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HomeMy WebLinkAbout012-230-00-2100-SAN-2020-244.■if. '%0i:-Safety and SLdldinga DMsfon201 W.Washinflton Ave., P.O. Box 7162Macfiaon.WI 53707-7162Comity5<iU/YerSanhaty Penait Nlnnber (to be filled in 1^' Ca)Y>ji:79481Sanitary Permit Applicationin aceordanccuiili SPS3S3.2I(2), Wij. Adm. Code, submission ofthis form lolheapprtpnalesoi-onncnlol unilis required prior to obtaining a taniuiy permit Note: .Applioation fonns for ttalc-mvned POWTS ore submiUed toilie Deponmenl of Safety and Profentonnl Scrvies. Penonsl information you provide may bcu>cdfo^Iecondaly£U(2najn_accotdaDCeu^hJheP!incv_Lau|^^J_lSJ04^y^X^nl^State Tmnsoction Number1. .•VppUcntion InfoTPiatloB—Pieasc Print .All Informationnrqect diffc^t than muiiog address)OiAfv Rau'tPt RtjlRopoty OttocT's NameEr\K 6cK;elK<g ^ HoUy PefryPropcity Oiwtcr's MailingParcelsOlol QZoon c3too.Utltessp.p. P)n>c UCity. StaleCu£LILTypeof Buildins(^eckaU dut apply)1 or ZFamily Dwelling-bSunber ofBedroomsIhibiic'Commereial - Deseribc UseZip Code3Stale Owned - Describe UseProperty LooatlonGovL LotPhone Number_ ti, ! i. Seelion(dtcleamIjjtsCA.r\i4 81.}T Ho N: R Co °"eSnbdhirion NameBlock «CSM Numberl{<x^ Cic&C Aog6 CpfU^OCity ofVillt^e ofTown of _ y\^crIILTj'pc ofPenntC (Check only <mc bm on Dnc A. Complete line B If appUcable)liav SystemRqilaccmcnt SystemTicaimenl'Holding Tank Rsplaccmeat OnlyOihcr Modifisalion to Easting System (explain)B.Permit RenewalBefore ExpirationPermit RevisionChange ofPlumberPermit Transfer to NewOivnerList Previous Permit Number md Dale IssuedlU. Type ofCf«f;PiT-tjurired In-Giound■m/Comnoncnt/Dcricc; (Cheek all thntapplvPressurized tn-Ground .Vl-Gradc Mound >24 in. ofsuitable soil Mound <24 in, ofsuitable soilMolding Tank Other Ditpctssl Component (axnlarn) Prclrcatmonl Device (explain}\'. DbpcrsaUTrcatnient .Area Information:DDesign Flow (gpd)Hsoesi^ SiA AppUcatioo RaXe(gpdsOr?Dispenol .^Xiea Required (si)Dbpenal Area Prepared (sf)IS-oSyslsD BevalioD?6.o "to ^I^LoId\X Tank Infol^GoOCapaeilr inOalloRsNew TanksExbiing TankiTotalGallons?ofUnitsManufacturerP'C CiA'^t iid'J1•SI» BJiS0. O(9£USepcic or Tonl;XDming ClQjnber(pcO\1I. Rcspondbllity Statement- I. the undcnfened. assume responslMnty forimtallnthin ofthe POUTS shown on the attmhed pinna.Plumber's Name (Prim) Phnnb^JSignature .Cir>-G.<==. ^f^VifKPSdO Cx fyPlumber's AJKIfcss (Sucel, City/Slat^ 2iip Code) ^nocr s Auuress iouu«v wu), ^MP/hlPRS NumberBusiness!%oneNumberWniL Cgimtv/Dcparttitent Use Only^^IL CaunO'/:DisapprovedOwner Otvcn Reason for DeaisIPemiilFce^1^00.'^Dale IssuedIssuing Agent SignatureK. Conditions of Approval/Rensons for DisapprovalAttach KocoBpleto plans for the sjilsni and sobmllto shs Conutyaab' aa paper nat less ttmn fl 10 s 11 Inches In siteSBD-6398 (R. 11/11) PAGE 1 OF 5Pg1 ofSPg 2 of 5PgSofSPg4of5PgSofSIn-Ground Dosed-Gravity PlanIndex & Cover SheetComponent Manual Design References:Version 2.0, SBD-10705-P (N.01/01, R. 10/12)Index & Cover SheetPlot PlanDispersal Area Cross-Section & Plan ViewPump Tank SpecificationsManagement PlanAttachments:Enclosures:Pump CurvePOWTS Application for ReviewSoil Evaluation Report & Site MapProject Name I DescriptionOwnerName(s): (tCg ^ Ihlly P<g4ryOwner Address: 9.0. (o ^ LuX-Phone:Zip:Project Address: "iSSo-H Du.n 'Koiniv /-jo^y Ctr^jrGovt. Lot: 1/4 of 1/4, Section Ca T HO N-R (o E I lor W ^Township:County:Project Parcel ID#: 0/3 DO ^\oODesigner InformationDesigner Name: Phone: -Q(da -Designer Address: Zip: SH^9C:>E-mail: Jloftf-jvynpSyi llc(^ //ue. Cc>/n space reserved for approval stamp.License Number: 3,^0S/ORemarks:Signature:Date: <3/0Ortginan^nature required on lax)n submitted copy. CHECK BOX AS APPUCABLE.CHECK BOX AS APPUCAOJE.□ SOIL EVALUATIONSITE MAPPROJECT NAME:Fr-.x, y- MollyPROJECT ADDRESS: ^55*0 "N Qua Rou^;^ ^BM Symbol: BMBevaton: . /o^.O_ FTBM Descitpllon: t/\ <oK.We piA.g^'5% Well symbol (If applicable): ©Scale: 1" = 50'////A//^//////////.V/125'0 SYSTEM 2 OFPLOT PLANVS-QDESIGN FLOW:GPDAttach design flow calculations for commerdal plans.Pipe Mateiial / ASTM Standard (Tatrias 384.^ & 384.30^)Sanllaiy Sew8r_ / Puc.Force Mdn: fx/_"PPc"Indicale north bydrawing on omMon the appiopitle Una.IMPORTANT:Show ground elevation contours at suitable Intervals.•^SSo-tAPvaa Roo\<\ IN-GROUND DOSED-GRAVITY DISPERSAL AREAUniform Elevation Trenches with EZ1203HP Bundles3-ft Trench (down-sizing credit)SOIL COVERTYPICAL TRENCHPLAN VIEW(No Scale))GeotextieCover —12"min. trenctideptti(typtaal)-min, 12"(typical)TYPICAL TRENCHCROSS SECTION VIEW(No Scale)OBSERVATION PIPE DETAIL(No Scale)System Elevation ~ ^5.75' ft.(typical)Provide minimum 3 ftseparation between trenches.(Show location of Inlet / outlet pipe connection on plan view.)Screw-Type or -Stp Cap Ooote)4-0PVCPpeTop of pipe to termrabat or above fnished giaoe(AJIW-ia-XS-SOIs j@ SO apart /Anctiortrtg Device C; ^11 0 Observation pipe shall be nsaSedat junction between two tjrvb. ^Perforated Lateral Observation Rpe ^ "^y~ Cyp'^o (typical) ^ (typgal)INSTALL PER TRENCH:...L. VB= _7^ ft \ ^r-± (ty, =3.0 ft(typical)10-ft bundles @ 50 ff EISAyunitit5-ft bundles @ 25 ff EISA/unit =,= Proposed EISA per trench = ,(typical)= 3^0^ EZ1203H Bundle(typical)(mfd by infiltrator Systems, Inc.)Install pursuant to manufacbjrer's instructions.ft' Required Infiltration Area =trenches = Proposed Total EISA= 7-5b fi=— Finished Grade(mukdied & seeded)Topsoi Cover(min. 1 fool)' InftrtrationSurfaceDistribution Method: PAGE 4 OF 5GRAVITY-DOSEDSEPTIC / PUMP TANK SPECIFICATIONS(No Scale)4*0 Vent PipeIMPORTANT:Anchor tank(s) as necessarypursuant to SPS 383.43(8}(g)>10 R fromBuOdlng12* MIn. or 2.0 fl aboveEstablished Flood Elavalion(typical)Af^ifovadVent CapElectrical must oom|^ withSPS 316 and NEC 300Weatherproof—Junction Box\i/ \i/Finished GradeCAPACITIES @ gaWnDepth (in)Volume (gal)AinsloHJoB2.0[C]IS133,53DIIIUI7Extend manhole riser as necessary.Approved Locking Manholewith Warning Label Attached(typical)4* Min. or 2.0 R above/— Established Flood Elevation'/ (typical)^^^Pump Tank Uquld Level =Force Main Diameter =CondidAirtight SealOuick DIsconnecl18* Min.(lyirical)► Alarmn—Approved Jtmis withApproved Rpe 3 R ontoSolid Ground(typical)PUMP-OFF. ELEVATION = ftINSIDE BOTTOMELEVATION = ^SLS^ ftForce Main Length = ^Force Main Void Volume = gal[C] Total Dose Volume (TDV) = gal/dose3* Approved Bedding Material Beneath Tank— (< 0.2X design flow + force main void voiume)Vertical Lift = IS' r.PUMP TANK:Volume = 6? 3 ga'SEPTIC TANKfS):Total Volume galManufacturer S Pf<fLManufacturer's): Pr€Pumo Manufacturer (^0 t>L cl 3Install aooroved effluent filter at the seotlc tank outletImmediatelv uostream of the pump tank inlet.Controls/Alarm Manufacturer:Filter Manufacturer:Controls/Alarm Model:Filter Model: GjFloat switches containino mercurv are orohibited. ^GOULDS PUMPSSubmersibleEffluent PumpPEAPWCATONSSpedsUy de^neJ for thefollowing uses:• Mound Sysiam• EfRuentfDo^gSystentsn Low Pressure npeSystents..r-BBSwnsSDraMng• Heavy Out/SumpfDewalerlttgSPEQHCATIONSPump-General:• Discharge: IWNFT• Temperature: 104'FWO'Omaximum, continuous whenfu^ submerged.• S(Ads handing:maximum sph^• Automatic models tndude 3float svritd).• Manual models available.• Pumping range: sec .performance (hart or attve.refll Pump:n MaidmiRn ca^ed^ 50 GM• Maximum }k^:25'TDHPEAIPump:n Maidmum capad^ 60 GPM• Maximum head: 29'TONPE51 Pump:• Maidmum capad^ 70 St/I• Ma3dmumhead:37TDKMEURSMOTORGenesri:• Sngle phase•eOHeitz• HSvolls• fltdtln thomal overload pro-lECflon wMt automatic tesel• QassB Insulation.n OlMiRedde^n H^stiB^GBboit steelshaftPBT Motorn 33HP,30DORPMn 12.0 Marinum amps ■-•Shaded pole detignreAIMoton• .40 HP, 3400 Rm• 75Manimimamps• PSCdesignPE51 Motor•50HP.340DRPM• flJMai&mnnamps• PSCdengn• i -P^i TM0Das:»Bi.rwi.tt5i• i • r 5•| : : !. HP-.J3.ja.J0iF^ gSiEn-r-u-Ui-~ ^iFT jii.i.. i-MAiP^^^-^.- 4-r • - "t-pi^ -IT r-{- - j-t i-T ■-(• = I- i --T ■■ 'r-Tj--ht-p- --i-r-.4^■ |S••j"" •'- "4I Zf-iT. I.. -1-•+•4--rr±J.I.. - _5.i.-r !-i- -5'• i-j.4-.l-. j -:j .hV•:d.n.4 J- -h4 4-i-.,44-4^1'4-44-P1^t4T44-i: ■.t.'tti' i:'.'-.! i:i:JTr-iTi i' 4 j-j-i -1-; H- -i-iii- i i : J10CAtW«3TYeZIX)2 Goulds PumuEHceUniMmmber. 2002BPB1M1- 0^FEATURES■ Corrosion re^stantconstrutfoTL■ Cast iron bc^.■ Thetmopiasticimpelier andcover.■ Upper sleeve and lowerhe^ du^ bal beaiwgconsbuction.■ Motor is permanentlylubrioted hir BitBidedservice life.■ Powered for continuousoperation.■ Ml ratings are wdtiwihewQildng liidsofthe motm.■ Quick rflscmiea power□Mi 20* standard length,fteai^ du^ 160 Snw wIANEMA 5-15Prthree prong,115 volt grounding plug.■ Complete unit Is duty,portable and compacL■ Mechanical sal is carbon,sramic, BUNA and stainlesssted.■ Stainless steel teteneis.AGENCrUSTINGSC^^USTested to UL778 andCSA22210S StandardslyCmsdlnStaodwdsAssdaBonntMsasaa70 GPM BOm»/h PAGE 4 OF 4In-ground Dosed-Gravity Management PlanIMPORTANT:The owner of this in-ground dosed-gravity system shail be responsibie for its perpetual operation and maintenancepursuant to requirements of SPS 382-384, Wise. Admin. Code. Pursuant to SPS 383.52 (2), Wise. Admin. Code, thissystem shall be considered a human health hazard if not maintained In accordance with this approved managementplan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Malntainer inaccordance with SPS 383.52 (3), Wise. Admin. Code.Maximum Dispersal Area Operating Limits:Design Flow = HSO gpd; BOD5 £ 220 mgL'^ TSS S150 mgL'**; FOG i 30 mgL"^Inspection Checklist INSPECT EVERY 3 YEARSo type of useo age of systemo nuisance factors (/.e. odors, user complaints, ete.)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 I drop boxes)o neglect or Improper use {l.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, eto.)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 tankfsl shall be pumped by a certified septage sen/icing 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 NR113, 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 will 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: Qi)A ^^/npSio/1 SiiflS Phone: US' <364Local government unit: Cou/i/y/' Phone: (oZ^l~Local government unit address: lhC>/0 rhcC,f\Any 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 shail 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.Contlnaencv 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 beabandoned and replaced by a code-complying dispersal component In a pre-determlned 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.