HomeMy WebLinkAbout002-940-22-5109-SAN-2020-144Siifctv and Duildincs Division201 W. Washinclon Avc.. I'.O. Uox 7162MadisoaWI 53707-7162{Cs-x ao-o'?b^CounlySawyerSanilary Pcrmil Number (to be Tilled in by Co.)IiSanitary Permit ApplicationIII atoinlaiKC wiili s Comni X3.2I(2). Wis Adiii Code, iiibmissiun of Uiis fonii Ui ihc apprnpeialc KOMinimciiIal mill isleiluired poor lo oblaiiung a sanilary perxnil. Note Applicalioii foniLs for slale-ouTKd IXfWI.S are subniillcd to ihDepanmcnt of Comincn:e. Persona! infonnation >ou provide niav be used lor secondary' piirpose.s in necordanee with Ibe[Viv!..-^T I.. . isrurivrnv cm.oSlnlv Tnins!ielioQ.Numbor1. Application Information-Please Print All InformationProject Address (H'difTercnl than mailing address)8244N Ochu RdProperly Owner's NameCarol HallerParcel »022940225109Property Owner'.s Mailing Addrc-ss8758 Black Maple DriveCity, StateEden Prairie,MNZip Code5534411. Type of Building (check ail that apply)Q I or 2 I'amily Dwelling - Number of BedroomsD Public/Commercial - Describe UseQ Stale Owned - Describe UsePhone NumberUt#ihopcny LocationCiovt. Lot I'A, '/4, Section 22r 40 N; R 9W WSubdivision NameBlock #CSM Number□ City ofn Village of[7] Town ofIII. Tvoe of Permit: (Check only one bu» on line A. Complete line B if antilicahle)D New System 3 Replacement System 3'I'realmeiil/lloldinBTimk Repliiecmeiil Only3 Olhcr Modilicalion to Rxisting Sy.sicm (explain)B.^ Permit RenewalBefore I-xpiration3 Permit Revision3 Change of Plumber3 Pcnnil Transfer to NewOwnerList Previous Pcrmil Number and Date Issuedcst«20-096 ? uk\L.IV. Type of POWTS System/Component/Device: (Cheek all that apply)^Non-Prcssunzed In-Omund D Pressurized In-Ciround D Al-<irade D Mound > 24 in. of suitable soil D Mound <24 in. ofsuitable soiln i lolding i'ank D Other Dispersal Component (explain) D Prclreaiincnl Device (explain)V. Dispersal/Treatment Area Information: 45 Infiltrator Quick 4 Standard chambersDesign f low (gpd)450Design Soil Application Ra(c<gpdsl)0.5Dispersal Area Required (sf)900Di.vpcrsal Area Proposed (sf)915System lilcvalion ^96.50VI. Tank infoCapueily inGallonsTola!GallonsUofUnitsManufacturer ;Prefab1Concrete 'Site Con-sttSiccIfib reGlossPlasticNew TanksfAisting TanksScplic or Holding Tank100010001WicscrXfXising CtianitvcrVII. Responsibtiitv Statement- I. the nadcrsigntd. assume rfsitoasibilicv forinslaUation of the POWTS shown on Ibe iHachtd plans.Plumber's Namc(Prml)Travis BuneiileldPlumber's Address (Street, City. State, Zip Co^T14346 W Stoic Rd 77 Hayward. Wl 54843Plumber's SiMP/MPRS Number652879Business Phone Number715 634-8176Vlllt County/Department Use Onlv8 ApproD Disannrovcd□ Owner Oiven Rca.son for Deni.ilPermit I'ecDate Issued7-^4-tS/>oissuing Agent SignatureIX. Conditions of Approval/Reasons for Disapprovalk-ii.JUL 2 0 zmSAWYER COUNPi'ZONING ADMINISTRATIONAetath k•vaai[|vkhi plaM tii ihw nwii ■kJ witarat lo I'tuKf rwVy tmpafxt nt >r>* than ■ 10 i 11 nrhti aSBD-6398 (R. 10/11)
Carol Haller8244N Ochu Rd<90 2940225109SawyerProperty Owners NameProperty AddressTax Parcel NumberCounty822T40N9WTravis Butterfield652879(715) 634-817607/19/20Gov Lot or Qtr-Qtr/QtrSectionTownRangePage Index1 Property Information2 Data Entry3 Plot Plan4 Drainfield Cross-Section5 Dose Tank6 Maintenance Plan7 Contingency Plan8 County Parcel ListingPlumber's NamePlumber's SignaturePlumber's License NumberPlumber's Phone NumberDateNot an endorsement, written or implied for the following companies and products; DelZotto Concrete, Wieser Concrete ProductsInc., Skaw PreCast Co., Huffcutt Concrete Inc., Zabel Environmental Technology, ITT Industries(Goulds), The Pentair PumpGroup(Myers), Infiltrator Systems, ADS Products, Polylok Inc., Orenco Systems inc., SImfTech Filter Inc., Sla-Rite Industries,Page 1 of 8
In-Gfoutvl Soil Absorption SBD-10705-P (N.01/01) Version 2Component Manual Used3Number of Bedrooms3Percent Slope (%)108Depth to Soil Limiting Factor (in.)0.5In Situ soil application rate300Estimated Wastewater Flow (gpd)450Design Wastewater Flow (gpd)2Number of System Elevations96.5Proposed System Elevation #195.5Proposed System Elevation #2Proposed System Elevation #3Original Grade #198.5Finished Grade #1Original Grade #297.5Finished Grade #2Original Grade #3Finished Grade #3Infiltrator Quick 4 StandardChamber Type15Height of Chamber (in.)20sq.ft. per chamber3Rows of Chambers5.1sq.ft. per pair of end caps3Distance Between Ceils (ft.)45Proposed Number of Chambers Used900.0Minimum Distribution Cell Area Required (sq.ft.)915.3Distribution Cell Area Proposed (sq.ft.)Wieser 1000LPSeptic TankDose lank (if applicable)! jBest 8"Effluent Filter"select only if NOT using combo tankSoil BoringNumberSurfaceGradeElevation (ft.)Depth toLimitingFactor (in.)LowestElevationHighestElevationSystemElevationAcceptable197.5010891.5096.25FALSE298.5010892.5097.25TRUE397.5010891.5096.25FALSE45Page 2 of 8
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Cross Soction of a Three Cell Ingroimd ComponentUsing Leaching ChambersFinished GradeSlope 3%Finished GradeOriginal GradeTy,talOb««k-rv«Plp, Top of Chambery_^^System Elevation97.5096.7595.5097.7596.50Original GradeTop of ChamberSystem ElevationFinished Grade,~^73r=>Obf*iSi»/V^plp«lob»eBawiefcdmd««pp«dwMi«ti(iiowrfn^Ml«».eirih.[»wi>.it».,^?S-^.Original GradeT(^ of ChamberSystem Elevation 95,50 |Diagrams Not To ScaleO n ;0Of- OObsen/ation / Vent Pipes to be located 1/5 to 1/10 the length of the distrution cell measured from the end of the cells
Service EventService FrequencyInspect condition of tank(s)At least once every j 3|YearPump out contents of tank(s)When combined sludqe and scum = 1/3 of tan< volumeInspect dispersal cel!(s)At least once every3YearClean effluent filterAt least once every3YearInspect pump, pump controls & alarmAt least once everyCarol Haller8244N Ochu Rd2.94E+09Number of BedroomsEstimated Flow (average) gallons / dayDesign Flow (peak), (Estimated x t.5) gal/daySoil Application Rate gal/day/ft^3004500,5Influent I Effluent QualityFats, Oil & Grease (FOG)Biochemical Oxygen Demand (BODj)Total Suspended Solids (TSS)Monthly Average30 mg/L220 mg/L150 mg/LSeptic TankWieserlOOOLPEffluent FilterBest 8"Pump Tank#N/APump TypeIINOTEIIMaintenance ScheduleServicing frequency of 12 months or less requires theManagement Plan be recorded with the Register of Deeds.Maintenance InstructionsInspections of tanks and dispersal cells shall be made by an Individual carrying one of the followinglicenses or certifications;Master Plumber, Master Plumber Restricted Sewer. POWTS Maintainer, SeptageServicing Operator. Tank inspection must include a visual inspection of the tank(s) to identify any missingor broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum andto check for any backup or ponding of effluent on the ground surface. The dispersal cell(s) shall be visuallyinspected to check the effluent levels in the observation pipes and to check for any ponding of effluent onthe ground surface. The ponding of effluent on the ground surface may indicate a failing condition andrequires the immediate 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 County Zoning Department within 30 days of any serviceevent.Start-Up and OperationFor new construction, prior to use of the POWTS check treatment tank(s) for the presence ofpainting products or other chemicals that may impede the treatment process and / or damage thedispersal celi(s). If high concentrations are detected have the contents of the tank removed by alicensed Septage Service Operator.System start-up shall not occur when soli conditions are frozen at the infiltrative surfece.Page 6 of 8
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, painting products, pesticides, sanitary napkins, tampons, and water softener brine.AbandonmentWhen the POWTS fails 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 AdministrativeCode BPS 383.33;- Ail piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.- The contents of ail 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 (he POWTS fails and cannot be repaired the following measurers have been, or must be taken toprovide a code compliant replacement system: (Check One)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 areais available 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 replacementsoil 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 andwells. Failure to protect the replacements area will result in the need for a new soil and site evaluation toestablish a suitable replacement area. Replacement systems must comply with the rules in effect at thattime.iA suitable replacement area is not available due to setback and/or soil limitations. A holding tank maybe installed to replace the failed POWTS.ilWARNING!!Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient oxygen. Do notenter a septic, pump or other treatment tank under any circumstances. Death may result. Rescue of aperson from the interior of a tank may be difficult or impossible.POWTS InstallerNameTravis ButterfieldPhone #(715)634-8176POWTS MaintainerNameButterfield Inc.Phone #(715) 634-8176Septic PumperNameScott PoppePhone #(715) 634-1450Local Regulatory AuthorityAgencySawyer County ZoningPhone #715-634-8288Page 7 of 8