HomeMy WebLinkAbout010-841-36-5509-SAN-2020-130. ,, .''j" 'v•rte. \ * ./Industry Services Division1400 E Wasliingion AveP.O. Box 7162Madison, Wj 53707-7162^Sr , //.^rCounty —Sanitary Permit Number (lo be tilled in by Co.)Sanitary Permit ApplicationIn aceonlanee wilh SP.S J8.V2II2), Wis. Adm. Ccxie. submission oftliis I'onn to the appmpriate governmental unitis required pnor to obtaining a sanitary pennil. Note: .Ap|)liealioii fomis tiir sWieKiwned POVk' fS are submitted tothe Deiianmem orSafcl) and Professional Services. Personal mfoniialion you provide may be ii.sei! for secomtarypumoses in aceonlanee with the Pnvaev Law, s. 15.0411 Km), Slats.Slate Transaction NumberProject Address (il'difl'ercm than mailing address)1 5.^:7 / VJ S1. Application Information-Please Flint All Information .^Property Owner's Name S-€(|4t4'i.' t-A 'ftuvWu-^ ftUioiO Awm. C^iLrtU\Parcel UPropeity Owner's Mailing AddressUS'OS Ncrjic brProperty LocationOovt, LotCity, Slate£-diAa,Zip Code5irV3^Phone Number'/«. 14, Section 3^*T HI N- Rn. Type of Buildlni: (cbcck all that apply)I or2 Family Dwelling - NumberofBedroomsD Public/Commereial - iX-scribe UseD State Owned - IXscribc UseLol«Subdivision NameBlock WD CitvofCSM Number^ nqoD VillaseofB^ownofIII. Type of Permit; (Ciicck only one box on line A. Complete line D If npplieahic)A.D New SysiciiiI^^epLicemcnt SyslcinD Ireatmenl'l lolding Tank Replacement Only0 Other Modification to lixisling System (explain)B.n Permit RenewalBelore RxpiralionD I'cnnit RevisionD Change ol'PlumberD Peraiit Transfer to NewOwnerList Previous Permit Number and Dale Issued\^ni, ^IV. Type of POVVTS Systcni/Comiioiicnt/Dcvicc: (Check all tlmt nnnlvEPNoii-Piessiiri/ed lii-Grmmd □ Pressuri/ed lii-Cmmnd □ AKir.ide □ Moimd>24 in. of suitable soil □ Moiind<24 in. ol'siiilnhlesoilD HoklinB l ank D Other Dispersal Coiiiiiimenl (explain) □ Prelrealinenl Device (explain)V. DIspcrsaKTrciitnient Area Information:Design Flow (gpii)4^Design Soil Application Rate(gpdsf).7VI. Tank InfoDispersal /\rca Required (sOOf 3Capacity inGallonsS'ev. tankslisisiliig TanksTotalGallons«iifUnitsDispersal Area Proposed (sf)ManulaclurerSystem Flevaiion£ sfi. u51/1 v^ 3iZ OSeplic oritulUing tank/OOOfCODDosing ClumberVII. Rcspoiisiltility Stilicmcnt- 1. the untlersigned. assume rcsponsiblllly for installation of llic POWTS shown on the attached plans.Pliiiiilier'sJibrmifiireUliiinb^'s Name (Print)Plumber's Address (Sireel, City, Stale, Zip Code) ^r4.&>c Gb Ca.'hU^wxMP.MPftS Niimtwrurririiliisincss Phone Number7/r-7ff73n""SYs^fVin. CotJtity/DeiiiirtiiicMt Use OnlyVlll. Cogntv/De])DisappiovedD Owiiei Ciisen Reason fbi DctiialPennit Fee'(ioO.0dDole IssuedIX. Conditions of .Aiipruval/Keiisons for DisapprovalIssuing Agent SignatureORIGINALNO REFUNDS AFTERISSUE OF PERMITSBD-6398(R. 08/14)Atlich lo complete plans for ihc sisicm ami sukniil to the Counlv oniv oa paper not less than 8 1/2 < IjI Imiio laitey-.- —i _ — .W" ' ■ ■■■bJUL 0 9 2020SAWYER COUNTYZONING ADMINISTRATION
INDEX SHEETS FOR POWTSPROJECT NAME; ArpOWNER: AnavlADDRESS: 0SV5' V^or^iC brIWUPHONE:PROJECT ADDRESS: l^^7l W ^U<l^uJ4.rc| ^ I^XLEGAL DESCRIPTION: LdT^, CSm"*^ (\'aQS 3 6. r M-1 M. fa. f ^TdlOla o'f ^A-^wAr^Sfuo^^-trPARCEL NUMBER:1. INDEX SHEET2. PLOT PLAN3. SEPTIC TANK CROSS-SECTION4. CELL LAYOUT & CROSS-SECTION5. SOIL EVALUATION6. SOIL TESTER PLOT PLAN7. SYSTEM ELEV. VERIFICATION FORM8. SEPTIC SYSTEM MANAGEMENT PLANC.St * "^6 -Ol-SPLUMBERS SlGNATURE.^^::^l^^f^a^^ MP# (flSlS-lDATE: POWTS COMPONENT MANUAL #
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• D'" ~ t ... *.. 1 -: rji' ' 1'' * ~^ " • — - ~ • - 1 i 'j ' oM" Sct^-^OPVC IMSP.pTor 6 " W'?/ iPPVr(lohers Vnle-i ■rr\C-t\^vc\e ^ari=-d V " "*"' "lFINISHED GRADE_ WI NLETAPPROVEDPIPE 3'DM TO SOLIDSOIL-AppROV£D ff^eeta.-OR (^LTE^ ^M FG.model3" APPP.CyVED BEDDIHG UHDSR tA/VKSPECIFICATIQMSoEPTXCTAMK KAhfUFACUTREH: Ro^^iOATANK SIZES; SEPTIC \0CO GAL.approvedmanholeW/ Loc^cl-HIH.OUTLETMOTES :
INFILTRATOR CHAHSER CS055-5EOTI ON-f4" 3034orsch. 40'4- Sch. 40 VENT / INSPECTION PIPESdCELLfSj5 'end caps^ ^ CELLS WITH !(■> QUICK 4 CHAMBERS C^2. CHAMBERS AT 20 SQ. FT. = SQ. FT.^ SETS OF END CAPS 0 5.Z = /V.Lf ^Q. FT. V^ SETS OF END CAPS 0 5.2. = /V^Lf gg, rx.4 •• SCH 40PVC PIPE-4" APPROVED VENT CAP OR INSPECTION CAP/ PLUGGRADE JOO,S' 4i/4^Schemalic ofSingle-LayerSystem12" min./USING INFILTRATORQUICK 4 STANDARD plugCHAMBERSH-a•nSlinicr C.":ir-C{fiSYSTErtC^) = q(p,3,5'PAGEOF
PAGE 4 OF 4In-ground Gravity Management PlanIMPORTANT:The owner of this In-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant torequirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Code, this system shallbe considered a human health hazard if not maintained in accordance with this approved management plan.Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Malntalner inaccordance with SPS 383.52 {3), Wise. Admin. Code.Maximum Dispersal Area Operating Limits:Design Flow = gpd; BOD5 < 220 mgL ^ TSS < 150 mgL ^ FOG < 30 mgf^Inspection Checklist INSPECT EVERY 3 YEARSo type of useo age of systemo nuisance factors {i.e. odors, user complaints, etc.)o mechanical malfunction {i.e., pumps, valves, switches, floats, etc.)o material fatigue {i.e., leaks, breaks, corrosion, etc.)o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)o neglect or improper use (/.e., exceeding design capacities, prohibited activities, etc.)o extent of ponding in distribution cell prior to dosingo dosing irregularities - if applicable {i.e., pump re-cycling, float switch settings, etc.)o electrical components - if applicable {i.e., wiring, connections, switches, controls, timers, alarms, etc.)o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)o surface discharge of effluent or sewage back-up into structure servedMaintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)o Septic and dose tankfs) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.Stats, when the volume of solids In the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) oras required by local ordinance. Disposal of contents shall be pursuant to MR 113, Wise. Admin. Code.o Effluent fllterfsl shall be Inspected every 3 years and shall be cleaned when necessary to remove anyaccumulated solids according to manufacturer's specifications. A servicing period wili always be greater than 12months.System maintenance reports shall be submitted to the proper local government unit in accordance withSPS 383.55 Wise. Admin. Code. Report any component failure or malfunction to:Name of individual or company: Alldry RasmUSS6n & Sons, InC Phone: 715-798-3355Local government unit Sawysr County Zoning Phone: 715-634-8288Local government unit address: 10610 Main St. itf49 Hayward, Wl 2IP: 54843Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wise. Admin.Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wise. Admin. Code.No product for chemical or physical restoration of the POWTS may be used unless approved by the department inaccordance with SPS 384, Wise. Admin. Code.Contingencv PlanIn the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant toa plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may beatiandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils.System AbandonmentIf use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wise. Admin. Code.