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HomeMy WebLinkAbout032-539-02-5410-SAN-2020-245» Sp I"s .-i:-V. V i?"Safety and Buildings Oi\nsion201 W.Washington Ave.. P.O. Box 7162Macfison.WI 53707-7162County6Smrtan- Pennil h&imber (to be filled in tn' Co.)I■SLSanitary Permit ApplicationState Tnmsaction MumberIn accordance uiili SPS 383.21(2), tVis. /Vdjn. Code, lubmlaiion orthbfomi to the appropriate g<n-emmcnlal unitif required prior to obtaining a tonitaiypcnsii. Note; Application rotms ror>taie^\nedPOWTSarenibinil(c<i tothe Depaitmenl ofSafety and ProtcoionalSenHes. Penonol infonnatioa youpitnidemay bctucd forseeondaiyDuroafes in tscotda""-"''t' 'be Priyaev Law, i. li.MfDfml.S''"'tL .AppBcadon Information —Please Print .All InronnationPrqcct .Addrcai (ifdifferent than maUing sddreff)CoRopcrty Owner s NomePropcity Owner's Mailing .^ddnssftOv &nx t^6'QRaicel#037--537-07-CT/g(Vopcrlv LocationCit)'. StaleS Kct?er (\Zip CodeIL Type of Building (dteckali &at apply)I orZFamilyDtteTling-NumberofBedroonis.3Public^Coinincteinl - Dutoribc Use.Stale Owned - Describe Useao^^LolPhone NtunberVL ScetiaiA.•3 0 —(cirole oneUT 07 H: R O Eof^Lot^aSobdnirien NinneBlock ACSM Number2h/is3CiB'ofVillesecf.Tovvnirf_ Lj 'vivd-e/-IILTypeofPermlt (Check only one bmt on line A. Complete line B If applicable)New'Sj-slemRcpbccinenl SvilcmTieolmentHolding Tank Rcplaecmenl OnlyOther Modiifealion In Etdsling System (ecplnin)B.Permit RenewalBefore E.xpinUionPctmilRev-isionChange of PlumberPennit Tranifer to NewOwnerList Previous Pcnnil Number and Dale IssuedType oLEflmSA?tga/Coinponcni/Dcvicc; (Check all that applyNon-PnasurtKd In-OrouniL-^ Pressurized tn-Oround .At-Grade Monnd>24 in. ofstiilablcsoilMolding Tank Other Dispennl Component (e>qilam)Mound <2-1 in. of suitable soilPretrealracnt Device (ecplain)DbpersnUTrcatntent .Area Infonnation;Q.- C.£tli} IH y!.?«.; c*-A.;-fc5Design Plow(gpd)HsoDesign SnI .-^lieaiTOD RaleCgpdsf)"7Dispersal .Area Required (sf)Dispersal Area Proposed (sf)looSystem ElevalfonVI. Tank InfoCapacity inGallonsNew TanksEjcisiii^ TorOisTotalGallons"ofUnitsManurocnirerPre CjX"^j iidt3|.a Iti21 5£ OIe.Sqeicor Kaldii^ TankliOCPDmif^ OuRiber1TI. Rcsponstbilltv Statement- I. the undmlgned, assume responsibility for InstnlbtinnofthePOMTSslunm on the attached plans.PiumbcrV^ignaiure/ » aPlumber's Name (Print)Adflros (Stre£L Clxv, Zip CNIP/^SPRS NumberBusiness RioneNumber1Plumber's .<Vd9r6sf (Street. Citv, Skal^ Zip Code)MILCponty/Dcpamnent Use Only, Permit FeeDisapproved ^Owner Given ftcason for Denial I VOD.0»Dale Issued/0-lp^^dc^Inuino AaenI ScgaLV. Omditions of .Approval/Reasons for Dlsapprcn*aiOElGIKilaNO REFUNDS AFTERISSUE OF PERMITAlloch to cooplite plsu for tli« lysUm end snbmil to the Conaty eab' en paptr not Ins Uian 8 la z 1:SBD-6398 (R.U/n)1SEP 2 8 2020SAWYER CO; •■•■TV-ZONING ADMINiS'i ri.-M. ji'J Pg1of4Pg2of4Pg3of4Pg4of4In-Ground Gravity PlanIndex & Cover SheetComfx>nent Manual Design Refarances:Version 2.0, SBD-10705-P (N.01/01, R. 10/12)Index & Cover SheetPlot PlanDispersal Area Cross-Section & Plan ViewManagement PlanPAGE 1 OF 4Attachments:Enciosures:POWTS Application for ReviewSoil Evaluation Report & Site MapProject Name I DescriptionOwner NameCs): CTu-lle. AyerS Phone:Owner Address: P.O. 3LS3t /)lA. zip:Project Address: 113}^N Co 9-Ji ^Govt Lot: ^ 1/4 of 1/4, Section 3. . T 3^ N-R >5r EDof w|31Township: LProject Parcel ID #: 03^ OQCountv:Designer Name:Designer Address:Designer informationPhone:^ i ^ ^E-mail: cioivhWvpSbO lld^ J:ue, Co/ALicense Number: ^3-0)^ I ORemarks:'I'his space reserved lor approval slamp.Signature:dcopy.Date: <3Dsignal CHECK BOX AS APPUCABLE.□ SOIL EVALUATIONSITEMAPPROJECT NAME:v3~U.ll'g,CHECK BOX AS APPUCABIE.Scale: 1*= Ho'40 608010*%H SYSTEM page 2 OFPLOT PLANDESIGN FU2W;^SOGPDAttach dasign flow calciibtians for commercial plans.PROJECT ADDRESS:BMSymtxri:7/a-N c-0 E,a -g/oLS7BMBevalon:FTBM DeeerfpSon: 5p:i:g {/\ CUnvp ReJL 'WNISymbolOfoppIIeaMo): ©tmScslo north bydnnHtngonomwPlpo Material / ASTM Standard (Tabtes 384^ & 384.3(KS)J£1i^&aSanllarySewec.Force Main:on the tpproprttB InaIMPORTANT:Show ground elevation contours at sidlabis Intervals.t2io.TVier U«a-f-e■ — Vf *PorhieCo B eOLCOVBtIN-GROUND DOSED-GRAVITY DISPERSAL AREAUrilliEHTn Elevation Trenches with EZ1203HP BundlesTrench (down-sizing credit)TYPICAL TRENCHCROSS SECTION VIEW(No Scale)OBSERVATBSN PPE DETAIL(NaScsk)»«FUMf J'eyBtefflBevMofloOmIspwHwiaiMM}Piovtda minimum 3ftsepandon-beturaen (refnttaaTYPICAL TRENCHPLAN VIEW(No Scale)(amr Ido^ orhM/ouHatp^cannMlfcin on plan vIevK,)41SPVOP|paTdpofiitntoMMtiatarabnaMtadgndBMcimtaBOMto4"0PerlbtBtsd Lateral(lypteal)OfaMfwianP|».J^ft■arwrrEIAINSTALL PBRTRBUCH!"7 KMtbundteBfflSOtfEiaAAinBti "SSOff+ -Hi: e«lrandte8@2BtfEBflAmfta ffib3.0 ft(lypleaOEZ1203HBimdle(lyiMOnMteMlnlarSifatan^ tm.)iMtalpiawttrtteniamiteBhifa'btalrucflont.iG)mu>-Ha Ppppoaad EISA par trench a ft* RaoulradliiflamHiinAmao C.^/3 »X ^ IrBnoheBaPrODOBfldTBlalglflAa 7oO fl«I RESET Jni iiii II iiiiiiiin ni INTDisinxftion Method:(^n:Li;;4y 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, V^. Adirdn. Code. Pursuant to SPS 383.52 (2), VUtec. Admin. Code, this system shallbe considered a human health hazard if not maintained in accordance \aMi this approved management plan.Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintalner inaccordance with SPS 383.52 (3), Wise. Admin. Code.Maximum DIsnersai Area Operating Limits:Design Flow = gpd; BODs S 220 mgL'^ TSS i 160 mgL^; FOG 6 30 mgL'^Inspection Checklist INSPECT EVERY 3 YEARSo type of useo age of s^emo nuisance factors (i.e. odors, user complaints, etc.)o mechanical malfunction {i.e., pumps, valves, switches, floats, etc.)o material fatigue (/.e., leaks, breaks, corrosion, efc.)o solicte volume in anaerobic treatment tank(8) and any (fistribution appurtenance(s) (i-s., distribution / drop boxes)o neglect or improper use (/.e., exceeding de^gn capacities, prohibited activities, etc.)o extent of ponding in cBstribution ceil prior to dosingo dosing irregularities - if applicable {i.e., pump re-cyding, float switch settings, etc.)o electrical components - if appDcable (/.e., wiring, connections, switehes, controls, timers, alarms, etc.)o distribution lateral or lateral orifice plugging (measure lateral dstal pressure - compare to dedgn spe^cation)o surface disdiarge of effluent or sewage back-up into structure servedMaintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)o Septic and dmre tankfsl shall be pumped by a citified septage servicing operator licensed under s. 281.48 VYis.Stats, when the v<riume of solids in the tanl((s) exceeds one-thiid (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 fUteifst shall t>e inspected every 3 years and diall be cleaned when necessary to remove anyaccumulated solids according to manufacturer's spedfications. A senridng period vdB always be greater than 12morrths.System maintenance reports shall be submitted to the proper local government unit in accordance withSPS 383.55 Wise. Admin. Code. Report any component feilure or malfunction to:Name of incfividual or company: _ QoA Phone:Local government unit: ^)t\ Phone: 1 /S" 63^/"Local government unit address: Sn.t'Lg. ZIP: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 felled or malfunctioning components shall comply with SPS 383, lAtec. /Vdtrun. Code.No product for chemical or physical restoration of the POWTS may be used unless approved by the department inaccordance vnth SPS 384, Wise. Admin. Code.Corrtinaencv PtanIn the event that any felled 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 felled in-ground dispersal component may beabandoned and replaced liy a code-complying dispersal component in a pre-detemrined area of suitable soils.System AbandonmentIf use of this POWTS is discontinued, it shaO be abandoned in accordance with SPS 383.33, Wise. Adnfln. Code.