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INSPECTION REPORT R 01 e
GENERAL INFORMATION (ATTACH TO PERMIT( Pien ioxo. 0767 BBN(d6✓
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TANK INFORMATION ELEVATION DATA
TYPE
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TANK SETBACK INFORMATION
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System PLOT PLAN
-PROJECT Luke Pometb ADDRESS 116816]M M. Hammond Vol W15
Sw IM RE 114E 5 /T 29 117 µTOµN Hammond COUNTY SL CROIX
SYSTEM ELEVATION i D5.5' 1.7' sand lull 10/29/17 BEDROOM3
DATE
CONVENTIONAL AT GRADE CONVENTIONAL LET ROLi TANK
MOUND M SEPTIC TANK SIZE 1000 gallons LIFT TANK SEES DOSE TANK SEE 630
HOLDING TANK SIZE LOAD MEE I.D A6 DRAFTION AREA 656 M of clamors" none
BENCHMARH V.R.P. Top of au myIron ASSUME ELEVATION IN' Fill L.IteN0e Fal
❑BOREHOLE O WEW. 'R.R.P. Same as onndlmoA
_ Scale = 1/4" = 10'
166Property Ling 2aaelot
Well is to meet all worve aemacka
rading is to be done to divert
run-off away from system
3
mom
Houses
Hu%cuff Combo Tank
B-2
6]N st.
L)B
a to ❑B-3 smvaa23' Property LB-1❑
0'
t D3'
103.8' 104'
.zJE9 1copv
Od,^nr�we
DIVISION of INDUEHRY SERVICES
q,
2331 SAN LUIS PC STE f50
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GREEN MY WI N2(da6211
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re GutiNrex. Seri
November 20, 2017
CLOT ID No 226900 ATTV P0ffnp1ra➢etum
ZONING OFFICE
SH ILN R BIRD ET CROIX COLT ET SPIA
1432120TH ST 1101 CARMICHAEL RID
NEW RICHMOND WI 54017fi409 HUDSON WI 54016-]]09
DEPT OF SAFE
PROFESSIONAL 3
DIVISION OF INDUSTa
CONDITIONAL APPROVAL IdemificationNml6tts
PLAN APPROVAL EXPIRES: 11/20/2019 TraoeactianlDNa.3025164
SITE: Silem NO. 899]83
Please refer to bow identinamon answers,
Luke Forseth Luke
Formt above, in all correspondence with the argancy.
Town of Hammond
st Cmix County
SW I/4, NEI/4, S5, T29N, RISW
FOR:
cescription: Mound Saatem O Bedrooms - New Construction)
Object Type: POSTS Component Manual Regulated Object lD No.: 1736811
Maintenance required, 450 GPD Flo, into- 16 In Soil minimum depth to Innifing factor flow wiffiblad inside,
Systemfs): Mound Componsm plane)- Val _20, RED -10691-P (H.OIN I,R 10112), Pressure Distribution Component
Mason] - V,%2➢, NBD 10706P RCO1101, R. 10/12k Classic Filar
The mammal described above has boom renewed for conformance with applicable Wi earran Administrated, Carlos
and Wieconsin Statutes. The submittal has been CONDITIONALLY APPROVED. Lot system is to be communed
and located in accordance with the enclosed approved plans and with any component madmou s) referenced above.
The owner, as defined in chapter 10101 CIO), Wisconsin Stances, is res➢onsible for compliance coach all code
requirements.
No person may engage In or work at plumbing In the state unless licrnsed to do sD by the Department per S..145.06,
The fotawing canditions shall be met during combustion or woodland and prior to occupancy or area
• Preserve dispersal area prior and wants construction to avoid disturbance, compaction and use of fire site.
• With new construction; it is recommended not on aedvem the pump the done lank unlll the tars are pumped
poor to M1omnowner reactive,
• Wastewater generamtl from contractors cleaning of equipment and tools and/or left over combustion
products shall not be discharged into the draim discharging to the private ambe wastewater Memlaut system
NOWTV, Waste Occurred sort be properly disposed of on-slte or off site.
• Any tall gresses, Forces and snubs shall be cut shot) and removed prior to tilling the surface for installation to
prevent matting under me dispersal area. All learn wromic material to be removed from mound area
• Diver) surface water from POWER Area.
Prior• 11 of the dispersal h k the moisture content of He sot to a deb@ of 8 inches
Screening and compacting of wet sual aid treaty in difeducirm the implication canden' Ofthe small Promi
moisture content can be determined b Fell a a it sari In mrseen we hands, If it rolls into a 114 not w'
He site is No art to promare. If it crumbles, site weramoon am berancesedi If the site ii test wet to D� an
mooed until dries
• All piping shall common m 5P5 Table 384.30-3 and SIPS Table 384.30-5
Insulate building sewer beyond 30 Get pm SPS 382 30 (I Fact
Well setbacks to mM chs. NR 811 & 812
Tank Installation On fallow all manufactures recommendations.
• SPS JBJ.54D)(e)The management plan For a Pi shall specifically address the servicing mechamlos of an
seeable or anaerobic treatment mM or a holding funk where either of the following conditions exist:
I. The bottom ofinetalk 9located more man 5feet brow me elevation where One smOince bad is located
2, Two bottom ofinetook llocated mom than 50 feet harm vRom where the servic died is Wrifted,
• Verify Property Index) prior to installation.
Pump Floats to be set and verified per ammroved mlan. Anv CM1enen may resin In numn rnv.n to meet
TOH antl GPM SceeiOeatioot
• Areas that are occupied %th rack fragments, nee roots, stamps and boulders reduce the amount of sail
available for propertreatmene If no other site is available. trees n the basal area of the accord most be cutoff
at ground bleL A larger fill area Is necessary when any Of the Come conditions me encountered, to provide
sufficient intiloadve area.
Owner Responsibilities
• The mrmN doctor, and call Oriented Owner, shall reserve a copy of this lenermGudmg iuswaloms relating
no Proper as, and in oftbeaystem. Cownersshall receive COPY oftbe appropriate operationand
maintenance manual anchorowners manual! the POWTS described in this approval SPS J83.54(l
• In the event this soil absorption system or any of its component pans teal fiction so as to create a M1relm
M1anrd, the Congener owner must follow the commoreacy plan as described in the approved plans
A ropy of approved Plans, spmlfications and this letter Curb be on -site timing Commands and open to
inspection by auNmized representatives of line Department, which may include twat inspectors. All permits
required by me state or the local municipality shall be obtained prior to commencement of
canswmianpsallat1aNapemtlon.
In African this approval To Division of Industy Services reserves the right to Ontario changes or additions should
conditions arise making them sewsxry for code compliance. Asper state work 101.12(2b nmhing Im tM1ie roview
shall relieve the designer of the responsibility for despoing a safe buildinA structure, of compoomt.
Inquiries calculating this cmespondence may be matte to me at Me telephone number listed below, mat the address
on this letterhead.
The above left addressee shall provide a copy of the letter and Me POWIS management plan to One owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Pee Required S 25oD0
Vr 9"t TTis Amowl Will Be lnv teed
WM1en You Receive That Invoice,
Tim Vander Levi Please Ndude aCopy WiN Yow
Private Sewage Plan Reviewer, Division of Industry Services Pa)vnem Submittal.
(920)4921214, Monday- Friday 6 am To 330 am WMMART crde:]633
nm..andeaeem@ywiscnnaii
nd'. Edwin A Tay1m Wastewater Specialist, (715) 630.3484, Monday -Friday 8:00 am To 4:30 pm
S1NlT R euN PAS2 112MJV
Insulate building dome beyond 30 GA pa 4P8382.30 (11Mc)
Well adbactr to meet our N11811 & 812
Tank Installation to know, all admission's recommendations.
9PS 3835C(1)(e) The introduced plan for a PoWffi shall speaitlmuy Sol 0e swlcb,g mechanics of an
aerobic or anaerobic durmml tack or a holding mvk where ethics of We following conditions ease
1. T eptimi of do k i a located note than 15 feet or lht elevEB011 wide In Scummed vad'.
3 TF F she vad Is located
Verify prepares &a s)primto annotation,
pump Moats to ban set and veriffied per N plan. Any changes men result In numP nation to Mee
TDH and GPM Soeelficatiooa
Areasthat are occupied with mck founder, tee mots, romps and boulders reduce rise monuat of soil
nameable fleml larger
Oil
If in ocnafumy
of seees m Ne bawl mea ofNe mowdd, to pr ,adc
at found ministate
A Im en fill area k oecaumy when tiny of the *Gas conditions aremmunmred, to prmlde
sufficient mfiNa[ive erce.
Owner Respoueibili6es
The curtmt owno-, and each subsequent owner, shall receive a may of this loner mending iomuuctioua taking
to proper use and maintenance of so man Owners shed smim a copy Of rise appropriate Operator aid
maintenance mmual and/or umCrC n mual for Poe FOWT6 described in this approval BPS 3M.54(I).
N line event Was soil absorption ey9em or my of its ("mponem park malfunctions so as b create a health
handid, the protect owner rods follow the contingency plan as deuiided in the approved playa
A copy of an approved platen, specifications and this hour shall he mrsite doing construction and also to
irspanioo by affinniaedrcprcsmndves ofTee Deparweme which may include local wpedds AO permit,
required by Ne state or the local muncipalut? aFell be obtained prim to eommrncemmt of
comwctlou/Io.MllalwNopara[iao.
Is musing[Ns approval the Dividoa of Industry Semites restated & a dam to, require chaugee or additions mccold
conditions send making th®necessary Jim code compliance. As par Ame Sage 101, l=), Ending Amid renew
each salmon&a desidon of&a mspousktbhfof designing a sale buildlvg swc0aq m uompoveEe
Incomes macemng this correspondence may be Could mme mthe telephone E®bor listed below, or at me address
on this levemeed.
The above led addressee shall pmnde a copy of this lend and on lroWrS mmu Mint plan to We sister and any
others who ate responsible for the installation opdation or manhomce of the PoWTS.
Sincerely, Pae Regv'vedS 25000
trT, ?'%✓iadwg.eaY Ttis Amomt WW Be invoiced.
NTm You Raeive That invoice,
Pleme Ivdutle aCopy With Ymu
Tim VeMn
ITvaceedTMo- Reviewer, roofSeri2-2214,MiddayFlley6 Car To3:30 fed
timmended,dogwkcmngov PWay;SmMeNARSTubCmMiteW: 2.
633
CC: adwnA Taylor, Wasimmer Specialise (I15) 634 3484, Monday -Friday 8 00 inn To 4:30 pm
Cover Page
Shaun Birtl
Bird Plumbing Inc.
1432 12001 St.
New Richmond Wi 54017
715-246-4516
Date: 10/2717
Oanerl-uke Foresth
Location: SW1/4 NE1/4 S5 T29 KRIM 1168167th M. Hammond
Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12)
Pressure Distribution Manual Version 2.0 (N.01/01 R. 10112)
Page#
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross SectiorVPipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7-8. Maintance and Contigency plan
9. Filter Specificafions antl cross section
Attachments: Soil Test A/
Shaun Bird
Signature
License number 88
RECEIVED
NOV 01 2017 Page 1 of
INnUSTRY SERVICES
z5
System PLOT PLAN
PRODUCT Luke Po2e1M1 ADDRESS 116816M el. Hemmor Wi U015
3W 114 NE vas 5 /T 29 NIB 17 W TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 105.5' 1.T Sand liRl 10/29/17 BEDROOM 3
DATE
CONVENTIONAL AT -GRADE CONVENTIONAL TRY ROLDN'G TANK
MOUND SE C TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK 61ZE 630
BOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 0 OT [hamhva none
BENCHMARK V.R.P. Top of sunsy iron ASSUME ELEVATION 100' @Yl1eT LuostimE FIINS
❑BOREHOL (Z) A, 'H.R.P. 8rinmesternschmari
Scale = 1/4" = 10'
155' Property Line tame lot
Well is to meat all W ONR semis
Gratllno is to be done to divertrun-oB away from system
Pro 3
Betlroam
Heft
Huffoutt Combo Tank
B-2
16]1M1 s1.
Area 15below system is to ❑
remain undisturbed
6%Slope III'
423' Property Line B 1❑ 'lllul''ll'11
103'
103.W104'
2a�%
Mound System Cross Section and PIm View
MI =Topsoil =ASTM G33
Cap Malenil El sandfill
Geotnuile
Fabric
v J'�LFt Contour
1Rmeoeion
Fed
A
$
D
D
!,
E;
t
3.
F
G
H
K
y
$.8
w
c
w
z
s
=Clean aggregate =4 in sch. 40 pvc
''/,m2%iv. din 0 olrxrverion pipe
Slope Daecfion
GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The moved bawl mete (L x R') is plowed with a moldboard or
chisel plow. Plowing may act proceed if the soil is wd enough "a plow depth to from a''/, inch soil wire
when a sample is rolled between the pahns of the hands. ASTM C33 quality sand is placed immediately
after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or
is placed overhead by a backhoe. Special care roan be used when placing sand of less than one foot
thickness to minimize compaction of the plowed surface. After the topsoil cep is placed, the entire mound
is social and mulched to promote vegetative growth, limit erosion and protect from fieezing. The
obsetw1im pipes are sloudd in the lower 6 inches and sepural in place with mbar ora closet flange.
10/07lXj page f_
Pressure Lateral Layout
Two Laterals — End Manifold
� ibreaaca
clgW
Lateral TIIPlug
v-Im � Plug
Manifold _
1
o F
,iR ,... lYO.Av i I'D X
D'ntriboden NewrorkS
flow
LataW Diameter
Z
b.
Manifold Diamear
Z:.
lo.
Orifice Diameter
x Defice S
L
t
F
M old
FoMDiamebx
Force MaimL
S_
Ft.
T Long
39weep
A Bend
S7' Pressam 5yemm Cavetracaon
/ Law: s are wmvacred of SohedWe Q PVC
Pipe. Cbfli w are drilled petpendicwx W
Ube pipe with a shay drill bit and f down.
UwW tore -ups v=ate with a tbre
deanout plug and are ewlosed in a 6.8 imh
diameter lawn spridder valve box sccesa'ble
from fiviahW ®ade.
nano• Grade •#a��•
6-8InchLawn ..
Sprinkler Valve
Box
Page A of /
03/051®
Septic -Dose Tank Cross Section And Pump Performance Specifications
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GENERAL INS'rALLATWN: The W�dv° mdc re bedde3 evd bwk Glbd'm cadercc wdh the
blex®�delid'W ee a@er�aeMma meouficaue bck)
—k wPo&W_.*PPovd'F°M® mwme aPowdu P"d°bm®aHachw brlv�s k:mg., mW
eygaww
mW1�ed_P�nBA� Ain of appoeed melm'V'wGh d'S�JO PVCmb�Be:be moo
pop
Ieidm bbk wmaw�+�%«aePgy�B'fAe Wa mem 4WD 162n.
wiPoREC 300ad Ca®
mcnvnboamdfheabrouraebdwAati�. j of
OLDS U �—
HEAD CAPACRY CURVE
MODEL 152/153
aow PER MwNE
CONSULT FACTORY FOR SPECIAL APPLICATIONS
. mna
, nmmamna,.a.klatle. " aaaMeene..ogw.lm
1180" , eMgn My,.rea.
mgsa leltlanOdetl9Yes xRarelloelefamnYOlFip Tgk PA awe
WltlpnABtle IaNlYd sM.pMs a¢ieaJaW b,rFetle
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a. veReeM..Imma.Im�+o�s assa,emaawrev.weetram®01
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RESERVE POWERED DESIGN
Fot unusual [CMIEMs e,eaervesafeb�mf �g'9meeatl Nm Ne ce48n of every IDHaO�mP
Ws
mew^
OCa%,yal D]Zmllxe Co. All iyMe �eservM.
�o� 3
POWFS OWNERS MANUAL B MANAGEMENT PLAN _
o� e
m SPECIFICATIONS
H�SeMee Event
Servlee Frequency
travelcan?Raial tank(s)
NkaMuw every
Ommlk
a)
IMUMum ]yrs.)
PumpalaanR^ISNbnklsl
VAnen canto, sludge
Nkwlo�ewry
vM nam egwb
GngnNe
me-ema(V
e6)
0took whim¢
(Matlmum 3 ym.)
IM1speelaLyRaW eMlsl
geanelAuaRMm
aM.MaMaeyery
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r(s)
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ONA
Nlwsl oom wary
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ONA
MaMgIANSE INg1RUL NS
IrePalblsafdnla arA Ekpnsal on, alau o,Irele W an W NcmryVg one ofth Mbang icmusas or
cm fis Masrx FNnober, Mash PlumEx ReffiIdg! Se'ha. PONTS LupeGu; POWFS Ma§Ilallly: SepMge
smverc olm OPeMloo raa ineaaaau maM masses vmaMmep.mm�aMe MnWslmuannHanrmmwloatoown
kartre'ae. Maltlryarryaaaaa Wakb nmasMAimwlumeINmmNllee alue9eeM saun vMrod kfarany Oakeks
rcpwNlg aemuemmme amuse eulere. ife eisPaMalreNs)alw Ee veueP'inepec�maieal Na emuent Mves
in qe ocemaaa gaesamma�eal kram/pwd'uq ateMueManmeemam aamem. mePomi®INeMuem on me
amum.a r�mto may a�aratoa oars vwglEan em �Im maxnmeaet nor mname lam reyalamrvawK.m-
Wlwn Me wmNnetl mmuletion of aWEpe aM awm F e�lyfmkepuslameAliN�asM dam acmtlarcepwAh A MR
enike amlm6IN Me bnk eRM Oe rerwea M a Sege EaNa�g OPeiaW a
113. Wremnan Adninis9aNZ Cone.
Them'gaemuemmlees.metivecal,,pr 'bMP cornw^a^I%. P�eaoalFaenlmmPooenu.amany
pharmalnl¢Ilmtt a mwti4'ios al Navm of 1Y npnNs orbss YUF M µ+fvm� M auleMe POMRS MffiIWller.
Asarvbe rePalwn ce Pm`ieee m nw laml eeglioryauMomywMm IoaaiaIN wmPleean m amaemre areal
STARTUPANOOPEMTON PIWaasuromer
ffh�Fo(MNWnsWYcn.P'mbutt JNe PONTS CM1XkhaeinbttbnWq Mtlre Wasalxol
e JaS hava one wnls�nr of M UnMS) m�aiM by eeP�e seselvkNY oPr+ab�sPM"m M1e are
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N, Magid mlroallon NroTlel lnammlRe Sating M MPcammEwYEEnpp wPa's
e a w ME np mYetl •pk�n �F`AWT9 MandVWM Ivm m�Mm.M w.r.tlre "PUMP a"�"N• m �B mm�x I.�reb
YaMn N¢ Pump mk. tlNYYp I COMPEdL me Blw alNin
on na mre ar vea wNW. m.«mmam wnmapr�n•.�naam.=rMa+«,««MroX.�mewMMe POVlTb:
15 Mttbam Nvr<of aM moulMa 9
PeM�C1w�wNiminatlon of tl'P 1Wu'nnd kan Ne WeMPMmrMNm R6Y Nnp :odM(M00N PETS NmareY'
anv b : way waded 4PleNe bMs: mikrvnn: rmlm rvbW a.]�m.«°: mWYalbm: RN: WnNN aOaudR:
(amen PUMP) wale hull .M w9 ma wMa mllen« hMe.9meb'. FeRka.•: nee: ea.W
peulddee'. e.nitey nepkmiw Lu: l^°
ABANDONMENT w h0 mken tolNum mot ME MM0m u MdEa
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Mewl>uWM, InM End mOmN.
COMNNBENCY PLAN
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TTV W�TBINSTTA�LL/ ER POVlIB YNMTAINER
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SIINATURE Of AYPLIC.9NT(S) DATE
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0bi Nana® 226900
Bird Plumbing, Inc. Sneon Bird
Gse E.maauoa coae.aae 1ei,Pna�e aamea.
aaerez,
1006192n4 Ave, New Richmond, Wl540 7 �_ ' —pY )15-246-4516
/of 2z�r'
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The IXpemnem ofCamme ce is an qusl oppomnity novice prouder and employer. If you need assurance to acua smicm or
nttd nuunal in an alt=M (wmet plasre wnuct the department at 608-366-3151 or T 60 f2&4.8 /p.
N 3
Soil Test Plot Plan
project Name P.C. Collova Bldrs. Inc. She r
Address P.O. Box 489 j
Somerset WI 54025 G"M #226900
Lot 25 Subdivision Farm View Ridge Date 5MM4
SW 1/4 NE 1/4S 5 T 29 N/R17 W Township Hammond
❑ Boring (D Well PL Properly Line County ST. CROIX
kk BM pr VRP Assume Elevation 100 B. Top of Survey Iron
System Elevation 105.5' 'HRpSameas Benchmark
Alternate Benchmark Top of 1/T' Pipe rd 100.2'
155'
Property
une
Scale is 1" = 40'
unless otherwise
noted
6%
Slope
t03'
55' Pm Town
424'Property line Road
B-t
5'
120