HomeMy WebLinkAbout010-306-02-0300-SAN-2020-065Imlusiry Scniccs Division1400 li Wiisliingloii AvcP.O. Box 7162Madison. WI 53707-7162c^TI'ouiilySawygySaniuiry Perroil Number (lo be filled in by Co.)•SlISanitary Permit ApplicationIn accordance with SPS 383.21(21, \\ is. Ailiii. C'rxic. suiniiissiim ol'llus fonii (i> (he .ippropna(c giivemiiicntal uni(is required prior (o obraining a sanitary permit. Note: .Vpplicadrin I'oniis lor siale-otvned i'OWTS are subinilled lothe Department ol'Safety and Professional Serv ices. Personal iiifonnalioii you provitle may be used for secondarypurposes in accordance with the Privacy Law, s. I5.04( I )(m). Stats.Slate I ransaction Number1. Application Information - Please Print All InformaHonProject Address (il tHI'WProperty Owner's NameBrodUuPared «Ol O - - 02.Property OwnerVMailing AtldressAr\^e] Av^C.Property l.iKationCity. State|-W.iai--J.tunZip CodeII. Type of Building (check all that apply)0 I or 2 family Dwelling - Number of Bedrooms ^D Public/Commercial - Describe Use _D State Owned - Describe UsePhone NumberOovl. LotKl >JJ '4. W£. W, Sectionl.otHN; Rcircle one)i . L&r ^Subdivision NameBlock KU)€if□ City of.CSM Number□ Village ofS Town ofIII. Type of Permit: (Check only one box online A. Complete line B if npplicahlc)A.D New SystemB Replacement SystemCeaD Treatmenl/Holding'l unk ReplaeemenlOnly0 Dtber Mndilieation lo Lxisting System (explain)OHI fteglacr.tig. ^D Permit RenewalBefore ExpirationD Permit RevisiiD Change ofPlumberD Permit Transfer to NewOwnerList Previous Permit Number and Date Issued-i-t h^/9iIV. Type of POWTS Systcm/Componcnt/Devlce: (Check all that applyD Non-Pressurized In-Cround D Pressurized In-Ground D Al-Gradc B Mound >24 in.ol'suilahlesoil D Mound < 24 in. ol'suitabic soilD Molding lank D Otiicr Dispersal Component (explain) D Prelreatmem Device (explain)V. Dispersal/Treatment Area Information:Design Flow (gpd)Design Soil Application Raletgpdsf)('0Dispersal Area Required (sf)Dispersal Area Proposed (sf)System Elevation/a'/'8 'VI. Tank infoCapacity inGallonsNew TanksHxisting 'tanksTouilGallons«ofUnitsManufneHirerB oe, uinSi 2<1 OE.Seplk Qf llfllding Tank/oco-tUa^u-y-Dosing ChamberC>cOVII. Rcsponslhility Statement- 1. the undersigned, assume responsibility for Installation of the PONNTS shown on the allaclicd plans.Plumber's NametPrni)Plumber's SignaUireMI'/MPRS NumberOnsryr/Business Phone Number■7ts--79e-Bi:nrPlumber's .Address (Street. City, Slate, Zip Codelf 0 • Cdlyie.,UJX.SH62.I)|>rt>vcc1^^ D Di$approvcOOwner Given Reason forlTenialPcnnil FeeeHem. I Dale Iss^-i4.IssuedeAiW,l.\. Conditions of .Approval/Reasons for DisapprovalIssuing Agent SignatureORIGINALNO REFUNDS AFTERISSUE OF PERMITAlliieh |ciciim|>lclv- plims Pirllic syslcni unit subiiiil lo Ihr Cuunly only on |in|icr not Icsv ihanK 1/2 < II inches In sizeSBD-6398 (R. 08/14)^ISlSZSiAPR 3 0 2020SAWYER COUNTYZONING ADMINISTRATION
^ >-DIVISION OF INDUSTRY SERVICES10641 N RANCH RDHAWVAROWl 54643-6452Contact Through Rdayhttp'J/Api. wi.gov/programsAndustry •$ervtceswwrw.wisconsin.govTony Evero • GovernorDawn Crim • S«cfetaryApril 27, 2020CONDITIONAL APPROVALPLAN APPROVAL EXPIRES: 2022-04-27Plan Review: PWTS-042000629-CJASON KUETTELPO Box 66Cable W! 54821SITE:Bradley Lewis - Unit 316404W Lein CourtSawyer CountyTown of HaywardNW K • NE - S29 -T41N - R9WCOSD/TIOSALLYAPPROVEDOHT OF SAFETY ANO PROFESSIONAl SERVICESDIVISION OF INDUSTRY SERVICESSEE COPONDENCEFOR:Description:3 Bedroom EZFlow Mound - 450 GPD -Replacement - 32" to limiting factor-Effluent Filter - Maintenance requiredEZFlow Mound Component Manual - December2017 VersionPressure Distribution Component Manual - Ver.2.0, SBD-10706-P (N.01/01, R. 10/12)The submittal described above has been reviewed for conformance with applicable WisconsinAdministrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. Thissystem is to be constructed and located in accordance with the enclosed approved plans and with anycomponent manual(s) referenced above. The owner, as defined in chapter 101.01(10), WisconsinStatutes, 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 theDepartment per s.145.06, stats.The following conditions shall be met during construction or installation and prior to occupancy or use:Reminders• This is a recore and expansion of an existing 6' x 42' rock and pipe mound. The proposed moundwill be 9' X 50' EZFlow. Be sure the expansion is installed in the tested area. If it Is not, additionalsoil borings will need to be done to verify soil conditions. Be sure all topsoil is removed on themound only - not on the native ground surface - prior to plowing and sand placement onexpanded areas. Avoid compaction of expansion and downslope areas.• The following must be completed in addition to any comments made from the County inspector:a. Remove excess/overgrown vegetation from mound, mow and remove clippings.b. Pump out any standing wastewater through observation pipes.
c. Permit dispersal area to dry out.d. Remove and stockpile topsoil from the mound system.e. Remove distribution pipes and observation pipes. Dispose of properly.f. Remove aggregate from absorption area(s) and dispose of in approved manner. It cannotbe re-used.g. Remove clogged sand plus an additional 3 inches of clean sand and dispose ofproperly. This sand cannot be re-used.h. Sample remaining sand at several locations to assure it meets ASTM Specification C-33 forfine aggregate. If the sand does not meet ASTM Specification C-33 for fine aggregate, itmust be removed down to the natural soil.i. Install replacement mound system using procedure outlined in the approved moundsystem component manual.j. Ensure the expansion area has not been compacted by equipment. Any grasses longerthan 6" shall be cut short and removed. To avoid matting, any leaves or loose organicmatter shall be raked up and removed. Cut trees and shrubs flush to the ground andleave stumps.• Ensure the existing septic tank is watertight, structurally sound and baffles are In place. Anychanges made to the tank must be approved by the manufacturer.• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8Inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of thesoil. Proper soil moisture content can be determined by rolling a soil sample between the hands.If it roils Into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation canproceed. If the site is too wet to prepare, do not proceed until It dries.• A sanitary permit must be obtained from the county where this project is located in accordancewith the requirements of Sec. 145.19, Wis. Stats.• Inspection of the private sewage system instaiiation is required. Arrangements for inspection shalibe made with the designated county official in accordance with the provisions of Sec.145.20(2)(d), Wis. Stats.• A state approved effluent filter is required. Maintenance information must be given to the ownerof the tank expiainingthat periodic cleaning of the filter is required.• A coDVof the aporoved plans, specifications and this letter shall be on-site during construction andopen to inspection bv authorized representatives of the Department, which mav inciude locaiinspectors.Owner Responsibilities• The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall alsoreceive a copy of the appropriate operation and maintenance manual(s) and be responsible forensuring that POWTS is operated and maintained in accordance with this chapter and the approvedmanagement plan under s. SPS 383.54(1).• In the event this soil absorption system or any of its component parts malfunctions so as to create ahealth hazard, the property owner must follow the contingency plan as described in the approvedplans.• The owner is responsible for submitting a maintenance verification report acceptabie to the countyfor maintenance tracking purposes. Reports shail be submitted at intervais appropriate for thecomponent(s) utilized in the POWTS.In granting this approval the Division of Industry Services reserves the right to require changes oradditions should conditions arise making them necessary for code compliance. As per state stats101.12(2), nothing in this review shali 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, orat the address on this letterhead.The above left addressee shall provide a copy of this letter and the POWTS management plan to theowner and any others who are responsible for the installation, operation or maintenance of the POWTS.Sincerely,CeCe'KudnCcki/CeCe (Elizabeth) RudnickiWastewater Specialist/POWTS Plan Reviewer, Division of Industry Services(608) 400-3186elizabeth.rudnickiiSwisconsin.eov
EZflow -" MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGNINDEX AND TITLE PAGEProject Name:Owner's Name:Owner's Address:BRAD LEWIS MOUND CELL UPGRADEBRADLEY D. LEWIS15926W ANGEL AVE.HAYWARD.WI 54843CONDmO.yALLTAPPROVEDOEPT OF SAFETV AND PROFESSIONAL SERVICESDIVISION OF INDUSTRY SERVICES612-845-3325Legal Description:Township:County:Subdivision Name:Lot Number;NW. NE.S29.T41 N. R9WHAYWARDSAWYERSEE CORRESPONDENCE16404W LEINCT. UNIT 3 OF STONEWOOD WEST CONDO2Block Number:Parcel I.D. Number: 010-306-02-0300Plan Transaction No.:Page 1Index and titlePage 2Data entryPage 3EZffow mound drawingsPage 4Lateral and dose tankPage 5Distribution mediaPage 6System maintenance specificationsPage 7Management and contingency planPagesPump curve and specificationsPage 9Plot PlanPage 10Soil EvaluationPage 11Soil Tester Plot PlanPage 12Slate Plan # 16874 info (7/31/98)JASON KUETTELLicense Number: 66Date: 04/21/20Signature:Phone Number:75751 DSPS 27828C715-798-3355yDesigneij PursuanI lo tneBZflow Mound Comfionent Manual Ver August 20,2007.SSWMP Publication 9.6 Design of Pressure Distribulion Networks for ST-SAS (01/01) andPressure Distribution Component Manual Ver. 2.0 S6D-10706-P (N. 01/01)EZ//OW Mound Version 3.0 (R. 3/1/12)Page 1 of
Mound and Pressure Distribution Component DesignDesign Worksheet{f or c)Site InformationRResidential or Commercal DesignEstimated Wastev/ater Flow (gpd)Peaking Factor (e.g. 1.5 = 150%)Design Flow (gpd)Site Slope {%)installation Contour Line Elevation (ft)Depth to Limiting Factor (in)In-situ Soil Application Rate (gpd/ft")300.001.50450.005.00104.3032.00O.SO90.00;Contour Length Available (ft)9.00Distribution Celt InformationCell Width (ft) 3. 4. 5. 6 7, 8 9 or 10 OnlyDispersaf Cell Design Loading Rale (gpd/ft^)influent Wastewater Quality (1 or 2)1.00150.001 = Dispersal Cell Length (ft)[C 0'52.002.00!Pressure Disribution InformationCenter or End ManifoldLateral Spacing (ft)Number of LateralsOrifice Diameter (in) (e.g 0.25)&s!,ir,3;ed Orifice Spacing (ft) =Forcemain Diameter (in)Forcemain Length (ft)Inside Pump Tank Elevation (ft)Forcemain Filter Loss (ft)System Head (ft) x 1,3Vertical Lift (ft)Friction Loss (ft)Total Dynamic Head (ft)17. VV TbH30.0096^476,507,830.61Are the laterals the highest pointin the distribution [ Ynetwork?Enter Y or NIf N abovo, onter the elevation (ft)of the highest point. |□6,00ft"/orificeDoes the forcemain drain back? [Enter Y or N□Lateral Diameter Selectionin. dia.optionschoice0.751.001.25X1.50XX2,00X3,00XTreatment Tank Informationj lOOO.OOj SepUc Tank Capacity (gal)[HUFFCUTT [ManufacturerDose Tank Information600.00 Dose Tank Capacity (gal)Dose Tank Volume (gal/In)HUFFCUTT [Manufacturer4.8966.7271.6230.89Forcemain Drainback (gal)5x Void Volume (gal)Minimum Dose Volume (gal)System Demand (gpm)Manifold Diameter Selectionin. dia.optionschoiceX1.25X1,50X2.00X3.00Gallons/Inch Calculator (opt onaijTotal Tank Capacity (gal)Total Working Liquid Depth (in)gal/in (enter result in cell B49)Effluent Filter information[SIMTECHI100A2"Filler ManufacturerFilter Model NumberProject BRAD LEWIS MOUND CELL UPGRADEPage 2 of 12
Mound Plan Vieww. 1/10B4 yObservation Pipe■{§0B■ m■Tj4A1Mound Component DimensionsDown slope toe extension made.A9.00ftE11.40inH1.00ftK8.18ftB50.00ftF12.00inI9.00ftL66.35ftD6.00inG0.50ftJ5.22ftW23.22ft450.009.00(ft') Dispersal Cell Area(gpd/ft) Linear Loading Rate900.005.00(ft) Basal Area Available(ft) 1/10 B Obs. Pipe PlacementMound Cross Section ViewEZffow Dispersal AreaFinished Grade 106.80 (ft)104.80 (ft)Dispersal CellElevation105.30 (ft) LateralInvert ElevationDispersal5.0 % Site SlopeShading Keym. L.Topsoil CapnSubsoil CapElASTM C33 Sand□Tilled LayerBBZnow MediaP -o ®> o a(Lr Q.o £ e^ CO o5 d3 r-0 p£ *S lA(0 ^ ouT2.0 ft0.5 ft-if—104.30 (ft) Contour ElevationTypical Dispersal CellSee Page 5Approved Geotextile Fabric CoverSee details on page 4 for number, size, and spacing of laterals.Laterals are located in the 4' gravity distribution pipes as shown on page 5.Project: BRAD LEWIS MOUND CELL UPGRADEPage 3 of 12
End Connection Lateral Layout DiagramP/Jl-l- ADProct'^ito Laiffril PiMiran-. F'->m PiaN Hffiov.H— i -H ' !J Ofiliv'7 >-2c .rt-.-l v. I I- X - — I A.i i.;-r! caJ. •fSri Ofir.T. -+O.C'!^otcc n^ari ^ t« o» V'i> Jii al aft'p'trfii » » ai'-MfT.«nci>P'vC Sch4i>f.t JF: litt.. ie-» in-tOriltc*; pOiTiI u(; fr^'nf / 5Mi ofiis r "J""!!; dO'Ti let eft jTis^Sh!'Number of Laterals3Orifice Diameter0.125inLateral Diameter1.50inOrifice Spacing (X)2.02ftLateral Length (P)49.24ftOrifices per Lateral25Lateral End (Z)0.76ftOrifice Density6.00ft^/orificeLateral Spacing (S)3.00ftManifold Length6.00ftLateral Flow Rate10.30gpmManifold Diameter1.50inSi^tem Flow Rate30.89gpmForcemain Velocity3.16ftfsecDose Tank InformationElectncai as per NEC 300 ar<3SPS 316,300 WACTank component la propefly venlcdXLocKing cover with warninglabel and locking device andsoaied watertightHUFFCUTTCapacity600.00Volume14.00ManufacturerGallonsgal/inchDimensionInchesGallonsA23.74332.38B2.0028.00C5.1271.62D12.00168.00Total42.86600,00AcDDisconnectQ:v4 m. IBedding And Sackfilt As Per iVlanoracturerAlternate outletlocationForcemain diameterZZ52 in.Weep hole or anti-siphon device^ Pump off elevation (ft)97.471Dose tank elevation (ft)96.47Alarm ManufacturerAlarm Model NumberPump ManufacturerPump Mode! NumberPump Must DeliverSJE_ldlHW"MYERSME 40"W^ftTDH /7,3Q.89|gpm atNoie Sw;(chc.'}> contoiip, ,i_| mienturv i:i«y no' be used in tii's s'/slemProject: BRAD LEWIS MOUND CELL UPGRADE Page 4 of !2
EZflow Distribution Cell Media Layout9.00 I Cell Width (ft)1.50 iSldewall to Lateral (ft)0Distribution Cell Cross-section ArrangementsFnrne Main9 ft WideEndComponent LegendSR1-7A Bundle - 5 ft or 10 ft lengthsSR1-12A or EZ 1201A in 5 ft or 10 ft lengthsSR3-12H or EZ 1201P or 2H In 5 ft or 10 ft lengths4" Perforated Distribution Pipe With Pressure Lateral InsideTurnup Enclosure ----- Pressure LateralBundles are covered with approved geotextile fabric as per the their product approval.Distribution Cell Plan View Layout - Typical9.00 I Cell Width - A (ft) j 50.00 jCell Length - B (ft)Connection Lateral Layout Diagram9 ft WideProject: BRAD LEWIS MOUND CELL UPGRADEPage 5 of 12
Mound System Maintenance and Operation SpecificationsService Provider's NamePOWTS Regulator's Na<iieANDRY RASMUSSEN & SONSSAWYER COUNTY ZONINGPhonePhone715-798-3355715-634-6288System Flow and Load ParametersDesign Flow - PeakEstimated Flow - AverageSeptic Tank CapacitySoil Absorption Component SizeType of Wastewaler4503001000450Domesticgodgodgalft'Maximum Influent Particle SizeMaximum BODSMaximum TSSMaximum FOGMaximum Focal Coliform1/822015030>10E4inmg/Lm^Lmg/Lcfu/100 mLService FrequencySeptic and Pump TankEffluent FilterPump and ControlsAlarmPressure SystemMoundInspect and/or service once every 3 yearsInspect and clean as necessary at least once every 3 yearsTest once every 3 yearsShould test periodicallyLaterals should be flushed and pressure tested every 3 yearsInspect for ponding and seepage once every 3 yearsI ADO ,5 FRICTION LOSS SIMTECH FILTERMiscellaneous Construction and Materials Standards1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight capand are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007.2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound ComponentManual Ver August 20, 2007, Media is covered with an approved geotextile fabric.3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 wilt be seeded and mulched to prevent soil erosionand help reduce frost penetration.Lateral Tum-up DetailFinished Grade6-8" Diameter LawnSprinkler Valve BoxLateral Ends at Last Orifice WhereVariable Length Cleanout BeginsT-,-r L-rr-. r.*|; EZflow Synthetic Media 'nThreaded CleanoutPlug or Ball Valve2.02 Feet'Distribution LateralLateral CleanoutLena Sweep 90 or Two45 Degree Bends SameDiameter as LateralProject' BRAD LEWIS MOUND CELL UPGRADEPage 6 of 12
Mound System Management PlanPursuant to SPS 383.54, Wis. Adm. CodeGeneralThis system shall be operated In accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its* componentmanuals [EZffow Mound Component Manual 8/20/07. Pressure Distilbution Component Manual Ver. 2.0 SSO-10706-P (N. 01/01) andSSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintaiance r^rfng.Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longerused as POWTS components.Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openingsused for service and assessment shall be seated watertight upon the completion of service. Any opening deemed unsound, defective, orsubject to bilure must be replaced. Exposed access openings greater than 6-inches in diameter shall be secured by an effective lockingdevice to prevent acddenlal or unauthorized entry Into a tank or compon^it.Septic TankThe septic tank shall be maintained by an Individual cerWIed to service sepHc tanks under s. 281.48, Stats, The contents of the septictank shall be disposed of In accordance wilh NR113, Wis. Adm. Code. The operating condition of the septic tank and outlet filler shall beassessed at least once every 3 years by InspacUon.The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisionsare made to retain solids In the tank that may slough off Ihe filler when removed from Its enclosure. If the filter Is eqifipped with an atami, Ihefilter shaD be serviced If the alarm Is acfivated continuously. Intermittent ffitm'alarms may buficate surge flows or an Impeding continuoiealarm.The septic lank shall have Its contents removed when the volume of dudge and scum In the tardc exceeds 1/3 the fiqufd volume of the itank. If the contents of the tank are not removed at the time of a triennial assessment, malnterunce perscmnd shall advise ttie owner as towhen 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 productsare used Ihey shall be approved for septic tank use by the Wisconsin Department of Commerce.PumpTankThe dosing (pump) tank shall t>e Irepected at least once every 3 years. AO switches, alarms, and pumps shall be tested b> verify properoperation. If an efilumit filler is Installed wflhin the tank It shall t>o Inspected arxi serviced as necessary. If the force main has a weep tv>le. Itshould be noted If It Is fimt^onal during pump operation, and If not, It should be cleaned.*****Afo one should ever enter a sepf/c or doso tank since dangerous gases may be present that could cause death.'***Mound and Pressure Distribution SystemNo trees or shrubs should be planted on the mound. Planfings may be made around Ihe mound's perimeter, and the mound shall beseeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than forvegetativa maintenance) on ttie mound Is not recommended since soil compaction may hinder aeration of the InfUlrative surtece wittiln themound and snow compaction In the winter wiD promote frost penetration. Cold weather installations (October-February) dictate fiiat fiiemound be heavily mulched as protection from freezing.Influent qialify Into Ihe mound system may not exceed 220. mg/L BODg, ISO mg/L TSS, and 30 mg/L FOG for sepUc tank effluent or 30mg/L BOD), 30 mg/L TSS, 10 mg/L FOG, and 10*cfu/1C0 mL for highly frrated effluenL Influent flow may not exceed maximum design flowspecified In the permit for this Installation.The pressure distribution system is provided vylth a flushing point at the end of each lateral, arid It Is recdmmertded that each lateral beflushed of accumulated solids at least once every 3 years. When a pressure test Is performed it should t>o compared to the Init^ test whenfoe system was Installed to detennine If orifice clogging has occurred and If orifice cteantng Is requfred to maintain equal distribution withinthe dispersal cell.Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported fo the own«', and anylev^s above 4 Inches considered as an Impending hydraulic failure requiring additional, more frRiusnt monitoring.ContlnaencvPlanif the septic tank or any of Its components become defective the tank or component shall be repaired or replaced to keep the system Inproper operating condition.If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defecb've component(s) shall be Immediatelyrepafred or replaced with a component of the same or equal p«formance.If the mound component falls to accept wastewater or begins to discharge wastewater to Ihe ground surface. It will be repaired orreplaced In Its' present location by increasing basal area If toe leakage occurs or by removing biologically clogged absorption and dispersalmedia, and related piping, and replacing said components as deem^ necessa^ to bring the system Into proper operating condition.See Page 6 of this plan for the name and t^ephona number of your local POWTS regulator and service provider.Project: BRAD LEWIS MOUND CELL UPGRADE Page 7 of 12
MYERS® ME40-C1 SeriesCast Iron Submersible Effluent PumpsDIMENSIONSSECTIONAL VIEW2- FNPT7.J1Dimensions (in inches) are for estimating purposes only.PUMP PERFORMANCEb 29ez%CAPACITY LITERS PER MINITTE100190200H-+——_—\—--\.. ,.- •—— ---••i.......NN—"T"1s1-\i1 -1—\Esz9 QSH0 10 :0 30 40 so soCAPACmr GALLONS PER MINUTE►||>PENTAIRC 2013 Lttl All Rights RvservtdLSi 253 WRIGHT STREET, OELAVAN.WI 53115 WWW rEWEVEBS.COM PH. 88S-587-8677 ORDERS FAX: 800-i24-9444CANADA 249 TRILLIUM DRIVE. KITCHENER. ONTARIO. CANADA N2G 4W5 PH-5H-?4a-5470 ORDERS FA*. a88-4Q4-5484Because ws are conimuously impriwinQ our proaucls and eemcaa, Panijir reserves Ihe nghl lo thatige specilicaiions wiinoul prior noiiCe.M1053SSSE103/19/131
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Wrisconsm Oeparvnani el CommoicoDivision ol Saloly and BuildingsDuroau ol Iniegraied SsivicesSOIL AND SITE EVALUATIONin accordance wrth s. ILHR 83.09. Wis. Adm. CodePago _! d v3 .Attach comptete site dan on paper not less than 81/2 x 11 inches in size. Plan mustInclude, but not Emliad to: vortfeal and horizontal relerence poini (BM). directlen andpercent slope, scale or dimensions, north arrow, and location and dstaneo to nearest rood.APPUCANT INFORMATION - Please print atl Infomatlon.PeisenellnleanatlBnieuBrovlris may be used lor secendaiypumesos (Privacy tiiv.s. lS.04(i)(niH.County ~Parcel I.D. aReviewed by Date1Propeity Owner -• ^^<S£/L. CfloFF TuJjAi not^n)Properly locationOovttot A/uJiM AJ&W.S ;?9 T E{or)WPrapstty Ownai's Mailing AddresstoteBlockaSubaNamaorfiSttL caur »*■ ^t<Slbt^SjUtDOO lA^T SiOOAJi/UAmfACity t Slate Zip Code Phone NumbermvujAflo I OJt 1 )□ aiy □ vaiago Q^own of- NoaiostRoad^cuAX'B^Sldflntel/NinilliafOllMdlBaills adrfMantoMlednjlMinilliigOPubOeoreommeicial'Oesetibo;(TNewOonstfudlen Uso:DRoplBcemontCodoiteilvBd dally Bow <3^0 ftoaninmendflddBglanteaiflnaiaiB « had, gpdrf . toAbsoiptlon area required ^SO ftodmuindflsiflnioiitfinnnitii . 5 hnHnisMtgReoomnended (nSIbatlon suifaee elevalion(s) UA/IT 3? /flSg UkUT V.' /07.0 b (as reiefFod to site plan benoiunajti)AdditionaldesfgnAdleeonsMamtiflns StTS BMLMTtO/O ti /«/L Si. MOVfXiS . J/ilL £ke.rt tMJlT8 ■ Suiloblo (or systemU ■ UnsuStablsforsysiefliConventional□ s BIjMoundDuhvQiound Pressure□ s OilAT>Giade□ s oilSystoffllnPIIl□ s 01iHolifingTanlt□sSOIL DESCRIPTION REPORTBoringsGroundSlav.Depth toIbnlllnga.Boring #HorizonDepthbtDominant CdorMunsollMoDesQu.Sz. Cent ColorTextureSbueturaOr. Sz, Sti.ConslatoneeBwnda/yRootsGPDflt®BedTrenchApO'*}75l^L S/Z."Cf^5L• m flrMoPr.4*59'Jti1.6VA ¥14-^3JLmtjfvc:s.S.(osm M■tf-J mSbfcihi/fvasOFWpi-i>4SMt V/«/mpi .Si/fi.vSLom *mrfirIfr.St*L VHSLom PMfrRemarl,c. * i>£fin/VOAIAL/ ft^hrvAp0-1-tr6Lrn\)Ptas3F.S•(aB7v3^,7iiK. M-trHmSikjni/firoSfZf.Szt>.iHt Mtr1 tiiSbULW/frasw.5&C.<)«. f/iFift Sv/t. StP>6LornmPr—IP'>'^3Al^4■•Groundtriov.Doplhtolimitingladar¥(gln.Remarks:CSTNomo (Please Prim)CZoa^M /Telephone No.Its 3^97DaleStSf72>_ _ CST Number^ /ub re>t3f
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BsconsmDepartment of CommerceSafety and Buildings15837 USH63HAVWAROWI 54843-8107Tommy 0. Thompson, GovernorWilliam J. MeCoshen. SocrotaryJuly 31.1998CUSTIDNo,220915DANA A DEBUSPO BOX 177STONE LAKE WI S4876RE: CONDITIONAL APPROVALAPPROVAL EXPIRES: 07/31/2000SITE:Site ID: 16874SAWYER Counly, Town of HAVWARDNWI/4. NEI/4,329, T4IN, R9WROGER HOFF TWIN HOMES UNIT #3FOR:Description: NEW MOUND SYSTEMObject lype: POWT System Regulated Object ID No.: 37461Identiflcatlon Niunbeiatv. ■'Transaction ID No. 121429Site ID No. 16874Please idfer'tb both identiflcalioi: number^ 'above, In all coirespdndence with the ageaCT.Tbe submlttal described above has been reviewed for confonnanee with applicable Wisconsin Adnalnlstrative Codesand Wisconsin Statutes. The submlttal has been CONDITIONALLY APPROVED. The owner, as defined Inchapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.This plan approval Is for a 450gpd mound.The following conditions shall be met during construction or installation and prior to occupancy or use:• This plan action is subject to designer comments on the plan• CotTNpondence Note:• Maintain well setbacks per Comm. 83.13(4) ft 83.10(1).• Per Comm. 8323(3)(b)2, the area 25 feet below the downslope edge of the soil absorption system must remainundisturbed.A copy of the approved plans, specifications and this letter shall be on>site during construction and open toinfection by authorized representatives of the Department, which may include local Inspectors. All petmilsrequired by the state or the local municipally shall be obtained prior to commencement ofconstructlon/lnstallatlon/operation.P.O.'CondiAPPFDEPARTMEN'DIVISION Of SAFInquiries concerning this correspondence may be made to me at the telephone number listed below, or at the addresson this letterhead.SEE CORRiSincerely,.TOM BRAUNLPLAN REVIEWERIntegrated Services(715)634-3026, M - F 7:45 AM TO 4:30 PMTBRAUN@C0MMERCE.STATE.WI.USDATE RECEIVED 07/24/1998FEE REQUIRED $180.00FEE RECEIVED $180.00BALANCE DUE S0.00
isconsmDepartment of CommerceSafety and BuStSngs15837 USH63HAYWAROWI 548434107Tonuny G. Thompson, GovamorWilliam J. MeCeshon, SeeratafyJuly 31.1998CUSTIDNOJ209I5DANA A DEBUSPO BOX 177STONE LAKE Wl 54876RE: CONDrnONALAPPROVALAPPROVAL EXPIRES: 07/31/2000SITE:Site ID: 16874SAWYER County, Town of HAYWARDNWI/4. NEI/4, S29. T41N. R9WROGER HOFF TWIN HOMES UNIT 03FOR:Description: NEW MOUND SYSTEMObject 1>pe: POWT Systnn Regulated Object ID No.: 37461IdentiCcatlon Ntanberii^-.v-'TranncrioB ID No. 121429Site ID No. 16874Please hifer'tb both Identi&atitm'inuhbiaa^above, In all conespondencewltltlhd a^oey.The submittal described above has been reviewed for confonnance with applicable Wisconsin Adnblstiative Codesand Wlsconslo Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined inchapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.This plan approval Is for a dSOgpd mound.The following conditions shall be met during construction or faistallatlon and prior to ccciqian^ or use:This plan action Is subject to designer comments on the planCorrespondence Note:Maintain well setbacks per Comm. 83.15(4) & 83.10(1).Per Comm. 8323(3}(b)^ the area 25 feet below the downslope edge of the soil absotptlon system must remainundisturbed.A oopy ofthe approved plans, specifications and Ihls letter shall be on-slte during construction and open toInspe^on by authorized representatives of the Department, which m^ Include local Inspectors. All permitsrequired by the stale or the local municipality shall be obtained prior to commencement ofconslructlon/lnstallatlon/operatlon.Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the addresson this letterhead.P.p.'Condisincerely, / JroM braun^pLanTOMAPPFOEPARTMEN-llVISimMSAISEE CORR!REVIEWERIntegrated Services(715)634-3026. M • F 7:45 AM TO 4:30 PMTBRAUN@COMMERCESTATE.WI.USDATE RECEIVED 07/24/1998FEE REQUIRED $180.00FEE RECEIVED $180.00BALANCE DUE S0.00
IIRESIDENTIAL MOUND DESIGNEight Bedmom MaximumComplete Information In red framed boxes as necessary.(y Of n) I n |ls the system over creviced ttedreck?Slope SOO%i%Number of bedreoms 2Wastewater flow rale 300Depth to llmlUng factor 32gpdin1135.581.3LpdcmIn sliu soil Inflltralion rale (code)0.4gpd/n'.16.3 jUimContour line below the upslope edge of absorption cellUse standaid All depths? j x I OR Dedgner specTd depthInPlaeeXIn bat to usoatantlanltkpths px 24, A*4 bKhubn) ORspoeUyilealgn Wtfeptlk.L31.78m3cmCenter or end manifoldLateral spacingUsa a 0 lataal apadng for emtelm.Number Of laterals'otce main length1 c k"**)I 2.S Ifl80Estimated hole spaceMinimum dose >aPump tank elevationForce main diameterForce main actual dia.10992S67R NototUmlealeulatlon.limes void volumeA OutsUaiMttomoftank.InInProject:Plan I.D.HoffTwIn HomesSYSTEM SOLUTIONSEstimated dally flowInch-pounds1 30O IqpdMetric1 1136 [LpdAbsorption cellDesign load rate & area t 1.2 tgpSflF250.0te23.23linear load rats7.1gpd/ft88.0LpdfmDesign width (A)6fl1.83mCell length (B)42.0fl12.80mDepth of cell (F)9.9In25.1cmSand filterUpslope mi depth (D)12.0In30.5cmDownslope mi depth (E)15.6In39.6cmBasal area required tepd/infiltration rale)750r'69.68m'Supporting componentsTopsoll depth6.0In15.2cmSubson depth at center12.0in30.4cmSubsoil depth at cell wall6.0In15i2cmEnd slope toe length OO10.4R3.17mUpslope toe length (J)7.4R2.26mDownslope toe length (O11.9R3.63mTotal mound length (L)62.8R19.14mTotal mound width (VV)25.3fl7.71mCell media V* one only.Aggregate and ptpeChamber and pipeIncltrdes basal adjustmentPage 2 of 7
MOUND PLAN VIEWW =otHovotion pipes (typicaO1/-L =62.819.1ftm-sJlateralinvertelev.A X B refers to alisoiplion cell wfdUt and lengthJsupslopeMddthI ° downslope widthK » end slope dimensionMOUND CROSS SECTIONsut)soil capGDEE]EEmA =6.0ft1.83mBb42ft1^8mJ =7.4ft2.26m1 B11.9ft3.63mKb10.4ft3.17mHtyp. ol)s. pipefaflchondseeunl^cttsomm)f see noteE ASTMC33y eandFiS104.3 :ft contour'31.79 inslopeOb 12.0 in30.5cmEb 15.6 in39.6cmFb g.ein25.1cmkBIiffllia30.4cm45.6cmplowed layerD B upslope fill depthE B downslope All depthF s alisorptlon ceil depthG B subsoil topsoll depth at cell wallH B subsoil + topsoll depth at cell centerDesigner notes:If aggregate Is used, it Is covered with code compliant material.Mom: AbsorpUon cell media wIUconsist of aggregate and pipeor leaching ehamhemand pipeassailed | X lAflflfeoateatrtght I IchsmberProject: Hoff Twin HomesPlan I.D.Page 3 of
PRESSURE DISTRIBUTION CALCULATIONSAbsorption ceilInch-poundsMetricWidth (A)6n1.83mLength (8)42.0ft12.8mlateral specificationsNumber laterals4Holes/lateral7holesLateral length19.5ft5.9mPerforation dia.0.2Sin6.4mmLat dis. rate8.16gpm0.5UsSys. dis. rate3Z64gpm2.1UsHole spacing36In91.4cmLateral diameterPlpedamelerQwijnflpftOiitOMtpttchaie*De^inermustlloQSmfflXPtaceXinrettVC one choice1 tMndSnsmXboxofchosenfromlheopttons11/21iV4)innXXfttameter.prmldBd.ZnSOnvnX3in/7SmmXManifold diameterPipet&nnterOMipoertontDBripntooiBtDe^gnermust11n/25 minIX" one choke11/4in02fnmXPlace X In redttom the options1 l/SbVOinmXboxofchosenprovided.ibvSOmmXXtPameterSeVTSmmXttVICOnunXDIstrfbuSon ^tem eontabis 4 fateral(s).LATERAL DIAGRAM • CENTER CONNECTIONPlace eoneet laler^ diagfam bycBMtgbi one of the dravrings at right tM drag^ng the (Sagram Into tids area.FowniHlnccawc>ioo<i»ce»wcw«ston>iiaoM«M)p«w.k>LMfibmUtMlMlhpiealLMhoti eS44nM to *adMpHolts MM on Ih* benem of ih» btcraitquillispieHnitii-tfuunos'ig.s InLateral length (P)^■12^1 Lai«f«Ktifor«*nMhofPVC8dl40' ipwCOMMTabUM^> pffliMntm tnlmtriMtTfLateral spadhg (S)Manifold lengthHole diameterLateral diameterNumber of holes per pipeInvert elevation of laterals2.S2.50.251.5105.8nftInIniiiieuii.5.94m0.76m0.76m6.35mm40mmProject;Plan I.D.Hoff Twin HomesI 32.14 ImPage 4 of
Total dynamic headSystem head sVertical lift =Friction loss "Total dynamic head eDosa VolumeLateral veld volume &Minimum doseeDrain back »Dose volume s3.25ft0.99m5.70ft1.74m1.45ft0.44m10.40ft3.17m1 8.2gat31.0L1 82.0gal310.4L13.9gal^ SZAL[f 95.9 1gal383.0 1iAre tstofais ttw highest poM bi Uwsystem? Yes ■There.If fw.vrfiatls the highest elevationdownstream or pump? |Force main drainbQckielanlr?(Vone)YesNoTypical Pump Chamber LayoutIn combination wllh state approved treatment tank. Tank construction as per Comm 83.20(3) WAG.approved manhole coverH ^ wealhorpnaf ^ fX w^wfinghhelandpadlecltgrade lovels JuncOcntCK-Tvertplpor gradeleveiswaDofpumpchamber orcomMnaUonlank .etectilo as per NEC 300andComm 1&2e WAGalarm onpump onBpumpoff elev.100.130.5ft.m'AVLiaSemateoutlettocaUoniI8*(46cm}m!n.1/4* weep3'(75 mm) cfbeddhfl under tartc and anchor tank as ne^^iYTank specifications:Pump tank BPump tank volumes;PumpmanufacturenPump model numbenHoffcut Precast ConcretatSai/ln33[221'600|g^IptDVCd 1J ociUelKMGrade levelspenp Mk RBOMC ■ rmkt, one Mined yeSeponp tank eaa *100 on nfa Steve finiilied sad*•cm > ir oSi. abeveOnfaned godewnteaOOnnnki iteMiBiMwdgnds99.030.2ft Punp tank elevationm bottom of tankalMYERSM.E.40Project:Plan I.D.Hoff Twin HomesA«BbCsD =InchesGallons24.0336.1228.06.995.910140.0Page 5 of 7
Wisconsin D«t>aitmsnt of ConvnorcoSs^VpdB^ng^DMe^ -^3GENERAL INFORMATIONPRIVATE SEWAGE SYSTEMINSPECTION REPORT(ATTACH TO PERMIT)Permit Holder's MafT|Q;5ioeuvSo»\ <• Hott□ City □ Village [3 Townol;ACSTbMEIev.:lnsp.BMeiev.:fOO"BM Deicription: ,*MC ■ pi'iqCounty:-ev—s»ak.co>^-e\Sanitaty PermrtNo.:3og>tS3 Istate Plan ID No.r'Parcel Tax No.*:<Sl0«30fe-0^- - 0300TANK INFORMATIONTYPEMANUFAaURERCAPACITYSepticlAo-ffcoH- Cou«.bci(lOOODosingkooAerationHoldingELEVATION DATATANK SETBACK INFORMATIONTANKTOP/LWELLBLDG.Vent toAir IntakeROADSeptic4-«NADosing•1•1-ttNAAerationNAHoldingPUMP/SIPHON INFORMATIONManufacturerDemand33 GPMModel Numberue loTON uft sntdh„.m ftFdrcemain Length Dia. x" Di$LToweD4.xS'STATIONBSHIFSELEV.Benchmarke.V>loB.L(DOBIdg. SewerloY.HBStfHt inletB.3100.3St/Ht OuUetDt InletOt BottomIZ.13U.UTHeader/Man.IbLoDisL PipeBot System•S.MioS#i»Final Gradet/oTSOIL ABSORPTION SYSTEM tixtAu zb' xBED/TRENCHDIMENSIONSWidth ,fhcL LLengthNo.Of TrenchesPITDIMENSIONSNO.OfPlUInside Dia.Liquid DepthSETBACKINFORMATIONSYSTEM TOP/LBLDGWELLLAKE/STREAMLEACHINGCHAMBEROR UNITManufacturer:lypeoi .System: "A-t-iS"+*W•t-soModel Numtnr;DISTRIBUTION SYSTEMHeader/ManifoldLB.ngth ____ Dia. ____Distribution Pipefs)Length Dia.Spacing __X HoleSiseX Hole SpacingVentToAirintakeSOIL COVERX Pressure Systems OnlyXX Mound Or At*Grade Systems OnlyDepth OverDepth OverXX Depth OfXX Seeded/SoddedXX MulchedBed/Trench CenterBed/Trench EdgesTopsail□ Yet □ No□ Yet □ NoCOMMENTS: (Include code discrepancies, persons present, etc.)V\ooii^ 'ivcPlan revision required? □ Yes |Q NoUse other side for additional information.S8O-e7i0(R.3/97)DateInspector*! SignatureCert No
ADDITIONAL COMMENTS AND SKETCHSANITARY PERMIT NUMBER: 'aa.Q&lA■Lo+r-iTL.«rKli l«h Al1 I
APPLICATION FOR REVIEW•Compl«lo all pagas-NOTE Persorai infomiat on you cs/icJo may te used tor soconctary purposes(Privacy L3<vs 1504!ixm). Siais|Private OnslteWastewater TreatmentSystemsDivision of Indostfy ServicesD Plans 10 be E-fileb. Provide SharePoInt User name below:For plan status, check our website at hiio .'.'ctscr, vr- covEma'l technical code ouesticas in nva .lo DSP,s,kap£.wisTfcn.i?Ai on.Severe' counties have been delegated certain aulhority to review plans in lieu of Division of Industry services For a current list of thosecounties and their desionation check our websitn at i 'if> .vrtsns w m r1. Project Informalion - Fill in all known information.ProinrJ/Sile Nartw I '-'•(I (A/A.'.i-ittConfirmation of assignment to a reviewer.Transaction ID:1 1 JLocation, NumDer 8 Street of project (if unkrown. IniScated nearest roadllUMCf VV'' L-ie.n Ct".Previous Related Trans. ID:Estimatftd Complnfinn nrite-Legal DHsmntinn I,;. , tj e . !>' 1VHit. r t. iAsslaned Rnviawar;Coimlv j -- r"A-Sslonad Officn:D City D Village H Town of Uric.-. • » r-/lMall to your office of choice below:LaCrosse, Green BayNOTE: We reserve the right to re-distribute plans to another office ifneeded to reasonably balance turnaround times. Cheekhlto:/'(ISDS.wl tiov frv nn»l avnltahln mviow rtnia2. After plans are roviewod, please: (chock all that apply)0 Call customer 1, 2 (cirde number)*□ Roduesting party will pick up□ Mail plans to customer 1.2 {circle number)*^ 'Referstocustomofrumberfrombolow3, Complolo the following dosignar/ownerirequestlng informalion. Utilize the check bom when designer, owner or requesting party Is Uie same toavoid repeating Information.Oosignor Information (Customer 1) DSPSFirst Name Lest Name Customer NumberTcKi,-, Kk^j-f-r/Other Please Specify Below (Customer 2) DSPSRrsl Narrifi Last Name Customer Numt>er■p.-rvfl.-w b.CejmpanttName ,W. tujymrvv.lrwri •+Company NambAddress ^T.i^ . P.rVi C I-Address ^ ,i1 y'rU /4vlVc/ HCiCily /n 1 . stale Zip+4 (9 digits)Lkble LcnCriy/I, 1 State 2ip*4 (9 digits)u.rPtione Number E-mail address Cell phor>e7,y-7,/ Jiil-Phone Nt^ber ' E-mail address Cell phone(area code)Ci 2 -i-fi - 3jis-Check If applicablen OwnerChock il sppiicabto or specify relatOrtshipF1 Owner H Other-sDed^f^^lationshioInformation and Plan Submlttal Checklists. To request electronic plan review complete the appropriate application form and e-mail It,alono with vour rcaislered SharePoint username to DSPSSBPhinSrhr-f/iilPiOiWier-fin^in rr>v If nlnns nm hoinq suhmiltart via pa]aof theywill be assigned to a reviewer after receipt at a DSPS office. Submitial checklists can be found in each applicable component manualaooearlna on Iho POWTS prooram paoe under Publications PO'.V I S Contnon-jnis M.-inco'sHolmonfOnalasko Area DSPS2850 Midwest OrSte 104Onolaska, Wi 54650608-785-933-1Fax G08-785-9330Email DMi'.SIiPl.inSctk'ilutvni'A-i cxivGreen Bay DSPS2331 San Luis PlaceGreen Bay, WI 54304920-492-5601Fax 920-492-5604rmail nicr.St'Fi.tiiSch-'niilul'i'wi oovMaka Checks Payable to: Division of industry Services ORCheck box to invoice designer and sign belowDesigner SignatureTOTAL AMOUNT DUE SReview Code 7633SQD-10577(R 3/191
POWTS SUBMITTAL (chacfc all thai apply - tncompleto forms may result In processing dolays)D D Aerobic Treatment Unltfs)SI REPLACEMENT CfL.t Cfv i-y D Commercial System□ Chlorlnalor □ Tank Replacement Only□ UV Disinfection Unit gj Add Effluent FilterSYSTEM TYPEIS) NOTE: Submit separate shooto for each system If submitting mulUple systems on the same siteEnter FeeO Revision to previously approved plan□ Miscellaneous Review (i.e. replacement of a septic tank, addition of an effluent filter or pretreatmeni device to an exIsUng system, etc.) SBO/hrIS Component Manual□ Al-Grode Component Manual - Ver. 2.0. SBD-108S4 (N.03/07. R. 1/12)□ ln.grourttl Component Manual - Ver. 2.0, SBO-10705-P (N.01/01, RIO/12)□ Mound Component Manual-Ver. 2.0, SBC)-10691-P (N.01/01. R 10/12)D Pressure Distribution Component Manual - Ver. 2.0, SBD-1070S-P (N.01/01. RIO/12)SOthnr-Pleasespodfy e 2.-P-(v,W HAcilAtlDesignWastewater Flow InGallons Per dayGPDAll treatment components are previously approvedunder s. SPS 384.10 (2) or (3):Design wastewater flow of Ihe proposed system:1.000 gpd or less s 250.001.001 - 2.000 gpd $ 325.002.001 - 5,000 gpd s Of)Q Soil Based Individual Site Design*D At GradeO Non-Pressurized In-groundID Pressurized In-groundn MoundQ Orip-lineD Constnicled Wetlands' Documentation must be provided to support treatment and dispersal claims. In a separatestfitemeni. provide raUonala for tlw pn^ect and attacti supporting documents (code sections, testreports, technical papers, research articles, etc.)DesignWastewater Flow inGallons Per dayGPDOne or more treabnent components are nolpreviously approved under s. SPS 384.10 (2) or (3):(tndivldiial site design/devlallon from componentmanuals and use of components without productapproval):Design wastewater flow of the proposed system:1.000 gpd or less $450.001.001 - 2.000 gpd S600.002,001 - 5.000 gpd $750.00greater tfian 5.1^ gpd S900.00plus 50.08 for ea<m gallon over 5000 gpdStaie-ovvnsd facilities:ID Holding Tank Component Manual, Ver. 2.0. SBD-10855-P (N.03/07. R1/12)"* Non-state ovmad Commercial and Residential Holding tanks that completely uliliza this manualar>d have an estimated dally Oow of less than 3000 gaDons per day must be submitted to thoappropnate governmental unit for review instead of the Department (see SPS 383.32(3He)|DesignWastewater Row inGallons Per dayGPDHolding tanks previously approved under s. SPS384.10 (2){3). Design wastewater flow of theproposed system:5.000 gpd or less s 90.005.001 -10,.000 gpd $150.00greater than 10.000 gpd $225.00□ Holdmo T.ink Individual Siio Design*, (i.e. site constiuctod. <5 day holding capacity Co-mitigled wastcwater. etc.)Pleaso spodfy:• Docummtation must be provided to support me rationale for the project In a separate statementploasG include aO code sections, test fopods, technical papefs, research articles, ete.)DesignWastewater Flow InGallons Per dayGPDHolding tanks Including site constructed tanks NOTpreviously approved under s. SPS 384.10 (2) or (3).Design waslewatN flov^ of me proposed system;5.000 gpd or less S180.005.001 — 10.000 gpd S300.00greater than 10.000 gpd $450.00U Soil Saiuralion Delorminaticn Report (using observaUcn pipes) Q Interpretive Oeleimlnallon$240.00□ ExporL-TMnla! System (One lime additional fee). Subrrtt fee for Indvidual system as por epprcpriale above system typo)Experimoflt Numtier $400.COPriority Review (enter same amount as rwrinal review fee listed aixyve)Enter Total (rounded to the nearest dollar), -y.SSBD-10577 (R 3/19)