HomeMy WebLinkAbout026-1003-80-000ve PRIVATE SEWAGE SYSTEM
O.UnI' S1. CrOix
SAMEe.,a•amp C Veen
INSPECTION REPORT
SAVDHnn, ED
GENERAL INFORMATION (ATTACH TO PERMIT
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TANK INFORMATION I ELEVATION DATA
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PUMPISIPHON INFORMATION
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YY6}Ea OWNER
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Private Onsite Wastewater Treatment System
Title and Index Page
Pmlxt Namc
4SR Replacement
Oewer'a Name.
Andy Fneco
Dwner's Address
1741 Shamrock Lane
New Richmond Vdl 54017
612 502 71M
Legal Deacnpuon
AJ N
.Ss'
7e N
/I w
Municipality
❑Town,
® Village.
❑City of
Z/ r�M ea /. _
County Cluppewe
Subdivision Now
Lot Number Block Number'
Parcel 1 D Number
Page I Title and Index Page
Paget Site Plan--
Page3 Septic Tank Cross Section ar µ ••
Ldetime Fitter a
Paged _ _
Page 5 Infiltrator D4W H'
Page Filter Container 440
Page ] Management Plan ow •' "
Page 8 Management Plan
Page 9
Nameof Dabognv LMn Meaeet Telephone Number 7157208962
License Number D-1133 Dole &1&19
Designed Puraoant Tone Following POWTS Component Manuals And Comm 81-85
In- rc and Soil Absorption Component Manual S1313-10567-P (R 6190)
WA
Page I of 7
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TUFTITE COMPLETE RISER $121.40
SYSTEM (CRS) - 161
MORE VIEWS
This rut Tire 161 Complete Riser System
includes everything needed to install a riser on
your concrete septic tank The Complete Riser
System (CRS) makes R easy for our customers to
get the Im Tire products they need Now you Can
purchase a single item that includes some of our
most popular riser set ups. our Complete Riser
Systems will work for MOST concrete septic
systems All you need to do is select the correct
CPS for your system
Vle a e see below for information on how to
select the Correct Complete Riser System
OCRs) for our needs.
rely ] ADO TO CART
Add to All Add to Compare
Description
Additional nformation
Reviews
Description
TUF-TITE COMPLETE RISER SYSTEM ICRS) -16X14
Now to choose the correct Complete RiseCfi$�(�i.t�cy
TGWaslerealer uses mokesto give you the best shi no vpenence Ilyou continue to use our service, we
All Jy the Der nlydn 53
the diameter of the riser the And number us the hel)ffiPor the riser system
CLck hem b loam occur cook es
Step 1Choosing the diameter nr,k[b
4
417151 you need depends of the acess hole on your tank You cool want to measure the access hole
+est point Please use the chart below to determine the Attract diameter for your set-up NOTE If
\stem has a square access hole please use the corresponding cola mn
Your Access Hole
LRS
Diameter
Round
(Diameter)
Square (Side
Length)
16
16'or less
11"x1l"or less
20
20 or less
to"x 16"ar less
24
25"or less
181 or less
Step 2: Choosing the height
The height is up to you Most of our customer choose the height in order to bung the lid a few Inches
shove ground l evel However you can go taller or shorter R you wish
TUF-TITE COMPLETE RISER SYSTEM MRS) - 16XU INCLUDES:
• Is -Tuf-Tito 16" Tank Adapter Ring
• Is cut Tire 16x12 Riser
• lx-rut -Tire 16" Lid
• IN 20 Roll Butyl Seal
• lx- for -Tire Tar Screw At
• 8x - Stainless Steel Screws
HOW TO INSTALL TUF-TITE COMPLETE RISER SYSTEM
To learn he, to Install a rut -Top Complete oiler system on a concrete Septic tank CLICK HERE.
Additional Information
MANUFACTURER
TufiTte
ATIACHMLNT
C TarTito16 TAR Sol (36501 hip
AITACHMENI
L Tut- r It i611 Lid STre 156361 1
At LACIPLATT GTH TI1161Rn rJ27A2KIU
AT rACIIMI NT t Jet Th' inure Roe[ ST, (3799KU)
Reviews
PRODUCT REVIEWS
Rdiry S
TGVMWr64rNRrcCI%We.,a jolt YOU the sort shaping eryenenca If Ear, conmlMlnV/�(F�4CE�Ilyte
wIlAY9RPggR{Ulflgkh91G5he um ofJuch Arai Find outmare aboutcoobes and Just you ran refuse
them
1}* in Kbck here to learn about cookies
T Jeffrey the 05/07/20195/ 5 AGREE
40.
Al
INFILTRATOR
Qtl Standard
with Multil EndCap
The Ouick4i Saandard Chamber the in a 36' wide trench
and is Ideal per curved or stcmght systems It features the
patentpendingContour Sense Connection^ which p ants
turns up to 15`. right or left The MultiPart- concept all
multrp'e piping cphms and statements pipe firorge. The
cttaeres, s four toot "Ift pro'ndes [puma' ireWmem
flonpLry
Chamber Benefits
• Adoarmd conlouring corrections swivel up to 15°,
right or hall
• Lanching mBduncm albws W quick nstallahm
• Fourfootclumlvs Per easy to handle and n teP
• The wcka Standard Gurnee, snppona wlrea beds of
16 CLO IWab wish My 12- of ww
• Created by the International Associat'm /IE\
of PlumdpgaMMe apical OXlrab(l PMO) `ssl
MultiPert Enl Benefits:
pear -Out peas on ii pone pavga a light To to the pipe
Eight reardM-m InlelyaNlslS all
In, mvimum pipr9 fle"wery
Dimmmes qow fil
Fits on anner ri o1 tM Ouck<SlaStiva Cna'nix,
APPROVEDIn
The tluick4 Standard Chamber
Soil Absorobon System Cross Section
a'smeaue �e Final Grace
PVC Vert Pipe
NMn vent Cap
Leaching
Chamoer �A•�fl
~ System Elevation
3 fl 3 fl
Soil Absombon System Plan View
4114/ia
—i—ft 7 Ve Leaching
Leacbina Chamber se.cincabons
Manufacturer And Model f Fr•TIIN>•aR MVW
EISA Rating � sc fl per chamber Sml Application Rate .7 gpolsa fl
—gpd Design Flow -7 Soil Application Rate♦ EISA= 45 Changers
z rows of i1/ chambers each
Page 4 of i 2
POWTS OWNER'S MANUAL & MANAGEMENT PLAN P.ea nl 9
FILE INFORMATION SYSTEM SPECIFICATIONS
ovma. fswpr rastpLq
Tankhranuffactivar wfgyhgiN
Birseps, OWse 0NaidnO
m 150
DNA
gal
Perm11N
OESIGN PNUNETERS
Tank MmuMtlurw
fEGMIo D Dow D Happy;
vd
❑NA
gal
Nu adera EasmOm9
❑ NA
Number a Public Falllry Undu
fire but
EMueMFlXx Menukdurer /J/aT/Mf
Effluent Ald,hi M 3SMy
Gal
VNA
FnLmaled(,"raw) am
Al i
Oil proul park =(Esposaled x 15)
Are
kilo
Pump MawkcWrer
PUIry MWH
Q A
In SIW Soil APoIImtlen any
.7 war Ma
SWasM lnflumVEmuem Ouallfy
Fab, 01& Gal (FOG)
Fisca lml Nipper, Dropped d Os)
Tell Susmntletl 3alds RSS)
MmOAymp,mul
S30ngM1
420 MA
5150,it
❑NA
Pe4mlmem Unb
❑Salagert Filar
❑ Mecbanksl Aemllon
0Genksticn
mM,Amrer
DPuel Firm
❑WWand
❑ONar
addi
subeabtl EOLeM Cal
OMmkel Oxygen Oemm(SWa)
Twlsuapomm surds Dais)
Firl Witham anamablc mess)
Guerrier age
9omgM1
130 nal ¢FA
90'afts/ 1
OMpcad Call ❑NA
On-Ground(gan)p) olessor (p^ nu )
❑AAGA, ❑Mwmd
❑D,l ❑Oter
Maxknum Efflu lPagtle Sid,
%India ❑NA
WNA
❑NA
Valumlrylol brdmmxlkvaurvnmreM mpoeonketAvem
ear
�qA
Service EYenl
SaMw Frequency
maxGbkn nrmnx(a)
every ; gtel (Neal firs)
olu
ump oNmmeme of lenF(el
DYiIIe'Im �as�MdpeaM vun epui¢onaNdtl (!$leltank vduma
��
LTsVIIen Nen slam martivnKE
badM 3ryereel call
Jt ❑ with{¢)
(kYeb^nm 3yrre)
a`)
❑NA
Efrenemuemfimr
u leeapaa erery
❑fan
Moral sap. camp mno-ol:aaMm
almnoom erery omoomp)
gNA
FlW1 W,mdpepmeratl
AtkW mwrvry Omen y�al
L9'NA
At leallorlce ewer p❑meaM(sl
QqA
Ofia
fpal
MMNTENANCE INSTRRCIIONS
Imnder, Mal Fell responded panell PrOut as Made IdNOl We usual Indiana or mappear
ntern Manor rg PWTS Mann Smbm Spo Goaatr(pwo r) Talk
I rappe on¢ mud Include a xeual mspeNon of the all k Identdy any masking or broken Imrdwere, Identlly any aazN¢ or larks,
measure Ibe royal of Aerosol slutlge and aam and a cheaper far any bank up or heading a argument on Me ground sudden The
d4p mills) Mall be Msually Inspxkd to TeIX Meeffluent levels In the Mmrvabon pips and 10 Goods fir any eandng of effluent
on the grand surface The pending a effluent on the grand asked, may mdlrab: a ailing mMllbn and happens Me immedia e
neutral of Than bed requlalrry authority
NTan Me rvnbimd avumusem, N sludge and wen in any real tank awl nurtured (Gor many of Me tank wlumq Me enum
aMand M Me lank Mall be remorttl by a 3eplage sermrg Operal and dupmM of In e¢wWrm xM Seper NR 113, Weaken
AdminbOaNre Case
All uMw sanity, mdudmg but not ended to Me darning a aMuenl fih , men anal or pmsvnaed mnpanenk, praoealme d units,
thin Al Awarded; allmerv&¢ of 13 months An less mpuhe dnaumanmbn mmNsd an Me dead rradial mdmenenm rmulrar enb
A mrvim repair ahold m planned m in, Iwal rstulmory auMonry within 30 days of mmpktlm of any deeper avant
Gil Ovup1
"Ali UP AND OPERATION From 1- ajT
For new connrnnbn plmr to In of the POWTS check nealmem angel in, Me Presence of Pammor P,Muce or other merr iMa
that may impel Ida treatment Process anaAr da ate the alapgi cenbl II hwh concentrations we dented haw the tenants
of the tmMn mmxvc1 by a owner servicing operator prior 10 taw
System Iran UP shall not noon, w w son coMbroos we fro ed a in
the r varwe OUT...
During Power mtwas tamp tanks may ill above normal biabwaterivea When powor s restwW the.,C"s W weWmw was be
aixbargM to The dispersal Caul0 rat tine lot" ache ova W" the offs r and they result of the bill p, renne discharge of
enlnem To .vow this wumrnn have the contmta OI The PUMP lens rmmnvm by a Sesp edge Ssvmne Operator pry to reatohng
power To the effluent Pump or contact a Plumbers POwTS Menmwe to assist an marn es owning the pump control, m
n ore III levels with,, the pump lank
D, nor drive or Park court over tanks all dispersal Celle Do not dive or pairs over, or otherwise dnmrb or compeer, the area
within 15 feel down elope of any mound or at -grade soil absorption area
Reduction or elimination or the following from the wastewater etmun may Improve the perlormance and prolong Me Jiro of the
POWTS antibiotics: baby "spear ChIaratte butts, condemy cotton swabs, dopeaeera: dental floss; dlepn; eelnfintmb: fat,
foundation drain (sump pump) water; fruit and vegetable peslinge, gasoline, grease, herbicides, men wrion, medications . Od,
painting produce, pesticides nnntary napkins, tampons, and water mlteon brine
ABANOONMEM
When the POAFFS fails anamr m permanently Taken out Of welled the folbwing steps I be taken to mere that the system To
Properly and safely wranamea AT mmPhance with maptm Comm BJ Ja, Wisconsin Administrative Code
• All P,Pmg to tanks aid Pits shall In aaonnenW and The ebmamea pipe openmgs stale.
The Content, all all tank, ma oils shall be removed and wopwlY chmawre of by a Saba, Smvmma OWVor
• AM1armB. all ark. and Palo
excavated d fMOV W Or that covers removed aid re the vow spree bled wall
All, Moved a, wmthm mint wad material
CONTINGENCY PLAN
If Me POINTS falls and cannot had narki the following manures have been, w Most be taken, to Provide a cede compliant
replacement system.
❑ A wllabb replacement area has been evaluated and may be uM1bead for the Ipcmon Or awl absommm
system. The replacement area should be Protected from disturbance and competition and should (not belinlrnnged upon by
required setbacks from existing And pmpend structure, lot lines and wells Feature to pmfen the replacement area wall
result In the need (,, a new all mW s1Y ovaWatlon to establish s whmle replacement area Riar"I m it system, mail
comply with the rules in efon at that time
WA suitable replacement area
is not
available due to setback end/or soil gmitatmns Bening Wvancee In POWTS
ethnology a holding tank may be installed as a last radon to replace the fallen POINTS
❑ The site has not been evaluated to Identify a wnable replacement area Upon Immre of the POWTS a sca and n
evaluation must n mrformid to locate a suitable mpinement area If no replacement area n andable a hl tak
may be petalled as a last Town to repine the Inkd POINTS
❑ Mena and ITT grade III absorption systems may be rec,nst,uctW In piano following shall of the dome at the
Inblrrnrve surface RmmaWcrwns of such systems must comply with the rules an effect at that time
<<WARNINO> A
S C. PUMP AND OTHER IIIEATMFM TANKS MAY CONTAIN LETHAL GMSP MDIOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SE C. PUMP OR OTHER TREATMENT TANK UNDER ANY CNKUMSTANCES. DEATH MAY RESULT RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE OIFNCULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POINTS INSTALLER
POWTS MNMAINER
Name
/ai /TN HA.M./•s/6f
Name J$N M
Phone
7p/ Irn 28im
Phone el 9e
SWAGE SERVICING OPWTOR(PUMPER)
LOCAL IEOUTATORY AUTHOR
Name X• P•es/x C+f
palm• 7/S— M— %TO
Ties docum•nrw•,b.n.etin vvmanna with aNmer Comm e].xn71111lmem
N m 6] Sa1216 ul, wvawan Ad ItCallFetwe ce
Nwn.
� Nuivae,y
Poona
/ 9C
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that 1 have inspected the existing septic and/or dose tank
presently serving the followmggresidence:
(Streetaddress) I14j J4nrnroc.L' Znl located
an W %y�E—Y., Section Town N, Range W,
Town of Kr/'!'IMnAIY� , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
appears) to be functioning properly.
Most recent date of inspection or service
Did Flow back occur from absorption system? Yes_ No
(d no, skip next line )
Approximate volume or length of time: gallons minutes
Tank Capacity:
Construction. Prefab Concrete_ Steel_ Other /
Manufacturer (if known) J
Age of Tank (if known).
Permit number (if known)
1�1�'� KFt�FA NHIZ.i Y�it;S
(Licnsed lumber&gMmre) (PrmtName)
likstri -Ptm6c z 09g6 37
(Title) (License Number) MP/MPRS
i%�i7
(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.22012
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
f--OWNERSHIP CERTIFICATION FORM
Owner/Buyxr �"SY�d U'�I t'12 iCS1C(� / j
Melling Address �� Il� S4�rr �1 cic /-/4
Property Address 5OP)Px
(Venfci/ refuted firm Plan ..npass oning Oepanmem car new construction)
city/State IVCu��2MML/Of Parcel Identification Number O�G"/003-SD'uO0
LEGAL DESCRIPTION
Property Locationto A. Sec_, T36 N R�W, Town of C iVNC+ AIdo)
Subdivision Plat , Lot 0
Certified Survey Map ,Volume ,Paged
Warranty Deed k
(before 2009)Vulume , Page
and' Won Deli Lot bin, Micronesia OyesOnr
robot tau and mmrnenance oftouruMlc open could mull in us formaWn failure m male wane Paper
s o(pumpmg om lM1e upuu un4 every lM1ree yeas or inner ifnxded, by a Irtemed pump-r W ayru pm min
the systemanamet the mncron of the septic park as amentionl stage In the waste dieposalsystem planer maintenance
mpondbduer Are ¢perm W in CAPS 383 52( 11 end In ( hapur 13-sit CTmx County SamWy OMmanm
The post" owners&pee An submit to St ('rmx Cxurrry Planning As y^nmg Depmmcn( a wnlfcLmn farm, signed by the
owner and by a matter plumber, journeyman plumber, emitted plumber r a licensed pmnpor venfymg that (1) the on site
wastewater divi system is In proper opening perform andmr (2) after inspection and pumping (if nccrnay), the septic tank Is
Ins than I It full of sludge
liwe, the undemgned have real the edwnefmrements and agree to maintain the prove sewage thousand system with the
�e,ii Suit hot. hi an set by the lkWnmrof Snfny And Roeess vial Sm¢p and the RpNmem ofW mi Reno
'lure r",, n Carlim ing that urupnp ,,am was beenn uircd mum her wmplerN and renmW lrlM to Cry"
ting .,my Pland2,1119 Nimmemill xllbinn/no dq a of the Nree.wr expiration age
Iry emfy that all desi is xed ana
tithe ben of my. our knowledge Ice amarctbe ownegsl off¢
Poppow described abvS byvu,mlIev( y derimmed Regn of Ilia, suite
Nu rofbedrooms Y
c4kAds� Is
SIGNATURE OF APPLICAN9(S) DATE
,city m6rmi put v morepmenKd may result m the .um art i Mug revoked by the Planning H Zoning IXp anent eae
i:. hide I this Acquisition a tmrdm wamnty dad Ron We Reggae ou Dai once and a copy opted eemfiM sonic mnPif
, ordure IS made In The wanam, feed.
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