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Home My WebLink About024-741-03-2105-SAN-2020-131Industry' Services Division4822 Madison Yards Way 53705i'O Box 7162Madison, Wl 53705-7162mauouiit »* J( r<rj:>D^o7h)□micationSanitary Permit AppIIn accordance with SPS 383.21(2). Wis. Adm. Code, submission of this I'omi to the appropriate governmental unitis required prior to obtaining a saniiurj' pcmiit, Note: Application forms for state-owned POWTS arc submitted tothe I7epanmcnt of .Safety and Professional Servics Personal information j ou provide may be used for secondao'purposes in accordance with the Privacy t.aw, s. 15.04(1 Hm), Siais.I. Application Information - Please Print All InformationProperty Owner's NamePropcriy Owner's Mliiiing Addressbiling ICo fiCity, Slatent^yu)ar/M LOJII. Type of Btiiining (check nil that apply)Zip Code0 1 or 2 Family Dwelling - Number of Dedrooms.D Public/Commercial - Describe Use□ State Owned - Describe UsePhone NumberLot#IBlock #CSM Numberes2rP//'?7CountySanitary Permit Number (to be filled in by Co.)Slate Plan Review NumberPWTS--CProject Address (if different than mailing address)loen w HParcel#OiM- 7^I-05-Properly LocationGovi. Lot'/•. Section 02T N: R 09Subdivision Name□ City of.□ Village ofS' Town of piauvtfjkIII. Type of Permit: (Check only one box on line A. Complete line B if applicable)D Nexv SystemD Permit RenewalBefore ExpirationS Replacement SystemD Permit RevisionD Treatment/] lolding Tank Replacement OnlyD ChanaeofPlumber□ Pcmiit Transfer to NewOwner□ Other Modification to Existing System (explain)List Previous Permit Number and Dqp; Issued-f-IV. Type of POWTS Systcm/Componcnt/Devlce: (Check all that applyNon-Pressurired In-Groimd □ Prcssuri/cd In-Ground □ Ai-Grade □ Mound > 24 in, ofsuitable soli □ Mound < 24 in. of suitable soil□ Holding 'I'nnk □ Oilier Dispersiil Coinponcm (explain) □ I'retrentmcnt Device (explain)V. Dispersal/Treatment Area Information;Design Flow (gpd)3(50Design Soil Application Rate(gpdsf)0.7Dispersal Area Required (sODispersal Area Proposed (sf)'/5LC,System Elevation93.0VI. Tank InfoCapacity inGallonsTotalGallons#orUnitsManufai'turerfPrefabConcrete31•S i{/i MSteelFibreGlassPlcitsaNew TanksGxisling TanksSeptic or Holding Tank750—130)(^'leier CnfycreicVDosing ChamberVil. Responsibility Statement- I. the undersigned.rcsponslbiiily fur inslHllathin of the POWTS shown on the allachcd plans.naturePhimbcr's Name (Print) .-Ts; - = rt^lPlum'MP/MPRS NumberBusiness Phone Number9/S--7i7-666'«umber's-Address (Street, City. Slalel'Zip Code) ' ^•S^O'^S K). CiAie-1 Orij^ DfLttVNiryiohol. l/JTVIII. Ctwnty/Depnrtmcnt Use OnlyD DisapprovedD Owner (jiven Reason for DenialPermit Fee'Yoo-^Date IssuedIssuing Agent SignatureIX. Conditions of Approval/Reasons for DisapprovalORIGINALNO REFUNDS AFTERISSUE OF PERMFTAttach 10 complete plans for the svsiem am) submit to the Count} only on paper not less than 8 I/} fTTThdBKJpiifla^'i "17^(7/'Diis^iuja^Jl yy r.^iSBD-6398 (R. 04/19)SAmER COUi-.Vi YTONING AOMlNlSTFtAi iON Al & Mary Reinemann10811W State Hwy 77024-741-03-2105SawyerNE 1/4 NW 1/441N07WDouglas Manthgy715-739-68687/7/20Property Owners NameProperty AddressTax Parcel NumberCountyLegal DescriptionSectionTownRangePage Index1 Property Information2 Data Entry3 Plot Plan4 Dralnfield Cross-Section5 Tank Info(a Maintenance Plan7 Contingency PlanPlumber's NamePlumber's SignaturePlumber's License NumberPlumber's Phone NumberDateNot an endorsement, written or implied for the foilowing companies and products; DelZotto Concrete, Wieser Concrete Productsinc., Skaw PreCast Co., Huffcutt Concrete Inc., Zabel Environmental Technology, ITT Industries(Goulds), The Pentalr PumpGroup(Myers), Infiltrator S^tems, ADS Products, Polylok Inc., Orenco Systems Inc., SimfTech Filter Inc., Sta-Rite industries.Page_i of_)J_ Component Manual Used2Number of Bedrooms5Percent Slope (%)102Depth to Soil Limiting Factor (in.)0.7In Situ soil application rate200Estimated Wastewater Flow (gpd)300Design Wastewater Flow (gpd)1Number of System Elevations93Proposed System Elevation #1Proposed System Elevation #2Proposed System Elevation #396.5Original Grade #196.5Finished Grade #1Original Grade #2Finished Grade #295Original Grade #395Finished Grade #3Infiltrator Quick 4Chamber Type12Height of Chamber (in.)3^6sq.ft. per chamber2Rows of Chambers5.8sq.ft. per pair of end caps3Distance Between Cells (ft.)22Proposed Number of Chambers Used428.6Minimum Distribution Cell Area Required (sq.ft.)HShteDistribution Cell Area Proposed (sq.ft.)Wieser 750 |Septic TankOrenco 8" BiotubeEffluent FilterSoil BoringNumberSurfaceGradeElevation (ft.)Depth toLimitingFactor (in.)LowestElevationHighestElevationSystemElevationAcceptable196.4511490.095.5TRUE29510289.594.0TRUE396.411489.995.4TRUE43.0-1.0FALSE53.0-1.0FALSEPage ^ of M 1, feS ^XLo-Et ond S'BpCS JO Ol^rs 390^ ryvyjf^aonco \\\jl - r/d-97^/4 - vjOX)P ^0 AT*"0 II ^ _ (,S7'€h-S'0b 9 ,^b '1^ s\:os L* 'S ,5b 'T. ,Sh''^b M9 -A3i;ij<^ fy)S ' cWlVi^▼ ■ p^avMpjHjj Ag 0^-ZL ^ Lb)/QZ T -l-^'lmz.07; o/;b a.£o^ orjfv^N ^o - £0 -/b/-- '■ rJ' <d d^l og •r^n "'pafS rr^Jigo) ^hShS «9,.P^C>S^'Z1 UVitHy v«">»){/ ^ JvSnrno Cross Section of o Two Ceil In Ground ComponentUsing Leaching ChambersObservotion/Vent Pipes96.50Slope98.5094.00Finished Grade5%Original Gcads..Top of ChamberCejt^peratlon93.00 [System ElevationFinishedGrade>r' j&rfginal Gradex-^op of Chamber_ System Elevation94.0093.001i.TKeotnjent'find'bleperBdl .^orje. •' ** i {'i*- ■- * ! Limiting FoctorObservotion/Vent pipes to be constucted ond capped with opproved materials for the particular use.Diagrams Not To ScaleOLLJOPage V of N HLTERBAFFLE4" CAST-A-SEALTOP VIEWINLETOUTLETtPUMP PADSIDE VIEWTANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTSWLP750-MRTANK SPECIFICATIONSDIMENSIONS:WALL: 2 1/2"BOTTOM: 3"COVER: 4"MANHOLE: 24" I.D. PRECAST CONCRETE RISERHEIGHT: FLAT COVER 54" O.D.OUTSIDE DIAMETER: 84" O.D.BELOW INLET: 42" O.D.UOUID LEVEL: 37"WEIGHT: 6,150 LBS.INLET AND OUTLET:4" CAST-A-SEAL BOOT OR EQUALGASKET, CAST-A-SEAL BOOT OR EQUALINLET AND OUTLET BAFFLE AND FILTER:WISCONSIN, SEE DETAIL #10(OTHER STATES SEE CHART)LIQUID CAPACITY: 20.28 GAL/INHOLDING TANK:ACTUAL CAPACITY: 790 GALLONSOUTLET HOLE PLUGGEDLOADING DESIGN: 8' 0" UNSATURATED SOILTANK CAN BE USED AS:SEPTIC/ HOLDING/ PUMP OR SIPHONCOVER: MIX DESIGN #8 (NO FIBER)TANK: MIX DESIGN #10 (STRUCTURAL FIBER)CUSTOMIZED TANKS:FOR CUSTOM TANKS CONTACT WIESER CONCRETEDRAWINGS SUBMITTEDFOR APPROVALAPPROVED BY:APPROVAL DATE:PRODUaS NEEDED BY:UJ <g o9z OObJ ,§ '1 lo^ CMhO2 I1 °== K>(/)IoinQ.<Z<2OI-Q.Ul(/)SHEET NO.11 Service EventService FrequencyInspect condition of tank(s)At least once every3|Year |Pump out contents of tank(s)When combined siucge and scum = 1/3 of tank volumeInspect dispersal ceil(s)At least once every3YearClean effluent filterAt least once every18MonthInspect pump, pump controls & alarmAt least once everyAl & Mary Reinemann10811W State Hwy 77024-741-03-2105Estimated Flow (average) gallons / daySoli Application Rate gal/day/ftInfluent I Effluent QualityBiochemicai Oxygen Demand (BOD5)Total Suspended Solids (TSS)Maintenance ScheduleNumber of BedroomsDesign Flow (peak), (Estimated x 1.5) gal/day2003000.7=ats. Oil & Grease (FOG)Monthly Average30 mg/L220 mg/L150 mg/LSeptic TankWieser 750Effluent FilterOrenco 8" BiotubePump TankWieser 750Pump TypeIINOTEIIServicing frequency of 12 months or less requires theManagement Plan be recorded with the Register of Deeds.Maintenance InstructionsInspections of tanks and dispersal cells shall be made by an individual carrying one of the following licensesor certifications: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. MR 113, Wisconsin Administrative Code.A service report shall be provided to the Douglas County Zoning Department within 30 days of anyservice event.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 infiitrative surface.Page_^of_ll_ 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 CodeComm. 83.33;- 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 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.Continaencv PlanIf the POWTS falls and cannot be repaired the following measurers have been, or must be taken to providea code compliant replacement system: (Check One)1^ 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 replacementd,..l 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.A suitable replacement area is not available due to setback and/or soil limitations. A holding tank may beritalied to replace the failed POWTS.IIWARNINGIISeptic, 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 InstallerNameDouglas MantheyPhone #715-739-6868POWTS MaintainerNameAffordable SepticPhone #715-634-3355Septic PumperNameAffordable SepticPhone #715-634-3355Local Regulatory AuthorityAgencySawyer County ZoningPhone #715-634-8288Page 7 of i * �_��°�°""T�'�^'? PRIVATE ONSITE WASTE TREATMENT county • ~� (�� l SYSTEMS ' Sawyer �'R�E,�J 1 ( POWTS) ; �s"°"=� INSPECTION REPORT Sanitary Permit No: Safety and Buildings Division (ATTACH TO PERMIT) GENERAL INFORMATION � � , � Personal infonnation you pmvide may be used for secondary purposes[Privacy Law,s. 15.04(1)(m)] Permit Holder's Name: ❑City ❑ Village own of: State Plan Transaction ID#: /�� r" R�:nc+�ann p�,n 1 L.�..1�. Insp BM Elev: BM Description: Parcel Tax No: 00 . o ` as' ��ooc- s� o r n�(' .. 7y�_ a3- a! TAN INFORMATION � ° ELEVATI N DATA TYPE MANUFACTURER C P CITY ;� STATION BS ' HI LL FS ELEV Septic ;e, � � (� � � Benchmark ��. �� . �� p` Dosing - . � . ' x Aeration Bldg.Sewe`r`�"' !�'.?a,' . Holding " � '> - St/Ht Inlet � s' �r�'T' TANK SETBACK INFORMAT10�1 St I Ht Outlet $ � q , ' TANK TO P/L WELL `bG VENTTO ROAD Dt Inlet AIR INTAKE Septic � 0` ,} �S' •�h bj�v '�^�6Q NA . Dt Bottom Dosing � NA . Installation Contour Aeration NA < .Header I Man. +�,d' Holding � � . ' Dist. Pipe PUMP 1 SIPHONI INFORMATION Infiltrative 9 ��, � •O Surface Manufacturer Demand Final Grade Model Number GPM TDH Lift Friction Lo� � � 5ys Head TDH Ft Forcemain L . Dia � Dist.T�Well DISPERSAL CELL INFORMATION DIMENSIONS W '�' L ' � #of Cells � Type of System Distribution Media Manufacturer: � Conv ❑ Aggregate x�r SETBACK P/L Bld � Well OHWM of Nav � �GP �t Chamber INFORMATION 9 � Waters � AG ❑ EZFIow Model Number: CELLTO }ap' � "�0' }100' /�ja o Mound o Other QN•Lk ' DISTRIBUTION SYSTEM X Pcessure Systems Only Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes Length Dia Length Dia Spac Spacing ❑Yes ❑No SOIL COVER Depth Over Depth Over Depth of Seeded/Sodded Mulched Cell Center Cell Ed es Topsoil ❑Yes ❑No ❑Yes ❑ No COMMENTS: (Include code discrepancies,persons present,etc.� -. � '� �n S�"�'�'�� ' • f $� �a�[a� Plan revision required?❑Yes❑ No �t �� ,��S�• Q a 3 ��-G�� J � Use other side for additional information Date POWTS Inspector's Signature Certification Number SBD-6710(R.3/01) ' A�OITIONAL COMMENTS ANO SKETCH SANITARY PERMiT NUMBER:____��_-__I�_I______ �q . . . , , . . . � � � � � � -�. - : , � . �3� ' yt � � � . . — ±» _ . . �, ,.rzM �.�. y' �,l l. , QN.Z�t , y S � a,, .. � , � ' , 17� r�� / � co� __.. � a _ _ . ��+- 1�� .�� ' •. � . � . �� ( ;r' `7� 9 � . . �1 (�;o�� , � ` � �� Q�� k , . , . � 1 �`� � � �� dt Qw� � . . � ' I �0 8 �I , I� �y � � . . SCALE �"_