HomeMy WebLinkAbout012-284-00-0800-SAN-2020-203Industry Scmces Division1400 F WashingiDii AveP O Box 7162Madison, W! 53707-7162Sanitary Permit ApplicationId accordaiiccwiih SPS 383.21(2), WU. Adm. Code, suhniission iifcliis fomi lo Ibc appropriate go\'eiMicnlal unitli required pirnr to oHlaining a sanitary pcnnil. Note; Applicnliim fnims for siiKc-owncd I'OWT.S arc submitted !c>the Bcpaitmcm or' Safety and Prafessitmal Services. Personal int'oiniaiioii you provide may be lued for secondarynuirosia in accordance with the Privacy Law, s. IS.tMdKm), Stata.T. Application Information — Please Print All ItiformalionProperty Owner's NameCl.'H.rTn/srProperty Owner's Mailing Addresstl".City, Slate! <*'1'Zip CodeJ'VfV3II. Type of Buililiiig (check all Aat apply)5 1 or 2 Family Dwelling - Number of Bedrooms SD Public/Commercial - Describe Use.D Slate Owned-DescribeUsePlinnc NumberLolltU/,V ?niocknC.SM NumberCountySanitary Permit Nurnbei Itn he filled in by Co.)State Traiisaciion NumberI'rujcei AditicSh lit dillcieiii (li.in mniliugaddress)4'=II'2.aJtPaiccI UO/XZ floo erooProperty locationGosi. I.ot' •, Section / 7(circle one)T Ho N. R..^. F.<i4^Subdivision NameD City of□ Village of0Town ofin. Type i»f Permit; (Check only one bo* on line A. Complete line B if applicable)A.R.[3 New SystemD Permit RenewalRcfiire ExpiratiuiiD RcplatOTneni SystemD Permit RevisionD Treatmenl/Uotding Tanit RcpiucDncnl OnlyD ChangeofPtumhciD Pcnnit Transfer to NewOwnaD Other Modillciiiiiiii to Fxisling System (explain)List Previous Pcmiit Niiniiiei ami Dale IssuedrV. Type of POWTS Sysicm/Component/Dcvice: (Check all that aptily)S Non-Prcuurized In-Ground □ Pressurized In-Grountl □ Al-Gradc □ Mound > 24 in. ofsuitable soil □ Mound < 24 in. <if ^ultabte soil□ Holding Tank □ Other Dispersal Coniponcm (explain) ^ □ Prerrealment Device (explain),,V. Dlspcrial/Treatmept Area InformatioB:Design Flow Igpd)7X0Design Soil Application Rate(gpdsf)•7VT. Tank InfoScpnSoi lloldin-Tjalf^lo<ingCliambcCapacity inGalltmsDispersal Area Required {sf)New TinksisrjgIst,^yKsi<lJng TankcTotalCiallrHt.ststa1^6 yu ofUnitsDispersal Area Proposed (sf)/OIXManufacturerJk.Sy&tcin l\lev4CionA5 "OS 2Ifl WIIii: oVII. Retpiinsllillity Statclttent- I, the andersigDCil, asiumc rcsponilbllily fnr installation of the POWTS shown nn the attached plans.^^^MPRllI'iunibcr 's Nanic{Tiini)MlJie VI TCfMOA-Plumber's Signatllle,4^.S Numbernsincs.s Phone Number7/s- fYi /yttPluiiiba's Addicss (Street, City, State, iiip Code)197'/^ sr A// <40 ^x/'/jA/ayt4'j jfyg-zs-VLIljQmncy/Department Use OnlyD DisapprovedG Uwnicr Given Reason for DenialPermit FeeDate Issued9'3.c7/>cIssuing Agent SignatureTlOidkJ[X. CnntHtioDS of Approval/Reasons fnr DisapprovalNO refunds AFTERISSUE OF PERMITAnach M camplclc plant for the lyHcm andtobmli lutbc Cnanty unly on paper not less than S nr II Inefici In oSBD.6398 (R 08/14)ORIGINALI
Czarnecki Living TrustProperty Owners Name9138W Johnson RDProperty Address12284000800Tax Parcel NumberSawyerCountyJohnson Resort CondoLegal Description17Section40NTown6WRangePage Index1 Property Information2 Data Entry3 Plot Plan4 Drainfieid Cross-Section5 Tank Information6 Maintenance Plan7 Contingency PlanBruce VitcendaPlumber's NamePlumber's SignatureM.P. 220498Plumber's License Number715-943-2382Plumber's Phone Number8/31/20DatePage I of 7
In-Ground Soil Absorption SBU-1U/U5-P/N.01/01) Version 2Component Manual Used5Number of Bedrooms2Percent Slope (%)110Depth to Soli Limiting Factor (in.)0.7in Situ soil application rate500.Estimated Wastewater Flow (gpd)7501 Design Wastewater Flow (gpd)1Number of System Elevations96Proposed System Elevation #1naProposed System Elevation #2naProposed System Elevation #399Original Grade #199 to 100.5Finished Grade #1naOriginal Grade #2naFinished Grade #2naOriginal Grade #3naFinished Grade #3Skaw 1568/1568Orenco 8" BiotubeCombo tank or pump tankEffluent FilterBioDiffuser ARC 36Chamber Type13Height of Chamber (in.)25sq.ft. per chamber(ESIA)4.5sq.ft. per pair of end caps (EISA)5laying length of chamber(ft.)1.17length of endcap(ft.)33.75•Chamber width(in.)3Rows of Chambers3Distance Between Ceils (ft.)14Number of chambers in first row14Number of chambers in second row15Number of chambers in third row43Proposed Number of Chambers Used1071,4• Minimum Distribution Ceil Area Required (sq.ft.)1088.5^Distribution Ceil Area Proposed (sq.ft.)Page 2 of 7
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Cross Section of a Three Cell Inground ComponentUsing Leaching ChambersFinished GradeSlope 2%99 to 100.5Typkd ObMratkorVM npM^ XFinished GradeOriginal GradeTop of ChamberSystem ElevationnanaSVALUE!na99.0097.0896.00Original GradeTop of Chamber"System Elevation•- n - n I I i I ^ V . LrikM— Finished Grade^,.,y Original GradeTop of Chamt>erSystem Elevationnana#VALUE!na•• -I'• . " ,*OtacrvMioorVeet lo b* CBCMuettd end apped wMi (ppnmd mewriil* fbr (be r*—ma.Diagrams Not To Scale72.34 feet□72.34 feetfi^WK'P.er^* .77.34 feetObservation / Vent Pipes to be located at ttre ends of the distribution cells.3 feetbetween cellsPage 4 of 7
Approvedend Locking Device / •!" Miri. Abcvc ^'"o! G'ode4" Sch. 40 Vanl> or c to 12"Abova Ftnot GrodnWeolher Proof Jur»clloo Bo*fe.'*?Ctric pAr NtC 300 At COMM.16.23 WACInlof CBoffleOrenco 0" BiotubeIDiscooricsLSt<aw1568n56BBv.Altemote Outlet tocolion^ W/Approved A" Sleeve2 inch forcemaineep Hole or Anti Siphon DeviceD7 Vertical Difference Between Pump Off and Inlet to ChamberInches Gallons2 Forcemain Diameter (in,)A29.2969,30.92Friction Factor per 100ft.B266,51,10Friction LossC5,1169,68,10Total Dynamic HeadD12.0399,0TOTAL48,31604,45] Number of Doses per Day160 Gallons per Dose (Not to exceed 20% of Dally Design Flow)19,56169,56156833.25148,25Zoeller 98Volume of Forcemain BackflowTotal Dose VolumePump Tank Capacity (Gallons)Pump Tank Volume (Gallons / Inch)Liquid Level (in)Pump TypePUMP PERFORMANCE CURVEMODEL 98SJE Rhombus - Tank Alert 1Alarm.*'0 30 Jl) 50 00 'f) UUOALL'.'fi-'VUTErr? *.T60PLCv^'PCP MtfKlTE
Czarnecki Living Trust9138W Johnson RDEstimated Flow (average) gallons / dayDesign Flow (peak), (Estimated x 1.5) gal/daySoli Application Rate gal/day/ft^Fats, Oil & Grease (FOG)Biochemical Oxygen Demand (BODj)Total Suspended Solids (TSS)Maintenance Schedule1.23E+10Number of BedroomsMOJ500.7nfluent I Effluent QualityMonthly Average30 mg/L220 mg/L150 mg/LCombo or PurEffluent FilterSkawl 568/1568_Orenco 8" BlotubeServldng frequency of 12 months or less requires theManagement Plan be recorded with the Register of Deeds.Service EventInspect condition of tank(s)Pump out contents of tank(s)Inspect dispersal cell(s)Clean effluent filterInspect/test pump and alarmAt least once everyService Frequency~ 1 Year(s)When combined sludge and scum = 1/3 of tank volume1 Year(s)1 Year(s)At least once everyAt least once everyAt least once everyMaintenance InstructionsInspections of tanks and dispersal cells shall be made by an Individual carrying one of the following licensesor certificationsiMaster 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 tank volume,the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of inaccordance with ch. NR 113, Wisconsin Administrative Code.A service report shall be provided to theof any service event-Sawyer County Zoning Deptwithin 30 daysStart-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 I or damage the dispersal cell(s).If high concentrations are detected have the contents of the tank removed by a licensed Septage ServiceOperator.System start-up shall not occur when soil conditions are frozen at the infiltrative surface.Page 6 of 7
Septic, pump and other treatment tanks may contain lethal gasses and/or insufficient oxygen. Do not enter aseptic, pump or other treatment tank under any circumstances. Death may result. Rescue of a person from theinterior of a tank may be difficult or impossible.Contingency PlanIf the POWTS fails and cannot be repaired the following measurers have been, or must be taken to provide acode compliant replacement system: (Check One)Srhe site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soiland site evaluation shall be performed to locate a suitable replacement area. If no replacement area is availablea holding tank may be installed to replace the failed POWTS.Oa suitable replacement area has been evaluated and may be utilized for the location of a replacement soilabsorption system. The replacement area should be protected from disturbance and compaction and should notbe infringed upon by required setbacks from existing and proposed structures, lot lines and wells. Failure toprotect the replacements area will result in the need for a new soil and site evaluation to establish a suitablereplacement area. Replacement systems must comply with the rules In effect at that time.PI A suitable replacement area Is not available due to setback and/or soil limitations. A holding tank may beinstalled to replace the failed POWTS.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 and prolongthe life of the POWTS: antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers. dentalfloss, 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 to insurethat the system Is properly and safely abandoned in compliance with Wisconsin Administrative Code SPS383.33;- All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.- The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.- After pumping, all tanks and pits shall be excavated and removed or their covers removed and the voidspacefilled with soil, gravel or another inert solid material.POWTS InstallerSeptic PumperNamePhone #Bruce Vitcenda'715-943-2382NamePhone #Scott's Septic'715-634-7279POWTS MaintalnerLocal Regulatory AuthorityNamePhone #Scott's Septic'715-634-7279AgencySawyer County ZoningPhone #715-634-82887 of 7
WARNING DEATH MAY OCCUR IF TANK IS ENTEREDWITHOUT PROPER EQUIPMENTNOTE: SEE INNER WAU PHOTO ON THE 'EXCLUSIVELY AT SKAWS' PAGE.5.00INLET4 INCH PRESSSEAL GASKETINSTALLEDWHEN POUREDSECTION VIEW OF TANK AND COVER91.50-n.SKAWisesnses368027.0027.0027.0024.0024.00□ OUTLET8.00-18.00FLTER48.25OUTLET END VIEW OF TANKModel Number 1568/ 1568Approved for SEPTIC/SEPTIC.SEPTIC/PUMP.SEPTiaSIPHON OR HOLDINGSKAW PRE-CAST26255 105th Street, New AuburnWisconsin 54757www.skawprecast.comPhone: (715) 967-2277Toll Free: 1-800-924-8625Fax: (715) 967-2707weignt21,800 lbs.Inlet Dim.54-Oudet Dim.52-Uq. Depth48.25-Gal./ln. \Nom.Cap.32.49 1 1568 gal.
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