HomeMy WebLinkAbout002-106-07-3500-SAN-2020-133Industry' Sen'ices Division4822 Madison Yards Way 53705PO Box 7162iadison, Wi 53705-7162csn ;iv~oS3 )Count)'■ScLUiytf r-Saniiury Pomiii Number (to be filled in by Co.)Sanitary Permit ApplicationIn accordance with SPS 383.21(2), Wis. Adm Code, submission oflliis form to llie appropriate governmental unitis required prior to obtaining a sanitary pcmiii Note: Application forms for stale-owned fOWTS are submitted tothe Uepurtineiit of Safct) and Professional .Servics. I'eisonul information )'ou provide may be used for secondarypurposes in accordance with the Privac) I.aw. s. 15.04(1 )(m). Slats.State Plan Review NumberPWTS-_l£I. Application information - Please Print All InformationProject Address (if dilTereni than mailing address)AugProperly Owner's NameA. Uorena. N- ^c-itolz ^Parcel«Oo2^ /ot#-oO-SSt>oProperly Owner's Mailing AddressAutProperty LocntloiiGovt. LotCity. Stale/^orlow Grou<!^ !XL7,ip Code6>oc>s3n. Type of Building (check nil thai apply)I or 2 l-'amily Dwelling-Number of BedroomsD Public/Commercial - Describe UseD Stale Owned - Describe UsePhone NumberV*.'/•. SectionLot#.N; R.(circle one)EorW3\ -3.'=\Subdivision NameBlock «CSM NumberAlft?vxApTas.4' BegvcivD City ofD Village ofTown of_ Lcik^ill. Type of Permit: (Check only one box on line A. Complete line B ifapplicnbic)A.D New Sy stem^Replacement SystemD Treatment/I lolding Tank Replacement OnlyD Oilier Modification to Exi.sting S)'stem (explain)B.D Permit RenewalBefore ExpirationD Permit RevisionD Change of PlumberD Permit Transfer to New-OwnerList Previous Permit Number and Date IssuedvAavVt.IV. Type of POWTS System/Componcnt/Device: (Check all that apply^ Non-Pressurized In-Ground D i'ressuri/cd In-Ground D Al-Gradc D Mound > 24 in. of suitable soil D Mound < 24 in. of suitable soilD I lolding Tank D Other Dispersal Cunipoiienl (explain) D Preirenimcni IX-viee (explain)V. Dispersal/Treatment Area Information:Design Flow (gpd)3ooDesign Soil Application Raie(gpdsODispersal Area Required (sf)Dispersal Area Proposed (sf)System Elevation9(.VI. Tank InfoCapacity inGallonsNew TanksExisling TanksfoinlGallons«ofUnitsManufacturer:6Mi8Us'iZ tjMa.Septic or Holding Tank7ST>75t>Dosing ClianibeiVII. Respinisihilily Statement- I. the tindci'siened. iissi/ne fes|Hins(bili(y for Ipptiiilnlion of the POWT.S sitowii tin the nllaclicd plans.i'ldhiber's Name (Prim) . .I'lumhc/s SigAaiarcMI'/MPKS NumberBusiness Pitnnc NumberPlumber's Address (Street, City, State. Zip Code) r\AJ ■ Le>dc^ Ccjei^ ^ CP'S-VIII. Copntv/Denartment Use OnlyD Disapproved□ Owner Given Reason for DenialPermit FeeDate IssuedIssuing Agent SignatureIX. Conditions of Approval/Reasons for DisapprovalORIGINALNO REFUNDSAFTERISSUE OF PERMITARach to complete plans for tlie system and submit to Itie Count)' only on paper not less than 8 in > Im JUL 1 0 2020SDD-6398 (R. 04/19)SAWYER COUNTYZONING ADMINISTRATION
ots 31-39 BIk 7 Abendpost Beach 1st AddrEdward R., Lorena M. ScholzTmst7587N Fox Ave002-106-07-3500Sawyer3140N08WDouglas Manthey715-739-68687/10/20Property Owners NameProperty AddressTax Parcel NumberCountyLegal DescriptionSectionTownRangePage Index1 Property Information2 Data Entry3 Plot Plan4 Drainfield Cross-Section5 Sf^'cTank Info^ Maintenance Plan1 Contingency Planfl-U SoitTeirV-Plumber's NamePlumber's SignaturePlumber's License NumberPlumber's Phone NumberDateNot an endorsement, written or Implied for the following companies and products: DelZotto Concrete, Wloser Concrete ProductsInc.. Skaw PreCast Co., Huffcutt Concrete Inc.. Zabel Environmental Technology. ITT lndustrles(Goulds). The Pentair PumpGroup(Myers), Infiltrator Systems. ADS Products. Polylok Inc.. Orenco Systems Inc.. Sim/Tech Filter Inc., Sta-Rlte Industries.Page_| of t i
S8g -jz.io/ia)Component Manual Used2Number of BedroomsPercent Slope (%)108Depth to Soil Limiting Factor (in.)0.7In Situ soil application rate200Estimated Wastewater Flow (gpd)300Design Wastewater Flow (gpd)1Number of System Elevations96Proposed System Elevation #1Proposed System Elevation #2Proposed System Elevation #3100Original Grade #1100Finished Grade #1100Original Grade #2100Finished Grade #2Original Grade #3Finished Grade #3Infiltrator Quick 4 WChamber Type12Height of Chamber (in.)HOsq.ft. per chamber2Rows of Chambers5.8sq.ft. per pair of end caps3Distance Between Cells (ft.)22Proposed Number of Chambers Used428.6Minimum Distribution Cell Area Required (sq.ft.)9SJ.6Distribution Cell Area Proposed (sq.ft.)Wieser 750 |Septic TankOrenco 8" BiotubeEffluent FilterSoil BoringNumberSurfaceGradeElevation (ft.)Depth toLimitingFactor (in.)LowestElevationHighestElevationSystemElevationAcceptable199.9610894.099.0TRUE2100.0410894.099.0TRUE399.8510893.998.9TRUE43.0-1.0FALSE53.0-1.0FALSEPage ^ of 11
E"(iuj£tt-(I Lovevicv. M. 5"cMoiz. Ifvs-ir Co.^ Lk« i top.oc(fvi; LUtl((<^.iv\ 5c Inol'Z-TTt^s'f'e-'e. ?(N; ^o?-—fOfe—o"?—3SOO9^1/ Aoe. T HOtsi Z. OS^Ji'V\o*-4ofc\ G?CbO'€.^ HC AbcH^p»s4- SiXi Lasije-. '75"6-}aj Fox Aoe. 31 —61L 7miooAf/ t ros t\.±Zlo)bHvc^1^81 hi.3ji3j firt Ttr ±46'8£xDu>u}00<($LfyS WJ V Lafs 3/-39 fl/AlTpox Ao-c.ik.BV^iOo' btw^ci /Ot-O G»of\Bl.2. IDO-OH'3. "^Q.as'.1 Soils, Stid eL %'(jajvae qq.iS'-''4-2S'^hievo ST (rJ <^8.IB^ov^^6'l€V~U.eO€.l Sv'f'e' f»io ^ort*foorSI \O HOR*o lc»catn« e\<ii ^ysW"'^ 6fiA\roo*t~j !. • 1 1 i i f/ ^>4)\3oo <xPO r o.n -2^'X;LaC2o ) -f i».CS"-9) - VS"I.Oco(/tb>eyoiiAC<(. p"ip%nj i)« 9 ScViV^ov 5PR SvS" fOcO^MJ^^307X2So^M
Cross Section of o Two Cell In Ground ComponentUsing Leaching ChambersObservation/Veni Pipes100.00Finished GradeSlope100.0097.00Original GradeTop of Chamber96.00System ElevationI-- n .iv.Celt-^^erationI 3 Ife^tFinished Grade. _.-x'x)">\ X jfefiginal GradeX''X'''Top of ChamberSystem Elevation. : i.lreotnjefrt'pnd'DIaperedt .^otie. ' • * . i■?. ■ ■■ ^-v. r■; ■■, I100.001100.0097.0096.001Limiting FoclorObservation/Vent pipes to be constucted and capped with approved materials for the particular use.Diagrams Not To Scale#N/APage ^ of 11
0IjJ01OUJo:(/><INLETCMWLP750-MRTANK SPECIFICATIONSFILTERBAFFLE4" CAST-A-SEALDIMENSIONS;WALL: 2 1/2"BOTTOM: 3"COVER: 4"MANHOLE: 24" 1.0. PRECAST CONCRETE RISERHEIGHT: FLAT COVER 54" O.D.OUTSIDE DIAMETER: 84" O.D.BELOW INLET: 42" O.D.□QUID LEVEU 37"WEIGHT: 6.150 LBS.INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUALGASKET. CAST-A-SEAL BOOT OR EQUALINLET AND OUTLET BAFFLE AND FILTER:WISCONSIN. SEE DETAIL #10(OTHER STATES SEE CHART)LIQUID CAPACITY: 20.28 GAL/INHOLDING TANK:ACTUAL CAPACITY: 790 GALLONSOUTLET HOLE PLUGGEDTOP VIEWLOADING DESIGN: 8' 0" UNSATURATED SOILTANK CAN BE USED AS:SEPTIC/ HOLDING/ PUMP OR SIPHONCOVER: MIX DESIGN #8 (NO FIBER)TANK: MIX DESIGN #10 (STRUCTURAL FIBER)CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETE2r9r^roOUTLET)PUMP PADSIDE VIEWTANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTSDRAWINGS SUBMITTEDFOR APPROVALAPPROVED BY:APPROVAL date:PRODUaS NEEDED BY:t«J <(g o,sI X (O18 mo:z OOUJ I9 III= CMro|2 I!|8Iomr«.Q.<z<2OcnSHEET NO.1 ^^ 1clbo<0
Service EventService Frequencyinspect condition of tank(s)At least once every3|Year |Pump out contents of tank(s)When combined sludge and scum = 1/3 of tank volumeInspect dispersal ceii(s)At least once every3YearClean effluent filterAt least once every18MonthInspect pump, pump controls & alarmAt least once every7587N Fox Ave002-106-07-3500Design Flow (peak), (Estimated x 1.5) gal/daySoil Application Rate gal/day/fPTotal Suspended Solids (TSS)Edward R., Lorena M. Schoiz TrustNumber of BedroomsEstimated Flow (average) gallons / day2003000.7nfluent / Effluent Quality"ats. Oil & Grease (FOG)Biochemical Oxygen Demand (BOD5)Monthly Average30 mg/L220 mg/L150 mg/LSeptic TankWieser 750Effluent FilterOrenco 8" BiotubePump TankWieser 750Pump TypeIINOTEIIServicing frequency of 12 months or less requires theMaintenance InstructionsInspections of tanks and dispersal cells shall be made by an individual carrying one of the following licensesor certifications:Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer, Septage ServicingOperator. Tank inspection must include a visual inspection of the tank(s) to identify any missing or brokenhardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check forany backup or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected tocheck the effluent levels in the observation pipes and to check for any ponding of effluent on the groundsurface. The ponding of effluent on the ground surface may indicate a failing condition and requires theimmediate notification of the local regulatory authority.When the combined accumulation of sludge and scum in any tank equals 1/3 or more of the tankvolume, the entire contents of the tank shall be removed by a Septage Servicing Operator anddisposed of in accordance with ch. NR 113, Wisconsin Administrative Code.A service report shall be provided to the Douglas County Zoning Department within 30 days of anyservice event.Start-Up and OperationFor new construction, prior to use of the POWTS check treatment tank(s) for the presence of paintingproducts or other chemicals that may impede the treatment process and / or damage the dispersalceli(s). If high concentrations are detected have the contents of the tank removed by a licensedSeptage Service Operator.System start-up shall not occur when soil conditions are frozen at the infiitrative surface.Page of
Do not drive or park vehicles over tanks and dispersal cells.Reduction or elimination of the following from the wastewater stream may improve the performance andprolong the life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers,dental floss, diapers, disinfectants, fat, foundation drain (sump pump) water, gasoline, grease, oil, paintingproducts, pesticides, sanitary napkins, tampons, and water softener brine.AbandonmentWhen the POWTS falls and / or Is permanently taken out of service the following steps shall be taken toInsure that the system Is properly and safely abandoned In compliance with Wisconsin Administrative CodeComm. 83.33;- 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 ServicingOperator.- After pumping, all tanks and pits shall be excavated and removed or their covers removed and the voidspace filled with soil, gravel or another Inert solid material.Contingency PlanIf the POWTS falls and cannot be repaired the following measurers have been, or must be taken to providea code compliant replacement system: (Check One)1^ The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS asoil and site evaluation shall be performed to locate a suitable replacement area. If no replacement area Isavailable a holding tank may be Installed to replace the failed POWTS.A suitable replacement area has been evaluated and may be utilized for the location of a replacement;L.I absorption system. The replacement area should be protected from disturbance and compaction andshould not be infringed upon by required setbacks from existing and proposed structures, lot lines and wells.Failure to protect the replacements area will result In the need for a new soil and site evaluation to establisha 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. A holding tank may beF italled to replace the failed POWTS.IIWARNINGIISeptic, pump and other treatment tanks may contain lethal gasses and/or Insufficient oxygen. Do not entera septic, pump or other treatment tank under any circumstances. Death may result. Rescue of a personfrom the Interior of a tank may be difficult or Impossible.POWTS InstallerNameDouglas MantheyPhone #715-739-6868POWTS MalntalnerNameAffordable SepticPhone #715-634-3355Septic PumperNameAffordable SepticPhone #715-634-3355Local Regulatory AuthorityAgencySawyer County ZoningPhone #715-634-8288Pace ^ of /I