HomeMy WebLinkAbout010-841-36-5126-SAN-2020-070Siifcly iind Buildings Division201 W. Wusliington Avo.. P.O. Box 7162Madison, Wl 53707-7162Sanitary Permit ApplicationIII accoidancc with s. Comm. 8.'.21(2). Wis. Adni. Code, siilunisiion of lhi< form lo iIk iippro|)riacc govemincnlal unil isrcciulred pnor lo obxaining a sanilary pcnnil. Nwc: Application fonna for sialc-owncd TOWTS are submitted to theDcparnnenl of Commerce. Peraceial ioformalion you provide may be used for secondary purposes io accordance with ibcPrivarvljw s ISiWIVml Sinte1. Application Information-Please Prim All InformationProperty Owner's NameMark KellerProperty Owner's Mailing Address777 PlenlywiXKl LnCity, StaleBensenville,ILZip Code6010611. Type of Building (check all that apply)□ 1 or2 Family Dwelling-Number ol'Bednx)m.s 3n Public/Commercial-Describe UseI ! Slate Owned-Describe UsePhone Number1.01#Block#CSM NumberCountySawyerSanltao' Permit Number (to bo filled in by Co.)Slalc Transaction NumberProject Address (ifdifTcrcnl than mailing address)1248IWMoreland RdParcel#010841365126I'ropcny {.ocaiionGovL Lot I'A. v.. Section 36T 41 N; R 8 WSubdivision NameI I City ofn Village of0rowni>rIII, "^pe of Permit: (Check only one btii on line A. Complete line B if applicable)AC.B.H New System 3 Replacement SystemnPermit RenewalBefore Fxpiraiion3 Permit Revision3 rreatmcnt/l lolding Tank Replacement On^3ciiangc ofPlumbcr3 Permit TransfB'lo NewOwnerIV. Type of POWTS System/Component/Devlce: (Check all that apply)Ootber Modificalion lo Hxisling System (explain)List Previous Permit Number and Date Issueda-05-3. c/i?;/g6.J Non-Pressurbcd IrhGrwmd □ Pressurized In-Ground □ At-Orade □ Mound > 24 in. of sutl^k soil 0 Mound < 24 in. orsuit^iesoiiH i loiding T ank □ Other Dispersal Component (explain) □ Pretreatment Device (explain)V. Dispersal/Treatment Area information: 32 Infiltrator Quick 4 Standard chambersDesign ITow(gpd)450Design Soil Application Kalc(gpdsf)0.7Dispersal Area Required (sf)643Dispersal Area IVoposcd (sf)650System lilcvation100.00VI. Tank InfoCapacity inGallonsNew TanksRxisling ThinksTotalGallons# ofUnitsManufacturerU_2o.Scptic or Holding I nnk101101000WiescrDosing C'Inuiilicr600600WicserVII. Responsibility Statement- I. the undersigned, assume respiinsihillly for inslallalion of the POWTS shown on the allacticd plans.Plumber's Name (Print)Travis RullerfleldPlumber's Si;Plumber's Address (Sla-el. City. Stale. Zip (^odc)14346 W Stale Rd 77 Hayward, Wl 54843MP/MPRS Number652879Business Phone Number715 634-8176Vin. CountyfDepartinenl Use OnlyD DisapprovedD OwnerGiven Reason for DenialPcnnil FeeDale IssuedIX. Conditio^ns of Approval/Reasons for Disapprovalf ,1 I NO REFUNDS AFTERa I 11« M L ISSUE OF PERMITIssuing Agent SignatureAiii^Wturopkic pJaiu fid Ov fvMnti art] aitvnil (>>Sk Ctuvy<ikfy^ napcwd}«««(bs 8 n 11 ocbnSBD-6398 (R. 10/11)SAWYER COUNTYZONING ADMINISTRATION
Mark Keller12481WMore[and Rd0841365126SawyerProperty Owners NameProperty AddressTax Parcel NumberCounty836141NR8WGov Lot or Qtr-Qtr/QtrSectionTownRangeTravis Butterfield652879(715) 634-817605/07/20Page 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 Tectinology, ITT IndustriesfGouWs), The Pentair PumpGroupfMyers), Infiltrator Systems. ADS Products. Polylok Inc.. Orenco Systems Inc.. Sim/Tech Filter Inc.. Sta-Rite industries.Page 1 of 8
In-Ground Soil Absorption SBD-10705-P (N.01/01) Version 2Component Manual Used3Number of BedroomsPercent Slope (%)85Depth to Soil Limiting Factor (in.)0.7In Situ soil application rate300Estimated Wastewater Flow (qpd)450Design Wastewater Flow (qpd)1Number of System Elevations100Proposed System Elevation #1Proposed System Elevation #2Proposed System Elevation #3Original Grade #1103Finished Grade #1Original Grade #2Finished Grade #2Original Grade #3Finished Grade #3Infiltrator Quick 4 StandardChamber Type [15Height of Chamber (in.)20sq.ft. per chamber2Rows of Chambers5.1sq.ft. per pair of end caps3Distance Between Cells (ft.)32Proposed Number of Chambers Used642.9Minimum Distribution Cell Area Required (sq.ft.)650.2Distribution Cell Area Proposed (sq.ft.)Wieser 1000/60GLPSeptic TankDose Tank (if applicable)! 1BearEffluent Filter"select only if NOT using combo tankSoil BoringNumberSurfaceGradeElevation (ft.)Depth toLimitingFactor (in.)LowestElevationHighestElevationSystemElevationAcceptable1103.408599.32102.15TRUE2102.006999.25100.75TRUE3103.408599.32102.15TRUE45Page 2 of 8
I
'i,h yr-»^ z'l l*'S"^*l I
+ ■*.-^t3 at y'^'i I
_j»^o\f^<S>^i/o(?<t /
Sf% -■ »-^7
I
^Qh•^0^ -^"tl
,oo'tol-ZV
oh-ioi =i<3',<?OVO/ 'U^
9 ^>w99_y_
^ rilSh-C\Tf''"d
"57;;-s"?£iw^i<>»H
g>
Oh .-I =T"^
Cross Section of c Two Ceil In Ground ComponentUsing Leeching ChambersObservoUon/Vent Pipes103.00Finished GradeSlope101.25100.00Original Grade . .Top of ChamberSystem ElevationCeirSeperatiortFinished^rade —' \ ,jOfiginal Grade^v^'_^/-'''Top of ChamberSystem Elevation101.25100.00' • -Tregtnjent'iind'DteperBOi .Zone. *.... . • LirLimiting FoclorObservotion/Vent pipes to be constucted ond capped with opproved moterials for the porticulori(LI1Observation / Vent Pipes to be located 1/5 to 1/10 the length of the distrution cell measured from the end of the cellsPage 4 of 8
•op'owM Monno'e Covers *rnn »ro«irr<g Labc-.ond Locking Device / *' Min. Above Fir-ol Grodc4* Sch. 40 Vent> Of - to 12"Above Finoi GradeInletBaffleOiscontWieser 1000/600LPWeother Proof Junction Bo*Electric per NEC 300 A COMM.16.28 WACectAlternate Outlet Locationt W/Approved 4" SleeveForcemain Dian^er (in.) 2eep Hole or Anti Siphon Device2060Flow in GPMVertical Difference Between Pump Off and Inlet to ChamberLength of Forcemain(ft.) InchesGallons2Forcemain Diameter (in.)A5.13000.92Friction Factor per 100ft.B233.520.55Friction LossC6.099.789.55Total Dynamic HeadD9.9166.70TOTAL23.0600909.7899.7860016.76Gallons per Dose (Not to exceed 20% of Daily Design Flow)Volume of Forcemain BackflowTotal Dose VolumePump Tank Capacity (Gallons)Pump Tank Volume (Gallons / Inch)ZoeilerBNSS |Pump Type^Minimum Discharge Rate (Gallons per Minute)AlarmSJE Rhombus - Tank Alert 1HEAD CAPACITY CURVEMODEL "63 - 67" 1/3 HP10 20 20 40
Service EventService FrequencyInspect condition of tank(s)At least once every3|Year |Pump out contents of tank(s)When combined slueqe and scum = 1/3 of tank volumeInspect dispersal cell(s)At least once every3YearClean effluent filterAt least once every3YearInspect pump, pump controls & alarmAt least once everyMark Keller12481WMoreland Rd1.08E+10Number of BedroomsEstimated Flow (average) gallons / dayDesign Flow (peak), (Esllmated x 1.5) gal/daySoil Application Rate gal/day/ft^3004500.7Influent / Effluent QualityFats, Oil & Grease (FOG)Biochemical Oxygen Demand (BOD5)Total Suspended Solids (IBS)Monthly Average30 mg/L220 mg/L150 mg/LSeptic TankWieser1000/600LPEffluent FilterBearPump TankWieser1000/600LPPump TypeZoeller BN53liNOTEl!Maintenance ScheduleServicing frequency of 12 months or less requires theManagement Plan be recorded with the Register of Deeds.Maintenance InstructionsInspections of tanks and dispersal ceils shall be made by an individual carrying one of the following licensesor certificatlons: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 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 of paintingproducts or other chemicals that may impede the treatment process and / or damage the dispersalcell(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 infiltrative surface.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, paintingproducts, 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 Administrative CodeSPS 383.33;- All 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 the POWTS fails and cannot be repaired the following measurers have been, or must be taken to providea code compliant replacement system; (Ctieck 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 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 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 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.r A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may bematalled to replace the failed POWTS.IIWARNING!!Septic, 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 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