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Home My WebLink About030-737-34-2104-SAN-2020-228Industr)' Services Division1400 E Washington AveP.O. Box 7132Wadison, W; 53707—7162tO'jay .Saaitzi>'PenRitNuirJer{to be nfledinSaaitzi>4^^ 793^5"by Co.)Sanitarv Permit ADDlicationpurposes in accordange wth Ihe Privaoy Law, s. 15.04(I)[ia), Sta^.Stats Tiaisaccitffi tvuraberL Application Information - Please Print All iDformarionAdcL-ess (if diSrent to mailing address)Prapsrty Owner's S'eme - | ifi'iPii g/ ~Xn rtrr -/Iburna+n'STCSl -Property Owner's Mailing Address _ / -/n-im u) fy)&n<.k\i iKCZi? qoiCi:>', Sate i7odeProp^ Locanor.i^ lOT^ i^%GovL Co:hxu(y\\Mn. Type of Building (ehe^aU that apply)C 1 criramiiyDsveliisg-NunberofBedroomsMPhone Numbern public'Comcnereial - Describe Use.D Statt Owned - Descnbe UseLotf1rijb.i^, IMJ(l£' '/-U^ A, Seccci; ^(wrol! one). T N ; It EorWI-SubaivisronNajseV-d2.SBicc'x#GSM Number□ City ofr~i Village ofU^ieACfrm Type ofPermit: (Check only one box op line A. Complete Ime B if applicable)Ul. lype 01 rermii; ii^ucvi^uui* v.. w~, i f ■■ r. , , - ^A. 10 OfcMod=»o.»S;»«B.n Permit Renewal I □ PermitRevisios,3efere Exobadon :! □ Change of' Plumberi n Permit Transfer to New i ListPreviousPeimitNumberandDarelssued■r\r T,-p»nf-DnWT<5<;v<nftm,'CoiiipOD,eE.-vDevice; rOtBck all Aa: apply)□ Holding Tank □ Other Dispersal Component (explam) QpretmamentDevie-CeaJlaL.)V. Dispersal/TreaTment Area Information;^ ADDesign Soil Applieatiesign Flow (gpd)*-1519onRale(gsd$f)su.■ ■ Dispersal Area Recuired (St) : Dispersal-Ama Proposed (sf) ; Sywrr Bies^uo^uqa (. \ ^VD \ 9^^VL Tack InfoCauaoitj- i:tiarte: Gfiilonsur.iaSacstuic TasxsiX)^ CAM.-HoldmgTankDosina ChamberVU Responsibility Statement-1, the uaders^ned. assame responsibilhy■u^bif'g SignamrePJjMber'sName (Print) ."or installation of me PO^^TS shown on ibe attached plans.ColoPlumber's Address (Stree; City, State, Zi? Codi)f iUUlUQt 9 Wrf w.vs »—' *S tAd.Mil. Coimtt-jgepartlBept Use Only ^IS'Jfi^rWe^ □ Disappro^ ?trm:t.-eeD^PProvedBusinessPhoneNumber7IS-11j3I' n O'-vner Given Reason for Derdal i ^ (OQ.: Dase Issued Issuing Agent Si^-antm ,IX. Conditions of ApprovaLTleasons for DisapprovalOMGIHMSEP 2 1 2020..n^rb to eemplct. pl=r.s for tbt sy^r: ar.d submit to toe County uttl; o= paper uotless thou S irt x Index Sheet & Title Page for POWTS(Privately Owned Wastewater Treatment Systems)Project:-Owner:■^w.liurd —f-l bcry'^i»~i^\\j/-.yp U^irl I Lb*I SH3'6'5Phone:..pW c,3HLegal Description:. —, ■ ji / 11' /I I / ii ^^CKA.K3i \i^'^r'~Township:T. County:Lot No:.BIK:Subdivision:—! CSM:Parcei ID #Page 1 Index PagePage 2 Owners ManualPage 3 Abandonment & Contingency PlanPage 4 Tank & Cell Cross SectionPage 5 Site PlanPage 6 Design Calculationsp-2r.-"7S"7-Component D^n^anuaLJBDj^Signature:giihmitter: (oi^ TDate: JfjUjd^O -Designer: Clarence GiotfeltyCustomer ID # 220728Page 1 of 6 FILE INFORMATIONOwner "POWTS OWNER'S MANUAL & MANAGEMENT PLANSYSTEM SPECIFICATIONSPage.ofPermit#DESIGN PARAMETERSNumber Of Bedrooms3 DNANumber of Public Facility UnitsISnaEstimated (average) flow300 gal/dayDesign (peak) flow = (Estimated x 1.5)VSO gal/daySoil Application Ratee "7 qal/day/ft^Standard Influent/Effluent QualityMonthly averageFats, Oil & Grease (FOG)£30 mg/LBiochemical Ox^en Demand (BODs)£220 mg/L□ NATotal Suspended Solids (TSS)£150 mg/LHigh Strength Influent/EffluentMonthly averagerFats, Oil & Grease (FOG)230 mg/LBiochemical Oxygen Demand (BODs)2220 mg/L]^NATotal Suspended Solids (TSS)2150 mg/LPretreated Effluent QualityMonthly averageBiochemical Oxygen Demand (BODs)£30 mg/LTotal Suspended Solids (TSS)£30 mg/L[^NAFecal Conform (geometric mean)£10^ cfu/100mlMaximum Effluent Particle Size% in dia.□ NAother:9I^NATank Manufacturer UJ}a>e\ ^ NAI® Septic □ Dose □ Holdins r '■ ^ galTank Manufacturer .'v.- . 'i ! ' ■□ Septic Dose □ Holding vol.I9.NA/•-galVertical Distance^i^ottom(s) to Service Pad: ft.Horizontal Distance Tankfsi to Service Pad: ft./N.4Specific servicing mechanics must be provided If vertical Is >15 ft. orif horizontal Is >150 ft. Specific instructions to be provided on back.Effluent Filter Manufacturer V'Effluent Filter Modelzia□ NAPump Manu^cturerPump Model^NAPretreatment UnitManufacturer□ Mechanical Aeration□ Disinfection□ Sand/Gravel Filteri^NA□ Peat Filter□ Wetland□ Other.Soil Absorption SystemSI In-Ground (gravity)□ At-Grade□ Drip-LineIST-FkujJ In-Ground (pressurized)□ Mound□ Other:other.□ NAMAINTENANCE SCHEDULEService EventService FrequencyInspect condition oftank(s)At least once every:3Hyea"rS)®' (Maximum 3 years)□ NAPump out contents of tank(s)J8>When combined sludge and scum equals one-third (%) of tank volume□ When the high water alarm is activated□ NAInspecTdispersal ^ii(s)At least once every:3B yeaSf ^ (Maximum 3 years)□ NAClean effluent filterAt least once every:3□ monfli(s)13 year(s)□ NAInspect pump, pump controls & alarmAt least once every:□ month(s)□ year(s)S NAFlush laterals and pressure testAt least once every:□ month(s)□ year(s)SNAotherAt least once every:□ month(s)□ yeaits)fi'NAOther■ ^NAMAINTENANCE INSTRUCTIONSInspections of tar^ and dispersal cells shall be made by an individual carrying one or the following licenses or certifications: Master Plumber, MasterPlumber Restricted Sewer POWTS Inspector POWTS Maintainer Septage Servicing Operator (pumper). Tank inspections must Include a visualInspection of the tankfs) to Identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and acheck for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually Inspected to check the effluent levels in theobservation pipes and to check for any ponding of effluent on the ground sur^ce. The ponding of effluent on the ground surface may indicate a fallingcondition and requires the immediate notification of the local regulatory authority.When the combined accumuletton of sludge and scum In any treatment tank equals one-third (J^) or more of the tank volume, the entire contents of thetank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR113. Wisconsin Administrative Code.All other services, including but not limited to the servicing of effluent filters, mechanical or pressunzed components, pretreatment units, and any servicingat intervals of £12 months, shall be performed by a certified POWTS Maintainer.' \a seivica "iport sbpll te provided to the local regulatory authority within 30 days of completion of any service event. rv (rev 9/16) /rftKtii- :xJU "STARTUP AND OPERATIONFor new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products solvents or otherchemicals that may impede the treatment process and/or. damage the soil dispersal cell(s). If high concentrations are detected have thecontents of the tank(s) removed by a septage servidng operator prior to use.System start up shall not occur when soil conditions are frozen at the'infiltrative surface.During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater willbe discharged to the dispersal cell(s) in one iarge dose and may overload them resulting in the backup or surface discharge of effluent.To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to theeffluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levelswithin the pump tank.Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within15 feet down slope of any mound or at-grade soil absorption area.Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS:antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain(sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting pror'ucts;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 insure that the system is properlyand safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:1 r •• 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 void space filled with soil,gravel or another inert solid material.C0NTIN3ENCY PLANIf the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliantreplacement system:M A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption™ system The replacement area should be protected from disturbance and compaction and should not be infringed upon byrequired setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area willresult in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems mustcomply with the rules in effect at that time.□ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologya holding tank may be installed as a last resort to replace the failed POWTS.□ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and siteevaluation must be performed to locate a suitable replacement area If no replacement area is available a holding tank maybe installed as a last resort to replace the failed POWTSO Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at theinfiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.«WARNING»SEPTIC PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOTENTER A SEPTIC. PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF APERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.AODITIONAL COMMENTSPOWTS INSTALLER POWTS MAINTAINERName pNamePhoner*PhonePhone -7/5^SEPTAGE SERVICING OPERATOR (PUMPER) ^ LOCAL REGULATORY AUTHORITYName A/nrftt ij;i>A.4'' ^AV\'\-VtKTNameiiirr.-f Coil zPhone.I'M tvjiThis document was dralted by the staffs c' 'f-e Green Lake, Marquette and Waushara County Zoning and Sanitation agenciM in compliance with chapter IoiaKe^i'yh HHAjcJcT^ _y" Ufrflff'X *??•■»"«' UaiS'i tVijht Ci-Sltei i^4y»u^I r--N V !y ^ 3^1 ,1I ^ i. n—j I "» *jaV Sii>«-^r AV/-A-. ii^-VK-i' I ''';A~"ir!'-iAL"to 'il 5AHC3 ^Of'AViL :.!.^TiHT^ ''Cosiai-iSa ', App^etf /£sW<mmI ""^^GROUijQ LtV£L/6'V—" "-T?, ; 'fijeica-// /^.Sc__L__^>^* SMo ^ep9tH&tz j-jgtOfxNo'k: 5"^ hioLO Um-b)CpvJeroi "^Ir/i-' <|-Ak '»(U^ Jprc>^ce;/^'' boCfwUi y> ^H<'lj ie Distribution Cell TypeAggregate Leaching ChambersNumber of Bedrooms: ^Soil Application Rate (DLR) . e"7—(Design Loading Rate)Wastewater QualityTreated: Untreated :System SpecificationsIn-Ground Soil Absorption ComponentComponent Manual ~ PI M ^ AiProject Name:.Septic TankCombined WastewaterNumber of BedroomsGai/day/bedroom"xTsoMinimum Septic Tank Vol. Reo. „Proposed Septic Tank Vol.Manufacturer: _Effluent FilterManufacturer: l—t •^'c4'firn<Model: ^ jIPump Tankeallon. gallonsDaily Wastewater Flow = H gallonsClear and Graywater OnlyNumber of BedroomsGal/bedroom/day * 90Manufacturer:.Volume;Model:Daily Wastewater Flow = , gallons3—BlackwaterNumber of BedroomsGai/day/bedroomx60Distribution Component WDistribution BoxHydro- Splitter ____Other —Manufacturer:.Daily Wastewater Flow =_gal!onsDispersal Area Aggregate lA A-X = "(DWF) ( DLR )Dispersal Area (Leaching Chambers etc.)Infiltration Units = fc. Z- } |o.^ ^Chamber Size EISA Rating = 3i2—h "' 9T( DWF ) ( DLR)(EISA)noDiverter Valve _X yes ^F^ff„..fart"rpr I, \fhbem&rmjIf'l ^ PHir;H ^""S^AztL Sk<p/ ^ oj ffwr^ -x-iW j -jfpv?' ' ' ., h %) ■j(|?vr .S-9.h'®, :ag "H <-- -?<i2»S' /^/ ' iPi^ <0 ^•/ ' crj (7/7 \ \ «■• —X V - -y — - y;/ -^-5 X < ixl !/ p^l r .Qh--J^:^T' Hvid 10 la ^.1