordinary wear and has, alteration, accident, misse, abuse a
negiBdt of the Urft, the Units being subjected to vehicle trafBg or other oNldld" which a9 not
permitted by the Insteadon irntructioro; failure to mentein the minimum ground ewers set fart
In the Installation inaructions: the placement of improper materials Into the system amranlg the
Unit: talus of the Under or the septic system der to improper siting or improper shrug, sxcssiw
was usage, tMPrOM gross d $0084 a improper operation; or any other event not cased by
infiltrator This Lmr*W Warady end be void t the Holder ids to comply with an of the fame sot
fond in this United Warranty. Punter, In era event and Irdgbator be responsible for any bs a
damage to the Holder. the Unto or any third party reaAting from installation or shipment a from
any product liability chime of Holder a any gad party. For this Limited WaraMy to apply, to
Unit must be irotlled in accordance with d site conditions required by sus and JMW cods: an
other applicable tics; and Infiltrators installation instructions.
(d) No repreaenutive of Infiltrator has Me authority, to dhags a extend that United Warranty. No
warramy applies o MY Pang char than the Of" Hilda. The above reprsaht the Standard
United Warranty offered by nfinraor. A larded number of ass aid coah5es have difemm war -
wry requlemems Any purchaser of Was should contact nlltrator'a Corporate Headquarters n
Old Saylxoak. ConneclkuL Prior to such purchase, to obtain a copy of the applicable Warranty,
and should carefully read MM walamy prior to the purohm of Units.
U.S. Paerds; 4,759.881; 5,0/7,041; 5056,48t 5,39a,017; 3.401.11N 5.401AM 5511,9M; 5.118.1d3; 5,560,778:5A38A44 Canadian Patents; 1,32g 9M 2.004.5e4 Other patents pacing.
baitraor, Equalize, Ouiek4. aid 9kkWYda are regelaiat trademarks of arFAA, WitterTsehdoges. nldhatcr h a registered trademark n Fars. nester Water Technologies t a registered tradertmd In Maw.
Conan. aaaolealang, PWM, GanberSower. MdePort Pgellack, 0AM014 WpkPwi, ShMPLock and SSagmlock asaademan6 of n5leapr WNW TectsMogies,
PoKok Is a bedemvk of PaWk. tie TUF•TRE I. a ragkderad asdeoerk ofTUF-TrIE, B . URrPob 4 e bedew k W IPIX Inc.
O 2o151nadretor Water Tetlrdopes, ULC. N his reee< R In USA
O25 0816
I ontact irnuirator water i ecnnotogies1 technical Services Department for assistance at 1-800-221-4436
Page of
1— or 2— Family Dwelling In -;around Soil Absorption System 13-cell Conventional
Daily Wastewater Flow (DWF) _ q # of bedrooms x 150 gal/day/bedroom gal/day
Design Loading Rate (DLR) or Soil Application Rate = gpd/ftZ (per SPS Table 383.44-1, 2, or 3)
Required Distribution cell area = DWF Ge gal/day _ DLR . 6 gpd/ftZ = i 6 b& ftZ
# Chambers = Required Distribution cell area /DpU it, + '7111 ftZ/ unit EISA = 47-6 Chambers
Chamber Manufacturer and Model: d 14 kf r -0 toy (Xwt/(- G
Actual Distribution Area = Total Chambers distribution area 1&00 ftZ
+ `-A ftZ/ unit EISA End Cap Pair = _-61 ftZ
Cross -Section In -around Soil Absorption System (3-cell):
Max Bury Depth =Limiting Factor V, -1 4"14es - 36 Inches = b 7 imehe — —`—t
4" Schedule 40 PVC vent pipe with vent cap ASTM# Nt?
1 � T
12 inches minimum r 12Inches minimum~
1\1 1 N/1 N1 f .\I J �`/ 4 a�
It T1 FG it T2 FG` i , ft T3 Final Grade (FG)
Trench 11 System Elevation Trench 2 System Elevation
�ft ft �ft
$7 r Trench r
Separation
Inches Soil Cover
r. .�if 12—Inch Chamber Height
— 1O(— 87
Trench 3 System Elevation
ft,
PlanPlan View In -ground Soil Absorption System (3-cell):
3' ft
N it
Trench 1
%Q it with end caps
Draw 0 for a Vent and 9 for Observation Pipe above. They will be located
Vent pipes shall be Schedule 40 PVC and extend at least 12 inches above finished grade.
Observation pipes that extend above finished grade must also be 4 inch Schedule 40 PVC.
36 inch minimum separation from
Bottom of System & Limiting Factor
s
Limiting Factor =_
below ground surface
Modify
header/
design as
needed.
inch Header
ch. X/�9
ft from the end of the cell.
SUBMERSIBLE EFFLUENT PUMP
TECHNICAL BROCHURE
BPE
FEATURES
Corrosion resistant construction
Cast iron body
Thermoplastic impeller and cover.
Upper sleeve and lower heavy duty ball bearing construction.
Motor is permanently lubricated for extended service life.
Powered for continuous operation.
All ratings are within the working limits of the motor.
Quick disconnect power cord, 20' standard length, heavy duty 16/3
SJTW with 115 or 230 volt grounding plug.
Complete unit is heavy duty, portable and compact.
Mechanical seal is carbon, ceramic, BUNA and stainless steel.
Stainless steel fasteners
VGOULDS
a xylem brand
Wastewater
APPLICATIONS
Specially designed for the following uses:
• Mound Systems
• Effluent/Dosing Systems
• Low Pressure Pipe Systems
• Basement Draining
• Heavy Duty Sump/Dewatering
Pump — General:
• Discharge: 11/7' NPr
• Temperature: 104OF (40°C) maximum, continuous
when fully submerged.
• Solids handling: 'h° maximum sphere.
• Automatic models include a float switch.
• Manual models available.
• Pumping range: see performance chart or curve.
PE31 Pump:
• Maximum capacity: 53 GPM
• Maximum head: 25' TDH
PE41 Pump:
• Maximum capacity: 61 GPM
• Maximum head: 29' TDH
PE51 Pump:
• Maximum capacity: 70 GPM
• Maximum head: 37' TDH
PUMP INFORMATION
MOTOR
General:
• Single phase
• 60 Hertz
• 115 and 230 volts
• Built-in thermal overload protection with automatic
reset.
• Class B insulation
• Oil -filled design
• High strength carbon steel shaft
PE31 Motor:
• .33 HP, 3000 RPM
• 115 volts
• Shaded pole design
PE41 Motor:
• .40 HP, 3400 RPM
• 115 and 230 volts
• PSC design
PE51 Motor:
• .50 HP, 3400 RPM
• 115 and 230 volts
• PSC design
AGENCY LISTINGS
cTested to UL 778 and CSA 22.2 108 Standards
r By Canadian Standards Association
c us File #M8S49
Order No.
HP
Volta
Amps
Minimum
Circuit
Phase
Float Swtch
Cord
Discharge
Minimurn
Basin
Maximum
Solids
Shipping
Weight
Breaker
Style
Length
Connection
Diameter
size
Ibs/kg
PE31M
0.33
115
12
20
1
Manual/No Switch
2D'
1.5'
18,
.5
31 / 14.1
PE31PI
Piggyback Float Switch
PE41 M
0.4
7.5
15
Manual / No Switch
PE41 P1
Piggyback Float Switch
RE42M
230
3.7
10
Manual/ No Switch
PE42P1
Piggyback Float Switch
PE51 M
0.S
115
9.5
20
Manual / No Switch
PE51 Pt
Piggyback Float Switch
PE52M
23q
4.7
10
Manual/No Switch
PE52P1
Piggyback Float Switch
RAGE 2
Wastewater
vif
METERS FEET
1 40
1
30 PE41
o
i
25
u
2
20
0
15
10
5
0 00
0
PERFORMANCE RATINGS
PE31
MODELS: PE31, PE41, PE51
HP:.33, .40, .50
-► 2 GPM
1 FT
10 2Q 30 40 50 60
'5 10
CAPACITY
Total Head
(feet of water)
GPM
5
52
10
42
15
29
20
16
25
0
PE41
Total Head
(feet of water)
GPM
a
61
10
57
15
46
20
33
25
16
PES1
70 GPM 80
15 m3/h
Total Head
(feet of water)
GPM
10
67
15
59
20
50
25
39
30
26
35
8
PAGE 3
DIMENSIONS
(AII dimensions are in inches. Do not use for construction purposes.)
xylem
Let's Solve Water
t;
Xylem, Inc.
2881 East Bayard Street Ext., Suite A
Seneca Falls, NY 13148
Phone: (866) 325-4210
Fax: (888) 322-5877
www.xylem inc.com/brands/gouldswatertechnology
Gouide le a.oybtemd uedema.4 of Gould. Pmnp., Inc. enJ b uwd w.der Gcen.e.
0 2012 Xylem Inc. oPc rebruary 2012
4ARGE
D ' `
o iJ}j D
Wisconsin DepBP� al rvices
Division of Indu Services
NOV 15 M9 SCAL EVALUATION REPORT '
County
52, Croix County Ina ante with SPS385, Wis. Adm. Code tY
Attach complete site la St Croix
p +21ptDeus�1 11 inches in size. Plan must include,
but not limited to: ve �rorizo. re erence paint (BM), direction and percent slope, Parcel I.
scale or dimensions, north arrow, and location and distance to nearest road. 030-101
Please print all Information. Rev
cs, _0 01q-300
Page -of -
by
Property Owner
Property Location
/
�/
U, rZ
Gene Elks
Govt. Lot SE NW
I '%
% S 5 T 29
/ N 19
E (or) W
Property Owner's Mailing Address
I Lot #
I Block #
I Subd. NanA
or CSM#
City I State Zip Code Phone Number I ❑ City []Village ® Town
Nearest Road
® New Construction Use: ® Residential/Numberof bedrooms g Code derived design flow rate ¢00 GPD G< 10✓ O ✓�
❑ Replacement ❑ Public or commercial - Describe: _
Parent material Till Flood Plan elevation if applicable - ft.
General comments and recommendations: Drain field at 90'
�t+1
4 ] Boring Is ❑ Boring
® Pit Ground surface elev. 9�.5 ft. Depth to limiting factor 1 + in.
` .LLk
�/ Ile • S -/ 4vQ1 nIt � Snil Annlil rAfinn Rate I
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FP
*Eff#1
*Eff#2
1
0-10
5 YR 3/2
-
SIL
2MSBK
MFR
AS
2C
.6
.8
2
10-24
7.5 YR 4/4
SIL
2MSBK
MFR
AS
2C
.6
.8
3
24-0
7.5 YR 5/3
-
SIL
1MSBK
MVFR
CS
-
.6
.8
4
68-100
7.5 YR 5/3
-
SIL GRV
1MSBK
MVFR
CW
.6
.8
5
100-190+
7.5 YR 414
-
SL
2GR
ML
-
.6
1.0
Il
i�r� IIN'
goring # ❑ Boring
® Pit Ground su ace elev. 96.2 ft. Depth to limiting factor 155+ in.
Sail Anolication Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
*Eff#1
*Eff#2
1
0-10
5 YR 312
-
SIL
2MSBK
MFR
AS
2C
.6
.8
2
10-24
7.5 YR 414
-
SIL
2MSBK
MFR
AS
2C
.6
.8
3
24-48
7.5 YR 5/3
SIL
1MSBK
MVFR
CS
-
.6
.8
4
48-70
7.5 YR 513
-
SIL GRV
1MSBK
MVFR
CW
.6
.8
5
70-155+
7.5 Yf 414
SL
2GR
ML
-
.6
1.0
'Clr
1
rl
r
* Effluent #1 `- BOD. > 305 220 moll- and TSB 431) s N 50 mo/L *.9fflueat 42 dBOD_ > 30 5 220 mall- and TSS > 30 5 150 mall -
CST Name (Please Prim)
Signature
CST Number
Barton B'u stad
1283536
Address
Date Evaluation Conducted
Telephone Number
138513' ST Barron, WI 54812
11/05/19
715-418-1546
560-8330 (R04/15)
r>t
6] Boring # ❑ Boring
® Pit Ground surface elev. g .5 ft. Depth to limiting factor 150+ in.
Soll Acoll ieation Rate]
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FP
•EB#1
'Efi#2
1
0-10
5 YR 3/2
—
SIL
2MSBK
MFR
AS
2C
.6
.8
2
10-25
7.6 YR 414
—
SIL
2MSBK
MFR
AS
2C
.6
.8
3
25-50
7.5 YR 513
—
SIL
11VISSK
MVFR
CS
—
.6
.8
4
50-72
7.5YR513
--
SIL GRV
1MSBK
MVFR
CW
.6
.8
5
72-150+
7.5 YR 414
SL
2GR
ML
1�
;)
Borinj
❑ Boring # ❑ pit
❑ Pit
Ground surface elev. _ ft.
Depth to limiting factor_ in.
Soil Annticatinn Rate
Redox Description
Ou. Az. Cont. Color
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. _ ft.
Depth to limiting factor_ in.
Snil Amili-Atinn RaM
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eft#1
•Ef #2
' Ef0uent #1 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 - BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L
82
94 6' 931.
91
. % . %, ............ ..
BI
MT AD. W.3
Pmperty
Lim
=dPAar
County /
i g
D
Industry Services Division
St Croix
_
s
1400 E Washington Ave
P.O. Box 7,162
Sanitary Permit Number(to be filled in y o.)
5y3707-7162
Madison, WI _
h
7 7Q
vu
)
w Y�
Sanitaryt�l it Application
StateTransactionNumber
In accordance with SPS 383.21(2), AW, A4"odc: submission of this form to the appro • i
6 0
Fhoject Address (if different than mailing address)
is requited prior to obtaining asanitaiy permit. Note. Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Servies. Personal information you provide may be used for soc
purposesin accordance with the Privacy Law, s.1s.04(Ixm),Slats.
6
4"" River Rd. Hudson, WI 54016
1. Apolicafion Information - Plait Print AN Information
Property Ouricr's Name
Parcel N
Gene and Heather Eike
030-1019-60-000
Property Owner's Mailing Address
Property Location 0 S
1711 Fairway Dr.
Govt. Lot
SE 1/4, NW r/4, Section 5
City, State
Zip Code
Phone Number
Hudson, WI
54016
T 29 N; R t9 w
11. Type of Bonding (check all that apply)
Lot a
®Ior2Family Dwelling -Number of Bedroormrt 4
�
Subdivision Name
✓I
A
'Z A-tc;
Block
❑Public1Commereial-Describe Use
❑Cityof
❑State Owned -Describe Use 4
Q-
❑Village of
® To" of St Joseph
C' umber 'J
7 t 5 X CJ A,1
P.5
III. Ty (Check only one box on fine A. Complete line B ab
A
New S stem ® y
❑Replacement System
❑Treatment/Holdi eplacement Only
[]Other Modification to Existing System (explain)
B.
❑ Permit Renewal ❑ Pe. uit Revision ber
i_lperarit Transfer to New
Ust Previous Permit Number and Date Issued
/
Before Expiration ty
of POWTS S stem/Com onent/24 e: eck all that apply)
Owner
9 s (0
1V. Type
❑ Non -Pressurized ln-Ground ❑Pressurized In -Ground t-Grade ❑Mound > 24 in. of suitable Mound <24 in. of suitable soil
❑Holding Tank er Dispersal Component (explai 51 ❑Pretreatment Device exp I /
V. Dis ersaUTres at Area Information:
Design Flow (gpd) Design Soil Application Rate( sf)
Dispersal Area Required f)
Dispersal Area sf2 yssem Elevation
600 .6
600 tl�
,
600 0 -W*—
VL Tank Info
Capacity in
Total
q of
Manufacturer
Gallons
Gallons
Units
/ I
Pd
o Y
"fa'+
4,
B
u
g A
o
New Tanks
Existing Tanks
W ` I � Sz 5
cc a
in
in
c: v
a
Sepac or Holding Tank
1250
Weiser
)(
Dosing Chamber
750
Weiser
X
VII. Responsibility Statement- I, the underslArtkassume rtapo ability for installation of the POWTS shown on the attached plane.
Plumber's Name (Prim)
s Signature
MP/MPRS Number
Business Phone Number
Darren Bjugstad
679002
715-418-1608
Plumber's Address (Street. City. State, Zip Code) .f' Z�
1392 13th St, Barron, WI, 54812 O
VIH.Loun /Department Use Only
Approved
❑Disapproved
Permit Fee
Date su
Issuing t Signature
'al
S65o.�
gas l9
en Reason for
IJ{. Condil6o3'6vX4"lGtiNReasons for Disapproval S>s�a �^
1. 8tplp: tta^.k, tFflubm iittc :•ni [s�i,, r
as per marayarwlt plan Pin titlarl by plurnbe:.
2. Al ae9na� Ac reer.Nwr'wt's aMlal.Ita.CdtitiYsil.t
as Der -m6ctb;- rrY.•! ?:.RlipJaleld.
Attach to complete plans far the system and submit to the County only as paper not less than 8 in : 11 inches in sin
SBD-6398 (R0313)
030-101960400
SE1 /4 NW 1 /4 SS T29H R19W
DARREN SJUGSTAD
1392 13TH ST
BARRON, W 154812
LIC 979002
July 11, 2019
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2021-07-11
Plan Review: PWTS-071901097-C
DARREN EDWARD BJUGSTAD
1392 13th St
Barron WI 54812
SITE:
Gene Eike
xxx River Rd
Saint Croix
St. Joseph
FOR:
Object Type
Description: 600 GPD
Maitenance Required
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY WI 54304-5211
Contact Through Relay
httpJ/dsps.wl.goviprogramstindustry-services
www.wisconsin.gov
Tony Evers - Governor
Dawn Crim - Secretary
Mound Component Manual — Ver. 2.0, SBD-10691-P
(N.01/01, R 10/12)
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be
constructed and located in accordance with the enclosed approved plans and with any component manual(s)
referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance
with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
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- 1069 1 -P(N.01/01).
• The pressure network is to be constructed in accordance with publications SBD-I0706-P(NO1/01) "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
(0118l)"
• Private Interceptor Main shall be constructed in accordance with SPS 382.30(12) and SPS 382.35(3)(d)
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state 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,
Matthew Allen Janzen
Wastewater Specialist, Division of Industry Services
(715)340-0407
MOUND AND PRESSURE DISTRIBUTION COMPONI�NT rFs�S��N
Residential Application APPROVED
INDEX AND TITLE PAGE
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
Project Name: Eike Mound DIVISION OF INDUSTRY SERVICES
Owner's Name
Owner's Address:
Legal Description:
Township:
Gene Eke
xxx River Rd
SEE CORRESPONDENCE
Hudson, WI
SE1/4 NW 1/4 S5 T29N R19W
St Joseph
County: St Croix
Subdivision Name:
Lot Number: 2 Block Number:
Parcel I.D. Number: 030-1019-60-000
Plan Transaction No.:
Page 1
Index and title
Page 2
Data entry
Page 3
Mound drawings
Page 4
Lateral and dose tank
Page 5
System maintenance specifications
Page 6
Management and contingency plan
Page 7
Pump curve and specifications
Page 8
Tank Specifications
Page 9
Filter Specifications
Page 10
Alarm Specifications
Page 11
Plumber Site Plan
Page 12
CST Evaluation and Site Plan
Designer: 4ren Blu stad License Number: 679002
Date: 60 9/19 Phone Number: 715-418-1608
Signature: Ajk�N— t �MA
Deslgned Pursuant to the
Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver, 2.0 SBD-10706-P (N. 01/01, R. 10/12)
Version 7.0 (R. 11/12) Page 1 of 12
Mound and Pressure Distribution Component Design
Design Worksheet
(R or C)
21"
R
Residential or Commercial Design
Estimated Wastewater Flow (gpd)
Peaking Factor (e.g. 1.5 = 150%)
Design Flow (gpd)
Site Slope (%)
Contour Line Elevation (ft)
Depth to Limiting Factor (in)
In -situ Soil Application Rate (gpd/ft2)
400.00
1.50
600.00
12.00
94.60
: 00
0.60
Distribution Cell Information
80.001 Dispersal Cell Length Along Contour (ft) _
1.00 Dispersal Cell Design Loading Rate (gpd/ft2)
1 Influent Wastewater Quality (1 or 2)
(C or E)
Pressure
Distribution Information
Center or End Manifold
Lateral Spacing (ft)
Number of Laterals
Orifice Diameter (in)
Estimated Orifice Spacing (ft) _
Forcemain Diameter (in)
Forcemain Length (ft)
Pump Tank Elevation (it)
C
3.75
4
0.125
2.00
2.00
200.00
80.00
6.50
System Head (ft) x 1.3
15.43
Vertical Lift (ft)
4.61
Friction Loss (ft)
0.00
In -line Filter Loss (ft)
26.55
Total Dynamic Head (ft)
Lateral Diameter Selection
in. dia,
option
choice
0.75
1.00
x
1.25
x
1.50
x
x
2.00
x
3.00
x
Note: Sand fill (D) calculations assume a
Table 38344-3 In-shu soil treatment for
fecal ooliform of <= 36 Inches.
7.50 Cell Width (ft)
Are the laterals the highest point�
in the distribution L r J
network? Enter Y or N
If N above, enter the elevation ft
of the highest point.
7.50 ft2/orifice
Does the forcemain drain back? �Y
Enter Y or N
Forcemain Drainback (gal)
5x Void Volume (gal)
A
Minimum Dose Volume (gal)
System Demand (gpm)
Manifold Diameter Selection
in, dia.
options
I choice
1.25
x
1.50
x
x
2.00
3.00
Gallons/Inch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1250.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
Weiser Concrete I Manufacturer gal/in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
750.00 Dose Tank Capacity (gal) I Pol -Lok IFilter Manufacturer
16.121 Dose Tank Volume (gal/In) 525 Filter Model Number
Weiser Concrete Manufacturer
Project: Eike Mound Page 2 of 12
Mound Plan and Cross Section Views
B
L
-T
JJ
—I
A
2
Mound Component i�� pslons
� �16.13' � 10.48
A 7.50 ft E 24:80 in H 1.00 f�K 4@.23 ft
15" B 80,00 ft F 9.50 in z 1 45 74 ft L 1 Yo0-2r5 ft <-- 100.96'
D 74U0 in G 0.50 ft J �W
5.60'
600.00 (ft) Dispersal Cell Area 1859.38 (ft2) Basal Area Available
7.50 (gpd/ft) Linear Loading Rate 8.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 97.56 (ft) i
H
5 2: G I
I F D4ersal Cell 96.27 (ft) Lateral
95.Z7 (ft)—► Invert
Dispersal Cell
Elevation D
94.60 (ft) Contour Elevation
12.0 % Site Slope
/-�' Geotextile Fabric Cover
Shading Key v &
_ Topsoil Cap i C
1.5 ft
Subsoil Cap N 0
ASTM C33 Sand S Z
0 Tilled Layer a
a
40a`�
ft
Aggregate o
t
Dispersal Cell
See lateral details on
Page 4 for number, size,
O �
and spacing of laterals.
Laterals are equally
Typical Lateral; `
F spaced from the
distribution cell's
ICI,
centerline in the
dlstdbutlon cell (AxB).
A _T
Project: Eike Mound Page 3 of 12
Center Connection Lateral Layout Diagram
Force main connection via tee or class to manifold at anq point.
IN
•=Turn-upvdball valve or IE X--- x12
also n out plug
Holes dolled on the bottom of the lateral.
Number of Laterals
Lateral Diameter
Lateral Length (P)
Lateral Spacing (S)
Lateral Flow Rate
System Flow Rate
Total Dynamic Head
Laterals are Identical
Laterals Morcemain Sch 40 PVC
per SPS Table 384.30-6
Orifice Diameter
Orifice Spacing (X)
Orifices per Lateral
Orifice Density
Manifold Length
Manifold Diameter
Forcemaln Velocity
Dose Tank Information
Electrical as per NEC 300 and 10
SPS 316.300 WAC
Tank component Is property vented
Weiser Concrete
Capacityl
750.00
Volume
1 16.12
Manufacturer
Gallons
gal/inch
Dimension
Inches
Gallons
A
26.04
419.77
B
4.00
64.48
C
12.00
104.55
D
10.00
161.20
Total
51.00
750.00
Disconnect
�-A—
T
A
B
C
D
tank.
Locking cover with warning
label and locking device and
sealed watertight
4 in. min.
Alternate outlet
location
Forcemain diameter
2 In.
Weep hole or anti.
siphon device
Pump off elevation (ft)
80.83
_Dose tank elevation (ft
eo.00
Alarm Man uafacturer SJE Rhombus -Tank Alert Note: Switches
Alarm Model Number IXT containing mercury
may not be used in
Pump Manufacturer Goulds this system.
Pump Model Number PE51
Pump Must Deliver 33.00 gpm at 26.55 ft TDH
Project: Eike Mound Page 4 of 12
Mound System Maintenance and Operation Specifications
Service Provider's Name Darren B u stad Phone 715-418-1608
POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680
System Flow and Load Parameters
Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
Septic and Pump TanH
Effluent Filter
Pump and Controls
Alarrr
Pressure Systerr
Mound
Other
Service Frequency
Inspect and/or service once every 3 years
Should inspect and clean at least once every 3 years
Test once eve 3 years
Should test monthly
Laterals should be flushed and pressure tested every 1.5 years
Inspect for ponding and seepage once every 3 years
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm, Code.
4. Tillage of the basal area Is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Finished
Grade
6-8" Diameter Lawn
Sprinkler Valve Box
Distribution
Lateral
Lateral Turn -up Detail
...............
Threaded Cleanout
Plug or Ball Valve
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Eike Mound Page 5 of 12
Mound System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD-10691-P (N.01101, R. 11/12), SSWMP Publication 9.6 (01/81), and Pressure Dletributlon Component Manual Ver. 2.0 SBD-
10706-P (N. 01101, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic; and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Sepik: or pump lank manhole risers, access risers and covers should be Inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than 8-Inches In diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic lank shelf be maintained by an Individual certified to service septic tanks under a. 281.48, Slats, The contents of the septic lank
shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed
at least once every 3 years by Inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed untess provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filler Is equipped with an alarm, the
flier shall be serviced If the alarm is activated continuously. Intermittent filter alarms may Indicate surge flows or an Impending continuous
alarm.
The septic tank shall have Be contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when
the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance Is generally not required. However, it such products
are used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (doting) tank shall be Inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is Installed within the lank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mood shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative
maintenance) on the mound Is not recommended since soli compaction may hider aeration of the infiltrative surface within the mound and
snow compaction In the winter will promote frost penetration. Cold weather Installations (October -February) dictate that the mound be heavily
mulched as protection from freezing.
Influent quality Into the mound system may not exceed 220 mgfL BODs, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BODs, 30 mg/L TSS, 10 mgfL FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified In the permit for this installation.
The pressure distribution system Is provided with a flushing point at the end of each lateral, and it Is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test Is performed it should be compared to the initial test when
the system was Installed to determine If orifice dogging has occurred and if orifice cleaning is required to maintain equal dlsldbution within the
dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent pending. Pording levels shall be reported to the owner, and any
levels above 6 Inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring.
Continency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system In
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective 0e defective components) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component falls to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced
in its' present location by Increasing basal area 4 toe leakage occurs or by removing biologically clogged absorption and dispersal media, and
related piping, and replacing said components as deemed necessary to bring the system Into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider,
Pretreatment Units
The Information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection
units are attached as separate documents and are considered part of the overall management plan for this system.
PE
SUBMERSIBLE EFFLUENT PUMP
TECHNICAL BROCHURE
BPE
FEATURES
Corrosion resistant construction
Cast iron body
Thermoplastic impeller and cover.
Upper sleeve and lower heavy duty ball bearing construction.
Motor is permanently lubricated for extended service life.
Powered for continuous operation.
All ratings are within the working limits of the motor.
Quick disconnect power cord, 20' standard length, heavy duty 16/3
SJTW with 115 or 230 volt grounding plug.
Complete unit is heavy duty, portable and compact.
Mechanical seal is carbon, ceramic, BUNA and stainless steel.
Stainless steel fasteners
GOULDS
a xylem brand
Wastewater
APPLICATIONS
Specially designed for the following uses:
• Mound Systems
• Effluent/Dosing Systems
• Low Pressure Pipe Systems
• Basement Draining
• Heavy Duty Sump/Dewatering
SPECIFICATIONS
Pump — General:
• Discharge: 1'/7" NPT
• Temperature: 1040F (400C) maximum, continuous
when fully submerged.
• Solids handling: 'h" maximum sphere.
• Automatic models include a float switch.
• Manual models available.
• Pumping range: see performance chart or curve.
PE31 Pump:
• Maximum capacity: 53 GPM
• Maximum head: 25' TDH
PE41 Pump:
• Maximum capacity: 61 GPM
• Maximum head: 29' TDH
PE51 Pump:
• Maximum capacity: 70 GPM
• Maximum head: 3T TDH
PUMP INFORMATION
MOTOR
General:
• Single phase
• 60 Hertz
• 115 and 230 volts
• Built-in thermal overload protection with automatic
reset.
• Class B insulation
• Oil -filled design
• High strength carbon steel shaft
PE31 Motor:
• .33 HP, 3000 RPM
• 115 volts
• Shaded pole design
PE41 Motor:
• .40 HP, 3400 RPM
• 115 and 230 volts
• PSC design
PE51 Motor:
• .50 HP, 3400 RPM
• 115 and 230 volts
• PSC design
AGENCY LISTINGS
Tested to UL 778 and CSA 22.2 108 Standards
O's
By Canadian Standards Association
File #LR38549
Minimum
Minimum
Maximum
Shipping
Order No.
HP
Volts
Amps
Circuit
Phase
Float Switch
Card
Discharge
Basin
Solids
Weight
Breaker
Style
y
Length
eng
Connection
Diameter
Size
Ibs/kg
PE31M
0.33
115
12
20
1
Manual/No Switch
20'
1.5'
18"
.5
31 / 14.1
PE31 P1
Piggyback Float Switch
PE41 M
0.4
7.5
15
Manual / No Switch
PE41 P1
Piggyback Float Switch
PE42M
230
3.7
10
Manual/No Switch
RE42PI
Piggyback Float Switch
PE51M
0.5
115
9.5
20
Manual/No Switch
PE51 P7
Piggyback Float Switch
PE52M
230
4.7
10
Manual/No Switch
PE52P1
Piggyback Float Switch
PAGE 2
Wastewater
METERS FEE
40
35
r'
10t
01
30 PE41
20
15
10
5
00
1_
0
PERFORMANCE RATINGS
PE31
—► 2 GPM
1 FT
10 20 30 40 50
1
5 10
CAPACITY
Total Head
(feet of water)
GPM
5
52
10
42
15
29
20
16
25
0
PE41
Total Head
(feet of water)
GPM
8
61
10
57
15
46
20
33
25
16
MODELS: PE31, PE41, PE51
HP:.33, .40, .50
60 70 GPM 80
15 m3/h
PES1
Total Head
(feet of water)
GPM
10
67
15
59
20
50
25
39
30
26
35
8
PAGE 3
DIMENSIONS
(AII d'enensions are in inches. Do not use for construction purposes.)
xylem
Let's Solve Water
Xylem, Inc.
2881 East Bayard Street Ext., Suite A
Seneca Falls, NY 13148
Phone: (866) 325-4210
Fax: (888)322-5871
www.xyleminc.com/brandelgouldswatertechnology
GOOD It' a rwyliHBil {{4dany4 i ar o6wji Nc"*, sF . BIw Ib Ybij Ohdoi Ikisb..
62012Xyl.minc. OK rebmary2012
IARGE
u
P
TOP VIEW
a
u
W1250/750—MR
TANK SPECIFICATIONS
DIMENSIONS:
WALL 2 1/2-
BOTTOM: 3"
COVER: 6"
MANHOLE 24' I.D. PRECAST CONCRETE RISER
HEIGHT: 66" O.D.
LENGTH: 155" O.D.
WIDTH: 86' O.D.
BELOW INLET: 53' O.D.
LIQUID LEVEL- 48"
4" CAST —A —SEAL WEIGHT: 14,860 LBS. SEPTIC
INLET AND OUTLET:
4' CAST —A —SEAL BOOT OR EQUAL
GASKET, CAST —A —SEAL BOOT OR EQUAL
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #10
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 27.66 GAL/IN (SEPTIC)
16.12 GAL/IN (PUMP)
LOADING DESIGN: 8' 0" UNSATURATED SOIL
4" VENT TANK CAN BE USED AS:
sEPTC/SEPTIC, SEPTIC/PUMP
OR SEPTIC/SIPHON
COVER: MIX DESIGN #B NO FIBER)
— _ TANK: MIX DESIGN #10 STRUCTURAL FIBER)
CUSTOMIZED TANKS:
—9LOUTLET FOR CUSTOM TANKS CONTACT WIESER CONCRETE
I� c
PUMP PAD
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
W
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Mound Cell
89 x 7.S
70'
N Scale 1" = 70'
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I
Gene and Heattw Eke
w River Rd.
Hudson, Wl54019
030-1019E0-M
SE114 NW 114 S5 T29N R19W
DARREN BJUCSTAD
1392 13TH ST
BARRON, WI 54812
UC 679002
,;.'�
B2
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94.5'
93.1.
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98'
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943
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200' to carter
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Property
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6.5' (16b1cm) SEALED BALL
MATERIAL -HDPE
POLYLOK PL- 525 - 625 CUTAWAY
— -- 33.02 [83.9cmJ ---------------
20.71 [52.6 cm]1 LNG
FILTER CARTRIDGEMATERIAL-POLYPROPYLENE
14-7 cm]F----
MATERIAL- FILLED POLYPROPYLENE
BALL PUSH ROD SECTION A -A
FACTORY INSTALLED
MATERIAL - FILLED POLYPROPYLENE
4" AND 6" FACTORY—fOPnm& BUSHING —�
INTALLED PPE OUTLET (FOR 4" THIN WALL PIPE)
MATERIAL -PVC PART NO.30142-R
OR OPTIONAL FLOAT SWITCH
(FOR 110 MM. PIPE)
PART NO.30142-EUR
UN
Versatile, Indoor or outdoor liquid level alarm system.
This alarm system monitors liquid levels in lift pump chambers, sump pump basins, holding tanks,
sewage, agricultural, and other water applications.
The Tank Alert' XT indoor/outdoor alarm can serve as a high or low level alarm depending on the float
switch model used.
The alarm horn sounds and the red beacon illuminates when a potentially threatening liquid level
condition occurs. The horn can be silenced, but the alarm light remains on until the condition is
remedied. Once the condition is cleared, the alarm will automatically reset.
A "power on' light on the switch indicates power to the alarm panel.
Enclosure meets Type 3R water -tight standard.
Automatic alarm reset, horn silence switch, and alarm test switch.
Alarm horn sounds at 85 decibels at 10 feet (3 meters).
Alarm system (when Installed on separate circuit) operates even if
pump circuit fails.
Complete package includes standard SJE SignalMaster' control
switch with 15 feet (4.57 meters) of cable (other lengths available)
and mounting clamp.
UL Listed for indoor or outdoor use.
CSA Certified.
• Five-year limited warranty.
Emluu2a
SSPr sA®W �L
lRN245 naTEp
29e2
•' •
When ordered with the alarm, the system Is available with:
alternate float switch models for high or low liquid level warning.
auxiliary dry normally open contacts for easy attachment of remote
devices.
premounted terminal block so enclosure can also be used as a
junction box for splicing pump, pump switch, and pump power. Meets
NEC standard for junction boxes.
6 foot (1.8 meter) power cord and liquid -tight connectors.
VOLTAGE: 120 VAC, 50/60 Hz
ALARM ENCLOSURE: 6.5 x 4.5 x 3.0 inch
(16,51 x 11.43 x 7.62 cm), indoor -outdoor,
weatherproof, thermoplastic meets Type
3R water -tight standard
ALARM HORN: 85 decibels at 10 feet
(3 meters), meets Type 3R water -tight
standard as installed by factory
ALARM BEACON: UL Listed, Type 4x beacon
assembly
TEST/SILENCE SWITCH: certified to IP66 and
IP68 standards
AUXILIARY ALARM CONTACTS (OPTIONAL):
120 VAC, 5 amps max., 50/60 Hz
PRE -MOUNTED TERMINAL BLOCK
(OPTIONAL): 20 amps, 120/230 VAC
POWER CORD (OPTIONAL): 6 foot
(1.8 meter) cord with 120 VAC plug
FLOAT SWITCH: SJE SignalMaster• control
switch with mounting clamp
Cable:15 feet (4.57 meters), flexible 18
gauge, 2 conductor (UL) SJOW, water-
resistant (CPE)
Float: 2.74 inch diameter x 4.83 inch
long (7 can x 12.3 cm), high impact,
corrosion resistant polypropylene
housing for use in sewage and non -
potable water up to 140'F (60'C)
4>
SJE RHOMBUS.
1-888-DIAL-SJE • 1-218-847-1317
California Prop 65 requires the following: ®WARNING Cancer and Reproductive Harm- www.P65Wemings.ca.gov 1-218-847-4617 Fax
SEE REVERSE SIDE FOR ORDERING INFORMATION. email: customer.service@sjeinc.com
SEE PRICE BOOK FOR LIST PRICE. www.sjerhombus.com D.13
Versatile Indoor or outdoor liquid level alarm system.
ORDERING
STANDARD
Part#
INFORMATION
ALARM r Shipping
Description Weight
1009923
TAXT-01H (120 VAC w/15' SJE SignalMaster High Level)
3.00 lbs.
1010261
TAXI- 01L (120 VAC w/15' SJE SignalMaster Low Level)
3.00 lbs.
1004442
TAXT-01H (120 VAC w/15' SJE Sensor FloatHigh Level)
3.00 lbs.
1005140
TART-01L (120 VAC w/16' SJE Sensor Float Low Level)
3.00 lbs.
1005141
1 TAXT-01X (120 VAC no float)
1.50 Ibs.
STAN a +
Part#
• e ALARM (120 Block
Description
Shipping
Weight
1012416
TAXT-01HAUXTB (120 VAC w/15' SJE SignalMaster'
High Level Auxiliary Contacts TB
3.50 lbs.
1022241
TAXT-01HT8 120 VAC w/15' SJE SignalMaster' High Level TEI
2.00 lbs,
1005481
TAXI-01HT8 120 VAC w 5' Sensor Float' High Level TB
3.50 lbs.
Sensor FloaV Low Le
t
VAC no float TB
1009214
TAXT-01HAUXTB (120 VAC w/15' Sensor Float' High Level
Auxiliary Contacts TB)
3.b0 lbs.
STANDARD
r Options
Description
Shipping
Weight
Part#
1008850
TAXT-01HAUX (120 VAC w/15' Sensor Float° High Level 8 Aux Con)
3.50 lbs.
1008600
1 TAXT-01HPC (120 VAC w/15' Sensor Float' High Level Power Cord)
3.50 lbs.
H = High Level L = Low Level X = No Float TB = Includes Terminal Block PC = Power Cord
AUX = Auxiliary Contacts MASTER CARTON holds 12 boxed units.
SEE PRICE BOOK FOR LIST PRICE.
SPECIFICATIONS
VOLTAGE: 120 VAC, 50/60 Hz
ALARM ENCLOSURE: 6.5 x 4,5 x 3 inches (16.51 x 11.43 x 7.62 cm), Indoor
-outdoor, weatherproof, thermoplastic, meats Type 3R water -tight standard
ALARM HORN: 85 decibels at 10 feet (3 meters), meets Type 3R water -tight
standard as installed by factory
ALARM BEACON: UL Listed, Type 4X beacon assembly
TEST/SILENCE SWITCH: certified to IP66 and IP68 standards
AUXILIARY ALARM CONTACTS (OPTIONAL): 120 VAC, 5 amps max., 50/60 HZ
PRE -MOUNTED TERMINAL BLOCK (OPTIONAL): 20 amps,120/230 VAC
POWER CORD: (optional) 6 foot (1.8 meters) cord with 120 VAC plug
FLOAT SWITCH: SJE SignalMaster` control switch with mounting clamp
CABLE:15 feet (4.57 meters), flexible 18 gauge, 2 conductor (UL) SJOW,
water-resistant (CPF)
FLOAT: 2.74 Inch diameter x 4.83 inch long (7 cm x 12.3 cm), high Impact,
corrosion resistant polypropylene housing for use in sewage and
non -potable water up to 14U0fi^FF (60'C)
MAXIMUM WATER DEPTH: 30 feet (9 meters), 13 psi
ELECTRICAL: 5 amps,125 VAC/250 VAC, 50/60 Hz
CONTROL SWITCH
OPTIONS
The Tank Alerts
XT alarm system
comes standard
with a 15 foot SJE
SignalMaster" control
switch with mounting
clamp. Other float
switches are available.
See control switch
section of the catalog.
To determine the
price of alarm with an
alternate float add
the price of the part
number with *no float'
to the price of the
float switch.
UL Usted rN
Miss a III - -s
MUnee
o (CPO
urns L� 3+,
:ear
SSPf�
Option
Description
AUX
Auxiliary Alarm Contacts
(factory installed)
PC
6 foot power Cord with two
RCC81/2 Inch liquid -tight
connectors
f>
SJE RHOMBUS.
www.sjerhombus.com
customerservice@sjeinc.com
9600097E IWS
0 20% SJE, kv. Al Right. R.wrwd
SJE RHOMBUS is a tretlnnark or SJE, Im
PIOd,vt offerkv end prialrlg am su Bfit to churVe N<'(tx)I/t noble.
0.14 Please Est w ..yerhombus.com /or the most cement eifam don
Wisconsin Depanment of Safety and Professional Services Page of Z
Division of Industry Services
SOIL EVALUATION REPORT /
In accordance with SPS 385, Wis. Adm, Code Comity Sf r 7X'
Attach complete she plan on per not less than 8 1/2 x 11 inches in size. Plan must Include, Parcel I D
tart not llmtted to: vertical ar horizoraal reference point (BM), direction and percent slope, Q 30- /O/ — 60 —owe
or dimensions, north arrow, and location and distance to nearest road,
Please print all Information. Revlewed by Date
Personal information you provide may be used for secondary purcosers Wfl Law, a. 15.04 1 m .
Property Owner
// jblj
roperty Location //X�X ss.+ t✓r
'ail i C ovL Lot ,iE Y. /4JVK S T zq N R i� E (or)(55
Property Owner's Melling Address 7// �Q r ,/i�lock t Subd. Nema a CSIuv(/ City State Zlp Code Phone NumCity V11 Town Nearest Road
o, t yt� NO/61 1 $*1
New Construction use: Residential/ Numberofbedrooms �Code derived design Raw rate -A2GPD
Replacement ❑Publicorcommercial— Describe:
Parent materiel T-W Flood Plan elevation If applicable _ n.
General comments and recommendations:
n oo�� tt
a Boring * Pk g Ground surface efev, J L k. Depth to Ilmking factor 7 2 In.
Solt
Horizon
Depth
In.
Dominant Color
Munsell
Radox Description
Qu. Az. Cont. Color
Texture
Structure
Gr, Sz, Sh.
Consistence
Boundary
Roots
GPD/Ftr
•Effft
•EfN2
2Mv
w
2c
2
- s
7..S
4., 61r
►•+
as
Zc
6
3
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7X Y
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f s�
L
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V
r—
O
Boring B,
BoringrF�Q PR Ground surface elev. (� R. Depth to limiting
—factor
—21 In. —
Soil cool Ytation Rate I
Horizon
Depth
In,
Dominant Color
Munsell
Radox Description
Qu, Az. Cont. Color
Texture
Structure
Gr, Sz. Sh,
Consistence
Boundary
Roots
GPD/Ft'
•ERN
•Efle2
0-7
3. z
—
E
2►,
wrr
4
7-11
2S
Gej
2.1- ro
7 f 1
6
c
."
WvIri
10
2
CST Name (Please Prktt)�
Slgroture
CST Number
Address +3s S J „
Date Evaluation Conduc ed r
Telephone Number
171 Boring #
IBoring % Pft Ground surface elev. fin. Depth to limiting lector in.
Snll AmIlrwHnn Om.
Horizon
Depth
In,
Dominant Color
Mansell
Redox Description
Qu, Az. Corn, color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FP
•EH#1
•ER#2
f
0 7
S z
r—
G
Z
•«f,-
et
2 c
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• P
b
t*vler
41
5'
94 S
. YX C1
S'`
-fG.
el
❑ Spring #
❑ Soling
❑ pit Ground surface elev. _ ft. Depth to limiting factor _ In.
sue n .n Dee.
Patim Description
Qu, Ar. Com Color
Boring #
❑ Boring
❑ Pit Ground surface elev. _ rt. Depth to limiting factor _ In.
Soll Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu, Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FP
'Eff#1
'Elf#2
• Et0uent #1 - BOD, > 30 s 220 mp/L and TS8 > 30 s 150 mg& • Ef0uent #2 • SOD, > 30 1220 mg/L end T88 > 30 s 160 mplL
82 -,
94.8' 93.1. 'M
98' t93' iF 91' PMPWb
�;" ;W Liras
B3'•
98
B1
BM 100' 94.3
hwn � • _ rya,
sn.a
7W
Scak 1' = 70'
1
Gene and Heodw Eke
mac River Rd.
Hudsm WI 54018
030-1019,80-000 I '—
SE114 NW 114 S5 T29N R19W �f1ValNey
BARTON SJUGSTAD
1385 13TH ST
BARRON, WI 54812
CST 128563
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE A!
Property Address
AND
OWNERSIiIP CERTIFICATIONFORM
-9,);of t t 1,
1-70
D
%10�
from Piauning & Zoning Department for new construction.)
City/Stale ptV� aD wj W 1 Parcel Identification Number O 30 R - L,0 - 0 vn
LEGAL DESCRIPTION
PropertyLocation _t,�r/, , Aj k) % , Sec. 15� , T -;?,IN Rj' W, Town of S T- .�o-50yk.!
Subdivision Plat 3 33 LG r.y Lot # �L
Certified Survey Map # 3 33 6 00 , Volume , Page # �S 1- _.
Warranty Deed #
Spec Louse 0 yes)60
(before 2007)Volume , Page 4
Lot lines identifiable Vkes 0 no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result m its premature failure to handle wastes. Proper
Train anance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you pert into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 38352(1) and m Chapter 12 - St.Croix County Sanitary Ordinance.
The property owner agrees to submit to SL Croix Coumty Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, joimmeymaa plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1 /3 full of sludge.
I/we, the undersigned have read the above re#remeuts and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department ofNatu al Resources,
State of V, Isconsm. Certification stating that your septic system has been maintamed must be completed and retumed to the St Croix
Coutrty Planning & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on Th' form are true to the best of my/our knowledge. I/we am'are the owner(s) of the
property described above, by virtue of a deed recorded in Register of Deeds Office.
Number of bedrooms _�i_
SIGNATURE OF APPLICANT(S) DATE V
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoming Department ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed_
(REV. OVU)
St. Croix County
Accessary Structure Affidavit
E Fj��
Name — (owner) Typed or printed
being duly swom , states, under oath, that:
He/she is the legal owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume — Page = Document
Number 64Z St. Croix County Register of Deeds Office, Recan
being duly described as follows (include lot no. and subdivision/CSM or Name
detailed legal description):
Lb�- Z oC C�rrz�:� S ft/� •►�
✓o lv."�C_ L P,.��
i'lu a,ulgq�
1089997
BETH PABST
REGISTER OF DEEDS
ST. CROIX Co., WI
RECEIVED FOR RECORD
10/08/2019 10:43 AM
EXEMPT #:
REC FEE 30.00
COPY FEE 2.00
PAGES: 1
Area
d Return Address
LASehe u tke
d. 13aX se b
AAkow tAT 5L1
unification Number (PIN)
I-/ot9--('0—I
As owner of the above described property, I acknowledge that the Private Onsite Wastewater Treatment Systefm�
(POWTS) services both an existing principal dwelling and an accessory building on this lot and is sized for arwr(iL)
bedroom home, or a design flow of _�O gpd. This accessory building may not be used as a second residence on this
parcel. I also acknowledge that I will disclose this information and stipulation to any future parties interested in
purchasing this property.
Dated this �' ` day of
r
AUTHENTICATION
Signature(s)
!authenticated this day of
It
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, W is. Stars.)
TMSS INSTRUMENT WAS DRAFTED BY
✓T. Nd�fi C�OJ„�{.� GdMws.r.w:. �1.
(Signatures may be authenticated or acknowledged. Both are not
necessary)
ACKNOWLEDGMENT
STATE OF WISCONSIN )
)ss.
St. Croix County.
Personally came before me this day of C.
aD (4 the re
named
to me known to be
the person(s) who executed the foregoing instrument and acknowledge the
same. yssa�nasw
* �/,ILA.O A-.Pa�a,�
Notary Public, State of Wisconsin
My Commission is1 permanent. If not, state
Dak: � d- /oZ. f 2f j /
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE"
This information must be completed by submater: document title name & return address and PIN (if required). Other information such as the granting
clauses, legal description, etc. maybe placed an this first page of the document or maybe placed on additional pages of the document. Note: Use of this
cover page adds ane page to your document and E2.00 to the recordtne fee Wisconsin Statutes, 59.43.
St. Croix County 1089997 Page 1 of 1
IV
LEFT SI E ELEVATION
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OCT 02 2019
St. Croix County
Community Development
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Wisconsin i� ervices a Page — of —
Division of I —(
5 2019 SOIL F\/AI 1lAT_ I� 0��E=- J
MAY 1 Inac once with SPS385, Wis. Adm. Code County
Attach complete site Ian on Paper not &49 8 112 x 1 inches in size. Plan must Include,
but not limited to. ve ' al and �dri€6 119WOVO M), direction and percent slope, Parcel I.D. ®�O� O/ — 60 —Owen
scale or dimensions, pwu etanca to nearest road.
Please print all information. Re d by / i Date .7 /I
Property Ovmer// ---- - Property Location XXaX�Cd H«J/Ss.+t✓l- �I /�
i�en i Z Govt. Lot SE Y. /viy K S ,S T 2q N R i`� E (o)
Properly Owner's Mailing Address Lol #` Block # Subd. Name o CS
171/ FQir ,0-, 25-X
City State Zip Code Phone Number ❑ City ❑ Village CRT=n Nearest Road
�41T 1 rNOl6 V
New Construction Use: XResidential / Number of bedrooms �„ Code derived design flow rate _J62 GPD
Replacement ❑ Public or commercial — Describe:
Parem material Ti 11 Flood Plan elevation if applicable _ ft.
General comments and recommendations:
uBoring Y Prt 11y Ground surface elev. y J ft. Depth to IirnWng factor z2 in.
c,.a e�.•aet.,� Rmeam.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
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Structure
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S I AI mill tion Rate 1
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Depth
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Munsell
Redox Desuipllon
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
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Signature
CST Number' 24P 37 jj?
Address .1
7i s ulf4
Date Evaluation Conducted
Telephone Number
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❑ Pit
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Depth to limiting factor In.
SoilSoil A
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
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Texture
Structure
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Consistence
Boundary
Roots
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❑ Boring #
❑ Boring
❑ Pk Ground surface elev. _ h. Depth to IimPong factor _ in.
Sd1 Aoo
®®®Redox
Description
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Effluent #1 • SOD, > 30 9 220 mg1L and TSS > 30 s 160 mgA. • Effluent #2. BOD, > 30 s 220 mg/L and TSS > 30 s 150 mg1L
N Scale 1" = 70'
-
--Gem and Heather Eike
m River Rd.
Hudson, WI 5401E
030-1019-60-000
SE1 /4 NW 1 /4 S5 T29N R19W
BARTON BJUGSTAD
1385 13TH ST
BARRON, W 154812
CST 128563
B2
•. 94.6'
93.1
98'
B3••
86'
BM 100,
Neil in
IS
Tree
River Road
:9r
B1
94.3
Driveway
SM
Property
Line
Wsconsin Department of Commerce
PRIVATE SEWAGE SYSTEM
County. St. Crr01X
Safety and Building Division
INSPECTION REPORT
Sanitary Permit No:
GENERAL INFORMATION
(ATTACH TO PERMIT)
617708
State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)I
Permit Holder's Name.
City Village Township
Parcel Tax No.
Gene and Heather Eike
TOWN OF SAINT JOSEPH 1
030-1019-60-000
TANK INFORMATION IC„nos 7' A. t.-
TYPE
MANUFACTRPER
CAPACITY
Septic
)z 5 a wirxs-
I
25-a
Dosing
-75 c �o
T
r
o\ o S25
TANK SETBACIdINFORMATION 6% W),
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
85,
750
53`
5G'
Dosing
Aeration
Holding
PUMPISIPHON INFORMATION
Manufacturer
Demand
GPM-
Model Number
'PC/�V,�_J
u
TDH
Lill
Frictio
o,
System Heatl.�
I rI
U
Ft
Forcemain-I
Llengh
t Dia. It,
Dist. to wen 1� tTD
SOIL ABSORPTION SYSTEM
BED/TRENCH width I Lengtt
DIMENSIONS U L
SETBACK SYSTEM TO IF
Ing
SYSTEM
ELEVATION DATA
TATION
X3'.
BS
HI
FS
ELEV.
Benchmark
0•0
Wilt)
Alt. Bluff P
t
+3.1
Bldg. Sewer
wer
SUHt Inlet
om
n15
26
SUHt Outlet
Dt Inlet
Dt Bottom
��"
05-
ead Man.
IO s
8 1 5
Dist. Pipe
Bot. System
%i
�. Cl
I
Final Grade
2, S
I' 1 I
St Co
qr
14,
8
7rxcti"'T,t,,Ki 1%lAd-
13 • L
X7 1
U o
CHAMBEROR
UNIT
r.
Header/f ulanddold
th IF
9-
Len Dia
Distribution
x Hale Size
x Hole Spacing
Vent to Air Intake
i t ends
PIp9th Dia Spacing P 9
Len
SUIL GUVLK x Pressure Svstems Only xx Mound Or At•Grada Svsta an Only
Depth Over t
Bed/Trench Center ,1
Depth Over \ q
BediTrench Edges % I / I t
xx Depth o f
Topsoil I r t
xx See led7Sodded
-
xx Mulched
-
P1
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 51� -70 Inspection #2- /�
Location: No Address Available
l Y h, N � I�. -J_J �,,� �r
1.) Alt BM Description= T) I-kf CO V'(.� 6✓CL s 4&n A4- -1/
2.) Bldg sewer length = �� I„ � C LO / t
- amount of cover = 1 I r1 a 'Jj� �►�
c°� ®4rsee.��Eo�, � ns.g La,-k
% Plan revision Required? ❑Yes No �j\JI ,d
I
Use other side for additional information. v I qwi�h I
SBD-6710 (R.3/97) Dale Insepctor' igddture Cert. No.