HomeMy WebLinkAbout018-1094-14-000 (2)DiifOPY
PRIVATE SEWAGE SYSTEM
PAY
S St. Cd01%
Not nine ¢.im
INSPECTION REPORT
Amart ml xo.
61]]12
GENERALINFORMATION
(ATTACH TO PERMIT)
Ross Men 10NY
m,
IS MS
eMNeme�g
o Village"I¢wmn
weTOWN
nmx
Thomas & Christine Sauer
OF HAMMONO
018-1094-14-000
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TANK INFORMATION
ELEVATION DATA
TYPT
MANUFACTUREe
CAPAl
STATION
AS
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To
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seen¢
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TANK SETBACK
INFORMATION
StU,Gwe,
IANK O
4FA
m
in
lel
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seal:
) ZS
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Bottom
49.6
Dosing
7 LS
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Am Be,o
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PUMP/SIPHON INFORMATION
Ross Gi
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un 9 Fnale s
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5OIL ABSORPTION
YSTEM r pJ),9 9 ,
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UNIT
DISTRIBUTION SYSTEM " Ln¢ f17 yL a 51
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COMMENTS: Ilnowee cmaenoepencee wham geeem. eIy
Loollon'. VU1WTH AT
I ) At ON Del"Phs,. F1L,_ Gnu
Re,e,Mn, -
;o ,aaeN,w�lonamp
ANY
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n
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Safety�. M�.ya..-ido PD10= Sti. Crolz
�3a1 W WeMvgiw� Ave.. .0, 71U wu�y"R H�Nfi
rr; sp r' BC).032019 paaison1;iMrw-nsa_i (pI7712
Sanitary Pemhit Applica' air H
aa;m. W�. M. N�. f;��,,,
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& Cwsuae aauer
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CONVENTIONAL COMPONENT DESIGN
Feaikinpal PFpibmtkan
WDP[ AND TITLE PAGE
Project Name'.
Sauer Replawmrnl
Wnees Name.
Tom Sauer
Owrees ieldhms
962 WEI Street
Hammond Wi.
Legal Description
NW I/4 NE 1/4 S 19 T29N R 19W
Township
Ilammond
County
St. cmix
Subdivision Name.
Prairie Run
Lot Number
14
Parent ID Numt 019-1094-14-000
Paget
Ini and that
Page
Plot Plan
Page 3
System Suing B Creme tkxlron
Page
FiXer Space
Page 5
Maintenance Information
Page
Management Plan
Pagel
SI. Crw Cry Satire Tank Manlenence Form
Parer
Warranty(NhW
Page
CSM or Plat
Attachments. Sot Tm18 House Plars
)eSgner/Plumber. KN%KnudWn LIro+Ise Number. "W3
W1e 10/012019 Phone Number (651)470-1937
Signature
ii Pnun4 on, Irvamma eM Atan Aen C nt Mew' W FGWTS Worn, 205961PrOW IN 01100
Pga1
7"La-� Flan
ti W t./.P NF Vy S /7 MrN Q J7 UJ
71,povos d eh.r 'nr gA a
40f W 1eaioie XQ
!/t .w.+o� Tow,vsbJP
/obi �roq
1p"15
f - 8*� /_ Pv
F )6_( 96.A°
1 qG 00
�d /6-3 9L.oe
�G1sJ
m_ I e• �oi
—/G1 aT--
f96 6094.20 q
93.20
�iemeM F SyeM�n egs�wMn
3.00 q 4.00 q q
�R J
fl
fl
LWim CNmEr BoaeMetlluw
Menufedunr Mtl Mo l
EISARu"20_00 WftWOa r SW AyMkalM0R 2.30 OPyyq
450.QS 9M Desgn Flows 2.30 SMI Appfte0wiR s20.00 EISA= 51_00 CgsmpPn
3m of 1].00 cM1amEMsmM.
Pa a_M_
POWTS OWNER'S MANUAL& MANAGEMENT PLAN Page I of?
Owner Iout Sauer
Sock Trk CAmlty
03 102
lB
mnita
Swk T.nk Menurmma
vVilemal onR
hi
DESIGN PARAMERF
EIILmt end, Man MMM Zable
0No
Numbx of Bach 3
0 NA
EXLmn Fiifter all
m NA
Mmil M Nbrc F"My ends
0NA
Pump TOM, Capedry
S00X5-30NA
CI NA
FaLnartl Row l averap)
Wtl
I4mp Tmk Mm&r w
Wieser
0NA
snip, flow Ipaekl. IFs4mpri v 1.51
5%/
asap
rump MW.rtxWry
Goulds
0NA
M1 AM'syon eme
ale M
Pomp Mmm -
EP 04
0 NA
stendeMMNuenVE .t endue
fans, OR A Gmew YOGI
4Wimnical Orygen DmnmN IWOYI
TMM Sommtlm sabod Ml
MonrM1ly,vil •
90 m &
u20 mp/L 0NA
5150 nil
PfAr not end
0 SmdlGtwel Fba 0 Per FMx
0Mmhmi,,1 Am n 0weuwid
0 Dldmfe m 0 UMe
hWened Effluent Due"
9wCnk aal oxygen Domil (sued
Tom SuspmtlM Salted ffMR
Fsel CmHM,, leemneolc mev0
MonNN average
Ao ral
as "al 0 NA
51Mcru/(acme
Dis II CeIlls) 0 NA
¢'(rvZmad Mwe) 0InGwel Iprassuvafl
0 At -&Me 0 All
0Carei DOtM1w:
Mw imun EMuvrt Pickle Save
Ie in du.
0 NA
bass:
0 NA
o NA
°tln'
o NA
vat. rymml to, danem.t w,a,wamrw rotme mment
oNA
u
SMA,e Event
Seem finspodwer
Inapct mntlmon of ben l
At leant ones Mwy.
3 g' al¢I Mmrlum 3 evil
0 NA
oym My ma of rental
Man mmenetl apel and atom moat mrthad 161 of tank 11mare
0 NL
limo diapa¢Y cellis
At Met ono A) '
61Q IMvimo 3 fuel
/ 0
0 NA
a M
0 forshlel
DMA
Ckn Yemen NIN
At least min wT'
o mamhbl
0 NA
lupxt Wmp, qmp mntrdo & almm
At Ira rem evry:
'
0vi
0�
PUN INN¢ wY model test
At IUM moe wry
0 wnNl¢
0 ymlN
0 NA
O xA
MAINTENANCE INSTINGTION3
sim,,nms If trek¢ and disawal cYm sha l he mole by an mdiribna carried me of mM Intel room Of "Mandma:
Mastr pen ehm MMa w %urMNrviaa3 Sower: PDVR" Inapda wr PoNTS handsel.Seeing, Mrv,ing Draatn. Tank
apmticn¢ mua beady a NmY lesions, of tlm ni to idrtiN MY reason or bmkan dvdware, itlendly any cask, or 'Al.l
inn Me MeM, M wmil MMA sm More and to chat for MY seek up Or real of effluent an Ne ground surface.
The dM mil sYljM mull be .MUMIn iomenm he check the ,Mort l"S 0 NM ,bwvAie, pryer and M chock to, Pool
of mrsmst on the proano wima, fhe pending of Mmuem on the greed awtse may Indicate a fills Moil m and rme rn one
wMandim, notir amn of me AM rembedis Y mm.biny.
Wsr be wmb'mm onearrowal of soda, wil own in of tons rctla onsethind IVI m Mae
of Nbank ank rawmer ins
,mrsetl of Ne tmk shall the mnml by a Yomal Srnioing ClmN andd'apoead of inuwtlmawas mmaw MR 113,
Meadow Administrations Late.
All box snvicae, InclWsg but not freer tP th xrvtind of MNWam bill mecharal or pNu W cors anen4 prmMmnmt
marts. and my myeama or newe6 of 513 mntha, shall be pafoll b/ a maim! PoWrS MRSOMmr.
A derv® rend( shad M rovsM to MY same ugul ow, Metal mm, 10 days,( cmnPielea of my awlee avant
Pas Znf Z
START UP AND OPEMnoN
For new corporatism, paper to use m Me FOWR Mark bmVmlt modest Far we groan# OF p MMR praelx4 w proud MmlAals
Now pas impede Me O•atmmt precua maim damage May eiw•ra•I cool:). If high bloodstreams we d#•mW hands me conrerm
of the to lq mmovM by a eeptepa m%umg metal plim an ins
System Mart up shall not o=or whim mil mndiMma am around at Me nfkmiv euOl
Ourds power wasgm punw amb Mary IN above nnrmnl highwAd low)•. Mw pmva In rwmm Me "OM Wa wdw alit be
Willharyled to M• Model NRaI in one lazm ama, ovedo al Me caliph and may heat in and backup m • me dismmp• of
efenntc To ,aid min Mac# wa Me cm ma of pump tank and h • Sgmpme Sam cinggO Operator and, t on
pow o Me slRu•m parry 1w •Plumber 1hT3 Modanm m am# u8br o 'ng M• p comrok [we
rewor, momna' bvala withal My Wrap MIL
Do nN der• a park which• its trot• mtl diapxaal cull. Co not drive or perk par, or Yemeni dliburb or compact Me was
with, 15 test down abpe of My Mound or shared, soil et ergim am•.
Reduction m aMinedm of the folbwing Chun Me wa mW" Weer mry improve the p mme• and pmbng Me Me M the
PDWTS: amdodca: baby wipm; cgd#ae bowl condom¢; Mmm swell; dimm"mo demo bi distant; dianizxam.; M:
foundTim dram parts Wmpl ways; tm'n and veg•uble peefmga: Rwanda; Runyon, for ictlu; meat •Crrys, matliutial oil;
p•i,mg produPa: psadcpx: "Imly mpktoq tanpom: and within sokener bane.
AeANOONMEI
When th, POWTS falls aMbr u pe;mmmtN taken our of advim Me bllowlnp aaps MMI ba Mean 10 i m Mrt and blame b
V m,Y Intl "Nit wandomd "a mmpance with chnpmr Comm 83.33. Wxnnn AdminiNThv Cape:
• All iinot #tanks arm pimshuW Wdi ,naMW nay MeadaMo ohm openingsmNei.
• Th• controls of •II tanks vW pas shall be Ismael and ommary disposed of by a 5•ptege 9rvc'mB Operator.
• Man, rympinp, all tanks and pit, •hall be saturated and mmm'•d of M8c #vas demand •M del votl apes IIM wtth
bull, gmel or mots info mid material.
CONTMGEXCY PLAN
If me P0aI falls and c"Of be repaked Me folbwmp mee•mu head ban, or must be room, ao provide a mtl, cunpli•m
monwimisom miall
❑ A dable impedimenta will has taan ovals and and now be udliad Cm the p1MM Of n mMacsm•m •ol' admpdon
aymm. The eplam lee should be damnedest trim diaMAm mtl ce p c and should not be'mhinged team by
r•pwe! mmxm arms a µ¢dog and proepe•ed Nucwm. ha Nam and valid. mFlesh,m paraphernalia mMtst
pred will
remh m Me and she mull tom WW, ambleapls t.reaav Wm Imot
comply wM Me m�bnme aNam ndal
❑ A durable mpl••dmnt and, is not available due to •#beck ambr ail 4maidecm. Pvmq advmM an POWTS
/Q/� teeMM9Y o, homm lg fork may bs real by a am award to maybe Me raw PON?s IN an
laz. 1�i2DNIHTIfa HR N@r✓ �/wS(AJ�TLOhI k
0 Mound antl armed, •oil appiaMm, om ems may be Isconabuaad'a gam Moday al III of M• dinmm of Me
infiMenve surface. Isotherm ne of such aymemt area c Pit wild Me rubs nit effort for Ma Ihn0.
c c WARi>
SEP1K. RUMP AND OTHER TREATMFMT TANKS MAY COMTAM IETNAL GAEMM ANOIOR IN6LFMIEFIT OXYGEN W NOT
EXTER A SEPTC, PUMP OR OTHER MIUMN EM TANK UNDER PXY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
Pp6ON FROM THE INIMMOR OF A TANK MAY BE DIFFICULT OR MVbS5 .
mi INSTA11l31 PoWIS NAINFAV®r
Hama I Keith KnutltsoG None
From 1 651470.1737 Kroner
STAGE SERVII OPERATOR IRIMFFM I OGAL REGVIATOW AVTIIONTY
Note Powers LiquiE Waste Name S . C 1 ZWI
Ina. 71S2465]36 ill" —71! — 3w(o— (A a
,an museum win dnnaJ,n umprw®who chWah Comm M.uIZRMDRdISm aw s3.5411I, IZI AISI, wwv,um ABnm own.
ST. CROLC COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Thomas & Christine Sauer
MvlingAddress 962 167th St
ProPmry Address 962 167th St.
(vvifimticn nquiml6em elvming m IDwng CePerwe°I for new wwMNoo.)
ca,rslatc Hammond Wi. Parcel Idmdficationxumber 018-1094-14-000
LEGAL DESCRIPTION
Propeny, location NW v., NE_ v., Sec. 17 T29 NR17 w, Town of Hammond
Subdivision Plat Prairie Run
Certified Survey Map#Volume Page#
Warranty Deed# (before 2o07)Vohwe , Page #
Spec booze Ayespto Lotlios itWdfiebb�yes�m
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maiMeonoce afyour sepdc eystem uvula reSaM iuitz premature Giluretu M1udle wezte+. Proper
6uf Pompon& ottt NeSepncfunk everyehne Yews or motor, ifneedN, bYaliernSetl Pmnper. WMryuupN lets
the syuetn ian al&n We fuvction ofNe septic nnk ez atreawmrmga in Ne wrc tluposel ryaem. OxwmainNtmnce
mspansibilitio ate ipeciled in §SPA. 383.A(D and in Cbapl<r 12-SL Cron Counry genYary Orainume.
ne pmpntY Owner a8tves 4 submit m St Crom Counry➢lemon&& Zonin6DepattmetR a curifiealiou bole, signed by Le
owner sa by a mast,, plumbs, jonmryman plumber, usu,t dplumber ar a littnaed pmnper wifying that am 01ni4
weNewnm d'urese system is w proper opvating condition and/or (2) after inspection aM Pumping (iftucwwy). We septic mnk is
hot Am Ili WI of sludge,
Vue. the Mdersiuea love rude slow ;sMiremeats aM agme to maimein the private sewage disposed Assets With 0e
sadda set bnh,bm,n, inset byM D4armml of Safety Md Pmfssiml Smicesmd[be Neemnent ofNmvelRmmee;
smteawissensin. cenificLion Sutiog thnt yom5rytie 5y5tun hasbcn mainuitted leaucewtsvldea sod tautmadw We st Cloix
C Myy Planowg&Zmdng Depattmend wMin 30 days o[metlueeywexPimliatdete.
VAw cmify o,8,b sums, son Wu deed
trvemtha boosteroomkvowledgO. l/weaMarebeown(A)Oftlw
pmferty deamMdebove, by viNte ofa ytleed rewtdedw8egutu o(Deeds l>Sice.
Number of bearoome 3
SIGNATORP�,I EOF APCANT(S) DATE
xxapnY io[brmmion thvt is misrePresetned may rtsult intM zmitary Permitbeing rooked by IM Plvmmg&Zooing DepNmeN. x"
Include with Ws application a «mMed warranty deN oom the Registm ofDeMs Odce aM a wpy of me c utued survey map if
vi is Lowe mwe Wammy deed.
DIE,,. 01/I2)
PRESSURE FILTER INSTALLATION S SERVICE INSTRUCTIONS
amaclV: lE a$g33N lwrinr-sez-nun
rgnt a www 582.7324
INSTALLATION - — —
-
Whenins011inganSTF-IM screwfilterinbdischage pad Of any pump Mat hasa2' National Pipe Thread. Purnmanth
a smallard' Alage port may beabapte l to fit Men inslalfng an STF-100P2 a taudi ieca all male adamerwill need 0 be
atltl WereinWenddMefiW(eMappasifeofthecep)b Meaesired M1eghtanda2'unianwillneMbbe
atltlM b the ONlea ell (Me end presentative cap 8 on the side of the fiber), Allays instill the (hers in a
pashion wTrere bey can be easily sarvicetl. "Always use caution when pushing threads Oavad Mass
Veeeding", Plumblorce main intothaT soh SO PVC union. ^ e recommendmaathe union remain Operator
during gluing to insure that glueor deeper does not min O}mg or sealing Muni. For best performance, da
check valve is instilled it should only be after the outlet of the filter. "
SERVICE:
ServiceoffilWwreenlsdependentonusageaseverysystemisunique. FormostresitlegalsysMnswerecommend
inspecting the filter within the fist year to determine Me neereary service intervals Mlle filth Inhghwolumesystemswa
Recommend inspection wtmM Me Math months to determine rittessary serves intervals for Me fitler. Once the mvice
interval is determined it should be consistent unless something changes in the system. Always MSPI:d the filler sereenM
any damage or ommsion and replace if neasssary. If our STF-101 service alarm switch has been installed all adjusted
Pm"rly it will alarm IMen the filRr requires sery It should be servlcM no less Man when pem iO Pumpng of the settle
tankandpump Mamber is Performed Servicing will be more frequent it using any one ofouroptional filler socks(600
mIMm,150,190micron,an:100prict. Chic purloralhealthaepa tMsepmsyaMmservidrgrecgnmendatuns.
If Pre screen beMmes dogged a MM me pans pumping requirements, a high level alarm or light will indicate the need
M service. If system is equipped vnM a "pump on IIghY that says on longer than normal, this also may indicate a need to
service Near
To sery filter sMeeR un raw me C'eap. Pull filferscreen ban canister and wash had thoroughly in appropriate
law(m with proper protection do same cases an addhional fitler screen allows quicker service allowing the dihy filter to he
washed later at the shop. Not&that In cold condificros Me What maybe Went murwve. Keep Me (rttar iris warm area
preparation wa!drover Me cap beepm removing Once Me(Jkris Installed N the fad if mainfaira as Ve temperature
eMremaWp Iha cap wlrynIN Cy, a pmdem,
If the system is equipced with our Service Alarm Synder Me fitler screen does not need service uett Me Service Narm
SMOl activates a light or m io alarm. We sill recommend Mat me filter he lnrpectM once a year for Manage or corrosion.
NOTE: The Mel dynamic Read loss of the system must he increased by 0 5 feet of head b overcame hiNan lass through
thefilter.
SERVICE ALARM SWITCH
The alarm switch is available in three preasum ranges, low head, medium head, and high 11cad Installation ¢ simple, on
SIMRECH FILTER systems, remove Y' plug from base of fillx chamber and connect Wbe fourth Nent Run Me b bs up into
Me tank r and snnect M service alarm snitch. The alarm switch is fastened M Me side of Me neservia Me nylon strap
gpvtled. Runalarmwirebalatmbox. The service aHrm svntdl can Mwired will ifs own alarm orwMl Me high wafer
alarm
Pressure adjusts Ms made by removingtheend pug, and lweringthe 1l32allen. Cbckwree increases preswre. One
brneeualsappmximaRly 3 PSI, The tow head alarm snitch comes factory prextat 6 PSI and is completely field adjustable
wiM'musrznge(3O24PSI). Werocammend Me usbaci ball wade wharusingait aHrm svnclr. Oncayouhaveinxftd
Me dferandalarmswllch,, the ball valve can be cbsedoffto simulate apluggedfillerso that you can make only, the alarm
Much U w asu g mrrealy,
^'TRY OUR UDISCREEN REMOVAL WRENCH. Our wrench Mys filter lid firmly and hacks screen for easy removal and
iruMlladan. Made a PVC plsstic.
WARRAl4Ty`
al pW VAara warrentea ageitSlaeleGs in mmerik aria workmanpna rd a µn'M of tvo>pvra fNm m¢ dale of Earthen. M no emnt
Mail G R SIMRECH FILTER, INL. de lhtl¢g any consepicntial aemegesorany labtt, malaial, heyM1l oreWv¢es repuiral b
repkre, mrretl mramstall the PrOync GAG SIMRECH FILTER, INC .'s liabilly Is IxniRa M repeiratt ylamneM MPe pen. NI
nentiesanwiddMeprdUu hasbeenlmpropeaymodR,appliepmire1W,mbjMdrompuseor8buse. Exceptasonded
he n,MEeamnomrranlieseyneaseawimplied including the wwanty MmertAanlearyor Me tyMfM,w bra surval puryan.
EEFECTIVESMem 132005
PRNFTE SEYIRGE SYStEY
'
- SL C,ch
ssry.eewmeu.etr+
e
IXSPECfM1N REPORT
�N` 0
wTrncx roPElin
Pal mMFORM�TIOx
w woamMn<vusv� O
4 XT'aa'O
Than Mcl,ml
xnnmpntl Toxnel,
MNON NLW
IF
,mdb.
psalm.
NFM
r
rnxxMFMtxurwx
ELEvnnox onus
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ue HyWpOnb
mYwM p.V.yabbyewmY
mmm
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yvq
ilw
�CO� MMFMj ,mirgwmx aeasw.yv.wro+N�`t wcl li®wtlm`M:jj]P�Y s.wxc •m✓e+nnlflx x.mmmgrn Ym01Bx1N1E tN,�1M,MTv1 R&Nrenw,s
wh
3a
M° G:IllltY�A..fi...rt�„Fb,.�J.:..
Plan
31 m
" m —; --
ar .T
xx r l i✓�e -
min
SEPTIC TAN% E PUMF CNAMB-R CROSS SECTION ANC SY wau ��••--
4" CI VENT PIPE 1T' MIN. ABOVE GRADE E JUNCTION BOX APPR
> GB' FROM DOOR, WINDOW OR WITH CONDUIT WARN
FRESH AIR INTAKE W/ P
WARM
FINISHED GRADE 4" CI RISER- ,, �}� 4
loll
TT�--'
TIGHT SEALS nT GAS-
TIGHT
C I Aa RISER EXIT
PUMP OFF ELEV. FT. + OFF PERMITTED ONLY
D IF TANK
MANUFACTURER
HAS APPROVAL
B" APPROVED BEDDING UNDER TANK CONCRETE PAD
SPECIFTCATIONS
SEPTIC / DOSE NUMBER DOSES PER DAY:_
TANK MANUFACTURER:
TANK SITES: SEPTIC ddd GAL. DOSE VOLUME INCLUDINFLOWBACNG ((6 GAL.
DOSE GAL.
ALARM MANUFACTURER: CAPACITIES: A TO INCHES v 3YQ Al.G
-- MODEL NUMBER: B 2 INCHES . 9YGAL.
SWITCH TYPE1 •••arc '�> G
C = 7 INCHES • /(% AL.
PUMP MANUFACTURER:
MODEL NUMBER: D v INCHES • /S3 "L.SWITCH TYPE:
"GE
REQUIRED ➢ISCHARGE RATE W GPM PUMP 6 ALARM WIRING AS PER ILMN
FEET
WAC
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE FEET
• MINIMUM NETWORK SUPPLY FREE Tr • • FEET
♦ w FEET FORCEMAIN X 9 dS_FT/100 FTOTALIDYNAMMICAHTEADD '•'FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH i WIDTNDIAMETER
�_:�¢
LIQUID =F"r
SIGNED:
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ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTQAZATION 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) M 16M Sava located
at: r^'r Y+, na Yy Section 17 Townrs N, Range+r W,
Town of H... a St Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 39425, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service snv+e /
Did Flow back occur from absorption system? Yes Nox
(if no, skip next line.) Jd//
Approximate volume or length of time: gallons minutes
Tank Capacity:
Construction: Prefab Concrem x Steel Other
Manufacturer (if known): w
Age of Tank (if known)- bOr
Permit rancher (if known) �� ,z
%umMt 6i6113
Tide) (License Number) MPMIPRS
Fonn 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
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