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HomeMy WebLinkAbout040-1324-35-000wsconsin Department of Commerce PRIVATE SEWAGE SYSTEM county St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 617707 Personal infoonabon you provide may be used for secondary purposes (Privacy Law, s.15,04 (1((m)] Permit Holders Name. City Village Township Parcel Tax No', Robin Ingle and Michelle Kruse TOWN OF TROY 040-1324-35-000 CST BM Elev: Insp. BM Elev: BM Description- _f Section/Town/Range/Map No. 01.28.19.2190 TANK INFORMATION ELEVATIO A wh TYPE MANUFACTURER CAPACITY Septic c7 Dosing Go,A.l,o 9 7Sa oi'li am Holding TANK SETBACK INFORMATION C hU�I 'j Db"- " TANK TO PIL WELL BLDG. vent to Air take ROAD Septic 244 � lU/b' lad — — Dosing 2W ��QV y /0' 11'7 Manufacturer Demand GPM tj, Model Number Po 1✓i ,. TDH .,. %Friction#LO&A, Syst Flood TDH q Ft Forcemain Len th , Dia. .1 Z Dist. to Well �l SOIL AL35QKPTION SYSTEM BEDITRENCH Width 1 Length DIMENSIONS i-D O SETBACK SYSTEM TO IlJ INFORMATION I FS ELEV. Benchmark 16- 7Z 1Z3 • / / 3 Alt. BM F;I,L,.- 5,45 1►7rq Bldg. Sewer >•3 1 zz. St/tit Inlet p 7 St/Ht Outlet Dt Inlet Of Bottom ly. io9-s eatl /Man. Dist. Pipe Bot. System 710 /1# /,, Final Grade 1.6 (113.12 St Cover' 1 -l'. 5 I, 7' q vV .ys 113.41 , Ix BLDG WELL LAKE/STREAM LEACHING ^ CHAMBER OR lIN.I I_trt.Ati A11LI UNIT Header/Mandold I Distribution I Pipe(s I i� //�'� U z Hole Size f / 1 x Hole S acing h^ V to Air Intake Length Dia Length Dia I J' Spacing /' // SOIL COVAR x Pressure Systems Only xx Mound Or At -Grade Systems Only 14� d sl f /Irwlen r Dedth O ri 'rDe th Bed(TreOnch Edges " It 1, lh of � � 1/ Topso lI xx Seeded/Sodded es Na xor acne Yes No MMENTS: (Include code discrepencies, persons present, etc.) Location: 586SCHWALE D r(��� 1.) Alt BM Description = i� " "' ` _ 2.) Bldg sewer length = I Z7 It - amount of cover = /1/ 1 7 `%L A ""`•Vr`V Inspection #1: /Y/ V/ / Inspection #2: 5/ g/w GsL•R Gv-fG iak..1 Plan revision Required? Yes 4410 .... 1' 1 Use other side for additional informati 4 Date Insepctor' Signature Can. No. SBD-6710 (R.3197) Afv-an►a — 3a3 / I OCT 02 2019 s(. rev �o..Y Safety and Buildings Divsion 01 W. Washington,Ave., P.O. Box 7162 Madison, WI 53707-7162 -� Gn®ry ` Sanitary Permit Number (to be filled in by Co.) a (o 776-7 Sanitary Permit Applicationa= f A In accordance with SPS 38321(2), W is. Adm. Code, submission of this form to the appropriate governmental unit State T>a/a�sscuaQn N�x(m�ber/� Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note; Application forms for state-owned POWTS are sd6mitted to the Department of Safety and Professional Servies. Personal information you provide may be used for Pumosses in accordance with the Privet Law, s. 15.04 1 m , State. 586 SChwallen Drive, Hudson L Application Informadon — Please Print ormatlon Property Owner's Name Robin Ingle and Michelle Kruse/ Parcel q 040-1324 -000 Property Owner's Mailing Address Property Location 4030 Vera Cruz Ave, Robbinsdale, MN 55422 Gas Let 35 NE R NW rF Section 35 city, Stan zip Code Phone Number Robbindales MN (circle cam) T 28 N; R 1a 'ixw W II. Type of Building (check all that apply) Lot4 }�( 1 or 2 Family Dwelling - Number of Bedroo� 35 Subdivision Name Cottonwood South 1st add lockq ❑ PublidCgomerciel - Describe Use ❑ City of ❑ State Owned -Describe Use 1 k /CO ❑ Village of RCTown of Troy CSM Number IIL Type tt (Check only one box on line A. Complete line B if applicable) 7-e7.Q1 X Aa New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑Permit Renewal [I Permit Revision ❑Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiation Owner IV. Type of POWfS S stem/Com nent/Device: Check all that apply) u ❑ Non -Pressurized In -Ground ❑ Pressurized In-Gmumd ❑ AtGn de OD14ound Z 24 m. of suitable will ❑ Mound < 24 in. of suitable will ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) e / V. Dispersalfrreatonersit Area Informed : t Design Flow (gpd) Design Soil Applicati Rate(gpdsf) 4e0' �O� .4 Dispersal Area uired (sf) 600 �5� Dispersal Area st) son 5 �p System Elevati 112 VI. Tank Info - - Capacity in - Galloon Total I Gallons- q of Units maffmacturer /A� . / // / /bL 5 ,a@p S U oC oo Fi vgi pg LL U o P. New Tanks Existing Turks Septic or Holding Tank Weisel 1250 1 Wei6er Dosing Chamber Wieser 1750 Weiser VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plus. Plumber's Name (Prim) Plumber's Signature MPtMPRS Number Business Phone Number Tim DeYoung 664713 715-246-2660 Plumber's Address (Street, City, State, Zip Code) 321 Wisconsin Drive New Richmond WI 54017 Af Vill un /De artment Use Only Approved r� ^-"�� '-'J'T°�- /PPr'G'iven RR`easom&Denial uT)wrl4 Pe6/it Fee s v�D'0 Dace sued 7 )9 Issuin ant Si e IX. Condl eagogs for Disapproval 1t r 1. Septa: rk, cdluin; i e- c,n uiaper.:n cell must all ¢e is I asper,aacayemenlplan p-�,ioehLvPlwnbe,: C, /�- 2 All atlRark niG�as'.^e11ca m�ukt w r. arrt. it s i / in Pff txkrbh Wd4/a4AAM91, Araeh to Complete plans for the system and submit to the County only on paper not less than 812 x 11 inches In size SBD-6398 (R. 11/11) 1 a� BENCH MARK 100 TOP OF SUR- VEY IRON SCALE 1" =40 FEET NE 1/4 OF NW 1/4 S1T28R19 W ---------___-------'------"--0-- ;-- Mound 116x 2036 k System, •_..._.__.-----_--.` l� 11/2 force main -- - Weiser 1250 / 750 tank t �525 odc filter h� i 4 bedroom house 150 Slope 8% n 112 160 0 203.56 Nt October 1, 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2021-10-01 Plan Review:PWTS-101902062-C PAUL R KOEF LER 321 Wisconsin Dr New Richmond WI 54017 SITE: DERRICK/ INGLI-KRUSE 586 SCHWALEN DRIVE TownofTROY Saint Croix County Total Amount: $250.00 FOR: Description: 600 GPD Maintenance Required DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay hWidsps.wi.gov/programsrindustry-semices vnvw.wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual — Ver. 2.0, SBD-10691-P (N.01101, 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: 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 scats 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, Travis Wagner POWTS Wastewater Specialist, Division of Industry Services (608)598-0715 t rav is. wag ne r(awi. gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: DERRICK / INGLI - KRUSE Owner's Name: ROBIN INGLI-KRUSE Owner's Address: 4030 VERACRUZAVE ROBBINSDALE MN. 55420 Conditionally APPROVED 586 SCHWALEN DRIVE DEPT. OF SAFETY AND PROFESSI HUDSON WI SERVICES DIVISION OF INDUSTRY SERVIC Legal Description: NE1/4NW1/4 SEC 1 T 28 R19W Township: TROY O County: ST CROIX Subdivision Name: COTTON WOOD SOUTH 1ST ADDITION SEE CORRESPONDENCE Lot Number: 35 Block Number: Parcel I.D. Number: 040-1324-31-000 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 Designer: PAUL KOEHLER License Number: Date: 09/09/19 Phone Number: Signature: •'�/�> �� MP 225410 7152462660 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSW MP Publication 9.6 Design of Pressure Distribution Networks for STSAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of Mound and Pressure Distribution Component Design Design Worksheet (R or C) Site Information 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 (gpde) Cell Information Dispersal Cell Length Along Contour (ft) _ Dispersal Cell Design Loading Rate (gpd1e) Influent Wastewater Quality (1 or 2) R 400.00 1.50 600.D0 8.00 112.00 28.00 OAO Distribution 100.00 1.00 1 Pressure Dlsribution Information (C or E) E Center or End Manifold 3.00 Lateral Spacing (ft) 2 Number of Laterals 0.125 Orifice Diameter (in) Forcemain Diameter Pump Tank Elevation (ft) System Head (ft) x 1.3 Vertical Lift (ft) a Friction Loss (ft) In -line Filter Loss (ft) Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 1.50 x x 2.00 x _ 3.00 x Treatment Tank Information 1250.001 Septic Tank Capacity (gal) WIESER Manufacturer Note: Sand fill (D) calaAafi n assume a Table 6344-3 in-OlW sdl treatment for fecal colilonn of ¢ 361ndw3s. 6.00 Cell Width (fl) Are the laterals the highest point in the distribution 0 network? Enter Y or N If N above, enter the elevation ft of the highest point. 9.09 ftZ/orfiioe Does the forcemain drain back? N� Enter Y or N 0 Forcemain Dreinback (gal) 90.43 5x Void Volume (gal) 80.43 Minimum Dose Volume (gal) 27.19 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 3.00 Gallonslinch Calculator (optional) 1.001 Total Tank Capacity (gal) 43.00 Total Working Liquid Depth (in) 0.02 galln (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.00 Dose Tank Capacity (gal) POLYLOCK Filter Manufacturer 16.12 Dose Tank Volume (gal/in) 525 Filter Model Number WEISER Manufacturer Project: derrick / ingli - kruse Page 2 of 7 Mound Plan and Cross Section Views ................. K01 .................... Observation Pipe = B L Mound Component Dimensions Al6.00 ft E I 13.76 in BI 100.00 ft F 9.50 in D 8.00 in G 0.50 ft 600.00 (ffz) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate —t J _1 H 1.00ft K 8.10ft i 9.63ft L 116.19ft J 4.74 ft W 1 20.36 ft 1562.50 (ft) Basal Area AvaAable 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 114.46 (ft) 1 F 112.67 (ft) — • — Dispersal Cell(; Elevation Dispersal Cell D 8.0 % Site Slope Shading Key 10 Topsoil Cap c c 1.5 ft ❑2 Subsoil Cap c r° ASTM C33 Sand Tilled Layer I I 0.5 ft © M Aggregate a o G I I H 113.17 (ft) Lateral Invert t Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centedine in the distribution cell (AxB). Project: derrick / ingli - kruse Page 3 of 7 End Connection Lateral Layout Diagram Lateral! COW"" Over me A 6 e*M*nilOn Tunn p eibel l wW* or O/M n out plug p AN Werats art klent" fl.x�i Holesdriedon"bottom athetataral eW aay spaced 3 r Form main comlpalon Via toe or dross to matdfold at any point. Laterals a force main of PVC ScA 40 (per COMM Table 84.30•5) Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 2 1.50 in 98.56 ft 3.00 It 13.59 gpm 27.19 gpm 4.09 It Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and Comm 1628 WAC Tank component is properly vented WEISER Capacityl 750.00 Volume 1 16.12 Manufacturer Gallons gal/inch Dimension Inches Gallons A 26.92 433.89 B 2.00 32.24 C 5.61 90.43 D 12.00 193.44 Total 46.53 750.00 Alarm Manuafacturer Isj rombus Alarm Model Number Pump Manufacturer GOULDS Pump Model Number 1epo4 T A g C Pump Must Deliver 27.19 gpm at 4.09 ft TDH in ft/sec Looking cover with warning label and locking device and sealed watertight 4 In. min. E— Alternate outlet location Forcemain diameter --- 1 2 in. Weep hole or anti - siphon device rvation (ft) 118.00 Dose tank elevation (R 117.00 Project: derrick / ingli - kruse Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name COUNTRYSIDE PLG Phonel 715246-2660 POWTS Regulator's Name COUNTRYSIDE PLG Phone 715-246-26W System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years L Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84,30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6Xi), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, 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. Lateral Tum-up Detail Finished •........ • • Grade vt 6-8" Diameter Lawn Sprinkler Valve Box Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: derrick / ingli - kruse Page 5 of 7 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintalned in accordance with Ks' component manuals tSBD-10691-P (N.01101), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)) and local or stale 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 Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank 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. Seotic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48. Slats. The contents of the septic tank 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 unless 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 filter shall be serviced if the alarm Is activated continuously. Intermttentfiher alarms may Indicate surge flows or an Impending continuous alarm. The septic tank shall have its cements removed when the volume of sludge and scum in the tank exceeds 113 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, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) 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 tank 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 mend 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 rat recommended since soil compaction may hinder 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 mg/L SODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODy, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mLfor 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 N orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency 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 the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails 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 if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing saki 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 POWfS regulator and service provider. Pretreatment Units The information and schedule of mananagementand maintenance for prerealmentdevioes 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. Project: Page 6 of 7 i BENCH MARK 100 TOP OF SUR- VEY IRON SCALE 1" =40 FEET NE 1/4 OF NW 1/4 S1T28R19 W Nt POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 'I - FILE INFORMATION Owner INGLI- KRUSE Permit A DESIGN PARAMETERS Number of Bedrooms ❑ NA Number of Public Facility Units ❑ NA Estimated flow (average) gal/clay Design flow (peak), (Estimated x 1.5) al/d ay Soil Application Rate al/da /ft' Standard Influent/Effluent Quality Monthly average` Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODs) :=O mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD,) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ❑ NA Fecal Coldorm (geometric mean) 5104 cfu/1 DOMI Maximum Effluent Particle Size K in dia. ❑ NA Other. ❑ NA *Vslues typical for domestic wastewater and septic tank affluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 1 250 al ❑ NA Septic Tank Manufacturer ❑ NA Effluent Filter Manufacturer POLY LOCK ❑ NA Effluent Filter Model 525 ❑ NA Pump Tank Capacity 750al ❑ NA Pump Tank Mmufactuser wiF.❑ NA Pump Manufacturer ❑ NA Pump Model EP04 C NA Pretreatment Unit ❑ Send/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland ❑ Other: C NA Dispersal Collis) ❑ In -Ground Igrsv'rry) ❑ At -Grade ❑ Ddie-Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound ❑ Other: Other. 0 NA Other. ❑ NA Other: ❑ NA Service Event I Service Frequency Inspect condition of tankls) At least once every: 3 monthlsl (Maximum 3 years) ($ ear(a) ❑ NA Pump out coments of tankls) When combined sludge and scum equals one-third (Y,) of tank volume ❑ NA Inspect dispersal cellls) At least once every: month(s) 3 0 ❑ mar(g) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ Q( moearls)nths) ❑ NA Inspect pump, pump controls & alarm At least once every: - 3 ❑ TDnti'Ia) DI earls) ❑ NA arid pressure test Flush laterals a P At bast once every: �"• ❑ monthlsl ❑ earls) � NA Other: At bast once every: �: ❑ Monthly) ❑ years) ❑ NA Omer. ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; PDWTS Inspects, POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tanklsl to identity any missing or broken hardware, Identity any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or-ponding of effluent on the ground surface. The dispersal cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponderg of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a falling condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Ys) or more of the tank volume, the entire contents of the tank shag be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited 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 Melntainer. A service report shell be provided to the local regulatory authority within 10 days of completion of any service event Page Z' of Z START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(sl for the presence of palming products or other chemicals that may impede the treatment process and/or damage the dispersal collie). If high concentrations are detected have the contents of the tank(s) removed by a septago servicing operator prior to use. System start up shell not occur when soil conditions are frozen at the infiltrative surface, During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater Will be discharged to the dispersal cells) in one large dose, overloading the cellist and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or 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 Isump pump) water fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pas 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 lmy required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement arse wtll result in the7 need for a new soil and site 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 POINTS. WIN W •' ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL POWTS INSTALLER Name Cyr Phone SEPTAGE SERVICING OPERATOR fPUMPER) Name - r- Phone POWTS MAINTAINER Name /C Phone IIS= ? y ` 2� LOCAL REGULATORY AUTHORITY Name S . C I ZOtill�tl Phone %(s— 39'(0— i0 (7 This document was drafted in compliance with chapter Comm 83.2212)(b)(1)(d)&(f) and 83.54fI1, (2) & 13), Wisconsin Administrative Code. I Y Wisconek do.p.mwddca+erl(�� SOIL EVALUATION REPORT Paw—t—dl— �tyy /UIeCr oonrpbee r not leas linen ti 112 Y 11 Mares In size. Plan mra�' i ck,de, lout not and hoAmntel reftnen a point (BM), 6ecrion and pieta akpe, scale on, north crow, and location and dlbLnn LO rest ro Phase Pint e8 1MorrruBon. CO pareanel MRamween YW ernrlr mry w usee far ftowdep wvwer fP�l+KY talk S.a (1 c01ey ST Crilottr Parcet I.D. / / Proparty0i~ IYriaYt 4.s'f pJ GovLNO E 114A"WI14 S/ T .Z 9 N R /I E (06 aovety n s Mai V Lot:._ Block: &6t1 Nane or a" 2 id— SWA w, 6*11- ❑ Dtiy 0 image ® Town Nearest Road -r,. n, , $JNewCwwh dm UwMRalden6dINwtwdbadrocnru Codederheddesign low rate (coo GPD ❑ ReptaoeMM* pubic or om maralal - Deacr6s: prrd ,gf(3 Flood plan alewton If applicable fL Gerwtopmwra _I1 end namrwdaf : _//n System Type D CL r 1 System Elevation -rwP El Bahp # [� pit Ground aufaw elev. O tt Daplh to lnbV botor '� In. Sd Apolicelion Reps Horizon Depth h DamirwR Colm Muwei Rado>c Description Gu U Cara. Cdor Telarsa Stoat" Or. Sz Sh. Corriztsnce WxWery Rode 'Eftl I 'EM . l —,p /L C-; Ar- r.r ® Bong e ❑ Bowe Ph Grand suiare alev it. Depth to brft factor 340 In. Sd Application Rees Horizon Depth In. Dominant Colo Morsd Redox Description Dli SL C)1* Odor Tedue Sh n Gr. SZ Sh. Consistence Boudry Roots GpDM 'Ef1I1 'Ettp2 tD S 1 . 1r, . Z CI 3n,rjK crier do p .Y 4. P Y t l .m. mvFi 4 n 4 .2 i. - umeemn-ew, s W:5 Z. RGPL am 155>w- 150 m/L/ 'Mont 02— ROD- <30 ffn&"TMS 30 mdL 1008 192nd Ave, New Richrnond, WI 54(�1'`/ 11 -2.-I.—v 2 715-246.4516 r Parcel ID # Pape _d__ i �. a �'""^.'�FT•11 WIF _S ©® ..:..i. ®� EMAWA #1 - BOD, > 30 c 220 nplL end TSS>30 c 150 M91L • EMI #2• BODE S30 myl and TSS! 30 nVL The Department of Commerce is an equal opportunity service provider aad employer. If you need assistance to access III or need matcrial in an shemate fomud, please ewRect the department at 608-266-3151 or TTY 608-264-8777. 0 Soil Test Plot Pla "Project Name Kemon Bast S Bird Address 948 LaBarge Road Hudson WI 54016 CSTM #226900 g5 Lot _SubdlvlslonCottonwood South 1st Add ate 11/26/13 NE 1/4 NW 1/4S 1 T 28 N/R19 W Township Troy Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 % Top of Survey Iron System Elevation TBD *HRpSameasBenchmark ST. CROU COUNTY SEPTIC TA.NXMAMMANM AGREDAENT AND ONNfi L%nP CERTIFICATION FORM OwnmMuyer a81N 1►J±aj-1 A�J7 1U�J MaifingAddreas Pmpaty AddroI J 1 _ (VeiSationrewirea8amelmmng&: a�:. •':.� cit)atft Parcel kicnOcaticm Number R3;24 3l - coo UWPALMUKUMo Nwwty L amdiae m'r I/ Ml 3 1/. Qn I T 2C. m o t Q Qr....— -r-T)?t%v NGOULDS PUMPS APPLICATIONS Specifically designed for the following uses: • Effluent Systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatedng SPECIFICATIONS • Solids handling capability: a/<" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet • Discharge size: 11h• Nn • Mechanical seal: carbon- rotary/ceramic-stationary. BUNA-N elastomers. • Temperature: 1040 F (400 Q continuous 1400 F (600 Q intermittent • Fasteners: 300 series Stainless steel. • Capable of running dry without damage to components. Motor. • EPD4 Single phase: DA HP, 115 or 230 V, 60 Hz,1550 RPM, built in overload with automatic reset • EP05 Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset • Power cord:10 foot standard length 16/3 S1iW with three prong grounding plug. Optional 20 foot length,1613 SJ1W with three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ■ EP04 Impeller. Thermo- plastic semi -open design with pump out vanes for mechanical seal protection. METERS II FEET - 101 9r 30.., 8 Q 7 4 z 1 0 Submersible Effluent Pump EP04 & EP05 Series ■ EP05 Impeller. Thermo- plastic enclosed design for improved performance. ■ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ■ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ■ Motor Cover. Thermoplastic cover with integral handle and float switch attachment points. ■ Power Cable: Severe duty rated oil and water resistant 20'. 15 -- — i 0 2 4 6 8 CAPACrrY ■ Bearings: Upper and lower heavy duty ball beadng con- struction. AGENCY LISTING Canadian Standards Association c . File # LR38549 Goulds Planps is ISO 9001 Registered. I EPOS 40 so GPM 10 12 myh Goulds Pumps 620O5 0"1watertechnology, enc In Industries Effective January, 2005 63871 i 01 I I C_OT_TONWOOD SOU_ TM I Zj =D LANDS I 16 I 15 I 14 Ii I � . --30' WIDE DRAINAGE EASEMENT DOC. M836231 11316.W 3Tsso' q H.w.L.=1a1.o N89°50'23'E �' �' V- T 2oa ss El. c# z�- - BLOCK DST. l3o.ar = 626.17 I I 1 Fil f 1 1 2629 I I 125'29 I b9 I I I I zs l I I I '� 110_ I I 75 I LOT 38 I 2.00ACiES I LOT 35 1 M I LOT 34 1 I r ^I 1 a l I I zarACRES I' I 2.01 ACRES I Q 87,125 SO. Ff. 87,125 SD- FT. 67,562 SO. FT. 1 Ls.o.-1013.0 I 1 L.B.0.=10430 I� 1 I L.e.0.=1043.0 1 75' I I s 1 I I I IZ 1 I 1 . I I it L , C1226 �s B.M. ELEV. _ I I / z m --,_—S- --- 203.56 ---- 80.64' TEMPORARY CUL-DE,W 93 N!!8°50'43"E 457.76' -cSENUTES> — ---SCHWALEN DRIVE--- - NW5M3'E 457.36' a !te o M Mai- Cl ". .. N I I It I II p i REAR ELEVATION z i wNay 44 a,hm FRONT ELEVATION iiwuc o.m. o-a-�e ytia� auuaua o>e+-�r a.� wir auex er u. � sexn 1s5 L w�o xc rc ws -tis- v LOWER Q. F PLAN 800 4 1600 SQ. FT. TOTAL 1000 SQ. FT. FUTURE FINISH IBID SET —NOT FOR CONSTRUCTIONI 2 - 5 KKK msm Korws !°t ° 1NNM ! FL�MrI �l�rRLR a j� DOLL � r $i A p r�r w 'iF D/N/NLMm rr 1� ITM �r •^vie t II.0 .^•^r• � -vu -'^r' • rn O nnoa�mana w,•.r... __ It i N SS E .rro N ss S � I ' g i mar-Roav erNDR's cp i I w ay •" ; �. i �v � ------I r It 1 w I>uOeN III ry. I sa iv � �r o p r 1 4� z •a: __p44 up== xl W N "mH ..wQz -W an so, rr.,n. .,.......... •.�. --- - C : H w.nu. =eneoh k cietea «ass^ cart wrt u-m-n MAIN LEVEL PLAN 1800 SQ. FT. 165 165 SQ. FT. SCREEN PORCH 1865 SQ. FT. TOTAL +°• »^� ••••• aen° 3-5 mum- swo .nnn.•a. Q �PR----- 1 i n r_rQ cz I I I M CV I -----; RIGHT SIDE ELEVATION ' I CVI I� r �O-lqz i 14 '-- ---------------------------- 1 m wwt, J. — UaU " ti as ------------ ROOF PLAN D C) ti y a„+ a�� '—• wne �� Peaociclee .mrnr alai II �.... r-------___---------------- LEFT SIDE ELEVATION eaa one o-m- =1 —0 ____________aim 4-5 �!g Vv'rm mex/n!+ STWWAr SECTIONy2 tn u�.ea�ere.gea4. ... � low— ww�..... — F TYPICAL MALL SECTION ' SECTIONN3 m m asm.OF W)M s MG OF RS mv— O M N I e N w i. rq �-w h A aCDR! �y1"ti w Cl�a grhS� c..v ` 5 5 ' Wisconsin Department ofcom SOIL EVALUATION REPORT Division of Safety and Building, v Page I of 3 L 111 Glili11 Ud111iC Wltll VVIII111 e�1 "... MVII1. IiWC '* Attach complete site a p r not less than 8 112 x 11 inches in size. Plan mu�•'�a. include, but not Iim ft4 v cal and horizontal reference point (BM), direction and `� percent slope, scale mensions, north arrow, and location and distance fo rest ro 1 Please print all information. CO Personal infom,erion you provide may be useo for secondary purposes (Privacy LeaSL 15,04 (1 �m>9- County ST �l-tr py� I.p, j Date , I (l Property Owner �u w`L� &-nor, Qdt 5r� `t rp P c Locat Govt�LbtO E 114rI/ W114 S/ T.29 N R/I E(or)iS Property Oviciers Mailing Address _ 1 7 ,1 ' A.- ocaot Lot # � Block # �' Subd. Name or CSM# Coon wour% ford% / f'-�,r f�• City State Zip ode hone Number Eon %/I SY014 ( ) ' ❑ City ❑ Village ® Town Nearest Road -7-,-Gy ISCIC&CtleAl Ar. $f New Construction Use: IX Residential ! Number of bedrooms Code derived design flow rate —G OO GPD ❑Replacement ❑ Public or commercial - Describe: Parent material -MIS /J e �� Flood Plain elevation if applicable fL General comments 1 and remrnmendations: yy7 System Type / ' / U �� System Elevation TAp 1 Boring # Boring [� pit Ground surface elev. ft. Depth to limiting factor V7 in. 5-oi-Apoicahm Rate Horizon Depth in. Dominant Color Munsel Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPOM -Efff##1 -Eff#2 1 1 i z- je ® Boring # ° Boring Pit Ground surface elev 12, Xf Depth to limiting factor in. Soil Application Rate Horizon Depth in.)) Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD#f' 'Eff#1 'Eff#2 g �-& IC v 3)z- I 2 r Mrv- C.S I F Z C/ G I a ry.ri k y,, fr e s f Y &a Effluent #1 = BOD > 30 < 220 mglL and TSS >30 1150 ' Effluent #2 = BOD 130 mg& and TSS < 30 nxyL CST Name (Please Print) CST Number re Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 540 l!��� 715-246-4516 Property Owner Parcel ID # Page —of 12J# Boring ❑ Boring 00 l oft. Depth to limit facto _ in. Pit Ground surtace elev. n9 Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Colo Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDRf 'Eff#1 'Eff#2 2 r (D S� — U 3ntZY n�fl Cr y (� Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting fads in. Shc licetion Rate Horizon Depth I in. Dominant Colo Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD#f 'Eff#1 'EB#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Aoolicetion Rate Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = SOD, < 30 rtg& and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608.264-8777. WDP83 O(RbA ) Property Owner Parcel ID # Page _ of © Boring # a Bonng -//� ' Pit Ground surface elev. �'•'ft. Depth to limiting factor �_ in. Soil Application Rate Horizon I Depth in. Dominant Color Munsell Redox Description Du. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIff 'Eff#1 •Eff#2 Q ^ (o r ? tl I / -a n=..F. CS (F .4 'L (D xl C4 2rq..irk n.f✓ csif •4 'fr • �m ®®� ®®®®® Effluent #1 = BOO, > 30 < 220 mglL and TSS >30 1150 m94 • Effluent #2 = BOD, < 30 mgA- and TSS � 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sao-nw (x.bw) Soil Test Plot Project Name Kernon Bast Address 948 LaBarge Road Hudson Wi 54016 Bird STM #226900 Lot 34 SubdivisionCottonwood South 1 st Add ate 11 /26113 NE 1/4 N W 1/4S 1 T 28 N/R19 W Township Troy Boring (D Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation TBD *HRpSame as Benchmark r: COTTONWOOD SOUTH FIRST AD LOCATED IN PART OF THE FRACTIONAL NE1 /4 OF THE N 1, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY 1039.3 1 x �f 1040.6 x 16 � I s x �I 1038. I 1041.0 Z I �orroN_ _ _ _ ou_Tl-� I DRAINAGE EASEMENT x I mil 1040.4 i AG -RESIDENTIAL I aa9e�al� I 7941.0 DRAINAGE EAS_N838231 e i I � I � x 1046.2' i I 75' I 33 �40g f cR f 1043.0 11048.8x X, I / /N P / Ln 208.5 78' R LE TH 33' JL-OE-SA( opose RO fE N89'50M'E457.39 4.7 .� i n 117 r / 2 L�6c IN IR \ �- My����I, L.' .=1054.3 6('RGC m I J t SSWSW23"W 203.56" - -- - - -1040 II SOILTESTAREA - T — _ fi -1050 --- LOT 35 2.00ACRES - -- 040-1324'd5�8W_ _ - - Q I4.0 1062- -1066-HOHSr- —, 1 71j Tc _ I I o G ISA L ' I 8.09.0� ►J _ y I I � 1 1 I 1 I i T •r2o3s6• SCHWALEN DRIVE J � LEGEND O -WOOD HUB SET AT 10' OFFSET OR ON BUILDING EXTENSION FOUND 3/4• IRON BAR OR AS NOTED T.O.H.- TOP OF WOOD HUB ELEVATION T.O.B.- TOP OF IRON BAR ELEVATION SETBACK LINE: 75'FRONT 25' SIDE 25' REAR - - - - - - 12' UTLJTY EASEMENT ELEVATIONS SHOWN ARE NAVD 1988 DATUM. 0 40 80 PROPERTY ADDRESS: 589 SCHWALEN DRIVE HUDSON WI 54016 DERRICK CUSTOM HOMES INGU-KRUSE r., ... LOT 35, COTTONWOOD SOUTH IST ADD. ""` ]`lll-OY r-ra,a A1,O 0r-IY1. r SM 1, 749NlIYR, 10gI OF TROTS 8T CR01X COUiII'. WMMra-r,r Y.wr./� l61O HOUSE STAKEOUT PLAN soimi NMWAR